The effect of a healthy lifestyle programme on 8-9 year olds from social disadvantage.

PubMed

Breslin, Gavin; Brennan, Deirdre; Rafferty, Ruth; Gallagher, Alison M; Hanna, Donncha

2012-07-01

This study assessed the efficacy of a school-based healthy lifestyle intervention (Sport for LIFE) for increasing physical activity, decreasing sedentary behaviour, reducing screen time behaviour, encouraging healthy attitudes and behaviour to nutrition, and reducing body mass index (BMI) in 8-9-year-old primary school children from lower socioeconomic backgrounds in Northern Ireland. A non-randomised controlled trial of 416 children from 24 schools took part. Schools were randomly assigned to one of two groups, an intervention or control group with 12 schools in each group. The intervention group received a 12-week school-based programme based on social cognitive theory. At baseline and follow-up, groups completed questionnaires assessing physical activity, screen time behaviour and dietary patterns. On each occasion anthropometric assessments of height and weight were taken. Physical activity and sedentary behaviour were measured by accelerometry. Significant effects were observed for vigorous, moderate and light activity for the intervention group at follow-up. Sedentary behaviour was significantly reduced for the intervention group but not for the control group. No significant effects of the intervention on BMI, screen time behaviour or attitudes to nutrition, with the exception of non-core foods, were shown. The programme was effective in increasing physical activity and reducing sedentary behaviour, however no significant changes in screen time behaviour and attitude to nutrition, with the exception of non-core foods, were observed. Future research ideas are offered for tackling low levels of physical activity in children.

BMI Health Report Cards: Parents' Perceptions and Reactions.

PubMed

Jones, Marla; Huffer, Cassie; Adams, Tom; Jones, Logan; Church, Bryan

2017-12-01

In 2003, Arkansas became the first state to require body mass index (BMI) testing in public schools to raise awareness of the growing obesity epidemic among children and adolescents. Limited information exists regarding the effectiveness of school-based BMI screening programs. The purpose of this study was to determine if BMI health report cards affected parents' knowledge or actions regarding their child's health and to determine the accuracy of parents' perceptions of their child as underweight, normal weight, or overweight according to their child's BMI. A questionnaire was developed with the help of physical educators, pediatricians, and exercise scientists to determine parents' perceptions and behaviors regarding BMI report cards. The questionnaire was distributed to parents/guardians of children who sought medical care at two pediatrician's offices in Arkansas. Based on responses to survey questions, parents are not making changes to their child's diet and exercise habits if their child is classified as "at risk" or "overweight." However, parents did report that BMI health report cards are influencing their knowledge about their child's health. The majority of parents in the study (approximately 66%) did not accurately perceive their child's BMI category.

A Randomized controlled trial of culturally-tailored dance and reducing screen time to prevent weight gain in low-Income African-American girls: Stanford GEMS

PubMed Central

Robinson, Thomas N.; Matheson, Donna M.; Kraemer, Helena C.; Wilson, Darrell M.; Obarzanek, Eva; Thompson, Nikko S.; Alhassan, Sofiya; Spencer, Tirzah R.; Haydel, K. Farish; Fujimoto, Michelle; Varady, Ann; Killen, Joel D.

2013-01-01

Objective To test a 2-year community- and family-based obesity prevention intervention for low-income African-American girls. Design Randomized controlled trial with follow-up measures scheduled at 6, 12, 18 and 24 months. Setting Low-income areas of Oakland, CA. Participants 261 8–10 year old African-American girls and their parents/caregivers. Interventions Families were randomized to two-year, culturally-tailored interventions: (1) after school Hip-Hop, African and Step dance classes and a home/family-based intervention to reduce screen media use or (2) information-based health education. Main Outcome Measure Body mass index (BMI) change. Results Changes in BMI did not differ between groups (adjusted mean difference [95% confidence interval] = 0.04 [−.18, .27] kg/m2 per year). Among secondary outcomes, fasting total cholesterol (−3.49 [−5.28, −1.70] mg/dL per year), LDL-cholesterol (−3.02 [−4.74, −1.31] mg/dL per year), incidence of hyperinsulinemia (Relative Risk 0.35 [0.13, 0.93]), and depressive symptoms (−0.21 [−0.42, −0.001] per year) fell more among girls in the dance and screen time reduction intervention. In exploratory moderator analysis, the dance and screen time reduction intervention slowed BMI gain more than health education among girls who watched more television at baseline (P=.02) and/or those whose parents/guardians were unmarried (P<.01). Conclusions A culturally-tailored after-school dance and screen time reduction intervention for low-income, preadolescent African-American girls did not significantly reduce BMI gain compared to health education, but produced potentially clinically important reductions in lipids, hyperinsulinemia, and depressive symptoms. There was also evidence for greater effectiveness in high-risk subgroups of girls. PMID:21041592

A randomized controlled trial of culturally tailored dance and reducing screen time to prevent weight gain in low-income African American girls: Stanford GEMS.

PubMed

Robinson, Thomas N; Matheson, Donna M; Kraemer, Helena C; Wilson, Darrell M; Obarzanek, Eva; Thompson, Nikko S; Alhassan, Sofiya; Spencer, Tirzah R; Haydel, K Farish; Fujimoto, Michelle; Varady, Ann; Killen, Joel D

2010-11-01

To test a 2-year community- and family-based obesity prevention program for low-income African American girls: Stanford GEMS (Girls' health Enrichment Multi-site Studies). Randomized controlled trial with follow-up measures scheduled at 6, 12, 18, and 24 months. Low-income areas of Oakland, California. African American girls aged 8 to 10 years (N=261) and their parents or guardians. Families were randomized to one of two 2-year, culturally tailored interventions: (1) after-school hip-hop, African, and step dance classes and a home/family-based intervention to reduce screen media use or (2) information-based health education. Changes in body mass index (BMI). Changes in BMI did not differ between groups (adjusted mean difference [95% confidence interval] = 0.04 [-0.18 to 0.27] per year). Among secondary outcomes, fasting total cholesterol level (adjusted mean difference, -3.49 [95% confidence interval, -5.28 to -1.70] mg/dL per year), low-density lipoprotein cholesterol level (-3.02 [-4.74 to -1.31] mg/dL per year), incidence of hyperinsulinemia (relative risk, 0.35 [0.13 to 0.93]), and depressive symptoms (-0.21 [-0.42 to -0.001] per year) decreased more among girls in the dance and screen time reduction intervention. In exploratory moderator analysis, the dance and screen time reduction intervention slowed BMI gain more than health education among girls who watched more television at baseline (P = .02) and/or those whose parents or guardians were unmarried (P = .01). A culturally tailored after-school dance and screen time reduction intervention for low-income, preadolescent African American girls did not significantly reduce BMI gain compared with health education but did produce potentially clinically important reductions in lipid levels, hyperinsulinemia, and depressive symptoms. There was also evidence for greater effectiveness in high-risk subgroups of girls.

School-based survey participation: oral health and BMI survey of Ohio third graders.

PubMed

Detty, Amber M R

2013-09-01

During the 2009-2010 school year, the Ohio Department of Health conducted a statewide oral health and body mass index (BMI) screening survey among 3rd grade children. This marked the fifth school-based survey regarding the oral health of Ohio children since 1987. At 50 %, the participation rate of the 2009-2010 oral health and BMI survey was at the lowest level ever experienced. This study aimed to identify the factors associated with participation rates in a school-based survey. A stratified, random sample of 377 schools was drawn from the list of 1,742 Ohio public elementary schools with third grade students. All third grade children in the sampled schools with parent or guardian consent received an oral health screening and height/weight measurement by trained health professionals. Participation rates at the school level were then combined with data on school characteristics and survey implementation. Predictors of school form return, participation, and refusal rates were assessed by generalized linear modeling (GLM). High student mobility and larger school size were associated with lower form return (p = 0.000 and p = 0.001, respectively) and lower participation rates (p = 0.000 and p = 0.005, respectively). Surveying in the fall or spring (as opposed to winter) significantly decreased form return (p = 0.001 and p = 0.016, respectively) and participation rates (p = 0.008 and p = 0.002, respectively), while being surveyed by internal staff (versus external screeners) significantly increased form return (p = 0.003) and participation rates (p = 0.001). Efforts to increase participation should focus more on schools with higher student mobility and larger size. Additionally, participation could be improved by using internal staff and surveying during winter.

State-mandated school-based BMI screening and parent notification: a descriptive case study.

PubMed

Kaczmarski, Jenna M; DeBate, Rita D; Marhefka, Stephanie L; Daley, Ellen M

2011-11-01

To address childhood obesity, several states and local school districts across the United States have adopted body mass index (BMI) measurement initiatives. This descriptive case study explored psychosocial, environmental, and behavioral factors among parents of sixth-grade students who received BMI Health Letters (BMIHLs) in one Florida County. A nonexperimental postintervention design was employed to gather quantitative data via self-report Likert-type questionnaire. Participants were parents/guardians of sixth-grade students attending one Hillsborough County public middle school (n = 76). Results indicate three main findings: (a) most parents in this study (67.4%) who discussed the BMIHL with their child reported their child as "very" or "somewhat" uncomfortable with the discussion; (b) some parents of normal weight (NW) children responded by taking their child to a medical professional to control their weight; and (c) more parents of at risk of overweight/overweight (AR/OW) children (vs. NW) reported greater concern about their child's weight, using food restriction and physical activity to control their child's weight, and giving negative weight-related comments/behaviors. This case study illustrates the importance of adapting and tailoring state mandated BMIHLs for parents based on child's BMI status.

Perceived and Police Reported Neighborhood Crime: Linkages to Adolescent Activity Behaviors and Weight Status

PubMed Central

Wall, Melanie; Choo, Tse; Larson, Nicole; Van Riper, David; Neumark-Sztainer, Dianne

2015-01-01

Purpose Inadequate physical activity and obesity during adolescence are areas of public health concern. Questions exist about the role of neighborhoods in the etiology of these problems. This research addressed the relationships of perceived and objective reports of neighborhood crime to adolescent physical activity, screen media use, and BMI. Methods Socioeconomically and racially/ethnically diverse adolescents (N=2,455, 53.4% female) from 20 urban, public middle and high schools in Minneapolis/St. Paul, Minnesota responded to a classroom survey in the EAT 2010 (Eating and Activity in Teens) study. Body mass index (BMI) was measured by research staff. Participants’ mean age was 14.6 (SD=2.0); 82.7% represented racial/ethnic groups other than non-Hispanic white. Linear regressions examined associations between crime perceived by adolescents and crime reported to police and the outcomes of interest (BMI z-scores, physical activity, and screen time). Models were stratified by gender and adjusted for age, race/ethnicity, socioeconomic status, and school. Results BMI was positively associated with perceived crime among girls and boys and with reported crime in girls. For girls, there was an association between higher perceived crime and increased screen time; for boys, between higher reported property crime and reduced physical activity. Perceived crime was associated with reported crime, both property and personal, in both genders. Conclusions Few prior studies of adolescents have studied the association between both perceived and reported crime and BMI. Community-based programs for youth should consider addressing adolescents’ safety concerns along with other perceived barriers to physical activity. Interventions targeting actual crime rates are also important. PMID:26206444

A school-based intervention for diabetes risk reduction.

PubMed

Foster, Gary D; Linder, Barbara; Baranowski, Tom; Cooper, Dan M; Goldberg, Linn; Harrell, Joanne S; Kaufman, Francine; Marcus, Marsha D; Treviño, Roberto P; Hirst, Kathryn

2010-07-29

We examined the effects of a multicomponent, school-based program addressing risk factors for diabetes among children whose race or ethnic group and socioeconomic status placed them at high risk for obesity and type 2 diabetes. Using a cluster design, we randomly assigned 42 schools to either a multicomponent school-based intervention (21 schools) or assessment only (control, 21 schools). A total of 4603 students participated (mean [+/- SD] age, 11.3 [+/- 0.6 years; 54.2% Hispanic and 18.0% black; 52.7% girls). At the beginning of 6th grade and the end of 8th grade, students underwent measurements of body-mass index (BMI), waist circumference, and fasting glucose and insulin levels. There was a decrease in the primary outcome--the combined prevalence of overweight and obesity--in both the intervention and control schools, with no significant difference between the school groups. The intervention schools had greater reductions in the secondary outcomes of BMI z score, percentage of students with waist circumference at or above the 90th percentile, fasting insulin levels (P=0.04 for all comparisons), and prevalence of obesity (P=0.05). Similar findings were observed among students who were at or above the 85th percentile for BMI at baseline. Less than 3% of the students who were screened had an adverse event; the proportions were nearly equivalent in the intervention and control schools. Our comprehensive school-based program did not result in greater decreases in the combined prevalence of overweight and obesity than those that occurred in control schools. However, the intervention did result in significantly greater reductions in various indexes of adiposity. These changes may reduce the risk of childhood-onset type 2 diabetes. (Funded by the National Institutes of Health and the American Diabetes Association; ClinicalTrials.gov number, NCT00458029.)

Perceived and Police-Reported Neighborhood Crime: Linkages to Adolescent Activity Behaviors and Weight Status.

PubMed

Forsyth, Ann; Wall, Melanie; Choo, Tse; Larson, Nicole; Van Riper, David; Neumark-Sztainer, Dianne

2015-08-01

Inadequate physical activity and obesity during adolescence are areas of public health concern. Questions exist about the role of neighborhoods in the etiology of these problems. This research addressed the relationships of perceived and objective reports of neighborhood crime to adolescent physical activity, screen media use, and body mass index (BMI). Socioeconomically and racially/ethnically diverse adolescents (N = 2,455, 53.4% female) from 20 urban, public middle and high schools in Minneapolis/St. Paul, Minnesota responded to a classroom survey in the Eating and Activity in Teens 2010 study. BMI was measured by research staff. Participants' mean age was 14.6 (standard deviation = 2.0); 82.7% represented racial/ethnic groups other than non-Hispanic white. Linear regressions examined associations between crime perceived by adolescents and crime reported to police and the outcomes of interest (BMI z-scores, physical activity, and screen time). Models were stratified by gender and adjusted for age, race/ethnicity, socioeconomic status, and school. BMI was positively associated with perceived crime among girls and boys and with reported crime in girls. For girls, there was an association between higher perceived crime and increased screen time; for boys, between higher reported property crime and reduced physical activity. Perceived crime was associated with reported crime, both property and personal, in both genders. Few prior studies of adolescents have studied the association between both perceived and reported crime and BMI. Community-based programs for youth should consider addressing adolescents' safety concerns along with other perceived barriers to physical activity. Interventions targeting actual crime rates are also important. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The nutrition and enjoyable activity for teen girls study: a cluster randomized controlled trial.

PubMed

Dewar, Deborah L; Morgan, Philip J; Plotnikoff, Ronald C; Okely, Anthony D; Collins, Clare E; Batterham, Marijka; Callister, Robin; Lubans, David R

2013-09-01

Obesity prevention among youth of low SES is a public health priority given the higher prevalence of youth obesity in this population subgroup. To evaluate the 24-month impact of a school-based obesity prevention program among adolescent girls living in low-income communities. The study was a school-based group RCT, the Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) intervention. The study involved 12 secondary schools located in low-income communities in New South Wales, Australia. Participants were 357 adolescent girls (aged 13.2 ± 0.5 years). The 12-month multicomponent intervention was guided by social cognitive theory and involved strategies to promote physical activity, reduce sedentary behaviors, and improve dietary outcomes. The primary outcome was BMI, and secondary outcomes were BMI z-score; percentage body fat (bioelectrical impedance analysis); physical activity (accelerometers); dietary intake; and recreational screen-time (self-report). Data were collected in 2010-2012 and analyzed in 2012. After 24 months, there were no intervention effects on BMI (adjusted mean difference -0.33, 95% CI= -0.97, 0.28, p=0.353) and BMI z-score (-0.12, 95% CI= -0.27, 0.04, p=0.178). However, there was a group-by-time interaction for percentage body fat (-1.96%, 95% CI= -3.02, -0.89, p=0.006). Intervention effects for physical activity, screen time, and dietary intake were not significant. The NEAT Girls intervention did not result in effects on the primary outcome. Further study of youth who are "at risk" of obesity should focus on strategies to improve retention and adherence in prevention programs. This study is registered at Australian New Zealand Clinical Trials ACTRN1261000033004. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Rationale and study protocol for the 'active teen leaders avoiding screen-time' (ATLAS) group randomized controlled trial: an obesity prevention intervention for adolescent boys from schools in low-income communities.

PubMed

Smith, Jordan J; Morgan, Philip J; Plotnikoff, Ronald C; Dally, Kerry A; Salmon, Jo; Okely, Anthony D; Finn, Tara L; Babic, Mark J; Skinner, Geoff; Lubans, David R

2014-01-01

The negative consequences of unhealthy weight gain and the high likelihood of pediatric obesity tracking into adulthood highlight the importance of targeting youth who are 'at risk' of obesity. The aim of this paper is to report the rationale and study protocol for the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention intervention for adolescent boys living in low-income communities. The ATLAS intervention will be evaluated using a cluster randomized controlled trial in 14 secondary schools in the state of New South Wales (NSW), Australia (2012 to 2014). ATLAS is an 8-month multi-component, school-based program informed by self-determination theory and social cognitive theory. The intervention consists of teacher professional development, enhanced school-sport sessions, researcher-led seminars, lunch-time physical activity mentoring sessions, pedometers for self-monitoring, provision of equipment to schools, parental newsletters, and a smartphone application and website. Assessments were conducted at baseline and will be completed again at 9- and 18-months from baseline. Primary outcomes are body mass index (BMI) and waist circumference. Secondary outcomes include BMI z-scores, body fat (bioelectrical impedance analysis), physical activity (accelerometers), muscular fitness (grip strength and push-ups), screen-time, sugar-sweetened beverage consumption, resistance training skill competency, daytime sleepiness, subjective well-being, physical self-perception, pathological video gaming, and aggression. Hypothesized mediators of behavior change will also be explored. ATLAS is an innovative school-based intervention designed to improve the health behaviors and related outcomes of adolescent males in low-income communities. Copyright © 2013 Elsevier Inc. All rights reserved.

Parental recognition of overweight in school-age children.

PubMed

West, Delia S; Raczynski, James M; Phillips, Martha M; Bursac, Zoran; Heath Gauss, C; Montgomery, Brooke E E

2008-03-01

Examine the accuracy of parental weight perceptions of overweight children before and after the implementation of childhood obesity legislation that included BMI screening and feedback. Statewide telephone surveys of parents of overweight (BMI > or = 85th percentile) Arkansas public school children before (n = 1,551; 15% African American) and after (n = 2,508; 15% African American) policy implementation were examined for correspondence between parental perception of child's weight and objective classification. Most (60%) parents of overweight children underestimated weight at baseline. Parents of younger children were significantly more likely to underestimate (65%) than parents of adolescents (51%). Overweight parents were not more likely to underestimate, nor was inaccuracy associated with parental education or socioeconomic status. African-American parents were twice as likely to underestimate as whites. One year after BMI screening and feedback was implemented, the accuracy of classification of overweight children improved (53% underestimation). African-American parents had significantly greater improvements than white parents (P < 0.0001). Parental recognition of childhood overweight may be improved with BMI screening and feedback, and African-American parents may specifically benefit. Nonetheless, underestimation of overweight is common and may have implications for public health interventions.

Assessing the sustained impact of a school-based obesity prevention program for adolescent boys: the ATLAS cluster randomized controlled trial.

PubMed

Lubans, David R; Smith, Jordan J; Plotnikoff, Ronald C; Dally, Kerry A; Okely, Anthony D; Salmon, Jo; Morgan, Philip J

2016-08-20

Obesity prevention interventions targeting 'at-risk' adolescents are urgently needed. The aim of this study is to evaluate the sustained impact of the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention program. Cluster RCT in 14 secondary schools in low-income communities of New South Wales, Australia. Participants were 361 adolescent boys (aged 12-14 years) 'at risk' of obesity. The intervention was based on Self-Determination Theory and Social Cognitive Theory and involved: professional development, fitness equipment for schools, teacher-delivered physical activity sessions, lunch-time activity sessions, researcher-led seminars, a smartphone application, and parental strategies. Assessments for the primary (body mass index [BMI], waist circumference) and secondary outcomes were conducted at baseline, 8- (post-intervention) and 18-months (follow-up). Analyses followed the intention-to-treat principle using linear mixed models. After 18-months, there were no intervention effects for BMI or waist circumference. Sustained effects were found for screen-time, resistance training skill competency, and motivational regulations for school sport. There were no clinically meaningful intervention effects for the adiposity outcomes. However, the intervention resulted in sustained effects for secondary outcomes. Interventions that more intensively target the home environment, as well as other socio-ecological determinants of obesity may be needed to prevent unhealthy weight gain in adolescents from low-income communities. Australian Clinical Trial Registry ACTRN12612000978864.

Associations among Screen Time and Unhealthy Behaviors, Academic Performance, and Well-Being in Chinese Adolescents.

PubMed

Yan, Hanyi; Zhang, Rui; Oniffrey, Theresa M; Chen, Guoxun; Wang, Yueqiao; Wu, Yingru; Zhang, Xinge; Wang, Quan; Ma, Lu; Li, Rui; Moore, Justin B

2017-06-04

Screen time is negatively associated with markers of health in western youth, but very little is known about these relationships in Chinese youth. Middle-school and high-school students ( n = 2625) in Wuhan, China, completed questionnaires assessing demographics, health behaviors, and self-perceptions in spring/summer 2016. Linear and logistic regression analyses were conducted to determine whether, after adjustment for covariates, screen time was associated with body mass index (BMI), eating behaviors, average nightly hours of sleep, physical activity (PA), academic performance, and psychological states. Watching television on school days was negatively associated with academic performance, PA, anxiety, and life satisfaction. Television viewing on non-school days was positively associated with sleep duration. Playing electronic games was positively associated with snacking at night and less frequently eating breakfast, and negatively associated with sleep duration and self-esteem. Receiving electronic news and study materials on non-school days was negatively associated with PA, but on school days, was positively associated with anxiety. Using social networking sites was negatively associated with academic performance, but positively associated with BMI z-score, PA and anxiety. Screen time in adolescents is associated with unhealthy behaviors and undesirable psychological states that can contribute to poor quality of life.

Associations among Screen Time and Unhealthy Behaviors, Academic Performance, and Well-Being in Chinese Adolescents

PubMed Central

Yan, Hanyi; Zhang, Rui; Oniffrey, Theresa M.; Chen, Guoxun; Wang, Yueqiao; Wu, Yingru; Zhang, Xinge; Wang, Quan; Ma, Lu; Li, Rui; Moore, Justin B.

2017-01-01

Screen time is negatively associated with markers of health in western youth, but very little is known about these relationships in Chinese youth. Middle-school and high-school students (n = 2625) in Wuhan, China, completed questionnaires assessing demographics, health behaviors, and self-perceptions in spring/summer 2016. Linear and logistic regression analyses were conducted to determine whether, after adjustment for covariates, screen time was associated with body mass index (BMI), eating behaviors, average nightly hours of sleep, physical activity (PA), academic performance, and psychological states. Watching television on school days was negatively associated with academic performance, PA, anxiety, and life satisfaction. Television viewing on non-school days was positively associated with sleep duration. Playing electronic games was positively associated with snacking at night and less frequently eating breakfast, and negatively associated with sleep duration and self-esteem. Receiving electronic news and study materials on non-school days was negatively associated with PA, but on school days, was positively associated with anxiety. Using social networking sites was negatively associated with academic performance, but positively associated with BMI z-score, PA and anxiety. Screen time in adolescents is associated with unhealthy behaviors and undesirable psychological states that can contribute to poor quality of life. PMID:28587225

The role of culture in the context of school-based BMI screening.

PubMed

Fitzgibbon, Marian L; Beech, Bettina M

2009-09-01

The high prevalence of overweight and obesity is a significant public health concern in the United States. Minority populations are disproportionately affected, and the impact of obesity on minority children is especially alarming. In this article we discuss school-based BMI reporting, which is intended to increase parental awareness of their children's weight status. This information could potentially lead parents of overweight and obese children to carefully examine and possibly change their children's diet and activity patterns. However, any program related to child weight status must consider culturally defined aspects of body size and shape. In other words, the cultural context in which information on child BMI is presented to and received by parents must be considered. In this article we review parental perceptions of child weight. Multiple studies have shown that parents of overweight or obese children often fail to correctly perceive their children as overweight. Possible reasons for, and implications of, this misperception of child weight status among minority parents are then explored within a cultural framework. The PEN-3 model is used to examine influences on health behaviors and could help inform the development of a culturally sensitive BMI-notification program for minority parents. Reporting materials congruent with the social and cultural values and practices of the target audience are likely to maximize program effectiveness. A culturally based BMI-notification program should be conceptualized as a small step in a comprehensive plan to reduce childhood obesity and improve the current and future health of minority children.

Quantile regression analyses of associated factors for body mass index in Korean adolescents.

PubMed

Kim, T H; Lee, E K; Han, E

2015-05-01

This study examined the influence of home and school environments, and individual health-risk behaviours on body weight outcomes in Korean adolescents. This was a cross-sectional observational study. Quantile regression models to explore heterogeneity in the association of specific factors with body mass index (BMI) over the entire conditional BMI distribution was used. A nationally representative web-based survey for youths was used. Paternal education level of college or more education was associated with lower BMI for girls, whereas college or more education of mothers was associated with higher BMI for boys; for both, the magnitude of association became larger at the upper quantiles of the conditional BMI distribution. Girls with good family economic status were more likely to have higher BMIs than those with average family economic status, particularly at the upper quantile of the conditional BMI distribution. Attending a co-ed school was associated with lower BMI for both genders with a larger association at the upper quantiles. Substantial screen time for TV watching, video games, or internet surfing was associated with a higher BMI with a larger association at the upper quantiles for both girls and boys. Dental prevention was negatively associated with BMI, whereas suicide consideration was positively associated with BMIs of both genders with a larger association at a higher quantile. These findings suggest that interventions aimed at behavioural changes and positive parental roles are needed to effectively address high adolescent BMI. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Anthropometric methods for obesity screening in schoolchildren: the Ouro Preto Study.

PubMed

Cándido, A P C; Alosta, J P S; Oliveira, C T; Freitas, R N; Freitas, S N; Machado-Coelho, G L L

2012-01-01

Childhood obesity is increasing dramatically in last decades. To evaluate the usefulness of body mass index (BMI), skinfold thickness (ST), waist circumference (WC), and foot-to-foot bioelectrical impedance (BIA-FF) for screening for obesity in mixed-race population, using the tetrapolar bioelectrical impedance (BIA-T) technique as reference method. A cross-sectional-based population study was performed in the city of Ouro Preto, Brazil, in 2006. Schoolchildren aged 6-15 years (n = 788) was randomly selected according to age and sex stratified by the proportion of students in each schools of the city. Nonparametric receiver operating characteristic (ROC) analysis was used to define the sensitivity and specificity for each method studied using the tetrapolar method as reference. The BMI and the BIA-FF were the most suitable for adiposity screening in pre-pubertal and pubertal stages because they present a better balance between sensitivity and specificity, and smaller misclassification. For post-pubertal boys, the BF-ST-D was the best body fat assessment method. The results suggest that BIA-FF and BMI are choice methods for obesity screening in mixed population and that the method choice for body fat screening must be done according to sexual maturity of boys and girls. The present study demonstrates the need to perform studies in wider mixed-race population to determine anthropometric parameters and to examine the predictive ability of methods and cut-offs here elucidated in the development of obesity.

Stanford GEMS phase 2 obesity prevention trial for low-income African-American girls: design and sample baseline characteristics.

PubMed

Robinson, Thomas N; Kraemer, Helena C; Matheson, Donna M; Obarzanek, Eva; Wilson, Darrell M; Haskell, William L; Pruitt, Leslie A; Thompson, Nikko S; Haydel, K Farish; Fujimoto, Michelle; Varady, Ann; McCarthy, Sally; Watanabe, Connie; Killen, Joel D

2008-01-01

African-American girls and women are at high risk of obesity and its associated morbidities. Few studies have tested obesity prevention strategies specifically designed for African-American girls. This report describes the design and baseline findings of the Stanford GEMS (Girls health Enrichment Multi-site Studies) trial to test the effect of a two-year community- and family-based intervention to reduce weight gain in low-income, pre-adolescent African-American girls. Randomized controlled trial with measurements scheduled in girls' homes at baseline, 6, 12, 18 and 24 month post-randomization. Low-income areas of Oakland, CA. Eight, nine and ten year old African-American girls and their parents/caregivers. Girls are randomized to a culturally-tailored after-school dance program and a home/family-based intervention to reduce screen media use versus an information-based community health education Active-Placebo Comparison intervention. Interventions last for 2 years for each participant. Change in body mass index over the two-year study. Recruitment and enrollment successfully produced a predominately low-socioeconomic status sample. Two-hundred sixty one (261) families were randomized. One girl per family is randomly chosen for the analysis sample. Randomization produced comparable experimental groups with only a few statistically significant differences. The sample had a mean body mass index (BMI) at the 74 th percentile on the 2000 CDC BMI reference, and one-third of the analysis sample had a BMI at the 95th percentile or above. Average fasting total cholesterol and LDL cholesterol were above NCEP thresholds for borderline high classifications. Girls averaged low levels of moderate to vigorous physical activity, more than 3 h per day of screen media use, and diets high in energy from fat. The Stanford GEMS trial is testing the benefits of culturally-tailored after-school dance and screen-time reduction interventions for obesity prevention in low-income, pre-adolescent African-American girls.

Associations between Three School-Based Measures of Health: Is BMI Enough?

ERIC Educational Resources Information Center

Morgan, Emily H.; Houser, Robert F.; Au, Lauren E.; Sacheck, Jennifer M.

2013-01-01

School-based body mass index (BMI) notification programs are often used to raise parental awareness of childhood overweight and obesity, but how BMI results are associated with physical fitness and diet is less clear. This study examined the relationship between BMI, fitness, and diet quality in a diverse sample of urban schoolchildren…

Multilevel analysis of the Be Active Eat Well intervention: environmental and behavioural influences on reductions in child obesity risk.

PubMed

Johnson, B A; Kremer, P J; Swinburn, B A; de Silva-Sanigorski, A M

2012-07-01

The Be Active Eat Well (BAEW) community-based child obesity prevention intervention was successful in modestly reducing unhealthy weight gain in primary school children using a multi-strategy and multi-setting approach. To (1) examine the relationship between changes in obesity-related individual, household and school factors and changes in standardised child body mass index (zBMI), and (2) determine if the BAEW intervention moderated these effects. The longitudinal relationships between changes in individual, household and school variables and changes in zBMI were explored using multilevel modelling, with measurement time (baseline and follow-up) at level 1, individual (behaviours, n = 1812) at level 2 and households (n = 1318) and schools (n = 18) as higher levels (environments). The effect of the intervention was tested while controlling for child age, gender and maternal education level. This study confirmed that the BAEW intervention lowered child zBMI compared with the comparison group (-0.085 units, P = 0.03). The variation between household environments was found to be a large contributor to the percentage of unexplained change in child zBMI (59%), compared with contributions from the individual (23%) and school levels (1%). Across both groups, screen time (P = 0.03), sweet drink consumption (P = 0.03) and lack of household rules for television (TV) viewing (P = 0.05) were associated with increased zBMI, whereas there was a non-significant association with the frequency the TV was on during evening meals (P = 0.07). The moderating effect of the intervention was only evident for the relationship between the frequency of TV on during meals and zBMI, however, this effect was modest (P = 0.04). The development of childhood obesity involves multi-factorial and multi-level influences, some of which are amenable to change. Obesity prevention strategies should not only target individual behaviours but also the household environment and family practices. Although zBMI changes were modest, these findings are encouraging as small reductions can have population level impacts on childhood obesity levels.

Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial: Post-Intervention Results

PubMed Central

Fitzgibbon, M. L.; Stolley, M. R.; Schiffer, L.; Braunschweig, C. L.; Gomez, S. L.; Van Horn, L.; Dyer, A.

2013-01-01

The preschool years offer an opportunity to interrupt the trajectory toward obesity in black children. The Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial was a group-randomized controlled trial assessing the feasibility and effectiveness of a teacher-delivered weight control intervention for black preschool children. The 618 participating children were enrolled in 18 schools administered by the Chicago Public Schools. Children enrolled in the 9 schools randomized to the intervention group received a 14-week weight control intervention delivered by their classroom teachers. Children in the 9 control schools received a general health intervention. Height and weight, physical activity, screen time, and diet data were collected at baseline and post-intervention. At post-intervention, children in the intervention schools engaged in more moderate-to vigorous physical activity than children in the control schools (difference between adjusted group means=7.46 min/day, p=.02). Also, children in the intervention group had less total screen time (−27.8 min/day, p=.05). There were no significant differences in BMI, BMI Z score, or dietary intake. It is feasible to adapt an obesity prevention program to be taught by classroom teachers. The intervention showed positive influences on physical activity and screen time, but not diet. Measuring diet and physical activity in preschool children remains a challenge, and interventions delivered by classroom teachers require both intensive initial training and ongoing individualized supervision. PMID:21193852

Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial: postintervention results.

PubMed

Fitzgibbon, Marian L; Stolley, Melinda R; Schiffer, Linda A; Braunschweig, Carol L; Gomez, Sandra L; Van Horn, Linda; Dyer, Alan R

2011-05-01

The preschool years offer an opportunity to interrupt the trajectory toward obesity in black children. The Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial was a group-randomized controlled trial assessing the feasibility and effectiveness of a teacher-delivered weight control intervention for black preschool children. The 618 participating children were enrolled in 18 schools administered by the Chicago Public Schools. Children enrolled in the nine schools randomized to the intervention group received a 14-week weight control intervention delivered by their classroom teachers. Children in the nine control schools received a general health intervention. Height and weight, physical activity, screen time, and diet data were collected at baseline and postintervention. At postintervention, children in the intervention schools engaged in more moderate-to-vigorous physical activity (MVPA) than children in the control schools (difference between adjusted group means = 7.46 min/day, P = 0.02). Also, children in the intervention group had less total screen time (-27.8 min/day, P = 0.05). There were no significant differences in BMI, BMI Z score, or dietary intake. It is feasible to adapt an obesity prevention program to be taught by classroom teachers. The intervention showed positive influences on physical activity and screen time, but not on diet. Measuring diet and physical activity in preschool children remains a challenge, and interventions delivered by classroom teachers require both intensive initial training and ongoing individualized supervision.

Smart-phone obesity prevention trial for adolescent boys in low-income communities: the ATLAS RCT.

PubMed

Smith, Jordan J; Morgan, Philip J; Plotnikoff, Ronald C; Dally, Kerry A; Salmon, Jo; Okely, Anthony D; Finn, Tara L; Lubans, David R

2014-09-01

The goal of this study was to evaluate the impact of the Active Teen Leaders Avoiding Screen-time (ATLAS) intervention for adolescent boys, an obesity prevention intervention using smartphone technology. ATLAS was a cluster randomized controlled trial conducted in 14 secondary schools in low-income communities in New South Wales, Australia. Participants were 361 adolescent boys (aged 12-14 years) considered at risk of obesity. The 20-week intervention was guided by self-determination theory and social cognitive theory and involved: teacher professional development, provision of fitness equipment to schools, face-to-face physical activity sessions, lunchtime student mentoring sessions, researcher-led seminars, a smartphone application and Web site, and parental strategies for reducing screen-time. Outcome measures included BMI and waist circumference, percent body fat, physical activity (accelerometers), screen-time, sugar-sweetened beverage intake, muscular fitness, and resistance training skill competency. Overall, there were no significant intervention effects for BMI, waist circumference, percent body fat, or physical activity. Significant intervention effects were found for screen-time (mean ± SE: -30 ± 10.08 min/d; P = .03), sugar-sweetened beverage consumption (mean: -0.6 ± 0.26 glass/d; P = .01), muscular fitness (mean: 0.9 ± 0.49 repetition; P = .04), and resistance training skills (mean: 5.7 ± 0.67 units; P < .001). This school-based intervention targeting low-income adolescent boys did not result in significant effects on body composition, perhaps due to an insufficient activity dose. However, the intervention was successful in improving muscular fitness, movement skills, and key weight-related behaviors. Copyright © 2014 by the American Academy of Pediatrics.

Screen-Time Weight-loss Intervention Targeting Children at Home (SWITCH): a randomized controlled trial.

PubMed

Maddison, Ralph; Marsh, Samantha; Foley, Louise; Epstein, Leonard H; Olds, Timothy; Dewes, Ofa; Heke, Ihirangi; Carter, Karen; Jiang, Yannan; Mhurchu, Cliona Ni

2014-09-10

Screen-based activities, such as watching television (TV), playing video games, and using computers, are common sedentary behaviors among young people and have been linked with increased energy intake and overweight. Previous home-based sedentary behaviour interventions have been limited by focusing primarily on the child, small sample sizes, and short follow-up periods. The SWITCH (Screen-Time Weight-loss Intervention Targeting Children at Home) study aimed to determine the effect of a home-based, family-delivered intervention to reduce screen-based sedentary behaviour on body composition, sedentary behaviour, physical activity, and diet over 24 weeks in overweight and obese children. A two-arm, parallel, randomized controlled trial was conducted. Children and their primary caregiver living in Auckland, New Zealand were recruited via schools, community centres, and word of mouth. The intervention, delivered over 20 weeks, consisted of a face-to-face meeting with the parent/caregiver and the child to deliver intervention content, which focused on training and educating them to use a wide range of strategies designed to reduce their child's screen time. Families were given Time Machine TV monitoring devices to assist with allocating screen time, activity packages to promote alternative activities, online support via a website, and monthly newsletters. Control participants were given the intervention material on completion of follow-up. The primary outcome was change in children's BMI z-score from baseline to 24 weeks. Children (n = 251) aged 9-12 years and their primary caregiver were randomized to receive the SWITCH intervention (n = 127) or no intervention (controls; n = 124). There was no significant difference in change of zBMI between the intervention and control groups, although a favorable trend was observed (-0.016; 95% CI: -0.084, 0.051; p = 0.64). There were also no significant differences on secondary outcomes, except for a trend towards increased children's moderate intensity physical activity in the intervention group (24.3 min/d; 95% CI: -0.94, 49.51; p = 0.06). A home-based, family-delivered intervention to reduce all leisure-time screen use had no significant effect on screen-time or on BMI at 24 weeks in overweight and obese children aged 9-12 years. Australian New Zealand Clinical Trials RegistryWebsite: http://www.anzctr.org.au ACTRN12611000164998.

Intraclass Correlation Coefficients for Obesity Indicators and Energy Balance-Related Behaviors Among New York City Public Elementary Schools.

PubMed

Gray, Heewon Lee; Burgermaster, Marissa; Tipton, Elizabeth; Contento, Isobel R; Koch, Pamela A; Di Noia, Jennifer

2016-04-01

Sample size and statistical power calculation should consider clustering effects when schools are the unit of randomization in intervention studies. The objective of the current study was to investigate how student outcomes are clustered within schools in an obesity prevention trial. Baseline data from the Food, Health & Choices project were used. Participants were 9- to 13-year-old students enrolled in 20 New York City public schools (n= 1,387). Body mass index (BMI) was calculated based on measures of height and weight, and body fat percentage was measured with a Tanita® body composition analyzer (Model SC-331s). Energy balance-related behaviors were self-reported with a frequency questionnaire. To examine the cluster effects, intraclass correlation coefficients (ICCs) were calculated as school variance over total variance for outcome variables. School-level covariates, percentage students eligible for free and reduced-price lunch, percentage Black or Hispanic, and English language learners were added in the model to examine ICC changes. The ICCs for obesity indicators are: .026 for BMI-percentile, .031 for BMIz-score, .035 for percentage of overweight students, .037 for body fat percentage, and .041 for absolute BMI. The ICC range for the six energy balance-related behaviors are .008 to .044 for fruit and vegetables, .013 to .055 for physical activity, .031 to .052 for recreational screen time, .013 to .091 for sweetened beverages, .033 to .121 for processed packaged snacks, and .020 to .083 for fast food. When school-level covariates were included in the model, ICC changes varied from -95% to 85%. This is the first study reporting ICCs for obesity-related anthropometric and behavioral outcomes among New York City public schools. The results of the study may aid sample size estimation for future school-based cluster randomized controlled trials in similar urban setting and population. Additionally, identifying school-level covariates that can reduce cluster effects is important when analyzing data. © 2015 Society for Public Health Education.

The Massachusetts BMI letter: A qualitative study of responses from parents of obese children

PubMed Central

Moyer, Lindsay J.; Carbone, Elena T.; Anliker, Jean A.; Goff, Sarah L.

2015-01-01

Objectives Massachusetts (MA) public schools conduct mandated body-mass index (BMI) screening and until recently, communicated results in a letter to parents/caregivers, to encourage primary care visits and provide aggregate data to the state Department of Public Health. This study assessed the letter's readability and qualitatively explored parents’ responses to it. Methods Readability of the BMI letter was calculated. Audio-taped 1-h focus groups were conducted with parents/caregivers of 8- to 14-year-old obese (≥95th BMI-for-age percentile) children. A semistructured interview guide was used to elicit responses. Qualitative content analysis was conducted on transcripts to identify emergent themes. Results Readability analysis showed higher grade levels than recommended. Eight focus groups consisting of two to six parents each were conducted (n = 29); 83% were female, mean age 41 ± 9 years, and 65% self-identified as Hispanic/Latino. Key themes identified included usefulness of the BMI letter, concerns about utility of BMI for screening, concerns about impacting self-esteem, and failure to understand the letter. Conclusions The MA BMI letter may not have been achieving its desired goal with some parents. Practice implications: Emergent themes from this study could be used to test effectiveness of similar BMI letters nationwide and develop strategies to improve communication to parents. PMID:24290240

The association of BMI status with adolescent preventive screening.

PubMed

Jasik, Carolyn Bradner; Adams, Sally H; Irwin, Charles E; Ozer, Elizabeth

2011-08-01

To examine the relationship between BMI status (normal, overweight, and obese) and preventive screening among adolescents at their last checkup. We used population-based data from the 2003-2007 California Health Interview Surveys, telephone interviews of adolescents aged 12 to 17 years with a checkup in the past 12 months (n = 9220). Respondents were asked whether they received screening for nutrition, physical activity, and emotional distress. BMI was calculated from self-reported height and weight: (1) normal weight or underweight (<85th percentile); (2) overweight (85th-94th percentile); and (3) obese (>95th percentile). Multivariate logistic regression models tested how screening by topic differed according to BMI status, adjusting for age, gender, income, race/ethnicity, and survey year. Screening percentages in the pooled sample (all 3 years) were higher for obese, but not overweight, adolescents for physical activity (odds ratio: 1.4; P < .01) and nutrition (odds ratio: 1.6; screening did not differ P < .01). Stratified analysis by year revealed higher screening for obese (versus normal-weight) adolescents for nutrition and physical activity in 2003 and for all 3 topics in 2005. However, by 2007, screening did not differ according to BMI status. Overall screening between 2003 and 2007 declined for nutrition (75%-59%; P < .01), physical activity (74%-60%; P < .01), and emotional distress (31%-24%; P < .01). Obese adolescents receive more preventive screening versus their normal-weight peers. Overweight adolescents do not report more screening, but standards of care dictate increased attention for this group. These results are discouraging amid a rise in pediatric obesity and new guidelines that recommend screening by BMI status.

Increasing Body Mass Index, Blood Pressure, and Acanthosis Nigricans Abnormalities in School-Age Children

ERIC Educational Resources Information Center

Otto, Debra E.; Wang, Xiaohui; Garza, Viola; Fuentes, Lilia A.; Rodriguez, Melinda C.; Sullivan, Pamela

2013-01-01

This retrospective quantitative study examined the relationships among gender, Acanthosis Nigricans (AN), body mass index (BMI), and blood pressure (BP) in children attending school Grades 1-9 in Southwest Texas. Of the 34,897 health screening records obtained for the secondary analysis, 32,788 were included for the study. A logistic regression…

Noninvasive Screening for Risk Factors of Type 2 Diabetes in Young, Rural, Caucasian Children

ERIC Educational Resources Information Center

Peterson, Sharon; Sheffer, Sarah; Long Roth, Sara; Bennett, Paul A.; Lloyd, Les

2010-01-01

School nurses play an important role in identifying students who are at risk for Type 2 diabetes mellitus (T2DM). Few studies have screened Caucasian students, and none have targeted rural, low-income, elementary children. The five noninvasive risk factors used for this study were family history, high body mass index (BMI) for age/sex,…

Changes in Body Mass Index During a 3-Year Elementary School-Based Obesity Prevention Program for American Indian and White Rural Students.

PubMed

Vogeltanz-Holm, Nancy; Holm, Jeffrey

2018-04-01

Childhood obesity is a significant but largely modifiable health risk, disproportionately affecting socioeconomically disadvantaged, racial/ethnic minority, and rural children. Elementary school-aged children typically experience the greatest increases in excess weight gain and therefore are important targets for reducing adolescent and adult obesity while improving children's health. Our study evaluated outcomes of a 3-year elementary school-based program for reducing obesity in American Indian and White students attending eight rural schools in the U.S. upper Midwest. Researchers measured body mass indexes (BMI) and other health indicators and behaviors of 308 beginning third-grade students and then again at the end of students' third, fourth, and fifth grades. The primary focus of this study is a mixed multilevel longitudinal model testing changes in age- and gender-adjusted BMI z scores ( zBMI). There was a significant decrease in zBMI across the 3-year study period. Ethnicity analyses showed that White students had overall decreases in zBMI whereas American Indian students' zBMIs remained stable across the program. Comparisons with children from an age- and cohort-matched national sample provided support for the effectiveness of the school program in reducing BMI and obesity during the study period. An elementary school-based health program that addresses a range of students' obesity-related health behaviors, the school health environment, and that involves educators and parents is an effective intervention for reducing or stabilizing BMI in rural White and American Indian students. School health programs for students living in rural communities may be especially effective due to greater school and community cohesiveness, and valuing of the school's primary role in improving community health.

Association between family divorce and children's BMI and meal patterns: the GENDAI Study.

PubMed

Yannakoulia, Mary; Papanikolaou, Katerina; Hatzopoulou, Ioanna; Efstathiou, Eleftheria; Papoutsakis, Constantina; Dedoussis, George V

2008-06-01

The aim of this work was to explore the associations between family factors, including divorce, and children's overweight as well as eating and physical activity patterns in a population-based sample of healthy school-aged children. In this cross-sectional study, 1,138 children (53% girls; age: 11.2 +/- 0.7 years) from elementary schools in the Attica region participated. Their parents provided sociodemographic information, including their marital status. Overweight status classification was based on weight and height measurements and BMI evaluation. Children completed a physical activity checklist and a questionnaire on meal patterns and eating behaviors. The Eating Style score was calculated: the higher the score, the more frequent a child was engaged in less-structured feeding practices promoting food intake for reasons other than hunger. Analysis revealed significant association between family divorce and children's overweight: compared with children of married parents, those of divorced had significantly higher BMI levels (20.0 +/- 3.6 kg/m(2) vs. 21.3 +/- 3.4 kg/m(2), respectively, P = 0.007). Controlling for socioeconomic and physical activity factors, divorce remains a significant predictor of a higher BMI, along with older age, higher father's and mother's BMI, less children in the family, and more minutes of daily screen time. Children who had experienced a divorce in their family also reported higher Eating Style score, even after adjusting for potential confounders. In conclusion, in this sample of fifth and sixth graders, unfavorable family circumstances have been associated with children's overweight, as well as with aspects of their eating behavior, namely eating style in relation to conditions around food consumption and hunger, independent of other socioeconomic factors.

Improved Body Mass Index Measures Following a Middle School-Based Obesity Intervention--The MATCH Program

ERIC Educational Resources Information Center

Lazorick, Suzanne; Fang, Xiangming; Hardison, George T.; Crawford, Yancey

2015-01-01

Background: Motivating Adolescents with Technology to CHOOSE Health™ (MATCH) is an educational and behavioral intervention in seventh grade. Methods: Teachers in 2 schools delivered the MATCH curriculum, with 1 control school. Using a quasi-experimental design, outcome measures included lessons completed, body mass index (BMI), BMI z-score (zBMI),…

Starting the Conversation - A Childhood Obesity Knowledge Project Using an App.

PubMed

Appel, Hoa B; Huang, Bu; Cole, Allison; James, Rosalina; Ai, Amy L

2014-04-01

Starting the Conversation was a pilot project to test an intervention for childhood obesity, a major public health epidemic, using a free smartphone application (app). The primary aim was to assess students' knowledge of nutritional indicators, physical exercise and use of screen time before and after the intervention. The study was conducted in 2011-2012. The sample, recruited from seven high schools in Snohomish County, Washington, was 65.3% minority participants. Of the 118 participants in the sample (n=118), 79 handwrote their responses (n=78) and 36 responded via the app (n=39). We compared the frequency and types of physical exercise, frequency of screen time, and nutritional variables of high school students. Participants used the cell phone app or a handwritten log to record their daily entries for 20 days. Both males (n=43) and females (n=75) grades 9-12 used the app or handwritten entries. Participants who used the app ate less fast food and exercised more, as compared with those who recorded their entries by hand. Screen time usage decreased over the course of the study, based on a comparison of the post-survey level and the pre-survey level. Knowledge of recommended daily consumption of vegetables increased post-test in the app group and knowledge of water consumption increased significantly in both groups. There was no significant difference in BMI pre and post-test. Patterns of nutritional intake, physical exercise and knowledge of these issues varied pre and post-test. It is critical to further examine factors associated with lack of physical activity and food intake patterns of youth using social media to further address the childhood obesity epidemic. Future research should focus on specific ethnic subgroups and an intervention at the school level aimed at the students with BMI ≥ 95 th percentile.

Variation in dietary intake and physical activity pattern as predictors of change in body mass index (BMI) Z-score among Brazilian adolescents.

PubMed

Enes, Carla C; Slater, Betzabeth

2013-06-01

To assess whether changes in dietary intake and physical activity pattern are associated with the annual body mass index (BMI) z-score change among adolescents. The study was conducted in public schools in the city of Piracicaba, Sao Paulo, Brazil, with a probabilistic sample of 431 adolescents participating in wave I (2004) (hereafter, baseline) and 299 in wave II (2005) (hereafter, follow-up). BMI, usual food intake, physical activity, screen time, sexual maturation and demographic variables were assessed twice. The association between annual change in food intake, physical activity, screen time, and annual BMI z-score changes were assessed by multiple regression. The study showed a positive variation in BMI z-score over one-year. Among variables related to physical activity pattern only playing videogame and using computer increased over the year. The intake of fruits and vegetables and sugar-sweetened beverages increased over one year, while the others variables showed a reduction. An increased consumption of fatty foods (β = 0.04, p = 0.04) and sweetened natural fruit juices (β = 0.05, p = 0.03) was positively associated with the rise in BMI z-score. Unhealthy dietary habits can predict the BMI z-score gain more than the physical activity pattern. The intake of fatty foods and sweetened fruit juices is associated with the BMI z-score over one year.

Prediction of Lateral Ankle Sprains in Football Players Based on Clinical Tests and Body Mass Index.

PubMed

Gribble, Phillip A; Terada, Masafumi; Beard, Megan Q; Kosik, Kyle B; Lepley, Adam S; McCann, Ryan S; Pietrosimone, Brian G; Thomas, Abbey C

2016-02-01

The lateral ankle sprain (LAS) is the most common injury suffered in sports, especially in football. While suggested in some studies, a predictive role of clinical tests for LAS has not been established. To determine which clinical tests, focused on potentially modifiable factors of movement patterns and body mass index (BMI), could best demonstrate risk of LAS among high school and collegiate football players. Case-control study; Level of evidence, 3. A total of 539 high school and collegiate football players were evaluated during the preseason with the Star Excursion Balance Test (SEBT) and Functional Movement Screen as well as BMI. Results were compared between players who did and did not suffer an LAS during the season. Logistic regression analyses and calculated odds ratios were used to determine which measures predicted risk of LAS. The LAS group performed worse on the SEBT-anterior reaching direction (SEBT-ANT) and had higher BMI as compared with the noninjured group (P < .001). The strongest prediction models corresponded with the SEBT-ANT. Low performance on the SEBT-ANT predicted a risk of LAS in football players. BMI was also significantly higher in football players who sustained an LAS. Identifying clinical tools for successful LAS injury risk prediction will be a critical step toward the creation of effective prevention programs to reduce risk of sustaining an LAS during participation in football. © 2015 The Author(s).

Prevention and anthropology.

PubMed

Jopp, Eilin; Scheffler, Christiane; Hermanussen, Michael

2014-01-01

Screening is an important issue in medicine and is used to early identify unrecognised diseases in persons who are apparently in good health. Screening strongly relies on the concept of "normal values". Normal values are defined as values that are frequently observed in a population and usually range within certain statistical limits. Screening for obesity should start early as the prevalence of obesity consolidates already at early school age. Though widely practiced, measuring BMI is not the ultimate solution for detecting obesity. Children with high BMI may be "robust" in skeletal dimensions. Assessing skeletal robustness and in particularly assessing developmental tempo in adolescents are also important issues in health screening. Yet, in spite of the necessity of screening investigations, appropriate reference values are often missing. Meanwhile, new concepts of growth diagrams have been developed. Stage line diagrams are useful for tracking developmental processes over time. Functional data analyses have efficiently been used for analysing longitudinal growth in height and assessing the tempo of maturation. Convenient low-cost statistics have also been developed for generating synthetic national references.

Bidirectional associations between activity-related parenting practices, and child physical activity, sedentary screen-based behavior and body mass index: a longitudinal analysis.

PubMed

Sleddens, Ester F C; Gubbels, Jessica S; Kremers, Stef P J; van der Plas, Eline; Thijs, Carel

2017-07-06

It has been generally assumed that activity-related parenting practices influence children's activity behavior and weight status. However, vice versa parents may also change their parenting behaviors in response to their perceptions of their child's activity behavior and weight status. This study examined the bidirectional relationships between activity-related parenting practices, and physical activity, sedentary screen-based behavior, and body mass index (BMI) between children's age of 5 and 7 years. Three scales of the Activity-related Parenting Questionnaire (i.e. 'restriction of sedentary behavior', 'stimulation of physical activity', and 'monitoring of physical activity') were completed by 1694 parents of the Dutch KOALA Birth Cohort Study at the child's age of around 5 and again around age 7. Physical activity, sedentary screen-based behavior and BMI were measured at both ages as well. Linear regression models were used to estimate the bidirectional associations between each parenting practice and the child's physical activity levels, sedentary screen-based behavior and BMI z-scores. Several parenting practices at age 5 predicted child physical activity, sedentary screen-based behavior, and BMI z-scores at age 7. Restriction of sedentary behavior positively predicted child BMI and sedentary screen-based behavior, whereas this practice negatively predicted child physical activity. In addition, stimulation of physical activity at age 5 was significantly associated with higher levels of child physical activity at age 7. The following child factors at age 5 predicted parenting practices at age 7: Child physical activity positively predicted parental stimulation of physical activity and monitoring activities. Sedentary screen-based behavior was associated with lower parental stimulation to be active. Findings generally revealed that parents and children mutually influence each other's behavior. A reinforcing feedback loop was present between parental stimulation of physical activity and child physical activity. Bidirectional parent-child interaction should be considered in future research in order to properly inform parenting-related intervention programs aimed at preventing or treating childhood overweight or obesity. System dynamic methods to explore the existence of reinforcing or balancing loops are needed in this regard.

Geographic differences in physical education and adolescent BMI: have legal mandates made a difference?

PubMed

Anderson, Laura M; Aycock, Katherine E; Mihalic, Caitlin A; Kozlowski, Darcie J; Detschner, Angela M

2013-02-01

The school environment is an ideal setting for healthy weight programming with adolescents. The federal government has reinforced the importance of school-based health promotion. The current study examined the preliminary influence of the 2006 school wellness policy requirement of the Child Nutrition and WIC Reauthorization Act (CNWICRA) on adolescent Body Mass Index (BMI) and physical education participation. Nationally representative data from the 2003 and 2007 Youth Risk Behavior Surveillance Survey (YRBSS) were used. The authors examined BMI percentile and physical education participation based on survey year and geographic region. Results suggest a slight decrease in BMI with no changes in physical education participation. A main effect for geographic region was found for both physical education participation and BMI percentile, while a geographic region-by-survey year interaction was discovered when analyzing BMI percentiles. Results suggest a need for continued investigation and may inform future healthy weight programming and geographically tailored wellness policies.

Obesity-risk behaviours and their associations with body mass index (BMI) in Korean American children.

PubMed

Jang, Myoungock; Grey, Margaret; Sadler, Lois; Jeon, Sangchoon; Nam, Soohyun; Song, Hee-Jung; Whittemore, Robin

2017-08-03

To describe obesity-risk behaviours (diet, physical activity and sedentary behaviour) and examine the relationships of the obesity-risk behaviours with body mass index (BMI) in school-aged Korean American children. Korean American children have a risk of becoming overweight or obese and developing obesity-related complications; however, there is limited research about obesity-risk behaviours in Korean American children. A cross-sectional study. Obesity-risk behaviours of children were assessed with well-validated self-report questionnaires (i.e., Elementary-level School-based Nutrition Monitoring Questionnaire) from children and their mothers. Height and weight of children were measured. Data were analysed with bivariate and multivariate analyses using mixed effects models to incorporate the correlation within siblings. A total of 170 Korean American children (mean age 10.9 [2.0] years; 52.4% girls; mean BMI 19.3 [3.2]; 28.7% ≥85 percentiles) participated in the study. Only 38.3% of Korean American children met established recommendations of five fruits/vegetables per day; 56.5% met recommendations for more than 3 days per week of vigorous physical activity; and 40.8% met recommendations for <2 hr of recreational screen time per day. Sixty per cent and 88.8% of children met the recommendation of sleep on a weekday and weekend, respectively. Only screen time was positively associated with child BMI z-score (β = 0.08; p < .03). Healthcare providers need to be aware of the increased rate of overweight and obesity in Korean American children and initiate clinical interventions to improve obesity-risk behaviours, especially sedentary behaviour, in Korean American children. Clinical assessment and management of the risk of developing overweight and obesity as well as obesity-related behaviours are important to improve obesity-related complications in overall Korean Americans. © 2017 John Wiley & Sons Ltd.

The association between higher body mass index and poor school performance in high school students.

PubMed

Tonetti, L; Fabbri, M; Filardi, M; Martoni, M; Natale, V

2016-12-01

This study aimed to examine the association between body mass index (BMI) and school performance in high school students by controlling for relevant mediators such as sleep quality, sleep duration and socioeconomic status. Thirty-seven high school students (mean age: 18.16 ± 0.44 years) attending the same school type, i.e. 'liceo scientifico' (science-based high school), were enrolled. Students' self-reported weight and height were used to calculate BMI. Participants wore an actigraph to objectively assess the quality and duration of sleep. School performance was assessed through the actual grade obtained at the final school-leaving exam, in which higher grades indicate higher performance. BMI, get-up time, mean motor activity, wake after sleep onset and number of awakenings were negatively correlated with the grade, while sleep efficiency was positively correlated. When performing a multiple regression analysis, BMI proved the only significant (negative) predictor of grade. When controlling for sleep quality, sleep duration and socioeconomic status, a higher BMI is associated with a poorer school performance in high school students. © 2015 World Obesity Federation.

The Relationship among State Laws, District Policies, and Elementary School-Based Measurement of Children's Body Mass Index

ERIC Educational Resources Information Center

Sandoval, Anna; Turner, Lindsey; Nicholson, Lisa; Chriqui, Jamie; Tortorelli, Megan; Chaloupka, Frank J.

2012-01-01

Background: School-based measurement of children's body mass index (BMI) is a useful tool for tracking childhood obesity rates, and may be an effective intervention strategy for reducing the increasing trends in obesity. This article examines the relationship between state law, district policy, and school-level BMI measurement practices.…

Prevalence of obesity in elementary school children and its association with dental caries

PubMed Central

Farsi, Deema J.; Elkhodary, Heba M.; Merdad, Leena A.; Farsi, Najat M.A.; Alaki, Sumer M.; Alamoudi, Najlaa M.; Bakhaidar, Haneen A.; Alolayyan, Mohammed A.

2016-01-01

Objectives To investigate the prevalence of obesity among elementary school children and to examine the association between obesity and caries activity in the mixed dentition stage. Methods This cross-sectional study was conducted in King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between September 2014 and June 2015 using a multi-stage stratified sample of 915 elementary school children (482 boys, 433 girls) in Jeddah, Saudi Arabia. Anthropometric measurements, consisting of height, weight, body mass index (BMI), and waist circumference (WC), were obtained. Children were classified as underweight/healthy, overweight, or obese and as non-obese or obese according to their BMI and WC, respectively. Each child’s caries experience was assessed using the decay score in the primary and permanent teeth. Results Based on BMI, 18% of children were obese, 18% were overweight, and 64% were underweight/normal. Based on WC, 16% of children were obese, and 84% were non-obese. Girls had a significantly higher prevalence of obesity based on WC measurements (p<0.001), but not BMI. Children enrolled in private schools had a significantly higher prevalence of obesity (p<0.05) than those in public schools. For primary and permanent teeth combined, children with higher BMI and WC had a lower prevalence of caries (p<0.05). Conclusion The prevalence of obesity was high among male and female elementary school children. Overall caries activity was inversely proportional to BMI and WC. PMID:27874156

Prevalence of obesity in elementary school children and its association with dental caries.

PubMed

Farsi, Deema J; Elkhodary, Heba M; Merdad, Leena A; Farsi, Najat M A; Alaki, Sumer M; Alamoudi, Najlaa M; Bakhaidar, Haneen A; Alolayyan, Mohammed A

2016-12-01

To investigate the prevalence of obesity among elementary school children and to examine the association between obesity and caries activity in the mixed dentition stage. Methods: This cross-sectional study was conducted in King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between September 2014 and June 2015 using a multi-stage stratified sample of 915 elementary school children (482 boys, 433 girls) in Jeddah, Saudi Arabia. Anthropometric measurements, consisting of height, weight, body mass index (BMI), and waist circumference (WC), were obtained. Children were classified as underweight/healthy, overweight, or obese and as non-obese or obese according to their BMI and WC, respectively. Each child's caries experience was assessed using the decay score in the primary and permanent teeth. Results: Based on BMI, 18% of children were obese, 18% were overweight, and 64% were underweight/normal. Based on WC, 16% of children were obese, and 84% were non-obese. Girls had a significantly higher prevalence of obesity based on WC measurements (p less than 0.001), but not BMI. Children enrolled in private schools had a significantly higher prevalence of obesity (p less than 0.05) than those in public schools. For primary and permanent teeth combined, children with higher BMI and WC had a lower prevalence of caries (p less than 0.05). Conclusion: The prevalence of obesity was high among male and female elementary school children. Overall caries activity was inversely proportional to BMI and WC.

Screen time and adiposity in adolescents in Mexico

PubMed Central

Lajous, Martín; Chavarro, Jorge; Peterson, Karen E; Hernández-Prado, Bernardo; Cruz-Valdéz, Aurelio; Hernández-Ávila, Mauricio; Lazcano-Ponce, Eduardo

2014-01-01

Objective To assess the association of time spent viewing television, videos and videogames with measures of fat mass [body mass index (BMI)] and distribution [triceps and subscapular skin folds (TSF, SSF)]. Design Cross-sectional validated survey, self-administered to students to assess screen time (TV, videos and videogames) and lifestyle variables. Trained personnel obtained anthropometry. The association of screen time with fat mass and distribution, stratified by sex, was modeled with multivariable linear regression, adjusting for potential confounders and correlation of observations within schools. Subjects and setting 3519 males and 5613 females aged 11 to 18 years attending urban and rural schools in the State of Morelos, Mexico Results In males, ≥5 hr/day compared with < 2 hr/day of screen time, was significantly associated with a 0.13 (95%CI 0.04, 0.23) higher BMI z score, 0.73 mm (95% CI 0.24, 1.22) higher SSF and 1.08 mm (95% CI 0.36, 1.81) higher TSF. The positive association of screen time with SSF was strongest in males 11–12 yr. Sexual maturity appeared to modify the association in females; a positive between screen time and SSF was observed in those who had not undergone menarche (p-trend 0.04) but not among sexually mature females (p-trend 0.75). Conclusion Screen time is associated with fat mass and distribution among adolescent males in Mexico. Maturational tempo appears to affect the relationship of screen time with adiposity in boys and girls. Findings suggest obesity preventive interventions in the Mexican context should explore strategies to reduce screen time among youth in early adolescence. PMID:19232154

Combine body mass index and body fat percentage measures to improve the accuracy of obesity screening in young adults.

PubMed

Hung, Shang-Ping; Chen, Ching-Yu; Guo, Fei-Ran; Chang, Ching-I; Jan, Chyi-Feng

Obesity screening among young adult groups is meaningful. Body mass index (BMI) is limited to discriminate between fat and lean mass. Asian young adult group tends to have lower BMI and higher body fat percentage (BFP) than other ethnic groups. Accuracy of obesity screening by commonly used BMI criteria is unclear in young Taiwanese population. A total of 894 young adults (447 males and 447 females) aged 20-26 were recruited. BMI, regional fat percentage and BFP determined by bioelectrical impedance analysis (BIA) were measured. BMI cutoff points were based on the criteria adopted by the Ministry of Health and Welfare in Taiwan. Cutoff points of low or high BFP were defined as 24% in men and 31.4% in women. Prevalence of BFP defining obesity was 14.8% in young men and 27.3% in young women. 23.2% of young men and only 8.3% of young women were classified to overweight or obesity categories according to the BMI criteria. Disagreement was noticed mainly among overweight males and normal weight females. 68.7% of BMI defining overweight young men had low BFP; however, 29.7% of young women of BMI defining normal group had high BFP. Up to 69.7% of young women with high BFP would be missed by BMI category only. Disagreement between BMI and BFP was significant among young adults, especially young women. We suggest combining BMI and BIA for obesity and overweight screening in Asian young adults. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Improved Body Mass Index Measures Following a Middle School-Based Obesity Intervention-The MATCH Program.

PubMed

Lazorick, Suzanne; Fang, Xiangming; Hardison, George T; Crawford, Yancey

2015-10-01

Motivating Adolescents with Technology to CHOOSE Health™ (MATCH) is an educational and behavioral intervention in seventh grade. Teachers in 2 schools delivered the MATCH curriculum, with 1 control school. Using a quasi-experimental design, outcome measures included lessons completed, body mass index (BMI), BMI z-score (zBMI), BMI percentile, weight category, and self-reported lifestyle behaviors. We used multiple regression models to compare group results. For the MATCH group (N = 189), teachers provided lessons over 14 weeks; the control group (N = 173) received usual curriculum. Postintervention, the MATCH group had significant decreases in BMI measures compared with the control. In combined overweight and obese participants, the mean (95% confidence interval) zBMI change was -0.05 (-0.07, -0.03) in MATCH and -0.01 (-0.04, 0.02) in control, p = .034 between groups. After 1 year, improvements are sustained: for the overweight subgroup, the mean zBMI decreased from 1.34 to 1.26 post-MATCH, then to 1.26 after 1 year; for the obese subgroup, mean zBMI = 2.16, to 2.13 post-MATCH to 2.08 after 1 year. Self-reported lifestyle behaviors showed no differences. MATCH integrates theory-based strategies into standard curriculum delivered by teachers. No prior middle-school intervention has shown sustained change in BMI measures. MATCH warrants further study as a strategy to address obesity. © 2015, American School Health Association.

Diagnostic accuracy of different body weight and height-based definitions of childhood obesity in identifying overfat among Chinese children and adolescents: a cross-sectional study.

PubMed

Wang, Lin; Hui, Stanley Sai-chuen

2015-08-20

Various body weight and height-based references are used to define obese children and adolescents. However, no study investigating the diagnostic accuracies of the definitions of obesity and overweight in Hong Kong Chinese children and adolescents has been conducted. The current study aims to investigate the diagnostic accuracy of BMI-based definitions and 1993 HK reference in screening excess body fat among Hong Kong Chinese children and adolescents. A total of 2,134 participants (1,135 boys and 999 girls) were recruited from local schools. The foot-to-foot BIA scale was applied to assess %BF using standard methods. The criterion of childhood obesity (i.e., overfat) was defined as over 25 %BF for boys and over 30 %BF for girls. Childhood obesity was also determined from four BMI-based references and the 1993 HK reference. The diagnostic accuracy of these existing definitions for childhood obesity in screening excess body fat was evaluated using diagnostic indices. Overall, %BF was significantly correlated with anthropometry measurements in both genders (in boys, r = 0.747 for BMI 0.766 for PWH; in girls, r = 0.930 for BMI 0.851 for PWH). The prevalence rates of overweight and obesity determined by BMI-based references were similar with the prevalence rates of obesity in the 1993 HK reference in both genders. All definitions for childhood obesity showed low sensitivity (in boys, 0.325-0.761; in girls, 0.128-0.588) in detecting overfat. Specificities were high for cut-offs among all definitions for childhood obesity (in boys, 0.862-0.980; in girls, 0.973-0.998). In conclusion, prevalence rates of childhood obesity or overweight varied widely according to the diagnostic references applied. The diagnostic performance for weight and height-based references for obesity is poorer than expected for both genders among Hong Kong Chinese children and adolescents. In order to improve the diagnosis accuracy of childhood obesity, either cut-off values of body weight and height-based definitions of childhood obesity should be revised to increase the sensitivity or the possibility of using other indirect methods of estimating the %BF should be explored.

Explaining the Positive Relationship between Fourth-Grade Children’s Body Mass Index and Energy Intake at School-Provided Meals (Breakfast and Lunch)

PubMed Central

Baxter, Suzanne Domel; Royer, Julie A.; Hitchcock, David B.

2013-01-01

BACKGROUND A positive relationship exists between children’s body mass index (BMI) and energy intake at school-provided meals. To help explain this relationship, we investigated 7 outcome variables concerning aspects of school-provided meals—energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school-meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades. METHODS We observed children in grade 4 (N=465) eating school-provided breakfast and lunch on one to 4 days per child. We measured children’s weight and height. For daily values at school meals, a generalized linear model was fit with BMI (dependent variable) and the 7 outcome variables, sex, and age (independent variables). RESULTS BMI was positively related to amounts eaten of standardized school-meal portions (p < .0001) and increased 8.45 kg/m2 per serving, controlling for other variables in the model. BMI was positively related to energy intake from flavored milk (p = .0041) and increased 0.347 kg/m2 for every 100-kcal consumed. BMI was negatively related to energy intake received in trades (p = .0003) and decreased 0.468 kg/m2 for every 100-kcal received. BMI was not significantly related to 4 outcome variables. CONCLUSIONS Knowing that relationships between BMI and actual consumption, not selection, at school-provided meals explained the (previously found) positive relationship between BMI and energy intake at school-provided meals is helpful for school-based obesity interventions. PMID:23517000

Districts Weigh Obesity Screening

ERIC Educational Resources Information Center

Butler, Kevin

2008-01-01

Parents of children in most elementary grades in Minnesota's Independent School District 191 receive an annual notice with potentially life-altering data for their children--and they are not state test scores, attendance rates, or grades. The notice contains the child's body mass index (BMI) score, which estimates whether the student has excess…

Explaining the positive relationship between fourth-grade children's body mass index and energy intake at school-provided meals (breakfast and lunch).

PubMed

Guinn, Caroline H; Baxter, Suzanne D; Royer, Julie A; Hitchcock, David B

2013-05-01

A 2010 publication showed a positive relationship between children's body mass index (BMI) and energy intake at school-provided meals (as assessed by direct meal observations). To help explain that relationship, we investigated 7 outcome variables concerning aspects of school-provided meals: energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school-meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades. Fourth-grade children (N = 465) from Columbia, SC, were observed eating school-provided breakfast and lunch on 1 to 4 days per child. Researchers measured children's weight and height. For daily values at school meals, a generalized linear model was fit with BMI (dependent variable) and the 7 outcome variables, sex, and age (independent variables). BMI was positively related to amounts eaten of standardized school-meal portions (p < .0001) and increased 8.45 kg/m(2) per serving, controlling for other variables in the model. BMI was positively related to energy intake from flavored milk (p = .0041) and increased 0.347 kg/m(2) for every 100 kcal consumed. BMI was negatively related to energy intake received in trades (p = .0003) and decreased 0.468 kg/m(2) for every 100 kcal received. BMI was not significantly related to 4 outcome variables. Knowing that relationships between BMI and actual consumption, not selection, at school-provided meals explained the (previously found) positive relationship between BMI and energy intake at school-provided meals is helpful for school-based obesity interventions. © 2013, American School Health Association.

Greater screen time is associated with adolescent obesity: a longitudinal study of the BMI distribution from Ages 14 to 18.

PubMed

Mitchell, Jonathan A; Rodriguez, Daniel; Schmitz, Kathryn H; Audrain-McGovern, Janet

2013-03-01

Previous research has examined the association between screen time and average changes in adolescent body mass index (BMI). Until now, no study has evaluated the longitudinal relationship between screen time and changes in the BMI distribution across mid to late adolescence. Participants (n = 1,336) were adolescents who were followed from age 14 to age 18 and surveyed every 6 months. Time spent watching television/videos and playing video games was self-reported (<1 h day(-1) , 1 h day(-1) , 2 h day(-1) , 3 h day(-1) , 4 h day(-1) , or 5+ h day(-1) ). BMI (kg m(-2) ) was calculated from self-reported height and weight. Longitudinal quantile regression was used to model the 10th, 25th, 50th, 75th, and 90th BMI percentiles as dependent variables. Study wave and screen time were the main predictors, and adjustment was made for gender, race, maternal education, hours of sleep, and physical activity. Increases at all the BMI percentiles over time were observed, with the greatest increase observed at the 90th BMI percentile. Screen time was positively associated with changes in BMI at the 50th (0.17, 95% CI: 0.06, 0.27), 75th (0.31, 95% CI: 0.10, 0.52), and 90th BMI percentiles (0.56, 95% CI: 0.27, 0.82). No associations were observed between screen time and changes at the 10th and 25th BMI percentiles. Positive associations between screen time and changes in the BMI at the upper tail of the BMI distribution were observed. Therefore, lowering screen time, especially among overweight and obese adolescents, could contribute to reducing the prevalence of adolescent obesity. Copyright © 2013 The Obesity Society.

Examining social norm impacts on obesity and eating behaviors among US school children based on agent-based model.

PubMed

Wang, Youfa; Xue, Hong; Chen, Hsin-jen; Igusa, Takeru

2014-09-06

Although the importance of social norms in affecting health behaviors is widely recognized, the current understanding of the social norm effects on obesity is limited due to data and methodology limitations. This study aims to use nontraditional innovative systems methods to examine: a) the effects of social norms on school children's BMI growth and fruit and vegetable (FV) consumption, and b) the effects of misperceptions of social norms on US children's BMI growth. We built an agent-based model (ABM) in a utility maximization framework and parameterized the model based on empirical longitudinal data collected in a US nationally representative study, the Early Childhood Longitudinal Study - Kindergarten Cohort (ECLS-K), to test potential mechanisms of social norm affecting children's BMI growth and FV consumption. Intraclass correlation coefficients (ICC) for BMI were 0.064-0.065, suggesting that children's BMI were similar within each school. The correlation between observed and ABM-predicted BMI was 0.87, indicating the validity of our ABM. Our simulations suggested the follow-the-average social norm acts as an endogenous stabilizer, which automatically adjusts positive and negative deviance of an individual's BMI from the group mean of a social network. One unit of BMI below the social average may lead to 0.025 unit increase in BMI per year for each child; asymmetrically, one unit of BMI above the social average, may only cause 0.015 unit of BMI reduction. Gender difference was apparent. Social norms have less impact on weight reduction among girls, and a greater impact promoting weight increase among boys. Our simulation also showed misperception of the social norm would push up the mean BMI and cause the distribution to be more skewed to the left. Our simulation results did not provide strong support for the role of social norms on FV consumption. Social norm influences US children's BMI growth. High obesity prevalence will lead to a continuous increase in children's BMI due to increased socially acceptable mean BMI. Interventions promoting healthy body image and desirable socially acceptable BMI should be implemented to control childhood obesity epidemic.

School-based obesity prevention: a blueprint for taming the epidemic.

PubMed

Baranowski, Tom; Cullen, Karen W; Nicklas, Theresa; Thompson, Deborah; Baranowski, Janice

2002-01-01

To review the literature on school-based obesity prevention programs to identify what can be done to minimize the increasing levels of obesity. Twenty articles reporting school-based dietary or physical activity change programs were identified that used BMI or skinfolds as part of the evaluation. Seven studies obtained change in BMI and differed from those not finding change in 3 ways: program implementers were not classroom teachers; intervention targeted middle or high schools; and inactivity reduction was promoted. An 8-step research strategy was delineated to develop and evaluate programs with a maximum chance of taming the obesity epidemic.

Relationship between anthropometry and motor abilities at pre-school age.

PubMed

De Toia, Daniela; Klein, Daniel; Weber, Sarah; Wessely, Nicolas; Koch, Benjamin; Tokarski, Walter; Dordel, Sigrid; Struder, Heiko; Graf, Christine

2009-01-01

Little is known to date about the relationship between poor motor abilities and overweight or obese pre-school children. Thus, this study examined the association between motor abilities and weight status in 1,228 kindergarten children (45.8% female). Anthropometric data were assessed; age 4.7 + or - 1.0 years; height 108.6 + or - 8.0 cm; weight 19.1 + or - 3.6 kg; BMI 16.1 + or - 1.5 kg/m(2). The modified Karlsruher Motor Ability Screening Test was carried out to determine the motor abilities of speed strength, muscular endurance, coordination, flexibility, and speed. Based on the German BMI reference values, 3.5% of the children were obese, 9.6% overweight, 83.4% normal weight, and 3.5% underweight. During various test tasks, below-average motor abilities were discovered in 44.0-47.3%. In all age groups, overweight and obese children did not differ from their normal and underweight counterparts; except for underweight children which fared worse in flexibility. In contrast to former studies with first graders, overweight or obese pre-school children did not possess worse motor abilities than normal weight children. However, the high number of overweight children and motor deficits suggests that preventive measures should start at this early age. Copyright 2009 S. Karger AG, Basel.

Subjective social status in the school and change in adiposity in female adolescents: findings from a prospective cohort study.

PubMed

Lemeshow, Adina R; Fisher, Laurie; Goodman, Elizabeth; Kawachi, Ichiro; Berkey, Catherine S; Colditz, Graham A

2008-01-01

To determine whether subjective social standing in school predicts a change in body mass index (BMI) in adolescent girls during a 2-year period. Prospective cohort study. Self-report questionnaires from a community-based population of adolescent girls living across the United States from 1999 to 2001. Of 5723 girls aged 12 to 18 years participating in the Growing Up Today Study (GUTS), adequate information was available for 4446 (78%), who provided the analytic sample. Low subjective social status in the school. Change in BMI between 1999 and 2001 and multivariable odds ratio for a 2-U increase in BMI in girls with low subjective social status in the school compared with girls with higher subjective social status in the school. After adjusting for age, race/ethnicity, baseline BMI, diet, television viewing, depression, global and social self-esteem, menarche, height growth, mother's BMI, and pretax household income, adolescent girls who placed themselves on the low end of the school subjective social status scale had a 69% increased odds of having a 2-unit increase in BMI (odds ratio, 1.69; 95% confidence interval, 1.10-2.60) during the next 2 years compared with other girls. Higher subjective social standing in school may protect against gains in adiposity in adolescent girls.

Pet dogs and child physical activity: the role of child-dog attachment.

PubMed

Gadomski, A M; Scribani, M B; Krupa, N; Jenkins, P

2017-10-01

Dog ownership has been associated with increased physical activity in children which in turn may mitigate childhood obesity. To measure the association between child-dog attachment and child physical activity and screen time. Cross-sectional study including 370 children (ages 4-10) who had pet dogs in the home. Parents completed the DartScreen, a web-based screener, before a well-child visit. Screener domains included child body mass index (BMI), physical activity, screen time and dog-related questions. The Companion Animal Bonding Scale (CABS) was used to measure child attachment to the dog. Clinic nurses weighed and measured the children. Associations between CABS, BMI z-score, screen time and physical activity were estimated. CABS was strongly associated with time spent being active with the dog (F = 22.81, p < 0.0001), but not with BMI z-score or screen time. A higher level of child attachment to a pet dog is associated with increased child physical activity. © 2016 World Obesity Federation.

The Association between Screen Time and Weight Status in Hispanic Children

PubMed Central

Doherty, M; Santiago-Torres, M; Cui, Y; Schoeller, D; LaRowe, T; Adams, A; Carrel, A

2016-01-01

Background About one-third of U.S. children are overweight or obese and the number is even higher among Hispanics children (41%). In this regards, the time spent in sedentary behaviours is higher among Hispanic children versus non-Hispanic white children. But whether the home environment contributes to the obesity disparity among Hispanic children through the promotion of sedentary behaviours at home is less known. We aimed to investigate the associations between the home environment, parental limiting, and screen time with Hispanic children’s body weight. Methods Study participants were middle school Hispanic children (n=187), ages 10–14 years and their parents. Children’s anthropometrics were measured and used to calculate BMI z-scores. Questionnaires were used to assess children’s time spent on physical activity (PA), sedentary activities, and to query parents on the home environment and parental limiting. Results Total time (h/d) spent watching television (TV) was positively associated with children’s BMI z-score (P=0.02). However, no association was found between total screen time (TV, video games, and computer) and PA and with children’s BMI z-score. Sleeping time (h/d) was inversely associated with children’s BMI z-score (P=0.02); while there was a significant interaction between sleeping time and gender (P-interaction=0.02). Further, having a screen in the bedroom was positively associated with children’s TV and total screen time (P<0.05); while parental limits on screen time was inversely associated with children’s screen time (P<0.05). Conclusions Screen and sleep time may contribute to higher body weight among Hispanic children, independently of associations with physical activity. Our findings suggest a differential effect of gender in the contribution of sleep time to higher body weight, in that girls spent less time sleeping when compared to boys. These findings can inform obesity-prevention efforts to intervene at the family level in improving sleeping patterns and increasing physical activity while reducing sedentary opportunities at home. PMID:27747312

Measurement and Interpretation of Body Mass Index during Childhood and Adolescence

ERIC Educational Resources Information Center

Malone, Susan Kohl; Zemel, Babette S.

2015-01-01

The landscape of childhood health and disease has changed over the past century, and school nurses are now in a unique position to address the conditions that lead to chronic disease, such as obesity. Measuring body mass index (BMI) during childhood and adolescence is the recommended method for screening and/or monitoring obesity in school…

A population study of 5 to 15 year olds: full time maternal employment not associated with high BMI. The importance of screen-based activity, reading for pleasure and sleep duration in children's BMI.

PubMed

Taylor, Anne W; Winefield, Helen; Kettler, Lisa; Roberts, Rachel; Gill, Tiffany K

2012-04-01

To describe the relationship between maternal full time employment and health-related and demographic variables associated with children aged 5-15 years, and the factors associated with child overweight/obesity. Data from a chronic disease and risk factor surveillance system were limited to children aged 5-15 years whose mothers responded on their behalf (n = 641). Univariate/multivariate analyses described the differences between mothers who did and did not work full time. The same data were analysed comparing children who are overweight/obese against those with a normal BMI. The children of mothers who worked full time are more likely to be older, live in a household with a higher household income, be an only child or have one sibling or other child in the household, have a sole mother family structure and not spend any time reading for pleasure. No relationship was found between maternal employment and BMI. Compared with children of normal weight, those who were overweight/obese were more likely to spend no time studying, spend more than 2 h per day in screen-based activity and sleep less than 10 h per night. Child BMI status was not related to maternal employment. Although this analysis included eight diet related variables none proved to be significant in the final models.This study has shown that mothers' working status is not related to children's BMI. The relationship between overweight/obesity of children and high levels of screen-based activity, low levels of studying, and short sleep duration suggests a need for better knowledge and understanding of sedentary behaviours of children.

Obesity Increases Prevalence of Colonic Adenomas at Screening Colonoscopy: A Canadian Community-Based Study

PubMed Central

Chen, Grant I.; Devlin, Tim; Gibbs, Alison; Murray, Iain C.; Tran, Stanley; Weigensberg, Corey

2017-01-01

Background and Aims Obesity is a risk factor for colorectal neoplasia. We examined the influence of obesity and metabolic syndrome (MetS) on prevalence of neoplasia at screening colonoscopy. Methods We evaluated 2020 subjects undergoing first screening colonoscopy. Body mass index (BMI) was calculated at enrolment. Hyperlipidemia (HL), hypertension (HT), and diabetes mellitus (DM) were identified. Details of colonoscopy, polypectomy, and histology were recorded. Odds for adenomas (A) and advanced adenomas (ADV) in overweight (BMI 25.1–30) and obese (BMI > 30) subjects were assessed by multinomial regression, adjusted for covariates. Analyses included relationships between HL, HT, DM, age, tobacco usage, and neoplasia. Discriminatory power of HT, HL, DM, and BMI for neoplasia was assessed by binary logistic regression. Odds were calculated for neoplasia in each colonic segment related to BMI. Results A and ADV were commoner in overweight and obese males, obese females, older subjects, and smokers. HL, HT, and DM were associated with increased odds for neoplasia, significantly for A with hypertension. BMI alone predicted neoplasia as well as HT, HL, DM, or combinations thereof. All segments of the colon were affected. Multiple polyps were particularly prevalent in the obese. Conclusions Obesity and MetS are risk factors for colonic neoplasia in a Canadian population. PMID:28781966

Exploring the relationship between parental concern and the management of childhood obesity.

PubMed

Moore, Lucas C; Harris, Carole V; Bradlyn, Andrew S

2012-05-01

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.

Effects of the Youth Fit 4 Life physical activity/nutrition protocol on body mass index, fitness and targeted social cognitive theory variables in 9- to 12-year-olds during after-school care.

PubMed

Annesi, James J; Walsh, Stephanie M; Greenwood, Brittney L; Mareno, Nicole; Unruh-Rewkowski, Jennifer L

2017-04-01

Childhood overweight and obesity is unacceptably high in industrialised nations. School-based interventions have largely been atheoretical and ineffective. This study aimed to test a new theory-based protocol for its effects on measures of fitness and body mass index (BMI), and its proposed psychosocial mediators, during elementary after-school (out-of-school hours) care. Nine- to 12-year-old participants of YMCA-based after-school care in the southeastern Unites States were randomised into either the experimental Youth Fit 4 Life (YF4L) treatment group (n = 86) or a typical care group (n = 55) for 45 min/day. YF4L is based on social cognitive theory, emphasising mastery over physical activities and the development of self-management/self-regulatory skills to support healthy behaviours. Physiological and psychosocial variables were assessed over a 9-month elementary school year. Of the overall sample, 28% were overweight or obese at baseline. YF4L was associated with significantly greater improvements in BMI, and measures of self-regulation, mood, self-efficacy, cardiovascular endurance and strength over both 3 and 9 months. Changes in self-regulation, mood and self-efficacy significantly mediated the treatment type-BMI relationship over both 3 months (R 2 = 0.12, P = 0.002) and 9 months (R 2 = 0.13, P = 0.001), with change in self-regulation being a significant independent mediator. Changes in BMI and self-regulation reciprocally reinforced one another. Gender was not a significant moderator of those relationships. The YF4L treatment mitigated rise in BMI in 9- to 12-year-old enrollees of after-school care. The treatment's basis in social cognitive theory was supported. Because of its positive effects and ability to utilise existing staff, large-scale application is warranted after sufficient replication. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Secondary analyses of data from four studies with fourth-grade children show that sex, race, amounts eaten of standardized portions, and energy content given in trades explain the positive relationship between BMI and energy intake at school-provided meals

PubMed Central

Baxter, Suzanne Domel; Paxton-Aiken, Amy E.; Tebbs, Joshua M.; Royer, Julie A.; Guinn, Caroline H.; Finney, Christopher J.

2012-01-01

Results from a 2012 article showed a positive relationship between children’s body mass index (BMI) and energy intake at school-provided meals. To help explain that positive relationship, secondary analyses investigated 1) whether the relationship differed by sex and race, and 2) the relationship between BMI and six aspects of school-provided meals—amounts eaten of standardized portions, energy content given in trades, energy intake received in trades, energy intake from flavored milk, energy intake from a la carte ice cream, and breakfast type. Data were from four studies conducted one per school year (1999–2000 to 2002–2003). Fourth-grade children (n=328; 50% female; 54% Black) from 13 schools total were observed eating school-provided breakfast and lunch on one to three days per child for 1,178 total meals (50% breakfast). Children were weighed and measured. Marginal regression models were fit using BMI as the dependent variable. For Purpose One, independent variables were energy intake at school-provided meals, sex, race, age, and study; additional models included interaction terms involving energy intake and sex/race. For Purpose Two, independent variables were the six aspects of school-provided meals, sex, race, age, and study. The relationship between BMI and energy intake at school-provided meals differed by sex (p<0.0001; stronger for females) and race (p=0.0063; stronger for Black children). BMI was positively related to amounts eaten of standardized portions (p<0.0001) and negatively related to energy content given in trades (p=0.0052). Explaining the positive relationship between BMI and energy intake at school-provided meals may contribute to school-based obesity prevention efforts. PMID:23084638

Growth disorders among 6-year-old Iranian children.

PubMed

Kelishadi, Roya; Amiri, Masoud; Motlagh, Mohammad Esmaeil; Taslimi, Mahnaz; Ardalan, Gelayol; Rouzbahani, Reza; Poursafa, Parinaz

2014-06-01

Sociodemographic factors are important determinants of weight disorders. National representative studies provide a view on this health problem at national and regional levels. This study aimed to assess the distribution of growth disorders in terms of body mass index (BMI) and height in 6-year-old Iranian children using geographical information system (GIS). In this cross-sectional nationwide survey, all Iranian children entering public and private elementary schools were examined in a mandatory national screening program in 2009. Descriptive analysis was used to calculate the prevalence of underweight, overweight, obesity, and short stature. Then, ArcGIS software was used to draw the figures. The study population consisted of 955388 children (48.5% girls and 76.5% urban). Overall, 20% of children were underweight, and 14.3% had high BMI, consisted of 10.9% overweight and 3.4% obese. The corresponding figure for short stature was 6.6%; however, these growth disorders were not equally distributed across various provinces. Our results confirmed unequal distribution of BMI and height of 6-year-old children in Iran generally and in most of its provinces particularly. The differences among provinces cannot be fully explained by the socioeconomic pattern. These findings necessitate a comprehensive national policy with provincial evidence-based programs.

Children's body mass index, participation in school meals, and observed energy intake at school meals.

PubMed

Baxter, Suzanne Domel; Hardin, James W; Guinn, Caroline H; Royer, Julie A; Mackelprang, Alyssa J; Devlin, Christina M

2010-03-24

Data from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI) with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location (classroom; cafeteria). Data were collected in 17, 17, and 8 schools during three school years. For the three years, six, six, and seven of the schools had breakfast in the classroom; all other schools had breakfast in the cafeteria. Information about 180 days of school breakfast and school lunch participation during fourth grade for each of 1,571 children (90% Black; 53% girls) was available in electronic administrative records from the school district. Children were weighed and measured, and BMI was calculated. Each of a subset of 465 children (95% Black; 49% girls) was observed eating school breakfast and school lunch on the same day. Mixed-effects regression was conducted with BMI as the dependent variable and school as the random effect; independent variables were breakfast participation, lunch participation, combined participation (breakfast and lunch on the same day), average observed energy intake for breakfast, average observed energy intake for lunch, sex, age, breakfast location, and school year. Analyses were repeated for BMI category (underweight/healthy weight; overweight; obese; severely obese) using pooled ordered logistic regression models that excluded sex and age. Breakfast participation, lunch participation, and combined participation were not significantly associated with BMI or BMI category irrespective of whether the model included observed energy intake at school meals. Observed energy intake at school meals was significantly and positively associated with BMI and BMI category. For the total sample and subset, breakfast location was significantly associated with BMI; average BMI was larger for children with breakfast in the classroom than in the cafeteria. Significantly more kilocalories were observed eaten at breakfast in the classroom than in the cafeteria. For fourth-grade children, results provide evidence of a positive relationship between BMI and observed energy intake at school meals, and between BMI and school breakfast in the classroom; however, BMI and participation in school meals were not significantly associated.

Indices of Abdominal Adiposity and Cardiorespiratory Fitness Test Performance in Middle-School Students

PubMed Central

Burns, Ryan; Hannon, James C.; Brusseau, Timothy A.; Shultz, Barry; Eisenman, Patricia

2013-01-01

Background. Previous research suggests that use of BMI as a screening tool to assess health in youth has limitations. Valid alternative measures to assess body composition are needed to accurately identify children who are aerobically fit, which is an indicator of health status. The purpose of this study was to examine the associations between select anthropometric measures and cardiorespiratory fitness test performance in middle-school students. Methods. Participants included 134 students (65 boys and 69 girls) recruited from the 6th, 7th, and 8th grades. Anthropometric measures consisted of BMI, waist circumference (WC), waist-to-height ratio (WHtR), and percent body fat estimated from two-site skinfolds (%BF-SKF), as well as the hand-held OMRON BIA device (%BF-BIA). Cardiorespiratory fitness tests included the one-mile run and PACER test. Data were collected on four separate testing days during the students' physical education classes. Results. There were statistically significant moderate correlations between the %BF estimations, WHtR, and cardiorespiratory fitness test scores in both genders (P < .001). BMI at best only displayed weak correlations with the cardiorespiratory fitness test scores. Conclusions. The results suggest that alternative measures such as %BF-SKF, %BF-BIA, and WHtR may be more valid indicators of youth aerobic fitness lending to their preferred use over BMI. PMID:23533727

Indices of abdominal adiposity and cardiorespiratory fitness test performance in middle-school students.

PubMed

Burns, Ryan; Hannon, James C; Brusseau, Timothy A; Shultz, Barry; Eisenman, Patricia

2013-01-01

Previous research suggests that use of BMI as a screening tool to assess health in youth has limitations. Valid alternative measures to assess body composition are needed to accurately identify children who are aerobically fit, which is an indicator of health status. The purpose of this study was to examine the associations between select anthropometric measures and cardiorespiratory fitness test performance in middle-school students. Participants included 134 students (65 boys and 69 girls) recruited from the 6th, 7th, and 8th grades. Anthropometric measures consisted of BMI, waist circumference (WC), waist-to-height ratio (WHtR), and percent body fat estimated from two-site skinfolds (%BF-SKF), as well as the hand-held OMRON BIA device (%BF-BIA). Cardiorespiratory fitness tests included the one-mile run and PACER test. Data were collected on four separate testing days during the students' physical education classes. There were statistically significant moderate correlations between the %BF estimations, WHtR, and cardiorespiratory fitness test scores in both genders (P < .001). BMI at best only displayed weak correlations with the cardiorespiratory fitness test scores. The results suggest that alternative measures such as %BF-SKF, %BF-BIA, and WHtR may be more valid indicators of youth aerobic fitness lending to their preferred use over BMI.

Sedentary behaviors in fifth-grade boys and girls: where, with whom, and why?

PubMed

Taverno Ross, Sharon E; Byun, Wonwoo; Dowda, Marsha; McIver, Kerry L; Saunders, Ruth P; Pate, Russell R

2013-12-01

An understanding of the context surrounding screen- and non-screen-based sedentary behavior would facilitate efforts to reduce children's overall sedentary behavior. This study examined the prevalence of specific types of sedentary behavior in children, the social and physical contexts surrounding these behaviors, and differences by gender. Participants included 686 fifth graders participating in the Transitions and Activity Changes in Kids Study (TRACK). The Physical Activity Choices instrument measured child participation in seven sedentary behaviors, the social (i.e., with whom) and physical (i.e., where) contexts, and perceptions (i.e., why) of those behaviors. Analysis included mixed-model regression adjusted for race/ethnicity, BMI, and socioeconomic status. Children participated in both screen- and non-screen-based sedentary behaviors at very high frequencies. The most popular activities included watching television or videos, listening to music, playing video games (boys only), and talking on the phone or texting (girls only). Children engaged in sedentary behaviors most often at home, at school, or in their neighborhood. In general, the patterns of social context for the behaviors were similar for boys and girls, with the exception of video game playing. Girls perceived listening to music and talking on the phone or texting to be more fun than boys; children did not differ in their other perceptions (i.e., how much choice or how important) of the behaviors. Multi-level interventions that target reducing sedentary behavior in the home, neighborhood, and school context may be most effective; however, the approach needed will likely differ by gender.

Adiposity and different types of screen time.

PubMed

Falbe, Jennifer; Rosner, Bernard; Willett, Walter C; Sonneville, Kendrin R; Hu, Frank B; Field, Alison E

2013-12-01

Few prospective studies have examined separate forms of screen time in relation to adiposity. Our objective was to assess independent relations of television, electronic games (video/computer), and digital versatile disc (DVD)/videos and total screen time with change in adolescent BMI. Using data from the 2004, 2006, and 2008 waves of the ongoing Growing up Today Study II, we assessed baseline and 2-year change in reported screen time in relation to concurrent change in BMI among 4287 girls and 3505 boys aged 9 to 16 years in 2004. Gender-specific models adjusted for previous BMI, age, race/ethnicity, growth/development, months between questionnaires, and physical activity. Among girls and boys, each hour per day increase in reported television viewing was associated with a 0.09 increase in BMI (Ps < .001), and each hour per day increase in total screen time was associated with a 0.07 increase among girls and 0.05 increase among boys (Ps < .001). Among girls only, greater baseline television, games, and total screen time and change in DVDs/videos were associated with gains in BMI (Ps < .05). BMI gains associated with change in television and total screen time were stronger among overweight girls than lean girls (Ps-heterogeneity < .001). Television, which remains the steadiest source of food advertising, was most consistently associated with BMI gains. Among girls, electronic games and DVDs/videos were also related to increased BMI, possibly due to influences of product placements and advergames on diet and/or distracted eating. Adolescents, especially overweight adolescents, may benefit from reduced time with multiple types of media.

Adiposity and Different Types of Screen Time

PubMed Central

Rosner, Bernard; Willett, Walter C.; Sonneville, Kendrin R.; Hu, Frank B.; Field, Alison E.

2013-01-01

OBJECTIVE: Few prospective studies have examined separate forms of screen time in relation to adiposity. Our objective was to assess independent relations of television, electronic games (video/computer), and digital versatile disc (DVD)/videos and total screen time with change in adolescent BMI. METHODS: Using data from the 2004, 2006, and 2008 waves of the ongoing Growing up Today Study II, we assessed baseline and 2-year change in reported screen time in relation to concurrent change in BMI among 4287 girls and 3505 boys aged 9 to 16 years in 2004. Gender-specific models adjusted for previous BMI, age, race/ethnicity, growth/development, months between questionnaires, and physical activity. RESULTS: Among girls and boys, each hour per day increase in reported television viewing was associated with a 0.09 increase in BMI (Ps < .001), and each hour per day increase in total screen time was associated with a 0.07 increase among girls and 0.05 increase among boys (Ps < .001). Among girls only, greater baseline television, games, and total screen time and change in DVDs/videos were associated with gains in BMI (Ps < .05). BMI gains associated with change in television and total screen time were stronger among overweight girls than lean girls (Ps-heterogeneity < .001). CONCLUSIONS: Television, which remains the steadiest source of food advertising, was most consistently associated with BMI gains. Among girls, electronic games and DVDs/videos were also related to increased BMI, possibly due to influences of product placements and advergames on diet and/or distracted eating. Adolescents, especially overweight adolescents, may benefit from reduced time with multiple types of media. PMID:24276840

Age, BMI, and race are less important than random plasma glucose in identifying risk of glucose intolerance: the Screening for Impaired Glucose Tolerance Study (SIGT 5).

PubMed

Ziemer, David C; Kolm, Paul; Weintraub, William S; Vaccarino, Viola; Rhee, Mary K; Caudle, Jane M; Irving, Jade M; Koch, David D; Narayan, K M Venkat; Phillips, Lawrence S

2008-05-01

Age, BMI, and race/ethnicity are used in National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and American Diabetes Association (ADA) guidelines to prompt screening for pre-diabetes and diabetes, but cutoffs have not been evaluated rigorously. Random plasma glucose (RPG) was measured and 75-g oral glucose tolerance tests were performed in 1,139 individuals without known diabetes. Screening performance was assessed by logistic regression and area under the receiver operating characteristic curve (AROC). NIDDK/ADA indicators age >45 years and BMI >25 kg/m(2) provided significant detection of both diabetes and dysglycemia (both AROCs 0.63), but screening was better with continuous-variable models of age, BMI, and race and better still with models of age, BMI, race, sex, and family history (AROC 0.78 and 0.72). However, screening was even better with RPG alone (AROCs 0.81 and 0.72). RPG >125 mg/dl could be used to prompt further evaluation with an OGTT. Use of age, BMI, and race/ethnicity in guidelines for screening to detect diabetes and pre-diabetes may be less important than evaluation of RPG. RPG should be investigated further as a convenient, inexpensive screen with good predictive utility.

Relationship between echocardiographic LV mass and ECG based left ventricular voltages in an adolescent population: related or random?

PubMed

Czosek, Richard J; Cnota, James F; Knilans, Timothy K; Pratt, Jesse; Guerrier, Karine; Anderson, Jeffrey B

2014-09-01

In attempts to detect diseases that may place adolescents at risk for sudden death, some have advocated for population-based screening. Controversy exists over electrocardiography (ECG) screening due to the lack of specificity, cost, and detrimental effects of false positive or extraneous outcomes. Analyze the relationship between precordial lead voltage on ECG and left ventricle (LV) mass by echocardiogram in adolescent athletes. Retrospective cohort analysis of a prospectively obtained population of self-identified adolescent athletes during sports screening with ECG and echocardiogram. Correlation between ECG LV voltages (R wave in V6 [RV6] and S wave in lead V1 [SV1]) was compared to echocardiogram-based measurements of left ventricular mass. Potential effects on ECG voltages by body anthropometrics, including weight, body mass index (BMI), and body surface area were analyzed, and ECG voltages indexed to BMI were compared to LV mass indices to analyze for improved correlation. A total of 659 adolescents enrolled in this study (64% male). The mean age was 15.4 years (14-18). The correlations between LV mass and RV6, SV1, and RV6 + SV1 were all less than 0.20. The false positive rate for abnormal voltages was relatively high (5.5%) but improved if abnormal voltages in both RV6 and SV1 were mandated simultaneously (0%). Indexing ECG voltages to BMI significantly improved correlation to LV mass, though false positive findings were increased (12.9%). There is poor correlation between ECG precordial voltages and echocardiographic LV mass. This relationship is modified by BMI. This finding may contribute to the poor ECG screening characteristics. ©2014 Wiley Periodicals, Inc.

Variation in obesity among American secondary school students by school and school characteristics.

PubMed

O'Malley, Patrick M; Johnston, Lloyd D; Delva, Jorge; Bachman, Jerald G; Schulenberg, John E

2007-10-01

Body mass index (BMI) is known to vary by individual characteristics, but little is known about whether BMI varies by school and by school characteristics. Nationally representative samples of United States schools and students are used to determine the extent to which BMI and percent of students at or above the 85th percentile of BMI vary by school and by school characteristics. Data from the 1991-2004 Monitoring the Future (MTF) study were analyzed in 2006 and 2007. A relatively small proportion of variance in BMI lies between schools; intraclass correlations are on the order of 3%. Still, this is sufficient variation to provide very different environments for students attending schools that are low versus high in average BMI. There is some modest variation by school type (public, Catholic private, non-Catholic private); school size (number of students in the sampled grade); region of the country; and population density. There is more variation as a function of school socioeconomic status (SES) and racial/ethnic composition of the school. School SES in particular was negatively associated with BMI levels, even after controlling individual-level SES and racial/ethnic status. The residual differences in BMI by school suggest that some characteristic of the school and/or community environment--perhaps cultural factors or peer role modeling or differences in school food, beverage, or physical education policies--facilitate obesity in schools with a high concentration of lower socioeconomic students, beyond individual-level factors.

The differential effect of socio-economic status, birth weight and gender on body mass index in Australian Aboriginal Children.

PubMed

Kim, S; Macaskill, P; Baur, L A; Hodson, E M; Daylight, J; Williams, R; Kearns, R; Vukasin, N; Lyle, D M; Craig, J C

2016-07-01

Adult Aboriginal Australians have 1.5-fold higher risk of obesity, but the trajectory of body mass index (BMI) through childhood and adolescence and the contribution of socio-economic factors remain unclear. Our objective was to determine the changes in BMI in Australian Aboriginal children relative to non-Aboriginal children as they move through adolescence into young adulthood, and to identify risk factors for higher BMI. A prospective cohort study of Aboriginal and non-Aboriginal school children commenced in 2002 across 15 different screening areas across urban, regional and remote New South Wales, Australia. Socio-economic status was recorded at study enrolment and participants' BMI was measured every 2 years. We fitted a series of mixed linear regression models adjusting for age, birth weight and socio-economic status for boys and girls. In all, 3418 (1949 Aboriginal) participants were screened over a total of 11 387 participant years of follow-up. The prevalence of obesity was higher among Aboriginal children from mean age 11 years at baseline (11.6 vs 7.6%) to 16 years at 8 years follow-up (18.6 vs 12.3%). The mean BMI increased with age and was significantly higher among Aboriginal girls compared with non-Aboriginal girls (P<0.01). Girls born of low birth weight had a lower BMI than girls born of normal birth weight (P<0.001). Socio-economic status and low birth weight had a differential effect on BMI for Aboriginal boys compared with non-Aboriginal boys (P for interaction=0.01). Aboriginal boys of highest socio-economic status, unlike those of lower socio-economic status, had a higher BMI compared with non-Aboriginal boys. Non-Aboriginal boys of low birth weight were heavier than Aboriginal boys. Socio-economic status and birth weight have differential effects on BMI among Aboriginal boys, and Aboriginal girls had a higher mean BMI than non-Aboriginal girls through childhood and adolescence. Intervention programs need to recognise the differential risk for obesity for Aboriginal and non-Aboriginal boys and girls to maximise their impact.

BMI and breast cancer prognosis benefit: mammography screening reveals differences between normal weight and overweight women.

PubMed

Crispo, Anna; Grimaldi, Maria; D'Aiuto, Massimiliano; Rinaldo, Massimo; Capasso, Immacolata; Amore, Alfonso; D'Aiuto, Giuseppe; Giudice, Aldo; Ciliberto, Gennaro; Montella, Maurizio

2015-02-01

Few studies are available on the potential impact of body weight on breast cancer prognosis in screen-detected patients. Moreover, it is not known whether body mass index (BMI) could have a different prognostic impact in screen-detected versus symptomatic breast cancer patients. To investigate these unsolved issues, we carried out a retrospective study evaluating the effect of BMI on breast cancer prognosis in screen-detected vs symptomatic breast cancer patients. We conducted a follow-up study on 448 women diagnosed with incident, histologically-confirmed breast cancer. Patients were categorized according to their BMI as normal weight, overweight and obese. Disease free survival (DFS), overall survival (OS), and BMI curves were compared according to mode of cancer detection. Among screen-detected patients, higher BMI was associated with a significant lower DFS, whereas no significant difference was observed among symptomatic patients. OS showed similar results. In the multivariate analysis adjusting for age, education, tumor size, nodal status, estrogen receptor (ER), progesterone receptor (PR) and menopausal status, the risk for high level of BMI among screen-detected patients did not reach the statistical significance for either recurrence or survival. Our study highlights the potential impact of high bodyweight in breast cancer prognosis, the findings confirm that obesity plays a role in women breast cancer prognosis independently from diagnosis mode. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sociodemographic and home environment predictors of screen viewing among Spanish school children.

PubMed

Hoyos Cillero, Itziar; Jago, Russell

2011-09-01

Higher screen-viewing levels increase the risk of obesity. Understanding the correlates of screen viewing is an important first step in designing interventions but there is lack of information on the correlates among Spanish children. This study examined associations among environmental, sociocultural, age variables and screen viewing among Spanish children. Children completed a questionnaire about time spent in screen viewing. BMI was assessed and children were classified into obesity groups using International Obesity Task Force cut-off points. Parents completed a questionnaire about sociodemographic, environmental and sociocultural variables. Participants were 247 primary and 256 secondary school-aged children and their parents. Time spent in screen viewing increased with age. Males spent more time than females in screen viewing. Greater access to bedroom media sources was associated with higher screen viewing. Younger children from single-parent households and older children having a younger parent, siblings and a father who was not working were higher screen-viewers on weekends and weekdays, respectively. For older children parental TV viewing time appeared to be a significant correlate, while parental rules was a determinant predictor for younger children on weekdays. Environmental and sociocultural factors influence the time children spend in screen viewing. Parents play a central role in child's screen viewing; therefore, interventions that target environmental and family TV viewing practices are likely to be effective.

Secondary analyses of data from 4 studies with fourth-grade children show that sex, race, amounts eaten of standardized portions, and energy content given in trades explain the positive relationship between body mass index and energy intake at school-provided meals.

PubMed

Baxter, Suzanne Domel; Paxton-Aiken, Amy E; Tebbs, Joshua M; Royer, Julie A; Guinn, Caroline H; Finney, Christopher J

2012-09-01

Results from a 2012 article showed a positive relationship between children's body mass index (BMI) and energy intake at school-provided meals. To help explain that positive relationship, secondary analyses investigated (1) whether the relationship differed by sex and race and (2) the relationship between BMI and 6 aspects of school-provided meals--amounts eaten of standardized portions, energy content given in trades, energy intake received in trades, energy intake from flavored milk, energy intake from a la carte ice cream, and breakfast type. Data were from 4 studies conducted 1 per school year (1999-2000 to 2002-2003). Fourth-grade children (n = 328; 50% female; 54% black) from 13 schools total were observed eating school-provided breakfast and lunch on 1 to 3 days per child for 1178 total meals (50% breakfast). Children were weighed and measured. Marginal regression models were fit using BMI as the dependent variable. For purpose 1, independent variables were energy intake at school-provided meals, sex, race, age, and study; additional models included interaction terms involving energy intake and sex/race. For purpose 2, independent variables were the 6 aspects of school-provided meals, sex, race, age, and study. The relationship between BMI and energy intake at school-provided meals differed by sex (P < .0001; stronger for females) and race (P = .0063; stronger for black children). BMI was positively related to amounts eaten of standardized portions (P < .0001) and negatively related to energy content given in trades (P = .0052). Explaining the positive relationship between BMI and energy intake at school-provided meals may contribute to school-based obesity prevention efforts. Copyright © 2012 Elsevier Inc. All rights reserved.

"Proceedings of the 22nd Aschauer Soiree on Growth and Health Screening", held at Altenhof, Germany, November 15th, 2014.

PubMed

Hermanussen, Michael; Anisimova, Anna; Abmann, Christian; Van Buuren, Stef; Camara, Antonio D; Elhusseini, Mona Abbas; Hassan, Mortada; El-Shabrawi, Mortada Hassan; Godina, Elena Zinovyevna; Gomula, Aleksandra; Groth, Detlef; Koziel, Slawomir; Lieberman, Leslie Sue; Meigen, Christof; Mumm, Rebekka; Nariyama, Koichi; Nowak-Szczepanska, Natalia; Novokmet, Natalija; Satake, Takashi; Scheffler, Christiane; Soderhall, Jani; Suchomlinov, Andrej; Tutkuviene, Janina; Wit, Jan M; Witwer-Backofen, Ursula; Yestrebsky, Cherie Lynn

2015-03-01

Twenty-five scientists met at Aschauhof, Altenhof, Germany, to discuss various aspects of the complex network of modern health screening, focusing on current scientific topics including medical sciences, human biology, and mathematics; on problems in implementing these results at the practical level of physicians, nurses, technicians, and engineers; and the level of administrative and political decisions. Whereas major scientific advancements have been published in the understanding and the bio-statistical evaluation of anthropometric screening parameters such as serial measurements of height and weight for preventive medical check-ups, BMI screening and surveillance in schools, etc., the implementation of these advancements into current health screening concepts, strategies and decision-making is poor. Fear of discrimination, misperception of body image, behavioural responses and political concerns, meanwhile dominate and negatively interfere with the implementation of recent scientific results into public health screening concepts and practices.

Childhood body mass index in adolescent-onset anorexia nervosa.

PubMed

Berkowitz, Staci A; Witt, Ashley A; Gillberg, Christopher; Råstam, Maria; Wentz, Elisabet; Lowe, Michael R

2016-11-01

Although weight history is relevant in predicting eating disorder symptom severity, little is known about its role in the etiology of anorexia nervosa (AN). This study aimed to determine whether BMI or BMI trajectory differed between individuals who later developed adolescent-onset AN and a comparison group of HCs between school grades 1 through 6. This study was based on longitudinal data that identified 51 adolescents with AN and 51 matched HCs. Cases were identified through community screening in Sweden and included individuals born in 1969 through 1977. Measured weights and heights were retrieved and BMIs and weight trajectories of the AN and HC groups were compared using growth curve analysis. Main outcome measures included measured BMI and BMI trajectories from grades 1-6. Secondary outcomes examined included ponderal index at birth and maternal body weight. Individuals who later developed AN had higher BMIs than HCs between grades 1 and 6, by an average of 1.42 BMI-units. There was no difference in rate of weight gain between groups. Ponderal index at birth was higher for the AN as compared with HC group. Maternal weight did not differ significantly between groups. These findings, combined with those previously reported on the premorbid BMIs of those with bulimia nervosa, suggest that a predisposition toward elevated premorbid BMIs during childhood characterizes those who later develop anorexia or bulimia nervosa. These findings are consistent with a transdiagnostic perspective and suggest shared risk factors for AN and obesity. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1002-1009). © 2016 Wiley Periodicals, Inc.

The usefulness of body image tests in the prevention of eating disorders.

PubMed

Yamamoto, Chie; Uemoto, Masaharu; Shinfuku, Naotaka; Maeda, Kiyoshi

2007-01-01

Individual psychological factors such as mental conditions and self-esteem and family relational factors are thought to be predisposing factors in the development of eating disorders. In this study, we conducted a survey of 12-15 year-old public junior high school students to extract factors related to abnormal eating behavior and determine what information could be used by schools to prevent eating disorders. Self-descriptive surveys were distributed and collected during homeroom time at school. The survey consisted of the 26-item Eating Attitude Test (EAT-26) to measure the degree of abnormal eating behavior, Stunkard, Sorensen and Schlusinger's Body Image Scale to determine predisposing factors, the Family Adaptability and Cohesion Scale III (FACES III), General Health Questionnaire (GHQ), and Rosenberg's Self-Esteem Scale. 483 students (263 boys and 220 girls) participated in the survey. School-year height and weight data was used to calculate BMI. Approximately 7% of girls and 3% of boys showed clear indications of abnormal eating behavior. We found no direct relationship between abnormal eating behavior and family factors in this study, but an indirect relationship was suggested through other factors such as psychological complaints and self-esteem. There were relationships between abnormal eating behavior and the individual factors of psychological complaints, current and ideal body image, and low self-esteem. Furthermore, cluster analysis showed that there were students with high BMI who thought of themselves as fat, as well as students who perceived themselves as fat despite having average BMI. These students had a high frequency of abnormal eating behaviors, a great deal of psychological complaints, and low self-esteem. An understanding of BMI, along with body image, is essential for students who feel that they are overweight. Schools can practice preventative education by teaching these students about healthy body weight and by screening for the eating disorders that have become so rampant in our thin-worshiping culture.

Influence of sports, physical education, and active commuting to school on adolescent weight status.

PubMed

Drake, Keith M; Beach, Michael L; Longacre, Meghan R; Mackenzie, Todd; Titus, Linda J; Rundle, Andrew G; Dalton, Madeline A

2012-08-01

To compare the associations between weight status and different forms of physical activity among adolescents. We conducted telephone surveys with 1718 New Hampshire and Vermont high school students and their parents as part of a longitudinal study of adolescent health. We surveyed adolescents about their team sports participation, other extracurricular physical activity, active commuting, physical education, recreational activity for fun, screen time, diet quality, and demographics. Overweight/obesity (BMI for age ≥ 85th percentile) and obesity (BMI for age ≥ 95 percentile) were based on self-reported height and weight. Overall, 29.0% (n = 498) of the sample was overweight/obese and 13.0% (n = 223) were obese. After adjustments, sports team participation was inversely related to overweight/obesity (relative risk [RR] = 0.73 [95% confidence interval (CI): 0.61, 0.87] for >2 sports teams versus 0) and obesity (RR = 0.61 [95% CI: 0.45, 0.81] for >2 sports teams versus 0). Additionally, active commuting to school was inversely related to obesity (RR = 0.67 [95% CI: 0.45, 0.99] for >3.5 days per week versus 0). Attributable risk estimates suggest obesity prevalence would decrease by 26.1% (95% CI: 9.4%, 42.8%) if all adolescents played on 2 sports teams per year and by 22.1% (95% CI: 0.1%, 43.3%) if all adolescents walked/biked to school at least 4 days per week. Team sport participation had the strongest and most consistent inverse association with weight status. Active commuting to school may reduce the risk of obesity, but not necessarily overweight, and should be studied further. Obesity prevention programs should consider strategies to increase team sport participation among all students.

Effectiveness of selective risk based screening for Gestational Diabetes (GDM) in Malaysia: A retrospective cohort study based on the National Obstetric Registry (NOR) of Malaysia.

PubMed

Muniswaran, G; Soelar, S A; Karalasingam, S D; Bujang, M A; Jeganathan, R; Suharjono, H

2017-02-01

Gestational diabetes (GDM) has significant maternal and foetal implications. screening allows active interventions which significantly improves pregnancy outcomes. Despite World Health Organization (WHO), FIGO and National Institute of clinical Excellence (NIcE) recommendations for universal screening especially among high risk population; Malaysia currently adopts a selective risk based screening for GDM. the objective is to audit the effectiveness of the current practice of selective risk based screening in detection of GDM in Malaysia. this is a retrospective cohort study based on the National Obstetric Registry (NOR) which comprises of 14 major tertiary hospitals in Malaysia. the study period was from 1st January 2011 till 31st December 2012 and a total of 22,044 patients with GDM were analysed. Logistic regression analysis was used to calculate the crude odd ratio. the incidence of GDM in Malaysia is 8.4%. Maternal age of ≥25, booking bMI ≥27kg/m2, booking weight ≥80kg and previous hypertension are non-significant risk of developing GDM in Malaysia. Parity 5 and more was only associated with an odds-ratio of 1.02 (95% confidence Interval: 0.90-1.17) as compared to parity below 5. the association of women with previous stillbirth with GDM was not significant. current risk based screening for GDM based on maternal age, booking bMI, weight and hypertension is inappropriate. An ideal screening tool should precede disease complications, which is the novel objective of screening. Universal screening for GDM in Malaysia may be a more accurate measure, especially with regards to reducing maternal and foetal complications.

School-Based Screening to Identify At-Risk Students Not Already Known to School Professionals: The Columbia Suicide Screen

PubMed Central

Wilcox, Holly C.; Schonfeld, Irvin Sam; Davies, Mark; Hicks, Roger C.; Turner, J. Blake; Shaffer, David

2009-01-01

Objectives. We sought to determine the degree of overlap between students identified through school-based suicide screening and those thought to be at risk by school administrative and clinical professionals. Methods. Students from 7 high schools in the New York metropolitan area completed the Columbia Suicide Screen; 489 of the 1729 students screened had positive results. The clinical status of 641 students (73% of those who had screened positive and 23% of those who had screened negative) was assessed with modules from the Diagnostic Interview Schedule for Children. School professionals nominated by their principal and unaware of students' screening and diagnostic status were asked to indicate whether they were concerned about the emotional well-being of each participating student. Results. Approximately 34% of students with significant mental health problems were identified only through screening, 13.0% were identified only by school professionals, 34.9% were identified both through screening and by school professionals, and 18.3% were identified neither through screening nor by school professionals. The corresponding percentages among students without mental health problems were 9.1%, 24.0%, 5.5%, and 61.3%. Conclusions. School-based screening can identify suicidal and emotionally troubled students not recognized by school professionals. PMID:19059865

The persistent clustering of adult body mass index by school attended in adolescence.

PubMed

Evans, Clare Rosenfeld; Lippert, Adam M; Subramanian, S V

2016-03-01

It is well known that adolescent body mass index (BMI) shows school-level clustering. We explore whether school-level clustering of BMI persists into adulthood. Multilevel models nesting young adults in schools they attended as adolescents are fit for 3 outcomes: adolescent BMI, self-report adult BMI and measured adult BMI. Sex-stratified and race/ethnicity-stratified (black, Hispanic, white, other) analyses were also conducted. School-level clustering (wave 1 intraclass correlation coefficient (ICC)=1.3%) persists over time (wave 4 ICC=2%), and results are comparable across stratified analyses of both sexes and all racial/ethnic groups (except for Hispanics when measured BMIs are used). Controlling for BMI in adolescence partially attenuates this effect. School-level clustering of BMI persists into young adulthood. Possible explanations include the salience of school environments in establishing behaviours and trajectories, the selection of adult social networks that resemble adolescent networks and reinforce previous behaviours, and characteristics of school catchment areas associated with BMI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia.

PubMed

Gathirua-Mwangi, Wambui G; Monahan, Patrick; Song, Yiqing; Zollinger, Terrell W; Champion, Victoria L; Stump, Timothy E; Imperiale, Thomas F

2017-11-01

Waist circumference (WC) is a stronger predictor of colon cancer (CRC) risk than body mass index (BMI). However, how well change in either WC or BMI predicts risk of advanced colorectal neoplasia (AN) is unclear. To determine the relationship between change in BMI and WC from early adulthood to later age and the risk of AN and which change measure is a stronger predictor. In 4500 adults, ages 50-80, with no previous neoplasia and undergoing screening colonoscopy, BMI and WC at age 21 and at time of screening were reported. Changes in BMI and WC were defined using universal risk cutoffs. Known CRC risk factors were controlled in the logistic models. Overall, model statistics showed WC change (omnibus test χ 2  = 10.15, 2 DF, p value = 0.006) was a statistically stronger predictor of AN than BMI change (omnibus test χ 2  = 5.66, 5 DF, p value = 0.34). Independent of BMI change, participants who increased WC (OR 1.44; 95% CI 1.05-1.96) or maintained a high-risk WC (OR 2.50; 95% CI 1.38-4.53) at age 21 and at screening had an increased risk of AN compared to those with a low-risk WC. Study participants who were obese at age 21 and at screening had an increased risk of AN (OR 1.87; 95% CI 1.08-3.23) compared to those who maintained a healthy BMI. Maintaining an overweight BMI or increasing BMI was not associated with AN. Maintaining an unhealthy BMI and WC throughout adult life may increase risk of AN. WC change may be a better predictor of AN than BMI change.

Fitness Trends and Disparities Among School-Aged Children in Georgia, 2011-2014.

PubMed

Bai, Yang; Saint-Maurice, Pedro F; Welk, Gregory J

Although FitnessGram fitness data on aerobic capacity and body mass index (BMI) have been collected in public schools in Georgia since the 2011-2012 school year, the data have not been analyzed. The primary objective of our study was to use these data to assess changes in fitness among school-aged children in Georgia between 2011 and 2014. A secondary objective was to determine if student fitness differed by school size and socioeconomic characteristics. FitnessGram classifies fitness into the Healthy Fitness Zone (HFZ) or not within the HFZ for aerobic capacity and BMI. We used data for 3 successive school years (ie, 2011-2012 to 2013-2014) obtained from FitnessGram testing of students in >1600 schools. We calculated the percentage of students who achieved the HFZ for aerobic capacity and BMI. We used growth curve models to estimate the annual changes in these proportions, and we determined the effect of school size and socioeconomic status on these changes. Both elementary school boys (β = 1.31%, standard error [SE] = 0.23%, P < .001) and girls (β = 1.53%, SE = 0.26%, P < .001) had significant annual increases in achievement of HFZ for aerobic capacity. Elementary school boys (β = 3.11%, SE = 0.32%, P < .001) and girls (β = 3.09%, SE = 0.32%, P < .001) also had significant increases in their BMI HFZ achievement proportions, although these increases occurred primarily between 2011-2012 and 2012-2013. Body mass index HFZ achievement proportions were mixed for middle school students, and we did not observe increases for high school students. Larger school size and higher school socioeconomic status were associated with better aerobic capacity and BMI fitness profiles. Surveillance results such as these may help inform the process of designing state and local school-based fitness promotion and public health programs and tracking the results of those programs.

Malnutrition and poor oral health status are major risks among primary school children at Lasbela, Balochistan, Pakistan.

PubMed

Mustufa, Muhammad Ayaz; Jamali, Abdul Karim; Sameen, Ifra; Burfat, Fateh Muhammad; Baloch, Mir Yousaf; Baloch, Abdul Hameed; Baloch, Ghulam Rasool; Lashari, Shazia Kulsoom; Ayaz, Sobiya Mohiuddin; Baloch, Muhammad Younus

2017-05-19

This survey was focusing on health and oral hygiene status of primary school children at Lasbela district considering the comparatively less developed and socio demographically deprived part of the Country. A cross sectional survey was conducted to determine the health status of primary school children in seven tehseels of district Lasbela, Balochistan after applying proportionate sampling technique from March 2015 to July 2015. Field teams visited assigned schools to screen children and collect health related data on predesigned and pre coded proforma. Out of 200 schools, 196 schools found opened, while 2% of schools (04) remained closed. A total of 6363 students were clinically screened. About 45% of the school children had normal body mass index (BMI) and rest were falling in different categories of malnutrition. More than 19% had ear, nose and throat (ENT) problems and around 19% presented with clinical anemia. Less than 50% of children had scar of BCG vaccination and 4% informed about use of gutka/supari chewing (smokeless tobacco use). In conclusion, we estimated high prevalence of malnutrition, poor oral health including smokeless tobacco use, and low BCG coverage among primary school children at Lasbela. Current scenario suggests immediate and contextually focused interventions to confine existing public health risks and avoid future burden of disease.

Translational research: are community-based child obesity treatment programs scalable?

PubMed

Hardy, Louise L; Mihrshahi, Seema; Gale, Joanne; Nguyen, Binh; Baur, Louise A; O'Hara, Blythe J

2015-07-14

Community-based obesity treatment programs have become an important response to address child obesity; however the majority of these programs are small, efficacy trials, few are translated into real-world situations (i.e., dissemination trials). Here we report the short-term impact of a scaled-up, community-based obesity treatment program on children's weight and weight-related behaviours disseminated under real world conditions. Children age 6-15 years with a body mass index (BMI) ≥ 85th percentile with no co-morbidities, and their parents/carers participated in a twice weekly, 10-week after-school child obesity treatment program between 2009 and 2012. Outcome information included measures of weight and weight-related behaviours. Analyses were adjusted for clustering and socio-demographic variables. Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions). Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p < 0.001). Children who completed ≥ 75% of the program were more likely to have beneficial changes in BMI, self-esteem and diet (sugar sweetened beverages, lollies/chocolate, hot chips and takeaways) compared with children completing <75% of the program. This is one of the few studies to report outcomes of a government-funded, program at scale in a real-world setting, and shows that investment in a community-based child obesity treatment program holds potential to produce short-term changes in weight and weight-related behaviours. The findings support government investment in this health priority area, and demonstrate that community-based models of child obesity treatment are a promising adjunctive intervention to health service provision at all levels of care.

Screening and counseling for childhood obesity: results from a national survey.

PubMed

Sesselberg, Tracy S; Klein, Jonathan D; O'Connor, Karen G; Johnson, Mark S

2010-01-01

To examine family physicians' beliefs and practices about using body mass index (BMI) percentiles to screen for childhood overweight and obesity. Surveys about management of childhood overweight were mailed to 1800 American Academy of Family Physician members in 2006. 729 surveys were returned; 445 were eligible. Most (71%) members were familiar with BMI guidelines; 41% were familiar with American Academy of Family Physician recommendations about overweight. Most (78%) had tools available to calculate BMI; fewer have enough time for overweight screening (55%), and only 45% reported computing BMI percentile at most or every well visit for children older than 2. Having an electronic health record increased BMI screening rates. Family physicians felt prepared to discuss weight, but only 43% believed their counseling was effective and many (55%) lack community or referral services. Most (72%) wanted simple diet and exercise recommendations for patients. Reimbursement for weight-related services is insufficient: 86% say that patients cannot pay for services not covered by insurance. Factor analysis identified clinician self-efficacy, resources, and reimbursement as factors related to calculating BMI percentiles. BMI is underutilized by family physicians. Most believe they should try to prevent overweight and have tools to use BMI, but clinicians have few resources available for treatment, have low self-efficacy, and report inadequate reimbursement.

Maternal glucose level and body mass index measured at gestational diabetes mellitus screening and the risk of macrosomia: results from a perinatal cohort study.

PubMed

Liu, Jian; Leng, Junhong; Tang, Chen; Liu, Gongshu; Hay, John; Wang, Jing; Wen, Shiwu; Li, Zhenling; She, Ye

2014-05-20

To examine the impact of maternal blood glucose (BG) level and body mass index (BMI) measured at gestational diabetes mellitus (GDM) screening on the risk of macrosomia. A perinatal cohort of women were followed up from receiving perinatal healthcare to giving birth. Beichen District, Tianjin, China between June 2011 and October 2012. 1951 women aged 19-42 years with valid values of BMI and BG level at GDM screening (24-28 weeks gestation), singleton birth and birth weight (BW)>2500 g. Primary outcome was macrosomia (BW>4000 g). BG level and BMI were measured at GDM screening. 191 (9.7%) newborns were macrosomia. The ORs (95% CIs) of macrosomia from multiple logistic regression were 1.14 (1.10 to 1.19, p<0.0001) for BMI and 1.11 (1.01 to 1.23, p=0.03) for BG. When BMI and BG levels (continuous) were modelled simultaneously, the OR for BMI was similar, but significantly attenuated for BG. Areas of receiver operating characteristics (ROC) were 0.6530 (0.6258 to 0.6803) for BMI and 0.5548 (0.5248 to 0.5848) for BG (χ(2)=26.17, p<0.0001). BG (mmol/L, <6.7, 6.7-7.8 or ≥7.8) and BMI in quintiles (Q1-Q5) were evaluated with BG <6.7 and Q2 BMI as the reference group. The ORs of macrosomia were not statistically different for mothers in Q1 or Q2 of BMI regardless of the BG levels; the ORs for ≥Q3 of BMI were elevated significantly with the highest OR observed in Q5 of BMI and BG levels ≥7.8 (6.93 (2.61 to 18.43), p<0.0001). High BMI measured at GDM screening was the most important determinant for risk of macrosomia. These findings suggest that GDM screening may be a critical gestational time point to initiate maternal weight control oriented intervention strategy to lower the risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Prevalence and factors associated with body mass index in children aged 9-11 years.

PubMed

Ferrari, Gerson Luis de Moraes; Matsudo, Victor; Katzmarzyk, Peter T; Fisberg, Mauro

This study aimed to identify the prevalence and factors associated with body mass index (BMI) in children aged 9-11 years. The study is part of the International Study of Childhood Obesity Lifestyle and the Environment (ISCOLE). Body composition was determined using the bipolar bioimpedance technique. The mean BMI value was categorized as recommended by the World Health Organization. For seven consecutive days, participants used an accelerometer to objectively monitor sedentary behavior (SB) and moderate to vigorous physical activity. Individual factors (anthropometric and behavioral), family aspects, and family and school environment were provided by participants and parents and were analyzed by multilevel linear regression adjusted for gender, ethnicity, school, number of siblings, and total annual family income. The mean BMI was 20.1kg/m 2 , and 51.8% of the children were overweight/obese (50.3% boys, 53.4% girls, p=0.014). Considering all participants, the associated factors of BMI were body fat percentage (BF%, β=0.0216, p<0.001) and screen time (ST, β=0.0050, p=0.006). In boys, the associated factors were BF% (β=0.0209, p<0.001), ST (β=0.006, p=0.036), and healthy eating policies or practices (β=0.0276, p=0.025). In girls, only BF% was associated (β=0.0221, p<0.001) with BMI. High prevalence of overweight/obesity was observed in children from São Caetano do Sul. Different associated factors were identified between the genders, with only BF% being common in both genders. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The Relationship of School Absenteeism with Body Mass Index, Academic Achievement, and Socioeconomic Status among Fourth-Grade Children

PubMed Central

Royer, Julie A.; Hardin, James W.; Guinn, Caroline H.; Devlin, Christina M.

2014-01-01

Background Data from a school-based study concerning fourth-grade children’s dietary recall accuracy were linked with data from the South Carolina Department of Education (SCDE) through the South Carolina Budget and Control Board Office of Research and Statistics (ORS) to investigate the relationships of children’s school absenteeism with body mass index (BMI), academic achievement, and socioeconomic status (SES). Methods Data for all variables were available for 920 fourth-grade children during two school years (2005–2006, 2006–2007). Number of school days absent for each child and eligibility for free/reduced-price school meals (SES measure) were provided to ORS by SCDE. Children’s weight and height were measured by research staff; age/sex specific BMI percentile was calculated and grouped into categories. For academic achievement, Palmetto Achievement Challenge Tests scores were provided by the school district. The associations of absenteeism with BMI, academic achievement, SES, and school year were investigated with logistic binomial models using the modified sandwich variance estimator to adjust for multiple outcomes within schools. Results The relationships between absenteeism and each of BMI percentile category and SES were not significant (all coefficient p values > 0.118). The relationship between absenteeism and academic achievement was inversely significant (p value < 0.0001; coefficient = −0.087). Conclusions These results support the inverse relationship between absenteeism and academic achievement that was expected and has been found by other researchers. The lack of significant results concerning the relationships between absenteeism and both BMI and SES disagrees with earlier, limited research. More research to investigate these relationships is needed. PMID:21668882

Elementary School Nurses' Perceptions and Practices regarding Body Mass Index Measurement in School Children

ERIC Educational Resources Information Center

Hendershot, Candace; Telljohann, Susan K.; Price, James H.; Dake, Joseph A.; Mosca, Nancy W.

2008-01-01

This study examines elementary school nurses' perceived efficacy expectations, perceived barriers, and perceived benefits to measuring body mass index (BMI) in students in schools with mandated BMI policies versus schools without mandated policies. Of the 2,629 school nurses participating in the study, 67% believe nurses should measure BMI in…

Screening for diabetes and prediabetes should be cost-saving in patients at high risk.

PubMed

Chatterjee, Ranee; Narayan, K M Venkat; Lipscomb, Joseph; Jackson, Sandra L; Long, Qi; Zhu, Ming; Phillips, Lawrence S

2013-07-01

Although screening for diabetes and prediabetes is recommended, it is not clear how best or whom to screen. We therefore compared the economics of screening according to baseline risk. Five screening tests were performed in 1,573 adults without known diabetes--random plasma/capillary glucose, plasma/capillary glucose 1 h after 50-g oral glucose (any time, without previous fast, plasma glucose 1 h after a 50-g oral glucose challenge [GCTpl]/capillary glucose 1 h after a 50-g oral glucose challenge [GCTcap]), and A1C--and a definitive 75-g oral glucose tolerance test. Costs of screening included the following: costs of testing (screen plus oral glucose tolerance test, if screen is positive); costs for false-negative results; and costs of treatment of true-positive results with metformin, all over the course of 3 years. We compared costs for no screening, screening everyone for diabetes or high-risk prediabetes, and screening those with risk factors based on age, BMI, blood pressure, waist circumference, lipids, or family history of diabetes. Compared with no screening, cost-savings would be obtained largely from screening those at higher risk, including those with BMI >35 kg/m(2), systolic blood pressure ≥130 mmHg, or age >55 years, with differences of up to -46% of health system costs for screening for diabetes and -21% for screening for dysglycemia110, respectively (all P < 0.01). GCTpl would be the least expensive screening test for most high-risk groups for this population over the course of 3 years. From a health economics perspective, screening for diabetes and high-risk prediabetes should target patients at higher risk, particularly those with BMI >35 kg/m(2), systolic blood pressure ≥130 mmHg, or age >55 years, for whom screening can be most cost-saving. GCTpl is generally the least expensive test in high-risk groups and should be considered for routine use as an opportunistic screen in these groups.

Effects of a 2-Year School-Based Intervention of Enhanced Physical Education in the Primary School

ERIC Educational Resources Information Center

Sacchetti, Rossella; Ceciliani, Andrea; Garulli, Andrea; Dallolio, Laura; Beltrami, Patrizia; Leoni, Erica

2013-01-01

Background: This study aimed to assess whether a school-based physical education intervention was effective in improving physical abilities and influencing daily physical activity habits in primary school children. The possible effect on body mass index (BMI) was also considered. Methods: Twenty-six 3rd-grade classes were randomly selected…

The School Food Environment and Student BMI and Food Consumption: 2004 to 2007 National Data

PubMed Central

Terry-McElrath, Yvonne M.; O’Malley, Patrick M.; Delva, Jorge; Johnston, Lloyd D.

2009-01-01

Purpose This study identifies trends in the availability of various food choices in United States’ middle and high schools from 2004–2007, and examines the potential associations between such food availability and students’ self-reported eating habits and BMI-related outcomes. Methods Data are based on nationally representative samples of 78,442 students in 684 secondary schools surveyed from 2004 to 2007 as part of the Youth, Education, and Society (YES) study and the Monitoring the Future (MTF) study. In the YES study, school administrators and food service managers completed self-administered questionnaires on their school’s food environment. In the MTF study, students in the same schools completed self-administered questionnaires, providing data used to construct BMI and food consumption measures. Results Overall, there was a decrease in the availability of regular sugar/fat food items in both middle and high schools, and some indication of an increase high school availability of reduced fat food items through school lunch or a la carte. Some minimal evidence was found for relationships between the school food environment and student BMI-related outcomes and food consumption measures. Conclusions United States secondary schools are making progress in the types of foods offered to students, with food items of lower nutritional value becoming less prevalent in recent years. Continued monitoring of food environment trends may help clarify if and how such factors relate to youth health outcomes. PMID:19699436

Body weight perception, unhealthy weight control behaviors, and suicidal ideation among Korean adolescents.

PubMed

Kim, Dong-Sik; Cho, Youngtae; Cho, Sung-Il; Lim, In-Sook

2009-12-01

This study examined the mediating function of body weight perception (BWP) in the relation between body mass index (BMI) and unhealthy weight control behaviors (UWCBs; eg, fasting, using diet pills, or laxatives), and between BMI and suicidal ideation. It also explored the correlation between exposure to multiple UWCBs and suicidal ideation among Korean adolescents. Data on BMI, BWP, UWCBs, and suicidal ideation were obtained from the 2006 Korean Youth Risk Behavior Web-based Survey, a school-based survey conducted on a nationally representative sample of students in grades 7-12 (36,463 boys and 33,433 girls). Data were analyzed using bivariate and multivariate logistic regression. BMI was significantly associated with both UWCB and suicidal ideation among boys and girls, even after controlling for covariates. However, the significance and magnitude of the association between BMI and UWCB were considerably attenuated when BWP was added to the model. When BWP was included, the association between overweight BMI status and suicidal ideation became nonsignificant in both sexes, whereas the association between underweight BMI status and suicidal ideation remained significant among boys. Adolescent boys and girls engaging in multiple UWCBs were at greater risk for experiencing suicidal thoughts. This study suggests that BWP represents a potential mediator between BMI and UWCB, and between BMI and suicidal ideation among both boys and girls. Thus, school programs addressing issues related to BWP should be developed and targeted at adolescents to reduce the potential risks for both UWCB and suicidal behavior.

Lifestyle predictors for non-participation and outcome in the second round of faecal immunochemical test in colorectal cancer screening.

PubMed

Knudsen, Markus Dines; Berstad, Paula; Hjartåker, Anette; Gulichsen, Elisabeth Haagensen; Hoff, Geir; de Lange, Thomas; Bernklev, Tomm; Botteri, Edoardo

2017-08-08

To reduce colorectal cancer (CRC) mortality through population-based screening programmes using faecal tests, it is important that individuals continue to participate in the repeated rounds of screening. We aimed to identify lifestyle predictors for discontinuation of faecal immunochemical test (FIT) screening after the first round, as well as lifestyle predictors for colorectal neoplasia detected in the second-round FIT screening. In this longitudinal study, we invited 6959 individuals aged 50-74 years from south-east Norway for a first round of FIT screening and to complete a self-reported lifestyle questionnaire on demographic factors, body mass index (BMI, kg m -2 ), smoking habits, physical activity, consumption of alcohol and dietary items. Two years later, we estimated the associations between these factors, non-participation and screening results in the second round of FIT screening using adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Of the 3114 responders to the questionnaire who completed the first-round FIT and who were invited to participate in second-round FIT screening, 540 (17%) did not participate. The OR and (95% CI) for discontinuation of FIT screening after the first round was 1.61 (1.24-2.10) for current smoking compared with non-smoking; 2.01 (1.25-3.24) for BMI⩾35 kg m -2 compared with BMI 16.9-24.9 kg m -2 and 0.70 (0.52-0.94) for physical activity in the third quartile vs the first. Among participants, smoking, high BMI and high alcohol consumption were associated with an increased odds of detecting colorectal neoplasia (n=107). These results may indicate that Norwegian FIT screening participants who discontinue after the first round have lifestyle behaviours associated with increased risk of CRC.

Leisure time computer use and adolescent bone health--findings from the Tromsø Study, Fit Futures: a cross-sectional study.

PubMed

Winther, Anne; Ahmed, Luai Awad; Furberg, Anne-Sofie; Grimnes, Guri; Jorde, Rolf; Nilsen, Ole Andreas; Dennison, Elaine; Emaus, Nina

2015-04-22

Low levels of physical activity may have considerable negative effects on bone health in adolescence, and increasing screen time in place of sporting activity during growth is worrying. This study explored the associations between self-reported screen time at weekends and bone mineral density (BMD). In 2010/2011, 1038 (93%) of the region's first-year upper-secondary school students (15-18 years) attended the Tromsø Study, Fit Futures 1 (FF1). A follow-up survey (FF2) took place in 2012/2013. BMD at total hip, femoral neck and total body was measured as g/cm(²) by dual X-ray absorptiometry (GE Lunar prodigy). Lifestyle variables were self-reported, including questions on hours per day spent in front of television/computer during weekends and hours spent on leisure time physical activities. Complete data sets for 388/312 girls and 359/231 boys at FF1/FF2, respectively, were used in analyses. Sex stratified multiple regression analyses were performed. Many adolescents balanced 2-4 h screen time with moderate or high physical activity levels. Screen time was positively related to body mass index (BMI) in boys (p=0.002), who spent more time in front of the computer than girls did (p<0.001). In boys, screen time was adversely associated with BMDFF1 at all sites, and these associations remained robust to adjustments for age, puberty, height, BMI, physical activity, vitamin D levels, smoking, alcohol, calcium and carbonated drink consumption (p<0.05). Screen time was also negatively associated with total hip BMD(FF2) (p=0.031). In contrast, girls who spent 4-6 h in front of the computer had higher BMD than the reference (<2 h). In Norwegian boys, time spent on screen-based sedentary activity was negatively associated with BMD levels; this relationship persisted 2 years later. Such negative associations were not present among girls. Whether this surprising result is explained by biological differences remains unclear. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Physical growth and non-verbal intelligence: Associations in Zambia

PubMed Central

Hein, Sascha; Reich, Jodi; Thuma, Philip E.; Grigorenko, Elena L.

2014-01-01

Objectives To investigate normative developmental BMI trajectories and associations of physical growth indicators (ie, height, weight, head circumference [HC], body mass index [BMI]) with non-verbal intelligence in an understudied population of children from Sub-Saharan Africa. Study design A sample of 3981 students (50.8% male), grades 3 to 7, with a mean age of 12.75 years was recruited from 34 rural Zambian schools. Children with low scores on vision and hearing screenings were excluded. Height, weight and HC were measured, and non-verbal intelligence was assessed using UNIT-symbolic memory and KABC-II-triangles. Results Results showed that students in higher grades have a higher BMI over and above the effect of age. Girls showed a marginally higher BMI, although that for both boys and girls was approximately 1 SD below the international CDC and WHO norms. Controlling for the effect of age, non-verbal intelligence showed small but significant positive relationships with HC (r = .17) and BMI (r = .11). HC and BMI accounted for 1.9% of the variance in non-verbal intelligence, over and above the contribution of grade and sex. Conclusions BMI-for-age growth curves of Zambian children follow observed worldwide developmental trajectories. The positive relationships between BMI and intelligence underscore the importance of providing adequate nutritional and physical growth opportunities for children worldwide and in sub-Saharan Africa in particular. Directions for future studies are discussed with regard to maximizing the cognitive potential of all rural African children. PMID:25217196

Skipping breakfast, overconsumption of soft drinks and screen media: longitudinal analysis of the combined influence on weight development in primary schoolchildren.

PubMed

Traub, Meike; Lauer, Romy; Kesztyüs, Tibor; Wartha, Olivia; Steinacker, Jürgen Michael; Kesztyüs, Dorothea

2018-03-16

Regular breakfast and well-balanced soft drink, and screen media consumption are associated with a lower risk of overweight and obesity in schoolchildren. The aim of this research is the combined examination of these three parameters as influencing factors for longitudinal weight development in schoolchildren in order to adapt targeted preventive measures. In the course of the Baden-Württemberg Study, Germany, data from direct measurements (baseline (2010) and follow-up (2011)) at schools was available for 1733 primary schoolchildren aged 7.08 ± 0.6 years (50.8% boys). Anthropometric measurements of the children were taken according to ISAK-standards (International Standard for Anthropometric Assessment) by trained staff. Health and lifestyle characteristics of the children and their parents were assessed in questionnaires. A linear mixed effects regression analysis was conducted to examine influences on changes in waist-to-height-ratio (WHtR), weight, and body mass index (BMI) measures. A generalised linear mixed effects regression analysis was performed to identify the relationship between breakfast, soft drink and screen media consumption with the prevalence of overweight, obesity and abdominal obesity at follow-up. According to the regression analyses, skipping breakfast led to increased changes in WHtR, weight and BMI measures. Skipping breakfast and the overconsumption of screen media at baseline led to higher odds of abdominal obesity and overweight at follow-up. No significant association between soft drink consumption and weight development was found. Targeted prevention for healthy weight status and development in primary schoolchildren should aim towards promoting balanced breakfast habits and a reduction in screen media consumption. Future research on soft drink consumption is needed. Health promoting interventions should synergistically involve children, parents, and schools. The Baden-Württemberg Study is registered at the German Clinical Trials Register (DRKS) under the DRKS-ID: DRKS00000494 .

Improving the fitness and physical activity levels of primary school children: results of the Fit-4-Fun group randomized controlled trial.

PubMed

Eather, Narelle; Morgan, Philip J; Lubans, David R

2013-01-01

To evaluate the impact of a multi-component school-based physical activity intervention (Fit-4-Fun) on health-related fitness and objectively measured physical activity in primary school children. Four Hunter primary schools were recruited in April, 2011 and randomized by school into treatment or control conditions. Participants included 213 children (mean age = 10.72 years ± 0.6; 52.2% female) with the treatment group (n = 118) completing the 8-week Fit-4-Fun Program. Participants were assessed at baseline and 6-month follow-up, with a 91% retention rate. Cardio-respiratory fitness (CRF) (20 m shuttle run) was the primary outcome, and secondary outcomes included body composition (BMI, BMI(Z)), muscular fitness (7-stage sit-up test, push-up test, basketball throw test, Standing Jump), flexibility (sit and reach) and physical activity (7 days pedometry). After 6-months, significant treatment effects were found for CRF (adjusted mean difference, 1.14 levels, p < 0.001), body composition (BMI mean, -0.96 kg/m(2), p < 0.001 and BMI z-score mean -0.47 z-scores, p < 0.001), flexibility (sit and reach mean, 1.52 cm, p = 0.0013), muscular fitness (sit-ups) (mean 0.62 stages, p = 0.003) and physical activity (mean, 3253 steps/day, p < 0.001). There were no group by time effects for the other muscular fitness measures. A primary school-based intervention focusing on fitness education significantly improved health-related fitness and physical activity levels in children. Copyright © 2012 Elsevier Inc. All rights reserved.

School level contextual factors are associated with the weight status of adolescent males and females.

PubMed

Richmond, Tracy K; Subramanian, S V

2008-06-01

To determine whether school context influences the BMI of adolescent males and females. Our sample was 17,007 adolescents (aged 12-19) from the National Longitudinal Study of Adolescent Health (Add Health). We used gender-stratified multilevel modeling to examine the contribution of schools to the overall variance in adolescent BMIs, calculated from self-reported weight and height. We then examined the associations of individual attributes with BMI after controlling for the average BMI of the school and the association of two school-level variables with BMI. Participants attended schools that were segregated by race/ethnicity and socioeconomic status (SES). In females, when controlling only for individual-level attributes, individual household income was inversely associated (beta = -0.043, P = 0.01) while Hispanic (beta = 0.89, P < 0.001) and black (beta = 1.61, P < 0.001) race/ethnicity were positively associated with BMI. In males, Hispanic (beta = 0.67, P < 0.001) race/ethnicity was positively associated with BMI; there was no difference in the BMIs of blacks compared with whites (beta = 0.24, P = 0.085). After controlling for the school racial/ethnic makeup and the school level median household income, the relationship between individual race/ethnicity and BMI was attenuated in both male and female adolescents. Higher school level median household income was associated with lower individual BMIs in adolescent girls (gamma = -0.37, P < 0.001) and boys (gamma = -0.29, P < 0.001) suggesting a contextual effect of the school. Male and female adolescents attending schools with higher median household incomes have on average lower BMIs. Resources available to or cultural norms within schools may constitute critical mechanisms through which schools impact the BMI of their students.

Healthy weight regulation and eating disorder prevention in high school students: a universal and targeted Web-based intervention.

PubMed

Jones, Megan; Taylor Lynch, Katherine; Kass, Andrea E; Burrows, Amanda; Williams, Joanne; Wilfley, Denise E; Taylor, C Barr

2014-02-27

Given the rising rates of obesity in children and adolescents, developing evidence-based weight loss or weight maintenance interventions that can be widely disseminated, well implemented, and are highly scalable is a public health necessity. Such interventions should ensure that adolescents establish healthy weight regulation practices while also reducing eating disorder risk. This study describes an online program, StayingFit, which has two tracks for universal and targeted delivery and was designed to enhance healthy living skills, encourage healthy weight regulation, and improve weight/shape concerns among high school adolescents. Ninth grade students in two high schools in the San Francisco Bay area and in St Louis were invited to participate. Students who were overweight (body mass index [BMI] >85th percentile) were offered the weight management track of StayingFit; students who were normal weight were offered the healthy habits track. The 12-session program included a monitored discussion group and interactive self-monitoring logs. Measures completed pre- and post-intervention included self-report height and weight, used to calculate BMI percentile for age and sex and standardized BMI (zBMI), Youth Risk Behavior Survey (YRBS) nutrition data, the Weight Concerns Scale, and the Center for Epidemiological Studies Depression Scale. A total of 336 students provided informed consent and were included in the analyses. The racial breakdown of the sample was as follows: 46.7% (157/336) multiracial/other, 31.0% (104/336) Caucasian, 16.7% (56/336) African American, and 5.7% (19/336) did not specify; 43.5% (146/336) of students identified as Hispanic/Latino. BMI percentile and zBMI significantly decreased among students in the weight management track. BMI percentile and zBMI did not significantly change among students in the healthy habits track, demonstrating that these students maintained their weight. Weight/shape concerns significantly decreased among participants in both tracks who had elevated weight/shape concerns at baseline. Fruit and vegetable consumption increased for both tracks. Physical activity increased among participants in the weight management track, while soda consumption and television time decreased. Results suggest that an Internet-based, universally delivered, targeted intervention may support healthy weight regulation, improve weight/shape concerns among participants with eating disorders risk, and increase physical activity in high school students. Tailored content and interactive features to encourage behavior change may lead to sustainable improvements in adolescent health.

BMI, health behaviors, and quality of life in children and adolescents: a school-based study.

PubMed

Chen, Gang; Ratcliffe, Julie; Olds, Tim; Magarey, Anthea; Jones, Michelle; Leslie, Eva

2014-04-01

To explore the relationship between weight status (BMI) and health-related quality of life in children and adolescents through application of the Child Health Utility 9D, a new generic preference-based instrument. Data were collected from primary and high school students in rural and metropolitan regions of South Australia. Consenting participants (2588 in grades 4-6 and 765 in grades 9-10) were weighed and measured and categorized as underweight, healthy weight, overweight, or obese according to International Obesity Taskforce BMI cutoff points (primary outcome). Participants also completed a questionnaire including the Child Health Utility 9D and standardized measures of physical activity, sedentary behavior, sleep patterns, and eating behavior (secondary outcomes). Descriptive and multivariate linear regression analyses were undertaken to calculate mean utility differences. In comparison with healthy-weight primary school students, adjusted mean utilities were lower for overweight (-0.016, P = .02) or obese (-0.039, P = .001) students. For high school students, the adjusted mean utilities were also lower for overweight and obese students but were nonsignificant (-0.018, P > .10). Physical activity, sedentary behavior, sleep patterns, and eating behavior were all found to be significantly associated with utilities. Irrespective of BMI, young people engaging in more physical activities or less sedentary behavior, and having healthier sleep patterns or eating behavior exhibited higher utilities. Associations between utilities and sleep patterns or eating behavior were stronger than the associations with BMI. Future economic evaluations for obesity interventions should more formally investigate the relationship between changes over time in weight status and health-related quality of life for children and adolescents.

The Influence of Parental Health Literacy Status on Reach, Attendance, Retention, and Outcomes in a Family-Based Childhood Obesity Treatment Program, Virginia, 2013-2015.

PubMed

Zoellner, Jamie M; Hill, Jennie; You, Wen; Brock, Donna; Frisard, Madlyn; Alexander, Ramine; Silva, Fabiana; Price, Bryan; Marshall, Ruby; Estabrooks, Paul A

2017-09-28

Few interventions have evaluated the influence of parent health literacy (HL) status on weight-related child outcomes. This study explores how parent HL affects the reach, attendance, and retention of and outcomes in a 3-month multicomponent family-based program to treat childhood obesity (iChoose). This pre-post, quasiexperimental trial occurred in the Dan River Region, a federally designated medically underserved area. iChoose research protocol and intervention strategies were designed using an HL universal precautions approach. We used validated measures, standardized data collection techniques, and generalized linear mixed-effect parametric models to determine the moderation effect of parent HL on outcomes. No significant difference in HL scores were found between parents who enrolled their child in the study and those who did not. Of 94 enrolled parents, 34% were low HL, 49% had an annual household income of less than $25,000, and 39% had a high school education or less. Of 101 enrolled children, 60% were black, and the mean age was 9.8 (standard deviation, 1.3) years. Children of parents with both low and high HL attended and were retained at similar rates. Likewise, parent HL status did not significantly influence improvements in effectiveness outcomes (eg, child body mass index [BMI] z scores, parent BMI, diet and physical activity behaviors, quality of life), with the exception of child video game/computer screen time; low HL decreased and high HL increased screen time (coefficient = 0.52, standard error, 0.11, P < .001). By incorporating design features that attended to the HL needs of parents, children of parents with low HL engaged in and benefited from a family-based childhood obesity treatment program similar to children of parents with high HL.

Prevalence of obesity and motor performance capabilities in Tyrolean preschool children.

PubMed

Greier, Klaus; Riechelmann, Herbert; Burtscher, Martin

2014-07-01

The childrens' world of movement has changed dramatically during the last decades. As a consequence motor performance decreases particularly in children affected by overweight and obesity. This study analyses the influence of the body mass index (BMI) on motor performance of pre-school children. In a cross-sectional study including 41 kindergartens in Tyrol (Austria), 4- to 5-year-old children (n = 1,063) were recruited. Four BMI groups were used according to a German BMI reference system: Group I (anorexic/underweight), group II (normal weight), group III (overweight) and group IV (obese). Motor performance was assessed by the use of the Karlsruhe Motorik-Screening (KMS 3-6). Out of the 1,063 preschool children (550 ♂, 513 ♀) 7.6 % (n = 81) were overweight and 5.5 % (n = 58) were obese. The results demonstrate that motor performance of under- and overweight preschool-children is not different from children with normal BMI, but obese children had significantly lower motor performance (p < 0.001). The prevalence of overweight and obese Tyrolean preschool children is similar to those of non-mountainous areas of Austria and Germany. The fact that motor performance is reduced only in obese children suggests that targeted promotion of physical activity is urgently needed for preschool children particularly considering children with a risk to develop obesity. Besides the efforts of parents, nursery schools are the ideal setting for intervention measures.

Parental body mass index is associated with adolescent overweight and obesity in Mashhad, Iran.

PubMed

Shafaghi, Khosro; Shariff, Zalilah Mohd; Taib, Mohd Nasir Mohd; Rahman, Hejar Abdul; Mobarhan, Majid Ghayour; Jabbari, Hadi

2014-01-01

This cross-sectional study was carried out to determine the prevalence of overweight and obesity among secondary school children aged 12 to 14 years in the city of Mashhad, Iran and its association with parental body mass index. A total of 1189 secondary school children (579 males and 610 females) aged 12- 14 years old were selected through a stratified multistage random sampling. All adolescents were measured for weight and height. Household socio-demographic information and parental weight and height were self-reported by parents. Adolescents were classified as overweight or obese based on BMI-for age Z-score. Multivariable logistic Regression (MLR) determined the relationship between parental BMI and adolescent overweight and obesity. The overall prevalence of overweight and obesity among secondary school children in Mashhad was 17.2% and 11.9%, respectively. A higher proportion of male (30.7%) than female (27.4%) children were overweight or obese. BMI of the children was significantly related to parental BMI (p<0.001), gender (p= 0.02), birth order (p<0.01), parents' education level (p<0.001), father's employment status (p<0.001), and family income (p<0.001). MLR showed that the father's BMI was significantly associated with male BMI (OR: 2.02) and female BMI (OR: 1.59), whereas the mother's BMI was significantly associated with female BMI only (OR: 0.514). The high prevalence of overweight/obesity among the research population compared with previous studies in Iran could be related to the changing lifestyle of the population. The strong relationship with parental BMI was probably related to a combination of genetic and lifestyle factors. Strategies to address childhood obesity should consider the interaction of these factors.

Physical Activity and Screen-based Activity in Healthy Development of School-aged Children.

PubMed

Hamřík, Zdeněk; Bobáková, Daniela; Kalman, Michal; Veselská, Zuzana Dankulincová; Klein, Daniel; Gecková, Andrea Madarasová

2015-11-01

Physical and screen-based activity in adolescents plays a crucial role in future health outcomes. Therefore, the aim of the study was to examine the associations of physical activity and screen-based activity with behavioural and psychosocial characteristics of school-aged children. Data on 11, 13 and 15 years old elementary school pupils (N=9,014; mean age=13.59) who participated in the cross-sectional Health Behaviour in School-aged Children 2009/2010 study in the Czech Republic and the Slovak Republic were analyzed. The associations of vigorous physical activity and screen-based activity with substance use, violent behaviour, eating habits and school-related outcomes adjusted for age were explored using logistic regression. Vigorous physical activity was positively associated with some of the health-related behaviours (smoking, breakfast consumption, vegetable and fruit consumption) and school related outcomes (perceived school achievement and school pressure), with gender and country based differences. Screen-based activity was significantly associated with all examined health-related behaviours and school related outcomes with only some country and gender based differences. Vigorous physical activity is positively associated with healthy development of adolescents. Screen-based behaviour shows an inverse relationship with adolescents' healthy development, especially in the group of 11 and 13 years old children. Supporting physical activity conducive environments might lead to a reduction in screen-based behaviour in adolescents and should be highlighted in health-promoting strategies. Copyright© by the National Institute of Public Health, Prague 2015.

School scoliosis screening programme-a systematic review.

PubMed

Sabirin, J; Bakri, R; Buang, S N; Abdullah, A T; Shapie, A

2010-12-01

A systematic review on the effectiveness and cost-effectiveness of school scoliosis screening programme was carried out. A total of 248 relevant titles were identified, 117 abstracts were screened and 28 articles were included in the results. There was fair level of evidence to suggest that school scoliosis screening programme is safe, contributed to early detection and reduction of surgery. There was also evidence to suggest that school-based scoliosis screening programme is cost-effective. Based on the above review, screening for scoliosis among school children is recommended only for high risk group such as girls at twelve years of age.

Postnatal BMI changes in children with different birthweights: A trial study for detecting early predictive factors for pediatric obesity

PubMed Central

Nakagawa, Yuichi; Nakanishi, Toshiki; Satake, Eiichiro; Matsushita, Rie; Saegusa, Hirokazu; Kubota, Akira; Natsume, Hiromune; Shibata, Yukinobu; Fujisawa, Yasuko

2018-01-01

Abstract. The purpose of this study was to clarify the degree of early postnatal growth by birthweight and detect early predictive factors for pediatric obesity. Body mass index (BMI) and degree of obesity were examined in children in the fourth year of elementary school and second year of junior high school. Their BMI at birth and three years of age were also examined. Based on birthweight, participants were divided into three groups: low (< 2500 g), middle (2500–3500 g), and high (> 3500 g). Furthermore, according to the degree of obesity, they were divided into two groups: obese (20% ≤) and non-obese (20% >). The change of BMI from birth to three years of age (ΔBMI) showed a strong inverse relationship with birthweight and was significantly different among the three birthweight groups (low > middle > high). The ΔBMI and BMI at three years of age were higher in obese than in non-obese children and showed significant positive correlations with the degree of obesity. Early postnatal growth might be determined by birthweight and was higher in obese than in non-obese children. The ΔBMI from birth to three years of age and BMI at age of three years could be predictive factors for pediatric obesity. PMID:29403153

The Trajectory and the Related Physical and Social Determinants of Body Mass Index in Elementary School Children: Results from the Child and Adolescent Behaviors in Long-Term Evolution Study

PubMed Central

Chang, Hsing-Yi; Luh, Dih-Ling; Hurng, Baai-Shyun; Yen, Lee-Lan

2014-01-01

This study explored developmental trajectory patterns of BMI and associated factors. Participants included 1,609 students who were followed from age 7 to 12 years. Data collection involved annual self-administered questionnaires and records of height and weight. An ecological model was used to identify the factors associated with BMI trajectories. Group-based trajectory models and multinomial logit models were used in the statistical analysis. There were gender differences in BMI trajectories. Among boys, four BMI trajectories were normal or slightly underweight, persistently normal weight, overweight becoming obese, and persistently obese. Among girls, four BMI trajectories were persistently slightly underweight, persistently normal weight, persistently overweight, and persistently obese. The mean BMI in each trajectory group demonstrated an upward trend over time. In boys, BMI trajectories were significantly associated with after-school exercise, academic performance, family interactions, overweight parents, and father's education level. In girls, BMI trajectories were significantly associated with television viewing or computer use, family interactions, peer interactions, and overweight parents. Children under age 7 years who are already overweight or obese are an important target for interventions. The different factors associated with BMI trajectories can be used for targeting high risk groups. PMID:25114800

Effective multi-level, multi-sector, school-based obesity prevention programming improves weight, blood pressure, and academic performance, especially among low-income, minority children.

PubMed

Hollar, Danielle; Lombardo, Michelle; Lopez-Mitnik, Gabriella; Hollar, Theodore L; Almon, Marie; Agatston, Arthur S; Messiah, Sarah E

2010-05-01

Successfully addressing childhood onset obesity requires multilevel (individual, community, and governmental), multi-agency collaboration. The Healthier Options for Public Schoolchildren (HOPS)/OrganWise Guys (OWG) quasi-experimental controlled pilot study (four intervention schools, one control school, total N=3,769; 50.2% Hispanic) was an elementary school-based obesity prevention intervention designed to keep children at a normal, healthy weight, and improve health status and academic achievement. The HOPS/OWG included the following replicable, holistic components: (1) modified dietary offerings, (2) nutrition/lifestyle educational curricula; (3) physical activity component; and (4) wellness projects. Demographic, anthropometric (body mass index [BMI]), blood pressure, and academic data were collected during the two-year study period (2004-6). Statistically significant improvements in BMI, blood pressure, and academic scores, among low-income Hispanic and White children in particular, were seen in the intervention versus controls. Holistic school-based obesity prevention interventions can improve health outcomes and academic performance, in particular among high-risk populations.

Comparison of the prevalence of malnutrition diagnosis in head and neck, gastrointestinal and lung cancer patients by three classification methods

PubMed Central

Platek, Mary E.; Popp KPf, Johann V.; Possinger, Candi S.; DeNysschen, Carol A.; Horvath, Peter; Brown, Jean K.

2011-01-01

Background Malnutrition is prevalent among patients within certain cancer types. There is lack of universal standard of care for nutrition screening, lack of agreement on an operational definition and on validity of malnutrition indicators. Objective In a secondary data analysis, we investigated prevalence of malnutrition diagnosis by three classification methods using data from medical records of a National Cancer Institute (NCI)-designated comprehensive cancer center. Interventions/Methods Records of 227 patients hospitalized during 1998 with head and neck, gastrointestinal or lung cancer were reviewed for malnutrition based on three methods: 1) physician diagnosed malnutrition related ICD-9 codes; 2) in-hospital nutritional assessment summary conducted by Registered Dietitians; and 3) body mass index (BMI). For patients with multiple admissions, only data from the first hospitalization was included. Results Prevalence of malnutrition diagnosis ranged from 8.8% based on BMI to approximately 26% of all cases based on dietitian assessment. Kappa coefficients between any methods indicated a weak (kappa=0.23, BMI and Dietitians and kappa=0.28, Dietitians and Physicians) to fair strength of agreement (kappa=0.38, BMI and Physicians). Conclusions Available methods to identify patients with malnutrition in an NCI designated comprehensive cancer center resulted in varied prevalence of malnutrition diagnosis. Universal standard of care for nutrition screening that utilizes validated tools is needed. Implications for Practice The Joint Commission on the Accreditation of Healthcare Organizations requires nutritional screening of patients within 24 hours of admission. For this purpose, implementation of a validated tool that can be used by various healthcare practitioners, including nurses, needs to be considered. PMID:21242767

School gardens and adolescent nutrition and BMI: Results from a national, multilevel study.

PubMed

Utter, Jennifer; Denny, Simon; Dyson, Ben

2016-02-01

The aim of the current study was to determine the impact of school gardens on student eating behaviors, physical activity and BMI in New Zealand secondary schools. The current study also aimed to determine if school gardens could buffer the association between household poverty and adolescent BMI. Data were drawn from a national study of the health and wellbeing of New Zealand secondary school students (n=8500) conducted in 2012. Multilevel regression models were used to determine the association between school gardens (school-level) and student nutrition behaviors, physical activity and measured BMI (student-level). Approximately half of secondary schools had a fruit/vegetable garden for students to participate in. School gardens were associated with lower student BMI (p=0.01) and lower prevalence of overweight (p<0.01). School gardens appear to have a positive impact on student health. Future research may explore how school gardens are implemented to better understand their impact and to extend the benefits beyond the school community. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving Community Health While Satisfying a Critical Community Need: A Case Study for Nonprofit Hospitals

PubMed Central

Kephart, Donna K.; Dillon, Judith F.; McCullough, Jody R.; Blatt, Barbara J.; Kraschnewski, Jennifer L.

2015-01-01

Background School-based student health screenings identify issues that may affect physical and intellectual development and are an important way to maintain student health. Nonprofit hospitals can provide a unique resource to school districts by assisting in the timely completion of school-based screenings and meet requirements of the Affordable Care Act. This case study describes the collaboration between an academic medical center and a local school district to conduct school-based health screenings. Community Context Penn State Milton S. Hershey Medical Center and Penn State Hershey PRO Wellness Center collaborated with Lebanon School District to facilitate student health screenings, a need identified in part by a community health needs assessment. Methods From June 2012 through February 2013, district-wide student health screenings were planned and implemented by teams of hospital nursing leadership, school district leadership, and school nurses. In fall 2013, students were screened through standardized procedures for height, weight, scoliosis, vision, and hearing. Outcomes In 2 days, 3,105 students (67% of all students in the district) were screened. Letters explaining screening results were mailed to parents of all students screened. Debriefing meetings and follow-up surveys for the participating nurses provided feedback for future screenings. Interpretation The 2-day collaborative screening event decreased the amount of time spent by school nurses in screening students throughout the year and allowed them more time in their role as school wellness champion. Additionally, parents found out early in the school year whether their child needed physician follow-up. Partnerships between school districts and hospitals to conduct student health screenings are a practical option for increasing outreach while satisfying community needs. PMID:26513441

Compañeros: High School Students Mentor Middle School Students to Address Obesity Among Hispanic Adolescents.

PubMed

Arlinghaus, Katherine R; Moreno, Jennette P; Reesor, Layton; Hernandez, Daphne C; Johnston, Craig A

2017-10-12

Promotoras, Hispanic community health workers, are frequently employed to promote health behavioral change with culturally bound Hispanic lifestyle behaviors. Peer health mentors have been used in schools to promote healthy nutrition and physical activity behaviors among students. This study investigates the efficacy of combining these 2 approaches by training high school health mentors, called compañeros, to engage Hispanic middle school students in a school-based obesity intervention as a strategy to promote and sustain reductions in standardized body mass index (zBMI). High school compañeros were trained to participate in a 6-month obesity program alongside middle school students in Houston, Texas. Middle school students were randomized to participate in the program either with compañeros (n = 94) or without compañeros (n = 95). The intervention was conducted from 2013 through 2016 in 3 cohorts of students, 1 each school year. Students were followed for 12 months. The primary outcome was zBMI, which was analyzed at baseline, 6 months, and 12 months. Significant differences were found between conditions across time (F = 4.58, P = .01). After the 6-month intervention, students in the condition with compañeros had a larger decrease in zBMI (F = 6.94, P = .01) than students in the condition without compañeros. Furthermore, students who received the intervention with compañeros showed greater sustained results at 12 months (F = 7.65, P = .01). Using high school compañeros in an obesity intervention for Hispanic middle school students could be effective in promoting and maintaining reductions in zBMI.

Psychosis screening practices in schools: A survey of school-based mental health providers.

PubMed

Kline, Emily R; Chokran, Cole; Rodenhiser-Hill, Janine; Seidman, Larry J; Woodberry, Kristen A

2018-05-04

Many school districts in the United States employ mental health professionals to provide assessment, counselling and crisis interventions within the school setting; however, little is known about actual clinical practices of psychosis screening in schools. The aim of the present study is to examine attitudes and practices regarding psychosis screening among school mental health providers in metropolitan Boston, Massachusetts. School-based mental health clinicians (N = 100) completed an anonymous survey assessing familiarity, screening, and involvement with psychosis and psychosis risk prior to attending trainings on psychosis. Providers reported screening for psychosis less often than other mental health problems and rated themselves as less confident treating psychosis relative to other mental health concerns. Frequency of screening for psychosis was significantly associated with familiarity with psychosis assessment and case management, confidence providing treatment for individuals experiencing psychosis, and the number of students with or at risk for psychosis with whom providers had been involved. Frequency of screening for psychosis was not associated with years of practice, suggesting that both novice and experienced school-based providers may benefit from training on this issue. Community outreach via school-based provider training on assessment and management of psychosis may help to increase providers' understanding of psychosis and increase the practice of verbal or written screening for psychosis and psychosis risk within schools. © 2018 John Wiley & Sons Australia, Ltd.

Body Mass Index Is Better than Other Anthropometric Indices for Identifying Dyslipidemia in Chinese Children with Obesity

PubMed Central

Jing, Jin; Ma, Jun; Chen, Yajun; Li, Xiuhong; Yang, Wenhan; Guo, Li; Jin, Yu

2016-01-01

Background Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are used in screening and predicting obesity in adults. However, the best identifier of metabolic complications in children with obesity remains unclear. This study evaluated lipid profile distribution and investigated the best anthropometric parameter in association with lipid disorders in children with obesity. Methods A total of 2243 school children aged 7–17 years were enrolled in Guangzhou, China, in 2014. The anthropometric indices and lipid profiles were measured. Dyslipidemia was defined according to the US Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. The association between anthropometry (BMI, WC, and WHR) and lipid profile values was examined using chi-square analysis and discriminant function analysis. Information about demography, physical activity, and dietary intake was provided by the participant children and their parents. Results Children aged 10–14 and 15–17 years old generally had higher triglyceride values but lower median concentration of total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol compared with children aged 7–9 years old (all P < 0.001). These lipid parameters fluctuated in children aged 10–14 years old. The combination of age groups, BMI, WC and WHR achieved 65.1% accuracy in determining dyslipidemic disorders. BMI correctly identified 77% of the total dyslipidemic disorders in obese children, which was higher than that by WHR (70.8%) (P< 0.05). Conclusion The distribution of lipid profiles in Chinese children differed between younger and older age groups, and the tendency of these lipid levels remarkably fluctuated during 10 to 14 years old. BMI had better practical utility in identifying dyslipidemia among school-aged children with obesity compared with other anthropometric measures. PMID:26963377

Body Mass Index Is Better than Other Anthropometric Indices for Identifying Dyslipidemia in Chinese Children with Obesity.

PubMed

Zhu, Yanna; Shao, Zixian; Jing, Jin; Ma, Jun; Chen, Yajun; Li, Xiuhong; Yang, Wenhan; Guo, Li; Jin, Yu

2016-01-01

Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are used in screening and predicting obesity in adults. However, the best identifier of metabolic complications in children with obesity remains unclear. This study evaluated lipid profile distribution and investigated the best anthropometric parameter in association with lipid disorders in children with obesity. A total of 2243 school children aged 7-17 years were enrolled in Guangzhou, China, in 2014. The anthropometric indices and lipid profiles were measured. Dyslipidemia was defined according to the US Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. The association between anthropometry (BMI, WC, and WHR) and lipid profile values was examined using chi-square analysis and discriminant function analysis. Information about demography, physical activity, and dietary intake was provided by the participant children and their parents. Children aged 10-14 and 15-17 years old generally had higher triglyceride values but lower median concentration of total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol compared with children aged 7-9 years old (all P < 0.001). These lipid parameters fluctuated in children aged 10-14 years old. The combination of age groups, BMI, WC and WHR achieved 65.1% accuracy in determining dyslipidemic disorders. BMI correctly identified 77% of the total dyslipidemic disorders in obese children, which was higher than that by WHR (70.8%) (P< 0.05). The distribution of lipid profiles in Chinese children differed between younger and older age groups, and the tendency of these lipid levels remarkably fluctuated during 10 to 14 years old. BMI had better practical utility in identifying dyslipidemia among school-aged children with obesity compared with other anthropometric measures.

Predicting failure to follow-up screened high blood pressure in Japan: a cohort study.

PubMed

Kuriyama, Akira; Takahashi, Yoshimitsu; Tsujimura, Yuka; Miyazaki, Kikuko; Satoh, Toshihiko; Ikeda, Shunya; Nakayama, Takeo

2015-09-01

This study aimed to determine the prevalence and predictors of working-age individuals who did not follow-up for possible hypertension that was detected in the population-based screening. We conducted a retrospective cohort study, using the database of health insurance claims and health checkups from several health insurance societies for employees in Japan. Screened participants aged ≥20 years, with possible hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) and without known antihypertensive treatment, were included. The outcome was lack of clinical follow-up for possible hypertension within 6 months of the latest screening. Multivariate logistic regression analysis was performed to identify predictors. Among 17,173 participants (15,793 males and 1380 females) who were identified as possible hypertensives, 89.7 and 82.3% of them, respectively, did not consult physicians for screened possible hypertension. Predictors of no clinical follow-up for males included younger age, lower body mass index (BMI), lower hemoglobin A1c and milder hypertension. Predictors for females included younger age, lower BMI and being insured. Approximately 80% of participants failed to consult physicians even with positive screening results. Younger individuals with lower BMI are at high risk of no clinical follow-up. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Predictors of advanced colorectal neoplasia for colorectal cancer screening.

PubMed

Wong, Martin C S; Lam, Thomas Y T; Tsoi, Kelvin K F; Chan, Victor C W; Hirai, Hoyee W; Ching, Jessica Y L; Sung, Joseph J Y

2014-05-01

The Asia-Pacific Colorectal Screening (APCS) score based on age, gender, family history, and smoking is useful to predict advanced colorectal neoplasia (ACN) in asymptomatic Asian subjects. To evaluate the factors in addition to those of APCS associated with ACN colonoscopic findings. Data from 5,220 asymptomatic subjects aged between 50 and 70 years who underwent screening colonoscopy in a community center between 2008 and 2012 were analyzed. One binary logistic regression analysis was conducted in 2013 with the presence of ACN or cancer as the outcome, controlling for APCS score, alcohol consumption, BMI, hypertension, and other chronic diseases as independent variables. The average participant age was 57.7 years (SD=4.9) and 47.5% were men. Advanced neoplasms or cancers were identified at colonoscopy in 5.6% of all screening participants. From multivariate regression analysis, APCS score≥4 (adjusted OR [AOR]=1.74, 95% CI=1.34, 2.25, p<0.001); overweight (BMI=23-24.9, AOR=1.52, 95% CI=1.12, 2.07, p=0.007); obesity (BMI≥25, AOR=1.56, 95% CI=1.15, 2.10, p=0.004); hypertension (AOR=1.58, 95% CI=1.21, 2.06, p=0.001); and alcohol consumption (AOR=1.47, 95% CI=1.05, 2.06, p=0.025) were associated with ACN. The c-statistic of APCS score alone was 0.560 (95% CI=0.524, 0.595, p=0.001) and that of APCS score plus BMI, hypertension, and alcohol consumption was 0.613 (95% CI=0.578, 0.648, p<0.001). Alcohol consumption, hypertension, and BMI are independent predictors of ACN, which could be incorporated into the APCS for prioritizing Asian asymptomatic subjects for colorectal cancer screening. Copyright © 2014. Published by Elsevier Inc.

The MATCH Program: Long-Term Obesity Prevention Through a Middle School Based Intervention.

PubMed

Lazorick, Suzanne; Fang, Xiangming; Crawford, Yancey

2016-04-01

Motivating Adolescents with Technology to CHOOSE Health™ (MATCH) has been provided for eight years in North Carolina middle schools with high obesity prevalence. Seventh grade teachers in two schools delivered MATCH lessons in 2009, with one control school. In 2013 students were remeasured and completed a health behavior survey. Outcomes include BMI, BMI z-score (zBMI), weight category, and self-reported behaviors. Comparisons used t tests (continuous measures), Fisher's exact test (categorical measures), and linear mixed models (trend between groups). Of original participants, 104/189 (55%) of MATCH and 117/173 (68%) of control were remeasured. In the control group, retained participants had lower baseline BMI and were higher percent white. Among all participants, zBMI decreased in MATCH (mean change -0.15 with SD = 0.60) and increased in control (mean change 0.04 with SD = 0.52); between groups p = 0.02. In mixed models for the all overweight subgroup, MATCH had a downward trend in zBMI over time that was significantly different from control (slope MATCH -0.0036 versus control 0.0009; p = 0.01). For shifts in weight category: incidence of obesity was lower in MATCH (13%) versus control (39%); remission of overweight to healthy weight was greater in MATCH (40%) versus control (26%). MATCH participants self-reported lower frequency of intake of sweetened beverages and snacks and hours of weekday TV time than control students. MATCH participation can result in long-term prevention of obesity compared to control, with differences in self-reported health behavior changes to support an underlying mechanism for the observed BMI differences.

Summer effects on body mass index (BMI) gain and growth patterns of American Indian children from kindergarten to first grade: a prospective study

PubMed Central

2011-01-01

Background Overweight and obesity are highly prevalent among American Indian children, especially those living on reservations. There is little scientific evidence about the effects of summer vacation on obesity development in children. The purpose of this study was to investigate the effects of summer vacation between kindergarten and first grade on growth in height, weight, and body mass index (BMI) for a sample of American Indian children. Methods Children had their height and weight measured in four rounds of data collection (yielded three intervals: kindergarten, summer vacation, and first grade) as part of a school-based obesity prevention trial (Bright Start) in a Northern Plains Indian Reservation. Demographic variables were collected at baseline from parent surveys. Growth velocities (Z-score units/year) for BMI, weight, and height were estimated and compared for each interval using generalized linear mixed models. Results The children were taller and heavier than median of same age counterparts. Height Z-scores were positively associated with increasing weight status category. The mean weight velocity during summer was significantly less than during the school year. More rapid growth velocity in height during summer than during school year was observed. Obese children gained less adjusted-BMI in the first grade after gaining more than their counterparts during the previous two intervals. No statistically significant interval effects were found for height and BMI velocities. Conclusions There was no indication of a significant summer effect on children's BMI. Rather than seasonal or school-related patterns, the predominant pattern indicated by weight-Z and BMI-Z velocities might be related to age or maturation. Trial registration Bright Start: Obesity Prevention in American Indian Children Clinical Trial Govt ID# NCT00123032 PMID:22192795

Physical growth and nonverbal intelligence: associations in Zambia.

PubMed

Hein, Sascha; Reich, Jodi; Thuma, Philip E; Grigorenko, Elena L

2014-11-01

To investigate normative developmental body mass index (BMI) trajectories and associations of physical growth indicators--height, weight, head circumference (HC), and BMI--with nonverbal intelligence in an understudied population of children from sub-Saharan Africa. A sample of 3981 students (50.8% male), grades 3-7, with a mean age of 12.75 years was recruited from 34 rural Zambian schools. Children with low scores on vision and hearing screenings were excluded. Height, weight, and HC were measured, and nonverbal intelligence was assessed using the Universal Nonverbal Intelligence Test, Symbolic Memory subtest and Kaufman Assessment Battery for Children, Second Edition, Triangles subtest. Students in higher grades had a higher BMI over and above the effect of age. Girls had a marginally higher BMI, although that for both boys and girls was approximately 1 SD below the international Centers for Disease Control and Prevention and World Health Organization norms. When controlling for the effect of age, nonverbal intelligence showed small but significant positive relationships with HC (r = 0.17) and BMI (r = 0.11). HC and BMI accounted for 1.9% of the variance in nonverbal intelligence, over and above the contribution of grade and sex. BMI-for-age growth curves of Zambian children follow observed worldwide developmental trajectories. The positive relationships between BMI and intelligence underscore the importance of providing adequate nutritional and physical growth opportunities for children worldwide and in sub-Saharan Africa in particular. Directions for future studies are discussed with regard to maximizing the cognitive potential of all rural African children. Copyright © 2014 Elsevier Inc. All rights reserved.

Large calf circumference indicates non-sarcopenia despite body mass

PubMed Central

Kusaka, Satomi; Takahashi, Tetsuya; Hiyama, Yoshinori; Kusumoto, Yasuaki; Tsuchiya, Junko; Umeda, Masaru

2017-01-01

[Purpose] The purpose of this study is to evaluate the applicability of the calf circumference as a tool for screening sarcopenia. [Subjects and Methods] One hundred sixteen community-dwelling elderly females were enrolled. Calf circumference of the dominant leg was measured using a plastic measuring tape. Subjects were divided into 3 groups based on body mass index (BMI); subjects with the values for BMI <18.5 kg/m2; those with BMI 18.5 to 25.0; those with BMI ≥25.0 kg/m2. Positive predictive value and negative predictive value of sarcopenia were calculated based on the obtained cut off values of calf circumference and the diagnosis of sarcopenia in each group. [Results] Prevalence rate of sarcopenia was 9.4% (n=10). Cut off value of the calf circumference was 32.8 cm (sensitivity: 73.0%, specificity: 80.0%, AUC: 0.792). Each BMI group showed high negative predictive value of sarcopenia based on the calf circumference cut off value of 32.8 cm. [Conclusion] These results suggested that to identify non-sarcopenia by larger calf circumference is more reasonable and useful than to identify sarcopenia due to the smaller calf circumference regardless of BMI. PMID:29200625

School effects on non-verbal intelligence and nutritional status in rural Zambia

PubMed Central

Hein, Sascha; Tan, Mei; Reich, Jodi; Thuma, Philip E.; Grigorenko, Elena L.

2015-01-01

This study uses hierarchical linear modeling (HLM) to examine the school factors (i.e., related to school organization and teacher and student body) associated with non-verbal intelligence (NI) and nutritional status (i.e., body mass index; BMI) of 4204 3rd to 7th graders in rural areas of Southern Province, Zambia. Results showed that 23.5% and 7.7% of the NI and BMI variance, respectively, were conditioned by differences between schools. The set of 14 school factors accounted for 58.8% and 75.9% of the between-school differences in NI and BMI, respectively. Grade-specific HLM yielded higher between-school variation of NI (41%) and BMI (14.6%) for students in grade 3 compared to grades 4 to 7. School factors showed a differential pattern of associations with NI and BMI across grades. The distance to a health post and teacher’s teaching experience were the strongest predictors of NI (particularly in grades 4, 6 and 7); the presence of a preschool was linked to lower BMI in grades 4 to 6. Implications for improving access and quality of education in rural Zambia are discussed. PMID:27175053

Associations between Food Outlets around Schools and BMI among Primary Students in England: A Cross-Classified Multi-Level Analysis.

PubMed

Williams, Julianne; Scarborough, Peter; Townsend, Nick; Matthews, Anne; Burgoine, Thomas; Mumtaz, Lorraine; Rayner, Mike

2015-01-01

Researchers and policy-makers are interested in the influence that food retailing around schools may have on child obesity risk. Most previous research comes from North America, uses data aggregated at the school-level and focuses on associations between fast food outlets and school obesity rates. This study examines associations between food retailing and BMI among a large sample of primary school students in Berkshire, England. By controlling for individual, school and home characteristics and stratifying results across the primary school years, we aimed to identify if the food environment around schools had an effect on BMI, independent of socio-economic variables. We measured the densities of fast food outlets and food stores found within schoolchildren's home and school environments using Geographic Information Systems (GIS) and data from local councils. We linked these data to measures from the 2010/11 National Child Measurement Programme and used a cross-classified multi-level approach to examine associations between food retailing and BMI z-scores. Analyses were stratified among Reception (aged 4-5) and Year 6 (aged 10-11) students to measure associations across the primary school years. Our multilevel model had three levels to account for individual (n = 16,956), home neighbourhood (n = 664) and school (n = 268) factors. After controlling for confounders, there were no significant associations between retailing near schools and student BMI, but significant positive associations between fast food outlets in home neighbourhood and BMI z-scores. Year 6 students living in areas with the highest density of fast food outlets had an average BMI z-score that was 0.12 (95% CI: 0.04, 0.20) higher than those living in areas with none. We found little evidence to suggest that food retailing around schools influences student BMI. There is some evidence to suggest that fast food outlet densities in a child's home neighbourhood may have an effect on BMI, particularly among girls, but more research is needed to inform effective policies targeting the effects of the retail environment on child obesity.

Associations between Food Outlets around Schools and BMI among Primary Students in England: A Cross-Classified Multi-Level Analysis

PubMed Central

Williams, Julianne; Scarborough, Peter; Townsend, Nick; Matthews, Anne; Burgoine, Thomas; Mumtaz, Lorraine; Rayner, Mike

2015-01-01

Introduction Researchers and policy-makers are interested in the influence that food retailing around schools may have on child obesity risk. Most previous research comes from North America, uses data aggregated at the school-level and focuses on associations between fast food outlets and school obesity rates. This study examines associations between food retailing and BMI among a large sample of primary school students in Berkshire, England. By controlling for individual, school and home characteristics and stratifying results across the primary school years, we aimed to identify if the food environment around schools had an effect on BMI, independent of socio-economic variables. Methods We measured the densities of fast food outlets and food stores found within schoolchildren’s home and school environments using Geographic Information Systems (GIS) and data from local councils. We linked these data to measures from the 2010/11 National Child Measurement Programme and used a cross-classified multi-level approach to examine associations between food retailing and BMI z-scores. Analyses were stratified among Reception (aged 4-5) and Year 6 (aged 10-11) students to measure associations across the primary school years. Results Our multilevel model had three levels to account for individual (n = 16,956), home neighbourhood (n = 664) and school (n = 268) factors. After controlling for confounders, there were no significant associations between retailing near schools and student BMI, but significant positive associations between fast food outlets in home neighbourhood and BMI z-scores. Year 6 students living in areas with the highest density of fast food outlets had an average BMI z-score that was 0.12 (95% CI: 0.04, 0.20) higher than those living in areas with none. Discussion We found little evidence to suggest that food retailing around schools influences student BMI. There is some evidence to suggest that fast food outlet densities in a child’s home neighbourhood may have an effect on BMI, particularly among girls, but more research is needed to inform effective policies targeting the effects of the retail environment on child obesity. PMID:26186610

The prevalence, risk factors, and screening measure for prediabetes and diabetes among Emirati overweight/obese children and adolescents.

PubMed

Al Amiri, Elham; Abdullatif, Mona; Abdulle, Abdishakur; Al Bitar, Nibal; Afandi, Elham Zaki; Parish, Monira; Darwiche, Gassan

2015-12-24

The aim of the study was to estimate the prevalence of prediabetes and type 2 diabetes (T2D) among overweight/obese children and adolescents using different diagnostic/screening methods in comparison. We recruited overweight/obese Emirati students; grade 6-12 (age 11-17 years) from 16 government schools in Sharjah (UAE). Anthropometric, demographic, and clinical history data was measured by standard methods. Body mass index (BMI) was categorized according to BMI percentile charts for age and sex - CDC. Capillary fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) were measured by finger prick test, followed by confirmatory oral glucose tolerance tests (OGTT) and venous HbA1c for students with abnormal capillary FBG and/or HbA1c. Of a total of 1034 participants (45 % females) median age 14.7 years, 443 (43 %) students had abnormal screening results. The prevalence of prediabetes and T2D was 5.4 % and 0.87 %, respectively, based on OGTT (gold standard). HbA1c showed a considerable discrepancy regarding the prevalence of prediabetes (21.9 %), but not diabetes. There was a statistically significant difference in the BMI Z-scores between the three different groups of students showing normal glycemic testing, prediabetes and T2D (p = 0.041). Univariate logistic regression analysis showed that glycemic status was significantly associated with family history of T2D first-degree relatives [OR 1.87: 95 % CI: 1.04-3.36; P = 0.036], parents employment [OR 1.79: 95 % CI: 1.06-3.02; P = 0.029] and levels of triglycerides [OR 2.28: 95 % CI: 1.11-4.68; P = 0.024]. The prevalence of prediabetes and diabetes was high among overweight/obese Emirati children and adolescents. The numbers for prediabetes were considerably higher when using HbA1c as compared to OGTT. Overall adiposity, family history of T2D, employment and high levels of triglycerides were risk factors associated with abnormal glycemic testing.

Obesity and Insulin Resistance Screening Tools in American Adolescents: National Health and Nutrition Examination Survey (NHANES) 1999 to 2010.

PubMed

Lee, Joey A; Laurson, Kelly R

2016-08-01

To identify which feasible obesity and insulin resistance (IR) screening tools are most strongly associated in adolescents by using a nationally representative sample. Adolescents aged 12.0 to 18.9 years who were participating in the National Health and Nutrition Examination Survey (NHANES) (n=3584) and who were measured for height, weight, waist circumference (WC), triceps and subscapular skinfold thickness, glycated hemoglobin, fasting glucose (FG) and fasting insulin (FI) level were included. Adolescents were split by gender and grouped by body mass index (BMI) percentile. Age- and gender-specific classifications were constructed for each obesity screening tool measure to account for growth and maturation. General linear models were used to establish groups objectively for analysis based on when IR began to increase. Additional general linear models were used to identify when IR significantly increased for each IR measure as obesity group increased and to identify the variance accounted for among each obesity-IR screening tool relationship. As the obesity group increased, homeostasis model assessment-insulin resistance (HOMA-IR) and FI significantly increased, while FG increased only (above the referent) in groups with BMI percentiles ≥95.0, and glycated hemoglobin level did not vary across obesity groups. The most strongly associated screening tools were WC and FI in boys (R(2)=0.253) and girls (R(2)=0.257). FI had the strongest association with all of the obesity measures. BMI associations were slightly weaker than WC in each in relation to IR. Our findings show that WC and FI are the most strongly associated obesity and IR screening tool measures in adolescents. These feasible screening tools should be utilized in screening practices for at-risk adolescents. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Body mass index predicts selected physical fitness attributes but is not associated with performance on military relevant tasks in U.S. Army Soldiers.

PubMed

Pierce, Joseph R; DeGroot, David W; Grier, Tyson L; Hauret, Keith G; Nindl, Bradley C; East, Whitfield B; McGurk, Michael S; Jones, Bruce H

2017-11-01

Army body composition standards are based upon validated criteria; however, certain field-expedient methodologies (e.g., weight-for-height, body mass index [BMI]) may disqualify individuals from service who may otherwise excel on physical performance and military-relevant tasks. The purpose was to assess soldier physical performance and military-specific task/fitness performance stratified by BMI. Cross-sectional observational study. Male (n=275) and female (n=46) soldiers performed a wide-array of physical fitness tests and military-specific tasks, including the Army physical fitness test (APFT). Within-sex performance data were analyzed by BMI tertile stratification or by Army Body Composition Program (ABCP) weight-for-height (calculated BMI) screening standards using ANOVA/Tukey post-hoc or independent t-tests, respectively. BMI stratification (higher vs. lower BMI) was associated with significant improvements in muscular strength and power, but also with decrements in speed/agility in male and female soldiers. Within the military specific tasks, a higher BMI was associated with an increased APFT 2-Mile Run time; however, performance on a 1600-m Loaded March or a Warrior Task and Battle Drill obstacle course was not related to BMI in either sex. Male and Female soldiers who did not meet ABCP screening standards demonstrated a slower 2-Mile Run time; however, not meeting the ABCP BMI standard only affected a minimal number (∼6%) of soldiers' ability to pass the APFT. Military body composition standards require a careful balance between physical performance, health, and military readiness. Allowances should be considered where tradeoffs exist between body composition classifications and performance on physical tasks with high military relevance. Published by Elsevier Ltd.

Developing a coordinated school health approach to child obesity prevention in rural Appalachia: results of focus groups with teachers, parents, and students.

PubMed

Schetzina, Karen E; Dalton, William T; Lowe, Elizabeth F; Azzazy, Nora; Vonwerssowetz, Katrina M; Givens, Connie; Stern, Harold P

2009-01-01

High prevalence rates of obesity, particularly among those residing in US rural areas, and associated physical and psychosocial health consequences, direct attention to the need for effective prevention programs. The current study describes an initial step in developing a school-based obesity prevention program in rural Appalachia, USA. The program, modeled on the Centers for Disease Control and Prevention Coordinated School Health (CSH) Program, includes a community-based participatory research approach to addressing the health needs specific to this region. Focus groups with teachers, parents, and 4th grade students were used to understand perceptions and school policy related to nutrition, physical activity, and the role of the school in obesity prevention. Results revealed that these community stakeholders were concerned about the problem of child obesity and supported the idea of their school doing more to improve the diet and physical activity of its students. Specifically, all groups thought that foods and drinks consumed by students at school should be healthier and that they should have more opportunities for physical activity. However, they cited limitations of the school environment, academic pressures, and lack of parental support as potential barriers to making such changes. Parents were most concerned that their children were not getting enough to eat and they and the teachers were not in favor of BMI screening at the school. Parents were in favor of increasing physical activity during school and thought that parent volunteers should help students select foods in the cafeteria. Students cited examples of how diet and physical activity affect their health and school performance, and thought that they should have more physical education time and recess. The data collected in the current study contributed to the limited knowledge base regarding rural populations as well as identified strengths and potential barriers to assist with the development of a pilot program based on the CSH model, Winning with Wellness.

Examining the Association Between School Vending Machines and Children's Body Mass Index by Socioeconomic Status.

PubMed

O'Hara, Jeffrey K; Haynes-Maslow, Lindsey

2015-01-01

To examine the association between vending machine availability in schools and body mass index (BMI) among subgroups of children based on gender, race/ethnicity, and socioeconomic status classifications. First-difference multivariate regressions were estimated using longitudinal fifth- and eighth-grade data from the Early Childhood Longitudinal Study. The specifications were disaggregated by gender, race/ethnicity, and family socioeconomic status classifications. Vending machine availability had a positive association (P < .10) with BMI among Hispanic male children and low-income Hispanic children. Living in an urban location (P < .05) and hours watching television (P < .05) were also positively associated with BMI for these subgroups. Supplemental Nutrition Assistance Program enrollment was negatively associated with BMI for low-income Hispanic students (P < .05). These findings were not statistically significant when using Bonferroni adjusted critical values. The results suggest that the school food environment could reinforce health disparities that exist for Hispanic male children and low-income Hispanic children. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Factors associated with Chlamydia trachomatis testing in a high school based screening and previously in clinical practice: a cross-sectional study in Norway

PubMed Central

2013-01-01

Background High school based chlamydia screening has been shown to increase uptake and detect hidden infections among sexually active adolescents. Our study aimed to: i) examine the proportions of 15–20 year-olds tested in a high school based screening and previously in clinical practice, ii) determine chlamydia prevalence according to testing pattern, and iii) examine factors associated with testing in the two settings. Methods A population based cross-sectional study was conducted in 5 high schools in Norway in 2009, using web-questionnaires and Chlamydia trachomatis PCR in first-void urine (800 girls/818 boys, mean age 17.2 years). Only sexually active participants at risk for chlamydia infections were included in the analyses. Crude and multivariable logistic regression models were applied with ‘clinic based testing’ and ‘school based screening’ as outcome variables. Results 56% of girls and 21% of boys reported previous clinic based testing. In the school based screening, 93% were tested with no gender difference. 42% of girls and 74% of boys were tested for the first time at school (‘school-only test’). Both girls with clinic based testing and girls with school-only test had high chlamydia prevalence (7.3% vs 7.2%). Boys with clinic based testing had twice the prevalence of those with school-only test (6.2% vs 3.0%, p = 0.01). Half of infections were detected in participants with school-only test. One-fifth were repeat infections. In multivariable analysis of girls and boys combined, female gender, older age, early sexual debut, no condom use at first and last intercourse, steady relationship, and higher number of lifetime partners increased the odds of clinic based testing. The odds of school based screening increased with male gender, academic affiliation, later sexual debut, condom use at first intercourse, and current urogenital symptoms in multivariable analysis. Conclusions More than half the girls had been tested prior to the school based screening and had high prevalence independent of previous clinic based testing. School screening was mostly associated with factors unknown to increase chlamydia infection risk, while clinic based testing was associated with traditional risk factors. The unusually high and equal participation between genders and the detection of a large chlamydia reservoir confirms the value of school based screening suggesting this approach to be further explored in Norway. PMID:23915415

Predictors of body mass index change in Australian primary school children.

PubMed

Hesketh, Kylie; Carlin, John; Wake, Melissa; Crawford, David

2009-01-01

To assess associations between multiple potential predictors and change in child body mass index (BMI). In the 1997 Health of Young Victorians Study, children in Grades preparatory to three (aged 5-10 years) had their height and weight measured. Parents provided information on potential predictors of childhood overweight across six domains (children's diet, children's activity level, family composition, sociodemographic factors, prenatal factors and parental adiposity). Measures were repeated three years later in 2000/1. BMI was transformed to standardised (z) scores using the US 2000 Growth Chart data and children were classified as non-overweight or overweight according to international cut-points. Regression analyses, including baseline BMI z-score as a covariate, assessed the contribution of each potential predictor to change in BMI z-score, development of overweight and spontaneous resolution of overweight in 1,373 children. BMI z-score change was positively associated with frequency of take-away food, food quantity, total weekly screen time, non-Australian paternal country of birth, maternal smoking during pregnancy, and maternal and paternal BMI. Inverse associations were noted for the presence of siblings and rural residence (all p<0.05). Predictors of categorical change (development and resolution of overweight) were less clearly identified, apart from an association between maternal BMI and overweight development (p=0.02). Multivariable models suggested individual determinants have a cumulative effect on BMI change. Strong short-term tracking of BMI makes it difficult to identify predictors of change. Nonetheless, putative determinants across all domains assessed were independently associated with adiposity change. Multi-faceted solutions are likely to be required to successfully deal with the complexities of childhood overweight.

Urinary Phthalate Metabolites Are Associated with Body Mass Index and Waist Circumference in Chinese School Children

PubMed Central

Wang, Hexing; Zhou, Ying; Tang, Chuanxi; He, Yanhong; Wu, Jingui; Chen, Yue; Jiang, Qingwu

2013-01-01

Background Lab studies have suggested that ubiquitous phthalate exposures are related to obesity, but relevant epidemiological studies are scarce, especially for children. Objective To investigate the association of phthalate exposures with body mass index (BMI) and waist circumference (WC) in Chinese school children. Methods A cross-sectional study was conducted in three primary and three middle schools randomly selected from Changning District of Shanghai City of China in 2011–2012. According to the physical examination data in October, 2011, 124 normal weight, 53 overweight, and 82 obese students 8–15 years of age were randomly chosen from these schools on the basis of BMI-based age- and sex-specific criterion. First morning urine was collected in January, 2012, and fourteen urine phthalate metabolites (free plus conjugated) were determined by ultra-performance liquid chromatography coupled to tandem mass spectrometry. Multiple linear regression was used to explore the associations between naturally log-transformed urine phthalate metabolites and BMI or WC. Results The urine specific gravity-corrected concentrations of nine urine phthalate metabolites and five molar sums were positively associated with BMI or WC in Chinese school children after adjustment for age and sex. However, when other urine phthalate metabolites were included in the models together with age and sex as covariables, most of these significant associations disappeared except for mono (2-ethylhexyl) phthalate (MEHP) and monoethyl phthalate (MEP). Additionally, some associations showed sex- or age-specific differences. Conclusions Some phthalate exposures were associated with BMI or WC in Chinese school children. Given the cross-sectional nature of this study and lack of some important obesity-related covariables, further studies are needed to confirm the associations. PMID:23437242

Intrusions in children's dietary recalls: the roles of BMI, sex, race, interview protocol, and social desirability.

PubMed

Guinn, Caroline H; Baxter, Suzanne D; Hardin, James W; Royer, Julie A; Smith, Albert F

2008-09-01

Dietary-reporting validation study data and school foodservice production records were used to examine intrusions (reports of uneaten items) in school meals in 24-h recalls. Fourth-grade children [20 low-BMI (> or = 5th and < 50th percentiles); 20 high-BMI (> or = 85th percentile); 50% boys; 75% black] were each observed eating two school meals (breakfast, lunch) and interviewed about the prior 24h that evening (24E) or the previous day the next morning (PDM). Social desirability was assessed. Intrusions were classified as stretches (on meal tray), internal confabulations (in school foodservice environment but not on meal tray), and external confabulations (not in school foodservice environment). For breakfast, reported items were less likely to be intrusions for black than white children, and for low-BMI boys than the other BMI-x-sex groups, and to be external confabulations for high-BMI girls than high-BMI boys. For lunch, reported items and intrusions were more likely to be stretches for 24E than PDM interviews. As social desirability increased, fewer items were reported for breakfast, and reported items and intrusions were more likely to be internal confabulations for lunch. For breakfast, compared to low-BMI girls, as social desirability increased, intruded amounts were larger for high-BMI boys and smaller for high-BMI girls. For lunch, intruded amounts were smaller for high-BMI girls than the other BMI-x-sex groups. Amounts reported were smaller for stretches than internal confabulations and external confabulations for breakfast, and external confabulations for lunch. To better understand intrusions, dietary-reporting validation studies are needed with larger samples by BMI-group, sex, and race.

Relationship between prostate-specific antigen and obesity in prostate cancer screening: analysis of a large cohort in Japan.

PubMed

Kubota, Yasuaki; Seike, Kensaku; Maeda, Shinichi; Shinohara, Yuka; Iwata, Masamitsu; Sugimoto, Norio

2011-01-01

Previous studies have shown that lower prostate-specific antigen (PSA) levels in obese men might decrease the sensitivity of prostate cancer screening, leading to delayed diagnosis and unfavorable prognosis. We examined whether the effect of obesity is important in prostate cancer screening of Japanese men, who have a low prevalence of obesity. We analyzed 19,294 male subjects from a large cohort of Toyota Motor Corporation (TMC) employees (aged > 50 years, serum PSA level ≤ 4.0 ng/mL) who underwent physical examinations from August 2006 to December 2009. The relationship between PSA level and obesity-related factors was analyzed by simple and multiple regression analysis. The relationships between six body mass index (BMI) categories, and PSA level and PSA mass (PSA concentration × plasma volume) were analyzed. PSA level decreased significantly with increasing BMI, but the coefficient of determination was very low. Mean PSA values decreased from 1.02 to 0.85 ng/mL as BMI increased from underweight (BMI <18.5) to morbidly obese (BMI >35). However, PSA mass peaked in the overweight category and was slightly reduced with increasing BMI. On multiple regression analysis, PSA level was influenced by age, diastolic blood pressure and high-density lipoprotein as well as BMI. We found an inverse but weak relationship between PSA level and BMI. Obesity seems to have very limited influence on prostate cancer screening in this population. Nonetheless, when considering indications for prostatic biopsy in obese men, we should be aware that the hemodilution effect might reduce PSA levels. © 2010 The Japanese Urological Association.

Obesity-Related Metabolic Risk in Sedentary Hispanic Adolescent Girls with Normal BMI.

PubMed

van der Heijden, Gert-Jan; Wang, Zhiyue J; Chu, Zili D; Haymond, Morey; Sauer, Pieter J J; Sunehag, Agneta L

2018-06-15

Hispanic adolescent girls with normal BMI frequently have high body fat %. Without knowledge of body fat content and distribution, their risk for metabolic complications is unknown. We measured metabolic risk indicators and abdominal fat distribution in post-pubertal Hispanic adolescent girls with Normal BMI (N-BMI: BMI < 85th percentile) and compared these indicators between girls with Normal BMI and High Fat content (N-BMI-HF: body fat ≥ 27%; n = 15) and Normal BMI and Normal Fat content (N-BMI-NF: body fat < 27%; n = 8). Plasma concentrations of glucose, insulin, adiponectin, leptin and Hs-CRP were determined. Insulin resistance was calculated using an oral glucose tolerance test. Body fat % was measured by DXA and subcutaneous, visceral and hepatic fat by MRI/MRS. The N-BMI-HF girls had increased abdominal and hepatic fat content and increased insulin resistance, plasma leptin and Hs-CRP concentrations ( p < 0.05) as compared to their N-BMI-NF counterparts. In N-BMI girls, insulin resistance, plasma insulin and leptin correlated with BMI and body fat % ( p < 0.05). This research confirms the necessity of the development of BMI and body fat % cut-off criteria per sex, age and racial/ethnic group based on metabolic risk factors to optimize the effectiveness of metabolic risk screening procedures.

How to identify students for school-based depression intervention: can school record review be substituted for universal depression screening?

PubMed

Kuo, Elena S; Vander Stoep, Ann; Herting, Jerald R; Grupp, Katherine; McCauley, Elizabeth

2013-02-01

Early identification and intervention are critical for reducing the adverse effects of depression on academic and occupational performance. Cost-effective approaches are needed for identifying adolescents at high depression risk. This study evaluated the utility of school record review versus universal school-based depression screening for determining eligibility for an indicated depression intervention program implemented in the middle school setting. Algorithms derived from grades, attendance, suspensions, and basic demographic information were evaluated with regard to their ability to predict students' depression screening scores. The school information-based algorithms proved poor proxies for individual students' depression screening results. However, school records showed promise for identifying low, medium, and high-yield subgroups on the basis of which efficient screening targeting decisions could be made. Study results will help to guide school nurses who coordinate indicated depression intervention programs in school settings as they evaluate options of approaches for determining which students are eligible for participation. © 2012 Wiley Periodicals, Inc.

Parental Perceptions of the Rural School's Role in Addressing Childhood Obesity

ERIC Educational Resources Information Center

Stalter, Ann M.; Kaylor, Marybeth; Steinke, Jessica D.; Barker, Rosanta M.

2011-01-01

This study employed cross-sectional, descriptive design with convenience sampling to explore rural parent perceptions of child obesity, use of Body Mass Index (BMI) in schools, preferences for receipt of BMI information and, the rural school's role in obesity prevention/treatment. The survey "Parental Perceptions of BMI and Obesity in the…

A Multifaceted School-based Intervention to Reduce Risk for Type 2 Diabetes in At-Risk Youth

PubMed Central

Grey, Margaret; Jaser, Sarah S.; Holl, Marita G.; Jefferson, Vanessa; Dziura, James; Northrup, Veronika

2009-01-01

Objective To evaluate the impact of a multifaceted, school-based intervention on inner city youth at high risk for type 2 diabetes mellitus (T2DM) and to determine whether the addition of coping skills training (CST) and health coaching improves outcomes. Method 198 students in New Haven, CT at risk for T2DM (BMI > 85th percentile and family history of diabetes) were randomized by school to an educational intervention with or without the addition of CST and health coaching. Students were enrolled from 2004–2007 and followed for 12 months. Results Students in both groups showed some improvement in anthropometric measures, lipids, and depressive symptoms over 12 months. BMI was not improved by the intervention. Students who received CST showed greater improvement on some indicators of metabolic risk than students who received education only. Conclusion A multifaceted, school-based intervention may hold promise for reducing metabolic risk in urban, minority youth. PMID:19643125

An intervention to preschool children for reducing screen time: a randomized controlled trial.

PubMed

Yilmaz, G; Demirli Caylan, N; Karacan, C D

2015-05-01

Screen time, defined as time spent watching television, DVDs, or videos or playing computer or video games, has been related to serious health consequences in children, such as impaired language acquisition, violent behaviour, tobacco smoking and obesity. Our aim was to determine if a simple intervention aimed at preschool-aged children, applied at the health maintenance visits, in the primary care setting, would be effective in reducing screen time. We used a two group randomized controlled trial design. Two- to 6-year-old children and their parents were randomly assigned to receive an intervention to reduce their screen time, BMI and parental report of aggressive behaviour. At the end of the intervention we made home visits at 2, 6 and 9 months and the parents completed questionnaire. Parents in the intervention group reported less screen time and less aggressive behaviour than those in the control group but there were no differences in BMI z scores. This study shows that a preschool-based intervention can lead to reductions in young children's television/video viewing. © 2014 John Wiley & Sons Ltd.

Body Mass Index Measurement in Schools

ERIC Educational Resources Information Center

Nihiser, Allison J.; Lee, Sarah M.; Wechsler, Howell; McKenna, Mary; Odom, Erica; Reinold, Chris; Thompson, Diane; Grummer-Strawn, Larry

2007-01-01

Background: School-based body mass index (BMI) measurement has attracted much attention across the nation from researchers, school officials, legislators, and the media as a potential approach to address obesity among youth. Methods: An expert panel, convened by the Centers for Disease Control and Prevention (CDC) in 2005, reviewed and provided…

Characteristics of screen media use associated with higher BMI in young adolescents.

PubMed

Bickham, David S; Blood, Emily A; Walls, Courtney E; Shrier, Lydia A; Rich, Michael

2013-05-01

This study investigates how characteristics of young adolescents' screen media use are associated with their BMI. By examining relationships between BMI and both time spent using each of 3 screen media and level of attention allocated to use, we sought to contribute to the understanding of mechanisms linking media use and obesity. We measured heights and weights of 91 13- to 15-year-olds and calculated their BMIs. Over 1 week, participants completed a weekday and a Saturday 24-hour time-use diary in which they reported the amount of time they spent using TV, computers, and video games. Participants carried handheld computers and responded to 4 to 7 random signals per day by completing onscreen questionnaires reporting activities to which they were paying primary, secondary, and tertiary attention. Higher proportions of primary attention to TV were positively associated with higher BMI. The difference between 25th and 75th percentiles of attention to TV corresponded to an estimated +2.4 BMI points. Time spent watching television was unrelated to BMI. Neither duration of use nor extent of attention paid to video games or computers was associated with BMI. These findings support the notion that attention to TV is a key element of the increased obesity risk associated with TV viewing. Mechanisms may include the influence of TV commercials on preferences for energy-dense, nutritionally questionable foods and/or eating while distracted by TV. Interventions that interrupt these processes may be effective in decreasing obesity among screen media users.

The Sensitivity of Adolescent School-Based Hearing Screens Is Significantly Improved by Adding High Frequencies

ERIC Educational Resources Information Center

Sekhar, Deepa L.; Zalewski, Thomas R.; Beiler, Jessica S.; Czarnecki, Beth; Barr, Ashley L.; King, Tonya S.; Paul, Ian M.

2016-01-01

High frequency hearing loss (HFHL), often related to hazardous noise, affects one in six U.S. adolescents. Yet, only 20 states include school-based hearing screens for adolescents. Only six states test multiple high frequencies. Study objectives were to (1) compare the sensitivity of state school-based hearing screens for adolescents to gold…

Validity of Indian Diabetes Risk Score and its association with body mass index and glycosylated hemoglobin for screening of diabetes in and around areas of Lucknow

PubMed Central

Khan, Mohammad Mustufa; Sonkar, Gyanendra Kumar; Alam, Roshan; Mehrotra, Sudhir; Khan, M. Salman; Kumar, Ajay; Sonkar, Satyendra Kumar

2017-01-01

Objectives: The present study aimed to assess the validity of Indian Diabetes Risk Score (IDRS) and its association with body mass index (BMI) and glycosylated hemoglobin (HbA1c) for screening of diabetes and obesity. Methodology: A cross-sectional study was designed, and samples were randomly enrolled from Lucknow and its adjoining areas. Totally, 405 subjects were included in the study. We used diabetes risk factors (age, waist circumference, physical activity, and family history of diabetes) for screening of diabetes and abdominal obesity (AO) and BMI for screening of general obesity. HbA1c was used for confirming the diabetes patients in this population. Statistical analysis was applied to all data using SPSS software (version 20.0). P < 0.05 was considered statistically significant. Results: All 405 subjects were assessed for diabetic risk factors, BMI, and glycated hemoglobin. Of these, 56.3% subjects were aged ≥50 years. 1° and 2° AO was found in 47.9% and 40% subjects, respectively. About 27.1% subjects were found to have sedentary lifestyle, and 72.6% were found to have no family history of diabetes. According to IDRS, 272 subjects (67.2%) were found at high risk of diabetes (score ≥60). Based on BMI calculation, 198 subjects were obese, of which 79.3% were found at high risk for diabetes. A significant association was found between subjects with higher risk score and BMI (P < 0.001). Assessment of HbA1c showed that 97 (23.9%) were prediabetic and 204 (50.4%) were diabetic, of which 63.9% and 77%, respectively was at high risk for diabetes as per IDRS. A significant association was found between subjects with higher risk score and HbA1c (P < 0.001). Conclusion: Our study fully supports the validity of IDRS, as it can be used as a cost-effective tool for primary mass screening of diabetes. Moreover, its combination with BMI value and HbA1c can be used for strict monitoring for diabetes and obesity at primary health care centers to reduce the early development of diabetes complications and severe obesity comorbidities. PMID:29302549

Screen-time Weight-loss Intervention Targeting Children at Home (SWITCH): A randomized controlled trial study protocol

PubMed Central

2011-01-01

Background Approximately one third of New Zealand children and young people are overweight or obese. A similar proportion (33%) do not meet recommendations for physical activity, and 70% do not meet recommendations for screen time. Increased time being sedentary is positively associated with being overweight. There are few family-based interventions aimed at reducing sedentary behavior in children. The aim of this trial is to determine the effects of a 24 week home-based, family oriented intervention to reduce sedentary screen time on children's body composition, sedentary behavior, physical activity, and diet. Methods/Design The study design is a pragmatic two-arm parallel randomized controlled trial. Two hundred and seventy overweight children aged 9-12 years and primary caregivers are being recruited. Participants are randomized to intervention (family-based screen time intervention) or control (no change). At the end of the study, the control group is offered the intervention content. Data collection is undertaken at baseline and 24 weeks. The primary trial outcome is child body mass index (BMI) and standardized body mass index (zBMI). Secondary outcomes are change from baseline to 24 weeks in child percentage body fat; waist circumference; self-reported average daily time spent in physical and sedentary activities; dietary intake; and enjoyment of physical activity and sedentary behavior. Secondary outcomes for the primary caregiver include change in BMI and self-reported physical activity. Discussion This study provides an excellent example of a theory-based, pragmatic, community-based trial targeting sedentary behavior in overweight children. The study has been specifically designed to allow for estimation of the consistency of effects on body composition for Māori (indigenous), Pacific and non-Māori/non-Pacific ethnic groups. If effective, this intervention is imminently scalable and could be integrated within existing weight management programs. Trial Registration ACTRN12611000164998 PMID:21718543

The Cheer Study to Reduce BMI in Elementary School Students: A School-Based, Parent-Directed Study in Framingham, Massachusetts

ERIC Educational Resources Information Center

Resnick, Elissa A.; Bishop, Marilyn; O'Connell, Anne; Hugo, Beverly; Isern, Germinal; Timm, Alison; Ozonoff, Al; Geller, Alan C.

2009-01-01

Childhood obesity may be lessened by parent-focused interventions. A pilot parent-directed trial with 46 parents of overweight and obese elementary school students was conducted at two ethnically diverse public schools in Framingham, Massachusetts. Parents were randomly assigned to either the Materials Group, which received mailed educational…

Obstructive sleep apnea in North American commercial drivers.

PubMed

Kales, Stefanos N; Straubel, Madeleine G

2014-01-01

The most common medical cause of excessive daytime sleepiness (EDS) is obstructive sleep apnea (OSA). Specifically, among an estimated 14 million US commercial drivers, 17-28% or 2.4 to 3.9 million are expected to have OSA. Based on existing epidemiologic evidence, most of these drivers are undiagnosed and not adequately treated. Untreated OSA increases the risk of vehicular crashes as documented in multiple independent studies and by meta-analysis. Therefore, identifying commercial drivers with OSA and having them effectively treated should decrease crash-related fatalities and injuries. Several strategies are available for screening and identifying drivers with OSA. The simplest and most effective objective strategies use body mass index (BMI) cutoffs for obesity. Functional screens are promising adjuncts to other objective tests. The most effective approach will likely be a combination of a good questionnaire; BMI measures; and a careful physician-obtained history complemented by a functional screen.

Intrusions in Children’s Dietary Recalls: The Roles of Body Mass Index, Sex, Race, Interview Protocol, and Social Desirability

PubMed Central

Baxter, Suzanne Domel; Hardin, James W.; Royer, Julie A.; Smith, Albert F.

2008-01-01

Dietary-reporting validation study data and school foodservice production records were used to examine intrusions (reports of uneaten items) in school meals in 24-hour recalls. Fourth-grade children (20 low-body mass index [BMI; ≥5th and <50th percentiles]; 20 high-BMI [≥85th percentile];50% boys; 75% Black) were each observed eating two school meals (breakfast, lunch) and interviewed about the prior 24 hours that evening (24E) or the previous day the next morning (PDM). Social desirability was assessed. Intrusions were classified as stretches (on meal tray), internal confabulations (in school foodservice environment but not on meal tray), and external confabulations (not in school foodservice environment). For breakfast, reported items were less likely to be intrusions for Black than White children, and for low-BMI boys than the other BMI-x-sex groups, and to be external confabulations for high-BMI girls than high-BMI boys. For lunch, reported items and intrusions were more likely to be stretches for 24E than PDM interviews. As social desirability increased, fewer items were reported for breakfast, and reported items and intrusions were more likely to be internal confabulations for lunch. For breakfast, compared to low-BMI girls, as social desirability increased, intruded amounts were larger for high-BMI boys and smaller for high-BMI girls. For lunch, intruded amounts were smaller for high-BMI girls than the other BMI-x-sex groups. Amounts reported were smaller for stretches than internal confabulations and external confabulations for breakfast, and external confabulations for lunch. To better understand intrusions, dietary-reporting validation studies are needed with larger samples by BMI-group, sex, and race. PMID:18535542

Body weight status of school adolescents in Terengganu, Malaysia: a population baseline study.

PubMed

Ahmad, Aryati; Zulaily, Nurzaime; Abdul Manan, Nor Saidah; Shahril, Mohd Razif; Syed Saadun Tarek Wafa, Sharifah Wajihah Wafa; Mohd Amin, Rahmah; Syed Abdullah, Engku Fadzli Hasan; Ahmed, Amran

2017-01-05

Body weight is highly associated with overall health status. Being severely thin or obese may impose the risk of many health problems. Early detection of body mass index (BMI) status may help to reduce the associated comorbidities. Although many studies in the literature have investigated the BMI of school adolescents in Malaysia, the data on status of body weight among school adolescents in suburban states like Terengganu is limited. This study aimed to describe the body weight status of the whole population of school adolescents in all seven districts in Terengganu, Malaysia. Using a cross-sectional study design, body weight and height were measured, and BMI was calculated and classified using WHO BMI-for-age Z-score. Data was obtained using the National Fitness Standard (SEGAK) assessment, which was uploaded in a specific Health Monitoring System (HEMS). From a total of 62,567 school adolescents, 50.7% were boys and 49.3% were girls. Girls had significantly higher BMI than boys in age groups of 13 to 15 and 16 to 17 years old. Among boys and girls, there were significant differences in mean BMI of school adolescents between rural and urban school locations in all age groups (p < 0.001). There were also significant differences in BMI between boys and girls in all districts in Terengganu, except Kemaman and Kuala Terengganu, for all age groups (p < 0.001). Overall, the prevalence of thinness, normal, overweight and obesity were 8.4, 64.6, 15.0 and 12.0%, respectively. There were significant differences between BMI categories and genders in total participants, and within rural and urban school locations (p < 0.05). In all districts except Marang and Dungun, significant difference was also found between BMI categories and genders. The prevalence of thinness, overweight and obesity in Terengganu were substantial. In this study, BMI category was associated with gender, age, school location and district. However, the actual effects of these factors on the prevalence of thinness and obesity among this population demand further investigation.

Child and teacher acceptability of school-based echocardiographic screening for rheumatic heart disease in Uganda.

PubMed

Ploutz, Michelle; Aliku, Twalib; Bradley-Hewitt, Tyler; Dantin, Andrea; Lemley, Bethan; Gillespie, Catherine W; Lwabi, Peter; Sable, Craig; Beaton, Andrea

2017-01-01

Introduction Rheumatic heart disease causes substantial morbidity in children in low-income countries. School-based echocardiographic screening has been suggested as a means to identify children with latent disease; however, little is known about the experience of children and teachers participating in screenings. The aim of our study was to assess students' and teachers' experience of school-based echocardiographic screening and identify areas for improvement. Materials and methods A school-based echocardiographic screening programme was conducted in five schools in Northern Uganda in 2013. After 8 months, an age- and gender-stratified population that included 5% of the participating students and teachers completed a questionnaire via an in-person interview. Responses were reviewed by question and coded to identify key themes. A total of 255 students (mean 10.7 years; 48% male) and 35 teachers participated in our study. In total, 95% of the students and 100% of the teachers were happy to have participated in the screening; however, students reported feeling scared (35%) and nervous (48%) during the screening process. Programmatic strengths included the following: knowing one's health status, opportunity to receive treatment, and staff interactions. Although 43% of the patients did not suggest a change with open-ended questioning, concerns regarding privacy, fear of the screening process, and a desire to include others in the community were noted. Discussion School-based echocardiographic rheumatic heart disease screening was well received by students and teachers. Future programmes would likely benefit from improved pre-screening education regarding the screening process and diagnosis of rheumatic heart disease. Furthermore, education of teachers and students could improve screening perception and establish realistic expectations regarding the scope of screening.

Racial Differences in Quantitative Measures of Area and Volumetric Breast Density

PubMed Central

McCarthy, Anne Marie; Keller, Brad M.; Pantalone, Lauren M.; Hsieh, Meng-Kang; Synnestvedt, Marie; Conant, Emily F.; Armstrong, Katrina; Kontos, Despina

2016-01-01

Abstract Background: Increased breast density is a strong risk factor for breast cancer and also decreases the sensitivity of mammographic screening. The purpose of our study was to compare breast density for black and white women using quantitative measures. Methods: Breast density was assessed among 5282 black and 4216 white women screened using digital mammography. Breast Imaging-Reporting and Data System (BI-RADS) density was obtained from radiologists’ reports. Quantitative measures for dense area, area percent density (PD), dense volume, and volume percent density were estimated using validated, automated software. Breast density was categorized as dense or nondense based on BI-RADS categories or based on values above and below the median for quantitative measures. Logistic regression was used to estimate the odds of having dense breasts by race, adjusted for age, body mass index (BMI), age at menarche, menopause status, family history of breast or ovarian cancer, parity and age at first birth, and current hormone replacement therapy (HRT) use. All statistical tests were two-sided. Results: There was a statistically significant interaction of race and BMI on breast density. After accounting for age, BMI, and breast cancer risk factors, black women had statistically significantly greater odds of high breast density across all quantitative measures (eg, PD nonobese odds ratio [OR] = 1.18, 95% confidence interval [CI] = 1.02 to 1.37, P = .03, PD obese OR = 1.26, 95% CI = 1.04 to 1.53, P = .02). There was no statistically significant difference in BI-RADS density by race. Conclusions: After accounting for age, BMI, and other risk factors, black women had higher breast density than white women across all quantitative measures previously associated with breast cancer risk. These results may have implications for risk assessment and screening. PMID:27130893

Weight management for Mexican American adolescents: school-based program

USDA-ARS?s Scientific Manuscript database

The objective of the current study was to assess change in weight over time for children participating in a school-based weight management program. A total of 47 participants between the ages of 10 and 14 who exceeded the 85th percentile for BMI were randomized into an intensive intervention (II) o...

National Disparities in Colorectal Cancer Screening Among Obese Adults.

PubMed

Seibert, Ryan G; Hanchate, Amresh D; Berz, Jonathan P; Schroy, Paul C

2017-08-01

Obesity is a major risk factor for colorectal cancer (CRC), particularly among men. The purpose of this study was to characterize the prevalence of guideline-adherent CRC screening among obese adults using nationally representative data, assess trends in screening strategies, and identify obesity-specific screening barriers. Data from 8,550 respondents aged 50-75 years in the 2010 National Health Interview Survey, representing >70 million adults, were analyzed in 2015 using multivariable logistic regression. Prevalence of guideline-adherent CRC screening, endoscopic versus fecal occult blood test screening, and reasons for non-adherence were compared across BMI categories. Obese class III men (BMI ≥40), compared with normal-weight men, were significantly less likely to be adherent to screening guidelines (38.7% vs 55.8%, AOR=0.35, 95% CI=0.17, 0.75); less likely to have used an endoscopic test (36.7% vs 53.0%, AOR=0.37, 95% CI=0.18, 0.79); and had a trend toward lower fecal occult blood test use (4.2% vs 8.9%, AOR=0.42, 95% CI=0.14, 1.27). Among women, odds of guideline adherence and use of different screening modalities were similar across all BMI categories. Reasons for non-adherence differed by gender and BMI; lacking a physician screening recommendation differed significantly among men (29.7% obese class III vs 15.4% non-obese, p=0.04), and pain/embarrassment differed significantly among women (11.6% obese class III vs 2.6% non-obese, p=0.002). Despite elevated risk, severely obese men were significantly under-screened for CRC. Addressing the unique screening barriers of obese adults may promote screening uptake and lessen disparities among the vulnerable populations most affected by obesity. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Gender differences in the association between stop-signal reaction times, body mass indices and/or spontaneous food intake in pre-school children: an early model of compromised inhibitory control and obesity.

PubMed

Levitan, R D; Rivera, J; Silveira, P P; Steiner, M; Gaudreau, H; Hamilton, J; Kennedy, J L; Davis, C; Dube, L; Fellows, L; Wazana, A; Matthews, S; Meaney, M J

2015-04-01

Poor inhibitory control is associated with overeating and/or obesity in school-age children, adolescents and adults. The current study examined whether an objective and reliable marker of response inhibition, the stop-signal reaction time (SSRT), is associated with body mass index (BMI) z-scores and/or food intake during a snack test in pre-school children. The current sample consisted of 193 pre-school children taking part in a longitudinal study of early brain development (Maternal Adversity, Vulnerability and Neurodevelopment (the MAVAN project)). Linear mixed-effect models were used to examine whether the SSRT measured at age 48 months associated with BMI z-scores and/or dietary intake during a laboratory-based snack test. After controlling for significant covariates including maternal BMI, there was a significant gender by SSRT interaction effect in predicting 48-month BMI z-scores. Post-hoc analysis revealed an association between longer SSRTs (poor response inhibition) and higher BMIs in girls but not boys. Across both girls and boys, longer SSRTs were associated with greater intake of carbohydrates and sugars during the snack test. The association between SSRT scores and BMI z-scores in girls was not statistically mediated by carbohydrate or sugar intake. At 48 months of age, slower response inhibition on the Stop-Signal Task associates with higher BMI z-scores in girls, and with higher intake of carbohydrates and sugars during a snack test across both genders. Ongoing follow-up of these children will help clarify the implications of these associations for longer term macronutrient intake, eating-related pathology and/or pathological weight gain over time.

The Toxic Food Environment Around Elementary Schools and Childhood Obesity in Mexican Cities.

PubMed

Barrera, Lucia Hernandez; Rothenberg, Stephen J; Barquera, Simon; Cifuentes, Enrique

2016-08-01

The childhood obesity epidemic is a global concern. There is limited evidence in Mexico linking the local food environment to obesity. The purpose of this study is to describe the links between the local food environment around elementary schools and schoolchildren's BMI in two Mexican cities. Cross-sectional surveys were conducted in 60 elementary schools in two Mexican cities (i.e., Cuernavaca and Guadalajara) in 2012-2013. Anthropometric measurements on schoolchildren were collected, as well as environmental direct audits and observations in a 100-m buffer around schools. Children's BMI was evaluated according to WHO-recommended procedures. In BMI models, the explanatory variable was the number of retail food sources. These models were adjusted for child's characteristics, schools' socioeconomic background, compliance with federal guidelines concerning unhealthy foods within schools' facilities, and corresponding city. Analysis was conducted in 2014. The number of mobile food vendors was higher around public schools than outside private schools (p<0.05). Linear regression procedures showed a significant positive statistical association between children's BMI and the number of mobile food vendors around schools. Schoolchildren from the highest tertile of mobile food vendors showed 6.8% higher BMI units than those from the lowest tertile. Children attending schools within the highest tertile of food stores also had 4.7% higher BMI units than children from schools in the lowest tertile. Health policy in Mexico should target the obesogenic environment surrounding elementary schools, where children may be more exposed to unhealthy foods. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

School-based programs aimed at the prevention and treatment of obesity: evidence-based interventions for youth in Latin America.

PubMed

Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K; Nagle, Brian J; Arredondo, Elva M; Barquera, Simón; Elder, John P

2013-09-01

Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be gathered from such interventions. We performed a systematic review of papers published between 1965 and December 2010. Interventions were considered eligible if they had a school-based component, were done in Latin America, evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z-score), and compared youth exposed vs not exposed. Ten studies were identified as having a school-based component. Most interventions had a sample of normal and overweight children. The most successful interventions focused on prevention rather than treatment, had longer follow-ups, a multidisciplinary team, and fewer limitations in execution. Three prevention and 2 treatment interventions found sufficient improvements in obesity-related outcomes. We found sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America. Evidence-based interventions in the school setting should be promoted as an important component for integrated programs, policies, and monitoring frameworks designed to reverse the childhood obesity in the region. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Relationships between the family environment and school-based obesity prevention efforts: can school programs help adolescents who are most in need?

PubMed Central

Bauer, K. W.; Neumark-Sztainer, D.; Hannan, P. J.; Fulkerson, J. A.; Story, M.

2011-01-01

Identifying factors that contribute to students' behavior and weight improvements during school-based obesity prevention interventions is critical for the development of effective programs. The current study aims to determine whether the support and resources that adolescent girls received from their families were associated with improvements in physical activity (PA), television use, dietary intake, body mass index (BMI) and body composition during participation in New Moves, a school-based intervention to prevent obesity and other weight-related problems. Adolescent girls in the intervention condition of New Moves (n = 135), and one parent of each girl, were included in the current analysis. At baseline, parents completed surveys assessing the family environment. At baseline and follow-up, 9–12 months later, girls' behaviors were self-reported, height and weight were measured by study staff and body fat was assessed using dual-energy X-ray absorptiometry. Results showed few associations between family environment factors and girls' likelihood of improving behavior, BMI or body composition. These findings suggest that in general, school-based interventions offer similar opportunities for adolescent girls to improve their PA, dietary intake, and weight, regardless of family support. PMID:21536714

Obesity Prevention: A Systematic Review of Setting-Based Interventions from Nordic Countries and the Netherlands

PubMed Central

Tanggaard Andersen, Pernille; Aro, Arja R.

2018-01-01

Aim Effective evidence-based interventions have an important role in obesity prevention. Our aim was to present a qualitative synthesis of setting-based health promotion interventions on obesity, from Nordic countries and the Netherlands. Methods A systematic review of the literature was completed for studies in the community, schools, and worksite, with BMI as an outcome. A descriptive analysis was completed for all full-text articles meeting the inclusion criteria. Results Thirty-three articles were identified: 7 whole of community, 3 worksite, and 23 school-based interventions. The studies were largely quasiexperimental in design (21/33), with follow-up from 4 months to 8 years. The explicit use of theory was not featured in many of the studies (20/33). No consistent direction for BMI change could be identified in the whole of community interventions (2/7 positive, 2/7 negative, and 3/7 no effect) and no effect for worksite (3/3 no effect) or many of the school-based interventions (1/23 negative, 4/23 positive, 15/23 no effect, 1/23 BMI significant increase only for control group and 3/23 no data available). Conclusions There is a need to prioritise interventions with study designs of high quality, theory, and a participatory approach, for optimal implementation and evaluation of obesity prevention interventions. PMID:29808116

Obesity screening in the pediatric emergency department.

PubMed

Vaughn, Lisa M; Nabors, Laura; Pelley, Terri J; Hampton, Rebecca R; Jacquez, Farrah; Mahabee-Gittens, E Melinda

2012-06-01

The purposes of this study were (1) to examine parental perception of childhood obesity and race with measured body mass index (BMI), (2) to determine if parents are receptive to obesity screening in the pediatric emergency department and if receptivity varies by race or weight status, and (3) to determine eating habits that are predictors of obesity. This study is a cross-sectional study, with a convenience sample of 213 patients (aged 4-16 years accompanied by a parent/legal guardian to a pediatric emergency department). Weight and height were obtained, and parents were asked to complete a survey about perception of their child's weight, nutrition, and exercise habits. The current study found that parent perception of weight status was fairly accurate, and perception was predictive of BMI. Race, however, was not predictive of BMI. Parents were generally receptive of weight screening in the pediatric emergency department, and this did not vary as a function of weight status; however, receptivity did vary based on ethnicity, with African American parents being more receptive than white parents. Large portion sizes and the number of times a child eats fast food per week were found to be predictive of obesity. Greater than half of the children presenting to our pediatric emergency department were overweight or obese. Parents were generally accurate in their perception of their child's weight but were still receptive to obesity prevention and screening in the pediatric emergency department.

Geographic Differences in Physical Education and Adolescent BMI: Have Legal Mandates Made a Difference?

ERIC Educational Resources Information Center

Anderson, Laura M.; Aycock, Katherine E.; Mihalic, Caitlin A.; Kozlowski, Darcie J.; Detschner, Angela M.

2013-01-01

The school environment is an ideal setting for healthy weight programming with adolescents. The federal government has reinforced the importance of school-based health promotion. The current study examined the preliminary influence of the 2006 school wellness policy requirement of the "Child Nutrition and WIC Reauthorization Act"…

Obesity in Korean pre-adolescent school children: comparison of various anthropometric measurements based on bioelectrical impedance analysis.

PubMed

Yoo, S; Lee, S-Y; Kim, K-N; Sung, E

2006-07-01

To examine the relationships between body mass index (BMI), percentage-weight-for-height (PWH) and percentage body fat (PBF), and to compare their validity based on PBF with the BMI criteria of International Obesity Task Force (IOTF) for childhood obesity in Korean pre-adolescent school children. Statistical comparative analysis for anthropometric measures. Korean pre-adolescent children (438 boys and 454 girls, aged 8-12 years, mean BMI 19.5+/-3.4 kg/m2). Body mass index and PWH were calculated as body size indices from height and weight. Hand-to-foot bioelectrical impedance analysis (BIA) was performed to obtain PBF values, with obese children defined as PBF above 35%. Sensitivity and specificity were displayed with the gold standard of PBF, and receiver operating characteristic (ROC) curves were used to assess the performance of BMI and PWH in detecting obesity. The prevalence of obesity varied by the criteria: 18.8% by Korean BMI standards for 95 percentile, 11% by the IOTF-BMI 30 kg/m2 and 29.4% by Korean PWH cutoffs. Body mass index and PWH were significantly correlated with PBF after adjusting for age, 0.910 (P<0.01) and 0.915 (P<0.01), respectively. The sensitivity and specificity of the PWH cutoffs were 0.909 and 0.882, respectively. The local BMI 95 percentiles had lower sensitivity (0.714) and specificity (0.790). The IOTF-BMI definition showed much lower sensitivity (0.457) and higher specificity (0.990). The BMI cutoffs corresponding with the highest accuracy were smaller than IOTF-BMI 30 kg/m2 for all age groups in both boys and girls. The prevalence of obesity among Korean pre-adolescent children widely varied according to the diagnostic criteria applied. Universally recommended cutoffs for children by IOTF showed the lowest sensitivity among the criteria used, and may therefore underestimate obesity in this population.

Are BMI and Sedentariness Correlated? A Multilevel Study in Children

PubMed Central

Gomes, Thayse Natacha; Katzmarzyk, Peter T.; dos Santos, Fernanda Karina; de Chaves, Raquel Nichele; Santos, Daniel; Pereira, Sara; Champagne, Catherine M.; Hedeker, Donald; Maia, José

2015-01-01

The purpose of this research was to investigate the relationship between body mass index (BMI) and sedentariness (Sed) in children and to examine the influence of child and school correlates on their variation. The sample comprises 580 children (337 girls, 9–11 years). Sedentariness was assessed with an accelerometer, and BMI was computed. Child- and school-level covariates were analyzed using multilevel models. No significant correlation between Sed and BMI was found. School context explains 5% and 1.5% of the total variance in Sed and BMI, respectively. At the child level, only moderate-to-vigorous physical activity was associated with both Sed (β = −0.02 ± 0.002) and BMI (β = −0.005 ± 0.002). Sleep time is related to Sed (β = −0.42 ± 0.04), while sex (β = 1.97 ± 0.13), biological maturity (β = 1.25 ± 0.07), media in the bedroom (β = 0.26 ± 0.08) and healthy (β = −0.09 ± 0.03) and unhealthy (β = −0.07 ± 0.04) diet scores were associated with BMI. None of the school-level covariates were related to BMI, but access to cafeteria (β = −0.97 ± 0.25), playground equipment (β = −0.67 ± 0.20) and restaurants (β = 0.16 ± 0.08) were related to Sed. In conclusion, Sed and BMI were not correlated. Further, they have different correlates, while children’s traits seem to play more relevant roles in their differences in Sed and BMI than the school milieu. This information should be taken into account when strategies to reduce Sed and BMI are implemented. PMID:26193311

A holistic school-based intervention for improving health-related knowledge, body composition, and fitness in elementary school students: an evaluation of the HealthMPowers program

PubMed Central

2014-01-01

Background Over the past 30 years, obesity in the United States has increased twofold in children and threefold in adolescents. In Georgia, nearly 17% of children aged 10 – 17 are obese. In response to the high prevalence of child obesity in Georgia and the potential deleterious consequences that this can have, HealthMPowers was founded in 1999 with the goal of preventing childhood obesity by improving health-enhancing behaviors in elementary schools, utilizing a holistic three-year program. This study measures the effectiveness of the HealthMPowers program in improving the school environment, student knowledge, behavior, cardiovascular fitness levels, and Body Mass Index (BMI). Methods The present analysis utilizes data from 40 schools that worked with HealthMPowers over the course of the 2012 – 2013 school year (including schools at each of the three years of the intervention period) and provided information on demographics, student knowledge and behaviors, BMI, performance on the PACER test of aerobic capacity, and school practices and policies (measured via school self-assessment with the HealthMPowers-developed instrument “Continuous Improvement Tracking Tool” or CITT), measured at the beginning and end of each school year. Paired two-sample T tests were used to compare continuous variables (e.g., student knowledge scores, BMI-for-age Z scores), while chi-squared tests were used to assess categorical variables (e.g., trichotomized PACER performance). Results Students across all grades and cohorts demonstrated improvements in knowledge and self-reported behaviors, with particularly significant improvements for third-graders in schools in the second year of the HealthMPowers program (p < 0.0001). Similarly, decreases were observed in BMI-for-Age Z scores for this cohort (and others) across grades and gender, with the most significant decreases for students overweight or obese at baseline (p < 0.0005). Students also showed significant increases in performance on the PACER test across grades and cohorts (p < 0.0001). Lastly, schools tended to improve their practices over time, as measured via the CITT instrument. Conclusions The present report demonstrates the effectiveness of the HealthMPowers program in producing positive change in school policies and practices, student knowledge and behaviors, and student fitness and BMI, supporting the use of holistic interventions to address childhood obesity. PMID:24969618

WHO European Childhood Obesity Surveillance Initiative: School Nutrition Environment and Body Mass Index in Primary Schools

PubMed Central

Wijnhoven, Trudy M.A.; van Raaij, Joop M.A.; Sjöberg, Agneta; Eldin, Nazih; Yngve, Agneta; Kunešová, Marie; Starc, Gregor; Rito, Ana I.; Duleva, Vesselka; Hassapidou, Maria; Martos, Éva; Pudule, Iveta; Petrauskiene, Ausra; Farrugia Sant’Angelo, Victoria; Hovengen, Ragnhild; Breda, João

2014-01-01

Background: Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. Objective: To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Methods: Data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively). School personnel provided information on 18 school environmental characteristics on nutrition and physical activity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children’s weight and height; BMI-for-age (BMI/A) Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children’s BMI/A Z-scores was calculated. Results: Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%−95% of schools) and school nutrition environment scores (range: 0.30−0.93). Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania) graded less than three characteristics as supportive. High-score (≥0.70) countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.20−1.02), indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the school nutrition environment score and the school BMI/A Z-score was not observed. Conclusions: Some European countries have implemented more school policies that are supportive to a healthy nutrition environment than others. However, most countries with low school nutrition environment scores also host schools with supportive school environment policies, suggesting that a uniform school policy to tackle the “unhealthy” school nutrition environment has not been implemented at the same level throughout a country and may underline the need for harmonized school policies. PMID:25361044

WHO European Childhood Obesity Surveillance Initiative: School nutrition environment and body mass index in primary schools.

PubMed

Wijnhoven, Trudy M A; van Raaij, Joop M A; Sjöberg, Agneta; Eldin, Nazih; Yngve, Agneta; Kunešová, Marie; Starc, Gregor; Rito, Ana I; Duleva, Vesselka; Hassapidou, Maria; Martos, Eva; Pudule, Iveta; Petrauskiene, Ausra; Sant'Angelo, Victoria Farrugia; Hovengen, Ragnhild; Breda, João

2014-10-30

Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively). School personnel provided information on 18 school environmental characteristics on nutrition and physical activity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children's weight and height; BMI-for-age (BMI/A) Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children's BMI/A Z-scores was calculated. Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%-95% of schools) and school nutrition environment scores (range: 0.30-0.93). Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania) graded less than three characteristics as supportive. High-score (≥0.70) countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.20-1.02), indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the school nutrition environment score and the school BMI/A Z-score was not observed. Some European countries have implemented more school policies that are supportive to a healthy nutrition environment than others. However, most countries with low school nutrition environment scores also host schools with supportive school environment policies, suggesting that a uniform school policy to tackle the "unhealthy" school nutrition environment has not been implemented at the same level throughout a country and may underline the need for harmonized school policies.

Characteristics of Screen Media Use Associated With Higher BMI in Young Adolescents

PubMed Central

Blood, Emily A.; Walls, Courtney E.; Shrier, Lydia A.; Rich, Michael

2013-01-01

OBJECTIVES: This study investigates how characteristics of young adolescents’ screen media use are associated with their BMI. By examining relationships between BMI and both time spent using each of 3 screen media and level of attention allocated to use, we sought to contribute to the understanding of mechanisms linking media use and obesity. METHODS: We measured heights and weights of 91 13- to 15-year-olds and calculated their BMIs. Over 1 week, participants completed a weekday and a Saturday 24-hour time-use diary in which they reported the amount of time they spent using TV, computers, and video games. Participants carried handheld computers and responded to 4 to 7 random signals per day by completing onscreen questionnaires reporting activities to which they were paying primary, secondary, and tertiary attention. RESULTS: Higher proportions of primary attention to TV were positively associated with higher BMI. The difference between 25th and 75th percentiles of attention to TV corresponded to an estimated +2.4 BMI points. Time spent watching television was unrelated to BMI. Neither duration of use nor extent of attention paid to video games or computers was associated with BMI. CONCLUSIONS: These findings support the notion that attention to TV is a key element of the increased obesity risk associated with TV viewing. Mechanisms may include the influence of TV commercials on preferences for energy-dense, nutritionally questionable foods and/or eating while distracted by TV. Interventions that interrupt these processes may be effective in decreasing obesity among screen media users. PMID:23569098

Population attributable risk of modifiable risk factors associated with invasive breast cancer in women aged 45-69 years in Queensland, Australia.

PubMed

Wilson, Louise F; Page, Andrew N; Dunn, Nathan A M; Pandeya, Nirmala; Protani, Melinda M; Taylor, Richard J

2013-12-01

To quantify the population attributable risk of key modifiable risk factors associated with breast cancer incidence in Queensland, Australia. Population attributable fractions (PAFs) for high body mass index (BMI), use of hormone replacement therapy (HRT), alcohol consumption and inadequate physical activity were calculated, using prevalence data from a representative survey of women attending mammographic screening at BreastScreen Queensland in 2008 and relative risk estimates sourced from published literature. Attributable cancers were calculated using 'underlying' breast cancer incidence data for 2008 based on Poisson regression models, adjusting for the inflation of incidence due to the effects of mammographic screening. Attributable burden of breast cancer due to high body mass index (BMI), use of hormone replacement therapy (HRT), alcohol consumption and inadequate physical activity. In Queensland women aged 45-69 years, an estimated 12.1% (95% CI: 11.6-12.5%) of invasive breast cancers were attributable to high BMI in post-menopausal women who have never used HRT; 2.8% (95% CI: 2.7-2.9%) to alcohol consumption; 7.6% (95% CI: 7.4-7.9%) to inadequate physical activity in post-menopausal women and 6.2% (95% CI: 5.5-7.0%) to current use of HRT after stratification by BMI and type of HRT used. Combined, just over one quarter (26.0%; 95% CI: 25.4-26.6%) of all invasive breast cancers in Queensland women aged 45-69 years in 2008 were attributable to these modifiable risk factors. There is benefit in targeting prevention strategies to modify lifestyle behaviours around BMI, physical activity, HRT use and alcohol consumption, as a reduction in these risk factors could decrease invasive breast cancer incidence in the Queensland population. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Junk Food in Schools and Childhood Obesity.

PubMed

Datar, Ashlesha; Nicosia, Nancy

2012-01-01

Despite limited empirical evidence, there is growing concern that junk food availability in schools has contributed to the childhood obesity epidemic. In this paper, we estimate the effects of junk food availability on BMI, obesity, and related outcomes among a national sample of fifth-graders. Unlike previous studies, we address the endogeneity of the school food environment by controlling for children's BMI at school entry and estimating instrumental variables regressions that leverage variation in the school's grade span. Our main finding is that junk food availability does not significantly increase BMI or obesity among this fifth grade cohort despite the increased likelihood of in-school junk food purchases. The results are robust to alternate measures of junk food availability including school administrator reports of sales during school hours, school administrator reports of competitive food outlets, and children's reports of junk food availability. Moreover, the absence of any effects on overall food consumption and physical activity further support the null findings for BMI and obesity.

Screen time, cardiorespiratory fitness and adiposity among school-age children from Monteria, Colombia.

PubMed

Arango, Carlos M; Parra, Diana C; Gómez, Luis F; Lema, Lucía; Lobelo, Felipe; Ekelund, Ulf

2014-09-01

To explore the association between electronic media exposure (television viewing time, personal computer/video game use, total screen time), and waist circumference and body mass index, and study whether this association is independent of cardiorespiratory fitness, in a representative sample of adolescents from Montería, Colombia. Cross-sectional study analyzing data from 546 students aged 11-18 years, from fourteen randomly selected schools. Z-scores for WC and BMI were calculated. The physical activity module of the Global School Health Survey 2007 was used to determine EME, and the shuttle run test was used to assess CRF. Linear regression models adjusted by age, school location, physical activity level, type of institution (public or private), consumption of sweetened beverages, fast food, and fried food were used. Among boys, independently of cardiorespiratory fitness, high television viewing time (≥ 2 h/day) (β=+0.22; p<0.02), was positively associated with waist circumference. High total screen time (>3h/day) was positively associated with waist circumference (β=+0.34; p<0.01), and body mass index (β=+0.39; p<0.01). Among girls, sedentary behavior was not associated with adiposity, but cardiorespiratory fitness (β=-0.04; p<0.02) was negatively associated with body mass index. These findings support the evidence on the negative impact of excessive electronic media exposure and low cardiorespiratory fitness, and highlight the need for interventions and prevention strategies. Copyright © 2013 Sports Medicine Australia. All rights reserved.

Nonsignificant relationship between participation in school-provided meals and body mass index during the fourth-grade school year.

PubMed

Paxton, Amy E; Baxter, Suzanne Domel; Tebbs, Joshua M; Royer, Julie A; Guinn, Caroline H; Devlin, Christina M; Finney, Christopher J

2012-01-01

Data from four cross-sectional studies involving fourth-grade children were analyzed to investigate the relationship between participation in school-provided meals and body mass index (BMI), and the effect observed energy intake has on that relationship. Participation and BMI data were available on 1,535 children (51% black; 51% girls) for 4 school years (fall 1999 to spring 2003; one study per school year) at 13 schools total. Direct meal observations were available for a subset of 342 children (54% black; 50% girls) for one to three breakfasts and one to three lunches per child for a total of 1,264 school meals (50% breakfast). Participation in breakfast, lunch, and combined (both meals on the same day) was determined from nametag records compiled for meal observations for each study. Weight and height were measured. A marginal regression model was fit with BMI as the dependent variable; independent variables were breakfast participation, lunch participation, combined participation, sex, age, race, and study. For the subset of children, observed energy intake at breakfast, lunch, and combined was included in additional analyses. Participation in breakfast, lunch, and combined was not significantly associated with BMI regardless of whether analyses included observed energy intake (P values >0.181). The relationship between observed energy intake at breakfast and lunch, separately and combined, with BMI was positive (P values <0.01). In conclusion, these results do not support a relationship between school-meal participation and BMI but do support a relationship between observed energy intake at school meals and BMI during fourth grade. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Family-based hip-hop to health: outcome results.

PubMed

Fitzgibbon, Marian L; Stolley, Melinda R; Schiffer, Linda; Kong, Angela; Braunschweig, Carol L; Gomez-Perez, Sandra L; Odoms-Young, Angela; Van Horn, Linda; Christoffel, Katherine Kaufer; Dyer, Alan R

2013-02-01

This pilot study tested the feasibility of Family-Based Hip-Hop to Health, a school-based obesity prevention intervention for 3-5-year-old Latino children and their parents, and estimated its effectiveness in producing smaller average changes in BMI at 1-year follow-up. Four Head Start preschools administered through the Chicago Public Schools were randomly assigned to receive a Family-Based Intervention (FBI) or a General Health Intervention (GHI). Parents signed consent forms for 147 of the 157 children enrolled. Both the school-based and family-based components of the intervention were feasible, but attendance for the parent intervention sessions was low. Contrary to expectations, a downtrend in BMI Z-score was observed in both the intervention and control groups. While the data reflect a downward trend in obesity among these young Hispanic children, obesity rates remained higher at 1-year follow-up (15%) than those reported by the National Health and Nutrition Examination Survey (2009-2010) for 2-5-year-old children (12.1%). Developing evidence-based strategies for obesity prevention among Hispanic families remains a challenge. Copyright © 2012 The Obesity Society.

Effectiveness of a 5-year school-based intervention programme to reduce adiposity and improve fitness and lifestyle in Indian children; the SYM-KEM study.

PubMed

Bhave, Sheila; Pandit, Anand; Yeravdekar, Rajiv; Madkaikar, Vaishali; Chinchwade, Trushna; Shaikh, Nasreen; Shaikh, Tasneem; Naik, Shraddha; Marley-Zagar, Ella; Fall, Caroline H D

2016-01-01

Non-randomised non-blinded school-based intervention study. Two schools in the cities of Pune and Nasik, India. The intervention group comprised children attending a Pune school from 7-10 years until 12-15 years of age. Two control groups comprised children of the same age attending a similar school in Nasik, and children in the Pune intervention school but aged 12-15 years at the start of the study. A 5-year multi-intervention programme, covering three domains: physical activity, diet and general health, and including increased extracurricular and intracurricular physical activity sessions; daily yoga-based breathing exercises; making physical activity a 'scoring' subject; nutrition education; healthier school meals; removal of fast-food hawkers from the school environs; and health and nutrition education for teachers, pupils and families. Body mass index (BMI), waist circumference, physical fitness according to simple tests of strength, flexibility and endurance; diet; and lifestyle indicators (time watching TV, studying and actively playing). After 5 years the intervention children were fitter than controls in running, long jump, sit-up and push-up tests (p<0.05 for all). They reported spending less time sedentary (watching TV and studying), more time actively playing and eating fruit more often (p<0.05). The intervention did not reduce BMI or the prevalence of overweight/obesity, but waist circumference was lower than in the Pune controls (p=0.004). It was possible to achieve multiple health-promoting changes in an academically competitive Indian school. These changes resulted in improved physical fitness, but had no impact on the children's BMI or on the prevalence of overweight/obesity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

An investigation into utilising gestational body mass index as a screening tool for adverse birth outcomes and maternal morbidities in a group of pregnant women in Khayelitsha

PubMed Central

Davies, HR; Visser, J; Tomlinson, M; Rotheram-Borus, MJ; Gissane, C; Harwood, J; LeRoux, I

2014-01-01

Objective The aim of this study was to investigate the ability of the gestational body mass index (BMI) method to screen for adverse birth outcomes and maternal morbidities. Design This was a substudy of a randomised controlled trial, the Philani Mentor Mothers’ study. Setting and subjects The Philani Mentor Mothers’ study took place in a peri-urban settlement, Khayelitsha, between 2009 and 2010. Pregnant women living in the area in 2009-2010 were recruited for the study. Outcome measures Maternal anthropometry (height and weight) and gestational weeks were obtained at baseline to calculate the gestational BMI, which is maternal BMI adjusted for gestational age. Participants were classified into four gestational BMI categories: underweight, normal, overweight and obese. Birth outcomes and maternal morbidities were obtained from clinic cards after the births. Results Pregnant women were recruited into the study (n = 1 058). Significant differences were found between the different gestational BMI categories and the following birth outcomes: maternal (p-value = 0.019), infant hospital stay (p-value = 0.03), infants staying for over 24 hours in hospital (p-value = 0.001), delivery mode (p-value = 0.001), birthweight (p-value = 0.006), birth length (p-value = 0.007), birth head circumference (p-value = 0.007) and pregnancy-induced hypertension (p-value = 0.001). Conclusion To the best of our knowledge, this is the first study that has used the gestational BMI method in a peri-urban South African pregnant population. Based on the findings that this method is able to identify unfavourable birth outcomes, it is recommended that it is implemented as a pilot study in selected rural, peri-urban and urban primary health clinics, and that its ease and effectiveness as a screening tool is evaluated. Appropriate medical and nutritional advice can then be given to pregnant women to improve both their own and their infants’ birth-related outcomes and maternal morbidities. PMID:25324710

Investigating the prostate specific antigen, body mass index and age relationship: is an age-BMI-adjusted PSA model clinically useful?

PubMed

Harrison, Sean; Tilling, Kate; Turner, Emma L; Lane, J Athene; Simpkin, Andrew; Davis, Michael; Donovan, Jenny; Hamdy, Freddie C; Neal, David E; Martin, Richard M

2016-12-01

Previous studies indicate a possible inverse relationship between prostate-specific antigen (PSA) and body mass index (BMI), and a positive relationship between PSA and age. We investigated the associations between age, BMI, PSA, and screen-detected prostate cancer to determine whether an age-BMI-adjusted PSA model would be clinically useful for detecting prostate cancer. Cross-sectional analysis nested within the UK ProtecT trial of treatments for localized cancer. Of 18,238 men aged 50-69 years, 9,457 men without screen-detected prostate cancer (controls) and 1,836 men with prostate cancer (cases) met inclusion criteria: no history of prostate cancer or diabetes; PSA < 10 ng/ml; BMI between 15 and 50 kg/m 2 . Multivariable linear regression models were used to investigate the relationship between log-PSA, age, and BMI in all men, controlling for prostate cancer status. In the 11,293 included men, the median PSA was 1.2 ng/ml (IQR: 0.7-2.6); mean age 61.7 years (SD 4.9); and mean BMI 26.8 kg/m 2 (SD 3.7). There were a 5.1% decrease in PSA per 5 kg/m 2 increase in BMI (95% CI 3.4-6.8) and a 13.6% increase in PSA per 5-year increase in age (95% CI 12.0-15.1). Interaction tests showed no evidence for different associations between age, BMI, and PSA in men above and below 3.0 ng/ml (all p for interaction >0.2). The age-BMI-adjusted PSA model performed as well as an age-adjusted model based on National Institute for Health and Care Excellence (NICE) guidelines at detecting prostate cancer. Age and BMI were associated with small changes in PSA. An age-BMI-adjusted PSA model is no more clinically useful for detecting prostate cancer than current NICE guidelines. Future studies looking at the effect of different variables on PSA, independent of their effect on prostate cancer, may improve the discrimination of PSA for prostate cancer.

Trends in Biometric Health Indices Within an Employer-Sponsored Wellness Program With Outcome-Based Incentives.

PubMed

Fu, Patricia Lin; Bradley, Kent L; Viswanathan, Sheila; Chan, June M; Stampfer, Meir

2016-07-01

To evaluate changes in employees' biometrics over time relative to outcome-based incentive thresholds. Retrospective cohort analysis of biometric screening participants (n = 26 388). Large employer primarily in Western United States. Office, retail, and distribution workforce. A voluntary outcome-based biometric screening program, incentivized with health insurance premium discounts. Body mass index (BMI), cholesterol, blood glucose, blood pressure, and nicotine. Followed were participants from their first year of participation, evaluating changes in measures. On average, participants who did not meet the incentive threshold at baseline decreased their BMI (1%), glucose (8%), blood pressure (systolic 9%, diastolic 8%), and total cholesterol (8%) by year 2 with improvements generally sustained or continued during each additional year of participation. On average, individuals at high health risk who participated in a financially incentivized biometric assessment program improved their health indices over time. Further research is needed to understand key determinants that drive health improvement indicated here. © The Author(s) 2016.

Dietary Habits and Body Size Perception of Elementary School Children

ERIC Educational Resources Information Center

Murimi, Mary W.

2004-01-01

This study assessed the attitudes and concerns of children in grades 1 through 5 regarding their perceived body size and ideal body size, and it assessed their Body Mass Index (BMI) and dietary habits. This study found an overweight prevalence of 11.4%, based on the children's BMI. Most of the overweight students were either African American or…

Effects of a school-based pediatric obesity prevention program

USDA-ARS?s Scientific Manuscript database

The purpose of this study was to evaluate a school-based pediatric obesity program for elementary children. Children (n = 782) were between the ages of 7 and 9 and in the 2nd grade. A total of 323 (189 males) children who exceeded the 85th percentile for BMI were randomized into an integrated health...

Achieving long-term weight maintenance in Mexican-American adolescents with a school-based intervention

USDA-ARS?s Scientific Manuscript database

This study evaluated 24-month outcomes of a school-based intensive lifestyle weight management program targeting overweight Mexican American adolescents. A total of 71 adolescents (32 males, 45.1%) between the ages of 10 and 14 at or above the 85th percentile for body mass index (BMI) were recruited...

Prevalence of and factors associated with obesity among Pakistani schoolchildren: a school-based, cross-sectional study.

PubMed

Ahmed, J; Laghari, A; Naseer, M; Mehraj, V

2013-03-01

Childhood obesity is nowadays a concern in the developing world. This cros-sectional study was conducted on 501 randomly selected students from 10 high schools in an urban setting in Hyderabad, Pakistan. Children who were underweight were excluded. Interviews were conducted to determine demographic data, dietary intake, physical activity and other variables that may be associated with obesity. Overall 58 students (12%) had body mass index (BMI)>or=95th percentile, 40 (8%) BMI>or=85th percentile and 403 (80%) had BMI<85th percentile (WHO age- and sex-specific cut-offs). The prevalence of obesity was higher in boys than girls (15% than 8% respectively). In multivariate regression analysis significant risk factors for obesity/overweight were male sex, middle socioeconomic status, poor self-rated athletic ability, trying to lose weight and eating fruit<4 times per week. Childhood obesity is determined by factors in the home, school and society and a multidisciplinary approach is needed to prevention.

Junk Food in Schools and Childhood Obesity

PubMed Central

Nicosia, Nancy

2011-01-01

Despite limited empirical evidence, there is growing concern that junk food availability in schools has contributed to the childhood obesity epidemic. In this paper, we estimate the effects of junk food availability on BMI, obesity, and related outcomes among a national sample of fifth-graders. Unlike previous studies, we address the endogeneity of the school food environment by controlling for children’s BMI at school entry and estimating instrumental variables regressions that leverage variation in the school’s grade span. Our main finding is that junk food availability does not significantly increase BMI or obesity among this fifth grade cohort despite the increased likelihood of in-school junk food purchases. The results are robust to alternate measures of junk food availability including school administrator reports of sales during school hours, school administrator reports of competitive food outlets, and children’s reports of junk food availability. Moreover, the absence of any effects on overall food consumption and physical activity further support the null findings for BMI and obesity. PMID:23729952

[Association between polymorphism of rs10185316 in insulin-induced gene 2 and blood pressure among children and adolescents].

PubMed

Yang, Y D; Song, J Y; Liu, F H; Shang, X R; Wang, H J; Ma, J

2017-10-06

Objective: To examine the association between polymorphism of rs10185316 in insulin-induced gene 2 (INSIG2) and blood pressure among children and adolescents. Methods: 9 junior middle schools in Dongcheng District of Beijing and 5 schools (3 primary junior middle schools, 2 primary schools) in Haidian District of Beijing were chosen in 2005 and 2007, respectively. According to the Chinese BMI percentile criteria for screening overweight and obesity in school children, we recruited 1 425 overweight or obese children and 605 normal weight children. A total of 2 018 students with complete data of blood pressure and genotype data were included in this study. According to the blood pressure criterion of children and adolescents, 702 participants were categorized into high blood pressure group and 1 316 into normal blood pressure group. Participants' information of gender, age, height, weight and blood pressure were collected by questionnaire and physical examination. Genomic DNA was extracted from peripheral blood sample for genotyping of INSIG2 rs10185316 polymorphism. Multiple linear regression was conducted to analyze the associations between rs10185316 polymorphism in INSIG2 and SBP, DBP, mean arterial pressure (MAP) and pulse pressure. Results: The age, BMI, SBP and DBP of the high blood pressure group were separately (14.3±1.4) years old, (27.3±4.2) kg/m(2), (130.5±10.9) and (76.7±13.3) mmHg (1 mmHg=0.133 kPa), all higher than that of the normal blood pressure group, which were (12.2±2.9) years old, (22.0±4.0) kg/m(2), (104.4±10.9) and(54.6±15.2) mmHg, respectively (all P values<0.001). After age, sex, district and BMI adjusted, compared with the participants carrying INSIG2 rs10185316 CC genotype, CG/GG genotype carriers had lower DBP (β(95 %CI ):-1.67(-2.84--0.50), P= 0.005), higher PP(β(95 %CI ): 1.91(0.61-3.20), P= 0.004), and lower MAP(β(95 %CI ):=-1.03(-2.01--0.05), P= 0.039). Conclusion: INSIG2 rs10185316 polymorphism was associated with DBP, PP and MAP among children and adolescents in an independent way from BMI.

Insufficient sleep among elementary and middle school students is linked with elevated soda consumption and other unhealthy dietary behaviors.

PubMed

Franckle, Rebecca L; Falbe, Jennifer; Gortmaker, Steven; Ganter, Claudia; Taveras, Elsie M; Land, Thomas; Davison, Kirsten K

2015-05-01

This study examines the extent to which insufficient sleep is associated with diet quality in students taking part in the Massachusetts Childhood Obesity Research Demonstration Project. Data were collected in Fall 2012 for all 4th and 7th grade children enrolled in public schools in two Massachusetts communities. During annual body mass index (BMI) screening, students completed a survey that assessed diet, physical activity, screen time, and sleep. Of the 2456 enrolled students, 1870 (76%) had complete survey data. Generalized estimating equations were used to examine associations between sleep duration and dietary outcomes (vegetables, fruits, 100% juice, juice drinks, soda, sugar-sweetened beverages and water), accounting for clustering by school. Models were adjusted for community, grade, race/ethnicity, gender, television in the bedroom, screen time, and physical activity. In adjusted models, students who reported sleeping < 10 hours/day consumed soda more frequently (β = 0.11, 95% CI: 0.03, 0.20) and vegetables less frequently (β = -0.09, 95% CI: -0.18, -0.01) compared with students who reported ≥ 10 hours/day. No significant associations were observed between sleep duration and fruits, 100% juice, juice drinks or water. In this population, insufficient sleep duration was associated with more frequent soda and less frequent vegetable consumption. Longitudinal research is needed to further examine these relationships. Copyright © 2015. Published by Elsevier Inc.

Influencing Factors of the Body Mass Index of Elementary Students in Southern Taiwan

PubMed Central

Chou, Li-Na; Chen, Min-Li

2017-01-01

The body mass index (BMI) of school children in Taiwan is markedly increasing. According to statistical data from the Taiwan Ministry of Education, the prevalence of obesity in school children from the southern part of the country is the highest in Taiwan. Thus, exploring the factors influencing BMI in elementary school children from southern Taiwan is crucial. This study investigated the influencing factors including physical activity levels, sedentary behaviors, dietary habits, and perceived body shape on the BMIs of elementary school children from southern Taiwan. A cross-sectional design was used, and the participants consisted of 3251 fifth-grade students (1628 boys, 50.1%; 1623 girls, 49.9%). The average BMI values for boys and girls were 19.69 and 18.70 (kg/cm) respectively. Statistically significant associations were observed between BMI and sex, 31–60 min of daily vigorous or moderate physical activities levels, length of time spent watching television, time spent on video games or the computer, and intake of vegetable or meat gravy with rice (p < 0.001). Perceived body shape also affected the BMI of school children. The results of this study enable educational institutions in Taiwan to understand the factors affecting the BMI of school children and use this information as the basis for future healthy body weight policies. PMID:28241506

Influencing Factors of the Body Mass Index of Elementary Students in Southern Taiwan.

PubMed

Chou, Li-Na; Chen, Min-Li

2017-02-23

The body mass index (BMI) of school children in Taiwan is markedly increasing. According to statistical data from the Taiwan Ministry of Education, the prevalence of obesity in school children from the southern part of the country is the highest in Taiwan. Thus, exploring the factors influencing BMI in elementary school children from southern Taiwan is crucial. This study investigated the influencing factors including physical activity levels, sedentary behaviors, dietary habits, and perceived body shape on the BMIs of elementary school children from southern Taiwan. A cross-sectional design was used, and the participants consisted of 3251 fifth-grade students (1628 boys, 50.1%; 1623 girls, 49.9%). The average BMI values for boys and girls were 19.69 and 18.70 (kg/cm) respectively. Statistically significant associations were observed between BMI and sex, 31-60 min of daily vigorous or moderate physical activities levels, length of time spent watching television, time spent on video games or the computer, and intake of vegetable or meat gravy with rice ( p < 0.001). Perceived body shape also affected the BMI of school children. The results of this study enable educational institutions in Taiwan to understand the factors affecting the BMI of school children and use this information as the basis for future healthy body weight policies.

Verification regarding changing construction in accumulation of fat for BMI based on change with age estimated from body composition balance.

PubMed

Fujii, Katsunori; Tanaka, Nozomi; Mishima, Takaaki

2013-12-01

In the present study, a regression analysis of BMI and body fat percentage in each school year was performed with cross-sectional data in school-aged children. The qualitative changes in physique during the school-age years were examined by showing the changes in the level of body fat accu- mulation with age. The subjects were 789 boys and girls (469 boys, 320 girls) aged 7 to 14 years who participated in regular sports activities. Height, weight and body fat percentage were measured. Fat free mass was calculated by subtracting fat mass from body weight. BMI was calculated as body weight (kg) divided by the square of height (m). Regression analysis was conducted for fat percentage against BMI in boys and girls of all school years, and the level of body fat accumulation was considered, the distributions of the frequency of age change were examined. As a result, in the frequency distribution charts there was a shift from excessive fat to low fat from age 7 to 14 years. A χ2 test was then performed for these frequency distribution charts, and the results showed a significant difference in the frequency distribution in each year (P < 0.01). This trend was clearly in boys, and meaning was found in clarifying the changes with age in the body composition balance in boys and girls.

[Intake of sugar-sweetened non-alcoholic beverages and body mass index: A national sample of Chilean school children].

PubMed

Araneda, Jacqueline; Bustos, Patricia; Cerecera, Francisco; Amigo, Hugo

2015-01-01

To estimate the association between the intake of sugar-sweetened non-alcoholic beverages and body mass index (BMI) in Chilean school children. Food consumption frequency data were analyzed for school children aged 6 to 18. The association between consumption of sugar-sweetened beverages and BMI was estimated by multivariate lineal regression models. Sugar-sweetened beverages are consumed on a daily basis by 92% (95%CI:90-94) of subjects with daily intake medians of 424 mL (p25-p75:212-707). Every extra daily portion of sugar-sweetened beverages consumed by school children aged 6 to 13 is associated with 0.13 BMI z-scores (95%CI:0.04-0.2;p=0.01). School children consume sugar-sweetened beverages daily with intake medians close to 0.5L. There is an association between sugar-sweetened beverage consumption and higher BMI in Chilean school children.

Evidence-Based Suicide Prevention Screening in Schools

PubMed Central

Joe, Sean; Bryant, Heather

2009-01-01

Screening for suicidality, as called for by the President’s New Freedom Commission on Mental Health, is a major public health concern. As a place where adolescents spend a considerable amount of their waking hours, school is an important venue for screening adolescents for suicidal behaviors and providing preventive education and risk management. Social workers, as the largest occupational group of mental health professionals in the United States, have a significant role to play in the national strategy to prevent youth suicide, especially at the school level. This article reviews the literature on suicide prevention screening, warning signs, and risk factors to gain a better understanding of evidence-based screening strategies and discuss the implications for school social workers, counselors, and psychologists. It focuses on the identification of research-based information and explication of potential means for guiding preventive screening and clinical practice with suicidal adolescents. PMID:21113412

Examining body mass index in an urban core population: from health screening to physician visit.

PubMed

O'Connor, Kaitlin Ann; Sahrmann, Julie Marie; Magie, Richard E; Segars, Larry W

2013-04-01

BACKGROUND. Childhood obesity is commonly encountered in the primary care office and disproportionately affects those from low income or minority backgrounds. To determine how accurately primary care clinicians in an urban setting identified patients with body mass indices (BMIs) at or above the 95th percentile for age and to determine which obesity treatment strategies are used. The study population consisted of school-aged, inner-city children with a BMI at or above the 95th percentile for age whose charts were made available for data collection by retrospective chart review. A total of 158 patient medical charts were reviewed. Of these, 90 (57%) patients failed to be identified by the provider as having an elevated BMI. Obesity treatment was initiated in only 68 (43%) of these patients. Providers are not effectively recognizing childhood obesity and are not consistently implementing effective obesity treatment strategies.

School-Based Obesity Prevention Intervention in Chilean Children: Effective in Controlling, but not Reducing Obesity

PubMed Central

Kain, Juliana; Concha, Fernando; Moreno, Lorena; Leyton, Bárbara

2014-01-01

Objective. To evaluate the effectiveness of a 12-month multicomponent obesity prevention intervention. Setting. 9 elementary schools in Santiago, Chile. Subjects. 6–8 y old low-income children (N = 1474). Design. Randomized controlled study; 5 intervention/4 control schools. We trained teachers to deliver nutrition contents and improve the quality of PE classes. We determined % healthy snacks brought from home, children's nutrition knowledge, nutritional status, duration of PE classes, and % time in moderate/vigorous activity (MVA). Effectiveness was determined by comparing Δ BMI Z between intervention and control children using PROCMIXED. Results. % obesity increased in boys from both types of schools and in girls from control schools, while decreasing in girls from intervention schools (all nonsignificant). % class time in MVA declined (24.5–16.2) while remaining unchanged (24.8–23.7%) in classes conducted by untrained and trained teachers, respectively. In boys, BMI Z declined (1.33–1.24) and increased (1.22–1.35) in intervention and control schools, respectively. In girls, BMI Z remained unchanged in intervention schools, while increasing significantly in control schools (0.91–1.06, P = 0.024). Interaction group ∗ time was significant for boys (P < 0.0001) and girls (P = 0.004). Conclusions. This intervention was effective in controlling obesity, but not preventing it. Even though impact was small, results showed that when no intervention is implemented, obesity increases. PMID:24872892

The association between BMI and body weight perception among children and adolescents in Jilin City, China

PubMed Central

Liu, Hongjian; Wu, Fangyuan; Yang, Xiaodi; Yue, Mengjia; Pang, Yingxin; Li, Xuanxuan; Ma, Juan; Zhou, Ge; Gong, Ping; Liu, Meitian

2018-01-01

Objectives We evaluated the association between BMI and body weight perception in a sample of children and adolescents. Methods A cross-sectional school-based study was conducted among 7–18 year-olds (N = 9727) from 4 districts in Jilin City, China. We calculated BMI from measured weight and height and assessed body weight perception using a single questionnaire item. We analyzed these data using SPSS version 20.0. Results Approximately 19.8% of these youth perceived themselves as underweight, 57.8% as normal weight, and 22.4% as overweight. In reality, 4.9% were underweight, 64.3% were normal weight, and 30.8% were overweight. Furthermore, approximately 66.4% of these Chinese youth correctly perceived their body image, 28.2% underestimated their true body image, and 5.4% overestimated their weight status. Girls were more likely than boys to overestimate their weight (χ2 = 135.4, p < 0.05). Adolescents 13–18 years old were more likely than children 7–12 years old to overestimate their weight (χ2 = 248.4, p < 0.05). Senior high school students were the most likely to overestimate their weight (χ2 = 297.6, p < 0.05). Kappa tests revealed significant differences in consistency analysis of BMI and body weight perception (Kappa = 0.352, p < 0.05). Kappa < 0.4, the consistency of BMI and body weight perception was poor. Conclusions A mismatch existed between BMI and body weight perception among these children and adolescents. Thus, schools and parents should take steps to help them improve weight management and overall health awareness. PMID:29579108

Bridging the Gap: Using School-Based Health Services to Improve Chlamydia Screening Among Young Women

PubMed Central

Provost, Jackie M.

2010-01-01

Objectives. We implemented a chlamydia screening program targeted at young women accessing reproductive health care services in a school-based setting, and we assessed racial/ethnic factors associated with infection. Methods. The California Family Health Council partnered with 9 health care agencies receiving federal Title X family planning funding and 19 educational institutions to implement the Educational Partnerships to Increase Chlamydia Screening (EPICS) program from January 2008 through December 2008. Results. EPICS agencies provided reproductive health services to 3396 unique sexually active females, 85% of whom self-reported no other source for reproductive health care. Chlamydia screening was provided to 3026 clients (89.1% chlamydia screening coverage). Of those screened for chlamydia, 5.6% tested positive. Clients who were African American (odds ratio [OR] = 7.5; 95% confidence interval [CI] = 3.9, 14.3), Pacific Islander (OR = 4.1; 95% CI = 1.1, 15.5), or Asian (OR = 3.3; 95% CI = 1.4, 8.1) were more likely to have a positive test than were White clients. Conclusions. Chlamydia screening programs implemented in school-based settings have the capacity to identify and treat a significant amount of asymptomatic infection in a population that otherwise may not be reached. To facilitate screening, school-based clinics should implement outreach strategies that target their school population and clinical strategies that maximize opportunities for screening. PMID:20634446

Associations of physical fitness and academic performance among schoolchildren.

PubMed

Van Dusen, Duncan P; Kelder, Steven H; Kohl, Harold W; Ranjit, Nalini; Perry, Cheryl L

2011-12-01

Public schools provide opportunities for physical activity and fitness surveillance, but are evaluated and funded based on students' academic performance, not their physical fitness. Empirical research evaluating the connections between fitness and academic performance is needed to justify curriculum allocations to physical activity programs. Analyses were based on a convenience sample of 254,743 individually matched standardized academic (TAKS™) and fitness (FITNESSGRAM(®) ) test records of students, grades 3-11, collected by 13 Texas school districts. We categorized fitness results in quintiles by age and gender and used mixed effects regression models to compare the academic performance of the top and bottom fitness groups for each test. All fitness variables except body mass index (BMI) showed significant, positive associations with academic performance after adjustment for socio-demographic covariates, with standardized mean difference effect sizes ranging from .07 to .34. Cardiovascular fitness showed the largest interquintile difference in TAKS score (32-75 points), followed by curl-ups. Additional adjustment for BMI and curl-ups showed dose-response associations between cardiovascular fitness and academic scores (p < .001 for both genders and outcomes). Analysis of BMI demonstrated limited, nonlinear association with academic performance after socio-demographic and fitness adjustments. Fitness was strongly and significantly related to academic performance. Cardiovascular fitness showed a dose-response association with academic performance independent of other socio-demographic and fitness variables. The association appears to peak in late middle to early high school. We recommend that policymakers consider physical education (PE) mandates in middle high school, school administrators consider increasing PE time, and PE practitioners emphasize cardiovascular fitness. © 2011, American School Health Association.

Healthier School Environment Leads to Decreases in Childhood Obesity: The Kearney Nebraska Story.

PubMed

Heelan, Kate A; Bartee, R Todd; Nihiser, Allison; Sherry, Bettylou

2015-10-01

Schools play a role in addressing childhood obesity by implementing healthy eating and physical activity strategies. The primary aim of this case study was to describe prevalence of overweight and obesity among elementary school students in a rural Mid-western community between 2006 and 2012. The secondary aim was to use a novel approach called "population dose" to retrospectively evaluate the impact dose of each strategy implemented and its estimated potential population level impact on changes in overweight and obesity. Weight and height were directly measured annually beginning in January 2006 to assess weight status, using BMI (kg/m(2)), for all kindergarten to fifth-grade students (N ≈ 2400 per year). Multiple evidence-based strategies were implemented in nine schools to increase physical activity and healthy eating behaviors. BMI reporting and revised school meal programs were implemented districtwide. Comprehensive school physical activity programs, school food environment, and supportive/promotional strategies were implemented at individual schools. The absolute change in prevalence of obesity (BMI ≥95th percentile) decreased from 16.4% to 13.9%, indicating a 15.2% relative change in prevalence of obesity in 6 years. There was an inverse relationship between the number of strategies implemented and prevalence of overweight and obesity over time. District and school-level approaches have the potential to impact childhood obesity. Schools can successfully implement strategies to address overweight and obesity, but the extent of implementation between schools may vary. Population dose analysis can be used to estimate impact of clusters of strategies to address overweight/obesity.

Contribution of the After-School Period to Children's Daily Participation in Physical Activity and Sedentary Behaviours.

PubMed

Arundell, Lauren; Hinkley, Trina; Veitch, Jenny; Salmon, Jo

2015-01-01

Children's after-school physical activity (PA) and sedentary behaviours (SB) are not well understood, despite the potential this period holds for intervention. This study aimed to describe children's after-school physical activity and sedentary behaviours; establish the contribution this makes to daily participation and to achieving physical activity and sedentary behaviours guidelines; and to determine the association between after-school moderate- to vigorous-intensity physical activity (MVPA), screen-based sedentary behaviours and achieving the physical activity and sedentary behaviour guidelines. Children (n = 406, mean age 8.1 years, 58% girls) wore an ActiGraph GT3X accelerometer. The percentage of time and minutes spent sedentary (SED), in light- physical activity (LPA) and MVPA between the end-of-school and 6pm (weekdays) was calculated. Parents (n = 318, 40 years, 89% female) proxy-reported their child's after-school participation in screen-based sedentary behaviours. The contribution that after-school SED, LPA, MVPA, and screen-based sedentary behaviours made to daily levels, and that after-school MVPA and screen-based sedentary behaviours made to achieving the physical activity/sedentary behaviour guidelines was calculated. Regression analysis determined the association between after-school MVPA and screen-based sedentary behaviours and achieving the physical activity/sedentary behaviours guidelines. Children spent 54% of the after-school period SED, and this accounted for 21% of children's daily SED levels. Boys spent a greater percentage of time in MVPA than girls (14.9% vs. 13.6%; p<0.05), but this made a smaller contribution to their daily levels (27.6% vs 29.8%; p<0.05). After school, boys and girls respectively performed 18.8 minutes and 16.7 minutes of MVPA, which is 31.4% and 27.8% of the MVPA (p<0.05) required to achieve the physical activity guidelines. Children spent 96 minutes in screen-based sedentary behaviours, contributing to 84% of their daily screen-based sedentary behaviours and 80% of the sedentary behaviour guidelines. After-school MVPA was positively associated with achieving the physical activity guidelines (OR: 1.31, 95%CI 1.18, 1.44, p<0.05), and after-school screen-based sedentary behaviours were negatively associated with achieving the sedentary behaviours guidelines (OR: 0.97, 95%CI: 0.96, 0.97, p<0.05). The after-school period plays a critical role in the accumulation of children's physical activity and sedentary behaviours. Small changes to after-school behaviours can have large impacts on children's daily behaviours levels and likelihood of meeting the recommended levels of physical activity and sedentary behaviour. Therefore interventions should target reducing after-school sedentary behaviours and increasing physical activity.

We Run This City: Impact of a Community-School Fitness Program on Obesity, Health, and Fitness.

PubMed

Borawski, Elaine A; Jones, Sarah Drewes; Yoder, Laura Danosky; Taylor, Tara; Clint, Barbara A; Goodwin, Meredith A; Trapl, Erika S

2018-05-03

The We Run This City (WRTC) Youth Marathon Program is a community-supported, school-based fitness program designed to increase physical activity in a large, urban school district by engaging middle school youth to train 12 to 14 weeks to run or walk 1.2 miles, 6.2 miles, or 13.1 miles of the Rite Aid Cleveland Marathon. The objective of our study was to evaluate the effect of the intervention on adolescent health. We assessed changes in obesity, health, and fitness, measured before training and postintervention, among 1,419 sixth- to eighth-grade students participating in WRTC for the first time, with particular interest in the program's effect on overweight (85th-94th body mass index percentile) or obese (≥95th percentile) students. We collected data from 2009 through 2012, and analyzed it in 2016 and 2017. Outcomes of interest were body mass index (BMI), waist-to-hip ratio (WHR), elevated blood pressure, and fitness levels evaluated by using the Progressive Aerobic Cardiovascular Endurance Run (PACER) test and the sit-to-stand test. We saw significant improvements overall in fitness and blood pressure. Controlling for demographics, program event, and training dosage, BMI percentile increased among normal weight participants and decreased among overweight and obese participants (P < .001). WHR increased among obese participants, whereas reductions in blood pressure among those with elevated blood pressure were associated with higher amounts of training and lower baseline BMI. Even small amounts of regular physical activity can affect the health and fitness of urban youths. School-community partnerships offer a promising approach to increasing physical activity by supporting schools and making a school-based activity inclusive, fun, and connected to the broader fitness community.

Design of a school randomized trial for nudging students towards healthy diet and physical activity to prevent obesity: PAAPAS Nudge study protocol.

PubMed

Cunha, Diana Barbosa; Verly Junior, Eliseu; Paravidino, Vitor Barreto; Araújo, Marina Campos; Mediano, Mauro Felippe Felix; Sgambato, Michele Ribeiro; de Souza, Bárbara da Silva Nalin; Marques, Emanuele Souza; Baltar, Valéria Troncoso; de Oliveira, Alessandra Silva Dias; da Silva, Ana Carolina Feldenheimer; Pérez-Cueto, Federico J; Pereira, Rosangela Alves; Sichieri, Rosely

2017-12-01

To evaluate the effectiveness of nudge activities at school on the students' body mass index (BMI). School-based factorial randomized community trial. Eighteen public schools in the municipality of Duque de Caxias, metropolitan area of Rio de Janeiro, Brazil. The 18 schools will be randomized into 4 group arms: group 1-control (without any activity); group 2-will receive educational activities in the classroom; group 3-will receive changes in the school environment (nudge strategies); group 4-will receive educational activities and changes in the school environment. Activities will occur during the 2018 school-year. The primary (BMI) and secondary (body fat percentage) outcomes will be assessed at baseline and after the study using a portable electronic scale with a segmental body composition monitor. The height will be measured by a portable stadiometer. Statistical analyses for each outcome will be conducted through linear mixed models that took into account the missing data and cluster effect of the schools. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Design of a school randomized trial for nudging students towards healthy diet and physical activity to prevent obesity

PubMed Central

Cunha, Diana Barbosa; Verly Junior, Eliseu; Paravidino, Vitor Barreto; Araújo, Marina Campos; Mediano, Mauro Felippe Felix; Sgambato, Michele Ribeiro; de Souza, Bárbara da Silva Nalin; Marques, Emanuele Souza; Baltar, Valéria Troncoso; de Oliveira, Alessandra Silva Dias; da Silva, Ana Carolina Feldenheimer; Pérez-Cueto, Federico J.; Pereira, Rosangela Alves; Sichieri, Rosely

2017-01-01

Abstract Objective: To evaluate the effectiveness of nudge activities at school on the students’ body mass index (BMI). Design: School-based factorial randomized community trial. Setting: Eighteen public schools in the municipality of Duque de Caxias, metropolitan area of Rio de Janeiro, Brazil. Participants and intervention: The 18 schools will be randomized into 4 group arms: group 1—control (without any activity); group 2—will receive educational activities in the classroom; group 3—will receive changes in the school environment (nudge strategies); group 4—will receive educational activities and changes in the school environment. Activities will occur during the 2018 school-year. Main outcome measure(s): The primary (BMI) and secondary (body fat percentage) outcomes will be assessed at baseline and after the study using a portable electronic scale with a segmental body composition monitor. The height will be measured by a portable stadiometer. Analysis: Statistical analyses for each outcome will be conducted through linear mixed models that took into account the missing data and cluster effect of the schools. PMID:29390278

Outcomes of an Elementary School-Based Vision Screening Program in North Carolina

ERIC Educational Resources Information Center

Kemper, Alex R.; Helfrich, Anya; Talbot, Jennifer; Patel, Nita

2012-01-01

School nurses can play a key role in the detection of significant refractive error. The purpose of this study was to assess the impact of a statewide school nurse vision screening program by evaluating the outcomes of screening among first, third, and fifth graders in 10 schools in North Carolina during the 2009-2010 school year. Of the 2,726…

Cost-Effectiveness of a School-Based Emotional Health Screening Program

ERIC Educational Resources Information Center

Kuo, Elena; Stoep, Ann Vander; McCauley, Elizabeth; Kernic, Mary A.

2009-01-01

Background: School-based screening for health conditions can help extend the reach of health services to underserved populations. Screening for mental health conditions is growing in acceptability, but evidence of cost-effectiveness is lacking. This study assessed costs and effectiveness associated with the Developmental Pathways Screening…

Energy Balance--Related Behavior and Anthropometric Measures among Adolescents across Three Educational Levels: A Cross-Sectional Study in Dutch Schools

ERIC Educational Resources Information Center

Ridder, Monica A. M.; Koning, Maaike; Visscher, Tommy L. S.; Hirasing, Remy A.; Seidell, Jacob C.; Renders, Carry M.

2018-01-01

Energy balance-related behavior on schooldays and beliefs about school-based interventions may differ between students in different educational levels, sexes, and BMI (body mass index) categories. In Zwolle (the Netherlands), 1,084 adolescents (13-15 years) at 9 secondary schools completed a questionnaire. Overweight prevalence (boys 18.1%, girls…

Association between behavioural factors and BMI-for-age among early adolescents in Hulu Langat district, Selangor, Malaysia.

PubMed

Woon, Fui Chee; Chin, Yit Siew; Mohd Nasir, Mohd Taib

2015-01-01

This paper investigates the association between behavioural factors and BMI-for-age among early adolescents (10-11 years old) in Hulu Langat district, Selangor. This cross-sectional study was conducted among 333 primary school students. Body weight and height of the students were measured and their BMI-for-age was calculated. Eating behaviours, energy intake, energy expenditure, physical activity, and screen time were assessed using the Eating Behaviours Questionnaire and a 2-day dietary and physical activity recall, respectively. Data were analysed using multiple linear regression analysis. The prevalence of overweight and obesity (28.2%) was about twice the prevalence of thinness (11.1%). The mean energy intake and energy expenditure of the students was 1772±441kcal/day and 1705±331kcal/day, respectively. Three in five of the students (60.1%) skipped at least one meal and 98.2% snacked between meals daily. A majority of them (55.3%) were sedentary. Low energy intake (p<0.05) and low energy expenditure (p<0.05) were associated with high BMI-for-age. Energy expenditure (β=-0.033) and energy intake (β=-0.090) significantly explained 65.1% of the variances in BMI-for-age (F=119.170, p<0.05). These findings suggested that promoting healthy eating and active lifestyle should be targeted in the prevention and management of obesity among early adolescents. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Effect of changes to the school food environment on eating behaviours and/or body weight in children: a systematic review.

PubMed

Driessen, C E; Cameron, A J; Thornton, L E; Lai, S K; Barnett, L M

2014-12-01

Previous school obesity-prevention reviews have included multi-component interventions. Here, we aimed to review the evidence for the effect of isolated food environment interventions on both eating behaviours (including food purchasing) and/or body weight. Five electronic databases were searched (last updated 30 November 2013). Of the 1,002 unique papers identified, 55 reported on school food environment changes, based on a review of titles and abstracts. Thirty-seven further papers were excluded, for not meeting the inclusion criteria. The final selection consisted of 18 papers (14 United States, 4 United Kingdom). Two studies had a body mass index (BMI) outcome, 14 assessed purchasing or eating behaviours and two studies assessed both weight and behaviour. Seventeen of 18 papers reported a positive outcome on either BMI (or change in BMI) or the healthfulness of food sold or consumed. Two studies were rated as strong quality and 11 as weak. Only three studies included a control group. A school environment supportive of healthy eating is essential to combat heavy marketing of unhealthy food. Modification of the school food environment (including high-level policy changes at state or national level) can have a positive impact on eating behaviours. A need exists, however, for further high-quality studies. © 2014 World Obesity.

Dissemination of an effective weight management program for Mexican American children in schools

USDA-ARS?s Scientific Manuscript database

The rates of child obesity are epidemic in the United States, and Mexican American children are at particular risk. We have found an intensive, multi-component, school-based, weight management intervention to be efficacious at reducing standardized body mass index (zBMI) in overweight children. Our ...

Effect of a park-based after-school program on participant obesity-related health outcomes.

PubMed

Messiah, Sarah E; Diego, Allison; Kardys, Jack; Kirwin, Kevin; Hanson, Eric; Nottage, Renae; Ramirez, Shawn; Arheart, Kristopher L

2015-01-01

The objective of this study was to examine the effect of a structured after-school program housed in a large county parks system on participant health and wellness outcomes. Longitudinal cohort study over one school year (fall 2011-spring 2012). A total of 23 county parks in Florida. Children ages 5 to 16 (N = 349, 55% non-Hispanic black, 40% Hispanic, mean age 8.9 years). An after-school program called Fit-2-Play that integrates daily standardized physical activity and health and wellness education components. Preintervention (August/September 2011) and postintervention (May/June 2012) anthropometric, systolic/diastolic blood pressure, fitness, and health and wellness knowledge measurements were collected. Comparison of pre-post outcome measure means were assessed via general linear mixed models for normal-weight (body mass index [BMI] <85th percentile for age and sex) and overweight/obese (BMI ≥85th percentile for age and sex) participants. The overweight/obese group significantly decreased their mean (1) BMI z score (2.0 to 1.8, p < .01) and (2) subscapular skinfold measurements (19.4 to 17.5 mm, p < .01) and increased (1) mean laps on the Progressive Aerobic Cardiovascular Endurance Run test (10.8 to 12.5, p = .04) and (2) percentage with normal systolic blood pressure (58.1% to 71.0%, p = .03) from pretest to posttest. On average, participants significantly improved their health and wellness knowledge over the school year (p < .01). Normal-weight participants maintained healthy BMI ranges and significantly increased fitness levels. Findings suggest that the Fit-2-Play after-school programs can be a significant resource for combating childhood obesity and instilling positive physical health in children, particularly among ethnic and socioeconomically diverse communities.

Screening High School Students for Eating Disorders: Validity of Brief Behavioral and Attitudinal Measures

ERIC Educational Resources Information Center

Haines, Jess; Ziyadeh, Najat J.; Franko, Debra L.; McDonald, Julia; Mond, Jonathan M.; Austin, S. Bryn

2011-01-01

Background: Early identification can greatly impact the trajectory of eating disorders, and school-based screening is 1 avenue for identifying those at risk. To be feasible in a school setting, a screening program must use a brief, valid screening tool. The aim of this study was to assess how well brief attitudinal and behavioral survey items…

A longitudinal study of childhood obesity, weight status change, and subsequent academic performance in Taiwanese children.

PubMed

Chen, Li-Jung; Fox, Kenneth R; Ku, Po-Wen; Wang, Ching-Hui

2012-09-01

This study examined the association among childhood obesity, weight status change, and subsequent academic performance at 6-year follow-up. First-grade students from one elementary school district in Taichung City, Taiwan were followed for 6 years (N = 409). Academic performance was extracted from the school records at the end of each grade. Weight and height were measured at the beginning of each grade. A weight change variable was created based on each child's weight status difference at grades 1 and 6. A multivariate linear regression model for predicting academic performance at grade 6 was developed with adjustment for individual characteristics and family factors. A latent growth curve (LGC) showed the association between changes in body mass index (BMI) and in academic performance across a 6-year period. BMI in children increased significantly across 6 years. The rate of increase in BMI over 6 years was higher for children with higher baseline BMIs than it was for children with lower baseline BMIs. However, BMI changes were not significantly associated with changes of academic performance. There was no significant relationship between initial obesity or change in weight status and subsequent academic performance. It appears that either being or becoming overweight/obese did not impact academic achievement for these Taiwanese children. © 2012, American School Health Association.

Detection of impaired glucose tolerance and undiagnosed type 2 diabetes in UK South Asians: an effective screening strategy.

PubMed

Hanif, M W; Valsamakis, G; Dixon, A; Boutsiadis, A; Jones, A F; Barnett, A H; Kumar, S

2008-09-01

We tested a stepwise, community-based screening strategy for glucose intolerance in South Asians using a health questionnaire in conjunction with body mass index (BMI). Anthropometric measurements (waist and hip circumference, sagittal diameter and percentage body fat) were then conducted in a hospital setting followed by an oral glucose tolerance test (OGTT) to identify subjects at the highest risk and analyse the factors predicting that risk. A health questionnaire was administered to 435 subjects in a community setting and BMI was measured. Subjects were graded by a risk score based on the health questionnaire as high, medium and low. Subjects with high and medium risk scores and a representative sample of those with low scores had anthropometric measurements in hospital followed by an OGTT. In total, 205 (47%) of the subjects had an OGTT performed. In total, 48.7% of the subjects tested with an OGTT had evidence of glucose dysregulation: 20% had diabetes and 28.7% had impaired glucose tolerance (IGT). Logistic regression model explained 49.1% of the total variability. The significant predictors of diabetes and IGT were Blood Glucose Monitoring Strips (BMI), random blood glucose (BM), sibling with diabetes and presence of diagnosed hypertension or ischaemic disease. Most of these predictors along with other heredity diabetes factors create a composite score, with high predictability, as the receiver operating curve analysis shows. We describe a simple, stepwise strategy in a community setting, based on a health questionnaire and anthropometric measurements, to explain about 50% of cases with IGT and diabetes and diagnose about 50% of cases from the population screened. We have also identified factors that predict the risk.

Body image, BMI, and physical activity in girls and boys aged 14-16 years.

PubMed

Kantanista, Adam; Osiński, Wiesław; Borowiec, Joanna; Tomczak, Maciej; Król-Zielińska, Magdalena

2015-09-01

The aim of this study was to investigate the relationship between body image, body mass index (BMI), and physical activity in adolescents. The study included 1702 girls and 1547 boys aged 14-16 years. Moderate-to-vigorous physical activity (MVPA) was evaluated by the Physical Activity Screening Measure. Body image was assessed using the Feelings and Attitudes Towards the Body Scale, and participants' BMI was determined based on measured height and weight. Compared to boys, girls reported more negative body image (p<.05). The results of the three-way hierarchical regression revealed that body image was a statistically significant positive predictor of MVPA for adolescents, regardless of BMI. Additionally, body image was a stronger predictor of MVPA in boys than in girls. These findings suggest that body image, rather than BMI, is important in undertaking physical activity in adolescents and should be considered when preparing programs aimed at improving physical activity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Identifying symptoms of depression and anxiety in students in the school setting.

PubMed

Allison, Virginia L; Nativio, Donna G; Mitchell, Ann M; Ren, Dianxu; Yuhasz, Janet

2014-06-01

Early detection of mental health problems in school-age children offers the opportunity for prompt referral to treatment which is critical to their success in school. School nurses are in a key position to screen for mental health issues in the school setting. This article discusses how school nurses began a new initiative to use two validated screening tools, the Patient Health Questionnaire-9 item for detecting depression and the 5-item Screen for Child Anxiety Related Emotional Disorders for detecting anxiety in middle school/high school-aged children in selected urban schools. Students having positive screens were referred to the multidisciplinary school-based Student Assistance Program team for further evaluation and referral. These screens improved the identification and referral for treatment of children suffering from anxiety and/or depression by expediting the connection to services.

Positive school climate is associated with lower body mass index percentile among urban preadolescents.

PubMed

Gilstad-Hayden, Kathryn; Carroll-Scott, Amy; Rosenthal, Lisa; Peters, Susan M; McCaslin, Catherine; Ickovics, Jeannette R

2014-08-01

Schools are an important environmental context in children's lives and are part of the complex web of factors that contribute to childhood obesity. Increasingly, attention has been placed on the importance of school climate (connectedness, academic standards, engagement, and student autonomy) as 1 domain of school environment beyond health policies and education that may have implications for student health outcomes. The purpose of this study is to examine the association of school climate with body mass index (BMI) among urban preadolescents. Health surveys and physical measures were collected among fifth- and sixth-grade students from 12 randomly selected public schools in a small New England city. School climate surveys were completed district-wide by students and teachers. Hierarchical linear modeling was used to test the association between students' BMI and schools' climate scores. After controlling for potentially confounding individual-level characteristics, a 1-unit increase in school climate score (indicating more positive climate) was associated with a 7-point decrease in students' BMI percentile. Positive school climate is associated with lower student BMI percentile. More research is needed to understand the mechanisms behind this relationship and to explore whether interventions promoting positive school climate can effectively prevent and/or reduce obesity. © 2014, American School Health Association.

Comparison of Student BMI before and after the National School Lunch Program Nutritional Changes of 2012

ERIC Educational Resources Information Center

Ritenour, Cris Ann

2017-01-01

This study examined differences in grade school students' BMI percentiles before and after the "Healthy, Hunger Free Kids Act" of 2012 and factors that may have influenced those differences. Using publically available data from the Pennsylvania Departments of Health and Education, a comparative analysis of BMI percentiles, ethnicity,…

Parent/Student Risk and Protective Factors in Understanding Early Adolescent's Body Mass Index

ERIC Educational Resources Information Center

Fitzpatrick, Kevin M.; Willis, Don

2016-01-01

This article's aim is to examine correlates of middle school students' body mass index (BMI). Little research simultaneously has considered both child and parent correlates in predicting child's BMI; we examine the interrelationships between middle school students and their parent's risks and protective factors and their impact on the child's BMI.…

Is BMI a relevant marker of fat mass in 4 year old children? Results from the MINISTOP trial.

PubMed

Delisle Nyström, Christine; Henriksson, Pontus; Ek, Anna; Henriksson, Hanna; Ortega, Francisco B; Ruiz, Jonatan R; Löf, Marie

2018-03-20

Due to the increase in childhood obesity, identifying children with excess body fat as early as possible is essential. Body mass index (BMI) is commonly used as a marker of body fat in children, adolescents, and adults, yet whether BMI is a valid marker of body fat in pre-school aged children remains to be confirmed. Therefore, we analyzed the associations of BMI with fat and fat-free mass in healthy 4-year-old Swedish children. The study comprised of 303 children (135 girls) participating in the MINISTOP obesity prevention trial. Fat and fat-free mass were measured using air displacement plethysmography and we computed fat mass index (FMI) and fat free mass index (FFMI) as fat and fat free mass (kg)/height 2 (m). BMI was positively yet weakly associated with percent fat mass (boys: r 2  = 0.120, P < 0.001 and girls: r 2  = 0.224, P < 0.001). There was a strong association between BMI and the FMI (boys: r 2  = 0.468, P < 0.001 and girls r 2  = 0.598, P < 0.001) as well as between BMI and the FFMI (boys: r 2  = 0.621, P < 0.001 and girls: r 2  = 0.499, P < 0.001). Children classified as normal weight had a wide range of percent fat mass (12.3 to 35.3%) and FMI (1.75 to 5.78 kg/m 2 ). BMI was strongly associated to both FMI and FFMI. Therefore, caution is needed when interpreting body fat status based on BMI values in pre-school children.

Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study.

PubMed

Gonzalez, Andrea; Boyle, Michael H; Georgiades, Katholiki; Duncan, Laura; Atkinson, Leslie R; MacMillan, Harriet L

2012-09-09

Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI); however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties) and family level (parental income and education, parental mental and physical health, and family functioning) on BMI in early adulthood. We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4-16 years) enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21-35 years). Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood. At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood. Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.

Prevalence and Prediction of Overweight and Obesity among Elementary School Students

ERIC Educational Resources Information Center

Moreno, Geraldine; Johnson-Shelton, Deb; Boles, Shawn

2013-01-01

Background: The high rates of childhood overweight and obesity in the United States have generated interest in schools as sites for monitoring body mass index (BMI) information. This study established baseline values for a 5-year longitudinal assessment of BMI of elementary school children and examined variation across the schools, because little…

The Cost-Effectiveness of School-Based Eating Disorder Screening

PubMed Central

Austin, S. Bryn; LeAnn Noh, H.; Jiang, Yushan; Sonneville, Kendrin R.

2014-01-01

Objectives. We aimed to assess the value of school-based eating disorder (ED) screening for a hypothetical cohort of US public school students. Methods. We used a decision-analytic microsimulation model to model the effectiveness (life-years with ED and quality-adjusted life-years [QALYs]), total direct costs, and cost-effectiveness (cost per QALY gained) of screening relative to current practice. Results. The screening strategy cost $2260 (95% confidence interval [CI] = $1892, $2668) per student and resulted in a per capita gain of 0.25 fewer life-years with ED (95% CI = 0.21, 0.30) and 0.04 QALYs (95% CI = 0.03, 0.05) relative to current practice. The base case cost-effectiveness of the intervention was $9041 per life-year with ED avoided (95% CI = $6617, $12 344) and $56 500 per QALY gained (95% CI = $38 805, $71 250). Conclusions. At willingness-to-pay thresholds of $50 000 and $100 000 per QALY gained, school-based ED screening is 41% and 100% likely to be cost-effective, respectively. The cost-effectiveness of ED screening is comparable to many other accepted pediatric health interventions, including hypertension screening. PMID:25033131

Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study)

PubMed Central

Pallan, Miranda J; Lancashire, Emma R; Hemming, Karla; Frew, Emma; Barrett, Tim; Bhopal, Raj; Cade, Janet E; Canaway, Alastair; Clarke, Joanne L; Daley, Amanda; Deeks, Jonathan J; Duda, Joan L; Ekelund, Ulf; Gill, Paramjit; Griffin, Tania; McGee, Eleanor; Hurley, Kiya; Martin, James; Parry, Jayne; Passmore, Sandra; Cheng, K K

2018-01-01

Abstract Objective To assess the effectiveness of a school and family based healthy lifestyle programme (WAVES intervention) compared with usual practice, in preventing childhood obesity. Design Cluster randomised controlled trial. Setting UK primary schools from the West Midlands. Participants 200 schools were randomly selected from all state run primary schools within 35 miles of the study centre (n=980), oversampling those with high minority ethnic populations. These schools were randomly ordered and sequentially invited to participate. 144 eligible schools were approached to achieve the target recruitment of 54 schools. After baseline measurements 1467 year 1 pupils aged 5 and 6 years (control: 28 schools, 778 pupils) were randomised, using a blocked balancing algorithm. 53 schools remained in the trial and data on 1287 (87.7%) and 1169 (79.7%) pupils were available at first follow-up (15 month) and second follow-up (30 month), respectively. Interventions The 12 month intervention encouraged healthy eating and physical activity, including a daily additional 30 minute school time physical activity opportunity, a six week interactive skill based programme in conjunction with Aston Villa football club, signposting of local family physical activity opportunities through mail-outs every six months, and termly school led family workshops on healthy cooking skills. Main outcome measures The protocol defined primary outcomes, assessed blind to allocation, were between arm difference in body mass index (BMI) z score at 15 and 30 months. Secondary outcomes were further anthropometric, dietary, physical activity, and psychological measurements, and difference in BMI z score at 39 months in a subset. Results Data for primary outcome analyses were: baseline, 54 schools: 1392 pupils (732 controls); first follow-up (15 months post-baseline), 53 schools: 1249 pupils (675 controls); second follow-up (30 months post-baseline), 53 schools: 1145 pupils (621 controls). The mean BMI z score was non-significantly lower in the intervention arm compared with the control arm at 15 months (mean difference −0.075 (95% confidence interval −0.183 to 0.033, P=0.18) in the baseline adjusted models. At 30 months the mean difference was −0.027 (−0.137 to 0.083, P=0.63). There was no statistically significant difference between groups for other anthropometric, dietary, physical activity, or psychological measurements (including assessment of harm). Conclusions The primary analyses suggest that this experiential focused intervention had no statistically significant effect on BMI z score or on preventing childhood obesity. Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments. Trial registration Current Controlled Trials ISRCTN97000586. PMID:29437667

Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study).

PubMed

Adab, Peymane; Pallan, Miranda J; Lancashire, Emma R; Hemming, Karla; Frew, Emma; Barrett, Tim; Bhopal, Raj; Cade, Janet E; Canaway, Alastair; Clarke, Joanne L; Daley, Amanda; Deeks, Jonathan J; Duda, Joan L; Ekelund, Ulf; Gill, Paramjit; Griffin, Tania; McGee, Eleanor; Hurley, Kiya; Martin, James; Parry, Jayne; Passmore, Sandra; Cheng, K K

2018-02-07

To assess the effectiveness of a school and family based healthy lifestyle programme (WAVES intervention) compared with usual practice, in preventing childhood obesity. Cluster randomised controlled trial. UK primary schools from the West Midlands. 200 schools were randomly selected from all state run primary schools within 35 miles of the study centre (n=980), oversampling those with high minority ethnic populations. These schools were randomly ordered and sequentially invited to participate. 144 eligible schools were approached to achieve the target recruitment of 54 schools. After baseline measurements 1467 year 1 pupils aged 5 and 6 years (control: 28 schools, 778 pupils) were randomised, using a blocked balancing algorithm. 53 schools remained in the trial and data on 1287 (87.7%) and 1169 (79.7%) pupils were available at first follow-up (15 month) and second follow-up (30 month), respectively. The 12 month intervention encouraged healthy eating and physical activity, including a daily additional 30 minute school time physical activity opportunity, a six week interactive skill based programme in conjunction with Aston Villa football club, signposting of local family physical activity opportunities through mail-outs every six months, and termly school led family workshops on healthy cooking skills. The protocol defined primary outcomes, assessed blind to allocation, were between arm difference in body mass index (BMI) z score at 15 and 30 months. Secondary outcomes were further anthropometric, dietary, physical activity, and psychological measurements, and difference in BMI z score at 39 months in a subset. Data for primary outcome analyses were: baseline, 54 schools: 1392 pupils (732 controls); first follow-up (15 months post-baseline), 53 schools: 1249 pupils (675 controls); second follow-up (30 months post-baseline), 53 schools: 1145 pupils (621 controls). The mean BMI z score was non-significantly lower in the intervention arm compared with the control arm at 15 months (mean difference -0.075 (95% confidence interval -0.183 to 0.033, P=0.18) in the baseline adjusted models. At 30 months the mean difference was -0.027 (-0.137 to 0.083, P=0.63). There was no statistically significant difference between groups for other anthropometric, dietary, physical activity, or psychological measurements (including assessment of harm). The primary analyses suggest that this experiential focused intervention had no statistically significant effect on BMI z score or on preventing childhood obesity. Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments. Current Controlled Trials ISRCTN97000586. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Trends in Obesity, Overweight, and Thinness in Children in the Seychelles Between 1998 and 2016.

PubMed

Aly, Rim; Viswanathan, Bharathi; Mangroo, Gaynor; Gedeon, Jude; Bovet, Pascal

2018-03-01

This study assessed trends in the prevalence of children and adolescents with obesity, overweight, and thinness in the Seychelles, a rapidly developing nation in the Indian Ocean, and changes in the distribution of BMI over time. Between 1998 and 2016, examination surveys were conducted every year in all students of four selected school grades (kindergarten, primary 4, secondary 1, and secondary 4) in all schools. We categorized BMI by using the International Obesity Task Force criteria. Based on 70,187 observations, the prevalence of combined overweight or obesity increased largely and monotonically between 1998 and 2016, from 8.9% to 20.0% in boys and from 12.3% to 23.6% in girls, but the prevalence of underweight did not decrease. BMI increased mostly in the upper range of the BMI population distribution: percentile 5 (P5), -1.7%; P10, -0.8%; P25, 0.3%; P50, 2.5%; P75, 7.4%; P90, 12.7%; and P95, 13.3%. The distribution of BMI was increasingly skewed, with a rising prevalence of obesity, a modest or null increase in BMI in a substantial proportion of the population, and a continued burden of underweight. Further studies should assess child growth trajectories and their underlying determinants, which may bear significance for weight control strategies. © 2018 The Obesity Society.

Interethnic differences in the accuracy of anthropometric indicators of obesity in screening for high risk of coronary heart disease

PubMed Central

Herrera, VM; Casas, JP; Miranda, JJ; Perel, P; Pichardo, R; González, A; Sanchez, JR; Ferreccio, C; Aguilera, X; Silva, E; Oróstegui, M; Gómez, LF; Chirinos, JA; Medina-Lezama, J; Pérez, CM; Suárez, E; Ortiz, AP; Rosero, L; Schapochnik, N; Ortiz, Z; Ferrante, D; Diaz, M; Bautista, LE

2009-01-01

Background Cut points for defining obesity have been derived from mortality data among Whites from Europe and the United States and their accuracy to screen for high risk of coronary heart disease (CHD) in other ethnic groups has been questioned. Objective To compare the accuracy and to define ethnic and gender-specific optimal cut points for body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) when they are used in screening for high risk of CHD in the Latin-American and the US populations. Methods We estimated the accuracy and optimal cut points for BMI, WC and WHR to screen for CHD risk in Latin Americans (n=18 976), non-Hispanic Whites (Whites; n=8956), non-Hispanic Blacks (Blacks; n=5205) and Hispanics (n=5803). High risk of CHD was defined as a 10-year risk ≥20% (Framingham equation). The area under the receiver operator characteristic curve (AUC) and the misclassification-cost term were used to assess accuracy and to identify optimal cut points. Results WHR had the highest AUC in all ethnic groups (from 0.75 to 0.82) and BMI had the lowest (from 0.50 to 0.59). Optimal cut point for BMI was similar across ethnic/gender groups (27 kg/m2). In women, cut points for WC (94 cm) and WHR (0.91) were consistent by ethnicity. In men, cut points for WC and WHR varied significantly with ethnicity: from 91 cm in Latin Americans to 102 cm in Whites, and from 0.94 in Latin Americans to 0.99 in Hispanics, respectively. Conclusion WHR is the most accurate anthropometric indicator to screen for high risk of CHD, whereas BMI is almost uninformative. The same BMI cut point should be used in all men and women. Unique cut points for WC and WHR should be used in all women, but ethnic-specific cut points seem warranted among men. PMID:19238159

Healthe Kids: An Assessment of Program Performance and Participation

ERIC Educational Resources Information Center

Dean, Bonnie B.; Kindermann, Sylvia L.; Carson, Tabetha; Gavin, Jan; Frerking, Melissa; Bergren, Martha Dewey

2014-01-01

Many states in the United States have mandated school health screenings for early identification and referral to professional services for a set of health conditions. Healthe Kids, a community-based program, began offering school-based health screenings to Missouri elementary schools in March 2007. The purpose of the article is to provide a…

The Role of BMI in Hip Fracture Surgery.

PubMed

Akinleye, Sheriff D; Garofolo, Garret; Culbertson, Maya Deza; Homel, Peter; Erez, Orry

2018-01-01

Obesity is an oft-cited cause of surgical morbidity and many institutions require extensive supplementary screening for obese patients prior to surgical intervention. However, in the elderly patients, obesity has been described as a protective factor. This article set out to examine the effect of body mass index (BMI) on outcomes and morbidity after hip fracture surgery. The National Surgical Quality Improvement Program database was queried for all patients undergoing 1 of 4 surgical procedures to manage hip fracture between 2008 and 2012. Patient demographics, BMI, and known factors that lead to poor surgical outcomes were included as putative predictors for complications that included infectious, cardiac, pulmonary, renal, and neurovascular events. Using χ 2 tests, 30-day postoperative complication rates were compared between 4 patient groups stratified by BMI as low weight (BMI < 20), normal (BMI = 20-30), obese (BMI = 30-40), and morbidly obese (BMI > 40). A total of 15 108 patients underwent surgery for hip fracture over the examined 5-year period. Of these, 18% were low weight (BMI < 20), 67% were normal weight (BMI = 20-30), 13% were obese (BMI = 30-40), and 2% were morbidly obese (BMI > 40). The low-weight and morbidly obese patients had both the highest mortality rates and the lowest superficial infection rates. There was a significant increase in blood transfusion rates that decreased linearly with increasing BMI. Deep surgical site infection and renal failure increased linearly with increasing BMI, however, these outcomes were confounded by comorbidities. This study demonstrates that patients at either extreme of the BMI spectrum, rather than solely the obese, are at greatest risk of major adverse events following hip fracture surgery. This runs contrary to the notion that obese hip fracture patients automatically require additional preoperative screening and perioperative services, as currently implemented in many institutions.

Sedentary Screen Time and Left Ventricular Structure and Function: the CARDIA Study

PubMed Central

Gibbs, Bethany Barone; Reis, Jared P.; Schelbert, Erik B.; Craft, Lynette L.; Sidney, Steve; Lima, Joao; Lewis, Cora E.

2013-01-01

Sedentary screen time (watching TV or using a computer) predicts cardiovascular outcomes independently from moderate and vigorous physical activity and could impact left ventricular structure and function through the adverse consequences of sedentary behavior. Purpose To determine whether sedentary screen time is associated with measures of left ventricular structure and function. Methods The Coronary Artery Risk Development in Young Adults (CARDIA) Study measured screen time by questionnaire and left ventricular structure and function by echocardiography in 2,854 black and white participants, aged 43–55 years, in 2010–2011. Generalized linear models evaluated cross-sectional trends for echocardiography measures across higher categories of screen time and adjusting for demographics, smoking, alcohol, and physical activity. Further models adjusted for potential intermediate factors (blood pressure, antihypertensive medication use, diabetes, and body mass index (BMI). Results The relationship between screen time and left ventricular mass(LVM) differed in blacks vs. whites. Among whites, higher screen time was associated with larger LVM (P<0.001), after adjustment for height, demographics, and lifestyle variables. Associations between screen time and LVM persisted when adjusting for blood pressure, antihypertensive medication use, and diabetes (P=0.008) but not with additional adjustment for BMI (P=0.503). Similar relationships were observed for screen time with LVM indexed to height2.7, relative wall thickness, and mass-to-volume ratio. Screen time was not associated with left ventricular structure among blacks or left ventricular function in either race group. Conclusions Sedentary screen time is associated with greater LVM in white adults and this relationship was largely explained by higher overall adiposity. The lack of association in blacks supports a potential qualitative difference in the cardiovascular consequences of sedentary screen-based behavior. PMID:23863618

Cross-sectional and prospective associations of meeting 24-h movement guidelines with overweight and obesity in preschool children.

PubMed

Berglind, D; Ljung, R; Tynelius, P; Brooke, H L

2018-01-31

Cross-sectional studies report that meeting the newly developed 24-h movement guidelines (≥60 min moderate to vigorous physical activity (MVPA), ≤120 min screen time and 9-11 h sleep duration) are associated with lower adiposity indicators in children. However, prospective data are absent. The study sample consisted of 830 children from the PRIMROSE study with GT3X+ accelerometer measured physical activity and parent reported screen time and sleep duration at age 4 years and objectively measured anthropometrics at age 4 and 5 years. The main outcome variables were weight status, body mass index (BMI) and BMI z-score at ages 4 and 5 years. Exposure variables were defined as meeting vs. not meeting the 24-h movement guidelines and combinations of these recommendations. On average, 18.4% of the total study sample met the combination of MVPA, sleep duration and screen time recommendations. In isolation, the MVPA, screen time and sleep guidelines were met by 31%, 63% and 98% of the total study sample, respectively. Adherence to any single recommendation, or any combination of recommendations at age 4 years, was not associated with being overweight or obese nor with BMI and BMI z-score at age 4 or 5 years. In contrast to previous cross-sectional studies, neither individual movement behaviours nor combinations of behaviours at age 4 years was associated with overweight or obesity, BMI or BMI z-score at age 4 or 5 years. More prospective data are needed before effects on weight status from meeting the 24-h movement guidelines are elucidated. © 2018 World Obesity Federation.

Associations Between Sedentary Behaviors, Sleep Patterns, and BMI in Young Dancers Attending a Summer Intensive Dance Training Program.

PubMed

Stracciolini, Andrea; Stein, Cynthia J; Kinney, Susan; McCrystal, Tara; Pepin, Michael J; Meehan Iii, William P

2017-09-15

The purpose of this study was to investigate associations between sedentary behaviors, sleep hours, and body mass index (BMI) in 12- to 17-year-old dancers. This was a cross sectional survey in which bivariate correlation and simple linear regression were used to determine associations between self-reported components. One hundred fifteen dancers were queried, 91.3% of whom were female. The mean BMI was 19.6 ± 2.3 kg/m2. Two-thirds of dancers fell below the 50th percentile for age-adjusted BMI, and 30.4% fell below the 25th percentile. Better than 12% of dancers reported a history of anxiety, and 2.6% reported depression. Mean hours of sleep per night was 7.8 ± 0.9, with 58% of the dancers getting less than 8 hours of sleep per night. The mean total screen time for dancers was 3.4 ± 2.1 hours/day, which consisted of tablet and computer usage: 1.6 ± 1.1 hours/day; texting: 0.5 ± 1.1 hours/day; watching television: 1.2 ± 1.1 hours/day; and playing video games 1.2 ± 1.1 hours/ day. Total screen time was independently associated positively with BMI, explaining nearly 10% of the variability in BMI. Age, hours dancing per day, and hours of sleep per night were not independently associated with BMI. To summarize: screen time was associated with increased BMI in this young dancer cohort; the majority of dancers slept less than 8 hours per night; anticipatory guidance addressing media use and sleep hygiene in the adolescent dancer population is needed.

Positive School Climate Is Associated With Lower Body Mass Index Percentile Among Urban Preadolescents

PubMed Central

Gilstad-Hayden, Kathryn; Carroll-Scott, Amy; Rosenthal, Lisa; Peters, Susan M.; McCaslin, Catherine; Ickovics, Jeannette R.

2015-01-01

BACKGROUND Schools are an important environmental context in children’s lives and are part of the complex web of factors that contribute to childhood obesity. Increasingly, attention has been placed on the importance of school climate (connectedness, academic standards, engagement, and student autonomy) as 1 domain of school environment beyond health policies and education that may have implications for student health outcomes. The purpose of this study is to examine the association of school climate with body mass index (BMI) among urban preadolescents. METHODS Health surveys and physical measures were collected among fifth- and sixth-grade students from 12 randomly selected public schools in a small New England city. School climate surveys were completed district-wide by students and teachers. Hierarchical linear modeling was used to test the association between students’ BMI and schools’ climate scores. RESULTS After controlling for potentially confounding individual-level characteristics, a 1-unit increase in school climate score (indicating more positive climate) was associated with a 7-point decrease in students’ BMI percentile. CONCLUSIONS Positive school climate is associated with lower student BMI percentile. More research is needed to understand the mechanisms behind this relationship and to explore whether interventions promoting positive school climate can effectively prevent and/or reduce obesity. PMID:25040118

Improving physical self-perception in adolescent boys from disadvantaged schools: psychological outcomes from the Physical Activity Leaders randomized controlled trial.

PubMed

Morgan, P J; Saunders, K L; Lubans, D R

2012-06-01

To evaluate the effect of a school-based obesity prevention programme on physical self-perception and key physical-activity related cognitions in adolescent boys from disadvantaged secondary schools. A secondary objective was to determine if any psychological changes were associated with improved weight status. Participants (n = 100, age = 14.3[0.6]) were randomized to the PALS (Physical Activity Leaders) intervention (n = 50) or a control group (n = 50) and assessed at baseline, 3- and 6-month follow up. Measures included BMI, BMI z-score and % body fat (bioelectrical impedance analysis). Students also completed the Children's Physical Self-Perception Profile and a physical activity-related cognitions questionnaire. The findings include secondary data analyses. Relative to the controls, the PALS group significantly increased their physical self worth (p = .01), perceived physical condition (p = .02), resistance training self efficacy (p < .001) and their use of physical activity behavioural strategies (p = .02). A school-based obesity prevention programme that targeted leadership skills improved psychological health in the physical domain in adolescent boys from disadvantaged schools. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

Young children's after-school activities - there's more to it than screen time: a cross-sectional study of young primary school children.

PubMed

Engelen, Lina; Bundy, Anita C; Bauman, Adrian; Naughton, Geraldine; Wyver, Shirley; Baur, Louise

2015-01-01

Children can spend substantial amounts of leisure time in sedentary activities, dominated by TV/screen time. However, objective real-time measurement of activities after school among young school children is seldom described. School children (n = 246, 5-7 years old, mean 6.0) and their parents were recruited by random selection from 14 schools across Sydney, Australia. Parents used a real-time objective measure (Experience Sampling Method, ESM) to record children's activities and whether they were indoors or outdoors at 3 random times each day after school. Data were collected across 4 weekdays in 1 week and then, 13 weeks later, another 4 weekdays in 1 week. Results were based on 2940 responses from 214 child-parent dyads showed that 25% of behavior involved physical activity, 51% was spent in sedentary activities, and 22% was TV/screen time. Most instances (81%) occurred indoors. Despite a high proportion of TV/screen time, children were also engaged in a range of other sedentary and physically active pursuits after school. Hence TV/screen time is not a suitable proxy for all sedentary behavior, and it is important to gather information on other non-screen-based sedentary and physically active behaviors. Future research is warranted to further investigate after-school activities in young primary school children.

BMI, total and abdominal fat distribution, and cardiovascular risk factors in school-age children.

PubMed

Gishti, Olta; Gaillard, Romy; Durmus, Busra; Abrahamse, Marieke; van der Beek, Eline M; Hofman, Albert; Franco, Oscar H; de Jonge, Layla L; Jaddoe, Vincent W V

2015-05-01

More specific total body and abdominal fat mass measures might be stronger associated with cardiovascular risk factors in childhood, than BMI. We examined the independent associations of total and abdominal fat measures with cardiovascular risk factors in school age children. We performed a population-based cohort study among 6,523 children. At the age of 6 y, we measured childhood BMI, and general and abdominal fat mass, using dual-energy X-ray absorptiometry, and ultrasound and cardiovascular risk factors. Conditional on BMI, higher fat mass percentage and abdominal fat mass were associated with higher blood pressure, total- and low-density lipoprotein (LDL)-cholesterol, insulin and c-peptide levels, but with lower left ventricular mass and high-density lipoprotein (HDL)-cholesterol (P values < 0.05). These associations differed between underweight, normal weight, overweight, and obese children. Higher childhood adiposity measures were associated with increased odds of cardiovascular risk factors clustering, with the strongest effect for fat mass percentage (odds ratios: 3.01 (95% confidence interval: 2.67, 3.9). Our results suggest that general and abdominal fat measures are associated with cardiovascular risk factors in childhood, independent from BMI. These measures may provide additional information for identification of children with an adverse cardiovascular profile.

The effect of interventions targeting screen time reduction: A systematic review and meta-analysis.

PubMed

Wu, Lei; Sun, Samio; He, Yao; Jiang, Bin

2016-07-01

Previous studies have evaluated the effectiveness of interventions aimed at screen time reduction, but the results have been inconsistent. We therefore conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to summarize the accumulating evidence of the impact of interventions targeting screen time reduction on body mass index (BMI) reduction and screen time reduction. The PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for RCTs on the effect of interventions targeting screen time reduction. The primary and secondary outcomes were the mean difference between the treatment and control groups in the changes in BMI and changes in screen viewing time. A random effects model was used to calculate the pooled mean differences. Fourteen trials including 2238 participants were assessed. The pooled analysis suggested that interventions targeting screen time reduction had a significant effect on BMI reduction (-0.15 kg/m, P < 0.001, I = 0) and on screen time reduction (-4.63 h/w, P = 0.003, I = 94.6%). Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention was <7 months and that the types of interventions in those studies were health promotion curricula or counseling. Interventions for screen time reduction might be effective in reducing screen time and preventing excess weight. Further rigorous investigations with larger samples and longer follow-up periods are still needed to evaluate the efficacy of screen time reduction both in children and in adults.

Relationship of body mass index to percent body fat and waist circumference among schoolchildren in Japan--the influence of gender and obesity: a population-based cross-sectional study.

PubMed

Ochiai, Hirotaka; Shirasawa, Takako; Nishimura, Rimei; Morimoto, Aya; Shimada, Naoki; Ohtsu, Tadahiro; Kujirai, Emiko; Hoshino, Hiromi; Tajima, Naoko; Kokaze, Akatsuki

2010-08-18

Although the correlation coefficient between body mass index (BMI) and percent body fat (%BF) or waist circumference (WC) has been reported, studies conducted among population-based schoolchildren to date have been limited in Japan, where %BF and WC are not usually measured in annual health examinations at elementary schools or junior high schools. The aim of the present study was to investigate the relationship of BMI to %BF and WC and to examine the influence of gender and obesity on these relationships among Japanese schoolchildren. Subjects included 3,750 schoolchildren from the fourth and seventh grade in Ina-town, Saitama Prefecture, Japan between 2004 and 2008. Information about subject's age, sex, height, weight, %BF, and WC was collected from annual physical examinations. %BF was measured with a bipedal biometrical impedance analysis device. Obesity was defined by the following two criteria: the obese definition of the Centers for Disease Control and Prevention, and the definition of obesity for Japanese children. Pearson's correlation coefficients between BMI and %BF or WC were calculated separately for sex. Among fourth graders, the correlation coefficients between BMI and %BF were 0.74 for boys and 0.97 for girls, whereas those between BMI and WC were 0.94 for boys and 0.90 for girls. Similar results were observed in the analysis of seventh graders. The correlation coefficient between BMI and %BF varied by physique (obese or non-obese), with weaker correlations among the obese regardless of the definition of obesity; most correlation coefficients among obese boys were less than 0.5, whereas most correlations among obese girls were more than 0.7. On the other hand, the correlation coefficients between BMI and WC were more than 0.8 among boys and almost all coefficients were more than 0.7 among girls, regardless of physique. BMI was positively correlated with %BF and WC among Japanese schoolchildren. The correlations could be influenced by obesity as well as by gender. Accordingly, it is essential to consider gender and obesity when using BMI as a surrogate for %BF and WC for epidemiological use.

Presenters in Focus: School-Based Social-Emotional and Behavior Screening--Using Data to Guide Interventions

ERIC Educational Resources Information Center

Eklund, Katie; Kilgus, Stephen

2017-01-01

Systematic screening for behavioral and social-emotional concerns at school is one way to ensure that at-risk children are identified and provided services. School psychologists play a critical role in creating multitiered systems of support that consider universal screening, early intervention, and ongoing progress monitoring to help support…

Hip-Hop to Health Jr. Randomized Effectiveness Trial: 1-Year Follow-up Results.

PubMed

Kong, Angela; Buscemi, Joanna; Stolley, Melinda R; Schiffer, Linda A; Kim, Yoonsang; Braunschweig, Carol L; Gomez-Perez, Sandra L; Blumstein, Lara B; Van Horn, Linda; Dyer, Alan R; Fitzgibbon, Marian L

2016-02-01

The preschool years provide a unique window of opportunity to intervene on obesity-related lifestyle risk factors during the formative years of a child's life. The purpose of this study was to assess the impact of a preschool-based obesity prevention effectiveness trial at 1-year follow-up. RCT. Primarily African American children (aged 3-5 years, N=618) attending Head Start preschool programs administered by Chicago Public Schools. Eighteen preschools were randomly assigned in 2007-2008 to receive either (1) a 14-week teacher-delivered intervention focused on healthy lifestyle behaviors or (2) a 14-week teacher-delivered general health curriculum (control group). The primary outcome, BMI, was measured at baseline, postintervention, and 1-year follow-up. Diet and screen time behaviors were also assessed at these time points. Multilevel mixed effects models were used to test for between-group differences. Data were analyzed in 2014. Significant between-group differences were observed in diet, but not in BMI z-score or screen time at 1-year follow-up. Diet differences favored the intervention arm over controls in overall diet quality (p=0.02) and in subcomponents of diet quality, as measured by the Healthy Eating Index-2005, and in fruit intake (servings/day, excludes juice) (p=0.02). Diet quality worsened more among controls than the intervention group at 1-year follow-up. The adaptation of Hip-Hop to Health Jr. produced modest benefits in diet quality but did not significantly impact weight gain trajectory. Not unlike other effectiveness trials, this real-world version delivered by Head Start teachers produced fewer benefits than the more rigorous efficacy trial. It is important to understand and build upon the lessons learned from these types of trials so that we can design, implement, and disseminate successful evidence-based programs more widely and effectively. This study is registered at www.clinicaltrials.gov NCT00241878. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Hip-Hop to Health Jr. Randomized Effectiveness Trial

PubMed Central

Kong, Angela; Buscemi, Joanna; Stolley, Melinda R.; Schiffer, Linda A.; Kim, Yoonsang; Braunschweig, Carol L.; Gomez-Perez, Sandra L.; Blumstein, Lara B.; Van Horn, Linda; Dyer, Alan R.; Fitzgibbon, Marian L.

2015-01-01

Introduction The preschool years provide a unique window of opportunity to intervene on obesity-related lifestyle risk factors during the formative years of a child’s life. The purpose of this study was to assess the impact of a preschool-based obesity prevention effectiveness trial at 1-year follow-up. Design RCT. Settings/participants Primarily African American children (aged 3–5 years, N=618) attending Head Start preschool programs administered by Chicago Public Schools. Methods Eighteen preschools were randomly assigned in 2007–2008 to receive either: (1) a 14-week teacher-delivered intervention focused on healthy lifestyle behaviors; or (2) a 14-week teacher-delivered general health curriculum (control group). Main outcome measures The primary outcome, BMI, was measured at baseline, post-intervention, and 1-year follow-up. Diet and screen time behaviors were also assessed at these time points. Multilevel mixed effects models were used to test for between-group differences. Data were analyzed in 2014. Results Significant between-group differences were observed in diet, but not in BMI z-score or screen time at 1-year follow-up. Diet differences favored the intervention arm over controls in overall diet quality (p=0.02) and in subcomponents of diet quality, as measured by the Healthy Eating Index-2005, and in fruit intake (servings/day, excludes juice) (p=0.02). Diet quality worsened more among controls than the intervention group at 1-year follow-up. Conclusions The adaptation of Hip-Hop to Health Jr. produced modest benefits in diet quality, but did not significantly impact weight gain trajectory. Not unlike other effectiveness trials, this real-world version delivered by Head Start teachers produced fewer benefits than the more rigorous efficacy trial. It is important to understand and build upon the lessons learned from these types of trials so that we can design, implement, and disseminate successful evidence-based programs more widely and effectively. PMID:26385162

Universal Emotional Health Screening at the Middle School Transition

PubMed Central

Stoep, Ann Vander; McCauley, Elizabeth; Thompson, Kelly A.; Herting, Jerald R.; Kuo, Elena S.; Stewart, David G.; Anderson, Cheryl A.; Kushner, Siri

2011-01-01

This article describes the implementation of the Developmental Pathways Screening Program (DPSP) and an evaluation of program feasibility, acceptability, and yield. Using the Mood and Feelings Questionnaire (MFQ) and externalizing questions from the Youth Self Report (YSR; Achenbach, 2001), universal classroom-based emotional health screening was implemented with students as they began middle school. Of all sixth graders enrolled in four participating Seattle schools, 861 (83%) were screened. Students who screened positive for emotional distress (15% of students screened) received onsite structured clinical evaluations with children's mental health professionals. Seventy-one percent of students who were evaluated were found to be experiencing significant emotional distress, with 59% warranting referral to academic tutoring, school counselor, and/or community mental health services. Successful implementation of in-class screening was facilitated by strong collaboration between DPSP and school staff. Limitations of emotional health screening and the DPSP are discussed, and future steps are outlined. PMID:21430789

Prevalence of Mammographically Dense Breasts in the United States

PubMed Central

Gangnon, Ronald E.; Burt, Veronica; Trentham-Dietz, Amy; Hampton, John M.; Wellman, Robert D.; Kerlikowske, Karla; Miglioretti, Diana L.

2014-01-01

Background National legislation is under consideration that would require women with mammographically dense breasts to be informed of their breast density and encouraged to discuss supplemental breast cancer screening with their health care providers. The number of US women potentially affected by this legislation is unknown. Methods We determined the mammographic breast density distribution by age and body mass index (BMI) using data from 1518 599 mammograms conducted from 2007 through 2010 at mammography facilities in the Breast Cancer Surveillance Consortium (BCSC). We applied these breast density distributions to age- and BMI-specific counts of the US female population derived from the 2010 US Census and the National Health and Nutrition Examination Survey (NHANES) to estimate the number of US women with dense breasts. Results Overall, 43.3% (95% confidence interval [CI] = 43.1% to 43.4%) of women 40 to 74 years of age had heterogeneously or extremely dense breasts, and this proportion was inversely associated with age and BMI. Based on the age and BMI distribution of US women, we estimated that 27.6 million women (95% CI = 27.5 to 27.7 million) aged 40 to 74 years in the United States have heterogeneously or extremely dense breasts. Women aged 40 to 49 years (N = 12.3 million) accounted for 44.3% of this group. Conclusion The prevalence of dense breasts among US women of common breast cancer screening ages exceeds 25 million. Policymakers and healthcare providers should consider this large prevalence when debating breast density notification legislation and designing strategies to ensure that women who are notified have opportunities to evaluate breast cancer risk and discuss and pursue supplemental screening options if deemed appropriate. PMID:25217577

Diabetes risk factors in children: a partnership between nurse practitioner and high school students.

PubMed

Lipman, Terri H; Schucker, Mary McGrath; Ratcliffe, Sarah J; Holmberg, Tyler; Baier, Scott; Deatrick, Janet A

2011-01-01

This project was a 4-year university/community collaboration to (1) screen for diabetes risk factors in children from in an inner-city community; (2) assess children's knowledge of nutrition and measure their physical endurance; and (3) survey parents about barriers to healthy living. Descriptive cross-sectional study utilizing a community participatory-based research approach. For a 4-week period each year, nurse practitioner students and high school students partnered in an evaluation of elementary school children that included assessment of (1) height, weight, waist circumference, BMI, and acanthosis nigricans; (2) scores on a nutrition knowledge test; and (3) recovery heart rate after a dance activity. Parents of the children were surveyed regarding barriers to healthy eating and activity. A total of 240 African American children were evaluated: 25% were obese, 24% had a waist circumference >95th percentile, and 14% had acanthosis nigricans. The mean score of a nutrition knowledge test was 65%, and recovery heart rates were significantly higher than preexercise heart rates. Of 48 parents surveyed, the most common barrier to eating healthy reported was the children's picky eating (62%), and most common barrier to activity was lack of access to safe places to play (54%). Nurses working with children from inner-city communities should be especially aware of the children's many risk factors for diabetes. Clinicians who hope to make a difference in altering these risks should collaborate with the community to target high-risk populations for diabetes screening, promote good nutrition and exercise, and address barriers to healthy living. When developing plans of care for children, regardless of setting, it is critical to understand the community and incorporate the families as partners in developing culturally relevant interventions.

Peer mentor versus teacher delivery of a physical activity program on the effects of BMI and daily activity: protocol of a school-based group randomized controlled trial in Appalachia.

PubMed

Smith, Laureen H; Petosa, Rick L; Shoben, Abigail

2018-05-16

Rural Appalachian populations have poorer health and fewer positive health-related behaviors compared to other United States populations. Appalachians are the most sedentary U.S. population and teens are particularly sedentary. Obesity prevention through improving physical activity is a top priority in Rural Healthy People 2020. Obesity prevalence among Appalachian teens exceeds the national rates of 13.9% and has consistently been greater than 26%. Organized sports has not been effective at improving daily physical activity or health outcomes for Appalachian teens. The purpose of this study is to test the efficacy of a 10-week school-based intervention in promoting self-regulation of physical activity among adolescents not participating in organized sports. By using accelerometers, our study will measure both sedentary time and planned exercise during waking hours. The design for this four-year study is a group-randomized controlled trial (G-RCT). We will recruit high schools in 3 waves, with 4 in Wave 1, 8 in Wave 2, and 8 in Wave 3, for a total of 20 schools. For each wave of schools, we will randomly assign half of the schools to each condition--intervention (peer-to-peer mentoring [MBA]) and comparison (teacher-led [PBA])--for a total of 10 schools in each of the two conditions by study's end. We will collect data at baseline (T 1 ), 3 months post intervention (T 2 ), and 6 months post intervention (T 3 ). Linear Mixed Models (LMMs) and Generalized Linear Mixed Models (GLMMs) will be used to test the main hypotheses. Power for this study was based the primary analysis comparing BMI outcomes at T 2 between the groups, adjusting for baseline BMI values. This study provides age-appropriate lifestyle education and skill building. Peer-to-peer mentoring by local high school students and school-based tailored support strengthens sustainable behavioral change. Focusing on unique healthy-lifestyle challenges prevalent in low-resource areas such as Appalachia such as overcoming environmental, social, and psychological barriers may improve adherence to physical activity. Serving as role models, peer mentors may improve their own lifestyle behaviors, providing a dual intervention. NCT02329262 .

Development and Validation of the Social, Academic, and Emotional Behavior Risk Screener-Student Rating Scale

ERIC Educational Resources Information Center

von der Embse, Nathaniel P.; Iaccarino, Stephanie; Mankin, Ariel; Kilgus, Stephen P.; Magen, Eran

2017-01-01

School systems are the primary providers for the increasing number of children with mental health needs. School-based universal screening offers a valuable way to identify children that would benefit from school-based mental health services. However, many existing screening systems rely on teacher ratings alone and do not incorporate student…

Meeting new Canadian 24-Hour Movement Guidelines for the Early Years and associations with adiposity among toddlers living in Edmonton, Canada.

PubMed

Lee, Eun-Young; Hesketh, Kylie D; Hunter, Stephen; Kuzik, Nicholas; Rhodes, Ryan E; Rinaldi, Christina M; Spence, John C; Carson, Valerie

2017-11-20

Canada has recently released guidelines that include toddler-specific recommendations for physical activity, screen-based sedentary behaviour, and sleep. This study examined the proportions of toddlers meeting the new Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years) and associations with body mass index (BMI) z-scores in a sample from Edmonton, Canada. Participants included 151 toddlers (aged 19.0 ± 1.9 months) for whom there was complete objectively measured physical activity data from the Parents' Role in Establishing healthy Physical activity and Sedentary behaviour habits (PREPS) project. Toddlers' physical activity was measured using ActiGraph wGT3X-BT monitors. Toddlers' screen time and sleep were measured using the PREPS questionnaire. Toddlers' height and weight were objectively measured by public health nurses and BMI z-scores were calculated using World Health Organization growth standards. Meeting the overall 24-Hour Movement Guidelines was defined as: ≥180 min/day of total physical activity, including ≥1 min/day of moderate- to vigorous-intensity physical activity; no screen time per day (for those aged 12-23 months) or ≤1 h/day of screen time per day (ages 24-35 months); and 11-14 h of sleep per 24-h period. Frequency analyses and linear regression models were conducted. Only 11.9% of toddlers met the overall 24-Hour Movement Guidelines, but this finding was largely driven by screen time. The majority of toddlers met the individual physical activity (99.3%) and sleep (82.1%) recommendations, while only 15.2% of toddlers met the screen time recommendation. No associations were observed between meeting specific and general combinations of recommendations within the guidelines and BMI z-scores. Most toddlers in this sample were meeting physical activity and sleep recommendations but were engaging in more screen time than recommended. Consequently, only a small proportion of toddlers met the overall guidelines. Based on the findings of this study, identifying modifiable correlates of screen time to inform appropriate strategies to reduce screen time appears key for increasing the proportion of toddlers meeting the 24-Hour Movement Guidelines for the Early Years. Future research should examine the associations between meeting the new guidelines and other health indicators. Furthermore, future high-quality studies examining dose-response relationships between movement behaviours and health indicators are needed to inform guideline updates.

Gender differences in physiologic markers and health behaviors associated with childhood obesity.

PubMed

Govindan, Morgen; Gurm, Roopa; Mohan, Sathish; Kline-Rogers, Eva; Corriveau, Nicole; Goldberg, Caren; Durussel-Weston, Jean; Eagle, Kim A; Jackson, Elizabeth A

2013-09-01

Previous studies have demonstrated gender-related differences in body composition, physical activity, and diet. This observational study assesses gender variance in independent predictors for obesity to determine targeted areas for intervention. Data from 1714 sixth-grade students enrolled in Project Healthy Schools were compared by using health behaviors and physiologic markers (lipids, random glucose, blood pressure, and resting and recovery heart rates). Students were stratified by gender and obesity (BMI ≥95th percentile by age and gender). Physiologic markers and behaviors were compared by using χ(2) analysis. Univariate associations with P < .10 were included in a stepwise logistic regression model to determine independent predictors for obesity by gender. Nonobese students (both boys and girls) showed significantly healthier physiologic parameters compared with their obese counterparts. Two behaviors independently correlated with obesity in both boys and girls: regularly eating school lunches (odds ratio [OR] 1.29, 95% confidence interval [CI] 1.01-1.64; OR 1.27, 95% CI 1.00-1.62, respectively) and watching ≥2 hours of television per day (OR 1.19, 95% CI 1.07-1.32; OR 1.19, 95% CI 1.06-1.34, respectively). Vigorous physical activity and involvement in school sports teams appeared to be protective against obesity in boys (OR 0.90, 95% CI 0.82-0.98; OR 0.77, 95% CI 0.64-0.94, respectively), whereas milk consumption appeared protective in girls (OR 0.81, 95% CI 0.67-0.98). Among middle-school children, we observed gender-related differences in factors associated with obesity. Additional research is warranted to determine the beneficial impact of improving school lunches and decreasing screen time, while improving our understanding of gender-related differences in milk consumption and physical activities in relation to BMI.

[Evaluation of an education intervention for childhood obesity prevention in basic schools in Chile].

PubMed

Lobos Fernández, Luz Lorena; Leyton Dinamarca, Bárbara; Kain Bercovich, Juliana; Vio del Río, Fernando

2013-01-01

The aim of this study was to evaluate a comprehensive intervention in nutrition education and physical activity to prevent childhood obesity in primary school children of low socioeconomic status in Macul county in Chile, with a two year follow-up (2008 and 2009) of the children. The intervention consisted in teacher nutrition training in healthy eating and the implementation of educational material based on Chilean dietary guidelines. In addition, there was an increase in physical education classes to 3-4 hours per week and physical education teachers were recruited for that purpose. Weight, height and six minutes walk test (6MWT) were measured and body mass index (BMI), BMI Z score, prevalence of normal, overweight and obese children were calculated with WHO 2007reference. Changes between baseline and BMI Z in each period and 6MWT/height, and changes in nutrition knowledge through questionnaires were measured. There was no significant difference in BMI Z score between the initial and final periods and in the evolution of the nutritional status of children. Nutrition knowledge improved significantly between the two measurements. There was a significant increase in 6MWT/height (10 meters between baseline and follow-up, p < 0.001). We conclude that although there was an improvement in nutrition knowledge and physical fitness of children, there was a stabilization of BMI Z score in the period of the study. New educational interventions are required according to the reality of each community to obtain a positive impact to prevent childhood obesity in primary schools. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Depressive Symptoms Are Associated with Excess Weight and Unhealthier Lifestyle Behaviors in Urban Adolescents

PubMed Central

Castillo, Fiorella; Francis, Lori; Wylie-Rosett, Judith

2014-01-01

Abstract Background: Adolescence is a critical period for the development of depressive symptoms and obesity. This study examined the association of depressive symptoms with standardized BMI (BMI z-score), lifestyle behaviors, and self-efficacy measures in a sample of urban adolescents. Methods: A school-based study was conducted among adolescents (N=1508) enrolled from 11 public schools. Depressive symptoms were assessed with Kandel's depressive symptoms scale for adolescents. Fruit and vegetable intake and intake of energy-dense foods were assessed by a short food frequency questionnaire. Sedentary behavior and physical activity (PA) were obtained by self-report. Height and weight were measured directly and BMI z-scores were calculated. Mixed-effects models were used to examine the association of depressive symptoms with BMI z-score and lifestyle behaviors, accounting for clustering at school level and adjusting for confounders. Self-efficacy measures were evaluated as potential mediators. Results: The sample was 53% female, 75% Hispanic, and 82% US born, with a mean age of 13.9 years. Higher depressive symptoms were associated with higher BMI z-score (β=0.02; p=0.02), intake of energy-dense foods (β=0.42; p<0.001), and sedentary behavior (β=0.48; p<0.001), but lower PA (β=−0.03; p=0.01). There was an interaction by gender in the association of depressive symptoms and PA. Self-efficacy mediated the association of depressive symptoms and PA. Conclusions: Obesity prevention and treatment programs should consider addressing the role of negative emotions as part of their preventive strategies. PMID:25181530

Teacher and peer reports of overweight and bullying among young primary school children.

PubMed

Jansen, Pauline W; Verlinden, Marina; Dommisse-van Berkel, Anke; Mieloo, Cathelijne L; Raat, Hein; Hofman, Albert; Jaddoe, Vincent W V; Verhulst, Frank C; Jansen, Wilma; Tiemeier, Henning

2014-09-01

Overweight is a potential risk factor for peer victimization in late childhood and adolescence. The current study investigated the association between BMI in early primary school and different bullying involvement roles (uninvolved, bully, victim, and bully-victim) as reported by teachers and children themselves. In a population-based study in the Netherlands, measured BMI and teacher-reported bullying behavior were available for 4364 children (mean age = 6.2 years). In a subsample of 1327 children, a peer nomination method was used to obtain child reports of bullying. In both teacher- and child-reported data, a higher BMI was associated with more victimization and more bullying perpetration. For instance, a 1-point increase in BMI was associated with a 0.05 increase on the standardized teacher-reported victimization score (95% confidence interval, 0.03 to 0.07; P < .001). Combining the victimization and bullying scores into different types of bullying involvement showed that children with obesity, but not children with overweight, had a significantly higher risk to be a bully-victim (odds ratio = 2.25; 95% confidence interval, 1.62 to 3.14) than normal-weight peers. At school entry, a high BMI is a risk factor associated with victimization and bullying perpetration, with obese children particularly likely to be victims and aggressors. Results were consistent for teacher and child reports of bullying, supporting the validity of our findings. Possibly, obesity triggers peer problems, but the association may also reflect a common underlying cause that makes obese children vulnerable to bullying involvement. Copyright © 2014 by the American Academy of Pediatrics.

The Healthy Fitness Zone Continuum Score as a Measure of Change in Body Mass Index of School-Aged Children and Adolescents, Georgia, 2012-2014.

PubMed

Saint-Maurice, Pedro F; Welk, Gregory J; Bai, Yang

The FitnessGram Healthy Fitness Zone continuum (HFZc) score reflects the relative difference of a person's body mass index (BMI) from the established FitnessGram standard. As such, it may provide added utility for public health programming and research on obesity among school-aged children and adolescents. We used the standard BMI Z (BMIz) score and the alternative HFZc score to describe changes in BMI of school-aged children and adolescents in Georgia over time. We compiled 2012-2014 BMI data from the Georgia FitnessGram database. The sample included 162 992 boys and 141 711 girls enrolled in 239 schools from a large urban district in Georgia. We analyzed trends in BMIz and HFZc scores separately for normal-weight, overweight, and obese categories for school-aged children and adolescents using hierarchical linear models. From 2012 to 2014, the BMIz score shifted favorably in up to 40.7% (2052/5047) of normal-weight, 51.0% (758/1485) of overweight, and 52.8% (5430/10 279) of obese students. We also found favorable shifts in HFZc score in up to 69.8% (105 831/151 739) of normal-weight, 78.3% (3605/4603) of overweight, and 80.8% (8305/10 279) of obese students. Compared with the BMIz score, the HFZc score may be a better indicator of favorable changes in BMI over time among school-aged children and adolescents with different baseline BMI levels, making it potentially valuable for use in individualized assessments, school programs, obesity research, and public health curriculum and policy development.

Stunting and weight statuses of adolescents differ between public and private schools in urban Gambia.

PubMed

Juwara, Alimatou; Huang, Nicole; Chien, Li-Ying; Chen, Hsin-Jen

2016-07-01

This study assessed the disparity in nutritional status of adolescents between public and private schools in urban Gambia. This is a school-based cross-sectional study in six private and six public upper basic schools in urban Gambia. This study recruited 491 students from public and 469 students from private schools (13-15 years of age). The prevalence of stunting (WHO height-for-age Z < -2SD) was 13.4 % for public school students and 4.5 % for private schools. After adjustment for children's sex, age, and family socioeconomic status, the differences in prevalence of stunting and underweight were significant between public and private schools. Private school students are more likely to be overweight/obese (WHO BMI-for-age Z > +1SD) (OR = 2.85, 95 % CI 1.55-5.22), but less likely to be thin (BMI-for-age Z < -2SD) (OR = 0.61 [0.39-0.96]), compared to public school students. Children from lower income families had lower odds for overweight/obese than normal weight, compared to those from higher income families (OR = 0.34 [0.15-0.76]). Public and private schools in urban regions of the Gambia may face different nutritional challenges due to differences in school environment and resources.

The Body Mass Index of Adolescents Attending Seventh-Day Adventist Schools in Australia: 2001-2012.

PubMed

Craig, Bevan A; Morton, Darren P; Kent, Lillian M; Butler, Terry L; Rankin, Paul M; Price, Kevin R

2017-08-01

We examined the body mass index (BMI) of students attending Seventh-day Adventist (Adventist) schools in Australia in 2001 and 2012. A total of 3069 students attending Adventist schools in Australia responded to a health and lifestyle survey in 2001 (N = 1335) and 2012 (N = 1734). The survey captured self-reported height and weight, demographics (age, sex, year level, religion), and select health behaviors. Compared with national norms, lower rates of overweight and obesity were observed in the study cohort, but higher rates of underweight. There was no change in the mean BMI of the students attending Adventist schools in Australia from 2001 to 2012. Regression analyses indicated that a lower BMI was associated with age, sex, more regularly eating breakfast, consuming less soft drink, and having a regular exercise program. The students reported a high consumption of fruits, vegetables, and whole grains compared with Australian national norms, and 29% claimed to be vegetarian. Students attending Adventist schools appear to have a lower prevalence of overweight and obesity than the secular population, but a higher prevalence of underweight. The mechanisms through which Adventist schools may influence student's BMI warrants further investigation. © 2017, American School Health Association.

School-based sports participation and its effects on weight maintenance in Mexican American adolescents: A two-year analysis

USDA-ARS?s Scientific Manuscript database

Participation in sports has been shown to decrease standardized body mass index (zBMI), especially in school settings. Few studies have examined the impact of sports participation in a Mexican American sample. The purpose of this investigation was to examine the effect of sports participation on wei...

Lifestyle modifications in an adolescent dormitory: a clinical trial.

PubMed

Abu-Kishk, Ibrahim; Alumot-Yehoshua, Michal; Reisler, Gadi; Efrati, Shai; Kozer, Eran; Doenyas-Barak, Keren; Feldon, Michal; Dagan, Zahi; Reifen, Rami; Berkovitch, Matitiahu

2014-12-01

Childhood obesity is an increasing public health issue worldwide. We examined dietary patterns among adolescents in a dormitory school, identified obese adolescents and tried to intervene to improve food habits and physical activity. We conducted an experimental prospective longitudinal study based on 36 obese (body mass index [BMI]≥95th percentile) adolescents (aged 12-18 years) compared with controls (healthy children: normal age-appropriate BMI (BMI≤85th percentile). Six months' intervention included lifestyle-modification counseling (once a week by a clinical dietician), and an exercise regimen twice a week, 60 minutes each time, instructed by a professional pediatric trainer). Both groups underwent baseline measurements at the beginning of the study and 6 months later (arterial stiffness, blood pressure, pulse, weight and height, hemoglobin, creatinine, liver enzymes, highly sensitive C-reactive protein and complete lipid profile). Twenty-one participants completed the study. Low compliance from participants, school staff and parents was observed (participation in planned meetings; 71%-83%). BMI significantly decreased from 32.46±3.93 kg/m(2) to 30.32±3.4 kg/m(2) (P=0.002) in the study group. Arterial stiffness was not significantly different between the 2 groups and did not change significantly after 6 months' intervention (P=0.494). No significant changes in CRP and lipid profile were observed after the intervention. Making lifestyle modifications among adolescents in a dormitory school is a complex task. Active intervention indeed ameliorates BMI parameters. However, in order to maximize the beneficial effects, a multidisciplinary well-trained team is needed, with emphasis on integrating parents and the school environment.

Short-term Effects of a Physical Activity Intervention on Obesity and Aerobic Fitness of Adolescent Girls.

PubMed

Kelishadi, Roya; Minasian, Vazgen; Marandi, Sayed Mohammad; Farajzadegan, Ziba; Khalighinejad, Pooyan; Shirdavani, Soheila; Omidi, Razieh

2014-12-01

In the past two decades, physical activity has decreased during both childhood and adolescence, and particularly adolescence. It seems that schools are attractive settings in which to implement interventions designed in order to promote physical activity in children; but in Iranian students, few studies have evaluated the effects of such interventions on overweight and obese children. The aim of this study was to evaluate the effects of a short-term school-based physical activity on obesity and aerobic fitness in 12-14 years aged girls. This is a study with single group pretest and posttest design, in which 129 middle school girls in city of Isfahan were assessed based on preventive plan of inactivity in children at the Provincial Health Office. Variables, including weight, height, body mass index (BMI), waist-hip ratio (WHR), body fat percentage and aerobic power of subjects were measured using valid tests. This study showed that subjects' body fat percentage changed about 3.6% (37.74% pretest vs. 36.39% posttest), VO2 max changed 7.43% (29.72 pretest vs. 31.93 posttest), WHR changed 1.12% (0.89 pretest vs. 0.88 posttest), whereas BMI was changed 1.65% (27.80 pretest vs. 27.34 posttest). Findings also revealed that there were significant differences between fat percent, (P = 0.001) and VO2 max (P = 0.001) of subjects, but there was no difference between BMI of them in pre- and post-tests (P = 0.361). These results suggest that even a short-term exercise intervention may lead to positive changes in body fat percentage, WHR and aerobic fitness of overweight children. Therefore, school-based physical activity interventions can be an effective preventive strategy to control obesity and overweight in students.

Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: The role of built, socioeconomic, and social environments

PubMed Central

Carroll-Scott, Amy; Gilstad-Hayden, Kathryn; Rosenthal, Lisa; Peters, Susan M.; McCaslin, Catherine; Joyce, Rebecca; Ickovics, Jeannette R.

2014-01-01

Obesity prevalence among US children and adolescents has tripled in the past three decades. Consequently, dramatic increases in chronic disease incidence are expected, particularly among populations already experiencing health disparities. Recent evidence identifies characteristics of “obesogenic” neighborhood environments that affect weight and weight-related behaviors. This study aimed to examine associations between built, socioeconomic, and social characteristics of a child’s residential environment on body mass index (BMI), diet, and physical activity. We focused on pre-adolescent children living in New Haven, Connecticut to better understand neighborhood environments’ contribution to persistent health disparities. Participants were 1048 fifth and sixth grade students who completed school-based health surveys and physical measures in fall 2009. Student data were linked to US Census, parks, retailer, and crime data. Analyses were conducted using multilevel modeling. Property crimes and living further from a grocery store were associated with higher BMI. Students living within a 5-min walk of a fast food outlet had higher BMI, and those living in a tract with higher density of fast food outlets reported less frequent healthy eating and more frequent unhealthy eating. Students’ reported perceptions of access to parks, playgrounds, and gyms were associated with more frequent healthy eating and exercise. Students living in more affluent neighborhoods reported more frequent healthy eating, less unhealthy eating, and less screen time. Neighborhood social ties were positively associated with frequency of exercise. In conclusion, distinct domains of neighborhood environment characteristics were independently related to children’s BMI and health behaviors. Findings link healthy behaviors with built, social, and socioeconomic environment assets (access to parks, social ties, affluence), and unhealthy behaviors with built environment inhibitors (access to fast food outlets), suggesting neighborhood environments are an important level at which to intervene to prevent childhood obesity and its adverse consequences. PMID:23642646

Body Mass Index and Sociodemographic Predictors of School Lunch Purchase Behavior during a Year-Long Environmental Intervention in Middle School.

PubMed

Greece, Jacey A; Kratze, Alyssa; DeJong, William; Cozier, Yvette C; Quatromoni, Paula A

2015-06-10

Modifying the school food environment is on the national agenda as one strategy to improve the nutritional quality of children's diets. Because few environmental-level interventions have been rigorously evaluated, the evidence base to inform programs and policies is limited. Of concern is the impact that changes to cafeteria offerings will have on participation in school meal programs. This study evaluates school lunch participation in the setting of a year-long middle school cafeteria intervention by examining the association between body mass index (BMI), sociodemographics, and the purchases of school lunch meals. IMOVE meals were healthier choices that met stringent nutritional criteria and were offered alongside standard lunch meals. Students who were overweight had a significantly higher purchase rate for both types of meals compared to those with a healthy BMI. Non-white race, younger age, being male, and low-income status were also significantly associated with participation in school lunch. Results indicate that nutritionally vulnerable students participate in school lunch and are equally likely to buy healthy alternatives or standard meals. This behavioral observation has important implications for school foodservice programs and policies. These results are timely given recent federal legislation to improve the school food environment to influence students' food choice behaviors.

Body Mass Index and Sociodemographic Predictors of School Lunch Purchase Behavior during a Year-Long Environmental Intervention in Middle School

PubMed Central

Greece, Jacey A.; Kratze, Alyssa; DeJong, William; Cozier, Yvette C.; Quatromoni, Paula A.

2015-01-01

Modifying the school food environment is on the national agenda as one strategy to improve the nutritional quality of children’s diets. Because few environmental-level interventions have been rigorously evaluated, the evidence base to inform programs and policies is limited. Of concern is the impact that changes to cafeteria offerings will have on participation in school meal programs. This study evaluates school lunch participation in the setting of a year-long middle school cafeteria intervention by examining the association between body mass index (BMI), sociodemographics, and the purchases of school lunch meals. IMOVE meals were healthier choices that met stringent nutritional criteria and were offered alongside standard lunch meals. Students who were overweight had a significantly higher purchase rate for both types of meals compared to those with a healthy BMI. Non-white race, younger age, being male, and low-income status were also significantly associated with participation in school lunch. Results indicate that nutritionally vulnerable students participate in school lunch and are equally likely to buy healthy alternatives or standard meals. This behavioral observation has important implications for school foodservice programs and policies. These results are timely given recent federal legislation to improve the school food environment to influence students’ food choice behaviors. PMID:26067683

Functional Movements in Japanese Mini-Basketball Players

PubMed Central

Kuzuhara, Kenji; Shibata, Masashi; Iguchi, Junta; Uchida, Ryo

2018-01-01

Abstract Functional movement screen (FMS) has been used to establish normative data and determine potential injury risk for young adults and athletes, but there are few data in elementary school-age children. The purpose of this study was to establish fundamental values for the FMS in elementary school-age mini-basketball players. Secondary purposes were to examine relationships between functional movement patterns and age, peak height velocity (PHV), and body mass index (BMI), and to compare functional movement patterns between boys and girls and between individuals with and without a history of injury. The mean composite FMS score was 16.5 ± 2.2 (16.5 ± 2.4 for boys, 16.5 ± 1.7 for girls). The composite FMS score was positively correlated with age (r = .312) and negatively correlated with the BMI (r = − .371). However, the FMS score was not correlated with PHV or with PHV age. The FMS score was not different between boys and girls or between individuals who reported a previous injury and those who did not. However, boys in the mini-basketball teams performed better than girls on the trunk stability push-up and rotary stability tests. Age and the body mass index were significantly associated with better and poorer functional movement, respectively. PMID:29599859

Functional Movements in Japanese Mini-Basketball Players.

PubMed

Kuzuhara, Kenji; Shibata, Masashi; Iguchi, Junta; Uchida, Ryo

2018-03-01

Functional movement screen (FMS) has been used to establish normative data and determine potential injury risk for young adults and athletes, but there are few data in elementary school-age children. The purpose of this study was to establish fundamental values for the FMS in elementary school-age mini-basketball players. Secondary purposes were to examine relationships between functional movement patterns and age, peak height velocity (PHV), and body mass index (BMI), and to compare functional movement patterns between boys and girls and between individuals with and without a history of injury. The mean composite FMS score was 16.5 ± 2.2 (16.5 ± 2.4 for boys, 16.5 ± 1.7 for girls). The composite FMS score was positively correlated with age (r = .312) and negatively correlated with the BMI (r = - .371). However, the FMS score was not correlated with PHV or with PHV age. The FMS score was not different between boys and girls or between individuals who reported a previous injury and those who did not. However, boys in the mini-basketball teams performed better than girls on the trunk stability push-up and rotary stability tests. Age and the body mass index were significantly associated with better and poorer functional movement, respectively.

Effective nationwide school-based participatory extramural program on adolescent body mass index, health knowledge and behaviors.

PubMed

Heo, Moonseong; Jimenez, Camille C; Lim, Jean; Isasi, Carmen R; Blank, Arthur E; Lounsbury, David W; Fredericks, Lynn; Bouchard, Michelle; Faith, Myles S; Wylie-Rosett, Judith

2018-01-16

Adolescent obesity is a major public health concern. Open to all high school students regardless of weight status, HealthCorps is a nationwide program offering a comprehensive high school-based participatory educational program to indirectly address obesity. We tested a hypothesis that the HealthCorps program would decrease BMI z-scores among overweight or obese students, and reduce obesity rates, and evaluated its effects on health knowledge and behaviors. HealthCorps aimed to improve student knowledge and behaviors regarding nutrition quality, physical activity, sleep, breakfast intake, and mental resilience. Participating students received through HealthCorps coordinators weekly or bi-weekly classroom lessons either for a semester or a year in addition to various during- and after-school health-promoting activities and mentorship. Self-reported height and weight were collected along with questionnaires assessing knowledge and behaviors during 2013-2014 academic year among 14 HealthCorps-participating New York City high schools. This quasi experimental two-arm pre-post trial included 611 HealthCorps and 221 comparison arm students for the analytic sample. Sex-specific analyses stratified by weight status were adjusted for age and Hispanic ethnicity with clustering effects of schools and students taken into account. HealthCorps female overweight/obese and obese student had a significant decrease in BMI z-scores (post-pre delta BMI z-score = -0.16 (95%CI = (-0.26, -0.05), p = 0.004 for the former; and = -0.23 (-0.44, -0.03), p = 0.028, for the latter) whereas comparison female counterparts did not. The HealthCorps students, but not the comparison students, had a significant increase for all knowledge domains except for the breakfast realm, and reported a greater number of significant behavior changes including fruit and vegetable intake and physical activities. The HealthCorps program was associated with reduced BMI z-score in overweight/obese and obese female adolescents, with enhanced health knowledge and behavior for both sexes. With its wide reach, this may be a promising program to help combat adolescent obesity in schools. This study is registered as a clinical trial at the ClinicalTrials.gov registry with trial number NCT02277496 on September 10, 2014 (Retrospectively registered).

Current data in Greek children indicate decreasing trends of obesity in the transition from childhood to adolescence; results from the National Action for Children’s Health (EYZHN) program

PubMed Central

TAMBALIS, K.D.; PANAGIOTAKOS, D.B.; PSARRA, G.; SIDOSSIS, L.S.

2018-01-01

Summary Introduction The aim of the study is to present the most recent estimates of obesity (total and central) prevalence in Greek children and associated risk factors. Methods Population data are derived from a yearly, school-based health survey polled in 2015 on 336,014 (51% boys) children aged 4 to 17 years old from almost 40% of all schools of primary and secondary education in Greece. Anthropometric and physical fitness measurements were obtained by trained investigators. Dietary habits, physical activity status, sedentary activities and sleeping hours were assessed through self-completed questionnaires. The gender and age-specific Body Mass Index (BMI) cut-off points were used in order to define BMI groups. Results The prevalence of overweight and obesity in the whole population was 22.2% and 9.0% in boys and 21.6% and 7.5% in girls, respectively. Obesity presented decreasing trends in the transition from childhood to adolescence. Central obesity was diagnosed in 95.3% and 93.5% of the simple obese boys and girls, respectively, in almost two to three of overweight children (68.6% of boys and 64.3% of girls), and in 12% of normal weight children. Age, physical fitness, low adherence to Mediterranean diet, insufficient sleeping hours, inadequate physical activity levels and increased screen time were all associated with higher odds of total and central obesity. Conclusions Serious and urgent actions need to be taken from public health policy makers in order not only to prevent a further increase in obesity rates but, more important, to treat obesity and/or the obesity associated co-morbidities. PMID:29938238

Associations between the use of social networking sites and unhealthy eating behaviours and excess body weight in adolescents.

PubMed

Sampasa-Kanyinga, Hugues; Chaput, Jean-Philippe; Hamilton, Hayley A

2015-12-14

Unhealthy eating behaviour and excess body weight have been related to sedentary behaviour, particularly screen time, in adolescents; however, little is known about their associations with the use of social networking sites (SNS). We investigated the associations between time spent using SNS and unhealthy eating behaviours (including breakfast skipping, consumption of sugar-sweetened beverages (SSB) and energy drinks) and body weight in adolescents. Data on 9858 students (mean age: 15·2 (SD 1·9) years) in grades 7 through 12 were derived from the 2013 cycle of the Ontario Student Drug Use and Health Survey--a cross-sectional school-based survey of middle and high school students. The majority (81·5%) of students reported daily use of SNS and an additional 10·7% reported using them on an irregular basis. Multivariate logistic regression analyses revealed that the use of SNS was associated with increased odds of skipping breakfast (P trend<0·01) and consuming SSB (P trend<0·01) and energy drinks (P trend<0·01) in a dose-response manner with adjustments for age, sex, ethnicity, socio-economic status, tobacco, alcohol and cannabis use as well as BMI. However, there was no evidence of a significant association between use of SNS and BMI before or after adjusting for all the covariates and unhealthy eating behaviours. In conclusion, our results suggest associations between the use of SNS and unhealthy eating behaviours among youth. Given the popularity of SNS, more efforts are needed to better understand the impact of social networks on eating behaviours and risk of excess weight.

Ocular and visual status among children in special schools in Wales: the burden of unrecognised visual impairment.

PubMed

Woodhouse, J Margaret; Davies, Nathan; McAvinchey, Aideen; Ryan, Barbara

2014-06-01

The high prevalence of visual defects among children with special needs is well reported and guidelines for vision screening are in place. However, recent research has suggested that vision care for such children is neglected. This study set out to evaluate the current status of vision screening and eye care in special schools in Wales. In phase 1, all 44 special schools in Wales received a questionnaire on current vision screening practices. In phase 2, full eye examinations were conducted with 173 pupils of five schools with no screening service; the pupils were aged 2-21 years. In phase 3, feedback about the service was obtained from all schools and from 15 parents whose children took part. In phase 1, vision screening was patchy and inconsistent among the 39 schools responding. In phase 2, there is a high proportion of pupils (42%) reporting no previous eye examination. Overall, 17% of the pupils in the five schools presented with low vision (WHO definition, poorer than 0.3 LogMAR), 50% needed a first-time or updated spectacle prescription and 51% had some ocular abnormality that was either sight-limiting or warranted action to prevent risk to sight. In phase 3, school staff and parents reported that school-based eye examinations were valuable and, for those children with previous experience, likely to be more successful than clinic-based or practice-based examinations for this particular population. There is an urgent need for a school-based optometric service for this vulnerable group of children and young people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Waaler revisited: The anthropometrics of mortality.

PubMed

Koch, Daniel

2011-01-01

Although many studies have been written about the relationship between BMI and human height on the one hand and mortality on the other, the issue of socio-economic status as confounding variable has been at times less emphasized. This study analyzes the influence of education and income on the relationship between BMI and mortality and between height and mortality. It is based on data collected between 1963 and 1975 by the Norwegian National Health Screening Service. 1.7 million subjects were recorded. The Norwegian statistics bureau linked these data to the national death records and to socio-economic information. We apply Cox proportional hazards regressions in order to determine whether adding income and education as covariates affects the relations among BMI, height, and mortality. Previous findings and insights are either not present or ambiguous. We conclude that the omission of SES does not significantly bias the effect of BMI on most causes of death, with one exception: type 2 diabetes mellitus, where the effect of BMI is substantially lower for both adults and adolescents when adjusted for education. Copyright © 2010 Elsevier B.V. All rights reserved.

Effects of Mischievous Responding on Universal Mental Health Screening: I Love Rum Raisin Ice Cream, Really I Do!

ERIC Educational Resources Information Center

Furlong, Michael J.; Fullchange, Aileen; Dowdy, Erin

2017-01-01

Student surveys are often used for school-based mental health screening; hence, it is critical to evaluate the authenticity of information obtained via the self-report format. The objective of this study was to examine the possible effects of mischievous response patterns on school-based screening results. The present study included 1,857 high…

Sedentary behaviours among Australian adolescents.

PubMed

Hardy, Louise L; Dobbins, Timothy; Booth, Michael L; Denney-Wilson, Elizabeth; Okely, Anthony D

2006-12-01

To describe the prevalence and distribution (by demographic characteristics and body mass index [BMI] category) of sedentary behaviour among Australian adolescents aged 11-15 years. Cross-sectional representative population survey of school students (n = 2,750) in New South Wales, conducted in 2004. Students' self-reported time spent during a usual week in five categories of sedentary behaviour (small screen recreation [SSR], education, cultural, social and non-active travel). Height and weight were measured. Grade 6, 8 and 10 students spent approximately 34 hours, 41 hours and 45 hours/week of their discretionary time, respectively, engaged in sedentary behaviour. Urban students and students from Asian-speaking backgrounds spent significantly more time sedentary than students from rural areas or other cultural backgrounds. SSR accounted for 60% and 54% of sedentary behaviour among primary and high school students, respectively. Overweight and obese students spent more time in SSR than healthy weight students. Out-of-school hours educational activities accounted for approximately 20% of sedentary behaviour and increased with age. Girls spent twice the time in social activities compared with boys. Time spent in cultural activities declined with age. Sedentary behaviours among young people differ according to sex, age and cultural background. At least half of all time spent in sedentary behaviours was spent engaged in SSR. BMI was significantly associated with sedentary behaviour among some children, but not consistently across age groups. A clear understanding of young people's patterns of sedentary behaviour is required to develop effective and sustainable intervention programs to promote healthy living.

Identifying at-risk children at school entry: the usefulness of multibehavioral problem profiles.

PubMed

Flanagan, Kelly S; Bierman, Karen L; Kam, Chi-Ming

2003-09-01

Found that 1st-grade teacher ratings of aggressive, hyperactive-inattentive, and low levels of prosocial behaviors made unique contributions to the prediction of school outcomes (measured 2 years later) for 755 children. Person-oriented analyses compared the predictive utility of 5 screening strategies based on child problem profiles to identify children at risk for school problems. A broad screening strategy, in which children with elevations in any 1 of the 3 behavior problem dimensions were identified as "at-risk," showed lower specificity but superior sensitivity, odds ratios, and overall accuracy in the prediction of school outcomes than the other screening strategies that were more narrowly focused or were based on a total problem score. Results are discussed in terms of implications for the screening and design of preventive interventions.

Insufficient Sleep Duration and Overweight/Obesity among Adolescents in a Chinese Population.

PubMed

Gong, Qing-Hai; Li, Si-Xuan; Li, Hui; Cui, Jun; Xu, Guo-Zhang

2018-05-15

The objective of this study was to investigate the relationship between sleep duration and overweight/obesity among Chinese adolescents. A school-based cross-sectional study was conducted among Chinese adolescents in 2016. In total, 2795 school-aged Chinese children aged 12 to 13 years participated in this study. Participants were asked to complete self-administered surveys during a 45-min class period in their classroom. Details of the questionnaire about health-related behaviors included sleep habits, physical activity, screen time, cigarette use, and alcohol use. Height, weight, waist circumference and hip circumference were directly measured. The mean sleep duration was 8.7 h/day. In total, 43.0% of the participants had a sleep duration of less than 9 h/day. Sleep duration was significantly inversely related to BMI, waist circumference, hip circumference and WHtR in multiple linear regression analyses in both genders. Logistic regression models showed that insufficient sleep (<9 h/day) was associated with high odds of overweight/obesity among both young boys and girls. Insufficient sleep duration was associated with overweight/obesity in Chinese adolescents, and short sleep duration was probably associated with central adiposity, especially among boys.

Meal patterns among children and adolescents and their associations with weight status and parental characteristics.

PubMed

Würbach, Ariane; Zellner, Konrad; Kromeyer-Hauschild, Katrin

2009-08-01

To describe the meal patterns of Jena schoolchildren and their associations with children's weight status and parental characteristics. Cross-sectional study. Twenty schools in Jena (100,000 inhabitants), south-east Germany. A total of 2054 schoolchildren aged 7-14 years with information on BMI standard deviation score (BMI-SDS) and weight status (based on German reference values), of whom 1571 had additional information about their parents (parental education and employment status, weight status according to WHO guidelines) and meal patterns (school lunch participation rate, meal frequencies, breakfast consumption and frequency of family meals). Weight status of the children was associated with weight status, education and employment status of the parents. Meal patterns were strongly dependent on children's age and parental employment. As age increased, the frequency of meal consumption, participation rate in school lunches and the number of family meals decreased. Using linear regression analysis, a high inverse association between BMI-SDS and meal frequency was observed, in addition to relationships with parental weight status and paternal education. Age-specific prevention programmes should encourage greater meal frequency. The close involvement of parents is essential in any strategy for improving children's (families') diets.

Obesity and Hypertension among School-going Adolescents in Peru.

PubMed

Nam, Eun Woo; Sharma, Bimala; Kim, Ha Yun; Paja, Doris Jackeline Vasquez; Yoon, Young Min; Lee, Sun Ha; Kim, Eun Hwan; Oh, Chung Hyeon; Kim, Yun Seop; Song, Chang Hoon; Kim, Jong Koo

2015-09-01

Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p < 0.01). The prevalence of obesity and hypertension observed in the study area is relatively high. Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.

Using BMI to Determine Cardiovascular Risk in Childhood: How Do the BMI Cutoffs Fare?

PubMed Central

Skinner, Asheley Cockrell; Mayer, Michelle L.; Flower, Kori; Perrin, Eliana M.; Weinberger, Morris

2010-01-01

OBJECTIVE Although adverse health outcomes are increased among children with BMI above the 85th (overweight) and 95th (obese) percentiles, previous studies have not clearly defined the BMI percentile at which adverse health outcomes begin to increase. We examined whether the existing BMI percentile cutoffs are optimal for defining increased risk for dyslipidemia, dysglycemia, and hypertension. METHODS This was a cross-sectional analysis of the National Health and Nutrition Examination Survey from 2001 to 2006. Studied were 8216 children aged 6 to 17 years, representative of the US population. BMI was calculated by using measured height and weight and converted to percentiles for age in months and gender. Outcome measures (dyslipidemia, dysglycemia, and hypertension) were based on laboratory and physical examination results; these were analyzed as both continuous and categorical outcomes. RESULTS Significant increases for total cholesterol values and prevalence of abnormal cholesterol begin at the 80th percentile. Significant increases in glycohemoglobin values and prevalence of abnormal values begin at the 99th percentile. Consistent significant increases in the prevalence of high or borderline systolic blood pressure begin at the 90th percentile. CONCLUSIONS Intervening for overweight children and their health requires clinical interventions that target the right children. On the basis of our data, a judicious approach to screening could include consideration of lipid screening for children beginning at the 80th percentile but for dysglycemia at the 99th percentile. Current definitions of overweight and obese may be more useful for general recognition of potential health problems and discussions with parents and children about the need to address childhood obesity. WHAT'S KNOWN ON THIS SUBJECT: Previous research has shown that cardiovascular risk factors are related to the currently used definitions of obesity in children but has not specified the BMI percentiles at which risk increases.WHAT THIS STUDY ADDS: Nationally representative data indicate greater risk for abnormal lipid values in children who are not considered overweight by current definitions, risk for diabetes only in very obese children, and risk for hypertension at the 90th percentile of BMI. PMID:19858150

Implementing Child-focused Activity Meter Utilization into the Elementary School Classroom Setting Using a Collaborative Community-based Approach.

PubMed

Lynch, B A; Jones, A; Biggs, B K; Kaufman, T; Cristiani, V; Kumar, S; Quigg, S; Maxson, J; Swenson, L; Jacobson, N

2015-12-01

The prevalence of pediatric obesity has increased over the past 3 decades and is a pressing public health program. New technology advancements that can encourage more physical in children are needed. The Zamzee program is an activity meter linked to a motivational website designed for children 8-14 years of age. The objective of the study was to use a collaborative approach between a medical center, the private sector and local school staff to assess the feasibility of using the Zamzee Program in the school-based setting to improve physical activity levels in children. This was a pilot 8-week observational study offered to all children in one fifth grade classroom. Body mass index (BMI), the amount of physical activity by 3-day recall survey, and satisfaction with usability of the Zamzee Program were measured pre- and post-study. Out of 11 children who enrolled in the study, 7 completed all study activities. In those who completed the study, the median (interquartile range) total activity time by survey increased by 17 (1042) minutes and the BMI percentile change was 0 (8). Both children and their caregivers found the Zamzee Activity Meter (6/7) and website (6/7) "very easy" or "easy" to use. The Zamzee Program was found to be usable but did not significantly improve physical activity levels or BMI. Collaborative obesity intervention projects involving medical centers, the private sector and local schools are feasible but the effectiveness needs to be evaluated in larger-scale studies.

Computed tomographic colonography for colorectal cancer screening: risk factors for the detection of advanced neoplasia.

PubMed

Hassan, Cesare; Pooler, B Dustin; Kim, David H; Rinaldi, Antonio; Repici, Alessandro; Pickhardt, Perry J

2013-07-15

The objective of this study was to determine whether age, sex, a positive family history of colorectal cancer, and body mass index (BMI) are important predictors of advanced neoplasia in the setting of screening computed tomographic colonography (CTC). Consecutive patients who were referred for first-time screening CTC from 2004 to 2011 at a single medical center were enrolled. Results at pathology were recorded for all patients who underwent polypectomy. Logistic regression was used to identify significant predictor variables for advanced neoplasia (any adenoma ≥ 10 mm or with villous component, high-grade dysplasia, or adenocarcinoma). Odds ratios (ORs) were used to express associations between the study variables (age, sex, BMI, and a positive family history of colorectal cancer) and advanced neoplasia. In total, 7620 patients underwent CTC screening. Of these, 276 patients (3.6%; 95% confidence interval [CI], 3.2%-4.1%) ultimately were diagnosed with advanced neoplasia. At multivariate analysis, age (mean OR per 10-year increase, 1.8; 95% CI, 1.6-2.0) and being a man (OR, 1.7; 95% CI, 1.3-2.2) were independent predictors of advanced neoplasia, whereas BMI and a positive family history of colorectal cancer were not. The number needed to screen to detect 1 case of advanced neoplasia varied from 51 among women aged ≤ 55 years to 10 among men aged >65 years. The number of post-CTC colonoscopies needed to detect 1 case of advanced neoplasia varied from 2 to 4. Age and sex were identified as important independent predictors of advanced neoplasia risk in individuals undergoing screening CTC, whereas BMI and a positive family history of colorectal cancer were not. These results have implications for appropriate patient selection. © 2013 American Cancer Society.

Needs assessment of school and community physical activity opportunities in rural West Virginia: the McDowell CHOICES planning effort.

PubMed

Kristjansson, Alfgeir L; Elliott, Eloise; Bulger, Sean; Jones, Emily; Taliaferro, Andrea R; Neal, William

2015-04-03

McDowell CHOICES (Coordinated Health Opportunities Involving Communities, Environments, and Schools) Project is a county wide endeavor aimed at increasing opportunities for physical activity (PA) in McDowell County, West Virginia (WV). A comprehensive needs-assessment laid the foundation of the project. During the 6 month needs assessment, multiple sources of data were collected in two Town Hall Meetings (n = 80); a student online PA interest survey (n = 465); a PA and nutrition survey among 5(th) (10-11 years) and 8(th) graders (13-14 years) with questions adapted from the CDC's Youth Risk Behavior Surveillance Survey (n = 442, response rate = 82.2%); six semi-structured school and community focus groups (n = 44); school site visits (n = 11); and BMI screening (n = 550, response rate = 69.7%). One third of children in McDowell County meet the national PA minimum of 60 minutes daily. At least 40% of 5(th) and 8(th) graders engage in electronic screen activity for 3 hours or more every day. The prevalence of obesity in 5(th) graders is higher in McDowell County than the rest of WV (~55% vs. 47% respectively). SWOT analyses of focus group data suggest an overall interest in PA but also highlight a need for increase in structured PA opportunities. Focus group data also suggested that a central communication (e.g. internet-based) platform would be beneficial to advertise and boost participation both in current and future programs. Schools were commonly mentioned as potential facilities for public PA participation throughout the county, both with regards to access and convenience. School site visits suggest that schools need more equipment and resources for before, during, and after school programs. An overwhelming majority of participants in the McDowell CHOICES needs assessment were interested to participate in more PA programs throughout the county as well as to improve opportunities for the provision of such programs. Public schools were widely recognized as the hub of the communities and provide the best venue for PA promotion for both students and adult citizens, and can potentially serve as a platform for change in rural communities such as McDowell County.

Longitudinal associations between television in the bedroom and body fatness in a UK cohort study

PubMed Central

Heilmann, A; Rouxel, P; Fitzsimons, E; Kelly, Y; Watt, R G

2017-01-01

Objective: To assess longitudinal associations between screen-based media use (television (TV) and computer hours, having a TV in the bedroom) and body fatness among UK children. Methods: Participants were 12 556 children from the UK Millennium Cohort Study who were followed from age 7 to age 11 years. Associations were assessed between screen-based media use and the following outcomes: body mass index (BMI), fat mass index (FMI), and overweight. Results: In fully adjusted models, having a bedroom TV at age 7 years was associated with significantly higher BMI and FMI (excess BMI for boys=0.29, 95% confidence interval (CI) 0.06–0.52; excess BMI for girls=0.57, 95% CI 0.31–0.84; excess FMI for boys=0.20, 95% CI 0.04–0.37; excess FMI for girls=0.39, 95% CI 0.21–0.57) and increased risk of being overweight (relative risk (RR) for boys=1.21, 95% CI 1.07–1.36; RR for girls=1.31, 95% CI 1.15–1.48) at age 11 years, compared with having no bedroom TV. Hours spent watching TV or digital versatile disks were associated with increased risk of overweight among girls only. Computer use at age 7 years was not related to later body fatness for either gender. Conclusion: Having a TV in the child’s bedroom was an independent risk factor for overweight and increased body fatness in this nationally representative sample of UK children. Childhood obesity prevention strategies should consider TVs in children’s bedrooms as a risk factor for obesity. PMID:28566749

Enhancing School-Based Mental Health Services with a Preventive and Promotive Approach to Universal Screening for Complete Mental Health

ERIC Educational Resources Information Center

Dowdy, Erin; Furlong, Michael; Raines, Tara C.; Bovery, Bibliana; Kauffman, Beth; Kamphaus, Randy W.; Dever, Bridget V.; Price, Martin; Murdock, Jan

2015-01-01

Universal screening for complete mental health is proposed as a key step in service delivery reform to move school-based psychological services from the back of the service delivery system to the front, which will increase emphasis on prevention, early intervention, and promotion. A sample of 2,240 high school students participated in a schoolwide…

Unhealthy food consumption in adolescence: role of sedentary behaviours and modifiers in 11-, 13- and 15-year-old Italians

PubMed Central

Lemma, Patrizia; Berchialla, Paola; Cappello, Nazario; Inchley, Joanna; Dalmasso, Paola; Charrier, Lorena; Cavallo, Franco

2016-01-01

Abstract Backgrounds and aim: Unhealthy eating behaviours increase with age and have been associated with adverse health consequences in adulthood. We examined the influence of screen-based sedentary behaviours (SBs) on unhealthy food consumption, such as energy-dense foods and sweetened drinks, among a representative sample of nearly 60 000 adolescents and assessed the role of possible modifiers. Methods: Data come from the Italian 2009–10 Health Behaviour in School-aged Children (HBSC) survey. Data on Eating patterns, SBs, physical activity, peers network, BMI and socio-economic status (SES) were collected following the HBSC study protocol. Hierarchical logistic regression models were used. Results: Unhealthy food consumption was significantly associated with a lower intake of fruit and vegetables and with the increase of SBs in both sexes and in all ages. The risk was interestingly higher in normal weight adolescents, in those with wider relationships with peers and in low SES children. Conclusions: This study adds evidence to support the importance of investing more resources in educational initiatives both to increase parents’ awareness to support adolescents on dietary choices and on time spent in screen-based behaviours, independently of their adiposity status; and to develop youth’s ability to access and appropriately use media and technologies. Policy makers should also increase their attention on introducing regulatory policies on television food advertising to which youth are exposed. PMID:27085192

Impact of screening for metabolic syndrome on the evaluation of obese living kidney donors.

PubMed

Marcusa, Daniel P; Schaubel, Douglas E; Woodside, Kenneth J; Sung, Randall S

2018-01-01

We report our experience with metabolic syndrome screening for obese living kidney donor candidates to mitigate the long-term risk of CKD. We retrospectively reviewed 814 obese (BMI≥30) and 993 nonobese living kidney donor evaluations over 12 years. Using logistic regression, we explored interactions between social/clinical variables and candidate acceptance before and after policy implementation. Obese donor candidate acceptance decreased after metabolic syndrome screening began (56.3%, 46.3%, p < 0.01), while nonobese candidate acceptance remained similar (59.6%, 59.2%, p = 0.59). Adjusting for age, gender, race, BMI, and number of prior evaluations, acceptance of obese candidates decreased significantly more than nonobese (p = 0.025). In candidates without metabolic syndrome, there was no significant change in how age, sex, race, or BMI affected a donor candidate's probability of acceptance. Metabolic syndrome screening is a simple stratification tool for centers with liberal absolute BMI cut-offs to exclude potentially higher-risk obese candidates. Copyright © 2017 Elsevier Inc. All rights reserved.

Changes in Weight over the School Year and Summer Vacation: Results of a 5-Year Longitudinal Study

ERIC Educational Resources Information Center

Moreno, Jennette P.; Johnston, Craig A.; Woehler, Deborah

2013-01-01

Background: Evidence suggests that children gain more weight during the summer months compared with the school year. To examine the impact of the school and summer environment on children's weight further, we conducted a 5-year longitudinal study examining changes in standardized BMI (zBMI) of students entering kindergarten. Methods: Heights and…

Screening for kidney disease in children on World Kidney Day in Jalisco, Mexico.

PubMed

Koshy, Susan M; Garcia-Garcia, Guillermo; Pamplona, Jacob Sandoval; Renoirte-Lopez, Karina; Perez-Cortes, Gustavo; Gutierrez, Ma Luisa Salazar; Hemmelgarn, Brenda; Lloyd, Anita; Tonelli, Marcello

2009-06-01

World Kidney Day (WKD) is intended to raise awareness and increase detection of chronic kidney disease (CKD), but most emphasis is placed on adults rather than children. We examined yield of screening for CKD and hypertension among poor children in Mexico. On WKD (2006, 2007), children (age < 18 years) without known CKD were invited to participate at two screening stations. We measured body mass index (BMI), blood pressure, and serum creatinine, and performed dipstick urinalysis. The Schwartz equation was used to estimate glomerular filtration rate (GFR; reduced GFR defined as < 60 ml/min per 1.73 m(2)). Proteinuria and hematuria were defined by a reading of >or= 1+ protein or blood on dipstick. Hypertension was defined by gender, age, and height-specific norms. In total, 240 children were screened (mean age 8.9 +/- 4.1 years; 44.2% male). Proteinuria and hematuria were detected in 38 (16.1%) and 41 (17.5%), respectively; 15% had BMI > 95th percentile for age. Reduced GFR was detected in four (1.7%) individuals. Systolic hypertension was more prevalent in younger children (age 0-8 years, 19.6%; age 9-13 years, 7.1%; age 14-17 years, 5.3%) suggesting a possible white-coat effect. Hematuria, proteinuria, hypertension and obesity were frequently detected among children in a community based screening program in Mexico. This form of screening might be useful in identifying children with CKD and hypertension in developing nations.

Use of Data Mining to Reveal Body Mass Index (BMI): Patterns among Pennsylvania Schoolchildren, Pre-K to Grade 12

ERIC Educational Resources Information Center

YoussefAgha, Ahmed H.; Lohrmann, David K.; Jayawardene, Wasantha P.

2013-01-01

Background: Health eTools for Schools was developed to assist school nurses with routine entries, including height and weight, on student health records, thus providing a readily accessible data base. Data-mining techniques were applied to this database to determine if clinically signi?cant results could be generated. Methods: Body mass index…

Grand Canyon Trekkers: school-based lunchtime walking program.

PubMed

Hawthorne, Alisa; Shaibi, Gabriel; Gance-Cleveland, Bonnie; McFall, Sarah

2011-02-01

The incidence of childhood overweight is especially troubling among low income Latino youth. Grand Canyon Trekkers (GCT) was implemented as a quasi-experimental study in 10 Title 1 elementary schools with a large Latino population to examine the effects of a 16-week structured walking program on components of health-related physical fitness: Body Mass Index (BMI), waist circumference, and cardio-respiratory. Data on 1,074 research participants revealed no significance changes in BMI or waist circumference (p > .05); however, cardio-respiratory fitness increased by 37.1% over baseline. Cardiovascular fitness is an independent determinant of long-term health; therefore, the GCT program may have significantly improved the future health profile of the participants and decreased their risk of metabolic diseases.

Fourth-grade children's dietary recall accuracy for energy intake at school meals differs by social desirability and body mass index percentile in a study concerning retention interval.

PubMed

Guinn, Caroline H; Baxter, Suzanne D; Royer, Julie A; Hardin, James W; Mackelprang, Alyssa J; Smith, Albert F

2010-05-01

Data from a study concerning retention interval and school-meal observation on children's dietary recalls were used to investigate relationships of social desirability score (SDS) and body mass index percentile (BMI%) to recall accuracy for energy for observed (n = 327) children, and to reported energy for observed and unobserved (n = 152) children. Report rates (reported/observed) correlated negatively with SDS and BMI%. Correspondence rates (correctly reported/observed) correlated negatively with SDS. Inflation ratios (overreported/observed) correlated negatively with BMI%. The relationship between reported energy and each of SDS and BMI% did not depend on observation status. Studies utilizing children's dietary recalls should assess SDS and BMI%.

Anthropometric measures as fitness indicators in primary school children: The Health Oriented Pedagogical Project (HOPP).

PubMed

Mamen, Asgeir; Fredriksen, Per Morten

2018-05-01

As children's fitness continues to decline, frequent and systematic monitoring of fitness is important. Easy-to-use and low-cost methods with acceptable accuracy are essential in screening situations. This study aimed to investigate how the measurements of body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) relate to selected measurements of fitness in children. A total of 1731 children from grades 1 to 6 were selected who had a complete set of height, body mass, running performance, handgrip strength and muscle mass measurements. A composite fitness score was established from the sum of sex- and age-specific z-scores for the variables running performance, handgrip strength and muscle mass. This fitness z-score was compared to z-scores and quartiles of BMI, WC and WHtR using analysis of variance, linear regression and receiver operator characteristic analysis. The regression analysis showed that z-scores for BMI, WC and WHtR all were linearly related to the composite fitness score, with WHtR having the highest R 2 at 0.80. The correct classification of fit and unfit was relatively high for all three measurements. WHtR had the best prediction of fitness of the three with an area under the curve of 0.92 ( p < 0.001). BMI, WC and WHtR were all found to be feasible measurements, but WHtR had a higher precision in its classification into fit and unfit in this population.

Nutrition Education and Body Mass Index in Grades K-12: A Systematic Review.

PubMed

Price, Cayla; Cohen, Deborah; Pribis, Peter; Cerami, Jean

2017-09-01

Overweight and obese body mass index (BMI) status affects an increasing number of children in the United States. The school setting has been identified as a focus area to implement obesity prevention programs. A database search of PubMed, Education Search Complete, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted for peer-reviewed articles published between January 2005 and December 2015 pertaining to programs offered in the school setting to grades K-12 in the United States with a nutrition education component and measured BMI percentile or BMI z-score as an outcome. Seven studies focused on elementary (K-5) populations and 2 studies focused on grades 6-8. Among the 9 identified studies, those with long-term (greater than 1 year) implementation showed more pronounced results with positive impact on reducing overweight/obese BMI measures. This set of studies suggests that long-term nutrition education delivered in the school setting can provide children with tools to attain a healthy weight status. Additional studies examining participants' BMI status years after the initial study, and studies examining programs in grades 9-12 are needed to determine the most effective delivery time and methods. © 2017, American School Health Association.

Exergaming for health: a community-based pediatric weight management program using active video gaming.

PubMed

Christison, Amy; Khan, Huma Ali

2012-04-01

To evaluate the efficacy and feasibility of a multifaceted, community-based weight intervention program for children using exergaming technology (activity-promoting video gaming). This is a prospective observational pilot study. Forty-eight children, between the ages of 8 and 16 years, who are overweight or obese, enrolled in Exergaming for Health, a multidisciplinary weight management program, which used active video gaming. Primary outcome measures were change in body mass index (BMI) z scores. Most children (n = 40, 83%) completed the program and participated in outcome evaluations. The average BMI change was -0.48 kg/m(2) (SD = 0.93), P < .002 (BMI z-score change was -0.072, SD = 0.14, P < .0001). The average Global Self-Worth score improved, screen time and soda intake reduced, and exercise hours per week increased. The Exergaming for Health program may be an effective weight management intervention that is feasible with high participation rates. A larger randomized controlled trial is needed to confirm these results.

WHO European Childhood Obesity Surveillance Initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010.

PubMed

Wijnhoven, Trudy M A; van Raaij, Joop M A; Spinelli, Angela; Starc, Gregor; Hassapidou, Maria; Spiroski, Igor; Rutter, Harry; Martos, Éva; Rito, Ana I; Hovengen, Ragnhild; Pérez-Farinós, Napoleón; Petrauskiene, Ausra; Eldin, Nazih; Braeckevelt, Lien; Pudule, Iveta; Kunešová, Marie; Breda, João

2014-08-07

The World Health Organization (WHO) Regional Office for Europe has established the Childhood Obesity Surveillance Initiative (COSI) to monitor changes in overweight in primary-school children. The aims of this paper are to present the anthropometric results of COSI Round 2 (2009/2010) and to explore changes in body mass index (BMI) and overweight among children within and across nine countries from school years 2007/2008 to 2009/2010. Using cross-sectional nationally representative samples of 6-9-year-olds, BMI, anthropometric Z-scores and overweight prevalence were derived from measured weight and height. Significant changes between rounds were assessed using variance and t-tests analyses. At Round 2, the prevalence of overweight (including obesity; WHO definitions) ranged from 18% to 57% among boys and from 18% to 50% among girls; 6 - 31% of boys and 5 - 21% of girls were obese. Southern European countries had the highest overweight prevalence. Between rounds, the absolute change in mean BMI (range: from -0.4 to +0.3) and BMI-for-age Z-scores (range: from -0.21 to +0.14) varied statistically significantly across countries. The highest significant decrease in BMI-for-age Z-scores was found in countries with higher absolute BMI values and the highest significant increase in countries with lower BMI values. The highest significant decrease in overweight prevalence was observed in Italy, Portugal and Slovenia and the highest significant increase in Latvia and Norway. Changes in BMI and prevalence of overweight over a two-year period varied significantly among European countries. It may be that countries with higher prevalence of overweight in COSI Round 1 have implemented interventions to try to remedy this situation.

Validation of a school-based amblyopia screening protocol in a kindergarten population.

PubMed

Casas-Llera, Pilar; Ortega, Paula; Rubio, Inmaculada; Santos, Verónica; Prieto, María J; Alio, Jorge L

2016-08-04

To validate a school-based amblyopia screening program model by comparing its outcomes to those of a state-of-the-art conventional ophthalmic clinic examination in a kindergarten population of children between the ages of 4 and 5 years. An amblyopia screening protocol, which consisted of visual acuity measurement using Lea charts, ocular alignment test, ocular motility assessment, and stereoacuity with TNO random-dot test, was performed at school in a pediatric 4- to 5-year-old population by qualified healthcare professionals. The outcomes were validated in a selected group by a conventional ophthalmologic examination performed in a fully equipped ophthalmologic center. The ophthalmologic evaluation was used to confirm whether or not children were correctly classified by the screening protocol. The sensitivity and specificity of the test model to detect amblyopia were established. A total of 18,587 4- to 5-year-old children were subjected to the amblyopia screening program during the 2010-2011 school year. A population of 100 children were selected for the ophthalmologic validation screening. A sensitivity of 89.3%, specificity of 93.1%, positive predictive value of 83.3%, negative predictive value of 95.7%, positive likelihood ratio of 12.86, and negative likelihood ratio of 0.12 was obtained for the amblyopia screening validation model. The amblyopia screening protocol model tested in this investigation shows high sensitivity and specificity in detecting high-risk cases of amblyopia compared to the standard ophthalmologic examination. This screening program may be highly relevant for amblyopia screening at schools.

Reasons Given by High School Students for Refusing Sexually Transmitted Disease Screening

ERIC Educational Resources Information Center

Sanders, Ladatra S.; Nsuami, Malanda; Cropley, Lorelei D.; Taylor, Stephanie N.

2007-01-01

Objective: To determine reasons given by high school students for refusing to participate in a school-based noninvasive chlamydia and gonorrhea screening that was offered at no cost to students, using the health belief model as theoretical framework. Design: Cross-sectional survey. Setting: Public high schools in a southern urban United States…

The spinal posture of computing adolescents in a real-life setting

PubMed Central

2014-01-01

Background It is assumed that good postural alignment is associated with the less likelihood of musculoskeletal pain symptoms. Encouraging good sitting postures have not reported consequent musculoskeletal pain reduction in school-based populations, possibly due to a lack of clear understanding of good posture. Therefore this paper describes the variability of postural angles in a cohort of asymptomatic high-school students whilst working on desk-top computers in a school computer classroom and to report on the relationship between the postural angles and age, gender, height, weight and computer use. Methods The baseline data from a 12 month longitudinal study is reported. The study was conducted in South African school computer classrooms. 194 Grade 10 high-school students, from randomly selected high-schools, aged 15–17 years, enrolled in Computer Application Technology for the first time, asymptomatic during the preceding month, and from whom written informed consent were obtained, participated in the study. The 3D Posture Analysis Tool captured five postural angles (head flexion, neck flexion, cranio-cervical angle, trunk flexion and head lateral bend) while the students were working on desk-top computers. Height, weight and computer use were also measured. Individual and combinations of postural angles were analysed. Results 944 Students were screened for eligibility of which the data of 194 students are reported. Trunk flexion was the most variable angle. Increased neck flexion and the combination of increased head flexion, neck flexion and trunk flexion were significantly associated with increased weight and BMI (p = 0.0001). Conclusions High-school students sit with greater ranges of trunk flexion (leaning forward or reclining) when using the classroom computer. Increased weight is significantly associated with increased sagittal plane postural angles. PMID:24950887

Nutritional status in sick children and adolescents is not accurately reflected by BMI-SDS.

PubMed

Fusch, Gerhard; Raja, Preeya; Dung, Nguyen Quang; Karaolis-Danckert, Nadina; Barr, Ronald; Fusch, Christoph

2013-01-01

Nutritional status provides helpful information of disease severity and treatment effectiveness. Body mass index standard deviation scores (BMI-SDS) provide an approximation of body composition and thus are frequently used to classify nutritional status of sick children and adolescents. However, the accuracy of estimating body composition in this population using BMI-SDS has not been assessed. Thus, this study aims to evaluate the accuracy of nutritional status classification in sick infants and adolescents using BMI-SDS, upon comparison to classification using percentage body fat (%BF) reference charts. BMI-SDS was calculated from anthropometric measurements and %BF was measured using dual-energy x-ray absorptiometry (DXA) for 393 sick children and adolescents (5 months-18 years). Subjects were classified by nutritional status (underweight, normal weight, overweight, and obese), using 2 methods: (1) BMI-SDS, based on age- and gender-specific percentiles, and (2) %BF reference charts (standard). Linear regression and a correlation analysis were conducted to compare agreement between both methods of nutritional status classification. %BF reference value comparisons were also made between 3 independent sources based on German, Canadian, and American study populations. Correlation between nutritional status classification by BMI-SDS and %BF agreed moderately (r (2) = 0.75, 0.76 in boys and girls, respectively). The misclassification of nutritional status in sick children and adolescents using BMI-SDS was 27% when using German %BF references. Similar rates observed when using Canadian and American %BF references (24% and 23%, respectively). Using BMI-SDS to determine nutritional status in a sick population is not considered an appropriate clinical tool for identifying individual underweight or overweight children or adolescents. However, BMI-SDS may be appropriate for longitudinal measurements or for screening purposes in large field studies. When accurate nutritional status classification of a sick patient is needed for clinical purposes, nutritional status will be assessed more accurately using methods that accurately measure %BF, such as DXA.

[Effectiveness of a school weight control program].

PubMed

Huang, Hsiu-Mei; Wu, Mei-Chan; Chen, Kuei-Hsiang

2010-06-01

School-based health promotion programs have been shown to reduce the incidence of obesity in students and improve student physical fitness. However, few longitudinal evaluations of the effectiveness of such programs have been conducted. The purpose of this study was to assess the effectiveness of an in-school weight control program. Data was collected prior to and after the school's summer vacation period. The study utilized a one-group pretest-posttest design. Overweight and obese children from the fifth grade in an elementary school in Taipei City were selected as purposive samples. The study, which was conducted between March and June 2007, introduced general obesity concepts, taught basic nutrition education, and organized a physical activity program that comprised two 45-min exercise sessions during the week and one 30-min session activity each weekend. The obesity index assessed the body mass index (BMI) and waist-to-height ratio (WHtR), with physical fitness tests conducted before and after student summer vacations to assess achieved weight control results. The nonparametric test and repeat measure were used to assess weight control program effectiveness. After the weight control program, significant declines in BMI and WHtR (p < .001), significant improvements in 800-m run/walk (p < .01) and 1-minute sit-up tests (p < .05) were recorded. However, no significant comparative improvement was achieved on either obesity index or physical fitness test. Weight control programs represent an effective approach to reduce BMI and WHtR and improve physical fitness. An appropriate diet and exercise are important for school-aged children to maintain effective weight control and physical fitness health.

Influence of body mass index, gender, and Hispanic ethnicity on physical activity in urban children.

PubMed

Wright, Kynna N

2011-04-01

This community-based participatory research study examined the association between overweight status and activity among Hispanic urban, school-age children. In a sample of 140 children, activities were assessed using the Youth Risk Behavior Survey's questions about physical activity (PA) and team sports. Thirty-nine percent were overweight (body mass index [BMI] >85%). Normal-weight children had higher levels of PA and team sports. Females had lower levels of PA and team sports. Significant associations included BMI and sports team participation, and BMI and Hispanic ethnicity. Nurses should be aware that Hispanic urban children are at risk for lower activity. © 2011, Wiley Periodicals, Inc.

Screening for prostate cancer: are digital rectal examinations being performed?

PubMed

Federman, Daniel G; Pitkin, Patricia; Carbone, Vera; Concato, John; Kravetz, Jeffrey D

2014-04-01

Prostate cancer is common and prostate cancer screening is controversial; this retrospective observational study was conducted to determine the prevalence of digital rectal examination (DRE) in those in whom a prostate-specific antigen (PSA) test was performed. A manual review was performed of the electronic medical record for male veterans in the VA Connecticut Healthcare System without a history of known prostate cancer aged between 50 and 74 years who underwent PSA testing. Documentation of DRE (or refusal) within 12 months before or after the performance of a PSA test. Less than half (47.6%) of patients underwent DRE. An additional 6.9% were offered DRE and refused. Although the provider gender was not associated with DRE, resident physicians were less likely to perform DRE than nonresidents; P = 0.01. Patients whose PSA was > 4.0 ng/mL were more likely to undergo DRE than those whose PSA was ≤ 4.0 ng/mL; P = 0.002. Those with body mass index (BMI) > 40 kg/m 2 were less likely to undergo DRE than those with BMI < 30 kg/m 2 ; P = 0.04. Screening for prostate cancer remains controversial. We found a low rate of DRE among veterans in whom prostate cancer screening was entertained. Although the provider gender does not seem to influence DRE, resident physicians were less likely to perform DRE than other providers. Our finding that BMI > 40 kg/m 2 is associated with a lower rate of DRE than those with BMI < 30 kg/m 2 is consistent with screening for other cancers and should be explored further.

The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents

PubMed Central

Ozmen, Dilek; Ozmen, Erol; Ergin, Dilek; Cetinkaya, Aynur Cakmakci; Sen, Nesrin; Dundar, Pinar Erbay; Taskin, E Oryal

2007-01-01

Background The purpose of this study was to determine the prevalence of overweight and obesity and to examine the effects of actual weight status, perceived weight status and body satisfaction on self-esteem and depression in a high school population in Turkey. Methods A cross-sectional survey of 2101 tenth-grade Turkish adolescents aged 15–18 was conducted. Body mass index (BMI) was calculated using weight and height measures. The overweight and obesity were based on the age- and gender-spesific BMI cut-off points of the International Obesity Task Force values. Self-esteem was measured using the Rosenberg Self-Esteem Scale, and depression was measured using Children's Depression Inventory. Logistic regression analysis was used to examine relationships among the variables. Results Based on BMI cut-off points, 9.0% of the students were overweight and 1.1% were obese. Logistic regression analysis indicated that (1) being male and being from a higher socio-economical level were important in the prediction of overweight based on BMI; (2) being female and being from a higher socio-economical level were important in the prediction of perceived overweight; (3) being female was important in the prediction of body dissatisfaction; (4) body dissatisfaction was related to low self-esteem and depression, perceived overweight was related only to low self-esteem but actual overweight was not related to low self-esteem and depression in adolescents. Conclusion The results of this study suggest that school-based adolescents in urban Turkey have a lower risk of overweight and obesity than adolescents in developed countries. The findings of this study suggest that psychological well-being of adolescents is more related to body satisfaction than actual and perceived weight status is. PMID:17506879

The SNAQ(RC), an easy traffic light system as a first step in the recognition of undernutrition in residential care.

PubMed

Kruizenga, H M; de Vet, H C W; Van Marissing, C M E; Stassen, E E P M; Strijk, J E; Van Bokhorst-de Van der Schueren, M A E; Horman, J C H; Schols, J M G A; Van Binsbergen, J J; Eliens, A; Knol, D L; Visser, M

2010-02-01

Development and validation of a quick and easy screening tool for the early detection of undernourished residents in nursing homes and residential homes. Multi-center, cross sectional observational study. Nursing homes and residential homes. The screening tool was developed in a total of 308 residents (development sample; sample A) and cross validated in a new sample of 720 residents (validation sample) consisting of 476 nursing home residents (Sample B1) and 244 residential home residents (sample B2). Patients were defined severely undernourished when they met at least one of the following criteria: BMI or= 5% unintentional weight loss in the past month and/or >or= 10% unintentional weight loss in the past 6 months. Patients were defined as moderately undernourished if they met the following criteria: BMI 20.1-22 kg/m2 and/or 5-10% unintentional weight loss in the past six months. The most predictive questions (originally derived from previously developed screening instruments) of undernourishment were selected in sample A and cross validated in sample B. In a second stage BMI was added to the SNAQRC in sample B. The diagnostic accuracy of the screening tool in the development and validation samples was expressed in sensitivity, specificity, and the negative and positive predictive value. The four most predictive questions for undernutrition related to: unintentional weight loss more than 6 kg during the past 6 months and more than 3 kg in the past month, capability of eating and drinking with help, and decreased appetite during the past month. The diagnostic accuracy of these questions alone was insufficient (Se=45%, Sp=87%, PPV=50% and NPV=84%). However, combining the questions with measured BMI sufficiently improved the diagnostic accuracy (Se=87%, Sp=82%, PPV=59% and NPV=95%). Early detection of undernourished nursing- and residential home residents is possible using four screening questions and measured BMI.

Long-term prediction of prostate cancer diagnosis and death using PSA and obesity related anthropometrics at early middle age: data from the malmö preventive project

PubMed Central

Assel, Melissa J.; Gerdtsson, Axel; Thorek, Daniel L.J.; Carlsson, Sigrid V.; Malm, Johan; Scardino, Peter T.; Vickers, Andrew; Lilja, Hans; Ulmert, David

2018-01-01

Objectives To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. Results After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. Materials and Methods In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data. Rates of PSA screening in the cohort were very low. Documentation of PCa diagnosis and disease-specific death up to 2014 was retrieved through national registries. Among men with anthropometric measurements available at baseline, a total of 1692 men diagnosed with PCa were matched to 4190 controls, and 464 men who died of disease were matched to 1390 controls. Multivariable conditional logistic regression was used to determine whether diagnosis or death from PCa were associated with weight and body mass index (BMI) at adulthood after adjusting for PSA. Conclusions Men with higher BMI and weight at early middle age have an increased risk of PCa diagnosis and death after adjusting for PSA. However, in a multi-variable numerical statistical model, BMI and weight do not importantly improve the predictive accuracy of PSA. Risk-stratification of screening should be based on PSA without reference to anthropometrics. PMID:29464033

Long-term prediction of prostate cancer diagnosis and death using PSA and obesity related anthropometrics at early middle age: data from the malmö preventive project.

PubMed

Assel, Melissa J; Gerdtsson, Axel; Thorek, Daniel L J; Carlsson, Sigrid V; Malm, Johan; Scardino, Peter T; Vickers, Andrew; Lilja, Hans; Ulmert, David

2018-01-19

To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data. Rates of PSA screening in the cohort were very low. Documentation of PCa diagnosis and disease-specific death up to 2014 was retrieved through national registries. Among men with anthropometric measurements available at baseline, a total of 1692 men diagnosed with PCa were matched to 4190 controls, and 464 men who died of disease were matched to 1390 controls. Multivariable conditional logistic regression was used to determine whether diagnosis or death from PCa were associated with weight and body mass index (BMI) at adulthood after adjusting for PSA. Men with higher BMI and weight at early middle age have an increased risk of PCa diagnosis and death after adjusting for PSA. However, in a multi-variable numerical statistical model, BMI and weight do not importantly improve the predictive accuracy of PSA. Risk-stratification of screening should be based on PSA without reference to anthropometrics.

Presence of diabetes risk factors in a large U.S. eighth-grade cohort.

PubMed

Baranowski, T; Cooper, D M; Harrell, J; Hirst, K; Kaufman, F R; Goran, M; Resnicow, K

2006-02-01

The study was conducted in 12 middle schools to determine the prevalence of diabetes, pre-diabetes, and diabetes risk factors in eighth-grade students who were predominantly minority and evaluate the feasibility of collecting physical and laboratory data in schools. Anthropometric measurements and fasting and 2-h post-glucose load blood draws were obtained from approximately 1,740 eighth-grade students. Mean recruitment rate was 50% per school, 49% had BMI > or = 85th percentile, 40.5% had fasting glucose > or = 100 mg/dl, 0.4% had fasting glucose > or = 126 mg/dl, and 2.0% had 2-h glucose > or = 140 mg/dl and 0.1% > or = 200 mg/dl. Mean fasting insulin value was 30.1 microU/ml, 36.2% had fasting insulin > or = 30 microU/ml, and 2-h mean insulin was 102.1 microU/ml. Fasting and 2-h glucose and insulin values increased across BMI percentiles, and fasting glucose was highest in Hispanic and Native American students. There was a high prevalence of risk factors for diabetes, including impaired fasting glucose (> or =100 mg/dl), hyperinsulinism suggestive of insulin resistance (fasting insulin > or = 30 microU/ml), and BMI > or = 85th percentile. These data suggest that middle schools are appropriate targets for population-based efforts to decrease overweight and diabetes risk.

Lifestyle modifications in an adolescent dormitory: a clinical trial

PubMed Central

Alumot-Yehoshua, Michal; Reisler, Gadi; Efrati, Shai; Kozer, Eran; Doenyas-Barak, Keren; Feldon, Michal; Dagan, Zahi; Reifen, Rami; Berkovitch, Matitiahu

2014-01-01

Purpose Childhood obesity is an increasing public health issue worldwide. We examined dietary patterns among adolescents in a dormitory school, identified obese adolescents and tried to intervene to improve food habits and physical activity. Methods We conducted an experimental prospective longitudinal study based on 36 obese (body mass index [BMI]≥95th percentile) adolescents (aged 12-18 years) compared with controls (healthy children: normal age-appropriate BMI (BMI≤85th percentile). Six months' intervention included lifestyle-modification counseling (once a week by a clinical dietician), and an exercise regimen twice a week, 60 minutes each time, instructed by a professional pediatric trainer). Both groups underwent baseline measurements at the beginning of the study and 6 months later (arterial stiffness, blood pressure, pulse, weight and height, hemoglobin, creatinine, liver enzymes, highly sensitive C-reactive protein and complete lipid profile). Results Twenty-one participants completed the study. Low compliance from participants, school staff and parents was observed (participation in planned meetings; 71%-83%). BMI significantly decreased from 32.46±3.93 kg/m2 to 30.32±3.4 kg/m2 (P=0.002) in the study group. Arterial stiffness was not significantly different between the 2 groups and did not change significantly after 6 months' intervention (P=0.494). No significant changes in CRP and lipid profile were observed after the intervention. Conclusion Making lifestyle modifications among adolescents in a dormitory school is a complex task. Active intervention indeed ameliorates BMI parameters. However, in order to maximize the beneficial effects, a multidisciplinary well-trained team is needed, with emphasis on integrating parents and the school environment. PMID:25653685

Effect of a School-Based Water Intervention on Child Body Mass Index and Obesity.

PubMed

Schwartz, Amy Ellen; Leardo, Michele; Aneja, Siddhartha; Elbel, Brian

2016-03-01

Decreasing the amount of caloric beverages consumed and simultaneously increasing water consumption is important to promoting child health and decreasing the prevalence of childhood obesity. To estimate the impact of water jets (electrically cooled, large clear jugs with a push lever for fast dispensing) on standardized body mass index, overweight, and obesity in elementary school and middle school students. Milk purchases were explored as a potential mechanism for weight outcomes. This quasi-experimental study used a school-level database of cafeteria equipment deliveries between the 2008-2009 and 2012-2013 and included a sample of 1227 New York, New York, public elementary schools and middle schools and the 1,065,562 students within those schools. Installation of water jets in schools. Individual body mass index (BMI) was calculated for all students in the sample using annual student-level height and weight measurements collected as part of New York's FITNESSGRAM initiative. Age- and sex-specific growth charts produced by the Centers for Disease Control and Prevention were used to categorize students as overweight and obese. The hypothesis that water jets would be associated with decreased standardized BMI, overweight, and obesity was tested using a difference-in-difference strategy, comparing outcomes for treated and nontreated students before and after the introduction of a water jet. This study included 1 065 562 students within New York City public elementary schools and middle schools. There was a significant effect of water jets on standardized BMI, such that the adoption of water jets was associated with a 0.025 (95% CI, -0.038 to -0.011) reduction of standardized BMI for boys and a 0.022 (95% CI, -0.035 to -0.008) reduction of standardized BMI for girls (P < .01). There was also a significant effect on being overweight. Water jets were associated with a 0.9 percentage point reduction (95% CI, 0.015-0.003) in the likelihood of being overweight for boys and a 0.6 percentage reduction (95% CI, 0.011-0.000) in the likelihood of being overweight for girls (P < .05). We also found a 12.3 decrease (95% CI, -19.371 to -5.204) in the number of all types of milk half-pints purchased per student per year (P < .01). Results from this study show an association between a relatively low-cost water availability intervention and decreased student weight. Milk purchases were explored as a potential mechanism. Additional research is needed to examine potential mechanisms for decreased student weight, including reduced milk taking, as well as assessing impacts on longer-term outcomes.

Effect of a School-Based Water Intervention on Child Body Mass Index and Obesity

PubMed Central

Schwartz, Amy Ellen; Leardo, Michele; Aneja, Siddhartha; Elbel, Brian

2016-01-01

IMPORTANCE Decreasing the amount of caloric beverages consumed and simultaneously increasing water consumption is important to promoting child health and decreasing the prevalence of childhood obesity. OBJECTIVE To estimate the impact of water jets (electrically cooled, large clear jugs with a push lever for fast dispensing) on standardized body mass index, overweight, and obesity in elementary school and middle school students. Milk purchases were explored as a potential mechanism for weight outcomes. DESIGN, SETTING, AND PARTICIPANTS This quasi-experimental study used a school-level database of cafeteria equipment deliveries between the 2008-2009 and 2012-2013 and included a sample of 1227 New York, New York, public elementary schools and middle schools and the 1 065 562 students within those schools. INTERVENTION Installation of water jets in schools. MAIN OUTCOMES AND MEASURES Individual body mass index (BMI) was calculated for all students in the sample using annual student-level height and weight measurements collected as part of New York’s FITNESSGRAM initiative. Age- and sex-specific growth charts produced by the Centers for Disease Control and Prevention were used to categorize students as overweight and obese. The hypothesis that water jets would be associated with decreased standardized BMI, overweight, and obesity was tested using a difference-in-difference strategy, comparing outcomes for treated and nontreated students before and after the introduction of a water jet. RESULTS This study included 1 065 562 students within New York City public elementary schools and middle schools. There was a significant effect of water jets on standardized BMI, such that the adoption of water jets was associated with a 0.025 (95% CI, −0.038 to −0.011) reduction of standardized BMI for boys and a 0.022 (95% CI, −0.035 to −0.008) reduction of standardized BMI for girls (P < .01). There was also a significant effect on being overweight. Water jets were associated with a 0.9 percentage point reduction (95% CI, 0.015-0.003) in the likelihood of being overweight for boys and a 0.6 percentage reduction (95% CI, 0.011-0.000) in the likelihood of being overweight for girls (P < .05). We also found a 12.3 decrease (95% CI, −19.371 to −5.204) in the number of all types of milk half-pints purchased per student per year (P < .01). CONCLUSIONS AND RELEVANCE Results from this study show an association between a relatively low-cost water availability intervention and decreased student weight. Milk purchases were explored as a potential mechanism. Additional research is needed to examine potential mechanisms for decreased student weight, including reduced milk taking, as well as assessing impacts on longer-term outcomes. PMID:26784336

Relationship of body mass index to percent body fat and waist circumference among schoolchildren in Japan - the influence of gender and obesity: a population-based cross-sectional study

PubMed Central

2010-01-01

Background Although the correlation coefficient between body mass index (BMI) and percent body fat (%BF) or waist circumference (WC) has been reported, studies conducted among population-based schoolchildren to date have been limited in Japan, where %BF and WC are not usually measured in annual health examinations at elementary schools or junior high schools. The aim of the present study was to investigate the relationship of BMI to %BF and WC and to examine the influence of gender and obesity on these relationships among Japanese schoolchildren. Methods Subjects included 3,750 schoolchildren from the fourth and seventh grade in Ina-town, Saitama Prefecture, Japan between 2004 and 2008. Information about subject's age, sex, height, weight, %BF, and WC was collected from annual physical examinations. %BF was measured with a bipedal biometrical impedance analysis device. Obesity was defined by the following two criteria: the obese definition of the Centers for Disease Control and Prevention, and the definition of obesity for Japanese children. Pearson's correlation coefficients between BMI and %BF or WC were calculated separately for sex. Results Among fourth graders, the correlation coefficients between BMI and %BF were 0.74 for boys and 0.97 for girls, whereas those between BMI and WC were 0.94 for boys and 0.90 for girls. Similar results were observed in the analysis of seventh graders. The correlation coefficient between BMI and %BF varied by physique (obese or non-obese), with weaker correlations among the obese regardless of the definition of obesity; most correlation coefficients among obese boys were less than 0.5, whereas most correlations among obese girls were more than 0.7. On the other hand, the correlation coefficients between BMI and WC were more than 0.8 among boys and almost all coefficients were more than 0.7 among girls, regardless of physique. Conclusions BMI was positively correlated with %BF and WC among Japanese schoolchildren. The correlations could be influenced by obesity as well as by gender. Accordingly, it is essential to consider gender and obesity when using BMI as a surrogate for %BF and WC for epidemiological use. PMID:20716379

Associations of Anthropometric, Behavioral, and Social Factors on Level of Body Esteem in Peripubertal Girls.

PubMed

Szamreta, Elizabeth A; Qin, Bo; Ohman-Strickland, Pamela A; Devine, Katie A; Stapleton, Jerod L; Ferrante, Jeanne M; Bandera, Elisa V

2017-01-01

Lower body esteem may decrease self-esteem and lead to adverse health effects in children. This study explored the role of anthropometric, behavioral, and social factors on body esteem in peripubertal girls. We evaluated associations of body esteem (measured by the Revised Body Esteem Scale) with body mass index (BMI), mother's BMI, puberty, physical activity, role models for appearance, and screen time among girls (ages 9 and 10) participating in the Jersey Girl Study (n = 120). Linear models were used to evaluate differences in body esteem scores. Overweight/obese girls had a significantly lower mean body esteem score compared with underweight/healthy weight girls {14.09 (95% confidence interval [CI]: 12.53-15.27) vs. 17.17 (95% CI: 16.87-17.43)}. Girls who were physically active for at least 7 hours per week had a significantly higher body esteem score than those who were less active, after adjusting for BMI (17.00 [95% CI: 16.62-17.32] vs. 16.39 [95% CI: 15.82-16.86]). Girls whose mothers were overweight/obese, who had entered puberty, and who cited girls at school or females in the media as role models had lower body esteem scores, but differences disappeared after adjusting for girl's BMI. A trend of higher body esteem scores was found for girls whose mothers were role models. Lower BMI and higher levels of physical activity are independently associated with higher body esteem score. Having classmates or girls/women in the media as role models may detrimentally affect girls' body esteem, but having mothers as role models may have a positive effect.

Associations of anthropometric, behavioral, and social factors on level of body esteem in peripubertal girls

PubMed Central

Szamreta, Elizabeth A.; Qin, Bo; Ohman-Strickland, Pamela A.; Devine, Katie A.; Stapleton, Jerod L.; Ferrante, Jeanne M.; Bandera, Elisa V.

2016-01-01

Objective Lower body esteem may decrease self-esteem and lead to adverse health effects in children. This study explored the role of anthropometric, behavioral, and social factors on body esteem in peripubertal girls. Method We evaluated associations of body esteem (measured by the Revised Body Esteem Scale) with body mass index (BMI), mother’s BMI, puberty, physical activity, role models for appearance, and screen time among girls (ages 9 and 10) participating in the Jersey Girl Study (n=120). Linear models were used to evaluate differences in body esteem scores. Results Overweight/obese girls had a significantly lower mean body esteem score compared to underweight/healthy weight girls [14.09 (95% CI 12.53–15.27) vs. 17.17 (95% CI 16.87–17.43)]. Girls who were physically active for at least 7 hours per week had a significantly higher body esteem score than those who were less active, after adjusting for BMI [17.00 (95% CI 16.62–17.32) vs. 16.39 (95% CI 15.82–16.86)]. Girls whose mothers were overweight/obese, who had entered puberty, and who cited girls at school or females in the media as role models had lower body esteem scores, but differences disappeared after adjusting for girl’s BMI. A trend of higher body esteem scores was found for girls whose mothers were role models. Conclusion Lower BMI and higher levels of physical activity are independently associated with higher body esteem score. Having classmates or girls/women in the media as role models may detrimentally affect girls’ body esteem, but having mothers as role models may have a positive effect. PMID:27902543

Determinants of Body Mass Index and Intelligence Quotient of Elementary School Children in Mountain Area of Nepal: An Explorative Study.

PubMed

Ranabhat, Chhabi; Kim, Chun-Bae; Park, Myung Bae; Kim, Chang Soo; Freidoony, Leila

2016-02-03

The physical growth and cognitive development of elementary school children are very crucial and this group is large in number but has little research dedicated to it. The physical growth and cognitive development of children occur simultaneously and can be measured by body mass index (BMI) and intelligence quotient (IQ). Previous studies could not sufficiently focus on both aspects. The aim of this study was to identify determinants of BMI and IQ of students in two elementary schools in the Humla district of Nepal. Two randomly selected elementary schools and all children available there (n = 173) participated in the study. BMI was calculated with the objective of proper measurement of height and weight of the children. Likewise, the updated universal nonverbal intelligence test (UNIT) was applied for IQ. Descriptive statistics, t-test, analysis of variance and multiple linear regressions were used when appropriate. Study findings showed that one-tenth of the children had grade 2 thinness (-2SD) and about one-third had poor IQ (<85). The age of the children (p < 0.05) and household economic status (p < 0.001) were significant for the BMI. Likewise, frequencies of illness in the previous year, mother's education (p < 0.05) and father's education (p < 0.001) were significant factors for the IQ score. More commonly, BMI and IQ scores were significantly lower in the ultra-poor group. Economic status and parent education are still major determinants of IQ and BMI in these students. Special programs and strategies should be launched to improve the poor ranking of IQ and BMI.

The long-run effect of education on obesity in the US.

PubMed

Kim, Young-Joo

2016-05-01

The proportion of obese population has been gradually increasing in the US over the past few decades. In this study I investigate how education is associated with Body Mass Index (BMI) in later stages of life. BMI, weight(kg)/height(m)(2), is the principle measure used for classifying people as obese. Using sibling data and methods that take account of unobserved endowments and environment shared by siblings, I find that there is large variation in BMI between siblings and that education is negatively associated with BMI. One more year of schooling is associated with an estimated reduction of 0.15 in BMI. When considering different education levels, completing college education is associated with 0.7 reduction in BMI relative to high school graduation only. The significant effect of education on obesity that remains in the long-run has policy implications. Copyright © 2015 Elsevier B.V. All rights reserved.

Prevalence and predictors of adolescent idiopathic scoliosis in adolescent ballet dancers.

PubMed

Longworth, Brooke; Fary, Robyn; Hopper, Diana

2014-09-01

To determine any differences between the prevalence of adolescent idiopathic scoliosis in ballet dancers who are girls compared with age-matched nondancers, and to establish if any relations exist between the presence of scoliosis and generalized joint hypermobility, age of menarche, body mass index (BMI), and the number of hours of dance training per week. Cross-sectional, matched pair study. Dance school. Dancers (n=30) between the ages of 9 and 16 years were recruited from a certified dance school in Western Australia; each dancer provided a consenting age-matched nondancer (n=30). Not applicable. Measurements were taken for angle of trunk rotation using a scoliometer (presence of scoliosis) and for height and weight to produce generalized joint hypermobility using Beighton criteria and an age-adjusted BMI, respectively. A subjective questionnaire regarding age of menarche and participation in dance and other sports was completed. Thirty percent of dancers tested positive for scoliosis compared with 3% of nondancers. Odds ratio calculations suggest that dancers were 12.4 times more likely to have scoliosis than nondancers of the same age. There was a higher rate of hypermobility in the dancer group (70%) compared with the nondancers (3%); however, there were no statistically significant relations between scoliosis and hypermobility, age of menarche, BMI, or hours of dance per week. Adolescent dancers, similar to adult dancers, are at significantly higher risk of developing scoliosis than nondancers of the same age. Vigilant screening and improved education of dance teachers and parents of dance students may be beneficial in earlier detection and, consequently, reducing the risk of requiring surgical intervention. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Tests Screening Reading Difficulty in Malayalam among Upper Primary School Boys

ERIC Educational Resources Information Center

Gafoor, K. Abdul

2014-01-01

Design of a screening test for identifying reading difficult students in Malayalam and validation thereof among boys is made to help schools proactively intervene with such students. A battery of tests developed based on extant literature on screening tests, reviewed difficulties in reading Malayalam, and discrimination power of the draft tests is…

Trend, projection, and appropriate body mass index cut-off point for diabetes and hypertension in Bangladesh.

PubMed

Rahman, Md Mizanur; Akter, Shamima; Jung, Jenny; Rahman, Md Shafiur; Sultana, Papia

2017-04-01

Rapid increasing of high body mass index (BMI) is a global health concern. Population with high BMI predicts an increased risk of diabetes and hypertension. The objective of the present study is to estimate the trend and prediction of diabetes and hypertension in Bangladesh, to examine the association of BMI with risk of diabetes and hypertension, and to ascertain an appropriate BMI cut-off point for screening diabetes. We searched PubMed from inception to August 2016 and identified studies reporting diabetes and hypertension prevalence in Bangladesh. Bangladesh Demographic and Health Survey 2011 data was also included in this study. Bayesian model was used to estimate trend and projection in diabetes and hypertension prevalence by sex and residence. Receiver operating characteristic curves was used to determine the optimal BMI cut-off point for screening diabetes. Of 535 articles reviewed, 35 studies reported prevalence of diabetes and hypertension. Prevalence of diabetes (95% credible interval) increased between 1992 and 2015 from 3.2% (2.2-4.3) to 12.1% (9.1-15.4) in men, and from 2.5% (1.8-3.5) to 13.4% (9.7-17.6) in women. Diabetes prevalence in 2030 is expected to reach 23.6% (13.6-36.3) for men and 33.5% (19.9-50.9) for women. Hypertension prevalence increased between 1992 and 2015 from 11.0% (8.6-13.7) to 20.4% (18.4-22.4%) in 2015 in men, and from 14.0% (10.3-19.0) to 21.3% (19.0-23.6) in women. Annual average rate of change for diabetes prevalence was higher among women and in rural areas, while for hypertension prevalence it was higher in men and urban areas. Adults with BMI of 22.5kg/m 2 or above had a higher risk of diabetes and hypertension in this study. The optimal BMI cut-off point for screening diabetes was 23kg/m 2 for overall population, 22kg/m 2 for men, and 23kg/m 2 for women. Diabetes is more prevalent among women and rural population groups, while hypertension is more prevalent among men and urban population groups in Bangladesh. A BMI of 22.5kg/m 2 or more is risk factors for developing diabetes and hypertension. Screening for diabetes may be considered for all Bangladeshi adults with a BMI of ⩾23kg/m 2 . Copyright © 2017 Elsevier B.V. All rights reserved.

Fourth-grade children’s dietary recall accuracy for energy intake at school meals differs by social desirability and body mass index percentile in a study concerning retention interval

PubMed Central

Guinn, Caroline H.; Baxter, Suzanne D.; Royer, Julie A.; Hardin, James W.; Mackelprang, Alyssa J.; Smith, Albert F.

2010-01-01

Data from a study concerning retention interval and school-meal observation on children’s dietary recalls were used to investigate relationships of social desirability score (SDS) and body mass index percentile (BMI%) to recall accuracy for energy for observed (n=327) children, and to reported energy for observed and unobserved (n=152) children. Report rates (reported/observed) correlated negatively with SDS and BMI%. Correspondence rates (correctly reported/observed) correlated negatively with SDS. Inflation ratios (overreported/observed) correlated negatively with BMI%. The relationship between reported energy and each of SDS and BMI% did not depend on observation status. Studies utilizing children’s dietary recalls should assess SDS and BMI%. PMID:20460407

Medical comorbidity in polycystic ovary syndrome with special focus on cardiometabolic, autoimmune, hepatic and cancer diseases: an updated review.

PubMed

Glintborg, Dorte; Andersen, Marianne

2017-12-01

Polycystic ovary syndrome (PCOS) is defined by hyperandrogenism, irregular menses and polycystic ovaries when other causes are excluded. The possible implication of increased morbidity in PCOS for screening and follow-up is uncertain and is reviewed in this article. The increased risk of type 2 diabetes and cardiovascular disease in PCOS is closely associated with BMI. Women with PCOS should be screened for the elements of the metabolic syndrome upon diagnosis. Measurement of HbA1c and the lipid accumulation product could be important tools to differentiate women with high metabolic risk. The immune function in PCOS is impaired with increased secretion of autoantibodies and increased risk of type 1 diabetes, asthma and thyroid disease. The occurrence of thyroid disease could be modified by BMI and D-vitamin status. Screening for diabetes and thyroid disease is part of routine evaluation for endocrine diseases at baseline in PCOS, whereas the necessity of prospective screening for thyroid disease awaits future studies. Especially obese women with PCOS are at an increased risk of nonalcoholic fatty liver disease, gall bladder disease and endometrial cancer. Recent data support that screening and follow-up in patients with PCOS should be stratified according to BMI.

Exploring Categorical Body Mass Index Trajectories in Elementary School Children

ERIC Educational Resources Information Center

Moreno-Black, Geraldine; Boles, Shawn; Johnson-Shelton, Deb; Evers, Cody

2016-01-01

Background: Studies of body mass index (BMI) change have focused on understanding growth trajectories from childhood to adolescence and adolescence to adulthood, but few have explored BMI trajectories solely in elementary (grades K-5) school children. This report complements these studies by exploring changes in obesity status using analytic…

Evaluating Referral, Screening, and Assessment Procedures for Middle School Trauma/Grief-Focused Treatment Groups

ERIC Educational Resources Information Center

Grassetti, Stevie N.; Williamson, Ariel A.; Herres, Joanna; Kobak, Roger; Layne, Christopher M.; Kaplow, Julie B.; Pynoos, Robert S.

2018-01-01

There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require…

"L.I.F.E.": A School-Based Heart-Health Screening and Intervention Program

ERIC Educational Resources Information Center

Northrup, Karen L.; Cottrell, Lesley A.; Wittberg, Richard A.

2008-01-01

This article describes the development and growth of "Lifestyle Improvements in the Family Environment" ("L.I.F.E."), a school-based heart-health screening and intervention program. The primary goals of "L.I.F.E." through three rounds of grant funding remained constant: (a) to identify cardiovascular risk factors in…

Psychological Distress Is More Prevalent in Fertile Age and Premenopausal Women With PCOS Symptoms: 15-Year Follow-Up.

PubMed

Karjula, Salla; Morin-Papunen, Laure; Auvinen, Juha; Ruokonen, Aimo; Puukka, Katri; Franks, Stephen; Järvelin, Marjo-Riitta; Tapanainen, Juha S; Jokelainen, Jari; Miettunen, Jouko; Piltonen, Terhi T

2017-06-01

Polycystic ovary syndrome (PCOS) is associated with increased psychological distress, obesity and hyperandrogenism being suggested as key promoters. To investigate the prevalence of anxiety/depression and their coexistence in women with PCOS/PCOS-related symptoms at ages 31 and 46. The roles of obesity, hyperandrogenism, and awareness of PCOS on psychological distress were also assessed. Population-based follow-up. Northern Finland Birth Cohort 1966 with 15-year follow-up. At age 31, a questionnaire-based screening for oligoamenorrhea (OA) and hirsutism (H): 2188 asymptomatic (controls), 331 OA, 323 H, and 125 OA plus H (PCOS). Follow-up at age 46: 1576 controls, 239 OA, 231 H, and 85 PCOS. Questionnaire-based screening for anxiety and depression symptoms (Hopkins Symptom Checklist-25) and previously diagnosed/treated depression at ages 31 and 46. Body mass index (BMI), serum testosterone/free androgen index, and awareness of polycystic ovaries/PCOS on psychological distress were also assessed. Population-based prevalence of anxiety and/or depression in women with PCOS/PCOS-related symptoms at ages 31 and 46. Anxiety and/or depression symptoms, their coexistence, and rate of depression were increased at ages 31 and 46 in women with PCOS or isolated H compared with controls. High BMI or hyperandrogenism did not associate with increased anxiety or depression symptoms. The awareness of PCOS was associated with increased anxiety. Women with PCOS or isolated H present more often with anxiety and/or depression symptoms and their coexistence compared with controls. High BMI or hyperandrogenism did not provoke psychological distress in PCOS. The awareness of PCOS increased anxiety but did not associate with severe anxiety or depression. Copyright © 2017 by the Endocrine Society

Psychological Distress Is More Prevalent in Fertile Age and Premenopausal Women With PCOS Symptoms: 15-Year Follow-Up

PubMed Central

Karjula, Salla; Morin-Papunen, Laure; Auvinen, Juha; Ruokonen, Aimo; Puukka, Katri; Franks, Stephen; Järvelin, Marjo-Riitta; Tapanainen, Juha S.; Jokelainen, Jari; Miettunen, Jouko

2017-01-01

Context: Polycystic ovary syndrome (PCOS) is associated with increased psychological distress, obesity and hyperandrogenism being suggested as key promoters. Objectives: To investigate the prevalence of anxiety/depression and their coexistence in women with PCOS/PCOS-related symptoms at ages 31 and 46. The roles of obesity, hyperandrogenism, and awareness of PCOS on psychological distress were also assessed. Design: Population-based follow-up. Setting: Northern Finland Birth Cohort 1966 with 15-year follow-up. Participants: At age 31, a questionnaire-based screening for oligoamenorrhea (OA) and hirsutism (H): 2188 asymptomatic (controls), 331 OA, 323 H, and 125 OA plus H (PCOS). Follow-up at age 46: 1576 controls, 239 OA, 231 H, and 85 PCOS. Interventions: Questionnaire-based screening for anxiety and depression symptoms (Hopkins Symptom Checklist-25) and previously diagnosed/treated depression at ages 31 and 46. Body mass index (BMI), serum testosterone/free androgen index, and awareness of polycystic ovaries/PCOS on psychological distress were also assessed. Main Outcomes: Population-based prevalence of anxiety and/or depression in women with PCOS/PCOS-related symptoms at ages 31 and 46. Results: Anxiety and/or depression symptoms, their coexistence, and rate of depression were increased at ages 31 and 46 in women with PCOS or isolated H compared with controls. High BMI or hyperandrogenism did not associate with increased anxiety or depression symptoms. The awareness of PCOS was associated with increased anxiety. Conclusions: Women with PCOS or isolated H present more often with anxiety and/or depression symptoms and their coexistence compared with controls. High BMI or hyperandrogenism did not provoke psychological distress in PCOS. The awareness of PCOS increased anxiety but did not associate with severe anxiety or depression. PMID:28323926

Sensitivity and specificity of waist circumference as a single screening tool for identification of overweight and obesity among Malaysian adults.

PubMed

Kee, C C; Jamaiyah, H; Geeta, A; Ali, Z Ahmad; Safiza, M N Noor; Suzana, S; Khor, G L; Rahmah, R; Jamalludin, A R; Sumarni, M G; Lim, K H; Faudzi, Y Ahmad; Amal, N M

2011-12-01

Generalised obesity and central obesity are risk factors for Type II diabetes mellitus and cardiovascular diseases. Waist circumference (WC) has been suggested as a single screening tool for identification of overweight or obese subjects in lieu of the body mass index (BMI) for weight management in public health program. Currently, the recommended waist circumference cut-off points of > or = 94cm for men and > or =80cm for women (waist action level 1) and > or = 102cm for men and > or = 88cm for women (waist action level 2) used for identification of overweight and obesity are based on studies in Caucasian populations. The objective of this study was to assess the sensitivity and specificity of the recommended waist action levels, and to determine optimal WC cut-off points for identification of overweight or obesity with central fat distribution based on BMI for Malaysian adults. Data from 32,773 subjects (14,982 men and 17,791 women) aged 18 and above who participated in the Third National Health Morbidity Survey in 2006 were analysed. Sensitivity and specificity of WC at waist action level 1 were 48.3% and 97.5% for men; and 84.2% and 80.6% for women when compared to the cut-off points based on BMI > or = 25kg/m2. At waist action level 2, sensitivity and specificity were 52.4% and 98.0% for men, and 79.2% and 85.4% for women when compared with the cut-off points based on BMI (> or = 30 kg/m2). Receiver operating characteristic analyses showed that the appropriatescreening cut-off points for WC to identify subjects with overweight (> or = 25kg/m2) was 86.0cm (sensitivity=83.6%, specificity=82.5%) for men, and 79.1cm (sensitivity=85.0%, specificity=79.5%) for women. Waist circumference cut-off points to identify obese subjects (BMI > or = 30 kg/m2) was 93.2cm (sensitivity=86.5%, specificity=85.7%) for men and 85.2cm (sensitivity=77.9%, specificity=78.0%) for women. Our findings demonstrated that the current recommended waist circumference cut-off points have low sensitivity for identification of overweight and obesity in men. We suggest that these newly identified cut-off points be considered.

Socioeconomic differences in childhood BMI trajectories in Belarus.

PubMed

Patel, Rita; Tilling, Kate; Lawlor, Debbie A; Howe, Laura D; Hughes, Rachael A; Bogdanovich, Natalia; Matush, Lidia; Nicoli, Emily; Oken, Emily; Kramer, Michael S; Martin, Richard M

2018-02-28

To examine associations of parental socioeconomic position with early-life offspring body mass index (BMI) trajectories in a middle-income country. Overall, 12,385 Belarusian children born 1996-97 and enrolled in a randomised breastfeeding promotion trial at birth, with 3-14 measurements of BMI from birth to 7 years. Cohort analysis in which exposures were parental education (common secondary or less; advanced secondary or partial university; completed university) and occupation (manual; non-manual) at birth, and the outcome was BMI z-score trajectories estimated using multilevel linear spline models, controlling for trial arm, location, parental BMI, maternal smoking status and number of older siblings. Infants born to university-educated mothers were heavier at birth than those born to secondary school-educated mothers [by 0.13 BMI z-score units (95% confidence interval, CI: 0.07, 0.19) for girls and 0.11 (95% CI: 0.05, 0.17) for boys; equivalent for an infant of average birth length to 43 and 38 g, respectively]. Between the ages of 3-7 years children of the most educated mothers had larger BMI increases than children of the least educated mothers. At age 7 years, after controlling for trial arm and location,  children of university-educated mothers had higher BMIs than those born to secondary school-educated mothers by 0.11 z-score (95% CI: 0.03, 0.19) among girls and 0.18 (95% CI: 0.1, 0.27) among boys, equivalent to differences in BMI for a child of average height of 0.19 and 0.26 kg/m 2 , respectively. After further controlling for parental BMI, these differences attenuated to 0.08 z-score (95% CI: 0, 0.16) and 0.16 z-score (95% CI: 0.07, 0.24), respectively, but changed very little after additional adjustment for number of older siblings and mother's smoking status. Associations were similar when based on paternal educational attainment and highest household occupation. In Belarus, consistent with some middle-income countries, higher socioeconomic position was associated with greater BMI trajectories from age 3 onwards.

Low body mass index can identify majority of osteoporotic inflammatory bowel disease patients missed by current guidelines.

PubMed

Atreja, Ashish; Aggarwal, Ashish; Licata, Angelo A; Lashner, Bret A

2012-01-01

Patients with inflammatory bowel disease (IBD) are at high risk of developing osteoporosis. Our objective was to determine the usefulness of IBD guidelines in identifying patients at risk for developing osteoporosis. We utilized institutional repository to identify patients seen in IBD center and extracted data on demographics, disease history, conventional, and nonconventional risk factors for osteoporosis and Dual Energy X-ray Absorptiometry (DXA) findings. 59% of patients (1004/1703) in our IBD cohort had at least one risk factor for osteoporosis screening. DXA was documented in 263 patients with indication of screening (provider adherence, 26.2%), and of these, 196 patients had DXA completed ("at-risk" group). Ninety-five patients not meeting guidelines-based risk factors also had DXA completed ("not at-risk" group). 139 (70.9%) patients in "at-risk" group had low BMD, while 51 (53.7%) of "not-at-risk" patients had low BMD. Majority of the patients with osteoporosis (83.3%) missed by the current guidelines had low BMI. Multivariate logistic regression analysis showed that low BMI was the strongest risk factor for osteoporosis (OR 3.07; 95% CI, 1.47-6.42; P = 0.003). Provider adherence to current guidelines is suboptimal. Low BMI can identify majority of the patients with osteoporosis that are missed by current guidelines.

Screening for sarcopenia in obesity

NASA Astrophysics Data System (ADS)

Sammarco, R.; Marra, M.; Montagnese, C.; De Rosa, E.; Onufrio, M.; Amato, V.; Santarpia, L.; De Caprio, C.; Contaldo, F.; Pasanisi, F.

2013-04-01

Sarcopenia is a progressive and generalized loss of skeletal muscle mass (SM) and function which can also be found in obese adults. The aim of the study was to evaluate the prevalence of sarcopenia in 1 245 obese women (18 - 67 years, weight 114.7±24.5 kg; BMI 44.1±9.2 fat mass 49.0±6.2%) from Southern Italy. Body composition was evaluated by bioimpedance analysis (BIA) and SM calculated by using Janssen's equation; therefore the sex-specific cut-off points of percentage skeletal muscle index were used. The whole population was divided in two age groups: A (18-40 years; n. 808; weight 115.4±23.5 kg; BMI 43.8±8.8 kg/m2) and B (41-67 years; n. 438; weight 113.4±26.3 kg; BMI 44.8±9.9 kg/m2). In all the sample there was 2.7% moderate and 0.6% severe sarcopenia; in group A, 1.9% moderate and 0.6% severe sarcopenia whilst in group B 4.3% moderate and 0.7% severe sarcopenia. The results of our study suggest that, based on a screening examination by BIA, moderate/severe sarcopenia can be detected in an unselected middle-aged obese population. Further studies are required to clarify the diagnosis with functional tests.

Identifying Adolescents at Risk through Voluntary School-Based Mental Health Screening

ERIC Educational Resources Information Center

Husky, Mathilde M.; Kaplan, Adam; McGuire, Leslie; Flynn, Laurie; Chrostowski, Christine; Olfson, Mark

2011-01-01

This study compares referrals for mental health services among high school students randomized to two means of referral to mental health services: referral via systematic identification through a brief mental health screening procedure (n = 365) or referral via the usual process of identification by school personnel, parents, or students…

Physical activity, screen time and obesity status in a nationally representative sample of Maltese youth with international comparisons.

PubMed

Decelis, Andrew; Jago, Russell; Fox, Kenneth R

2014-06-28

There is some evidence that physical activity (PA), sedentary time and screen time (ST) are associated with childhood obesity, but research is inconclusive and studies are mainly based on self-reported data. The literature is dominated by data from North American countries and there is a shortage of objective data from Malta which has one of the highest prevalences of childhood obesity in the world. The aims of this study were to assess the PA levels and ST patterns of Maltese boys and girls and how they compared with children in other countries while also examining differences in PA and ST by weight status. A nationally representative sample of 1126 Maltese boys and girls aged 10-11 years, of which 811 provided complete data. Physical activity was assessed using accelerometry, and ST by questionnaire. Body mass index (BMI) was computed from measured height and weight. Only 39% of boys and 10% of girls met the recommendation of one hour of daily MVPA. Comparison with international data indicated that mean MVPA (58.1 min for boys; 41.7 min for girls) was higher than in North America and Australia, but lower than in England. Girls were less active than boys at all measured times and spent less time in ST. A quarter of the children exceeded guidelines of two hours of TV on weekends, and double the amount on weekdays. Obese children were less active than normal weight children on weekdays and on weekends, reaching significance during the period after school, and they spent more time in ST than their normal weight counterparts. A low percentage of Maltese 10-11 year olds, particularly girls, reached the recommended levels of daily MVPA and spent large amounts of time engaged in screen time. Obese children were less active than non-obese children. As children spend most of their waking time at school and that activity during this time is less than one third of the daily requirements, aiming to increase MVPA at school for all Maltese children is likely to be an important strategy to promote MVPA. Targeting less active and obese children is important.

Effectiveness of school dental screening on dental visits and untreated caries among primary schoolchildren: study protocol for a cluster randomised controlled trial.

PubMed

Alayadi, Haya; Sabbah, Wael; Bernabé, Eduardo

2018-04-13

Dental caries is one of the most common diseases affecting children in Saudi Arabia despite the availability of free dental services. School-based dental screening could be a potential intervention that impacts uptake of dental services, and subsequently, dental caries' levels. The purpose of this study is to evaluate the effectiveness of two alternative approaches for school-based dental screening in promoting dental attendance and reducing untreated dental caries among primary schoolchildren. This is a cluster randomised controlled trial comparing referral of screened-positive children to a specific treatment facility (King Saud University Dental College) against conventional referral (information letter advising parents to take their child to a dentist). A thousand and ten children in 16 schools in Riyadh, Saudi Arabia, will be recruited for the trial. Schools (clusters) will be randomly selected and allocated to either group. Clinical assessment for dental caries will be conducted at baseline and after 12 months by dentists using the World Health Organisation (WHO) criteria. Data on sociodemographic, behavioural factors and children's dental visits will be collected through structured questionnaires at baseline and follow-up. The primary outcome is the change in number of teeth with untreated dental caries 12 months after referral. Secondary outcomes are the changes in the proportions of children having untreated caries and of those who visited the dentist over the trial period. This project should provide high level of evidence on the clinical benefits of school dental screening. The findings should potentially inform policies related to the continuation/implementation of school-based dental screening in Saudi Arabia. ClinicalTrials.gov , ID: NCT03345680 . Registered on 17 November 2017.

Service Use by At-Risk Youth after School-Based Suicide Screening

PubMed Central

2009-01-01

Objective We sought to examine follow-up service use by students identified at risk for suicidal behavior in a school-based screening program, and assess barriers to seeking services as perceived by youth and parents. Method We conducted a longitudinal study of 317 at-risk youth identified by a school-based suicide screening in six high schools in New York State. The at-risk teenagers and their parents were interviewed approximately two years after the initial screen to assess service use during the intervening period and identify barriers that may have interfered with seeking treatment. Results At the time of the screen, 72% of the at-risk students were not receiving any type of mental health service. Of these students, 51% were deemed in need of services and subsequently referred by us to a mental health professional. Nearly 70% followed through with the screening’s referral recommendations. Youth and their parents reported perceptions about mental health problems, specifically relating to the need for treatment, as the primary reasons for not seeking service. Conclusions Screening appears to be effective in enhancing the likelihood that students at risk for suicidal behavior will get into treatment. Well developed and systematic planning is needed to ensure that screening and referral services are coordinated so as to facilitate access for youth into timely treatment. PMID:19858758

Obesity in the Transition to Adulthood: Predictions across Race-Ethnicity, Immigrant Generation, and Sex

PubMed Central

Harris, Kathleen Mullan; Perreira, Krista; Lee, Dohoon

2009-01-01

Objectives With longitudinal data we traced how race, ethnic, and immigrant disparities in body mass index (BMI) change over time as adolescents (ages 11–19) transition to young adulthood (ages 20–28). Design We used growth curve modeling to estimate the pattern of change in BMI from adolescence through the transition to adulthood. Setting All participants in the study were residents of the United States enrolled in high school or junior high school during the 1994–95 school year. Participants We used nationally representative data on 20,000+ adolescents interviewed at Wave I (1994–95) of Add Health, followed in Wave II (1996) and Wave III (2001–02) when the sample was in early adulthood. Main Exposure(s) Exposures of interest include race-ethnicity, immigrant generation, and sex. Main Outcome Measure(s) Our main outcome measure is BMI. Results Findings indicate significant differences in both the level and change in BMI across age by sex, race-ethnicity, and immigrant generation. Females, second and third generation immigrants, and Hispanics and blacks experience more rapidly increasing BMI as adolescents age into young adulthood. Increases in BMI are relatively lower for males, first generation immigrants, and whites and Asians. Conclusions Disparities in BMI and percent overweight and obese widen with age as adolescents leave home and begin independent lives as young adults in their 20s. PMID:19884593

Trend in gender disparities of BMI and height between 2004 and 2011 among adolescents aged 17-18 years in Changzhou China.

PubMed

Chen, Wenying; Shi, Zumin

2013-01-01

to describe the trend in gender disparities of overweight/obesity and underweight, as well as height, among Chinese adolescents. the study is based on population-based data from annual health checks of approximately 7,000 students finishing high school each year between 2004-2011. Height and weight were measured. Overweight/obesity and underweight were defined using International Obesity Task Force (IOTF) criteria. School level socioeconomic status (SES) was constructed based on real-estate prices near each school. there was a slight increase in the prevalence of obesity between 2004 and 2011; 3.7% to 4.7% in boys and 1.1% to 1.5% in girls. The prevalence of overweight was quite stable in both genders (boys: 12%-15%; girls: 7%-10%). In most years, the prevalence of underweight was above 10%. The prevalence of underweight in girls born after 1991 increased dramatically. However, the opposite trend was seen in boys. School SES was positively associated with overweight and inversely associated with underweight among boys. There was a significant increase in height in both genders. Height and BMI was positively associated in boys but this relation was inversely associated in girls. between 2004 and 2011, the prevalence of overweight/obesity was plateauing among adolescents finishing high school. A substantial increase in the prevalence of underweight was observed among girls born after 1991 but this seemed to be positively associated with high SES.

Parental Characteristics Have a Larger Effect on Children's Health Behaviour than Their Body Weight

PubMed Central

Drenowatz, Clemens; Erkelenz, Nanette; Wartha, Olivia; Brandstetter, Susanne; Steinacker, Jürgen M.

2014-01-01

Objective Parents take an important role in a child's development, but there is currently limited information on parental correlates with children's health behaviour. The purpose of this study, therefore, was to examine whether parental characteristics, such as body weight, TV consumption and sport participation, affect children's body weight and health behaviour. Methods To examine the effects of parental characteristics on children's body weight and health behaviour, baseline data of 1,118 elementary school children (7.6 ± 0.4 years) participating in a school-based intervention in southwest Germany was used. Children's height and weight were measured and parent as well as child behaviour was assessed via questionnaire. Results BMI percentiles of children were positively associated with parental BMI (r = 0.2, p < 0.01). Further, high parental TV time increased the odds for high TV time in children (ORmother = 2.2, ORfather = 2.3) and parental club sport participation increased the odds for club sport participation in children (ORmother = 1.9, ORfather = 1.7). The relationship between parental and child behaviour was stronger than the relationship between parental BMI and BMI percentiles of the child. Conclusion These results suggest that parental behaviour and role modelling provide an important contribution to childrens’ health behaviour, especially at younger ages. PMID:25434370

Parental characteristics have a larger effect on children's health behaviour than their body weight.

PubMed

Drenowatz, Clemens; Erkelenz, Nanette; Wartha, Olivia; Brandstetter, Susanne; Steinacker, Jürgen M

2014-01-01

Parents take an important role in a child's development, but there is currently limited information on parental correlates with children's health behaviour. The purpose of this study, therefore, was to examine whether parental characteristics, such as body weight, TV consumption and sport participation, affect children's body weight and health behaviour. To examine the effects of parental characteristics on children's body weight and health behaviour, baseline data of 1,118 elementary school children (7.6 ± 0.4 years) participating in a school-based intervention in southwest Germany was used. Children's height and weight were measured and parent as well as child behaviour was assessed via questionnaire. BMI percentiles of children were positively associated with parental BMI (r = 0.2, p <0.01). Further, high parental TV time increased the odds for high TV time in children (OR mother= 2.2, OR father = 2.3) and parental club sport participation increased the odds for club sport participation in children (OR mother = 1.9, OR father = 1.7). The relationship between parental and child behaviour was stronger than the relationship between parental BMI and BMI percentiles of the child. These results suggest that parental behaviour and role modeling provide an important contribution to childrens' health behaviour, especially at younger ages.

Consideration of Base Rates within Universal Screening for Behavioral and Emotional Risk: A Novel Procedural Framework

ERIC Educational Resources Information Center

Kilgus, Stephen P.; Eklund, Katie R.

2016-01-01

Universal screening for behavioral and emotional risk represents an important component of multitiered systems of support, being a means by which schools identify at-risk students and evaluate the effectiveness of Tier 1 programming. Despite its importance, many schools have not adopted universal screening procedures, instead relying upon more…

[Nutritional status of Kaingáng Indians enrolled in 12 indigenous schools in the State of Rio Grande do Sul, Brazil].

PubMed

Castro, Teresa Gontijo de; Schuch, Ilaine; Conde, Wolney Lisboa; Veiga, Juracilda; Leite, Maurício Soares; Dutra, Carmem Lucia Centeno; Zuchinali, Priccila; Barufaldi, Laura Augusta

2010-09-01

The study's objective was to characterize the nutritional status of 3,254 Kaingáng Indians in indigenous schools in Rio Grande do Sul State, Brazil. This was a school-based study. Weight (W), height (H), and waist circumference (WC) were measured according to World Health Organization guidelines (1995). Children's nutritional status classification included H/A, W/A, and W/H according to the National Center for Health Statistics (WHO, 1995) and H/A, W/A, and body mass index/age (BMI/A) according to WHO (2006). Adolescents were classified for BMI/A (WHO, 1995 and 2006) and H/A (WHO, 2006). Adults were classified for BMI (WHO, 1995) and WC (WHO, 2003). Adolescents represented 56% of the sample, children 42.5%, adults 1.4%, and elderly 0.1%. Prevalence rates for stunting were 15.1% (WHO, 1983) and 15.5% (WHO, 2006) in children and 19.9% in adolescents. Prevalence rates for overweight were 11% (WHO, 1983) and 5.7% (WHO, 2006) in children, 6.7% in adolescents, and 79.2% in adults. 45.3% of adults were at increased risk of metabolic diseases. A nutritional transition was observed in the group, characterized by significant prevalence of stunting in children and adolescents and prominent overweight in all age groups.

Peer effects in adolescent BMI: evidence from Spain.

PubMed

Mora, Toni; Gil, Joan

2013-05-01

This paper extends the recent literature on the influence of peers on adolescent weight on three new fronts. First, based on a survey of secondary school students in Spain in which peers are formed by nominated classmate friends, we find a more powerful positive and significant causal effect of friends' mean BMI on adolescent BMI than previous US-based research. These results are in line with international data, which show that peer group contact tends to vary across countries. Our findings cover a large set of controls, fixed effects, the testing of correlated unobservables, contextual influences and instrumental variables. Second, social interactions are identified through the property of intransitivity in network relationships. Finally, we report evidence of a strong, positive effect of peer pressure on several subgroups of adolescents in an attempt to study their vulnerability to social influences. Copyright © 2012 John Wiley & Sons, Ltd.

Medial tibial stress syndrome in high school cross-country runners: incidence and risk factors.

PubMed

Plisky, Melody S; Rauh, Mitchell J; Heiderscheit, Bryan; Underwood, Frank B; Tank, Robert T

2007-02-01

Prospective cohort. To determine (1) the cumulative seasonal incidence and overall injury rate of medial tibial stress syndrome (MTSS) and (2) risk factors for MTSS with a primary focus on the relationship between navicular drop values and MTSS in high school cross-country runners. MTSS is a common injury among runners. However, few studies have reported the injury rate and risk factors for MTSS among adolescent runners. Data collected included measurement of bilateral navicular drop and foot length, and a baseline questionnaire regarding the runner's height, body mass, previous running injury, running experience, and orthotic or tape use. Runners were followed during the season to determine athletic exposures (AEs) and occurrence of MTSS. The overall injury rate for MTSS was 2.8/1000 AEs. Although not statistically different, girls had a higher rate (4.3/1000 AEs) than boys (1.7/1000 AEs) (P = .11). Logistic regression modeling indicated that only gender and body mass index (BMI) were significantly associated with the occurrence of MTSS. However, when controlled for orthotic use, only BMI was associated with risk of MTSS. No significant associations were found between MTSS and navicular drop or foot length. Our findings suggest that navicular drop may not be an appropriate measure to identify runners who may develop MTSS during a cross-country season; thus, additional studies are needed to identify appropriate preseason screening tools.

Food consumption, body mass index and risk for oral health in adolescents.

PubMed

Bica, Isabel; Cunha, Madalena; Reis, Margarida; Costa, José; Costa, Patricia; Bica, Alexandra

2014-11-01

The food intake has great influence on the oral health of adolescents, being relevant to analyze the type of food consumed by adolescents and their relationship with the DMFT index (decayed, missing and filled), the plaque index (PI) and the body mass index (BMI). Epidemiological study conducted in public schools of the 3rd cycle of basic education, central Portugal. The sociodemographic and dietary habits and frequency characterization was obtained through a self-administered questionnaire completed by adolescents and validated for the population under study. The DMFT index was evaluated according to WHO criteria, oral hygiene was evaluated based on the plaque index and BMI through weight and height in adolescents. Random sample by clusters (schools) with 661 adolescents, 84.1% female and 15.9% male. Adolescents with mean age 13.22 years (± 1.139). The mean DMFT was 2.23 (± 2.484), the prevalence of PI was 96.4%, and ≥ 5 BMI <85. Adolescents with a higher DMFT index consume more cariogenic foods (r=0.160; P=.000). Adolescents with a higher BMI consume less cariogenic foods (r=-0.1343; P=.001). The value of t reveals that the consumption of cariogenic foods explains 1.8% of the variance of the BMI and 2.6% DMFT. The cariogenic foods are presented as a risk factor for dental caries. The results suggest that it is important to develop up actions for health education. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

A composite score combining waist circumference and body mass index more accurately predicts body fat percentage in 6- to 13-year-old children.

PubMed

Aeberli, I; Gut-Knabenhans, M; Kusche-Ammann, R S; Molinari, L; Zimmermann, M B

2013-02-01

Body mass index (BMI) and waist circumference (WC) are widely used to predict % body fat (BF) and classify degrees of pediatric adiposity. However, both measures have limitations. The aim of this study was to evaluate whether a combination of WC and BMI would more accurately predict %BF than either alone. In a nationally representative sample of 2,303 6- to 13-year-old Swiss children, weight, height, and WC were measured, and %BF was determined from multiple skinfold thicknesses. Regression and receiver operating characteristic (ROC) curves were used to evaluate the combination of WC and BMI in predicting %BF against WC or BMI alone. An optimized composite score (CS) was generated. A quadratic polynomial combination of WC and BMI led to a better prediction of %BF (r (2) = 0.68) compared with the two measures alone (r (2) = 0.58-0.62). The areas under the ROC curve for the CS [0.6 * WC-SDS + 0.4 * BMI-SDS] ranged from 0.962 ± 0.0053 (overweight girls) to 0.982 ± 0.0046 (obese boys) and were somewhat greater than the AUCs for either BMI or WC alone. At a given specificity, the sensitivity of the prediction of overweight and obesity based on the CS was higher than that based on either WC or BMI alone, although the improvement was small. Both BMI and WC are good predictors of %BF in primary school children. However, a composite score incorporating both measures increased sensitivity at a constant specificity as compared to the individual measures. It may therefore be a useful tool for clinical and epidemiological studies of pediatric adiposity.

The validity of self-reported vs. measured body weight and height and the effect of self-perception.

PubMed

Gokler, Mehmet Enes; Bugrul, Necati; Sarı, Ahu Ozturk; Metintas, Selma

2018-01-01

The objective was to assess the validity of self-reported body weight and height and the possible influence of self-perception of body mass index (BMI) status on the actual BMI during the adolescent period. This cross sectional study was conducted on 3918 high school students. Accurate BMI perception occurred when the student's self-perception of their BMI status did not differ from their actual BMI based on measured height and weight. Agreement between the measured and self-reported body height and weight and BMI values was determined using the Bland-Altman metod. To determine the effects of "a good level of agreement", hierarchical logistic regression models were used. Among male students who reported their BMI in the normal region, 2.8% were measured as overweight while 0.6% of them were measured as obese. For females in the same group, these percentages were 1.3% and 0.4% respectively. Among male students who perceived their BMI in the normal region, 8.5% were measured as overweight while 0.4% of them were measured as obese. For females these percentages were 25.6% and 1.8% respectively. According to logistic regression analysis, residence and accurate BMI perception were significantly associated with "good agreement" ( p ≤ 0.001). The results of this study demonstrated that in determining obesity and overweight statuses, non-accurate weight perception is a potential risk for students.

Feasibility of Screening Adolescents for Suicide Risk in “Real-World” High School Settings

PubMed Central

Hallfors, Denise; Brodish, Paul H.; Khatapoush, Shereen; Sanchez, Victoria; Cho, Hyunsan; Steckler, Allan

2006-01-01

Objectives. We evaluated the feasibility of a population-based approach to preventing adolescent suicide. Methods. A total of 1323 students in 10 high schools completed the Suicide Risk Screen. Screening results, student follow-up, staff feedback, and school responses were assessed. Results. Overall, 29% of the participants were rated as at risk of suicide. As a result of this overwhelming percentage, school staffs chose to discontinue the screening after 2 semesters. In further analyses, about half of the students identified were deemed at high risk on the basis of high levels of depression, suicidal ideation, or suicidal behavior. Priority rankings evidenced good construct validity on correlates such as drug use, hopelessness, and perceived family support. Conclusions. A simpler, more specific screening instrument than the Suicide Risk Screen would identify approximately 11% of urban high school youths for assessment, offering high school officials an important opportunity to identify young people at the greatest levels of need and to target scarce health resources. Our experiences from this study show that lack of feasibility testing greatly contributes to the gap between science and practice. PMID:16380568

Associations of Neighborhood and School Socioeconomic and Social Contexts With Body Mass Index Among Urban Preadolescent Students

PubMed Central

Gilstad-Hayden, Kathryn; Rosenthal, Lisa; Eldahan, Adam; McCaslin, Catherine; Peters, Susan M.; Ickovics, Jeannette R.

2015-01-01

Objectives. We examined independent and synergistic effects of school and neighborhood environments on preadolescent body mass index (BMI) to determine why obesity rates nearly double during preadolescence. Methods. Physical measures and health surveys from fifth and sixth graders in 12 randomly selected schools in New Haven, Connecticut, in 2009 were matched to student sociodemographics and school- and residential census tract–level data, for a total of 811 urban preadolescents. Key independent variables included school connectedness, neighborhood social ties, and school and neighborhood socioeconomic status. We estimated cross-classified random-effects hierarchical linear models to examine associations between key school and neighborhood characteristics with student BMI. Results. Greater average connectedness felt by students to their school was significantly associated with lower BMI. This association was stronger among students living in neighborhoods with higher concentrations of affluent neighbors. Conclusions. How schools engage and support students may affect obesity rates preferentially in higher-income neighborhoods. Further research should explore the associations between multiple environments to which children are exposed and obesity-related behaviors and outcomes. This understanding of the multiple social–spatial contexts that children occupy has potential to inform comprehensive and sustainable child obesity prevention efforts. PMID:26469652

Ten Years of TAKE 10!(®): Integrating physical activity with academic concepts in elementary school classrooms.

PubMed

Kibbe, Debra L; Hackett, Jacqueline; Hurley, Melissa; McFarland, Allen; Schubert, Kathryn Godburn; Schultz, Amy; Harris, Suzanne

2011-06-01

Current literature supports the link between physical activity (PA) or fitness and a child's ability to achieve academically; however, little structured activity time is incorporated into elementary school classrooms. This paper explores the impact of a classroom-based PA program, TAKE 10!, and health-academic integration through existing state and federal policy and programming. Evidence from journal articles, published abstracts, and reports were examined to summarize the impact of TAKE 10! on student health and other outcomes. This paper reviews 10 years of TAKE 10! studies and makes recommendations for future research. Teachers are willing and able to implement classroom-based PA integrated with grade-specific lessons (4.2 days/wk). Children participating in the TAKE 10! program experience higher PA levels (13%>), reduced time-off-task (20.5%), and improved reading, math, spelling and composite scores (p<0.01). Furthermore, students achieved moderate energy expenditure levels (6.16 to 6.42 METs) and studies suggest that BMI may be positively impacted (decreases in BMI z score over 2 years [P<0.01]). TAKE 10! demonstrates that integrating movement with academics in elementary school classrooms is feasible, helps students focus on learning, and enables them to realize improved PA levels while also helping schools achieve wellness policies. Copyright © 2011. Published by Elsevier Inc.

Impact of parental weight status on a school-based weight management programme designed for Mexican-American children.

PubMed

Moreno, J P; Johnston, C A; Hernandez, D C; LeNoble, J; Papaioannou, M A; Foreyt, J P

2016-10-01

While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impact of having zero, one or two obese parents on children's success in a school-based weight management programme. Sixty-one Mexican-American children participated in a 24-week school-based weight management intervention which took place in 2005-2006. Children's heights and weights were measured at baseline, 3, 6 and 12 months. Parental weight status was assessed at baseline. Repeated measures anova and ancova were conducted to compare changes in children's weight within and between groups, respectively. Within-group comparisons revealed that the intervention led to significant decreases in standardized body mass index (zBMI) for children with zero (F = 23.16, P < .001) or one obese (F = 4.99, P < .05) parent. Between-group comparisons indicated that children with zero and one obese parents demonstrated greater decreases in zBMI compared to children with two obese parents at every time point. The school-based weight management programme appears to be most efficacious for children with one or no obese parents compared to children with two obese parents. These results demonstrate the need to consider parental weight status when engaging in childhood weight management efforts. © 2015 World Obesity.

Neighborhoods, Schools and Obesity: The Potential for Place-Based Approaches to Reduce Childhood Obesity

PubMed Central

Elbel, Brian; Corcoran, Sean P.; Schwartz, Amy Ellen

2016-01-01

A common policy approach to reducing childhood obesity aims to shape the environment in which children spend most of their time: neighborhoods and schools. This paper uses richly detailed data on the body mass index (BMI) of all New York City public school students in grades K-8 to assess the potential for place-based approaches to reduce child obesity. We document variation in the prevalence of obesity across NYC public schools and census tracts, and then estimate the extent to which this variation can be explained by differences in individual-level predictors (such as race and household income). Both unadjusted and adjusted variability across neighborhoods and schools suggest place-based policies have the potential to meaningfully reduce child obesity, but under most realistic scenarios the improvement would be modest. PMID:27309533

Neighborhoods, Schools and Obesity: The Potential for Place-Based Approaches to Reduce Childhood Obesity.

PubMed

Elbel, Brian; Corcoran, Sean P; Schwartz, Amy Ellen

2016-01-01

A common policy approach to reducing childhood obesity aims to shape the environment in which children spend most of their time: neighborhoods and schools. This paper uses richly detailed data on the body mass index (BMI) of all New York City public school students in grades K-8 to assess the potential for place-based approaches to reduce child obesity. We document variation in the prevalence of obesity across NYC public schools and census tracts, and then estimate the extent to which this variation can be explained by differences in individual-level predictors (such as race and household income). Both unadjusted and adjusted variability across neighborhoods and schools suggest place-based policies have the potential to meaningfully reduce child obesity, but under most realistic scenarios the improvement would be modest.

Predictive Validity of a Student Self-Report Screener of Behavioral and Emotional Risk in an Urban High School

ERIC Educational Resources Information Center

Dowdy, Erin; Harrell-Williams, Leigh; Dever, Bridget V.; Furlong, Michael J.; Moore, Stephanie; Raines, Tara; Kamphaus, Randy W.

2016-01-01

Increasingly, schools are implementing school-based screening for risk of behavioral and emotional problems; hence, foundational evidence supporting the predictive validity of screening instruments is important to assess. This study examined the predictive validity of the Behavior Assessment System for Children-2 Behavioral and Emotional Screening…

Pattern of teen menstruation among secondary school girls in south east Nigeria.

PubMed

Nwokocha, Ada R C; Chinawa, Josephat M; Ubesie, Agozie C; Onukwuli, Vivian I; Manyike, Pius C

2016-03-01

Menstruation in the teenage age has assumed variable trends which is been influenced by several variables. This study is aimed at determining the pattern and trend of menstruation among teens attending secondary school in south east Nigeria and associated factors. Menstruation patterns were investigated using a stratified random sampling method of teens from junior secondary schools in Enugu, south east Nigeria. A self-administered questionnaire was developed and data analyzed using SPSS version 19. A total of 897 female teenagers aged 9-18 years completed the questionnaire with a mean age of 13.9±1.9 years. The mean age (SD) at onset of menarche was 12.5±1.2 years. Teenage girls with higher BMI achieved menarche earlier at age 8 and 9 when compared with their counterparts with lower BMI and this is statistically significant. F=7.60, df=8, p<0.001. Teens with a 14-day cycle had a higher BMI when compared with teens with longer cycle but this is not statistically significant. F=1.05, df=4, p=0.381. There is a statistical significance difference between teens duration of menstrual flow and BMI. Those with higher BMI had longer duration(4-5 days) compared with those with lower BMI. F=3.329, df=4, p=0.01 CONCLUSIONS: This study revealed that the mean age at onset of menarche was 12.5±1.2 years showing a continuing decreasing trend. Teens with higher BMI attain menarche earlier and had longer days of periods when compared with their counterpart with lower BMI.

Reconnoitring the association of nutritional status with oral health in elementary school-going children of Ghaziabad City, North India.

PubMed

Sood, Shveta; Ahuja, Vipin; Chowdhry, Swati

2014-01-01

The purpose of this study was to evaluate the association between anthropometric measurements and oral health status in the primary dentition of school-going children. In this study, 280 elementary school children (116 girls and 164 boys, age: 3-6 years) were examined. Body mass index (BMI) of each subject was calculated and compared with age and gender using Centers for Disease Control and Prevention (CDC) pediatric growth charts. Based on these growth charts, the sample population was distributed into three groups: Group I: Normal weight (5 th -85 th percentiles), Group II: Risk of overweight/obese (>85 th percentile), and Group III: Underweight (<5 th percentile). Each subject was examined for caries frequency (decayed and filled primary teeth (dft) values) and plaque status (plaque index (PI)) and these values were compared with their BMI figures. Among the study group, 58.3% of children were suffering from malnutrition. Out of the total population, 33.9% had caries affecting their primary dentition. The largest section (39.5%) of caries affected children was underweight. The mean number of dft in Group II was highest at 1.47 ± 2.77 followed by Groups I and III, respectively. The mean value of PI in Group III was highest at 0.33 ± 0.53 followed by Groups II and I. A definite correlation was observed between the oral health status and BMI of elementary school-going children.

Cardiorespiratory fitness and adiposity in overweight and nonoverweight 8-year-old school children.

PubMed

Ostojic, S M; O'neil, M; Calleja, J; Terrados, N; Stojanovic, M

2010-12-01

The objective of the present study was to determine relationship between cardiorespiratory fitness and body fatness in both nonoverweight and overweight 8-year-old school children. The study participants were a 245 healthy second-grade elementary school children aged 8.9 ± 0.4 yrs (125 boys, 120 girls). Anthropometric data (height, body mass, waist circumference, five skinfold thickness) were collected and body fat percentage was calculated. Body Mass Index (BMI) sex- and age-specific cutoff points were used for overweight and obesity definition and children were placed in two groups: overweight/obese and nonoverweight. Aerobic fitness was assessed with the multistage shuttle-run fitness test. Subjects were grouped into high (upper two quintiles) and low (lower two quintiles) aerobic fitness based on age and sex distributions. BMI, waist circumference, five skinfold thicknesses and total body fat were lower in overweight and obese children with high aerobic fitness in comparison with youths at the same BMI category with low fitness level (P < 0.01). The beneficial effect of high aerobic fitness was also presented in nonoverweight children (P < 0.01). Finally, aerobic fitness was moderately correlated with total body fat in the whole group of subjects (r = -0.48, P < 0.01). Indicators of local and total adiposity were lower in overweight and obese children with high aerobic fitness. Being fit may reduce the hazards of obesity in population of 8-year-old school children.

Neighbourhood food, physical activity, and educational environments and black/white disparities in obesity: a complex systems simulation analysis.

PubMed

Orr, Mark G; Kaplan, George A; Galea, Sandro

2016-09-01

Multiple approaches that can contribute to reducing obesity have been proposed. These policies may share overlapping pathways, and may have unanticipated consequences, creating considerable complexity. Aiming to illuminate the use of agent-based models to explore the consequences of key policies, this paper simulates the effects of increasing neighbourhood availability of good food stores, physical activity infrastructure and higher school quality on the reduction of black/white disparities in body mass index (BMI) in the USA. We used an agent-based model, with parameters derived from the empirical literature, which included individual and neighbourhood characteristics over the life course as determinants of behaviours thought to impact BMI. We systematically varied the strength of the 3 policy interventions, examining the impact of 125 different policy scenarios on black/white BMI disparities. In the absence of any of these policies, black/white BMI disparities generally increased over time. However, we found that some combinations of these policies resulted in reductions in BMI, yielding decreases in the black/white BMI disparity as large as a 90%. Within the structure of relationships captured in this simulation model, there is support for the further use of agent-based simulation models to explore upstream policies as plausible candidates for the reduction of black/white disparities in BMI. These results highlight the potential insights into important public health problems, such as obesity, that can come from uniting the systems science approach with policy analysis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Walking or bicycling to school and weight status among adolescents from Montería, Colombia.

PubMed

Arango, Carlos Mario; Parra, Diana C; Eyler, Amy; Sarmiento, Olga; Mantilla, Sonia C; Gomez, Luis Fernando; Lobelo, Felipe

2011-09-01

Active school transport (AST) is a recommended strategy to promote physical activity (PA) and prevent overweight (OW) in school-aged children. In many developing countries, such as Colombia, this association has not been well characterized. To determine the association between AST and weight status in a representative sample of adolescents from Montería, Colombia. Participants were 546 adolescents (278 boys) aged 11 to 18 years old from 14 randomly selected schools in Montería, Colombia in 2008. The PA module of the Global School Health Survey (GSHS-2007) was used to determine the prevalence of AST. To identify OW, participants were classified according to CDC 2000 criteria (BMI ≥ 85th percentile). Association between AST and OW was determined by binomial logistic regression. Odds ratios adjusted for age, sex, location of school, compliance with PA, and screen time recommendations showed that adolescents who reported AST had a significantly lower likelihood to be OW compared with adolescents who reported nonactive transportation (OR = 0.5, 95% CI 0.3-0.8, P < .05). These results support the importance of AST as a useful PA domain with potential implications for overweight prevention, in rapidly developing settings. Further epidemiologic and intervention studies addressing AST are needed in the region.

Dieting and unhealthy weight control behaviors during adolescence: Associations with 10-year changes in body mass index

PubMed Central

Neumark-Sztainer, Dianne; Wall, Melanie; Story, Mary; Standish, Amber R

2011-01-01

Background Dieting and unhealthy weight control behaviors are common among adolescents and questions exist regarding their long-term effect on weight status. Objective To examine 10-year longitudinal associations between dieting and unhealthy weight control behaviors and changes in body mass index (BMI) from adolescence to young adulthood. Methods and Procedures A diverse population-based sample of middle school and high school adolescents was followed for 10 years. Participants (N=1,902) completed surveys in 1998–99 (Project EAT-I), 2003–04 (Project EAT-II), and 2008–09 (Project EAT-III). Dieting and unhealthy weight control behaviors at Time 1 and Time 2 were used to predict 10-year changes in BMI at Time 3, adjusting for sociodemographic characteristics and Time 1 BMI. Results Dieting and unhealthy weight control behaviors at both Time 1 and Time 2 predicted greater BMI increases at Time 3 in males and females, as compared to no use of these behaviors. For example, females using unhealthy weight control behaviors at both Time 1 and Time 2 increased their BMI by 4.63 units as compared to 2.29 units in females not using these behaviors (p<.001). Associations were found in both overweight and non-overweight respondents. Specific weight control behaviors at Time 1 that predicted larger BMI increases at Time 3 included skipping meals and reporting eating very little (females and males), use of food substitutes (males), and diet pill use (females). Conclusions Findings clearly indicate that dieting and unhealthy weight control behaviors, as reported by adolescents, predict significant weight gain over time. PMID:22188838

Body mass index is not a good predictor of bone density: results from WHI, CHS, and EPIDOS.

PubMed

Robbins, John; Schott, Anne-Marie; Azari, Rahman; Kronmal, Richard

2006-01-01

Body mass index (BMI) is often used to predict bone mineral density (BMD). This may be flawed. Large epidemiologic studies with BMI and BMD data were analyzed. Weight alone is a better predictor of BMD than BMI. Thus, when selecting individuals for dual-energy X-ray absorptiometry, weight should be used instead of BMI. Low body mass index (BMI) is frequently suggested as one of the factors that indicates the need for bone mineral density (BMD) screening for osteoporosis. The inclusion of the height-squared term in the denominator of this predictive factor is taken on faith or from other data, but it may not be reasonable in this case. We used data from three large epidemiologic studies to test the BMI, height, and weight as predictors of BMD: (1) the Women's Health Initiative (WHI) with 11,390 women; (2) the Cardiovascular Health Study (CHS) with 1,578 men and women; (3) and EPIDOS with 7,598 women. Dual-energy X-ray absorptiometry data on one or more BMD sites, the total hip, the femoral neck, and the lumbar spine from the three studies, as well as height and weight were examined. Correlation coefficients for BMI and weight with BMD were compared. Log transformed models were evaluated to compare the strengths of the models. The result of weight alone was a much better predictor of BMD for all sites in the three studies than BMI. Taller participants had larger BMDs than would have been predicted by BMI. In conclusion, BMIs should not be used to select individuals for BMD screening. A regression model using weight alone or weight and height is a better predictor of BMD in all three populations.

The prevalence of overweight/obesity in high school adolescents in Jeddah and the association of obesity association with dental caries.

PubMed

Farsi, Deema Jamil; Elkhodary, Heba Mohammed

2017-01-01

The prevalence of overweight/obesity in children in Saudi Arabia is among the highest in the world. The prevalence of dental caries is also high in Saudi children. Studies on the relationship between caries and obesity in Saudi adolescents are lacking. To study the prevalence of overweight/obesity in adolescents, and determine any association between obesity and caries. An analytical cross-sectional study. Private and public schools in Jeddah. The study sample comprised high school children from public and private schools selected by multistage stratified random sampling. Height, weight, waist circumference (WC), and body mass index (BMI) were measured for all children, who were then classified as underweight/normal, overweight, or obese according to their BMI values, and nonobese or obese according to their WC values. The presence of caries was assessed using the Association of State and Territorial Dental Directors criteria. The prevalence of overweight/obesity and the association of obesity with the number of decayed permanent teeth. 801 high school children (48% boys, 49% from public schools) with a mean (SD) age of 16.5 (0.9) years. When the BMI classification was used, 24%, 16%, and 60% adolescents were obese, overweight, and underweight/normal, respectively. When the WC classification was used, 19% and 81% were obese and nonobese, respectively. Obesity was more prevalent in boys and in students attending private schools (P < .05). The number of decayed permanent teeth showed a very weak and insignificant correlation with BMI and WC. One in every four adolescents residing in Jeddah was obese, with a high obesity prevalence in boys and in children attending private schools. The prevalence of caries in the permanent dentition was not associated with BMI or WC. It was difficult to establish temporality in this cross-sectional study. Data on common risk factors were not adjusted for in the analyses.

Association of Smoking with Body Weight in US High School Students, 1999-2005

ERIC Educational Resources Information Center

Seo, Dong-Chul; Jiang, Nan; Kolbe, Lloyd J.

2009-01-01

Objectives: To investigate the association of current smoking with body mass index (BMI) and perceived body weight among high school students in the United States. Methods: We analyzed data from the 1999-2005 Youth Risk Behavior Survey. Results: Perceived body weight and BMI were associated with adolescents' current smoking. Adjusted odds ratios…

Community and school mental health professionals' knowledge and use of evidence based substance use prevention programs.

PubMed

Evans, Steven W; Randy Koch, J; Brady, Christine; Meszaros, Peggy; Sadler, Joanna

2013-07-01

Youth with learning and behavioral problems are at elevated risk for substance use during adolescence. Although evidence-based substance use prevention and screening practices are described in the literature, the extent with which these are provided to these youth is unclear. Mental health professionals in schools and community mental health centers are in an ideal position to conduct substance use screening and prevention practices since they have frequent contact with this high risk group. In order to determine whether these mental health professionals were using evidence based substance use screening and prevention programs with these youth, we analyzed 345 completed surveys from mental health professionals in schools and community clinics throughout a mid-Atlantic state. Results indicated that a large portion of the respondents were unfamiliar with evidence based practices and they were infrequently used. Implications for the division of labor at schools and community mental health centers are discussed in relation to time allotment and priority for these procedures.

Concordance of obesity classification between body mass index and percent body fat among school children in Saudi Arabia.

PubMed

Al-Mohaimeed, Abdulrahman; Ahmed, Saifuddin; Dandash, Khadiga; Ismail, Mohammed Saleh; Saquib, Nazmus

2015-03-05

In Saudi Arabia, where childhood obesity is a major public health issue, it is important to identify the best tool for obesity classification. Hence, we compared two field methods for their usefulness in epidemiological studies. The sample consisted of 874 primary school (grade I-IV) children, aged 6-10 years, and was obtained through a multi-stage random sampling procedure. Weight and height were measured, and BMI (kg/m(2)) was calculated. Percent body fat was determined with a Futrex analyzer that uses near infrared reactance (NIR) technology. Method specific cut-off values were used for obesity classification. Sensitivity, specificity, positive and negative predictive values were determined for BMI, and the agreement between BMI and percent body fat was calculated. Compared to boys, the mean BMI was higher in girls whereas the mean percent body fat was lower (p-values < 0.0001). According to BMI, the prevalence of overweight or obesity was significantly higher in girls (34.3% vs. 17.3%); as oppose to percent body fat, which was similar between the sexes (6.6% vs. 7.0%). The sensitivity of BMI to classify overweight or obesity was high (boys = 93%, girls = 100%); and its false-positive detection rate was also high (boys = 63%, girls = 81%). The agreement rate was low between these two methods (boys = 0.48, girls =0.24). There is poor agreement in obesity classification between BMI and percent body fat, using NIR method, among Saudi school children.

Increased augmentation index and central systolic arterial pressure are associated with lower school and motor performance in young adolescents.

PubMed

Vogrin, Bernarda; Slak Rupnik, Marjan; Mičetić-Turk, Dušanka

2017-12-01

Objective In adults, improper arterial function has been linked to cognitive impairment. The pulse wave velocity (PWV), augmentation index (AIx) and other vascular parameters are useful indicators of arterial health. In our study, we monitored arterial properties, body constitution, school success, and motor skills in young adolescents. We hypothesize that reduced cognitive and motor abilities have a vascular origin in children. Methods We analysed 81 healthy school children aged 11-16 years. Anthropometry central systolic arterial pressure, body mass index (BMI), standard deviation scores (SDS) BMI, general school performance grade, and eight motor tests were assessed. PWV, AIx, and central systolic arterial pressure (SBPao) were measured. Results AIx and SBPao correlated negatively with school performance grades. Extremely high AIx, PWV and SBPao values were observed in 5% of children and these children had average to low school performance. PWV correlated significantly with weight, height, and waist and hip circumference. AIx, PWV, school success, and BMI correlated strongly with certain motor functions. Conclusions Increased AIx and SBPao are associated with lower school and motor performance in children. PWV is influenced by the body's constitution.

Prevalence of uncorrected refractive errors among school-age children in the School District of Philadelphia.

PubMed

Mayro, Eileen L; Hark, Lisa A; Shiuey, Eric; Pond, Michael; Siam, Linda; Hill-Bennett, Tamara; Tran, Judie; Khanna, Nitasha; Silverstein, Marlee; Donaghy, James; Zhan, Tingting; Murchison, Ann P; Levin, Alex V

2018-06-01

To determine the prevalence and severity of uncorrected refractive errors in school-age children attending Philadelphia public schools. The Wills Eye Vision Screening Program for Children is a community-based pediatric vision screening program designed to detect and correct refractive errors and refer those with nonrefractive eye diseases for examination by a pediatric ophthalmologist. Between January 2014 and June 2016 the program screened 18,974 children in grades K-5 in Philadelphia public schools. Children who failed the vision screening were further examined by an on-site ophthalmologist or optometrist; children whose decreased visual acuity was not amenable to spectacle correction were referred to a pediatric ophthalmologist. Of the 18,974 children screened, 2,492 (13.1%) exhibited uncorrected refractive errors: 1,776 (9.4%) children had myopia, 459 (2.4%) had hyperopia, 1,484 (7.8%) had astigmatism, and 846 (4.5%) had anisometropia. Of the 2,492 with uncorrected refractive error, 368 children (14.8%) had more than one refractive error diagnosis. In stratifying refractive error diagnoses by severity, mild myopia (spherical equivalent of -0.50 D to < -3.00 D) was the most common diagnosis, present in 1,573 (8.3%) children. In this urban population 13.1% of school-age children exhibited uncorrected refractive errors. Blurred vision may create challenges for students in the classroom; school-based vision screening programs can provide an avenue to identify and correct refractive errors. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Effects of daily physical education on physical fitness and weight status in middle school adolescents.

PubMed

Erfle, Stephen E; Gamble, Abigail

2015-01-01

In 2009, the Pennsylvania Department of Health developed the Active Schools Program (ASP) which required 30 minutes of daily physical education (PE) in middle schools to reduce childhood obesity. This investigation evaluated the ASP effects on physical fitness and weight status in middle school adolescents throughout 1 academic year. A quasi-experimental design was used to recruit middle schools into an intervention group (N = 30) or control group (N = 9). Physical fitness outcomes had larger intervention effects than weight status outcomes. These effects were most profound among at-risk students. Multiple linear regression analysis provided a best-guess effect of daily PE on body mass index (BMI) percentile of -1.2, 95% confidence interval (CI) (-1.9, -0.5) for at-risk females and -0.8, 95% CI (-1.5, -0.1) for at-risk males. Much of this benefit is attributable to the differential increase in physical fitness achieved by students with the benefit of having daily PE. Thirty minutes of daily PE can be considered a scientific approach to ameliorate health outcomes in at-risk middle school adolescents, particularly among females. Improvements on BMI percentile among at-risk youth are presaged by greater improvements in physical fitness. This investigation supports a school-based approach aimed to improve behavioral risk factors as a means to reduce childhood obesity. © 2014, American School Health Association.

State-level school competitive food and beverage laws are associated with children’s weight status

PubMed Central

Oh, April; Agurs-Collins, Tanya; Chriqui, Jamie F.; Mâsse, Louise C.; Moser, Richard P.; Perna, Frank

2014-01-01

BACKGROUND This study attempted to determine whether state laws regulating low nutrient, high energy-dense foods and beverages sold outside of the reimbursable school meals program (referred to as ‘competitive foods’) are associated with children’s weight status. METHODS We use the Classification of Laws Associated with School Students (CLASS) database of state codified law(s) relevant to school nutrition. States were classified as having strong, weak, or no competitive food laws in 2005 based on strength and comprehensiveness. Parent-reported height and weight along with demographic, behavioral, family, and household characteristics were obtained from the 2007 National Survey of Children’s Health. Bivariate and logistic regression analyses estimated the association between states’ competitive food laws and children’s overweight and obesity status (BMI-for-age ≥ 85th percentile). Children (n=16271) between the ages of 11–14 years with a BMI for age ≥ 5th percentile who attended public school were included. RESULTS Children living in states with weak competitive food laws for middle schools had over a 20% higher odds of being overweight or obese than children living in states with either no or strong school competitive food laws. CONCLUSION State-level school competitive food and beverage laws merit attention with efforts to address the childhood obesity epidemic. Attention to the specificity and requirements of these laws should also be considered. PMID:25117896

Body mass index, new modes of TV viewing and active video games.

PubMed

Falbe, J; Willett, W C; Rosner, B; Field, A E

2017-10-01

Recent technologies have changed screen time. TV can be viewed anywhere, anytime. Content can be collected via digital recorders and online streaming and viewed on smartphones. Video games are no longer strictly sedentary. We sought to assess the unknown relations between new modes of TV viewing - recorded, online, downloaded and on hand-held devices - and active video games with body mass index (BMI). Cross-sectional analysis of the 2011 wave of the Growing Up Today Study 2 cohort. We used gender-specific generalized estimating equations to examine screen time and BMI among 3071 women and 2050 men aged 16-24 years. Among women, each hour/day of online TV (0.47; confidence interval [CI]: 0.12, 0.82) and total non-broadcast TV (0.37; CI: 0.14, 0.61) was associated with higher BMI, as was watching ≥ 1/2 h week -1 of TV on hand-held devices (1.04; CI: 0.32-1.77). Active video games were associated with BMI among women, but not after restricting to those not trying to lose/maintain weight. Broadcast TV was associated with higher BMI (kg m -2 ) among women and men (P < 0.05). Among women, online TV, TV viewed on hand-held devices and the sum of non-broadcast TV time were associated with higher BMI. Broadcast TV was also associated with BMI in women and men. © 2016 World Obesity Federation.

Birth weight, childhood body mass index, and height in relation to mammographic density and breast cancer: a register-based cohort study.

PubMed

Andersen, Zorana J; Baker, Jennifer L; Bihrmann, Kristine; Vejborg, Ilse; Sørensen, Thorkild I A; Lynge, Elsebeth

2014-01-20

High breast density, a strong predictor of breast cancer may be determined early in life. Childhood anthropometric factors have been related to breast cancer and breast density, but rarely simultaneously. We examined whether mammographic density (MD) mediates an association of birth weight, childhood body mass index (BMI), and height with the risk of breast cancer. 13,572 women (50 to 69 years) in the Copenhagen mammography screening program (1991 through 2001) with childhood anthropometric measurements in the Copenhagen School Health Records Register were followed for breast cancer until 2010. With logistic and Cox regression models, we investigated associations among birth weight, height, and BMI at ages 7 to 13 years with MD (mixed/dense or fatty) and breast cancer, respectively. 8,194 (60.4%) women had mixed/dense breasts, and 716 (5.3%) developed breast cancer. Childhood BMI was significantly inversely related to having mixed/dense breasts at all ages, with odds ratios (95% confidence intervals) ranging from 0.69 (0.66 to 0.72) at age 7 to 0.56 (0.53 to 0.58) at age 13, per one-unit increase in z-score. No statistically significant associations were detected between birth weight and MD, height and MD, or birth weight and breast cancer risk. BMI was inversely associated with breast cancer, with hazard ratios of 0.91 (0.83 to 0.99) at age 7 and 0.92 (0.84 to 1.00) at age 13, whereas height was positively associated with breast cancer risk (age 7, 1.06 (0.98 to 1.14) and age 13, 1.08 (1.00 to 1.16)). After additional adjustment for MD, associations of BMI with breast cancer diminished (age 7, 0.97 (0.88 to 1.06) and age 13, 1.01 (0.93 to 1.11)), but remained with height (age 7, 1.06 (0.99 to 1.15) and age 13, 1.09 (1.01 to 1.17)). Among women 50 years and older, childhood body fatness was inversely associated with the breast cancer risk, possibly via a mechanism mediated by MD, at least partially. Childhood tallness was positively associated with breast cancer risk, seemingly via a pathway independent of MD. Birth weight was not associated with MD or breast cancer in this age group.

Family, Community and Clinic Collaboration to Treat Overweight and Obese Children: Stanford GOALS -- a Randomized Controlled Trial of a Three-Year, Multi-Component, Multi-Level, Multi-Setting Intervention

PubMed Central

Robinson, Thomas N.; Matheson, Donna; Desai, Manisha; Wilson, Darrell M.; Weintraub, Dana L.; Haskell, William L.; McClain, Arianna; McClure, Samuel; Banda, Jorge; Sanders, Lee M.; Haydel, K. Farish; Killen, Joel D.

2013-01-01

Objective To test the effects of a three-year, community-based, multi-component, multi-level, multi-setting (MMM) approach for treating overweight and obese children. Design Two-arm, parallel group, randomized controlled trial with measures at baseline, 12, 24, and 36 months after randomization. Participants Seven through eleven year old, overweight and obese children (BMI ≥ 85th percentile) and their parents/caregivers recruited from community locations in low-income, primarily Latino neighborhoods in Northern California. Interventions Families are randomized to the MMM intervention versus a community health education active-placebo comparison intervention. Interventions last for three years for each participant. The MMM intervention includes a community-based after school team sports program designed specifically for overweight and obese children, a home-based family intervention to reduce screen time, alter the home food/eating environment, and promote self-regulatory skills for eating and activity behavior change, and a primary care behavioral counseling intervention linked to the community and home interventions. The active-placebo comparison intervention includes semi-annual health education home visits, monthly health education newsletters for children and for parents/guardians, and a series of community-based health education events for families. Main Outcome Measure Body mass index trajectory over the three-year study. Secondary outcome measures include waist circumference, triceps skinfold thickness, accelerometer-measured physical activity, 24-hour dietary recalls, screen time and other sedentary behaviors, blood pressure, fasting lipids, glucose, insulin, hemoglobin A1c, C-reactive protein, alanine aminotransferase, and psychosocial measures. Conclusions The Stanford GOALS trial is testing the efficacy of a novel community-based multi-component, multi-level, multi-setting treatment for childhood overweight and obesity in low-income, Latino families. PMID:24028942

Family, community and clinic collaboration to treat overweight and obese children: Stanford GOALS-A randomized controlled trial of a three-year, multi-component, multi-level, multi-setting intervention.

PubMed

Robinson, Thomas N; Matheson, Donna; Desai, Manisha; Wilson, Darrell M; Weintraub, Dana L; Haskell, William L; McClain, Arianna; McClure, Samuel; Banda, Jorge A; Sanders, Lee M; Haydel, K Farish; Killen, Joel D

2013-11-01

To test the effects of a three-year, community-based, multi-component, multi-level, multi-setting (MMM) approach for treating overweight and obese children. Two-arm, parallel group, randomized controlled trial with measures at baseline, 12, 24, and 36 months after randomization. Seven through eleven year old, overweight and obese children (BMI ≥ 85th percentile) and their parents/caregivers recruited from community locations in low-income, primarily Latino neighborhoods in Northern California. Families are randomized to the MMM intervention versus a community health education active-placebo comparison intervention. Interventions last for three years for each participant. The MMM intervention includes a community-based after school team sports program designed specifically for overweight and obese children, a home-based family intervention to reduce screen time, alter the home food/eating environment, and promote self-regulatory skills for eating and activity behavior change, and a primary care behavioral counseling intervention linked to the community and home interventions. The active-placebo comparison intervention includes semi-annual health education home visits, monthly health education newsletters for children and for parents/guardians, and a series of community-based health education events for families. Body mass index trajectory over the three-year study. Secondary outcome measures include waist circumference, triceps skinfold thickness, accelerometer-measured physical activity, 24-hour dietary recalls, screen time and other sedentary behaviors, blood pressure, fasting lipids, glucose, insulin, hemoglobin A1c, C-reactive protein, alanine aminotransferase, and psychosocial measures. The Stanford GOALS trial is testing the efficacy of a novel community-based multi-component, multi-level, multi-setting treatment for childhood overweight and obesity in low-income, Latino families. © 2013 Elsevier Inc. All rights reserved.

Assessing the accuracy and feasibility of a refractive error screening program conducted by school teachers in pre-primary and primary schools in Thailand.

PubMed

Teerawattananon, Kanlaya; Myint, Chaw-Yin; Wongkittirux, Kwanjai; Teerawattananon, Yot; Chinkulkitnivat, Bunyong; Orprayoon, Surapong; Kusakul, Suwat; Tengtrisorn, Supaporn; Jenchitr, Watanee

2014-01-01

As part of the development of a system for the screening of refractive error in Thai children, this study describes the accuracy and feasibility of establishing a program conducted by teachers. To assess the accuracy and feasibility of screening by teachers. A cross-sectional descriptive and analytical study was conducted in 17 schools in four provinces representing four geographic regions in Thailand. A two-staged cluster sampling was employed to compare the detection rate of refractive error among eligible students between trained teachers and health professionals. Serial focus group discussions were held for teachers and parents in order to understand their attitude towards refractive error screening at schools and the potential success factors and barriers. The detection rate of refractive error screening by teachers among pre-primary school children is relatively low (21%) for mild visual impairment but higher for moderate visual impairment (44%). The detection rate for primary school children is high for both levels of visual impairment (52% for mild and 74% for moderate). The focus group discussions reveal that both teachers and parents would benefit from further education regarding refractive errors and that the vast majority of teachers are willing to conduct a school-based screening program. Refractive error screening by health professionals in pre-primary and primary school children is not currently implemented in Thailand due to resource limitations. However, evidence suggests that a refractive error screening program conducted in schools by teachers in the country is reasonable and feasible because the detection and treatment of refractive error in very young generations is important and the screening program can be implemented and conducted with relatively low costs.

Using appropriate body mass index cut points for overweight and obesity among Asian Americans

PubMed Central

Jih, Jane; Mukherjea, Arnab; Vittinghoff, Eric; Nguyen, Tung T.; Tsoh, Janice Y.; Fukuoka, Yoshimi; Bender, Melinda S.; Tseng, Winston; Kanaya, Alka M.

2014-01-01

Objective Asian Americans have low prevalence of overweight/obesity based on standard BMI cut points yet have higher rates of diabetes. We examined the prevalence of overweight/obesity, using lower BMI cut points recommended by the World Health Organization (WHO) for Asians, and diabetes in Asian American subgroups in California. Method Secondary analysis of the 2009 adult California Health Interview Survey (n = 45,946) of non-Hispanic Whites (NHW), African Americans, Hispanics and Asians (Vietnamese, Chinese, Korean, Filipino, South Asian and Japanese). WHO Asian BMI cut points (overweight = 23–27.5 kg/m2; obese ≥ 27.5 kg/m2) were used for Asian subgroups. Standard BMI cut points (overweight = 25–29.9 kg/m2; obese ≥ 30 kg/m2) were applied for other groups. Results Among Asian subgroups, overweight/obesity was highest among Filipinos (78.6%), which was higher than NHWs (p < 0.001) but similar to African Americans and Hispanics. Compared to NHW, diabetes prevalence was higher for Vietnamese, Koreans, Filipinos and South Asians with BMI = 23–24.9 kg/m2 and Koreans, Filipinos and Japanese with BMI = 27.5–29.9 kg/m2, the ranges WHO recommends as overweight or obese for Asians but not for other groups. Conclusions Filipinos should be a priority population for overweight/obesity screening. Filipinos, Vietnamese, Korean, South Asians and Japanese have higher diabetes prevalence at lower BMI cut points. WHO Asian BMI cut points may have clinical utility to identify at-risk Asian Americans. PMID:24736092

Using appropriate body mass index cut points for overweight and obesity among Asian Americans.

PubMed

Jih, Jane; Mukherjea, Arnab; Vittinghoff, Eric; Nguyen, Tung T; Tsoh, Janice Y; Fukuoka, Yoshimi; Bender, Melinda S; Tseng, Winston; Kanaya, Alka M

2014-08-01

Asian Americans have low prevalence of overweight/obesity based on standard BMI cut points yet have higher rates of diabetes. We examined the prevalence of overweight/obesity, using lower BMI cut points recommended by the World Health Organization (WHO) for Asians, and diabetes in Asian American subgroups in California. Secondary analysis of the 2009 adult California Health Interview Survey (n=45,946) of non-Hispanic Whites (NHW), African Americans, Hispanics and Asians (Vietnamese, Chinese, Korean, Filipino, South Asian and Japanese). WHO Asian BMI cut points (overweight=23-27.5kg/m(2); obese≥27.5kg/m(2)) were used for Asian subgroups. Standard BMI cut points (overweight=25-29.9kg/m(2); obese≥30kg/m(2)) were applied for other groups. Among Asian subgroups, overweight/obesity was highest among Filipinos (78.6%), which was higher than NHWs (p<0.001) but similar to African Americans and Hispanics. Compared to NHW, diabetes prevalence was higher for Vietnamese, Koreans, Filipinos and South Asians with BMI=23-24.9kg/m(2) and Koreans, Filipinos and Japanese with BMI=27.5-29.9kg/m(2), the ranges WHO recommends as overweight or obese for Asians but not for other groups. Filipinos should be a priority population for overweight/obesity screening. Filipinos, Vietnamese, Korean, South Asians and Japanese have higher diabetes prevalence at lower BMI cut points. WHO Asian BMI cut points may have clinical utility to identify at-risk Asian Americans. Copyright © 2014 Elsevier Inc. All rights reserved.

Nurse-Role Dimensions of a School-Based Hypertension Screening, Education, and Follow-Up Program.

ERIC Educational Resources Information Center

Spratlen, Lois Price

1982-01-01

A hypertension screening and followup program was made available to inner-city adolescents. Results support the idea that research studies on hypertension in adolescents have a greater impact on participants when the school nurse is a member of the research team. The role of the school nurse should be that of educator, followup facilitator,…

Asian Adolescents with Excess Weight are at Higher Risk for Insulin Resistance than Non-Asian Peers.

PubMed

Elsamadony, Ahmed; Yates, Kathy F; Sweat, Victoria; Yau, Po Lai; Mangone, Alex; Joseph, Adriana; Fierman, Arthur; Convit, Antonio

2017-11-01

The purpose of this study was to evaluate whether Asian American adolescents have higher metabolic risk from excess weight than non-Asians. Seven hundred thirty-three students, aged 14 to 19 years old, completed a school-based health screening. The 427 Asian and 306 non-Asian students were overall equivalent on age, sex, and family income. Height, weight, waist circumference, percent body fat, and blood pressure were measured. Fasting triglycerides, high- and low-density lipoproteins, glucose, and insulin levels were measured. Asian and non-Asians in lean or overweight/obesity groups were contrasted on the five factors that make up the metabolic syndrome. Asian adolescents carrying excess weight had significantly higher insulin resistance (IR), triglyceride levels, and waist-height ratios (W/H), despite a significantly lower overall BMI than corresponding non-Asians. Similarly, Asians had a stronger relationship between W/H and the degree of IR than non-Asian counterparts; 35% and 18% of the variances were explained (R 2  = 0.35, R 2  = 0.18) respectively, resulting in a significant W/H by racial group interaction (F change [1,236] = 11.56, P < 0.01). Despite lower overall BMI, Asians have higher IR and triglyceride levels from excess weight than their non-Asian counterparts. One-size-fits-all public health policies targeting youth should be reconsidered and attention paid to Asian adolescents, including those with mild degrees of excess weight. © 2017 The Obesity Society.

The discriminative ability of waist circumference, body mass index and waist-to-hip ratio in identifying metabolic syndrome: Variations by age, sex and race.

PubMed

Cheong, Kee C; Ghazali, Sumarni M; Hock, Lim K; Subenthiran, Soobitha; Huey, Teh C; Kuay, Lim K; Mustapha, Feisul I; Yusoff, Ahmad F; Mustafa, Amal N

2015-01-01

Many studies have suggested that there is variation in the capabilities of BMI, WC and WHR in predicting cardiometabolic risk and that it might be confounded by gender, ethnicity and age group. The objective of this study is to examine the discriminative abilities of body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR) to predict two or more non-adipose components of the metabolic syndrome (high blood pressure, hypertriglyceridemia, low high density lipoprotein-cholesterol and high fasting plasma glucose) among the adult Malaysian population by gender, age group and ethnicity. Data from 2572 respondents (1044 men and 1528 women) aged 25-64 years who participated in the Non Communicable Disease Surveillance 2005/2006, a population-based cross sectional study, were analysed. Participants' socio-demographic details, anthropometric indices (BMI, WC and WHR), blood pressure, fasting lipid profile and fasting glucose level were assessed. Receiver operating characteristics curves analysis was used to evaluate the ability of each anthropometric index to discriminate MetS cases from non-MetS cases based on the area under the curve. Overall, WC had better discriminative ability than WHR for women but did not perform significantly better than BMI in both sexes, whereas BMI was better than WHR in women only. Waist circumference was a better discriminator of MetS compared to WHR in Malay men and women. Waist circumference and BMI performed better than WHR in Chinese women, men aged 25-34 years and women aged 35-44 years. The discriminative ability of BMI and WC is better than WHR for predicting two or more non-adipose components of MetS. Therefore, either BMI or WC measurements are recommended in screening for metabolic syndrome in routine clinical practice in the effort to combat cardiovascular disease and type II diabetes mellitus. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Pilot intervention to increase physical activity among sedentary urban middle school girls: a two-group pretest-posttest quasi-experimental design.

PubMed

Robbins, Lorraine B; Pfeiffer, Karin A; Maier, Kimberly S; Lo, Yun-Jia; Wesolek Ladrig, Stacey M

2012-08-01

The primary purpose of the study was to determine whether girls in one school receiving nurse counseling plus an after-school physical activity club showed greater improvement in physical activity, cardiovascular fitness, and body composition than girls assigned to an attention control condition in another school (N = 69). Linear regressions controlling for baseline measures showed no statistically significant group differences, but the directionality of differences was consistent with greater intervention group improvement for minutes of moderate to vigorous physical activity/hour (t = 0.95, p = .35), cardiovascular fitness (t = 1.26, p = .22), body mass index (BMI; t = -1.47, p = .15), BMI z score (t = -1.19, p = .24), BMI percentile (t = -0.59, p = .56), percentage body fat (t = -0.86, p = .39), and waist circumference (t = -0.19, p = .85). Findings support testing with a larger sample.

Pilot intervention to increase physical activity among sedentary urban middle school girls: a two-group pretest-posttest quasi-experimental design

PubMed Central

Robbins, Lorraine B.; Pfeiffer, Karin A.; Maier, Kimberly S.; Lo, Yun-Jia; Wesolek, Stacey M.

2012-01-01

The primary purpose of the study was to determine if girls in one school receiving nurse counseling plus an after-school Physical Activity Club showed greater improvement in physical activity, cardiovascular fitness, and body composition than girls assigned to an attention control condition in another school (N = 69). Linear regressions controlling for baseline measures showed no statistically significant group differences, but directionality of differences was consistent with greater intervention group improvement for minutes of moderate to vigorous physical activity/hour (t = 0.95, p = .35), cardiovascular fitness (t = 1.26, p = .22), body mass index (BMI; t = −1.47, p = .15), BMI z-score (t = −1.19, p = .24), BMI percentile (t = −0.59, p = .56), percent body fat (t = −0.86, p = .39), and waist circumference (t = −0.19, p = .85). Findings support testing with a larger sample. PMID:22472632

Results of a Multi-level Intervention to Prevent and Control Childhood Obesity among Latino Children: The Aventuras Para Niños Study

PubMed Central

Crespo, Noe C.; Elder, John P.; Ayala, Guadalupe X.; Campbell, Nadia R.; Arredondo, Elva M.; Slymen, Donald J.; Baquero, Barbara; Sallis, James F.; McKenzie, Thomas L.

2014-01-01

Background Community-based behavioral interventions are needed to reduce the burden of childhood obesity. Purpose This study evaluated the impact of a multi-level promotora-based (Community Health Advisor) intervention to promote healthy eating and physical activity (PA) and prevent excess weight gain among Latino children. Methods Thirteen elementary schools were randomized to one of four intervention conditions: individual and family level (Fam-only), school and community level (Comm-only), combined Fam+Comm intervention, or a measurement-only condition. Participants were 808 Latino parents and their children enrolled in kindergarten through 2nd grade. Measures included parent and child BMI and a self-administered parent survey that assessed several parent and child behaviors. Results There were no intervention effects on children's BMI z-score. The Fam-only and Fam+Comm interventions changed several obesity-related child behaviors and these were mediated by changes in parenting variables. Discussion A promotora-based behavioral intervention was efficacious at changing parental factors and child obesity-related health behaviors. PMID:22215470

Adipokines and Insulin Resistance According to Characteristics of Pregnant Women with Gestational Diabetes Mellitus.

PubMed

Jeon, Eon Ju; Hong, Seong Yeon; Lee, Ji Hyun

2017-12-01

The aim of this study was to evaluate adipokines concentration and insulin resistance according to maternal age or obesity at pregnancy and weight change at diagnosed gestational diabetes mellitus (GDM) in pregnant women with GDM. This study included 57 pregnant women who were diagnosed with GDM at 24 to 28 weeks of gestation. The subjects were classified into two or three groups according to pre-pregnancy body mass index (BMI, <25 kg/m² vs. ≥25 kg/m²), maternal age at pregnancy (<35 years old vs. ≥35 years old), and weight change during pregnancy at screening for GDM (weight change below, within, and in excess of the recommended range). They were respectively compared in each group. Leptin, homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA2-%B were increased in the group with pre-pregnancy BMI ≥25 kg/m². Leptin and HOMA-IR were positively correlated with BMI both before pregnancy and at screening for GDM. There were no significant correlations between HOMA-IR and adipokines. HOMA-IR showed positive correlation with HOMA2-%B and negative correlation with HOMA2-%S. Leptin and HOMA-IR at diagnosed GDM were increased in the GDM patients with obesity before pregnancy. They were positively correlated with BMI both before pregnancy and at screening for GDM. The effect of maternal age at pregnancy and weight change during pregnancy at GDM screening on adipokines and insulin resistance might be less pronounced than the effect of maternal obesity. Copyright © 2017 Korean Diabetes Association

The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study.

PubMed

Winkler, Thomas W; Justice, Anne E; Graff, Mariaelisa; Barata, Llilda; Feitosa, Mary F; Chu, Su; Czajkowski, Jacek; Esko, Tõnu; Fall, Tove; Kilpeläinen, Tuomas O; Lu, Yingchang; Mägi, Reedik; Mihailov, Evelin; Pers, Tune H; Rüeger, Sina; Teumer, Alexander; Ehret, Georg B; Ferreira, Teresa; Heard-Costa, Nancy L; Karjalainen, Juha; Lagou, Vasiliki; Mahajan, Anubha; Neinast, Michael D; Prokopenko, Inga; Simino, Jeannette; Teslovich, Tanya M; Jansen, Rick; Westra, Harm-Jan; White, Charles C; Absher, Devin; Ahluwalia, Tarunveer S; Ahmad, Shafqat; Albrecht, Eva; Alves, Alexessander Couto; Bragg-Gresham, Jennifer L; de Craen, Anton J M; Bis, Joshua C; Bonnefond, Amélie; Boucher, Gabrielle; Cadby, Gemma; Cheng, Yu-Ching; Chiang, Charleston W K; Delgado, Graciela; Demirkan, Ayse; Dueker, Nicole; Eklund, Niina; Eiriksdottir, Gudny; Eriksson, Joel; Feenstra, Bjarke; Fischer, Krista; Frau, Francesca; Galesloot, Tessel E; Geller, Frank; Goel, Anuj; Gorski, Mathias; Grammer, Tanja B; Gustafsson, Stefan; Haitjema, Saskia; Hottenga, Jouke-Jan; Huffman, Jennifer E; Jackson, Anne U; Jacobs, Kevin B; Johansson, Åsa; Kaakinen, Marika; Kleber, Marcus E; Lahti, Jari; Mateo Leach, Irene; Lehne, Benjamin; Liu, Youfang; Lo, Ken Sin; Lorentzon, Mattias; Luan, Jian'an; Madden, Pamela A F; Mangino, Massimo; McKnight, Barbara; Medina-Gomez, Carolina; Monda, Keri L; Montasser, May E; Müller, Gabriele; Müller-Nurasyid, Martina; Nolte, Ilja M; Panoutsopoulou, Kalliope; Pascoe, Laura; Paternoster, Lavinia; Rayner, Nigel W; Renström, Frida; Rizzi, Federica; Rose, Lynda M; Ryan, Kathy A; Salo, Perttu; Sanna, Serena; Scharnagl, Hubert; Shi, Jianxin; Smith, Albert Vernon; Southam, Lorraine; Stančáková, Alena; Steinthorsdottir, Valgerdur; Strawbridge, Rona J; Sung, Yun Ju; Tachmazidou, Ioanna; Tanaka, Toshiko; Thorleifsson, Gudmar; Trompet, Stella; Pervjakova, Natalia; Tyrer, Jonathan P; Vandenput, Liesbeth; van der Laan, Sander W; van der Velde, Nathalie; van Setten, Jessica; van Vliet-Ostaptchouk, Jana V; Verweij, Niek; Vlachopoulou, Efthymia; Waite, Lindsay L; Wang, Sophie R; Wang, Zhaoming; Wild, Sarah H; Willenborg, Christina; Wilson, James F; Wong, Andrew; Yang, Jian; Yengo, Loïc; Yerges-Armstrong, Laura M; Yu, Lei; Zhang, Weihua; Zhao, Jing Hua; Andersson, Ehm A; Bakker, Stephan J L; Baldassarre, Damiano; Banasik, Karina; Barcella, Matteo; Barlassina, Cristina; Bellis, Claire; Benaglio, Paola; Blangero, John; Blüher, Matthias; Bonnet, Fabrice; Bonnycastle, Lori L; Boyd, Heather A; Bruinenberg, Marcel; Buchman, Aron S; Campbell, Harry; Chen, Yii-Der Ida; Chines, Peter S; Claudi-Boehm, Simone; Cole, John; Collins, Francis S; de Geus, Eco J C; de Groot, Lisette C P G M; Dimitriou, Maria; Duan, Jubao; Enroth, Stefan; Eury, Elodie; Farmaki, Aliki-Eleni; Forouhi, Nita G; Friedrich, Nele; Gejman, Pablo V; Gigante, Bruna; Glorioso, Nicola; Go, Alan S; Gottesman, Omri; Gräßler, Jürgen; Grallert, Harald; Grarup, Niels; Gu, Yu-Mei; Broer, Linda; Ham, Annelies C; Hansen, Torben; Harris, Tamara B; Hartman, Catharina A; Hassinen, Maija; Hastie, Nicholas; Hattersley, Andrew T; Heath, Andrew C; Henders, Anjali K; Hernandez, Dena; Hillege, Hans; Holmen, Oddgeir; Hovingh, Kees G; Hui, Jennie; Husemoen, Lise L; Hutri-Kähönen, Nina; Hysi, Pirro G; Illig, Thomas; De Jager, Philip L; Jalilzadeh, Shapour; Jørgensen, Torben; Jukema, J Wouter; Juonala, Markus; Kanoni, Stavroula; Karaleftheri, Maria; Khaw, Kay Tee; Kinnunen, Leena; Kittner, Steven J; Koenig, Wolfgang; Kolcic, Ivana; Kovacs, Peter; Krarup, Nikolaj T; Kratzer, Wolfgang; Krüger, Janine; Kuh, Diana; Kumari, Meena; Kyriakou, Theodosios; Langenberg, Claudia; Lannfelt, Lars; Lanzani, Chiara; Lotay, Vaneet; Launer, Lenore J; Leander, Karin; Lindström, Jaana; Linneberg, Allan; Liu, Yan-Ping; Lobbens, Stéphane; Luben, Robert; Lyssenko, Valeriya; Männistö, Satu; Magnusson, Patrik K; McArdle, Wendy L; Menni, Cristina; Merger, Sigrun; Milani, Lili; Montgomery, Grant W; Morris, Andrew P; Narisu, Narisu; Nelis, Mari; Ong, Ken K; Palotie, Aarno; Pérusse, Louis; Pichler, Irene; Pilia, Maria G; Pouta, Anneli; Rheinberger, Myriam; Ribel-Madsen, Rasmus; Richards, Marcus; Rice, Kenneth M; Rice, Treva K; Rivolta, Carlo; Salomaa, Veikko; Sanders, Alan R; Sarzynski, Mark A; Scholtens, Salome; Scott, Robert A; Scott, William R; Sebert, Sylvain; Sengupta, Sebanti; Sennblad, Bengt; Seufferlein, Thomas; Silveira, Angela; Slagboom, P Eline; Smit, Jan H; Sparsø, Thomas H; Stirrups, Kathleen; Stolk, Ronald P; Stringham, Heather M; Swertz, Morris A; Swift, Amy J; Syvänen, Ann-Christine; Tan, Sian-Tsung; Thorand, Barbara; Tönjes, Anke; Tremblay, Angelo; Tsafantakis, Emmanouil; van der Most, Peter J; Völker, Uwe; Vohl, Marie-Claude; Vonk, Judith M; Waldenberger, Melanie; Walker, Ryan W; Wennauer, Roman; Widén, Elisabeth; Willemsen, Gonneke; Wilsgaard, Tom; Wright, Alan F; Zillikens, M Carola; van Dijk, Suzanne C; van Schoor, Natasja M; Asselbergs, Folkert W; de Bakker, Paul I W; Beckmann, Jacques S; Beilby, John; Bennett, David A; Bergman, Richard N; Bergmann, Sven; Böger, Carsten A; Boehm, Bernhard O; Boerwinkle, Eric; Boomsma, Dorret I; Bornstein, Stefan R; Bottinger, Erwin P; Bouchard, Claude; Chambers, John C; Chanock, Stephen J; Chasman, Daniel I; Cucca, Francesco; Cusi, Daniele; Dedoussis, George; Erdmann, Jeanette; Eriksson, Johan G; Evans, Denis A; de Faire, Ulf; Farrall, Martin; Ferrucci, Luigi; Ford, Ian; Franke, Lude; Franks, Paul W; Froguel, Philippe; Gansevoort, Ron T; Gieger, Christian; Grönberg, Henrik; Gudnason, Vilmundur; Gyllensten, Ulf; Hall, Per; Hamsten, Anders; van der Harst, Pim; Hayward, Caroline; Heliövaara, Markku; Hengstenberg, Christian; Hicks, Andrew A; Hingorani, Aroon; Hofman, Albert; Hu, Frank; Huikuri, Heikki V; Hveem, Kristian; James, Alan L; Jordan, Joanne M; Jula, Antti; Kähönen, Mika; Kajantie, Eero; Kathiresan, Sekar; Kiemeney, Lambertus A L M; Kivimaki, Mika; Knekt, Paul B; Koistinen, Heikki A; Kooner, Jaspal S; Koskinen, Seppo; Kuusisto, Johanna; Maerz, Winfried; Martin, Nicholas G; Laakso, Markku; Lakka, Timo A; Lehtimäki, Terho; Lettre, Guillaume; Levinson, Douglas F; Lind, Lars; Lokki, Marja-Liisa; Mäntyselkä, Pekka; Melbye, Mads; Metspalu, Andres; Mitchell, Braxton D; Moll, Frans L; Murray, Jeffrey C; Musk, Arthur W; Nieminen, Markku S; Njølstad, Inger; Ohlsson, Claes; Oldehinkel, Albertine J; Oostra, Ben A; Palmer, Lyle J; Pankow, James S; Pasterkamp, Gerard; Pedersen, Nancy L; Pedersen, Oluf; Penninx, Brenda W; Perola, Markus; Peters, Annette; Polašek, Ozren; Pramstaller, Peter P; Psaty, Bruce M; Qi, Lu; Quertermous, Thomas; Raitakari, Olli T; Rankinen, Tuomo; Rauramaa, Rainer; Ridker, Paul M; Rioux, John D; Rivadeneira, Fernando; Rotter, Jerome I; Rudan, Igor; den Ruijter, Hester M; Saltevo, Juha; Sattar, Naveed; Schunkert, Heribert; Schwarz, Peter E H; Shuldiner, Alan R; Sinisalo, Juha; Snieder, Harold; Sørensen, Thorkild I A; Spector, Tim D; Staessen, Jan A; Stefania, Bandinelli; Thorsteinsdottir, Unnur; Stumvoll, Michael; Tardif, Jean-Claude; Tremoli, Elena; Tuomilehto, Jaakko; Uitterlinden, André G; Uusitupa, Matti; Verbeek, André L M; Vermeulen, Sita H; Viikari, Jorma S; Vitart, Veronique; Völzke, Henry; Vollenweider, Peter; Waeber, Gérard; Walker, Mark; Wallaschofski, Henri; Wareham, Nicholas J; Watkins, Hugh; Zeggini, Eleftheria; Chakravarti, Aravinda; Clegg, Deborah J; Cupples, L Adrienne; Gordon-Larsen, Penny; Jaquish, Cashell E; Rao, D C; Abecasis, Goncalo R; Assimes, Themistocles L; Barroso, Inês; Berndt, Sonja I; Boehnke, Michael; Deloukas, Panos; Fox, Caroline S; Groop, Leif C; Hunter, David J; Ingelsson, Erik; Kaplan, Robert C; McCarthy, Mark I; Mohlke, Karen L; O'Connell, Jeffrey R; Schlessinger, David; Strachan, David P; Stefansson, Kari; van Duijn, Cornelia M; Hirschhorn, Joel N; Lindgren, Cecilia M; Heid, Iris M; North, Kari E; Borecki, Ingrid B; Kutalik, Zoltán; Loos, Ruth J F

2015-10-01

Genome-wide association studies (GWAS) have identified more than 100 genetic variants contributing to BMI, a measure of body size, or waist-to-hip ratio (adjusted for BMI, WHRadjBMI), a measure of body shape. Body size and shape change as people grow older and these changes differ substantially between men and women. To systematically screen for age- and/or sex-specific effects of genetic variants on BMI and WHRadjBMI, we performed meta-analyses of 114 studies (up to 320,485 individuals of European descent) with genome-wide chip and/or Metabochip data by the Genetic Investigation of Anthropometric Traits (GIANT) Consortium. Each study tested the association of up to ~2.8M SNPs with BMI and WHRadjBMI in four strata (men ≤50y, men >50y, women ≤50y, women >50y) and summary statistics were combined in stratum-specific meta-analyses. We then screened for variants that showed age-specific effects (G x AGE), sex-specific effects (G x SEX) or age-specific effects that differed between men and women (G x AGE x SEX). For BMI, we identified 15 loci (11 previously established for main effects, four novel) that showed significant (FDR<5%) age-specific effects, of which 11 had larger effects in younger (<50y) than in older adults (≥50y). No sex-dependent effects were identified for BMI. For WHRadjBMI, we identified 44 loci (27 previously established for main effects, 17 novel) with sex-specific effects, of which 28 showed larger effects in women than in men, five showed larger effects in men than in women, and 11 showed opposite effects between sexes. No age-dependent effects were identified for WHRadjBMI. This is the first genome-wide interaction meta-analysis to report convincing evidence of age-dependent genetic effects on BMI. In addition, we confirm the sex-specificity of genetic effects on WHRadjBMI. These results may provide further insights into the biology that underlies weight change with age or the sexually dimorphism of body shape.

The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study

PubMed Central

Feitosa, Mary F.; Chu, Su; Czajkowski, Jacek; Esko, Tõnu; Fall, Tove; Kilpeläinen, Tuomas O.; Lu, Yingchang; Mägi, Reedik; Mihailov, Evelin; Pers, Tune H.; Rüeger, Sina; Teumer, Alexander; Ehret, Georg B.; Ferreira, Teresa; Heard-Costa, Nancy L.; Karjalainen, Juha; Lagou, Vasiliki; Mahajan, Anubha; Neinast, Michael D.; Prokopenko, Inga; Simino, Jeannette; Teslovich, Tanya M.; Jansen, Rick; Westra, Harm-Jan; White, Charles C.; Absher, Devin; Ahluwalia, Tarunveer S.; Ahmad, Shafqat; Albrecht, Eva; Alves, Alexessander Couto; Bragg-Gresham, Jennifer L.; de Craen, Anton J. M.; Bis, Joshua C.; Bonnefond, Amélie; Boucher, Gabrielle; Cadby, Gemma; Cheng, Yu-Ching; Chiang, Charleston W. K.; Delgado, Graciela; Demirkan, Ayse; Dueker, Nicole; Eklund, Niina; Eiriksdottir, Gudny; Eriksson, Joel; Feenstra, Bjarke; Fischer, Krista; Frau, Francesca; Galesloot, Tessel E.; Geller, Frank; Goel, Anuj; Gorski, Mathias; Grammer, Tanja B.; Gustafsson, Stefan; Haitjema, Saskia; Hottenga, Jouke-Jan; Huffman, Jennifer E.; Jackson, Anne U.; Jacobs, Kevin B.; Johansson, Åsa; Kaakinen, Marika; Kleber, Marcus E.; Lahti, Jari; Leach, Irene Mateo; Lehne, Benjamin; Liu, Youfang; Lo, Ken Sin; Lorentzon, Mattias; Luan, Jian'an; Madden, Pamela A. F.; Mangino, Massimo; McKnight, Barbara; Medina-Gomez, Carolina; Monda, Keri L.; Montasser, May E.; Müller, Gabriele; Müller-Nurasyid, Martina; Nolte, Ilja M.; Panoutsopoulou, Kalliope; Pascoe, Laura; Paternoster, Lavinia; Rayner, Nigel W.; Renström, Frida; Rizzi, Federica; Rose, Lynda M.; Ryan, Kathy A.; Salo, Perttu; Sanna, Serena; Scharnagl, Hubert; Shi, Jianxin; Smith, Albert Vernon; Southam, Lorraine; Stančáková, Alena; Steinthorsdottir, Valgerdur; Strawbridge, Rona J.; Sung, Yun Ju; Tachmazidou, Ioanna; Tanaka, Toshiko; Thorleifsson, Gudmar; Trompet, Stella; Pervjakova, Natalia; Tyrer, Jonathan P.; Vandenput, Liesbeth; van der Laan, Sander W; van der Velde, Nathalie; van Setten, Jessica; van Vliet-Ostaptchouk, Jana V.; Verweij, Niek; Vlachopoulou, Efthymia; Waite, Lindsay L.; Wang, Sophie R.; Wang, Zhaoming; Wild, Sarah H.; Willenborg, Christina; Wilson, James F.; Wong, Andrew; Yang, Jian; Yengo, Loïc; Yerges-Armstrong, Laura M.; Yu, Lei; Zhang, Weihua; Zhao, Jing Hua; Andersson, Ehm A.; Bakker, Stephan J. L.; Baldassarre, Damiano; Banasik, Karina; Barcella, Matteo; Barlassina, Cristina; Bellis, Claire; Benaglio, Paola; Blangero, John; Blüher, Matthias; Bonnet, Fabrice; Bonnycastle, Lori L.; Boyd, Heather A.; Bruinenberg, Marcel; Buchman, Aron S; Campbell, Harry; Chen, Yii-Der Ida; Chines, Peter S.; Claudi-Boehm, Simone; Cole, John; Collins, Francis S.; de Geus, Eco J. C.; de Groot, Lisette C. P. G. M.; Dimitriou, Maria; Duan, Jubao; Enroth, Stefan; Eury, Elodie; Farmaki, Aliki-Eleni; Forouhi, Nita G.; Friedrich, Nele; Gejman, Pablo V.; Gigante, Bruna; Glorioso, Nicola; Go, Alan S.; Gottesman, Omri; Gräßler, Jürgen; Grallert, Harald; Grarup, Niels; Gu, Yu-Mei; Broer, Linda; Ham, Annelies C.; Hansen, Torben; Harris, Tamara B.; Hartman, Catharina A.; Hassinen, Maija; Hastie, Nicholas; Hattersley, Andrew T.; Heath, Andrew C.; Henders, Anjali K.; Hernandez, Dena; Hillege, Hans; Holmen, Oddgeir; Hovingh, Kees G; Hui, Jennie; Husemoen, Lise L.; Hutri-Kähönen, Nina; Hysi, Pirro G.; Illig, Thomas; De Jager, Philip L.; Jalilzadeh, Shapour; Jørgensen, Torben; Jukema, J. Wouter; Juonala, Markus; Kanoni, Stavroula; Karaleftheri, Maria; Khaw, Kay Tee; Kinnunen, Leena; Kittner, Steven J.; Koenig, Wolfgang; Kolcic, Ivana; Kovacs, Peter; Krarup, Nikolaj T.; Kratzer, Wolfgang; Krüger, Janine; Kuh, Diana; Kumari, Meena; Kyriakou, Theodosios; Langenberg, Claudia; Lannfelt, Lars; Lanzani, Chiara; Lotay, Vaneet; Launer, Lenore J.; Leander, Karin; Lindström, Jaana; Linneberg, Allan; Liu, Yan-Ping; Lobbens, Stéphane; Luben, Robert; Lyssenko, Valeriya; Männistö, Satu; Magnusson, Patrik K.; McArdle, Wendy L.; Menni, Cristina; Merger, Sigrun; Milani, Lili; Montgomery, Grant W.; Morris, Andrew P.; Narisu, Narisu; Nelis, Mari; Ong, Ken K.; Palotie, Aarno; Pérusse, Louis; Pichler, Irene; Pilia, Maria G.; Pouta, Anneli; Rheinberger, Myriam; Ribel-Madsen, Rasmus; Richards, Marcus; Rice, Kenneth M.; Rice, Treva K.; Rivolta, Carlo; Salomaa, Veikko; Sanders, Alan R.; Sarzynski, Mark A.; Scholtens, Salome; Scott, Robert A.; Scott, William R.; Sebert, Sylvain; Sengupta, Sebanti; Sennblad, Bengt; Seufferlein, Thomas; Silveira, Angela; Slagboom, P. Eline; Smit, Jan H.; Sparsø, Thomas H.; Stirrups, Kathleen; Stolk, Ronald P.; Stringham, Heather M.; Swertz, Morris A; Swift, Amy J.; Syvänen, Ann-Christine; Tan, Sian-Tsung; Thorand, Barbara; Tönjes, Anke; Tremblay, Angelo; Tsafantakis, Emmanouil; van der Most, Peter J.; Völker, Uwe; Vohl, Marie-Claude; Vonk, Judith M.; Waldenberger, Melanie; Walker, Ryan W.; Wennauer, Roman; Widén, Elisabeth; Willemsen, Gonneke; Wilsgaard, Tom; Wright, Alan F.; Zillikens, M. Carola; van Dijk, Suzanne C.; van Schoor, Natasja M.; Asselbergs, Folkert W.; de Bakker, Paul I. W.; Beckmann, Jacques S.; Beilby, John; Bennett, David A.; Bergman, Richard N.; Bergmann, Sven; Böger, Carsten A.; Boehm, Bernhard O.; Boerwinkle, Eric; Boomsma, Dorret I.; Bornstein, Stefan R.; Bottinger, Erwin P.; Bouchard, Claude; Chambers, John C.; Chanock, Stephen J.; Chasman, Daniel I.; Cucca, Francesco; Cusi, Daniele; Dedoussis, George; Erdmann, Jeanette; Eriksson, Johan G.; Evans, Denis A.; de Faire, Ulf; Farrall, Martin; Ferrucci, Luigi; Ford, Ian; Franke, Lude; Franks, Paul W.; Froguel, Philippe; Gansevoort, Ron T.; Gieger, Christian; Grönberg, Henrik; Gudnason, Vilmundur; Gyllensten, Ulf; Hall, Per; Hamsten, Anders; van der Harst, Pim; Hayward, Caroline; Heliövaara, Markku; Hengstenberg, Christian; Hicks, Andrew A; Hingorani, Aroon; Hofman, Albert; Hu, Frank; Huikuri, Heikki V.; Hveem, Kristian; James, Alan L.; Jordan, Joanne M.; Jula, Antti; Kähönen, Mika; Kajantie, Eero; Kathiresan, Sekar; Kiemeney, Lambertus A. L. M.; Kivimaki, Mika; Knekt, Paul B.; Koistinen, Heikki A.; Kooner, Jaspal S.; Koskinen, Seppo; Kuusisto, Johanna; Maerz, Winfried; Martin, Nicholas G; Laakso, Markku; Lakka, Timo A.; Lehtimäki, Terho; Lettre, Guillaume; Levinson, Douglas F.; Lind, Lars; Lokki, Marja-Liisa; Mäntyselkä, Pekka; Melbye, Mads; Metspalu, Andres; Mitchell, Braxton D.; Moll, Frans L.; Murray, Jeffrey C.; Musk, Arthur W.; Nieminen, Markku S.; Njølstad, Inger; Ohlsson, Claes; Oldehinkel, Albertine J.; Oostra, Ben A.; Palmer, Lyle J; Pankow, James S.; Pasterkamp, Gerard; Pedersen, Nancy L.; Pedersen, Oluf; Penninx, Brenda W.; Perola, Markus; Peters, Annette; Polašek, Ozren; Pramstaller, Peter P.; Psaty, Bruce M.; Qi, Lu; Quertermous, Thomas; Raitakari, Olli T.; Rankinen, Tuomo; Rauramaa, Rainer; Ridker, Paul M.; Rioux, John D.; Rivadeneira, Fernando; Rotter, Jerome I.; Rudan, Igor; den Ruijter, Hester M.; Saltevo, Juha; Sattar, Naveed; Schunkert, Heribert; Schwarz, Peter E. H.; Shuldiner, Alan R.; Sinisalo, Juha; Snieder, Harold; Sørensen, Thorkild I. A.; Spector, Tim D.; Staessen, Jan A.; Stefania, Bandinelli; Thorsteinsdottir, Unnur; Stumvoll, Michael; Tardif, Jean-Claude; Tremoli, Elena; Tuomilehto, Jaakko; Uitterlinden, André G.; Uusitupa, Matti; Verbeek, André L. M.; Vermeulen, Sita H.; Viikari, Jorma S.; Vitart, Veronique; Völzke, Henry; Vollenweider, Peter; Waeber, Gérard; Walker, Mark; Wallaschofski, Henri; Wareham, Nicholas J.; Watkins, Hugh; Zeggini, Eleftheria; Chakravarti, Aravinda; Clegg, Deborah J.; Cupples, L. Adrienne; Gordon-Larsen, Penny; Jaquish, Cashell E.; Rao, D. C.; Abecasis, Goncalo R.; Assimes, Themistocles L.; Barroso, Inês; Berndt, Sonja I.; Boehnke, Michael; Deloukas, Panos; Fox, Caroline S.; Groop, Leif C.; Hunter, David J.; Ingelsson, Erik; Kaplan, Robert C.; McCarthy, Mark I.; Mohlke, Karen L.; O'Connell, Jeffrey R.; Schlessinger, David; Strachan, David P.; Stefansson, Kari; van Duijn, Cornelia M.; Hirschhorn, Joel N.; Lindgren, Cecilia M.; Heid, Iris M.; North, Kari E.; Borecki, Ingrid B.; Kutalik, Zoltán; Loos, Ruth J. F.

2015-01-01

Genome-wide association studies (GWAS) have identified more than 100 genetic variants contributing to BMI, a measure of body size, or waist-to-hip ratio (adjusted for BMI, WHRadjBMI), a measure of body shape. Body size and shape change as people grow older and these changes differ substantially between men and women. To systematically screen for age- and/or sex-specific effects of genetic variants on BMI and WHRadjBMI, we performed meta-analyses of 114 studies (up to 320,485 individuals of European descent) with genome-wide chip and/or Metabochip data by the Genetic Investigation of Anthropometric Traits (GIANT) Consortium. Each study tested the association of up to ~2.8M SNPs with BMI and WHRadjBMI in four strata (men ≤50y, men >50y, women ≤50y, women >50y) and summary statistics were combined in stratum-specific meta-analyses. We then screened for variants that showed age-specific effects (G x AGE), sex-specific effects (G x SEX) or age-specific effects that differed between men and women (G x AGE x SEX). For BMI, we identified 15 loci (11 previously established for main effects, four novel) that showed significant (FDR<5%) age-specific effects, of which 11 had larger effects in younger (<50y) than in older adults (≥50y). No sex-dependent effects were identified for BMI. For WHRadjBMI, we identified 44 loci (27 previously established for main effects, 17 novel) with sex-specific effects, of which 28 showed larger effects in women than in men, five showed larger effects in men than in women, and 11 showed opposite effects between sexes. No age-dependent effects were identified for WHRadjBMI. This is the first genome-wide interaction meta-analysis to report convincing evidence of age-dependent genetic effects on BMI. In addition, we confirm the sex-specificity of genetic effects on WHRadjBMI. These results may provide further insights into the biology that underlies weight change with age or the sexually dimorphism of body shape. PMID:26426971

Utilization of Professional Mental Health Services Related to Population-Level Screening for Anxiety, Depression, and Post-traumatic Stress Disorder Among Public High School Students.

PubMed

Prochaska, John D; Le, Vi Donna; Baillargeon, Jacques; Temple, Jeff R

2016-08-01

This study examines results from three mental health screening measures in a cohort of adolescent public school students in seven public schools in Southeast Texas affiliated with the Dating it Safe study. We estimated the odds of receiving professional mental health treatment in the previous year given results from different mental health screening batteries: the CES-D 10 battery for depression screening, the Screen for Child Anxiety Related Disorders, and the Primary Care Posttraumatic Stress Disorder screen. Overall, students with higher scores on screening instruments for depression, posttraumatic stress disorder, and combinations of screening instruments were more likely to have sought past-year professional mental health treatment than non-symptomatic youth. However, the proportion of students screening positive and receiving professional treatment was low, ranging from 11 to 16 %. This study emphasizes the need for broader evaluation of population-based mental health screening among adolescents.

Utilization of Professional Mental Health Services Related to Population-Level Screening for Anxiety, Depression, and Post-traumatic Stress Disorder among Public High School Students

PubMed Central

Prochaska, John D.; Le, Vi Donna; Baillargeon, Jacques; Temple, Jeff R.

2016-01-01

This study examines results from three mental health screening measures in a cohort of adolescent public school students in seven public schools in Southeast [State removed for peer review] affiliated with the [name of study removed for blind review]. We estimated the odds of receiving professional mental health treatment in the previous year given results from different mental health screening batteries: the CES-D 10 battery for depression screening, the Screen for Child Anxiety Related Disorders (SCARED), and the Primary Care Posttraumatic Stress Disorder screen (PC-PTSD). Overall, students with higher scores on screening instruments for depression, posttraumatic stress disorder, and combinations of screening instruments were more likely to have sought past-year professional mental health treatment than non-symptomatic youth. However, the proportion of students screening positive and receiving professional treatment was low, ranging from 11 to 16%. This study emphasizes the need for broader evaluation of population-based mental health screening among adolescents. PMID:26733335

Study of blood pressure and blood sugar levels in adolescence and comparison with body mass index.

PubMed

Borade, Ashwin; Kadam, Gauri Shashank; Bhide, Gayatri; Dhongade, Ram

2011-07-01

Worldwide prevalence of overweight and obesity is increasing and its consequences prompted the WHO to designate obesity as a global epidemic in 2002. Being overweight is a risk factor for significant illness, especially diabetes and hypertension in adult life. To study the blood pressure and blood sugar levels and lifestyle parameters in adolescence and comparison with body mass index. In a prospective case control study, out of the 1000 screened, a total of 200 adolescents were considered out of which 100 were with high body mass index (BMI) and the other 100 were with normal BMI. Height, weight, BMI, waist hip ratio (WHR), blood pressure (BP), BSL, and associated risk factors like physical activity, fast food consumption, and computer/television watching were measured and screened. 109 (54.5%) males and 91 (45.5%) females were included. Maximum number [90 (45%)] of adolescents screened were in the age group of 17-19 years, while 54 (27%) and 56 (28%) adolescents were in the age group of 10-13 years and 14-16 years, respectively. According to CDC charts 2000, prevalence of overweight was 24% which was double when compared to WHO charts 2007. There was significant difference in prevalence of obesity; according to CDC chart it was 26%, whereas according to WHO chart it was 39%. The difference in blood pressures between cases and controls as per both CDC and WHO charts was found to be statistically significant (P < 0.0001). Positive family history of hypertension has a highly significant correlation (P < 0.001) with BMI. Blood sugar level (BSL) was significantly higher in cases (high BMI) when compared to controls (normal BMI). The comparison of WHR in the study group showed highly significant correlation ( P < 0.0001) between cases and controls. The present study shows highly significant correlation of physical activity ( P < 0.0001) and fast food ( P < 0.05) between cases and controls, whereas there was no significant correlation of computer/television watching ( P > 0.05) with BMI. The adolescents seem to have become heavier owing to environmental influences on growth patterns. So, a consideration should be given to shift the cut-offs for overweight and obesity to higher BMI percentiles if recent growth charts are to be followed. Adolescents with a BMI above the 95 th percentile (obese) are most likely to have obesity-related health risks.

Systematic review and meta-analysis of randomised controlled trials on the effectiveness of school-based dental screening versus no screening on improving oral health in children.

PubMed

Joury, Easter; Bernabe, Eduardo; Sabbah, Wael; Nakhleh, Kamal; Gurusamy, Kurinchi

2017-03-01

The current study aimed to evaluate the effectiveness of school-based dental screening versus no screening on improving oral health in children aged 3-18 years by a systematic review and meta-analysis of randomised controlled trials. Three sets of independent reviewers searched MEDLINE, EMBASE, Web of Science and other sources through April 2016 to identify published and nonpublished studies without language restrictions and extracted data. Primary outcomes included prevalence and mean number of teeth with caries, incidence of dental attendance and harms of screening. Cochrane's criteria for risk of bias assessment were used. A total of five cluster RCTs (of unclear or high risk of bias), including 28,442 children, were meta-analysed. For an intracluster correlation coefficient of 0.030, there was no statistically significant difference in dental attendance between children who received dental screening and those who did not receive dental screening (RR 1.11, 95% 0.97, 1.27). The Chi-square test for heterogeneity and the Higgin's I 2 value indicated a substantial heterogeneity. Only one study reported the prevalence and mean number of deciduous and permanent teeth with dental caries and found no significant differences between the screening and no screening groups. There is currently no evidence to support or refute the clinical benefits or harms of dental screening. Routine dental screening may not increase the dental attendance of school children, but there is a lot of uncertainty in this finding because of the quality of evidence. Evidence from the reviewed trials suggests no clinical benefit from school-based screening in improving children's oral health. However, there is a lot of uncertainty in this finding because of the quality of evidence. There is a need to conduct a well-designed trial with an intensive follow-up arm and cost-effectiveness analysis. CRD42016038828 (PROSPERO database). Copyright © 2016 Elsevier Ltd. All rights reserved.

Healthy Schools

MedlinePlus

... 2015) Body Mass Index (BMI) Measurement in Schools Physical Education and Physical Activity Physical Activity Facts Physical Education Recess Classroom Physical Activity Before and After School ...

Factors Affecting Underweight and Obesity Among Elementary School Children in South Korea.

PubMed

Lee, GyuYoung; Ham, Ok Kyung

2015-12-01

The purpose of the study was to determine factors associated with underweight and obesity in elementary school children in Korea. Study participants included 4,895 children attending 59 elementary schools across Korea. Children were grouped into underweight [< 5% body mass index (BMI)-for-age], normal weight (5%-85% BMI-for-age), and overweight/obese (≥ 85% BMI-for age). The questionnaire included demographic characteristics, health status, and diet and exercise behavior of children, and environmental characteristics of schools. Twelve percent of the children were overweight or obese. The results showed that demographic (age and gender), health status (atopic dermatitis and poor subjective health), and the characteristics of diet and exercise (unbalanced diet and diet experiences) were associated with underweight (p < .05), while demographic (age and gender), health status (poor subjective health), behavioral characteristics (fast food consumption and diet experiences), and school environmental characteristics (rural area) were associated with overweight/obesity (p < .05). Programs and interventions to reduce underweight and overweight/obesity in Korean elementary schools must consider behavioral and environmental characteristics of children. Copyright © 2015. Published by Elsevier B.V.

Sleep duration and adiposity in older adolescents from Otago, New Zealand: relationships differ between boys and girls and are independent of food choice.

PubMed

Skidmore, Paula M L; Howe, Anna S; Polak, Maria A; Wong, Jyh Eiin; Lubransky, Alex; Williams, Sheila M; Black, Katherine E

2013-09-14

While relationships between sleep and BMI have been extensively studied in younger children the effect of sleep duration on adiposity in adolescents, who are undergoing rapid growth periods, is less well known. There is also a lack of consistent evidence on the role of sleep on other measures of adolescent body composition which may be more reflective of health than BMI in this age group. Previous research investigating whether these relationships differ between sexes is also inconsistent. Therefore the objective of this study was to investigate relationships between sleep duration and multiple body composition measures in older adolescents and to investigate if these relationships differ between boys and girls. A web-based cross-sectional survey and anthropometric measurement of 685 adolescents (mean age 15.8 years) from 11 schools in Otago, New Zealand. Height and weight were measured by trained researchers and fat mass and fat-free mass were estimated using bio-impedance. Generalised estimating equations were used to examine associations between sleep duration and the following body composition measures: BMI, waist circumference (WC), waist-to-height ratio (WHtR), fat mass index (FMI), and fat-free mass index (FFMI). Analyses were adjusted for ethnicity, deprivation, the number of screens in the bedroom and fruit and vegetable consumption. When data from all participants were analysed together, no significant relationships were seen between sleep duration and any body composition measure but significant sex interactions were seen. An hour increase in average nightly sleep duration in boys only was associated with decreases of 1.2% for WC, 0.9% for WHtR, 4.5% for FMI and 1.4% for FFMI in multivariate models. Similar results were seen for weekday and weekend night sleep duration. Sex specific factors may play a role in relationships between sleep and body composition in older adolescents. The results in boys were most pronounced for FMI, a measure of total adiposity, which suggests that insufficient sleep in adolescent boys may affect fat mass more than lean mass and that the use of measures such as BMI may result in an under-estimation of relationships.

Effects of mischievous responding on universal mental health screening: I love rum raisin ice cream, really I do!

PubMed

Furlong, Michael J; Fullchange, Aileen; Dowdy, Erin

2017-09-01

Student surveys are often used for school-based mental health screening; hence, it is critical to evaluate the authenticity of information obtained via the self-report format. The objective of this study was to examine the possible effects of mischievous response patterns on school-based screening results. The present study included 1,857 high school students who completed a schoolwide screening for complete mental health. Student responses were reviewed to detect possible mischievous responses and to examine their association with other survey results. Consistent with previous research, mischievous responding was evaluated by items that are legitimate to ask of all students (e.g., How much do you weigh? and How many siblings do you have?). Responses were considered "mischievous" when a student selected multiple extreme, unusual (less than 5% incidence) response options, such as weighing more than 225 pounds and having 10 or more siblings. Only 1.8% of the students responded in extreme ways to 2 or more of 7 mischievous response items. When compared with other students, the mischievous responders were less likely to declare that they answered items honestly, were more likely to finish the survey in less than 10 min, reported lower levels of life satisfaction and school connectedness, and reported higher levels of emotional and behavioral distress. When applying a dual-factor mental health screening framework to the responses, mischievous responders were less likely to be categorized as having complete mental health. Implications for school-based mental health screening are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Adolescents bullying and young adults body mass index and obesity: a longitudinal study.

PubMed

Mamun, A A; O'Callaghan, M J; Williams, G M; Najman, J M

2013-08-01

To examine whether adolescent males and females who were victims of bullying were at greater risk of a higher body mass index (BMI) and obesity by young adulthood. Secondary analysis of data from a community-based cohort study. A sub-sample of 1694 offspring (50% males) who were participants in the Mater-University of Queensland Study of Pregnancy (MUSP), Brisbane, and who provided bullying information at 14 years and physical assessment at 21 years. BMI and its categories as normal, overweight or obese at 21 years. One in two adolescent males and one in three adolescent females reported that they had been bullied at school by others. We found that adolescent males and females who were bullied were at a significantly greater risk of a higher BMI and obesity by young adulthood. Fourteen-year-old males who were occasionally/often bullied at school had 0.64 (95% confidence interval (CI): 0.02, 1.27) kg m(2) greater mean BMI by 21 years compared with males who were never bullied by 14 years. This mean difference in BMI was 1.52, (95% CI: 0.75, 2.29) kg m(2) for females. Similarly, the odds of being obese were 2.54 (95% CI: 1.58, 4.09) times at 21 years for those males who were bullied occasionally/often compared with adolescent males who were never bullied. For females, this was 2.18 (95% CI: 1.40, 3.39). Overweight adolescents who experienced bullying had the greatest increase in BMI by young adulthood. Adjusting for potential confounding or mediating factors, the associations remain strong for males but are attenuated for females. The findings of this study suggest that both male and female adolescents who were bullied often/sometimes by their peer group at 14 years were at greater risk of higher BMI and obesity by young adulthood.

Untreated severe dental decay: a neglected determinant of low Body Mass Index in 12-year-old Filipino children.

PubMed

Benzian, Habib; Monse, Bella; Heinrich-Weltzien, Roswitha; Hobdell, Martin; Mulder, Jan; van Palenstein Helderman, Wim

2011-07-13

Dental decay is the most common childhood disease worldwide and most of the decay remains untreated. In the Philippines caries levels are among the highest in the South East Asian region. Elementary school children suffer from high prevalence of stunting and underweight.The present study aimed to investigate the association between untreated dental decay and Body Mass Index (BMI) among 12-year-old Filipino children. Data collection was part of the National Oral Health Survey, a representative cross-sectional study of 1951 11-13-year-old school children using a modified, stratified cluster sampling design based on population classifications of the Philippine National Statistics Office. Caries was scored according to WHO criteria (1997) and odontogenic infections using the PUFA index. Anthropometric measures were performed by trained nurses. Some socio-economic determinants were included as potential confounding factors. The overall prevalence of caries (DMFT + dmft > 0) was 82.3% (95%CI; 80.6%-84.0%). The overall prevalence of odontogenic infections due to caries (PUFA + pufa > 0) was 55.7% (95% CI; 53.5%-57.9%) The BMI of 27.1% (95%CI; 25.1%-29.1%) of children was below normal, 1% (95%CI; 0.5%-1.4%) had a BMI above normal. The regression coefficient between BMI and caries was highly significant (p < 0.001). Children with odontogenic infections (PUFA + pufa > 0) as compared to those without odontogenic infections had an increased risk of a below normal BMI (OR: 1.47; 95% CI: 1.19-1.80). This is the first-ever representative survey showing a significant association between caries and BMI and particularly between odontogenic infections and below normal BMI. An expanded model of hypothesised associations is presented that includes progressed forms of dental decay as a significant, yet largely neglected determinant of poor child development.

The Efficacy of a Family-Based Intervention Program on Childhood Obesity: A Quasi-Experimental Design.

PubMed

Chen, Chia-Ying; Kao, Chia-Chan; Hsu, Hsiu-Yueh; Wang, Ruey-Hsia; Hsu, Shu-Hua

2015-10-01

The purpose of this quasi-experimental study was to assess the efficacy of a family-based (FB) weight-loss and behavior-modification intervention among overweight/obese children (age 9-11 years) and their parents in Taiwan. The intervention group (52 child-parent dyads) participated in an FB program for 7 weeks. The control group (55 child-parent dyads) received an educational pamphlet about obesity prevention. The children's body mass index (BMI) z-scores were the primary outcome variable. The parents' BMI, high-calorie (HC) food-intake behaviors, screen-related behaviors, and restrictions on children's consumption of HC foods and screen-related behaviors and the availability of HC foods at home were the secondary outcome variables. Outcome variables were measured at baseline (T0), at the end of the intervention (T1), and 4 weeks after the end of the intervention (T2). A linear mixed model was used to assess the efficacy of the FB program. Results indicated that the children's BMI z-scores decreased significantly more from T0 to T2 in the experimental group than in the control group. The decreases in parents' HC food-intake behaviors and availability of HC foods at home and the increase in parental restrictions on children's consumption of HC foods were significantly greater in the experimental than in the control group from T0 to T1 and T0 to T2. The FB program was effective in modifying parental behaviors and the weight of overweight/obese children in a Taiwanese population. © The Author(s) 2015.

Severe Obesity in Cancer Care.

PubMed

Streu, Erin

2016-05-01

Increasing weight and body fat composition has an impact on cancer detection and staging. Obese women are less likely to engage in breast and cervical screening practices. Excessive adipose tissue makes physical assessment more difficult, and patients with a BMI greater than 35 kg/m2 may have deeper and wider pelvic structures, which make internal examinations problematic. A retrospective review of 324 primary surgical patients found that patients with a BMI greater than 40 kg/m2 are seven times less likely to undergo complete surgical staging for endometrial cancer compared with individuals with a BMI less than 40 kg/m2. In addition, healthcare provider bias against the need for screening, feelings of discomfort and embarrassment, as well as patient's fears of guilt, humiliation, and shame pose significant barriers to addressing the issue of obesity in clinical care with patients and family members. 
.

Using handgrip strength to screen for diabetes in developing countries.

PubMed

Eckman, Molly; Gigliotti, Christopher; Sutermaster, Staci; Butler, Peter J; Mehta, Khanjan

2016-01-01

Lack of access to healthcare in the developing world has created a need for locally-based primary and pre-primary healthcare systems. Many regions of the world have adopted Community Health Worker (CHW) programmes, but volunteers in these programmes lack the tools and resources to screen for disease. Because of its simplicity of operation, handgrip strength (HGS) measurements have the potential to be an affordable and effective screening tool for conditions that cause muscle weakness in this context. In the study described in this report, translators were used to collect data on age, gender, height, weight, blood pressure, HGS and key demographic data. HGS was significantly lower for diabetics than patients without diabetes. A simple binary logistic model was created that used HGS, age, blood pressure and BMI to predict a patient's probability of having diabetes. This study develops a predictive model for diabetes using HGS and other basic health measurements and shows that HGS-based screening is a viable method of early detection of diabetes.

BMI calculation in older people: The effect of using direct and surrogate measures of height in a community-based setting.

PubMed

Butler, Rose; McClinchy, Jane; Morreale-Parker, Claudia; Marsh, Wendy; Rennie, Kirsten L

2017-12-01

There is currently no consensus on which measure of height should be used in older people's body mass index (BMI) calculation. Most estimates of nutritional status include a measurement of body weight and height which should be reliable and accurate, however at present several different methods are used interchangeably. BMI, a key marker in malnutrition assessment, does not reflect age-related changes in height or changes in body composition such as loss of muscle mass or presence of oedema. The aim of this pilot study was to assess how the use of direct and surrogate measures of height impacts on BMI calculation in people aged ≥75 years. A cross-sectional study of 64 free-living older people (75-96 yrs) quantified height by two direct measurements, current height (H C ), and self-report (H R ) and surrogate equations using knee height (H K ) and ulna length (H U ). BMI calculated from current height measurement (BMI C ) was compared with BMI calculated using self-reported height (BMI R ) and height estimated from surrogate equations for knee height (BMI K ) and ulna length (BMI U ). Median difference of BMI C -BMI R was 2.31 kg/m 2 . BMI K gave the closest correlation to BMI C . The percentage of study participants identified at increased risk of under-nutrition (BMI < 20 kg/m 2 ) varied depending on which measure of height was used to calculate BMI; from 5% (BMI C ), 7.8% (BMI K ), 12.5% (BMI U ), to 14% (BMI R ) respectively. The results of this pilot study in a relatively healthy sample of older people suggest that interchangeable use of current and reported height in people ≥75 years can introduce substantial significant systematic error. This discrepancy could impact nutritional assessment of older people in poor health and lead to misclassification during nutritional screening if other visual and clinical clues are not taken into account. This could result in long-term clinical and cost implications if individuals who need nutrition support are not correctly identified. A consensus is required on which method should be used to quantify height in older people to improve accuracy of nutritional assessment and clinical care. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

A Randomized-Controlled Trial of School-Based Active Videogame Intervention on Chinese Children's Aerobic Fitness, Physical Activity Level, and Psychological Correlates.

PubMed

Lau, Patrick Wing Chung; Wang, Jing Jing; Maddison, Ralph

2016-12-01

Active videogames (AVGs) that require body movements to play offer a novel opportunity to turn a traditionally sedentary behavior into a physically active one. We sought to determine the effect of a school-based AVG intervention on Chinese children's aerobic fitness, physical activity (PA) level, and PA-related psychological correlates. Eighty 8-11-year-old Chinese children (55 males) were recruited from one Hong Kong primary school and were allocated at random to either an AVG intervention or control group. Children in the intervention group played an AVG, Xbox 360, twice per week during after-school hours, each for 60 minutes over 12 weeks in duration. The control group received no intervention. Children's body-mass index (BMI), objective PA, aerobic fitness (maximum oxygen consumption [VO 2max ]), PA task efficacy, barrier efficacy, and enjoyment were assessed. Compared with the control group, significant increases were found in the intervention group in VO 2max [mean and 95% confidence interval (CI): 1.58 (0.74, 2.42) mL/(kg·min)], objective moderate-to-vigorous PA [6.73 (1.70, 11.76) min/day], and total PA [27.19 (9.33, 45.04) min/day], but not for BMI. No significant differences in PA task efficacy, barrier efficacy, and enjoyment were observed. A 12-week (60 minutes × twice per week) school-based AVG intervention can improve Chinese children's aerobic fitness and PA level. These findings indicated that AVGs could be used as an alternative means to engage Chinese children in PA in school setting. However, the treatment effects of AVGs on PA-related psychological correlates and body composition need more investigation.

Physical Activity and BMI: Evidence from the Panel Study of Income Dynamics Child Development Supplement

ERIC Educational Resources Information Center

Hohensee, Caroline W.; Nies, Mary A.

2012-01-01

Background: This study assessed the association between amount of physical activity and body mass index (BMI) percentile among middle and high school children. Total daily physical activity needs to include both in and out of school physical activity. Methods: A secondary data analysis was performed on 1306 children drawn from the Panel Study of…

Prevalence of Overweight in North Florida Elementary and Middle School Children: Effects of Age, Sex, Ethnicity, and Socioeconomic Status

ERIC Educational Resources Information Center

Johnson, Suzanne B.; Pilkington, Lorri L.; Deeb, Larry C.; Jeffers, Sheila; He, Jianghua; Lamp, Camilla

2007-01-01

Background: The number of overweight children has been rapidly increasing, although its prevalence varies by age, sex, ethnicity, and socioeconomic (SES) status. Methods: Height and weight assessments were used to calculate body mass index (BMI) and BMI percentile on more than 17,000 children in 1 north Florida school district's elementary and…

Harassment and Mental Distress Among Adolescent Female Students by Sexual Identity and BMI or Perceived Weight Status.

PubMed

Johns, Michelle Marie; Lowry, Richard; Demissie, Zewditu; Robin, Leah

2017-08-01

Sexual minority girls (lesbian/bisexual) and girls with overweight/obesity experience high rates of discrimination and mental distress. This study explored whether BMI or perceived weight status might compound sexual minority girls' risk for harassment and mental distress. Data on female students from the national 2015 Youth Risk Behavior Survey (n = 7,006) were analyzed. Logistic regression was used to examine differences in bullying, harassment, and mental distress across sexual identity/BMI groups: heterosexual/normal-weight, heterosexual/overweight, sexual minority/normal-weight, and sexual minority/overweight. Procedures were repeated with four analogous groups created from sexual identity and perceived weight. Across sexual identity/BMI groups, being overweight increased heterosexual females' odds of being bullied or experiencing suicidal thoughts and behaviors. Regardless of weight status, sexual minority females had greater odds for each outcome than heterosexual females. Sexual minority females who perceived themselves as overweight had greater odds of suicidality than all other sexual minority/perceived weight groups. Double jeopardy may exist for sexual minority female students who perceive themselves as overweight. Professional development with school staff on how to create a positive climate for sexual minorities and those with overweight/obesity and addressing positive identity and body image within school-based suicide prevention efforts may be important to the well-being of adolescent girls. © 2017 The Obesity Society.

The effect of socioeconomic indicators and macronutrient intake rate on body composition in adolescents 12 to 16 years old in Merida, Yucatan.

PubMed

Datta Banik, Sudip; Andrade Olalde, Ana Carolina; Rodriguez, Luis; Dickinson, Federico

2014-01-01

Intake pattern of macronutrients (protein, lipid, carbohydrate) and socioeconomic status (SES) are major causes of high child and adolescent overweight and obesity prevalences in Mexico. An evaluation was done of the relationship between body mass index (BMI)-based nutritional status and body composition (BC), macronutrient intake rates (MIR) and SES indicators in 127 boys and 156 girls aged 12 to 16 years attending schools in Merida, Mexico. Anthropometric variables included height, weight, and BMI. The BC (body fat mass, fat-free mass, dry lean mass) was estimated by bioelectrical impedance (Bodystat 1500 MDD). The MIR were estimated following FAO/WHO/UNO standard (1985). Proxy socioeconomic indicators included parents' age (as a maturity indicator) and education, fathers' occupation, school type and monthly household food expenditure per capita. Excess weight (overweight + obesity) assessed by BMI, was higher in boys (40.16 %) than in girls (33.97 %). Boys had higher BMI, less fat mass and higher fat-free mass than girls. The MIR did not vary significantly in response to age, sex, BC or SES. Participants with higher SES were taller and heavier, had higher fat-free mass and lower fat mass. In the studied adolescents, anthropometric and BC values, and overweight and obesity rates were more associated with SES than MIR.

Neighborhood and family perceived environments associated with children's physical activity and body mass index.

PubMed

Lavin Fueyo, Julieta; Totaro Garcia, Leandro Martin; Mamondi, Veronica; Pereira Alencar, Gizelton; Florindo, Alex Antonio; Berra, Silvina

2016-01-01

A growing body of research has been examining neighborhood environment related to children's physical activity and obesity. However, there is still not enough evidence from Latin America. To investigate the association of neighborhood and family perceived environments, use of and distance to public open spaces with leisure-time physical activity (LTPA) and body mass index (BMI) in Argentinean school-aged children. School-based, cross-sectional study with 1777 children (9 to 11years) and their parents, in Cordoba city during 2011. Children were asked about LTPA and family perceived environment. Parents were asked about neighborhood perceived environment, children's use of public open spaces and distance. Weight and height were measured for BMI. We modeled children's LTPA and BMI z-score with structural equation models with latent variables for built, social and safety neighborhood environments. Parents' perceived neighborhood environment was not related with children's LTPA and BMI. Children's perceived autonomy and family environment were positively associated with LTPA. Use of unstructured open spaces and, indirectly, the distance to these, was associated with LTPA among girls. Greater distance to parks reduced their use by children. Policies to increase children's LTPA should include access to better public open spaces, increasing options for activity. A family approach should be incorporated, reinforcing its role for healthy development. Copyright © 2015 Elsevier Inc. All rights reserved.

"For whom was it effective?" Moderators of the effect of a school-based intervention on potential physical activity determinants among Brazilian students.

PubMed

Barbosa Filho, Valter Cordeiro; da Silva, Kelly Samara; Mota, Jorge; Vieira, Neiva Francenely Cunha; Gubert, Fabiane do Amaral; Lopes, Adair da Silva

2017-04-01

Knowledge about the effects of school-based interventions on modifiable physical activity (PA) determinants (e.g., social support), and whether the intervention effect differs according to students' characteristics (e.g., age and gender) are relevant PA promotion topics. This study aims to answer these topics among Brazilian students. This cluster-randomized controlled trial was conducted with 548 students in the intervention group and 537 in the control group (51.5% of boys; aged 11-18years). The four-month intervention included strategies focused on training teachers, opportunities for PA in the school environment, and health education. Potential PA determinants (attitude, self-efficacy, support of friends, parents, and teachers, perceived neighborhood environment and PA facilities in school) and moderators (gender, age, socioeconomic status (SES), and PA level at baseline) were assessed using self-reported instrument. Height and weight were measured to estimate the students' body mass index (BMI) status. Generalized linear models were used. In general, there was a significant and positive intervention effect for attitude, support of friends and teachers for PA, as well as PA facilities in school; effect size was 0.29, 0.24, 0.34, and 0.29, respectively (P<0.05). Age (support of friends, parents and teachers, and PA facilities in school), SES (support of friends and PA facilities in school), and BMI status (support of friends) were moderators of the intervention effect on some outcomes. In conclusion, the intervention improved potential PA determinants, but some changes occurred differently according to students' characteristics. These findings should be considered in PA policies in the school context. This study is registered at Clinicaltrials.govNCT02439827. Copyright © 2017 Elsevier Inc. All rights reserved.

Does more education cause lower BMI, or do lower-BMI individuals become more educated? Evidence from the National Longitudinal Survey of Youth 1979.

PubMed

Benson, Rebecca; von Hippel, Paul T; Lynch, Jamie L

2017-03-21

More educated adults have lower average body mass index (BMI). This may be due to selection, if adolescents with lower BMI attain higher levels of education, or it may be due to causation, if higher educational attainment reduces BMI gain in adulthood. We test for selection and causation in the National Longitudinal Survey of Youth 1979, which has followed a representative US cohort from age 14-22 in 1979 through age 47-55 in 2012. Using ordinal logistic regression, we test the selection hypothesis that overweight and obese adolescents were less likely to earn high school diplomas and bachelor's degrees. Then, controlling for selection with individual fixed effects, we estimate the causal effect of degree completion on BMI and obesity status. Among 18-year-old women, but not among men, being overweight or obese predicts lower odds of attaining higher levels of education. At age 47-48, higher education is associated with lower BMI, but 70-90% of the association is due to selection. Net of selection, a bachelor's degree predicts less than a 1 kg reduction in body weight, and a high school credential does not reduce BMI. Copyright © 2017 Elsevier Ltd. All rights reserved.

Distribution and correlates of non-high-density lipoprotein cholesterol and triglycerides in Lebanese school children.

PubMed

Gannagé-Yared, Marie-Hélène; Farah, Vanessa; Chahine, Elise; Balech, Nicole; Ibrahim, Toni; Asmar, Nadia; Barakett-Hamadé, Vanda; Jambart, Selim

2016-01-01

The prevalence of dyslipidelmia in pediatric Middle-Eastern populations is unknown. Our study aims to investigate the distribution and correlates of non-high-density lipoprotein cholesterol (non-HDL-C) and triglycerides among Lebanese school children. A total of 969 subjects aged 8-18 years were included in the study (505 boys and 464 girls). Recruitment was done from 10 schools located in the Great Beirut and Mount-Lebanon areas. Non-fasting total cholesterol, triglycerides, and HDL-cholesterol (HDL-C) were measured. Non-HDL-C was calculated. Schools were categorized into 3 socioeconomic statuses (SESs; low, middle, and high). In the overall population, the prevalence of high non-HDL-C (>3.8 mmol/L), very high non-HDL-C (>4.9 mmol/L), and high triglycerides (>1.5 mmol/l) are respectively 9.2%, 1.24%, and 26.6%. There is no significant gender difference for non-HDL-C or triglycerides. Non-HDL-C and triglycerides are inversely correlated with age in girls (P < .0001 for both variables) but not in boys. They are also positively correlated with body mass index (BMI) in boys and girls (P < .0001 for all variables). There is no relationship between schools' socioeconomic process (SES) and non-HDL-C. However, triglycerides are higher in children from lower SES schools. After adjustment for age and body mass index (BMI), testosterone is inversely associated with triglycerides in boys (P < .0001). In a multivariate regression analysis, non-HDL-C is independently associated with age and BMI in girls (P < .0001 for both variables) but only with BMI in boys (P < .0001), whereas triglycerides are independently associated with BMI and schools' SES in both girls and boys. This study confirms, in our population, the association between obesity and both high non-HDL-C and triglycerides, and between high triglycerides and low SES. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Socioeconomic Status and Body Mass Index Among Hispanic Children of Immigrants and Children of Natives

PubMed Central

Van Hook, Jennifer

2009-01-01

Objectives. We examined how Hispanic parents' income and education, combined with their nativity status, influenced the body mass index (BMI) of their children, compared with non-Hispanic White children and their parents. Methods. We used data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998–99 to estimate linear growth curve models of children's initial BMI in kindergarten and change in BMI through fifth grade. Socioeconomic status was measured by logged household income and parental educational attainment (less than high school, high school graduate, some college, college graduate or higher). Results. Parental education was negatively associated with children's BMI (baseline and growth) for non-Hispanic White children. Among Hispanic children, the association of parental education with growth in BMI was negative but much weaker. The weak effect of parental education was not explained by the presence of immigrants in the Hispanic population. Income was strongly negatively associated with children's BMI in kindergarten among children of Hispanic and White natives, but positively associated among Hispanic immigrant families. Conclusions. The positive income–BMI association among Hispanic immigrant children might reflect cultural differences that immigrant parents carry with them from their countries of origin. PMID:19846690

Impact of Game-Based Health Promotion Programs on Body Mass Index in Overweight/Obese Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

PubMed

Ameryoun, Ahmad; Sanaeinasab, Hormoz; Saffari, Mohsen; Koenig, Harold G

Sedentary lifestyle is growing among children and adolescents that may contribute to problems such as overweight and obesity. Consequently, interventions to improve weight loss in this population are necessary. The aim of this current review was to evaluate the effectiveness of game-based interventions to reduce body mass index (BMI) among children who were overweight or obese. All randomized controlled trials with a game-based approach for lowering weight in obese/overweight youths aged 5-18 years old were identified from January 2005 to June 2017 across PubMed, Web of Science, Embase, Scopus, and ScienceDirect. Two independent reviewers completed data extraction sheets on information such as sample size, country of origin, age of participants, type of interventions, and BMI change from pre- to posttest. A consensus on collected data was obtained, and a final list of studies meeting inclusion and exclusion criteria was arrived at. Data were analyzed using Comprehensive Meta-analysis software, and effect size was measured by standardized mean difference (SMD) and Hedges' g measure. Heterogeneity and publication bias were also examined using I 2 index and funnel plot. A total of 388 articles were identified from electronic and manuals' searches. After deletion of duplicated articles, 138 articles remained that were then screened in terms of relevance. Of those, 41 articles were examined to determine eligibility. Finally, 10 articles met inclusion/exclusion criteria and were entered into the quantitative meta-analysis. Results indicated a small but significant effect size in terms of BMI reduction [SMD, -0.234; standard error (SE), 0.069] among included studies. The average BMI z-score reduction was -0.181 (SE, 0.071). Trials which used other types of interventions along with active game-based approaches achieved greater effect sizes than single game-based interventions. There was a significant difference between studies based on their country of origin, BMI value, and intervention type. Those conducted in United States, those including participants with BMI ≥30, and studies with multicomponent intervention reported a higher reduction of BMI than others. However, no significant difference in BMI was found in terms of variables such as age, sample size, type of participant (overweight/obese), intervention duration, or participant gender. No publication bias was identified, and studies were homogenous (I 2  = 22.5%). Interventions that involve active gaming may produce small effects in terms of improving BMI among children who are overweight/obese. Therefore, we recommend that supplemental interventions be used to enhance the effectiveness of game-based interventions.

Maternal BMI and diabetes in pregnancy: Investigating variations between ethnic groups using routine maternity data from London, UK.

PubMed

Nishikawa, Erin; Oakley, Laura; Seed, Paul T; Doyle, Pat; Oteng-Ntim, Eugene

2017-01-01

To investigate the ethnicity-specific association between body mass index (BMI) and diabetes in pregnancy, with a focus on the appropriateness of using BMI cut-offs to identify pregnant women at risk of diabetes. Analysis of routinely-collected data from a maternity unit in London, UK. Data were available on 53 264 women delivering between 2004 and 2012. Logistic regression was used to explore the association between diabetes in pregnancy and BMI among women of different ethnicities, and adjusted probability estimates were used to derive risk equivalent cut-offs. ROC curve analysis was used to assess the performance of BMI as a predictor of diabetes in pregnancy. The prevalence of diabetes in pregnancy was 2.3% overall; highest in South and East Asian women (4.6% and 3.7%). In adjusted analysis, BMI category was strongly associated with diabetes in all ethnic groups. Modelled as a continuous variable with a quadratic term, BMI was an acceptable predictor of diabetes according to ROC curve analysis. Applying a BMI cut-off of 30 kg/m2 would identify just over half of Black women with diabetes in pregnancy, a third of White (32%) and South Asian (35%) women, but only 13% of East Asian women. The 'risk equivalent' (comparable to 30 kg/m2 in White women) threshold for South Asian and East Asian women was approximately 21 kg/m2, and 27.5 kg/m2 for Black women. This study suggests that current BMI thresholds are likely to be ineffective for diabetes screening in South and East Asian women, as many cases of diabetes will occur at low BMI levels. Our results suggest that East Asian women appear to face a similarly high risk of diabetes to South Asian women. Current UK guidelines recommend diabetes screening should be offered to all pregnant South Asian women; extending this recommendation to include women of East Asian ethnicity may be appropriate.

Low hospital referral rates of school scoliosis screening positives in an urban district of mainland China.

PubMed

Guo, Yawen; Jiang, Qingwu; Tanimoto, Tetsuya; Kami, Masahiro; Luo, Chunyan; Leppold, Claire; Nishimura, Koichi; He, Yongpin; Kato, Shigeaki; Ding, Xiaocang

2017-04-01

Significant prevalence rates of adolescent scoliosis in China were suggested in previous studies. However, school screenings for adolescent scoliosis have been suspended due to low rates of positive detection under the past screening system in China. The present study was undertaken to screen for adolescent scoliosis in middle school students under a modern assessment system in a district of Shanghai. We performed a population-based, cross-sectional study of a middle school scoliosis screening program in the Jingan district. In 2015, schoolchildren were initially screened by visual inspection of clinical signs and the forward-bending test. Suspected cases were referred for radiography in hospital for scoliosis diagnosis. A total of 5327 middle school students (grades 6-8) were screened with 520 (9.76%) positives (the positive rates of girls and boys at 15.28% and 4.59%, respectively) and no statistically significant difference among grades. Only 301 positives (57.9%) followed the referral for hospital radiography. There were 102 cases (33.9%) that were diagnosed with scoliosis by radiography criteria (Cobb angle ≥10°) including mild scoliosis (Cobb 10-25) for 94 cases and moderate scoliosis (Cobb 25-40) for 8 cases, and false-positives (Cobb 0) for 39 cases. The putative prevalence rate was estimated as 1.9% from the referred students. Under an accurate and modern assessment system, school screenings can detect scoliosis at a significant rate, but awareness of scoliosis risks is needed for residents in China to take up referrals for hospital diagnosis after school screenings.

Association between body mass index and health outcomes among adolescents: the mediating role of traditional and cyber bullying victimization.

PubMed

Lee, Byung; Jeong, Seokjin; Roh, Myunghoon

2018-05-30

It is well-documented that obese children and adolescents tend to experience a variety of negative physical and psychological health consequences. Despite the association between obesity and physical and psychological well-being, few studies have examined the role of off-line and on-line forms of bullying victimization in this link. The main objective of the current study is to investigate the direct and mediating effects of traditional and cyber bullying victimization in explaining the relationship between the body mass index (BMI) and physical/psychological distress. A nationally representative sample of 10,160 school children (mean age = 12.95 ± 1.75) were collected from the 2009 Health Behavior in School-aged Children (HBSC) study. Data were collected on body mass index, physical and psychological health, bullying victimization experience, and demographic information. A seemingly unrelated regression (SUR) was employed to assess and compare the indirect effects in multiple mediation models. While a significant direct association was found between BMI and both physical and psychological health, the indirect effect of BMI on physical distress was significant only via traditional bullying victimization. Both forms of bullying victimization had a mediating impact between BMI and psychological distress. However, the indirect effect on psychological distress was manifested through a negative mediating role of cyberbullying victimization. The negative relation between cyberbullying victimization and psychological distress warrants further exploration. Obesity represents a serious risk to adolescent health and well-being, both physically and psychologically. If becoming a victim of traditional bullying mediates (specifically exacerbates) the level of physical and psychological distress among obese and overweight adolescents, health professionals need to focus on raising awareness of the importance of weight-based victimization for children and adolescents with obesity. School administrators and teachers could increase the efforts to identify school-age children who are stigmatized for their weight and recommend coping strategies for distressed victims of traditional and cyberbullying.

At least one in three people with Type 2 diabetes mellitus referred to a diabetes centre has symptomatic obstructive sleep apnoea.

PubMed

Storgaard, H; Mortensen, B; Almdal, T; Laub, M; Tarnow, L

2014-11-01

To investigate the prevalence of symptomatic obstructive sleep apnoea in unselected patients with Type 2 diabetes referred to a tertiary diabetes clinic. In a cross-sectional design, all newly referred patients were offered a stepwise screening for obstructive sleep apnoea with: (1) The Berlin questionnaire; then, if indicative: (2) overnight home monitoring with the ApneaLink™ device. Patients with an apnoea-hypopnoea index ≥ 5/h were offered referral for diagnostic polygraphy and treatment initiation. A total of 200 patients participated (61% men; age 59.6 ± 10.5 years, diabetes duration 8.3 ± 6.3 years and BMI 31.7 ± 6.7 kg/m²). According to the questionnaire, 106 patients showed 'high risk' of obstructive sleep apnoea, and 72 of these were referred to polygraphy based on ApneaLink screening corresponding to a prevalence of symptomatic obstructive sleep apnoea of 39%. Patients with symptomatic obstructive sleep apnoea had significantly higher BMI, poorer glycaemic control and lower plasma HDL cholesterol levels as compared with patients unlikely to have obstructive sleep apnoea. The groups were not different with respect to sex, age, diabetes duration, blood pressure, diabetic complications or medication use. In multiple regression analyses, age, BMI and HDL cholesterol levels were all significant, independent predictors of obstructive sleep apnoea. At least one third of people with Type 2 diabetes referred to a diabetes clinic in Denmark has symptomatic obstructive sleep apnoea. Our data suggest higher age, a compromised plasma lipid profile and a more obese phenotype in patients with Type 2 diabetes who have obstructive sleep apnoea, highlighting the need to focus on screening and treatment of obstructive sleep apnoea in these patients. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Adult obesity management in primary care, 2008-2013.

PubMed

Fitzpatrick, Stephanie L; Stevens, Victor J

2017-06-01

In the U.S., the occurrence of weight counseling in primary care for patients with obesity decreased by 10% between 1995-1996 and 2007-2008. There have been several national recommendations and policies to improve obesity management since 2008. The purpose of this study was to examine the rates of body mass index (BMI) screening, obesity diagnosis, and weight management counseling in the U.S. from 2008 to 2013. The National Ambulatory Medical Care Survey visit-level data for adults 18 and over with a primary care visit during survey years 2008-2009, 2010-2011, and 2012-2013 was included in the analyses using SAS v9.3. Study outcomes included percent of visits with: BMI screening; obesity diagnosis; and weight counseling. We compared survey years on these outcomes using 2008-2009 as the reference as well as examined patient and practice-level predictors. Analyses were conducted from 2015 to early 2017. Of the total 55,608 adult primary care visits sampled, 14,143 visits (25%) were with patients with obesity. BMI screening significantly increased between 2008-2009 and 2012-2013 from 54% to 73% (OR=1.75, 95% CI 1.28-2.41); however, percent of visits with an obesity diagnosis remained low at <30%. Weight management counseling during visits significantly declined from 33% to 21% between 2008-2009 and 2012-2013 (OR=0.62, 95% CI 0.41-0.92). Despite emerging recommendations and policies, from 2008 to 2013, obesity management in primary care remained suboptimal. Identifying practical strategies to enforce policies and implement evidence-based behavioral treatment in primary care should be a high priority in healthcare reform. Copyright © 2017 Elsevier Inc. All rights reserved.

Novel simple and practical nutritional screening tool for cancer inpatients: a pilot study.

PubMed

Zekri, Jamal; Morganti, Julie; Rizvi, Azhar; Sadiq, Bakr Bin; Kerr, Ian; Aslam, Mohamed

2014-05-01

There is lack of consensus on how nutritional screening and intervention should be provided to cancer patients. Nutritional screening and support of cancer patients are not well established in the Middle East. We report our systematic and practical experience led by a qualified specialist dietician in a cancer inpatient setting, using a novel nutritional screening tool. Ninety-seven consecutive inpatients underwent nutritional screening and categorised into three nutritional risk groups based on oral intake, gastrointestinal symptoms, body mass index (BMI) and weight loss. Nutritional support was introduced accordingly. Statistical tests used included ANOVA, Bonferroni post hoc, chi-square and log rank tests. Median age was 48 (19-87)years. Patients were categorised into three nutritional risk groups: 55 % low, 37 % intermediate and 8 % high. Nutritional intervention was introduced for 36 % of these patients. Individually, weight, BMI, oral intake, serum albumin on admission and weight loss significantly affected nutritional risk and nutritional intervention (all significant P values). Eighty-seven, 60 and 55 % of patients admitted for chemotherapy, febrile neutropenia and other reasons, respectively, did not require specific nutritional intervention. There was a statistically significant relationship between nutritional risk and nutritional intervention (P=0.005). Significantly more patients were alive at 3 months in low (91 %) than intermediate (75 %) than high (37 %)-risk groups. About a third of cancer inpatients require nutritional intervention. The adopted nutritional risk assessment tool is simple and practical. The validity of this tool is supported by its significant relation with known individual nutritional risk factors. This should be confirmed in larger prospective study and comparing this new tool with other established ones.

Electronic screen use and selected somatic symptoms in 10-12 year old children.

PubMed

Taehtinen, Richard E; Sigfusdottir, Inga Dora; Helgason, Asgeir R; Kristjansson, Alfgeir L

2014-10-01

Screen-based media use by children and adolescents has increased in recent years but the consequences of their use are not well understood. The objective of this study was to provide a comprehensive examination of the relationship between screen-based activities and a selection of single and multiple self-reported somatic symptoms in a large sample of 10-12 year old children. We use data from the population-based 2011 Youth in Iceland school survey (N=10,829, response rate: 84.5%, boys: 49.9%) that is conducted triennially in 5th-7th grades in all secondary schools in Iceland. Self-reported measures of common screen-based activities were hypothesized to predict the odds of dizziness, tremors, headaches, stomach aches, and multiple symptoms. In general the reported prevalence of symptoms increased with greater number of hours reported on screen based activity for boys and girls. This held for all individual screen activities as well as the cumulative measure of daily minutes spent on screen-based media and prevalence of one or more somatic symptoms. This study confirms previous findings and puts forth additional information concerning the relationship between the prevalence of electronic screen use and somatic symptoms in 10-12 year old children. Copyright © 2014 Elsevier Inc. All rights reserved.

Antibiosis and bmyB Gene Presence As Prevalent Traits for the Selection of Efficient Bacillus Biocontrol Agents against Crown Gall Disease.

PubMed

Frikha-Gargouri, Olfa; Ben Abdallah, Dorra; Bhar, Ilhem; Tounsi, Slim

2017-01-01

This study aimed to improve the screening method for the selection of Bacillus biocontrol agents against crown gall disease. The relationship between the strain biocontrol ability and their in vitro studied traits was investigated to identify the most important factors to be considered for the selection of effective biocontrol agents. In fact, previous selection procedure relying only on in vitro antibacterial activity was shown to be not suitable in some cases. A direct plant-protection strategy was performed to screen the 32 Bacillus biocontrol agent candidates. Moreover, potential in vitro biocontrol traits were investigated including biofilm formation, motility, hemolytic activity, detection of lipopeptide biosynthetic genes ( sfp, ituC and bmyB ) and production of antibacterial compounds. The obtained results indicated high correlations of the efficiency of the biocontrol with the reduction of gall weight ( p = 0.000) and the antibacterial activity in vitro ( p = 0.000). Moreover, there was strong correlations of the efficiency of the biocontrol ( p = 0.004) and the reduction in gall weight ( p = 0.000) with the presence of the bmyB gene. This gene directs the synthesis of the lipopeptide bacillomycin belonging to the iturinic family of lipopeptides. These results were also confirmed by the two-way hierarchical cluster analysis and the correspondence analysis showing the relatedness of these four variables. According to the obtained results a new screening procedure of Bacillus biocontrol agents against crown gall disease could be advanced consisting on two step selection procedure. The first consists on selecting strains with high antibacterial activity in vitro or those harbouring the bmyB gene. Further selection has to be performed on tomato plants in vivo . Moreover, based on the results of the biocontrol assay, five potent strains exhibiting high biocontrol abilities were selected. They were identified as Bacillus subtilis or Bacillus amyloliquefaciens . These strains were found to produce either surfactin or surfactin and iturin lipopeptides. In conclusion, our study presented a new and effective method to evaluate the biocontrol ability of antagonistic Bacillus strains against crown gall disease that could increase the efficiency of screening method of biocontrol agents. Besides, the selected strains could be used as novel biocontrol agents against pathogenic Agrobacterium tumefaciens strains.

Antibiosis and bmyB Gene Presence As Prevalent Traits for the Selection of Efficient Bacillus Biocontrol Agents against Crown Gall Disease

PubMed Central

Frikha-Gargouri, Olfa; Ben Abdallah, Dorra; Bhar, Ilhem; Tounsi, Slim

2017-01-01

This study aimed to improve the screening method for the selection of Bacillus biocontrol agents against crown gall disease. The relationship between the strain biocontrol ability and their in vitro studied traits was investigated to identify the most important factors to be considered for the selection of effective biocontrol agents. In fact, previous selection procedure relying only on in vitro antibacterial activity was shown to be not suitable in some cases. A direct plant-protection strategy was performed to screen the 32 Bacillus biocontrol agent candidates. Moreover, potential in vitro biocontrol traits were investigated including biofilm formation, motility, hemolytic activity, detection of lipopeptide biosynthetic genes (sfp, ituC and bmyB) and production of antibacterial compounds. The obtained results indicated high correlations of the efficiency of the biocontrol with the reduction of gall weight (p = 0.000) and the antibacterial activity in vitro (p = 0.000). Moreover, there was strong correlations of the efficiency of the biocontrol (p = 0.004) and the reduction in gall weight (p = 0.000) with the presence of the bmyB gene. This gene directs the synthesis of the lipopeptide bacillomycin belonging to the iturinic family of lipopeptides. These results were also confirmed by the two-way hierarchical cluster analysis and the correspondence analysis showing the relatedness of these four variables. According to the obtained results a new screening procedure of Bacillus biocontrol agents against crown gall disease could be advanced consisting on two step selection procedure. The first consists on selecting strains with high antibacterial activity in vitro or those harbouring the bmyB gene. Further selection has to be performed on tomato plants in vivo. Moreover, based on the results of the biocontrol assay, five potent strains exhibiting high biocontrol abilities were selected. They were identified as Bacillus subtilis or Bacillus amyloliquefaciens. These strains were found to produce either surfactin or surfactin and iturin lipopeptides. In conclusion, our study presented a new and effective method to evaluate the biocontrol ability of antagonistic Bacillus strains against crown gall disease that could increase the efficiency of screening method of biocontrol agents. Besides, the selected strains could be used as novel biocontrol agents against pathogenic Agrobacterium tumefaciens strains. PMID:28855909

A school-based public health model to reduce oral health disparities.

PubMed

Dudovitz, Rebecca N; Valiente, Jonathan E; Espinosa, Gloria; Yepes, Claudia; Padilla, Cesar; Puffer, Maryjane; Slavkin, Harold C; Chung, Paul J

2018-12-01

Although dental decay is preventable, it remains the most common pediatric chronic disease. We describe a public health approach to implementing a scalable and sustainable school-based oral health program for low-income urban children. The Los Angeles Trust for Children's Health, a nonprofit affiliated with the Los Angeles Unified School District, applied a public health model and developed a broad-based community-coalition to a) establish a District Oral Health Nurse position to coordinate oral health services, and b) implement a universal school-based oral health screening and fluoride varnishing program, with referral to a dental home. Key informant interviews and focus groups informed program development. Parent surveys assessed preventative oral health behaviors and access to oral health services. Results from screening exams, program costs and rates of reimbursement were recorded. From 2012 to 2015, six elementary schools and three dental provider groups participated. Four hundred ninety-one parents received oral health education and 89 served as community oral health volunteers; 3,399 screenings and fluoride applications were performed on 2,776 children. Sixty-six percent of children had active dental disease, 27 percent had visible tooth decay, and 6 percent required emergent care. Of the 623 students who participated for two consecutive years, 56 percent had fewer or no visible caries at follow-up, while only 17 percent had additional disease. Annual program cost was $69.57 per child. Using a broad based, oral health coalition, a school-based universal screening and fluoride varnishing program can improve the oral health of children with a high burden of untreated dental diseases. © 2017 American Association of Public Health Dentistry.

Ultra-processed food consumption and adiposity trajectories in a Brazilian cohort of adolescents: ELANA study.

PubMed

Cunha, Diana Barbosa; da Costa, Teresa Helena Macedo; da Veiga, Gloria Valeria; Pereira, Rosangela Alves; Sichieri, Rosely

2018-05-25

In Brazil, the increase in obesity rates has been accompanied by increased consumption of ultra-processed food (UPF). The objective of this paper was to evaluate body mass index (BMI) and body fat percentage (%BF) trajectories in adolescents over a 3-year follow-up according to the frequency of UPF consumption. Data of three consecutive years (2010, 2011, and 2012) were obtained from the Adolescent Nutritional Assessment Longitudinal Study (ELANA) that aimed to assess changes in anthropometric indicators of nutritional status, and 1035 adolescents enrolled in the 1st year of high school from six schools (four private and two public) in the metropolitan area of Rio de Janeiro, Brazil were included. At three follow-ups, they had their weights and heights measured. Body composition was measured at the first and second follow-ups. Mixed linear regression models were used to estimate BMI and %BF trajectories based on quartiles of UPF intake, adjusting for type of school, sex, physical activity, and underreporting. Compared to their counterparts in the 1st quartile, adolescents in the 4th quartile of UPF consumption had a lower daily intake of fruits, cooked vegetables, and raw vegetables and a higher intake of total sugar and physical activity levels (p < 0.001). There was an inverse association between UPF consumption and BMI both at baseline and at follow-up. Values for %BF followed the same trend. Adolescents in the 4th quartile had the greatest level of physical activity and lowest total energy intake. This study confirmed that greater intake of UPF is a marker of an unhealthy diet, but did not support the hypothesis of a high rate of change in BMI associated with greater UPF consumption, even after adjusting for physical activity.

Stand-Biased Versus Seated Classrooms and Childhood Obesity: A Randomized Experiment in Texas

PubMed Central

Wendel, Monica L.; Zhao, Hongwei; Jeffrey, Christina

2016-01-01

Objectives. To measure changes in body mass index (BMI) percentiles among third- and fourth-grade students in stand-biased classrooms and traditional seated classrooms in 3 Texas elementary schools. Methods. Research staff recorded the height and weight of 380 students in 24 classrooms across the 3 schools at the beginning (2011–2012) and end (2012–2013) of the 2-year study. Results. After adjustment for grade, race/ethnicity, and gender, there was a statistically significant decrease in BMI percentile in the group that used stand-biased desks for 2 consecutive years relative to the group that used standard desks during both years. Mean BMI increased by 0.1 and 0.4 kilograms per meter squared in the treatment and control groups, respectively. The between-group difference in BMI percentile change was 5.24 (SE = 2.50; P = .037). No other covariates had a statistically significant impact on BMI percentile changes. Conclusions. Changing a classroom to a stand-biased environment had a significant effect on students’ BMI percentile, indicating the need to redesign traditional classroom environments. PMID:27552276

School dental screening programmes for oral health.

PubMed

Arora, Ankita; Khattri, Shivi; Ismail, Noorliza Mastura; Kumbargere Nagraj, Sumanth; Prashanti, Eachempati

2017-12-21

School dental screening refers to visual inspection of children's oral cavity in a school setting followed by making parents aware of their child's current oral health status and treatment needs. Screening at school intends to identify children at an earlier stage than symptomatic disease presentation, hence prompting preventive and therapeutic oral health care for the children. This review evaluates the effectiveness of school dental screening in improving oral health status. To assess the effectiveness of school dental screening programmes on overall oral health status and use of dental services. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 March 2017), the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Register of Studies, to 15 March 2017), MEDLINE Ovid (1946 to 15 March 2017), and Embase Ovid (15 September 2016 to 15 March 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status when searching the electronic databases; however, the search of Embase was restricted to the last six months due to the Cochrane Centralised Search Project to identify all clinical trials and add them to CENTRAL. We included randomised controlled trials (RCTs) (cluster or parallel) that evaluated school dental screening compared with no intervention or with one type of screening compared with another. We used standard methodological procedures expected by Cochrane. We included six trials (four were cluster-RCTs) with 19,498 children who were 4 to 15 years of age. Four trials were conducted in the UK and two were based in India. We assessed two trials to be at low risk of bias, one trial to be at high risk of bias and three trials to be at unclear risk of bias.None of the six trials reported the proportion of children with untreated caries or other oral diseases.Four trials evaluated traditional screening versus no screening. We performed a meta-analysis for the outcome 'dental attendance' and found an inconclusive result with high heterogeneity. The heterogeneity was found it to be, in part, due to study design (three cluster-RCTs and one individual-level RCT). Due to the inconsistency, we downgraded the evidence to 'very low certainty' and are unable to draw conclusions about this comparison.Two cluster-RCTs (both four-arm trials) evaluated criteria-based screening versus no screening and showed a pooled effect estimate of RR 1.07 (95% CI 0.99 to 1.16), suggesting a possible benefit for screening (low-certainty evidence). There was no evidence of a difference when criteria-based screening was compared to traditional screening (RR 1.01, 95% CI 0.94 to 1.08) (very low-certainty evidence).In one trial, a specific (personalised) referral letter was compared to a non-specific one. Results favoured the specific referral letter with an effect estimate of RR 1.39 (95% CI 1.09 to 1.77) for attendance at general dentist services and effect estimate of RR 1.90 (95% CI 1.18 to 3.06) for attendance at specialist orthodontist services (low-certainty evidence).One trial compared screening supplemented with motivation to screening alone. Dental attendance was more likely after screening supplemented with motivation, with an effect estimate of RR 3.08 (95% CI 2.57 to 3.71) (low-certainty evidence).None of the trials had long-term follow-up to ascertain the lasting effects of school dental screening.None of the trials reported cost-effectiveness and adverse events. The trials included in this review evaluated short-term effects of screening, assessing follow-up periods of three to eight months. We found very low certainty evidence that was insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance. For criteria-based screening, we found low-certainty evidence that it may improve dental attendance when compared to no screening. However, when compared to traditional screening there was no evidence of a difference in dental attendance (very low-certainty evidence).We found low-certainty evidence to conclude that personalised or specific referral letters improve dental attendance when compared to non-specific counterparts. We also found low-certainty evidence that screening supplemented with motivation (oral health education and offer of free treatment) improves dental attendance in comparison to screening alone.We did not find any trials addressing cost-effectiveness and adverse effects of school dental screening.

Weight, height and body mass index of children and adolescents living at moderate altitude in Colombia.

PubMed

Díaz Bonilla, Edilberto; Torres Galvis, Claudia L; Gómez Campos, Rossana; de Arruda, Miguel; Pacheco Carrillo, Jaime; Cossio Bolaños, Marco

2018-04-01

There is increasing concern over the study of physical growth in different regions of the world, although altitude is not considered an adjustment factor. Compare physical growth variables and body mass index (BMI) patterns with the Centers for Disease Control and Prevention (CDC) 2012 reference data and develop percentiles for children and adolescents. School children living at moderate altitude in Bogotá (Colombia) were studied. Their weight and height were evaluated and their BMI was calculated. Anthropometric variables were compared against reference data of the CDC-2012, Brazil, Peru and Argentina. Curves were constructed using the least mean square (LMS) method. A total of 2241 school children (1159 girls) aged 6.0 to 17.9 years were included. There were no significant differences in weight and BMI in 6 to 8 year-olds relative to CDC-2012 reference data; in 9 to 17 year-old children, however, this sample evidenced lower values in terms of weight and BMI as compared to those of the CDC-2012. As far as height is concerned, in both sexes, values were lower than those of the CDC-2012. Comparisons against the regional curves of Argentina, Peru and Brazil yielded relatively similar results, with the exception of girls' BMI, as 13 to 17 year-old girls exhibited lower values. Growth variables of school children were lower relative to the CDC-2012 reference data. There were slight discrepancies in physical growth and BMI in relation to the curves of Argentina, Peru and Brazil. Curves were constructed to evaluate growth in school children living at moderate altitude in Colombia. Sociedad Argentina de Pediatría.

The malnutrition screening tool versus objective measures to detect malnutrition in hip fracture.

PubMed

Bell, J J; Bauer, J D; Capra, S

2013-12-01

The Malnutrition Screening Tool (MST) is the most commonly used screening tool in Australia. Poor screening tool sensitivity may lead to an under-diagnosis of malnutrition, with potential patient and economic ramifications. The present study aimed to determine whether the MST or anthropometric parameters adequately detect malnutrition in patients who were admitted to a hip fracture unit. Data were analysed for a prospective convenience sample (n = 100). MST screening was independently undertaken by nursing staff and a nutrition assistant. Mid upper arm circumference (MUAC) was measured by a trained nutrition assistant. Nutritional risk [MST score ≥ 2, body mass index (BMI) < 22 kg m(-2) , or MUAC < 25 cm] was compared with malnutrition diagnosed by accredited practicing dietitians using International Classification of Diseases version 10-Australian Modification (ICD10-AM) coding criteria. Malnutrition prevalence was 37.5% using ICD10-AM criteria. Delirium, dementia or preadmission cognitive impairment was present in 65% of patients. The BMI as a nutrition risk screen was the most valid predictor of malnutrition (sensitivity 75%; specificity 93%; positive predictive value 73%; negative predictive value 84%). Nursing MST screening was the least valid (sensitivity 73%; specificity 55%; positive predictive value 50%; negative predictive value 77%). There was only fair agreement between nursing and nutrition assistant screening using the MST (κ = 0.28). In this population with a high prevalence of delirium and dementia, further investigation is warranted into the performance of nutrition screening tools and anthropometric parameters such as BMI. All tools failed to predict a considerable number of patients with malnutrition. This may result in the under-diagnosis and treatment of malnutrition, leading to case-mix funding losses. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Cross-sectional associations between high-deprivation home and neighbourhood environments, and health-related variables among Liverpool children

PubMed Central

Noonan, Robert J; Boddy, Lynne M; Knowles, Zoe R; Fairclough, Stuart J

2016-01-01

Objectives (1) To investigate differences in health-related, home and neighbourhood environmental variables between Liverpool children living in areas of high deprivation (HD) and medium-to-high deprivation (MD) and (2) to assess associations between these perceived home and neighbourhood environments and health-related variables stratified by deprivation group. Design Cross-sectional study. Setting 10 Liverpool primary schools in 2014. Participants 194 children aged 9–10 years. Main outcome measures Health-related variables (self-reported physical activity (PA) (Physical Activity Questionnaire for Older Children, PAQ-C), cardiorespiratory fitness, body mass index (BMI) z-scores, waist circumference), home environment variables: (garden/backyard access, independent mobility, screen-based media restrictions, bedroom media) and neighbourhood walkability (Neighbourhood Environment Walkability Scale for Youth, NEWS-Y). Explanatory measures Area deprivation. Results There were significant differences between HD and MD children's BMI z-scores (p<0.01), waist circumference (p<0.001) and cardiorespiratory fitness (p<0.01). HD children had significantly higher bedroom media availability (p<0.05) and independent mobility scores than MD children (p<0.05). MD children had significantly higher residential density and neighbourhood aesthetics scores, and lower crime safety, pedestrian and road traffic safety scores than HD children, all of which indicated higher walkability (p<0.01). HD children's BMI z-scores (β=−0.29, p<0.01) and waist circumferences (β=−0.27, p<0.01) were inversely associated with neighbourhood aesthetics. HD children's PA was negatively associated with bedroom media (β=−0.24, p<0.01), and MD children's PA was positively associated with independent mobility (β=0.25, p<0.01). MD children's independent mobility was inversely associated with crime safety (β=−0.28, p<0.01) and neighbourhood aesthetics (β=−0.24, p<0.05). Conclusions Children living in HD areas had the least favourable health-related variables and were exposed to home and neighbourhood environments that are unconducive to health-promoting behaviours. Less access to bedroom media equipment and greater independent mobility were strongly associated with higher PA in HD and MD children, respectively. Facilitating independent mobility and encouraging outdoor play may act as effective strategies to enhance PA levels and reduce sedentary time in primary school-aged children. PMID:26769779

Vision Screening of School Children by Teachers as a Community Based Strategy to Address the Challenges of Childhood Blindness.

PubMed

Kaur, Gurvinder; Koshy, Jacob; Thomas, Satish; Kapoor, Harpreet; Zachariah, Jiju George; Bedi, Sahiba

2016-04-01

Early detection and treatment of vision problems in children is imperative to meet the challenges of childhood blindness. Considering the problems of inequitable distribution of trained manpower and limited access of quality eye care services to majority of our population, innovative community based strategies like 'Teachers training in vision screening' need to be developed for effective utilization of the available human resources. To evaluate the effectiveness of introducing teachers as the first level vision screeners. Teacher training programs were conducted for school teachers to educate them about childhood ocular disorders and the importance of their early detection. Teachers from government and semi-government schools located in Ludhiana were given training in vision screening. These teachers then conducted vision screening of children in their schools. Subsequently an ophthalmology team visited these schools for re-evaluation of children identified with low vision. Refraction was performed for all children identified with refractive errors and spectacles were prescribed. Children requiring further evaluation were referred to the base hospital. The project was done in two phases. True positives, false positives, true negatives and false negatives were calculated for evaluation. In phase 1, teachers from 166 schools underwent training in vision screening. The teachers screened 30,205 children and reported eye problems in 4523 (14.97%) children. Subsequently, the ophthalmology team examined 4150 children and confirmed eye problems in 2137 children. Thus, the teachers were able to correctly identify eye problems (true positives) in 47.25% children. Also, only 13.69% children had to be examined by the ophthalmology team, thus reducing their work load. Similarly, in phase 2, 46.22% children were correctly identified to have eye problems (true positives) by the teachers. By random sampling, 95.65% children were correctly identified as normal (true negatives) by the teachers. Considering the high true negative rates and reasonably good true positive rates and the wider coverage provided by the program, vision screening in schools by teachers is an effective method of identifying children with low vision. This strategy is also valuable in reducing the workload of the eye care staff.

Is There a Relationship between Body Mass Index, Fitness, and Academic Performance? Mixed Results from Students in a Southeastern United States Elementary School

ERIC Educational Resources Information Center

Wingfield, Robert Joshua; Graziano, Paulo A.; McNamara, Joseph P. H., Janicke, David M.

2011-01-01

The purpose of this study was to investigate relationships between body mass index (BMI), physical fitness, and academic performance in elementary school students. Specifically, BMI and scores on the President's Challenge Physical Activity and Fitness Awards Program, a physical fitness test, were compared to reading and mathematics scores on the…

The Relationship between Physical Activity Level, Body Mass Index, and Body Fat Percentages in Urban and Rural Elementary School Students

ERIC Educational Resources Information Center

Orhan, Özlem

2015-01-01

The purpose of this study is to compare the physical activity levels, physical activity types, Body Mass Index (BMI) and body fat percentage (BF%) values of elementary school students living in rural and urban. Body height (BH), body weight (BW), BF% and BMI data were measured. Physical activity questionnaire was conducted to determine the…

[Nutritional status of children in the North Backa Region based on the body mass index].

PubMed

Pavlović, M

2000-01-01

Monitoring nutritional status of children at a population level represents an important index of the nutritional quality and quantity in a certain period of time. The aim of this paper was to determine the body mass index (BMI kg/m2) and evaluate the nutritional status of children in the North Backa Region (Subotica, Backa Topola and Mali Idos). A transversal anthropometric study examining body weight and height during a mass screening of children in Health centers in the North Backa Region, 25.790 children aged 1-18 have been examined in the period 1995-1998. Evidence and statistical evaluation of data have been processed using the software "CHILD" determining the percentile values of BMI and nutritional status according to reference values of the First National Healts and Nutrition Examination Survey (NHANES 1). Analyzing the nutritional status of children aged 6-18 in the North Backa Region we found 4.39% boys and 5.41 girls with BMI < P5 as underweight, moderate underweight with BMI P5-15 were 7.28% boys and 6.96% girls, whereas normal nutritional status (BMI P15-85) was found in 67.13% boys and 67.25% girls. 12.77% of boys and 11.78% of girls were overweight (BMI P85-95) and obesity (BMI > P95) was registered in 8.46% boys and 8.60% girls. Using the same software and based on results for the whole group of children aged 1-18, reference values were calculated for BMI as a regional reference data which can be used in everyday public health setting. This research is the first examination of the nutritional status of children at a population level in the North Backa Region in regard to BMI. This model of nutritional status monitoring in children using the above mentioned software will be used at a national level. These results show an inadequate nutritional status of children in the North Backa Region which can be associated with unbalanced nutrition and life style. Therefore, permanent monitoring of the nutritional status in children has been established in order to take adequate preventive measures to realize nutrition of children and adolescents.

Correlation between obesity and fat-infiltrated axillary lymph nodes visualized on mammography.

PubMed

diFlorio Alexander, Roberta M; Haider, Steffen J; MacKenzie, Todd; Goodrich, Martha E; Weiss, Julie; Onega, Tracy

2018-01-05

Using screening mammography, this study investigated the association between obesity and axillary lymph node (LN) size and morphology. We conducted a retrospective review of 188 females who underwent screening mammography at an academic medical centre. Length and width of the LN and hilum were measured in the largest, mammographically visible axillary node. The hilo-cortical ratio (HCR) was calculated as the hilar width divided by the cortical width. Measurements were performed by a board certified breast radiologist and a resident radiology physician. Inter-rater agreement was assessed with Pearson correlation coefficient. We performed multivariable regression analysis for associations of LN measurements with body mass index (BMI), breast density and age. There was a strong association between BMI and LN dimensions, hilum dimensions and HCR (p < 0.001 for all metrics). There was no significant change in cortex width with increasing BMI (p = 0.15). Increases in LN length and width were found with increasing BMI [0.6 mm increase in length per unit BMI, 95% CI (0.4-0.8), p < 0.001 and0.3 mm increase in width per unit BMI, 95% CI(0.2-0.4), p < 0.001, respectively]. Inter-rater reliability for lymph node and hilum measurements was 0.57-0.72. We found a highly significant association between increasing BMI and axillary LN dimensions independent of age and breast density with strong interobserver agreement. The increase in LN size was driven by expansion of the LN hilum secondary to fat infiltration. Advances in knowledge: This preliminary work determined a relationship between fat infiltrated axillary lymph nodes and obesity.

[Relationship of the elderly nutrition knowledge and their education level in Nanjing].

PubMed

Liu, Chen; Su, Yamei; Jin, Bangquan

2013-07-01

To study the relationship of the elderly nutrition knowledge, eating behavior and BMI status with their education level. A questionnaire was designed to investigate 1367 elders in 26 nursing homes and communities of Nanjing. Accoording to the education lever, elders nutrition knowledge in college and high school was more than that in middle and primary school, significantly (P < 0.05, P < 0.01). Elders in college and high school groups could obtain much more informations via diversification, such as book, journal or magazine, interpersonal communication and TV or radio. While, 50% elders in lower education groups (middle and primary school) usually watch TV or lisen to the radio get knowledge. The higher education level, the higher income for elders. For this reason, their dietary structure and eating behavior were tending to be reasonable. Compared with the education lever, age and BMI, the effect of age on BMI was more than education lever. The ratio of weight loss and obesity in 75 years old was clearly increased, their nutrition supplment needs more care. elderly education lever was a key factor on their nutrition knowledge and eating behavior (P = 0.00). In college and high school groups, elders nutrition knowledge and income were better than lower education level. However, the age was closed relative to BMI. When elders was over 75 years old, their body weight tend to loss or over and need more nutritional attention.

Prevalence of obesity among Arab school children in Nazareth, Israel: comparison with national (Jewish) and international data.

PubMed

Ram, E; Marcus, O; Joubran, S; Abdo, B; Asal, N R

2013-12-01

Lack of published data. Absence of Ethnic specific data. Lack of focus on obesity prevention in Arab schools. First set of data on obesity for Arab children. Data will be used as reference data. Alert health/school official for intervention. Objective The objective is to produce the first set of obesity prevalence data and use the data as reference values of body mass index (BMI) trends for Arab children in Israel and compare with Jewish and international data. Methods A prevalence study was carried out in 2009 in which 4130 children aged 6-12, were selected from eight Arab sector schools representing the Nazareth Municipality. Height, weight and BMI measurements were obtained and presented by age, mean age, size, weight, gender and percentile. Appropriate epidemiological and statistical methods used for comparison. Results The obesity and overweight prevalence rates in Arab children by age ranges from 0% to 2.6% and 0% to 11.2%, respectively. Comparison with international and Jewish data revealed differences in almost all age groups but higher rates in Arabs, especially boys. Discussion The higher rates/trends in Arab children may be explained by more Arab women entering the workforce, increase in single-parent families and changes in food and physical activity environments. Conclusion Based on our data, we recommend either an ethnic-specific BMI reference curves and/or inclusion of Arab data in the Israeli data system. Research need to focus on reasons for the increase and interventions to reverse/slow the trend. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Sources of variability in childhood obesity indicators and related behaviors.

PubMed

Katzmarzyk, P T; Broyles, S T; Chaput, J-P; Fogelholm, M; Hu, G; Lambert, E V; Maher, C; Maia, J; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tremblay, M S; Tudor-Locke, C

2018-01-01

The purpose of this study was to describe sources of variability in obesity-related variables in 6022 children aged 9-11 years from 12 countries. The study design involved recruitment of students, nested within schools, which were nested within study sites. Height, weight and waist circumference (WC) were measured and body mass index (BMI) was calculated; sleep duration and total and in-school moderate-to-vigorous physical activity (MVPA) and sedentary time were measured by accelerometry; and diet scores were obtained by questionnaire. Variance in most variables was largely explained at the student level: BMI (91.9%), WC (93.5%), sleep (75.3%), MVPA (72.5%), sedentary time (76.9%), healthy diet score (88.3%), unhealthy diet score (66.2%), with the exception of in-school MVPA (53.8%) and in-school sedentary time (25.1%). Variance explained at the school level ranged from 3.3% for BMI to 29.8% for in-school MVPA, and variance explained at the site level ranged from 3.2% for WC to 54.2% for in-school sedentary time. In general, more variance was explained at the school and site levels for behaviors than for anthropometric traits. Given the variance in obesity-related behaviors in primary school children explained at school and site levels, interventions that target policy and environmental changes may enhance obesity intervention efforts.

Effects of Before-School Physical Activity on Obesity Prevention and Wellness.

PubMed

Whooten, Rachel C; Perkins, Meghan E; Gerber, Monica W; Taveras, Elsie M

2018-04-01

The effects of Build Our Kids Success-a 12-week, 1-hour before-school physical activity program-on BMI and social-emotional wellness among kindergarten to eighth grade students was examined. This was a nonrandomized trial. Participants were from 24 schools in Massachusetts; there were 707 children from kindergarten to eighth grade. Children registered for Build Our Kids Success in 2015-2016 participated in a 2 days/week or 3 days/week program. Nonparticipating children served as controls. At baseline and 12 weeks, study staff measured children's heights/weights; children aged ≥8 years completed surveys. Main outcomes were 12-week change in BMI z-score, odds of a lower BMI category at follow-up, and child report of social-emotional wellness. Analyses were completed in March-June 2017. Follow-up BMI was obtained from 67% of children and self-reported surveys from 72% of age-eligible children. Children in the 3 days/week group had improvements in BMI z-score (-0.22, 95% CI= -0.31, -0.14) and this mean change was significantly different than the comparison group (-0.17 difference, 95% CI= -0.27, -0.07). Children in the 3 days/week group also had higher odds of being in a lower BMI category at follow-up (OR=1.35, 95% CI=1.12, 1.62); significantly different than the comparison group (p<0.01). Children in the 2 days/week program had no significant changes in BMI outcomes. Children in the 3 days/week group demonstrated improvement in their student engagement scores (0.79 units, p=0.05) and had nonsignificant improvements in reported peer relationships, affect, and life satisfaction versus comparison. The 2 days/week group had significant improvements in positive affect and vitality/energy versus comparison. A 3 days/week before-school physical activity program resulted in improved BMI and prevented increases in child obesity. Both Build Our Kids Success groups had improved social-emotional wellness versus controls. This study is registered at www.clinicaltrials.gov NCT03190135. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The association between physical activity, sedentary behavior, sleep, and body mass index z-scores in different settings among toddlers and preschoolers.

PubMed

Kuzik, Nicholas; Carson, Valerie

2016-07-20

Physical activity, sedentary behavior, and sleep are all movement behaviors that range on a continuum from no or low movement, to high movement. Consistent associations between movement behaviors and adiposity indicators have been observed in school-age children. However, limited information exists in younger children. Since approximately 50 % of Canadian children ≤5 years of age attend non-parental care, movement behaviors within and outside of the child care setting are important to consider. Therefore, this study examined the association between movement behaviors (physical activity, sedentary behavior and sleep) inside and outside of child care, with body mass index (BMI) z-scores, among a sample of toddlers and preschoolers. Children aged 19-60 months (n = 100) from eight participating child care centers throughout Alberta, Canada participated. Movement behaviors inside child care were accelerometer-derived (light physical activity, moderate to vigorous physical activity (MVPA), sedentary time, and time spent in sedentary bouts lasting 1-4, 5-9, 10-14 and ≥15 min) and questionnaire-derived (daytime sleep). Movement behaviors outside of child care were questionnaire-derived (MVPA, screen and non-screen sedentary behavior, and nighttime sleep). Demographic information (child age, child sex, and parental education) was also questionnaire-derived. Height and weight were measured, and age- and sex-specific BMI z-scores were calculated using World Health Organization growth standards. The association between movement behaviors and BMI z-scores were examined using linear regression models. Hours/day of sedentary bouts lasting 1-4 min (β =-0.8, 95 % CI:-1.5,-0.1) and nighttime sleep (β = 0.2, 95 % CI: 0.1, 0.4) were associated with BMI z-scores. However, after adjusting for demographics variables, sedentary bouts lasting 1-4 min (β =-0.7; 95 % CI:-1.5, 0.0) became borderline non-significant, while nighttime sleep (β = 0.2, 95 % CI: 0.1, 0.4) remained significant. No other movement behaviors inside/outside of child care were associated with BMI z-scores. All children must engage in some sedentary behavior in a day, but promoting the sedentary behavior in short bouts during child care may be important for the primary prevention of overweight and obesity. Future research is needed to understand the mechanisms between sleep and adiposity in this age group and to confirm these findings in large representative samples.

Assessment of social and economic influences on blood pressure of adolescents in public and private schools: an epidemiological study.

PubMed

de Almeida, Fernando Antonio; Konigsfeld, Henrique Pinheiro; Machado, Lígia Maria de Oliveira; Canadas, Andréa Farias; Issa, Evelyn Yuri Okumura; Giordano, Roberto Hernandes; Cadaval, Ricardo Augusto de Miranda

2011-01-01

The high prevalence of hypertension in high school students in Sorocaba, São Paulo, Brazil, has already been described. In this study, within a new sample of high school students from public and private schools, we evaluated if socioeconomic and lifestyle influence on blood pressure values. This is an epidemiological study, which is part of the activities of a community-based work conducted by medical students. They give speeches to high school students aiming at stimulating a healthy lifestyle and primary prevention of hypertension. In a random sample of 410 students in junior high school (209 from public schools and 201 from private schools), we determined the weight, height, and blood pressure, furthermore, a questionnaire identifying epidemiological and socioeconomic status was applied. No statistical differences were found among students from public and private schools regarding the distribution of gender, body mass index (BMI), systolic and diastolic blood pressure, prevalence of hypertension (16.3%), percentage of smokers (5.9%), regular physical activity, and family history of hypertension. In public schools, there is a higher percentage of African descendents students and a higher percentage of students who also work due to low family income. Men from public and private schools have higher prevalence of hypertension, and their mean blood pressure is higher than in women. BMI has a positive correlation with systolic and diastolic blood pressure. Hypertension and other cardiovascular risk factors have an early beginning and require educational interventions for primary prevention. Socioeconomic factors do not affect blood pressure in adolescence.

Application of receiver operating characteristic curve in the assessment of the value of body mass index, waist circumference and percentage of body fat in the Diagnosis of Polycystic Ovary Syndrome in childbearing women.

PubMed

Dou, Pan; Ju, Huiyan; Shang, Jing; Li, Xueying; Xue, Qing; Xu, Yang; Guo, Xiaohui

2016-08-24

There are various parameters to analyze obesity, however, no standard reference to predict, screen or diagnose PCOS with various obesity parameters has been established, and the accuracy of these parameters still needs to be studied.This study was to use the receiver operating characteristic (ROC) curve to explore the different values of three obesity parameters, body mass index (BMI), waist circumference (WC) and percentage of body fat (PBF) in the diagnosis of polycystic ovary syndrome (PCOS) in Chinese childbearing women. Three hundred patients who were diagnosed with PCOS at Center of Reproductive Medicine and Genetics of Peking University First Hospital were enrolled in this study, and 110 healthy age-matched women were enrolled as controls. The characteristics of BMI, WC and PBF in PCOS patients were analyzed. Compared with the control group, all the three obesity parameters were significantly increased in PCOS group. In terms of ROC area under the curve, WC > PBF > BMI, and they were all significantly different from those of the control. At a cut-off point of 80.5 cm, WC has a sensitivity of 73.6 % and a specificity of 85 % in diagnosis of PCOS; At a cut-off point of 29 %, PBF has a sensitivity of 88.2 % and a specificity of 57.7 % in diagnosis of PCOS; and at a cut-off point of 26.6 kg/m(2), BMI has a sensitivity of 54.5 % and a specificity of 98 % in diagnosis of PCOS. WC, BMI and PBF are valuable in screening and diagnosis of PCOS in Chinese childbearing women. PBF can be used to screen PCOS as it has a better sensitivity, while BMI can be used in the diagnosis of PCOS as it has a better specificity.

Nutritional status of Vietnamese outpatients with chronic obstructive pulmonary disease.

PubMed

Hogan, D; Lan, L T T; Diep, D T N; Gallegos, D; Collins, P F

2017-02-01

Nutritional screening and assessment is not currently part of routine clinical practice in Vietnam. Therefore, the present study aimed to investigate the utility of the commonly used methods for identifying malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). A cross-sectional pilot study and a larger retrospective study were carried out in outpatients with COPD who were attending a respiratory clinic in Ho Chi Minh City, Vietnam. Routine clinical data were collected [body mass index (BMI), forced expiratory volume in 1 s (FEV 1 )]. Nutritional screening and assessment were performed using the Malnutrition Screening Tool (MST) and Subjective Global Assessment (SGA) as the gold standard to diagnose malnutrition. In total, 393 outpatients had documented BMI and 29 were prospectively assessed using SGA: males, n = 25; females, n = 4; mean (SD) age 69.7 (9.6) years; mean (SD) BMI 21.0 (3.4) kg m -2 ; mean (SD) FEV 1 percentage predicted 57.0% (19.7%). Malnutrition risk was identified in 20.7% (n = 6) of patients using the MST (38% sensitivity; 94% specificity). However, 45% (n = 13) were diagnosed as malnourished using the SGA (31% mild/moderate; 14% severe). All malnourished patients not identified by the MST had evidence of muscle wasting. BMI had a strong negative correlation with muscle wasting as assessed using the SGA (r = -0.857, n = 28; P < 0.001) and all malnourished patients had a BMI <21 kg m -2 (range 14.6-20.8 kg m -2 , nourished range 20.0-27.6 kg m -2 ). Malnutrition is common in Vietnamese outpatients with COPD. A BMI threshold of <21 kg m -2 appears to represent a useful and pragmatic cut-off point for identifying outpatients requiring comprehensive nutritional assessment and support. © 2016 The British Dietetic Association Ltd.

Screening for malnutrition in nursing home residents: comparison of different risk markers and their association to functional impairment.

PubMed

Stange, I; Poeschl, K; Stehle, P; Sieber, C C; Volkert, D

2013-04-01

To identify nursing home residents with malnutrition or at risk of malnutrition by using different markers, determine if the Mini Nutritional Assessment (MNA®) is able to identify all residents at risk according to single risk markers and explore the relation between risk markers and functional impairment. Cross-sectional study. Six German nursing homes. 286 residents (86±7y, 89% female). Screening for malnutrition or its risk included low BMI (≤22 kg/m²), recent weight loss (WL), low food intake (LI) as single risk markers and MNA (<24 points, p.) as composite marker. Prevalence of single nutritional risk markers in different MNA categories was compared by cross-tables. Mental (cognition, mood) and physical function (mobility) were assessed by interviewing nursing staff and association of impaired status to nutritional risk markers determined by Chi² test. 32.9% of residents had a low BMI, 11.9% WL and 21.3% LI. 60.2% were categorized malnourished (18.2%) or at risk of malnutrition (42.0%) by MNA. 64% presented at least one of these nutritional risk markers. Of those classified malnourished by MNA, 96.2% also showed low BMI, WL or LI. In contrast, eleven residents (9.6%) considered well-nourished by MNA presented single risk markers (9 low BMI, 2 WL). Cognitive impairment, depressive symptoms and immobility was present in 59.0%, 20.8% and 25.5%, respectively. Functional impairment, and in particular severe impairment, was to a higher proportion present in residents at nutritional risk independent of the chosen marker (MNA<24 p., low BMI, WL, LI). The high prevalence of nutritional risk highlights the importance of regular screening of nursing home residents. The MNA identified nearly all residents with low BMI, WL and LI. The close association between nutritional risk and functional impairment requires increased awareness for nutritional problems especially in functionally impaired residents, to early initiate nutritional measures and thus, prevent further nutritional and functional deterioration.

Body mass index (BMI)-for-age and health-related quality of life (HRQOL) among high school students in Tehran.

PubMed

Jalali-Farahani, S; Chin, Y S; Amiri, P; Mohd Taib, M N

2014-09-01

The study aimed to determine the association between body mass index (BMI)-for-age and health-related quality of life (HRQOL) among high school students in Tehran. A total of 465 high school students (227 girls and 238 boys) and their parents were participated in this cross-sectional study. Body weight and height of the students were measured. For assessing HRQOL, both adolescent self-report and parent proxy-report of the Persian version of Pediatric Quality of Life Inventory (PedsQL™4.0) questionnaire were completed by adolescents and their parents respectively. The prevalence of overweight and obesity (38.5%) was higher than severe thinness and thinness (2.8%). Mean of adolescent self-reported and parent proxy-reported HRQOL total score were 80.26 ± 12.07 and 81.30 ± 14.08 respectively. In terms of HRQOL subscale scores, the highest subscale score of HRQOL was reported in social functioning (87.27 ± 14.40) and the lowest score was reported in emotional functioning (69.83 ± 18.69). Based on adolescent self-report, adolescent boys had significantly higher mean score for total and all subscale scores of HRQOL compared with girls (P < 0.05). BMI-for-age was inversely correlated to adolescent self-reported HRQOL total score (r = -0.25, P < 0.05). Based on adolescents self-report, HRQOL total score was significantly different by body weight status (F = 16.16, P < 0.05). Normal weight adolescents had significantly higher HRQOL total score compared with overweight (mean difference: 7.32; P < 0.05) and obese adolescents (mean difference: 9.10, P < 0.05). The HRQOL total score was not significantly different between normal weight and underweight adolescents (mean difference: 1.65, P = 0.96). However, based on parent proxy-reports, HRQOL total score was not significantly different by body weight status (F = 2.64, P = 0.059). More than one-third of adolescents were overweight and obese. BMI-for-age was inversely correlated to adolescent self-reported HRQOL. Based on adolescents' perspective, overweight and obese adolescents had poorer HRQOL compared with normal weight adolescents. Intervention studies are needed to improve the HRQOL of overweight and obese adolescents in Tehran. © 2013 John Wiley & Sons Ltd.

Predictors of blood pressure at 7-13 years: The "new millennium baby" study.

PubMed

Brambilla, P; Bedogni, G; Pietrobelli, A; Cianfarani, S; Agostoni, C

2016-08-01

The purpose of this study is to evaluate the association between blood pressure (BP) at 7-13 years of age and body mass index (BMI), early feeding, lifestyle indicators, and parental characteristics. Retrospective plus cross-sectional cohort study was started in 1294 children born in 2000-2004, right from their birth in primary care settings. Early feeding was estimated by measuring breast-feeding (BF) duration, complementary feeding (CF) introduction time, and lifestyle indicators such as daily screen time and weekly extracurricular sports activity time. Parental education, smoking, and obesity-related diseases were also considered. Multivariable linear regression and mediation analysis were used. CF introduction at 5-6 months of age was a negative predictor of systolic and diastolic BP (mean systolic BP-standard deviation score (SDS) -0.38 [95% CI: -0.47, -0.29] (p < 0.001); mean diastolic BP-SDS -0.32 [95% CI: -0.40, -0.24]) (p < 0.001); BMI was a positive predictor of systolic and diastolic BP (p < 0.001); and parental hypertension was a positive predictor of diastolic BP (p < 0.05). Predictors of mean BMI-SDS at 7-13 years of age were birth weight, screen time, and parental obesity and smoking (p < 0.001). BF had no effect on BP or BMI. Mediation analysis showed virtually no indication of the effect of CF on BP mediated by BMI. CF introduction between 5 and 6 months of age could be associated with low BP at 7-13 years. The effect of CF on BP seems to be independent of BMI. Low screen time is associated with low BMI. CF time may play a role in the occurrence of surrogates of noncommunicable disorders in future. Copyright © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Telephone-Based Adiposity Prevention for Families with Overweight Children (T.A.F.F.-Study): One Year Outcome of a Randomized, Controlled Trial

PubMed Central

Markert, Jana; Herget, Sabine; Petroff, David; Gausche, Ruth; Grimm, Andrea; Kiess, Wieland; Blüher, Susann

2014-01-01

The one-year outcome of the randomized controlled T.A.F.F. (Telephone based Adiposity prevention For Families) study is presented. Screening of overweight (BMI-SDS > 90th centile) children 3.5–17.4 years was performed via the German CrescNet database, and candidates were randomized to an intervention group (IG) and control group (CG). The intervention consisted of computer-aided telephone counselling for one year, supported by mailed newsletters. The primary endpoint was change in BMI-SDS; secondary endpoints were eating behavior, physical activity, media consumption, quality of life. Data from 289 families (145 IG (51% females); 144 CG (50% females)) were analyzed (Full Analysis Set: FAS; Per Protocol Set: PPS). Successful intervention was defined as decrease in BMI-SDS ≥ 0.2. In the FAS, 21% of the IG was successful as compared to 16% from the CG (95% CI for this difference: (−4, 14), p = 0.3, mean change in BMI-SDS: −0.02 for IG vs. 0.02 for CG; p = 0.4). According to the PPS, however, the success rate was 35% in the IG compared to 19% in the CG (mean change in BMI-SDS: −0.09 for IG vs. 0.02 for CG; p = 0.03). Scores for eating patterns (p = 0.01), media consumption (p = 0.007), physical activity (p = 9 × 10−9), quality of life (p = 5 × 10−8) decreased with age, independent of group or change in BMI-SDS. We conclude that a telephone-based obesity prevention program suffers from well-known high attrition rates so that its effectiveness could only be shown in those who adhered to completion. The connection between lifestyle and weight status is not simple and requires further research to better understand. PMID:25286167

Correlation of Body Mass Index (BMI) with Thyroid Function in Euthyroid Pregnant Women in Manipur, India.

PubMed

Kumar, Sumit; Chiinngaihlun, T; Singh, M Rameswar; Punyabati, O

2017-04-01

Body Mass Index (BMI) is significantly increased during pregnancy due to gain of weight with normal progression of pregnancy. The exact influence of thyroid function on BMI are ill defined in euthyroid pregnant women. To correlate serum levels of Free Triiodothyronine (FT3), Free Thyroxine (FT4) and Thyroid Stimulating Hormone (TSH) level with BMI of participant normal pregnant women in all the three trimesters. In this cross-sectional comparative study, total of 210 healthy pregnant women comprising of 70 participants in each trimester, attending Obstetrics Outpatient Department (OPD) for antenatal check-up were consecutively selected. Estimation of serum FT3, FT4 and TSH level was done by ELISA based methods. The correlation of BMI with serum levels of FT3, FT4 and TSH was done using Pearson correlation test (r) by SPSS version 21.0 software. TSH level of participant normal pregnant women showed significant positive correlation with BMI during first (r=0.254 and p=0.034) and second trimester (r=0.263 and p=0.028) of pregnancy. FT4 level showed significant negative correlation in second (r= -0.454 and p<0.001) and third trimester (r= -0.351 and p=0.003) of pregnancy. Correlation between BMI and FT3 level showed no significant association in any of the trimesters. BMI correlates positively with TSH level in first and second trimesters while it correlates negatively with FT4 level in second and third trimesters, but, failed to demonstrate significant association with FT3 level in any of trimesters in euthyroid pregnant women. Serum TSH along with FT4 level appears more useful modality compared to serum TSH alone for targeted thyroid screening particularly in obese pregnant women.

[Nutritional status in telarche and menarche in indigenous and non indigenous Chilean adolescents].

PubMed

Amigo, Hugo; Costa Machado, Thais; Bustos, Patricia

2009-09-01

A compensatory effect of chronic malnutrition that influences excess of weight has been reported. This effect would be more evident in indigenous populations. The aim of this study was to find out the association between ethnic group (mapuche) and body composition in the telarche and menarche of indigenous and non indigenous adolescents. This was a cross sectional design. At the beginning, a screening of 10,121 girls from 168 schools in the Araucania Region, Chile was done. 230 adolescent in telarche (grade II of the development of the mammary gland): 112 indigenous and 118 non indigenous and 239 in menarche (113 indigenous and 126 non indigenous) were identified. Body mass index (BMI), waist circumference (WC), lean mass (LM) and fat mass (FM) were evaluated. BMI, WC and LM were higher in the indigenous adolescent in telarche. For those with menarche, the differences decreased, reaching with higher values for indigenous girls only in BMI and FM (p=0,04 and 0,02, respectively). Belonging to the indigenous group increased the BMI in 0.37 z scores in telarche (95% CI: 0,17-0,58) and 0,44 in menarche (95% CI:0,18-0,70). Being mapuche was also associated to higher WC: 3.33 cm (CI 1,67 - 4,99) in telarche and 3,17 cm (CI 0,73-5,60) in menarche and to higher lean mass only for those adolescents with telarche (1,3 CI: 0,11-2,43) and to fat mass only for those with menarche (2,4 CI: 1,02-3,77). The body composition indicators in indigenous adolescents are of concern and underscores the importance of programs to promote healthy lifestyles that take into account resources from the indigenous communities.

Pediatric obesity and depression: a cross-sectional analysis of absolute BMI as it relates to children's depression index scores in obese 7- to 17-year-old children.

PubMed

Benson, Levi P; Williams, Ronald J; Novick, Marsha B

2013-01-01

Depression and obesity are important in children because they affect health in childhood and later life. The exact relationship between obesity and depression, especially in children, remains undefined. Using a cross-sectional chart review design, our study looked at a weight management clinic-based sample of 117 obese children, 7 to 17 years old, to determine the relationship between absolute BMI and depression as measured by the Children's Depression Index (CDI) while accounting for confounders, such as the child's medical problems, physical activity, and family structure. There was no correlation between depression as measured by the CDI and increasing BMI in obese children seeking weight management. However, we did demonstrate a positive correlation between depression and paternal absence and daily television/computer/video game time. Clinicians should encourage decreasing screen time and might consider family therapy for obese children in families that lack paternal involvement.

A Ballroom Dance Classroom Program Promotes Moderate to Vigorous Physical Activity in Elementary School Children

PubMed Central

2013-01-01

Purpose To determine if an existing ballroom dance classroom program meets national recommendations to engage children in moderate to vigorous physical activity (MVPA) for > 50% of class time and to determine class effects on body mass index (BMI). Design Prospective descriptive study. Setting Two New York City public schools. Subjects Seventy-nine fourth and fifth grade students. Measurements The System for Observing Fitness Instruction Time (SOFIT) and direct heart rate monitoring were used to determine subjects’ MVPA levels during class time. Weight and height were measured to calculate BMI. Analysis Means were calculated for continuous variables; frequency counts and percentages were calculated for categorical variables. Change in BMI percentiles was assessed using Bhapkar’s chi-square test of overall marginal homogeneity. Results Data from SOFIT observations showed that a mean of 50.0% and 67.0% of class time in the first and second halves of the program were spent in MVPA. Data from the heart rate monitoring data revealed that 71.1% of students were at ≥25% heart rate reserve, indicating MVPA, for ≥50% of class time. Improvement was seen in BMI percentile (P=0.051). Conclusion Ballroom dance provides MVPA in elementary school children for ≥50 % of class time and has a positive impact on BMI percentiles. PMID:22208413

Higher weight, lower education: a longitudinal association between adolescents' body mass index and their subsequent educational achievement level?

PubMed

Larsen, Junilla K; Kleinjan, Marloes; Engels, Rutger C M E; Fisher, Jennifer O; Hermans, Roel C J

2014-12-01

The purpose of this study was to examine the association between adolescents' body mass index (BMI) z-scores and their subsequent level of schooling, extending previous longitudinal research by using objectively measured weight and height data. A longitudinal study with 3 study waves (1-year intervals) involving 1248 Dutch adolescents (49% girls; mean age = 13.7 years) at schools providing different educational levels was used to determine adolescents who moved and did not move to a lower educational level in the first year, or in the second year, and to examine whether this movement could be predicted by BMI z-scores (zBMI), after controlling for a large range of potential confounding factors. A total of 1164 Dutch adolescents continued in the same level of education, whereas 84 adolescents moved to a lower educational level (43 moved in the first and 41 in the second year). A higher zBMI significantly increased the risk of a general transition to a lower educational level, and of a transition in the first year, but not in the second year, after controlling for potential demographic, behavioral, and psychological confounds. Findings suggest that a higher zBMI during adolescence immediately lowers educational achievement level during general secondary education. © 2014, American School Health Association.

Energy expenditure and enjoyment of common children's games in a simulated free-play environment.

PubMed

Howe, Cheryl A; Freedson, Patty S; Feldman, Henry A; Osganian, Stavroula K

2010-12-01

To measure the energy expenditure and enjoyment of children's games to be used in developing a school-based intervention for preventing excessive weight gain. Healthy weight (body mass index [BMI] < 85th percentile) and overweight or obese (BMI ≥ 85th percentile) third-grade children (15 boys; 13 girls) were recruited. In a large gymnasium, children performed 10 games randomly selected from 30 games used in previous interventions. Total energy expenditure was measured with a portable metabolic unit and perceived enjoyment was assessed using a 9-point Likert scale of facial expressions. Mean physical activity energy expenditure (PAEE = total energy expenditure minus resting metabolism) and enjoyment of the games were adjusted for sex and BMI classification. PAEE and enjoyment were compared using a repeated-measures ANOVA with sex, BMI classification, and games as main effects. The games elicited a moderate intensity effort (mean ± standard deviation = 5.0 ± 1.3 metabolic equivalents, 123 ± 36 kcal/30 min). PAEE was higher for boys than for girls (0.12 ± 0.04 versus 0.11 ± 0.04 kcal/kg/min) and for healthy weight compared with overweight children (0.13 ± 0.04 versus 0.11 ± 0.03 kcal/kg/min). Twenty-two of the 30 games elicited a sufficiently high PAEE (≥ 100 kcal/30 min) and enjoyment (≥ neutral expression) for inclusion in future school-based interventions. Not all children's games are perceived as enjoyable or resulted in an energy expenditure that was sufficiently high for inclusion in future physical activity interventions to prevent the excess weight gain associated with childhood obesity. Copyright © 2010 Mosby, Inc. All rights reserved.

Fitness change and subsequent academic performance in adolescents.

PubMed

Chen, Li-Jung; Fox, Kenneth R; Ku, Po-Wen; Taun, Chih-Yang

2013-09-01

This study examined the association between fitness change and subsequent academic performance in Taiwanese schoolchildren from 7th grade to 9th grade. The 7th graders from 1 junior high school district participated in this study (N = 669). Academic performance was extracted from school records at the end of each grade. Cardiovascular (CV) fitness, sit-and-reach flexibility, bent-leg curl-ups, and height and weight for calculating body mass index (BMI) were assessed at the start of each grade. The results showed that improvement in CV fitness, but not muscular endurance or flexibility, is significantly related to greater academic performance. A weak and nonsignificant academic-BMI relationship was seen. CV fitness exhibits stronger longitudinal associations with academic performance than other forms of fitness or BMI for adolescents. © 2013, American School Health Association.

Insufficient evidence for the role of school dental screening in improving oral health.

PubMed

Holmes, Richard D

2018-03-23

Data sourcesThe Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform databases.Study selectionRandomised controlled trials (cluster or parallel) evaluating school dental screening compared with no intervention or with one type of screening compared with another were included.Data extraction and synthesisTwo reviewers independently abstracted data and assessed risk of bias. Risk ratios were calculated for dichotomous outcomes, with data being pooled where appropriate. The GRADE approach was used to interpret findings.ResultsSix trials involving 19,498 children were included. Two were considered to be at low risk of bias, three at unclear risk and one at high risk. No conclusions could be made from four studies comparing traditional screening versus no screening because the evidence was inconsistent. Two trials evaluating criteria-based screening versus no screening suggested a possible benefit; RR = 1.07 (95% CI; 0.99-1.16). No difference was found when comparing criteria-based screening with traditional screening, RR = 1.01, (95% CI; 0.94-1.08). No trials reported on long-term follow-up or cost-effectiveness and adverse events.ConclusionsThe trials included in this review evaluated short-term effects of screening, assessing follow-up periods of three to eight months. We found very low certainty evidence that was insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance. For criteria-based screening, we found low-certainty evidence that it may improve dental attendance when compared to no screening. However, when compared to traditional screening there was no evidence of a difference in dental attendance (very low-certainty evidence).We found low-certainty evidence to conclude that personalised or specific referral letters improve dental attendance when compared to non-specific counterparts. We also found low-certainty evidence that screening supplemented with motivation (oral health education and offer of free treatment) improves dental attendance in comparison to screening alone.We did not find any trials addressing cost-effectiveness and adverse effects of school dental screening.

School outbreak of Escherichia coli O157 with high levels of transmission, Staffordshire, England, February 2012.

PubMed

Bayliss, Laura; Carr, Robert; Edeghere, Obaghe; Knapper, Elizabeth; Nye, Kathy; Harvey, Gareth; Adak, Goutam; Duggal, Harsh

2016-09-01

Verocytotoxin-producing Escherichia coli (VTEC) are bacteria that cause infectious gastroenteritis and in certain settings can cause widespread infection due to secondary transmission. We describe the findings of an investigation of a school-based outbreak of VTEC in Staffordshire, England. Outbreak investigation at a school in February 2012 after two children were diagnosed with VTEC infection. Cases were defined as pupils and staff (or their household contacts) with gastrointestinal symptoms or asymptomatic screened persons, with laboratory confirmed VTEC O157 infection (phage type 32, verocytotoxin 2) occurring on or after 1 February 2012. Microbiological tests of food and faecal samples plus screening of asymptomatic contacts were undertaken. Epidemiological and clinical data were descriptively analysed. Thirty-eight cases were detected. Nineteen were asymptomatic and identified via screening of 191 pupils. Infection was introduced into the school from an earlier household cluster, followed by extensive person-to-person transmission within the nursery/infant group with limited spread to the wider school population. Control measures included several interventions, in particular, universal screening of pupils and staff. Screening during school outbreaks is not underpinned by guidance but proved to be a key control measure. Screening of asymptomatic contacts should be considered in similar outbreaks. © Crown copyright 2015.

Lack of follow-up exams after failed school vision screenings: an investigation of contributing factors.

PubMed

Kimel, Linda S

2006-06-01

Programs to facilitate professional eye exams after failed school vision screenings often are based on the assumption that funding and access to services are major obstacles to care. Despite such programs, many children do not receive professional exams. The purpose of this study was to identify additional barriers to follow-up eye care. School nurses in an urban, midwestern public school district identified elementary school students who had not received follow-up eye exams after failed school vision screenings. Parents of these students were interviewed during the summer to determine financial, logistical, social/family, and perceptual barriers to care. Family issues, parental perceptions of vision problems, and difficulty planning ahead were found to be significant factors. Strategies to increase follow-up compliance and recommendations for overcoming barriers to care were also identified.

Why Can't Johnny Read? The Abell Report. Volume 23, No.7

ERIC Educational Resources Information Center

Jacobson, Joan

2010-01-01

Baltimore's school-based vision-screening program may be leaving thousands of children with uncorrected eyesight problems. Vision screening in public schools is essential for students to learn, especially when low-income children face a high rate of eyesight problems and have poor access to health care. Left undetected and uncorrected, vision…

Nutritional status and height, weight and BMI centiles of school-aged children and adolescents of 6-18-years from Kinshasa (DRC).

PubMed

Buhendwa, Rudahaba Augustin; Roelants, Mathieu; Thomis, Martine; Nkiama, Constant E

2017-09-01

The last study to establish centiles of main anthropometric measurements in Kinshasa was conducted over 60 years ago, which questions its current adequacy to describe or monitor growth in this population. To assess the nutritional status of school-aged children and adolescents and to estimate centile curves of height, weight and body mass index (BMI). A representative sample of 7541 school-aged children and adolescents (48% boys) aged 6-18 years was measured between 2010-2013. Smooth centiles of height, weight and BMI-for-age were estimated with the LMS method and compared with the WHO 2007 reference. Nutritional status was assessed by comparing measurements of height and BMI against the appropriate WHO cut-offs. Compared to the WHO reference, percentiles of height and BMI were generally lower. This difference was larger in boys than in girls and increased as they approached adolescence. The prevalence of short stature (< -2 SD) and thinness (< -2 SD) was higher in boys (9.8% and 12%) than in girls (3.4% and 6.1%), but the prevalence of overweight (> 1 SD) was higher in girls (8.6%) than in boys (4.5%). Children from Kinshasa fall below WHO centile references. This study established up-to-date centile curves for height, weight and BMI by age in children and adolescents. These reference curves describe the current status of these anthropometric markers and can be used as a basis for comparison in future studies.

Pattern of beverage intake and milk and dairy products sufficiency among high-school students in Kuwait.

PubMed

Nassar, M F; AbdelKader, A M; Al-Refaee, F A; Al-Dhafiri, S S

2014-12-17

High consumption of soft drinks has been associated with lower intakes of milk and calcium-rich foods and higher body mass index (BMI). This study aimed to explore the pattern of beverage intake among Kuwaiti high-school students. A questionnaire on knowledge, attitudes and practices concerning beverages and milk and dairy products intake was completed by 190 Kuwaiti students aged 16-18 years and BMI was calculated for 181 of them. Intake of sweetened carbonated beverages and to a lesser extent packaged fruit juices affected the sufficiency of milk and dairy products intake among the sample of high-school students in Kuwait. Although BMI was not related to milk and dairy insufficiency, more of the overweight and obese students displayed incorrect practices. Nutritional education of high-school students on the importance of milk and dairy products as well as the hazards of excess sweetened carbonated beverages and packaged juice is recommended to prevent the obesity epidemic prevailing in Kuwait.

Adverse Events With Sustained-Release Donepezil in Alzheimer Disease: Relation to Body Mass Index.

PubMed

Lee, Chunsoo; Lee, Kyungsang; Yu, Hyewon; Ryu, Seung-Ho; Moon, Seok Woo; Han, Changsu; Lee, Jun-Young; Lee, Young Min; Kim, Shin-Gyeom; Kim, Ki Woong; Lee, Dong Woo; Kim, Seong Yoon; Lee, Sang-Yeol; Bae, Jae Nam; Jung, Young-Eun; Kim, Jeong Lan; Kim, Byung-Soo; Shin, Il-Seon; Kim, Young Hoon; Kim, Bong Jo; Kang, Hyo Shin; Myung, Woojae; Carroll, Bernard J; Kim, Doh Kwan

2017-08-01

Sustained-release, high-dose (23 mg/d) donepezil has been approved for treatment of moderate to severe Alzheimer disease (AD). Based on a previous clinical trial, body weight of less than 55 kg is a risk factor for adverse events with donepezil 23 mg/d treatment in global population. To clarify whether this finding is consistent across ethnic groups that vary in absolute body mass, we recruited Korean patients aged 45 to 90 years with moderate to severe AD who had been receiving standard donepezil immediate release 10 mg/d for at least 3 months. After screening, we analyzed a final cohort of 166 patients who received donepezil 23 mg/d for 24 weeks to compare the occurrence of treatment-emergent adverse events (TEAEs) between patients with high versus low body mass index (BMI) based on the World Health Organization overweight criteria for Asian populations (23 kg/m). Treatment-emergent adverse events were reported by 79.45% of patients in the lower BMI group and 58.06% of patients in the higher BMI group (odds ratio, 2.79; 95% confidence interval, 1.39-5.63; χ = 7.58, P = 0.006). In a multivariable survival analysis, the group with lower BMI showed a higher occurrence of TEAEs (hazard ratio, 1.83; 95% confidence interval, 1.25-2.68; P = 0.002). In Korean patients with moderate to severe AD receiving high-dose donepezil over 24 weeks, TEAEs were significantly more common in those with lower BMI (not clinically overweight), especially nausea. This finding may inform clinical practice for Asian patients.

State policies targeting junk food in schools: racial/ethnic differences in the effect of policy change on soda consumption.

PubMed

Taber, Daniel R; Stevens, June; Evenson, Kelly R; Ward, Dianne S; Poole, Charles; Maciejewski, Matthew L; Murray, David M; Brownson, Ross C

2011-09-01

We estimated the association between state policy changes and adolescent soda consumption and body mass index (BMI) percentile, overall and by race/ethnicity. We obtained data on whether states required or recommended that schools prohibit junk food in vending machines, snack bars, concession stands, and parties from the 2000 and 2006 School Health Policies and Programs Study. We used linear mixed models to estimate the association between 2000-2006 policy changes and 2007 soda consumption and BMI percentile, as reported by 90 730 students in 33 states and the District of Columbia in the Youth Risk Behavior Survey, and to test for racial/ethnic differences in the associations. Policy changes targeting concession stands were associated with 0.09 fewer servings of soda per day among students (95% confidence interval [CI] = -0.17, -0.01); the association was more pronounced among non-Hispanic Blacks (0.19 fewer servings per day). Policy changes targeting parties were associated with 0.07 fewer servings per day (95% CI = -0.13, 0.00). Policy changes were not associated with BMI percentile in any group. State policies targeting junk food in schools may reduce racial/ethnic disparities in adolescent soda consumption, but their impact appears to be too weak to reduce adolescent BMI percentile.

The relationships of body mass index, waist-to-height ratio, and body fat percentage with blood pressure and its hemodynamic determinants in Korean adolescents: a school-based study.

PubMed

Kim, Na Young; Hong, Young Mi; Jung, Jo Won; Kim, Nam Su; Noh, Chung Il; Song, Young-Hwan

2013-12-01

Obesity is an important risk factor for hypertension in adolescents. We investigated the relationship of obesity-related indices (body mass index [BMI], waist-to-height ratio [WHR], and body fat percentage [%BF]) with blood pressure and the hemodynamic determinants of blood pressure in Korean adolescents. In 2008, 565 adolescents, aged 12-16 years, were examined. The %BF of the participants was measured by bioelectrical impedance analysis. Echocardiography and brachial artery pulse tracing were used to estimate the stroke volume (SV), cardiac output (CO), total vascular resistance (TVR), and total arterial compliance (TAC). We noted that BMI, WHR, and %BF were positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP). The positive correlation between BMI and blood pressure (SBP and DBP) persisted after adjustment for WHR and %BF. However, after adjustment for BMI, the positive associations between blood pressure (SBP and DBP) and WHR as well as %BF, were not noted. With regard to the hemodynamic factors, BMI, but not WHR and %BF, was an independent positive factor correlated with SV and CO. TVR had an independent negative association with BMI; however, it was not associated with WHR or %BF. Moreover, we noted that BMI, WHR, and %BF did not affect TAC. In Korean adolescents, BMI had an independent positive correlation with SBP and DBP, possibly because of its effects on SV, CO, and TVR. WHR and %BF are believed to indirectly affect SBP and DBP through changes in BMI.

Effectiveness of a universal parental support programme to promote health behaviours and prevent overweight and obesity in 6-year-old children in disadvantaged areas, the Healthy School Start Study II, a cluster-randomised controlled trial.

PubMed

Nyberg, Gisela; Norman, Åsa; Sundblom, Elinor; Zeebari, Zangin; Elinder, Liselotte Schäfer

2016-01-21

There is increasing evidence for the effectiveness of parental support programmes to promote healthy behaviours and prevent obesity in children, but only few studies have been conducted among groups with low socio-economic status. The aim of this study was to develop and evaluate the effectiveness of a parental support programme to promote healthy dietary and physical activity habits and to prevent overweight and obesity in six-year-old children in disadvantaged areas. A cluster-randomised controlled trial was carried out in disadvantaged areas in Stockholm. Participants were six-year-old children (n = 378) and their parents. Thirty-one school classes from 13 schools were randomly assigned to intervention (n = 16) and control groups (n = 15). The intervention lasted for 6 months and included: 1) Health information for parents, 2) Motivational Interviewing with parents and 3) Teacher-led classroom activities with children. Physical activity was measured by accelerometry, dietary intake and screen time with a questionnaire, body weight and height were measured and BMI standard deviation score was calculated. Measurements were conducted at baseline, post-intervention and at 5months follow-up. Group effects were examined using Mixed-effect Regression analyses adjusted for sex, parental education and baseline values. Fidelity to all three intervention components was satisfactory. Significant intervention effects were found regarding consumption of unhealthy foods (p = 0.01) and unhealthy drinks (p = 0.01). At follow-up, the effect on intake of unhealthy foods was sustained for boys (p = 0.03). There was no intervention effect on physical activity. Further, the intervention had no apparent effect on BMI sds for the whole sample, but a significant difference between groups was detected among children who were obese at baseline (p = 0.03) which was not sustained at follow-up. The Healthy School Start study shows that it is possible to influence intake of unhealthy foods and drinks and weight development in obese children by providing individual parental support in a school context. However, the effects were short-lived. Therefore, the programme needs to be prolonged and/or intensified in order to obtain stronger and sustainable effects. This study is an important contribution to the further development of evidence-based parental support programmes to prevent overweight and obesity in children in disadvantaged areas.

EdAl-2 (Educació en Alimentació) programme: reproducibility of a cluster randomised, interventional, primary-school-based study to induce healthier lifestyle activities in children.

PubMed

Llauradó, Elisabet; Tarro, Lucia; Moriña, David; Queral, Rosa; Giralt, Montse; Solà, Rosa

2014-11-20

To assess the reproducibility of an educational intervention EdAl-2 (Educació en Alimentació) programme in 'Terres de l'Ebre' (Spain), over 22 months, to improve lifestyles, including diet and physical activity (PA). Reproduction of a cluster randomised controlled trial. Two semi-rural town-group primary-school clusters were randomly assigned to the intervention or control group. Pupils (n=690) of whom 320 constituted the intervention group (1 cluster) and 370 constituted the control group (1 cluster). Ethnicity was 78% Western European. The mean age (±SD) was 8.04±0.6 years (47.7% females) at baseline. Inclusion criteria for clusters were towns from the southern part of Catalonia having a minimum of 500 children aged 7-8 year; complete data for participants, including name, gender, date and place of birth, and written informed consent from parents or guardians. The intervention focused on eight lifestyle topics covered in 12 activities (1 h/activity/session) implemented by health promoting agents in the primary school over three academic years. The primary outcome was obesity (OB) prevalence and the secondary outcomes were body mass index (BMI) collected every year and dietary habits and lifestyles collected by questionnaires filled in by parents at baseline and end-of-study. At 22 months, the OB prevalence and BMI values were similar in intervention and control groups. Relative to children in control schools, the percentage of boys in the intervention group who performed ≥4 after-school PA h/week was 15% higher (p=0.027), whereas the percentage of girls in both groups remained similar. Also, 16.6% more boys in the intervention group watched ≤2 television (TV) h/day (p=0.009), compared to controls; and no changes were observed in girls in both groups. Our school-based intervention is feasible and reproducible by increasing after-school PA (to ≥4 h/week) in boys. Despite this improvement, there was no change in BMI and prevalence of OB. Clinical Trials NCT01362023. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

EdAl-2 (Educació en Alimentació) programme: reproducibility of a cluster randomised, interventional, primary-school-based study to induce healthier lifestyle activities in children

PubMed Central

Llauradó, Elisabet; Tarro, Lucia; Moriña, David; Queral, Rosa; Giralt, Montse; Solà, Rosa

2014-01-01

Objectives To assess the reproducibility of an educational intervention EdAl-2 (Educació en Alimentació) programme in ‘Terres de l'Ebre’ (Spain), over 22 months, to improve lifestyles, including diet and physical activity (PA). Design Reproduction of a cluster randomised controlled trial. Setting Two semi-rural town-group primary-school clusters were randomly assigned to the intervention or control group. Participants Pupils (n=690) of whom 320 constituted the intervention group (1 cluster) and 370 constituted the control group (1 cluster). Ethnicity was 78% Western European. The mean age (±SD) was 8.04±0.6 years (47.7% females) at baseline. Inclusion criteria for clusters were towns from the southern part of Catalonia having a minimum of 500 children aged 7–8 year; complete data for participants, including name, gender, date and place of birth, and written informed consent from parents or guardians. Intervention The intervention focused on eight lifestyle topics covered in 12 activities (1 h/activity/session) implemented by health promoting agents in the primary school over three academic years. Primary and secondary outcomes The primary outcome was obesity (OB) prevalence and the secondary outcomes were body mass index (BMI) collected every year and dietary habits and lifestyles collected by questionnaires filled in by parents at baseline and end-of-study. Results At 22 months, the OB prevalence and BMI values were similar in intervention and control groups. Relative to children in control schools, the percentage of boys in the intervention group who performed ≥4 after-school PA h/week was 15% higher (p=0.027), whereas the percentage of girls in both groups remained similar. Also, 16.6% more boys in the intervention group watched ≤2 television (TV) h/day (p=0.009), compared to controls; and no changes were observed in girls in both groups. Conclusions Our school-based intervention is feasible and reproducible by increasing after-school PA (to ≥4 h/week) in boys. Despite this improvement, there was no change in BMI and prevalence of OB. Trial registration number: Clinical Trials NCT01362023. PMID:25412862

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18.

PubMed

Dobbins, Maureen; Husson, Heather; DeCorby, Kara; LaRocca, Rebecca L

2013-02-28

The World Health Organization (WHO) estimates that 1.9 million deaths worldwide are attributable to physical inactivity and at least 2.6 million deaths are a result of being overweight or obese. In addition, WHO estimates that physical inactivity causes 10% to 16% of cases each of breast cancer, colon, and rectal cancers as well as type 2 diabetes, and 22% of coronary heart disease and the burden of these and other chronic diseases has rapidly increased in recent decades. The purpose of this systematic review was to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents. The search strategy included searching several databases to October 2011. In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews. Primary authors of included studies were contacted as needed for additional information. To be included, the intervention had to be relevant to public health practice (focused on health promotion activities), not conducted by physicians, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, included all school-attending children, and be implemented for a minimum of 12 weeks. In addition, the review was limited to randomized controlled trials and those that reported on outcomes for children and adolescents (aged 6 to 18 years). Primary outcomes included: rates of moderate to vigorous physical activity during the school day, time engaged in moderate to vigorous physical activity during the school day, and time spent watching television. Secondary outcomes related to physical health status measures including: systolic and diastolic blood pressure, blood cholesterol, body mass index (BMI), maximal oxygen uptake (VO2max), and pulse rate. Standardized tools were used by two independent reviewers to assess each study for relevance and for data extraction. In addition, each study was assessed for risk of bias as specified in the Cochrane Handbook for Systematic Reviews of Interventions. Where discrepancies existed, discussion occurred until consensus was reached. The results were summarized narratively due to wide variations in the populations, interventions evaluated, and outcomes measured. In the original review, 13,841 records were identified and screened, 302 studies were assessed for eligibility, and 26 studies were included in the review. There was some evidence that school-based physical activity interventions had a positive impact on four of the nine outcome measures. Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol. Generally, school-based interventions had little effect on physical activity rates, systolic and diastolic blood pressure, BMI, and pulse rate. At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity resulted in positive effects.In this update, given the addition of three new inclusion criteria (randomized design, all school-attending children invited to participate, minimum 12-week intervention) 12 of the original 26 studies were excluded. In addition, studies published between July 2007 and October 2011 evaluating the effectiveness of school-based physical interventions were identified and if relevant included. In total an additional 2378 titles were screened of which 285 unique studies were deemed potentially relevant. Of those 30 met all relevance criteria and have been included in this update. This update includes 44 studies and represents complete data for 36,593 study participants. Duration of interventions ranged from 12 weeks to six years.Generally, the majority of studies included in this update, despite being randomized controlled trials, are, at a minimum, at moderate risk of bias. The results therefore must be interpreted with caution. Few changes in outcomes were observed in this update with the exception of blood cholesterol and physical activity rates. For example blood cholesterol was no longer positively impacted upon by school-based physical activity interventions. However, there was some evidence to suggest that school-based physical activity interventions led to an improvement in the proportion of children who engaged in moderate to vigorous physical activity during school hours (odds ratio (OR) 2.74, 95% confidence interval (CI), 2.01 to 3.75). Improvements in physical activity rates were not observed in the original review. Children and adolescents exposed to the intervention also spent more time engaged in moderate to vigorous physical activity (with results across studies ranging from five to 45 min more), spent less time watching television (results range from five to 60 min less per day), and had improved VO2max (results across studies ranged from 1.6 to 3.7 mL/kg per min). However, the overall conclusions of this update do not differ significantly from those reported in the original review. The evidence suggests the ongoing implementation of school-based physical activity interventions at this time, given the positive effects on behavior and one physical health status measure. However, given these studies are at a minimum of moderate risk of bias, and the magnitude of effect is generally small, these results should be interpreted cautiously. Additional research on the long-term impact of these interventions is needed.

Change with age in regression construction of fat percentage for BMI in school-age children.

PubMed

Fujii, Katsunori; Mishima, Takaaki; Watanabe, Eiji; Seki, Kazuyoshi

2011-01-01

In this study, curvilinear regression was applied to the relationship between BMI and body fat percentage, and an analysis was done to see whether there are characteristic changes in that curvilinear regression from elementary to middle school. Then, by simultaneously investigating the changes with age in BMI and body fat percentage, the essential differences in BMI and body fat percentage were demonstrated. The subjects were 789 boys and girls (469 boys, 320 girls) aged 7.5 to 14.5 years from all parts of Japan who participated in regular sports activities. Body weight, total body water (TBW), soft lean mass (SLM), body fat percentage, and fat mass were measured with a body composition analyzer (Tanita BC-521 Inner Scan), using segmental bioelectrical impedance analysis & multi-frequency bioelectrical impedance analysis. Height was measured with a digital height measurer. Body mass index (BMI) was calculated as body weight (km) divided by the square of height (m). The results for the validity of regression polynomials of body fat percentage against BMI showed that, for both boys and girls, first-order polynomials were valid in all school years. With regard to changes with age in BMI and body fat percentage, the results showed a temporary drop at 9 years in the aging distance curve in boys, followed by an increasing trend. Peaks were seen in the velocity curve at 9.7 and 11.9 years, but the MPV was presumed to be at 11.9 years. Among girls, a decreasing trend was seen in the aging distance curve, which was opposite to the changes in the aging distance curve for body fat percentage.

The outcomes of health-promoting communities: being active eating well initiative-a community-based obesity prevention intervention in Victoria, Australia.

PubMed

Bolton, K A; Kremer, P; Gibbs, L; Waters, E; Swinburn, B; de Silva, A

2017-07-01

The aim of this study is to evaluate the impact of the Health-Promoting Communities: Being Active Eating Well (HPC:BAEW, 2007-2010) initiative, which comprised community-based multi-component interventions adapted to community context in five separate communities. The intervention aimed to promote healthy eating, physical activity and stronger, healthier communities. A mixed method and multilevel quasi-experimental evaluation of the HPC:BAEW initiative captured process, impact and outcome data. The evaluation involved both cross-sectional (children and adolescents) and longitudinal designs (adults) with data collected pre- and post-intervention in intervention (n=2408 children and adolescents from 18 schools, n=501 adults from 22 workplaces) and comparison groups (n=3163 children and adolescents from 33 schools, n=318 adults from seven workplaces). Anthropometry, obesity-related behavioural and environmental data, information regarding community context and implementation factors were collected. The primary outcomes were differences in anthropometry (weight, waist, body mass index (BMI) and standardised BMI (BMI z-score)) over time compared with comparison communities. Baseline data was collected 2008/2009 and post-intervention collected in 2010 with an average intervention time frame of approximately 12 months. The strategies most commonly implemented were related to social marketing, stakeholder engagement, network and partnership development, community-directed needs assessment and capacity building. Analysis of post-intervention data showed gains in community capacity, but few impacts on environments, policy or individual knowledge, skills, beliefs and perceptions. Relative to the comparison group, one community achieved a lower prevalence of overweight/obesity, lower weight, waist circumference and BMI (P<0.005). One community achieved a higher level of healthy eating policy implementation in schools; two communities achieved improved healthy eating-related behaviours (P<0.03); one community achieved lower sedentary behaviours; and one community achieved higher levels of physical activity in schools (P<0.05). All effect sizes were in the small-to-moderate range. This was a complex and ambitious initiative, which attempted to expand a previously successful community-based intervention in Victoria into five new contexts and communities. Overall, project success was quite inconsistent, and some significant differences were in the unanticipated direction. However, there are many important learnings that should inform future health-promotion activities. The heterogeneity of outcomes of HPC:BAEW communities reflects the reality of life whereby effectiveness of intervention strategies is dependent on individual and community factors. Future health promotion should consider a systems approach whereby existing systems are modified rather than relying heavily on the addition of new activities, with longer time frames for implementation.

Preparticipation Screening of Athletic Officials: SEC Football Referees at Risk.

PubMed

Turner, John L; Walters, Rod; Leski, Mark J; Saywell, Robert M; Wooldridge, J Scott

2003-03-01

Although preparticipation screening for athletes is commonplace, few studies have addressed the issue for those officiating at games. To review current data on physiologic stress on sports officials, to obtain prevalence data on health parameters for football officials, and to determine the outcomes when screening criteria are applied in preseason exams. A protocol was established using health history questionnaires and physical exams with laboratory screening to assess the health of all football officials working in the Southeastern Conference (SEC) from 1997 to 2000. The main outcome measure was the prevalence of cardiac risk factors as determined by American College of Sports Medicine guidelines. Initial screening of 102 football officials revealed that 10.1% of SEC referees had elevated systolic blood pressure, 13.9% had elevated diastolic blood pressure, and 3.8% had resting tachycardia. Average body mass index (BMI) was 28.6 kg/m2, with 87.3% having a BMI that exceeded 25 (overweight). About one-third (31.6%) had a BMI greater than 30 (obese). Total fasting cholesterol exceeded 200 mg/dL in 44.2%, HDL levels were below 35 mg/dL in 34.3%, and LDL levels were above 120 mg/dL in 62.3%. Compared with age-adjusted national data, there were more overweight and more obese officials, but they had lower systolic and diastolic blood pressures and lower mean total cholesterol levels. Using the Framingham Study prediction model to estimate coronary heart disease (CHD) risk, analysis revealed that referees had a lower risk than the national 10-year CHD risk but a higher risk compared with that of the low-risk population. These data reveal a greater need for graded exercise testing. The higher rates of obesity among officials will promote further screening for CHD risk factors.

Maternal and paternal parenting practices and their influence on children's adiposity, screen-time, diet and physical activity.

PubMed

Lloyd, Adam B; Lubans, David R; Plotnikoff, Ronald C; Collins, Clare E; Morgan, Philip J

2014-08-01

The primary aim of this study was to examine a range of potential behavioral and maternal/paternal correlates of adiposity in children. Secondary aims were to examine (a) correlates of screen-time, diet and physical activity and (b) if there were differences in maternal and paternal physical activity- and dietary-related parenting practices. Cross-sectional analysis was conducted using 70 families with children (59% boys (41/70), mean age 8.4 (±2.4) years). Parenting practices were measured using the Parenting Strategies for Eating and Activity Scale. Children's outcomes included: 7-day pedometry (physical activity), screen-time, percent energy from core foods (Food frequency questionnaire) and BMI z-score. Multiple regression models were generated to examine the associations between maternal and paternal parenting practices and children's variables. In the regression analyses, fathers' BMI (p < .01) and mothers' control (p < .001) were significantly associated with child weight status. Fathers' reinforcement (p < .01) was significantly associated with child physical activity. For screen-time, mothers' monitoring (p < .001) and child characteristics [age (p = .01), sex (p = .01), BMI z-score (p = .03)] were significant predictors. Mothers' parenting practices [limit setting (p = .01), reinforcement (p = .02)] and child screen-time (p = .02) were significantly associated with intake of core foods. Despite some similarities within families, three out of five parenting constructs were significantly different between mothers and fathers. Mothers and fathers have different parental influences on their children's weight status and lifestyle behaviors and both should be included in lifestyle interventions targeting children. A focus on maternal parenting specifically relating to screen-time and diet, and father's physical activity parenting and weight status may support their children in developing more healthy behaviors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Fast-food outlets and walkability in school neighbourhoods predict fatness in boys and height in girls: a Taiwanese population study.

PubMed

Chiang, Po-Huang; Wahlqvist, Mark L; Lee, Meei-Shyuan; Huang, Lin-Yuan; Chen, Hui-Hsin; Huang, Susana Tzy-Ying

2011-09-01

There is increasing evidence that the school food environment contributes to childhood obesity and health in various locations. We investigated the influence of fast-food stores and convenience food stores (FS and CS, respectively) on growth and body composition in a range of residential densities for North-east Asian food culture. Anthropometrics and birth weight of schoolchildren were obtained. Geocoded mapping of schools and food outlets was conducted. Multivariable linear regression models, adjusted for father's ethnicity and education, as well as for household income, pocket money, birth weight, physical activity, television watching, food quality and region, were used to predict body composition from school food environments. Elementary schools and school neighbourhoods in 359 townships/districts of Taiwan. A total of 2283 schoolchildren aged 6-13 years from the Elementary School Children's Nutrition and Health Survey in Taiwan conducted in 2001-2002. Remote and socially disadvantaged locations had the highest prevalence of lower weight, BMI, waist circumference and triceps skinfold thickness. Food store densities, FS and CS, were highest in urban Taiwan and lowest in remote Taiwan. In the fully adjusted models, FS densities predicted weight and BMI in boys; there was a similar association for waist circumference, except when adjusted for region. FS densities also predicted height for girls. Except for weight and BMI in boys, CS did not have effects evident with FS for either boys or girls. A high FS density, more than CS density, in Taiwan increased the risk of general (BMI) and abdominal (waist circumference) obesity in boys and stature in girls. These findings have long-term implications for chronic disease in adulthood.

The cut-off values of anthropometric variables for predicting mild cognitive impairment in Malaysian older adults: a large population based cross-sectional study.

PubMed

Won, Huiloo; Abdul, Manaf Zahara; Mat Ludin, Arimi Fitri; Omar, Mohd Azahadi; Razali, Rosdinom; Shahar, Suzana

2017-01-01

Older adults are at risk of mild cognitive impairment (MCI), and simple anthropometric measurements can be used to screen for this condition. Thus, the aim of this study was to explore the cut-off values of body mass index (BMI) and waist circumference (WC) for predicting the risk of MCI in older Malaysian adults. A total of 2,240 Malaysian older adults aged ≥60 years were recruited using multistage random sampling in a population based cross-sectional study. Receiver operating characteristic (ROC) curve was used to determine the cut-off values of BMI and WC with optimum sensitivity and specificity for the detection of MCI. Age, gender, years of education, smoking habit, alcohol consumption, depression, and medical conditions were used as confounding factors in this analysis. A BMI cut-off value of 26 kg/m 2 (area under the receiver operating characteristic curve [AUC] 0.725; sensitivity 90.5%; specificity 38.8%) was appropriate in identifying the risk of getting MCI in both men and women. The optimum WC cut-offs for likelihood of MCI were 90 cm (AUC 0.745; sensitivity 78.0%; specificity 59.8%) for men and 82 cm (AUC 0.714; sensitivity 84.3%; specificity 49.7%) for women. The optimum calf circumference (CC) cut-off values for identifying MCI were 29 cm (AUC 0.731; sensitivity 72.6%; specificity 61.1%) for men and 26 cm (AUC 0.598; sensitivity 79.1%; specificity 45.3%) for women. The cut-off values could be advocated and used as part of the screening of MCI among older Malaysian adults. There is a need to further determine the predictive values of these cut-off points on outcomes through longitudinal study design.

How Does Exercise Benefit Performance on Cognitive Tests in Primary-School Pupils?

ERIC Educational Resources Information Center

Hill, Liam J. B.; Williams, Justin H. G.; Aucott, Lorna; Thomson, Jenny; Mon-Williams, Mark

2011-01-01

Aim: We have previously demonstrated improved cognitive performance after a classroom-based exercise regime. In this study, we examined the reproducibility of this effect in a more socio-economically diverse sample and also investigated whether cognitive benefits of exercise were moderated by body mass index (BMI) or symptoms of…

The association between body mass index and academic performance

PubMed Central

Alswat, Khaled A.; Al-shehri, Abdullah D.; Aljuaid, Tariq A.; Alzaidi, Bassam A.; Alasmari, Hassan D.

2017-01-01

Objectives: To examine the relation between body mass index (BMI) and the academic performance of students from Taif city, Kingdom of Saudi Arabia (KSA) using the grade point average (GPA). Method: A cross-sectional study that includes students from intermediate and high schools located in Taif city, KSA between April 2014 and June 2015. Height and weight were measured and BMI calculated. Related risk factors including dietary habits, activity, parent’s education, sleeping pattern, and smoking were recorded. Result: A total of 14 schools included 424 students. 24.5% were either overweight or obese. The mean age was 15.44 year, 74.8% of the students were male, 53.8% were high school students, and 83.7% attended public schools. The mean overall GPA was 82.44% and the mean GPA for science subjects was 70.91%. No statically significant difference in the BMI was found between those who achieved >90% of the overall grade compared with those who achieved <90%. Post hoc 1-way-analysis of variance showed that obese students were performing worse in physics than normal weight peers (p=0.049). Students who achieved >90% overall grade are more likely to attend private school (p<0.05), live with their parents (p=0.013), having educated parents (p=0.037), getting optimal sleep (p<0.05), and they rarely eat their food outside their home (p<0.05). Conclusion: There was no correlation between the BMI and school performance, except in physics results where obese students perform worse than normal-weight students. PMID:28133692

Leveraging social influence to address overweight and obesity using agent-based models: the role of adolescent social networks.

PubMed

Zhang, J; Tong, L; Lamberson, P J; Durazo-Arvizu, R A; Luke, A; Shoham, D A

2015-01-01

The prevalence of adolescent overweight and obesity (hereafter, simply "overweight") in the US has increased over the past several decades. Individually-targeted prevention and treatment strategies targeting individuals have been disappointing, leading some to propose leveraging social networks to improve interventions. We hypothesized that social network dynamics (social marginalization; homophily on body mass index, BMI) and the strength of peer influence would increase or decrease the proportion of network member (agents) becoming overweight over a simulated year, and that peer influence would operate differently in social networks with greater overweight. We built an agent-based model (ABM) using results from R-SIENA. ABMs allow for the exploration of potential interventions using simulated agents. Initial model specifications were drawn from Wave 1 of the National Longitudinal Study of Adolescent Health (Add Health). We focused on a single saturation school with complete network and BMI data over two waves (n = 624). The model was validated against empirical observations at Wave 2. We focused on overall overweight prevalence after a simulated year. Five experiments were conducted: (1) changing attractiveness of high-BMI agents; (2) changing homophily on BMI; (3) changing the strength of peer influence; (4) shifting the overall BMI distribution; and (5) targeting dietary interventions to highly connected individuals. Increasing peer influence showed a dramatic decrease in the prevalence of overweight; making peer influence negative (i.e., doing the opposite of friends) increased overweight. However, the effect of peer influence varied based on the underlying distribution of BMI; when BMI was increased overall, stronger peer influence increased proportion of overweight. Other interventions, including targeted dieting, had little impact. Peer influence may be a viable target in overweight interventions, but the distribution of body size in the population needs to be taken into account. In low-obesity populations, strengthening peer influence may be a useful strategy. Copyright © 2014 Elsevier Ltd. All rights reserved.

Leveraging social influence to address overweight and obesity using agent-based models: the role of adolescent social networks

PubMed Central

Zhang, J; Tong, L; Lamberson, PJ; Durazo, R; Luke, A; Shoham, DA

2014-01-01

The prevalence of adolescent overweight and obesity (hereafter, simply “overweight”) in the US has increased over the past several decades. Individually-targeted prevention and treatment strategies targeting individuals have been disappointing, leading some to propose leveraging social networks to improve interventions. We hypothesized that social network dynamics (social marginalization; homophily on body mass index, BMI) and the strength of peer influence would increase or decrease the proportion of network member (agents) becoming overweight over a simulated year, and that peer influence would operate differently in social networks with greater overweight. We built an agent-based model (ABM) using results from R-SIENA. ABMs allow for the exploration of potential interventions using simulated agents. Initial model specifications were drawn from Wave 1 of the National Longitudinal Study of Adolescent Health (Add Health). We focused on a single saturation school with complete network and BMI data over two waves (n=624). The model was validated against empirical observations at Wave 2. We focused on overall overweight prevalence after a simulated year. Five experiments were conducted: (1) changing attractiveness of high-BMI agents; (2) changing homophily on BMI; (3) changing the strength of peer influence; (4) shifting the overall BMI distribution; and (5) targeting dietary interventions to highly connected individuals. Increasing peer influence showed a dramatic decrease in the prevalence of overweight; making peer influence negative (ie, doing the opposite of friends) increased overweight. However, the effect of peer influence varied based on the underlying distribution of BMI; when BMI was increased overall, stronger peer influence increased proportion of overweight. Other interventions, including targeted dieting, had little impact. Peer influence may be a viable target in overweight interventions, but the distribution of body size in the population needs to be taken into account. In low-obesity populations, strengthening peer influence may be a useful strategy. PMID:24951404

Crowdsourcing novel childhood predictors of adult obesity.

PubMed

Bevelander, Kirsten E; Kaipainen, Kirsikka; Swain, Robert; Dohle, Simone; Bongard, Josh C; Hines, Paul D H; Wansink, Brian

2014-01-01

Effective and simple screening tools are needed to detect behaviors that are established early in life and have a significant influence on weight gain later in life. Crowdsourcing could be a novel and potentially useful tool to assess childhood predictors of adult obesity. This exploratory study examined whether crowdsourcing could generate well-documented predictors in obesity research and, moreover, whether new directions for future research could be uncovered. Participants were recruited through social media to a question-generation website, on which they answered questions and were able to pose new questions that they thought could predict obesity. During the two weeks of data collection, 532 participants (62% female; age  =  26.5±6.7; BMI  =  29.0±7.0) registered on the website and suggested a total of 56 unique questions. Nineteen of these questions correlated with body mass index (BMI) and covered several themes identified by prior research, such as parenting styles and healthy lifestyle. More importantly, participants were able to identify potential determinants that were related to a lower BMI, but have not been the subject of extensive research, such as parents packing their children's lunch to school or talking to them about nutrition. The findings indicate that crowdsourcing can reproduce already existing hypotheses and also generate ideas that are less well documented. The crowdsourced predictors discovered in this study emphasize the importance of family interventions to fight obesity. The questions generated by participants also suggest new ways to express known predictors.

Ethnic differences in weight loss behavior among secondary school students in Beirut: the role of weight perception.

PubMed

Mehio-Sibai, Abla; Kanaan, Nabil; Chaaya, Monique; Rahal, Boushra; Abdullah, Ahmad; Sibai, Tarek

2003-01-01

Assessing the prevalence of weight loss attempts in Beirut, Lebanon, a country characterized by a diversity of ethnic and religious groups and examining the interplay between ethnicity, body mass index (BMI) and weight perception and their relationship to weight loss behavior. A school-based survey of risk behaviors conducted among secondary students (grade 10-12) in 1997. Subjects consisted of 827 boys and girls, aged 15 to 23 years, the majority of whom were Moslems (65.4%). Multiple logistic regression was used to estimate the association between ethnicity and weight perception with the likelihood of trying to lose weight controlling for BMI and a number of potential covariates. The prevalence of weight loss attempts was 19.1% and 42.6% in boys and girls respectively. Christians were more likely to perceive themselves as overweight and to attempt weight loss than Moslems across all BMI levels, however this trend was significant in the underweight category. While controlling for BMI did not change appreciably the results observed, after controlling for weight perception, ethnic differences in weight-loss behavior disappeared. Findings of the study suggest that whereas actual weight may constitute only partially the driving force for differentials by ethnicity, the perception of body weight acts as a mediating factor in the relationship between ethnicity and weight loss behavior. Understanding the disparities in weight management behavior across various adolescent groups is key to develop culturally appropriate educational and intervention programs for the youths.

Healthy Eating in Out-of-School Time: The Promise and the Challenge

ERIC Educational Resources Information Center

Wiecha, Jean L.; Hall, Georgia; Gannett, Ellen; Roth, Barbara

2012-01-01

More than 30 percent of American children are either overweight or obese, with a body mass index (BMI) in the 85th percentile or above. Although prevalence varies by age, sex, and ethnicity, all groups are affected. Risk of serious health problems increases with increasing BMI. Childhood obesity, characterized by BMI in the 95th percentile or…

Relationship between breast-feeding and adiposity in infants and pre-school children.

PubMed

Gopinath, Bamini; Subramanian, Indhu; Flood, Victoria M; Baur, Louise A; Pfund, Natalie; Burlutsky, George; Mitchell, Paul

2012-09-01

We aimed to establish associations of duration of breast-feeding with mean BMI and waist circumference, as well as the likelihood of being overweight/obese, during early childhood. Cross-sectional, population-based study. Height, weight and waist circumference were measured and BMI calculated. Interviewer-administered questionnaire determined whether the child was ever breast-fed and the duration of breast-feeding. Sydney, Australia. Infants and pre-school children (n 2092) aged 1-6 years were examined in the Sydney Paediatric Eye Disease Study during 2007-2009. Of the children aged 1-6 years, 1270 had been breast-fed compared with 822 who were never breast-fed. After multivariable adjustment, 1-6-year-old children who were ever breast-fed compared with those who were not had significantly lower BMI, 16·7 (se 0·1) kg/m2 v. 17·1 (se 0·2) kg/m2 (P = 0·01). Decreasing BMI was associated with increasing duration of breast-feeding (P trend = 0·002). After multivariable adjustment, each month increase in breast-feeding was associated with an average BMI decrease of 0·04 kg/m2 (P = 0·002) and 0·03 kg/m2 (P = 0·03) among children aged 1-2 years and 3-4 years, respectively. In 1-2-year-old children, each month increase in breast-feeding duration was associated with a 0·06 cm decrease in waist circumference (P = 0·04). Significant associations were not observed among 5-6-year-old children. Children who were ever breast-fed v. those never breast-fed were less likely to be overweight/obese (multivariable-adjusted OR = 0·54; 95 % CI 0·36, 0·83). We demonstrated a modest influence of breast-feeding on children's BMI during early childhood, particularly among those aged less than 5 years.

Trends in physical activity, health-related fitness, and gross motor skills in children during a two-year comprehensive school physical activity program.

PubMed

Brusseau, Timothy A; Hannon, James C; Fu, You; Fang, Yi; Nam, Kahyun; Goodrum, Sara; Burns, Ryan D

2018-01-06

The purpose of this study was to examine the trends in school-day step counts, health-related fitness, and gross motor skills during a two-year Comprehensive School Physical Activity Program (CSPAP) in children. Longitudinal trend analysis. Participants were a sample of children (N=240; mean age=7.9±1.2 years; 125 girls, 115 boys) enrolled in five low-income schools. Outcome variables consisted of school day step counts, Body Mass Index (BMI), estimated VO 2 Peak , and gross motor skill scores assessed using the Test of Gross Motor Development-3rd Edition (TGMD-3). Measures were collected over a two-year CSPAP including a baseline and several follow-up time-points. Multi-level mixed effects models were employed to examine time trends on each continuous outcome variable. Markov-chain transition models were employed to examine time trends for derived binary variables for school day steps, BMI, and estimated VO 2 Peak . There were statistically significant time coefficients for estimated VO 2 Peak (b=1.10mL/kg/min, 95% C.I. [0.35mL/kg/min-2.53mL/kg/min], p=0.009) and TGMD-3 scores (b=7.8, 95% C.I. [6.2-9.3], p<0.001). There were no significant changes over time for school-day step counts or BMI. Boys had greater change in odds of achieving a step count associating with 30min of school day MVPA (OR=1.25, 95% C.I. [1.02-1.48], p=0.044). A two-year CSPAP related to increases in cardio-respiratory endurance and TGMD-3 scores. School day steps and BMI were primarily stable across the two-year intervention. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Prevalences of overweight and obesity among children in remote Aboriginal communities in central Australia.

PubMed

Schultz, Rosalie

2012-01-01

The chronic diseases associated with overweight and obesity are major contributors to the excess disease burden of Aboriginal Australians. Surveillance of overweight and obesity is required to monitor these conditions, and to develop and evaluate interventions to improve health and wellbeing. Remote Aboriginal communities in Australia's Northern Territory (NT) are where approximately two-thirds of the NT Aboriginal people live, a proportion which has been stable over many years. However the remote communities suffer significant socioeconomic disadvantage including limited education and employment opportunities, and poor quality and overcrowded housing. Approximately one-third of Aboriginal people in NT live in central Australia, which consists of the Alice Springs and Barkly districts. The Healthy School-Aged Kids Program includes health promotion and child health screening, and is run in remote Aboriginal communities of NT. This report provides estimates of prevalences of overweight and obesity among children in central Australia who participated in health checks as part of Healthy School-Aged Kids Program in 2010. All children in remote central Australian Aboriginal communities were invited to participate in health checks. Children who attended were weighed and measured. Date of birth, sex, height and weight for each child were used to determine prevalence of overweight (≥+1 standard deviation [SD] BMI-for-age) and obesity (≥+2 SD BMI-for-age) according to WHO Growth standards. Differences in proportions of overweight and obesity by age group and sex, and their statistical significance were calculated. Weight, height, sex and age data were available for 996 children from a population of 1764. It was found that 22.1% of girls and 20.7% of boys were overweight; and 5.1% of girls and 5.8% of boys were obese as defined by BMI-for-age. Prevalence of overweight but not obesity increased with age (for overweight z=3.28, p=0.0011; for obesity z=0.68; p=0.50). The prevalences of overweight and obesity as estimated by BMI-for-age among children in remote central Australian Aboriginal communities were compared with those in other Australian surveys. They appear unlikely to reflect future relative risk of the chronic diseases with which overweight and obesity are associated. Routine collection of data on BMI-for-age may not provide adequate estimation of future risk of chronic disease burden attributable to overweight and obesity among these children. Alternative measures for surveillance for overweight such as waist circumference may prove more useful. Appropriate interventions to reduce risk of chronic disease are required, including interventions to reduce prevalences of overweight and obesity.

Healthy caregivers-healthy children (HC2) phase 2: Integrating culturally sensitive childhood obesity prevention strategies into childcare center policies.

PubMed

Messiah, Sarah E; Lebron, Cynthia; Moise, Rhoda; Sunil Mathew, M; Sardinas, Krystal; Chang, Catherina; Palenzuela, Joanne; Walsh, Jennifer; Shelnutt, Karla P; Spector, Rachel; Altare, Fiorella; Natale, Ruby

2017-02-01

Despite the high prevalence of obesity among preschool-aged children, most states lack childcare center (CCC) nutrition and physical activity policies. The Healthy Caregivers, Healthy Children (HC) Phase 2 project is examining the relationship between the CCC nutrition and physical activity environment and child dietary intake/physical activity patterns and body mass index (BMI). A total of 24 "Quality Counts" (Miami Dade County, Florida's Quality Rating Improvement System [QRIS)]) CCCs serving low resource families with ≥50 2-to-5year olds attending have been randomized to either intervention (n=12) or control (n=12). The HC2 intervention arm CCCs receive implementation of a daily curricula for (1) teachers/parents; (2) children; (3) snack, beverage, physical activity, and screen time policies; and (4) technical assistance with menu modifications. Control arm schools receive an attention control safety curriculum. HC2 is delivered once a month in year 1, quarterly in year 2 and will be disseminated throughout the Quality Counts network in year 3. Primary outcome measures include the Environment and Policy Assessment and Observation tool (EPAO), standardized dietary intake and physical activity patterns surveys, and child BMI. The 'Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM)' framework will guide the interpretation of outcome measures. CCCs are in need of evidence-based standardized nutrition and physical activity policies. The intersection of RE-AIM and early childhood obesity prevention in the childcare setting could generate robust and new information to the field about potential barriers, facilitators, adoption, and sustainability in this setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Association between BMI and Dental Caries among School Children and Adolescents in Jiangsu Province, China.

PubMed

Li, Wei; Hussein Musa, Taha; Gao, Rong; Li, Xiao Shan; Wang, Wei Xiang; Hong, Lei; Wei, Ping Min

2017-10-01

Obesity and dental caries are increasing epidemics, especially among children and adolescents. This epidemiological observational cross-sectional study was conducted to assess the possible association between body mass index (BMI) and dental caries among 111,792 school children and adolescents in Jiangsu Province. We found that 13.14% participants of the study sample were overweight, and 7.37% were obese. The prevalence of dental caries was 12.95% in overweight and 7.89% in obese students. There were significant differences in caries prevalence by sex, region, age group, and BMI. Overweight and obesity statuses were associated with dental caries among the study population. BMI and dental caries present a continuous health problem. Thus, we recommend that oral health promotion be used for caries prevention and control. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study.

PubMed

Roman-Viñas, Blanca; Chaput, Jean-Philippe; Katzmarzyk, Peter T; Fogelholm, Mikael; Lambert, Estelle V; Maher, Carol; Maia, Jose; Olds, Timothy; Onywera, Vincent; Sarmiento, Olga L; Standage, Martyn; Tudor-Locke, Catrine; Tremblay, Mark S

2016-11-25

The Canadian 24-h movement guidelines were developed with the hope of improving health and future health outcomes in children and youth. The purpose of this study was to evaluate adherence to the 3 recommendations most strongly associated with health outcomes in new 24-h movement guidelines and their relationship with adiposity (obesity and body mass index z-score) across countries participating in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Cross-sectional results were based on 6128 children aged 9-11 years from the 12 countries of ISCOLE. Sleep duration and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. Screen time was measured through self-report. Body weight and height were measured. Body mass index (BMI, kg · m -2 ) was calculated, and BMI z-scores were computed using age- and sex-specific reference data from the World Health Organization. Obesity was defined as a BMI z-score > +2 SD. Meeting the overall 24-h movement guidelines was defined as: 9 to 11 h/night of sleep, ≤2 h/day of screen time, and at least 60 min/day of MVPA. Age, sex, highest parental education and unhealthy diet pattern score were included as covariates in statistical models. Associations between meeting vs. not meeting each single recommendation (and combinations) with obesity were assessed with odds ratios calculated using generalized linear mixed models. A linear mixed model was used to examine the differences in BMI z-scores between children meeting vs. not meeting the different combinations of recommendations. The global prevalence of children meeting the overall recommendations (all three behaviors) was 7%, with children from Australia and Canada showing the highest adherence (15%). Children meeting the three recommendations had lower odds ratios for obesity compared to those meeting none of the recommendations (OR = 0.28, 95% CI 0.18-0.45). Compared to not meeting the 24-h movement recommendations either independently or combined, meeting them was significantly associated with a lower BMI z-score. Whenever the MVPA recommendation was included in the analysis the odds ratios for obesity were lower. For ISCOLE participants meeting these 3 healthy movement recommendations the odds ratios of being obese or having high BMI z-scores were lower. However, only a small percentage of children met all recommendations. Future efforts should aim to find promising ways to increase daily physical activity, reduce screen time, and ensure an adequate night's sleep in children. The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was registered at ClinicalTrials.gov (Identifier NCT01722500) (October 29, 2012).

The Costs and Cost-Effectiveness of a School-Based Comprehensive Intervention Study on Childhood Obesity in China

PubMed Central

Meng, Liping; Xu, Haiquan; Liu, Ailing; van Raaij, Joop; Bemelmans, Wanda; Hu, Xiaoqi; Zhang, Qian; Du, Songming; Fang, Hongyun; Ma, Jun; Xu, Guifa; Li, Ying; Guo, Hongwei; Du, Lin; Ma, Guansheng

2013-01-01

Background The dramatic rise of overweight and obesity among Chinese children has greatly affected the social economic development. However, no information on the cost-effectiveness of interventions in China is available. The objective of this study is to evaluate the cost and the cost-effectiveness of a comprehensive intervention program for childhood obesity. We hypothesized the integrated intervention which combined nutrition education and physical activity (PA) is more cost-effective than the same intensity of single intervention. Methods And Findings: A multi-center randomized controlled trial conducted in six large cities during 2009-2010. A total of 8301 primary school students were categorized into five groups and followed one academic year. Nutrition intervention, PA intervention and their shared common control group were located in Beijing. The combined intervention and its’ control group were located in other 5 cities. In nutrition education group, ‘nutrition and health classes’ were given 6 times for the students, 2 times for the parents and 4 times for the teachers and health workers. "Happy 10" was carried out twice per day in PA group. The comprehensive intervention was a combination of nutrition and PA interventions. BMI and BAZ increment was 0.65 kg/m2 (SE 0.09) and 0.01 (SE 0.11) in the combined intervention, respectively, significantly lower than that in its’ control group (0.82±0.09 for BMI, 0.10±0.11 for BAZ). No significant difference were found neither in BMI nor in BAZ change between the PA intervention and its’ control, which is the same case in the nutrition intervention. The single intervention has a relative lower intervention costs compared with the combined intervention. Labor costs in Guangzhou, Shanghai and Jinan was higher compared to other cities. The cost-effectiveness ratio was $120.3 for BMI and $249.3 for BAZ in combined intervention, respectively. Conclusions The school-based integrated obesity intervention program was cost-effectiveness for children in urban China. Trial Registration Chinese Clinical Trial Registry ChiCTR-PRC-09000402 URL:http://www.chictr.org/cn/ PMID:24205050

Nutritional status among primary school children in rural Sri Lanka; a public health challenge for a country with high child health standards.

PubMed

Naotunna, N P G C R; Dayarathna, M; Maheshi, H; Amarasinghe, G S; Kithmini, V S; Rathnayaka, M; Premachandra, L; Premarathna, N; Rajasinghe, P C; Wijewardana, G; Agampodi, T C; Agampodi, S B

2017-01-10

Nutritional status of pre adolescent children is not widely studied in Sri Lanka. The purpose of this study was to determine the nutritional status among pre-adolescent school children in a rural province of Sri Lanka. A school based cross sectional study was carried out in North Central Province in 100 rural schools, selected using multi stage cluster sampling with probability proportionate to size. Children in grade one to five were enrolled with a maximum cluster size of fifty. Anthropometric measurements were done by trained data collectors and venesection was done at site by trained nurses. WHO AnthoPlus was used to calculate the BMI, height for age and weight for age Z scores. Survey design adjusted prevalence estimates with linearized standard errors were generated using svy function of STATA. Mean haemoglobin concentration (Hb) was calculated using methaeamoglobin method. Screening for iron deficiency and thalassemia trait was done using peripheral blood films. Height and weight measurements were done for 4469 of children and the Hb data was available for 4398 children. Based on the survey design adjusted estimates, prevalence of severe thinness, thinness, overweight and obesity in this population was 8.60% (SE 0.94), 2.91%(SE 0.74), 2.95%(0.26) and 2.43%(SE 0.92) respectively. Similarly, survey design adjusted prevalence of underweight and stunting were, 25.93% (95% CI 24.07-27.89%) and 43.92%(95% CI 40.55-47.56%). Adjusted mean estimates for hemoglobin was 12.20 (95% CI 12.16-12.24) g/dL. Prevalence of anemia was 17.3% (n = 749). Prevalence of mild and moderate anemia was 9.4 and 7.6% respectively. This study confirms that malnutrition is still a major problem in North Central Province, Sri Lanka.

Association between television, movie, and video game exposure and school performance.

PubMed

Sharif, Iman; Sargent, James D

2006-10-01

The relationship between media exposure and school performance has not been studied extensively in adolescents. The purpose of this work was to test the relative effects of television, movie, and video game screen time and content on adolescent school performance. We conducted a population-based cross-sectional survey of middle school students (grades 5-8) in the Northeastern United States. We looked at weekday television and video game screen time, weekend television and video game screen time, cable movie channel availability, parental R-rated movie restriction, and television content restriction. The main outcome was self-report of school performance (excellent, good, average, or below average). We used ordinal logistic-regression analysis to test the independent effects of each variable, adjusting for demographics, child personality, and parenting style. There were 4508 students who participated in the study; gender was equally represented, and 95% were white. In multivariate analyses, after adjusting for other covariates, the odds of poorer school performance increased with increasing weekday television screen time and cable movie channel availability and decreased with parental restriction of television content restriction. As compared with children whose parents never allowed them to watch R-rated movies, children who watched R-rated movies once in a while, sometimes, or all of the time had significantly increased cumulative odds of poorer school performance. Weekend screen time and video game use were not associated with school performance. We found that both content exposure and screen time had independent detrimental associations with school performance. These findings support parental enforcement of American Academy of Pediatrics guidelines for media time (particularly weekdays) and content limits to enhance school success.

Maternal BMI and diabetes in pregnancy: Investigating variations between ethnic groups using routine maternity data from London, UK

PubMed Central

Nishikawa, Erin; Seed, Paul T.; Doyle, Pat; Oteng-Ntim, Eugene

2017-01-01

Objective To investigate the ethnicity-specific association between body mass index (BMI) and diabetes in pregnancy, with a focus on the appropriateness of using BMI cut-offs to identify pregnant women at risk of diabetes. Study design Analysis of routinely-collected data from a maternity unit in London, UK. Data were available on 53 264 women delivering between 2004 and 2012. Logistic regression was used to explore the association between diabetes in pregnancy and BMI among women of different ethnicities, and adjusted probability estimates were used to derive risk equivalent cut-offs. ROC curve analysis was used to assess the performance of BMI as a predictor of diabetes in pregnancy. Results The prevalence of diabetes in pregnancy was 2.3% overall; highest in South and East Asian women (4.6% and 3.7%). In adjusted analysis, BMI category was strongly associated with diabetes in all ethnic groups. Modelled as a continuous variable with a quadratic term, BMI was an acceptable predictor of diabetes according to ROC curve analysis. Applying a BMI cut-off of 30 kg/m2 would identify just over half of Black women with diabetes in pregnancy, a third of White (32%) and South Asian (35%) women, but only 13% of East Asian women. The ‘risk equivalent’ (comparable to 30 kg/m2 in White women) threshold for South Asian and East Asian women was approximately 21 kg/m2, and 27.5 kg/m2 for Black women. Conclusions This study suggests that current BMI thresholds are likely to be ineffective for diabetes screening in South and East Asian women, as many cases of diabetes will occur at low BMI levels. Our results suggest that East Asian women appear to face a similarly high risk of diabetes to South Asian women. Current UK guidelines recommend diabetes screening should be offered to all pregnant South Asian women; extending this recommendation to include women of East Asian ethnicity may be appropriate. PMID:28640854

The relationship between obesity and forced vital capacity among university students.

PubMed

Sun, Xugui; Chen, Xiaohong

2015-05-01

We sought to explore the relationship between vital capacity and obesity among university students in China. A cross-sectional study was designed to collect the routine health screening data for university students in 2013. The height, weight and force vital capacity of students were measured, and BMI was calculated with height and weight, so as to estimate the relationship between force vital capacity and obesity. Based on Working Group on Obesity references in China, obesity has a higher force vital capacity in both male and female university students. No correlation was found between vital capacity and BMI. obesity may have effect on pulmonary function among university students, which is a reference for further epidemic study. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Healthier School Environment Leads to Decreases in Childhood Obesity – The Kearney Nebraska Story

PubMed Central

Heelan, Kate A.; Bartee, R. Todd; Nihiser, Allison; Sherry, Bettylou

2016-01-01

Background Schools play a role in addressing childhood obesity by implementing healthy eating and physical activity strategies. The primary aim of this case study was to describe prevalence of overweight and obesity among elementary school students in a rural Mid-western community between 2006 and 2012. The secondary aim was to use a novel approach called “population dose” to retrospectively evaluate the impact dose of each strategy implemented and its estimated potential population level impact on changes in overweight and obesity. Methods Weight and height were directly measured annually beginning in January 2006 to assess weight status, using body mass index (kg·m2), for all kindergarten – fifth grade students (N ≈ 2,400 per year). Multiple evidence-based strategies were implemented in nine schools to increase physical activity and healthy eating behaviors. BMI reporting and revised school meal programs were implemented district-wide. Comprehensive school physical activity programs (CSPAP), school food environment, and supportive/promotional strategies were implemented at individual schools. Results The absolute change in prevalence of obesity (BMI ≥ 95th percentile) decreased from 16.4% to 13.9%, indicating a 15.2% relative change in prevalence of obesity in 6 years. There was an inverse relationship between the number of strategies implemented and prevalence of overweight and obesity over time. Conclusions District and school-level approaches have the potential to impact childhood obesity. Schools can successfully implement strategies to address overweight and obesity, but the extent of implementation between schools may vary. Population dose analysis can be used to estimate impact of clusters of strategies to address overweight/obesity. PMID:26440386

Outpatient evaluation, recognition, and initial management of pediatric overweight and obesity in U.S. military medical treatment facilities.

PubMed

Dickey, Wayne; Arday, David R; Kelly, Joseph; Carnahan, Col David

2017-02-01

As childhood obesity is a concern in many communities, this study investigated outpatient evaluation and initial management of overweight and obese pediatric patients in U.S. military medical treatment facilities (MTFs). Samples of 579 overweight and 341 obese patients (as determined by body mass index [BMI]) aged 3-17 years were drawn from MTFs. All available FY2011 outpatient records were searched for documentation of BMI assessment, overweight/obesity diagnosis, and counseling. Administrative data for these patients were merged to assess coded diagnostic and counseling rates and receipt of recommended laboratory screenings. Generic BMI documentation was high, but BMI percentile assessments were found among fewer than half the patients. Diagnostic recording or recognition totaled 10.9% of overweight and 32.0% of obese. Counseling rates were higher, with 46.4% and 61.0% of overweight and obese patients, respectively, receiving weight related counseling. Among patients 10 years of age or older, rates of recommended lab screenings for diabetes, liver abnormality, and dyslipidemia were not greater than 33%. BMI percentile recording was strongly associated with diagnostic recording, and diagnostic recording was strongly associated with counseling. Improvements to electronic health records or implementation of local procedures to facilitate better diagnostic recording would likely improve adherence to clinical practice guidelines. ©2016 American Association of Nurse Practitioners.

Two-year controlled effectiveness trial of a school-based intervention to prevent obesity in Chilean children.

PubMed

Kain, Juliana; Leyton, Barbara; Cerda, Ricardo; Vio, Fernando; Uauy, Ricardo

2009-09-01

Obesity prevalence among Chilean children is 19.4%. The present study aimed to assess the effectiveness of a school-based obesity prevention programme. Non-randomized controlled study. The intervention included activities in nutrition and physical activity, fully applied the first year and partially in the second one. Primary outcomes were BMI Z-score (BMIZ) and obesity prevalence; secondary outcomes were waist circumference and triceps skinfold thickness. Time effects were assessed by changes in BMI-related variables by gender and period (ANOVA and Tukey test), while intervention effects were determined by comparing changes in (i) obesity prevalence by gender and period (PROC GENMOD) and (ii) BMIZ according gender, age and period (PROC MIXED). Primary schools in the Chilean cities of Casablanca (intervention group) and Quillota (control group). One thousand seven hundred and fifty-nine children from three schools (intervention group) and 671 from one school (control group). Over the two years, obesity prevalence and BMIZ declined significantly in the intervention group; from 17.0% to 12.3% and 14.1% to 10.3% in boys and girls, respectively, and from 0.62 to 0.53 and 0.64 to 0.58, respectively. In the control group, obesity remained stable at about 21% and 15%, while BMIZ increased significantly in the second year. BMIZ declined in both genders and all age categories in the intervention group during the first year (significant only in younger boys). No changes occurred during the summer, while during the second year, BMIZ increased in boys and girls from both groups (significant only in the younger control boys). Obesity declined significantly only in boys during the first year. Effectiveness was greater in the first school year and more evident in younger boys.