Correlates of self worth and body size dissatisfaction among obese Latino youth

PubMed Central

Mirza, Nazrat M; Mackey, Eleanor Race; Armstrong, Bridget; Jaramillo, Ana; Palmer, Matilde M

2011-01-01

The current study examined self-worth and body size dissatisfaction, and their association with maternal acculturation among obese Latino youth enrolled in a community-based obesity intervention program. Upon entry to the program, a sample of 113 participants reported global self-worth comparable to general population norms, but lower athletic competence and perception of physical appearance. Interestingly, body size dissatisfaction was more prevalent among younger respondents. Youth body size dissatisfaction was associated with less acculturated mothers and higher maternal dissatisfaction with their child's body size. By contrast, although global self-worth was significantly related to body dissatisfaction, it was not influenced by mothers’ acculturation or dissatisfaction with their own or their child’s body size. Obesity intervention programs targeted to Latino youth need to address self-worth concerns among the youth as well as addressing maternal dissatisfaction with their children’s body size. PMID:21354881

Time with friends and physical activity as mechanisms linking obesity and television viewing among youth.

PubMed

Vandewater, Elizabeth A; Park, Seoung Eun; Hébert, Emily T; Cummings, Hope M

2015-07-27

Though bivariate relationships between childhood obesity, physical activity, friendships and television viewing are well documented, empirical assessment of the extent to which links between obesity and television may be mediated by these factors is scarce. This study examines the possibility that time with friends and physical activity are potential mechanisms linking overweight/obesity to television viewing in youth. Data were drawn from children ages 10-18 years old (M = 13.81, SD = 2.55) participating in the 2002 wave of Child Development Supplement (CDS) to the Panel Study of Income Dynamics (PSID) (n = 1,545). Data were collected both directly and via self-report from children and their parents. Path analysis was employed to examine a model whereby the relationships between youth overweight/obesity and television viewing were mediated by time spent with friends and moderate-to-vigorous physical activity (MVPA). Overweight/obesity was directly related to less time spent with friends, but not to MVPA. Time spent with friends was directly and positively related to MVPA, and directly and negatively related to time spent watching television without friends. In turn, MVPA was directly and negatively related to watching television without friends. There were significant indirect effects of both overweight/obesity and time with friends on television viewing through MVPA, and of overweight/obesity on MVPA through time with friends. Net of any indirect effects, the direct effect of overweight/obesity on television viewing remained. The final model fit the data extremely well (χ2 = 5.77, df = 5, p<0.0001, RMSEA = 0.01, CFI = 0.99, TLI =0.99). We found good evidence that the positive relationships between time with friends and physical activity are important mediators of links between overweight/obesity and television viewing in youth. These findings highlight the importance of moving from examinations of bivariate relationships between weight status and television

Time with friends and physical activity as mechanisms linking obesity and television viewing among youth

PubMed Central

2015-01-01

Background Though bivariate relationships between childhood obesity, physical activity, friendships and television viewing are well documented, empirical assessment of the extent to which links between obesity and television may be mediated by these factors is scarce. This study examines the possibility that time with friends and physical activity are potential mechanisms linking overweight/obesity to television viewing in youth. Methods Data were drawn from children ages 10-18 years old (M = 13.81, SD = 2.55) participating in the 2002 wave of Child Development Supplement (CDS) to the Panel Study of Income Dynamics (PSID) (n = 1,545). Data were collected both directly and via self-report from children and their parents. Path analysis was employed to examine a model whereby the relationships between youth overweight/obesity and television viewing were mediated by time spent with friends and moderate-to-vigorous physical activity (MVPA). Results Overweight/obesity was directly related to less time spent with friends, but not to MVPA. Time spent with friends was directly and positively related to MVPA, and directly and negatively related to time spent watching television without friends. In turn, MVPA was directly and negatively related to watching television without friends. There were significant indirect effects of both overweight/obesity and time with friends on television viewing through MVPA, and of overweight/obesity on MVPA through time with friends. Net of any indirect effects, the direct effect of overweight/obesity on television viewing remained. The final model fit the data extremely well (χ2 = 5.77, df = 5, p<0.0001, RMSEA = 0.01, CFI = 0.99, TLI =0.99). Conclusions We found good evidence that the positive relationships between time with friends and physical activity are important mediators of links between overweight/obesity and television viewing in youth. These findings highlight the importance of moving from examinations of bivariate relationships

A Systematic Review of Environmental Correlates of Obesity-Related Dietary Behaviors in Youth

ERIC Educational Resources Information Center

van der Horst, Klazine; Oenema, A.; Ferreira, I.; Wendel-Vos, W.; Giskes, K.; van Lenthe, F.; Brug, J.

2007-01-01

There is increasing interest in the role the environment plays in shaping the dietary behavior of youth, particularly in the context of obesity prevention. An overview of environmental factors associated with obesity-related dietary behaviors among youth is needed to inform the development of interventions. A systematic review of observational…

Overweight and obesity among youth participants in American football.

PubMed

Malina, Robert M; Morano, Peter J; Barron, Mary; Miller, Susan J; Cumming, Sean P; Kontos, Anthony P; Little, Bertis B

2007-10-01

To estimate the prevalence of overweight and obesity among participants in youth American football 9 to 14 years of age. Cross-sectional, 653 boys, 8.7 to 14.6 years. Height and weight were measured; body mass index (BMI) was calculated. Overweight and obesity were defined by international (International Obesity Task Force [IOTF]) and United States (Centers for Disease Control [CDC]) criteria. Prevalence and 95% confidence interval were calculated. Player age, height, and weight and midparent height were used to predict mature height; current height was expressed as a percentage of predicted mature height as an estimate of maturity status. Overall 45.0% (41.2% to 48.9%) and 42.6% (38.8% to 46.5%) of players were overweight or obese by CDC and IOTF criteria, respectively. Prevalence was highest in early maturing boys. Based on position-activity at time of injury (n = 180), overweight and obesity were more common among offensive and defensive linemen. Overweight and obesity were more prevalent in youth football players than in national samples of American boys. Allowing for limitations of the BMI and the relative stability of the BMI from adolescence into adulthood, a relatively large number of football participants may be at risk for later overweight or obesity, and the risk appears to be greater for offensive and defensive line positions.

Promoting Social Nurturance and Positive Social Environments to Reduce Obesity in High Risk Youth

PubMed Central

Wilson, Dawn K.; Sweeney, Allison M.; Kitzman-Ulrich, Heather; Gause, Haylee; St. George, Sara M.

2017-01-01

Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth’s behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family and social-environmental level factors contribute to the development of nurturing environments. In this paper, we summarize evidence-based randomized controlled trials that integrate positive parenting, motivational, and behavioral skills strategies in different contexts, including primary care, home, community, and school-based settings. Taken together, these studies suggest that youth and parents are most likely to benefit when youth receive individual-level behavioral skills, family-level support and communication, and autonomous motivational support from the broader social environment. Future investigators and health care providers should consider integrating these evidence-based approaches that support the effects of positive social climate-based interventions on promoting healthy eating, physical activity, and weight management in youth. PMID:28229248

The additive and interactive effects of parenting style and temperament in obese youth seeking treatment

PubMed Central

Zeller, MH; Boles, RE; Reiter-Purtill, J

2009-01-01

Objective To examine maternal parenting behaviors, child temperament and their potential interactions in families of obese children and demographically similar families of nonoverweight children. Design A total of 77 obese youth (M body mass index (BMI) z-score values, zBMI = 2.4; ages 8–16, 59% female, 50% African American) and their parents were recruited from a pediatric weight management clinic and compared to 69 families of nonoverweight youth (M zBMI = − 0.03). Comparison youth were classmates of each obese participant matched on gender, race and age. Measurements Maternal report of child temperament, parenting style and anthropometric assessments were obtained. Results Compared to nonoverweight youth, mothers of obese youth described their child as having a more difficult temperament and their parenting style as lower in behavioral control. A logistic regression model indicated that difficult temperament, lower behavioral control and the interaction of low maternal warmth and difficult child temperament were associated with increased odds of a child being classified as obese. Conclusions Treatment-seeking obese youth and their parents are characterized by different parent and child factors when compared to nonoverweight comparison families. These findings direct investigators to test more complex models of the relation between parent and child characteristics and their mutual role in the weight-related behavior change process. PMID:18698318

Translating Evidence Based Violence and Drug Use Prevention to Obesity Prevention: Development and Construction of the Pathways Program

ERIC Educational Resources Information Center

Sakuma, Kari-Lyn K.; Riggs, Nathaniel R.; Pentz, Mary Ann

2012-01-01

Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health,…

Do youth sports prevent pediatric obesity? A systematic review and commentary

PubMed Central

Nelson, Toben F.; Stovitz, Steven D.; Thomas, Megan; LaVoi, Nicole M.; Bauer, Katherine W.; Neumark-Sztainer, Dianne

2015-01-01

Sport is a promising setting for obesity prevention among youth, but little is known about whether it prevents obesity. We reviewed research comparing sport participants with non-participants on weight status, physical activity and diet. Among nineteen studies we found no clear pattern of association between body weight and sport participation. Among seventeen studies we found that sport participants are more physically active than those who do not participate. Seven studies examined the relationship between sport participation and diet and found that sport participation is associated with more fruit, vegetable and milk consumption, but also more fast food and sugar sweetened beverage consumption and greater overall calorie intake. It is unclear from these results whether sports programs, as currently offered, protect youth from becoming overweight or obese. Additional research may foster understanding about how sport, and youth sport settings, can help promote energy balance and healthy body weight. PMID:22071397

Obesity and Associated Factors in Youth with an Autism Spectrum Disorder

ERIC Educational Resources Information Center

Granich, Joanna; Lin, Ashleigh; Hunt, Anna; Wray, John; Dass, Alena; Whitehouse, Andrew J. O.

2016-01-01

Weight status on children and youth with autism spectrum disorder is limited. We examined the prevalence of overweight/obesity in children and youth with autism spectrum disorder, and associations between weight status and range of factors. Children and youth with autism spectrum disorder aged 2-16 years (n = 208) and their parents participated in…

How many days of accelerometer monitoring predict weekly physical activity behaviour in obese youth?

PubMed

Vanhelst, Jérémy; Fardy, Paul S; Duhamel, Alain; Béghin, Laurent

2014-09-01

The aim of this study was to determine the type and the number of accelerometer monitoring days needed to predict weekly sedentary behaviour and physical activity in obese youth. Fifty-three obese youth wore a triaxial accelerometer for 7 days to measure physical activity in free-living conditions. Analyses of variance for repeated measures, Intraclass coefficient (ICC) and regression linear analyses were used. Obese youth spent significantly less time in physical activity on weekends or free days compared with school days. ICC analyses indicated a minimum of 2 days is needed to estimate physical activity behaviour. ICC were 0·80 between weekly physical activity and weekdays and 0·92 between physical activity and weekend days. The model has to include a weekday and a weekend day. Using any combination of one weekday and one weekend day, the percentage of variance explained is >90%. Results indicate that 2 days of monitoring are needed to estimate the weekly physical activity behaviour in obese youth with an accelerometer. Our results also showed the importance of taking into consideration school day versus free day and weekday versus weekend day in assessing physical activity in obese youth. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Obesity in Rural Youth: Looking beyond Nutrition and Physical Activity

ERIC Educational Resources Information Center

Reed, Debra B.; Patterson, Patti J.; Wasserman, Nicole

2011-01-01

Contributors to excessive obesity in rural youth include well-documented nutrition and physical activity behaviors. However, emerging research suggests that preventing excessive weight gain and smoking during pregnancy, teen pregnancy, and child abuse also could reduce obesity in this vulnerable population. These traditional and emerging,…

The Role of Youth Sports in Promoting Children's Physical Activity and Preventing Pediatric Obesity: A Systematic Review.

PubMed

Lee, Jung Eun; Pope, Zachary; Gao, Zan

2018-01-01

Youth sport participation plays an important role in promoting physical activity among children and may be a possible venue for the prevention of pediatric obesity. To design effective physical activity interventions, it is imperative to understand how different aspects of sport participation influence physical activity (PA). The purpose of this article is to present a comprehensive review of the impact of youth sport participation on children's PA and obesity status. A total of 44 studies published up to January 2014 concerning youth sport participation, PA, and obesity status were identified. Inclusion criteria were studies comparing PA levels of sport participants to nonparticipants or those comparing PA levels in different sport types and settings. Studies with the outcome variables of obesity status (e.g., body mass index, fat percentage, waist circumference) were also included. Participation in youth sport was positively associated with children's PA levels, and youth participating in sports were more likely to persist in their PA. However, the relationship between youth sport participation and obesity status was inconclusive. Educators and sports professionals should find ways to involve children in various sports settings and policies and help obese children engage more in sports.

BMI Trajectories Associated With Resolution of Elevated Youth BMI and Incident Adult Obesity.

PubMed

Buscot, Marie-Jeanne; Thomson, Russell J; Juonala, Markus; Sabin, Matthew A; Burgner, David P; Lehtimäki, Terho; Hutri-Kähönen, Nina; Viikari, Jorma S A; Jokinen, Eero; Tossavainen, Paivi; Laitinen, Tomi; Raitakari, Olli T; Magnussen, Costan G

2018-01-01

Youth with high BMI who become nonobese adults have the same cardiovascular risk factor burden as those who were never obese. However, the early-life BMI trajectories for overweight or obese youth who avoid becoming obese adults have not been described. We aimed to determine and compare the young-childhood BMI trajectories of participants according to their BMI status in youth and adulthood. Bayesian hierarchical piecewise regression modeling was used to analyze the BMI trajectories of 2717 young adults who had up to 8 measures of BMI from childhood (ages 3-18 years) to adulthood (ages 34-49 years). Compared with those with persistently high BMI, those who resolved their high youth BMI by adulthood had lower average BMI at age 6 years and slower rates of BMI change from young childhood. In addition, their BMI levels started to plateau at 16 years old for females and 21 years old for males, whereas the BMI of those whose high BMI persisted did not stabilize until 25 years old for male subjects and 27 years for female subjects. Compared with those youth who were not overweight or obese and who remained nonobese in adulthood, those who developed obesity had a higher BMI rate of change from 6 years old, and their BMI continued to increase linearly until age 30 years. Efforts to alter BMI trajectories for adult obesity should ideally commence before age 6 years. The natural resolution of high BMI starts in adolescence for males and early adulthood for females, suggesting a critical window for secondary prevention. Copyright © 2018 by the American Academy of Pediatrics.

Cardiac abnormalities in youth with obesity and type 2 diabetes

USDA-ARS?s Scientific Manuscript database

Childhood obesity has been linked to cardiovascular disease (CVD) risk in adulthood. Of great concern is the expected increase in the population's CVD burden in relation to childhood obesity. This is compounded by the risk related to chronic hyperglycemia exposure in youth with type 2 diabetes. We h...

Receptivity to Television Fast-Food Restaurant Marketing and Obesity Among U.S. Youth

PubMed Central

McClure, Auden C.; Tanski, Susanne E.; Gilbert-Diamond, Diane; Adachi-Mejia, Anna M.; Li, Zhigang; Li, Zhongze; Sargent, James D.

2013-01-01

Background Advertisement of fast food on TV may contribute to youth obesity. Purpose The goal of the study was to use cued recall to determine whether TV fast-food advertising is associated with youth obesity. Methods A national sample of 2541 U.S. youth, aged 15–23 years, were surveyed in 2010–2011; data were analyzed in 2012. Respondents viewed a random subset of 20 advertisement frames (with brand names removed) selected from national TV fast-food restaurant advertisements (n=535) aired in the previous year. Respondents were asked if they had seen the advertisement, if they liked it, and if they could name the brand. A TV fast-food advertising receptivity score (a measure of exposure and response) was assigned; a 1-point increase was equivalent to affirmative responses to all three queries for two separate advertisements. Adjusted odds of obesity (based on self-reported height and weight), given higher TV fast-food advertising receptivity, are reported. Results The prevalence of overweight and obesity, weighted to the U.S. population, was 20% and 16%, respectively. Obesity, sugar-sweetened beverage consumption, fast-food restaurant visit frequency, weekday TV time, and TV alcohol advertising receptivity were associated with higher TV fast-food advertising receptivity (median=3.3 [interquartile range: 2.2–4.2]). Only household income, TV time, and TV fast-food advertising receptivity retained multivariate associations with obesity. For every 1-point increase in TV fast-food advertising receptivity score, the odds of obesity increased by 19% (OR=1.19, 95% CI=1.01, 1.40). There was no association between receptivity to televised alcohol advertisements or fast-food restaurant visit frequency and obesity. Conclusions Using a cued-recall assessment, TV fast-food advertising receptivity was found to be associated with youth obesity. PMID:24139768

Receptivity to television fast-food restaurant marketing and obesity among U.S. youth.

PubMed

McClure, Auden C; Tanski, Susanne E; Gilbert-Diamond, Diane; Adachi-Mejia, Anna M; Li, Zhigang; Li, Zhongze; Sargent, James D

2013-11-01

Advertisement of fast food on TV may contribute to youth obesity. The goal of the study was to use cued recall to determine whether TV fast-food advertising is associated with youth obesity. A national sample of 2541 U.S. youth, aged 15-23 years, were surveyed in 2010-2011; data were analyzed in 2012. Respondents viewed a random subset of 20 advertisement frames (with brand names removed) selected from national TV fast-food restaurant advertisements (n=535) aired in the previous year. Respondents were asked if they had seen the advertisement, if they liked it, and if they could name the brand. A TV fast-food advertising receptivity score (a measure of exposure and response) was assigned; a 1-point increase was equivalent to affirmative responses to all three queries for two separate advertisements. Adjusted odds of obesity (based on self-reported height and weight), given higher TV fast-food advertising receptivity, are reported. The prevalence of overweight and obesity, weighted to the U.S. population, was 20% and 16%, respectively. Obesity, sugar-sweetened beverage consumption, fast-food restaurant visit frequency, weekday TV time, and TV alcohol advertising receptivity were associated with higher TV fast-food advertising receptivity (median=3.3 [interquartile range: 2.2-4.2]). Only household income, TV time, and TV fast-food advertising receptivity retained multivariate associations with obesity. For every 1-point increase in TV fast-food advertising receptivity score, the odds of obesity increased by 19% (OR=1.19, 95% CI=1.01, 1.40). There was no association between receptivity to televised alcohol advertisements or fast-food restaurant visit frequency and obesity. Using a cued-recall assessment, TV fast-food advertising receptivity was found to be associated with youth obesity. © 2013 American Journal of Preventive Medicine.

Do Puerto Rican youth with asthma and obesity have higher odds for mental health disorders?

PubMed

Acosta-Pérez, Edna; Canino, Glorisa; Ramírez, Rafael; Prelip, Michael; Martin, Molly; Ortega, Alexander N

2012-01-01

Island Puerto Rican (PR) youth experience disproportionately high asthma and obesity rates compared with other racial/ethnic groups on the U.S. mainland. Previous research has demonstrated associations of chronic disease with psychiatric disorders. We examined the relationship among anxiety/depressive disorders, asthma, and obesity in an epidemiologic community sample of youth. The sample (n = 656) was derived from the second wave of an island-wide probabilistic representative household sample of PR youth stratified and based on whether or not they had a diagnosis of asthma and/or depressive/anxiety disorder. For this study, we used the subpopulation ages 10-19 years. Asthma and obesity were significantly related to higher odds of depressive/anxiety disorders in youth. Obesity moderated the relationship between asthma attacks and depressive/anxiety disorders. The relationship between asthma attack and higher odds for depressive/anxiety disorders was only present in the non-obese group. Among the obese, females show a significant increase from 11% to 36% in the prevalence of anxiety/depressive disorders. Asthma and obesity were highly prevalent and a significant association was found between asthma attack and depressive/anxiety disorders. The effects of asthma and obesity were not additive; the prevalence for psychiatric disorder for those having both conditions did not increase above the prevalence associated having only one of the conditions. Future studies should consider including longitudinal designs and examine the extent to which important variables not included in this study, such as body image dissatisfaction (particularly among females), teasing, and discrimination may moderate the relationship among obesity and depressive and anxiety disorders in youth. Published by Elsevier Inc.

Overweight and obesity prevalence rates among youth in the Carolinas.

PubMed

Terrell, Debra F

2002-01-01

Overweight and obesity have become major public health concerns in the United States, reaching epidemic proportions among adults and children in recent years. According to the most recent national surveys, American adults have experienced a 50% increase in the prevalence of overweight and obesity. Moreover, an alarming 100% increase has been observed among children and adolescents since the 1970s. To assess the status of overweight and obesity prevalence among youth in the Carolinas, weight, height, waist, and hip circumferences were monitored during routine cholesterol screenings among 11- to 14-year-olds in two school districts. Of the twelve hundred students screened, 32.4% percent were overweight and 16.4% were obese, exceeding national averages of 22% and 11%, respectively. The overweight and obesity prevalence rates were even more dramatic when broken down by gender and ethnic/racial groups. For instance, 54% of black girls and 45% of black boys were overweight, and better than half of these students were obese. Overweight and obesity prevalence rates among black girls were nearly twice the rates observed for white girls. Ethnic differences in percentage of overweight and obese boys were not as great as those observed among girls. A number of factors may contribute to the unprecedented levels of overweight and obesity observed among American youth, including physical inactivity, poor nutritional habits (i.e., high-fat meals and snacks, and super-sizing), economic, and social factors. Consequently, the coordinated efforts of physicians, school nurses, teachers, parents, and students will be necessary to effectively address the growing problem of childhood obesity.

Obesity and youth diabetes: distinguishing characteristics between islet cell antibody positive vs. negative patients over time.

PubMed

Rivera-Vega, Michelle Y; Flint, Amanda; Winger, Daniel G; Libman, Ingrid; Arslanian, Silva

2015-08-01

Obese youth clinically diagnosed with type 2 diabetes mellitus (T2DM) frequently have evidence of islet cell autoimmunity. We investigated the clinical and biochemical differences, and therapeutic modalities among autoantibody positive (Ab+) vs. autoantibody negative (Ab-) youth at the time of diagnosis and over time in a multi-provider clinical setting. Chart review of 145 obese youth diagnosed with T2DM from January 2003 to July 2012. Of these, 70 patients were Ab+ and 75 Ab-. The two groups were compared with respect to clinical presentation, physical characteristics, laboratory data, and therapeutic modalities at diagnosis and during follow up to assess the changes in these parameters associated with disease progression. At presentation, Ab+ youth with a clinical diagnosis of T2DM were younger, had higher rates of ketosis, higher hemoglobin A1c (HbA1c) and glucose levels, and lower insulin and c-peptide concentrations compared with the Ab- group. The Ab- group had a higher body mass index (BMI) z-score and cardiometabolic risk factors at diagnosis and such difference remained over time. Univariate analysis revealed that treatment modality had no effect on BMI in either group. Generalized estimating equations for longitudinal data analysis revealed that (i) BMI z-score and diastolic blood pressure (DBP) were significantly affected by duration of diabetes; (ii) systolic blood pressure (SBP) and ALT were affected by changes in BMI z-score; and (iii) changes in HbA1c had an effect on lipid profile and cardiometabolic risk factors regardless of antibody status. Irrespective of antibody status and treatment modality, youth who present with obesity and diabetes, show no improvement in obesity status over time, with the deterioration in BMI z-score affecting blood pressure (BP) and ALT, but the lipid profile being mostly impacted by HbA1c and glycemic control. Effective control of BMI and glycemia are needed to lessen the future macrovascular complications irrespective

Low Family Support and Risk of Obesity among Black Youth: Role of Gender and Ethnicity

PubMed Central

Assari, Shervin; Caldwell, Cleopatra Howard

2017-01-01

Most studies on the role of family environment in developing risk of obesity among youth have focused on parenting behaviors that are directly involved in energy balance in regional, non-representative White samples. Using a national sample of ethnically diverse Black youth, the current study tested the association between low family support and risk of obesity. We also tested the heterogeneity of this association based on gender, ethnicity, and their intersection. We used data from the National Survey of American Life-Adolescent Supplement (NSAL-A), a national survey of Black adolescents in the United States. The study enrolled 1170 African American and Caribbean Black 13–17 year old youth. Obesity was defined based on the cutoff points of body mass index (BMI) appropriate for age and gender of youth. Family support was measured using a five-item measure that captured emotional and tangible social support. Age, gender, and ethnicity were also measured. Logistic regressions were utilized in the pooled sample, and also based on gender, ethnicity, and their intersection, to test the link between low family support and risk for obesity. Results: In the pooled sample, low family support was not associated with an increased risk of obesity (OR = 1.35, 95% Confidence Interval (CI) = 0.96–1.89). The association between low family support and risk of obesity was, however, significant among African American females (OR = 1.60, 95% CI = 1.01–2.55). There was no association for African American males (OR = 1.26, 95% CI = 0.82–1.92), Caribbean Black males (OR = 0.68, 95% CI = 0.01–54.85), and Caribbean Black females (OR = 0.78, 95% CI = 0.42–1.44). In conclusion, policies and programs that enable African American families to provide additional family support may prevent obesity among African American female youth. Future research should test the efficacy of promoting family support as a tool for preventing obesity among African American female youth. PMID:28498351

Coronary artery calcification in obese youth: What are the phenotypic and metabolic determinants?

USDA-ARS?s Scientific Manuscript database

Obesity in adolescence has been associated with increased risk for coronary heart disease in adulthood. This study evaluated subclinical atherosclerosis in obese youth and the underlying risk factors. Ninety obese adolescents (37 normal glucose tolerant, 27 prediabetes, and 26 type 2 diabetes) under...

Self-esteem outcomes over a summer camp for obese youth.

PubMed

McGregor, S; McKenna, J; Gately, P; Hill, A J

2016-12-01

Variation in the existing literature on the psychosocial benefits of weight loss in obese youth results, in part, from methodological limitations and modest weight loss. Accordingly, this research assessed perceived self-competence and low self-esteem during an intensive weight loss programme in a large sample of obese youth and related these to starting weight, gender and weight loss. Over 4 years, 303 obese male and female adolescents (body mass index [BMI] 34.3 kg m -2 , BMI standard deviation score 2.99; 14.7 years) attended a residential weight loss camp for a mean duration of 31 d. Outcome variables included dimensional self-esteem (Harter) and weight change over the camp. At the start of camp, obese youth scored highest on social acceptance and lowest on physical appearance and athletic competence. Global self-worth and most domains of self-competence improved significantly over the intervention. The proportion with low global self-worth reduced from 35% to 16%, but there was little change in the proportion reporting high self-competence (23%). Mean weight loss was -5.5 kg (BMI standard deviation scores -0.25) with boys and those heaviest at the start losing most. Weight loss was significantly correlated with improved physical appearance (r = 0.13) and athletic competence (r = 0.19), but not global self-worth. This intensive weight loss intervention yielded significant psychological benefit, especially in self-competence and among individuals achieving most weight loss. The weak association with weight loss suggests the influence of other contributing environmental or social features that should be the focus of further research. © 2016 World Obesity Federation.

Overweight and obesity prevalence among Cree youth of Eeyou Istchee according to three body mass index classification systems.

PubMed

St-Jean, Audray; Meziou, Salma; Ayotte, Pierre; Lucas, Michel

2017-11-22

Little is known about the suitability of three commonly used body mass index (BMI) classification systems for Indigenous youth. We estimated overweight and obesity prevalence among Cree youth of Eeyou Istchee according to three BMI classification systems, assessed the level of agreement between them, and evaluated their accuracy through body fat and cardiometabolic risk factors. Data on 288 youth (aged 8-17 years) were collected. Overweight and obesity prevalence were estimated with Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF) and World Health Organization (WHO) criteria. Agreement was measured with weighted kappa (κw). Associations with body fat and cardiometabolic risk factors were evaluated by analysis of variance. Obesity prevalence was 42.7% with IOTF, 47.2% with CDC, and 49.3% with WHO criteria. Agreement was almost perfect between IOTF and CDC (κw = 0.93), IOTF and WHO (κw = 0.91), and WHO and CDC (κw = 0.94). Means of body fat and cardiometabolic risk factors were significantly higher (P trend  < 0.001) from normal weight to obesity, regardless of the system used. Youth considered overweight by IOTF but obese by CDC or WHO exhibited less severe clinical obesity. IOTF seems to be more accurate in identifying obesity in Cree youth.

Thinness, overweight and obesity in indigenous youth in Oaxaca, 1970 and 2007.

PubMed

Malina, Robert M; Peña-Reyes, María Eugenia; Bali-Chávez, Guillermo; Little, Bertis B

2013-08-01

To evaluate change in body mass index (BMI) and weight status of indigenous youth in Oaxaca between the 1970s and 2007. Heights and weights were measured in cross-sectional samples of school children 6-14 years in the 1970s (2 897) and 2007 (4 305); BMI was calculated. International Obesity Task Force cutoffs for weight status were used. BMI and prevalence of severe and moderate thinness, overweight and obesity were compared by year. BMI increased significantly across time. Primary change in weight status occurred in overweight, 1970s, <2%; 2007, 7 to 12%. Little change occurred in thinness (<2%) and obesity (≤ 1%) in both surveys, except in children 6-9 years (obesity=4% in 2007). BMI and prevalence of overweight increased across all ages from the 1970s to 2007, but children 6-9 years appeared to be more at risk for obesity than youth 10-14 years. Prevalence of thinness was unchanged.

After School Activities, Overweight, and Obesity among Inner City Youth

ERIC Educational Resources Information Center

Elkins, Whitney L.; Cohen, Deborah A.; Koralewicz, Lisa M.; Taylor, Stephanie N.

2004-01-01

We examined the association of adolescent obesity with participation in sports among 5489 low-income, inner city public high school students. Among inner city youth 28.5% of males and 33.7% of females were overweight and 15.9% of boys and 16.4% of girls were obese. For both males and females, participation in an increasing number of athletic…

SaludableOmaha: development of a youth advocacy initiative to increase community readiness for obesity prevention, 2011-2012.

PubMed

Frerichs, Leah; Brittin, Jeri; Stewart, Catherine; Robbins, Regina; Riggs, Cara; Mayberger, Susan; Cervantes, Alberto; Huang, Terry T-K

2012-01-01

Childhood obesity rates in minority populations continue to rise despite leveling national trends. Although interventions that address social and environmental factors exist, processes that create demand for policy and environmental change within communities have not been identified. We developed a pilot program in South Omaha, a Nebraska Latino community, based on the community readiness model (CRM), called SaludableOmaha. We used CRM to explore the potential of youth advocacy to shift individual and community norms regarding obesity prevention in South Omaha and to advocate for health-promoting community environments. We used CRM to assess supply and demand for health programs, engage the community, determine the community's baseline readiness to address childhood obesity, and guide youth advocacy program development. We conducted our project in 2 phases. In the first, we trained a cohort of youth. In the second, the youth cohort created and launched a Latino health movement, branded as SaludableOmaha. A third phase, which is currently under way, is directed at institutionalizing youth advocacy in communities. At baseline, the community studied was at a low stage of readiness for change. Our program generated infrastructure and materials to support the growth and institutionalization of youth advocacy as a means of increasing community readiness for addressing obesity prevention. CRM is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community. Community partnerships such as SaludableOmaha can aid the adoption of obesity prevention programs.

Prevalence of obesity among youths in Mississippi: United States, 1999-2015.

PubMed

Aranmolate, Rasaki

2017-11-23

Background The prevalence of obesity among youths has become a public health problem. The trend in the prevalence of obesity among high school students in Mississippi has not been examined in the last 17 years. Methods The data from the Mississippi High School Youth Risk Behavior Survey from 1999 to 2015 were used to determine the prevalence of obesity. The definition of obesity was based on age- and sex-specific body mass index (BMI) of more than 95th percentile, according to 2000 Centers for Disease Control and Prevention (CDC) growth charts. The differences in the groups were examined using the univariate t-test statistical analysis at p < 0.05 and frequency distribution to determine the percentage differences. Results There was a decline in the prevalence of obesity from 1999 to 2015 among Whites but no significant decrease among Blacks. The prevalence based on race in 2105 was 18.9%, which is higher than 14.4% in 1999 and remaining years. The rate of obesity based on race and sex was 27.7% among Blacks and 15.9% among White males in 2015. The Black females had prevalence of 20.6%, which is higher than their White counterpart (12.1%) in 2015 and previous years. Conclusion The prevalence of obesity among Blacks was higher when compared to White students. There was an increased prevalence of obesity in males over females. Students in 9th and 10th grade had a higher prevalence of obesity than those in 11th and 12th grade.

Are overweight and obese youths more often bullied by their peers? A meta-analysis on the correlation between weight status and bullying.

PubMed

van Geel, M; Vedder, P; Tanilon, J

2014-10-01

Research suggests that overweight and obese youths are stigmatized in contemporary society, and are more likely than normal-weight youths to become the victims of bullying. In the current study, meta-analyses were performed to analyze to what extent overweight and obese youths are more likely than normal-weight youths to be the victims of bullying. The databases Psychinfo, ERIC and Medline were searched for relevant articles. Retrieved articles were scanned to find further articles. Language was not used as an exclusion criterion. A total of 14 articles (N=55 231) were included in a meta-analysis on bullying and overweight youths, and a total of 16 articles (N=58 520) were included in a meta-analysis on bullying and obese youths. The results suggested that both overweight and obese youths were more likely to be victims of bullying. The results were not moderated by gender, overweight and obese boys and girls were equally likely to be victimized. Results remained significant after adjustment for publication bias. Both overweight and obesity are risk factors for being a victim of bullying.

Mini-review: Obesity in Caribbean Youth.

PubMed

Traboulay, E A; Hoyte, O P-A

2015-06-01

Our focus was on the determination of the growing number of youths of every race and ethnicity, diagnosed with obesity and its co-morbidities in the Caribbean. We reviewed the causes and strategies to combat obesity, and the implications of the fast food industry in enabling the escalation of obesity. We consulted several databases such as PubMed, MEDLINE, the Obesity Gene Map Database, and the USEPA Toxicity Reference Database. Organizations such as the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), Organization for Economic Co-operation and Development (OECD) and the Pan American Health Organization (PAHO) were used as information sources. Transgenerational effects and triggers like obesogens, pathogens, environmental stress, antibiotics and gut microbiota are some of the causes of obesity, and some of these triggers are imprinted epigenetically early in embryonic development, leading to lifelong obesity. With an estimated population of 42 million in the Caribbean, the economic cost of obesity, including medical, absenteeism, presenteeism, insurance, disability, direct and indirect cost, was estimated cost of 68.5 billion USD with 88.2 million quality-adjusted life years lost. Genome-wide association studies have established that genetics play a role in the aetiology of this "non-communicable" disease. While the development of personalized interventions according to genotype is futuristic, we must focus on effective nutrition and physical education classes in schools and establishing monitoring programmes using simple tools such as scales and tape measures as suggested intervention. A Pigovian tax to control the fast food industry is mandatory. Nevertheless, lifestyle adjustment, including alterations in diet and increased physical activity, continues to be a sound recommendation.

Mini-review: Obesity in Caribbean Youth

PubMed Central

Traboulay, EA; Hoyte, OPA

2015-01-01

ABSTRACT Objective: Our focus was on the determination of the growing number of youths of every race and ethnicity, diagnosed with obesity and its co-morbidities in the Caribbean. We reviewed the causes and strategies to combat obesity, and the implications of the fast food industry in enabling the escalation of obesity. Methods: We consulted several databases such as PubMed, MEDLINE, the Obesity Gene Map Database, and the USEPA Toxicity Reference Database. Organizations such as the World Health Organization (WHO), Centres for Disease Control and Prevention (CDC), Organization for Economic Co-operation and Development (OECD), and the Pan American Health Organization (PAHO) were used as information sources. Results: Transgenerational effects and triggers like obesogens, pathogens, environmental stress, antibiotics and gut microbiota are some of the causes of obesity, and some of these triggers are imprinted epigenetically early in embryonic development, leading to lifelong obesity. With an estimated population of 42 million in the Caribbean, the economic cost of obesity, including medical, absenteeism, presenteeism, insurance, disability, direct and indirect cost, was estimated at 68.5 billion USD with 88.2 million quality-adjusted life years lost. Conclusion: Genome-wide association studies have established that genetics play a role in the aetiology of this “non-communicable” disease. While the development of personalized interventions according to genotype is futuristic, we must focus on effective nutrition and physical education (PE) classes in schools and establishing monitoring programmes using simple tools such as scales and tape measures as suggested intervention. A Pigovian tax to control the fast food industry is mandatory. Nevertheless, lifestyle adjustment, including alterations in diet and increased physical activity, continues to be a sound recommendation. PMID:26426179

Partnering with Carryouts: Implementation of a Food Environment Intervention Targeting Youth Obesity

ERIC Educational Resources Information Center

Perepezko, K.; Tingey, L.; Sato, P.; Rastatter, S.; Ruggiero, C.; Gittelsohn, J.

2018-01-01

Youth obesity is a major public health problem in the United States, especially among urban-based, minority youth. The B'More Healthy Communities for Kids (BHCK) trial worked at multiple levels of the food environment, including carryouts, to increase access to and demand for healthy, affordable foods. The objective of this article is to describe…

Translating evidence based violence and drug use prevention to obesity prevention: development and construction of the pathways program.

PubMed

Sakuma, Kari-Lyn K; Riggs, Nathaniel R; Pentz, Mary Ann

2012-04-01

Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health, a school-based obesity prevention program that was developed by translating from evidence-based violence and drug use prevention programs, Promoting Alternative THinking Strategies and the Midwestern Prevention Project STAR (STAR). We illustrate how a hypothesized underlying behavior change mechanism in two domains of risk behavior, violence and substance use, can be applied to obesity prevention. A 4-step translational process is provided and may be relevant for use in developing other curricula to address multiple health risk behaviors. Practical application and decision points are also provided.

Translating evidence based violence and drug use prevention to obesity prevention: development and construction of the Pathways program

PubMed Central

Sakuma, Kari-Lyn K.; Riggs, Nathaniel R.; Pentz, Mary Ann

2012-01-01

Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health, a school-based obesity prevention program that was developed by translating from evidence-based violence and drug use prevention programs, Promoting Alternative THinking Strategies and the Midwestern Prevention Project STAR (STAR). We illustrate how a hypothesized underlying behavior change mechanism in two domains of risk behavior, violence and substance use, can be applied to obesity prevention. A 4-step translational process is provided and may be relevant for use in developing other curricula to address multiple health risk behaviors. Practical application and decision points are also provided. PMID:21987475

SaludableOmaha: Development of a Youth Advocacy Initiative to Increase Community Readiness for Obesity Prevention, 2011–2012

PubMed Central

Frerichs, Leah; Brittin, Jeri; Stewart, Catherine; Robbins, Regina; Riggs, Cara; Mayberger, Susan; Cervantes, Alberto

2012-01-01

Background Childhood obesity rates in minority populations continue to rise despite leveling national trends. Although interventions that address social and environmental factors exist, processes that create demand for policy and environmental change within communities have not been identified. Community Context We developed a pilot program in South Omaha, a Nebraska Latino community, based on the community readiness model (CRM), called SaludableOmaha. We used CRM to explore the potential of youth advocacy to shift individual and community norms regarding obesity prevention in South Omaha and to advocate for health-promoting community environments. Methods We used CRM to assess supply and demand for health programs, engage the community, determine the community’s baseline readiness to address childhood obesity, and guide youth advocacy program development. We conducted our project in 2 phases. In the first, we trained a cohort of youth. In the second, the youth cohort created and launched a Latino health movement, branded as SaludableOmaha. A third phase, which is currently under way, is directed at institutionalizing youth advocacy in communities. Outcome At baseline, the community studied was at a low stage of readiness for change. Our program generated infrastructure and materials to support the growth and institutionalization of youth advocacy as a means of increasing community readiness for addressing obesity prevention. Interpretation CRM is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community. Community partnerships such as SaludableOmaha can aid the adoption of obesity prevention programs. PMID:23217590

A Conceptual Framework for the Expansion of Behavioral Interventions for Youth Obesity: A Family-Based Mindful Eating Approach

PubMed Central

Brody, Janet L.; Staples, Julie K.; Sedillo, Donna

2015-01-01

Abstract Background: Currently, over 30% of US youth are overweight and 1 in 6 have metabolic syndrome, making youth obesity one of the major global health challenges of the 21st century. Few enduring treatment strategies have been identified in youth populations, and the majority of standard weight loss programs fail to adequately address the impact of psychological factors on eating behavior and the beneficial contribution of parental involvement in youth behavior change. Methods: A critical need exists to expand treatment development efforts beyond traditional education and cognitive-behavioral programs and explore alternative treatment models for youth obesity. Meditation-based mindful eating programs represent a unique and novel scientific approach to the current youth obesity epidemic given that they address key psychological variables affecting weight. Results: The recent expansion of mindfulness programs to include family relationships shows the immense potential for broadening the customarily individual focus of this intervention to include contextual factors thought to influence youth health outcomes. Conclusions: This article provides an overview of how both mindful eating and family systems theory fits within a conceptual framework in order to guide development of a comprehensive family-based mindful eating program for overweight youth. PMID:26325143

A conative educational model for an intervention program in obese youth.

PubMed

Vanhelst, Jérémy; Béghin, Laurent; Fardy, Paul Stephen; Bui-Xuan, Gilles; Mikulovic, Jacques

2012-06-07

Obesity in children has increased in recent years throughout the world and is associated with adverse health consequences. Early interventions, including appropriate pedagogy strategies, are important for a successful intervention program. The aim of this study was to assess changes in body mass index, the ability to perform sport activities, behavior in the classroom and academic performance following one year of a health-wellness intervention program in obese youth. The CEMHaVi program included 37 obese children (19 girls and 18 boys). Participants received an intervention program consisting of physical activity and health education. Assessment included body mass index, academic performance, classroom performance and ability to perform sport activities. Paired t tests were used to assess the effects of intervention, and chi square was used to assess inter-action between measures. Findings of the study suggest significant decrease in Z scores of Body Mass Index and an improvement of academic performance, classroom behavior and the ability to perform sport activities (p < 0.05). Chi square testing showed significant positive inter-actions between body mass index, classroom behavior and academic performance. Results following year one of CEMHaVi showed that a program of physical activity and health education had positive effects on obesity, behavior in the classroom and the ability to perform sport activities in obese adolescents. Significant inter-action in changes between variables was observed. Findings are important for designing intervention models to improve health in obese youth.

Association between the Family Nutrition and Physical Activity Screening Tool and obesity severity in youth referred to weight management.

PubMed

Tucker, Jared M; Howard, Kathleen; Guseman, Emily H; Yee, Kimbo E; Saturley, Heather; Eisenmann, Joey C

The Family Nutrition and Physical Activity Screening Tool (FNPA) evaluates family behavioural and environmental factors associated with pediatric obesity, but it is unknown if FNPA scores differ among youth across obesity severities. Our aim was to determine the association between the FNPA and obesity severity in youth referred to weight management. Upon initiating treatment, height, weight, and the FNPA were collected according to standard procedures. Cut-points for overweight/obesity, severe obesity (SO) class 2, and SO class 3 were calculated. FNPA scores were compared across weight status groups using analysis of covariance, and odds of SO across FNPA quartiles were evaluated with multiple logistic regression. Participants included 564 5-18year old who initiated treatment and completed the FNPA. After adjustment, FNPA scores differed by weight status with higher/healthier scores in youth with overweight/obesity (56.6±8.5) when compared to those with SO class 2 (55.0±7.1; p=0.015) or SO class 3 (53.6±9.0; p<0.001). Compared to those in the highest FNPA quartile, youth in the 2nd quartile had 1.8 (95% CI: 1.1, 2.9) times higher odds of SO, and those in the lowest FNPA quartile had 2.1 (95% CI: 1.3, 3.4) times higher odds of SO. Youth with SO had unhealthier subscale scores among 6 of 10 constructs, including nutritional, physical activity, sedentary, and sleep behaviours. Results suggest a consistent inverse relationship between the FNPA and adiposity among youth presenting for weight management. The FNPA is a useful metric for programs and clinicians targeting family behaviours and the home environment to combat obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Obesity, islet cell autoimmunity, and cardiovascular risk factors in youth at onset of type 1 autoimmune diabetes.

PubMed

Cedillo, Maribel; Libman, Ingrid M; Arena, Vincent C; Zhou, Lei; Trucco, Massimo; Ize-Ludlow, Diego; Pietropaolo, Massimo; Becker, Dorothy J

2015-01-01

The current increase in childhood type 1 diabetes (T1D) and obesity has led to two conflicting hypotheses and conflicting reports regarding the effects of overweight on initiation and spreading of islet cell autoimmunity vs earlier clinical manifestation of preexisting autoimmune β-cell damage driven by excess weight. The objective of the study was to address the question of whether the degree of β-cell autoimmunity and age are related to overweight at diabetes onset in a large cohort of T1D youth. This was a prospective cross-sectional study of youth with autoimmune T1D consecutively recruited at diabetes onset. The study was conducted at a regional academic pediatric diabetes center. Two hundred sixty-three consecutive children younger than 19 years at onset of T1D participated in the study. Relationships between body mass index and central obesity (waist circumference and waist to height ratio) and antigen spreading (islet cell autoantibody number), age, and cardiovascular (CVD) risk factors examined at onset and/or 3 months after the diagnosis were measured. There were no significant associations between number of autoantibodies with measures of adiposity. Age relationships revealed that a greater proportion of those with central obesity (21%) were in the youngest age group (0-4 y) compared with those without central obesity (6%) (P = .001). PATIENTS with central obesity had increased CVD risk factors and higher onset C-peptide levels (P < .05). No evidence was found to support the concept that obesity accelerates progression of autoantibody spreading once autoimmunity, marked by standard islet cell autoantibody assays, is present. Central obesity was present in almost one-third of the subjects and was associated with early CVD risk markers already at onset.

The Association of Parental/Caregiver Chronic Stress with Youth Obesity: Findings from the Study of Latino Youth and the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

PubMed

Isasi, Carmen R; Hua, Simin; Jung, Molly; Carnethon, Mercedes R; Perreira, Krista; Vidot, Denise C; Salazar, Christian R; McCurley, Jessica L; Sotres-Alvarez, Daniela; Van Horn, Linda; Delamater, Alan M; Llabre, Maria M; Gallo, Linda C

2017-08-01

Prior studies indicate that chronic stress is associated with obesity in adults. However, whether parental/caregiver stress is associated with obesity in their offspring has not been widely examined in Hispanic/Latino populations. In this study, we evaluated the role of caregiver chronic stress on child obesity and whether home food environment or child lifestyle behaviors explained the association. The study included a sample of Hispanic/Latino youth and their caregivers (n = 473) from the Study of Latinos (SOL) Youth study and the Hispanic Community Health Study/SOL Sociocultural Study, which enrolled children aged 8-16 years from four cities (Bronx, Chicago, Miami, and San Diego), and provided assessments of adult chronic stress. Poisson regression models were used to assess the association between parental/caregiver stress and child obesity, adjusting for potential confounders. Twenty-two percent of caregivers did not report any chronic stressors, 48% reported 1-2, and 29% reported ≥3 stressors. The prevalence of obesity in youth increased with number of caregiver stressors from 23% among those without caregiver stressors to 35% among those with ≥3 stressors (p for trend 0.03). After model adjustment, youths whose caregivers reported ≥3 stressors were more likely to be obese than youths whose caregivers reported no stressors (prevalence ratio = 1.53; 95% confidence interval 1.01-2.32). This association was independent of food home environment, child diet quality, and child physical activity, but it was not independent of caregiver obesity. These findings suggest that parental/caregiver chronic stress is related to obesity in their children. Future research is needed to confirm this association in longitudinal studies and in other population groups.

A Systematic Review of Literature on Culturally Adapted Obesity Prevention Interventions for African American Youth

ERIC Educational Resources Information Center

Lofton, Saria; Julion, Wrenetha A.; McNaughton, Diane B.; Bergren, Martha Dewey; Keim, Kathryn S.

2016-01-01

Obesity and overweight prevalence in African American (AA) youth continues to be one of the highest of all major ethnic groups, which has led researchers to pursue culturally based approaches as a means to improve obesity prevention interventions. The purpose of this systematic review was to evaluate culturally adapted obesity prevention…

Impact of a 12-week high-intensity interval training without caloric restriction on body composition and lipid profile in sedentary healthy overweight/obese youth

PubMed Central

Khammassi, Marwa; Ouerghi, Nejmeddine; Hadj-Taieb, Sameh; Feki, Moncef; Thivel, David; Bouassida, Anissa

2018-01-01

Although High-intensity interval training (HIIT) has shown its effectiveness in improving body composition, cardio-respiratory fitness and lipid profile in obese adults, evidences remain limited in overweight/obese youth. This study was conducted to investigate the effect of a 12-week HIIT program without caloric restriction on body composition and lipid profile among young overweight/obese men. Twenty healthy obese youth were randomly allocated into two groups; experimental group (HIIT) and control group. The HIIT program consisted in 3 exercises sessions per week (30 sec of work at 100% maximal aerobic velocity [MAV]) interspersed by 30 sec of active recovery at 50% MAV, starting by 15 repetitions to reach 27 by the end of the program. Aerobic capacity (MAV and maximum oxygen uptake [VO2max]), body composition (body mass index [BMI], waist circumference [WC], and fat mass percent) and lipid profile (triglycerides [TG] and total, high-density lipoprotein [HDL] and low-density lipoprotein [LDL] cholesterol) were determined before and after the HIIT program. Following 12 weeks of HIIT, WC, BMI (P<0.01), and fat mass percent (P<0.05) were significantly decreased. MAV and VO2max were significantly improved in the HIIT group, only. Total cholesterol (P<0.05) and TG (P<0.05) decreased significantly in the HIIT group, while LDL and HDL cholesterol levels remained unchanged in both groups. HIIT may be particularly useful in overweight/obese youth to improve body composition, aerobic fitness and lipid profile. PMID:29511662

Impact of a 12-week high-intensity interval training without caloric restriction on body composition and lipid profile in sedentary healthy overweight/obese youth.

PubMed

Khammassi, Marwa; Ouerghi, Nejmeddine; Hadj-Taieb, Sameh; Feki, Moncef; Thivel, David; Bouassida, Anissa

2018-02-01

Although High-intensity interval training (HIIT) has shown its effectiveness in improving body composition, cardio-respiratory fitness and lipid profile in obese adults, evidences remain limited in overweight/obese youth. This study was conducted to investigate the effect of a 12-week HIIT program without caloric restriction on body composition and lipid profile among young overweight/obese men. Twenty healthy obese youth were randomly allocated into two groups; experimental group (HIIT) and control group. The HIIT program consisted in 3 exercises sessions per week (30 sec of work at 100% maximal aerobic velocity [MAV]) interspersed by 30 sec of active recovery at 50% MAV, starting by 15 repetitions to reach 27 by the end of the program. Aerobic capacity (MAV and maximum oxygen uptake [VO2max]), body composition (body mass index [BMI], waist circumference [WC], and fat mass percent) and lipid profile (triglycerides [TG] and total, high-density lipoprotein [HDL] and low-density lipoprotein [LDL] cholesterol) were determined before and after the HIIT program. Following 12 weeks of HIIT, WC, BMI ( P <0.01), and fat mass percent ( P <0.05) were significantly decreased. MAV and VO2max were significantly improved in the HIIT group, only. Total cholesterol ( P <0.05) and TG ( P <0.05) decreased significantly in the HIIT group, while LDL and HDL cholesterol levels remained unchanged in both groups. HIIT may be particularly useful in overweight/obese youth to improve body composition, aerobic fitness and lipid profile.

Establishment of the Pediatric Obesity Weight Evaluation Registry: A National Research Collaborative for Identifying the Optimal Assessment and Treatment of Pediatric Obesity.

PubMed

Kirk, Shelley; Armstrong, Sarah; King, Eileen; Trapp, Christine; Grow, Mollie; Tucker, Jared; Joseph, Madeline; Liu, Lenna; Weedn, Ashley; Sweeney, Brooke; Fox, Claudia; Fathima, Samreen; Williams, Ronald; Kim, Roy; Stratbucker, William

2017-02-01

Prospective patient registries have been successfully utilized in several disease states with a goal of improving treatment approaches through multi-institutional collaboration. The prevalence of youth with severe obesity is at a historic high in the United States, yet evidence to guide effective weight management is limited. The Pediatric Obesity Weight Evaluation Registry (POWER) was established in 2013 to identify and promote effective intervention strategies for pediatric obesity. Sites in POWER provide multicomponent pediatric weight management (PWM) care for youth with obesity and collect a defined set of demographic and clinical parameters, which they regularly submit to the POWER Data Coordinating Center. A program profile survey was completed by sites to describe characteristics of the respective PWM programs. From January 2014 through December 2015, 26 US sites were enrolled in POWER and had submitted data on 3643 youth with obesity. Ninety-five percent were 6-18 years of age, 54% female, 32% nonwhite, 32% Hispanic, and 59% publicly insured. Over two-thirds had severe obesity. All sites included a medical provider and used weight status in their referral criteria. Other program characteristics varied widely between sites. POWER is an established national registry representing a diverse sample of youth with obesity participating in multicomponent PWM programs across the United States. Using high-quality data collection and a collaborative research infrastructure, POWER aims to contribute to the development of evidence-based guidelines for multicomponent PWM programs.

School-Based Programs Aimed at the Prevention and Treatment of Obesity: Evidence-Based Interventions for Youth in Latin America

ERIC Educational Resources Information Center

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

2013-01-01

Background: 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…

Overweight and obesity in youth in schools-the role of the school nurse: position statement.

PubMed

2014-05-01

It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as the school nurse) has the knowledge and expertise to promote the prevention of overweight and obesity and address the needs of overweight and obese youth in schools. The school nurse collaborates with students, families, school personnel, and health care providers to promote healthy weight and identify overweight and obese youth who may be at risk for health problems. The school nurse can refer and follow up with students who may need to see a health care provider. The school nurse also educates and advocates for changes in school and district policies that promote a healthy lifestyle for all students.

Food, fun, and fitness internet program for girls: Pilot evaluation of an e-Health youth obesity prevention program examining predictors of obesity

USDA-ARS?s Scientific Manuscript database

This pilot study tested whether an Internet-based intervention could achieve change in fruit, juice, and vegetable consumption, physical activity, and self-efficacy in youth at-risk of obesity. Participants were 80 8- to 10-year-old African American girls at-risk of obesity, with a home computer, In...

Nocturnal Anxiety in a Youth with Rapid-onset Obesity, Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD).

PubMed

Grudnikoff, Eugene; Foley, Carmel; Poole, Claudette; Theodosiadis, Eva

2013-08-01

Behavioral and psychiatric disorders are common in youth with rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD). We outline a rational approach to psychiatric treatment of a patient with a complex medical condition. We report the course of symptoms in a teen with ROHHAD, the inpatient treatment, and review current evidence for use of psychopharmacologic agents in youth with sleep and anxiety disturbances. A 14-year-old female began rapidly gaining weight as a preschooler, developed hormonal imbalance, and mixed sleep apnea. Consultation was requested after a month of ROHHAD exacerbation, with severe anxiety, insomnia, and auditory hallucinations. Olanzapine and citalopram were helpful in controlling the symptoms. Following discharge, the patient gained weight and olanzapine was discontinued. Lorazepam was started in coordination with pulmonary service. Relevant pharmacologic considerations included risk of respiratory suppression, history of paradoxical reaction to hypnotics, hepatic isoenzyme interactions and side effects of antipsychotics. Core symptoms of ROHHAD may precipitate psychiatric disorders. A systematic evidence-based approach to psychopharmacology is necessary in the setting of psychiatric consultation.

Nocturnal Anxiety in a Youth with Rapid-onset Obesity, Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD)

PubMed Central

Grudnikoff, Eugene; Foley, Carmel; Poole, Claudette; Theodosiadis, Eva

2013-01-01

Objective: Behavioral and psychiatric disorders are common in youth with rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD). We outline a rational approach to psychiatric treatment of a patient with a complex medical condition. Methods: We report the course of symptoms in a teen with ROHHAD, the inpatient treatment, and review current evidence for use of psychopharmacologic agents in youth with sleep and anxiety disturbances. Results: A 14-year-old female began rapidly gaining weight as a preschooler, developed hormonal imbalance, and mixed sleep apnea. Consultation was requested after a month of ROHHAD exacerbation, with severe anxiety, insomnia, and auditory hallucinations. Olanzapine and citalopram were helpful in controlling the symptoms. Following discharge, the patient gained weight and olanzapine was discontinued. Lorazepam was started in coordination with pulmonary service. Relevant pharmacologic considerations included risk of respiratory suppression, history of paradoxical reaction to hypnotics, hepatic isoenzyme interactions and side effects of antipsychotics. Conclusions: Core symptoms of ROHHAD may precipitate psychiatric disorders. A systematic evidence-based approach to psychopharmacology is necessary in the setting of psychiatric consultation. PMID:23970913

Cardiovascular consequences of childhood obesity.

PubMed

McCrindle, Brian W

2015-02-01

Childhood and adolescent overweight and obesity is an important and increasingly prevalent public health problem in Canada and worldwide. High adiposity in youth is indicated in clinical practice by plotting body mass index on appropriate percentile charts normed for age and sex, although waist measures might be a further tool. High adiposity can lead to adiposopathy in youth, with associated increases in inflammation and oxidative stress, changes in adipokines, and endocrinopathy. This is manifest as cardiometabolic risk factors in similar patterns to those in noted in obese adults. Obesity and cardiometabolic risk factors have been shown to be associated with vascular changes indicative of early atherosclerosis, and ventricular hypertrophy, dilation, and dysfunction. These cardiovascular consequences are evident in youth, but childhood obesity is also predictive of similar consequences in adulthood. Childhood obesity and risk factors have been shown to track into adulthood and worsen in most individuals. The result is an exponential acceleration of atherosclerosis, which can be predicted to translate into an epidemic of premature cardiovascular disease and events. A change in paradigm is needed toward preventing and curing atherosclerosis and not just preventing cardiovascular disease. This would necessarily create an imperative for preventing and treating childhood obesity. Urgent attention, policy, and action are needed to avoid the enormous future social and health care costs associated with the cardiovascular consequences of obesity in youth. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Parental and Home Environmental Facilitators of Sugar-Sweetened Beverage Consumption among Overweight and Obese Latino Youth

PubMed Central

Bogart, Laura M.; Cowgill, Burt O.; Sharma, Andrea J.; Uyeda, Kimberly; Sticklor, Laurel A.; Alijewicz, Katie E.; Schuster, Mark A.

2013-01-01

Objective To explore parental and home environmental facilitators of sugar-sweetened beverage (SSB) and water consumption among obese/overweight Latino youth. Methods Semi-structured interviews were conducted with 55 overweight/obese Latino youth aged 10-18 and 55 parents, recruited from school-based clinics and a school in one West-coast district. All youth consumed SSBs regularly and lived in a home where SSBs were available. We used qualitative methods to examine key themes around beliefs about SSBs and water, facilitators of SSB and water consumption, and barriers to reducing SSB consumption. Results A few parents and youth believed that sports drinks are healthy. Although nearly all felt that water is healthy, most parents and about half of youth thought that tap water is unsafe. About half of parent-child dyads had discordant beliefs regarding their perceptions of tap water. About half of parents believed that home-made culturally relevant drinks (e.g., aguas frescas), which typically contain sugar, fruit, and water, were healthy due to their “natural” ingredients. Participants cited home availability as a key factor in SSB consumption. About half of parents set no rules about SSB consumption at home. Among those with rules, most parent-child pairs differed on their beliefs about the content of the rules, and youth reported few consequences for breaking rules. Conclusions Obesity programs for Latino youth should address misconceptions around water, and discuss culturally relevant drinks and sports drinks as potential sources of weight gain. Healthcare providers can help parents set appropriate rules by educating about the risks of keeping SSBs at home. PMID:23680295

Upstream ecological risks for overweight and obesity among African American youth in a rural town in the Deep South, 2007.

PubMed

Scott, Alison J; Wilson, Rebecca F

2011-01-01

Few studies have focused on overweight and obesity among rural African American youth in the Deep South, despite disproportionately high rates in this group. In addition, few studies have been conducted to elucidate how these disparities are created and perpetuated within rural communities in this region. This descriptive study explores community-based risks for overweight and obesity among African American youth in a rural town in the Deep South. We used ecological theory in conjunction with embodiment theory to explore how upstream ecological factors may contribute to risk of overweight and obesity for African American youth in a rural town in the Deep South. We conducted and analyzed in-depth interviews with African American community members who interact with youth in varying contexts (home, school, church, community). Participants most commonly stated that race relations, poverty, and the built environment were barriers to maintaining a healthy weight. Findings suggested the need for rural, community-based interventions that target obesity at multiple ecological levels and incorporate issues related to race, poverty, and the built environment. More research is needed to determine how disparities in obesity are created and perpetuated in specific community contexts.

The CEMHaVi program: control, evaluation, and modification of lifestyles in obese youth.

PubMed

Vanhelst, Jérémy; Marchand, Frédéric; Fardy, Paul; Zunquin, Gautier; Loeuille, Guy-André; Renaut, Hervé; Mikulovic, Jacques; Hurdiel, Rémy; Béghin, Laurent; Theunynck, Denis

2010-01-01

Obesity in children has increased in recent years. Many studies with differing methodologies have been undertaken to treat obesity. The Control, Evaluation, and Modification of Lifestyles in Obese Youth (CEMHaVi) program is a unique 2-year health-wellness program of physical activity and health education for obese youth. Findings of this study represent results at 1-year follow-up. The purpose of this study was to evaluate the effects of the CEMHaVi program. Physician-referred subjects (N = 26) participated in the study, 14 girls (13.4 +/- 2.9 years) and 12 boys (12.3 +/- 2.8 years). Measurements included height, weight, body mass index (BMI), academic performance, sleep habits, and health knowledge. The intervention consisted of a unique program of physical activity, including a variety of games specifically selected to be enjoyable, maintain interest, and motivate subjects to adhere. Activity sessions were offered once per week, 2 hours each session, for 12 months. A health education program was offered once every 3 months for 2 hours per session. Health knowledge, academic performance, self-esteem, and sleep were assessed before and after the intervention. Means were calculated at baseline and following intervention and were compared by paired t tests. Findings suggest significant improvements in academic performance (P < .001), quality and quantity of sleep (P < .05), and obesity (P < .05). The program reduced BMI and improved health knowledge, sleep, and academic performance in obese children. The feasibility of a beneficial lifestyle intervention program is encouraging in addressing obesity and related issues in young boys and girls.

Effects of an afterschool community center physical activity program on fitness and body composition in obese youth.

PubMed

Crouter, Scott E; Salas, Carlos; Wiecha, Jean

2017-06-01

Physical activity (PA) promotes health in obese youth and is an important adjunct to medical weight management. Access to structured fitness programmes for obese, low-income youth is limited and potential benefits of such programmes are poorly understood. We describe an urban afterschool fitness programme for obese youth and participants' changes in fitness and body composition. A case series of 30 youth (age: 11.5 ± 2.5 years) with BMI ≥95th percentile and physician referral received a 24-wk programme scholarship. The programme, offered 4 times a week for 90-min.session, included aerobic, strength, and self-organised PA. Primary outcomes, measured at baseline (BL) time 1 (4-8 wk) and time 2 (12-16 wk) were BMI, per cent body fat (%BF), fat-free mass (FFM), heart rate during a treadmill test, and muscular strength (one repetition maximum (1RM)) and endurance (reps at 70% of 1RM) on the leg press (LP) and chest press (CP). Average participation was 1.5 ± 0.6 visits per week for 18.7 ± 6.5 weeks. Between BL and time 2, LP and CP 1RM and endurance significantly improved (P < 0.05). Additionally, there was a significant interaction for %BF with boys losing 5.2% (P > 0.05) while girls lost 0% (>0.05). Obese youth attending an urban fitness programme for at least three months improved strength and body composition, but average attendance was below planned levels.

Body Fat Distribution Ratios and Obstructive Sleep Apnea Severity in Youth With Obesity.

PubMed

Glicksman, Amy; Hadjiyannakis, Stasia; Barrowman, Nicholas; Walker, Scott; Hoey, Lynda; Katz, Sherri Lynne

2017-04-15

Obesity and regional fat distribution, measured by neck fat mass percentage using dual-energy X-ray absorptiometry (DXA), correlate with obstructive sleep apnea (OSA) severity in adults. In obese children, neck-to-waist-circumference ratio predicts OSA. This study examined associations between body fat percentage and distribution and sleep-disordered breathing (SDB) severity in obese youth, measured with DXA. Cross-sectional retrospective study conducted at a tertiary children's hospital. Participants were aged 6 to 18 years with obesity (body mass index [BMI] > 99th percentile [BMI z-score 2.35] or > 95th percentile with comorbidity). They underwent polysomnography and DXA to quantify body fat percentage and distribution ratios (neck-to-abdominal fat percentage [NAF % ratio]). SDB was defined as apnea-hypopnea index (AHI) > 5 and OSA as obstructive AHI (OAHI) > 1 event/h. Relationships of BMI z-score and NAF % ratio to log AHI and log OAHI were evaluated. Thirty individuals participated; 18 male; median age 14.1 years. Twenty-four individuals had BMI z-scores > 2.35. Ten had AHI > 5 events/h. NAF % ratio was significantly associated with log AHI in males and with log OAHI in all, whereas total fat mass percent was not. The association between log OAHI and NAF % ratio was significant in males, but not females. NAF % ratio was significantly associated with log OAHI in those with BMI z-score above 2.35. NAF % ratio was associated with OSA severity in males and youth with BMI > 99th percentile; however, total fat mass percentage was not, suggesting that body fat distribution is associated with OSA risk in youth. © 2017 American Academy of Sleep Medicine

Depressive Symptoms, Ethnic Identity, and Health-Related Quality of Life in Obese Youth.

PubMed

Lim, Crystal S; Gowey, Marissa A; Silverstein, Janet; Dumont-Driscoll, Marilyn; Janicke, David M

2016-05-01

Examine relations between depressive symptoms, ethnic identity, and health-related quality of life (HRQOL) in overweight or obese (OV/OB) children. A total of 166 OV/OB 8- to 17-year-olds (M = 12.94 years; 86.7% obese; 50.6% racial/ethnic minority) attending an outpatient pediatric obesity medical clinic participated. Children completed the Children's Depression Inventory-Short Form, Multigroup Ethnic Identity Measure (MEIM), and Pediatric Quality of Life Inventory. Increased depressive symptoms significantly predicted reduced total, physical, and psychosocial HRQOL. For minority OV/OB youth only, MEIM Affirmation/Belonging moderated depressive symptoms and total HRQOL (effect = -2.59, t = -2.24, p = .027; R(2) overall model = 0.315) and depressive symptoms and psychosocial HRQOL (effect = -3.01, t = -2.47, p = .015; R(2) overall model = 0.331). Depressive symptoms are negatively associated with HRQOL. In minority OV/OB youth, high ethnic identity may be protective when depressive symptoms are minimal. Ethnic identity and other cultural factors are important to consider in psychosocial treatments for pediatric obesity. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A multi-tiered approach to addressing the mental health issues surrounding obesity in children and youth.

PubMed

Bazyk, Susan; Winne, Rebecca

2013-04-01

Obesity in children and youth is a major public health concern known to have a significant impact on physical and mental health. Although traditional approaches to obesity have emphasized diet and exercise at the individual level, broader attention to the mental health consequences of obesity is crucial. Individuals who are obese live in a world where they are often less accepted resulting in social exclusion and discrimination. A public health multi-tiered approach to obesity focusing on mental health promotion, prevention, and individualized intervention is presented.

Physical Activity is Related to Fatty Liver Marker in Obese Youth, Independently of Central Obesity or Cardiorespiratory Fitness

PubMed Central

Martins, Clarice; Aires, Luisa; Júnior, Ismael Freitas; Silva, Gustavo; Silva, Alexandre; Lemos, Luís; Mota, Jorge

2015-01-01

), and increased PA plays a protective role against fatty liver, we hypothesized that it might be an association between PA and fatty liver in obese youth, independently of central adiposity or CRF; No other study has investigated these associations in obese youth; Our findings stresses the fact that moderate-to-vigorous and light physical activities, as well as lower sedentary behavior, is associated with lower fatty liver marker, independent of the effect of potential mediators, such as central obesity or CRF. PMID:25729297

Childhood Obesity Policy Research and Practice Evidence for Policy and Environmental Strategies

PubMed Central

Brennan, Laura K.; Brownson, Ross C.; Orleans, C. Tracy

2016-01-01

Investigators developed a review system to evaluate the growing literature on policy and environmental strategies to prevent childhood obesity. Over 2000 documents published between January 2000 and May 2009 in the scientific and grey literature were identified (2008–2009) and systematically analyzed (2009–2012). These focused on policy or environmental strategies to reduce obesity/overweight, increase physical activity, and/or improve nutrition/diet among youth (aged 3–18 years). Guided by the RE-AIM framework, investigators abstracted studies of 24 intervention strategies and assessed evidence for their effectiveness (i.e., study design, intervention duration, and outcomes) and population impact (i.e., effectiveness and reach – participation or exposure, and representativeness) in 142 evaluation study groupings and 254 associational study groupings (n=396 groupings of 600 peer-reviewed studies). The 24 strategies yielded 25 classifications (school wellness policies yielded nutrition and physical activity classifications): 1st-tier effective (n=5); 2nd-tier effective (n=6); “promising” (n=5); or “emerging” (n=9). Evidence for intervention effectiveness was reported in 56% of the evaluation, and 77% of the associational, study groupings. Among the evaluation study groupings, only 49% reported sufficient data for population impact ratings, and only 22% qualified for a rating of high population impact. Effectiveness and impact ratings were summarized in graphic evidence maps, displaying effects/associations with behavioral and obesity/overweight outcomes. This paper describes the results and products of the review, with recommendations for policy research and practice. PMID:24355679

Prevalence and predictors of alanine aminotransferase elevation among normal weight, overweight and obese youth in Mexico.

PubMed

Purcell, Maura; Flores, Yvonne N; Zhang, Zuo-Feng; Denova-Gutiérrez, Edgar; Salmeron, Jorge

2013-09-01

This study aimed to determine the prevalence of and risk factors associated with elevated alanine aminotransferase (ALT) levels among a sample of normal weight, overweight and obese youth from two urban populations in Central Mexico. Baseline data from 1262 youth aged 8-19 years who participated in the Mexican Health Worker Cohort Study from March 2004 to April 2006 were reviewed, including 680 girls and 582 boys, with a total of 83 participants with elevated ALT level (>40 U/L). Information was obtained from self-administered questionnaires, anthropometric results and clinical measurements. Associations of interest were examined using multivariate logistic regression models. A total of 3.8% of girls and 9.8% of boys had elevated ALT levels. Elevated ALT was observed in 28.9% of the obese and 14.2% of the overweight participants. Metabolic syndrome (MS) occurred in 6.1% of the study population and those with MS had a high percentage of elevated ALT (14.5% of girls and 40.0% of boys, respectively). Abdominal obesity and insulin resistance were also associated with a greater risk of elevated ALT. Obesity and certain metabolic risk factors are important predictors for elevated ALT. Screening for ALT levels in obese youth could help to identify those at risk and reduce the possibility of future liver diseases. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.

Addressing Prediabetes in Childhood Obesity Treatment Programs: Support from Research and Current Practice

PubMed Central

Grow, H. Mollie; Fernandez, Cristina; Lukasiewicz, Gloria J.; Rhodes, Erinn T.; Shaffer, Laura A.; Sweeney, Brooke; Woolford, Susan J.; Estrada, Elizabeth

2014-01-01

Abstract Background: Type 2 diabetes mellitus (T2DM) and prediabetes have increased in prevalence among overweight and obese children, with significant implications for long-term health. There is little published evidence on the best approaches to care of prediabetes among overweight youth or the current practices used across pediatric weight management programs. Methods: This article reviews the literature and summarizes current practices for screening, diagnosis, and treatment of prediabetes at childhood obesity treatment centers. Findings regarding current practice were based on responses to an online survey from 28 pediatric weight management programs at 25 children's hospitals in 2012. Based on the literature reviewed, and empiric data, consensus support statements on prediabetes care and T2DM prevention were developed among representatives of these 25 children's hospitals' obesity clinics. Results: The evidence reviewed demonstrates that current T2DM and prediabetes diagnostic parameters are derived from adult-based studies with little understanding of clinical outcomes among youth. Very limited evidence exists on preventing progression of prediabetes. Some evidence suggests that a significant proportion of obese youth with prediabetes will revert to normoglycemia without pharmacological management. Evidence supports lifestyle modification for children with prediabetes, but further study of specific lifestyle changes and pharmacological treatments is needed. Conclusion: Evidence to guide management of prediabetes in children is limited. Current practice patterns of pediatric weight management programs show areas of variability in practice, reflecting the limited evidence base. More research is needed to guide clinical care for overweight youth with prediabetes. PMID:25055134

Endocrinology and Adolescence: aerobic exercise reduces insulin resistance markers in obese youth: a meta-analysis of randomized controlled trials.

PubMed

García-Hermoso, Antonio; Saavedra, Jose M; Escalante, Yolanda; Sánchez-López, Mairena; Martínez-Vizcaíno, Vicente

2014-10-01

The purpose of this meta-analysis was to examine the evidence for the effectiveness of aerobic exercise interventions on reducing insulin resistance markers in obese children and/or adolescents. A secondary outcome was change in percentage of body fat. A computerized search was made from seven databases: CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, ERIC, MEDLINE, PsycINFO, and Science Citation Index. The analysis was restricted to randomized controlled trials that examined the effect of aerobic exercise on insulin resistance markers in obese youth. Two independent reviewers screened studies and extracted data. Effect sizes (ES) and 95% confidence interval (CI) were calculated, and the heterogeneity of the studies was estimated using Cochran's Q-statistic. Nine studies were selected for meta-analysis as they fulfilled the inclusion criteria (n=367). Aerobic exercise interventions resulted in decreases in fasting glucose (ES=-0.39; low heterogeneity) and insulin (ES=-0.40; low heterogeneity) and in percentage of body fat (ES=-0.35; low heterogeneity). These improvements were specifically accentuated in adolescents (only in fasting insulin), or through programs lasting more than 12 weeks, three sessions per week, and over 60 min of aerobic exercise per session. This meta-analysis provides insights into the effectiveness of aerobic exercise interventions on insulin resistance markers in the obese youth population. © 2014 European Society of Endocrinology.

The cumulative impact of physical activity, sleep duration, and television time on adolescent obesity: 2011 Youth Risk Behavior Survey.

PubMed

Laurson, Kelly R; Lee, Joey A; Eisenmann, Joey C

2015-03-01

Physical activity (PA), television time (TV), and sleep duration (SLP) are considered individual risk factors for adolescent obesity. Our aim was to investigate the concurrent influence of meeting PA, SLP, and TV recommendations on adolescent obesity utilizing 2011 Youth Risk Behavior Surveillance Survey (YRBSS) data. Subjects included 9589 (4874 females) high school students. PA, SLP, and TV were categorized utilizing established national recommendations and youth were cross-tabulated into 1 of 8 groups based on meeting or not meeting each recommendation. Logistic models were used to examine the odds of obesity for each group. Youth meeting the PA recommendation were not at increased odds of obesity, regardless of SLP or TV status. However, not meeting any single recommendation, in general, led to increased odds of not meeting the other two. In boys, 11.8% met all recommendations while 14.1% met 0 recommendations. In girls, only 5.0% met all recommendations while 17.8% met none. Boys and girls not meeting any of the recommendations were 4.0 and 3.8 times more likely to be obese compared with their respective referent groups. Further research considering the simultaneous influence these risk factors may have on obesity and on one another is warranted.

A pilot study evaluating the effects of a youth advocacy program on youth readiness to advocate for environment and policy changes for obesity prevention.

PubMed

Millstein, Rachel A; Woodruff, Susan I; Linton, Leslie S; Edwards, Christine C; Sallis, James F

2016-12-01

Youth advocacy for obesity prevention is a promising but under-evaluated intervention. The aims of this study are to evaluate a youth advocacy program's outcomes related to youth perceptions and behaviors, develop an index of youth advocacy readiness, and assess potential predictors of advocacy readiness. Youth ages 9-22 in an advocacy training program (n = 92 matched pairs) completed surveys before and after training. Youth outcomes and potential predictors of advocacy readiness were assessed with evaluated scales. All 20 groups who completed the evaluation study presented their advocacy projects to a decision maker. Two of six perception subscales increased following participation in the advocacy program: self-efficacy for advocacy behaviors (p < .001) and participation in advocacy (p < .01). Four of five knowledge and skills subscales increased: assertiveness (p < .01), health advocacy history (p < .001), knowledge of resources (p < .01), and social support for health behaviors (p < .001). Youth increased days of meeting physical activity recommendations (p < .05). In a mixed regression model, four subscales were associated with the advocacy readiness index: optimism for change (B = 1.46, 95 % CI = .49-2.44), sports and physical activity enjoyment (B = .55, 95 % CI = .05-1.05), roles and participation (B = 1.81, 95 % CI = .60-3.02), and advocacy activities (B = 1.49, 95 % CI = .64-2.32). The youth advocacy readiness index is a novel way to determine the effects of multiple correlates of advocacy readiness. Childhood obesity-related advocacy training appeared to improve youths' readiness for advocacy and physical activity.

Green and lean: Is neighborhood park and playground availability associated with youth obesity? Variations by gender, socioeconomic status, and race/ethnicity.

PubMed

Morgan Hughey, S; Kaczynski, Andrew T; Child, Stephanie; Moore, Justin B; Porter, Dwayne; Hibbert, James

2017-02-01

Parks and park features are important for promoting physical activity and healthy weight, especially for low-income and racial/ethnic minority youth who have disproportionately high obesity rates. This study 1) examined associations between neighborhood park and playground availability and youth obesity, and 2) assessed whether these associations were moderated by youth race/ethnicity and socioeconomic status (SES). In 2013, objectively measured height and weight were collected for all 3rd-5th grade youth (n=13.469) in a southeastern US county to determine body mass index (BMI) percentiles. Enumeration and audits of the county's parks (n=103) were concurrently conducted. Neighborhood park and playground availability were calculated as the number of each facility within or intersecting each youth's Census block group. Multilevel linear regression models were utilized to examine study objectives. For boys, no main effects were detected; however, SES moderated associations such that higher park availability was associated with lower BMI percentile for low-SES youth but higher BMI percentile for high-SES youth. For girls, the number of parks and playgrounds were significantly associated with lower BMI (b=-2.2, b=-1.1, p<0.05, respectively) and race/ethnicity and SES moderated associations between playground availability and BMI percentile. Higher playground availability was associated with lower BMI percentile for White and high-SES girls but higher BMI percentile for African American and low-SES girls. Considerable variation was detected in associations between park and playground availability and youth obesity by SES and race/ethnicity, highlighting the importance of studying the intersection of these characteristics when exploring associations between built environment features and obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

Healthy Lifestyle Fitness Camp: A Summer Approach to Prevent Obesity in Low-Income Youth.

PubMed

George, Gretchen Lynn; Schneider, Constance; Kaiser, Lucia

2016-03-01

To examine the effect of participation in a summer camp focused on nutrition and fitness among low-income youth. In 2011-2012, overweight and obese youth (n = 126) from Fresno, CA participated in a free 6-week summer program, Healthy Lifestyle Fitness Camp (HLFC), which included 3 h/wk of nutrition education provided by University of California CalFresh and 3 hours of daily physical activity through Fresno Parks and Recreation. The researchers used repeated-measures ANOVA to examine changes in weight, waist circumference, and waist-to-height ratio (WHtR) between HLFC and the comparison group (n = 29). Significant pre-post WHtR reductions were observed in HLFC: 0.64 to 0.61 (P < .001). In addition, WHtR reductions were maintained in HLFC 2 months afterward whereas an increase occurred in the comparison group (P < .007). Understanding the impact of nutrition- and fitness-themed summer camps during unstructured months of summer is integral to obesity prevention among low-income youth. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Are American Children and Youth Fit?: It's Time We Learned

ERIC Educational Resources Information Center

Morrow, James R., Jr.

2005-01-01

The current state of physical fitness in American youth is unknown. While evidence exists that obesity levels are increasing in children and youth, data on declines in physical fitness measures (i.e., cardiorespiratory and musculoskeletal fitness) are lacking. Tracking of physical fitness components has been poorly done. Surveillance of behaviors…

Overweight and Obesity in Youth in Schools--The Role of the School Nurse. Position Statement. Revised

ERIC Educational Resources Information Center

Mehrley, Melissa; Leibold, Nancyruth

2011-01-01

It is the position of the National Association of School Nurses that school nurses have the knowledge and expertise to promote the prevention of overweight and obesity and address the needs of overweight and obese youth in schools. The school nurse collaborates with students, families, school personnel, and health care providers to promote healthy…

The Wii Club: Gaming for Weight Loss in Overweight and Obese Youth

PubMed Central

Abraham, Anisha A.; Calvert, Sandra L.

2012-01-01

Abstract Our 20-week “Wii Club” intervention for overweight and obese adolescents demonstrated weight loss, increased self-efficacy, and improved peer support from cooperative exergame play. Videogames that require motor activity in a social context may be a fun, effective tool to promote healthy weight and physical activity among youth. PMID:23565349

Adolescent Summer Care Arrangements and Risk for Obesity the Following School Year

PubMed Central

Mahoney, Joseph L.

2010-01-01

This longitudinal study identified common summer care arrangements for adolescents and examined whether those arrangements predicted risk for obesity (Body Mass Index (BMI) ≥ 85th percentile for age and gender) the following school year. Participants were a nationally representative sample of 1,766 adolescents ages 10–18 from the Panel Study of Income Dynamics-Child Development Supplement. Results showed that, beyond measures of BMI taken before the summer and several demographic aspects known to predict obesity, youth whose summer arrangements involved regular participation in organized activities (e.g., sports) showed significantly lower risk for obesity than other youth. This was most evident during early adolescence. Youth whose regular summer arrangement was predominated by parent care without organized activity participation showed the greatest risk for obesity. PMID:20863556

Diabetes in Navajo Youth

PubMed Central

Dabelea, Dana; DeGroat, Joquetta; Sorrelman, Carmelita; Glass, Martia; Percy, Christopher A.; Avery, Charlene; Hu, Diana; D'Agostino, Ralph B.; Beyer, Jennifer; Imperatore, Giuseppina; Testaverde, Lisa; Klingensmith, Georgeanna; Hamman, Richard F.

2009-01-01

OBJECTIVE—To estimate the prevalence and incidence of diabetes, clinical characteristics, and risk factors for chronic complications among Navajo youth, using data collected by the SEARCH for Diabetes in Youth Study (SEARCH study). RESEARCH DESIGN AND METHODS—The SEARCH study identified all prevalent cases of diabetes in 2001 and all incident cases in 2002–2005 among Navajo youth. We estimated denominators with the user population for eligible health care facilities. Youth with diabetes also attended a research visit that included questionnaires, physical examination, blood and urine collection, and extended medical record abstraction. RESULTS—Diabetes is infrequent among Navajo youth aged <10 years. However, both prevalence and incidence of diabetes are high in older youth. Among adolescents aged 15–19 years, 1 in 359 Navajo youth had diabetes in 2001 and 1 in 2,542 developed diabetes annually. The vast majority of diabetes among Navajo youth with diabetes is type 2, although type 1 diabetes is also present, especially among younger children. Navajo youth with either diabetes type were likely to have poor glycemic control, high prevalence of unhealthy behaviors, and evidence of severely depressed mood. Youth with type 2 diabetes had more metabolic factors associated with obesity and insulin resistance (abdominal fat deposition, dyslipidemia, and higher albumin-to-creatinine ratio) than youth with type 1 diabetes. CONCLUSIONS—Our data provide evidence that diabetes is an important health problem for Navajo youth. Targeted efforts aimed at primary prevention of diabetes in Navajo youth and efforts to prevent or delay the development of chronic complications among those with diabetes are warranted. PMID:19246579

Overweight and Obesity Among North American Indian Infants, Children, and Youth

PubMed Central

SCHELL, LAWRENCE M.; GALLO, MIA V.

2012-01-01

The frequency of overweight and obesity among North American Indian children and youth exceeds that of other ethnic groups in the United States. This observation is based on studies using body mass index as the primary measure of overweight and obesity. In the mid-20th century, there were regional differences among North American Indian groups in sub-adults’ size and shape and only a few Southwestern groups were characterized by high rates of overweight and obesity. In most populations, the high prevalence of overweight and obesity developed in the last decades of the 20th century. Childhood obesity may begin early in life as many studies report higher birth weights and greater weight-for-height in the preschool years. Contributing factors include higher maternal weights, a nutritional transition from locally caught or raised foods to store bought items, psychosocial stress associated with threats to cultural identity and national sovereignty, and exposure to obesogenic pollutants, all associated to some degree with poverty. Obesity is part of the profile of poor health among Native Americans in the US and Canada, and contributes to woefully high rates of diabetes, cardiovascular disease, and early mortality. Interventions that are culturally appropriate are needed to reduce weights at all points in the lifespan. PMID:22378356

Confirmatory Factor Analysis of Sizing Me Up: Validation of an Obesity-Specific Health-Related Quality of Life Measure in Latino Youth.

PubMed

Tripicchio, Gina L; Borner, Kelsey B; Odar Stough, Cathleen; Poppert Cordts, Katrina; Dreyer Gillette, Meredith; Davis, Ann M

2017-05-01

This study aims to validate an obesity-specific health-related quality of life (HRQOL) measure, Sizing Me Up (SMU), in treatment-seeking Latino youth. Pediatric obesity has been associated with reduced HRQOL; therefore, valid measures are important for use in diverse populations that may be at increased risk for obesity and related comorbidities. Structural equation modeling tested the fit of the 5-subscale, 22-item SMU measure in Latino youth, 5-13 years of age, with obesity ( N = 204). Invariance testing was conducted to examine equivalence between Latino and non-Latino groups ( N = 250). SMU achieved acceptable fit in a Latino population [χ 2 = 428.33, df = 199, p < .001, Root Mean Squared Error of Approximation = 0.072 (0.062-0.082), Comparative Fit Index = 0.915, Tucker-Lewis Index = 0.901, Weighted Root Mean Square Residual = 1.2230]. Additionally, factor structure and factor loadings were invariant across Latino and non-Latino groups, but thresholds were not invariant. SMU is a valid measure of obesity-specific HRQOL in treatment-seeking Latino youth with obesity. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

WAVE~Ripples for Change Obesity Two-Year Intervention in High School Soccer Players: Process Evaluation, Best Practices, and Youth Engagement.

PubMed

Meng, Yu; Wong, Siew Sun; Manore, Melinda M; Patton-López, Mēgan

2018-06-01

This paper reports the process data on program fidelity, best practices for intervention implementation, youth and coach engagement, and youth application of knowledge and skills for the two-year WAVE~Ripples for Change (WAVE) obesity prevention intervention program focused on healthy eating, physical activity, and life skills with high school (HS) soccer players aged 14⁻19 years. Internal (staff: n = 7; volunteers: n = 27) and external (youth: n = 100; coaches: n = 9) stakeholders were interviewed/ surveyed. Staff rated program fidelity as high (94%), as did volunteers (85%). Best practices included coach encouragement for athlete participation, use of on-line consent for enrollment, building relationships with HS staff to complete assessments, sending text reminders, and providing incentives. Study results showed an enrollment rate of 72%, completion of baseline assessments of 89⁻98%, attendance of sports nutrition lessons in Year 1 and Year 2 of 90% and 39%, respectively, and team-building workshop (TBW) attendance of 25⁻31%. Activities exceeding youth expectations (>90%) included, (1) activities with their soccer team; (2) the TBW-cooking; and (3) sports nutrition lessons. The obesity prevention skills most applied by youth were obtained from the TBW-gardening and harvesting (49%), the TBW-cooking (43%), and sports nutrition lessons (44%). Coaches also rated the sports nutrition lessons highly and reported increased awareness for hydration/fueling during sport by the athletes. Using sport teams/clubs to engage youth in obesity prevention is a feasible model for future study.

Drug disposition in obesity: toward evidence-based dosing.

PubMed

Knibbe, Catherijne A J; Brill, Margreke J E; van Rongen, Anne; Diepstraten, Jeroen; van der Graaf, Piet Hein; Danhof, Meindert

2015-01-01

Obesity and morbid obesity are associated with many physiological changes affecting pharmacokinetics, such as increased blood volume, cardiac output, splanchnic blood flow, and hepatic blood flow. In obesity, drug absorption appears unaltered, although recent evidence suggests that this conclusion may be premature. Volume of distribution may vary largely, but the magnitude and direction of changes seem difficult to predict, with extrapolation on the basis of total body weight being the best approach to date. Changes in clearance may be smaller than in distribution, whereas there is growing evidence that the influence of obesity on clearance can be predicted on the basis of reported changes in the metabolic or elimination pathways involved. For obese children, we propose two methods to distinguish between developmental and obesity-related changes. Future research should focus on the characterization of physiological concepts to predict the optimal dose for each drug in the obese population.

The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds.

PubMed

Giannini, Cosimo; Santoro, Nicola; Caprio, Sonia; Kim, Grace; Lartaud, Derek; Shaw, Melissa; Pierpont, Bridget; Weiss, Ram

2011-08-01

We evaluated whether the triglyceride-to-HDL cholesterol (TG/HDL-C) ratio is associated with insulin resistance (IR) in a large multiethnic cohort of obese youths. Obese youths (1,452) had an oral glucose tolerance test and a fasting lipid profile. Insulin sensitivity was estimated using the whole body insulin sensitivity index (WBISI) and homeostasis model assessment (HOMA)-IR and evaluated, in a subgroup of 146 obese youths, by the hyperinsulinemic-euglycemic clamp. The cohort was divided by ethnicity (612 whites, 357 Hispanics, and 483 African Americans) and then stratified into ethnicity-specific tertiles of TG/HDL-C ratio. Differences across tertiles were evaluated, and the association between the TG/HDL-C ratio and insulin sensitivity (WBISI) was defined by a multiple stepwise linear regression analysis. The area under the receiver operating characteristic (ROC) curve (AUC) was determined to calculate the TG/HDL-C ratio cutoff to identify insulin-resistant subjects by ethnicity. In each ethnic group and across rising tertiles of TG/HDL-C ratio, insulin sensitivity (WBISI) progressively decreased, whereas 2-h glucose and the AUC-glucose progressively increased. The cutoff for TG/HDL-C ratio was 2.27, and the odds of presenting with IR, in youths with TG/HDL-C ratio higher than the cutoff, was 6.023 (95% CI 2.798-12.964; P < 0.001) in white girls and boys, whereas for both Hispanics and African Americans the AUC-ROCs were not significant, thus not allowing the calculation of an optimal cutoff TG/HDL-C value. The TG/HDL-C ratio is associated with IR mainly in white obese boys and girls and thus may be used with other risk factors to identify subjects at increased risk of IR-driven morbidity.

Emerging epidemic of type 2 diabetes in youth.

PubMed

Rosenbloom, A L; Joe, J R; Young, R S; Winter, W E

1999-02-01

This review considers the epidemiologic evidence of an increasing incidence of type 2 diabetes in youth, the classification and diagnostic issues related to diabetes in young populations, pathophysiologic mechanisms relevant to the increasing incidence, the role of genetics and environment, and the community challenge for prevention and treatment. Type 2 diabetes in youth has been recognized to be frequent in populations of native North Americans and to comprise some 30 percent of new cases of diabetes in the 2nd decade of life, largely accounted for by minority populations and associated with obesity. Among Japanese schoolchildren, type 2 diabetes is seven times more common than type 1, and its incidence has increased more than 30-fold over the past 20 years, concomitant with changing food patterns and increasing obesity rates. The forms of diabetes seen in children and youth include typical type 1, occurring in all races; type 2, seen predominantly in minority youth; atypical diabetes, seen as an autosomal dominantly transmitted disorder in African-American populations; and maturity-onset diabetes of the young (MODY), seen rarely and only in Caucasians. Of the nonautoimmune forms of diabetes seen in youth, only type 2 diabetes is increasing in incidence. Proper classification requires consideration of onset (acute/severe versus insidious), ethnicity, family history, presence of obesity, and if necessary, studies of diabetes related autoimmunity. Insulin resistance predicts the development of diabetes in Pima Indians, in offspring of parents with type 2 diabetes, and in other high-risk populations. African-American children and youth have greater insulin responses during glucose tolerance testing and during hyperglycemic clamp study than do whites. There is also evidence of altered beta-cell function preceding the development of hyperglycemia. Of particular interest is the evidence that abnormal fetal and infantile nutrition is associated with the development of

Adaptation and dissemination of an evidence-based obesity prevention intervention: design of a comparative effectiveness trial.

PubMed

Buscemi, Joanna; Odoms-Young, Angela; Stolley, Melinda L; Blumstein, Lara; Schiffer, Linda; Berbaum, Michael L; McCaffrey, Jennifer; Montoya, Anastasia McGee; Braunschweig, Carol; Fitzgibbon, Marian L

2014-07-01

Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families. Copyright © 2014 Elsevier Inc. All rights reserved.

Adaptation and Dissemination of an Evidence-Based Obesity Prevention Intervention: Design of a Comparative Effectiveness Trial

PubMed Central

Buscemi, Joanna; Odoms-Young, Angela; Stolley, Melinda L.; Blumstein, Lara; Schiffer, Linda; Berbaum, Michael L.; McCaffrey, Jennifer; Montoya, Anastasia McGee; Braunschweig, Carol; Fitzgibbon, Marian L.

2014-01-01

Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program--Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families. PMID:24952282

Obesity Prevention Programs for Children and Youth: Why Are Their Results so Modest?

ERIC Educational Resources Information Center

Thomas, Helen

2006-01-01

The purpose of this paper is to critically reflect upon the mixed/modest results of the primary studies related to the effectiveness of physical activity enhancement and improving nutritional intake in obesity prevention programs for children and youth. The results of a recent review of this topic that included 57 randomized controlled trials…

Prevalence and Predictors of Bullying Behavior among Overweight and Obese Youth in a Nationally Representative Sample.

PubMed

Odar Stough, Cathleen; Merianos, Ashley; Nabors, Laura; Peugh, James

2016-08-01

Child and adolescent overweight and obesity are independent risk factors for poor social outcomes. Whether children who are overweight display greater bullying behaviors than normal weight peers, controlling for demographic and other social-ecological factors, was examined. The influence of child (e.g., mental health), family (e.g., income, parent mental health, and exposure to domestic violence), and community (e.g., exposure to neighborhood violence, unfair treatment based on race or ethnic group) factors on bullying risk in the subset of children who are overweight and obese was explored. We conducted a secondary data analysis of the 2011-2012 National Survey of Children's Health, a cross-sectional study providing a nationally representative sample of participants, using a series of multinomial logistic regressions in Mplus software (Muthén & Muthén, Los Angeles, CA). Participants were 41,361 youth ages 10-17 years. Despite statistically significant differences in unadjusted analyses, no differences were found in bullying behavior by weight status once controlling for other factors. Child, family, and neighborhood factors predicted bullying behavior in both the overall sample and the subset of overweight and obese youth. However, some risk factors were unique to children who were overweight or obese. Children who are overweight or obese are not at greater risk for engaging in bullying behavior than normal weight peers. Health professionals targeting bullying behavior should be aware of the impact child, family, and neighborhood factors have on bullying by overweight and obese children and adolescents.

High-intensity interval training programme for obese youth (HIP4YOUTH): A pilot feasibility study.

PubMed

Lee, SoJung; Spector, Jenna; Reilly, Stephanie

2017-09-01

Recently, there has been growing interest in high-intensity interval training (HIT) as a strategy to improve health. In this pilot study, we examined the feasibility of a 4-week low-volume HIT and its effects on cardiorespiratory fitness (CRF), blood pressure (BP) and enjoyment in overweight and obese youth. Twelve adolescents (body mass index (BMI): 34.8 ± 3.9 kg · m ‒ 2 , 14.9 ± 1.5 years) participated in 12 sessions of HIT (10 × 60 s cycling bouts eliciting ~90% maximal heart rate, interspersed with 90 s recovery, 30 min/session, 3 sessions/week) over ~4 weeks. All the participants completed the study and exercise attendance averaged 92%. Despite no changes in body weight and total fat, HIT resulted in significant (P < 0.01) increases in CRF (pre: 20.1 versus post: 22.2 ml · kg ‒1 · min ‒1 ) and exercise time (pre: 425 versus post: 509 s) during peak oxygen uptake test, and a reduction in resting systolic BP (pre: 115.8 versus post: 107.6 mmHg). The majority of study participants (83%) enjoyed HIT and more than half of the participants (58%) reported that HIT is a more enjoyable form of exercise compared to other types of exercises. Low-volume HIT is a useful strategy to promote exercise participation and improve cardiovascular health in overweight and obese youth.

Longitudinal Associations Between Teasing and Health-related Quality of Life Among Treatment-seeking Overweight and Obese Youth

PubMed Central

Steele, Ric G.

2012-01-01

Objectives To examine concurrent and prospective associations between perceptions of teasing and health-related quality of life (HRQOL) over the course of a behavioral/educational intervention and the subsequent year in a sample of overweight and obese children and adolescents. Method A clinical sample of 93 overweight or obese youths (ages 7–17 years) and 1 parent/guardian completed measures of teasing and HRQOL at pre- and posttreatment and follow-up assessments. Structural equation modeling was used to examine the factor structure of the measures and to assess prospective associations over a 15-month period. Results Results indicate that, concurrently, weight-related teasing is inversely associated with HRQOL and that, prospectively, HRQOL is inversely associated with subsequent teasing. Conclusions Study findings are suggestive of a directional relationship with lower quality of life predicting subsequent higher levels of teasing. Results suggest the potential for interventions designed to improve HRQOL to reduce teasing experiences for overweight and obese youth. PMID:22262915

Evidence-Based Youth Psychotherapy in the Mental Health Ecosystem

ERIC Educational Resources Information Center

Weisz, John R.; Ugueto, Ana M.; Cheron, Daniel M.; Herren, Jenny

2013-01-01

Five decades of randomized trials research have produced dozens of evidence-based psychotherapies (EBPs) for youths. The EBPs produce respectable effects in traditional efficacy trials, but the effects shrink markedly when EBPs are tested in practice contexts with clinically referred youths and compared to usual clinical care. We considered why…

Food insecurity, food assistance and weight status in US youth: new evidence from NHANES 2007-08.

PubMed

Kohn, M J; Bell, J F; Grow, H M G; Chan, G

2014-04-01

To investigate food assistance participation as a risk factor for overweight and obesity in youth, and food insecurity as an effect modifier. The sample included youth ages 4-17, in families ≤200% of the federal poverty line in the 2007-2008 National Health and Nutrition Examination Survey (n = 1321). Food insecurity was measured with the US Department of Agriculture survey module. Food assistance participation was assessed for Supplemental Nutrition Assistance Program, Special Supplemental Nutrition Program for Women, Infants and Children and school meals. Body size was classified by age- and sex-specific body mass index (BMI) percentile, BMI z-score and waist circumference percentile. Regression models with direct covariate adjustment and programme-specific propensity scores, stratified by food insecurity, estimated associations between food assistance participation and body size. Food assistance participation was not associated with increased body size among food-insecure youth in models with direct covariate adjustment or propensity scores. Compared with low-income, food-secure youth not participating in food assistance, BMI z-scores were higher among participants in models with direct covariate adjustment (0.27-0.38 SD and 0.41-0.47 SD, for boys and girls, respectively). Using propensity scores, results were similar for boys, but less so for girls. Food assistance programme participation is associated with increased body size in food-secure youth, but not food-insecure youth. Using both direct covariate adjustment and a propensity score approach, self-selection bias may explain some, but not all, of the associations. Providing healthy food assistance that improves diet quality without contributing to excessive intake remains an important public health goal. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Characterizing severe obesity in children and youth referred for weight management.

PubMed

Salawi, Hebah A; Ambler, Kathryn A; Padwal, Rajdeep S; Mager, Diana R; Chan, Catherine B; Ball, Geoff D C

2014-06-19

Severe obesity (SO) in pediatrics has become increasing prevalent in recent decades.The objective of our study was to examine differences in demographic, anthropometric, cardiometabolic, and lifestyle variables in children and youth with SO versus their less overweight/obese (OW/OB) peers. A retrospective medical record review of 6-19 year old participants enrolled in an outpatient pediatric weight management clinic was conducted. SO (body mass index [BMI] ≥99(th) percentile) and OW/OB (BMI ≥85(th) and <99(th) percentile) groups were created according to Centers for Disease Control and Prevention definitions. Demographic, anthropometric, cardiometabolic and lifestyle data reported at baseline (pre-intervention) were retrieved. Of the 345 participants, most were girls (56.2%), Caucasian (78.7%), and had family incomes > $50,000/year (65.7%). The SO group (n = 161) had lower HDL-cholesterol and higher liver enzymes, insulin resistance and blood pressure than the OW/OB group (n = 184; all p < 0.01). They also reported higher total energy intakes, fewer steps/day, less moderate-to-vigorous physical activity, and more leisure time screen time (all p < 0.02) than their leaner peers. Compared to the OW/OB group, a higher proportion of individuals in the SO group possessed cardiometabolic risk factors, including high triglycerides (45.8% vs 58.5%), alanine aminotransferase (55.4% vs 81.4%), insulin resistance (55.6% vs 82.1%), systolic blood pressure (11.5% vs 27.3%), diastolic blood pressure (17.8% vs 30.0%), and low HDL-cholesterol (44.6% vs 64.6%; all p < 0.02). Aside from the ~75% of participants (groups combined) who met the daily recommended intakes of grain and meat products, <50% of boys and girls met any of the remaining nutrition and physical activity-related recommendations. Compared to the OW/OB group, greater proportions of children and youth in the SO group failed to meet moderate-to-vigorous physical activity (48.4% vs 31.9%) and leisure

Obesity and reproductive function: a review of the evidence.

PubMed

Klenov, Violet E; Jungheim, Emily S

2014-12-01

Over the last decade, the evidence linking obesity to impaired reproductive function has grown. In this article, we review this evidence and discuss the underlying pathophysiology. Obese women are less likely than normal-weight women to achieve pregnancy. Female obesity adversely affects reproductive function through alterations in the hypothalamic-pituitary-ovarian axis, oocyte quality, and endometrial receptivity. It is unclear which mechanism contributes the most to subfecundity, and it is likely a cumulative process. Emerging data highlight the contribution of male obesity to impaired reproductive function and that couple obesity has synergistic adverse effects. Once pregnant, obese women are at higher risk for adverse pregnancy outcomes. Weight loss improves reproductive potential in obese patients. As obese women surpass 35 years of age, age may be more important than body mass index in determining reproductive potential. Obstetrician gynecologists need to be aware of the negative impact of obesity on reproductive function so that they appropriately counsel their patients. Further work is needed to clarify the underlying pathophysiology responsible for adverse effects of obesity on reproduction so that novel treatment approaches may be developed.

Physical Activity, Dietary Habits and Overall Health in Overweight and Obese Children and Youth with Intellectual Disability or Autism

ERIC Educational Resources Information Center

Hinckson, Erica A.; Dickinson, Annette; Water, Tineke; Sands, Madeleine; Penman, Lara

2013-01-01

In children and youth with disability, the risk of obesity is higher and is associated with lower levels of physical activity, inappropriate eating behaviors, and chronic health conditions. We determined the effectiveness of a program in managing weight, through changes in physical activity and nutrition behaviors in overweight and obese New…

Culturally-grounded diabetes prevention program for obese Latino youth: Rationale, design, and methods.

PubMed

Williams, Allison N; Konopken, Yolanda P; Keller, Colleen S; Castro, Felipe Gonzalez; Arcoleo, Kimberly J; Barraza, Estela; Patrick, Donald L; Olson, Micah L; Shaibi, Gabriel Q

2017-03-01

Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities. To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14-16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months. The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations. Copyright © 2017 Elsevier Inc. All rights reserved.

Culturally-grounded diabetes prevention program for obese Latino youth: Rationale, design, and methods

PubMed Central

Williams, AN; Konopken, YP; Keller, CS; Castro, FG; Arcoleo, K; Barraza, E; Patrick, DL; Olson, ML; Shaibi, GQ

2017-01-01

Background Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities. Objectives To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14–16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months. Conclusions The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations. PMID:28104469

Prevalence of Obesity Among Youths by Household Income and Education Level of Head of Household - United States 2011-2014.

PubMed

Ogden, Cynthia L; Carroll, Margaret D; Fakhouri, Tala H; Hales, Craig M; Fryar, Cheryl D; Li, Xianfen; Freedman, David S

2018-02-16

Obesity prevalence varies by income and education level, although patterns might differ among adults and youths (1-3). Previous analyses of national data showed that the prevalence of childhood obesity by income and education of household head varied across race/Hispanic origin groups (4). CDC analyzed 2011-2014 data from the National Health and Nutrition Examination Survey (NHANES) to obtain estimates of childhood obesity prevalence by household income (≤130%, >130% to ≤350%, and >350% of the federal poverty level [FPL]) and head of household education level (high school graduate or less, some college, and college graduate). During 2011-2014 the prevalence of obesity among U.S. youths (persons aged 2-19 years) was 17.0%, and was lower in the highest income group (10.9%) than in the other groups (19.9% and 18.9%) and also lower in the highest education group (9.6%) than in the other groups (18.3% and 21.6%). Continued progress is needed to reduce disparities, a goal of Healthy People 2020. The overall Healthy People 2020 target for childhood obesity prevalence is <14.5% (5).

Metabolic Basis of Ethnic Differences in Diabetes Risk in Overweight and Obese Youth

PubMed Central

Alderete, TL; Toledo-Corral, CM; Goran, MI

2015-01-01

The global pandemic of childhood obesity has led to increased risk for prediabetes and type 2 diabetes mellitus (T2DM). Studies have shown decreased insulin sensitivity and/or secretion with increasing adiposity and consistently observed greater risk for T2DM in obese, non-Caucasian youth. In the current review we describe recent advances in understanding how obesity and metabolic status in children and adolescents confers various risk profiles for T2DM among Latinos, African-Americans, Caucasians, Asians and Native Americans. These possible determinants include ectopic fat distribution, adipose tissue inflammation and fibrosis, and elevated plasma levels of non-esterified free fatty acids. Future work should aim to elucidate the ethnic-specific pathophysiology of T2DM in order to develop and implement appropriate prevention and treatment strategies based on different ethnic profiles of diabetes risk. PMID:24445905

Acute post-exercise energy and macronutrient intake in lean and obese youth: a systematic review and meta-analysis.

PubMed

Thivel, D; Rumbold, P L; King, N A; Pereira, B; Blundell, J E; Mathieu, M-E

2016-10-01

This review aims to determine if acute exercise affects subsequent energy and macronutrients intake in obese and non-obese children and adolescents. Databases were searched between January 2015 and December 2015 for studies reporting energy and/or macronutrients intake immediately after an acute exercise and control condition, in children and adolescents. From the initial 118 references found, 14 were included for subsequent analysis after screening representing 31 acute exercise conditions that varied in intensity, duration and modality. One study found increased energy intake after exercise, seven decreased and 23 revealed no change. The meta-analysis revealed a significant effect of acute exercise on intake in obese but not in lean youth by a mean difference of -0.430 (95% confidence interval=-0.703 to -0.157, P=0.002) displaying low heterogeneity (I 2 =0.000; Q=5.875; d f =9, P=0.752). The analysis showed that intense exercise only reduces intake in obese children (no intensity effect in lean). Unchanged macronutrients intake was reported in nine studies as opposed to three which found modified lipids, protein and/or carbohydrate intake. Although acute exercise does not affect energy intake in lean, it appears to reduced food intake in obese youth when intense, without altering the macronutrients composition of the meal.

Childhood obesity and cardiovascular disease: links and prevention strategies

PubMed Central

Nadeau, Kristen J.; Maahs, David M.; Daniels, Stephen R.; Eckel, Robert H.

2015-01-01

The prevalence and severity of pediatric obesity have dramatically increased since the late 1980s, raising concerns about a subsequent increase in cardiovascular outcomes. Strong evidence, particularly from autopsy studies, supports the concept that precursors of adult cardiovascular disease (CVD) begin in childhood, and that pediatric obesity has an important influence on overall CVD risk. Lifestyle patterns also begin early and impact CVD risk. In addition, obesity and other CVD risk factors tend to persist over time. However, whether childhood obesity causes adult CVD directly, or does so by persisting as adult obesity, or both, is less clear. Regardless, sufficient data exist to warrant early implementation of both obesity prevention and treatment in youth and adults. In this Review, we examine the evidence supporting the impact of childhood obesity on adult obesity, surrogate markers of CVD, components of the metabolic syndrome, and the development of CVD. We also evaluate how obesity treatment strategies can improve risk factors and, ultimately, adverse clinical outcomes. PMID:21670745

Pathophysiology of type 2 diabetes mellitus in youth: the evolving chameleon.

PubMed

Tfayli, Hala; Arslanian, Silva

2009-03-01

Type 2 diabetes mellitus (T2DM) in children and adolescents is an important Public Health problem against the backdrop of the epidemic of childhood obesity. The clinical presentation of T2DM in youth is heterogeneous from minimal symptomatology to diabetic ketoacidosis. The increasing rates of youth T2DM have paralleled the escalating rates of obesity, which is the major risk factor impacting insulin sensitivity. Additional risk factors include minority race, family history of diabetes mellitus, maternal diabetes during pregnancy, pubertal age group and conditions associated with insulin resistance (IR) - such as polycystic ovary syndrome (PCOS). The pathophysiology of T2DM has been studied extensively in adults, and it is widely accepted that IR together with beta-cell failure are necessary for the development of clinical diabetes mellitus in adulthood. However, pathophysiologic studies in youth are limited and in some cases conflicting. Similar to adults, IR is a prerequisite, but beta-cell failure is necessary for progression from normal glucose tolerance to prediabetes and frank diabetes in youth. Even though rates of T2DM in youth are increasing, the overall prevalence remains low if compared with type 1 diabetes mellitus (T1DM). However, as youth with T1DM are becoming obese, the clinical distinction between T2DM and obese T1DM has become difficult, because of the overlapping clinical picture with evidence of islet cell autoimmunity in a significant proportion of clinically diagnosed youth with T2DM. The latter are most likely obese children with autoimmune T1DM who carry a misdiagnosis of T2DM. Further research is needed to probe the pathophysiological, immunological, and metabolic differences between these two groups in the hopes of assigning appropriate therapeutic regimens. These challenges combined with the evolving picture of youth T2DM and its future complications provide unending opportunities for acquisition of new knowledge in the field of childhood

Preventing Obesity Across Generations: Evidence for Early Life Intervention.

PubMed

Haire-Joshu, Debra; Tabak, Rachel

2016-01-01

To prevent the intergenerational transfer of obesity and end the current epidemic, interventions are needed across the early life stages, from preconception to prenatal to infancy through the age of 2 years. The foundation for obesity is laid in early life by actions and interactions passed from parent to child that have long-lasting biologic and behavioral consequences. The purpose of this paper is to examine the best evidence about (a) factors in parents and offspring that promote obesity during the early life stages, (b) the social determinants and dimensions of obesity in early life, (c) promising and effective interventions for preventing obesity in early life, and (d) opportunities for future research into strategies to disrupt the intergenerational cycle of obesity that begins early in life. The pathway for halting the intergenerational obesity epidemic requires the discovery and development of evidence-based interventions that can act across multiple dimensions of influence on early life.

Preventing Obesity Across Generations: Evidence for Early Life Intervention

PubMed Central

Haire-Joshu, Debra; Tabak, Rachel

2017-01-01

To prevent the intergenerational transfer of obesity and end the current epidemic, interventions are needed across the early life stages, from preconception to prenatal to infancy through the age of 2 years. The foundation for obesity is laid in early life by actions and interactions passed from parent to child that have long-lasting biologic and behavioral consequences. The purpose of this paper is to examine the best evidence about (a) factors in parents and offspring that promote obesity during the early life stages, (b) the social determinants and dimensions of obesity in early life, (c) promising and effective interventions for preventing obesity in early life, and (d) opportunities for future research into strategies to disrupt the intergenerational cycle of obesity that begins early in life. The pathway for halting the intergenerational obesity epidemic requires the discovery and development of evidence-based interventions that can act across multiple dimensions of influence on early life. PMID:26989828

Essential elements for community engagement in evidence-based youth violence prevention.

PubMed

Miao, Tai-An; Umemoto, Karen; Gonda, Deanna; Hishinuma, Earl S

2011-09-01

In the field of youth violence prevention, there has been increasing emphasis on "evidence based" programs and principles shown through scientific research as reaching their intended outcomes. Community mobilization and engagement play a critical role in many evidence-based programs and strategies, as it takes a concerted effort among a wide range of people within a community to alter behavior and maintain behavioral change. How do concerned individuals and groups within a community engage others within and outside of that community to effectively plan, develop and implement appropriate EB programs as well as evaluate the outcomes and impacts of locally developed programs yet to be proven? The authors discuss five elements essential for community engagement in evidence-based youth violence prevention based on their work in a university-community partnership through the Asian/Pacific Islander Youth Violence Prevention Center (API Center), a National Academic Center for Excellence on Youth Violence Prevention Center supported by the Centers for Disease Control and Prevention. They include: (a) aligning EBPs with a community's shared vision and values; (b) establishing an inclusive environment for the planning, implementation and evaluation of EBPs; (c) nurturing collaboration for increased effectiveness and efficacy of EBPs; (d) building adequate leadership and community capacity to develop and sustain EBPs; and (e) building a learning community for evaluation and self-reflection. The authors propose placing greater emphasis on "evaluative thinking" and organizational capacity for evaluation as we pursue evidence-based practices for youth violence prevention. This is especially important for ethnic groups for which an evidence base is not well established.

High HOMA-IR, adjusted for puberty, relates to the metabolic syndrome in overweight and obese Chilean youths.

PubMed

Burrows, Raquel A; Leiva, Laura B; Weisstaub, Gerardo; Lera, Lydia M; Albala, Cecilia B; Blanco, Estela; Gahagan, Sheila

2011-05-01

To determine how the homeostasis model assessment of insulin resistance (HOMA-IR) is related to metabolic risk in a sample of overweight and obese Chilean youths accounting for Tanner stage. A cross-sectional study assessing 486 overweight and obese youths (aged 5-15 years) recruited from the University of Chile, Pediatric Obesity Clinic. We measured anthropometry, Tanner stage, HOMA-IR, and laboratory tests related to metabolic risk. HOMA-IR was categorized by quartile for children (Tanner stages I and II) and adolescents (Tanner stage III and above) from a normative Chilean sample. Children and adolescents with HOMA-IR in the highest quartile were likely to have higher body mass index (BMI) Z-scores, elevated waist circumference, systolic and diastolic blood pressure, and triglycerides and low high-density lipoprotein. HOMA-IR had good negative predictive value for characteristics of the metabolic syndrome (MetS; 0.82). In a multivariate regression model, BMI Z-score [odds ratio (OR) 1.5] and HOMA-IR (OR 3.3) predicted 22% of the variance for the MetS, with 36% of the explained variance attributed to HOMA-IR. In a large clinical sample of overweight and obese Chilean youths, HOMA-IR ≥ 75th percentile was significantly associated with the cluster of factors referred to as the MetS. We emphasize the importance of establishing percentiles for HOMA-IR based on a normative sample and taking Tanner stage into account. Although BMI is easy to assess and interpret with minimal costs in a clinical setting, adding HOMA-IR explains more of the variance in the MetS than BMI Z-score alone. © 2011 John Wiley & Sons A/S.

Indices of insulin secretion during a liquid mixed-meal test in obese youth with diabetes

USDA-ARS?s Scientific Manuscript database

To compare indices of insulin secretion, insulin sensitivity (IS),and oral disposition index (oDI) during the liquid mixed-meal test in obese youth with clinically diagnosed type 2 diabetes mellitus (T2DM) and negative autoantibodies (Ab-) versus those with T2DM and positive autoantibodies (Ab+) to ...

Evidence and Obesity Prevention: Developing Evidence Summaries to Support Decision Making

ERIC Educational Resources Information Center

Clark, Rachel; Waters, Elizabeth; Armstrong, Rebecca; Conning, Rebecca; Allender, Steven; Swinburn, Boyd

2013-01-01

Public health practitioners make decisions based on research evidence in combination with a variety of other influences. Evidence summaries are one of a range of knowledge translation options used to support evidence-informed decision making. The literature relevant to obesity prevention requires synthesis for it to be accessible and relevant to…

The Prevalence and Determinants of Overweight and Obesity among French Youths and Adults with Intellectual Disabilities Attending Special Education Schools

ERIC Educational Resources Information Center

Begarie, Jerome; Maiano, Christophe; Leconte, Pascale; Ninot, Gregory

2013-01-01

This study examines the prevalence of overweight and obesity and a panel of potential determinants among French youths and adults with an intellectual disability (ID). The sample used consisted of 1120 youths and adults with an ID, from 5 to 28 years old, attending a French special education school. The results indicated that 19.8% of the…

Behavioral intervention in the treatment of obesity in children and adolescents: implications for Mexico.

PubMed

Jelalian, Elissa; Evans, E Whitney

2017-01-01

Pediatric obesity is a worldwide health epidemic affecting both developed and developing countries. Mexico ranks second to the United States in rates of pediatric obesity. Obesity among youth has immediate and long-term consequences on physical and psychosocial development, including cardiovascular, respiratory, and health-related quality of life. Eventual amelioration of this epidemic will require change at the level of the family and community, along with policy initiatives to support healthier eating and activity habits. Evidence-based interventions for overweight/obese youth include family-based lifestyle programs that incorporate attention to diet quantity and quality, physical activity, sedentary behavior, and behavioral strategies to support change. While much of this research has been conducted in the United States, several recent studies suggest the efficacy of similar approaches for youth in Mexico. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Prevalence of overweight, obesity, underweight and normal weight in French youth from 2009 to 2013.

PubMed

Vanhelst, Jérémy; Baudelet, Jean-Benoît; Fardy, Paul S; Béghin, Laurent; Mikulovic, Jacques; Ulmer, Zékya

2017-04-01

To determine the prevalence of underweight, overweight and obesity in French youth from 2009 to 2013 and to determine if there are differences in weight categories according to socio-economic status. Cross-sectional study performed in different regions of France. Physical measures included weight, height and BMI. Underweight, overweight and obesity were defined according to age- and sex-specific BMI cut-off points from the International Obesity Task Force. France. Children and adolescents (n 9670; 4836 boys, 4834 girls) from the French national BOUGE Program between 2009 and 2013. The prevalence of obesity was higher in boys than girls (P0·05) and remained unchanged in boys (7·1-7·3 %) between 2009 and 2013. Overweight and obesity were higher in low socio-economic families (P<0·0001). Findings suggest that the prevalence of overweight was stable although high in French children and adolescents, while the prevalence of obesity increased significantly. Changes in underweight, although not significant, were high in girls and merit further attention. Improving public health interventions, especially in high-risk low socio-economic populations, may help to modify the behaviour that contributes to underweight, overweight and obesity in young boys and girls.

Muscle Strength and Fitness in Pediatric Obesity: a Systematic Review from the European Childhood Obesity Group

PubMed Central

Thivel, David; Ring-Dimitriou, Susanne; Weghuber, Daniel; Frelut, Marie-Laure; O'Malley, Grace

2016-01-01

The increasing prevalence of paediatric obesity and related metabolic complications has been mainly associated with lower aerobic fitness while less is known regarding potential musculoskeletal impairments. The purpose of the present systematic review was to report the evidence regarding muscular fitness in children and adolescents with obesity. A systematic article search was conducted between November 2014 and June 2015 using MEDLINE, EMBASE, CINAHL psycINFO, SPORTDiscus and SocINDEX. Articles published in English and reporting results on muscle strength and muscular fitness in children and adolescents aged 6 to 18 years were eligible. Of 548 identified titles, 36 studies were included for analyses. While laboratory-based studies described higher absolute muscular fitness in youth with obesity compared with their lean peers, these differences are negated when corrected for body weight and lean mass, then supporting field-based investigations. All interventional studies reviewed led to improved muscular fitness in youth with obesity. Children and adolescents with obesity display impaired muscular fitness compared to healthy-weight peers, which seems mainly due to factors such as excessive body weight and increased inertia of the body. Our analysis also points out the lack of information regarding the role of age, maturation or sex in the current literature and reveals that routinely used field tests analysing overall daily muscular fitness in children with obesity provide satisfactory results when compared to laboratory-based data. PMID:26901423

Urban sprawl and its relationship with active transportation, physical activity and obesity in Canadian youth.

PubMed

Seliske, Laura; Pickett, William; Janssen, Ian

2012-06-01

Urban sprawl is a potential environmental influence on youth overweight/obesity. However, little is known about the association between urban sprawl and behaviours that influence obesity such as active transportation and physical activity. The study population consisted of 7,017 respondents aged 12 to 19 to the 2007/2008 Canadian Community Health Survey, living in Canada's 33 census metropolitan areas (CMAs). Factor analysis was used to obtain an urban sprawl score for each CMA, incorporating dwelling density, percentage of single or detached dwelling units, and percentage of the population living in the urban core. Multi-level logistic regression examined whether urban sprawl was associated with frequent active transportation (30 or more minutes a day), moderate-to-vigorous physical activity (MVPA) (60 or more minutes a day), and overweight/obesity. Urban sprawl was associated with active transportation among 12- to 15-year-olds, with the relative odds of engaging in at least 30 minutes of active transportation per day increasing by 24% (95% CI: 10-39%) for each standard deviation (SD) increase in the urban sprawl score. For the entire sample aged 12 to 19, higher urban sprawl was associated with MVPA (odds ratio per SD increase = 1.10, 95% CI: 1.01-1.20), but not with overweight/obesity (odds ratio per SD increase = 1.06, 95% CI: 0.94-1.18). Urban sprawl was associated with active transportation and MVPA in Canadian youth, although in the opposite direction to what has been reported in the literature for adults.

Obesity-promoting factors in Mexican children and adolescents: challenges and opportunities.

PubMed

Aceves-Martins, Magaly; Llauradó, Elisabet; Tarro, Lucia; Solà, Rosa; Giralt, Montse

2016-01-01

Mexico is a developing country with one of the highest youth obesity rates worldwide; >34% of children and adolescents between 5 and 19 years of age are overweight or obese. The current review seeks to compile, describe, and analyze dietary conditions, physical activity, socioeconomic status, and cultural factors that create and exacerbate an obesogenic environment among Mexican youth. A narrative review was performed using PubMed and the Cochrane Library databases, as well as grey literature data from the Mexican government, academics, and statistical reports from nongovernmental organizations, included in electronic formats. The recent socioeconomic and nutritional transition has resulted in reduced healthy meal options at public schools, high rates of sedentary lifestyles among adolescents, lack of open spaces and playgrounds, socioeconomic deprivation, false or misunderstood sociocultural traditional beliefs, misconceptions about health, a high percentage of overweight or obese adults, and low rates of maternal breastfeeding. Some of the factors identified are exacerbating the obesity problem in this population. Current evidence also shows that more policies and health programs are needed for prevention of childhood and adolescent obesity. Mexico presents alarming obesity levels, which need to be curtailed and urgently reversed. The present narrative review presents an overview of dietary, physical activity, societal and cultural preconceptions that are potentially modifiable obesity-promoting factors in Mexican youth. Measures to control these factors need to be implemented in all similar developing countries by governments, policy makers, stakeholders, and health care professionals to tackle obesity in children and young people.

Effectiveness of social marketing strategies to reduce youth obesity in European school-based interventions: a systematic review and meta-analysis

PubMed Central

Aceves-Martins, Magaly; Llauradó, Elisabet; Tarro, Lucia; Moreno-García, Carlos Francisco; Trujillo Escobar, Tamy Goretty; Giralt, Montse

2016-01-01

Context: The use of social marketing to modify lifestyle choices could be helpful in reducing youth obesity. Some or all of the 8 domains of the National Social Marketing Centre’s social marketing benchmark criteria (SMBC) are often used but not always defined in intervention studies. Objective: The aim of this review is to assess the effectiveness of European school-based interventions to prevent obesity relative to the inclusion of SMBC domains in the intervention. Data Sources: The PubMed, Cochrane, and ERIC databases were used. Study Selection: Nonrandomized and randomized controlled trials conducted from 1990 to April 2014 in participants aged 5 to 17 years were included. Data Extraction: After the study selection, the 8 domains of the SMBC were assessed in each included study. Results: Thirty-eight publications were included in the systematic review. For the meta-analysis, randomized controlled trials (RCTs) reporting body mass index or prevalence of overweight and obesity were considered. Eighteen RCTs with a total of 8681 participants included at least 5 SMBC. The meta-analysis showed a small standardized mean difference in body mass index of −0.25 (95%CI, −0.45 to −0.04) and a prevalence of overweight and obesity odds ratio of 0.72 (95%CI, 0.5–0.97). Conclusion: Current evidence indicates that the inclusion of at least 5 SMBC domains in school-based interventions could benefit efforts to prevent obesity in young people. PROSPERO registration number: CRD42014007297. PMID:27018054

Cardiovascular risk and metabolic syndrome in obese youth enrolled in a multidisciplinary medical weight management program: implications of musculoskeletal pain, cardiorespiratory fitness, and health-related quality of life.

PubMed

Briggs, Matthew S; Spees, Colleen; Bout-Tabaku, Sharon; Taylor, Christopher A; Eneli, Ihuoma; Schmitt, Laura C

2015-04-01

Obese youth demonstrate the same obesity-associated morbidities observed in obese adults, including poor cardiorespiratory fitness, poor quality of life, and reports of musculoskeletal pain. The purposes of this study were to compare the prevalence of cardiovascular risk factors and evaluate the odds of metabolic syndrome in obese youth based on measures of cardiorespiratory fitness, quality of life, and pain. A medical chart review of 183 obese youth in a medical weight management program was conducted. Measures of cardiovascular risk and metabolic syndrome were recorded. Groups were categorized based on Progressive Aerobic Cardiovascular Endurance Run (PACER) score, Pediatric Quality of Life (PedsQL)-Physical Function score, PedsQL-Psychosocial Health score, and reports of musculoskeletal pain. Statistical analysis included independent t-tests, Mann-Whitney U-test, chi-squared test, and logistic regression. Thirty-three percent of the entire sample had C-reactive protein (CRP) levels >3.0 mg/dL and 30% were categorized as having metabolic syndrome. Patients with lower PACER scores demonstrated a greater prevalence of CRP levels >3.0 mg/dL versus those with higher PACER scores (45% vs. 12%; P=0.01). There were no other differences in the prevalence of cardiovascular risk factors or metabolic syndrome when categorized by PACER, PedsQL, or pain. Those with CRP levels >3.0 mg/dL demonstrated increased odds of metabolic syndrome-[odds (95% confidence interval, CI): 4.93 (1.24-19.61); P=0.02]. Overall, results do not show differences in cardiovascular risk in obese youth when categorized by PACER, PedsQL, or reports of MSK pain. Elevated CRP may be a useful predictor of metabolic syndrome in obese youth and warrants further investigation.

Dietary determinants of hepatic steatosis and visceral adiposity in overweight and obese youth at risk of type 2 diabetes.

PubMed

Mollard, Rebecca C; Sénéchal, Martin; MacIntosh, Andrea C; Hay, Jacqueline; Wicklow, Brandy A; Wittmeier, Kristy D M; Sellers, Elizabeth A C; Dean, Heather J; Ryner, Lawrence; Berard, Lori; McGavock, Jonathan M

2014-04-01

Dietary determinants of hepatic steatosis, an important precursor for nonalcoholic fatty liver disease, are undefined. We explored the roles of sugar and fat intake as determinants of hepatic steatosis and visceral obesity in overweight adolescents at risk of type 2 diabetes. This was a cross-sectional study of dietary patterns and adipose tissue distribution in 74 overweight adolescents (aged: 15.4 ± 1.8 y; body mass index z score: 2.2 ± 0.4). Main outcome measures were hepatic steatosis (≥5.5% fat:water) measured by magnetic resonance spectroscopy and visceral obesity (visceral-to-subcutaneous adipose tissue ratio ≥0.25) measured by magnetic resonance imaging. Main exposure variables were dietary intake and habits assessed by the Harvard Youth Adolescent Food Frequency Questionnaire. Hepatic steatosis and visceral obesity were evident in 43% and 44% of the sample, respectively. Fried food consumption was more common in adolescents with hepatic steatosis than in adolescents without hepatic steatosis (41% compared with 18%; P = 0.04). Total fat intake (β = 0.51, P = 0.03) and the consumption of >35% of daily energy intake from fat (OR: 11.8; 95% CI: 1.6, 86.6; P = 0.02) were both positively associated with hepatic steatosis. Available carbohydrate (β = 0.54, P = 0.02) and the frequent consumption of soda were positively associated with visceral obesity (OR: 6.4; 95% CI: 1.2, 34.0; P = 0.03). Daily fiber intake was associated with reduced odds of visceral obesity (OR: 0.82; 95% CI: 0.68, 0.98; P = 0.02) but not hepatic steatosis. Hepatic steatosis is associated with a greater intake of fat and fried foods, whereas visceral obesity is associated with increased consumption of sugar and reduced consumption of fiber in overweight and obese adolescents at risk of type 2 diabetes.

Direct and Indirect Effects of a Family-Based Intervention in Early Adolescence on Parent-Youth Relationship Quality, Late Adolescent Health, and Early Adult Obesity

PubMed Central

Van Ryzin, Mark J.; Nowicka, Paulina

2013-01-01

We explored family processes in adolescence that may influence the likelihood of obesity in early adulthood using a randomized trial of a family-based intervention (the Family CheckUp, or FCU). The FCU has been shown to reduce escalations in antisocial behavior and depression in adolescence by supporting positive family management practices, but no research has examined the mechanisms by which the FCU could influence health-related attitudes and behaviors linked to obesity. Participants were 998 adolescents (n = 526 male; n = 423 European American; M age 12.21 yrs) and their families, recruited in 6th grade from 3 middle schools in the Pacific Northwest. We used structural equation modeling (SEM) and an Intent-To-Treat (ITT) design to evaluate the direct and indirect effects of the FCU on parent–youth relationship quality (ages 12–15), healthy lifestyle behaviors, eating attitudes, depressive symptoms (all measured at age 17), and obesity (age 22). We found that the FCU led to greater parent–youth relationship quality, which predicted enhanced health-related behaviors, reduced maladaptive eating attitudes, and reduced depression. In turn, reduced maladaptive eating attitudes predicted reduced odds of obesity. The indirect effect of the FCU on obesity by way of parent–youth relationship quality and eating attitudes was significant. Our findings illustrate how family processes may influence adolescent health and suggest that family functioning may be an additional factor to consider when developing intervention programs for obesity. PMID:23421838

Direct and indirect effects of a family-based intervention in early adolescence on parent-youth relationship quality, late adolescent health, and early adult obesity.

PubMed

Van Ryzin, Mark J; Nowicka, Paulina

2013-02-01

We explored family processes in adolescence that may influence the likelihood of obesity in early adulthood using a randomized trial of a family-based intervention (the Family Check-Up, or FCU). The FCU has been shown to reduce escalations in antisocial behavior and depression in adolescence by supporting positive family management practices, but no research has examined the mechanisms by which the FCU could influence health-related attitudes and behaviors linked to obesity. Participants were 998 adolescents (n = 526 male; n = 423 European American; M age 12.21 years) and their families, recruited in 6th grade from 3 middle schools in the Pacific Northwest. We used structural equation modeling (SEM) and an Intent-To-Treat (ITT) design to evaluate the direct and indirect effects of the FCU on parent-youth relationship quality (ages 12-15), healthy lifestyle behaviors, eating attitudes, depressive symptoms (all measured at age 17), and obesity (age 22). We found that the FCU led to greater parent-youth relationship quality, which predicted enhanced health-related behaviors, reduced maladaptive eating attitudes, and reduced depression. In turn, reduced maladaptive eating attitudes predicted reduced odds of obesity. The indirect effect of the FCU on obesity by way of parent-youth relationship quality and eating attitudes was significant. Our findings illustrate how family processes may influence adolescent health and suggest that family functioning may be an additional factor to consider when developing intervention programs for obesity. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Use of Research Evidence in State Policymaking for Childhood Obesity Prevention in Minnesota

PubMed Central

Kite, Hanna A.; Benning, Sara J.; Callanan, Rachel A.; Weisman, Susan R.; Nanney, Marilyn S.

2014-01-01

Objectives. We describe how scientific evidence about obesity has been used in Minnesota legislative materials to understand how research evidence might more effectively be translated into policymaking. Methods. We selected 13 obesity-related bills introduced from 2007 to 2011 in Minnesota. Using state archives, we collected all legislative committee meeting materials and floor testimony related to each bill. We used a coding instrument to systematically analyze the content of a sample of 109 materials for their use of research evidence and non–research-based information. Results. Research evidence was mentioned in 41% of all legislative materials. Evidence was often used to describe the prevalence or consequences of obesity or policy impacts but not to describe health disparities. In 45% of materials that cited evidence, no source of evidence was indicated. By contrast, 92% of materials presented non–research-based information, such as expert beliefs, constituent opinion, political principles, and anecdotes. Conclusions. Despite an abundance of available research evidence on obesity, less than half of legislative materials cited any such evidence in discussions around obesity-related bills under consideration in Minnesota. PMID:25122015

Use of research evidence in state policymaking for childhood obesity prevention in Minnesota.

PubMed

Gollust, Sarah E; Kite, Hanna A; Benning, Sara J; Callanan, Rachel A; Weisman, Susan R; Nanney, Marilyn S

2014-10-01

We describe how scientific evidence about obesity has been used in Minnesota legislative materials to understand how research evidence might more effectively be translated into policymaking. We selected 13 obesity-related bills introduced from 2007 to 2011 in Minnesota. Using state archives, we collected all legislative committee meeting materials and floor testimony related to each bill. We used a coding instrument to systematically analyze the content of a sample of 109 materials for their use of research evidence and non-research-based information. Research evidence was mentioned in 41% of all legislative materials. Evidence was often used to describe the prevalence or consequences of obesity or policy impacts but not to describe health disparities. In 45% of materials that cited evidence, no source of evidence was indicated. By contrast, 92% of materials presented non-research-based information, such as expert beliefs, constituent opinion, political principles, and anecdotes. Despite an abundance of available research evidence on obesity, less than half of legislative materials cited any such evidence in discussions around obesity-related bills under consideration in Minnesota.

Mental Health, Wellness, and Childhood Overweight/Obesity

PubMed Central

Russell-Mayhew, Shelly; McVey, Gail; Bardick, Angela; Ireland, Alana

2012-01-01

Childhood obesity is a growing concern, and while progress has been made to understand the association between multiple biological factors (i.e., genetics, nutrition, exercise etc.), little is known about the relationship between mental health and childhood obesity. In this paper, we offer a review of current evidence about the association between mental health and childhood obesity. A systematic literature search of peer-reviewed, English-language studies published between January 2000 and January 2011 was undertaken and resulted in 759 unique records, of which 345 full-text articles were retrieved and 131 articles were included. A theoretical model is proposed to organize the paper and reflect the current state of the literature and includes psychological factors (i.e., depression and anxiety, self-esteem, body dissatisfaction, eating disordered symptoms, and emotional problems); psychosocial mediating variables (i.e., weight-based teasing and concern about weight and shape), and wellness factors (i.e., quality of life and resiliency/protective factors). We conclude with a number of recommendations to support the creation of solutions to the rise in childhood obesity rates that do not further marginalize overweight and obese children and youth and that can potentially improve the well-being of all children and youth regardless of their weight status. PMID:22778915

Associations of youth and parent weight status with reported versus predicted daily energy intake and hemoglobin A1c in youth with type 1 diabetes mellitus.

PubMed

Sands, Amanda L P; Higgins, Laurie A; Mehta, Sanjeev N; Nansel, Tonja R; Lipsky, Leah M; Laffel, Lori M B

2013-01-01

The epidemic of overweight/obesity affects youth with type 1 diabetes mellitus (T1DM) and their families. In youth with T1DM and their parents, we examined weight status with reported and expected energy intake and with youth hemoglobin A1c (HbA1c). In 243 youth (48% female, 13 ± 3 years) and their parents (84% female, 45 ± 6 years), we assessed body mass index (BMI), prevalence of overweight/obesity, reported energy intake (REI), and youth glycemic control (HbA1c). The REI was compared with predicted daily energy requirements (DER; based on age, weight, sex, and physical activity). Youth had diabetes duration of 6.3 ± 3.4 years and HbA1c of 8.5% ± 1.3%; 69% used insulin pump therapy. Overweight and obesity affected 23% and 11% of youth and 30% and 24% of parents, respectively. Youth and parent BMI (r = 0.38; p < .001) and weight status (overweight/obese; p < .001) were significantly associated. The ratio of REI:DER was significantly lower in overweight/obese compared with underweight/normal weight parents (1.0 ± 0.4 versus 1.2 ± 0.5; p = .001) but did not differ among youth by weight status. Both youth and parent BMI were positively correlated with youth HbA1c (r = 0.14, p = .02; r = 0.16, p = .01, respectively). Hemoglobin A1c tended to be higher in obese than in overweight and normal weight youth (mean ± standard deviation [SD] 8.4 ± 1.4, 8.4 ± 1.3, and 8.8 ± 1.0, respectively; p = .06) and was significantly higher in youth whose parents were obese versus overweight or underweight/normal weight (mean ± SD 8.2 ± 1.2, 8.5 ± 1.4, and 8.9 ± 1.5, respectively; p < .001). Similar to the general population, overweight and obesity are prevalent among families of youth with T1DM. Weight status appears to influence self-REI in parents and glycemic control in youth with T1DM, suggesting the need for family-based dietary interventions. © 2012 Diabetes Technology Society.

Muscle Strength and Fitness in Pediatric Obesity: a Systematic Review from the European Childhood Obesity Group.

PubMed

Thivel, David; Ring-Dimitriou, Susanne; Weghuber, Daniel; Frelut, Marie-Laure; O'Malley, Grace

2016-01-01

The increasing prevalence of paediatric obesity and related metabolic complications has been mainly associated with lower aerobic fitness while less is known regarding potential musculoskeletal impairments. The purpose of the present systematic review was to report the evidence regarding muscular fitness in children and adolescents with obesity. A systematic article search was conducted between November 2014 and June 2015 using MEDLINE, EMBASE, CINAHL psycINFO, SPORTDiscus and SocINDEX. Articles published in English and reporting results on muscle strength and muscular fitness in children and adolescents aged 6 to 18 years were eligible. Of 548 identified titles, 36 studies were included for analyses. While laboratory-based studies described higher absolute muscular fitness in youth with obesity compared with their lean peers, these differences are negated when corrected for body weight and lean mass, then supporting field-based investigations. All interventional studies reviewed led to improved muscular fitness in youth with obesity. Children and adolescents with obesity display impaired muscular fitness compared to healthy-weight peers, which seems mainly due to factors such as excessive body weight and increased inertia of the body. Our analysis also points out the lack of information regarding the role of age, maturation or sex in the current literature and reveals that routinely used field tests analysing overall daily muscular fitness in children with obesity provide satisfactory results when compared to laboratory-based data. © 2016 S. Karger GmbH, Freiburg.

The Integration of a Family Systems Approach for Understanding Youth Obesity, Physical Activity, and Dietary Programs

PubMed Central

Wilson, Dawn K.; St. George, Sara M.; Lawman, Hannah; Segal, Michelle; Fairchild, Amanda

2012-01-01

Rates of overweight in youth have reached epidemic proportions and are associated with adverse health outcomes. Family-based programs have been widely used to treat overweight in youth. However, few programs incorporate a theoretical framework for studying a family systems approach in relation to youth health behavior change. Therefore, this review provides a family systems theory framework for evaluating family-level variables in weight loss, physical activity, and dietary approaches in youth. Studies were reviewed and effect sizes were calculated for interventions that manipulated the family system, including components that targeted parenting styles, parenting skills, or family functioning, or which had novel approaches for including the family. Twenty-one weight loss interventions were identified, and 25 interventions related to physical activity and/or diet were identified. Overall, family-based treatment programs that incorporated training for authoritative parenting styles, parenting skills, or child management, and family functioning had positive effects on youth weight loss. Programs to improve physical activity and dietary behaviors that targeted the family system also demonstrated improvements in youth health behaviors; however, direct effects of parent-targeted programming is not clear. Both treatment and prevention programs would benefit from evaluating family functioning and parenting styles as possible mediators of intervention outcomes. Recommendations are provided to guide the development of future family-based obesity prevention and treatment programs for youth. PMID:20689989

Marketing to America's youth: evidence from corporate documents.

PubMed

Cummings, K M; Morley, C P; Horan, J K; Steger, C; Leavell, N-R

2002-03-01

To evaluate the claim that the tobacco industry does not market its products to youth. The data for this study come from tobacco industry documents collected from the tobacco industry's document websites, presently linked at http://www.tobaccoarchives.com. The websites were searched using "request for production" (RFP) codes, specified keyword searches, and serendipitous terms identified in document citations found with RFP and keyword searches. Industry documents show that the cigarette manufacturers carefully monitored the smoking habits of teenagers over the past several decades. Candid quotes from industry executives refer to youth as a source of sales and as fundamental to the survival of the tobacco industry. The documents reveal that the features of cigarette brands (that is, use of filters, low tar, bland taste, etc), packaging (that is, size, colour and design), and advertising (that is, media placements and themes and imagery) were developed specifically to appeal to new smokers (that is, teenagers). Evidence also indicates that relevant youth oriented marketing documents may have been destroyed and that the language used in some of the more recent documents may have been sanitised to cover up efforts to market to youth. The tobacco industry's internal documents reveal an undeniable interest in marketing cigarettes to underage smokers. The industry's marketing approaches run counter to and predicate methods for tobacco prevention: (1) keep the price of the product high; (2) keep product placements and advertising away from schools and other areas with a high volume of youth traffic; (3) make cigarette advertising (that is, themes and visual images) unappealing to youth; (4) make product packaging unappealing to youth; and (5) design the product so it is not easy to inhale.

Obesity-promoting factors in Mexican children and adolescents: challenges and opportunities

PubMed Central

Aceves-Martins, Magaly; Llauradó, Elisabet; Tarro, Lucia; Solà, Rosa; Giralt, Montse

2016-01-01

Background Mexico is a developing country with one of the highest youth obesity rates worldwide; >34% of children and adolescents between 5 and 19 years of age are overweight or obese. Objectives The current review seeks to compile, describe, and analyze dietary conditions, physical activity, socioeconomic status, and cultural factors that create and exacerbate an obesogenic environment among Mexican youth. Design A narrative review was performed using PubMed and the Cochrane Library databases, as well as grey literature data from the Mexican government, academics, and statistical reports from nongovernmental organizations, included in electronic formats. Results The recent socioeconomic and nutritional transition has resulted in reduced healthy meal options at public schools, high rates of sedentary lifestyles among adolescents, lack of open spaces and playgrounds, socioeconomic deprivation, false or misunderstood sociocultural traditional beliefs, misconceptions about health, a high percentage of overweight or obese adults, and low rates of maternal breastfeeding. Some of the factors identified are exacerbating the obesity problem in this population. Current evidence also shows that more policies and health programs are needed for prevention of childhood and adolescent obesity. Mexico presents alarming obesity levels, which need to be curtailed and urgently reversed. Conclusions The present narrative review presents an overview of dietary, physical activity, societal and cultural preconceptions that are potentially modifiable obesity-promoting factors in Mexican youth. Measures to control these factors need to be implemented in all similar developing countries by governments, policy makers, stakeholders, and health care professionals to tackle obesity in children and young people. PMID:26787421

Evidence in obese children: contribution of hyperlipidemia, obesity-inflammation, and insulin sensitivity.

PubMed

Chang, Chi-Jen; Jian, Deng-Yuan; Lin, Ming-Wei; Zhao, Jun-Zhi; Ho, Low-Tone; Juan, Chi-Chang

2015-01-01

Evidence shows a high incidence of insulin resistance, inflammation and dyslipidemia in adult obesity. The aim of this study was to assess the relevance of inflammatory markers, circulating lipids, and insulin sensitivity in overweight/obese children. We enrolled 45 male children (aged 6 to 13 years, lean control = 16, obese = 19, overweight = 10) in this study. The plasma total cholesterol, HDL cholesterol, triglyceride, glucose and insulin levels, the circulating levels of inflammatory factors, such as TNF-α, IL-6, and MCP-1, and the high-sensitive CRP level were determined using quantitative colorimetric sandwich ELISA kits. Compared with the lean control subjects, the obese subjects had obvious insulin resistance, abnormal lipid profiles, and low-grade inflammation. The overweight subjects only exhibited significant insulin resistance and low-grade inflammation. Both TNF-α and leptin levels were higher in the overweight/obese subjects. A concurrent correlation analysis showed that body mass index (BMI) percentile and fasting insulin were positively correlated with insulin resistance, lipid profiles, and inflammatory markers but negatively correlated with adiponectin. A factor analysis identified three domains that explained 74.08% of the total variance among the obese children (factor 1: lipid, 46.05%; factor 2: obesity-inflammation, 15.38%; factor 3: insulin sensitivity domains, 12.65%). Our findings suggest that lipid, obesity-inflammation, and insulin sensitivity domains predominantly exist among obese children. These factors might be applied to predict the outcomes of cardiovascular diseases in the future.

Effectiveness of social marketing strategies to reduce youth obesity in European school-based interventions: a systematic review and meta-analysis.

PubMed

Aceves-Martins, Magaly; Llauradó, Elisabet; Tarro, Lucia; Moreno-García, Carlos Francisco; Trujillo Escobar, Tamy Goretty; Solà, Rosa; Giralt, Montse

2016-05-01

The use of social marketing to modify lifestyle choices could be helpful in reducing youth obesity. Some or all of the 8 domains of the National Social Marketing Centre's social marketing benchmark criteria (SMBC) are often used but not always defined in intervention studies. The aim of this review is to assess the effectiveness of European school-based interventions to prevent obesity relative to the inclusion of SMBC domains in the intervention. The PubMed, Cochrane, and ERIC databases were used. Nonrandomized and randomized controlled trials conducted from 1990 to April 2014 in participants aged 5 to 17 years were included. After the study selection, the 8 domains of the SMBC were assessed in each included study. Thirty-eight publications were included in the systematic review. For the meta-analysis, randomized controlled trials (RCTs) reporting body mass index or prevalence of overweight and obesity were considered. Eighteen RCTs with a total of 8681 participants included at least 5 SMBC. The meta-analysis showed a small standardized mean difference in body mass index of -0.25 (95%CI, -0.45 to -0.04) and a prevalence of overweight and obesity odds ratio of 0.72 (95%CI, 0.5-0.97). Current evidence indicates that the inclusion of at least 5 SMBC domains in school-based interventions could benefit efforts to prevent obesity in young people. PROSPERO registration number: CRD42014007297. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute.

Evidence-Based Psychosocial Treatments for Ethnic Minority Youth

ERIC Educational Resources Information Center

Huey, Stanley J., Jr.; Polo, Antonio J.

2008-01-01

This article reviews research on evidence-based treatments (EBTs) for ethnic minority youth using criteria from Chambless et al. (1998), Chambless et al. (1996), and Chambless and Hollon (1998). Although no "well-established" treatments were identified, "probably efficacious" or "possibly efficacious" treatments were found for ethnic minority…

Age-related consequences of childhood obesity.

PubMed

Kelsey, Megan M; Zaepfel, Alysia; Bjornstad, Petter; Nadeau, Kristen J

2014-01-01

The severity and frequency of childhood obesity has increased significantly over the past three to four decades. The health effects of increased body mass index as a child may significantly impact obese youth as they age. However, many of the long-term outcomes of childhood obesity have yet to be studied. This article examines the currently available longitudinal data evaluating the effects of childhood obesity on adult outcomes. Consequences of obesity include an increased risk of developing the metabolic syndrome, cardiovascular disease, type 2 diabetes and its associated retinal and renal complications, nonalcoholic fatty liver disease, obstructive sleep apnea, polycystic ovarian syndrome, infertility, asthma, orthopedic complications, psychiatric disease, and increased rates of cancer, among others. These disorders can start as early as childhood, and such early onset increases the likelihood of early morbidity and mortality. Being obese as a child also increases the likelihood of being obese as an adult, and obesity in adulthood also leads to obesity-related complications. This review outlines the evidence for childhood obesity as a predictor of adult obesity and obesity-related disorders, thereby emphasizing the importance of early intervention to prevent the onset of obesity in childhood.

Continuous glucose monitoring and its relationship to hemoglobin A1c and oral glucose tolerance testing in obese and prediabetic youth.

PubMed

Chan, Christine L; Pyle, Laura; Newnes, Lindsey; Nadeau, Kristen J; Zeitler, Philip S; Kelsey, Megan M

2015-03-01

The optimal screening test for diabetes and prediabetes in obese youth is controversial. We examined whether glycosylated hemoglobin (HbA1c) or the oral glucose tolerance test (OGTT) is a better predictor of free-living glycemia as measured by continuous glucose monitoring (CGM). This was a cross-sectional study of youth 10-18 years old, body mass index (BMI) 85th percentile or greater, with diabetes risk factors. Participants (n = 118) with BMI 85th percentile or greater, not on medications for glucose management, were recruited from primary care and pediatric endocrinology clinics around Denver, Colorado. HbA1c, fasting plasma glucose, and 2-hour glucose were collected and all participants wore a blinded CGM for 72 hours. CGM outcomes were determined and descriptive statistics calculated. Performance characteristics at current American Diabetes Association cutpoints were compared with CGM outcomes. CGM data were successfully collected on 98 obese youth. Those with prediabetes had significantly higher average glucose, area under the curve (AUC), peak glucose, and time greater than 120 and greater than 140 mg/dL (P < .01) on CGM than youth with normal HbA1c or OGTT. HbA1c had a greater magnitude of correlation to CGM average glucose, AUC, and minimum glucose; 2-hour glucose had a greater magnitude of correlation to CGM SD, peak glucose, and time greater than 140 and greater than 200 mg/dL. However, there were no overall differences in the strength comparisons between 2-hour glucose and HbA1c correlations to CGM outcomes. In obese youth, HbA1c and 2-hour glucose performed equally well at predicting free-living glycemia on CGM, suggesting that both are valid tests for dysglycemia screening.

Weighing the Evidence of Common Beliefs in Obesity Research

PubMed Central

Casazza, Krista; Brown, Andrew; Astrup, Arne; Bertz, Fredrik; Baum, Charles; Brown, Michelle Bohan; Dawson, John; Durant, Nefertiti; Dutton, Gareth; Fields, David A.; Fontaine, Kevin R.; Levitsky, David; Mehta, Tapan; Menachemi, Nir; Newby, PK; Pate, Russell; Raynor, Hollie; Rolls, Barbara J.; Sen, Bisakha; Smith, Daniel L.; Thomas, Diana; Wansink, Brian; Allison, David B.

2014-01-01

Obesity is a topic on which many views are strongly held in the absence of scientific evidence to support those views, and some views are strongly held despite evidence to contradict those views. We refer to the former as “presumptions” and the latter as “myths”. Here we present nine myths and ten presumptions surrounding the effects of rapid weight loss; setting realistic goals in weight loss therapy; stage of change or readiness to lose weight; physical education classes; breast-feeding; daily self-weighing; genetic contribution to obesity; the “Freshman 15”; food deserts; regularly eating (versus skipping) breakfast; eating close to bedtime; eating more fruits and vegetables; weight cycling (i.e. yo-yo dieting); snacking; built environment; reducing screen time in childhood obesity; portion size; participation in family mealtime; and drinking water as a means of weight-loss. For each of these, we describe the belief and present evidence that the belief is widely held or stated, reasons to support the conjecture that the belief might be true, evidence to directly support or refute the belief, and findings from randomized controlled trials, if available. We conclude with a discussion of the implications of these determinations, conjecture on why so many myths and presumptions exist, and suggestions for limiting the spread of these and other unsubstantiated beliefs about obesity domain. PMID:24950157

Evidence-Based Psychosocial Treatments for Ethnic Minority Youth

PubMed Central

Huey, Stanley J.; Polo, Antonio J.

2008-01-01

This article reviews research on evidence-based treatments (EBTs) for ethnic minority youth using criteria from Chambless et al. (1998), Chambless et al. (1996), and Chambless and Hollon (1998). Although no well-established treatments were identified, probably efficacious or possibly efficacious treatments were found for ethnic minority youth with anxiety-related problems, attention-deficit/hyperactivity disorder, depression, conduct problems, substance use problems, trauma-related syndromes, and other clinical problems. In addition, all studies met either Nathan and Gorman's (2002) Type 1 or Type 2 methodological criteria. A brief meta-analysis showed overall treatment effects of medium magnitude (d = .44). Effects were larger when EBTs were compared to no treatment (d = .58) or psychological placebos (d = .51) versus treatment as usual (d = .22). Youth ethnicity (African American, Latino, mixed/other minority), problem type, clinical severity, diagnostic status, and culture-responsive treatment status did not moderate treatment outcome. Most studies had low statistical power and poor representation of less acculturated youth. Few tests of cultural adaptation effects have been conducted in the literature and culturally validated outcome measures are mostly lacking. Recommendations for clinical practice and future research directions are provided. PMID:18444061

The association between obesity and academic performance in youth: a systematic review.

PubMed

Santana, C C A; Hill, J O; Azevedo, L B; Gunnarsdottir, T; Prado, W L

2017-10-01

Previous studies have found that obesity could influence academic performance. The aim of this study was to systematically review the scientific evidence on the association between obesity and academic performance in school children. A systematic review of English articles was undertaken by using databases PubMed/Medline, ERIC, LILACS, SciELO and Web of Science. Cross-sectional and longitudinal studies examining the association between obesity and academic performance in children and adolescents, published between January 1990 and December 2016, were included. Risk of bias was assessed by using Strengthening the Reporting of Observational Studies in Epidemiology. Thirty-four studies (23 cross-sectional and 11 longitudinal) matched all inclusion criteria and were included. Seven studies were classified as low risk of bias, 23 as medium risk and four as high risk. After controlling for covariates such as socio-economic status, parental education and physical activity, the association between obesity and academic performance becomes uncertain for most of the studies (55.9%). Therefore, at present, there is insufficient evidence to support a direct link between obesity and poor academic performance in school age children. In order to clarify this issue, we need more longitudinal studies with adequate sample sizes and that control for potential confounders. © 2017 World Obesity Federation.

Obesity in Children and the 'Myth of Psychological Maladjustment': Self-Esteem in the Spotlight.

PubMed

Hill, Andrew J

2017-03-01

There are contrasting views regarding the psychological well-being of children with obesity. Responding to limitations of existing evidence, Jane Wardle in 2005 argued for a 'myth of psychological maladjustment'. This review looks again at self-esteem. The different characterisations of self-esteem each offer value. Global self-esteem is reduced in nearly all studies of youth with obesity. Dimensional self-esteem reveals physical appearance, athletic and social competence as the most affected areas, confirmed by research that has operationalised low self-competence. Children with obesity are also more likely to be victimised by their peers, generally and for their fatness. Victims who bully others appear to preserve some aspects of self-esteem. A relatively small proportion of youth with obesity has low self-esteem, but those with severe and persistent obesity are especially compromised. Weight loss is only weakly associated with improved self-competence suggesting the value of resilience and asset approaches to improving well-being.

Evidence for prospective associations among depression and obesity in population-based studies.

PubMed

Faith, M S; Butryn, M; Wadden, T A; Fabricatore, A; Nguyen, A M; Heymsfield, S B

2011-05-01

Obesity may lead to depression or be one of its consequences. We reviewed population-based studies in order to, first, identify the most commonly used research methods, and, second, to evaluate the strength of evidence for prospective associations among obesity and depression. We examined 25 studies, of which 10 tested 'obesity-to-depression' pathways, and 15 tested 'depression-to-obesity' pathways. Descriptive statistics summarized the frequency with which various measurements, designs and data analytic strategies were used. We tallied the number of studies that reported any vs. no statistically significant associations, and report on effect sizes, identified moderating variables within reports, and sought common findings across studies. Results indicated considerable methodological heterogeneity in the literature. Depression was assessed by clinical interview in 44% of studies, weight and height were directly measured in 32%, and only 12% used both. In total, 80% of the studies reported significant obesity-to-depression associations, with odds ratios generally in the range of 1.0 to 2.0, while only 53% of the studies reported significant depression-to-obesity associations. Sex was a common moderating variable. Thus, there was good evidence that obesity is prospectively associated with increased depression, with less consistent evidence that depression leads to obesity. Recommendations for future research regarding study samples, measurement and data analysis are provided. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

Beta-cell function, incretin effect, and incretin hormones in obese youth along the span of glucose tolerance from normal to prediabetes to Type 2 diabetes

USDA-ARS?s Scientific Manuscript database

Using the hyperglycemic and euglycemic clamp, we demonstrated impaired Beta-cell function in obese youth with increasing dysglycemia. Herein we describe oral glucose tolerance test (OGTT)-modeled Beta-cell function and incretin effect in obese adolescents spanning the range of glucose tolerance. Bet...

Marketing to America's youth: evidence from corporate documents

PubMed Central

Cummings, K; Morley, C; Horan, J; Steger, C; Leavell, N

2002-01-01

Design: The data for this study come from tobacco industry documents collected from the tobacco industry's document websites, presently linked at http://www.tobaccoarchives.com. The websites were searched using "request for production" (RFP) codes, specified keyword searches, and serendipitous terms identified in document citations found with RFP and keyword searches. Results: Industry documents show that the cigarette manufacturers carefully monitored the smoking habits of teenagers over the past several decades. Candid quotes from industry executives refer to youth as a source of sales and as fundamental to the survival of the tobacco industry. The documents reveal that the features of cigarette brands (that is, use of filters, low tar, bland taste, etc), packaging (that is, size, colour and design), and advertising (that is, media placements and themes and imagery) were developed specifically to appeal to new smokers (that is, teenagers). Evidence also indicates that relevant youth oriented marketing documents may have been destroyed and that the language used in some of the more recent documents may have been sanitised to cover up efforts to market to youth. Conclusions: The tobacco industry's internal documents reveal an undeniable interest in marketing cigarettes to underage smokers. The industry's marketing approaches run counter to and predicate methods for tobacco prevention: (1) keep the price of the product high; (2) keep product placements and advertising away from schools and other areas with a high volume of youth traffic; (3) make cigarette advertising (that is, themes and visual images) unappealing to youth; (4) make product packaging unappealing to youth; and (5) design the product so it is not easy to inhale. PMID:11893810

I choose health (Elijo Salud: impacting youth through parish nursing.

PubMed

Oakley, Janet; Hoebeke, Roberta

2014-01-01

The 2009-2010 National Health and Nutritional Examination Survey (NHANES) found that 34% of adolescents are overweight and 18% obese. The chance of an overweight/obese adolescent becoming an overweight/obese adult by age 35 is 60%. Hispanic youth are at risk for becoming obese related to eating habits. This paper describes an intervention, I Choose Health (Elijo Salud), with Hispanic church youth.

A decade of temporal trends in overweight/obesity in youth with type 1 diabetes after the Diabetes Control and Complications Trial.

PubMed

Baskaran, Charumathi; Volkening, Lisa K; Diaz, Monica; Laffel, Lori M

2015-06-01

Youth with type 1 diabetes (T1D) are at risk for weight gain due to the epidemic of childhood overweight/obesity and common use of intensive insulin therapy; the latter resulted in weight gain in the Diabetes Control and Complications Trial. To assess overweight/obesity prevalence and intensive insulin therapy use in youth with T1D over a decade and identify factors associated with weight status and glycemic control. We obtained cross-sectional data from four unique cohorts (1999, 2002, 2006, and 2009). Youth (N = 507, 49% male) were 8-16 yr old with T1D duration ≥6 months, A1c 6.0-12.0% (42-108 mmol/mol), and daily insulin dose ≥0.5 U/kg. Across cohorts, age, body mass index (BMI) percentile, and A1c ranged from 12.0 ± 2.2 to 12.8 ± 2.3 yr, 70 ± 22 to 72 ± 21, and 8.3 ± 1.0 (67 ± 11) to 8.5 ± 1.1% (69 ± 12 mmol/mol), respectively. Intensive insulin therapy use increased from 52 to 97% (p < 0.001) between 1999 and 2009. However, prevalence of overweight/obesity remained similar, 27% (1999), 36% (2002), 33% (2006), and 31% (2009) (p = 0.54), as did z-BMI. In multivariate analysis, higher A1c was related to higher insulin dose (p < 0.01), less frequent blood glucose monitoring (p < 0.001), and non-white race (p < 0.001); A1c was not related to z-BMI, intensive insulin therapy, or cohort. z-BMI was related to insulin dose (p < 0.005) but not intensive insulin therapy or cohort. Despite near-universal implementation of intensive insulin therapy, overweight/obesity prevalence in youth with T1D remained stable over a decade, similar to the general pediatric population. However, A1c remained suboptimal, underscoring the need to optimize T1D treatment to reduce future complication risk. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The prevalence and determinants of overweight and obesity among French youths and adults with intellectual disabilities attending special education schools.

PubMed

Bégarie, Jérôme; Maïano, Christophe; Leconte, Pascale; Ninot, Grégory

2013-05-01

This study examines the prevalence of overweight and obesity and a panel of potential determinants among French youths and adults with an intellectual disability (ID). The sample used consisted of 1120 youths and adults with an ID, from 5 to 28 years old, attending a French special education school. The results indicated that 19.8% of the participants with an ID are classified as overweight and 8.6% as obese. Multivariate logistic regression analyses revealed that there are nearly three times more girls/women classified as overweight than boys/men. Additionally, they showed that there are nearly two times more participants from southern France classified as overweight than from northern France, and that the risk of being classified as overweight significantly increases with seniority in the school. Next, the interaction effects observed indicated first that there are nearly two times more boys/men on psychotropic medication classified as overweight than boys/men not on psychotropic medication. Second, they revealed that the odds of being classified as overweight for boys/men not on psychotropic medication are 47% lower than for girls/women not on psychotropic medication. Third, they indicated that there are nearly two times more boys/men from southern France classified as obese than boys/men from northern France. Fourth, they showed that the odds of being classified as obese for boys/men from northern France are 52% lower than for girls/women from northern France. In conclusion, these results should be viewed as preliminary and need to be replicated since, to our knowledge, this study is the first one to examine this topic while simultaneously controlling for all of the potential determinants and relying on a sample of youths and adults. Copyright © 2013 Elsevier Ltd. All rights reserved.

Adolescent Obesity and Insulin Resistance: Roles of Ectopic Fat Accumulation and Adipose Inflammation.

PubMed

Caprio, Sonia; Perry, Rachel; Kursawe, Romy

2017-05-01

As a consequence of the global rise in the prevalence of adolescent obesity, an unprecedented phenomenon of type 2 diabetes has emerged in pediatrics. At the heart of the development of type 2 diabetes lies a key metabolic derangement: insulin resistance (IR). Despite the widespread occurrence of IR affecting an unmeasurable number of youths worldwide, its pathogenesis remains elusive. IR in obese youth is a complex phenomenon that defies explanation by a single pathway. In this review we first describe recent data on the prevalence, severity, and racial/ethnic differences in pediatric obesity. We follow by elucidating the initiating events associated with the onset of IR, and describe a distinct "endophenotype" in obese adolescents characterized by a thin superficial layer of abdominal subcutaneous adipose tissue, increased visceral adipose tissue, marked IR, dyslipidemia, and fatty liver. Further, we provide evidence for the cellular and molecular mechanisms associated with this peculiar endophenotype and its relations to IR in the obese adolescent. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Weight stigma and narrative resistance evident in online discussions of obesity.

PubMed

De Brún, Aoife; McCarthy, Mary; McKenzie, Kenneth; McGloin, Aileen

2014-01-01

This study sampled 2872 obesity-relevant comments from three years of interest from a multi-topic online message board. An inductive thematic analysis was conducted and three themes were evident: reactions and responses to obesity and obese bodies, diminished status of overweight/obese persons, and narrative resistance to an overweight/obese identity. Obesity stigma was pervasive and the discussion of the issue revealed it to be highly acceptable. Consistent with previous research, dominant representations of obese persons as lazy and unintelligent with poor self-control were evident. The analysis provided valuable insight into experiences of explicit stigma, the social and psychological repercussions of overt stigma and norms regarding the perception of obese bodies. There was a prevailing notion that the opinions and insights of overweight and obese persons on the issue of weight were not credible and were perceived as biased. Furthermore, individuals sought to distance themselves from the undesirable labels of 'overweight' and 'obese' by enacting narrative resistance to negotiate the social meaning of excess weight and endeavouring to place themselves on the 'safe' side of this boundary. These results highlight the pervasive nature of weight stigma and the social acceptability of such attitudes and beliefs. Furthermore, it highlights the richness of data that may be obtained by examining social media interactions as a window into the naturally-occurring discourse on obesity and stigma. Copyright © 2013 Elsevier Ltd. All rights reserved.

The association of household food security, household characteristics and school environment with obesity status among off-reserve First Nations and Métis children and youth in Canada: results from the 2012 Aboriginal Peoples Survey

PubMed Central

Jasmin, Bhawra; Martin, J. Cooke; Yanling, Guo; Piotr, Wilk

2017-01-01

Introduction: Indigenous children are twice as likely to be classified as obese and three times as likely to experience household food insecurity when compared with non- Indigenous Canadian children. The purpose of this study was to explore the relationship between food insecurity and weight status among Métis and off-reserve First Nations children and youth across Canada. Methods: We obtained data on children and youth aged 6 to 17 years (n = 6900) from the 2012 Aboriginal Peoples Survey. We tested bivariate relationships using Pearson chisquare tests and used nested binary logistic regressions to examine the food insecurity− weight status relationship, after controlling for geography, household and school characteristics and cultural factors. Results: Approximately 22% of Métis and First Nations children and youth were overweight, and 15% were classified as obese. Over 80% of the sample was reported as food secure, 9% experienced low food security and 7% were severely food insecure. Off-reserve Indigenous children and youth from households with very low food security were at higher risk of overweight or obese status; however, this excess risk was not independent of household socioeconomic status, and was reduced by controlling for household income, adjusted for household size. Negative school environment was also a significant predictor of obesity risk, independent of demographic, household and geographic factors. Conclusion: Both food insecurity and obesity were prevalent among the Indigenous groups studied, and our results suggest that a large proportion of children and youth who are food insecure are also overweight or obese. This study reinforces the importance of including social determinants of health, such as income, school environment and geography, in programs or policies targeting child obesity. PMID:28273035

The association of household food security, household characteristics and school environment with obesity status among off-reserve First Nations and Métis children and youth in Canada: results from the 2012 Aboriginal Peoples Survey.

PubMed

Bhawra, Jasmin; Cooke, Martin J; Guo, Yanling; Wilk, Piotr

2017-03-01

Indigenous children are twice as likely to be classified as obese and three times as likely to experience household food insecurity when compared with non- Indigenous Canadian children. The purpose of this study was to explore the relationship between food insecurity and weight status among Métis and off-reserve First Nations children and youth across Canada. We obtained data on children and youth aged 6 to 17 years (n = 6900) from the 2012 Aboriginal Peoples Survey. We tested bivariate relationships using Pearson chi-square tests and used nested binary logistic regressions to examine the food insecurity-weight status relationship, after controlling for geography, household and school characteristics and cultural factors. Approximately 22% of Métis and First Nations children and youth were overweight, and 15% were classified as obese. Over 80% of the sample was reported as food secure, 9% experienced low food security and 7% were severely food insecure. Off-reserve Indigenous children and youth from households with very low food security were at higher risk of overweight or obese status; however, this excess risk was not independent of household socioeconomic status, and was reduced by controlling for household income, adjusted for household size. Negative school environment was also a significant predictor of obesity risk, independent of demographic, household and geographic factors. Both food insecurity and obesity were prevalent among the Indigenous groups studied, and our results suggest that a large proportion of children and youth who are food insecure are also overweight or obese. This study reinforces the importance of including social determinants of health, such as income, school environment and geography, in programs or policies targeting child obesity.

Youth Substance Use and Body Composition: Does Risk in One Area Predict Risk in the Other?

ERIC Educational Resources Information Center

Pasch, Keryn E.; Velazquez, Cayley E.; Cance, Jessica Duncan; Moe, Stacey G.; Lytle, Leslie A.

2012-01-01

Both substance use and obesity are prevalent among youth. As youth age, substance use rates increase and over the past three decades, obesity rates among youth have tripled. While these two factors have both short- and long-term health impacts, little research has explored how substance use and obesity among youth may be related. This study…

Evidence for the effects of yogurt on gut health and obesity.

PubMed

Pei, Ruisong; Martin, Derek A; DiMarco, Diana M; Bolling, Bradley W

2017-05-24

Obesity is associated with increased risk for chronic diseases, and affects both developed and developing nations. Yogurt is a nutrient-dense food that may benefit individuals with lactose intolerance, constipation and diarrheal diseases, hypertension, cardiovascular diseases, diabetes, and certain types of cancer. Emerging evidence suggests that yogurt consumption might also improve the health of obese individuals. Obesity is often accompanied by chronic, low-grade inflammation perpetuated by adipose tissue and the gut. In the gut, obesity-associated dysregulation of microbiota and impaired gut barrier function may increase endotoxin exposure. Intestinal barrier function can be compromised by pathogens, inflammatory cytokines, endocannabinoids, diet, exercise, and gastrointestinal peptides. Yogurt consumption may improve gut health and reduce chronic inflammation by enhancing innate and adaptive immune responses, intestinal barrier function, lipid profiles, and by regulating appetite. While this evidence suggests that yogurt consumption is beneficial for obese individuals, randomized-controlled trials are needed to further support this hypothesis.

Constructing "Packages" of Evidence-Based Programs to Prevent Youth Violence: Processes and Illustrative Examples From the CDC's Youth Violence Prevention Centers.

PubMed

Kingston, Beverly; Bacallao, Martica; Smokowski, Paul; Sullivan, Terri; Sutherland, Kevin

2016-04-01

This paper describes the strategic efforts of six National Centers of Excellence in Youth Violence Prevention (YVPC), funded by the U.S. Centers for Disease Control and Prevention, to work in partnership with local communities to create comprehensive evidence-based program packages to prevent youth violence. Key components of a comprehensive evidence-based approach are defined and examples are provided from a variety of community settings (rural and urban) across the nation that illustrate attempts to respond to the unique needs of the communities while maintaining a focus on evidence-based programming and practices. At each YVPC site, the process of selecting prevention and intervention programs addressed the following factors: (1) community capacity, (2) researcher and community roles in selecting programs, (3) use of data in decision-making related to program selection, and (4) reach, resources, and dosage. We describe systemic barriers to these efforts, lessons learned, and opportunities for policy and practice. Although adopting an evidence-based comprehensive approach requires significant upfront resources and investment, it offers great potential for preventing youth violence and promoting the successful development of children, families and communities.

[Scientific Evidence on Preventive Interventions in Childhood Obesity].

PubMed

Alba-Martín, Raquel

The increasing prevalence of obesity or overweight at all ages, their associated morbidity and mortality associated, and the increased perception of the problem by the society have generated several hypotheses in response to the scientific and the international community. Investigate the preventive interventions in childhood obesity so far. Integrative review during the study period from April 2013 to November 2014. The MEDLINE international database was used, including PubMed, the Cochrane Library (Issue 4 2002), the national database Isooc (CSIC) national database, as well as the Internet. The review included health articles published in Spanish and English between 1990 and 2014 that focused on or included education, prevention, diagnostic, and treatment of obesity interventions. Of the 726 articles identified, 34 of most relevant (peer reviewed) were selected. It was noted that there is limited generisable evidence on interventions that could be implemented in Primary Care or referral services available, although numerous studies suggest that improvements in the overweight are possible. Despite the abundant literature and that many institutions place childhood obesity as one of the priorities of Public Health, we face the paradox that the evidence on cost-effectiveness of prevention interventions is sparse. Knowing these gaps in knowledge should lead to filling them with rigorous and well-designed studies. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

What evidence and support do state-level public health practitioners need to address obesity prevention.

PubMed

Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

2014-01-01

Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

[Health hazards in childhood obesity: Evidence based on Chinese population].

PubMed

Ye, Peiyu; Chen, Fangfang; Mi, Jie

2016-01-01

Childhood obesity has become a critical issue in public health area. We searched Wanfang Data and PubMed databases for published studies on health hazards of childhood obesity in China during 2000-2015. From the evidence of the Chinese population studies, we know childhood obesity brings not only cardiovascular, endocrine and respiratory system health hazards, but also other health hazards to liver, moving skeleton, psychological behavior and cognition intelligence, et al. Only to understand the health hazards of childhood obesity, and put the key preventable period of chronic diseases forward to childhood, can pandemic of chronic diseases be controlled from the sources.

Influence of non-dietary factors on the prevalence of abdominal obesity as a major component of the metabolic syndrome among 17-18-year-old youth.

PubMed

Piotrowska, Ewa; Broniecka, Anna; Biernat, Jadwiga; Wyka, Joanna; Bronkowska, Monika

2015-01-01

Youth nutrition and their nutritional status are conditioned by many factors, some of the main ones being: economic, social, climatic, cultural, and psychological factors as well as nutritional knowledge. With the growing problem of overweight and obesity among children and young people, the incidence of the metabolic syndrome is also increasing. The aim of the study was to assess the impact of demographic, sociological and psychological factors on the incidence of obesity among 17-18-year-old adolescents from Wroclaw and vicinity as a major risk factor for the development of the metabolic syndrome. The study was conducted in three upper-secondary schools in Wroclaw, Poland. In the surveyed group (17-18 years old, n = 269) girls accounted for 59.5% and boys constituted 40.5%. Majority of young people were Wroclaw citizens (72.9%). Centile charts elaborated by the Children's Memorial Health Institute were adopted for the evaluation of anthropometric parameters. Evaluation of the impact of non-dietary factors on the manner of nutrition was carried out using own questionnaire. Based on the tests, abdominal obesity was determined among 34.5% of adolescents aged 17 years and among 65.5% of these aged 18 years. Obesity was more common in girls carrying genetic burden of the disease. Youth with the largest waist circumference most often declared to use slimming diets - 6.7%, and the lowest hunger sensation in stress - 3.4%. In addition, 30.5% of the adolescents with the smallest waist circumference and 11.5% with the largest waist circumference declared to be non-smoking. Occasional alcohol consumption was declared by 30.1% of young people with the smallest waist circumference, and 13.4% with the largest waist circumference. Youth with abdominal obesity significantly more likely than those with normal waist circumference applied slimming diets. Significant impact on the formation of abdominal obesity among girls had inherited disease burden.

Trends in underweight and overweight/obesity prevalence in Chinese youth, 2004-2009.

PubMed

Seo, Dong-Chul; Niu, Jingjing

2014-08-01

There is a paucity of recent data on Chinese childhood overweight and underweight prevalence especially since 2004. The purpose of this study was to examine trends in underweight and overweight/obesity ("overweight" hereafter) prevalence and energy balance-related behaviors of Chinese youth from 2004 to 2009. Data from the China Health and Nutrition Survey, 2004-2009 (N = 4,061 students aged 6-18 years), were analyzed. Trained health workers took anthropometric measures at the participant's house or at a local clinic following a reference protocol recommended by the World Health Organization. The international age- and sex-specific body mass index reference standard proposed by the International Obesity Task Force was used to define underweight and overweight children in this study. Among 6- to 11-year-old boys, underweight prevalence increased from 14.5% (2004) to 20.1% (2009, p = 0.068). Among 12- to 18-year-old boys, however, overweight prevalence increased from 7.5 to 12.6% (p = 0.034). From 2004 to 2009, after-school sedentary behavior increased from 2.3 to 3.4 h/day for 6- to 11-year-olds (p < 0.001) and from 2.2 to 3.1 h/day for 12- to 18-year-olds (p < 0.01). Meanwhile, the total energy intake decreased 7% for 6- to 11-year-olds (p < 0.05) and 10% for 12- to 18-year-olds (p < 0.01). Both underweight and overweight Chinese students are increasing, with underweight increases more pronounced in 6- to 11-year-olds and overweight increases more pronounced in 12- to 18-year-olds. Nationwide efficacious interventions are needed that improve the diet, decrease sedentary behavior, and encourage a healthy and realistic body image in Chinese youth.

Food and Beverage Marketing to Youth.

PubMed

Cheyne, Andrew; Mejia, Pamela; Nixon, Laura; Dorfman, Lori

2014-12-01

After nearly a decade of concern over the role of food and beverage marketing to youth in the childhood obesity epidemic, American children and adolescents - especially those from communities of color - are still immersed in advertising and marketing environments that primarily promote unhealthy foods and beverages. Despite some positive steps, the evidence shows that the food and beverage industry self-regulation alone is not likely to significantly reduce marketing of unhealthy foods and beverages to youth. A variety of research is needed to monitor industry marketing of unhealthy products to young people, and identify the most promising approaches to improve children's food marketing environments. The continued presence of unhealthy marketing toward children despite years of industry self-regulation suggests it is time for stronger action by policymakers to protect young people from harmful marketing practices.

Oportunidades to reduce overweight and obesity in Mexico?

PubMed

Andalón, Mabel

2011-09-01

This paper investigates the causal effect of Oportunidades, a conditional cash-transfer program in Mexico, on overweight and obesity of adolescents living in poor rural areas. Affecting youth weight was not a goal of this program. However, health economics research suggests that the provision of schooling, health information sessions and sizable cash transfers to Oportunidades participants could have substantially changed their overweight and obesity rates. Exploiting an exogenous jump in program participation by means of a fuzzy Regression Discontinuity (RD) design, the evidence of this paper suggests that Oportunidades decreased obesity among participant women. The identified local average treatment effect (LATE) at the threshold for program eligibility suggests that female obesity would decrease if the program was expanded to cover slightly better-off households. The design of the program does not allow disentangling the causal pathways that contributed to the lower prevalence of obesity among women, but the effect likely resulted from increased access to information and schooling, improved dietary quality, increased monitoring of health outcomes and (possibly) increased physical activity. Suggestive evidence shows that teen pregnancy rates were higher among non-participants. Therefore, weight gain after childbirth might also explain higher obesity rates among non-participant females. Copyright © 2011 John Wiley & Sons, Ltd.

The Effect of Age on the Prevalence of Obesity among US Youth with Autism Spectrum Disorder.

PubMed

Must, Aviva; Eliasziw, Misha; Phillips, Sarah M; Curtin, Carol; Kral, Tanja V E; Segal, Mary; Sherwood, Nancy E; Sikich, Linmarie; Stanish, Heidi I; Bandini, Linda G

2017-02-01

We sought to assess the association between age and the prevalence of obesity among children with and without autism spectrum disorder (ASD) in the 2011-2012 National Survey of Children's Health. Analyses were restricted to 43,777 children, ages 10-17, with valid measures of parent-reported weight, height, and ASD status. Exploratory analyses describe the impact of sex, race/ethnicity, and household income on the relationship between age and obesity in ASD. Although the overall prevalence of obesity among children with ASD was significantly (p < 0.001) higher than among children without ASD (23.1% vs. 14.1%, 95% confidence interval for difference 3.6 to 14.4), child age significantly (p = 0.035) modified this difference. In a multivariable logistic regression analysis, adjusted for sex, race/ethnicity, and household income, the odds of obesity among children with ASD compared with children without ASD increased monotonically from ages 10 to 17 years. This pattern arose due to a consistently high prevalence of obesity among children with ASD and a decline in prevalence with advancing age among children without ASD. These findings were replicated using a propensity score analysis. Exploratory analyses suggested that the age-related change in obesity disparity between children with and without ASD may be further modified by sex, race/ethnicity, and household income. The patterns of prevalence observed with increasing age among children with and without ASD were unexpected. A better understanding of the etiological and maintenance factors for obesity in youth with ASD is needed to develop interventions tailored to the specific needs of these children.

25-hydroxyvitamin D in obese youth across the spectrum of glucose tolerance from normal to prediabetes to type 2 diabetes

USDA-ARS?s Scientific Manuscript database

The objective of this study was to 1) determine if plasma 25-hydroxyvitamin D (25[OH]D) concentrations differ among obese youth with normal glucose tolerance (NGT) versus prediabetes versus type 2 diabetes and 2) assess the relationships between 25(OH)D and in vivo insulin sensitivity and Beta-cell ...

5-2-1-0 Activity and Nutrition Challenge for Elementary Students: New, Evidence-Based, Promising

ERIC Educational Resources Information Center

Lovell, Cynthia Miller

2018-01-01

Obesity prevention in youth is a health priority, and teaching healthy habits toward this end is one of a school nurse's many responsibilities. A school nurse developed and implemented a school-wide, 2-week-long Activity and Nutrition Challenge (ANC) using the evidence-based 5-2-1-0 initiative to prevent and fight childhood obesity. Despite…

Policy and Practice-Relevant Youth Physical Activity Research Center Agenda.

PubMed

Botchwey, Nisha; Floyd, Myron F; Pollack Porter, Keshia; Cutter, Carmen L; Spoon, Chad; Schmid, Tom L; Conway, Terry L; Hipp, J Aaron; Kim, Anna J; Umstattd Meyer, M Renee; Walker, Amanda L; Kauh, Tina J; Sallis, Jim F

2018-06-08

The Physical Activity Research Center developed a research agenda that addresses youth physical activity (PA) and healthy weight, and aligns with the Robert Wood Johnson Foundation's Culture of Health. This paper summarizes prioritized research studies with a focus on youth at higher risk for inactive lifestyles and childhood obesity in urban and rural communities. Systematic literature reviews, a survey, and discussions with practitioners and researchers provided guidance on research questions to build evidence and inform effective strategies to promote healthy weight and PA in youth across race, cultural, and economic groups. The research team developed a matrix of potential research questions, identified priority questions, and designed targeted studies to address some of the priority questions and inform advocacy efforts. The studies selected examine strategies advocating for activity-friendly communities, Play Streets, park use, and PA of youth in the summer. A broader set of research priorities for youth PA is proposed. Establishing the Physical Activity Research Center research agenda identified important initial and future research studies to promote and ensure healthy weight and healthy levels of PA for at-risk youth. Results will be disseminated with the goal of promoting equitable access to PA for youth.

Youth Excel: towards a pan-Canadian platform linking evidence and action for prevention.

PubMed

Riley, Barbara L; Manske, Steve; Cameron, Roy

2011-05-15

Population-level intervention is required to prevent cancer and other chronic diseases. It also promotes health for those living with established risk factors and illness. In this article, the authors describe a vision and approach for continuously improving population-level programs and policies within and beyond the health sector. The vision and approach are anchored in contemporary thinking about what is required to link evidence and action in the field of population and public health. The authors believe that, as a cancer prevention and control community, organizations and practitioners must be able to use the best available evidence to inform action and continually generate evidence that improves prevention policies and programs on an ongoing basis. These imperatives require leaders in policy, practice, and research fields to work together to jointly plan, conduct, and act on relevant evidence. The Propel Center and colleagues are implementing this approach in Youth Excel-a pan-Canadian initiative that brings together national and provincial organizations from health and education sectors and capitalizes on a history of collaboration. The objective of Youth Excel is to build sustainable capacity for knowledge development and exchange that can guide and redirect prevention efforts in a rapidly evolving social environment. This goal is to contribute to creating health-promoting environments and to accelerate progress in preventing cancer and other diseases among youth and young adults and in the wider population. Although prevention is the aim, health-promoting environments also can support health gains for individuals of all ages and with established illness. In addition, the approach Youth Excel is taking to link evidence and action may be applicable to early intervention and treatment components of cancer control. © 2011 American Cancer Society

Global Evidence on the Association between POS Advertising Bans and Youth Smoking Participation.

PubMed

Shang, Ce; Huang, Jidong; Cheng, Kai-Wen; Li, Qing; Chaloupka, Frank J

2016-03-09

Point-of-sale (POS) tobacco advertising has been linked to youth smoking susceptibility and experimental smoking. However, there is limited evidence of the association between POS advertising bans and youth smoking participation. This study aims to examine how such bans are associated with current smoking, daily smoking, and regular smoking (≥ 1 cigarettes per day) participation among youth. one to two waves (primarily one wave) of the Global Youth Tobacco Survey were conducted in 130 countries between 2007 and 2011. These surveys were linked to the WHO "MPOWER" data using country and year identifiers to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and smoking participation in the past month. Weighted logistic regressions were employed to analyze this association while controlling for age, gender, parents' smoking status, 6 MPOWER policy scores, and GDP per capita. We find that in countries with POS advertising bans, current smoking (OR = 0.73, p ≤ 0.1), daily smoking (OR = 0.70, p ≤ 0.1), and regular smoking (OR = 0.75, p ≤ 0.05) participation in the past month is significantly lower, suggesting that POS promotion bans can potentially reduce youth smoking. This study provides evidence to support the implementation of POS promotion regulations by the US FDA and implementation of the WHO FCTC guidelines regarding restrictions on tobacco POS promotion.

Juvenile Obesity, Physical Activity, and Lifestyle Changes.

ERIC Educational Resources Information Center

Bar-Or, Oded

2000-01-01

Because many obese children become obese adults, the recent rapid increase in juvenile obesity poses a major public health challenge. Enhanced physical activity is a cornerstone in a multidisciplinary approach to preventing and treating juvenile obesity. Giving exercise recommendations focused for obese youth is critical. Cutting down on sedentary…

Is childhood obesity influenced by dog ownership? No cross-sectional or longitudinal evidence.

PubMed

Westgarth, Carri; Heron, Jon; Ness, Andrew R; Bundred, Peter; Gaskell, Rosalind M; Coyne, Karen; German, Alexander J; McCune, Sandra; Dawson, Susan

2012-01-01

To examine whether dog ownership is associated with lower risk of childhood obesity. Cross-sectional study of 7,759 children at age 7 years in the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK. In addition, longitudinal analyses were conducted between age 7 and 9 years. BMI at age 7 and 9 years was calculated from clinic-measured weight and height and standardised in reference to 1990 UK data. Dog ownership data were collected by carer questionnaire at various time points. After adjustment for confounding factors associated with dog ownership or obesity, there was no evidence of an association between obesity and dog ownership at 7 years OR = 1.18, 95% confidence interval = 0.88-1.59, p = 0.27), or dog ownership history. There was also no evidence for an effect of dog ownership on BMI change between 7 and 9 years, nor acquisition of a dog on the change in weight status of obese children between 7 and 9 years. This study provides no evidence for a protective effect of dog ownership on the development of childhood obesity. Further investigation is required to determine the impact of dog ownership on physical activity in overweight and obese children. Copyright © 2012 S. Karger GmbH, Freiburg

Growing Youth Growing Food: How Vegetable Gardening Influences Young People's Food Consciousness and Eating Habits

ERIC Educational Resources Information Center

Libman, Kimberly

2007-01-01

Much attention is currently being paid to rising rates of obesity, especially among youth. In this context, garden-based education can have a role in improving public health. A qualitative study conducted at the Brooklyn Botanic Garden (BBG) Children's Garden provides supporting evidence for the claim that growing vegetables can improve the…

Compliance with behavioral guidelines for diet, physical activity and sedentary behaviors is related to insulin resistance among overweight and obese youth.

PubMed

Huang, Jeannie S; Gottschalk, Michael; Norman, Gregory J; Calfas, Karen J; Sallis, James F; Patrick, Kevin

2011-02-01

Overweight and obesity are established risk factors for insulin resistance in youth. A number of behavioral recommendations have been publicized with the goal of improving glycemic control. However, there is limited information about whether meeting these behavioral recommendations actually reduces insulin resistance. 92 youths 11 - 16 years with BMI ≥ 85% underwent oral glucose tolerance testing. HOMA-IR and AUCInsulin/AUCGlucose were calculated as measures of insulin resistance. Dietary and physical activity (PA) measures were performed. Assessments included whether or not participants met recommended levels of diet, PA and sedentary behaviors.62% youths met criteria for insulin resistance. 82% (75/92) met at least one behavioral recommendation. Participants who met ≥ 1 dietary, sedentary, or PA recommendations had significantly reduced insulin resistance as compared with youth who did not. This relationship remained significant in multivariate modeling of insulin resistance adjusting for age, sex, and BMI. Even relatively minor behavior change may reduce insulin resistance in youth at risk for diabetes. Our findings support the relevance of current behavioral interventions for glycemic control. Clinical Trials #NCT00412165.

The Effect of Age on the Prevalence of Obesity among US Youth with Autism Spectrum Disorder

PubMed Central

Eliasziw, Misha; Phillips, Sarah M.; Curtin, Carol; Kral, Tanja V.E.; Segal, Mary; Sherwood, Nancy E.; Sikich, Linmarie; Stanish, Heidi I.; Bandini, Linda G.

2017-01-01

Abstract Background: We sought to assess the association between age and the prevalence of obesity among children with and without autism spectrum disorder (ASD) in the 2011–2012 National Survey of Children's Health. Methods: Analyses were restricted to 43,777 children, ages 10–17, with valid measures of parent-reported weight, height, and ASD status. Exploratory analyses describe the impact of sex, race/ethnicity, and household income on the relationship between age and obesity in ASD. Results: Although the overall prevalence of obesity among children with ASD was significantly (p < 0.001) higher than among children without ASD (23.1% vs. 14.1%, 95% confidence interval for difference 3.6 to 14.4), child age significantly (p = 0.035) modified this difference. In a multivariable logistic regression analysis, adjusted for sex, race/ethnicity, and household income, the odds of obesity among children with ASD compared with children without ASD increased monotonically from ages 10 to 17 years. This pattern arose due to a consistently high prevalence of obesity among children with ASD and a decline in prevalence with advancing age among children without ASD. These findings were replicated using a propensity score analysis. Exploratory analyses suggested that the age-related change in obesity disparity between children with and without ASD may be further modified by sex, race/ethnicity, and household income. Conclusions: The patterns of prevalence observed with increasing age among children with and without ASD were unexpected. A better understanding of the etiological and maintenance factors for obesity in youth with ASD is needed to develop interventions tailored to the specific needs of these children. PMID:27704874

Development of a Systems Science Curriculum to Engage Rural African American Teens in Understanding and Addressing Childhood Obesity Prevention.

PubMed

Frerichs, Leah; Hassmiller Lich, Kristen; Young, Tiffany L; Dave, Gaurav; Stith, Doris; Corbie-Smith, Giselle

2018-06-01

Engaging youth from racial and ethnic minority communities as leaders for change is a potential strategy to mobilize support for addressing childhood obesity, but there are limited curricula designed to help youth understand the complex influences on obesity. Our aim was to develop and pilot test a systems science curriculum to elicit rural African American youth perspectives on childhood obesity and enhance their understanding of and support for obesity prevention solutions. The curriculum was designed so it could be integrated with existing positive youth development curricula that help youth advocate for and implement identified solutions. We conducted four workshop sessions with youth that engaged them in systems learning activities such as guided systems diagramming activities. The participants ( n = 21) completed validated surveys presession and postsession that assessed their causal attributions of obesity and support for obesity prevention policies. The youths' perception that environmental factors cause obesity increased ( p < .05), and perceptions that individual behavior and biology cause obesity did not change. Their support for policies that addressed food access and food pricing significantly increased ( p < .05). The youths' system diagrams elucidated links between multilevel factors such as personal attitudes, social influence, and the built environment, which provides important information for designing synergistic solutions. The changes we observed in youths' perceptions of obesity and support for policy changes have important implications for youths' interest and willingness to advocate for social and environmental changes in their community. The strategies have a promising role in supporting community mobilization to address childhood obesity.

Ethnic Differences in Lipid Profiles of Overweight, Obese, and Severely Obese Children and Adolescents 6-19 Years of Age.

PubMed

Dhuper, Sarita; Bayoumi, Nagla S; Shah, Yash D; Mehta, Shilpa

2017-06-01

Ethnic differences in lipid profiles exist in children and adolescents. This study assessed whether variations in lipid profiles present in overweight and obese youth were also observed in severely obese youth. Variations could explain the lower prevalence of the metabolic syndrome in certain ethnic groups at even severe levels of obesity. Data were obtained from the National Health and Nutrition Examination Survey for the years of 2001 through 2012. Subjects were divided into groups according to BMI classification. Normal weight was defined as a BMI less than the 85th percentile. Overweight was defined as a BMI between the 85th and 95th percentile. Class 1 obesity was defined as a BMI greater than the 95th percentile up to 120% of the 95th percentile. A BMI between 120% and 140% of the 95th percentile was defined as Class 2 obesity. Class 3 was defined as a BMI above 140% of the 95th percentile. Primary outcomes were mean total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein levels (HDL). The sample included 14,481 non-Hispanic black (NHB) (N = 4710), non-Hispanic white (N = 4910), and Mexican American (N = 4861) subjects. Across all BMI categories, the NHB group had significantly lower mean TG and higher mean HDL levels (p < 0.0001). Ethnic variations in lipid profiles were found in severely obese youth. These findings could explain the lower prevalence of the metabolic syndrome in NHB youth. Ethnic-specific guidelines are necessary for improved identification of those at risk at all levels of obesity.

Results From Nigeria's 2016 Report Card on Physical Activity for Children and Youth.

PubMed

Adeniyi, Ade F; Odukoya, Olukemi O; Oyeyemi, Adewale L; Adedoyin, Rufus A; Ojo, Olatunde S; Metseagharun, Edirin; Akinroye, Kingsley K

2016-11-01

The Nigerian Report card on Physical Activity (PA) in Children and Youth was first developed in 2013 to inform practice and policy on healthy living and prevention of noncommunicable diseases among Nigerian children and youth. This article summarizes the results of the 2016 report card and provides updated evidence on the current situation in Nigeria. A comprehensive review of literature was undertaken by the Report Card Working Group. Grades were assigned to 10 PA indicators based on the criteria used for the 2013 edition. Grades assigned to the indicators were Overall PA, D; Active Play and Leisure, C; Active Transportation, B; Sedentary Behaviors (screen-based, F and nonscreen-based, D); Overweight and Obesity, A; PA in Schools, C-; Government/Nongovernment Organizations/Private Sector/Policy, B. The following indicators were graded as Incomplete: Organized Sport and PA, Community and Built Environment, and Family and Peers. The overall PA levels of Nigerian children and youth seemed to be declining compared with the 2013 Report card but with slight improvement in active play and leisure, and PA in school settings. A substantial number of Nigerian children and youth still have high sedentary behaviors, overweight and obesity. Efforts are needed to promote PA among them.

Obesity is associated with more activated neutrophils in African American male youth.

PubMed

Xu, X; Su, S; Wang, X; Barnes, V; De Miguel, C; Ownby, D; Pollock, J; Snieder, H; Chen, W; Wang, X

2015-01-01

There is emerging evidence suggesting the role of peripheral blood leukocytes in the pathogenesis of obesity and related diseases. However, few studies have taken a genome-wide approach to investigating gene expression profiles in peripheral leukocytes between obese and lean individuals with the consideration of obesity-related shifts in leukocyte types. We conducted this study in 95 African Americans (AAs) of both genders (age 14-20 years, 46 lean and 49 obese). Complete blood count with differential test (CBC) was performed in whole blood. Genome-wide gene expression analysis was obtained using the Illumina HumanHT-12 V4 Beadchip with RNA extracted from peripheral leukocytes. Out of the 95 participants, 64 had neutrophils stored. The validation study was based on real-time PCR with RNA extracted from purified neutrophils. CBC test suggested that, in males, obesity was associated with increased neutrophil percentage (P=0.03). Genome-wide gene expression analysis showed that, in males, the majority of the most differentially expressed genes were related to neutrophil activation. Validation of the gene expression levels of ELANE (neutrophil elastase) and MPO (myeloperoxidase) in purified neutrophils demonstrated that the expression of these two genes--important biomarkers of neutrophils activation--were significantly elevated in obese males (P=0.01 and P=0.02, respectively). The identification of increased neutrophil percentage and activation in obese AA males suggests that neutrophils have an essential role in the pathogenesis of obesity-related disease. Further functional and mechanistic studies on neutrophils may contribute to the development of novel intervention strategies reducing the burden associated with obesity-related health problems.

Metabolomic Profiling of Fatty Acid and Amino Acid Metabolism in Youth With Obesity and Type 2 Diabetes

PubMed Central

Mihalik, Stephanie J.; Michaliszyn, Sara F.; de las Heras, Javier; Bacha, Fida; Lee, SoJung; Chace, Donald H.; DeJesus, Victor R.; Vockley, Jerry; Arslanian, Silva A.

2012-01-01

OBJECTIVE We compared acylcarnitine (AcylCN) species, common amino acid and fat oxidation (FOX) byproducts, and plasma amino acids in normal weight (NW; n = 39), obese (OB; n = 64), and type 2 diabetic (n = 17) adolescents. RESEARCH DESIGN AND METHODS Fasting plasma was analyzed by tandem mass spectrometry, body composition by dual energy X-ray absorptiometry and computed tomography, and total-body lipolysis and substrate oxidation by [2H5]glycerol and indirect calorimetry, respectively. In vivo insulin sensitivity (IS) was assessed with a 3-h hyperinsulinemic-euglycemic clamp. RESULTS Long-chain AcylCNs (C18:2-CN to C14:0-CN) were similar among the three groups. Medium- to short-chain AcylCNs (except C8 and C10) were significantly lower in type 2 diabetes compared with NW, and when compared with OB, C2-, C6-, and C10-CN were lower. Amino acid concentrations were lower in type 2 diabetes compared with NW. Fasting lipolysis and FOX were higher in OB and type 2 diabetes compared with NW, and the negative association of FOX to C10:1 disappeared after controlling for adiposity, Tanner stage, and sex. IS was lower in OB and type 2 diabetes with positive associations between IS and arginine, histidine, and serine after adjusting for adiposity, Tanner stage, and sex. CONCLUSIONS These metabolomics results, together with the increased rates of in vivo FOX, are not supportive of defective fatty acid or amino acid metabolism in obesity and type 2 diabetes in youth. Such observations are consistent with early adaptive metabolic plasticity in youth, which over time—with continued obesity and aging—may become dysfunctional, as observed in adults. PMID:22266733

Association of cardiovascular risk factors between Hispanic/Latino parents and youth: the Hispanic Community Health Study/Study of Latino Youth.

PubMed

Carnethon, Mercedes R; Ayala, Guadalupe X; Bangdiwala, Shrikant I; Bishop, Virginia; Daviglus, Martha L; Delamater, Alan M; Gallo, Linda C; Perreira, Krista; Pulgaron, Elizabeth; Reina, Samantha; Talavera, Gregory A; Van Horn, Linda H; Isasi, Carmen R

2017-04-01

Hispanic/Latinos have a high burden of cardiovascular disease (CVD) risk factors which may begin at young ages. We tested the association of CVD risk factors between Hispanic/Latino parents and their children. We conducted a cross-sectional study in the Hispanic Community Health Study/Study of Latinos Youth study. Girls (n = 674) and boys (n = 667) aged 8 to 16 years (mean age 12.1 years) and their parents (n = 942) had their CVD risk factors measured. CVD risk factors in parents were significantly positively associated with those same risk factors among youth. After adjustment for demographic characteristics, diet and physical activity, obese parents were significantly more likely to have youth who were overweight (odds ratios [ORs], 2.39; 95% confidence interval [CI], 1.20-4.76) or obese (OR, 6.16; 95% CI, 3.23-11.77) versus normal weight. Dyslipidemia among parents was associated with 1.98 higher odds of dyslipidemia among youth (95% CI, 1.37-2.87). Neither hypertension nor diabetes was associated with higher odds of high blood pressure or hyperglycemia (prediabetes or diabetes) in youth. Findings were consistent by sex and in younger (age <12 years) versus older (≥12 years) youth. Hispanic/Latino youth share patterns of obesity and CVD risk factors with their parents, which portends high risk for adult CVD. Copyright © 2017 Elsevier Inc. All rights reserved.

Global Evidence on the Association between POS Advertising Bans and Youth Smoking Participation

PubMed Central

Shang, Ce; Huang, Jidong; Cheng, Kai-Wen; Li, Qing; Chaloupka, Frank J.

2016-01-01

Background: Point-of-sale (POS) tobacco advertising has been linked to youth smoking susceptibility and experimental smoking. However, there is limited evidence of the association between POS advertising bans and youth smoking participation. This study aims to examine how such bans are associated with current smoking, daily smoking, and regular smoking (≥1 cigarettes per day) participation among youth. Methods: one to two waves (primarily one wave) of the Global Youth Tobacco Survey were conducted in 130 countries between 2007 and 2011. These surveys were linked to the WHO “MPOWER” data using country and year identifiers to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and smoking participation in the past month. Weighted logistic regressions were employed to analyze this association while controlling for age, gender, parents’ smoking status, 6 MPOWER policy scores, and GDP per capita. Results and Conclusions: We find that in countries with POS advertising bans, current smoking (OR = 0.73, p ≤ 0.1), daily smoking (OR = 0.70, p ≤ 0.1), and regular smoking (OR = 0.75, p ≤ 0.05) participation in the past month is significantly lower, suggesting that POS promotion bans can potentially reduce youth smoking. This study provides evidence to support the implementation of POS promotion regulations by the US FDA and implementation of the WHO FCTC guidelines regarding restrictions on tobacco POS promotion. PMID:27005651

Food prices and body fatness among youths.

PubMed

Grossman, Michael; Tekin, Erdal; Wada, Roy

2014-01-01

We examine the effect of food prices on clinical measures of obesity, including body mass index (BMI) and percentage body fat (PBF) measures derived from bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA), among youths ages 12 through 18 in the National Health and Nutrition Examination Survey. This is the first study to consider clinically measured levels of body composition rather than BMI to investigate the effects of food prices on obesity outcomes among youths classified by gender and race/ethnicity. Our findings suggest that increases in the real price per calorie of food for home consumption and the real price of fast-food restaurant food lead to improvements in obesity outcomes among youths. We also find that a rise in the real price of fruits and vegetables leads to increased obesity. Finally, our results indicate that measures of PBF derived from BIA and DXA are no less sensitive and in some cases more sensitive to the prices just mentioned than BMI, and serve an important role in demonstrating that rising food prices (except fruit and vegetable prices) are indeed associated with reductions in obesity rather than with reductions in body size proportions alone. Copyright © 2013 Elsevier B.V. All rights reserved.

A Youth Mentor-Led Nutritional Intervention in Urban Recreation Centers: A Promising Strategy for Childhood Obesity Prevention in Low-Income Neighborhoods

ERIC Educational Resources Information Center

Sato, Priscila M.; Steeves, Elizabeth A.; Carnell, Susan; Cheskin, Lawrence J.; Trude, Angela C.; Shipley, Cara; Mejía Ruiz, M. J.; Gittelsohn, Joel

2016-01-01

B'More Healthy Community for Kids (BHCK) is an ongoing multi-level intervention to prevent childhood obesity in African-American low-income neighborhoods in Baltimore city, MD. Although previous nutrition interventions involving peer mentoring of youth have been successful, there is a lack of studies evaluating the influence of cross-age peers…

Implementing and Evaluating Comprehensive Evidence-Based Approaches to Prevent Youth Violence: Partnering to Create Communities Where Youth Are Safe From Violence.

PubMed

Matjasko, Jennifer L; Massetti, Greta M; Bacon, Sarah

2016-04-01

Violence, including its occurrence among youth, results in considerable physical, emotional, social, and economic consequences in the U.S. Youth violence prevention work at the Division of Violence Prevention (DVP) at the Centers for Disease Control and Prevention (CDC) emphasizes preventing youth violence-related behaviors, injuries, and deaths by collaborating with academic and community partners and stakeholders. Since 2000, DVP has funded three rounds of CDC's National Centers of Excellence in Youth Violence Prevention (YVPCs) in 5-year cycles, with the goal of supporting university-community partnerships so that the best science can be utilized in order to prevent youth violence. The current YVPCs focus on: (a) partnering with communities to identify community needs; (b) selecting and implementing the best comprehensive evidence-based programs to meet those needs; and (c) rigorously evaluating whether those efforts have a community-level impact on youth violence rates. The introduction to this special issue on the current YVPCs provides a brief historical overview on the YVPC Program; outlines the YVPCs' accomplishments to date; and describes the current YVPCs, their community partners, and their activities. The introduction concludes with an overview of the special issue.

Nutritional intakes in children with Prader–Willi syndrome and non-congenital obesity

PubMed Central

Rubin, Daniela A.; Nowak, Jill; McLaren, Erin; Patiño, Monzeratt; Castner, Diobel M.; Dumont-Driscoll, Marilyn C.

2015-01-01

Background Individuals with Prader–Willi syndrome (PWS) have extremely regulated diets to prevent the development of morbid obesity. Objective This study evaluated potential deficiencies in macro and micronutrients in a cohort of youth with PWS and compared them to a group of children with non-congenital obesity and to US national recommendations. Design Participants were 32 youth with PWS (age=10.8±2.6 years, body fat=46.7±10.1%) and 48 children without PWS but classified as obese (age=9.7±1.2 years, body fat=43.4±5.7%). Participants’ parents completed a training session on food recording before completing a 3-day food record during a typical week including a weekend day and two weekdays, as well as a screening form indicating nutritional supplements use. Results Youth with PWS reported less calories (1,312±75 vs. 1,531±61 kcal, p=0.03), carbohydrate (175±10 vs. 203±8 g), and sugars (67±5 vs. 81±4 g; p=0.04 for both) than obese. Youth with PWS consumed more vegetables (1.1±0.1 vs. 0.6±0.1 cups) and more of them met the daily recommendation (p<0.01 for both). Likewise, youth with PWS consumed more calcium than obese (899±53 vs. 752±43 mg) and more of them met the recommended daily dose (p=0.04 for both). The majority of participants in this study did not meet the vitamin D recommendation. Conclusion Despite consuming less calories, youth with PWS had a similar proportion of macronutrients in their diet as children with obesity. Micronutrient deficiencies in calcium and vitamin D in youth with PWS were noted despite a third of youth with PWS consuming multivitamin supplements. Special attention must be paid to the diets of youth with PWS and with obesity to ensure they are meeting micronutrient needs during this period of growth and development. PMID:26652260

Is high-intensity interval training more effective on improving cardiometabolic risk and aerobic capacity than other forms of exercise in overweight and obese youth? A meta-analysis.

PubMed

García-Hermoso, A; Cerrillo-Urbina, A J; Herrera-Valenzuela, T; Cristi-Montero, C; Saavedra, J M; Martínez-Vizcaíno, V

2016-06-01

The scientific interest in high-intensity interval training (HIIT) has greatly increased during recent years. The objective of this meta-analysis was to determine the effectiveness of HIIT interventions on cardio-metabolic risk factors and aerobic capacity in overweight and obese youth, in comparison with other forms of exercise. A computerized search was made using seven databases. The analysis was restricted to studies that examined the effect of HIIT interventions on cardio-metabolic and/or aerobic capacity in pediatric obesity (6-17 years old). Nine studies using HIIT interventions were selected (n = 274). Standarized mean difference (SMD) and 95% confidence intervals were calculated. The DerSimonian-Laird approach was used. HIIT interventions (4-12 week duration) produced larger decreases in systolic blood pressure (SMD = 0.39; -3.63 mmHg) and greater increases in maximum oxygen uptake (SMD = 0.59; 1.92 ml/kg/min) than other forms of exercise. Also, type of comparison exercise group and duration of study were moderators. HIIT could be considered a more effective and time-efficient intervention for improving blood pressure and aerobic capacity levels in obese youth in comparison to other types of exercise. © 2016 World Obesity. © 2016 World Obesity.

Active video games for youth: A systematic review

USDA-ARS?s Scientific Manuscript database

Whether a population level increase in physical activity (PA) is critical to reduce obesity in youth. Video games are highly popular and active video games (AVGs) have the potential to play a role in promoting youth PA. Studies on AVG play energy expenditure (EE) and maintenance of play in youth wer...

Dietary and Physical Activity Behaviors of Middle School Youth: The Youth Physical Activity and Nutrition Survey

ERIC Educational Resources Information Center

Zapata, Lauren B.; Bryant, Carol A.; McDermott, Robert J.; Hefelfinger, Jennie A.

2008-01-01

Background: Obesity has become a national epidemic among youth. Declining physical activity and poor nutrition contribute to this epidemic. The purpose of this study was to obtain data on middle school students' physical activity and nutrition knowledge and practices. Methods: The Youth Physical Activity and Nutrition Survey was developed and…

Kidney Disease and Youth Onset Type 2 Diabetes: Considerations for the General Practitioner

PubMed Central

Dart, Allison B.; Sellers, Elizabeth A.; Dean, Heather J.

2012-01-01

Youth onset type 2 diabetes (T2DM) continues to increase worldwide, concomitant with the rising obesity epidemic. There is evidence to suggest that youth with T2DM are affected by the same comorbidities and complications as adults diagnosed with T2DM. This review highlights specifically the kidney disease associated with youth onset T2DM, which is highly prevalent and associated with a high risk of end-stage kidney disease in early adulthood. A general understanding of this complex disease by primary care providers is critical, so that at-risk individuals are identified and managed early in the course of their disease, such that progression can be modified in this high-risk group of children and adolescents. A review of the pediatric literature will include a focus on the epidemiology, risk factors, pathology, screening, and treatment of kidney disease in youth onset T2DM. PMID:22315622

Community Mental Health Providers' Beliefs About Addressing Weight Loss Among Youth Clients with Serious Emotional Disturbance and Overweight/Obesity: An Elicitation Study.

PubMed

Wykes, Thomas L; Bourassa, Katelynn A; Slosser, Andrea E; McKibbin, Christine L

2018-02-09

Youth with Serious Emotional Disturbance (SED) have high rates of overweight/obesity. Factors influencing mental health provider intentions to deliver weight-related advice are unclear. This study used qualitative methodology and Theory of Planned Behavior (TPB) constructs to examine these factors. Community mental health providers serving youth with SED were recruited via convenience sampling and an online provider list. Participants completed an open-ended TPB-based questionnaire online. Content analysis identified thematic beliefs. Twenty-one providers completed the questionnaire. Providers identified behavioral beliefs (e.g., client defensiveness), normative beliefs (e.g., medical professionals), and control beliefs (e.g., limited resources) that impact decisions to provide weight-related advice. Knowledge of factors that may influence providers' delivery of weight-related advice may lead to more effective healthy lifestyle programming for youth with SED.

RELATIONSHIP OF ADIPOKINES AND PROINFLAMMATORY CYTOKINES AMONG ASIAN INDIANS WITH OBESITY AND YOUTH ONSET TYPE 2 DIABETES.

PubMed

Gokulakrishnan, Kuppan; Amutha, Anandakumar; Ranjani, Harish; Bibin, Subramanian Y; Balakumar, Mahalingam; Pandey, Gautam Kumar; Anjana, Ranjit Mohan; Ali, Mohammed K; Narayan, K M Venkat; Mohan, Viswanathan

2015-10-01

It is well known that inflammation is associated with diabetes, but it is unclear whether obesity mediates this association in individuals with youth-onset type 2 diabetes mellitus (T2DM-Y). We recruited individuals with T2DM-Y (age at onset <25 years) and age-matched normal glucose tolerance (NGT) subjects. Participants were further classified using Asia-Pacific body mass index cut-points for obesity and categorized as: nonobese NGT (n = 100), Obese NGT (n = 50), nonobese T2DM-Y (n = 50), and obese T2DM-Y (n = 50). We compared adipokines (adiponectin and leptin) and proinflammatory cytokines (tumor necrosis factor alpha [TNF-α] and monocyte chemotactic protein-1 [MCP-1]) across groups. Compared to nonobese NGT, the other 3 groups (obese NGT, nonobese T2DM-Y, and obese T2DM-Y) were found to have lower adiponectin (7.7 vs. 5.7, 4.2, 3.8 μg/mL, P<.01), and higher leptin (3.6 vs. 5.4, 5.7, 7.9 μg/mL, P<.001) and MCP 1 (186 vs. 272, 340, 473 pg/mL, P<.001) respectively. However, TNF-α levels were higher only among nonobese T2DM-Y (112 pg/mL) and obese T2DM-Y (141 pg/mL, P<.01 for each). After adjusting for age, sex, waist, hypertension, homeostatic model assessment of insulin resistance (HOMA-IR), serum cholesterol, triglycerides, and family history of diabetes, adiponectin was associated with 33% and 41% lower odds of being nonobese T2DM and obese T2DM, respectively. However, adjusted for same factors, leptin, TNF-α, and MCP-1 were associated with markedly higher odds (5- to 14-fold) of nonobese and obese T2DM. In young Asian Indians, leptin and proinflammatory cytokines are positively, and adiponectin negatively, associated with both nonobese and obese T2DM-Y compared to nonobese NGT individuals.

CHILE: An Evidence-Based Preschool Intervention for Obesity Prevention in Head Start

ERIC Educational Resources Information Center

Davis, Sally M.; Sanders, Sarah G.; FitzGerald, Courtney A.; Keane, Patricia C.; Canaca, Glenda F.; Volker-Rector, Renee

2013-01-01

Background: Obesity is a major concern among American Indians and Hispanics. The Child Health Initiative for Lifelong Eating and Exercise (CHILE) is an evidence-based intervention to prevent obesity in children enrolled in 16 Head Start (HS) Centers in rural communities. The design and implementation of CHILE are described. Methods: CHILE uses a…

Adherence to nutritional therapy in obese adolescents; a review.

PubMed

França, Silvana Lima Guimarães; Sahade, Viviane; Nunes, Mônica; Adan, Luis F

2013-01-01

Considering the controversies existent on the subject, the aim of this review is to discuss adherence to diet in obese adolescents. The selection of articles was made in the SCOPUS, COCHRANE, APA Psyc Net, SciELO, LILACS, CAPES Journals, PUBMED/MEDLINE and GOOGLE ACADEMIC databases. Studies published between 2002 and 2012 were selected. There was lack of evidence of conceptual discussion about adherence to diet in obesity in the child-youth context, in addition to scarcity of data on adherence to diet itself in obese adolescents and the methods of evaluating this. Lastly, multiple interdependent factors were found which both facilitated and made the process of adherence to diet difficult for obese youngsters. The majority of these (factors) belong to the socioeconomic and cultural dimension, in addition to pointing out cognitive and psychological factors and those associated with health services and professionals. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Consumption of added sugars from liquid but not solid sources predicts impaired glucose homeostasis and insulin resistance among youth at risk of obesity.

PubMed

Wang, Jiawei; Light, Kelly; Henderson, Mélanie; O'Loughlin, Jennifer; Mathieu, Marie-Eve; Paradis, Gilles; Gray-Donald, Katherine

2014-01-01

Little is known about longitudinal associations between added sugar consumption (solid and liquid sources) and glucose-insulin homeostasis among youth. Caucasian children (8-10 y) with at least one obese biological parent were recruited in the QUébec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort (n = 630) and followed-up 2 y later (n = 564). Added sugars were assessed by 3 24-h dietary recalls at baseline. Two-year changes were examined in multivariate linear regression models, adjusting for baseline level, age, sex, Tanner stage, energy intake, fat mass (dual-energy X-ray absorptiometry), and physical activity (7 d accelerometer). Added sugar intake in either liquid or solid sources was not related to changes in adiposity measures (fat mass, body mass index, or waist circumference). However, a higher consumption (10 g/d) of added sugars from liquid sources was associated with 0.04 mmol/L higher fasting glucose, 2.3 pmol/L higher fasting insulin, 0.1 unit higher homeostasis model assessment of insulin resistance (HOMA-IR), and 0.4 unit lower Matsuda-insulin sensitivity index (Matsuda-ISI) in all participants (P < 0.01). No associations were observed with consumption of added sugars from solid sources. Overweight/obese children at baseline had greater increases in adiposity indicators, fasting insulin, and HOMA-IR and decreases in Matsuda-ISI during those 2 y than normal-weight children. Consumption of added sugars from liquid or solid sources was not associated with changes in adiposity, but liquid added sugars were a risk factor for the development of impaired glucose homeostasis and insulin resistance over 2 y among youth at risk of obesity.

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review.

PubMed

Armstrong, Sarah; Lazorick, Suzanne; Hampl, Sarah; Skelton, Joseph A; Wood, Charles; Collier, David; Perrin, Eliana M

2016-02-01

Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits. Copyright © 2016 by the American Academy of Pediatrics.

Modulation of obesity-induced inflammation by dietary fats: mechanisms and clinical evidence

PubMed Central

2014-01-01

Obesity plays a pivotal role in the development of low-grade inflammation. Dietary fatty acids are important modulators of inflammatory responses. Saturated fatty acids (SFA) and n-6 polyunsaturated fatty acids (PUFA) have been reported to exert pro-inflammatory effects. n-3 PUFA in particular, possess anti-inflammatory properties. Numerous clinical studies have been conducted over decades to investigate the impact of dietary fatty acids on inflammatory response in obese individuals, however the findings remained uncertain. High fat meals have been reported to increase pro-inflammatory responses, however there is limited evidence to support the role of individual dietary fatty acids in a postprandial state. Evidence in chronic studies is contradictory, the effects of individual dietary fatty acids deserves further attention. Weight loss rather than n-3 PUFA supplementation may play a more prominent role in alleviating low grade inflammation. In this context, the present review provides an update on the mechanistic insight and the influence of dietary fats on low grade inflammation, based on clinical evidence from acute and chronic clinical studies in obese and overweight individuals. PMID:24476102

Open-access evidence database of controlled trials and systematic reviews in youth mental health.

PubMed

De Silva, Stefanie; Bailey, Alan P; Parker, Alexandra G; Montague, Alice E; Hetrick, Sarah E

2018-06-01

To present an update to an evidence-mapping project that consolidates the evidence base of interventions in youth mental health. To promote dissemination of this resource, the evidence map has been translated into a free online database (https://orygen.org.au/Campus/Expert-Network/Evidence-Finder or https://headspace.org.au/research-database/). Included studies are extensively indexed to facilitate searching. A systematic search for prevention and treatment studies in young people (mean age 6-25 years) is conducted annually using Embase, MEDLINE, PsycINFO and the Cochrane Library. Included studies are restricted to controlled trials and systematic reviews published since 1980. To date, 221 866 publications have been screened, of which 2680 have been included in the database. Updates are conducted annually. This shared resource can be utilized to substantially reduce the amount of time involved with conducting literature searches. It is designed to promote the uptake of evidence-based practice and facilitate research to address gaps in youth mental health. © 2017 John Wiley & Sons Australia, Ltd.

Relationship Between Exclusive Breastfeeding and Lower Risk of Childhood Obesity: A Narrative Review of Published Evidence.

PubMed

Uwaezuoke, Samuel N; Eneh, Chizoma I; Ndu, Ikenna K

2017-01-01

The pattern of infant feeding during the first 1000-day period-from conception to the second birthday-has a significant influence on the child's growth trajectory. The relationship between exclusive breastfeeding and lower risk of childhood obesity has elicited much scientific interest, given the fact that this form of malnutrition is becoming a global epidemic. This narrative review aims to examine the evidence in the literature linking exclusive breastfeeding with reduction in obesity in children. Using appropriate search terms, PubMed database was searched for relevant articles that met the review objective. Evidence for the protective effect of exclusive breastfeeding against childhood obesity have been provided by studies which explored 5 physiologic mechanisms and those that established the causality between breastfeeding and lower risk of obesity. The few studies that disputed this relationship highlighted the influence of confounding factors. A new insight on molecular mechanisms, however, points to a direct and indirect effect of human milk oligosaccharides on the prevention of overweight and obesity. The preponderance of current evidence strongly suggests that exclusivity in breastfeeding can prevent the development of obesity in children.

Invited Commentary: Childhood and Adolescent Obesity--Psychological and Behavioral Issues in Weight Loss Treatment

ERIC Educational Resources Information Center

Sarwer, David B.; Dilks, Rebecca J.

2012-01-01

The prevalence of childhood and adolescent obesity has tripled in the past three decades. This increase has been accompanied by a dramatic rise in obesity-related health complications among American youth. Thus, many obese youth are now experiencing illnesses that will threaten their life expectancy in the absence of significant weight loss.…

Pharmacotherapy in the Management of Pediatric Obesity.

PubMed

Kelly, Aaron S; Fox, Claudia K

2017-08-01

This review provides a rationale for the use of pharmacotherapy in pediatric weight management, summarizes results of some of the key pediatric clinical trials of approved and "off-label" obesity medications, introduces new options in the pediatric pipeline, and offers a glimpse into the future of pediatric obesity medicine. Despite the need for adjunctive treatments to enhance the outcomes of lifestyle modification therapy among youth with obesity, none of the obesity medications evaluated to date have been shown to meaningfully reduce BMI or cardiometabolic risk factors. Promising medications recently approved for the treatment of obesity in adults will soon be tested in pediatric trials, offering hope that new therapeutic options will soon be available. As new medications are approved to treat pediatric obesity, it will be important to evaluate the safety and efficacy of combination pharmacotherapy and investigate predictors of response. Application of precision medicine approaches to the field of pediatric obesity management will improve the long-term outlook for the tens of millions of youth afflicted with this serious and recalcitrant disease.

Tools for Identifying and Prioritizing Evidence-Based Obesity Prevention Strategies, Colorado

PubMed Central

Juhl, Ashley L.; Gujral, Indira B.; Hoaglin-Wagner, Andrea L.; Gabella, Barbara A.; McDermott, Kristin M.

2013-01-01

Colorado’s adult obesity rate has more than doubled since 1995, prompting its Department of Public Health and Environment to list obesity as its top prevention priority. To initiate comprehensive and effective action, the department used a well-known evidence-based public health framework developed by Brownson and others. This article describes the tools and process developed to conduct 2 of the 7 stages in this framework that challenge public health organizations: reviewing the literature and prioritizing effective strategies from that literature. Forty-five department staff participated in an intensive literature review training to identify physical activity and nutrition strategies that effectively address obesity and worked with external stakeholders to prioritize strategies for the state. Divided into 8 multidisciplinary teams organized by the setting where public health could exert leverage, they scanned the scientific literature to identify potential strategies to implement. These teams were trained to use standardized tools to critique findings, systematically abstract key information, and classify the evidence level for each of 58 identified strategies. Next, departmental subject matter experts and representatives from local public health and nonprofit health agencies selected and applied prioritization criteria to rank the 58 strategies. A team charter, group facilitation tools, and 2 web-based surveys were used in the prioritization stage. This process offered the staff a shared experience to gain hands-on practice completing literature reviews and selecting evidence-based strategies, thereby enhancing Colorado’s obesity prevention efforts and improving public health capacity. Practitioners can use these tools and methodology to replicate this process for other health priorities. PMID:23806801

Youth-Adult Partnerships and Youth Identity Style.

PubMed

Ramey, Heather L; Rose-Krasnor, Linda; Lawford, Heather L

2017-02-01

Youth-adult partnerships (e.g., youth leading programs, participating as members of advisory boards) are a common and widely recommended practice in youth work and youth-serving program settings. Although researchers have suggested that these opportunities contribute to youth's identity development, empirical evidence is lacking. In the current study, we tested associations between identity style and degree of youth voice, collaborative youth-adult relationships, and youth's program engagement in 194 youth participating in youth-adult partnerships (M age  = 17.6, 62 % female). We found that these characteristics of youth-adult partnerships predicted higher informational identity style, although only program engagement emerged as a unique predictor. Furthermore, exploratory analysis indicated that these associations were moderated by the type of organization. The findings suggest the need for more research on the multiple dimensions of youth-adult partnerships and their association with youth functioning, as well as pointing to the importance of the broader organizational context of youth-adult partnerships.

A youth mentor-led nutritional intervention in urban recreation centers: a promising strategy for childhood obesity prevention in low-income neighborhoods

PubMed Central

Sato, Priscila M.; Steeves, Elizabeth A.; Carnell, Susan; Cheskin, Lawrence J.; Trude, Angela C.; Shipley, Cara; Mejía Ruiz, M. J.; Gittelsohn, Joel

2016-01-01

B’More Healthy Community for Kids (BHCK) is an ongoing multi-level intervention to prevent childhood obesity in African-American low-income neighborhoods in Baltimore city, MD. Although previous nutrition interventions involving peer mentoring of youth have been successful, there is a lack of studies evaluating the influence of cross-age peers within interventions targeting youth. This article evaluates the implementation of the BHCK intervention in recreation centers, and describes lessons learned. Sixteen youth leaders delivered bi-weekly, interactive sessions to 10- to 14-y olds. Dose, fidelity and reach are assessed, as is qualitative information regarding what worked well during sessions. Dose is operationalized as the number of interactive sessions, and taste tests, giveaways and handouts per session; fidelity as the number of youth leaders participating in the entire intervention and per session and reach as the number of interactions with the target population. Based on a priori set values, number of interactive sessions was high, and number of taste tests, giveaways and handouts was moderate to high (dose). The number of participating youth leaders was also high (fidelity). Of the 14 planned sessions, the intervention was implemented with high/moderate reach. Data suggest that working with cross-age peers is a promising nutritional intervention for recreation centers. PMID:26936480

Physical environmental correlates of childhood obesity: a systematic review.

PubMed

Dunton, G F; Kaplan, J; Wolch, J; Jerrett, M; Reynolds, K D

2009-07-01

Increasing rates of childhood obesity in the USA and other Western countries are a cause for serious public health concern. Neighborhood and community environments are thought to play a contributing role in the development of obesity among youth, but it is not well understood which types of physical environmental characteristics have the most potential to influence obesity outcomes. This paper reports the results of a systematic review of quantitative research examining built and biophysical environmental variables associated with obesity in children and adolescents through physical activity. Literature searches in PubMed, PsychInfo and Geobase were conducted. Fifteen quantitative studies met the inclusion criteria for this systematic review. The majority of studies were cross-sectional and published after 2005. Overall, few consistent findings emerged. For children, associations between physical environmental variables and obesity differed by gender, age, socioeconomic status, population density and whether reports were made by the parent or child. Access to equipment and facilities, neighborhood pattern (e.g. rural, exurban, suburban) and urban sprawl were associated with obesity outcomes in adolescents. For most environmental variables considered, strong empirical evidence is not yet available. Conceptual gaps, methodological limitations and future research directions are discussed.

Bariatric surgery for people with diabetes and morbid obesity: an evidence-based analysis.

PubMed

2009-01-01

In June 2008, the Medical Advisory Secretariat began work on the Diabetes Strategy Evidence Project, an evidence-based review of the literature surrounding strategies for successful management and treatment of diabetes. This project came about when the Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the Ministry's newly released Diabetes Strategy.After an initial review of the strategy and consultation with experts, the secretariat identified five key areas in which evidence was needed. Evidence-based analyses have been prepared for each of these five areas: insulin pumps, behavioural interventions, bariatric surgery, home telemonitoring, and community based care. For each area, an economic analysis was completed where appropriate and is described in a separate report.To review these titles within the Diabetes Strategy Evidence series, please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/masabout.html,DIABETES STRATEGY EVIDENCE PLATFORM: Summary of Evidence-Based AnalysesContinuous Subcutaneous Insulin Infusion Pumps for Type 1 and Type 2 Adult Diabetics: An Evidence-Based AnalysisBehavioural Interventions for Type 2 Diabetes: An Evidence-Based AnalysisBARIATRIC SURGERY FOR PEOPLE WITH DIABETES AND MORBID OBESITY: An Evidence-Based SummaryCommunity-Based Care for the Management of Type 2 Diabetes: An Evidence-Based AnalysisHome Telemonitoring for Type 2 Diabetes: An Evidence-Based AnalysisApplication of the Ontario Diabetes Economic Model (ODEM) to Determine the Cost-effectiveness and Budget Impact of Selected Type 2 Diabetes Interventions in Ontario The purpose of this evidence-based analysis was to examine the effectiveness and cost-effectiveness of bariatric surgery for the management of diabetes in morbidly obese people. This report summarized evidence specific to bariatric surgery and the

Weight training in youth-growth, maturation, and safety: an evidence-based review.

PubMed

Malina, Robert M

2006-11-01

To review the effects of resistance training programs on pre- and early-pubertal youth in the context of response, potential influence on growth and maturation, and occurrence of injury. Evidence-based review. Twenty-two reports dealing with experimental resistance training protocols, excluding isometric programs, in pre- and early-pubertal youth, were reviewed in the context of subject characteristics, training protocol, responses, and occurrence of injury. Experimental programs most often used isotonic machines and free weights, 2- and 3-day protocols, and 8- and 12-week durations, with significant improvements in muscular strength during childhood and early adolescence. Strength gains were lost during detraining. Experimental resistance training programs did not influence growth in height and weight of pre- and early-adolescent youth, and changes in estimates of body composition were variable and quite small. Only 10 studies systematically monitored injuries, and only three injuries were reported. Estimated injury rates were 0.176, 0.053, and 0.055 per 100 participant-hours in the respective programs. Experimental training protocols with weights and resistance machines and with supervision and low instructor/participant ratios are relatively safe and do not negatively impact growth and maturation of pre- and early-pubertal youth.

Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review

PubMed Central

Hafeez, Hudaisa; Zeshan, Muhammad; Tahir, Muhammad A; Jahan, Nusrat

2017-01-01

About 3.5% Americans identify themselves as lesbian, gay, or bisexual while 0.3% identify themselves as transgender. The LGBT (lesbian, gay, bisexual, and transgender) community belongs to almost every race, ethnicity, religion, age, and socioeconomic group. The LGBT youth are at a higher risk for substance use, sexually transmitted diseases (STDs), cancers, cardiovascular diseases, obesity, bullying, isolation, rejection, anxiety, depression, and suicide as compared to the general population. LGBT youth receive poor quality of care due to stigma, lack of healthcare providers’ awareness, and insensitivity to the unique needs of this community. The main objective of this literature review is to highlight the challenges faced by the LGBT youth and to enhance the awareness among physicians about the existing disparities in order to provide a more comprehensive, evidence-based, and humane medical care to this community. PMID:28638747

The development of scientific evidence for health policies for obesity: why and how

PubMed Central

Richardson, Molly B.; Williams, Michelle S.; Fontaine, Kevin R.; Allison, David B.

2017-01-01

Potential obesity-related policy approaches have recently been receiving more attention. While some have been implemented and others only proposed, few have been formally evaluated. We discuss the relevance, and in some cases irrelevance, of some of the types of evidence that are often brought to bear in considering obesity-related policy decisions. We discuss major methods used to generate such evidence, emphasizing study design and the varying quality of the evidence obtained. Third, we consider what the standards of evidence should be in various contexts, who ought to set those standards, as well as the inherent subjectivity involved in making policy decisions. Finally, we suggest greater transparency from both academics and policymakers in the acknowledgment of subjectivities so they can distinguish and communicate the roles played by empirical evidence and subjective values in the formulation of policy. PMID:28293021

Relationship Between Exclusive Breastfeeding and Lower Risk of Childhood Obesity: A Narrative Review of Published Evidence

PubMed Central

Uwaezuoke, Samuel N; Eneh, Chizoma I; Ndu, Ikenna K

2017-01-01

Background: The pattern of infant feeding during the first 1000-day period—from conception to the second birthday—has a significant influence on the child’s growth trajectory. The relationship between exclusive breastfeeding and lower risk of childhood obesity has elicited much scientific interest, given the fact that this form of malnutrition is becoming a global epidemic. Aim: This narrative review aims to examine the evidence in the literature linking exclusive breastfeeding with reduction in obesity in children. Literature search: Using appropriate search terms, PubMed database was searched for relevant articles that met the review objective. Results: Evidence for the protective effect of exclusive breastfeeding against childhood obesity have been provided by studies which explored 5 physiologic mechanisms and those that established the causality between breastfeeding and lower risk of obesity. The few studies that disputed this relationship highlighted the influence of confounding factors. A new insight on molecular mechanisms, however, points to a direct and indirect effect of human milk oligosaccharides on the prevention of overweight and obesity. Conclusions: The preponderance of current evidence strongly suggests that exclusivity in breastfeeding can prevent the development of obesity in children. PMID:28469518

Relationship Between Physical Activity and Overweight and Obesity in Children: Findings From the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey

PubMed Central

Hong, Ickpyo; Coker-Bolt, Patty; Anderson, Kelly R.; Lee, Danbi

2016-01-01

OBJECTIVE. This study examined the relationship between childhood obesity and overweight and functional activity and its enjoyment. METHOD. A cross-sectional design was used to analyze data from the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey. Multivariate logistic regression models were used. RESULTS. Data for 1,640 children ages 3–15 yr were retrieved. Physical activity was negatively associated with risk of obesity (odds ratio [OR] = 0.93; 95% confidence interval [CI] [0.87, 0.98]). Although children who were obese and overweight were more likely to have functional limitations (ORs = 1.58–1.61), their enjoyment of physical activity participation was not significantly different from that of the healthy-weight group. CONCLUSION. Physical activity lowered the risk of obesity. Children who were obese had functional limitations compared with healthy-weight children, but both groups enjoyed physical activity equally. Future studies are needed to determine barriers to participation among these children in recreation and sporting activities. PMID:27548862

Relationship Between Physical Activity and Overweight and Obesity in Children: Findings From the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey.

PubMed

Hong, Ickpyo; Coker-Bolt, Patty; Anderson, Kelly R; Lee, Danbi; Velozo, Craig A

2016-01-01

This study examined the relationship between childhood obesity and overweight and functional activity and its enjoyment. A cross-sectional design was used to analyze data from the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey. Multivariate logistic regression models were used. Data for 1,640 children ages 3-15 yr were retrieved. Physical activity was negatively associated with risk of obesity (odds ratio [OR] = 0.93; 95% confidence interval [CI] [0.87, 0.98]). Although children who were obese and overweight were more likely to have functional limitations (ORs = 1.58-1.61), their enjoyment of physical activity participation was not significantly different from that of the healthy-weight group. Physical activity lowered the risk of obesity. Children who were obese had functional limitations compared with healthy-weight children, but both groups enjoyed physical activity equally. Future studies are needed to determine barriers to participation among these children in recreation and sporting activities. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Youth advocacy as a tool for environmental and policy changes that support physical activity and nutrition: an evaluation study in San Diego County.

PubMed

Linton, Leslie S; Edwards, Christine C; Woodruff, Susan I; Millstein, Rachel A; Moder, Cheryl

2014-03-27

As evidence grows about the benefits of policy and environmental changes to support active living and healthy eating, effective tools for implementing change must be developed. Youth advocacy, a successful strategy in the field of tobacco control, should be evaluated for its potential in the field of obesity prevention. San Diego State University collaborated with the San Diego County Childhood Obesity Initiative to evaluate Youth Engagement and Action for Health! (YEAH!), a youth advocacy project to engage youth and adult mentors in advocating for neighborhood improvements in physical activity and healthy eating opportunities. Study objectives included documenting group process and success of groups in engaging in community advocacy with decision makers. In 2011 and 2012, YEAH! group leaders were recruited from the San Diego County Childhood Obesity Initiative's half-day train-the-trainer seminars for adult leaders. Evaluators collected baseline and postproject survey data from youth participants and adult group leaders and interviewed decision makers. Of the 21 groups formed, 20 completed the evaluation, conducted community assessments, and advocated with decision makers. Various types of decision makers were engaged, including school principals, food service personnel, city council members, and parks and recreation officials. Eleven groups reported change(s) implemented as a result of their advocacy, 4 groups reported changes pending, and 5 groups reported no change as a result of their efforts. Even a brief training session, paired with a practical manual, technical assistance, and commitment of adult leaders and youth may successfully engage decision makers and, ultimately, bring about change.

Youth Advocacy as a Tool for Environmental and Policy Changes That Support Physical Activity and Nutrition: An Evaluation Study in San Diego County

PubMed Central

Edwards, Christine C.; Woodruff, Susan I.; Millstein, Rachel A.; Moder, Cheryl

2014-01-01

Background As evidence grows about the benefits of policy and environmental changes to support active living and healthy eating, effective tools for implementing change must be developed. Youth advocacy, a successful strategy in the field of tobacco control, should be evaluated for its potential in the field of obesity prevention. Community Context San Diego State University collaborated with the San Diego County Childhood Obesity Initiative to evaluate Youth Engagement and Action for Health! (YEAH!), a youth advocacy project to engage youth and adult mentors in advocating for neighborhood improvements in physical activity and healthy eating opportunities. Study objectives included documenting group process and success of groups in engaging in community advocacy with decision makers. Methods In 2011 and 2012, YEAH! group leaders were recruited from the San Diego County Childhood Obesity Initiative’s half-day train-the-trainer seminars for adult leaders. Evaluators collected baseline and postproject survey data from youth participants and adult group leaders and interviewed decision makers. Outcomes Of the 21 groups formed, 20 completed the evaluation, conducted community assessments, and advocated with decision makers. Various types of decision makers were engaged, including school principals, food service personnel, city council members, and parks and recreation officials. Eleven groups reported change(s) implemented as a result of their advocacy, 4 groups reported changes pending, and 5 groups reported no change as a result of their efforts. Interpretation Even a brief training session, paired with a practical manual, technical assistance, and commitment of adult leaders and youth may successfully engage decision makers and, ultimately, bring about change. PMID:24674636

Canadian sedentary behaviour guidelines for children and youth.

PubMed

Tremblay, Mark S; Leblanc, Allana G; Janssen, Ian; Kho, Michelle E; Hicks, Audrey; Murumets, Kelly; Colley, Rachel C; Duggan, Mary

2011-02-01

The Canadian Society for Exercise Physiology (CSEP), in partnership with the Healthy Active Living and Obesity Research Group (HALO) at the Children's Hospital of Eastern Ontario Research Institute, and in collaboration with ParticipACTION, and others, has developed the Canadian Sedentary Behaviour Guidelines for Children (aged 5-11 years) and Youth (aged 12-17 years). The guidelines include a preamble to provide context, followed by the specific recommendations for sedentary behaviour. The entire development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which is the international standard for clinical practice guideline development. Thus, the guidelines have gone through a rigorous and transparent developmental process and the recommendations are based on evidence from a systematic review and interpretation of the research evidence. The final guidelines benefitted from an extensive online consultation process with 230 domestic and international stakeholders and key informants. The final guideline recommendations state that for health benefits, children (aged 5-11 years) and youth (aged 12-17 years) should minimize the time that they spend being sedentary each day. This may be achieved by (i) limiting recreational screen time to no more than 2 h per day - lower levels are associated with additional health benefits; and (ii) limiting sedentary (motorized) transport, extended sitting time, and time spent indoors throughout the day. These are the first evidence-based Canadian Sedentary Behaviour Guidelines for Children and Youth and provide important and timely recommendations for the advancement of public health based on a systematic synthesis, interpretation, and application of the current scientific evidence.

Unsupportive parenting moderates the effects of family psychosocial intervention on metabolic syndrome in African American youth.

PubMed

Chen, E; Miller, G E; Yu, T; Brody, G H

2018-04-01

Family relationships have been linked to obesity and related disorders in youth, but few studies have provided causal evidence of this association. This study tested the impact of a family psychosocial intervention on components of metabolic syndrome-a condition driven largely by abdominal obesity-in African American youth. In particular, the study tested whether effects were strongest among those who started at highest risk, that is, with high levels of unsupportive parenting at baseline. Randomized clinical trial of a community sample of 391 African American youth (mean age=11.2 years) conducted in 2001-2002, with follow-up metabolic syndrome assessment in 2014-2015. Participants were assigned either to receive a weekly family intervention or to a control group. The primary study outcome was the number of components of metabolic syndrome that were clinically elevated at age 25, including central adiposity, blood pressure, triglycerides, glucose and low high-density lipoproteins. Unsupportive parenting was measured by questionnaires at baseline. Significant interaction effects were found between group assignment and baseline unsupportive parenting on counts of metabolic syndrome components in youth (beta=-0.17, P=0.03). Among those who started with higher levels of unsupportive parenting at age 11, participation in the family intervention reduced the number of clinically elevated components of the metabolic syndrome at age 25 relative to the control group. No such effect was seen among those who started with good parenting. Mediation analyses suggested that changes in the psychosocial targets of the parenting intervention partially accounted for the effects amongst those high in unsupportive parenting at baseline (effect size=-0.350, s.e.=0.178). These findings suggest that efforts to improve family relationships may be able to ameliorate the detrimental effects that harsh and unsupportive parenting have on obesity-related outcomes such as metabolic syndrome in

Unsupportive Parenting Moderates the Effects of Family Psychosocial Intervention on Metabolic Syndrome in African American Youth

PubMed Central

Chen, Edith; Miller, Greg; Yu, Tianyi; Brody, Gene H.

2017-01-01

Background/Objective Family relationships have been linked to obesity and related disorders in youth, but few studies have provided causal evidence of this association. This study tested the impact of a family psychosocial intervention on components of metabolic syndrome – a condition driven largely by abdominal obesity - in African American youth. In particular, the study tested whether effects were strongest among those who started at highest risk, that is, with high levels of unsupportive parenting at baseline. Subjects/Methods Randomized clinical trial of a community sample of 391 African American youth (mean age=11.2 years) conducted in 2001–2002, with follow-up metabolic syndrome assessment in 2014–2015. Participants were assigned either to receive a weekly family intervention or to a control group. The primary study outcome was the number of components of metabolic syndrome that were clinically elevated at age 25, including central adiposity, blood pressure, triglycerides, glucose, and low high-density lipoproteins. Unsupportive parenting was measured by questionnaires at baseline. Results Significant interaction effects were found between group assignment and baseline unsupportive parenting on counts of metabolic syndrome components in youth (beta=−.17, p=.03). Among those who started with higher levels of unsupportive parenting at age 11, participation in the family intervention reduced the number of clinically elevated components of the metabolic syndrome at age 25 relative to the control group. No such effect was seen among those who started with good parenting. Mediation analyses suggested that changes in the psychosocial targets of the parenting intervention partially accounted for the effects amongst those high in unsupportive parenting at baseline (effect size=−.350, se=.178). Conclusions These findings suggest that efforts to improve family relationships may be able to ameliorate the detrimental effects that harsh and unsupportive

Infusing Culture into Practice: Developing and Implementing Evidence-Based Mental Health Services for African American Foster Youth

ERIC Educational Resources Information Center

Briggs, Harold Eugene; McBeath, Bowen

2010-01-01

The lack of culturally appropriate health and mental health care has contributed to the large number of African American youth and families involved in the child welfare system. This article reviews the consequences of the insufficient access to culturally sensitive, evidence-supported interventions for African American foster youth. The authors…

Subtraction of subcutaneous fat to improve the prediction of visceral adiposity: exploring a new anthropometric track in overweight and obese youth.

PubMed

Samouda, H; De Beaufort, C; Stranges, S; Van Nieuwenhuyse, J-P; Dooms, G; Keunen, O; Leite, S; Vaillant, M; Lair, M-L; Dadoun, F

2017-08-01

The efficiency of traditional anthropometric measurements such as body mass index (BMI) or waist circumference (Waist C) used to replace biomedical imaging for assessing visceral adipose tissue (VAT) is still highly controversial in youth. We evaluated the most accurate model predicting VAT in overweight/obese youth, using various anthropometric measurements and their correlation with different body fat compartments, especially by testing, for the first time in youth, the hypothesis that subtracting the anthropometric measurement the most highly correlated with subcutaneous abdominal adipose tissue (SAAT) and less correlated possible with VAT from an anthropometric abdominal measurement highly correlated with visceral and total abdominal adipose tissue (TAAT), predicts VAT with higher accuracy. VAT and SAAT data resulted from magnetic resonance imaging (MRI) analysis performed on 181 boys and girls (7-17 y) from Diabetes & Endocrinology Care Paediatrics Clinic in Luxembourg. Height, weight, abdominal diameters, waist, hip, and thigh circumferences were measured with a view to developing the anthropometric VAT predictive algorithms. In girls, subtracting proximal thigh circumference (Proximal Thigh C), the most closely correlated anthropometric measurement with SAAT, from Waist C, the most closely correlated anthropometric measurement with VAT was instrumental in improving VAT prediction, in comparison with the most accurate single VAT anthropometric surrogate. [Formula: see text] Residual analysis showed a negligible estimation error (5 cm 2 ). In boys, Waist C was the best VAT predictor. Subtraction of abdominal subcutaneous fat is important to predict VAT in overweight/obese girls. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Perceived health status and cardiometabolic risk among a sample of youth in Mexico

PubMed Central

Flores, Yvonne N.; Shaibi, Gabriel Q.; Morales, Leo S.; Salmerón, Jorge; Skalicky, Anne M.; Edwards, Todd C.; Gallegos-Carrillo, Katia; Patrick, Donald L.

2015-01-01

Purpose To examine differences in self-reported perceived mental and physical health status (PHS), as well as known cardiometabolic risk factors in a sample of normal weight, overweight, and obese Mexican youths. Methods Cross-sectional analysis of 164 youths aged 11-18 years recruited in Cuernavaca, Mexico. Participants completed a self-administered questionnaire that included measures of generic and weight-specific quality of life (QoL), perceived health, physical function, depressive symptoms, and body shape satisfaction. Height, weight and waist circumference were measured and body mass index (BMI) was determined. Fasting blood samples from participants yielded levels of glucose, triglycerides, and cholesterol (total, HDL and LDL). Results Nearly 50% of participants were female, 21% had a normal BMI, 39% were overweight, and 40% were obese. Obese youths reported significantly lower measures of PHS and showed an increase in cardiometabolic risk, compared to normal weight youths. Physical functioning, generic and weight-specific QoL were inversely associated with BMI, waist circumference and glucose. Depressive symptoms were positively correlated with BMI, waist circumference, glucose levels and HDL cholesterol. No correlation was found between PHS and cardiometabolic risk measures after controlling for BMI. Conclusions In this sample of Mexican youths, obesity was associated with a significantly lower PHS and increased cardiometabolic risk. PMID:25648756

Screen Time and Health Indicators Among Children and Youth: Current Evidence, Limitations and Future Directions.

PubMed

Saunders, Travis J; Vallance, Jeff K

2017-06-01

Despite accumulating evidence linking screen-based sedentary behaviours (i.e. screen time) with poorer health outcomes among children and youth <18 years of age, the prevalence of these behaviours continues to increase, with roughly half of children and youth exceeding the public health screen time recommendation of 2 h per day or less. The purpose of this article is to provide an overview of key research initiatives aimed at understanding the associations between screen time and health indicators including physical health, quality of life and psychosocial health. Available evidence suggests that screen time is deleteriously associated with numerous health indicators in child and youth populations, including adiposity, aerobic fitness, quality of life, self-esteem, pro-social behaviour, academic achievement, depression and anxiety. However, few longitudinal or intervention studies have been conducted, with most of these studies focusing on physical health indicators. While most studies have used self-reported assessments of screen time, the availability of more objective assessment methods presents important opportunities (e.g. more accurate and precise assessment of sedentary time and screen time) and challenges (e.g. privacy and participant burden). Novel statistical approaches such as isotemporal substitution modelling and compositional analysis, as well as studies using longitudinal and experimental methodologies, are needed to better understand the health impact of excessive screen time, and to develop strategies to minimise or reverse the negative impacts of these behaviours. The evidence to date suggests a clear need for policy aimed at minimising the hazardous health consequences associated with screen time among children and youth.

Behavioral Weight Loss Treatment in Antipsychotic Treated Youth.

PubMed

Nicol, Ginger E; Kolko, Rachel P; Mills, Monica; Gunnarsdottir, Thrudur; Yingling, Michael D; Schweiger, Julia A; Lenze, Eric J; Newcomer, John W; Wilfley, Denise

2016-05-01

Antipsychotic-treated youth have increased risk for the development of obesity and type 2 diabetes. Behavioral weight loss treatments show promise in reducing obesity and diabetes risk in antipsychotic treated adults, but have received no study in antipsychotic treated youth. We describe a rationale for behavioral weight loss interventions in high-weight antipsychotic treated youth, and report behavioral, anthropomorphic, and metabolic findings from a case series of obese antipsychotic-treated adolescents participating in a short-term, family-based behavioral weight loss intervention. We adapted the Traffic Light Plan, a 16-week family-based weight loss intervention that promotes healthy energy balance using the colors of the traffic light to categorize the nutritional value of foods and intensity of physical activity, adapting a social ecological framework to address health behavior change in multiple social contexts. The intervention was administered to three obese adolescents with long-term antipsychotic medication exposure. Efficacy of the intervention was evaluated with a battery of anthropomorphic and metabolic assessments including weight, body mass index percentile, whole body adiposity, liver fat content, and fasting plasma glucose and lipids. Participants and their parents also filled out a treatment satisfaction questionnaire upon study completion. Two males and 1 female (all aged 14 years) participated. All 3 participants attended all 16 sessions, and experienced beneficial changes in adiposity, fasting lipids and liver fat content associated with weight stabilization or weight loss. Adolescents and their parents all reported a high level of satisfaction with the treatment. Family-based behavioral weight loss treatment can be feasibly delivered and is acceptable to antipsychotic-treated youth and their families. Randomized controlled trials are needed to fully evaluate the effectiveness and acceptability of behavioral weight loss interventions in

Energy prediction equations are inadequate for obese Hispanic youth.

PubMed

Klein, Catherine J; Villavicencio, Stephan A; Schweitzer, Amy; Bethepu, Joel S; Hoffman, Heather J; Mirza, Nazrat M

2011-08-01

Assessing energy requirements is a fundamental activity in clinical dietetics practice. A study was designed to determine whether published linear regression equations were accurate for predicting resting energy expenditure (REE) in fasted Hispanic children with obesity (aged 7 to 15 years). REE was measured using indirect calorimetry; body composition was estimated with whole-body air displacement plethysmography. REE was predicted using four equations: Institute of Medicine for healthy-weight children (IOM-HW), IOM for overweight and obese children (IOM-OS), Harris-Benedict, and Schofield. Accuracy of the prediction was calculated as the absolute value of the difference between the measured and predicted REE divided by the measured REE, expressed as a percentage. Predicted values within 85% to 115% of measured were defined as accurate. Participants (n=58; 53% boys) were mean age 11.8±2.1 years, had 43.5%±5.1% body fat, and had a body mass index of 31.5±5.8 (98.6±1.1 body mass index percentile). Measured REE was 2,339±680 kcal/day; predicted REE was 1,815±401 kcal/day (IOM-HW), 1,794±311 kcal/day (IOM-OS), 1,151±300 kcal/day (Harris-Benedict), and, 1,771±316 kcal/day (Schofield). Measured REE adjusted for body weight averaged 32.0±8.4 kcal/kg/day (95% confidence interval 29.8 to 34.2). Published equations predicted REE within 15% accuracy for only 36% to 40% of 58 participants, except for Harris-Benedict, which did not achieve accuracy for any participant. The most frequently accurate values were obtained using IOM-HW, which predicted REE within 15% accuracy for 55% (17/31) of boys. Published equations did not accurately predict REE for youth in the study sample. Further studies are warranted to formulate accurate energy prediction equations for this population. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Urban green space and obesity in older adults: Evidence from Ireland.

PubMed

Dempsey, Seraphim; Lyons, Seán; Nolan, Anne

2018-04-01

We examine the association between living in an urban area with more or less green space and the probability of being obese. This work involves the creation of a new dataset which combines geo-coded data at the individual level from the Irish Longitudinal Study on Ageing with green space data from the European Urban Atlas 2012. We find evidence suggestive of a u-shaped relationship between green space in urban areas and obesity; those living in areas with the lowest and highest shares of green space within a 1.6 km buffer zone have a higher probability of being classified as obese (BMI [Formula: see text]). The unexpected result that persons in areas with both the lowest and highest shares of green space have a higher probability of being obese than those in areas with intermediate shares, suggests that other characteristics of urban areas may be mediating this relationship.

The readiness and motivation interview for families (RMI-Family) managing pediatric obesity: study protocol.

PubMed

Ball, Geoff D C; Spence, Nicholas D; Browne, Nadia E; O'Connor, Kathleen; Srikameswaran, Suja; Zelichowska, Joanna; Ho, Josephine; Gokiert, Rebecca; Mâsse, Louise C; Carson, Valerie; Morrison, Katherine M; Kuk, Jennifer L; Holt, Nicholas L; Kebbe, Maryam; Gehring, Nicole D; Cesar, Melody; Virtanen, Heidi; Geller, Josie

2017-04-11

Experts recommend that clinicians assess motivational factors before initiating care for pediatric obesity. Currently, there are no well-established clinical tools available for assessing motivation in youth with obesity or their families. This represents an important gap in knowledge since motivation-related information may shed light on which patients might fail to complete treatment programs. Our study was designed to evaluate the measurement properties and utility of the Readiness and Motivational Interview for Families (RMI-Family), a structured interview that utilizes a motivational interviewing approach to (i) assess motivational factors in youth and their parents, and (ii) examine the degree to which motivation and motivation-related concordance between youth and parents are related to making changes to lifestyle habits for managing obesity in youth. From 2016 to 2020, this prospective study will include youth with obesity (body mass index [BMI] ≥97th percentile; 13-17 years old; n = 250) and their parents (n = 250). The study will be conducted at two primary-level, multidisciplinary obesity management clinics based at children's hospitals in Alberta, Canada. Participants will be recruited and enrolled after referral to these clinics, but prior to initiating clinical care. Each youth and their parent will complete the RMI-Family (~1.5 h) at baseline, and 6- and 12-months post-baseline. Individual (i.e., youth or parent) and family-level (i.e., across youth and parent) responses to interview questions will be scored, as will aspects of interview administration (e.g., fidelity to motivational interviewing tenets). The RMI-Family will also be examined for test-retest reliability. Youth data collected at each time point will include demography, anthropometry, lifestyle habits, psychosocial functioning, and health services utilization. Cross-sectional and longitudinal associations between individual and family-level interview scores on the RMI

The Role of Social Support for Promoting Quality of Life among Persistently Obese Adolescents: Importance of Support in Schools

ERIC Educational Resources Information Center

Wu, Yelena P.; Reiter-Purtill, Jennifer; Zeller, Meg H.

2014-01-01

Background: Despite school-based and other interventions for pediatric obesity, many obese youth of the present generation will persist in their obesity into adolescence and adulthood. Thus, understanding not only how better to tailor weight interventions but how to promote overall adjustment for persistently obese youth is of utmost importance.…

The mediating effects of dietary habits on the relationship between television viewing and body mass index among youth.

PubMed

Carson, Valerie; Janssen, Ian

2012-10-01

There is evidence to suggest that excessive television viewing is an independent determinant of obesity in young people. However, the pathways between television viewing and obesity are not fully understood. Therefore, the purpose of this study was to examine whether the relationship between television and body mass index (BMI) is mediated by television snacking and junk food consumption. Results are based on 15,973 youth in grades 6-10 who participated in the Canadian 2009/2010 health behaviour in school-aged children survey (HBSC). Participants self-reported their weight and height and BMI z-scores were calculated based on World Health Organization growth standards. Participants reported the frequency of snacking while watching television and the frequency of eating junk food (sweets, soft drinks, baked goods, French fries, potato chips). Total hours per week of television were calculated. A contemporary multiple mediation analysis was used to examine associations. A modest positive relationship was observed between television viewing and BMI. The mean BMI z-score was 0.15 units higher in youth in the highest television viewing quartile by comparison with the youth in the lowest quartile. However, contrary to our hypothesis, television snacking and junk food consumption were not significant positive mediators of the television and BMI relationship. The pathways between television viewing and obesity are complicated and remain poorly understood. Future research using longitudinal or experimental designs, more precise measurement tools and formal mediation analyses is needed. This research should consider mediators related to both energy intake and expenditure. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

Physical activity does not attenuate the relationship between daily cortisol and metabolic syndrome in obese youth.

PubMed

Guseman, Emily Hill; Pfeiffer, Karin A; Carlson, Joseph J; Stansbury, Kathy; Eisenmann, Joey C

2016-01-01

We examined the associations among daily cortisol, physical activity (MVPA) and continuous metabolic syndrome score (cMetS) in obese youth. Fifty adolescents (mean age 14.8 ± 1.9 years) were recruited from medical clinics. Daily MVPA (min/day) was assessed by accelerometry. Saliva was sampled at prescribed times: immediately upon waking; 30 min after waking; and 3, 6 and 9 h after waking. Fasting lipids, glucose, waist circumference and blood pressure were used to calculate a continuous metabolic syndrome score (cMetS). Multiple linear regression analysis was used to examine associations among variables. The mean cMetS score was 4.16 ± 4.30 and did not differ by clinic or sex. No significant relationship was found between cortisol area under the curve (cAUC) and cMetS, nor did the interaction of MVPA with cAUC significantly predict cMetS. Physical activity, cortisol, and metabolic risk were not associated in this sample of obese adolescents. Future research should examine the role of insulin sensitivity in these relationships.

Barriers to optimizing investments in the built environment to reduce youth obesity: policy-maker perspectives.

PubMed

Grant, Jill L; MacKay, Kathryn C; Manuel, Patricia M; McHugh, Tara-Leigh F

2010-01-01

To identify factors which limit the ability of local governments to make appropriate investments in the built environment to promote youth health and reduce obesity outcomes in Atlantic Canada. Policy-makers and professionals participated in focus groups to discuss the receptiveness of local governments to introducing health considerations into decision-making. Seven facilitated focus groups involved 44 participants from Atlantic Canada. Thematic discourse analysis of the meeting transcripts identified systemic barriers to creating a built environment that fosters health for youth aged 12-15 years. Participants consistently identified four categories of barriers. Financial barriers limit the capacities of local government to build, maintain and operate appropriate facilities. Legacy issues mean that communities inherit a built environment designed to facilitate car use, with inadequate zoning authority to control fast food outlets, and without the means to determine where schools are built or how they are used. Governance barriers derive from government departments with distinct and competing mandates, with a professional structure that privileges engineering, and with funding programs that encourage competition between municipalities. Cultural factors and values affect outcomes: people have adapted to car-oriented living; poverty reduces options for many families; parental fears limit children's mobility; youth receive limited priority in built environment investments. Participants indicated that health issues have increasing profile within local government, making this an opportune time to discuss strategies for optimizing investments in the built environment. The focus group method can foster mutual learning among professionals within government in ways that could advance health promotion.

Effects of group sports on health-related physical fitness of overweight youth: A systematic review and meta-analysis.

PubMed

Oliveira, Ana; Monteiro, Ângela; Jácome, Cristina; Afreixo, Vera; Marques, Alda

2017-06-01

Group sports interventions have been developed to improve health-related physical fitness of overweight/obese youth. However, its benefits are not systematically documented. This study synthesizes the evidence about the effects of group sports on health-related physical fitness of overweight/obese youth. Pubmed, Web of Knowledge, Scopus, Medline, CINAHL, SportDiscus, and Academic Search Complete were searched in February 2016. Studies assessing the effects of group sports on body composition, cardiorespiratory endurance, muscle strength, flexibility, and neuromotor fitness of overweight/obese youth (aged <18 years) were included. Effect sizes (ES) were calculated with Cohen's d and its 95% confidence intervals (CI). Improvements were found in (i) body composition - percentage of fat body mass (pooled ES = 0.67; 95% CI = 0.24-1.10) and waist circumference (ES = 0.69; P = 0.004); (ii) cardiorespiratory endurance - peak oxygen consumption (pooled ES = 0.53; 95% CI = 0.13-0.92) and (iii) muscle strength - hand grip strength (ES = 0.72; P = 0.003). No significant effects were found for body mass index (pooled ES = 0.27; 95% CI = -0.14 to 0.69), percentage of lean body mass (ES = 0.01; P > 0.05), maximal power output (ES from 0 to 0.06; P > 0.05), sit-and-reach test (pooled ES = 0.26; 95% CI = -0.16 to 0.68) and agility test (ES = 0; P = 0.48). Group sports improve body composition, cardiorespiratory endurance, and hand grip strength of overweight/obese youth. Flexibility and neuromotor fitness do not seem to change following group sports. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Antepartum Care of Women Who Are Obese During Pregnancy: Systematic Review of the Current Evidence.

PubMed

Carlson, Nicole S; Leslie, Sharon Lynn; Dunn, Alexis

2018-05-14

Nearly 40% of US women of childbearing age are obese. Obesity during pregnancy is associated with multiple risks for both the woman and fetus, yet clinicians often feel unprepared to provide optimal antepartum care for this group of women. We collected and reviewed current evidence concerning antepartum care of women who are obese during pregnancy. We conducted a systematic review using PRISMA guidelines. Current evidence relating to the pregnancy care of women with a prepregnancy body mass index of 30kg/m 2 or higher was identified using MEDLINE databases via PubMed, Embase, and Web of Science Core Collection between January 2012 and February 2018. A total of 354 records were located after database searches, of which 63 met inclusion criteria. Topic areas for of included studies were: pregnancy risk and outcomes related to obesity, communication between women and health care providers, gestational weight gain and activity/diet, diabetic disorders, hypertensive disorders, obstructive sleep apnea, mental health, pregnancy imaging and measurement, late antepartum care, and preparation for labor and birth. Midwives and other health care providers can provide better antepartum care to women who are obese during pregnancy by incorporating evidence from the most current clinical investigations. © 2018 by the American College of Nurse-Midwives.

Food-Related Impulsivity in Obesity and Binge Eating Disorder-A Systematic Update of the Evidence.

PubMed

Giel, Katrin E; Teufel, Martin; Junne, Florian; Zipfel, Stephan; Schag, Kathrin

2017-10-27

The specific eating pattern of Binge Eating Disorder (BED) patients has provoked the assumption that BED might represent a phenotype within the obesity spectrum that is characterized by increased impulsivity. Following the guidelines of the PRISMA statement (preferred reporting items for systematic reviews and meta-analyses), we here provide a systematic update on the evidence on food-related impulsivity in obese individuals, with and without BED, as well as normal-weight individuals. We separately analyzed potential group differences in the impulsivity components of reward sensitivity and rash-spontaneous behavior. Our search resulted in twenty experimental studies with high methodological quality. The synthesis of the latest evidence consolidates conclusions drawn in our initial systematic review that BED represents a distinct phenotype within the obesity spectrum that is characterized by increased impulsivity. Rash-spontaneous behavior in general, and specifically towards food, is increased in BED, while food-specific reward sensitivity is also increased in obese individuals without BED, but potentially to a lesser degree. A major next step for research entails the investigation of sub-domains and temporal components of inhibitory control in BED and obesity. Based on the evidence of impaired inhibitory control in BED, affected patients might profit from interventions that address impulsive behavior.

Internet-Based Delivery of Evidence-Based Health Promotion Programs Among American Indian and Alaska Native Youth: A Case Study.

PubMed

Markham, Christine M; Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross

2016-11-21

American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet's potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths' perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using previously established measures. Sites

Internet-Based Delivery of Evidence-Based Health Promotion Programs Among American Indian and Alaska Native Youth: A Case Study

PubMed Central

Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross

2016-01-01

Background American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. Objective We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet’s potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. Methods This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths’ perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using

Ozone Exposure, Cardiopulmonary Health, and Obesity: A Substantive Review.

PubMed

Koman, Patricia D; Mancuso, Peter

2017-07-17

From 1999-2014, obesity prevalence increased among adults and youth. Obese individuals may be uniquely susceptible to the proinflammatory effects of ozone because obese humans and animals have been shown to experience a greater decline in lung function than normal-weight subjects. Obesity is independently associated with limitations in lung mechanics with increased ozone dose. However, few epidemiologic studies have examined the interaction between excess weight and ozone exposure among adults. Using PubMed keyword searches and reference lists, we reviewed epidemiologic evidence to identify potential response-modifying factors and determine if obese or overweight adults are at increased risk of ozone-related health effects. We initially identified 170 studies, of which seven studies met the criteria of examining the interaction of excess weight and ozone exposure on cardiopulmonary outcomes in adults, including four short-term ozone exposure studies in controlled laboratory settings and three community epidemiologic studies. In the studies identified, obesity was associated with decreased lung function and increased inflammatory mediators. Results were inconclusive about the effect modification when data were stratified by sex. Obese and overweight populations should be considered as candidate at-risk groups for epidemiologic studies of cardiopulmonary health related to air pollution exposures. Air pollution is a modifiable risk factor that may decrease lung function among obese individuals with implications for environmental and occupational health policy.

Autonomic Dysfunction: A Possible Pathophysiological Pathway Underlying the Association Between Sleep and Obesity in Children At-Risk for Obesity

PubMed Central

Jarrin, Denise C.; Poirier, Paul

2017-01-01

While mounting evidence suggests that sleep plays an important role in the etiology of obesity, the underlying pathogenic pathways are complex and unresolved. Experimental sleep deprivation studies demonstrate sympathovagal imbalance, indicative of diminished parasympathetic activity and/or heightened sympathetic activity, is consequent to poor sleep. Further, obese children exhibit sympathovagal imbalance, particularly during the night, compared to non-obese children. The question remains whether sympathovagal imbalance is one potential pathophysiological pathway underlying the association between sleep and obesity. The aim of the present study was to examine whether sympathovagal imbalance contributed to the association between sleep and obesity in children. Participants included 564 children aged 10 to 12 years (M = 11.67, SD = 0.95; 43.5 % girls) from the QUALITY Cohort, a longitudinal study of children at-risk for the development of obesity. While children were at-risk due to confirmed parental obesity status, 57.7 % of children were of normal body mass index (5–85th percentile). Sleep duration, sleep timing, and sleep disturbances were based on child- and parent-report. Anthropometrics were measured for central adiposity (waist circumference) and body composition (body mass index, fat mass index). Sympathovagal imbalance was derived from heart rate variability spectral analyses. Estimated path coefficients revealed that sympathovagal imbalance partially contributed to the association between poor sleep (later bedtimes, sleep-disordered breathing) and obesity. These findings highlight the importance of better understanding sympathovagal imbalance and its role in the etiology and maintenance of obesity. Future research should consider investigating nocturnal sympathovagal balance in youth. PMID:25480401

Sensitizing Future Health Professionals to Determinants of Childhood Obesity.

PubMed

Rosemond, Tiara N; Blake, Christine E; Buff, Scotty M; Blake, Elizabeth W; Dunn, Brianne L; Browne, Teri; Bell, Bethany A; Iachini, Aidyn L

2016-07-01

Long-term solutions to the childhood obesity epidemic will require concerted interdisciplinary efforts that are sensitive to both individual and social determinants of health. The Junior Doctors of Health© (JDOH) program involves interprofessional education (IPE) with university students from health science fields (e.g., medicine, pharmacy, social work, public health) who deliver an interactive program in teams to at-risk school-aged youth. The purpose of this study was to assess the impact of participation in the JDOH IPE program on university students' beliefs about childhood obesity. Fifty-three of the 71 health sciences students enrolled in the JDOH IPE program between 2011 and 2013 participated in this study. Pre- and post-surveys assessed students' beliefs about the importance, causes of, and responsibility for reducing childhood obesity with both closed- and open-ended questions. In 2013, quantitative data were analyzed using Wilcoxon matched-pairs signed-rank tests and qualitative data were analyzed through open coding to identify emergent themes. Results indicate that after participation in the JDOH IPE program, students' identification of social and environmental causes of childhood obesity increased significantly. Further, students' ranking of the importance of obesity was initially higher than those of different issues typically portrayed as social or environmental (e.g., youth violence) but it was similarly ranked after participation in JDOH. This suggests a greater sensitivity to social and environmental challenges faced by youth. Findings suggest that IPE experiences that bring clinical and community-oriented health professions together to engage with disadvantaged youth foster sensitivity to the complexities of childhood obesity in low-income settings. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Obesity and Sex Steroid Changes Across Puberty: Evidence for Marked Hyperandrogenemia in Pre- and Early Pubertal Obese Girls*

PubMed Central

McCartney, Christopher R.; Blank, Susan K.; Prendergast, Kathleen A.; Chhabra, Sandhya; Eagleson, Christine A.; Helm, Kristin D.; Yoo, Richard; Chang, R. Jeffrey; Foster, Carol M.; Caprio, Sonia; Marshall, John C.

2008-01-01

Context Peripubertal obesity is associated with abnormal sex steroid concentrations, but the timing of onset and degree of these abnormalities remain unclear. Objective To assess the degree of hyperandrogenemia across puberty in obese girls, and to assess overnight sex steroid changes in Tanner 1–3 girls. Design Cross-sectional analysis. Setting General Clinical Research Centers. Subjects Thirty normal weight (BMI-for-age < 85%) and 74 obese (BMI-for-age ≥ 95%) peripubertal girls. Intervention Blood samples (circa 0500–0700 h) while fasting. Samples from the preceding evening (circa 2300 h) were obtained in 23 Tanner 1–3 girls. Main outcome measures Hormone concentrations stratified by Tanner stage. Results Compared to normal weight girls, mean free testosterone (T) was elevated 2- to 9-fold across puberty in obese girls, while fasting insulin was 3-fold elevated in obese Tanner 1–3 girls (P < 0.05). Mean LH was lower in obese Tanner 1 and 2 girls (P < 0.05), but not in more mature girls. In a subgroup of normal weight Tanner 1–3 girls (n = 17), mean progesterone (P) and T increased overnight 2.3- and 2.4-fold, respectively (P ≤ 0.001). In obese Tanner 1–3 girls (n = 6), evening P and T were elevated, and both tended to increase overnight (mean 1.4- and 1.6-fold, respectively [P = 0.06]). Conclusions Peripubertal obesity is associated with hyperandrogenemia and hyperinsulinemia throughout puberty, being especially marked shortly before and during early puberty. Progesterone and testosterone concentrations in normal weight Tanner 1–3 girls increase overnight, with similar but less evident changes in obese girls. PMID:17118995

The primary health care service experiences and needs of homeless youth: a narrative synthesis of current evidence.

PubMed

Dawson, Angela; Jackson, Debra

2013-04-01

Homeless youth are a growing, vulnerable population with specific primary health care (PHC) requirements. There are no systematic reviews of evidence to guide the delivery of PHC interventions to best address the needs of homeless youth in Australia. We present a narrative synthesis of peer reviewed research designed to determine: (1) the PHC services homeless youth access; (2) experiences of services, reported outcomes and barriers to use; and, (3) the PHC service needs of homeless youth. Findings show that homeless youth access a variety of services and delivery approaches. Increased PHC use is associated with youth who recognise they need help. Street-based clinic linked services and therapy and case management alongside improved housing can positively impact upon mental health and substance use outcomes. Barriers to service use include knowledge; provider attitudes, financial constraints and inappropriate environments. Findings support targetted, co-ordinated networks of PHC and housing services with nurses working alongside community workers.

Joint influence of individual choices, parenting practices, and physician advice on adolescent obesity, Nebraska, 2008.

PubMed

Wang, Hongmei; Kim, Jungyoon; Su, Dejun; Xu, Liyan; Chen, Li-Wu; Huang, Terry T-K

2014-10-09

Reducing childhood obesity remains a public health priority given its high prevalence and its association with increased risk of adult obesity and chronic diseases. The objective of this study was to examine the joint influence of multiple risk factors on adolescent overweight status. We conducted a random-digit-dialed telephone survey of adolescents aged 12 to 19 years in fall 2008 in a Midwestern city in Nebraska. On the basis of survey data for 791 youths aged 12 to 18 years, we conducted latent class analysis to group youths by the joint occurrence of dietary behavior, physical activity, parenting practices, and physician advice. We then examined the association between the groups and overweight status by using logistic regression, controlling for age, sex, race/ethnicity, and parent and family information. Youths were clustered into 3 groups. Group I (52%) were youths with healthy dietary behavior and physical activity, less permissive parenting practices, and physician advice; Group II (30%) were youths with moderately healthy dietary behavior and physical activity, less permissive parenting practices, and no physician advice; and Group III (18%) were youths with unhealthy dietary behavior and physical activity, permissive parenting practices, and physician advice. Youths in Groups I and II were less likely to be overweight than youths in Group III. Youths with healthier behavior and less permissive parenting practices were less likely to be overweight. Study findings highlight the need to address obesity risk factors among youths with unhealthy dietary behavior, inadequate exercise, permissive parenting practices, and some physician advice. Tailored interventions should be used to target youths with different obesity risk factors.

Overweight and obesity in children and adolescents with Down syndrome-prevalence, determinants, consequences, and interventions: A literature review.

PubMed

Bertapelli, Fabio; Pitetti, Ken; Agiovlasitis, Stamatis; Guerra-Junior, Gil

2016-10-01

Children with Down syndrome (DS) are more likely to be overweight or obese than the general population of youth without DS. To review the prevalence of overweight and obesity and their determinants in youth with DS. The health consequences and the effectiveness of interventions were also examined. A search using MEDLINE, Embase, Web of Science, Scopus, CINAHL, PsycINFO, SPORTDiscus, LILACS, and COCHRANE was conducted. From a total of 4280 studies, we included 45 original research articles published between 1988 and 2015. The combined prevalence of overweight and obesity varied between studies from 23% to 70%. Youth with DS had higher rates of overweight and obesity than youths without DS. Likely determinants of obesity included increased leptin, decreased resting energy expenditure, comorbidities, unfavorable diet, and low physical activity levels. Obesity was positively associated with obstructive sleep apnea, dyslipidemia, hyperinsulinemia, and gait disorder. Interventions for obesity prevention and control were primarily based on exercise-based programs, and were insufficient to achieve weight or fat loss. Population-based research is needed to identify risk factors and support multi-factorial strategies for reducing overweight and obesity in children and adolescents with DS. Copyright © 2016 Elsevier Ltd. All rights reserved.

Understanding Pasifika youth and the obesogenic environment, Auckland and Wellington, New Zealand.

PubMed

Tupai-Firestone, Ridvan; Tuisano, Hana; Manukia, Moana; Kaholokula, Keawe'aimoku; Foliaki, Sunia; Kingi, Te Kani; Kruger, Rozanne; Breier, Bernhard; O'Connell, Angelique; Kruger, Rozanne; Borman, Barry; Ellison-Loschmann, Lis

2016-05-06

In New Zealand, the burden of obesity is greatest among Pacific people, especially in children and adolescents. We investigated the factors of the obesogenic environment that were indigenous to Pasifika youths' social-cultural context, their food purchasing behaviours, and associated anthropometric measures. An exploratory study of 30 Pasifika youth aged 16-24 years in Wellington and Auckland, New Zealand. A large proportion of the participants were obese (mean body mass index: 31.0kg/m2; waistto-hip ratio: 0.84; waist-to-height ratio: 0.6), suggesting that the future health and wellbeing trajectory of the studied Pasifika youth is poor. Purchasing behaviours of food and snacks over a 7-day period provided meaningful insights that could be a useful future research tool to examine the role of their physical environment on food access and availability. From this exploratory study, we highlight the following: (i) the future health trajectory of Pasifika youth is poor. Developing the youths' healthy lifestyle knowledge may lend itself to developing culturally relevant intervention programmes; (ii) identifying the enablers and barriers within the Pasifika ontext of an obesogenic environment can provide very useful information; (iii) use of spatial analysis using purchased food receipts adds to the current knowledge base of obesity-related research, although this was an exploratory investigation. We need to address these highlights if we are to reverse the trend of obesity for this population.

Food Prices and Obesity: Evidence and Policy Implications for Taxes and Subsidies

PubMed Central

Powell, Lisa M; Chaloupka, Frank J

2009-01-01

Context: Pricing policies have been posited as potential policy instruments to address the increasing prevalence of obesity. This article examines whether altering the cost of unhealthy, energy-dense foods, compared with healthy, less-dense foods through the use of fiscal pricing (tax or subsidy) policy instruments would, in fact, change food consumption patterns and overall diet enough to significantly reduce individuals' weight outcomes. Methods: This article examined empirical evidence regarding the food and restaurant price sensitivity of weight outcomes based on a literature search to identify peer-reviewed English-language articles published between 1990 and 2008. Studies were identified from the Medline, PubMed, Econlit, and PAIS databases. The fifteen search combinations used the terms obesity, body mass index, and BMI each in combination with the terms price, prices, tax, taxation, and subsidy. Findings: The studies reviewed showed that when statistically significant associations were found between food and restaurant prices (taxes) and weight outcomes, the effects were generally small in magnitude, although in some cases they were larger for low–socioeconomic status (SES) populations and for those at risk for overweight or obesity. Conclusions: The limited existing evidence suggests that small taxes or subsidies are not likely to produce significant changes in BMI or obesity prevalence but that nontrivial pricing interventions may have some measurable effects on Americans' weight outcomes, particularly for children and adolescents, low-SES populations, and those most at risk for overweight. Additional research is needed to be able to draw strong policy conclusions regarding the effectiveness of fiscal-pricing interventions aimed at reducing obesity. PMID:19298422

Food prices and obesity: evidence and policy implications for taxes and subsidies.

PubMed

Powell, Lisa M; Chaloupka, Frank J

2009-03-01

Pricing policies have been posited as potential policy instruments to address the increasing prevalence of obesity. This article examines whether altering the cost of unhealthy, energy-dense foods, compared with healthy, less-dense foods through the use of fiscal pricing (tax or subsidy) policy instruments would, in fact, change food consumption patterns and overall diet enough to significantly reduce individuals' weight outcomes. This article examined empirical evidence regarding the food and restaurant price sensitivity of weight outcomes based on a literature search to identify peer-reviewed English-language articles published between 1990 and 2008. Studies were identified from the Medline, PubMed, Econlit, and PAIS databases. The fifteen search combinations used the terms obesity, body mass index, and BMI each in combination with the terms price, prices, tax, taxation, and subsidy. The studies reviewed showed that when statistically significant associations were found between food and restaurant prices (taxes) and weight outcomes, the effects were generally small in magnitude, although in some cases they were larger for low-socioeconomic status (SES) populations and for those at risk for overweight or obesity. The limited existing evidence suggests that small taxes or subsidies are not likely to produce significant changes in BMI or obesity prevalence but that nontrivial pricing interventions may have some measurable effects on Americans' weight outcomes, particularly for children and adolescents, low-SES populations, and those most at risk for overweight. Additional research is needed to be able to draw strong policy conclusions regarding the effectiveness of fiscal-pricing interventions aimed at reducing obesity.

Remote Lifestyle Counseling Influences Cardiovascular Health Outcomes in Youth with Overweight or Obesity and Congenital Heart Disease.

PubMed

Altamirano-Diaz, Luis; Rombeek, Meghan; De Jesus, Stefanie; Welisch, Eva; Prapavessis, Harry; Dempsey, Adam A; Fraser, Douglas; Miller, Michael R; Norozi, Kambiz

2017-01-01

Children with overweight/obesity and congenital heart disease (CHD) are at increased cardiovascular risk. A lifestyle intervention may help reduce these risks. We sought to determine the feasibility of a smartphone-based lifestyle intervention to improve cardiovascular health outcomes in children with overweight/obesity and CHD. We examined the effect of bi-weekly nutrition and fitness counseling delivered via smartphone over 12 months. Thirty-four youth, previously diagnosed with CHD and with overweight or obesity, participated in the intervention. They were divided into two groups depending on whether the heart disease required surgical correction (operated, n  = 19) or not (non-operated, n  = 15). Anthropometry, body composition cardiorespiratory exercise capacity, and cardio-metabolic risk factors were assessed at baseline, 6 months, and 12 months. Statistically significant decreases in waist circumference (WC), body mass index z -score, WC z -score, and waist to height ratio z -score were observed at 6 and 12 months in the operated group. A significant linear increase in lean body mass was observed in both groups. The study also had a high retention rate and a low attrition rate. The observed changes in anthropometry were positive with significant improvement to some cardiovascular and metabolic risk indicators. However, this was only observed in the operated group suggesting that other factors, such as perception of condition and self-efficacy, may influence lifestyle behaviors. The results from this pilot study clearly demonstrate the feasibility to perform a larger controlled study on remote lifestyle intervention in children with congenital heart defects and overweight or obesity.

Engaging Adolescents Through Participatory and Qualitative Research Methods to Develop a Digital Communication Intervention to Reduce Adolescent Obesity.

PubMed

Livingood, William C; Monticalvo, David; Bernhardt, Jay M; Wells, Kelli T; Harris, Todd; Kee, Kadra; Hayes, Johnathan; George, Donald; Woodhouse, Lynn D

2017-08-01

The complexity of the childhood obesity epidemic requires the application of community-based participatory research (CBPR) in a manner that can transcend multiple communities of stakeholders, including youth, the broader community, and the community of health care providers. To (a) describe participatory processes for engaging youth within context of CBPR and broader community, (b) share youth-engaged research findings related to the use of digital communication and implications for adolescent obesity intervention research, and (c) describe and discuss lessons learned from participatory approaches. CBPR principles and qualitative methods were synergistically applied in a predominantly African American part of the city that experiences major obesity-related issues. A Youth Research Advisory Board was developed to deeply engage youth in research that was integrated with other community-based efforts, including an academic-community partnership, a city-wide obesity coalition, and a primary care practice research network. Volunteers from the youth board were trained to apply qualitative methods, including facilitating focus group interviews and analyzing and interpreting data with the goal of informing a primary care provider-based obesity reduction intervention. The primary results of these efforts were the development of critical insights about adolescent use of digital communication and the potential importance of messaging, mobile and computer apps, gaming, wearable technology, and rapid changes in youth communication and use of digital technology in developing adolescent nutrition and physical activity health promotion. The youth led work helped identify key elements for a digital communication intervention that was sensitive and responsive to urban youth. Many valuable lessons were also learned from 3 years of partnerships and collaborations, providing important insights on applying CBPR with minority youth populations.

Maternal Obesity and Developmental Programming of Metabolic Disorders in Offspring: Evidence from Animal Models

PubMed Central

Li, M.; Sloboda, D. M.; Vickers, M. H.

2011-01-01

The incidence of obesity and overweight has reached epidemic proportions in the developed world as well as in those countries transitioning to first world economies, and this represents a major global health problem. Concern is rising over the rapid increases in childhood obesity and metabolic disease that will translate into later adult obesity. Although an obesogenic nutritional environment and increasingly sedentary lifestyle contribute to our risk of developing obesity, a growing body of evidence links early life nutritional adversity to the development of long-term metabolic disorders. In particular, the increasing prevalence of maternal obesity and excess maternal weight gain has been associated with a heightened risk of obesity development in offspring in addition to an increased risk of pregnancy-related complications. The mechanisms that link maternal obesity to obesity in offspring and the level of gene-environment interactions are not well understood, but the early life environment may represent a critical window for which intervention strategies could be developed to curb the current obesity epidemic. This paper will discuss the various animal models of maternal overnutrition and their importance in our understanding of the mechanisms underlying altered obesity risk in offspring. PMID:21969822

Improving access and systems of care for evidence-based childhood obesity treatment: Conference key findings and next steps.

PubMed

Wilfley, Denise E; Staiano, Amanda E; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G; Dietz, William H; Cook, Stephen

2017-01-01

To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e., clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 h over 6 to 12 months to improve weight status) and to expand payment for these services. In July 2015, 43 cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multidisciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g., >25 h) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale up training to ensure quality of care. © 2016 The Obesity Society.

Relationships of Anxiety and Depression with Cardiovascular Health in Youth with Normal Weight to Severe Obesity.

PubMed

Gross, Amy C; Kaizer, Alexander M; Ryder, Justin R; Fox, Claudia K; Rudser, Kyle D; Dengel, Donald R; Kelly, Aaron S

2018-05-10

To evaluate the relationships of depression and anxiety symptoms with cardiovascular disease (CVD) risk factors and measures of vascular health in youth. Major depressive disorder and bipolar disorder are considered CVD risk factors in youth. Participants (n = 202) were 8- to 18-year-olds from a cross-sectional study evaluating cardiovascular health across a wide range of body mass index values (normal weight to severe obesity). CVD risk measurement included blood pressure, fasting lipids, glucose, insulin, carotid artery intima-media thickness, compliance and distensibility, brachial artery flow-mediated dilation, carotid-radial artery pulse wave velocity, body fat percentage, and a metabolic syndrome cluster score. Anxiety and depression symptoms were self-reported on the Screen for Child Anxiety Related Disorders and Center for Epidemiological Studies Depression Scale for Children. Two sets of adjustment variables were used in evaluation of differences between those with and without anxiety or depression symptomatology for the CVD risk factor and vascular outcomes. The first set included adjustment for Tanner stage, sex, and race; the second was additionally adjusted for percent body fat. Anxiety was not significantly associated with CVD risk factors or vascular health in either model. Depression was associated with high-density lipoprotein cholesterol, triglycerides, and metabolic syndrome cluster score; these relationships were attenuated when accounting for percent body fat. When accounting for body fat, we found no clear relationship of self-reported depression or anxiety symptoms with CVD risk factors or vascular health in youth. Copyright © 2018 Elsevier Inc. All rights reserved.

LA sprouts randomized controlled nutrition and gardening program reduces obesity and metabolic risk in Latino youth.

PubMed

Gatto, Nicole M; Martinez, Lauren C; Spruijt-Metz, Donna; Davis, Jaimie N

2015-06-01

To assess the effects of a 12-week gardening, nutrition, and cooking intervention ("LA Sprouts") on dietary intake, obesity parameters, and metabolic disease risk among low-income, primarily Hispanic/Latino youth in Los Angeles. The randomized controlled trial involved four elementary schools [two schools randomized to intervention (172 third-through fifth-grade students); two schools randomized to control (147 third-through fifth-grade students)]. Classes were taught in 90-minute sessions once a week to each grade level for 12 weeks. Data collected at pre- and postintervention included dietary intake via food frequency questionnaire (FFQ), anthropometric measures [BMI, waist circumference (WC)], body fat, and fasting blood samples. LA Sprouts participants had significantly greater reductions in BMI z-scores (0.1-vs. 0.04-point decrease, respectively; P = 0.01) and WC (-1.2 cm vs. no change; P < 0.001). Fewer LA Sprouts participants had the metabolic syndrome (MetSyn) after the intervention than before, while the number of controls with MetSyn increased. LA Sprouts participants had improvements in dietary fiber intake (+3.5% vs. -15.5%; P = 0.04) and less decreases in vegetable intake (-3.6% vs. -26.4%; P = 0.04). Change in fruit intake before and after the intervention did not significantly differ between LA Sprouts and control subjects. LA Sprouts was effective in reducing obesity and metabolic risk. © 2015 The Obesity Society.

Gendered dimensions of obesity in childhood and adolescence.

PubMed

Sweeting, Helen N

2008-01-14

The literature on childhood and adolescent obesity is vast. In addition to producing a general overview, this paper aims to highlight gender differences or similarities, an area which has tended not to be the principal focus of this literature. Databases were searched using the terms 'obesity' and 'child', 'adolescent', 'teenager', 'youth', 'young people', 'sex', 'gender', 'masculine', 'feminine', 'male', 'female', 'boy' and 'girl' (or variations on these terms). In order to limit the potential literature, the main focus is on other reviews, both general and relating to specific aspects of obesity. The findings of genetic studies are similar for males and females, and differences in obesity rates as defined by body mass index are generally small and inconsistent. However, differences between males and females due to biology are evident in the patterning of body fat, the fat levels at which health risks become apparent, levels of resting energy expenditure and energy requirements, ability to engage in certain physical activities and the consequences of obesity for the female reproductive system. Differences due to society or culture include food choices and dietary concerns, overall physical activity levels, body satisfaction and the long-term psychosocial consequences of childhood and adolescent obesity. This review suggests differences between males and females in exposure and vulnerability to obesogenic environments, the consequences of child and adolescent obesity, and responses to interventions for the condition. A clearer focus on gender differences is required among both researchers and policy makers within this field.

The Association Between Measures of Fitness and Metabolic Health in Treatment-Seeking Youth with Obesity.

PubMed

Guseman, Emily Hill; Cauffman, Samuel P; Tucker, Jared M; Smith, Lucie; Eisenmann, Joey C; Stratbucker, William

2017-04-01

Both cardiorespiratory fitness (CRF) and measures of muscular fitness are associated with metabolic syndrome in adults. However, limited information exists about these relationships in youth with severe obesity who are at increased risk of metabolic dysfunction. The purpose of this study was to examine the relationship between fitness and metabolic health in treatment-seeking youth with obesity. Data for this analysis were collected at the time of baseline visits at a stage 3 pediatric weight management center. Maximal voluntary contractions were obtained by using isometric hand-grip dynamometry, and CRF was obtained from a maximal treadmill test. Resting blood pressure and fasting measures of blood lipids, glucose, and insulin were used to calculate a continuous metabolic syndrome score (cMetS); homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from fasting insulin and glucose. Relationships between measures of fitness and metabolic health were evaluated by using partial correlations adjusted for age. Sixty-nine participants (21 boys, 48 girls) were included in this analysis. Of these, 46% (n = 32) met the criteria for metabolic syndrome. No differences were found between boys and girls for any variable analyzed. Muscular strength was positively associated with cMetS (r = 0.35), though this association weakened after adjustment for body mass index percentile. CRF was inversely associated with homeostasis model assessment of insulin resistance (HOMA-IR) (r = -0.26) and fasting insulin (r = -0.27). Body fat percentage was positively associated with insulin (r = 0.36). No significant relationship was found between CRF and cMetS. Contrary to previous studies, CRF was not associated with metabolic syndrome in this group. Muscular strength, however, was associated with cMetS. Notably, CRF was associated with elevated HOMA-IR, which may be seen as a precursor to metabolic syndrome. These results suggest that CRF and muscular

Choose Health: Food, Fun, and Fitness Youth Curriculum Promotes Positive Behaviors.

PubMed

Wolfe, Wendy S; Scott-Pierce, Michelle; Dollahite, Jamie

2017-11-20

Evaluate whether participation in Choose Health: Food, Fun, and Fitness (CHFFF), a hands-on, experiential curriculum aimed at third- to sixth-graders, resulted in improvements in the targeted obesity and chronic disease prevention behaviors. The researchers evaluated CHFFF in low-income youth participating in 2 federal programs in New York State during 2013-2015. Food and activity behaviors were assessed using the Expanded Food and Nutrition Education Program third- through fifth- and sixth- through eighth-grade pre-post surveys, along with 2 sets of added CHFFF-specific items completed by subsamples. Educators trained in CHFFF had youth complete the surveys as they delivered the curriculum, primarily in schools and after-school programs. Paired t tests showed significant (P < .01) positive changes before to after CHFFF education for consumption of vegetables, fruits, sweetened drinks, nutrition label reading, and other food and activity behaviors. Results provide practice-based evidence that CHFFF promotes positive behavior change in participating youth. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Stigma, Obesity, and the Health of the Nation's Children

ERIC Educational Resources Information Center

Puhl, Rebecca M.; Latner, Janet D.

2007-01-01

Preventing childhood obesity has become a top priority in efforts to improve our nation's public health. Although much research is needed to address this health crisis, it is important to approach childhood obesity with an understanding of the social stigma that obese youths face, which is pervasive and can have serious consequences for emotional…

Violent and Nonviolent Youth Offenders: Preliminary Evidence on Group Subtypes.

PubMed

Lai, Violet; Zeng, Gerald; Chu, Chi Meng

2016-07-01

Youth violence is a costly social problem. This study compared the risk and needs of nonviolent youth offenders, with those who had committed violent offenses only (violent only) and those who had committed violent and nonviolent offenses (violent plus) to determine whether violent youth were a different "type" from nonviolent youth. The case files of 3,744 youth offenders (3,327 males and 417 females, between 12 and 18 years old) were retrospectively coded, before official recidivism records were obtained. Multivariate analysis of variance (MANOVA), χ 2 , and Cox regressions were conducted. Violent-plus youth were younger; higher in their total risk and all criminogenic needs; more likely to have several noncriminogenic needs; and at higher risk of any reoffending, violent reoffending, and nonviolent reoffending than nonviolent youth. Violent-only youth had the same total risk and risk of general and violent recidivism as nonviolent offenders but presented different criminogenic and noncriminogenic needs and risk of nonviolent recidivism. Compared to violent-only youth, violent-plus youth were younger, had higher total risk and criminogenic needs on five domains, were more likely to have several noncriminogenic needs, and were at higher risk of all types of reoffending (except sexual reoffending), suggesting subtypes of violent youth offenders. The implication is that nonviolent and violent youth offenders require different dosage and types of intervention.

Growing Youth Food Citizens

ERIC Educational Resources Information Center

Wright, Wynne; Nault, Katherine

2013-01-01

How can youth be educated and empowered to become responsible food citizens? Evidence from a university-community partnership with youth in Michigan is presented to illuminate participatory approaches to youth engagement in food systems. We found that youth have valuable knowledge to enhance our understanding of food environments. At the same…

Meeting the needs of a community: teaching evidence-based youth violence prevention initiatives to members of strategic communities.

PubMed

Ruffolo, Daria C; Andresen, Pamela A; Winn, Keith L

2013-01-01

Youth violence is among the most serious health threats in the nation today. Violence disproportionately affects young people and people of color. Although the national rates of violent injury and homicide have shown a decline in most regions of the United States over the past 15 years, the rates of violence and related injuries among youth remain unacceptably high. The prevention of youth violence has been a priority of health departments nationwide, including the Cook County Department of Public Health. The goal of this project was to provide key community leaders, social service workers, and nurses within suburban Cook County with educational sessions on Blueprints for Violence Prevention, an initiative to promote evidence-based youth violence prevention programs.

Weight status of indigenous youth in Oaxaca, southern Mexico: concordance of IOTF and WHO criteria.

PubMed

Malina, Robert M; Peйa Reyes, Maria Eugenia; Chávez, Guillermo Bali; Little, Bertis B

2013-01-01

To compare the prevalence of thinness, overweight and obesity with IOTF and WHO criteria among indigenous school youth from the state of Oaxaca, southern Mexico. The sample included 11 454 indigenous youth (6216 boys, 5238 girls) 6-14 years of age. Heights and weights were measured in 2007 by trained staff. BMIs were calculated and classified as severely thin, moderately thin, normal, overweight or obese using age- and sex-specific IOTF and WHO cut-offs. Prevalence, percentage agreement between classifications, Spearman rank order correlations and Kappa coefficients were calculated. Prevalence of overweight and obesity was higher with WHO than IOTF criteria, while prevalence of severe and moderate thinness did not appreciably differ between criteria. Weight status with the two criteria was discordant in 839 boys (13.5%) and 383 girls (7.3%) and more often for overweight and obesity than thinness. Percentage agreement, correlations and Kappa coefficients were moderate-to-high and were higher in girls than boys. Prevalence of overweight and obesity among indigenous youth in Oaxaca was higher with WHO than IOTF criteria, whereas prevalence of severe and moderate thinness was similar. Differences in estimates for overweight and obesity have implications for surveillance.

Obesity and health expenditures: evidence from Australia.

PubMed

Buchmueller, Thomas C; Johar, Meliyanni

2015-04-01

Rising rates of obesity are a public health concern in every industrialized country. This study investigates the relationship between obesity and health care expenditure in Australia, where the rate of obesity has tripled in the last three decades. Now one in four Australians is considered obese, defined as having a body mass index (BMI, kg/m(2)) of 30 or over. The analysis is based on a random sample survey of over 240,000 adults aged 45 and over that is linked at the individual-level to comprehensive administrative health care claims for the period 2006-2009. This sub-population group has an obesity rate that is nearly 30% and is a major consumer of health services. Relative to the average annual health expenditures of those with normal weight, we find that the health expenditures of those with a BMI between 30 and 35 (obese type I) are 19% higher and expenditures of those with BMI greater than 35 (obese type II/III) are 51% higher. We find large and significant differences in all types of care: inpatient, emergency department, outpatient and prescription drugs. The obesity-related health expenditures are higher for obese type I women than men, but in the obese type II/III state, obesity-related expenditures are higher for men. When we stratify further by age groups, we find that obesity has the largest impact among men over age 75 and women aged 60-74 years old. In addition, we find that obesity impacts health expenditures not only through its link to chronic diseases, but also because it increases the cost of recovery from acute health shocks. Copyright © 2015 Elsevier B.V. All rights reserved.

Indicated prevention of adult obesity: reference data for weight normalization in overweight children

USDA-ARS?s Scientific Manuscript database

Background: Pediatric obesity is a major risk factor for adult obesity. Indicated prevention--that is, helping overweight or obese youth attain non-overweight status--has been suggested to prevent adult obesity. This study aimed to support the notion of indicated prevention by demonstrating that rel...

Do Evidence-Based Youth Psychotherapies Outperform Usual Clinical Care? A Multilevel Meta-Analysis

PubMed Central

Weisz, John R.; Kuppens, Sofie; Eckshtain, Dikla; Ugueto, Ana M.; Hawley, Kristin M.; Jensen-Doss, Amanda

2013-01-01

Context Research across four decades has produced numerous empirically-tested evidence-based psychotherapies (EBPs) for youth psychopathology, developed to improve upon usual clinical interventions. Advocates argue that these should replace usual care; but do the EBPs produce better outcomes than usual care? Objective This question was addressed in a meta-analysis of 52 randomized trials directly comparing EBPs to usual care. Analyses assessed the overall effect of EBPs vs. usual care, and candidate moderators; multilevel analysis was used to address the dependency among effect sizes that is common but typically unaddressed in psychotherapy syntheses. Data Sources The PubMed, PsychINFO, and Dissertation Abstracts International databases were searched for studies from January 1, 1960 – December 31, 2010. Study Selection 507 randomized youth psychotherapy trials were identified. Of these, the 52 studies that compared EBPs to usual care were included in the meta-analysis. Data Extraction Sixteen variables (participant, treatment, and study characteristics) were extracted from each study, and effect sizes were calculated for all EBP versus usual care comparisons. Data Synthesis EBPs outperformed usual care. Mean effect size was 0.29; the probability was 58% that a randomly selected youth receiving an EBP would be better off after treatment than a randomly selected youth receiving usual care. Three variables moderated treatment benefit: Effect sizes decreased for studies conducted outside North America, for studies in which all participants were impaired enough to qualify for diagnoses, and for outcomes reported by people other than the youths and parents in therapy. For certain key groups (e.g., studies using clinically referred samples and diagnosed samples), significant EBP effects were not demonstrated. Conclusions EBPs outperformed usual care, but the EBP advantage was modest and moderated by youth, location, and assessment characteristics. There is room for

Evidence for Site-Specific, Systematic Adaptation of Substance Prevention Curriculum with High-Risk Youths in Community and Alternative School Settings

ERIC Educational Resources Information Center

Holleran Steiker, Lori K.; Hopson, Laura M.; Goldbach, Jeremy T.; Robinson, Charletta

2014-01-01

The problem of substance use among older youths is often disregarded in prevention research. The prevailing perception has been that prevention programming is developmentally inappropriate for those who are actively experimenting with substances. This project examines the differential effectiveness of youth-driven adaptations of the evidence-based…

The obesity epidemic in children and adults: current evidence and research issues.

PubMed

Flegal, K M

1999-11-01

The term "epidemic" of obesity implies that obesity is a characteristic of populations, not only of individuals. The purpose of this paper is to review evidence on obesity in populations and to identify future research issues. To examine recent increases in the population prevalence of overweight or obesity, a literature search was undertaken. Trends in overweight or obesity among adults showed considerable variability internationally. Some countries, including Canada, Finland (men), New Zealand, the United Kingdom, the United States, and Western Samoa showed large increases in prevalence (>5 percentage points), whereas several other countries showed smaller or no increases. Overweight is also increasing among children and adolescents, at least in some countries. It is not clear what the expected prevalence of overweight or obesity might be in the current environment, and these findings may be most usefully viewed as shifts in the distribution of a population characteristic. The reasons for these shifts are not clear. The health implications of these shifts are also not clear, in part because trends in cardiovascular risk factors do not always parallel trends in obesity. Of the classic epidemiologic triad of host, agent, and environment, the environment has often received the least attention. The economic, social, and cultural factors that influence the distribution of body mass index in a population are not well understood. Future research needs include continued monitoring of trends in obesity and in related health conditions and observational studies to examine the causes of these trends. Public health research should aim at defining realistic goals and strategies to improve health in an environment conducive to high levels of overweight and obesity.

The Infant Gut Microbiome: Evidence for Obesity Risk and Dietary Intervention

PubMed Central

Koleva, Petya T.; Bridgman, Sarah L.; Kozyrskyj, Anita L.

2015-01-01

Increasing globally, particularly in children, obesity is a serious public health issue and risk factor for overweight and metabolic disease in later life. Both in experimental animal and human studies, advances in gene sequencing technologies have yielded intriguing possibilities for the role of the gut microbiome in later development of overweight status. Before translating study findings into practice, we must first reconcile inconsistencies between animal experimentation, and human adult and infant studies. Recent evidence for associations with gut microbiota and infant weight gain or child weight status, implicate Bacteroides and Lactobacillus species. Dietary manipulation with human milk and pre/probiotic formulations holds promise for preventing obesity. PMID:25835047

Is there evidence for neurodegenerative change following traumatic brain injury in children and youth? A scoping review.

PubMed

Keightley, Michelle L; Sinopoli, Katia J; Davis, Karen D; Mikulis, David J; Wennberg, Richard; Tartaglia, Maria C; Chen, Jen-Kai; Tator, Charles H

2014-01-01

While generalized cerebral atrophy and neurodegenerative change following traumatic brain injury (TBI) is well recognized in adults, it remains comparatively understudied in the pediatric population, suggesting that research should address the potential for neurodegenerative change in children and youth following TBI. This focused review examines original research findings documenting evidence for neurodegenerative change following TBI of all severities in children and youth. Our relevant inclusion and exclusion criteria identified a total of 16 articles for review. Taken together, the studies reviewed suggest there is evidence for long-term neurodegenerative change following TBI in children and youth. In particular both cross-sectional and longitudinal studies revealed volume loss in selected brain regions including the hippocampus, amygdala, globus pallidus, thalamus, periventricular white matter, cerebellum, and brain stem as well as overall decreased whole brain volume and increased CSF and ventricular space. Diffusion Tensor Imaging (DTI) studies also report evidence for decreased cellular integrity, particularly in the corpus callosum. Sensitivity of the hippocampus and deep limbic structures in pediatric populations are similar to findings in the adult literature and we consider the data supporting these changes as well as the need to investigate the possibility of neurodegenerative onset in childhood associated with mild traumatic brain injury (mTBI).

Anaesthetic management of obese parturients: what is the evidence supporting practice guidelines?

PubMed

Eley, V A; van Zundert, A A J; Lipman, J; Callaway, L K

2016-09-01

Increasing rates of obesity in western populations present management difficulties for clinicians caring for obese pregnant women. Various governing bodies have published clinical guidelines for the care of obese parturients. These guidelines refer to two components of anaesthetic care: anaesthetic consultation in the antenatal period for women with a body mass index (BMI) ≥ 40 kg/m 2 and the provision of early epidural analgesia in labour. These recommendations are based on the increased incidence of obstetric complications and the predicted risks and difficulties in providing anaesthetic care. The concept behind early epidural analgesia is logical-site the epidural early, use it for surgical anaesthesia and avoid general anaesthesia if surgery is required. Experts support this recommendation, but there is weak supporting evidence. It is known that the management of labour epidurals in obese women is complicated and that women with extreme obesity require higher rates of general anaesthesia. Anecdotally, anaesthetists view and apply the early epidural recommendation inconsistently and the acceptability of early epidural analgesia to pregnant women is variable. In this topic review, we critically appraise these two practice recommendations. The elements required for effective implementation in multidisciplinary maternity care are considered. We identify gaps in the current literature and suggest areas for future research. While prospective cohort studies addressing epidural extension ('top-up') in obese parturients would help inform practice, audit of local practice may better answer the question "is early epidural analgesia beneficial to obese women in my practice?".

Exercise-based interventions and C-reactive protein in overweight and obese youths: a meta-analysis of randomized controlled trials.

PubMed

García-Hermoso, Antonio; Sánchez-López, Mairena; Escalante, Yolanda; Saavedra, Jose M; Martínez-Vizcaíno, Vicente

2016-04-01

One of the most commonly measured markers of inflammation in clinical settings is C-reactive protein (CRP). The purpose of this meta-analysis was to examine the evidence for the effectiveness of physical exercise interventions on modifying the levels of serum CRP in children and adolescents with excess of weight. Two independent reviewers assessed articles from seven databases. Studies were limited to physical exercise interventions in children and adolescents diagnosed as overweight or obese, and including a comparison control group. Weighted mean difference (WMD) was calculated using random-effects model and potential moderators were explored (i.e., weight status, ages, duration of study, frequency of exercise per week, and duration of session). The heterogeneity of the studies was estimated using Cochran's Q-statistic and I(2). Nine randomized controlled trials met the inclusion criteria (n = 427 youths). Overall, results suggest a nonsignificant trend toward a reduction CRP levels (WMD = -0.72 mg/l; 95% confidence interval: -1.52 to 0.08; P = 0.077). Also, there were not significant moderators of exercise effects on CRP. These results suggest that exercise programs in children and adolescents not mitigate the inflammatory effects of excess weight, although there was a trend toward reduction.

School and seasonality in youth suicide: evidence from Japan.

PubMed

Matsubayashi, Tetsuya; Ueda, Michiko; Yoshikawa, Kanako

2016-11-01

Seasonality in youth suicide has been speculated to be associated with the school calendar, as it tends to increase at the beginning of the academic year or after a long break, but robust empirical evidence remains scarce. We examined the nationwide death records in the Vital Statistics of Japan to investigate the seasonal patterns of suicide among youth. Our data set included 108 968 suicides by individuals who died at 6-26 years of age between 1974 and 2014 in Japan. The daily frequencies of death were plotted against the Japanese school calendar, which has little regional and temporal variations. We also estimated a Poisson regression model to uncover the cyclical patterns of suicide deaths. We found that the frequencies of suicide by middle school students (ages 12-15 years) and high school students (ages 15-18 years) sharply increased around the dates when a school session began in April and September. These tended to be low during school breaks. The results of regression analysis suggested middle school students were more than twice as likely to die by suicide when the summer break ended and the second semester began, compared with the baseline week in July. Similarly, the frequency of suicide for high school students also increased by ∼40% at the end of the summer break. Importantly, no such pattern was found for those aged 18-26 years. Our findings strongly indicate that the cyclical pattern of youth suicide is closely related to the school calendar. 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/.

Breast-feeding, Leptin:Adiponectin Ratio, and Metabolic Dysfunction in Adolescents with Obesity.

PubMed

Mihalopoulos, Nicole L; Urban, Brittney M; Metos, Julie M; Balch, Alfred H; Young, Paul C; Jordan, Kristine C

2017-05-01

Increased adiposity increases leptin and decreases adiponectin concentrations, resulting in an increased leptin:adiponectin ratio (LAR). In adults, components of the metabolic syndrome and other cardiometabolic risk factors, what we classify here as "metabolic dysfunction," are associated with both a high LAR and a history of being breast-fed. The relation among breast-feeding, LAR, and degree of metabolic dysfunction in obese youth is unknown. The purpose of our pilot study was to explore this relation and estimate the effect size of the relations to determine the sample size needed to power future prospective studies. We obtained fasting levels of leptin, adiponectin, lipids, insulin, and glucose from obese youth (aged 8-17 years). Weight, height, waist circumference, blood pressure, and breast-feeding history also were assessed. Of 96 participants, 78 were breast-fed as infants, 54% of whom were breast-fed for >6 months. Wide variation was observed in LARs among children who were and were not breast-fed (>100% coefficient of variation). Overall, prevalence of metabolic dysfunction in the cohort was 94% and was not proven to be associated with higher LAR. In this cohort of obese youth, we found a high prevalence of breast-feeding, metabolic dysfunction, and wide variation in the LARs. Based on the effect size estimated, future studies would need to enroll >1500 patients or identify, stratify, and selectively enroll obese patients without metabolic dysfunction to accurately determine whether breast-feeding in infancy influences LARs or metabolic dysfunction among obese youth.

A systematic review of the evidence regarding efficacy of obesity prevention interventions among adults.

PubMed

Lemmens, V E P P; Oenema, A; Klepp, K I; Henriksen, H B; Brug, J

2008-09-01

In the past, interventions aimed at reducing obesity have mainly targeted at weight loss treatment in obese adults, with limited long-term effects. With the increasing number of people being obese and being at risk for obesity, there has been a shift in focus towards prevention of obesity. We conducted a systematic review of the peer-reviewed literature on the efficacy of obesity prevention interventions in adults in order to identify effective interventions and intervention elements. Pubmed, OVID, and Web of Science databases were searched from January 1996 to June 2006. Interventions aimed at primary prevention of weight gain among adults achieved by focusing on dietary intake, physical activity or the combination of both were included. The outcome measure had to be difference in change in body mass index or body weight between the intervention and the control groups. Nine studies were included, five long-term studies (at least 1 year) and four short-term (3 months to 1 year). Seven studies evaluated an intervention that focused on a combination of diet and physical activity to prevent weight gain, one on diet only and one on physical activity only. One dietary intervention (long-term), and three combined dietary and physical activity interventions (one long-term and two short-term) produced significantly positive results at end of follow-up. The two long-term, effective interventions consisted of intensive and long-term intervention implementation, including groups sessions designed to promote behavioural changes. The current evidence of efficacy of obesity prevention interventions is based on a very small number of studies. Some studies showed a positive impact on body mass index or weight status, but there was too much heterogeneity in terms of study design, theoretical underpinning and target population to draw firm conclusions about which intervention approaches are more effective than others. More research is urgently needed to extend the body of evidence.

Physical Activity and Fitness of First Nations Youth in a Remote and Isolated Northern Ontario Community: A Needs Assessment.

PubMed

Gates, Michelle; Hanning, Rhona; Gates, Allison; Stephen, Judy; Fehst, Andrew; Tsuji, Leonard

2016-02-01

Among a group of First Nations youth, this research aimed to obtain objective measures of anthropometry, physical activity (PA) and fitness; to identify any group-level differences by sex, body mass index, waist circumference and body fat categories; to assess the barriers and supports to PA. Youth participated in anthropometric measures (BMI, waist circumference, body fat percentage), PA assessment (3 days of accelerometry) and fitness testing (guided by the Canadian Physical Activity, Fitness and Lifestyle Approach). Barriers and supports were assessed via environmental scan and focus groups. Descriptive statistics were compared to reference data. Group differences by sex, BMI status, waist circumference and body fat categories were tested using Mann-Whitney U and Chi square tests (p ≤ 0.05). Qualitative data were assembled into one file and coded manually for categories and themes. Seventy-two youth (12.1 ± 1.1 years, 61.1% male) participated in at least one measure; 36 completed the accelerometry. Sixty-three percent were overweight or obese, 51% were abdominally obese and 21% had excess body fat. Most (86.1%) met Canada's PA guidelines. Boys were more active than girls (p = 0.025) and had greater cardiorespiratory endurance (p = 0.003). Overweight, obese, or abdominally obese youth had lower cardiorespiratory endurance than normal weight youth (p < 0.001). Barriers and supports fell under the main themes: motivation, role models, personnel and facilities, environment and programs. Based on this assessment, youth in this community are active, but not sufficiently physically fit, especially among those affected by obesity and abdominal obesity. The findings, in addition to the numerous barriers to PA, support the community's desire for school-based PA programming.

Exercise-Based School Obesity Prevention Programs: An Overview

ERIC Educational Resources Information Center

Yetter, Georgette

2009-01-01

Overweight and obesity are major health concerns for young people. Schools are particularly promising environments for preventing and treating obesity. The Institutes of Medicine recommends 60 minutes per day of physical activity for children and youth, including at least 30 minutes at school. Yet the amount of moderate to vigorous physical…

An evidence-based resource for the management of comorbidities associated with childhood overweight and obesity.

PubMed

Thompson, Nicole; Mansfield, Bobbe; Stringer, Meredith; Stewart, Brandy; Potter, Jami; Fernengel, Karen

2016-10-01

Overweight and obesity in children and adolescents is often accompanied by obesity-related comorbidities. An integrative review of the literature was performed to create a comprehensive algorithm to help primary care providers manage the common comorbidities associated with childhood overweight and obesity. The Cumulative Index to Nursing and Allied Health Literature, ProQuest Nursing and Allied Health Source, and PubMed databases were searched. Evidence from 2002 to present was reviewed. Guidelines and algorithms from the American Academy of Pediatrics, National Association of Pediatric Nurse Practitioners, American Heart Association, American Diabetes Association, Centers for Disease Control and Prevention, National Heart, Lung, and Blood Institute, Agency for Healthcare and Research Quality, U.S. Department of Health and Human Services, and the International Diabetes Federation were also reviewed. Key information was extracted and data sources ranked according to the Polit and Beck evidence hierarchy. Highest level evidence guided the selection and development of recommendations to formulate a comprehensive resource for the recognition and management of pediatric hypertension, sleep apnea, vitamin D deficiency, nonalcoholic fatty liver disease, dyslipidemia, thyroid disease, diabetes mellitus, insulin resistance, metabolic syndrome, and polycystic ovarian syndrome. The Childhood Overweight and Obesity Comorbidities Resource provides a consistent, convenient point-of-care reference to help primary care providers improve pediatric health outcomes. ©2016 American Association of Nurse Practitioners.

Resolved: There is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases

PubMed Central

Hu, Frank B.

2017-01-01

Sugar-sweetened beverages (SSBs) are the single largest source of added sugar and the top source of energy intake in the US diet. In this review, we evaluate whether there is sufficient scientific evidence that decreasing SSB consumption will reduce the prevalence of obesity and its related diseases. Since prospective cohort studies address dietary determinants of long-term weight gain and chronic diseases, whereas randomized controlled trials (RCTs) typically evaluate short-term effects of specific interventions on weight change, both types of evidence are critical in evaluating causality. Findings from well-powered prospective cohorts have consistently shown a significant association, established temporality, and demonstrated a direct dose-response relationship between SSB consumption and long-term weight gain and risk of type 2 diabetes (T2D). A recently published meta-analysis of RCTs commissioned by the World Health Organization (WHO) found that decreased intake of added sugars significantly reduced body weight (0.80 kg, 95% CI 0.39 to 1.21; P<0.001), whereas increased sugar intake led to a comparable weight increase (0.75 kg, 0.30 to 1.19; P=0.001). A parallel meta-analysis of cohort studies also found that higher intake of SSBs among children was associated with 55% (95% CI 32%-82%) higher risk of being overweight or obese compared to those with lower intake. Another meta-analysis of eight prospective cohort studies found that 1–2 servings/day of SSB intake was associated with a 26% (95% CI 12–41%) greater risk of developing T2D compared to occasional intake (< 1 serving/month). Recently, two large RCTs with a high degree of compliance provided convincing data that reducing consumption of SSBs significantly decreases weight gain and adiposity in children and adolescents. Taken together, the evidence that decreasing SSBs will decrease the risk of obesity and related diseases such as T2D is compelling. Several additional issues warrant further discussion

Socioeconomic Status and the Health of Youth: A Multilevel, Multidomain Approach to Conceptualizing Pathways

ERIC Educational Resources Information Center

Schreier, Hannah M. C.; Chen, Edith

2013-01-01

Previous research has clearly established associations between low socioeconomic status (SES) and poor youth physical health outcomes. This article provides an overview of the main pathways through which low SES environments come to influence youth health. We focus on 2 prevalent chronic health problems in youth today, asthma and obesity. We…

Gendered dimensions of obesity in childhood and adolescence

PubMed Central

Sweeting, Helen N

2008-01-01

Background The literature on childhood and adolescent obesity is vast. In addition to producing a general overview, this paper aims to highlight gender differences or similarities, an area which has tended not to be the principal focus of this literature. Methods Databases were searched using the terms 'obesity' and 'child', 'adolescent', 'teenager', 'youth', 'young people', 'sex', 'gender', 'masculine', 'feminine', 'male', 'female', 'boy' and 'girl' (or variations on these terms). In order to limit the potential literature, the main focus is on other reviews, both general and relating to specific aspects of obesity. Results The findings of genetic studies are similar for males and females, and differences in obesity rates as defined by body mass index are generally small and inconsistent. However, differences between males and females due to biology are evident in the patterning of body fat, the fat levels at which health risks become apparent, levels of resting energy expenditure and energy requirements, ability to engage in certain physical activities and the consequences of obesity for the female reproductive system. Differences due to society or culture include food choices and dietary concerns, overall physical activity levels, body satisfaction and the long-term psychosocial consequences of childhood and adolescent obesity. Conclusion This review suggests differences between males and females in exposure and vulnerability to obesogenic environments, the consequences of child and adolescent obesity, and responses to interventions for the condition. A clearer focus on gender differences is required among both researchers and policy makers within this field. PMID:18194542

Prevalence of Weight Problems among Youth with High-Incidence Disabilities in Residential Care

ERIC Educational Resources Information Center

Trout, Alexandra L.; Lambert, Matthew C.; Nelson, Timothy D.; Thompson, Ronald W.

2014-01-01

The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of…

SaludABLEOmaha: improving readiness to address obesity through healthy lifestyle in a Midwestern Latino community, 2011-2013.

PubMed

Frerichs, Leah; Brittin, Jeri; Robbins, Regina; Steenson, Sharalyn; Stewart, Catherine; Fisher, Christopher; Huang, Terry T-K

2015-02-12

A community's readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities. This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles. SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning in schools (ie, curricula that integrate hands-on community service with instruction and reflection), and 3) community and business engagement. Following the Community Readiness Model protocol (http://triethniccenter.colostate.edu/communityReadiness.htm), structured interviews were conducted with community leaders and analyzed before and 2.5 years after launch of the program. The community increased in readiness from stage 3 of the Community Readiness Model, "vague awareness," at baseline to stage 5, "preparation," at follow-up. SaludABLEOmaha improved community readiness (eg, community knowledge, community climate), which probably contributed to the observed increase in readiness to address obesity through healthy lifestyle. Community mobilization approaches such as youth activism integrated with social marketing and social media tactics can improve community responsiveness to obesity prevention and diminish health disparities.

Let's Get Physical: Sexual Orientation Disparities in Physical Activity, Sports Involvement, and Obesity Among a Population-Based Sample of Adolescents.

PubMed

Mereish, Ethan H; Poteat, V Paul

2015-09-01

We examined sexual orientation disparities in physical activity, sports involvement, and obesity among a population-based adolescent sample. We analyzed data from the 2012 Dane County Youth Assessment for 13,933 students in grades 9 through 12 in 22 Wisconsin high schools. We conducted logistic regressions to examine sexual orientation disparities in physical activity, sports involvement, and body mass index among male and female adolescents. When we accounted for several covariates, compared with heterosexual females, sexual minority females were less likely to participate in team sports (adjusted odds ratio [AOR] = 0.44; 95% confidence interval [CI] = 0.37, 0.53) and more likely to be overweight (AOR = 1.28; 95% CI = 1.02, 1.62) or obese (AOR = 1.88; 95% CI = 1.43, 2.48). Sexual minority males were less likely than heterosexual males to be physically active (AOR = 0.62; 95% CI = 0.46, 0.83) or to participate in team sports (AOR = 0.26; 95% CI = 0.20, 0.32), but the 2 groups did not differ in their risk of obesity. Sexual orientation health disparities in physical activity and obesity are evident during adolescence. Culturally affirming research, interventions, and policies are needed for sexual minority youths.

School-based obesity prevention programs: an evidence-based review.

PubMed

Kropski, Jonathan A; Keckley, Paul H; Jensen, Gordon L

2008-05-01

This review seeks to examine the effectiveness of school-based programs for reducing childhood overweight or obesity. A systematic review of the research literature published since 1990 was conducted to identify experimental or quasi-experimental school-based curricular or environmental preventive interventions, with evaluation>or=6 months after baseline, which reported outcomes in terms of a measure of overweight. Fourteen studies were identified, including one involving a nutrition-only program, two physical activity promotion interventions and eleven studies combining nutrition and physical activity components. Most studies (n=10) offered weak (grade 2) quality evidence. One study offered strong (grade 4) evidence reducing the odds ratio for overweight in girls only, while four grade 2 studies reported significant improvements in BMI or at-risk-for overweight or overweight prevalence in boys, girls, or both. Twelve studies reported significant improvement in at least one measure of dietary intake, physical activity, and/or sedentary behavior. Our ability to draw strong conclusions as to the efficacy of school-based obesity prevention programs is limited by the small number of published studies and by methodological concerns. Qualitative analysis suggests programs grounded in social learning may be more appropriate for girls, while structural and environmental interventions enabling physical activity may be more effective for boys. High-quality evaluation protocols should be considered essential components of future programs.

Improving Access and Systems of Care for Evidence-Based Childhood Obesity Treatment: Conference Key Findings and Next Steps

PubMed Central

Wilfley, Denise E.; Staiano, Amanda E.; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G.; Dietz, William H.; Cook, Stephen

2017-01-01

Objectives To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e. clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 hours over 6–12 months to improve weight status) and to expand payment for these services. Methods In July 2015, forty-three cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Results Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multi-disciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g. >25 hours) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Conclusion Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale-up training to ensure quality of care. PMID:27925451

Evidence mapping: illustrating an emerging methodology to improve evidence-based practice in youth mental health.

PubMed

Hetrick, Sarah E; Parker, Alexandra G; Callahan, Patrick; Purcell, Rosemary

2010-12-01

Within the field of evidence-based practice, a process termed 'evidence mapping' is emerging as a less exhaustive yet systematic and replicable methodology that allows an understanding of the extent and distribution of evidence in a broad clinical area, highlighting both what is known and where gaps in evidence exist. This article describes the general principles of mapping methodology by using illustrations derived from our experience conducting an evidence map of interventions for youth mental-health disorders. Evidence maps are based on an explicit research question relating to the field of enquiry, which may vary in depth, but should be informed by end-users. The research question then drives the search for, and collection of, appropriate studies utilizing explicit and reproducible methods at each stage. This includes clear definition of components of the research question, development of a thorough and reproducible search strategy, development of explicit inclusion and exclusion criteria, and transparent decisions about the level of information to be obtained from each study. Evidence mapping is emerging as a rigorous methodology for gathering and disseminating up-to-date information to end-users. Thoughtful planning and assessment of available resources (e.g. staff, time, budget) are required by those applying this methodology to their particular field of clinical enquiry given the potential scope of the work. The needs of the end-user need to be balanced with available resources. Information derived needs to be effectively communicated, with the uptake of that evidence into clinical practice the ultimate aim. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Impact of simulated ostracism on overweight and normal-weight youths' motivation to eat and food intake.

PubMed

Salvy, Sarah-Jeanne; Bowker, Julie C; Nitecki, Lauren A; Kluczynski, Melissa A; Germeroth, Lisa J; Roemmich, James N

2011-02-01

There is growing evidence that the experience of being ostracized can impair individuals' abilities to self-regulate, which in turn, leads to negative health behaviors, such as increased unhealthy eating. Research has focused on adults, but deficits in eating regulation in response to ostracism may be particularly detrimental for overweight or obese youth. This study examines the effects of a brief episode of ostracism on the motivation to eat and food intake of overweight and normal-weight young adolescents (M age=13.6 years). A computerized ball-tossing game (Cyberball) was used to induce ostracism or inclusion. Following the inclusion/ostracism manipulation, all participants completed an operant computer task to earn points exchangeable for portions of food or for time socializing with an unfamiliar peer. Participants' responses for food and their subsequent energy intake were recorded. As hypothesized, ostracized overweight participants responded more for food and had a greater energy intake than overweight participants in the inclusion/control condition; whereas this was not the case for normal-weight participants. These results are important as studies indicate that overweight and obese youth may be at risk of social isolation and peer difficulties. Social adversity, if left unchanged, may increase the difficulty of promoting long-term changes in overweight youths' health behaviors. Copyright © 2010 Elsevier Ltd. All rights reserved.

Three Cs of Translating Evidence-Based Programs for Youth and Families to Practice Settings

ERIC Educational Resources Information Center

Freire, Kimberley E.; Perkinson, Leah; Morrel-Samuels, Susan; Zimmerman, Marc A.

2015-01-01

Despite the growing number of evidence-based programs (EBPs) for youth and families, few are well-integrated in service systems or widely adopted by communities. One set of challenges to widespread adoption of EBPs relates to the transfer of programs from research and development to practice settings. This is often because program developers have…

Collaborating with community-based services to promote evidence-based practice: Process description of a national initiative to improve services for youth with mental health and substance use problems.

PubMed

Henderson, Joanna L; Chaim, Gloria; Brownlie, E B

2017-08-01

Many youth with significant mental health (MH) and/or substance use (SU) difficulties do not receive specialized services. Collaboration between service providers, researchers, and other stakeholders is essential to improve youth service system capacity to provide evidence-based services to meet the complex array of needs of youth. Facilitators and barriers of implementing evidence-based practice have been identified, but few studies provide examples of the processes of collaboration and implementation for youth MH services. This study explicates the design features and implementation processes of a project to improve screening activities in youth services. These processes supported the building of 16 collaborative networks of service providers from diverse youth-serving sectors (e.g., MH, youth justice, child welfare) in urban, rural, suburban, and remote Canadian communities. These cross-sectoral networks implemented an evidence-based practice (screening youth aged 12-24 years for MH and SU problems using the Global Assessment of Individual Needs-Short Screener [GAIN-SS]) across their services. Materials and resources were provided by a centralized research team. Core project components were standardized and adherence to these components was monitored. Over 800 service providers participated in cross-sectoral networks, capacity-building events, joint data analysis, or interpretation and recommendation sessions. Across the 89 participating agencies, service providers for 84% of participating youth implemented the evidence-based practice accurately in accordance with project protocols, with 98% of positive screens reviewed and addressed according to organizational protocols. Service provider feedback is reported. Facilitators, barriers, and implications of promoting implementation of evidence-based practices across sites and sectors are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

LA sprouts randomized controlled nutrition, cooking and gardening programme reduces obesity and metabolic risk in Hispanic/Latino youth.

PubMed

Gatto, N M; Martinez, L C; Spruijt-Metz, D; Davis, J N

2017-02-01

Many programmes for children that involve gardening and nutrition components exist; however, none include experimental designs allowing more rigorous evaluation of their impact on obesity. The objective of this study is to explore the effects of a novel 12-week gardening, nutrition and cooking intervention {'LA Sprouts'} on dietary intake, obesity parameters and metabolic disease risk among low-income, primarily Hispanic/Latino youth in Los Angeles.. This study used a randomized control trial involving four elementary schools [two randomized to intervention {172, 3rd-5th grade students}; two randomized to control {147, 3rd-5th grade students}]. Classes were taught in 90-min sessions once per week for 12 weeks. Data collected at pre-intervention and post-intervention included dietary intake via food frequency questionnaire, anthropometric measures {body mass index, waist circumference}, body fat, and fasting blood samples. LA Sprouts participants compared with controls had significantly greater reductions in body mass index z-scores {-0.1 vs. -0.04, respectively; p = 0.01} and waist circumference {-1.2 vs. 0.1 cm; p < 0.001}. Fewer LA Sprouts participants had the metabolic syndrome after the intervention than before, while controls with metabolic syndrome increased. LA Sprouts participants compared with controls increased dietary fiber intake {+3.4% vs. -16.5%; p = 0.04}. All participants decreased vegetable intake, but decreases were less in LA Sprouts than controls {-3.7% vs. -26.1%; p = 0.04}. Change in fruit intake did not differ between LA Sprouts and controls. LA Sprouts was effective in reducing obesity and metabolic risk; however, additional larger and longer-term studies are warranted. © 2016 World Obesity Federation.

Lowering Risk for Type 2 Diabetes in High-Risk Youth

ERIC Educational Resources Information Center

Bobo, Nichole; Schantz, Shirley; Kaufman, Francine R.; Kollipara, Sobha

2009-01-01

Among children and youth who develop type 2 diabetes (T2DM) there are a number of genetic and environmental factors that lead to a combination of insulin resistance and relative-cell secretory failure of the pancreas. These factors include ethnicity (highest in American Indian youth), obesity, sedentary behavior, family history of T2DM, puberty,…

Samoan Body and Soul: Adapting an Evidence-Based Obesity and Cancer Prevention Program

PubMed Central

Cassel, Kevin D.; Braun, Kathryn; Ka’opua, Lana; Soa, Fuamaila; Nigg, Claudio

2015-01-01

Obesity-associated chronic diseases persist in Samoan populations in the United States. Samoans and African Americans share cultural similarities such as church affiliation, perceptions of weight and body size, and obesity-related health risks. Adapting an effective energy balance intervention originally designed for African Americans—Body and Soul— might be useful in reducing obesity among U.S. Samoans. To determine potential attractiveness and adaptations, we used aspects of grounded theory to analyze key-informant and focus group interviews with 31 purposively selected Samoans in Hawaii. We incorporated participatory features into the research with Samoan community members conducting parts of the study. From interview narratives, we identified relevant themes from Samoan culture, such as fa’aSamoa or the Samoan way, and specific energy balance activities to include in an obesity and cancer prevention intervention for U.S.-dwelling Samoans. Our findings describe methods to address health disparities by incorporating culturally appropriate health concepts into existing evidence-based interventions. PMID:25212854

Samoan body and soul: adapting an evidence-based obesity and cancer prevention program.

PubMed

Cassel, Kevin D; Braun, Kathryn; Ka'opua, Lana; Soa, Fuamaila; Nigg, Claudio

2014-12-01

Obesity-associated chronic diseases persist in Samoan populations in the United States. Samoans and African Americans share cultural similarities such as church affiliation, perceptions of weight and body size, and obesity-related health risks. Adapting an effective energy balance intervention originally designed for African Americans--Body and Soul--might be useful in reducing obesity among U.S. Samoans. To determine potential attractiveness and adaptations, we used aspects of grounded theory to analyze key-informant and focus group interviews with 31 purposively selected Samoans in Hawaii. We incorporated participatory features into the research with Samoan community members conducting parts of the study. From interview narratives, we identified relevant themes from Samoan culture, such as "fa'aSamoa", or the Samoan way, and specific energy balance activities to include in an obesity and cancer prevention intervention for U.S.-dwelling Samoans. Our findings describe methods to address health disparities by incorporating culturally appropriate health concepts into existing evidence-based interventions. © The Author(s) 2014.

Addressing the policy cacophony does not require more evidence: an argument for reframing obesity as caloric overconsumption.

PubMed

Shelley, Jacob J

2012-11-30

Numerous policies have been proposed to address the public health problem of obesity, resulting in a policy cacophony. The noise of so many policy options renders it difficult for policymakers to determine which policies warrant implementation. This has resulted in calls for more and better evidence to support obesity policy. However, it is not clear that evidence is the solution. This paper argues that to address the policy cacophony it is necessary to rethink the problem of obesity, and more specifically, how the problem of obesity is framed. This paper argues that the frame "obesity" be replaced by the frame "caloric overconsumption", concluding that the frame caloric overconsumption can overcome the obesity policy cacophony. Frames are important because they influence public policy. Understood as packages that define issues, frames influence how best to approach a problem. Consequently, debates over public policy are considered battles over framing, with small shifts in how an issue is framed resulting in significant changes to the policy environment. This paper presents a rationale for reframing the problem of obesity as caloric overconsumption. The frame "obesity" contributes to the policy cacophony by including policies aimed at both energy output and energy input. However, research increasingly demonstrates that energy input is the primary cause of obesity, and that increases in energy input are largely attributable to the food environment. By focusing on policies that aim to prevent increases in energy input, the frame caloric overconsumption will reduce the noise of the obesity policy cacophony. While the proposed frame will face some challenges, particularly industry opposition, policies aimed at preventing caloric overconsumption have a clearer focus, and can be more politically palatable if caloric overconsumption is seen as an involuntary risk resulting from the food environment. The paper concludes that policymakers will be able to make better sense

Trends in the prevalence of extreme obesity among Korean children and adolescents from 2001 to 2014.

PubMed

Nam, Hyo-Kyoung; Kim, Hye Ryun; Rhie, Young-Jun; Lee, Kee-Hyoung

2017-05-01

We assessed nationwide trends in extreme obesity prevalence and its impact on metabolic syndrome in Korean youth. Data from 19,593 youth (10,271 boys) aged 2-19 were obtained from the Korean National Health and Nutrition Examination Surveys (2001-2014). The prevalence of extreme obesity and the odds ratio of metabolic syndrome were calculated. Questionnaires on body weight perceptions and weight control behaviors were administered. The prevalence of extreme obesity increased significantly among boys (p<0.05). The odds ratios of extreme obesity on metabolic syndrome compared with obesity were 3.781 and 1.979 in boys and girls, respectively. Obese teenage girls with appropriate weight perception attempted to lose weight more frequently than obese teenage boys did. Although the prevalence of childhood obesity in Korea was similar since early 2000s, extreme obesity prevalence has increased, especially among teenage boys. Considering greater morbidity risks, preventing progression to extreme obesity is crucial.

Breast-feeding, Leptin:Adiponectin Ratio, and Metabolic Dysfunction in Adolescents with Obesity

PubMed Central

Mihalopoulos, Nicole L.; Urban, Brittney M.; Metos, Julie M.; Balch, Alfred H.; Young, Paul C.; Jordan, Kristine C.

2017-01-01

Objectives Increased adiposity increases leptin and decreases adiponectin concentrations, resulting in an increased leptin:adiponectin ratio (LAR). In adults, components of the metabolic syndrome and other cardiometabolic risk factors, what we classify here as “metabolic dysfunction,” are associated with both a high LAR and a history of being breast-fed. The relation among breast-feeding, LAR, and degree of metabolic dysfunction in obese youth is unknown. The purpose of our pilot study was to explore this relation and estimate the effect size of the relations to determine the sample size needed to power future prospective studies. Methods We obtained fasting levels of leptin, adiponectin, lipids, insulin, and glucose from obese youth (aged 8–17 years). Weight, height, waist circumference, blood pressure, and breast-feeding history also were assessed. Results Of 96 participants, 78 were breast-fed as infants, 54% of whom were breast-fed for >6 months. Wide variation was observed in LARs among children who were and were not breast-fed (>100% coefficient of variation). Overall, prevalence of metabolic dysfunction in the cohort was 94% and was not proven to be associated with higher LAR. Conclusions In this cohort of obese youth, we found a high prevalence of breast-feeding, metabolic dysfunction, and wide variation in the LARs. Based on the effect size estimated, future studies would need to enroll >1500 patients or identify, stratify, and selectively enroll obese patients without metabolic dysfunction to accurately determine whether breast-feeding in infancy influences LARs or metabolic dysfunction among obese youth. PMID:28464176

Assessing tribal youth physical activity and programming using a community-based participatory research approach.

PubMed

Perry, Cynthia; Hoffman, Barbara

2010-01-01

American Indian youth experience a greater prevalence of obesity compared with the general U.S. population. One avenue to reverse the trend toward increasing obesity prevalence is through promoting physical activity. The goal of this project was to understand tribal youths' current patterns of physical activity behavior and their beliefs and preferences about physical activity. This assessment used a community-based participatory research approach. Sample included 35 Native youth aged 8-18. A Community Advisory Board was created that specifically developed an exercise survey for this assessment to explore physical activity patterns, preferences, and determinants. Twenty-six youth completed the survey. Descriptive statistics were analyzed, exploring differences by age group. Nine youth participated in 2 focus groups. Qualitative data were analyzed with thematic analysis. Youth distinguished between sports and exercise, with each possessing different determinants. Common motivators were friends, coach, and school, and barriers were lack of programs and school or work. None of the youth reported meeting the recommended 60 min of strenuous exercise daily. This tribal academic partnership responded to a tribal concern by developing an exercise survey and conducting focus groups that addressed tribal-specific questions. The results are informing program development.

Neighbourhood economic deprivation explains racial/ethnic disparities in overweight and obesity among children and adolescents in the U.S.A.

PubMed

Rossen, Lauren M

2014-02-01

Low-income and some racial and ethnic subpopulations are more likely to suffer from obesity. Inequities in the physical and social environment may contribute to disparities in paediatric obesity, but there is little empirical evidence to date. This study explored whether neighbourhood-level socioeconomic factors attenuate racial and ethnic disparities in obesity among youth in the U.S.A. and whether individual-level socioeconomic status (SES) interacts with neighbourhood deprivation. This analysis used data from 17,100 youth ages 2-18 years participating in the 2001-2010 National Health and Nutrition Examination Survey linked to census tract-level socioeconomic characteristics. Multilevel logistic regression models were used to examine neighbourhood deprivation in association with odds of obesity (age-specific and sex-specific body mass index percentile ≥95). The unadjusted prevalence of obesity was 15% among non-Hispanic white children and 21% among non-Hispanic black and Mexican-American children. Adjustment for individual-level SES neighbourhood deprivation and the interaction between these two factors resulted in a 74% attenuation of the disparity in obesity between non-Hispanic black and non-Hispanic white children and a 49% attenuation of the disparity between Mexican-American and non-Hispanic white children. There was a significant interaction between individual-level SES and neighbourhood deprivation where higher individual-level income was protective for children living in low-deprivation neighbourhoods, but not for children who lived in high-deprivation areas. Conversely, area deprivation was associated with higher odds of obesity, but only among children who were above the poverty threshold. Future research on disparities in obesity and other health outcomes should examine broader contextual factors and social determinants of inequities.

Toward scientific equity for the prevention of depression and depressive symptoms in vulnerable youth.

PubMed

Perrino, Tatiana; Beardslee, William; Bernal, Guillermo; Brincks, Ahnalee; Cruden, Gracelyn; Howe, George; Murry, Velma; Pantin, Hilda; Prado, Guillermo; Sandler, Irwin; Brown, C Hendricks

2015-07-01

Certain subgroups of youth are at high risk for depression and elevated depressive symptoms, and experience limited access to quality mental health care. Examples are socioeconomically disadvantaged, racial/ethnic minority, and sexual minority youth. Research shows that there are efficacious interventions to prevent youth depression and depressive symptoms. These preventive interventions have the potential to play a key role in addressing these mental health disparities by reducing youth risk factors and enhancing protective factors. However, there are comparatively few preventive interventions directed specifically to these vulnerable subgroups, and sample sizes of diverse subgroups in general prevention trials are often too low to assess whether preventive interventions work equally well for vulnerable youth compared to other youth. In this paper, we describe the importance and need for "scientific equity," or equality and fairness in the amount of scientific knowledge produced to understand the potential solutions to such health disparities. We highlight possible strategies for promoting scientific equity, including the following: increasing the number of prevention research participants from vulnerable subgroups, conducting more data synthesis analyses and implementation science research, disseminating preventive interventions that are efficacious for vulnerable youth, and increasing the diversity of the prevention science research workforce. These strategies can increase the availability of research evidence to determine the degree to which preventive interventions can help address mental health disparities. Although this paper utilizes the prevention of youth depression as an illustrative case example, the concepts are applicable to other health outcomes for which there are disparities, such as substance use and obesity.

The New Era of Treatment for Obesity and Metabolic Disorders: Evidence and Expectations for Gut Microbiome Transplantation

PubMed Central

Jayasinghe, Thilini N.; Chiavaroli, Valentina; Holland, David J.; Cutfield, Wayne S.; O'Sullivan, Justin M.

2016-01-01

Key Points The microbiome has been implicated in the development of obesity.Conventional therapeutic methods have limited effectiveness for the treatment of obesity and prevention of related complications.Gut microbiome transplantation may represent an alternative and effective therapy for the treatment of obesity. Obesity has reached epidemic proportions. Despite a better understanding of the underlying pathophysiology and growing treatment options, a significant proportion of obese patients do not respond to treatment. Recently, microbes residing in the human gastrointestinal tract have been found to act as an “endocrine” organ, whose composition and functionality may contribute to the development of obesity. Therefore, fecal/gut microbiome transplantation (GMT), which involves the transfer of feces from a healthy donor to a recipient, is increasingly drawing attention as a potential treatment for obesity. Currently the evidence for GMT effectiveness in the treatment of obesity is preliminary. Here, we summarize benefits, procedures, and issues associated with GMT, with a special focus on obesity. PMID:26925392

Brain PET imaging in obesity and food addiction: current evidence and hypothesis.

PubMed

Iozzo, Patricia; Guiducci, Letizia; Guzzardi, Maria Angela; Pagotto, Uberto

2012-01-01

The ongoing epidemics of obesity is one main health concern of the present time. Overeating in some obese individuals shares similarities with the loss of control and compulsive behavior observed in drug-addicted subjects, suggesting that obesity may involve food addiction. Here, we review the contributions provided by the use of positron emission tomography to the current understanding of the cerebral control of obesity and food intake in humans. The available studies have shown that multiple areas in the brain are involved with the reward properties of food, such as prefrontal, orbitofrontal, somatosensory cortices, insula, thalamus, hypothalamus, amygdala, and others. This review summarizes the current evidence, supporting the concepts that i) regions involved in the somatosensory response to food sight, taste, and smell are activated by palatable foods and may be hyperresponsive in obese individuals, ii) areas controlling executive drive seem to overreact to the anticipation of pleasure during cue exposure, and iii) those involved in cognitive control and inhibitory behavior may be resistant to the perception of reward after food exposure in obese subjects. All of these features may stimulate, for different reasons, ingestion of highly palatable and energy-rich foods. Though these same regions are similarly involved in drug abusers and game-addicted individuals, any direct resemblance may be an oversimplification, especially as the heterogeneities between studies and the prevalent exclusion of sensitive groups still limit a coherent interpretation of the findings. Further work is required to comprehensively tackle the multifaceted phenotype of obesity and identify the role of food dependency in its pathophysiology. Copyright © 2012 S. Karger GmbH, Freiburg.

In pursuit of change: youth response to intensive goal setting embedded in a serious video game.

PubMed

Thompson, Debbe; Baranowski, Tom; Buday, Richard; Baranowski, Janice; Juliano, Melissa; Frazior, McKee; Wilsdon, Jon; Jago, Russell

2007-11-01

Type 2 diabetes has increased in prevalence among youth, paralleling the increase in pediatric obesity. Helping youth achieve energy balance by changing diet and physical activity behaviors should decrease the risk for type 2 diabetes and obesity. Goal setting and goal review are critical components of behavior change. Theory-informed video games that emphasize development and refinement of goal setting and goal review skills provide a method for achieving energy balance in an informative, entertaining format. This article reports alpha-testing results of early versions of theory-informed goal setting and reviews components of two diabetes and obesity prevention video games for preadolescents. Two episodes each of two video games were alpha tested with 9- to 11-year-old youth from multiple ethnic groups. Alpha testing included observed game play followed by a scripted interview. The staff was trained in observation and interview techniques prior to data collection. Although some difficulties were encountered, alpha testers generally understood goal setting and review components and comprehended they were setting personal goals. Although goal setting and review involved multiple steps, youth were generally able to complete them quickly, with minimal difficulty. Few technical issues arose; however, several usability and comprehension problems were identified. Theory-informed video games may be an effective medium for promoting youth diabetes and obesity prevention. Alpha testing helps identify problems likely to have a negative effect on functionality, usability, and comprehension during development, thereby providing an opportunity to correct these issues prior to final production.

The Incidence of the Healthcare Costs of Obesity

PubMed Central

Bhattacharya, Jay; Bundorf, M. Kate

2013-01-01

Who pays the healthcare costs associated with obesity? Among workers, this is largely a question of the incidence of the costs of employer-sponsored coverage. Using data from the National Longitudinal Survey of Youth and the Medical Expenditure Panel Survey, we find that the incremental healthcare costs associated with obesity are passed on to obese workers with employer-sponsored health insurance in the form of lower cash wages. Obese workers without employer-sponsored insurance do not have a wage offset relative to their non-obese counterparts. A substantial part of the lower wages among obese women attributed to labor market discrimination can be explained by their higher health insurance premiums. PMID:19433210

The association between obesity and mental rotation ability in an adolescent sample.

PubMed

Kaltner, Sandra; Schulz, Anja; Jansen, Petra

Obesity has been related to deficient mental rotation performance. We assessed object-based and egocentric MR tasks in 19 obese and 19 normal-weight participants. Results showed slower response times of obese adolescents only for high angular disparities. This finding might emerge because of impairments in working memory, motor skills or perspective taking processes in obese youth. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

A common variant in the MTNR1b gene is associated with increased risk of impaired fasting glucose (IFG) in youth with obesity.

PubMed

Zheng, Chao; Dalla Man, Chiara; Cobelli, Claudio; Groop, Leif; Zhao, Hongyu; Bale, Allen E; Shaw, Melissa; Duran, Elvira; Pierpont, Bridget; Caprio, Sonia; Santoro, Nicola

2015-05-01

To explore the role of MTNR1B rs10830963 and G6PC2 rs560887 variants in the pathogenesis of impaired fasting glucose (IFG) in obese adolescents. A total of 346 Caucasians, 218 African-Americans, and 217 Hispanics obese children and adolescents underwent an oral glucose tolerance test (OGTT) and 518 underwent the evaluation of insulin secretion by the oral minimal model (OMM). Also, 274 subjects underwent a second OGTT after 3.0 ± 2.1 years. The MTNR1B rs10830963 variant was associated with higher fasting glucose levels and lower dynamic beta-cell response in Caucasians and Hispanics (P < 0.05) and conferred an increased risk of showing IFG to Caucasians (P = 0.05), African-Americans (P = 0.0066), and Hispanics (P = 0.024). Despite the association between the G6PC2 rs560887 and higher fasting glucose levels (P < 0.05), there was no association between this variant and IFG at baseline or at follow-up (all P > 0.10). It has been shown for the first time in obese youth that the MTNR1B variant is associated with an increased risk of IFG. © 2015 The Obesity Society.

The Shape of the Glucose Response Curve During an Oral Glucose Tolerance Test Heralds Biomarkers of Type 2 Diabetes Risk in Obese Youth

PubMed Central

Kim, Joon Young; Michaliszyn, Sara F.; Nasr, Alexis; Lee, SoJung; Tfayli, Hala; Hannon, Tamara; Hughan, Kara S.; Bacha, Fida; Arslanian, Silva

2016-01-01

OBJECTIVE The shape of the glucose response curve during an oral glucose tolerance test (OGTT), monophasic versus biphasic, identifies physiologically distinct groups of individuals with differences in insulin secretion and sensitivity. We aimed to verify the value of the OGTT-glucose response curve against more sensitive clamp-measured biomarkers of type 2 diabetes risk, and to examine incretin/pancreatic hormones and free fatty acid associations in these curve phenotypes in obese adolescents without diabetes. RESEARCH DESIGN AND METHODS A total of 277 obese adolescents without diabetes completed a 2-h OGTT and were categorized to either a monophasic or a biphasic group. Body composition, abdominal adipose tissue, OGTT-based metabolic parameters, and incretin/pancreatic hormone levels were examined. A subset of 106 participants had both hyperinsulinemic-euglycemic and hyperglycemic clamps to measure in vivo insulin sensitivity, insulin secretion, and β-cell function relative to insulin sensitivity. RESULTS Despite similar fasting and 2-h glucose and insulin concentrations, the monophasic group had significantly higher glucose, insulin, C-peptide, and free fatty acid OGTT areas under the curve compared with the biphasic group, with no differences in levels of glucagon, total glucagon-like peptide 1, glucose-dependent insulinotropic polypeptide, and pancreatic polypeptide. Furthermore, the monophasic group had significantly lower in vivo hepatic and peripheral insulin sensitivity, lack of compensatory first and second phase insulin secretion, and impaired β-cell function relative to insulin sensitivity. CONCLUSIONS In obese youth without diabetes, the risk imparted by the monophasic glucose curve compared with biphasic glucose curve, independent of fasting and 2-h glucose and insulin concentrations, is reflected in lower insulin sensitivity and poorer β-cell function, which are two major pathophysiological biomarkers of type 2 diabetes in youth. PMID:27293201

The wage effects of obesity: a longitudinal study.

PubMed

Baum, Charles L; Ford, William F

2004-09-01

We use National Longitudinal Survey of Youth (NLSY) data to examine the effects of obesity on wages by gender. Sample means indicate that both men and women experience a persistent obesity wage penalty over the first two decades of their careers. We then control for a standard set of socioeconomic and familial variables but find that standard covariates do not explain why obese workers experience persistent wage penalties. This suggests that other variables -- including job discrimination, health-related factors and/or obese workers' behavior patterns -- may be the channels through which obesity adversely affects wages. The study closes with a discussion of the public policy implications suggested by these findings.

Comanagement of Pediatric Depression and Obesity: A Clear Need for Evidence.

PubMed

Mihalopoulos, Nicole L; Spigarelli, Michael G

2015-09-01

The purpose of this article is to provide a review of the existing literature for the comanagement of depression and obesity in the pediatric population. A review of the current literature was conducted using EBSCOhost and EMBASE to identify evidence and recommendations for the comanagement of depression and obesity among children and adolescents (aged 2-18 years). Additional search criteria included peer-reviewed, English language-only full-text articles published before August 2015. Multiple factors contribute to and influence the interplay of obesity and depression in the pediatric population. These 2 chronic conditions are affected by multiple factors, including the roles of the family, school, health care practitioners, and access to health care. In addition, there are no formal recommendations for the treatment of depression in the setting of obesity for pediatric or adult populations, and there is only medication approved by the Food and Drug Administration (orlistat) for the treatment of obesity in the adolescent population. Bariatric surgery may play a role in some adolescents, but larger and long-term clinical studies with the use of therapeutic agents in conjunction with lifestyle modification need to be conducted to support this. The interrelatedness of these 2 separate diseases is not well understood; the presence of 1 of the diseases clearly contributes to the manifestation of the other and likely to the ability to treat the other disease. Current focus is on modifying behavior to decrease weight. Weight loss is associated with improvement in depressive symptoms but may not be adequate to treat depression. Copyright © 2015. Published by Elsevier Inc.

Physical Activity, BMI, and Blood Pressure in US Youth: NHANES 2003-2006.

PubMed

Betz, Heather Hayes; Eisenmann, Joey C; Laurson, Kelly R; DuBose, Katrina D; Reeves, Mathew J; Carlson, Joseph J; Pfeiffer, Karin A

2018-03-15

The objective of this study was to examine the independent and combined association of physical activity and body mass index (BMI) with blood pressure in youth. Youth aged 8-18 years from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) with BMI, blood pressure, and physical activity (accelerometer) were included in the analyses. A total of 2585 subjects (1303 males; 47% of all 8- to 18-year-olds) met these criteria. Obese youth had a systolic blood pressure that was 8 mm Hg higher than normal weight youth. A significant interaction between BMI and physical activity on blood pressure was found (P < .001), and group differences among the BMI/activity groups showed that the 3 obese groups and the overweight/least active group had significantly higher systolic blood pressure than the normal weight/active group across all analyses. The overweight/least active and normal weight/least active groups had significantly higher diastolic blood pressure than the normal weight/active group as well. This study showed a significant independent and combined association of BMI and physical activity with blood pressure in youth. Interventions need to focus on the reduction of fatness/BMI as a way to reduce the cardiovascular risk in youth.

Insights in public health: Building support for an evidence-based teen pregnancy and sexually transmitted infection prevention program adapted for foster youth.

PubMed

Smith, Tamara; Clark, Judith F; Nigg, Claudio R

2015-01-01

Hawai'i Youth Services Network (HYSN) was founded in 1980 and is incorporated as a 501(c) (3) organization. HYSN plays a key role in the planning, creation, and funding of local youth services. One of HYSN's focuses is teen pregnancy and sexually transmitted infections (STI) prevention among foster youth. Foster youth are at a greater risk for teen pregnancy and STI due to a variety of complex factors including instability, trauma, and emancipation from the foster care system. This article highlights how HYSN is leveraging both federal and local funding, as well as other resources, in order to implement an evidence-based teen pregnancy and STI prevention program adapted for foster youth.

Inflammation during obesity is not all bad: evidence from animal and human studies

PubMed Central

McGuinness, Owen P.

2013-01-01

Chronic inflammation is a characteristic of obesity and is associated with accompanying insulin resistance, a hallmark of type 2 diabetes mellitus (T2DM). Although proinflammatory cytokines are known for their detrimental effects on adipose tissue function and insulin sensitivity, their beneficial effects in the regulation of metabolism have not drawn sufficient attention. In obesity, inflammation is initiated by a local hypoxia to augment angiogenesis and improve adipose tissue blood supply. A growing body of evidence suggests that macrophages and proinflammatory cytokines are essential for adipose remodeling and adipocyte differentiation. Phenotypes of multiple lines of transgenic mice consistently suggest that proinflammatory cytokines increase energy expenditure and act to prevent obesity. Removal of proinflammatory cytokines by gene knockout decreases energy expenditure and induces adult-onset obesity. In contrast, elevation of proinflammatory cytokines augments energy expenditure and decreases the risk for obesity. Anti-inflammatory therapies have been tested in more than a dozen clinical trials to improve insulin sensitivity and glucose homeostasis in patients with T2DM, and the results are not encouraging. One possible explanation is that anti-inflammatory therapies also attenuate the beneficial effects of inflammation in stimulating energy expenditure, which may have limited the efficacy of the treatment by promoting energy accumulation. Thus, the positive effects of proinflammatory events should be considered in evaluating the impact of inflammation in obesity and type 2 diabetes. PMID:23269411

The Obesity Epidemic: A Call for Health Educators to Lead--A Commentary

ERIC Educational Resources Information Center

Snelling, Anastasia

2012-01-01

The childhood obesity epidemic is one of the defining health challenges of this decade and perhaps the 21st century. Obesity rates among youths have nearly tripled in the past three decades. Solving the obesity epidemic requires that students understand and accept the changes within the environment and ultimately modify their health behaviors to…

Headless, hungry, and unhealthy: a video content analysis of obese persons portrayed in online news.

PubMed

Puhl, Rebecca M; Peterson, Jamie Lee; DePierre, Jenny A; Luedicke, Joerg

2013-01-01

The news media has substantial influence on public perceptions of social and health issues. This study conducted a video content analysis to examine portrayals of obese persons in online news reports about obesity. The authors downloaded online news videos about obesity (N = 371) from 5 major news websites and systematically coded visual portrayals of obese and nonobese adults and youth in these videos. The authors found that 65% of overweight/obese adults and 77% of overweight/obese youth were portrayed in a negative, stigmatizing manner across multiple obesity-related topics covered in online news videos. In particular, overweight/obese individuals were significantly more likely than were nonoverweight individuals to be portrayed as headless, with an unflattering emphasis on isolated body parts, from an unflattering rear view of their excess weight, eating unhealthy foods, engaging in sedentary behavior, and dressed in inappropriately fitting clothing. Nonoverweight individuals were significantly more likely to be portrayed positively. In conclusion, obese children and adults are frequently stigmatized in online news videos about obesity. These findings have important implications for public perceptions of obesity and obese persons and may reinforce negative societal weight bias.

Disease Comorbidity Network Guides the Detection of Molecular Evidence for the Link Between Colorectal Cancer and Obesity.

PubMed

Chen, Yang; Li, Li; Xu, Rong

2015-01-01

Epidemiological studies suggested that obesity increases the risk of colorectal cancer (CRC). The genetic connection between CRC and obesity is multifactorial and inconclusive. In this study, we hypothesize that the study of shared comorbid diseases between CRC and obesity can offer unique insights into common genetic basis of these two diseases. We constructed a comorbidity network based on mining health data for millions of patients. We developed a novel approach and extracted the diseases that play critical roles in connecting obesity and CRC in the comorbidity network. Our approach was able to prioritize metabolic syndrome and diabetes, which are known to be associated with obesity and CRC through insulin resistance pathways. Interestingly, we found that osteoporosis was highly associated with the connection between obesity and CRC. Through gene expression meta-analysis, we identified novel genes shared among CRC, obesity and osteoporosis. Literature evidences support that these genes may contribute in explaining the genetic overlaps between obesity and CRC.

Carbohydrates and obesity: from evidence to policy in the UK.

PubMed

Jebb, Susan A

2015-08-01

Carbohydrates provide the major source of energy in the diet and hence the type and amount of carbohydrate consumed is an important consideration for weight control. Recent risk assessments have shown that there is no consistent association between the proportions of energy consumed as carbohydrate and body weight and reinforce the dominance of total energy intake as the primary determinant of body weight. However, they have highlighted evidence that different types of carbohydrate have specific effects on the risk of obesity. Short-term experimental studies suggest that some types of dietary fibre may be linked to increased satiation and cohort studies are supportive of an association between low intakes of fibre-rich, whole-grain foods and weight gain. But these observations are not supported by evidence of effects on body weight in randomised controlled trials, suggesting that high-fibre or whole-grain intake may simply be a marker of a broader dietary pattern. Recent attention has focused on the growing evidence of a positive association between the intake of free sugars and weight gain and particularly the risks linked to consumption of sugar-sweetened beverages (SSB). Given the high population-level intake of free sugars the challenge is to identify actions that will successfully reduce consumption to contribute to reductions in the prevalence of obesity. The present paper considers the range of policy options available, using the Nuffield ladder of intervention to provide a framework for risk management, with a focus on the consumption of SSB. Current policy interventions are largely based around consumer education and encouragement to industry to renovate products to reduce the sugar content of food and drinks and/or reduce portion size, but dietary change has been slow. Further measures, including the use of specific incentives/disincentives may be needed to change consumption patterns, some of which may infringe personal or commercial freedom. For these

Development of a Systems Science Curriculum to Engage Rural African American Teens in Understanding and Addressing Childhood Obesity Prevention

ERIC Educational Resources Information Center

Frerichs, Leah; Lich, Kristen Hassmiller; Young, Tiffany L.; Dave, Gaurav; Stith, Doris; Corbie-Smith, Giselle

2018-01-01

Engaging youth from racial and ethnic minority communities as leaders for change is a potential strategy to mobilize support for addressing childhood obesity, but there are limited curricula designed to help youth understand the complex influences on obesity. Our aim was to develop and pilot test a systems science curriculum to elicit rural…

The Effect of Weight on Self-Concept, and Psychosocial Correlates of Physical Activity in Youths

ERIC Educational Resources Information Center

Welk, Gregory J.; Joens-Matre, Roxane

2007-01-01

Much more attention has been given to the health implications of overweight and obesity than to the psychosocial implications. In order to combat obesity effectively, it is important to understand the implications of overweight on self-concept, self-esteem, and physical activity levels. Youth obesity has been associated with negative psychosocial…

School-day and overall physical activity among youth.

PubMed

Long, Michael W; Sobol, Arthur M; Cradock, Angie L; Subramanian, S V; Blendon, Robert J; Gortmaker, Steven L

2013-08-01

Increasing school-day physical activity through policy and programs is commonly suggested to prevent obesity and improve overall child health. However, strategies that focus on school-day physical activity may not increase total physical activity if youth compensate by reducing physical activity outside of school. Objectively measured, nationally representative physical activity data were used to test the hypothesis that higher school-day physical activity is associated with higher overall daily physical activity in youth. Accelerometer data from 2003-2004/2005-2006 National Health and Nutrition Examination Surveys were analyzed in 2012 to estimate physical activity levels during the school day (8AM-3PM) among youth aged 6-19 years (n=2548). Fixed-effects regressions were used to estimate the impact of changes in school-day minutes of moderate-to-vigorous physical activity (MVPA) on changes in total daily MVPA. Each additional minute of school-day MVPA was associated with an additional 1.14 minutes (95% CI=1.04, 1.24; p<0.001) of total daily MVPA, or 0.14 additional minutes (95% CI=0.04, 0.24; p=0.008) outside the school day, controlling for total daily accelerometer wear time and age, gender, race/ethnicity, and other non-time varying covariates. There were no differences in the effect of school-day MVPA on total MVPA by age group, gender, race/ethnicity, poverty status, or degree of change in MVPA. Higher school-day MVPA was associated with higher daily MVPA among U.S. youth with no evidence for same-day "compensation." Increasing school-based physical activity is a promising approach that can improve total daily physical activity levels of youth. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Prevalence of child and youth obesity in Spain in 2012.

PubMed

Sánchez-Cruz, José-Juan; Jiménez-Moleón, José J; Fernández-Quesada, Fidel; Sánchez, María J

2013-05-01

Obesity is a major cardiovascular risk factor. In Spain, few studies have physically measured height and weight to estimate the magnitude of the problem. The aim of this study was to determine the prevalence of child and adolescent obesity in Spain in 2012. We performed a cross-sectional probability sample of 1018 children, representative of the Spanish population aged between 8 and 17 years old, with objectively measured height and weight, along with other sociodemographic variables. We calculated the prevalence of overweight and obesity according to the criteria of the World Health Organization, the International Obesity Task Force, and the enKid study. In the group aged 8 to 17 years old, the prevalence of overweight and obesity was 26% and 12.6%, respectively; 4 in 10 young people were overweight or obese. Excess weight was found in 45% of the group aged 8 to 13 years and in 25.5% of that aged 14 to 17 years. This cardiovascular risk factor was associated with lower social class and lower educational level. The prevalence of overweight and obesity in children and adolescents in Spain remains high (close to 40%), but has not increased in the last 12 years. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Testing the Youth Physical Activity Promotion Model: Fatness and Fitness as Enabling Factors

ERIC Educational Resources Information Center

Chen, Senlin; Welk, Gregory J.; Joens-Matre, Roxane R.

2014-01-01

As the prevalence of childhood obesity increases, it is important to examine possible differences in psychosocial correlates of physical activity between normal weight and overweight children. The study examined fatness (weight status) and (aerobic) fitness as Enabling factors related to youth physical activity within the Youth Physical Activity…

Evidence for Site-Specific, Systematic Adaptation of Substance Prevention Curriculum With High Risk Youth in Community and Alternative School Settings.

PubMed

Holleran Steiker, Lori K; Hopson, Laura M; Goldbach, Jeremy T; Robinson, Charletta

2014-09-01

The problem of substance use among older youth is of great concern, but has received little attention in prevention research. This may be due to the perception that prevention programming is developmentally inappropriate for older youth who are actively experimenting with substances. This project examined the differential effectiveness of youth-driven adaptations of the evidence-based prevention program, keepin' it REAL (KiR). The participating sites included a juvenile justice day program, a homeless shelter, four alternative high schools, low-income housing programs, an LGBTQ youth center, and a youth group on the Texas-Mexico border. In the project's first phase, high risk youth in community settings tailored KiR workbooks and videos to increase the relevance for their peers, older adolescents who are likely to have already initiated drug use. The second phase of the study, discussed here in detail, evaluates the effectiveness of the adapted versions of KiR compared with the original version and a comparison condition. The study employed a quasi-experimental pretest posttest design with a 6-week follow-up. Youth also participated in focus groups. Both qualitative and quantitative data suggest that participants receiving the adapted version of the curriculum experienced greater improvement in acceptance and use of substances than youth in the other two groups.

Contingency management adapted for African-American adolescents with obesity enhances youth weight loss with caregiver participation: a multiple baseline pilot study.

PubMed

Hartlieb, Kathryn Brogan; Naar, Sylvie; Ledgerwood, David M; Templin, Thomas N; Ellis, Deborah A; Donohue, Bradley; Cunningham, Phillippe B

2015-12-07

Contingency management (CM) interventions, which use operant conditioning principles to encourage completion of target behavioral goals, may be useful for improving adherence to behavioral skills training (BST). Research-to-date has yet to explore CM for weight loss in minority adolescents. To examine the effects of CM in improving adolescent weight loss when added to BST. The study utilized an innovative experimental design that builds upon multiple baseline approaches as recommended by the National Institutes of Health. Six obese African-American youth and their primary caregivers living in Detroit, Michigan, USA. Adolescents received between 4 and 12 weeks of BST during a baseline period and subsequently received CM targeting weight loss. Youth weight. Linear mixed effects modeling was used in the analysis. CM did not directly affect adolescent weight loss above that of BST (p=0.053). However, when caregivers were involved in CM session treatment, contingency management had a positive effect on adolescent weight loss. The estimated weight loss due to CM when caregivers also attended was 0.66 kg/week (p<0.001, [95% CI; -1.96, -0.97]) relative to the baseline trajectory. This study demonstrates application of a novel experimental approach to intervention development and demonstrated the importance of parent involvement when delivering contingency management for minority youth weight loss. Lessons learned from contingency management program implementation are also discussed in order to inform practice.

Uric acid is linked to cardiometabolic risk factors in overweight and obese youths.

PubMed

Lurbe, Empar; Torro, María Isabel; Alvarez-Pitti, Julio; Redon, Josep; Borghi, Claudio; Redon, Pau

2018-06-18

Observational studies have indicated that high levels of serum uric acid are associated with the risk of cardiovascular disease. The aim of the present study is to investigate the association of uric acid with individual cardiometabolic risk factors, as well as their degree of clustering, in overweight and moderate obese youth. Three hundred and thirty-three Caucasians of both sexes (149 women), from 5-18 years of age from those who underwent an assessment of overweight/obesity. Anthropometric parameters, office and 24-h blood pressure measurements and metabolic profile, including HDL-cholesterol, triglycerides, insulin, HOMA index and uric acid were assessed. Uric acid was significantly higher in boys than in girls. A positive significant association between uric acid, and office, daytime and night-time SBP, insulin and triglycerides was observed. When boys and girls were grouped by sex-specific uric acid tertiles, a progressive increment was observed in BMI, BMI z-score and waist circumference as well as fasting insulin and HOMA index. In boys, this was also present in office and ambulatory SBP. Likewise, the number of abnormal metabolic risk factors also increases with the uric acid values and the higher the number of metabolic components the higher the uric acid values. Moreover, in a multiple regression analysis, uric acid was significantly related with male sex, waist circumference, both office and night-time SBP and birth weight. The present study found a positive association between uric acid and blood pressure, insulin and triglycerides. As uric acid levels increase there is a relevant clustering of metabolic risk factors, whereas elevated blood pressure is the risk factor less frequently present. Further studies need to assess the mechanistic link between uric acid and the cardiometabolic risk factors.

In Pursuit of Change: Youth Response to Intensive Goal Setting Embedded in a Serious Video Game

PubMed Central

Thompson, Debbe; Baranowski, Tom; Buday, Richard; Baranowski, Janice; Juliano, Melissa; Frazior, McKee; Wilsdon, Jon; Jago, Russell

2007-01-01

Background Type 2 diabetes has increased in prevalence among youth, paralleling the increase in pediatric obesity. Helping youth achieve energy balance by changing diet and physical activity behaviors should decrease the risk for type 2 diabetes and obesity. Goal setting and goal review are critical components of behavior change. Theory-informed video games that emphasize development and refinement of goal setting and goal review skills provide a method for achieving energy balance in an informative, entertaining format. This article reports alpha-testing results of early versions of theory-informed goal setting and reviews components of two diabetes and obesity prevention video games for preadolescents. Method Two episodes each of two video games were alpha tested with 9- to 11-year-old youth from multiple ethnic groups. Alpha testing included observed game play followed by a scripted interview. The staff was trained in observation and interview techniques prior to data collection. Results Although some difficulties were encountered, alpha testers generally understood goal setting and review components and comprehended they were setting personal goals. Although goal setting and review involved multiple steps, youth were generally able to complete them quickly, with minimal difficulty. Few technical issues arose; however, several usability and comprehension problems were identified. Conclusions Theory-informed video games may be an effective medium for promoting youth diabetes and obesity prevention. Alpha testing helps identify problems likely to have a negative effect on functionality, usability, and comprehension during development, thereby providing an opportunity to correct these issues prior to final production. PMID:19885165

Potassium and Obesity/Metabolic Syndrome: A Systematic Review and Meta-Analysis of the Epidemiological Evidence.

PubMed

Cai, Xianlei; Li, Xueying; Fan, Wenjie; Yu, Wanqi; Wang, Shan; Li, Zhenhong; Scott, Ethel Marian; Li, Xiuyang

2016-03-25

The objective of this study was to investigate the associations between potassium and obesity/metabolic syndrome. We identified eight relevant studies and applied meta-analysis, and nonlinear dose-response analysis to obtain the available evidence. The results of the pooled analysis and systematic review indicated that high potassium intake could not reduce the risk of obesity (pooled OR = 0.78; 95% CI: 0.61-1.01), while serum potassium and urinary sodium-to-potassium ratio was associated with obesity. Potassium intake was associated with metabolic syndrome (pooled OR = 0.75; 95% CI: 0.50-0.97). Nonlinear analysis also demonstrated a protective effect of adequate potassium intake on obesity and metabolic syndrome. Adequate intake of fruits and vegetables, which were the major sources of potassium, was highly recommended. However, additional pertinent studies are needed to examine the underlying mechanism.

Potassium and Obesity/Metabolic Syndrome: A Systematic Review and Meta-Analysis of the Epidemiological Evidence

PubMed Central

Cai, Xianlei; Li, Xueying; Fan, Wenjie; Yu, Wanqi; Wang, Shan; Li, Zhenhong; Scott, Ethel Marian; Li, Xiuyang

2016-01-01

The objective of this study was to investigate the associations between potassium and obesity/metabolic syndrome. We identified eight relevant studies and applied meta-analysis, and nonlinear dose-response analysis to obtain the available evidence. The results of the pooled analysis and systematic review indicated that high potassium intake could not reduce the risk of obesity (pooled OR = 0.78; 95% CI: 0.61–1.01), while serum potassium and urinary sodium-to-potassium ratio was associated with obesity. Potassium intake was associated with metabolic syndrome (pooled OR = 0.75; 95% CI: 0.50–0.97). Nonlinear analysis also demonstrated a protective effect of adequate potassium intake on obesity and metabolic syndrome. Adequate intake of fruits and vegetables, which were the major sources of potassium, was highly recommended. However, additional pertinent studies are needed to examine the underlying mechanism. PMID:27023597

HIV prevention for South African youth: which interventions work? A systematic review of current evidence

PubMed Central

2010-01-01

Background In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1) study design and outcomes, 2) intervention design (content, curriculum, theory, adaptation process), 3) thematic focus and HIV causal pathways, 4) intervention delivery (duration, intensity, who, how, where). Results Eight youth HIV prevention interventions were included; all were similar in HIV prevention content and objectives, but varied in thematic focus, hypothesised causal pathways, theoretical basis, delivery method, intensity and duration. Interventions were school- (5) or group-based (3), involving in- and out-of-school youth. Primary outcomes included HIV incidence (2), reported sexual risk behavior alone (4), or with alcohol use (2). Interventions led to reductions in STI incidence (1), and reported sexual or alcohol risk behaviours (5), although effect size varied. All but one targeted at least one structural factor associated with HIV infection: gender and sexual coercion (3), alcohol/substance use (2), or economic factors (2). Delivery methods and formats varied, and included teachers (5), peer educators (5), and older mentors (1). School-based interventions experienced frequent implementation challenges. Conclusions Key recommendations include: address HIV social risk factors, such as gender, poverty and alcohol; target the structural and institutional context; work to change social norms; and engage schools in new ways, including participatory learning. PMID:20187957

Obesity and Health Risk of Children in the Mississippi Delta

ERIC Educational Resources Information Center

Gamble, Abigail; Waddell, Dwight; Ford, M. Allison; Bentley, John P.; Woodyard, Catherine D.; Hallam, Jeffrey S.

2012-01-01

Background: Mississippi (MS) Delta adults and youth report obesity rates far exceeding those of the state and nation. State law requires in-school physical activity and nutrition practices to address childhood obesity but does not require evaluation of outcomes, specifically the impact on weight-related outcomes. This paper offers 3 things: (1)…

A Youth-Leader Program in Baltimore City Recreation Centers: Lessons Learned and Applications

PubMed Central

Trude, Angela C. B.; Steeves, Elizabeth Anderson; Shipley, Cara; Surkan, Pamela J.; de Morais Sato, Priscila; Estep, Tracey; Clanton, Stella; Lachenmayr, Lisa; Gittelsohn, Joel

2017-01-01

Peer-led interventions may be an effective means of addressing the childhood obesity epidemic; however, few studies have looked at the long-term sustainability of such programs. As part of a multilevel obesity prevention intervention, B’More Healthy Communities for Kids, 16 Baltimore college students were trained as youth-leaders (YLs) to deliver a skill-based nutrition curriculum to low-income African American children (10–14 years old). In April 2015, formative research was used to inform sustainability of the YL program in recreation centers. In-depth interviews were conducted with recreation center directors (n = 4) and the YLs (n = 16). Two focus groups were conducted with YLs (n = 7) and community youth-advocates (n = 10). Barriers to this program included difficulties with transportation, time constraints, and recruiting youth. Lessons learned indicated that improving trainings and incentives to youth were identified as essential strategies to foster continuity of the youth-led program and capacity building. High school students living close to the centers were identified as potential candidates to lead the program. Based on our findings, the initial intervention will be expanded into a sustainable model for implementation, using a train-the-trainer approach to empower community youth to be change agents of the food environment and role models. PMID:28899234

Perceptions of Healthful Eating and Influences on the Food Choices of Appalachian Youth

ERIC Educational Resources Information Center

Swanson, Mark; Schoenberg, Nancy E.; Davis, Rian; Wright, Sherry; Dollarhide, Kaye

2013-01-01

Objective: Patterns of overweight and obesity have an unequal geographic distribution, and there are elevated rates in Appalachia. Perceptions of Appalachian youth toward healthful eating and influences on food choice were examined as part of formative research to address these disparities. Methods: Eleven focus groups, averaging 6 youth (n = 68)…

SaludABLEOmaha: Improving Readiness to Address Obesity Through Healthy Lifestyle in a Midwestern Latino Community, 2011–2013

PubMed Central

Frerichs, Leah; Brittin, Jeri; Robbins, Regina; Steenson, Sharalyn; Stewart, Catherine; Fisher, Christopher

2015-01-01

Background A community’s readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities. Community Context This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles. Methods SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning in schools (ie, curricula that integrate hands-on community service with instruction and reflection), and 3) community and business engagement. Following the Community Readiness Model protocol (http://triethniccenter.colostate.edu/communityReadiness.htm), structured interviews were conducted with community leaders and analyzed before and 2.5 years after launch of the program. Outcome The community increased in readiness from stage 3 of the Community Readiness Model, “vague awareness,” at baseline to stage 5, “preparation,” at follow-up. Interpretation SaludABLEOmaha improved community readiness (eg, community knowledge, community climate), which probably contributed to the observed increase in readiness to address obesity through healthy lifestyle. Community mobilization approaches such as youth activism integrated with social marketing and social media tactics can improve community responsiveness to obesity prevention and diminish health disparities. PMID:25674679

Does obesity influence labour market outcomes among working-age adults? Evidence from Canadian longitudinal data.

PubMed

Larose, Samantha L; Kpelitse, Koffi A; Campbell, M Karen; Zaric, Gregory S; Sarma, Sisira

2016-03-01

Although a negative association between obesity and labour market outcomes is commonly reported in many studies, the causal nature of this relationship remains unclear. Using nationally representative longitudinal data from the last six confidential master files (2000/2001-2010/2011) of the National Population Health Survey, we examine the association between obesity and employment participation and earnings among working-age adults in Canada. After controlling for demographic and socioeconomic characteristics, lifestyle factors and time-invariant individual heterogeneity, our results show that obesity is not significantly associated with employment participation but is associated with reduced hourly wage rate and annual income among women by about 4% and 4.5%, respectively. The corresponding results for men show that obesity is associated with about 2% reduction in wage rate and income, but significant at 10% level. However, after controlling for the potential reverse causality bias using the lagged measure of obesity, the effect of obesity on wage rate and income became positive or statistically non-significant. Our findings suggest that obesity is not causally associated with negative labour market outcomes among working-age men in Canada. For working-age women, we find limited evidence of negative labour market outcomes. Copyright © 2015 Elsevier B.V. All rights reserved.

The link between obesity and the built environment. Evidence from an ecological analysis of obesity and vehicle miles of travel in California.

PubMed

Lopez-Zetina, Javier; Lee, Howard; Friis, Robert

2006-12-01

Obesity and physical inactivity are known to be risk factors for many chronic diseases including hypertension, coronary artery disease, diabetes, and cancer. We sought to explore the association between an indicator of transportation data (Vehicle Miles of Travel, VMT) at the county level as it relates to obesity and physical inactivity in California. Data from the California Health Interview Survey 2001 (CHIS 2001), the US 2000 Census, and the California Department of Transportation were merged to examine ecological correlations between vehicle miles of travel, population density, commute time, and county indicators of obesity and physical inactivity. Obesity was measured by body mass index (BMI). Physical inactivity was based on self-reported behaviors including walking, bicycling, and moderate to vigorous activity. The unit of analysis was the county. Thirty-three counties in California with population size greater than 100,000 persons per county were retained in the analyses. CHIS 2001 statewide obesity prevalence ranged from 11.2% to 28.5% by county. Physical inactivity ranged from 13.4% to 35.7%. Daily vehicle miles of travel ranged from 3.3 million to 183.8 million per county. By rank bivariate correlation, obesity and physical inactivity were significantly associated (p<0.01). Furthermore, by rank analysis of variance, the highest mean rank obesity was associated with the highest rank of VMT (p<0.01). Similar rank patterns were observed between obesity and physical inactivity and commute time. Associations between VMT and physical inactivity were examined but failed to reach statistical significance. This analysis adds to the growing evidence supporting the association between VMT (a measure of automobile transportation) and obesity. An urban design characterized by over dependence on motorized transportation may be related to adverse health effects.

Community Collaborations and Youth Development: Preliminary Findings on the State of the Evidence. Research Brief Series

ERIC Educational Resources Information Center

Center for Promise, 2013

2013-01-01

In 2004, the Aspen Institute Roundtable on Community Change emphasized the need for a comprehensive base of information on the effectiveness of community collaborations for youth--an accessible, evidence-rich resource that could guide local efforts to bring about meaningful change. Nearly 10 years later, this need remains largely unmet. In…

Treating Pediatric Obesity Using an Empirically Supported Treatment: A Case Report

ERIC Educational Resources Information Center

Cunningham, Phillippe B.; Ellis, Deborah A.; Naar-King, Sylvie

2010-01-01

Overweight and obesity are increasing dramatically in the United States of America, especially among children. Effective treatment of the multiple risk factors that promote youth obesity requires treatment approaches that are flexible and comprehensive enough to address each of these factors. One such treatment approach is Multisystemic Therapy…

What do individuals with morbid obesity report as a usual dietary intake? A narrative review of available evidence.

PubMed

Harbury, Cathy M; Verbruggen, Elisabeth E; Callister, Robin; Collins, Clare E

2016-06-01

In several developed countries, as obesity prevalence doubles it has quadrupled for morbid obesity (BMI ≥ 40 kgm -2 ). As more individuals with morbid obesity present for weight loss treatment there is a greater need to understand their dietary habits. No reviews were found in the literature, therefore this systematic review aims to identify and describe the existing evidence on the usual dietary intake of individuals with morbid obesity including those from a general population and those seeking treatment such as weight loss surgery. A literature search of ten databases from 1980 to June 2014 was conducted to identify original research of adults with morbid obesity (aged 18-60 years) that reported a usual dietary intake. Ten studies met all inclusion criteria and reported energy intake, most reported macronutrient composition, two assessed micronutrient intake, and one reported food-based outcomes. Other dietary outcomes were related to surgical intervention. The most plausible energy intake data suggest high intakes, >4000 Kcal/day for those weight stable at the highest levels of morbid obesity (up to BMI 97 kgm -2 ). Fat intakes are also high, around 40% of energy intake and up to 57% for some individuals. Suboptimal intakes of iron and calcium are reported. This review draws attention to a limited evidence base, offers preliminary insight suggesting individuals with morbid obesity are prone to consuming poor quality diets similar to those reported for obese populations, and highlights challenges for future research. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Prevalence of Obesity Among Adults and Youth: United States, 2015-2016.

PubMed

Hales, Craig M; Carroll, Margaret D; Fryar, Cheryl D; Ogden, Cynthia L

2017-10-01

Obesity is associated with serious health risks. Monitoring obesity prevalence is relevant for public health programs that focus on reducing or preventing obesity. Between 2003–2004 and 2013–2014, there were no significant changes in childhood obesity prevalence, but adults showed an increasing trend. This report provides the most recent national estimates from 2015–2016 on obesity prevalence by sex, age, and race and Hispanic origin, and overall estimates from 1999–2000 through 2015–2016. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Effectiveness of sugar-sweetened beverages taxes to reduce obesity: evidence brief for policy

PubMed

Bascuñán, Josefina; Cuadrado, Cristóbal

2017-10-25

The high prevalence of obesity in Chile, along with the increasing consumption of sugary drinks in the country, has made apparent the need to propose fiscal measures, through taxes on specific foods, as a complementary alternative to approach this problem. Since 2014, an additional 5% increase in the tax on sugar-sweetened nonalcoholic beverages has been in effect in Chile, an amount that may be insufficient to produce an impact on obesity levels. The evidence of the effectiveness of fiscal measures upon sugary beverages, in terms of price modification, generally reflects a high transfer of the tax to the final consumers, which is variable according to local conditions. After the analysis of the literature, a sensitivity of the demand to the changes in prices of sugary drinks was evidenced, by means of negative elasticity close to -1, for different groups observed, besides a decrease in the consumption of these products. On the other hand, effects on body weight after the application of these taxes were analyzed by several simulation studies, reporting a decrease on prevalence of obesity between 0.99% and 2.4%. Within the acceptability of a fiscal measure of this nature, there were variable support figures between 36% and 60% among general population. Regarding possible negative effects on employment, an international study even evidenced a rise in the figures for employment in two locations following the application of a tax on sugary drinks. The research showed that there is evidence to support the implementation of a fiscal measure upon sugary beverages in Chile; however, there is a lack of local simulation studies to explore the possible effects and implications of a new tax of this kind in the country. Taxation measures upon foods seem to be both viable and effective alternatives to address the problem of obesity in Chile, but they should be considered as part of an overall strategy with the clear goal of reducing the prevalence of national obesity.

Obesity and government.

PubMed

Kahan, Scott; Zvenyach, Tracy

2016-10-01

Despite much effort, obesity prevalence and disease severity continues to worsen. The purpose of this review is to describe the leading government supported food and nutrition interventions and policies to prevent and address obesity in the USA. The review also summarizes obesity interventions and policies that the government plays a role in, but further development is warranted. The government's role in obesity has largely focused on interventions and policies such as national surveillance, obesity education and awareness, grant-based food subsidy programs, zoning for food access, school-based nutrition programs, dietary guidelines, nutrition labeling, and food marketing and pricing policies. The government has played a lesser role in obesity interventions and policies that provide access to evidence-based obesity care to people affected by the disease. Given the magnitude of the obesity epidemic, the government should explore multiple evidence-based interventions and policies across prevention and clinical care.

Sugar-sweetened and artificially-sweetened beverages in relation to obesity risk.

PubMed

Pereira, Mark A

2014-11-01

The goal of this review was to critically evaluate the scientific evidence in humans on the potential effect of sweetened beverages on weight gain and risk of obesity in youth and adults. Two categories of these beverages were reviewed. Sugar-sweetened beverages (SSBs) include soft drinks, colas, other sweetened carbonated beverages, and fruit drinks with added sugar. Artificially sweetened beverages (ASBs), also referred to as non-nutritive sweetened beverages, are marketed and used as a replacement for SSBs for those who want to reduce sugar and caloric intake. The totality of evidence to date demonstrates a pattern across observational and experimental studies of an increased risk of weight gain and obesity with higher intake of SSBs. However, it remains difficult to establish the strength of the association and the independence from other potentially confounding factors. The primary reason for unclear conclusions regarding the robustness of any effect of SSBs is due to the heterogeneity and methodologic limitations of both observational and experimental studies on this topic. Although some observational studies have suggested that ASBs may cause increased risk of obesity and cardiometabolic diseases, there is no clear mechanism for this pathway, and the epidemiologic studies are highly inconsistent. An important issue with the observational studies on ASBs and obesity or disease risk is reverse causality bias, with higher-quality studies demonstrating this possibility. The field needs higher-quality experimental studies in humans, with relevant direct comparisons between sweetened beverages and their sweetened solid-food alternatives. © 2014 American Society for Nutrition.

High prevalence of overweight and obesity among inner city Chinese children in Shanghai, 2011.

PubMed

Jiang, Xiao-Xiao; Hardy, Louise L; Baur, Louise A; Ding, Ding; Wang, Ling; Shi, Hui-Jing

2014-01-01

In China, the prevalence of overweight and obesity appears to be increasing at unacceptable levels among young people living in major cities undergoing rapid economic growth. To report the prevalence of overweight and obesity among Shanghai inner city youth using the recently published International Obesity Task Force (IOTF) Asian definition. Secondary analysis of children aged 8-15 years who participated in the Shanghai Schools' Physical Fitness Examinations, a representative school-based survey. Height and weight were measured and body mass index (kg/m(2)) was calculated. The prevalence of overweight and obesity was determined using the IOTF children's BMI cut-points for Asian populations, equivalent to an adult BMI of 23 g/m(2) (overweight) and 27 kg/m(2) (obese). The prevalence of combined overweight and obesity was 49.1% for boys and 30.8% for girls aged 8-15-years. Almost one-in-five boys were obese, compared with 8.4% of girls. In boys the prevalence of overweight appeared to increase from age 10 years. The high prevalence of combined overweight and obesity among urban Chinese youth, especially among boys, requires immediate health promotion intervention.

CHILE: An Evidence-Based Preschool Intervention for Obesity Prevention in Head Start

PubMed Central

Sanders, Sarah G.; FitzGerald, Courtney A.; Keane, Patricia C.; Canaca, Glenda F.; Volker-Rector, Renee

2012-01-01

BACKGROUND Obesity is a major concern among American Indians and Hispanics. The Child Health Initiative for Lifelong Eating and Exercise (CHILE) is an evidence-based intervention to prevent obesity in children enrolled in 16 Head Start (HS) Centers in rural communities. The design and implementation of CHILE are described. METHODS CHILE uses a socio-ecological approach to improve dietary intake and increase physical activity. The intervention includes: a classroom curriculum; teacher and food service training; family engagement; grocery store participation; and health care provider support. RESULTS Lessons learned from CHILE include: the need to consider availability of recommended foods; the necessity of multiple training sessions for teachers and food service; the need to tailor the family events to local needs; consideration of the profit needs of grocery stores; and sensitivity to the time constraints of health care providers. CONCLUSIONS HS can play an important role in preventing obesity in children. CHILE is an example of a feasible intervention that addresses nutrition and physical activity for preschool children that can be incorporated into HS curricula and aligns with HS national performance standards. PMID:23343323

Predictors of Obesity in a US Sample of High School Adolescents with and without Disabilities

ERIC Educational Resources Information Center

Papas, Mia A.; Trabulsi, Jillian C.; Axe, Michelle; Rimmer, James H.

2016-01-01

Background: Childhood obesity is a major public health concern. Children with disabilities have a higher prevalence of obesity. Objective: We examined factors associated with obesity within a cross-sectional study of US adolescents with and without disabilities. Methods: Data were obtained from the 2011 Youth Risk Behavior Survey. Logistic…

Stigma and Minority Stress as Social Determinants of Health Among Lesbian, Gay, Bisexual, and Transgender Youth: Research Evidence and Clinical Implications.

PubMed

Hatzenbuehler, Mark L; Pachankis, John E

2016-12-01

In this article, we review theory and evidence on stigma and minority stress as social/structural determinants of health among lesbian, gay, bisexual, and transgender (LGBT) youth. We discuss different forms of stigma at individual (eg, identity concealment), interpersonal (eg, victimization), and structural (eg, laws and social norms) levels, as well as the mechanisms linking stigma to adverse health outcomes among LGBT youth. Finally, we discuss clinical (eg, cognitive behavioral therapy) and public health (eg, antibullying policies) interventions that effectively target stigma-inducing mechanisms to improve the health of LGBT youth. Copyright © 2016 Elsevier Inc. All rights reserved.

Family lifestyle dynamics and childhood obesity: evidence from the millennium cohort study.

PubMed

Gray, Laura A; Hernandez Alava, Monica; Kelly, Michael P; Campbell, Michael J

2018-04-16

The prevalence of childhood obesity has been increasing but the causes are not fully understood. Recent public health interventions and guidance aiming to reduce childhood obesity have focused on the whole family, as opposed to just the child but there remains a lack of empirical evidence examining this relationship. Using data from the longitudinal Millennium Cohort Study (MCS), we investigate the dynamic relationship between underlying family lifestyle and childhood obesity during early childhood. The MCS interviewed parents shortly after the birth of their child and follow up interviews were carried out when the child was 3, 5 and 7 years. We use a dynamic latent factor model, an approach that allows us to identify family lifestyle, its evolution over time (in this case between birth and 7 years) and its influence on childhood obesity and other observable outcomes. We find that family lifestyle is persistent, 87.43% of families which were above the 95th percentile on the lifestyle distribution, remained above the 95th percentile when the child was 7 years old. Family lifestyle has a significant influence on all outcomes in the study, including diet, exercise and parental weight status; family lifestyle accounts for 11.3% of the variation in child weight by age 7 years. The analysis suggests that interventions should therefore be prolonged and persuasive and target the underlying lifestyle of a family as early as possible during childhood in order to have the greatest cumulative influence. Our results suggest that children from advantaged backgrounds are more likely to be exposed to healthier lifestyles and that this leads to inequalities in the prevalence of obesity. To reduce inequalities in childhood obesity, policy makers should target disadvantaged families and design interventions specifically for these families.

Food and Nutrition Board update: What do SNAP allotments, physical fitness, and obesity prevention have in common?

PubMed

Meyers, Linda D; Murphy, Suzanne P; Yaktine, Ann L

2013-09-01

The Institute of Medicine's Food and Nutrition Board had a productive year, with important expert committee reports on the Supplemental Food Assistance Program, physical fitness, and accelerating obesity prevention efforts that provided grounding for dietary guidance and nutrition policies and programs. This summary describes Food and Nutrition Board activities, including current thinking on dietary reference intakes. The summary also highlights consensus reports on defining and measuring Supplemental Food Assistance Program benefit adequacy and on physical fitness and health outcomes in youth. In addition, current and new activities related to obesity prevention and care are addressed. What do these activities have in common? All adhere to the Institute of Medicine report model by filling gaps and by being analytical, evidence-based, and challenging.

The psychosocial burden of childhood overweight and obesity: evidence for persisting difficulties in boys and girls.

PubMed

Gibson, Lisa Y; Allen, Karina L; Davis, Elizabeth; Blair, Eve; Zubrick, Stephen R; Byrne, Susan M

2017-07-01

There is evidence that overweight and obese children tend to remain overweight or obese into adolescence and adulthood. However, little is known about the long-term psychosocial outcomes of childhood overweight and obesity. This study aimed to investigate the course of psychosocial difficulties over a 2-year period for children who were overweight or obese at baseline, and a sample of children who were a healthy weight at baseline. Participants were 212 children aged 8 to 13 years at baseline, who were participating in the Childhood Growth and Development (GAD) Study. Questionnaire and interview measures were used to assess children's self-esteem, depressive symptoms, body image, eating disorder symptoms, experiences with bullying, family satisfaction and quality of life. Linear mixed models were used to consider longitudinal changes in psychosocial variables. Overweight and obese children reported greater psychosocial distress than healthy weight children, and these differences were more pronounced for girls than boys. Weight and psychosocial impairment showed stability from baseline to 2-year follow-up. The results of this study suggest that psychosocial difficulties show considerable stability in childhood, for overweight/obese and healthy weight children. What is Known: • Childhood obesity tracks into adolescence and adulthood. • Physical health problems associated with childhood obesity also persist to adulthood. What is New: • Overweight and obese children are at risk of ongoing psychosocial distress from childhood into early adolescence.

Suicidal Ideation in Anxiety-Disordered Youth

ERIC Educational Resources Information Center

O'Neil, Kelly A.; Puleo, Connor M.; Benjamin, Courtney L.; Podell, Jennifer L.; Kendall, Philip C.

2012-01-01

Evidence is mixed regarding an independent association between anxiety and suicidality in youth. Study 1 examined suicidal ideation in treatment-referred, anxiety-disordered youth (N = 312, aged 7-17). Forty-one percent of anxiety-disordered youth endorsed suicidal ideation. Anxiety disorder severity, global impairment, and current depressive…

Obstructive sleep apnoea in obese adolescents and cardiometabolic risk markers.

PubMed

Watson, S E; Li, Z; Tu, W; Jalou, H; Brubaker, J L; Gupta, S; Huber, J N; Carroll, A; Hannon, T S

2014-12-01

In paediatric patients, obstructive sleep apnoea is associated with adiposity, especially visceral adiposity. In adults, obstructive sleep apnoea is also associated with a higher prevalence of cardiovascular disease and type 2 diabetes. There are limited and conflicting paediatric studies examining the association between obstructive sleep apnoea and biomarkers of risk for cardiovascular disease and type 2 diabetes in youth. Obstructive sleep apnoea is linked with greater cardiometabolic risk markers in obese adolescents. Fasting insulin and homeostasis model assessment-insulin resistance may be especially linked with obstructive sleep apnoea among obese male Hispanic adolescents. The relationship between obstructive sleep apnoea and cardiometabolic abnormalities in obese adolescents should be considered when evaluating patients found to have obstructive sleep apnoea. Paediatric studies examining the association between obstructive sleep apnoea (OSA) and insulin sensitivity/cardiometabolic risk are limited and conflicting. This study aims to determine if cardiometabolic risk markers are increased among obese youth with obstructive sleep apnoea as compared with their equally obese peers without OSA. We performed a retrospective analysis of 96 patients (age 14.2 ± 1.4 years) who underwent polysomnography for suspected OSA. Fasting lipids, glucose, insulin and haemoglobin A1 c (HbA1 c) were performed as part of routine clinical evaluation. Patients were categorized into two groups by degree of OSA as measured by the apnoea-hypopnoea index (AHI): none or mild OSA (AHI < 5) and moderate or severe OSA (AHI ≥ 5). Despite the similar degrees of obesity, patients with moderate or severe OSA had higher fasting insulin (P = 0.037) and homeostasis model assessment-insulin resistance (HOMA-IR [P = 0.0497]) as compared with those with mild or no OSA. After controlling for body mass index, there was a positive association between the AHI and log�

A youth-led social marketing intervention to encourage healthy lifestyles, the EYTO (European Youth Tackling Obesity) project: a cluster randomised controlled0 trial in Catalonia, Spain.

PubMed

Llauradó, Elisabet; Aceves-Martins, Magaly; Tarro, Lucia; Papell-Garcia, Ignasi; Puiggròs, Francesc; Arola, Lluís; Prades-Tena, Jordi; Montagut, Marta; Moragas-Fernández, Carlota M; Solà, Rosa; Giralt, Montse

2015-07-03

The encouragement of healthy lifestyles for obesity prevention in young people is a public health priority. The European Youth Tackling Obesity (EYTO) project is a multicentric intervention project with participation from the United Kingdom, Portugal, the Czech Republic and Spain. The general aim of the EYTO project is to improve lifestyles, including nutritional habits and physical activity practice, and to prevent obesity in socioeconomically disadvantaged and vulnerable adolescents. The EYTO project works through a peer-led social marketing intervention that is designed and implemented by the adolescents of each participating country. Each country involved in the project acts independently. This paper describes the "Som la Pera" intervention Spanish study that is part of the EYTO project. In Spain, the research team performed a cluster randomised controlled intervention over 2 academic years (2013-2015) in which 2 high-schools were designated as the control group and 2 high-schools were designated as the intervention group, with a minimum of 121 schoolchildren per group. From the intervention group, 5 adolescents with leadership characteristics, called "Adolescent Challenge Creators" (ACCs), were recruited. These 5 ACCs received an initial 4 h training session about social marketing principles and healthy lifestyle theory, followed by 24 sessions (1.30 h/session) divided in two academic years to design and implement activities presented as challenges to encourage healthy lifestyles among their peers, the approximately 180-200 high-school students in the intervention group. During the design of the intervention, it was essential that the ACCs used the 8 social marketing criteria (customer orientation, behaviour, theory, insight, exchange, competition, segmentation and methods mix). The expected primary outcomes from the Spanish intervention will be as follows: increases in the consumption of fruits and vegetables and physical activity practice along with

Patterns of habitual physical activity in youth with and without Prader-Willi Syndrome.

PubMed

Castner, Diobel M; Tucker, Jared M; Wilson, Kathleen S; Rubin, Daniela A

2014-11-01

Children classified as overweight or obese and those with disabilities are at a greater risk of not meeting the minimum recommendation of 60 min a day of moderate to vigorous physical activity (PA). Youth with Prader-Willi Syndrome (PWS) appear to participate in less PA compared to nonsyndromal children, likely due to syndrome-related factors. However, description of PA patterns in youth with PWS is lacking. The purpose of this study was to characterize PA in youth with PWS and to compare it to PA in children with nonsyndromal obesity. Twenty-four youth with PWS (ages 8-16 years) and 40 obese children without PWS (OB) (ages 8-11 years) wore accelerometers for eight consecutive days. Data were screened for compliance and classified into PA intensities: sedentary behavior (SED), light (LPA), moderate (MPA), vigorous (VPA) and moderate plus vigorous (MVPA). Youth with PWS spent 19.4% less time in weekly LPA (p=0.007) and 29.8% less time in weekly VPA compared to OB controls (p=0.036). All other intensities were similar between groups. In addition, PWS participated in less LPA and VPA during the weekends compared to OB, and less LPA on weekdays when compared to OB. There was also a trend towards PWS participating in less MVPA during the weekends and less VPA during the weekends than OB controls. There was a trend towards PWS participating in less VPA on weekends compared to weekdays, while OB participated similarly in VPA on weekdays and weekend days. On average, neither PWS nor OB children met minimum MVPA recommendations. The results suggest there is a need to design exercise programs for PWS youth that focus on integrating vigorous intensity activities, especially during the weekends when structured PA may not be available. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association between obesity indices and cardiovascular risk factors in late adolescence in the Seychelles.

PubMed

Bovet, Pascal; Arlabosse, Tiphaine; Viswanathan, Bharathi; Myers, Gary

2012-11-07

The ability of different obesity indices to predict cardiovascular risk is still debated in youth and few data are available in sub Saharan Africa. We compared the associations between several indices of obesity and cardiovascular risk factors (CVRFs) in late adolescence in the Seychelles. We measured body mass index (BMI), waist circumference, waist/hip ratio (WHiR), waist/height ratio (WHtR) and percent fat mass (by bioimpedance) and 6 CVRFs (blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides, fasting blood glucose and uric acid) in 423 youths aged 19-20 years from the general population. The prevalence of overweight/obesity and several CVRFs was high, with substantial sex differences. Except for glucose in males and LDL-cholesterol in females, all obesity indices were associated with CVRFs. BMI consistently predicted CVRFs at least as well as the other indices. Linear regression on BMI had standardized regression coefficients of 0.25-0.36 for most CVRFs (p<0.01) and ROC analysis had an AUC between 60%-75% for most CVRFs. BMI also predicted well various combinations of CVRFs: 36% of male and 16% of female lean subjects (BMI P90). There was an elevated prevalence of obesity and of several CVRFs in youths in Seychelles. BMI predicted single or combined CVRFs at least as well as other simple obesity indices.

Worksite Environmental Interventions for Obesity Prevention and Control: Evidence from Group Randomized Trials.

PubMed

Fernandez, Isabel Diana; Becerra, Adan; Chin, Nancy P

2014-06-01

Worksites provide multiple advantages to prevent and treat obesity and to test environmental interventions to tackle its multiple causal factors. We present a literature review of group-randomized and non-randomized trials that tested worksite environmental, multiple component interventions for obesity prevention and control paying particular attention to the conduct of formative research prior to intervention development. The evidence on environmental interventions on measures of obesity appears to be strong since most of the studies have a low (4/8) and unclear (2/8) risk of bias. Among the studies reviewed whose potential risk of bias was low, the magnitude of the effect was modest and sometimes in the unexpected direction. None of the four studies describing an explicit formative research stage with clear integration of findings into the intervention was able to demonstrate an effect on the main outcome of interest. We present alternative explanation for the findings and recommendations for future research.

Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review

ERIC Educational Resources Information Center

Wong, Connie; Odom, Samuel L.; Hume, Kara A.; Cox, Ann W.; Fettig, Angel; Kucharczyk, Suzanne; Brock, Matthew E.; Plavnick, Joshua B.; Fleury, Veronica P.; Schultz, Tia R.

2015-01-01

The purpose of this study was to identify evidenced-based, focused intervention practices for children and youth with autism spectrum disorder. This study was an extension and elaboration of a previous evidence-based practice review reported by Odom et al. ("Prev Sch Fail" 54:275-282, 2010b, doi:10.?1080/?1045988100378550?6). In the…

Physical activity for the prevention and management of youth-onset type 2 diabetes mellitus: focus on cardiovascular complications.

PubMed

McGavock, Jonathan; Sellers, Elizabeth; Dean, Heather

2007-12-01

With the growing prevalence of childhood obesity and type 2 diabetes mellitus (T2DM) in youth, the challenge of cardiovascular disease risk management has entered the paediatric realm, affecting specialists, family physicians and allied healthcare professionals alike. Currently, there is little evidence to support optimal strategies for management of T2DM in youth and the associated cardiovascular complications. Physical activity plays a powerful role in the prevention and management of T2DM and cardiovascular disease in adults. This review will focus on the role of physical activity for the prevention of T2DM in youth and its associated cardiovascular complications. The first part describes the prevalence of cardiovascular risk factors in this cohort. The second part focuses on the role of physical activity in the prevention and management of T2DM in youth. Collectively, the limited intervention and observation studies published to date suggest that daily targets of 60-90 minutes of physical activity and less than 60 minutes of screen time (i.e. time spent in front of a television, computer or video games) are required for the prevention and management of T2DM in youth. Large-scale intervention studies are needed to determine the most effective physical activity strategies for the prevention and management of T2DM in youth.

Type 2 diabetes in a 5-year-old and single center experience of type 2 diabetes in youth under 10.

PubMed

Hutchins, Jessica; Barajas, Rose Ann; Hale, Daniel; Escaname, Elia; Lynch, Jane

2017-11-01

The worrisome rise in pediatric type 2 diabetes (T2DM) is most prevalent among minority ethnic/racial populations. Typically, T2DM occurs during puberty in high risk obese adolescents with evidence of insulin resistance. Screening for T2DM in obese youth can be a daunting task for pediatricians and differentiating between pediatric T1DM and T2DM in obese youth can be challenging for pediatric endocrinologists. There is very limited data regarding the prevalence of T2DM among youth < 10 years of age. Here we present the case of a 5-year-old Hispanic male diagnosed with T2DM after referral by his pediatrician for abnormal weight gain, acanthosis nigricans and an elevated HbgA1c. He subsequently became symptomatic for diabetes with confirmed hyperglycemia and HbgA1c of 9.7% (83 mmol/mol) at the time of formal diagnosis. Type 1 diabetes autoantibodies (GAD65, Islet, and ZincT8) and monogenic diabetes genetic tests were negative. Due to elevated liver enzymes and baseline HbgA1c, he received basal insulin as his initial therapy. In this paper, we will discuss this case and present an IRB approved retrospective review of the characteristics of the 20 T2DM patients <10 years of age identified to date in our pediatric diabetes center. This review highlights that while uncommon, the diagnosis of T2DM merits consideration even in prepubertal children. This is especially true when working with a high risk population, such as our Hispanic South Texas youth. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Obesity and bone.

PubMed

Compston, Juliet

2013-03-01

Recent studies indicate that fractures in obese postmenopausal women and older men contribute significantly to the overall fracture burden. The effect of obesity is to some extent site-dependent, the risk being increased for some fractures and decreased for others, possibly related to different patterns of falling and the presence or absence of soft tissue padding. Risk factors for fracture in obese individuals appear to be similar to those in the nonobese population, although falls may be particularly important in the obese. There is some evidence that the morbidity associated with fractures in obese individuals is greater than in the nonobese; however, a recent study indicates that the mortality associated with fracture is lower in obese and overweight people than in those of normal weight. The evidence base for strategies to prevent fractures in obese individuals is weak and is an important area for future research.

The use of smartphones to influence lifestyle changes in overweight and obese youth with congenital heart disease: a single-arm study: Pilot and feasibility study protocol: Smart Heart Trial.

PubMed

Rombeek, Meghan; De Jesus, Stefanie; Altamirano-Diaz, Luis; Welisch, Eva; Prapavessis, Harry; Seabrook, Jamie A; Norozi, Kambiz

2017-01-01

Both obesity and congenital heart disease (CHD) are risk factors for the long-term cardiovascular health of children and adolescents. The addition of smart mobile technology to conventional lifestyle counseling for weight management offers great potential to appeal to technologically literate youth and can address a large geographical area with minimal burden to participants. This pilot study seeks to examine the influence of a 1-year lifestyle intervention on nutrition and physical activity-related health outcomes in overweight or obese children and adolescents with CHD. This is a pilot and feasibility study which utilizes a single-arm, prospective design with a goal to recruit 40 overweight and obese patients. The feasibility metrics will evaluate the integrity of the study protocol, data collection and questionnaires, recruitment and consent, and acceptability of the intervention protocol and primary outcome measures. The primary clinical outcome metrics are anthropometry, body composition, and cardiorespiratory exercise capacity. The secondary clinical metrics include quality of life, nutrition and physical activity behavior, lung and muscle function, and cardio-metabolic risk factors. Outcomes are assessed at baseline, 6 months, and 1 year. To date, a total of 36 children and youth (11 girls), aged 7-17 years (mean = 14.4 years), have commenced the intervention. Recruitment for the study was initiated in June 2012 and is currently ongoing. The information provided in this paper is intended to help researchers and health professionals with the development and evaluation of similar lifestyle intervention programs. Since the application of smartphones to pediatric cardiac health and obesity management is a novel approach, and continued research in this area is warranted, this paper may serve as a foundation for further exploration of this health frontier and inform the development of a broader strategy for obesity management in pediatric cardiology. This

Youth lead youth in Marshall Islands.

PubMed

Johnson, G

1988-01-01

The promotion of family planning and birth control in Pacific countries is often frustrated by traditional and religious beliefs, if not deterred by tremendous funding and logistics problems. In the central Pacific republic of the Marshall Islands, however, youthful health workers are taking a unique approach to health promotion that has spurred acceptance of the once controversial subjects of family planning and birth control. A group known as Youth to Youth in Health is spearheading a family planning outreach drive in the schools and community in the Marshall Islands. Coupling health presentations with traditional island music and dance to produce lively health shows, the group's programs on family planning, birth control, nutrition, and cancer have struck a responsive chord in a culture known for its religious and traditional conservatism. The group makes creative use of puppet shows, skits, health songs, and pantomimes, interspersed with contemporary renditions of Marshall Islands music and traditional dances. These have rekindled pride in their culture among the group and sparked a sense of urgency about the need to improve health conditions in the islands. As evidence of the group's impact, family planning staff point to a nearly 4-fold rise in the number of youth clients under 19 years since the Youth to Youth started in mid-1986. Their combination of traditional custom with family planning and other health information has proved to be an innovative and needed program for the islands.

Parenting style and obesity risk in children.

PubMed

Kakinami, Lisa; Barnett, Tracie A; Séguin, Louise; Paradis, Gilles

2015-06-01

Parents play a critical role in their children's lifestyle habits. The objective was to assess the effect of parenting style on the risk of childhood obesity, and to determine whether poverty was a moderator of the association. Participants were from the 1994-2008 cross-sectional samples of the National Longitudinal Survey of Children and Youth (NLSCY), a nationally representative survey of Canadian youth. Factor and cluster analyses identified four parenting styles consistent with Baumrind's parenting style prototypes. Multivariable logistic regression assessed the risk of obesity based on parenting style after adjusting for covariates. Analyses were stratified by age (preschool: 2-5years of age, n=19,026; school-age: 6-11years of age, n=18,551) and the moderating effect of poverty (household incomeobese, respectively. In preschool children, poverty moderated this association: authoritarian and negligent parenting was associated with 44% (CI: 1.3-1.7) and 26% (CI: 1.1-1.4) increased likelihood of obesity, respectively, but only among the children not living in poverty. In school-age children, poverty was not a moderator. Parenting style is associated with childhood obesity, but may be moderated by poverty. Successful strategies to combat childhood obesity should reflect the independent and interactive associations of sociodemographic and social-familial influences on health especially in early childhood. Copyright © 2015 Elsevier Inc. All rights reserved.

Reducing Cancer and Cancer Disparities: Lessons From a Youth-Generated Diabetes Prevention Campaign.

PubMed

Schillinger, Dean; Ling, Pamela M; Fine, Sarah; Boyer, Cherrie B; Rogers, Elizabeth; Vargas, Roberto Ariel; Bibbins-Domingo, Kirsten; Chou, Wen-Ying Sylvia

2017-09-01

Adolescence and young adulthood, a period essential for determining exposures over the life-course, is an ideal time to intervene to lower cancer risk. This demographic group can be viewed as both the target audience and generator of messages for cancer prevention, such as skin cancer, obesity-, tobacco-, and human papillomavirus-related cancers. The purpose of this paper is to encourage innovative health communications that target youth; youth behavior; and the structural, environmental, and social determinants of youth behavior as critical areas of focus for cancer prevention and disparities reduction. The authors describe the rationale, processes, products, and early impacts of an award-winning youth diabetes prevention communication campaign model (The Bigger Picture) that harnesses spoken-word messages in school-based and social media presentations. The campaign supports minority adolescent and young adult artists to create content that aligns with values held closely by youth-values likely to resonate and affect change, such as defiance against authority, inclusion, and social justice. This campaign can be leveraged to prevent obesity, which is a cancer risk factor. Then, the authors propose concrete ways that The Bigger Picture's pedagogical model could be adapted for broader cancer prevention messaging for youth of color and youth stakeholders regarding tobacco-related cancers, skin cancers, and human papillomavirus-related cancers. The goal is to demonstrate how a youth-generated and youth-targeted prevention campaign can: (1) reframe conversations about cancer prevention, (2) increase awareness that cancer prevention is about social justice and health equity, and (3) catalyze action to change social norms and confront the social and environmental drivers of cancer disparities. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

Relationship between urban sprawl and weight of United States youth.

PubMed

Ewing, Reid; Brownson, Ross C; Berrigan, David

2006-12-01

Among United States youth there is an obesity epidemic with potential life-long health implications. To date, relationships between the built environment and body mass index (BMI) have not been evaluated for youth, and have not been evaluated longitudinally. To determine if urban sprawl is associated with BMI for U.S. youth. Using data from the 1997 National Longitudinal Survey of Youth (NLSY97), both cross-sectional and longitudinal analyses were conducted. Hierarchical modeling was used to relate characteristics of individuals, households, and places to BMI. Individual and household data were extracted from the NLSY97. The independent variable of interest was the county sprawl index, which was derived with principal components analyses from census and other data. In a cross-sectional analysis, the likelihood of U.S. adolescents (aged 12-17 years) being overweight or at risk of overweight (> or =85th percentile relative to the Centers for Disease Control growth charts) was associated with county sprawl (p=0.022). In another cross-sectional analysis, after controlling for sociodemographic and behavioral covariates, the likelihood of young adults (aged 18-23 years) being obese was also associated with county sprawl (p=0.048). By contrast, in longitudinal analyses, BMI growth curves for individual youth over the 7 years of NLSY97, and BMI changes for individual youth who moved between counties, were not related to county sprawl (although coefficient signs were as expected). Cross-sectional analyses suggest that urban form is associated with being overweight among U.S. youth. The strength of these relationships proved comparable to those previously reported for adults. Longitudinal analyses show no such relationship. It is unclear why these approaches give different results, but sample sizes, latent effects, and confounders may contribute.

Relationship Between Urban Sprawl and Weight of United States Youth

PubMed Central

Ewing, Reid; Brownson, Ross C.; Berrigan, David

2007-01-01

Background Among United States youth there is an obesity epidemic with potential lifelong health implications. To date, relationships between the built environment and body mass index (BMI) have not been evaluated for youth, and have not been evaluated longitudinally. Objective To determine if urban sprawl is associated with BMI for U.S. youth. Method Using data from the 1997 National Longitudinal Survey of Youth (NLSY97), both cross-sectional and longitudinal analyses were conducted. Hierarchical modeling was used to relate characteristics of individuals, households, and places to BMI. Individual and household data were extracted from the NLSY97. The independent variable of interest was the county sprawl index, which was derived with principal components analyses from census and other data. Results In a cross-sectional analysis, the likelihood of U.S. adolescents (aged 12–17 years) being overweight or at risk of overweight (≥85th percentile relative to the Centers for Disease Control [CDC] growth charts) was associated with county sprawl (p=0.022). In another cross-sectional analysis, after controlling for sociodemographic and behavioral covariates, the likelihood of young adults (aged 18–23 years) being obese was also associated with county sprawl (p=0.048). By contrast, in longitudinal analyses, BMI growth curves for individual youth over the 7 years of NLSY97, and BMI changes for individual youth who moved between counties, were not related to county sprawl (although coefficient signs were as expected). Conclusions Cross-sectional analyses suggest that urban form is associated with overweight among U.S. youth. The strength of these relationships proved comparable to those previously reported for adults. Longitudinal analyses show no such relationship. It is unclear why these approaches give different results, but sample sizes, latent effects, and confounders may contribute. PMID:17169708

Anthropometric indices of First Nations children and youth on first entry to Manitoba/Saskatchewan residential schools-1919 to 1953.

PubMed

Hackett, F J Paul; Abonyi, Sylvia; Dyck, Roland F

2016-01-01

First Nations people are experiencing increasing rates of obesity and type 2 diabetes but no anthropometric information exists from before the 1950s to provide context to these epidemics. To compare anthropometric indices of First Nations children and youth on first entering residential schools with historical and contemporary reference groups. This observational cross-sectional study used archival records from the Department of Indian Affairs to calculate body mass index (BMI), height for age (HA) and weight for age (WA) of all known children and youth undergoing physical examinations on first entering residential schools in Saskatchewan and Manitoba from 1919 to 1953. Proportions of children and youth in each BMI category were determined by age, sex, time period and residential school. Z-scores for HA and WA were determined by age group and sex. Finally, median heights and weights were compared with a non-Indigenous cohort from the 1953 Canadian survey. On admission to residential schools, 1,767 First Nations children and youth (847 boys, 920 girls) were more likely to have normal BMIs (79.8%) than Canadian children and youth today (66.5%), but lower rates of overweight/obesity (10.9% vs. 32.0%) and higher rates of underweight (9.3% vs. <2.0%). There was an overall trend of diminishing levels of underweight and increasing levels of overweight/obesity over time. Although 6.6% of boys and 7.9% of girls had HA Z-scores >-2, age-specific median heights tended to be higher than Canadian children and youth in 1953. Under 3% of children and youth had WA Z-scores of >-2. A large majority of First Nations children and youth exhibited normal anthropometric indices on first entering residential schools in Manitoba and Saskatchewan from 1919 to 1953. These historical findings provide an important context to the current epidemics of obesity and type 2 diabetes and suggest that the nutritional conditions in these First Nations children's communities were satisfactory during

Is sleep deprivation a contributor to obesity in children?

PubMed

Chaput, Jean-Philippe

2016-03-01

Chronic lack of sleep (called "sleep deprivation") is common in modern societies with 24/7 availability of commodities. Accumulating evidence supports the role of reduced sleep as contributing to the current obesity epidemic in children and youth. Longitudinal studies have consistently shown that short sleep duration is associated with weight gain and the development of obesity. Recent experimental studies have reported that sleep restriction leads to weight gain in humans. Increased food intake appears to be the main mechanism by which insufficient sleep results in weight gain. Voluntary sleep restriction has been shown to increase snacking, the number of meals eaten per day, and the preference for energy-dense foods. Although the causes of sleep loss in the pediatric population are numerous, more research looking at screen exposure before bedtime and its effects on sleep is needed given the pervasiveness of electronic media devices in today's environment. Health professionals should routinely ask questions about sleep and promote a good night's sleep because insufficient sleep impacts activity and eating behaviors. Future research should examine the clinical benefits of increasing sleep duration on eating behaviors and body weight control and determine the importance of adequate sleep to improve the treatment of obesity.

Maternal Childhood Adversity, Prepregnancy Obesity, and Gestational Weight Gain.

PubMed

Ranchod, Yamini K; Headen, Irene E; Petito, Lucia C; Deardorff, Julianna K; Rehkopf, David H; Abrams, Barbara F

2016-04-01

Growing evidence suggests that exposure to childhood adversity may influence obesity across the life course. High maternal weight complicates pregnancy and increases the risk of child obesity. This study examined the association between maternal childhood adversity and pregnancy-related weight in a large U.S. Data on 6,199 pregnancies from 2,873 women followed from 1979 to 2012 by the National Longitudinal Survey of Youth 1979 were analyzed in 2014. Associations between three adversity exposures before age 18 years (history of physical abuse, alcohol problems, or mental illness in the household) and two maternal weight outcomes (prepregnancy obesity and excessive gestational weight gain) were modeled separately using survey-adjusted log-binomial models. After adjusting for race/ethnicity and early-life socioeconomic factors, childhood physical abuse was associated with a 60% increase in the risk of prepregnancy obesity (adjusted risk ratio=1.6, 95% CI=1.1, 2.2). Household alcohol abuse was associated with a 30% increase in prepregnancy obesity (adjusted risk ratio=1.3, 95% CI=1.0, 1.7), as was household mental illness (adjusted risk ratio=1.3, 95% CI=0.8, 1.9), but the mental illness exposure was not significant. Physical abuse and household alcohol abuse were associated with a significant 20% increase in the risk of excessive gestational weight gain; mental illness was not. Adversity in early life may affect maternal weight before and during pregnancy. Screening and treating women of reproductive age for childhood adversity and its negative effects could significantly reduce obesity-related health outcomes for women and their children. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Reaching the healthy people goals for reducing childhood obesity: closing the energy gap.

PubMed

Wang, Y Claire; Orleans, C Tracy; Gortmaker, Steven L

2012-05-01

The federal government has set measurable goals for reducing childhood obesity to 5% by 2010 (Healthy People 2010), and 10% lower than 2005-2008 levels by 2020 (Healthy People 2020). However, population-level estimates of the changes in daily energy balance needed to reach these goals are lacking. To estimate needed per capita reductions in youths' daily "energy gap" (calories consumed over calories expended) to achieve Healthy People goals by 2020. Analyses were conducted in 2010 to fit multivariate models using National Health and Nutrition Examination Surveys 1971-2008 (N=46,164) to extrapolate past trends in obesity prevalence, weight, and BMI among youth aged 2-19 years. Differences in average daily energy requirements between the extrapolated 2020 levels and Healthy People scenarios were estimated. During 1971-2008, mean BMI and weight among U.S. youth increased by 0.55 kg/m(2) and by 1.54 kg per decade, respectively. Extrapolating from these trends to 2020, the average weight among youth in 2020 would increase by ∼1.8 kg from 2007-2008 levels. Averting this increase will require an average reduction of 41 kcal/day in youth's daily energy gap. An additional reduction of 120 kcal/day and 23 kcal/day would be needed to reach Healthy People 2010 and Healthy People 2020 goals, respectively. Larger reductions are needed among adolescents and racial/ethnic minority youth. Aggressive efforts are needed to reverse the positive energy imbalance underlying the childhood obesity epidemic. The energy-gap metric provides a useful tool for goal setting, intervention planning, and charting progress. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States.

PubMed

DuBose, Stephanie N; Hermann, Julia M; Tamborlane, William V; Beck, Roy W; Dost, Axel; DiMeglio, Linda A; Schwab, Karl Otfried; Holl, Reinhard W; Hofer, Sabine E; Maahs, David M

2015-09-01

To examine the current extent of the obesity problem in 2 large pediatric clinical registries in the US and Europe and to examine the hypotheses that increased body mass index (BMI) z-scores (BMIz) are associated with greater hemoglobin A1c (HbA1c) and increased frequency of severe hypoglycemia in youth with type 1 diabetes (T1D). International (World Health Organization) and national (Centers for Disease Control and Prevention/German Health Interview and Examination Survey for Children and Adolescents) BMI references were used to calculate BMIz in participants (age 2-<18 years and ≥ 1 year duration of T1D) enrolled in the T1D Exchange (n = 11,435) and the Diabetes Prospective Follow-up (n = 21,501). Associations between BMIz and HbA1c and severe hypoglycemia were assessed. Participants in both registries had median BMI values that were greater than international and their respective national reference values. BMIz was significantly greater in the T1D Exchange vs the Diabetes Prospective Follow-up (P < .001). After stratification by age-group, no differences in BMI between registries existed for children 2-5 years, but differences were confirmed for 6- to 9-, 10- to 13-, and 14- to 17-year age groups (all P < .001). Greater BMIz were significantly related to greater HbA1c levels and more frequent occurrence of severe hypoglycemia across the registries, although these associations may not be clinically relevant. Excessive weight is a common problem in children with T1D in Germany and Austria and, especially, in the US. Our data suggest that obesity contributes to the challenges in achieving optimal glycemic control in children and adolescents with T1D. Copyright © 2015 Elsevier Inc. All rights reserved.

Prevention of Obesity and Eating Disorders: A Consideration of Shared Risk Factors

ERIC Educational Resources Information Center

Haines, Jess; Neumark-Sztainer, Dianne

2006-01-01

In response to the high prevalence of obesity, eating disorders and disordered eating behaviors among youth, researchers in both the obesity and eating disorders fields have proposed using an integrated approach to prevention that addresses the spectrum of weight-related disorders within interventions. The identification of risk factors that are…

Motor Skills of Obese and Severely Obese Children and Adolescents - A CIRCUIT Study.

PubMed

Häcker, Anna-Luisa; Bigras, Jean-Luc; Henderson, Mélanie; Barnett, Tracie A; Mathieu, Marie-Eve

2017-11-27

During childhood, excessive weight is negatively associated with the development of motor skills, with children with overweight or obesity having poorer motor skills compared to children with normal weight. The objectives of the current study are to identify the differences in motor skills between children and adolescent with obesity and severe obesity and the extent of this difference. To do so, we examined cross-sectionally 165 subjects. Physical fitness was analyzed in both participants with obesity (>97-99.9 BMI percentile) and severe obesity (>99.9 BMI percentile) using eight standardized tests: sit-and-reach, grip force, sit-ups, push-ups, balance, hand-eye coordination, standing long jump and 5-meter shuttle run. Poorer performance were observed in participants with severe obesity in sit-ups (children: 59%; 18.6±17.0 percentile value vs. 29.5±23.2 percentile value, p=0.008), balance (adolescent: 59%; 12.1±12.2 sec. v. 19.3±13.9 sec., p=0.034) and in the 5-meter shuttle run (children: 49%; 14.0±13.9 percentile value vs. 20.8 ± 19.4 percentile value, p=0.046; adolescents: 11%; 13.2±2.2 sec. vs. 11.8±1.6 sec., p=0.008) compared to obese counterparts. In conclusion, while physical performance was found to be similar between the different obesity levels for the majority of tests, youth with severe obesity demonstrated impairments ranging from 11 to 59% in specific tests.

Parental perceptions of weight terminology that providers use with youth.

PubMed

Puhl, Rebecca M; Peterson, Jamie Lee; Luedicke, Joerg

2011-10-01

Little research has been performed to examine patient perceptions of weight-related language, especially related to childhood obesity. In this study we assessed parental perceptions of weight-based terminology used by health care providers to describe a child's excess weight and assessed perceived connotations associated with these terms including stigma, blame, and motivation to reduce weight. A national sample of American parents with children aged 2 to 18 years (N = 445) completed an online survey to assess their perceptions of 10 common terms to describe excess body weight in youth (including "extremely obese," "high BMI," "weight problem," "unhealthy weight," "weight," "heavy," "obese," "overweight," "chubby," and "fat"). Parents were asked to use a 5-point rating scale to indicate how much they perceived each term to be desirable, stigmatizing, blaming, or motivating to lose weight. Regression models revealed that the terms "weight" and "unhealthy weight" were rated as most desirable, and "unhealthy weight" and "weight problem" were rated as the most motivating to lose weight. The terms "fat," "obese," and "extremely obese" were rated as the most undesirable, stigmatizing, blaming, and least motivating. Parents' ratings were consistent across sociodemographic variables, body weight, and child's body weight. The results of this study have important implications for the improvement of health care for youth with obesity; it may be advantageous for health care providers to use or avoid using specific weight-based language during discussions about body weight with families. Pediatricians play a key role in obesity prevention and treatment, but their efforts may be undermined by stigmatizing or offensive language that can hinder important discussions about children's health.

Gender-specific effects of early nutritional restriction on adult obesity risk: evidence from quasi-experimental studies.

PubMed

Robinson, Whitney R

2012-12-01

In countries undergoing nutrition transition and historically poor minority groups in wealthy countries, obesity tends to be more common in women than men. A potential contributor to this female excess of obesity is a mismatch between perinatal nutritional restriction and a later calorie-rich environment. Several epidemiologic and quasi-experimental studies support a gender-differential effect of early nutritional deprivation on adult obesity. The quasi-experimental studies are of particular interest because results of quasi-experimental studies are typically less vulnerable to confounding bias than observational studies. Four quasi-experimental studies-exploiting 20th century famines that occurred in Europe, Africa, and Asia-provide evidence that perinatal nutritional restriction followed by relative caloric abundance may increase adult obesity risk to a greater extent in women than men. If the findings are accurate and generalizable to contemporary food environments, they suggest that the female offspring of poor, or otherwise nutritionally restricted, women in rapidly developing and wealthy countries may be at particularly high risk of adult obesity. Research into gender-specific effects of early life nutritional deprivation and its interactions with later environmental exposures may provide insight into global gender differences in obesity prevalence.

Decomposing socioeconomic inequalities in childhood obesity: evidence from Ireland.

PubMed

Walsh, Brendan; Cullinan, John

2015-01-01

The objective of this paper is to quantify and decompose the socioeconomic gradient in childhood obesity in the Republic of Ireland. The analysis is performed using data from the first wave of the Growing Up in Ireland survey, a nationally representative survey of 8568 nine-year-old children conducted in 2007 and 2008. We estimate concentration indices to quantify the extent of the socioeconomic gradient in childhood obesity and undertake a subsequent decomposition analysis to pinpoint the key factors underpinning the observed inequalities. Overall the results confirm a strong socioeconomic gradient in childhood obesity in the Republic of Ireland. Concentration indices of obesity (CI=-0.168) and overweight/obese (CI=-0.057) show that the gradient is more pronounced in obese children, while results from the decomposition analysis suggest that the majority of the inequality in childhood obesity is explained by parental level variables. Our findings suggest that addressing childhood obesity inequalities requires coordinated policy responses at both the child and parental level. Copyright © 2014 Elsevier B.V. All rights reserved.

Obesity and hypertensive heart disease: focus on body composition and sex differences.

PubMed

de Simone, Giovanni; Mancusi, Costantino; Izzo, Raffaele; Losi, Maria Angela; Aldo Ferrara, L

2016-01-01

There is evidence that hypertension is frequently associated with overweight/obesity even in kids and adolescents. Either conditions influence development of left ventricular (LV) hypertrophy (LVH), through different biological and hemodynamic mechanisms: obesity is conventionally thought to elicit a coherent growth of LV chamber dimensions and myocardial wall thickness (eccentric LV geometry), whereas a more accentuated increase in wall-thickness (concentric LV geometry) is attributed to hypertension. While during youth these differences are visible, proportion of LV concentric geometry, the most harmful LV geometric pattern, sharply raises in obese individuals during middle age, and becomes the most frequent geometric patterns among obese-hypertensive individuals. Two conditions with elevated hemodynamic impact, severe obstructive sleep apnea and masked hypertension contribute to the development of such a geometric pattern, but non-hemodynamic factors, and specifically body composition, also influence prevalence of concentric LV geometry. Contrasting a general belief, it has been observed that adipose mass strongly influences LV mass, particularly in women, especially when fat-free mass is relatively deficient. Thus, though blood pressure control is mandatory for prevention and reduction of LVH in obese hypertensive patients, without reduction of visceral adiposity regression of LVH is difficult. Future researches should be addressed on (1) assessing whether LVH resulting from alteration of body composition carries the same prognosis as pressure overload LVH; (2) defining tissue characterization of the hypertrophic heart in obese-hypertensive patients; (3) evaluating whether assessment of hemodynamic loading conditions and biological markers can help defining management of the association of obesity with hypertension.

Childhood obesity prevention through a community-based cluster randomized controlled physical activity intervention among schools in china: the health legacy project of the 2nd world summer youth olympic Games (YOG-Obesity study)

PubMed Central

Wang, Z; Xu, F; Ye, Q; Tse, L A; Xue, H; Tan, Z; Leslie, E; Owen, N; Wang, Y

2018-01-01

Background: Childhood obesity has been becoming a worldwide public health problem. We conducted a community-based physical activity (PA) intervention program aiming at childhood obesity prevention in general student population in Nanjing of China, the host city of the 2nd World Summer Youth Olympic Games (YOG-Obesity study). Methods: This was a cluster randomized controlled intervention study. Participants were the 4th (mean age±s.e.: 9.0±0.01) and 7th (mean age±s.e.: 12.0±0.01) grade students (mean age±s.e.: 10.5±0.02) from 48 schools and randomly allocated (1:1) to intervention or control groups at school level. Routine health education was provided to all schools, whereas the intervention schools additionally received an 1-year tailored multi-component PA intervention program, including classroom curricula, school environment support, family involvement and fun programs/events. The primary outcome measures were changes in body mass index, obesity occurrence and PA. Results: Overall, 9858 (97.7%) of the 10091 enrolled students completed the follow-up survey. Compared with the baseline, PA level increased by 33.13 min per week (s.e. 10.86) in the intervention group but decreased by 1.76 min per week (s.e. 11.53) in the control group (P=0.028). After adjustment for potential confounders, compared with the control group, the intervention group were more likely to have increased time of PA (adj. Odds ratio=1.15, 95% confidence interval=1.06–1.25), but had a smaller increase in mean body mass index (BMI) (0.22 (s.e. 0.02) vs 0.46 (0.02), P=0.01) and BMI z-score (0.07 (0.01) vs 0.16 (0.01), P=0.01), and were less likely to be obese (adj. Odds ratio=0.7, 95% confidence interval=0.6, 0.9) at study end. The intervention group had fewer new events of obesity/overweight but a larger proportion of formerly overweight/obese students having normal weight by study end. Conclusions: This large community-based PA intervention was feasible and effective in promoting PA

Childhood obesity prevention through a community-based cluster randomized controlled physical activity intervention among schools in china: the health legacy project of the 2nd world summer youth olympic Games (YOG-Obesity study).

PubMed

Wang, Z; Xu, F; Ye, Q; Tse, L A; Xue, H; Tan, Z; Leslie, E; Owen, N; Wang, Y

2018-04-01

Childhood obesity has been becoming a worldwide public health problem. We conducted a community-based physical activity (PA) intervention program aiming at childhood obesity prevention in general student population in Nanjing of China, the host city of the 2nd World Summer Youth Olympic Games (YOG-Obesity study). This was a cluster randomized controlled intervention study. Participants were the 4th (mean age±s.e.: 9.0±0.01) and 7th (mean age±s.e.: 12.0±0.01) grade students (mean age±s.e.: 10.5±0.02) from 48 schools and randomly allocated (1:1) to intervention or control groups at school level. Routine health education was provided to all schools, whereas the intervention schools additionally received an 1-year tailored multi-component PA intervention program, including classroom curricula, school environment support, family involvement and fun programs/events. The primary outcome measures were changes in body mass index, obesity occurrence and PA. Overall, 9858 (97.7%) of the 10091 enrolled students completed the follow-up survey. Compared with the baseline, PA level increased by 33.13 min per week (s.e. 10.86) in the intervention group but decreased by 1.76 min per week (s.e. 11.53) in the control group (P=0.028). After adjustment for potential confounders, compared with the control group, the intervention group were more likely to have increased time of PA (adj. Odds ratio=1.15, 95% confidence interval=1.06-1.25), but had a smaller increase in mean body mass index (BMI) (0.22 (s.e. 0.02) vs 0.46 (0.02), P=0.01) and BMI z-score (0.07 (0.01) vs 0.16 (0.01), P=0.01), and were less likely to be obese (adj. Odds ratio=0.7, 95% confidence interval=0.6, 0.9) at study end. The intervention group had fewer new events of obesity/overweight but a larger proportion of formerly overweight/obese students having normal weight by study end. This large community-based PA intervention was feasible and effective in promoting PA and preventing obesity among the general

Implementing Evidence-Based Teen Pregnancy-Prevention Interventions in a Community-Wide Initiative: Building Capacity and Reaching Youth.

PubMed

House, L Duane; Tevendale, Heather D; Martinez-Garcia, Genevieve

2017-03-01

To describe efforts to implement evidence-based interventions (EBIs) within multicomponent, community-wide initiatives to reduce teen pregnancy. During 2011-2014, we collected information about the capacity (i.e., knowledge, confidence, training, and experience) of state and community-based organizations to support implementation of the following: EBIs, number and characteristics of youth served by EBIs, type of EBIs implemented, EBI settings, hours of training, and technical assistance provided. State and community-based organizations reported these data annually; however, training and technical assistance was reported monthly. We used aggregated data from these annual and monthly reports to describe the implementation of EBIs in the community-wide initiative project. From baseline in 2011-2014, state and community-based organizations increased their capacities to support program partners in delivering EBIs. They provided 5,015 hours of technical assistance and training on topics, including ensuring adequate capacity, process and outcome evaluation, program planning, and continuous quality improvement. Program partners increased the number of youth reached by an EBI in targeted communities by 349%, from 4,304 in the first year of implementation in 2012 to 19,344 in 2014. Most youth in 2014 received sexuality education programs (59%), whereas smaller percentages received abstinence-based, youth development, and clinic-based programs. Most youth were reached through schools (72%) and community-based organizations (16%), and smaller numbers were reached in other settings (e.g., faith-based organizations, health centers). Building and monitoring the capacity of program partners to deliver EBIs through technical assistance and training is important. In addition, partnering with schools leads to reaching more youth. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Proximity of fast-food restaurants to schools and adolescent obesity.

PubMed

Davis, Brennan; Carpenter, Christopher

2009-03-01

We examined the relationship between fast-food restaurants near schools and obesity among middle and high school students in California. We used geocoded data (obtained from the 2002-2005 California Healthy Kids Survey) on over 500,000 youths and multivariate regression models to estimate associations between adolescent obesity and proximity of fast-food restaurants to schools. We found that students with fast-food restaurants near (within one half mile of) their schools (1) consumed fewer servings of fruits and vegetables, (2) consumed more servings of soda, and (3) were more likely to be overweight (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02, 1.10) or obese (OR = 1.07; 95% CI = 1.02, 1.12) than were youths whose schools were not near fast-food restaurants, after we controlled for student- and school-level characteristics. The result was unique to eating at fast-food restaurants (compared with other nearby establishments) and was not observed for another risky behavior (smoking). Exposure to poor-quality food environments has important effects on adolescent eating patterns and overweight. Policy interventions limiting the proximity of fast-food restaurants to schools could help reduce adolescent obesity.

Sedentary behavior and physical activity in youth with recent onset of type 2 diabetes.

PubMed

Kriska, Andrea; Delahanty, Linda; Edelstein, Sharon; Amodei, Nancy; Chadwick, Jennifer; Copeland, Kenneth; Galvin, Bryan; El ghormli, Laure; Haymond, Morey; Kelsey, Megan; Lassiter, Chad; Mayer-Davis, Elizabeth; Milaszewski, Kerry; Syme, Amy

2013-03-01

With the rise of type 2 diabetes in youth, it is critical to investigate factors such as physical activity (PA) and time spent sedentary that may be contributing to this public health problem. This article describes PA and sedentary time in a large cohort of youth with type 2 diabetes and compares these levels with other large-scale investigations. The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) trial is a study in 699 youth, recruited from 15 US clinical centers, aged 10 to 17 years with <2 years of type 2 diabetes and a BMI ≥85th percentile. In comparison with the subset of the NHANES cohort who were obese (BMI ≥95th percentile), TODAY youth spent significantly more time being sedentary (difference averaging 56 minutes per day; P < .001) as assessed by accelerometry. Although moderate to vigorous activity levels in both obese cohorts for all age groups were exceptionally low, younger TODAY boys were still significantly less active than similarly aged NHANES youth. Comparisons between the TODAY girls and other investigations suggest that the TODAY girls also had relatively lower PA and fitness levels. Adolescents with type 2 diabetes from the large TODAY cohort appear to be less physically active and tend to spend more time being sedentary than similarly aged youth without diabetes identified from other large national investigations. Treatment efforts in adolescents with type 2 diabetes should include decreasing sitting along with efforts to increase PA levels.

Outcomes of group-based treatment program with parental involvement for the management of childhood and adolescent obesity.

PubMed

Santiprabhob, Jeerunda; Leewanun, Chanin; Limprayoon, Kawewan; Kiattisakthavee, Pornpimol; Wongarn, Renu; Aanpreung, Prapun; Likitmaskul, Supawadee

2014-10-01

An uncontrolled study was conducted to evaluate the effects of a group-based program on weight control, metabolic profiles, and obesity-related complications in obese youth. The program consisted of an initial in-patient session and five group sessions, one, two, three, six, and nine months into the study, providing participants and their parents with information about the consequences of obesity and lifestyle modifications. The severity of obesity and obesity-related complications were evaluated at baseline and 12 months after the intervention. The participants' and their parents' perceptions of the program were assessed. Of the obese youth recruited (n=126), 115 completed the study. Their percentage weight for height and percentage body fat decreased significantly (both p<0.001), and their insulin resistance, lipid profiles, and transaminases levels improved (all p<0.01). The prevalence of prediabetes, dyslipidemia, and elevated transaminases decreased significantly (all p<0.05). The participants and their parents perceived the program as valuable. A group-based program is effective in managing childhood obesity, improving metabolic profiles, and alleviating certain obesity-related complications. A group-based program that provides education and raises the awareness of obese children and their parents about the consequences of obesity is an effective model for treating childhood obesity. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

What are the associations between parenting, callous-unemotional traits, and antisocial behavior in youth? A systematic review of evidence.

PubMed

Waller, Rebecca; Gardner, Frances; Hyde, Luke W

2013-06-01

A growing body of research has examined callous-unemotional (CU) traits among samples of antisocial youth. Debate surrounds the malleability of CU traits and their responsiveness to parenting and parent-focused interventions. This review examines evidence from studies that have investigated various relationships between parenting, CU traits, and antisocial behavior (AB). Studies were categorized according to five distinct research questions each addressing associations among parenting, CU traits, and AB in a different way. The results suggest that dimensions of parenting are prospectively related to changes in CU traits. Subgroups of youth with both high levels of CU traits and AB also appear to have experienced negative parenting practices. However, negative parenting is not consistently related to AB in cross-sectional studies for youth with high levels of CU traits. At the same time, parenting-focused interventions appear effective in reducing the level of AB and CU traits in youth. The findings and implications for future studies are critically discussed as they pose challenges for current etiological theories of AB. Copyright © 2013 Elsevier Ltd. All rights reserved.

LA Sprouts Randomized Controlled Nutrition, Cooking and Gardening Program Reduces Obesity and Metabolic Risk in Latino Youth

PubMed Central

Gatto, Nicole M.; Martinez, Lauren C.; Spruijt-Metz, Donna; Davis, Jaimie N.

2015-01-01

Objective To assess the effects of a 12-week gardening, nutrition, and cooking intervention (“LA Sprouts”) on dietary intake, obesity parameters and metabolic disease risk among low-income, primarily Hispanic/Latino youth in Los Angeles. Methods Randomized control trial involving four elementary schools [2 schools randomized to intervention (172, 3rd–5th grade students); 2 schools randomized to control (147, 3rd–5th grade students)]. Classes were taught in 90-minute sessions once a week to each grade level for 12 weeks. Data collected at pre- and post-intervention included dietary intake via food frequency questionnaire (FFQ), anthropometric measures [BMI, waist circumference (WC)], body fat, and fasting blood samples. Results LA Sprouts participants had significantly greater reductions in BMI z-scores (0.1 versus 0.04 point decrease, respectively; p=0.01) and WC (−1.2 cm vs. no change; p<0.001). Fewer LA Sprouts participants had the metabolic syndrome (MetSyn) after the intervention than before, while the number of controls with MetSyn increased. LA Sprouts participants had improvements in dietary fiber intake (+3.5% vs. −15.5%; p=0.04) and less decreases in vegetable intake (−3.6% vs. −26.4%; p=0.04). Change in fruit intake before and after the intervention did not significantly differ between LAS and control subjects. Conclusions LA Sprouts was effective in reducing obesity and metabolic risk. PMID:25960146

Resistance Training Effects on Metabolic Function Among Youth: A Systematic Review.

PubMed

Bea, Jennifer W; Blew, Robert M; Howe, Carol; Hetherington-Rauth, Megan; Going, Scott B

2017-08-01

This systematic review evaluates the relationship between resistance training and metabolic function in youth. PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and ClinicalTrials. gov were searched for articles that (1): studied children (2); included resistance training (3); were randomized interventions; and (4) reported markers of metabolic function. The selected studies were analyzed using the Cochrane Risk-of-Bias Tool. Thirteen articles met inclusion criteria. Mean age ranged from 12.2 to 16.9 years, but most were limited to high school (n = 11) and overweight/obese (n = 12). Sample sizes (n = 22-304), session duration (40-60min), and intervention length (8-52 wks) varied. Exercise frequency was typically 2-3 d/wk. Resistance training was metabolically beneficial compared with control or resistance plus aerobic training in 5 studies overall and 3 out of the 4 studies with the fewest threats to bias (p ≤ .05); each was accompanied by beneficial changes in body composition, but only one study adjusted for change in body composition. Limited evidence suggests that resistance training may positively affect metabolic parameters in youth. Well-controlled resistance training interventions of varying doses are needed to definitively determine whether resistance training can mitigate metabolic dysfunction in youth and whether training benefits on metabolic parameters are independent of body composition changes.

Intended and unintended effects of restrictions on the sale of cigarillos to youth: evidence from Canada.

PubMed

Nguyen, Hai V; Grootendorst, Paul

2015-07-01

Youth consumption of cigarillos (ie, little cigars) has increased markedly in recent years. In July 2010, the Canadian government banned the sale of flavoured cigarillos and required unflavoured cigarillos to be sold in packs of at least 20 units. This paper assesses changes in young persons' use of cigarillos and regular cigars, which are potential substitutes, following the policy. To investigate of the change in cigar smoking following the policy, we constructed a segmented regression model that allowed the policy to change the height and the slope of the trend in the outcome variables. The model was estimated using data from the 2007-2011 Canadian Tobacco Use Monitoring Surveys. We obtained visual and regression-based evidence that use of cigarillos among youth declined following the policy. We also found a small, gradual increase in their use of regular cigars, possibly due to their compensatory switching from cigarillos to regular cigars. Overall, there was a net reduction in cigar use among youth after the intervention. The policy achieved its goal of reducing youth's consumption of cigarillos, but may have an unintended consequence of increasing their use of regular cigars. Policymakers should address the possibility that youth switch to regular cigars in response to restricted access to cigarillos. Possible ways of discouraging this substituting behaviour include extending the ban to cover all flavoured cigars and mandating a minimum pack size for all cigars, or raising taxes on flavoured cigars. 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.

Baroreflex sensitivity in children and adolescents: physiology, hypertension, obesity, diabetes mellitus.

PubMed

Honzíková, N; Závodná, E

2016-12-13

The increased prevalence of obesity in children and its complications have led to a greater interest in studying baroreflex sensitivity (BRS) in children. This review of BRS in children and adolescents includes subtopics on: 1. Resting values of BRS and their reproducibility, 2. Genetics of BRS, 3. The role of a primarily low BRS and obesity in the development of hypertension, and 4. Association of diabetes mellitus, BRS, and obesity. The conclusions specific to this age follow from this review: 1. The mean heart rate (HR) influences the measurement of BRS. Since the mean HR decreases during adolescence, HR should be taken into account. 2. A genetic dependency of BRS was found. 3. Low BRS values may precede pathological blood-pressure elevation in children with white-coat hypertension. We hypothesize that low BRS plays an active role in the emergence of hypertension in youth. A contribution of obesity to the development of hypertension was also found. We hypothesize that both factors, a primarily low BRS and obesity, are partially independent risk factors for hypertension in youths. 4. In diabetics, a low BRS compared to healthy children can be associated with insulin resistance. A reversibility of the BRS values could be possible after weight loss.

Obesity, family instability, and socioemotional health in adolescence

PubMed Central

Crosnoe, Robert

2017-01-01

The last two decades have witnessed dramatic increases in obesity and family instability. To the extent that the social stigma of obesity is a risk factor and family instability represents the potential compromise of important protective factors, their convergence may disrupt socioemotional health, especially during periods of heightened social uncertainty. Drawing on data from the National Longitudinal Study of Adolescent Health, this study found that obese youth at the start of high school had higher levels of internalizing symptoms and lower levels of perceived social integration in school only when they had also experienced multiple family transitions since birth. This pattern, however, did not hold for boys, and it did not extend to overweight (as opposed to obese) adolescents of either gender. PMID:22640529

Systematic Review of Cyberbullying Interventions for Youth and Parents With Implications for Evidence-Based Practice.

PubMed

Hutson, Elizabeth; Kelly, Stephanie; Militello, Lisa K

2018-02-01

Cyberbullying is a new risk factor for the well-being of pediatric populations. Consequences of cyberbullying include both physical and mental health concerns such as depression, anxiety, and somatic concerns. Adolescents who have been victims of cyberbullying and developed secondary symptoms are often recommended to visit a healthcare provider to obtain effective, evidence-based treatment. To date, no interventions exist in the healthcare setting for adolescents who are victims of cyberbullying. The purpose of this project is to review interventional studies on cyberbullying that have components for adolescents who have been involved with cyberbullying and their parents and to provide recommendations on effective intervention components with the goal of guiding clinical practice. A systematic review was conducted using the Institute of Medicine guidelines. A comprehensive electronic literature search was completed targeting interventions of cyberbullying in any setting. No date limits were used. Literature was searched in MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Communication and Mass Media Complete, Education Information Resource Center (ERIC), and PsycINFO databases. The following search terms were applied "cyberbullying" + "intervention" or "treatment" or "therapy" or "program." Only articles with a pediatric population were selected for review. Seventeen cyberbullying intervention programs in 23 articles were found to meet the search criteria. The most frequently used intervention components included education on cyberbullying for the adolescent, coping skills, empathy training, communication and social skills, and digital citizenship. Parent education on cyberbullying was also found to be important and was included in programs with significant outcomes. As youth present to healthcare providers with symptoms related to cyberbullying, effective interventions are needed to guide evidence-based practice. This review

Process and Outcomes From a Youth-Led Campaign to Address Healthy Eating in an Urban High School.

PubMed

Frerichs, Leah; Sjolie, Sarah; Curtis, Matthew; Peterson, Melissa; Huang, Terry T-K

2015-12-01

This article describes a pilot youth advocacy initiative for obesity prevention informed by social cognitive theory, social network theory, and theories of community mobilization. With assistance from school and health leaders, adolescent-aged youth led a cafeteria food labeling and social marketing campaign. We implemented an anonymous survey 2 weeks prior to and again at the conclusion of the campaign, and used cafeteria records to track servings of fruits and vegetables. The campaign resulted in a significant increase in youths' confidence to identify healthy foods (OR 1.97, 95 % CI 1.01, 3.84, p = .048), and a significant increase in per person per day servings of fruits (0.02, p = .03) and vegetables (0.01, p = .02). The results of our pilot were promising, and the integration of concepts from multiple theories benefited the implementation process. Obesity prevention initiatives should include strategies that encourage youth to create health promotion community networks and lead changes to their social and physical environments.

Parents’ Views on Engaging Families of Middle School Students in Obesity Prevention and Control in a Multiethnic Population

PubMed Central

Chung, Paul. J.; Thompson, Lindsey R.; Elijah, Jacinta; Lamb, Sheila; Garcia, Vanessa P.; Bastani, Roshan

2014-01-01

Introduction Overweight and obesity remain significant public health risks for youth in the United States, particularly among racial/ethnic minority groups. Efforts at obesity prevention and control have targeted youth and family members in diverse settings. Although involving parents in obesity prevention programs for youth may improve the potential of these programs, less is known about parents’ preferred methods of engagement, especially among racial/ethnic minority parents and parents whose primary language is not English. In this qualitative study, parents of middle-school–aged children were asked how best to engage their children in obesity prevention and control efforts. Methods We recruited 38 parents whose children attended Los Angeles middle schools to participate in focus groups. Two English-language focus groups with 14 parents of different racial/ethnic backgrounds and 2 Spanish language groups with 24 Latino parents were conducted from 2010 through 2011. We analyzed focus group transcripts by using content analysis using inductive and deductive techniques. Results Findings from focus groups confirmed that parents want to help their children avoid obesity but feel constrained in their ability to take action. Participants identified an overarching desire to become better parents as a potential incentive to engage in obesity prevention efforts. Parents advocated for family-focused approaches in obesity prevention programs, including family sports leagues and cooking classes. Most findings were consistent between language groups, but parents in the Spanish language groups cited language-related barriers. Conclusion The development and testing of simple programs that are sustainable, community-based, and family-focused may empower families to address obesity prevention and control. PMID:24698532

Parents' views on engaging families of middle school students in obesity prevention and control in a multiethnic population.