RESUMO
OBJECTIVE: To determine prevalence of overweight and obesity and weight control intentions of health care workers (HCWs) of the public community clinics on New Providence, The Bahamas. SUBJECTS AND METHOD: Using a cross-sectional study design, 163 HCWs of eight clinics were surveyed. Participants completed a questionnaire indicating weight control intentions and had weight, height and abdominal circumferences measured. Data were analysed using IBMSPSS, v 21. RESULTS: Of 163 participants, 92.0% (150) were females. Overall, mean (± SD) age was 44 (± 11.10) years. Healthcare workers were grouped into three main categories: physicians 8.0% (13), nurses 41.1% (67) and other HCWs 50.9% (83). The majority (68.5%; 111) of the participants had high-risk abdominal circumferences. Combined prevalence of overweight and obesity was 81.6% (133); 26.4% (43) were overweight and 55.2% (90)obese. Of the males, 23.1% (3) were overweight and 69.2% (9) obese. Of females, 26.7% (40) were overweight and 54.0% (81) obese. More than half (55.8%; 91) of HCWs misperceived their body mass index (BMI); 85.3%(139) of HCWs had weight concerns, 48.2% (67) were in a planning phase of change, another 48.2% (67) were in an action phase and a small percentage, 3.6% (5), were not ready to make any changes. Most (90.7%; 147) participants expressed a greater willingness to participate in a workplace healthy lifestyle programme, mean wellness inclination score of 15.3 (± 3.78).CONCLUSIONS: Healthcare workers had high-risk abdominal circumferences. Prevalence of overweight and obesity was 81.6%. Many misperceived their BMI, were concerned about their BMI status and were inclined to make changes for a healthier weight.
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Humanos , Obesidade , Sobrepeso , BahamasRESUMO
OBJECTIVE: To examine the role of maternal feeding styles on the risk of overweight in a cohort of Caribbean infants. DESIGN AND METHODS: Data from mother-child pairs participating in an intervention study from 3 Caribbean islands were analysed. At recruitment, maternal and infant socio demographic and anthropometric data were collected and maternal depression assessed usingthe Center for Epidemiology Studies (CES) depression scale questionnaire. At 12 months, feeding styles was assessed in mothers by questionnaire. Factor analysis yielded five feeding styles: uninvolved, indulgent, forceful, restrictive and responsive. Infant length and weight were measured using standardized protocols at 18 months and BMI Z-scores were calculated from World Health Organization 2006 growth charts. Z-scores ≥ 1 were classified as at risk for overweight. Associations between maternal feeding styles and risk for infant overweight were assessed using multilevel logistic regression accounting for country and clinic. RESULTS: Data from 366 mother-child pairs (mean age 26.08ñ7.05 years, 55.5% high school graduates, 67.5% employed) were evaluated. No association was found between uninvolved, indulgent, forceful and responsive feeding styles with risk for infant overweight. Restrictive feeding was associated with increased risk for infant overweight (β=0.46; 95%CI=0.21,0.72) and the association remained after adjustment for infant birth weight, maternal age, education, socio-economic status and BMI (β=0.48;95%CI=0.21,0.74). This associationstrengthened after adjusting for maternal depression (β=0.55;95%CI=0.27,0.82). CONCLUSION: Restrictive feeding increased the risk of infant overweight. Overweight/obesity prevention interventions focusing on identifying suitable maternal feeding control as well as larger studies aimed at understanding the underlying mechanisms for this association are important approaches to tackling childhood overweight.
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Dieta , Aleitamento Materno , Sobrepeso , Lactente , Nutrição do Lactente , Região do CaribeRESUMO
OBJECTIVE: To examine health perceptions, behaviours and overweight/obesity status of Turks and Caicos Islands (TCI) elementary school children. DESIGN AND METHODS: Baseline/pre-intervention data on knowledge, attitudes, practices, and behaviours were collected via questionnaire and anthropometry to assess the impact of infusing healthy lifestyle practices into the curriculum of Grades 3 6 (3 experimental and 3 controls). RESULTS: Assessments were conducted on 585 children (247 boys and 304 girls), mean (ñ SD) age 10.18ñ 1.17 yrs, with boys slightly older (p = 0.06) and after-school physical activities 3.01 ñ 2.31 activities. Most were born in TCI (324 [55.4%]) while 236 (40.3%) mothers were born in Haiti; 271 (48.6%) were overweight (21.7%) or obese (26.9%); significantly more girls were overweight/ obese (60% vs. 40%; p = 0.026) Few consumed fruits (35.8%) and vegetables (45.7%) ≥ 2/day while most consumed soda (75.9%) and fast food (89.7%) ≥1/day. Logistic regression revealed consumers of ≤ 2 fruits/servings were 68% more likely to be overweight/obese (OR = 1.68). A unit increase in self-efficacy was associated with significant increases of 11% in physical activities (p <0.05); 8% and 10% in the odds of eating ≥ 2 fruits and vegetables, respectively, (p <0.05). A unit increase in perceived benefits of diet was associated with 5% increase in the odds of consuming ≥ 2 vegetables (p <0.05). CONCLUSION: Childrens self-efficacy and health perceptions significantly impacted diet and physical activity, both well documented to prevent/reduce obesity. Therefore, a multifactoral approach to promote healthy lifestyles and prevent/reduce paediatric obesity and ultimately TCIs NCD burden and health care costs was imperative.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Sobrepeso , Obesidade , Nutrição da Criança , CurrículoRESUMO
OBJECTIVE: To investigate the role of parental characteristics and maternal perceptions of ways fathers might influence risk of overweight in Caribbean infants. DESIGN AND METHODS: Data from participants in a three island parenting intervention study were analyzed. Maternal and paternal characteristics were obtained by questionnaire at enrolment (infant age 6-10 weeks). At 18 months, 501 infants (82.9% of cohort) had weight and length measured using standardized methods and body mass index (BMI-Z scores) calculated. Participants with Z scores ≥1 were classified as at risk of overweight. Multi-level logistic regression analyses were utilized to assess the effect of parents characteristics on the risk of infant overweight. Additionally data from 4 focus group discussions among mothers with infants (6 - 24 months) in Jamaica were used to explore how any effects might be mediated. RESULTS: Overall 20.6% of the children were classified as at risk of overweight. The father was present in 52% of households. Fathers presence and higher paternal occupation level were associated with reduced risk of overweight after controlling for maternal age, education, occupation, receptive vocabulary and SES score. The presence of the father in the home (OR[95% CI] =0.78 (0.62 - 0.99)) decreased the odds of overweight in these infants. From focus group discussions mothers reported that the majority of fathers encouraged breastfeeding, healthier meal choices and discouraged use of unhealthy snacks. CONCLUSION: More information on paternal characteristics should be collected in future studies of childhood obesity. Interventions to address childhood overweight should include fathers as part of the strategy.
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Papel (figurativo) , Relações Pai-Filho , Sobrepeso , Desenvolvimento Infantil , Lactente , Região do CaribeRESUMO
OBJECTIVE: To examine the prevalence of overweight and obesity (OW/OB) among Grenadian adolescents and to determine associations with social determinants on urban and rural adolescents. DESIGN AND METHODS: A national sample of Form1 students (n = 689) aged 11 to 14 years, from all 23 secondary schools in Grenada were assessed as part of the Grenada School Nutrition Study (GSNS). Body Mass Index (BMI) was assessed using standard measures and standardized BMI percentile. Urban (n = 13) and rural (n = 10) schools were determined by location. Exposure to fast food outlets and shops which sold sugar sweetened beverages, candy, or highly processed foods was measured within a .75 km buffer surrounding each school and major transportation hub, between school and home. RESULTS: Overall, Grenadian adolescents had low rates of overweight (17.6%) and obesity (7.6%) compared to Grenadian adults. Girls, however, had nearly twice the rate of overweight compared to boys (i.e., 22.7% versus 12.2%). There were significant differences between rural and urban students for access to cars (40.7% versus 53.3%), computer access (61.6% versus 73.5%), and snacking after school (83.6% versus 90.5%) respectively. The rural school environment also had a lower mean density of snack shops (1.53 versus 3.39 shops/square km) and mean fast food outlet density (0 versus 1.17 outlets/square km). CONCLUSIONS: Grenadian adolescents demonstrate low rates of OW/OB compared to both Grenadian adults and their US counterparts. The low rates of OW/OB suggest Grenadian adolescents have not yet been affected by social determinants of the obesity epidemic.
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Prevalência , Sobrepeso , Obesidade , Adolescente , Granada , Fatores EpidemiológicosRESUMO
OBJECTIVES: To determine the effect of maternal overweight and obesity on pregnancy and birth outcome. DESIGN AND METHODS: This prospective study invited 160 women who attended their first antenatal visit at the University Hospital of the West Indies to participate in the study between June 2012 and February 2013. Maternal demographics, socioeconomic status, past medical and obstetric history, complications in pregnancy and birth outcome were collected. Body mass index (BMI) categories were created. Descriptive statistics reporting means ñ SD, Analysis of Variance (ANOVA), Chi Squared Test and regression analyses to determine whether maternal BMI or weight were independent predictors of birth and placental size were performed. RESULTS: Of the 160 women recruited, 126 (78.8%) were used for final analysis. There was an even distribution of mothers in each BMI category. A significant difference in blood pressure was seen between normal weight and obese women (systolic BP: p = 0.002, diastolic BP: p = 0.01). There was no statistical difference in women who developed an illness in pregnancy and in the admission rates across BMI categories (p = 0.92; p = 0.09 respectively). There was no significant difference in birth outcome across BMI categories. CONCLUSION: Overweight or class I obese women did not have an increased risk of adverse maternal and birth outcomes as compared to women with a normal BMI.
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Sobrepeso , Obesidade , Gravidez , Nascido Vivo , Resultado da GravidezRESUMO
OBJECTIVE: To identify modifiable barriers to physical activity and to explore factors that facilitate physical activity among overweight and obese women in Barbados. DESIGN AND METHODS: Seventeen women aged 25 to 35 years with a body mass index (BMI) ≥25, purposefully sampled from a population-based cross-sectional study, were recruited to participate in in-depth semi-structured interviews. Twelve women participated in one or more additional ethnographic sessions in which the researcher joined and observed a routine activity chosen by the participant. More than 50 hours of ethnographic data collection were accumulated and documented in field notes. Thematic content analysis was performed on transcribed interviews and field notes. RESULTS: Social, health-related, and structural barriers to physical activity were identified. Social factors related to gender norms and expectations. Women tended to be active with their female friends rather than partners or male peers, and reported peer support but also alienation. Being active also competed with family responsibilities and expectations. Health-related barriers included perceptions about chronic disease and competing strategies for weight loss. Structural barriers included few opportunities for active commuting, limited indoor space for exercise in the home, and low perceived access to convenient and affordable exercise classes. Several successful strategies associated with sustained activity were observed, including walking and highly social, low-cost exercise groups. CONCLUSIONS: This study highlights the role that gender norms and health beliefs play in shaping experiences of physical activity. Affordable and accessible group exercise classes are feasible within a Caribbean context and successful models have the potential to be replicated.