Observing the neighborhood multidimensionality and overweight in children of different developmental stages-the emergence of an unusual association.

The present study examines whether the association of the neighborhood environment and overweight in children is moderated by age. This was a cross-sectional study of 832 children aged 3 to 10 years living in the city of Oporto (Portugal). Children were recruited under the scope of the project "Inequalities in Childhood Obesity: The impact of the socioeconomic crisis in Portugal from 2009 to 2015." Overweight was defined according to the International Obesity Task Force criteria. Parents completed a self-administered questionnaire capturing sociodemographic characteristics and their perceptions of their neighborhood environment. Logistic regressions were used to examine the influence of parental perceived neighborhood characteristics (latent variables: attractiveness, traffic safety, crime safety, and walkability) on overweight in children. A stratified analysis by age category was conducted. Overall, 27.8% of the children were overweight, 17.4% were aged 3 to 5 years, and 31.8% were aged 6 to 10 years. Children aged 3 to 5 years were more sensitive to the neighborhood environment than children aged 6 to 10 years. For children aged 3 to 5 years, the risk of overweight was inversely associated with neighborhood crime safety (OR = 1.84; 95% CI 1.07-3.15; p = 0.030).    Conclusion: Our study suggests the existence of a sensitive age period in childhood at which exposure to a hostile neighborhood environment is most determining for weight gain. Until today, it was thought that the impact of the neighborhood environment on younger children would be less important as they are less autonomous. But it may not be true. What is Known: • The neighborhood environment may adversely affect children's weight status. However, the moderating role of child age in the association between neighborhood environment and overweight is uncertain. What is New: • The study highlights that the association between the neighborhood environment and child overweight is attenuated by age. It is stronger for preschoolers than for early school-age children.

Protective Association of APOC1/rs4420638 with Risk of Obesity: A case-control Study in Portuguese Children.

The association of the rs4420638 polymorphism, near the APOC1 gene, was examined with the risk of obesity among Portuguese children. A sample of 446 Portuguese individuals (231 boys and 215 girls) of European descent, aged 3.2 to 13.7 years old (mean age: 7.98 years), were selected to conduct a case-control study. Body mass index (BMI), BMI Z-scores, and waist circumference were calculated. Genotyping was performed by real time PCR using a pre-designed TaqMan probe. Logistic regression and the nonparametric Mann-Whitney test were used to test the associations. The association results revealed a significant protective effect from the minor G-allele of SNP rs4420638 against obesity, with an odds ratio (OR) of 0.619 (95% CI 0.421-0.913; p = 0.0155) in the additive model, and OR of 0.587 (95% CI 0.383-0.9; p = 0.0145) in the dominant model. Moreover, comparing genotype groups (AA vs. AG + GG), significantly lower values (p < 0.05) for the anthropometric traits weight, height, BMI, BMI Z-score and waist circumference, were observed in the carriers of allele G. The present study provides further evidence for the APOE/APOC1 candidate-region association with the risk of obesity. This was the first study to describe the protective association of the rs4420638 minor G-allele against obesity in childhood exclusively.

Body size, form, composition, and a healthy lifestyle associates with health-related quality of life among Portuguese children.

OBJECTIVES: This study aimed to describe the relationship between body size, form, and composition, and children's lifestyle on health-related quality of life (HRQoL). METHODS: This cross-sectional study comprised 1333 children (9.05 ± 0.75 years; 683 females) living in mainland Portugal. Objective anthropometric measures were collected. Parents answered a standardized questionnaire related with children's lifestyle (e.g., sport participation, screen- and sleep-time) and family socioeconomic status (e.g., parental education). HRQoL was measured using the Portuguese version of the KIDSCREEN-27. Scores were categorized into low and high using a sex-specific normative cut-off from European children. A healthier score was created including positive scores for body weight, abdominal obesity, sport participation, sleep- and screen-time. RESULTS: Body size, form and composition were correlated with children's physical wellbeing. However, sex differences were found in which parameters were associated with wellbeing. Among boys, the body mass index, waist circumference, waist-to-height ratio, subscapular and suprailiac skinfold were most correlated with wellbeing, while waist circumference and subscapular skinfold showed the strongest correlations for girls. Sleep duration and sport participation revealed a significant relationship with girls' HRQoL. A logistic regression analysis (adjusted for parental education) revealed that boys scoring 4 or 5 in the healthier index had an increased likelihood of high HRQoL level compared to those fulfilling none. CONCLUSIONS: Future programs aimed at reducing obesity, particularly central obesity, and incorporating multiple health indicators and behaviors, such as sport participation and sleep duration may help improve children's health and wellbeing.

Differential sex-association between PCSK1 polymorphisms and obesity risk in Portuguese children.

OBJECTIVES: The proprotein convertase subtilisin/Kexin type 1 gene (PCSK1) is implicated in hypothalamic appetite control. Several studies have addressed the relationship between PCSK1 polymorphisms and obesity, although conflicting results were observed. We tested the potential association of four PCSK1 variants with the risk of overweight/obesity and related variables in Portuguese children. METHODS: This is a case-control study, where four PCSK1 variants, rs6230 (c.-101T>C), rs6232 (p.N221D), rs6235 (p.S690T), and rs3811942 (c.*265T>C), were analyzed in Portuguese children (aged 5-13 years-old). Anthropometric measures were objectively collected and used to provide weight-for-age, height-for-age, and body mass index (BMI) for age. The indices generated were compared to standard reference values of WHO to obtain the corresponding Z-scores. RESULTS: Logistic regression, in the dominant model, revealed no significant associations between the four individual PCSK1 variants and the risk of overweight/obesity in the total population. However, stratifying the sample by sex, a marginally significant association was found between the rs6235 minor C-allele and increased overweight/obesity in boys (n = 345) (OR 1.55 [1.01-2.38] p = .044), but not in girls (n = 340) (OR 0.73 [0.46-1.14] p = .169). Consistently, boys with genotype GG presented lower BMI Z-score (0.62) when compared to those with the genotypes GC + CC (1.04). Testing for different effects in males versus females, a significant interaction was found between the rs6235 polymorphism and sex for BMI Z-score (p = .025). CONCLUSIONS: Results of this study suggest for a sex-differentiated association between PCSK1 rs6235 and overweight/ obesity in Portuguese children.

Sleep duration, risk of obesity, and parental perceptions of residential neighborhood environments in 6-9 years-old children.

OBJECTIVES: The present study aimed to analyze the association between healthy sleep duration of children and the parental perception of the social/built environment. METHODS: A cross-sectional study was done and a sample of 8273 children (4183 females) aged 6-9 years was observed. Height (cm) and weight (Kg) were measured, and the body mass index (BMI) was calculated. Participants were classified as normal weight or overweight/obese. Sleep habits, sedentary behaviors (i.e., TV viewing) and environmental variables were assessed by questionnaire. Logistic regressions were used, with adjustments for age, sex, BMI, and sedentary time. RESULTS: Children whose parents reported a positive perception of the built environment in the residential area were 1.21 times more likely to have regular sleep habits during weekdays. Furthermore, children whose parents reported a negative perception of the social environment and safety were 81% more likely to have irregular sleep habits during the weekdays. CONCLUSIONS: The present study revealed a positive association between regular sleep during the weekdays and the parental perception of the social/built environment (land use and urban design).

Sex-specific differences in somatic investment and strategies of physical activity among Portuguese schoolchildren.

OBJECTIVES: Physical activity (PA) is required for healthy growth, development, and maturation and plays an important role in the prevention of overweight and obesity in childhood and adolescence. Sex-differences in PA levels are well documented, with boys spending more time in PA, especially in moderate-to-vigorous activities. Following the Life History Theory, our aim is to study if PA affects the fat tissues increases during childhood and juvenile phases in both sexes. METHODS: Time spent in sedentary, light, and moderate-to-vigorous PA levels were measured in a sample of 415 Portuguese children and juveniles (207 females/208 males; aged 6-11 years), using an accelerometer for 7 days. Skinfolds related with body fat were objectively collected and socioeconomic status factors were reported using a parental questionnaire. RESULTS: The outcomes show that girls' and boys' fat variables increased during the end of the childhood and the juvenile phase. However, these variables were differently affected by PA. Girls increased fat variables with the sedentary activity while boys decreased fat variables with moderate-to-vigorous PA. Alike, active boys but not girls reduced the fat increase tendency with age. CONCLUSIONS: Although both sexes displayed a general fat increment with age, moderate-to-vigorous PA dampens the increase only in boys. In fact, active girls increased body fat in the same manner as non-active girls. From an evolutionary perspective, it could explain sex-specific somatic strategies related to future reproduction or, with future mating and intrasexual competition.

Socioeconomic inequalities in the prevalence of overweight and obesity among Portuguese preschool-aged children: Changes from 2009 to 2016.

OBJECTIVES: We evaluated, for the first time in Portugal, the prevalence of overweight and obesity according to parental education in a population of preschool-aged Portuguese children in 2009/2010 and 2016/2017. METHODS: Anthropometric data were collected in public and private preschools (n = 1996 in 2009/2010; n = 2077 in 2016/2017). Body mass index was calculated and weight status categories were based on the International Obesity Task Force cutoff points. Parental education level was self-reported. RESULTS: Prevalence of overweight (17.1%-14.1%; p < 0.001) and obesity (6.6%-3.9%, p < 0.001) was lower in 2016/2017 than in 2009/2010, with higher rates being found in the north of the country. Parental education was significantly associated with childhood overweight and obesity and inequalities between low- and high-education increased between the two periods. CONCLUSIONS: While a decrease in childhood overweight and obesity were positive findings, the prevalence is still high and shows pronounced socioeconomic differences. Policies for obesity prevention need to be inclusive and tackle inequalities, with interventions tailored to suit local contexts.

The Great Recession weighted on Portuguese children: A structural equation modeling approach considering eating patterns.

OBJECTIVES: Further evidence on how the Great Recession was associated with childhood obesity is needed, particularly when the world is facing a new and severe economic downturn caused by the COVID-19 pandemic. This study explores: (1) the direct association of the 2008's economic crisis with eating patterns and body mass index (BMI), among children, independently of their socioeconomic status (SES), and (2) the indirect association between the crisis and children's BMI, by using eating patterns as mediators. METHODS: A sample of children (n = 8472, mean age: 7.17 years old, 50.8% male) was recruited in schools from the cities of Porto, Coimbra and Lisbon, Portugal. Children's height and weight were objectively measured; BMI was calculated. Other data were collected by a parental questionnaire. A structural equation modeling studied the associations between the economic crisis impact, eating patterns, and BMI; model was adjusted for SES. RESULTS: Children in families that reported a greater impact of the economic crisis showed higher consumption of unhealthy food items and lower consumption of healthy foods, regardless of SES. Indirectly, children whose parents scored higher in the economic crisis impact had higher BMI mediated by a higher consumption of cakes/chocolates and lower intake of vegetables/salads. CONCLUSIONS: The economic crisis was associated with higher BMI and unhealthy eating patterns. Efforts to promote healthy diets and weight are needed at a population level rather than for specific social classes, particularly in the face of a new economic crisis caused by the COVID-19 pandemic.

Household Food Security and Associated Factors among Portuguese Children.

This study investigated the household food insecurity (HFI) among Portuguese children following the last world financial crisis. A cross-sectional study was conducted on 4737 Portuguese children (3-11 yrs). Socio-demographics, food insecurity, and household geographic location were assessed via questionnaire. Nutritional status was measured. Following the economic crisis, 14.2% of school children and 12.0% of preschool children experienced HFI. Preschool children having parents with low and medium parental education (paternal: OR = 4.4; 95% CI 2.7-7.1 and OR = 2.4; 95% CI 1.5-3.6; maternal: OR = 2.2; 95% CI 1.4-3.5 and OR = 1.6; 95% CI 1.1-2.3), living in the south (OR = 1.4; 95% CI 1.0-2.0) and being overweight/obese (OR = 1.1; 95% CI 0.7-1.3) were more likely to experience HFI than food secure household peers. Higher OR of belonging to a food insecure household were observed in school-aged children with low and medium parental education (paternal: OR = 2.9; 95% CI 1.9-4.6 and OR = 1.7; 95% CI 1.1-2.5; maternal: OR = 2.5; 95% CI 1.6-3.9 and OR = 2.3; 95% CI 1.6-3.3), living in Coimbra (OR = 1.7; 95% CI 1.1-2.6) and being overweight/obese (OR = 1.3; 95% CI 0.8-1.5) compared to food secure household peers. Data are instructive and support the need to increase awareness of HFI, reduce its incidence in overweight/obese children from low socio-economic status families and specific geographic areas, and increase food availability based on local ecology.

Socioeconomic inequalities in children's health-related quality of life according to weight status.

OBJECTIVES: This study explores the association between socioeconomic position (SEP) and health-related quality of life (HRQoL) among Portuguese children according to their weight status. METHODS: A total of 1215 primary school-aged children (mean age 8.78 years) from three Portuguese districts (Lisbon, Porto, Coimbra) were assessed during 2016/2017. Father and mother's education (low, medium, high) and work status (employed, unemployed/retired) were used as SEP indicators. Self-reported HRQoL was assessed with the KIDSCREEN-27. Height and weight were objectively measured and body mass index categorized in normal, overweight or obese. Age, sex, and district-adjusted linear regression models were fitted to estimate associations between SEP indicators and HRQoL dimensions, according to weight status. RESULTS: We found that 24.9% of children were categorized as having overweight/obesity. The mean scores of the Physical Well-Being, and School Environment dimensions of HRQoL were lower among children classified with overweight/obesity compared to children with normal weight (57.21 vs 54.11, P < .001 and 57.85 vs 56.04, P = .010, respectively). Father's education was significantly associated with all HRQoL dimensions in children with a normal weight, but the same was not observed among children presenting overweight/obesity. An increase in the level of maternal education was also significantly associated with all HRQoL dimensions among children classified with a normal weight, and only for the School Environment dimension among children classified with overweight/obesity. CONCLUSIONS: These results suggest the presence of socioeconomic inequalities in self-reported HRQoL from early age, particularly among children with normal weight.

Less obesity but higher inequalities in Portuguese children: Trends of childhood obesity between 2002-2016.

AIM: To observe the trends of overweight and obesity among Portuguese children from 2002 to 2016, before and during the years of the economic crisis, and compare these trends according to family's socio-economic position (SEP). METHODS: Prevalence rates were calculated using data from six studies providing comparable estimates from 2002, 2009, 2011, 2013 and 2016 for children aged 6-10-years living in the Portuguese Midlands (n = 7192; 50.2% girls). Height and weight were objectively measured; children and family characteristics were collected by standard questionnaires. A logistic regression was used to test the association between variables. RESULTS: Between 2002 and 2016, there was a decrease in the prevalence of overweight and obesity, which reached a statistical significance for girls. The prevalence of overweight, including obesity, was high (low-SEP = 30.5%; high-SEP = 20.5%) and a widening of socio-economic inequalities was found. Socio-economically disadvantaged children had more than 2 times the odds of having obesity than children from higher-SEP, even after adjusting for sex, physical activity and screen-time. CONCLUSION: While a decrease in overall rates of overweight and obesity was observed from 2002 to 2016, the social inequalities have been widened which suggest the need for public efforts to promote healthy weight at a population level, especially in lower socio-economic classes.

Screen media use by Portuguese children in 2009 and 2016: a repeated cross-sectional study.

BACKGROUND: Few studies have examined how access to mobile media is disrupting more traditional forms of media use. AIM: To examine screen-time in 2009/10 and 2016/17 among children aged 3-6 years and assess potential socio-economic determinants of adherence to screen-time recommendations. SUBJECTS AND METHODS: Two independent cross-sectional studies included 6874 Portuguese children. Screen-time (including television, computer, tablet, and smartphone) and proxy measures to calculate socioeconomic position (SEP) were parent-reported using a standardised questionnaire. Screen-time and adherence to screen-time recommendations were calculated for both periods. Determinants of excessive screen-time were identified using adjusted logistic regression models. RESULTS: In 2009/10 screen-time averaged 107 min/day for pre-school children and 149 min/day for school-aged children. In 2016/17 values were 142 min/day and 173 min/day, respectively. Screen-time allocated to television was the highest, independently of children's age. In 2016/17, mobile media use was common among pre-school (37 min/day) and school-aged children (43 min/day). Exceeding the recommended screen-time was more prevalent in boys than girls (adjusted odds ratio (aOR) between 1.02 and 1.59) and in children whose parents had lower education levels or were unemployed (aOR between 1.00 and 2.23). CONCLUSION: Screen-time was high among pre-school children, emphasising the need for earlier interventions, particularly among those from lower-SEP who had higher risk of exceeding the screen-time recommendations.

Self-reported symptoms of depression, anxiety and stress in Portuguese primary school-aged children.

BACKGROUND: Symptoms of depression, anxiety and stress experienced during childhood might have a negative impact on development. This study explores factors associated with such symptoms among Portuguese primary school-aged children. METHODS: A sample of children (n = 1022, mean age = 8.77 years old) was recruited in public and private schools from the cities of Coimbra, Lisbon and Porto, Portugal. The children's version of the Depression, Anxiety and Stress Scale (DASS-C) was self-administered. Multivariate logistic regression models were fitted to measure associations (expressed as Odds Ratio, OR and 95% Confidence Intervals, CI) between each DASS-C subscale, dichotomized by its 4th vs. 3rd or less quartiles (symptoms increase with scores), and covariates: child sex, age, socioeconomic status (SES), sports activity beyond school, children self-assessed health status, child and mother's body mass index and mother's DASS scores. RESULTS: Age was negatively associated with anxiety symptoms (adjusted OR, 95% CI: 0.70, 0.57-0.87) and girls, compared to boys, presented lower odds of depressive and stress symptoms (adjusted OR, 95% CI: 0.65, 0.47-0.92 and 0.57, 0.41-0.80, respectively). A low socioeconomic status was associated with more frequent symptoms of stress (adjusted OR, 95%CI for low compared to high SES: 1.61, 1.01-2.56). Children with poorer self-assessed health status and whose mothers scored higher in the DASS also presented significantly higher odds of scoring in the 4th quartile (vs. 3rd or less) of the three DASS-C subscales. CONCLUSIONS: These results suggest the need to tailor preventive efforts targeting childhood mental health symptoms.

Parental misperception of their child's weight status and how weight underestimation is associated with childhood obesity.

OBJECTIVES: Obesity is a major public health concern worldwide. This study aims to investigate the accuracy of parental perception of child's weight and related factors as well as how underestimation is associated with the prevalence of childhood obesity. METHODS: Data from 793 parents and respective children (6-10 years) were collected during the spring of 2013 and 2014. Height and weight were measured and used to calculate body mass index and obesity was classified using the International Obesity Task Force. Parents' perception of child's weight and socio-demographic characteristics were accessed by a questionnaire. Statistical tests were used, controlling for biological and social covariates. RESULTS: About 33% of parents misperceived their child's weight, of which 93% underestimated it. Different factors were found associated with greater parental underestimation according to children's weight status (ie, younger age) and sex (ie, higher mother's BMI, lower parental education, and household income for girls; living in an urban place for boys). Underestimation among girls, compared to boys, was more associated with socio-economic features of the family. For both sexes, children with excess weight were more likely to be underestimated by their parents. Parents who underestimated their child's weight were 10 to 20 times more likely to have an obese child. CONCLUSIONS: Findings suggest a social desirability bias in parental reports of child weight status. While some parents recognize their child's weight, others may feel embarrassed to discuss the fact that their child is overweight/obese and may feel reluctant in seeking the advice of a health care professional.

Influence of parental perceived environment on physical activity, TV viewing, active play and Body Mass Index among Portuguese children: A mediation analysis.

OBJECTIVES: The environment is believed to be key in obesity prevention, yet it is unclear how factors in the neighborhood influence weight-related behaviors. The present study aimed to investigate the influence of parental perceived environment on physical activity (PA), television (TV) time, active play and Body Mass Index (BMI) z score, and the mediating role of these weight-related behaviors on the relationship between neighborhood characteristics and children's BMI. METHODS: Data of 8472 Portuguese preschool (aged 3-6, n = 3819) and school-aged children (aged 7-11 years, n = 4653) were collected during 2016/2017. Structural equation modeling was used to estimate the associations between parents perceived neighborhood characteristics (latent variables: unsafety and built/physical environment) and child's BMI z score, PA and TV time. RESULTS: Among preschoolers, the latent variables of the perceived environment were not associated with the BMI, TV time, extracurricular PA, and active play. Among schoolchildren, the unsafety environment was positively associated with both the BMI (SC = 0.050, P = .008) and the time spent watching TV (SC = 0.052, P = .031) and negatively associated with extracurricular PA (SC = -0.125, P < .001). The latent variable Favorable Built Environment for PA (ie, environmental facilitating elements) was positively associated with active play (SC = 0.041, P = .031). Moreover, the TV time was a marginally significant mediator of the relationship between the perceived unsafe environment and the BMI of school-aged children (B = 0.002, P = .096). CONCLUSIONS: In conclusion, changes in the environment to targeting parental perception of neighborhood safety could have positive effects on the promotion of healthy weight and the adoption of a healthy lifestyle in school-aged children.

Social inequalities in traditional and emerging screen devices among Portuguese children: a cross-sectional study.

BACKGROUND: Children are often exposed to too much screen time but few studies have explored the use of old and new digital media among young children. This study assesses screen time, including traditional and mobile devices, in pre-school and elementary school-aged children, according to their gender, age, and socioeconomic position (SEP). METHODS: A total of 8430 children (3 to 10 years; 50.8% boys) from the north, center and south-central Portugal were included in the present study. Data was collected by a parental questionnaire during 2016/2017. Children's screen time (by media device, weekdays and at the weekend; calculated by mean minutes per day) were reported by parents. Analysis were carried to compare screen time by children's age, gender and family SEP (classified using father's educational degree). RESULTS: Daily screen time was high both in children aged 3 to 5 and 6 to 10 years - 154 min/day (95% CI: 149.51-158.91) and 200.79 min/day (95% CI: 197.08-204.50), respectively - and the majority of children, independently of their gender, exceed the recommended 2 h/day of screen viewing. Children are still primarily engaging in screen time through television but the use of mobile devices, particularly tablets, were already high among 3 year-old children and increased with age. SEP was a negative predictor of screen time in the linear regression analysis, including after adjustment. CONCLUSIONS: Considering the negative health impacts of excessive screen time, recognizing subgroups at risk of excessive screen time and identifying how each device is used according to age is fundamental to enable appropriate future interventions. The screen time in children aged 3-10 years is longer than the recommended, particularly among boys and in those children from lower SEP. Parents and policymakers should have in mind that children spend most of their screen time watching television but mobile devices are becoming extremely popular starting at a young age.

Prevalence of overweight and obesity in 3-to-10-year-old children: assessment of different cut-off criteria WHO-IOTF.

This study compares the prevalence of overweight and obesity between WHO/IOTF criteria. A total of 17,277 Portuguese children aged 3-10 years old were analysed. The prevalences of overweight-obesity were higher at WHO classification (19.8%-20.7%) than at IOTF classification (8.2%-16.1%), (p<0.001). Agreement between the criteria were substantial for overweight (Kappa= 0.67, p<0.001) and moderate for obesity (Kappa= 0.47, p<0.001). The prevalences ratio for inequality between criteria were greater for boys than for girls and lesser for children aged 6-7 than children aged 8-10 years old. The disparities between the two criteria and the higher overweight obesity prevalences highlight the needs to develop more studies.

Physical activity and the association between the FTO rs9939609 polymorphism and obesity in Portuguese children aged 3 to 11 years.

OBJECTIVES: To investigate whether objectively measured physical activity (PA) modulates the association between the FTO rs9939609 polymorphism and obesity variables in a sample of Portuguese children. METHODS: A total of 440 children (213 girls and 227 boys) aged 3 to 11 years were observed. Genotyping was performed using TaqMan assay. Body mass index (BMI), BMI Z scores, waist circumference (WC), and waist-to-height ratio (WHtR) were calculated. PA was estimated in 399 children by accelerometry. RESULTS: Linear regression, in the additive model, showed that the rs9939609 minor A-allele significantly associated with BMI (P = .029), BMI Z score (P = .017), WC (P = .016), and WHtR (P = .019). Logistic regression, in the additive model, showed a marginally significant association between the A-allele and overweight/obesity (odds ratio [OR]: 1.372; P = .049). When stratified by sex, rs9939609 showed marginal or significant associations with BMI (P = .08), BMI Z score (P = .07), WC (P = .005), WHtR (P = .02), and overweight/obesity (OR: 1.529; P = .064) in girls but not in boys (P > .05). Significant interactions were not found between the FTO polymorphism and PA (inactive vs active groups of children) for BMI (P = .461), BMI Z score (P = .387), WC (P = .757), or WHtR (P = .621). CONCLUSIONS: Findings of the present study highlight the association between FTO rs9939609 and obesity or body fat indices in girls but not in boys. PA was not found to mediate the impact of FTO genetic variation on risk of obesity.

Environmental and Socio-demographic Factors Associated with 6-10-Year-Old Children's School Travel in Urban and Non-urban Settings.

Walking or bicycling to school is an important source of physical activity and may help prevent childhood obesity. However, active commuting has been declining in recent decades. The purposes of this study were to explore travel characteristics in children and examine factors associated with active commuting in children living in urban and non-urban setting. Participants were 834 parents and corresponding children aged 6-10 years, living in the district of Coimbra, Portugal. Data were collected during April-June of 2013 and 2014. Anthropometric measures (height, weight, waist circumference) were taken in children. Mode shift and child/family demographics were assessed by a parental questionnaire. School and home addresses were geocoded and the shortest route (meters) was taken in consideration. Although car is the most common way of travel to school, active transportation is significantly more prevalent in children living in the non-urban setting. Different determinants were found associated with active travel according to the level of urbanization. The adjusted logistic regression revealed that, independently of the urbanization, children whose mothers actively commute to work, whose parents reported their neighbor as safe to walk, and children living less than 2000 m from school were significantly more likely to walk to school. Present findings highlight the need to consider models with different levels, including individual, social, and environmental characteristics, when developing interventions and policies to promote active transport to school.

Child participation in sports is influenced by patterns of lifestyle-related behaviors.

OBJECTIVES: The purpose of this study was to identify patterns of child and family characteristics and behaviors, and to determine the association of those patterns with child participation in sports. METHODS: A questionnaire and anthropometric measures were used to collect data on 834 parents and their 6- to 10-year-old children. A principal component analysis identified child and parental patterns, which were tested for association with child participation in extracurricular sports (ES). RESULTS: Seven patterns were identified: (1) socio-economic, (2) child obesity, (3) parental TV viewing, (4) father's physical activity (PA), (5) mother's PA, (6) child screen time, and (7) parental reported barriers. After adjustment, patterns 1 and 7 (P < .001), pattern 2 (P = .01), and patterns 5 and 6 (P = .04) were significantly associated with the number of sports practiced by children while, patterns 1 and 7 (P < .001), pattern 2 (P = .03), and patterns 4 and 5 (P = .01) were significantly associated with frequency of participation in ES. CONCLUSION: Future interventions to promote children's participation in sports should be based on a socio-ecological model and targeted to high-risk populations showing multiple risks such as a lower socio-economic status, inactive parents, or obese children.