The impact of weight, sex, and race/ethnicity on body dissatisfaction among urban children.

The purpose of the current study was to examine the relative contributions of weight status, race/ethnicity, sex, and age on body dissatisfaction in a large group of diverse children. Participants were 4th-6th graders (N=1212) in ten inner-city schools who participated in an obesity prevention study previously published. Children completed the body dissatisfaction subscale of the Eating Disorder Inventory-2 (EDI-2), and weight status was assessed by measured weights and heights. Multiple regression analyses were conducted. Relative weight status was the strongest predictor of body dissatisfaction, followed by race/ethnicity, and sex. Body dissatisfaction was greatest in obese, Asian, and female children. Overall, results indicated that children's body dissatisfaction varies based on relative weight status, as well as race/ethnicity and sex among urban children. Results highlight the strong need for additional research so that more definitive conclusions may be drawn regarding the development of body image among diverse groups of children.

Snacking in children: the role of urban corner stores.

OBJECTIVE: Childhood obesity is higher among ethnic minorities. One reason may be the limited access to affordable, healthy options. The disparate prevalence of urban corner stores in low-income and high-minority communities has been well documented. There are no data, however, on what children purchase in these environments before and after school. The purpose of this study was to document the nature of children's purchases in corner stores proximal to their schools. METHODS: This was an observational study from January to June 2008. Participants were children in grades 4 through 6 from 10 urban K-8 schools with >or=50% of students eligible for free or reduced-price meals. A total of 833 intercept surveys of children's purchases were conducted outside 24 corner stores before and after school. The main outcomes were type and energy content of items purchased. RESULTS: The most frequently purchased items were energy-dense, low-nutritive foods and beverages, such as chips, candy, and sugar-sweetened beverages. Students spent $1.07 +/- 0.93 on 2.1 +/- 1.3 items (1.6 +/- 1.1 food items and 0.5 +/- 0.6 beverage items) per purchase. The total number of calories purchased per trip was 1497.7 +/- 1219.3 kJ (356.6 +/- 290.3 kcal). More calories came from foods than from beverages. CONCLUSIONS: Purchases made in corner stores contribute significantly to energy intake among urban school children. Obesity prevention efforts, as well as broader efforts to enhance dietary quality among children in urban settings, should include corner store environments proximal to schools.

Associations between the Youth/Adolescent Questionnaire, the Youth/Adolescent Activity Questionnaire, and body mass index z score in low-income inner-city fourth through sixth grade children.

BACKGROUND: Diet and physical activity are important factors in the etiology, prevention, and treatment of chronic diseases such as obesity and its associated comorbidities. Accurate measures of diet and activity are critical in understanding how these lifestyle and behavioral factors covary to affect health status. OBJECTIVE: The purpose of this study was to investigate the relation between body mass index (BMI) z score and self-report measures of diet and activity, the Youth/Adolescent Questionnaire (YAQ) and the Youth/Adolescent Activity Questionnaire (YAAQ), respectively. DESIGN: Participants were 1092 students in grades 4 through 6 from 10 schools in a US city in the middle Atlantic region with >or=50% of students eligible for free or reduced-price meals. Students were assessed at baseline and again after 2 y. The relation between self-reported energy intake (YAQ) and activity (physical and sedentary) (YAAQ) and BMI z score was explored from both a cross-sectional and longitudinal perspective. RESULTS: The YAQ (energy intake) and YAAQ (physical and sedentary activity) did not relate to BMI z score in the expected directions from either a cross-sectional or longitudinal perspective. CONCLUSION: In this large, racially diverse sample, the YAQ and the YAAQ were not significantly associated with BMI z score or changes in BMI z score.

A policy-based school intervention to prevent overweight and obesity.

BACKGROUND: The prevalence and seriousness of childhood obesity has prompted calls for broad public health solutions that reach beyond clinic settings. Schools are ideal settings for population-based interventions to address obesity. OBJECTIVE: The purpose of this work was to examine the effects of a multicomponent, School Nutrition Policy Initiative on the prevention of overweight (85.0th to 94.9th percentile) and obesity (> 95.0th percentile) among children in grades 4 through 6 over a 2-year period. METHODS: Participants were 1349 students in grades 4 through 6 from 10 schools in a US city in the Mid-Atlantic region with > or = 50% of students eligible for free or reduced-price meals. Schools were matched on school size and type of food service and randomly assigned to intervention or control. Students were assessed at baseline and again after 2 years. The School Nutrition Policy Initiative included the following components: school self-assessment, nutrition education, nutrition policy, social marketing, and parent outreach. RESULTS: The incidences of overweight and obesity after 2 years were primary outcomes. The prevalence and remission of overweight and obesity, BMI z score, total energy and fat intake, fruit and vegetable consumption, body dissatisfaction, and hours of activity and inactivity were secondary outcomes. The intervention resulted in a 50% reduction in the incidence of overweight. Significantly fewer children in the intervention schools (7.5%) than in the control schools (14.9%) became overweight after 2 years. The prevalence of overweight was lower in the intervention schools. No differences were observed in the incidence or prevalence of obesity or in the remission of overweight or obesity at 2 years. CONCLUSION: A multicomponent school-based intervention can be effective in preventing the development of overweight among children in grades 4 through 6 in urban public schools with a high proportion of children eligible for free and reduced-priced school meals.

The relationship between relative weight and school attendance among elementary schoolchildren.

OBJECTIVE: To determine the relationship between relative weight and school attendance among elementary schoolchildren. RESEARCH METHODS AND PROCEDURES: A total of 1069 fourth to sixth graders from nine elementary schools in the inner city of Philadelphia, PA, were part of an ongoing randomized control trial to assess prevention strategies for obesity. The mean rate of students eligible for free/reduced meals was 82.9 +/- 11.5%. Weight was measured in the second semester of the academic year. Absentee data for the entire academic year were recorded by homeroom teachers. Participants were classified into relative weight categories described by the Institute of Medicine: underweight, normal-weight, overweight, and obese. RESULTS: ANOVA showed that overweight children were absent significantly more than normal-weight children (12.2 +/- 11.7 days vs.10.1 +/- 10.5 days) (p < 0.05). Linear regression showed that the obese category remained a significant contributor to the number of days absent even after adjusting for age, race/ethnicity, and gender. DISCUSSION: These data suggest that in addition to the medical and psychosocial consequences of being overweight, heavier children have greater risk for school absenteeism than their normal-weight peers. As the rate of childhood obesity increases, parallel increases in school absenteeism should be expected.