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1.
Artículo en Inglés | MEDLINE | ID: mdl-33153180

RESUMEN

Childhood and adolescence overweight and obesity have implications for both health consequences and economic burden. Although it has been an emerging public health problem for primary school children in rural China and the importance of the diet-health link has been stressed for many years, rigorous analysis of the dietary diversity and obesity among children is rare. To clarify this issue, this study provides a better understanding of the functional linkage between dietary diversity and obesity by analyzing data from nearly 8500 rural primary students (aged from 10 to 13 years old) covering three provinces in China. Our estimation results show that there is a significantly negative correlation between dietary diversity and the probability of being overweight among primary students. In particular, for subgroups with higher dietary diversity, the negative correlation between dietary diversity and the incidence of overweight or obesity is stronger, and the absolute value of the coefficient is greater. The results also suggest that the increase in the consumption frequency of all dietary categories can significantly lead to a lower proportion of overweight. Thus, we conclude that higher dietary diversity can help to lower the risk of overweight and obesity among primary school children, presumably through increasing the daily frequency of food intakes and developing a more diverse dietary pattern.


Asunto(s)
Dieta , Sobrepeso , Obesidad Pediátrica , Adolescente , Niño , Preescolar , China/epidemiología , Estudios Transversales , Humanos , Masculino , Sobrepeso/epidemiología , Sobrepeso/prevención & control , Obesidad Pediátrica/epidemiología , Obesidad Pediátrica/prevención & control , Población Rural , Instituciones Académicas
2.
Afr Health Sci ; 20(2): 903-911, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33163058

RESUMEN

Background: As Kenya continues to experience rapid development and urbanization, growing evidence shows an increasing prevalence of non-communicable diseases (NCDs) and overweight and obese citizens. Objectives: This study sought to explore the extent to which Kenyan overweight and obese participants reported receiving advice from physicians or health care providers to lose weight and to identify demographic characteristics associated with receipt of weight loss advice. Methods: Descriptive statistics analyzed sociodemographic characteristics and weight loss advice from the 2015 Kenya WHO STEPwise survey (n = 1335). A bivariate logistic regression model estimated the association between socio-demographic characteristics and weight loss advice reported from a physician or health care provider. Results: The prevalence of weight loss advice from health professionals among overweight and obese participants was 19%. Model results indicated that obese individuals [odds ratio (OR) = 2.11, 95% confidence interval (CI) (1.36, 3.26)], individuals with higher than a secondary education [OR = 2.26, 95% CI (1.39, 3.68)], urban dwellers [OR = 2.38, 95% CI (1.29, 4.39)], and women [OR = 3.13, 95% CI (1.60, 6.12)] were significantly more likely to receive weight loss advice from their physician or health care provider. Conclusion: This study found low levels of report of physician or health care provider advice for weight loss among overweight individuals. Advice was primarily reported by obese patients. Weight loss advice differed significantly based on educational attainment, geographical location, and gender thus calling for targeted interventions to increase equitable NCD prevention services from physicians.


Asunto(s)
Consejo/estadística & datos numéricos , Obesidad/epidemiología , Sobrepeso/epidemiología , Pérdida de Peso , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Kenia/epidemiología , Masculino , Persona de Mediana Edad , Obesidad/prevención & control , Obesidad/psicología , Sobrepeso/prevención & control , Sobrepeso/psicología , Relaciones Médico-Paciente , Atención Primaria de Salud/organización & administración
3.
PLoS One ; 15(10): e0240546, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33048990

RESUMEN

To analyze the effects of taxing sugar-sweetened beverages (SSBs) in Ecuador, this study estimates a Quadratic Almost Ideal Demand System model using data from the 2011-2012 National Survey of Income and Expenditure for Urban and Rural Households. We derive own- and cross-price elasticities by income quintiles and consumption deciles for five beverages, including two types of sugary drink: (i) milk, (ii) soft drinks, (iii) water, (iv) other sugary drinks, and (v) coffee and tea. Overall, results show that a 20% increase in the price of SSBs will decrease the consumption of soft drinks and other sugary drinks by 27% and 22%, respectively. Heterogeneous consumer behavior is revealed across income and consumption groups, as well as policy-relevant complementarity and substitution patterns. Policy impacts are simulated by considering an 18 cents per liter tax, implemented in Ecuador, and an ad-valorem 20% tax on the price. Estimated tax revenues and weight loss are larger for the latter. From a health perspective, high-income and heavy consumer households would benefit the most from this policy. Our study supports an evidence-based debate on how to correctly design and monitor food policy.


Asunto(s)
Comportamiento del Consumidor/estadística & datos numéricos , Política Nutricional/economía , Sobrepeso/prevención & control , Bebidas Azucaradas/economía , Impuestos , Comportamiento del Consumidor/economía , Ecuador , Ingestión de Energía/fisiología , Composición Familiar , Humanos , Renta/estadística & datos numéricos , Modelos Económicos , Sobrepeso/etiología , Sobrepeso/fisiopatología , Bebidas Azucaradas/efectos adversos , Bebidas Azucaradas/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos
4.
Artículo en Inglés | MEDLINE | ID: mdl-32927849

RESUMEN

BACKGROUND: Classroom Active Breaks (CABs), short active sessions integrated in the school time, have been recognized as a promising tool to reduce sedentary behavior and increase Physical Activity (PA) levels in children. "AulAttiva" is a six-month CABs-based program implemented in primary schools of the province of Naples. The aim of this study was to evaluate its effectiveness by comparing PA and sedentary time of participating pupils respect to a control group, considering also their weight status. METHODS: Four third-grade classes, each from 4 schools out of 32 participating in AulAttiva, and 4 third-grade classes, each from 4 schools out of 74 that did not take part, were randomly selected. Finally, 58 children composed the intervention group and 57 the control group. Age, gender, weight and height were registered for each participant. Weight status was classified as non-overweight and overweight/obesity. Sedentary time and PA were assessed through accelerometers along a school day. RESULTS: Light PA was 4 min higher in the AulAttiva group with respect to controls (p = 0.046). Within the non-overweight children, the AulAttiva group spent less time in sedentary behavior and more time in light and total PA than controls. No significant differences were found between the overweight/obese subgroups. CONCLUSIONS: The results support the effectiveness of CABs in increasing PA during the school day. Greater effects were registered among normal weight pupils, suggesting the possible influence of weight status on children's participation to the intervention. Further studies are needed to improve the compliance of overweight/obese children to this intervention.


Asunto(s)
Ejercicio Físico , Promoción de la Salud , Sobrepeso/prevención & control , Conducta Sedentaria , Niño , Estudios Transversales , Femenino , Humanos , Italia , Masculino , Instituciones Académicas
5.
Cochrane Database Syst Rev ; 9: CD012415, 2020 09 11.
Artículo en Inglés | MEDLINE | ID: mdl-32914461

RESUMEN

BACKGROUND: Overweight and obesity are increasing worldwide and are considered to be a major public health issue of the 21st century. Introducing taxation of the fat content in foods is considered a potentially powerful policy tool to reduce consumption of foods high in fat or saturated fat, or both. OBJECTIVES: To assess the effects of taxation of the fat content in food on consumption of total fat and saturated fat, energy intake, overweight, obesity, and other adverse health outcomes in the general population. SEARCH METHODS: We searched CENTRAL, Cochrane Database of Systematic Reviews, MEDLINE, Embase, and 15 other databases and trial registers on 12 September 2019. We handsearched the reference lists of all records of included studies, searched websites of international organizations and institutions (14 October 2019), and contacted review advisory group members to identify planned, ongoing, or unpublished studies (26 February 2020). SELECTION CRITERIA: In line with Cochrane Effective Practice and Organisation of Care Group (EPOC) criteria, we included the following study types: randomized controlled trials (RCTs), cluster-randomized controlled trials (cRCTs), non-randomized controlled trials (nRCTs), controlled before-after (CBA) studies, and interrupted time series studies. We included studies that evaluated the effects of taxes on the fat content in foods. Such a tax could be expressed as sales, excise, or special value added tax (VAT) on the final product or an intermediary product. Eligible interventions were taxation at any level, with no restriction on the duration or the implementation level (i.e. local, regional, national, or multinational). Eligible study populations were children (zero to 17 years) and adults (18 years or older) from any country and setting. We excluded studies that focused on specific subgroups only (e.g. people receiving pharmaceutical intervention; people undergoing a surgical intervention; ill people who are overweight or obese as a side effect, such as those with thyroiditis and depression; and people with chronic illness). Primary outcomes were total fat consumption, consumption of saturated fat, energy intake through fat, energy intake through saturated fat, total energy intake, and incidence/prevalence of overweight or obesity. We did not exclude studies based on country, setting, comparison, or population. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods for all phases of the review. Risk of bias of the included studies was assessed using the criteria of Cochrane's 'Risk of bias' tool and the EPOC Group's guidance. Results of the review are summarized narratively and the certainty of the evidence was assessed using the GRADE approach. These steps were done by two review authors, independently. MAIN RESULTS: We identified 23,281 records from searching electronic databases and 1173 records from other sources, leading to a total of 24,454 records. Two studies met the criteria for inclusion in the review. Both included studies investigated the effect the Danish tax on saturated fat contained in selected food items between 2011 and 2012. Both studies used an interrupted time series design. Neither included study had a parallel control group from another geographic area. The included studies investigated an unbalanced panel of approximately 2000 households in Denmark and the sales data from a specific Danish supermarket chain (1293 stores). Therefore, the included studies did not address individual participants, and no restriction regarding age, sex, and socioeconomic characteristics were defined. We judged the overall risk of bias of the two included studies as unclear. For the outcome total consumption of fat, a reduction of 41.8 grams per week per person in a household (P < 0.001) was estimated. For the consumption of saturated fat, one study reported a reduction of 4.2% from minced beef sales, a reduction of 5.8% from cream sales, and an increase of 0.5% to sour cream sales (no measures of statistical precision were reported for these estimates). These estimates are based on a restricted number of food types and derived from sales data; they do not measure individual intake. Moreover, these estimates do not account for other relevant sources of fat intake (e.g. packaged or processed food) or other food outlets (e.g. restaurants or cafeterias); hence, we judged the evidence on the effect of taxation on total fat consumption or saturated fat consumption to be very uncertain. We did not identify evidence on the effect of the intervention on energy intake or the incidence or prevalence of overweight or obesity. AUTHORS' CONCLUSIONS: Given the very low quality of the evidence currently available, we are unable to reliably establish whether a tax on total fat or saturated fat is effective or ineffective in reducing consumption of total fat or saturated fat. There is currently no evidence on the effect of a tax on total fat or saturated fat on total energy intake or energy intake through saturated fat or total fat, or preventing the incidence or reducing the prevalence of overweight or obesity.


Asunto(s)
Grasas de la Dieta/administración & dosificación , Obesidad/prevención & control , Impuestos , Adolescente , Adulto , Niño , Comercio/estadística & datos numéricos , Dinamarca , Humanos , Análisis de Series de Tiempo Interrumpido , Sobrepeso/prevención & control
6.
Int J Equity Health ; 19(1): 138, 2020 08 13.
Artículo en Inglés | MEDLINE | ID: mdl-32792002

RESUMEN

BACKGROUND: India is strongly committed to reducing the burden of child malnutrition, which has remained a persistent concern. Findings from recent surveys indicate co-existence of child undernutrition, micronutrient deficiency and overweight/obesity, i.e. the triple burden of malnutrition among children below 5 years. While considerable efforts are being made to address this challenge, and several composite indices are being explored to inform policy actions, the methodology used for creating such indices, i.e., linear averaging, has its limitations. Briefly put, it could mask the uneven improvement across different indicators by discounting the 'lagging' indicators, and hence not incentivising a balanced improvement. Signifying negative implications on policy discourse for improved nutrition. To address this gap, we attempt to develop a composite index for estimating the triple burden of malnutrition in India, using a more sensitive measure, MANUSH. METHODOLOGY: Data from publicly available nation-wide surveys - National Family Health Survey (NFHS) and Comprehensive National Nutrition Survey (CNNS), was used for this study. First, we addressed the robustness of MANUSH method of composite indexing over conventional aggregation methods. Second, using MANUSH scores, we assessed the triple burden of malnutrition at the subnational level over different periods NHFS- 3(2005-06), NFHS-4 (2015-16) and CNNS (2106-18). Using mapping and spatial analysis tools, we assessed neighbourhood dependency and formation of clusters, within and across states. RESULT: MANUSH method scores over other aggregation measures that use linear aggregation or geometric mean. It does so by fulfilling additional conditions of Shortfall and Hiatus Sensitivity, implicitly penalising cases where the improvement in worst-off dimension is lesser than the improvement in best-off dimension, or where, even with an overall improvement in the composite index, the gap between different dimensions does not reduce. MANUSH scores helped in revealing the gaps in the improvement of nutrition outcomes among different indicators and, the rising inequalities within and across states and districts in India. Significant clusters (p < 0.05) of high burden and low burden districts were found, revealing geographical heterogeneities and sharp regional disparities. A MANUSH based index is useful in context-specific planning and prioritising different interventions, an approach advocated by the newly launched National Nutrition Mission in India. CONCLUSION: MANUSH based index emphasises balanced development in nutritional outcomes and is hence relevant for diverse and unevenly developing economy like India.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Disparidades en el Estado de Salud , Indicadores de Salud , Desnutrición/epidemiología , Estado Nutricional , Obesidad/epidemiología , Características de la Residencia , Trastornos de la Nutrición del Niño/prevención & control , Preescolar , Comorbilidad , Femenino , Humanos , India/epidemiología , Lactante , Masculino , Desnutrición/prevención & control , Micronutrientes/deficiencia , Encuestas Nutricionales , Obesidad/prevención & control , Sobrepeso/epidemiología , Sobrepeso/prevención & control , Políticas , Factores de Riesgo , Factores Socioeconómicos , Análisis Espacial
7.
PLoS One ; 15(8): e0237720, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32834011

RESUMEN

BACKGROUND: Underweight, overweight, and obesity are major public health challenges among reproductive-age women of lower- and middle-income countries (including Tanzania). In those settings, obesogenic factors (attributes that promote excessive body weight gain) are increasing in the context of an existing high burden of undernutrition. The present study investigated factors associated with underweight, overweight, and obesity among reproductive age women in Tanzania. METHODS: This study used 2015-16 Tanzania Demographic and Health Survey data (n = 11735). To account for the hierarchical nature of the data (i.e., reproductive age women nested within clusters), multilevel multinomial logistic regression models were used to investigate the association between individual-level (socioeconomic, demographic and behavioural) and community-level factors with underweight, overweight, and obesity. RESULTS: Reproductive age women who were informally employed (relative risk ratio [RRR] = 0.79; 95% confidence interval [CI]: 0.64, 0.96), those who were currently married (RRR = 0.59; 95% CI: 0.43, 0.82) and those who used contraceptives (RRR = 0.70; 95% CI: 0.54, 0.90) were less likely to be underweight. Reproductive age women who attained secondary or higher education (RRR = 1.48; 95% CI: 1.11, 1.96), those who resided in wealthier households (RRR = 2.31; 95% CI: 1.78, 3.03) and those who watched the television (RRR = 1.26; 95% CI: 1.06, 1.50) were more likely to be overweight. The risk of experiencing obesity was higher among reproductive age women who attained secondary or higher education (RRR = 1.79; 95% CI: 1.23, 2.61), those who were formally employed (RRR = 1.50; 95% CI: 1.14, 1.98), those who resided in wealthier households (RRR = 4.77; 95% CI: 3.03, 7.50), those who used alcohol (RRR = 1.43; 95% CI: 1.12, 1.82) and/or watched the television (RRR = 1.70; 95% CI: 1.35, 2.13). CONCLUSION: Our study suggests that relevant government jurisdictions need to identify, promote, and implement evidence-based interventions that can simultaneously address underweight and overweight/obesity among reproductive age women in Tanzania.


Asunto(s)
Necesidades y Demandas de Servicios de Salud/organización & administración , Obesidad/epidemiología , Sobrepeso/epidemiología , Salud Reproductiva/estadística & datos numéricos , Delgadez/epidemiología , Adolescente , Adulto , Estudios Transversales , Medicina Basada en la Evidencia/organización & administración , Medicina Basada en la Evidencia/estadística & datos numéricos , Femenino , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Estado Nutricional/fisiología , Obesidad/fisiopatología , Obesidad/prevención & control , Sobrepeso/fisiopatología , Sobrepeso/prevención & control , Prevalencia , Servicios Preventivos de Salud/organización & administración , Servicios Preventivos de Salud/estadística & datos numéricos , Reproducción/fisiología , Factores de Riesgo , Factores Socioeconómicos , Tanzanía/epidemiología , Delgadez/fisiopatología , Delgadez/prevención & control , Adulto Joven
8.
PLoS One ; 15(8): e0237564, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32810194

RESUMEN

BACKGROUND: Prevention of overweight during early childhood seems promising. OBJECTIVE: To evaluate the effectiveness of the parenting-based BBOFT+ overweight prevention program on child BMI, child health behavior and parenting behavior among 0-36 month old children. BBOFT+ is an acronym for the key healthy lifestyle behaviors that are targeted in the BBOFT+ intervention: breastfeeding (B), daily breakfast (B), daily going outdoors (O), limiting sweet beverages (in Dutch, F) and minimal TV or computer time (T), complemented with healthy sleep behavior and improvement of parenting skills (+). METHODS: A cluster randomized controlled trial in newborn children visiting well-baby clinics, comparing the BBOFT+ intervention (N = 901) with care as usual (CAU) (N = 1094). In both groups, parents received regular well-child visits (±11 visits in the first 3 years). In the intervention group, care was supplemented with the BBOFT+ program, which focuses on improving parenting skills from birth onwards to increase healthy behavior. Questionnaires were filled in at child's age 2-4 weeks, 6, 14 and 36 months. In multivariate analyses we corrected for child's birthweight, age, ethnic background, mother's educational level and BMI. RESULTS: No differences were found in weight status at 36 months between intervention and control group children. At 6 months, BBOFT+ parents reported their child drinking less sweet beverages than control parents (48% vs 54%;p = .027), and going outdoors daily with their child less often (57% vs 62%;p = .03). At 14 months, more BBOFT+ parents than control parents reported to have breastfed for six months or longer (32% vs 29%;p = .022). At 36 months, more BBOFT+ parents than control parents reported their child going outside daily (78% vs 72%;p = .011) and having less TV/computer time on week- (38% vs 46%;p = .001) and weekend days (48% vs 56%;p = .002). Also, BBOFT+ parents reported having more parental control than control parents (3.92 vs 3.89;p = .02). No significant differences were found for daily breakfast, sleep duration and parenting practices in adjusted analyses. CONCLUSION: The BBOFT+ overweight prevention program showed small improvements in parent-reported child health behaviors, compared to care as usual; no effect was observed on child BMI. The identified modifiable elements are potentially relevant for interventions that aim to prevent overweight.


Asunto(s)
Índice de Masa Corporal , Educación no Profesional/métodos , Conductas Relacionadas con la Salud/fisiología , Sobrepeso/prevención & control , Responsabilidad Parental , Adulto , Desarrollo Infantil/fisiología , Servicios de Salud del Niño , Preescolar , Análisis por Conglomerados , Femenino , Humanos , Lactante , Recién Nacido , Estilo de Vida , Masculino , Países Bajos , Visita a Consultorio Médico , Relaciones Padres-Hijo , Obesidad Pediátrica/prevención & control , Prevención Primaria/métodos , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios
9.
Int J Public Health ; 65(6): 893-903, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32725393

RESUMEN

OBJECTIVES: The current study evaluates the effect of nutritional education based on Pender's health promotion model on breakfast consumption behavior among Egyptian school students. METHODS: A pre-posttest intervention study through a nutritional education message based on Pender's health promotion model was carried on 244 preparatory school students. Data were collected using questionnaires and measuring weight, height and blood pressure before and after educational intervention was conducted to the intervention group. RESULTS: The educational intervention was having a significant positive effect on all components of the model in the intervention group, the mean breakfast consumption, frequency of non-skipping and healthy breakfast per week (p ≤ 0.05). Overweight and obesity and higher blood pressure were significantly present among breakfast skippers. CONCLUSIONS: The nutritional educational intervention based on Pender's health promotion model was effective in increasing the frequency of healthy breakfast among the school students. There is a need to develop evidence-based policies, community, family, and school-based interventions to promote healthy lifestyle and nutritional behavior among adolescents for a better quality of life.


Asunto(s)
Conducta del Adolescente/psicología , Desayuno/psicología , Conducta Alimentaria/psicología , Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Sobrepeso/prevención & control , Estudiantes/psicología , Adolescente , Niño , Egipto , Femenino , Promoción de la Salud/estadística & datos numéricos , Humanos , Masculino , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios
10.
BMC Public Health ; 20(1): 1165, 2020 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-32711506

RESUMEN

BACKGROUND: Obesity is a major risk factor for the global burden of disease in countries that are economically developed or not. This study aimed to investigate the association between diet quality and obesity indicators applying DASH and aMed. METHODS: This cross-sectional study on adult nutrition and chronic disease in Inner Mongolia (n = 1320). Dietary data were collected using 24-h diet recall for 3 consecutive days and weighing method. DASH and aMed were used to assess the dietary quality. WC, BMI and WC-BMI were used as obesity indicators. Logistic regression models were used to examine the associations between diet quality and obesity indicators. RESULTS: Higher diet quality, assessed by DASH, was only associated with WC. The odds ratio (OR) for abdominal obesity in the highest tertile of DASH scores compared with the lowest was 0.71 (95% confidence interval (CI) 0.53, 0.96; Ptrend = 0.03). Furthermore, aMed was inversely associated with obesity indicators. OR for abdominal obesity in the highest tertile of aMed score compared with the lowest were 0.63 (95% CI 0.47, 0.87; Ptrend = 0.005) and 0.57 (95% CI 0.41, 0.77; Ptrend = 0.02) for overweight and obesity, respectively, and 0.60 (95% CI 0.44, 0.81; Ptrend = 0.02) for high obesity risk. CONCLUSIONS: Our findings suggest that dietary quality assessed using aMed is more closely associated with obesity than assessment using DASH in working-age adults in Inner Mongolia. The Mediterranean diet can be recommended as a healthy diet to control weight.


Asunto(s)
Índice de Masa Corporal , Dieta Saludable , Dieta Mediterránea , Conducta Alimentaria , Obesidad , Circunferencia de la Cintura , Adolescente , Adulto , Peso Corporal , China , Estudios Transversales , Dieta/métodos , Enfoques Dietéticos para Detener la Hipertensión , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estado Nutricional , Obesidad/prevención & control , Obesidad Abdominal , Oportunidad Relativa , Sobrepeso/prevención & control , Factores de Riesgo , Adulto Joven
11.
Artículo en Inglés | MEDLINE | ID: mdl-32708459

RESUMEN

BACKGROUND: Healthcare monitoring of child growth reduces with age, which may increase parental influences on children's weight development. This study aimed to examine the association between maternal underestimation of child's weight at age 5/6 and weight development between 5 and 12 years. METHODS: We performed univariate and multivariate linear regression analyses with data on maternal perception of child's weight and weight development (∆SDS body-mass index; BMI) derived from the Amsterdam Born Children and their Development (ABCD) birth-cohort study. Underestimation was defined by comparing maternal perception of child's weight with the actual weight status of her child. Associations were studied in two groups: children with overweight (n = 207) and children with normal weight (n = 1982) at baseline (children with underweight were excluded). RESULTS: Underestimation was 5.5% in children with normal weight and 79.7% in children with overweight. Univariate analyses in children with normal weight and overweight showed higher weight development for children with underestimated vs. accurately estimated weights (respectively: ß = 0.19, p < 0.01; ß = 0.22, p < 0.05). After adjusting for child sex and baseline SDS BMI, the effect size became smaller for children with a normal weight (ß = 0.15, p < 0.05) and overweight (ß = 0.18, p > 0.05). Paternal and maternal BMI, ethnicity, and educational level explained the association further (remaining ß = -0.11, p > 0.05 in children with normal weight; ß = 0.06, p > 0.05 in children with overweight). CONCLUSIONS: The relationship between maternal underestimation of child's weight and higher weight development indicates a need for promoting a realistic perception of child's weight, this is also the case if the child has a normal weight.


Asunto(s)
Peso Corporal , Conocimientos, Actitudes y Práctica en Salud , Madres/psicología , Sobrepeso/prevención & control , Índice de Masa Corporal , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Masculino , Sobrepeso/epidemiología
12.
Cad Saude Publica ; 36(6): e00116519, 2020.
Artículo en Portugués | MEDLINE | ID: mdl-32578807

RESUMEN

The article analyzes actions in the prevention and control of overweight and obesity that have been developed in the 92 municipalities (counties) in the state of Rio de Janeiro, Brazil, based on underlying principles in the typology of public policies developed by Lowi and Line of Care for Overweight and Obesity, according to the following analytical dimensions: program actions in prevention and control of obesity, characterization of macro policies according to the Lowi typology, and characterization of macro policies according to the Line of Care for Overweight and Obesity. The study is part of a research project from 2014 to 2018 that aimed to identify the strategies and challenges in the consolidation of the actions planned in the Line of Care for Overweight and Obesity, based on analysis of secondary data and government documents; searches in the municipalities' official websites; interviews; focus groups; and online questionnaires with health professionals and managers. The documents point to a series of actions such as individual consultations, support groups, health gyms, school health programs, and others, reinforced by the interviewees' narratives. Even with so many initiatives, the municipalities in the state of Rio de Janeiro face challenges with limited human resources and precarious infrastructure and equipment in the health units. To achieve mobilization in the actions to deal with obesity, the issue should be addressed specifically on the state and local agendas and not diluted among other activities and programs.


Asunto(s)
Obesidad , Sobrepeso , Brasil , Ciudades , Gobierno , Humanos , Obesidad/prevención & control , Sobrepeso/prevención & control
13.
BMC Endocr Disord ; 20(Suppl 2): 52, 2020 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-32370795

RESUMEN

BACKGROUND: Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies. METHODS: Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019. RESULTS: From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups. CONCLUSIONS: Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives.


Asunto(s)
Índice de Masa Corporal , Dieta Saludable , Terapia por Ejercicio , Promoción de la Salud , Sobrepeso/prevención & control , Obesidad Pediátrica/prevención & control , Peso Corporal , Familia , Humanos , Estilo de Vida , Metaanálisis como Asunto , Pronóstico , Instituciones Académicas
14.
Pediatr Obes ; 15(9): e12647, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32400070

RESUMEN

BACKGROUND: Primary prevention of overweight is to be preferred above secondary prevention, which has shown moderate effectiveness. OBJECTIVE: To develop and internally validate a dynamic prediction model to identify young children in the general population, applicable at every age between birth and age 6, at high risk of future overweight (age 8). METHODS: Data were used from the Prevention and Incidence of Asthma and Mite Allergy birth cohort, born in 1996 to 1997, in the Netherlands. Participants for whom data on the outcome overweight at age 8 and at least three body mass index SD scores (BMI SDS) at the age of ≥3 months and ≤6 years were available, were included (N = 2265). The outcome of the prediction model is overweight (yes/no) at age 8 (range 7.4-10.5 years), defined according to the sex- and age-specific BMI cut-offs of the International Obesity Task Force. RESULTS: After backward selection in a Generalized Estimating Equations analysis, the prediction model included the baseline predictors maternal BMI, paternal BMI, paternal education, birthweight, sex, ethnicity and indoor smoke exposure; and the longitudinal predictors BMI SDS, and the linear and quadratic terms of the growth curve describing a child's BMI SDS development over time, as well as the longitudinal predictors' interactions with age. The area under the curve of the model after internal validation was 0.845 and Nagelkerke R2 was 0.351. CONCLUSIONS: A dynamic prediction model for overweight was developed with a good predictive ability using easily obtainable predictor information. External validation is needed to confirm that the model has potential for use in practice.


Asunto(s)
Sobrepeso/epidemiología , Peso al Nacer , Índice de Masa Corporal , Niño , Preescolar , Estudios de Cohortes , Escolaridad , Grupos Étnicos , Femenino , Humanos , Lactante , Masculino , Países Bajos/epidemiología , Sobrepeso/prevención & control , Obesidad Pediátrica/epidemiología , Obesidad Pediátrica/prevención & control , Embarazo , Factores de Riesgo , Encuestas y Cuestionarios
15.
Br J Sports Med ; 54(22): 1321-1331, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32471813

RESUMEN

China is experiencing significant public health challenges related to social and demographic transitions and lifestyle transformations following unprecedented economic reforms four decades ago. Of particular public health concern is the fourfold increase in overweight and obesity rates in the nation's youth population, coupled with the low prevalence of adolescents meeting recommended levels of physical activity. Improving the overall health of China's more than 170 million children and adolescents has become a national priority. However, advancing nationwide health initiatives and physical activity promotion in this population has been hampered by the lack of a population-specific and culturally relevant consensus on recommendations for achieving these ends. To address this deficiency and inform policies to achieve Healthy China 2030 goals, a panel of Chinese experts, complemented by international professionals, developed this consensus statement. The consensus was achieved through an iterative process that began with a literature search from electronic databases; in-depth reviews, conducted by a steering committee, of the resulting articles; and panel group evaluations and discussions in the form of email correspondence, conference calls and written communications. Ultimately, the panel agreed on 10 major themes with strong scientific evidence that, in children and adolescents aged 6-17, participating in moderate to vigorous physical activities led to multiple positive health outcomes. Our consensus statement also (1) highlights major challenges in promoting physical activity, (2) identifies future research that addresses current knowledge gaps, and (3) provides recommendations for teachers, education experts, parents and policymakers for promoting physical activity among Chinese school-aged children and adolescents. This consensus statement aligns with international efforts to develop global physical activity guidelines to promote physical activity and health and prevent lifestyle-related diseases in children and adolescents. More importantly, it provides a foundation for developing culturally appropriate and effective physical activity interventions, health promotion strategies and policy initiatives to improve the health of Chinese children and adolescents.


Asunto(s)
Ejercicio Físico , Programas Gente Sana , Obesidad Pediátrica/prevención & control , Éxito Académico , Adolescente , Niño , China/epidemiología , Cognición/fisiología , Ambiente , Ejercicio Físico/psicología , Política de Salud , Estilo de Vida Saludable , Programas Gente Sana/métodos , Humanos , Sobrepeso/epidemiología , Sobrepeso/prevención & control , Obesidad Pediátrica/epidemiología , Aptitud Física , Clase Social
16.
Rev Epidemiol Sante Publique ; 68(3): 163-169, 2020 Jun.
Artículo en Francés | MEDLINE | ID: mdl-32417152

RESUMEN

BACKGROUND: A high level of physical fitness is associated with cardiovascular health in adolescents. We describe change in physical fitness levels assessed at two time points over 3 years. METHODS: The study presents a longitudinal design, with the first phase data collection at 8 years and the second phase carried out at 11 years. A total of 516 children (254 boys) aged to 7.7±0.4 years (in 2010) and 10.9±0.4 years (in 2010) and 10.9 ± 0.4 years (in 2013) participated to the study. Cardiorespiratory fitness, muscular strength, speed, and agility were assessed in this study. For each physical fitness test, determination of the situation (in terms of percentiles) of each child in 2010 and then in 2013 compared to national standards. The 2010 and 2013 percentiles are then compared using the Wilcoxon signed rank test. RESULTS: Muscular strength, agility and cardiorespiratory fitness decrease in both sex (p<0.01). A significant decrease was also found for all physical fitness components in normal weight children (p<0.05). For normal weight children in 2010 who became overweight or obese in 2013, there was a significant decrease in scores of cardiorespiratory fitness and agility tests (p<0.05). For overweight children in 2010 becoming from to normal weight status in 2013, only the agility test decreased significantly (p<0.05). Children being overweight or obese in 2010 and remaining in 2013, had a significant decrease in their physical fitness levels (p<0.05). CONCLUSIONS: Our results indicate that the physical fitness of French youth decrease between childhood and early adolescence. Developing and introducing a health promotion curriculum in the French schools is suggested to improve health and physical fitness.


Asunto(s)
Capacidad Cardiovascular/fisiología , Servicios de Salud del Niño/organización & administración , Promoción de la Salud/organización & administración , Aptitud Física/fisiología , Adolescente , Constitución Corporal/fisiología , Pesos y Medidas Corporales/métodos , Pesos y Medidas Corporales/normas , Niño , Preescolar , Ejercicio Físico/fisiología , Femenino , Francia , Promoción de la Salud/métodos , Estado de Salud , Humanos , Peso Corporal Ideal/fisiología , Estudios Longitudinales , Masculino , Fuerza Muscular/fisiología , Sobrepeso/prevención & control , Obesidad Pediátrica/prevención & control , Vigilancia de la Población/métodos , Evaluación de Programas y Proyectos de Salud
17.
PLoS One ; 15(4): e0232624, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32353069

RESUMEN

BACKGROUND: A global epidemic of obesity has been documented, particularly among African countries. While central obesity and overweight have been reported for many countries, very limited information exists about the prevalence of these health problems in Sudan, and these data are nonexistent for Eastern Sudan. The present study aimed to determine the prevalence of obesity and central obesity, as well as the factors associated with both, among adults in Gadarif, Eastern Sudan. METHODS: A cross-sectional study was conducted in Gadarif, Eastern Sudan, during the period of January through May 2018. Sociodemographic and health characteristics data were collected through a questionnaire. Body mass index (BMI) and waist circumference (WC) were measured using the standard methods. Both descriptive and inferential statics were applied to analyze the data. RESULTS: A total of 594 adults participated in the study; 70.4% of them were female. The mean (standard deviation) age was 44.98 (16.64) years. Of the 594 enrolled participants, 33.7%, 7.4%, 26.8%, and 32.2% were normal weight, underweight, overweight, and obese, respectively. The prevalence of central obesity was (67.8%). Approximately, one-third of the participants (29.29%) were obese and had central obesity. In the multinomial regression, being married was the main risk factor associated with overweight, and older age, female sex, being married and hypertension were significantly associated with obesity. In the binary regression, the main risk factors associated with central obesity were female sex and being married. CONCLUSION: The prevalence rates of both obesity and central obesity among the study participants were high. Older age and hypertension were only associated with obesity. Obesity and central obesity were significantly associated with female sex and being married. This study provided valuable baseline information to develop appropriate strategies for the prevention and control of obesity in Eastern Sudan.


Asunto(s)
Obesidad Abdominal/epidemiología , Sobrepeso/epidemiología , Adulto , Factores de Edad , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Masculino , Estado Civil/estadística & datos numéricos , Persona de Mediana Edad , Obesidad Abdominal/diagnóstico , Obesidad Abdominal/prevención & control , Sobrepeso/diagnóstico , Sobrepeso/prevención & control , Prevalencia , Factores de Riesgo , Factores Sexuales , Sudán/epidemiología , Circunferencia de la Cintura
18.
Nutrients ; 12(4)2020 Apr 13.
Artículo en Inglés | MEDLINE | ID: mdl-32295050

RESUMEN

To reduce the sugar content of processed foods through reformulation, the first step is to determine the content of the largest sources of sugars in each country's diet. The aim of this work was to describe the sugar content in the most commonly consumed processed foods in Spain and to compare that sugar's labelling and laboratory analysis values (LVs and AVs, respectively) to confirm its adequacy. A sample of the 1173 most commonly consumed processed foods in Spain (28 groups; 77 subcategories) was collected. For each product, the total sugar content was compared according to its AV and LV. The median (25th -75th percentiles, interquartile range) sugar content by group was calculated for the total sample, and the groups were classified as "high sugar content" when this value was above 22.5 g/100g of product. The adequacy of the LV, according to the European Union (EU) tolerance requirements, was then evaluated, and each subcategory median was compared with the AV to determine its appropriateness via a median test for independent samples (p < 0.05). In total, 10 out of 28 groups presented high sugar content. Moreover, 98.4% of the products met the EU tolerance ranges. Finally, only one subcategory ("cured ham") presented significant differences between the AV and LV median values (0.4 g vs. 0.1 g sugar/100g, p < 0.05). The groups of food products whose sugar content reduction could have the greatest impact on public health were identified. In addition, our study showed the high adequacy of LV with the EU labeling tolerance requirements, as well as the LV's appropriateness as a tool to implement actions aimed at reducing sugar consumption.


Asunto(s)
Azúcares de la Dieta/análisis , Etiquetado de Alimentos , Política Nutricional , Valor Nutritivo , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus/etiología , Diabetes Mellitus/prevención & control , Azúcares de la Dieta/efectos adversos , Análisis de los Alimentos , Humanos , Mercadotecnía , Neoplasias/etiología , Neoplasias/prevención & control , Sobrepeso/etiología , Sobrepeso/prevención & control , España
19.
Nutrients ; 12(4)2020 Apr 13.
Artículo en Inglés | MEDLINE | ID: mdl-32295057

RESUMEN

Eating faster is associated with greater body mass index (BMI), but less is known about the relationships between eating rate, energy intake, body composition, and cardio-metabolic risk factors in different Asian ethnic groups. Using data from the Singapore Multi-Ethnic Cohort (n = 7011; 21-75 y), we investigated associations between self-reported eating rate (SRER), with energy intake, body composition, blood pressure, and blood lipids. SRER and lifestyle was assessed using interviewer-administered questionnaires. Multivariable models were used to examine the associations of SRER with energy intake, body composition, blood pressure, and blood lipids after adjusting for covariates. General and abdominal overweight were defined as BMI ≥ 23 kg/m2 and waist circumference > 90cm (men) and > 80cm (women), respectively. On average, faster eaters (vs. slower eaters) consumed 105kcal/day more (p = 0.034), had ~5kg higher body weight (p < 0.001), 1.3 kg/m2 higher BMI (p < 0.001), and 3.1cm larger waist-circumference (p < 0.001). Faster eaters had significantly higher blood pressure, circulating triglycerides, and total-to-high-density lipoprotein cholesterol ratio than slower eaters. Faster eaters were twice as likely to develop general (multivariable-OR: 2.2;95%CI,1.8-2.6; p < 0.001), and abdominal (OR:1.8;95%CI, 1.5-2.2; p < 0.001) overweight than slower eaters. This association was observed across all subgroups by age, sex, and ethnicity. Findings suggest that SRER is a robust behavioral marker for increased risk of higher energy intake, obesity, and poor cardio-metabolic health, and a modifiable behavioral risk-factor for obesity prevention.


Asunto(s)
Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Ingestión de Alimentos/fisiología , Ingestión de Energía/fisiología , Conducta Alimentaria/fisiología , Autoinforme , Asia/etnología , Grupo de Ascendencia Continental Asiática , Presión Sanguínea , Composición Corporal , Femenino , Humanos , Lípidos/sangre , Masculino , Obesidad/etiología , Obesidad/prevención & control , Sobrepeso/etiología , Sobrepeso/prevención & control , Factores de Riesgo , Factores de Tiempo
20.
Artículo en Inglés | MEDLINE | ID: mdl-32326133

RESUMEN

Metabolically unhealthy obesity (MUO) is a regular state in people with primary hypertension (HTN), obesity, and who are physically inactive. To achieve and maintain a metabolically healthy overweight/obese (MHO) state should be a main treatment goal. The aims of the study were (1) to determine differences in metabolic profiles of overweight/obese, physically inactive individuals with HTN following a 16-week (POST) supervised aerobic exercise training (SupExT) intervention with an attentional control (AC) group, and (2) to determine whether the changes observed were maintained following six months (6 M) of unsupervised time. Participants (n = 219) were randomly assigned into AC or SupExT groups. All participants underwent a hypocaloric diet. At POST, all participants received diet and physical activity advice for the following 6 M, with no supervision. All measurements were assessed pre-intervention (PRE), POST, and after 6 M. From PRE to POST, MUO participants became MHO with improved (p < 0.05) total cholesterol (TC, ∆ = -12.1 mg/dL), alanine aminotransferase (∆ = -8.3 U/L), glucose (∆ = -5.5 mg/dL), C-reactive protein (∆ = -1.4 mg/dL), systolic blood pressure (SBP), and cardiorespiratory fitness (CRF) compared to unhealthy optimal cut-off values. However, after 6 M, TC, glucose, and SBP returned to unhealthy values (p < 0.05). In a non-physically active population with obesity and HTN, a 16-week SupExT and diet intervention significantly improves cardiometabolic profile from MUO to MHO. However, after 6 M of no supervision, participants returned to MUO. The findings of this study highlight the need for regular, systematic, and supervised diet and exercise programs to avoid subsequent declines in cardiometabolic health.


Asunto(s)
Dieta Reductora , Terapia por Ejercicio , Obesidad/terapia , Sobrepeso/terapia , Adulto , Humanos , Persona de Mediana Edad , Obesidad/prevención & control , Sobrepeso/prevención & control , Evaluación de la Tecnología Biomédica
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