Lowenstein, Lisa M; Perrin, Eliana M; Berry, Diane; Vu, Maihan B; Pullen Davis, Lisa; Cai, Jianwen; Tzeng, Janice P; Ammerman, Alice S
To prevent childhood obesity, parents and their children's healthcare providers need to engage in effective dialogue. We know much about mothers' experiences, but very little about fathers' experiences. We explored African-American, Caucasian, and Latino fathers' perceptions and experiences communicating with their children's provider during clinic visits regarding weight, diet, and physical activity. Focus groups (n=3), grouped by race/ethnicity, including a total of 24 fathers, were conducted. The men were asked open-ended questions; responses were recorded and transcribed, and analyzed using ATLAS.ti. Findings revealed that these fathers were involved in their children's healthcare and found providers to be helpful partners in keeping their children healthy, yet they generally felt "left out" during clinic appointments. The quality of the relationship with their children's provider influenced how receptive fathers were to discussing their children's weight, diet, and physical activity behaviors. Fathers made suggestions to help improve communication between providers and fathers, such as personalizing the discussion. These fathers expressed strong feelings about the provider-parent relationship when discussing weight, diet, and physical activity.
Full Text Available Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services.We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia.Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers.This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD
Spivack, Jordan G; Swietlik, Maggie; Alessandrini, Evaline; Faith, Myles S
This study evaluated primary care providers' (PCPs, pediatricians, and nurse practitioners) knowledge, current practices, and perceived barriers to childhood obesity prevention and treatment, with an emphasis on first-year well-child care visits. A questionnaire was distributed to 192 PCPs in the primary care network at The Children's Hospital of Philadelphia (CHOP) addressing (i) knowledge of obesity and American Academy of Pediatrics (AAP) guidelines, (ii) anticipatory guidance practices at well visits regarding nutrition and exercise, and (iii) perceived barriers to childhood obesity treatment and prevention. Eighty pediatricians and seven nurse practitioners responded, and a minority correctly identified the definition (26%) and prevalence (9%) of childhood overweight and AAP guidelines for exercise (39%) and juice consumption (44%). Most PCPs (81%) spent 11-20 min per well visit during the first 2 years, and 79% discussed diet, nutrition, and exercise for > or =3 min. Although >95% of PCPs discussed juice, fruits and vegetables, sippy cups, and finger foods during the first year, over 35% never discussed fast food, TV, or candy, and 55% never discussed exercise. Few rated current resources as adequate to treat or prevent childhood obesity. Over 90% rated the following barriers for obesity prevention and treatment as important or very important: parent is not motivated, child is not motivated, parents are overweight, families often have fast food, watch too much TV, and do not get enough exercise. In conclusion, there is much room to improve PCPs' knowledge of obesity and AAP guidelines. Although PCPs rate fast-food consumption, TV viewing, and lack of exercise as important treatment barriers, many never discussed these topics during the first year.
Full Text Available A systematic review of the literature was conducted to identify the barriers that prevent practitioners from identifying and counseling parents and caregivers of overweight or obese children. Once identified, barriers were organized into thematic categories (parental, provider, and professional barriers and recommendations were generated to facilitate discussion about childhood obesity between professionals and parents. Childhood obesity is a significant public health problem. Healthcare providers must be able to effectively communicate with caregivers and put childhood obesity at the front of healthcare discussions. This article provides a synthesis of the relevant literature and makes recommendations for healthcare providers to overcome the barriers allowing healthier outcomes for children.
This article describes five research-based recommendations for health care providers to help prevent both obesity and eating disorders among adolescents that they see within clinical, school, or other settings. The recommendations are based primarily upon findings from Project EAT, a large, population-based study of eating and weight-related issues in adolescents. Recommendations include the following: 1) discourage unhealthy dieting; instead encourage and support the use of eating and physical activity behaviors that can be maintained on an ongoing basis; 2) promote a positive body image; 3) encourage more frequent, and more enjoyable, family meals; 4) Encourage families to talk less about weight and do more at home to facilitate healthy eating and physical activity; and 5) assume that overweight teens have experienced weight mistreatment and address this issue with teens and their families. These recommendations stress the importance of helping adolescents and their families focus less on weight and more on sustained behavioral change.
Kim, Juhee; Shim, Jae Eun; Wiley, Angela R; Kim, Keunsei; McBride, Brent A
To compare the obesity related training, practices, and perceptions of home child care providers and center care providers. A self-administered survey was collected from child care providers who attended local child care training workshops in east central Illinois from March 2009 to August 2010. Study results were based on responses from 88 home care providers and 94 center providers. The survey questions addressed child care providers' training in the prior year, their obesity prevention practices including written policies, their perceptions of influences on children's health, and factors determining food menu selection. Paired t tests and Chi-square tests were used to compare the difference by child care type. 81.9% of home care providers and 58.6% of center care providers received nutrition training, while 66.7 and 43.0% of these providers received physical activity training, respectively. Nutrition content, guidelines or state regulations, and food availability were the most important factors that influenced both types of care providers' food service menus. Both care provider types perceived they have less influence on children's food preferences, eating habits, and weight status compared to the home environment. However, home care providers perceived a smaller discrepancy between the influences of child care and home environments compared to center care providers. Compared to center providers, home care providers were more likely to have had training, be involved with health promotion activities, and rate their influence higher on children's health behaviors. Findings underscore the need for obesity prevention efforts in both types of child care settings.
Rosenthal, Marjorie S; Crowley, Angela A; Curry, Leslie
To describe the perspective and strategies of family child care providers (FCCPs) to reduce children's suboptimal weight trajectories. In-person, in-depth interviews with FCCPs. Family child care homes. Seventeen FCCPs caring for children 6 weeks to 9 years old; 94% caring for children paying with a state subsidy. Strategies of FCCP to reduce children's suboptimal weight trajectories. Constant comparative method of qualitative data analysis. Family child care providers described 3 core strategies: (1) improving children's behavior, (2) engaging and educating parents, and (3) leveraging influences external to their relationship with parents to effect positive change and to avoid parental conflict. These strategies were framed within their knowledge of child development, parental communication, and community services. The findings suggest that FCCPs' role in obesity prevention may be framed within knowledge that may be commonly expected of a child care provider. Partnerships between public health policy makers and FCCP may reduce obesigenic environments by employing training and resources that link obesity prevention and child care provider expertise. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Childhood obesity is the metabolic disorder with the highest prevalence in both children and adults. Urgency to treat and prevent childhood obesity is based on the clear evidence that obesity tends to track from childhood to adulthood, is associated to morbidity also in childhood and to long-term mortality. Early life, i.e., intrauterine life and the first two years, is a sensitive window for prevention. Anatomical and functional maturation of the hypothalamic structures devoted to regulating...
Lanigan, Jane D.
Objective: To examine the association between child care practices and child care provider knowledge and beliefs about their role in supporting children's healthful eating. Design: Longitudinal design using survey and observation data from baseline and year 1 of the Encouraging Healthy Activity and Eating in Childcare Environments (ENHANCE) pilot…
Full Text Available Childhood obesity is the metabolic disorder with the highest prevalence in both children and adults. Urgency to treat and prevent childhood obesity is based on the clear evidence that obesity tends to track from childhood to adulthood, is associated to morbidity also in childhood and to long-term mortality. Early life, i.e., intrauterine life and the first two years, is a sensitive window for prevention. Anatomical and functional maturation of the hypothalamic structures devoted to regulating energy intake and expenditure and body size mainly occurs in the first 1,000 days of life. Therefore, factors affecting the foetal exposition to maternal metabolic environment and early postnatal nutrition are crucial in modulating the definition of the metabolic programming processes in the brain. Maternal diseases, mainly malnutrition for defect or excess, obesity and diabetes, placental disorders and dysfunctions, maternal use of alcohol and drugs, smoking, affect long term metabolic programming of the foetus with lifelong consequences. Similarly, early nutrition contributes to complete the long-term metabolic regulating framework initiated in the uterus. Breastfeeding, adequate weaning, attention to portion size and diet composition are potential tools for reducing the obesity risk later in childhood. Longitudinal randomized controlled studies are needed for exploring the efficacy of obesity prevention strategies initiated after conception.Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou
Ariza, Carles; Ortega-Rodríguez, Eduard; Sánchez-Martínez, Francesca; Valmayor, Sara; Juárez, Olga; Pasarín, M Isabel
The percentage of failure and relapse in the treatment of obesity is high. Where possible, the preferred strategy for preventing obesity is to modify eating habits and lifestyles. This article aims to provide a framework for evidence on the most effective interventions for addressing childhood obesity, both from a prevention point of view, as well as reducing it, when it is already established. After a review of the scientific literature, the issues that must be considered both in the universal and selective prevention of childhood obesity are presented. Also, in light of the controversy over the tools for measuring and controlling the problem, some clarification is provided on the criteria. Finally, the approach to the prevention of overweight and obesity with a community perspective is separated, with two short protocols being offered with diagrams of the basic procedure to follow. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Merchant Anwar T
Full Text Available Abstract Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Consequently, both over-consumption of calories and reduced physical activity are involved in childhood obesity. Almost all researchers agree that prevention could be the key strategy for controlling the current epidemic of obesity. Prevention may include primary prevention of overweight or obesity, secondary prevention or prevention of weight regains following weight loss, and avoidance of more weight increase in obese persons unable to lose weight. Until now, most approaches have focused on changing the behaviour of individuals in diet and exercise. It seems, however, that these strategies have had little impact on the growing increase of the obesity epidemic. While about 50% of the adults are overweight and obese in many countries, it is difficult to reduce excessive weight once it becomes established. Children should therefore be considered the priority population for intervention strategies. Prevention may be achieved through a variety of interventions targeting built environment, physical activity, and diet. Some of these potential strategies for intervention in children can be
Birch, L L; Ventura, A K
Rates of overweight in North American children and adolescents have increased dramatically since the 1970s. Childhood obesity has reached epidemic proportions and calls for prevention and treatment programs to reverse this trend have been made. However, the evidence base needed for effective action is still incomplete, especially for childhood obesity prevention programs. This paper focuses on primary prevention of childhood obesity and has three aims: (1) to briefly describe current primary prevention approaches for childhood obesity and the evidence for their impact; (2) to elucidate promising, but untested intervention strategies using an ecological framework and evidence from experimental and epidemiological research on factors influencing children's eating and weight status; and (3) to introduce a multiphase strategy for screening intervention components and building and evaluating potent interventions for childhood obesity. Most childhood obesity prevention programs have focused on school-aged children and have had little success. We suggest that, given these findings, prevention efforts should be expanded to explore other contexts in which children live as possible settings for intervention efforts, including the family and childcare settings. Given that 25% of preschool children are already overweight, intervening with children before school entry should be a priority. A review of experimental research on the developing controls of food intake in infancy and childhood suggests possible intervention strategies, focusing on parenting and aspects of the feeding environment. Epidemiological findings point to even earlier modifiable risk factors, including gestational weight gain, maternal prepregnancy weight, and formula feeding. However, the potential impact of altering these risk factors remains to be evaluated. In response to this problem, we suggest a new, multiphase method for accomplishing this, including screening intervention components, refining
Kain, Juliana; Hernández Cordero, Sonia; Pineda, Diana; de Moraes, Augusto Ferreira; Antiporta, Daniel; Collese, Tatiana; Costa de Oliveira Forkert, Elsie; González, Laura; Miranda, Juan Jaime; Rivera, Juan
In Latin American countries, obesity prevalence has increased significantly as a result of rapid urbanization and an improvement in socioeconomic conditions. We report the prevalence of overweight and/or obesity and prevention efforts in five countries: Mexico, Colombia, Brazil, Peru, and Chile. In children, the highest and lowest rates of obesity are found in Chile (23 % in 6-year-olds) and Peru (1.8 % in those obesity (around 35 %), whereas in Brazil and Colombia, the rates are around 20 % and 16.5 %, respectively. In general, the highest prevalence occurs in low-income women. Every country has developed initiatives to target obesity, from the government to the private sector and academia, mainly at the health sector and school settings. Food labeling is being addressed, but has not been implemented yet. Two interventions are described, a community-based in Mexico and a school-based in Chile. Because the increase in chronic diseases, especially diabetes, has paralleled that of obesity, effective prevention efforts are urgently needed.
Sabaté, Joan; Wien, Michelle
... that are beneficial in the primary prevention of obesity is warranted. The focus of this article is to review the relation between vegetarian diets and obesity, particularly as they relate to childhood obesity...
Aronne, Louis J; Wadden, Thomas; Isoldi, Kathy Keenan; Woodworth, Kristina A
The obesity epidemic has resulted in increasingly urgent calls for large-scale prevention strategies. Meanwhile, effective treatment approaches that result in sustainable weight loss are needed to attenuate the cardiometabolic risks that may lead to comorbid illnesses and early mortality. Public education efforts geared toward those afflicted with obesity should emphasize that a relatively modest reduction in body weight dramatically reduces disease risk, thereby improving overall long-term health. Setting realistic weight loss goals with patients should reduce the overwhelming frustration often associated with the belief that large amounts of weight loss are needed for improved health. This misconception often impedes overweight and obese individuals from seeking treatment. Effective strategies are available to help overweight and obese individuals achieve reasonable weight loss goals. Important challenges exist in preventing weight regain following weight loss intervention. Studies are underway to identify new therapeutic strategies to effectively reduce weight, as well as to provide long-term data on successful weight loss maintenance strategies.
Togashi, Kenji; Iguchi, Kosei; Masuda, Hidenari
The prevalence of childhood obesity and its comorbidities is high in Japan. Increasing prevalence of obesity among children emphasizes the importance of focusing on primary prevention to avoid health complications later in life. We emphasize the prevention of obesity by recommending breast-feeding of infants for at least 6 months and advocating that schools provide for 60 min of moderate to vigorous daily exercise in all grades. Treatment interventions include behavioral therapy, reduction in sedentary behavior, and dietary and exercise education. After dietary treatment combined with exercise treatment, the areas of subcutaneous and visceral fat decreased significantly. These data suggest that dietary treatment combined with exercise treatment in obese children normalizes the distribution of abdominal fat and reduces the risk factors for chronic disease.
Ten Have, Marieke
Programs to prevent overweight and obesity are needed in order to improve individual and public health, to support informed choice and to diminish the societal costs associated with overweight. However, lifestyle interventions frequently evoke ethical debate. The potential ethical pitfalls that arise with respect to the prevention of overweight regard consequences for physical health, psychosocial well-being, equality, informed choice, social and cultural values, privacy, the attributions of responsibilities and liberty. For doctors in gastroenterology, it is important to be aware of these ethical pitfalls, either because they apply directly to questions in the consulting-room, or because they help to create awareness of the societal context a patient lives in. An ethical framework is being presented to show which ethical issues play a role in obesity prevention and how they can be prevented, followed by reflection on the ethical issues in interventions and in policy and media debate. Copyright © 2014 Elsevier Ltd. All rights reserved.
Dugan, Sheila A
Childhood obesity is a key public health issue in the United States and around the globe in developed and developing countries. Obese children are at increased risk of acute medical illnesses and chronic diseases-in particular, osteoarthritis, diabetes mellitus, and cardiovascular disease, which can lead to poor quality of life; increased personal and financial burden to individuals, families, and society; and shortened lifespan. Physical inactivity and sedentary lifestyle are associated with being overweight in children and adults. Thus it is imperative to consider exercise and physical activity as a means to prevent and combat the childhood obesity epidemic. Familiarity with definitions of weight status in children and health outcomes like metabolic syndrome is crucial in understanding the literature on childhood obesity. Exercise and physical activity play a role in weight from the prenatal through adolescent time frame. A child's family and community impact access to adequate physical activity, and further study of these upstream issues is warranted. Recommended levels of physical activity for childhood obesity prevention are being developed.
Zulkepli, Jafri; Abidin, Norhaslinda Zainal; Zaibidi, Nerda Zura
Over the years, obesity prevention has been a broadly studied subject by both academicians and practitioners. It is one of the most serious public health issue as it can cause numerous chronic health and psychosocial problems. Research is needed to suggest a population-based strategy for obesity prevention. In the academic environment, the importance of obesity prevention has triggered various problem solving approaches. A good obesity prevention model, should comprehend and cater all complex and dynamics issues. Hence, the main purpose of this paper is to discuss the qualitative and quantitative approaches on obesity prevention study and to provide an extensive literature review on various recent modelling techniques for obesity prevention. Based on these literatures, the comparison of both quantitative and qualitative approahes are highlighted and the justification on the used of system dynamics technique to solve the population of obesity is discussed. Lastly, a potential framework solution based on system dynamics modelling is proposed.
A. A. Kamalova
Obesity prevention is a priority in health care. The paper gives the results ofstudies of the prevention of overweight and obesity in childhood. It discusses specific practical recommendations concerning antenatal prophylaxis, a balanced diet, complementary food, and infant feeding tactics. Inclusion of functional foods as an important component of dietary measures to prevent obesity is warranted.
Stockmarr, Anders; Hejgaard, Tatjana; Matthiessen, Jeppe
Previous studies have shown that mean BMI and prevalences of overweight/obesity and obesity have increased over the last decades in the Nordic countries, despite highly regulated societies with a focus on obesity prevention. We review recent overweight/obesity and obesity prevention initiatives...... within four of the five Nordic countries: Sweden, Denmark, Finland, and Iceland. Moreover, we analyze the current situation based on monitoring data on BMI collected in 2011 and 2014, and obtain overall estimates of overweight/obesity and obesity prevalences for the Nordic Region. Data analysis shows...... that obesity in adults has increased from 2011 to 2014, while no significant changes were found for children. No significant increases were found for mean BMI and overweight/obesity prevalence. Obesity prevention initiatives among the Nordic countries are highly similar although minor differences are present...
Obesity in the United States and throughout the world remains highly prevalent, especially among children and adolescents. Innumerable child obesity prevention trials emphasizing diet, physical activity, sedentary behavior, and recently sleep have been designed, implemented, and evaluated with the b...
Hursting, Stephen D.; DiGiovanni, John; Dannenberg, Andrew J; Azrad, Maria; LeRoith, Derek; Demark-Wahnefried, Wendy; Kakarala, Madhuri; Brodie, Angela; Berger, Nathan A.
Obesity is associated with increased risk and poor prognosis for many types of cancer. The mechanisms underlying the obesity-cancer link are becoming increasingly clear and provide multiple opportunities for primary to tertiary prevention. Several obesity-related host factors can influence tumor initiation, progression and/or response to therapy, and these have been implicated as key contributors to the complex effects of obesity on cancer incidence and outcomes. These host factors include in...
Ramos Salas, Ximena; Forhan, Mary; Caulfield, Timothy; Sharma, Arya M; Raine, Kim
Public health policies have been criticized for promoting a simplistic narrative that may contribute to weight bias. Weight bias can impact population health by increasing morbidity and mortality. The objectives of this study were to: 1) critically analyze Canadian obesity prevention policies and strategies to identify underlying dominant narratives; 2) deconstruct dominant narratives and consider the unintended consequences for people with obesity; and 3) make recommendations to change dominant obesity narratives that may be contributing to weight bias. We applied Bacchi's "what's-the-problem-represented-to-be?" (WPR) approach to 15 obesity prevention policies and strategies (1 national, 2 territorial and 12 provincial). Bacchi's WPR approach is composed of six analytical questions designed to identify conceptual assumptions as well as possible effects of policies. We identified five prevailing narratives that may have implications for public health approaches and unintended consequences for people with obesity: 1) childhood obesity threatens the health of future generations and must be prevented; 2) obesity can be prevented through healthy eating and physical activity; 3) obesity is an individual behaviour problem; 4) achieving a healthy body weight should be a population health target; and 5) obesity is a risk factor for other chronic diseases, not a disease in itself. The consistent way in which obesity is constructed in Canadian policies and strategies may be contributing to weight bias in our society. We provide some recommendations for changing these narratives to prevent further weight bias and obesity stigma.
Polfuss, Michele; Bandini, Linda G; Sawin, Kathleen J
Obesity is a common comorbidity in individuals with spina bifida. Carrying excess weight exacerbates the inherent health challenges associated with spina bifida, impedes the individual's ability to self-manage their condition, and creates further challenges for family members and caregivers. This manuscript provides a narrative review of key issues for understanding and prevention of obesity in persons with spina bifida within the context of the social ecological model. Specific variables related to obesity and spina bifida include individual factors (i.e., body composition and measurement issues, energy needs, eating patterns, physical activity, and sedentary activity) family factors (i.e., parenting/family, peers), community factors (i.e., culture, built environment, healthcare and healthcare providers, and school), and societal factors (i.e., policy issues). Due to the complex etiology of obesity and its increased prevalence in individuals with spina bifida, it is critical to initiate prevention efforts early with a multifactorial approach for this at-risk population. Increased research is warranted to support these efforts.
Merchant Anwar T; Akhtar-Danesh Noori; Dehghan Mahshid
Abstract Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising pre...
textabstractTaxes on unhealthy food, limits to commercial advertising, a ban on chocolate drink at schools, or compulsory physical exercise for obese employees: efforts to counter the rise in overweight and obesity sometimes raise questions about what is ethically acceptable. This thesis examines how a structured debate can be facilitated about the ethical issues that are involved in the prevention of overweight and obesity. In the first part of this introduction I explain why this question i...
Silva, A C F; Bortolini, G A; Jaime, P C
In Brazil, overweight and obesity are increasing in all age and income groups. Currently, 7.3% of children under 5 years of age, 30% of children aged 5-9 and 20% of preadolescents aged 10-19 are overweight. In the primary health-care (PHC) environment, activities are carried out to monitor eating habits and nutrition, as well as to prevent unhealthy habits and promote healthy eating behaviors consistent with the dietary guidelines for Brazilian children. Comprehensive care is being provided to overweight individuals. The Brazilian Breastfeeding and Complementary Feeding Strategy was launched in 2009 to support health teams to counsel families about healthy feeding, focused on child health and obesity prevention. Within the school environment, the School Health Program offers activities that are developed by PHC teams together with education professionals to focus on assessing health conditions, prevention and health promotion. To improve the nutritional profile of processed foods, terms of cooperation have been signed with the food industry to reduce fat and sodium content. Food industry advertising and marketing to infants and young children are now regulated by the Brazilian Regulation for the Marketing of Foods to Infants and Young Children.
Borys, J.M.; Le Bodo, Y.; De Henauw, S.; Moreno, L.A.; Romon, M.; Seidell, J.C.; Visscher, T.L.S.
Childhood obesity is a complex issue and needs multistakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. 'Ensemble Prévenons l'ObésitéDes Enfants' (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for
Granara, Brittany; Laurent, Jennifer
More than one third of American adults are obese. Extreme obesity is rapidly rising. Nine medications are approved for weight loss yet they remain underutilized with the focus primarily on lifestyle modifications. The objective was to determine current prescribing patterns and attitudes of weight loss medications in the management of obesity among primary care providers (PCPs). PCPs were surveyed to determine practice patterns, attitudes, barriers, and facilitators for prescribing weight loss medications. Ninety-four surveys were analyzed. Seventy-six percent of all PCPs did not prescribe weight loss medications for long-term weight loss and 58% of PCPs had negative perceptions of pharmacotherapy. Differences existed between prescribing patterns and attitudes of advanced practice clinicians and physicians. Safety concerns were the greatest barrier. Having 2+ comorbidities and severe obesity were facilitators for prescribing weight loss medications. Underutilization of pharmacotherapy suggests that PCPs may not have sufficient knowledge about medication safety profiles and efficacy. Delaying treatment until patients have reached a high level of morbidity may be less efficacious than earlier treatment. Education regarding effectiveness and risks of weight loss medications for obesity management is needed and earlier interventions with pharmacotherapy may prevent significant morbidity and mortality. ©2017 American Association of Nurse Practitioners.
Hursting, Stephen D.; DiGiovanni, John; Dannenberg, Andrew J.; Azrad, Maria; LeRoith, Derek; Demark-Wahnefried, Wendy; Kakarala, Madhuri; Brodie, Angela; Berger, Nathan A.
Obesity is associated with increased risk and poor prognosis for many types of cancer. The mechanisms underlying the obesity-cancer link are becoming increasingly clear and provide multiple opportunities for primary to tertiary prevention. Several obesity-related host factors can influence tumor initiation, progression and/or response to therapy, and these have been implicated as key contributors to the complex effects of obesity on cancer incidence and outcomes. These host factors include insulin, insulin-like growth factor-1, leptin, adiponectin, steroid hormones, cytokines, and inflammation-related molecules. Each of these host factors is considered in the context of energy balance and as potential targets for cancer prevention. The possibility of prevention at the systems level, including energy restriction, dietary composition and exercise is considered as is the importance of the newly-emerging field of stem cell research as a model for studying energy balance and cancer prevention. PMID:23034147
Hursting, Stephen D; Digiovanni, John; Dannenberg, Andrew J; Azrad, Maria; Leroith, Derek; Demark-Wahnefried, Wendy; Kakarala, Madhuri; Brodie, Angela; Berger, Nathan A
Obesity is associated with increased risk and poor prognosis for many types of cancer. The mechanisms underlying the obesity-cancer link are becoming increasingly clear and provide multiple opportunities for primary to tertiary prevention. Several obesity-related host factors can influence tumor initiation, progression and/or response to therapy, and these have been implicated as key contributors to the complex effects of obesity on cancer incidence and outcomes. These host factors include insulin, insulin-like growth factor-I, leptin, adiponectin, steroid hormones, cytokines, and inflammation-related molecules. Each of these host factors is considered in the context of energy balance and as potential targets for cancer prevention. The possibility of prevention at the systems level, including energy restriction, dietary composition, and exercise is considered as is the importance of the newly emerging field of stem cell research as a model for studying energy balance and cancer prevention.
Xu, Shumei; Xue, Ying
, and mitochondrial uncoupling proteins, are known to affect body weight. These molecules serve as potential targets for the pharmacological manipulation of obesity. Sibutramine and orlistat are primariliy used for the treatment of adult obesity, which produces modest weight loss, of 3-8% compared to placebo. For children and obese adolescents, metformin is used in the case of insulin resistance and hyperinsulinemia. Octreotide is used for hypothalamic obesity. Bariatric surgery is performed for the treatment of severe childhood obesity. The causes, symptoms, prevention and treatment of pediatric obesity are described in the present review.
Ananthapavan, J; Peeterson, A; Sacks, G
Curbing the obesity epidemic is likely to require a suite of interventions targeting the obesogenic environment as well as individual behaviour. Evidence suggests that the effectiveness of behaviour modification programmes can be enhanced by financial incentives that immediately reward weight loss behaviour. This systematic review investigated the effectiveness of incentives with a focus on assessing the relative effectiveness of incentives that target different behaviours as well as factors of importance when implementing these programmes in real-world settings (health insurer settings). A narrative review of the academic and grey literature including a variety of study designs was undertaken. Twenty studies met inclusion criteria and were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results suggest that incentivizing weight loss is effective in the short term while the incentives are in place. There are various incentive designs, and although the relative effectiveness of each of these on weight loss is not clear, it appears that positive incentives increase the uptake into programmes and may reduce dropouts. As with other weight loss initiatives, there is a need to explore ways to maintain weight loss in the longer term - incentives for weight maintenance could play a role. © 2017 World Obesity Federation.
Skouteris, Helen; Cox, Rachael; Huang, Terry; Rutherford, Leonie; Edwards, Susan; Cutter-Mackenzie, Amy
There is mounting evidence that current food production, transport, land use and urban design negatively impact both climate change and obesity outcomes. Recommendations to prevent climate change provide an opportunity to improve environmental outcomes and alter our food and physical activity environments in favour of a 'healthier' energy balance. Hence, setting goals to achieve a more sustainable society offers a unique opportunity to reduce levels of obesity. In the case of children, this approach is supported with evidence that even from a young age they show emerging understandings of complex environmental issues and are capable of both internalizing positive environmental values and influencing their own environmental outcomes. Given young children's high levels of environmental awareness, it is easy to see how environmental sustainability messages may help educate and motivate children to make 'healthier' choices. The purpose of this paper is to highlight a new approach to tackling childhood obesity by tapping into existing social movements, such as environmental sustainability, in order to increase children's motivation for healthy eating and physical activity behaviours and thus foster more wholesome communities. We contend that a social marketing framework may be a particularly useful tool to foster behaviour change beneficial to both personal and environmental health by increasing perceived benefits and reducing perceived costs of behaviour change. Consequently, we propose a new framework which highlights suggested pathways for helping children initiate and sustain 'healthier' behaviours in order to inform future research and potentially childhood obesity intervention strategies. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Power, Thomas G.; Bindler, Ruth C.; Goetz, Summer; Daratha, Kenneth B.
Background: Obesity is a significant health problem among today's youth; however, most school-based prevention programs in this area have had limited success. Focus groups were conducted with seventh- to eighth-grade students, parents, and teachers to provide insight into the development of a comprehensive program for the prevention of adolescent…
Lipek, Tobias; Igel, Ulrike; Gausche, Ruth; Kiess, Wieland; Grande, Gesine
Childhood obesity is a major concern for public health. There are multiple factors (e.g., genetic, social, and environmental) that contribute to unhealthy weight gain. Drawing from findings on "obesogenic environments" and core principles of preventive strategies to reduce health inequalities, this paper gives an overview of recent childhood prevention programs that target aspects of the physical environment ("environmental changes"). Out of the ten reviews we screened (including more than 300 studies), we identified very few that addressed aspects of the environment. We focus here on 14 programs that follow different approaches to environmental changes (e.g., access to/quality of playgrounds, changes in school cafeterias). Altering the environment offers opportunities for healthier behaviors and seems to be an effective strategy to prevent childhood obesity. However, the evaluation of those (mostly) multidimensional interventions does not allow drawing firm conclusions about the single effect of environmental changes. We conclude that obesity prevention programs should combine person-based and environmental approaches.
Ness-Abramof, Rosane; Apovian, Caroline M
The prevalence of obesity has risen sharply during the last 4 decades imposing a serious health burden to modern society. Obesity is known to cause and exacerbate many chronic diseases such as diabetes, hypertension, dyslipidemia, coronary heart disease, stroke, obstructive sleep apnea and certain cancers, among many others. The rise in obesity prevalence is mainly caused by overconsumption of energy, coupled to a sedentary life in susceptible individuals. Weight homeostasis is paramount for survival and its control is coordinated by neural and endocrine signals emanating from the fat tissue, digestive system and brain. During thousands of years humans were challenged by nutrient deprivation, developing an efficient mechanism to store energy. It explains the difficulty in losing weight, making obesity prevention the main effective health approach to halt the obesity epidemic.
Obesity is a complex disease of diverse etiology. Among the potential influences in the development of obesity, the food supply chain remains an important influence. We provide a conceptual overview related to the food industry's role in obesity prevention. We first discuss some limitations of current public health efforts. We then describe how a model that attends to personal autonomy in the context of supportive policy intervention can empower individuals in their efforts to navigate the food supply chain. We then provide an evidence informed overview of key areas where continued efforts to collaboratively engage the food industry, through solution-focused dialogue and action, have the potential to contribute to obesity prevention. While challenging, appropriately transparent, well-governed public-private partnerships have the demonstrated potential to benefit the communities we serve.
Bozzola, M; Bozzola, E; Abela, S; Amato, S
Obesity can be defined as an excess of adipose tissue. It is associated to a significantly increased risk of cardiovascular disease, hypertension, diabetes mellitus and hypercholesterolemia. The results of the Italian survey called Okkio alla Salute (2010), which was attended over 42'000 students of third-class of primary school and 44'000 parents, confirm bad eating habits, sedentary lifestyles and excess weight. In particular, 22,9% of the children resulted overweight and 11,1% obese. The prevalence of obesity is higher in the south of Italy than in the north and in males rather than in females. Moreover, parents do not always have a real idea of the physical aspect of their son: 36% of the mothers of overweight or obese children are do not believe their child is overweight. Just 29% of them think that the quantity of food eaten by their child is excessive. The relative risk for an obese child to become an obese adult increases with the age and is directly correlated to the severity of overweight. Among obese children of preschool age, 26 to 41% will be an obese adult., Among scholar children, the percentage increases to 69%. The paper describes a multidisciplinary approach the disease, in fact, dietary and behavioural modifications, associated with physical activity, have the purpose of educate overweight and of preventing the onset of complications or reducing their severity if already present and reversible.
To determine what secondary schoolchildren in Jordan want from overweight and obesity intervention strategies and prevention programmes. A school-based, cross-sectional study using a quantitative design was carried out during October 2014. The participants were secondary schoolchildren in grades 11 and 12. Data were analysed using SPSS program version 17. Percentages, standard deviations and means were computed. The main suggestions were for programmes at school, during school hours (n=962, 85.4%), followed by one that involved family and friends (n=951, 84.5%), and a programme at a convenient time free of charge (n=919, 81.6%). The students also suggested many strategies to tackle overweight and obesity, such as: taking more physical exercise (n=925, 82.1%), increasing consumption of more fruit and vegetables (n=712, 63.2%) eating less fast food (n=689, 61.2%). Schools, families, health providers and community organisations should encourage students to adopt healthy lifestyles, and facilitate their selection and participation in health programmes.
Morrison-Sandberg, Leslie F.; Kubik, Martha Y.; Johnson, Karen E.
Elementary schools are an optimal setting to provide obesity prevention interventions, yet little is known about the obesity prevention practices of elementary school nurses. The purpose of this study was to gain insight into current obesity-related school nursing practice in elementary schools in Minnesota, opinions regarding school nurse-led…
UNLABELLED: The overall aim of this paper is to describe important issues regarding paediatric obesity as a public health problem. This paper focuses on actions taken, and on the prevalence of obesity in children, teens and adults in Denmark. In addition, the paper describes some important...... prevention studies, all of which are performed outside Denmark. Thus, this paper is not a classical review but rather a highlight of some aspects that the author finds important. The latest Danish national figures show a marked increase in the prevalence of obesity, especially among young men-a sevenfold...... increase from 1987 to 2000 (0.7 to 4.9%). Among young women aged 16-24, the increase is threefold in the same period. Among teens, the prevalence has increased by 2-3 times in recent decades. Nevertheless, compared to other European countries and the US, Denmark has a relatively low prevalence of obesity...
Swinburn, B A; Millar, L; Utter, J
, Tonga, New Zealand and Australia) designed to prevent adolescent obesity. This paper overviews the project and the methods common to the four countries. Each country implemented a community-based intervention programme promoting healthy eating, physical activity and healthy weight in adolescents....... The evaluation tools common to each are described. Additional analytical studies included economic, socio-cultural and policy studies. The project pioneered many areas of obesity prevention research: using multi-country collaboration to build research capacity; testing a capacity-building approach in ethnic...... groups with very high obesity prevalence; costing complex, long-term community intervention programmes; systematically studying the powerful socio-cultural influences on weight gain; and undertaking a participatory, national, priority-setting process for policy interventions using simulation modelling...
Pratt, Michael; Charvel Orozco, Ana Sofia; Hernandez-Avila, Mauricio; Reis, Rodrigo S; Sarmiento, Olga L
This is an invited commentary for the Active Living Research (ALR) special issue. The commentary focuses on the lessons that can be learned from Latin America regarding obesity prevention. Examples from Brazil, Mexico, and Colombia that may inform US policy are described. Published by Elsevier Inc.
Camer, Danielle; Yu, Yinghua; Szabo, Alexander; Wang, Hongqin; Dinh, Chi H L; Huang, Xu-Feng
High-fat (HF) diet-induced obesity is associated with hypothalamic leptin resistance and low grade chronic inflammation, which largely impairs the neuroregulation of negative energy balance. Neuroregulation of negative energy balance is largely controlled by the mediobasal and paraventricular nuclei regions of the hypothalamus via leptin signal transduction. Recently, a derivative of oleanolic acid, bardoxolone methyl (BM), has been shown to have anti-inflammatory effects. We tested the hypothesis that BM would prevent HF diet-induced obesity, hypothalamic leptin resistance, and inflammation in mice fed a HF diet. Oral administration of BM via drinking water (10 mg/kg daily) for 21 weeks significantly prevented an increase in body weight, energy intake, hyperleptinemia, and peripheral fat accumulation in mice fed a HF diet. Furthermore, BM treatment prevented HF diet-induced decreases in the anorexigenic effects of peripheral leptin administration. In the mediobasal and paraventricular nuclei regions of the hypothalamus, BM administration prevented HF diet-induced impairments of the downstream protein kinase b (Akt) pathway of hypothalamic leptin signalling. BM treatment also prevented an increase in inflammatory cytokines, tumour necrosis factor alpha (TNFα) and interleukin 6 (IL-6) in these two hypothalamic regions. These results identify a potential novel neuropharmacological application for BM in preventing HF diet-induced obesity, hypothalamic leptin resistance, and inflammation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Uijtdewilligen, L; Waters, C N; Müller-Riemenschneider, F; Lim, Y W
The rapid economic growth in Asia in the past few decades has contributed to the global increase in childhood obesity prevalence. Yet, little is known about obesity prevention efforts in this region. This systematic review provides an overview of child obesity prevention programmes in Asia. Searches were performed in six electronic databases. Out of 4,234 studies, 17 were included, among them 11 controlled trials (of which five were randomized). Only one study was published before 2007. Identified studies were predominantly conducted in China and Thailand and targeted primary school children in a school setting. Most studies implemented different programmes, frequently targeting behavioural modification through nutrition/health education lectures and/or physical activity sessions. Programme effects related to obesity outcome measures were mixed. Most substantial effects were found for outcomes such as improved health knowledge and/or favourable lifestyle practices. The relatively small number of relevant publications in Asia highlights the need for scientific evaluations of existing and future programmes. This will help ensure the implementation and dissemination of evidence-based approaches that have been proven to be effective in the Asian context. Targeting preschool settings and applying a comprehensive multisectoral approach may increase the effectiveness and sustainability of childhood obesity prevention programmes. © 2016 World Obesity.
Sabaté, Joan; Wien, Michelle
The increased prevalence of childhood overweight and obesity is not unique to industrialized societies; dramatic increases are occurring in urbanized areas of developing countries. In light of the consensus that obesity is a significant public health concern and that many weight-loss interventions have been unsuccessful in the long term, an exploration of food patterns that are beneficial in the primary prevention of obesity is warranted. The focus of this article is to review the relation between vegetarian diets and obesity, particularly as they relate to childhood obesity. Epidemiologic studies indicate that vegetarian diets are associated with a lower body mass index (BMI) and a lower prevalence of obesity in adults and children. A meta-analysis of adult vegetarian diet studies estimated a reduced weight difference of 7.6 kg for men and 3.3 kg for women, which resulted in a 2-point lower BMI (in kg/m(2)). Similarly, compared with nonvegetarians, vegetarian children are leaner, and their BMI difference becomes greater during adolescence. Studies exploring the risk of overweight and food groups and dietary patterns indicate that a plant-based diet seems to be a sensible approach for the prevention of obesity in children. Plant-based diets are low in energy density and high in complex carbohydrate, fiber, and water, which may increase satiety and resting energy expenditure. Plant-based dietary patterns should be encouraged for optimal health and environmental benefits. Food policies are warranted to support social marketing messages and to reduce the cultural and economic forces that make it difficult to promote plant-based dietary patterns.
Wirth, Alfred; Wabitsch, Martin; Hauner, Hans
The high prevalence of obesity (24% of the adult population) and its adverse effects on health call for effective prevention and treatment. Pertinent articles were retrieved by a systematic literature search for the period 2005 to 2012. A total of 4495 abstracts were examined. 119 publications were analyzed, and recommendations were issued in a structured consensus procedure by an interdisciplinary committee with the participation of ten medical specialty societies. Obesity (body-mass index [BMI] ge;30 kg/m2) is considered to be a chronic disease. Its prevention is especially important. For obese persons, it is recommended that a diet with an energy deficit of 500 kcal/day and a low energy density should be instituted for the purpose of weight loss and stabilization of a lower weight. The relative proportion of macronutrients is of secondary importance for weight loss. If the BMI exceeds 30 kg/m2, formula products can be used for a limited time. More physical exercise in everyday life and during leisure time promotes weight loss and improves risk factors and obesity-associated diseases. Behavior modification and behavioral therapy support changes in nutrition and exercise in everyday life. With respect to changes in lifestyle, there is no scientific evidence to support any particular order of the measures to be taken. Weight-loss programs whose efficacy has been scientifically evaluated are recommended. Surgical intervention is more effective than conservative treatment with respect to reduction of bodily fat, improvement of obesity-associated diseases, and lowering mortality. Controlled studies indicate that, within 1 to 2 years, a weight loss of ca. 4 to 6 kg can be achieved by dietary therapy, 2 to 3 kg by exercise therapy, and 20 to 40 kg by bariatric surgery. There is good scientific evidence for effective measures for the prevention and treatment of obesity.
Peart, Tasha; de Leon Siantz, MaryLou
Though many studies have examined the level of physician obesity prevention counseling among the general population, little is known about how homeless patients are advised about healthy eating and physical activity by their health care provider. The homeless are an at-risk population with whom physicians and other health professionals can play a…
Childhood obesity is a problem because it is an important predictor of adult obesity; furthermore, obesity in childhood appears to increase the risk of subsequent morbidity, whether or not obesity persists into adulthood. Many studies have shown that except genetic factors, environmental factors such as dietary pattern and lifestyle are related to the occurrence of obesity and its related comorbidities. Systematic approaches to provide adequately nutritional education, dietary intervention, and encouraged regular physical activity are needed to prevent the occurrence of obesity and to reduce the increase of obesity-related disorders among children. Compared with that of adults, the obesity prevention and treatment programs for children and young adolescents have a better effect such as easier modifiable behavior, greater support from family members, and increase of lean body mass with age. More important, the guideline and approaches for prevention and treatment of children and young adolescents' obesity should be monitored and updated in the future.
Liu, Lucy; Segura, Abraham; Hagemann, Andrea R
Obesity is the cause of up to one-third of all cancers affecting women today, most notably endometrial, colon and breast cancer. Women's health providers are poised to advise women on obesity's link to cancer development, but often lack resources or training to provide appropriate counseling. Here, we review obesity's role in increasing the risk of several common reproductive system conditions faced by women, including polycystic ovarian syndrome, infertility, gynecologic surgical complications, and pregnancy complications. These events can be used as teachable moments to help frame the discussion of weight management and promote cancer prevention. We also review national guidelines and existing tangible weight-loss strategies that can be employed within the outpatient women's health setting to help women achieve weight loss goals and affect cancer prevention.
Jernigan, Amelia M; Tergas, Ana I; Satin, Andrew J; Fader, Amanda N
Obesity is associated with the development and risk of death from several women's cancers. The study objective was to describe and compare oncologic providers' attitudes and practices as they relate to obesity counseling and management in cancer survivors. Society of Gynecologic Oncology members (n = 924) were surveyed with the use of a web-based, electronic questionnaire. χ(2) and Fisher exact tests were used to analyze responses. Of the 240 respondents (30%), 92.9% were practicing gynecologic oncologists or fellows, and 5.1% were allied health professionals. Median age was 42 years; 50.8% of the respondents were female. Of the respondents, 42.7% reported that they themselves were overweight/obese and that ≥50% of their survivor patients were overweight/obese. Additionaly, 82% of the respondents believed that discussing weight would not harm the doctor-patient relationship. Most of the respondents (95%) agreed that addressing lifestyle modifications with survivors is important. Respondents believed that gynecologic oncologists (85.1%) and primary care providers (84.5%) were responsible for addressing obesity. More providers who were ≤42 years old reported undergoing obesity management training (P 42 years old (P = .017). After initial counseling, 81.5% of the respondents referred survivors to other providers for obesity interventions. Oncology provider respondents believe that addressing obesity with cancer survivors is important. Providers believed themselves to be responsible for initial counseling but believed that obesity interventions should be directed by other specialists. Further research is needed to identify barriers to care for obese cancer survivors and to improve physician engagement with obesity counseling in the "teachable moment" that is provided by a new cancer diagnosis. Copyright © 2013 Mosby, Inc. All rights reserved.
Pâmela Ferreira Todendi
Full Text Available At present, obesity configures a public health problem which calls for attention from different sectors, given the proportion it assumes all over the world. Several studies relate this problem to metabolic health problems, including endocrinal, cardiovascular, lung, gastrointestinal, psychiatric, hematological disturbances, among others. Obesity is not only associated with genetic and environmental factors, but also with unhealthy lifestyles. In view of its social importance, it is ascertained, through analyses of studies, that there are not many health prevention strategies focused on this situation. As a result of this ascertainment, the proposal is for updating prevention actions in the realm of obese schoolchildren, resulting from a work conducted during the Master’s Degree lessons in Health Promotion at the University of Santa Cruz do Sul (UNISC. The point in question is the fact that many schools pose no restrictions to products sold in their canteens. Food stuffs sold in schools should have adequate nutritional quality, and snacks prepared at school are extremely important in meeting all nutritional requirements. However, many children do not consume these school lunches, but they bring them from home or purchase them at the canteen, spending public resources, along with not taking in healthy foods and, as a consequence, leading to health problems over the years. For all this, it is of fundamental importance to carry out investigating processes with regard to how public actions and policies are being implemented towards this end, in view of the fact that obesity in schoolchildren is on a rising trend.
Fiese, Barbara H; Bost, Kelly K; McBride, Brent A; Donovan, Sharon M
Nearly 40% of US children are overweight or obese. We propose that a cell-to-society integrative approach is needed that takes into account biology, early child development, home and childcare environments, and public policy. This approach requires researchers, families, and policy makers to work together to develop preventative strategies and interventions that benefit the nutrition and wellbeing of young children and their families, and ultimately the health of the nation. Copyright © 2013 Elsevier Ltd. All rights reserved.
Von Hunolstein, Jean-Jacques; Nebigil, Canan G
Because of its increasing prevalence and morbi-mortality, obesity is a major health problem. Obesity etiology includes a combination of excess dietary calories and decreased physical activity, coupled with either predisposing genetic factors or metabolic disorders such as insulin resistance. Adipose tissue secretes several metabolically important proteins known as 'adipokines' that play a major role in obesity and insulin resistance. High levels of a newly identified group of adipokines, called prokineticins, have been found in obese adipose tissues. Prokineticins are peptide hormones released principally from macrophages and reproductive organs. They act on the G protein-coupled receptors PKR1 and PKR2. This review aims to provide an overview of current knowledge of the role of prokineticins and their receptors in the development of obesity and insulin resistance. The principal biological effect of prokineticins in the central nervous system is the control of food intake. Nevertheless, peripheral biological effects of prokineticin are associated with increasing insulin sensitivity and suppressing the adipose tissue expansion. We outline the biological significance of the central and peripheral effects of prokineticins, and the potential of their receptors as targets for the treatment of obesity and insulin resistance.
Hita-Contreras, Fidel; Martínez-Amat, Antonio; Cruz-Díaz, David; Pérez-López, Faustino R
Sarcopenia, obesity, and osteoporosis are three interrelated entities which may share common pathophysiological factors. In the last decades, overall survival has drastically increased. Postmenopausal women, due to their estrogen depletion, are at higher risk of developing any of these three conditions or the three, which is termed osteosarcopenic obesity. One of the most common health problems among these patients is the elevated risk of falls and fractures. Falls and fall-related injuries are one of the major causes of mortality and morbidity in older adults, and have a significant impact on social, economical and health-related costs. Several extrinsic and intrinsic risk factors have been described that play a role in the etiology of falls. A therapeutic approach to osteosarcopenic obesity aimed at the prevention of falls must include several factors, and act on those risk elements which can be effectively modified. An adequate weight-loss diet and a good nutritional intake, with an appropriate amount of vitamin D and the right protein/carbohydrates ratio, may contribute to the prevention of falls. The recommendation of physical exercise, both traditional (resistance or aerobic training) and more recent varieties (Tai Chi, Pilates, body vibration), can improve balance and positively contribute to fall prevention, whether by itself or in combination with other therapeutic strategies. Finally, a pharmacological approach, especially one focused on hormone therapy, has shown to have a positive effect on postmenopausal women's balance, leading to a decreased risk of falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Durant, Nefertiti H.; Bartman, Barbara; Person, Sharina D.; Collins, Felicia; Austin, S. Bryn
Objective: We assessed the influence of race/ethnicity and provider Communication oil overweight and obese patients' perceptions of the damage weight causes to their health. Methods: The-study included 1071 overweight and obese patients who completed the 2002 Community Health Center (CHC) User
Alexander, Dayna S; Alfonso, Moya L; Cao, Chunhua; Wright, Alesha R
Objectives African American maternal caregiver support for prevention of childhood obesity may be a factor in implementing, monitoring, and sustaining children's positive health behaviors. However, little is known about how perceptions of childhood obesity risk factors and health complications influence caregivers' support of childhood obesity prevention strategies. The objective of this study was to determine if childhood obesity risk factors and health complications were associated with maternal caregivers' support for prevention initiatives. Methods A convenience sample of maternal caregivers (N = 129, ages 22-65 years) completed the childhood obesity perceptions (COP) survey. A linear regression was conducted to determine whether perceptions about childhood obesity risk factors and subsequent health complications influenced caregivers' support for prevention strategies. Results Caregivers' perceptions of childhood obesity risk factors were moderate (M = 3.4; SD = 0.64), as were their perceptions of obesity-related health complications (M = 3.3; SD = 0.75); however, they perceived a high level of support for prevention strategies (M = 4.2; SD = 0.74). In the regression model, only health complications were significantly associated with caregiver support (β = 0.348; p Childhood obesity prevention efforts should emphasize health complications by providing education and strategies that promote self-efficacy and outcome expectations among maternal caregivers.
Swinburn, Boyd A
The commercial drivers of the obesity epidemic are so influential that obesity can be considered a robust sign of commercial success - consumers are buying more food, more cars and more energy-saving machines. It is unlikely that these powerful economic forces will change sufficiently in response to consumer desires to eat less and move more or corporate desires to be more socially responsible. When the free market creates substantial population detriments and health inequalities, government policies are needed to change the ground rules in favour of population benefits.Concerted action is needed from governments in four broad areas: provide leadership to set the agenda and show the way; advocate for a multi-sector response and establish the mechanisms for all sectors to engage and enhance action; develop and implement policies (including laws and regulations) to create healthier food and activity environments, and; secure increased and continued funding to reduce obesogenic environments and promote healthy eating and physical activity.Policies, laws and regulations are often needed to drive the environmental and social changes that, eventually, will have a sustainable impact on reducing obesity. An 'obesity impact assessment' on legislation such as public liability, urban planning, transport, food safety, agriculture, and trade may identify 'rules' which contribute to obesogenic environments. In other areas, such as marketing to children, school food, and taxes/levies, there may be opportunities for regulations to actively support obesity prevention. Legislation in other areas such as to reduce climate change may also contribute to obesity prevention ('stealth interventions'). A political willingness to use policy instruments to drive change will probably be an early hallmark of successful obesity prevention.
Raychaudhuri, Moutusi; Sanyal, Debmalya
Childhood obesity is a grave issue, which needs to be addressed urgently because it leads to several medical and psychosocial problems in children. High prevalence is being increasingly reported in children from developing countries as well. The combination of our genetic propensity to store fat, the ready availability of calorie dense foods, and sedentary lifestyle promotes overweight. The child's food environment at home and parental obesity are strong determinants. Urban poor in developed countries and urban rich in developing countries are both at risk. In developing countries, a number of beliefs passed down over generations are other important determinants. Evaluation includes assessing the child's lifestyle, excluding weight-promoting medication history; poor linear growth needs endocrine evaluation; genetic syndromes should be considered if there are clinical pointers. Overweight children should be evaluated for hypertension, dyslipidemia, T2DM, and NAFLD. Therapeutic lifestyle changes targeting food habits and physical activity through parental participation and social support are the cornerstones of preventing childhood obesity. Active travel and play by making the built environment more accessible, ban on 'junk' food advertising, and effective health education through active participation of clinicians, school systems, and the media will go a long way in reversing anticipated trends in childhood obesity.
Full Text Available Childhood obesity is a grave issue, which needs to be addressed urgently because it leads to several medical and psychosocial problems in children. High prevalence is being increasingly reported in children from developing countries as well. The combination of our genetic propensity to store fat, the ready availability of calorie dense foods, and sedentary lifestyle promotes overweight. The child′s food environment at home and parental obesity are strong determinants. Urban poor in developed countries and urban rich in developing countries are both at risk. In developing countries, a number of beliefs passed down over generations are other important determinants. Evaluation includes assessing the child′s lifestyle, excluding weight-promoting medication history; poor linear growth needs endocrine evaluation; genetic syndromes should be considered if there are clinical pointers. Overweight children should be evaluated for hypertension, dyslipidemia, T2DM, and NAFLD. Therapeutic lifestyle changes targeting food habits and physical activity through parental participation and social support are the cornerstones of preventing childhood obesity. Active travel and play by making the built environment more accessible, ban on ′junk′ food advertising, and effective health education through active participation of clinicians, school systems, and the media will go a long way in reversing anticipated trends in childhood obesity.
Tucker, Sharon; Lanningham-Foster, Lorraine M.
School-based childhood obesity prevention programs have grown in response to reductions in child physical activity (PA), increased sedentariness, poor diet, and soaring child obesity rates. Multiple systematic reviews indicate school-based obesity prevention/treatment interventions are effective, yet few studies have examined the school nurse role…
The overweight child should be detected as soon as possible to avoid the occurrence of a more severe obesity, source of early complications. Thus, it is essential to carefully follow the BMI curve in all children with particular attention to the age of the early adiposity rebound (between 1 and 5 years). Early rebound indicates predisposition, and represents a risk factor for later obesity. The announcement is not harmless and should avoid unnecessary judging or blaming the family outside rare situations of abuse. Overweight results from an energy imbalance favored by many risk factors often entangled. These predisposing factors are specific to the child (especially genetic and epigenetic origin) and environmental. Among these environmental factors, those occurring during pregnancy and the nutritional education (too permissive or too restrictive) represent targets for primary prevention.
Conclusions: This study provided important contextual data on where the emphasis should be placed in developing the childhood obesity prevention interventions for the school children in Tehran. The findings further highlight the importance of involving a wide range of stakeholders, and including multiple components to maximise the chances of success. Keywords: Child, Obesity, Prevention, Intervention, Qualitative research, Iran
Kimberly J. Rask
Full Text Available Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.
Döring, Nora; Ghaderi, Ata; Bohman, Benjamin
OBJECTIVE: The objective was to evaluate a manualized theory-driven primary preventive intervention aimed at early childhood obesity. The intervention was embedded in Swedish child health services, starting when eligible children were 9 to 10 months of age and continuing until the children reached...... age 4. METHODS: Child health care centers in 8 Swedish counties were randomized into intervention and control units and included 1355 families with 1369 infants. Over ?39 months, families in the intervention group participated in 1 group session and 8 individual sessions with a nurse trained...
Hayward, Joshua; Jacka, Felice N; Waters, Elizabeth; Allender, Steven
Background Emerging evidence supports a relationship between risk factors for obesity and the genesis of the common mental disorders, depression and anxiety. This suggests common mental disorders should be considered as a form of non-communicable disease, preventable through the modification of lifestyle behaviours, particularly diet and physical activity. Discussion Obesity prevention research since the 1970’s represents a considerable body of knowledge regarding strategies to modify diet an...
Full Text Available BACKGROUND: Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies that governments, communities and families can implement to prevent obesity, and promote health, has been accumulating but remains unclear. OBJECTIVE: This review primarily aims to update the previous Cochrane review of childhood obesity prevention research and determine the effectiveness of evaluated interventions intended to prevent obesity in children, assessed by change in Body Mass Index (BMI. Secondary aims were to examine the characteristics of the programs and strategies to answer the questions "What works for whom, why and for what cost?" METHODS: Search methods: The searches were re-run in CENTRAL, MEDLINE, EMBASE, PsychINFO and CINAHL in March 2010 and searched relevant websites. Non-English language papers were included and experts were contacted. Selection criteria: The review includes data from childhood obesity prevention studies that used a controlled study design (with or without randomisation. Studies were included if they evaluated interventions, policies or programs in place for twelve weeks or more. If studies were randomized at a cluster level, six clusters were required. Data collection and analysis: Two review authors independently extracted data and assessed the risk of bias of included studies. Data was extracted on intervention implementation, cost, equity and outcomes. Outcome measures were grouped according to whether they measured adiposity, physical activity (PA-related behaviours or diet-related behaviours. Adverse outcomes were recorded. A meta-analysis was conducted using available BMI or standardized BMI (zBMI score data with subgroup analysis by age group (0-5, 6-12, 13-18 years, corresponding to stages of developmental and childhood settings. MAIN RESULTS: This
XU, SHUMEI; XUE, YING
Pediatric or childhood obesity is the most prevalent nutritional disorder among children and adolescents worldwide. Approximately 43 million individuals are obese, 21?24% children and adolescents are overweight, and 16?18% of individuals have abdominal obesity. The prevalence of obesity is highest among specific ethnic groups. Obesity increases the risk of heart diseases in children and adults. Childhood obesity predisposes the individual to insulin resistance and type 2 diabetes, hypertensio...
Crowe, Kristi M; Allison, David
Research into bioactive food compounds (BFC) continues to evolve albeit with shared challenges among scientists in the fields of obesity and cancer treatment and prevention. Given the diversity of scientific disciplines involved in evaluating BFC, multidisciplinary conferences provide opportunities to update the state of the science and critically discuss conceptual and methodological challenges encountered in studying BFC in both preclinical and clinical trials. This overview is an introduction to presentations given at a conference sponsored by the National Cancer Institute of the National Institutes of Health and the University of Alabama at Birmingham, which convened a multidisciplinary group of researchers evaluating BFC in obesity and cancer prevention. Full presentations can be viewed in video format at http://www.norc.uab.edu/courses/conferences/conference2013.
Reilly, John J
Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity prevalence in some Western nations should not encourage the belief that the obesity prevention problem has been solved, although a better understanding of recent secular trends might be helpful for prevention strategy in future. An adequate body of evidence provides behavioral targets of preventive interventions, and there are frameworks for prioritizing these targets logically and models for translating them into generalizable interventions with a wide reach (e.g., school-based prevention interventions such as Planet Health). An improved understanding of the "energy gap" that children and adolescents experience would be helpful to the design of preventive interventions and to their tailoring to particular groups. In the United Kingdom, some recent etiological evidence has been taken as indicative of the need for paradigm shifts in obesity prevention, but this evidence from single studies has not been replicated, and paradigm shifts probably occur only rarely. Ensuring that the evidence base on etiology and prevention influences policy effectively remains one of the greatest challenges for childhood obesity researchers.
Teede, H J; Lombard, C; Deeks, A A
The prevalence of obesity is rising dramatically, impacting adversely on health and well-being at the menopause and across the lifespan. With menopause, abdominal adiposity selectively increases. The impact of obesity and abdominal adiposity on chronic disease, including diabetes and cardiovascular disease, is significant and quality of life is adversely affected. Yet accurate perception of the weight-related health-risk profile is lacking and there is inadequate focus on prevention and treatment of obesity and its complications. Research aimed at prevention and management of obesity at menopause is limited. Accurate risk perception, education and translation programs highlighting obesity risks and supporting sustainable lifestyle changes are needed, particularly around menopause.
Full Text Available Global increases in obesity have led public health experts to declare this disease a pandemic. Although prevalent in all ages, the dire consequences associated with maternal obesity have a pronounced impact on the long-term health of their children as a result of the intergenerational effects of developmental programming. Previously, fetal under-nutrition has been linked to the predisposition to pediatric obesity explained by the adiposity rebound and ‘catch-up’ growth that occurs when a child born to a nutrient deprived mother is exposed to the obesogenic environment of present day. Given the recent increase in maternal overweight/obesity (OW/OB our attention has shifted from nutrient restriction to overabundance and excess during pregnancy. Consideration must now be given to interventions that could mitigate pregravid body mass index (BMI, attenuate gestational weight gain (GWG and reduce postpartum weight retention (PPWR in an attempt to prevent the downstream signaling of pediatric obesity and halt the intergenerational cycle of weight related disease currently plaguing our world. Thus, this paper will briefly review current research that best highlights the proposed mechanisms responsible for the development of child OW/OB and related sequalae (e.g. type II diabetes (T2D and cardiovascular disease (CVD resulting from maternal obesity.
Full Text Available Global increases in obesity have led public health experts to declare this disease a pandemic. Although prevalent in all ages, the dire consequences associated with maternal obesity have a pronounced impact on the long-term health of their children as a result of the intergenerational effects of developmental programming. Previously, fetal under-nutrition has been linked to the predisposition to pediatric obesity explained by the adiposity rebound and ‘catch-up’ growth that occurs when a child born to a nutrient deprived mother is exposed to the obesogenic environment of present day. Given the recent increase in maternal overweight/obesity (OW/OB our attention has shifted from nutrient restriction to overabundance and excess during pregnancy. Consideration must now be given to interventions that could mitigate pregravid body mass index (BMI, attenuate gestational weight gain (GWG and reduce postpartum weight retention (PPWR in an attempt to prevent the downstream signaling of pediatric obesity and halt the intergenerational cycle of weight related disease currently plaguing our world. Thus, this paper will briefly review current research that best highlights the proposed mechanisms responsible for the development of child OW/OB and related sequalae (e.g. type II diabetes (T2D and cardiovascular disease (CVD resulting from maternal obesity.
Full Text Available Obesity is a medical condition in which excess body fat that it may have an adverse effect on health, leading to life expectancy and increased health problems. In keeping with the general international trend of rising prevalence of obesity, maternal obesity prevalence is rising. According to WHO, the prevalence of obesity in pregnancy ranges from 1.8 to 25.3%. Maternal obesity has been identified to be a risk factor for maternal and perinatal mortality. The aim of this article was reviewed in research about maternal obesity in Pubmed, which published between 2009 and 2010. 7 reviews and 13 studies was examined and they presented under this headings: impacts of maternal obesity in pregnancy, obstetric outcomes of maternal obesity, postpartum outcomes of maternal obesity, impact of maternal obesity on breastfeeding, impact of maternal obesity on procedure of anomaly scan and risk determination, maternal obesity and fetal complications, impact of maternal obesity on Apgar scores, obesity and infertility, pregnancy following bariatric surgery, long term effects of obesity, management of maternal obesity. [TAF Prev Med Bull 2012; 11(3.000: 353-364
Full Text Available Abstract Background Overweight and obesity have a dramatic negative impact on children's health not only during the childhood but also throughout the adult life. Preventing the development of obesity in children is therefore a world-wide health priority. There is an obvious urge for sustainable and evidenced-based interventions that are suitable for families with young children, especially for families with overweight or obese parents. We have developed a prevention program, Early STOPP, combating multiple obesity-promoting behaviors such unbalanced diet, physical inactivity and disturbed sleeping patterns. We also aim to evaluate the effectiveness of the early childhood obesity prevention in a well-characterized population of overweight or obese parents. This protocol outlines methods for the recruitment phase of the study. Design and methods This randomized controlled trial (RCT targets overweight and/or obese parents with infants, recruited from the Child Health Care Centers (CHCC within the Stockholm area. The intervention starts when infants are one year of age and continues until they are six and is regularly delivered by a trained coach (dietitian, physiotherapist or a nurse. The key aspects of Early STOPP family intervention are based on Swedish recommendations for CHCC, which include advices on healthy food choices and eating patterns, increasing physical activity/reducing sedentary behavior and regulating sleeping patterns. Discussion The Early STOPP trial design addresses weaknesses of previous research by recruiting from a well-characterized population, defining a feasible, theory-based intervention and assessing multiple measurements to validate and interpret the program effectiveness. The early years hold promise as a time in which obesity prevention may be most effective. To our knowledge, this longitudinal RCT is the first attempt to demonstrate whether an early, long-term, targeted health promotion program focusing on healthy
Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.
Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984
Whittemore, Robin; Jeon, Sangchoon; Grey, Margaret
To compare the effectiveness of two school-based internet obesity prevention programs for diverse adolescents on body mass index (BMI), health behaviors, and self-efficacy, and to explore moderators of program efficacy. It was hypothesized that the addition of coping skills training to a health education and behavioral support program would further enhance health outcomes. A randomized clinical trial with cluster randomization by class and repeated measures with follow-up at 3 and 6 months was conducted (n = 384). BMI was assessed by use of standard procedures. Sedentary behavior, physical activity, nutrition behavior, self-efficacy, and satisfaction were assessed with self-report measures. Data analysis consisted of mixed model analyses with autoregressive covariance structure for repeated data by use of intent-to-treat procedures. The mean age of students was 15.31 years (±0.69), with a mean BMI of 24.69 (±5.58). The majority were girls (62%) and of diverse race/ethnicity (65% non-white). There were no significant differences between groups on any outcomes and no change in BMI over time. There were significant improvements in health behaviors (sedentary behavior, moderate and vigorous physical activity, healthy eating, fruit and vegetable intake, sugar beverages, and junk food intake) and self-efficacy. Gender and lesson completion moderated select health outcomes. There was excellent participation and high satisfaction with the programs. School-based internet obesity prevention programs are appealing to adolescents and improve health behaviors. The differential effect of coping skills training may require longer follow-up. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Della Torre, Sophie Bucher; Akre, Christina; Suris, Joan-Carles
Background: In general, schools are an important setting to implement current recommendations for obesity prevention in children because the vast majority of children attend school. This study investigated the opinions of different school stakeholders on the feasibility and acceptability of current obesity prevention strategies that could be…
Full Text Available Background: Community-based initiatives show promise for preventing childhood obesity. They are characterized by community leaders and members working together to address complex local drivers of energy balance. Objectives: To present a protocol for a stepped wedge cluster randomized trial in ten communities in the Great South Coast Region of Victoria, Australia to test whether it is possible to: (1 strengthen community action for childhood obesity prevention, and (2 measure the impact of increased action on risk factors for childhood obesity. Methods: The WHO STOPS intervention involves a facilitated community engagement process that: creates an agreed systems map of childhood obesity causes for a community; identifies intervention opportunities through leveraging the dynamic aspects of the system; and, converts these understandings into community-built, systems-oriented action plans. Ten communities will be randomized (1:1 to intervention or control in year one and all communities will be included by year three. The primary outcome is childhood obesity prevalence among grade two (ages 7–8 y, grade four (9–10 y and grade six (11–12 y students measured using our established community-led monitoring system (69% school and 93% student participation rate in government and independent schools. An additional group of 13 external communities from other regions of Victoria with no specific interventions will provide an external comparison. These communities will also allow us to assess diffusion of the intervention to control communities during the first three years of the trial. Conclusion: This trial will test effectiveness, over a five-year period, of community-owned, -supported and -led strategies designed to address complex and dynamic causes of childhood obesity.
Allender, Steven; Millar, Lynne; Hovmand, Peter; Bell, Colin; Moodie, Marj; Carter, Rob; Swinburn, Boyd; Strugnell, Claudia; Lowe, Janette; de la Haye, Kayla; Orellana, Liliana; Morgan, Sue
Background: Community-based initiatives show promise for preventing childhood obesity. They are characterized by community leaders and members working together to address complex local drivers of energy balance. Objectives: To present a protocol for a stepped wedge cluster randomized trial in ten communities in the Great South Coast Region of Victoria, Australia to test whether it is possible to: (1) strengthen community action for childhood obesity prevention, and (2) measure the impact of increased action on risk factors for childhood obesity. Methods: The WHO STOPS intervention involves a facilitated community engagement process that: creates an agreed systems map of childhood obesity causes for a community; identifies intervention opportunities through leveraging the dynamic aspects of the system; and, converts these understandings into community-built, systems-oriented action plans. Ten communities will be randomized (1:1) to intervention or control in year one and all communities will be included by year three. The primary outcome is childhood obesity prevalence among grade two (ages 7-8 y), grade four (9-10 y) and grade six (11-12 y) students measured using our established community-led monitoring system (69% school and 93% student participation rate in government and independent schools). An additional group of 13 external communities from other regions of Victoria with no specific interventions will provide an external comparison. These communities will also allow us to assess diffusion of the intervention to control communities during the first three years of the trial. Conclusion: This trial will test effectiveness, over a five-year period, of community-owned, -supported and -led strategies designed to address complex and dynamic causes of childhood obesity.
Haire-Joshu, Debra; Tabak, Rachel
To prevent the intergenerational transfer of obesity and end the current epidemic, interventions are needed across the early life stages, from preconception to prenatal to infancy through the age of 2 years. The foundation for obesity is laid in early life by actions and interactions passed from parent to child that have long-lasting biologic and behavioral consequences. The purpose of this paper is to examine the best evidence about (a) factors in parents and offspring that promote obesity during the early life stages, (b) the social determinants and dimensions of obesity in early life, (c) promising and effective interventions for preventing obesity in early life, and (d) opportunities for future research into strategies to disrupt the intergenerational cycle of obesity that begins early in life. The pathway for halting the intergenerational obesity epidemic requires the discovery and development of evidence-based interventions that can act across multiple dimensions of influence on early life.
Wang, H; Zhai, F
By 2002, China's prevalence of overweight and obesity among adults was 18.9 and 2.9%, respectively. The replacement of traditional Chinese diet with 'Western diet', major declines in all phases of activity and increased sedentary activity are cited as the main reasons explaining the rapid increase in overweight and obesity, which bring major economic and health costs. The Nutrition Improvement Work Management Approach was released in 2010. Overweight and obesity prevention-related policies were added to national planning for disease prevention and control. The Guidelines for Prevention and Control of Overweight and Obesity of Chinese Adults and the School-age Children and Teenagers Overweight and Obesity Prevention and Control Guidelines in China were promulgated in 2003 and 2007, respectively. Few education programmes have been implemented. Selected academic intervention research projects dominate with a focus on reducing child obesity and promoting healthier diets; increasing physical activity and reducing sedentary time; and facilitating changes in family, school, social and cultural environments. Intervention samples are small and have not addressed the increasing rates of obesity throughout the entire population. Government provision of effective policy measures, multisectoral cooperation and increasing corporate social responsibility are keys to curbing the trend towards overweight and obesity in China. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.
... To Health Topics / Overweight and Obesity Overweight and Obesity Also known as Adiposity Leer en español Overweight ... information about lack of sleep. High amounts of stress Acute stress and chronic stress affect the brain ...
Dissecting and customising the Childhood Obesity Prevention Advisory Council (COPAC): the development and application of a community engagement framework to improve childhood obesity prevention among migrant populations.
Renzaho, A M N
Migrant communities in Australia bear a disproportionate childhood obesity burden. They also show poor engagement in obesity prevention initiatives which may contribute to widening obesity disparities. Community engagement has been shown to be effective in reducing health disparities by improving migrant communities' participation in prevention programmes. This study aimed to develop a community engagement framework to improve childhood obesity prevention among migrants. Based on the African Review Panel model and the Community-Based Participatory Research conceptual logic model, the Childhood Obesity Prevention Advisory Council (COPAC) framework was developed and established in four disadvantaged areas in Victoria, Australia. The COPAC included service providers and migrant community members from the same project's site. COPAC demonstrated several benefits including cross-organisational and multidisciplinary collaborations; understanding of the cultural barriers in childhood obesity prevention; enthusiasm from the COPAC members in addressing childhood obesity in their multicultural communities; equitable involvement, motivation, and empowerment of COPAC members in research development; and establishing organisational affiliations to foster long-term community involvement. This study also documented several challenges in community engagement including lack of prioritisation of migration-related childhood obesity disparities by the policymakers; staffing constraints among service providers leading to frequent disruptions in COPAC members' contributions; and lack of adequate training and skill-building of bicultural workers. The COPAC model adopted a flexible and dynamic community engagement process to suit the ongoing needs of the migrant community which incorporated the existing talents and resources within the community. For effective community engagement of migrant communities, it is important for policymakers to develop the knowledge, capacity and skills of the
Jatlaoui, Tara C; Zapata, Lauren B; Curtis, Kathryn M; Folger, Suzanne G; Marchbanks, Polly A; Mandel, Michele G; Jamieson, Denise J
Whether providers who regularly provide family planning services consider contraceptive methods as unsafe for women with obesity is unknown. We analyzed questionnaire responses received from December 2009 to March 2010 from 635 office-based physicians and 1323 Title X clinic providers delivering family planning services, who were randomly sampled (response rate 65%) before the release of national evidence-based contraception guidelines. We examined provider and clinical setting characteristics and clinic patient demographics for association with provider misconceptions about safety of combined oral contraceptives (COCs), depot medroxyprogesterone acetate (DMPA), or intrauterine devices (IUDs) for women with obesity. If providers considered methods as unsafe or do not know, we categorized those responses as misconceptions. We used multivariable logistic regression to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). A substantial proportion of respondents had misconceptions about the safety of COCs (31%), DMPA (24%), copper (Cu) (18%), and levonorgestrel (LNG)-IUDs (16%) for women with obesity. Provider type was associated with increased odds of misconceptions for all four methods compared with office-based obstetrician/gynecologists. Not having the method available onsite was associated with safety misconceptions of DMPA (aOR 1.90, 95% CI 1.07-3.36), Cu-IUD (aOR 4.19, 95% CI 1.51-11.61), and LNG-IUD (aOR 5.25, 95% CI 1.67-16.49). While the majority of providers considered all four contraceptive methods safe for women with obesity, substantial proportions had misconceptions about safety of COCs, DMPA, and IUDs. Provider education, particularly among certain specialties, is needed to increase knowledge regarding moderate and highly effective contraceptive methods among this patient population.
Weihrauch-Blüher, Susann; Koormann, Stefanie; Brauchmann, Jana; Wiegand, Susanna
The increasing prevalence of childhood obesity is - amongst other factors - due to changed leisure time habits with decreased physical activity and increased media consumption. However, electronic media such as tablets and smartphones might also provide a novel intervention approach to prevent obesity in childhood and adolescence. A summary of interventions applying electronic media to prevent childhood obesity is provided to investigate short term effects as well as long term results of these interventions. A systematic literature search was performed in PubMed/Web of Science to identify randomized and/or controlled studies that have investigated the efficacy of electronic media for obesity prevention below the age of 18. A total of 909 studies were identified, and 88 studies were included in the analysis. Active video games did increase physical activity compared to inactive games when applied within a peer group. Interventions via telephone had positive effects on certain lifestyle-relevant behaviours. Interventions via mobile were shown to decrease dropout rates by sending regular SMS messages. To date, interventions via smartphones are scarce for adolescents; however, they might improve cardiorespiratory fitness. The results from internet-based interventions showed a trend towards positive effects on lifestyle-relevant behaviors. The combination of different electronic media did not show superior results compared to interventions with only one medium. Interventions via TV, DVD or video-based interventions may increase physical activity when offered as an incentive, however, effects on weight status were not observed. Children and adolescents currently grow up in a technology- and media-rich society with computers, tablets, smartphones, etc. used daily. Thus, interventions applying electronic media to prevent childhood obesity are contemporary. Available studies applying electronic media are however heterogeneous in terms of applied medium and duration
Emre Yanikkerem; Selviye Mutlu
Obesity is a medical condition in which excess body fat that it may have an adverse effect on health, leading to life expectancy and increased health problems. In keeping with the general international trend of rising prevalence of obesity, maternal obesity prevalence is rising. According to WHO, the prevalence of obesity in pregnancy ranges from 1.8 to 25.3%. Maternal obesity has been identified to be a risk factor for maternal and perinatal mortality. The aim of this article was reviewed in...
Hilbert, Anja; Ried, Jens; Schneider, Daniel; Juttner, Clemens; Sosna, Marc; Dabrock, Peter; Lingenfelder, Michael; Voit, Wolfgang; Rief, Winfried; Hebebrand, Johannes
The primary prevention of adult obesity requires combined efforts by stakeholders at various societal levels, based on the knowledge from multiple disciplines. The goal of the present study was, therefore, to analyze current preventive approaches and delineate implications for future prevention research and practice by integrating knowledge from genetics, law, economics, psychology, and social ethics (Figure 1). Inconclusive evidence on the etiology of obesity, a complex, multifactorial condition, likely complicates prevention, contributing to a lack of specificity regarding target groups, focus, and techniques of prevention. Given the urgency and significance of the "obesity problem" that requires immediate and effective solutions, it is recommended that the various existing and developing prevention programs are evaluated to ensure orientation at current risk factor research. Results from genetic risk factor research can be used as a rationale to increase specificity of preventive measures regarding identification of high-risk groups, timing, and goals of prevention. Further, it is important to evaluate prevention programs for systematic application of behavior modification techniques and consideration of individual risk factors and resources to ensure promotion of long-term behavior change that leads to weight maintenance and a reduction of incidence rates of obesity in adults (Figure 3). Although the primary prevention of childhood obesity may lead to a reduction of incidence rates of obesity in adults, high rates of adult-onset obesity and the related medical and psychosocial sequelae in adulthood underscore the necessity of preventive efforts for adults. Concerning the environmental basis of obesity prevention, in many countries, the institutional and legal framework of preventive approaches requires further examination in order to improve funding, coordination between multiple stakeholders, and implementation of prevention in the health-care system. Evidence
Blouin, Chantal; Dubé, Laurette
To date the global health diplomacy agenda has focused primarily on infectious diseases. Policymakers have not dedicated the same level of attention to chronic diseases, despite their rising contribution to the global burden of disease. Negotiation of the Framework convention on tobacco control provides an apt example from global health diplomacy to tackle diet-related chronic diseases. What lessons can be learned from this experience for preventing obesity? This article looks at why a global policy response is necessary, at the actors and interests involved in the negotiations, and at the forum for diplomacy.
Huijun, Wang; Fengying, Zhai
By 2002, China’s prevalence of overweight and obesity among adults was 18.9 percent and 2.9 percent, respectively. The Chinese traditional diet has been replaced by the “Western diet” and major declines in all phases of activity and increased sedentary activity as the main reasons explaining the rapid increase in overweight and obesity, bring major economic and health costs. The Nutrition Improvement Work Management Approach was released in 2010. Overweight and obesity prevention-related poli...
Sothern, Melinda S
The current environmental experience of young children includes few opportunities for physical activity and an overabundance of high calorie foods. Sedentary lifestyles and poor nutrition challenge children who are predisposed to metabolic disorders. Obesity is a logical response to this challenge. To prevent clinically significant obesity and later metabolic disease in predisposed youth, all sectors of society must work together to support strategies to change public opinion and behavior across the life span. Parental education in all medical settings is strongly recommended, especially if the parent(s) are obese, beginning with the first pregnancy visit to the physician. Schools should be primary targets for efforts to educate parents concerning the reduction of TV, computer games, and unhealthy snacks. Schools should be encouraged to adopt vending machine policies that promote healthy drinks and food in appropriate portion sizes and discouraged from providing unhealthy food as rewards for positive behavior or academic accomplishment. Schools should provide daily physical education and frequent periods of unstructured play in young children. Clinical treatment should be both encouraged and financially supported in children who are already overweight. Community wide efforts to increase awareness and promote environments that encourage physical activity and healthy nutrition are needed.
Skouteris, Helen; Hill, Briony; McCabe, Marita; Swinburn, Boyd; Sacher, Paul; Chadwick, Paul
The aim of this paper was to compare the recruitment strategies of two recent studies that focused on the parental influences on childhood obesity during the preschool years. The first study was a randomised controlled trial (RCT) of the Mind, Exercise, Nutrition?…?Do It! 2-4 obesity prevention programme and the second was a longitudinal cohort…
Overweight and obesity are major health concerns for young people. Schools are particularly promising environments for preventing and treating obesity. The Institutes of Medicine recommends 60 minutes per day of physical activity for children and youth, including at least 30 minutes at school. Yet the amount of moderate to vigorous physical…
Farrell, Lucy C; Warin, Megan J; Moore, Vivienne M; Street, Jackie M
Intense concern about obesity in the public imagination and in political, academic and media discourses has catalysed advocacy efforts to implement regulatory measures to reduce the occurrence of obesity in Australia and elsewhere. This article explores public attitudes towards the possible implementation of regulations to address obesity by analysing emotions within popular discourses. Drawing on reader comments attached to obesity-relevant news articles published on Australian news and current affairs websites, we examine how popular anxieties about the 'obesity crisis' and vitriol directed at obese individuals circulate alongside understandings of the appropriate role of government to legitimise regulatory reform to address obesity. Employing Ahmed's theorisation of 'affective economies' and broader literature on emotional cultures, we argue that obesity regulations achieve popular support within affective economies oriented to neoliberal and individualist constructions of obesity. These economies preclude constructions of obesity as a structural problem in popular discourse; instead positioning anti-obesity regulations as a government-endorsed vehicle for discrimination directed at obese people. Findings implicate a new set of ethical challenges for those championing regulatory reform for obesity prevention. © 2015 Foundation for the Sociology of Health & Illness.
Lakerveld, Brug J, Bot S, Teixeira P, Rutter H, Woodward E, Samdal O, Stockley L, De Bourdeaudhuij I, van Assema P, Robertson A, Lobstein T, Oppert JM, Adány R, Nijpels G., Jeroen; Robertson, Aileen
Background The prevalence of overweight and obesity in Europe is high. It is a major cause of the overall rates of many of the main chronic (or non communicable) diseases in this region and is characterized by an unequal socio-economic distribution within the population. Obesity is largely determ...
M. ten Have (Marieke)
textabstractTaxes on unhealthy food, limits to commercial advertising, a ban on chocolate drink at schools, or compulsory physical exercise for obese employees: efforts to counter the rise in overweight and obesity sometimes raise questions about what is ethically acceptable. This thesis examines
Waters, Elizabeth; Swinburn, Boyd A.; Seidell, Jacob C.; Uauy, Ricardo
Obesity is one of the biggest public health challenges in the 21st century. Devising effective policy and practice to combat childhood obesity is a high priority for many governments and health professionals internationally. This book brings together contributors from around the world and showcases
Winter, Suzanne M.
Childhood obesity is epidemic in the United States and other industrialized countries across the globe. This trend is alarming, because childhood obesity is associated with the early onset of serious health problems, including Type II diabetes, cardiovascular disease, orthopedic problems, behavioral disorders, and asthma. Mounting evidence also…
Blüher, S; Kromeyer-Hauschild, K; Graf, C; Grünewald-Funk, D; Widhalm, K; Korsten-Reck, U; Markert, J; Güssfeld, C; Müller, M J; Moss, A; Wabitsch, M; Wiegand, S
Current guidelines for the prevention of obesity in childhood and adolescence are presented. A literature search was performed in Medline via PubMed, and appropriate studies were analysed. Programs to prevent childhood obesity were to date mainly school-based. Effects were limited to date. Analyses tailored to different age groups show that prevention programs have the best effects in younger children (adolescence, school-based interventions were most effective when adolescents were directly addressed. To date, obesity prevention programs have mainly focused on behavior oriented prevention. Recommendations for condition oriented prevention have been suggested by the German Alliance of Non-communicable Diseases and include one hour of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory quality standards for meals at kindergarten and schools as well as a ban on unhealthy food advertisement addressing children. Behavior oriented prevention programs showed hardly any or only limited effects in the long term. Certain risk groups for the development of obesity are not reached effectively by available programs. Due to the heterogeneity of available studies, universally valid conclusions cannot be drawn. The combination with condition oriented prevention, which has to counteract on an obesogenic environment, is crucial for sustainable success of future obesity prevention programs. © Georg Thieme Verlag KG Stuttgart · New York.
This podcast is based on the August, 2011 CDC Vital Signs report. Childhood obesity is an epidemic in the US. Breastfeeding can help prevent obesity, but one in three moms stop without hospital support. About 95% of hospitals lack policies that fully support breastfeeding moms. Hospitals need to do more to help moms start and continue breastfeeding. Created: 8/2/2011 by Centers for Disease Control and Prevention (CDC). Date Released: 8/2/2011.
Clarke, J L; Pallan, M J; Lancashire, E R; Adab, P
Schools are seen as important contributors to obesity prevention, yet face barriers in fulfilling this function. This qualitative study investigates headteacher views on the primary school role in preventing obesity. Semi-structured interviews were held with 22 headteachers from ethnically and socio-economically diverse schools in the West Midlands, UK. Data analysis was conducted using the framework approach. Two over-arching categories were identified: 'School roles and responsibilities' and 'Influencing factors'. Participants agreed that although schools contribute towards obesity prevention in many ways, a moral responsibility to support children's holistic development was the principal motivator, rather than preventing obesity per se. The perceived impact on learning was a key driver for promoting health. Parents were believed to have the main responsibility for preventing obesity, but barriers were identified. Whilst headteachers recognized the advantageous position of schools in offering support to parents, opinion varied on the degree to which schools could and should take on this role. Headteachers serving more deprived areas reported adopting certain responsibilities that elsewhere were fulfilled by parents, and were more likely to view working with families on healthy lifestyles as an important school function. Several factors were perceived as barriers to schools doing more to prevent obesity, including academic pressure, access to expert support and space. In conclusion, school leaders need more support, through resources and government policy, to enable them to maximize their role in obesity prevention. Additionally, school-based obesity prevention should be an integral part of the education agenda rather than bolt-on initiatives. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Adams, Alexandra K; Christens, Brian; Meinen, Amy; Korth, Amy; Remington, Patrick L; Lindberg, Sara; Schoeller, Dale
Obesity rates have increased dramatically, especially among children and disadvantaged populations. Obesity is a complex issue, creating a compelling need for prevention efforts in communities to move from single isolated programs to comprehensive multisystem interventions. To address these issues, we have established a childhood Obesity Prevention Initiative (Initiative) for Wisconsin. This Initiative seeks to test community change frameworks that can support multisystem interventions and provide data for local action as a means for influencing policies, systems, and environments that support individuals’ healthy eating and physical activity. The Initiative is comprised of three components: (1) infrastructure to support a statewide obesity prevention and health promotion network with state- and local-level public messaging and dissemination of evidence-based solutions (healthTIDE); (2) piloting a local, multisetting community-led intervention study in 2 Wisconsin counties; and (3) developing a geocoded statewide childhood obesity and fitness surveillance system. This Initiative is using a new model that involves both coalition action and community organizing to align resources to achieve health improvement at local and state levels. We expect that it will help lead to the implementation of cohesive and sustainable policy, system, and environment health promotion and obesity prevention strategies in communities statewide, and it has the potential to help Wisconsin become a national model for multisetting community interventions to address obesity. Addressing individual-level health through population-level changes ultimately will result in reductions in the prevalence of childhood obesity, current and future health care costs, and chronic disease mortality.
Suglia, Shakira F; Shelton, Rachel C; Hsiao, Amber; Wang, Y Claire; Rundle, Andrew; Link, Bruce G
The continuing obesity epidemic in the USA calls for the examination of antecedents to the well-known risk factors of physical activity and diet. The neighborhood built environment has been extensively studied in relation to obesity noting an increased risk of development and prevalence of obesity in relation to numerous built environment characteristics (lack of green spaces, higher number of fast food restaurants, low walkability indices). The neighborhood social environment, however, has been less extensively studied but is perhaps an equally important component of the neighborhood environment. The neighborhood social environment, particularly constructs of social capital, collective efficacy, and crime, is associated with obesity among both adults and children. Several studies have identified physical activity as a potential pathway of the neighborhood social environment and obesity association. Further work on social networks and norms and residential segregation, as well as the examination of dietary behaviors and mental health as potential mediating pathways, is necessary. Given the existing evidence, intervening on the neighborhood social environment may prove to be an effective target for the prevention on obesity. Intervention studies that promote healthy behaviors and prevent obesity while addressing aspects of the neighborhood social environment are necessary to better identify targets for obesity prevention.
Simmons, A; Mavoa, H M; Bell, A C
, gaps in skills and knowledge) and workshops with key stakeholders to create action plans for six diverse obesity prevention projects in Australia (n = 3), New Zealand, Fiji and Tonga from 2002 to 2005. Some sites included sociocultural contextual analyses in the environmental scans. Target groups were......Community-based interventions are an important component of obesity prevention efforts. The literature provides little guidance on priority-setting for obesity prevention in communities, especially for socially and culturally diverse populations. This paper reports on the process of developing...... under-5-year-olds (Australia), 4-12-year-olds (Australia) and 13-18-year-olds (all four countries). Over 120 potential behavioural, knowledge, skill and environmental elements were identified for prioritization leading into each 2-day workshop. Many elements were common across the diverse cultural...
Seidell, Jacob C; Halberstadt, Jutka
The prevalence of obesity is increasing at an alarming rate in many parts of the world. About 2 billion people are overweight and one third of them obese. The plight of the most affected populations, like those in high-income countries in North America, Australasia and Europe, has been well publicized. However, the more recent increases in population obesity in low- and middle-income countries that are now increasingly being observed have been less recognized. Based on the existing prevalence and trend data and the epidemiological evidence linking obesity with a range of physical and psychosocial health conditions, it is reasonable to describe obesity as a public health crisis that severely impairs the health and quality of life of people and adds considerably to national health-care budgets. Intersectoral action to manage and prevent obesity is urgently required to reverse current trends.
Full Text Available Nowadays obesity is one of the most important nutritional problems with features contemporary epidemic which concerns not only the developed but also the developing countries. Obesity during pregnancy associate with maternal and perinatal risks that make the management of obesity, before and during pregnancy imperative. The best and most effective treatment of obesity in pregnancy is prevention. A healthy diet and regular exercise of pregnant woman is crucial for the normal development of pregnancy. Moreover every obese pregnant woman should be informed about the importance of calorie - intake regulation and weight reduction both before and after pregnancy. Additional therapeutic options are bariatric surgical procedures that a woman can have before pregnancy and anticoagulation therapy during pregnancy. This article attempts brief review on the current scientific knowledge that exists about the role of nutrition and physical activity in controlling the weight of obese pregnant women and its beneficial contribution to the health of both the mother and the newborn.
Lund, Thomas Bøker; Sandøe, Peter; Lassen, Jesper
The aim of this study was to investigate the Danish public’s support for publicly funded obesity treatment and prevention. It was also examined whether levels of support could be explained by dislike of obese people and / or the belief that those who are obese are personally responsible...... for their condition. A representative survey of members of the Danish public (N=1,141) was conducted using a web-based questionnaire. The survey was designed to assess attitudes to public funding for obesityrelated health care, and to investigate the impact, on those attitudes, of dislike of obese people......, the perceived controllability of obesity, self-reported BMI, and additional attitudinal and sociodemographic characteristics. Public funding of some obesity treatments, such as weight-loss surgery, attracted only limited public support. A majority of the Danish public did support ‘softer’ treatment...
Wilson, Louise F.
Obesity is a major pediatric public health problem. Adolescents are a priority population for intervention strategies. School nurses are in key positions to design intervention strategies to promote healthy lifestyles and prevent adolescent obesity in the students they serve. To design effective programs, school nurses need to know what components…
Sleep may affect energy balance. Sleep may not be the only answer to the obesity pandemic, but its effect should be considered seriously, as even small changes in the energy balance are beneficial. Good sleep could be part of the obesity prevention approach.
Borys, J-M; Le Bodo, Y; Jebb, S A; Seidell, J C; Summerbell, C; Richard, D; De Henauw, S; Moreno, L A; Romon, M; Visscher, T L S; Raffin, S; Swinburn, B
Childhood obesity is a complex issue and needs multi-stakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. 'Ensemble Prévenons l'Obésité Des Enfants' (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity. At a central level, a coordination team, using social marketing and organizational techniques, trains and coaches a local project manager nominated in each EPODE community by the local authorities. The local project manager is also provided with tools to mobilize local stakeholders through a local steering committee and local networks. The added value of the methodology is to mobilize stakeholders at all levels across the public and the private sectors. Its critical components include political commitment, sustainable resources, support services and a strong scientific input--drawing on the evidence-base--together with evaluation of the programme. Since 2004, EPODE methodology has been implemented in more than 500 communities in six countries. Community-based interventions are integral to childhood obesity prevention. EPODE provides a valuable model to address this challenge. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.
Pérez Morente, Ma Angeles; Sánchez Ocón, Ma Teresa; Mingorance Ruiz, Ma Visitación; Pérez Robles, Angustias; Munoz de la Fuente, José Manuel; Sánchez De Arias, Celia
To determine the current epidemiological situation, prevention and management of child and youth obesity based on the best scientific evidence available. Literature search in PubMed, Cochrane, Science Direct, ENFISPO, Lilacs and SciELO, selecting articles about child and youth obesity, its prevention and treatment. Child and youth obesity is a multifactorial chronic disease that it has been increasing, tending to stay in adolescence and adulthood with greater intensity than more early starts. The data vary from country to country, although most articles are governed by body mass index (BMI). Pediatric overweight is defined by a BMI percentiles located between 91-98 and obesity by a percentile equal or greater than 99. Its prevalence varies according to time, geography, age, gender and race. The prevalence rates of obesity in Spain are one of the highest around the world. The overweight prevalence is lower slightly and there is no difference in gender. Its implications include the metabolic syndrome and diabetes mellitus II. Unanimously, the combination of interventions on life and dietary habits and physical activity is important for the management of obesity and overweight. Currently, the obesity management requires a generalized approach, with changes in lifestyle, diet and physical activity. The best solution for reducing this epidemic lies in prevention rather than treatment.
Lobstein, Tim; Brinsden, Hannah
This paper is written as a briefing document with the aim of providing support to policy-makers and government officials tackling obesity and related non-communicable diseases. It is based on a symposium Obesity and non-communicable diseases: Learning from international experiences convened by the International Association for the Study of Obesity (now the World Obesity Federation) and its policy section, the International Obesity TaskForce (now World Obesity - Policy and Prevention). The symposium discussed a wide range of proposals to tackle the consumption of unhealthy food products, including interventions in the market through fiscal policies and marketing restrictions, measures to strengthen public health legislation and measures to limit agri-food company lobbying activities. It recognized the need for government leadership and action in order to reduce preventable deaths while improving economic performance and identified a need for governments to take a systems wide approach to tackling obesity and to work with civil society, especially to monitor the drivers of disease and to hold all stakeholders accountable for progress. © 2014 The Authors. obesity reviews © 2014 World Obesity.
Nadeau, Kristen J.; Maahs, David M.; Daniels, Stephen R.; Eckel, Robert H.
The prevalence and severity of pediatric obesity have dramatically increased since the late 1980s, raising concerns about a subsequent increase in cardiovascular outcomes. Strong evidence, particularly from autopsy studies, supports the concept that precursors of adult cardiovascular disease (CVD) begin in childhood, and that pediatric obesity has an important influence on overall CVD risk. Lifestyle patterns also begin early and impact CVD risk. In addition, obesity and other CVD risk factors tend to persist over time. However, whether childhood obesity causes adult CVD directly, or does so by persisting as adult obesity, or both, is less clear. Regardless, sufficient data exist to warrant early implementation of both obesity prevention and treatment in youth and adults. In this Review, we examine the evidence supporting the impact of childhood obesity on adult obesity, surrogate markers of CVD, components of the metabolic syndrome, and the development of CVD. We also evaluate how obesity treatment strategies can improve risk factors and, ultimately, adverse clinical outcomes. PMID:21670745
Pépin, Jean Louis; Timsit, Jean François; Tamisier, Renaud; Borel, Jean Christian; Lévy, Patrick; Jaber, Samir
With the increase in the global prevalence of obesity, there is a parallel rise in the proportion of obese patients admitted to intensive care units, referred for major surgery or requiring long-term non-invasive ventilation (NIV) at home for chronic respiratory failure. We describe the physiological effect of obesity on the respiratory system mainly in terms of respiratory mechanics, respiratory drive, and patency of the upper airways. Particular attention is given to the prevention and the clinical management of respiratory failure in obese patients with a main focus on invasive and NIV in intensive care during the perioperative period and long-term use of NIV on return home. We also address other aspects of care of obese patients, including antibiotic dosing and catheter-related infections. Copyright © 2016 Elsevier Ltd. All rights reserved.
Smith, Tosha Woods; Calancie, Larissa; Ammerman, Alice
In recent years, social entrepreneurship has emerged as a new field to address social and public health challenges. Social entrepreneurship, which harnesses traditional business practices and market forces to address social challenges, may produce solutions that are more cost-effective and sustainable than those produced by governmental and nonprofit sectors. In this paper, we discuss whether and how social entrepreneurship can be harnessed for obesity prevention by defining and briefly reviewing the rise of social entrepreneurship in the USA, outlining the threat that obesity poses to US society and offering some examples of how social ventures are addressing the problem of obesity. Additional untapped opportunities are also discussed and recommendations given for how social entrepreneurship might impact obesity prevention in the future.
Pérez-Escamilla, R; Kac, G
Overweight/obese women are more likely to deliver newborns that also have a predisposition to store excessive amounts of fat since the early infancy period. Two evidence-based cycles are considered on the explanation of the maternal–child life-course approach for obesity prevention. The ‘maternal' cycle indicates that pre-pregnancy overweight primiparous women are more likely to gain excessive weight during gestation and to retain excessive weight postpartum. The ‘offspring' cycle indicates t...
Findholt, Nancy E; Davis, Melinda M; Michael, Yvonne L
To explore the perceived barriers, resources, and training needs of rural primary care providers in relation to implementing the American Medical Association Expert Committee recommendations for assessment, treatment, and prevention of childhood obesity. In-depth interviews were conducted with 13 rural primary care providers in Oregon. Transcribed interviews were thematically coded. Barriers to addressing childhood obesity fell into 5 categories: barriers related to the practice (time constraints, lack of reimbursement, few opportunities to detect obesity), the clinician (limited knowledge), the family/patient (family lifestyle and lack of parent motivation to change, low family income and lack of health insurance, sensitivity of the issue), the community (lack of pediatric subspecialists and multidisciplinary/tertiary care services, few community resources), and the broader sociocultural environment (sociocultural influences, high prevalence of childhood obesity). There were very few clinic and community resources to assist clinicians in addressing weight issues. Clinicians had received little previous training relevant to childhood obesity, and they expressed an interest in several topics. Rural primary care providers face extensive barriers in relation to implementing recommended practices for assessment, treatment, and prevention of childhood obesity. Particularly problematic is the lack of local and regional resources. Employing nurses to provide case management and behavior counseling, group visits, and telehealth and other technological communications are strategies that could improve the management of childhood obesity in rural primary care settings. © 2013 National Rural Health Association.
Schmandt, Rosemarie E; Iglesias, David A; Co, Ngai Na; Lu, Karen H
Worldwide, obesity has become a major public health crisis. Overweight and obesity not only increase the risk of cardiovascular disease and type-2 diabetes mellitus but also are now known risk factors for a variety of cancer types. Among all cancers, increasing body mass index is associated most strongly with endometrial cancer incidence and death. The molecular mechanisms underlying how adipose tissue and obesity contribute to the pathogenesis of endometrial cancer are becoming better understood and have revealed a number of rational strategies, both behavioral and pharmaceutical, for the prevention of both primary and recurrent disease. Copyright © 2011. Published by Mosby, Inc.
Robinson, Alison; Denney-Wilson, Elizabeth; Laws, Rachel; Harris, Mark
Overweight and obesity affects approximately 20% of Australian pre-schoolers. The general practice nurse (PN) workforce has increased in recent years; however, little is known of PN capacity and potential to provide routine advice for the prevention of child obesity. This mixed methods pilot study aims to explore the current practices, attitudes, confidence and training needs of Australian PNs surrounding child obesity prevention in the general practice setting. PNs from three Divisions of General Practice in New South Wales were invited to complete a questionnaire investigating PN roles, attitudes and practices in preventive care with a focus on child obesity. A total of 59 questionnaires were returned (response rate 22%). Semi-structured qualitative interviews were also conducted with a subsample of PNs (n = 10). Questionnaire respondent demographics were similar to that of national PN data. PNs described preventive work as enjoyable despite some perceived barriers including lack of confidence. Number of years working in general practice did not appear to strongly influence nurses' perceived barriers. Seventy per cent of PNs were interested in being more involved in conducting child health checks in practice, and 85% expressed an interest in taking part in child obesity prevention training. Findings from this pilot study suggest that PNs are interested in prevention of child obesity despite barriers to practice and low confidence levels. More research is needed to determine the effect of training on PN confidence and behaviours in providing routine healthy life-style messages for the prevention of child obesity. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
Visscher, Tommy L S; Kremers, Stef P J
The aim of this review is to discuss the state of the art regarding the field of health promotion in the context of childhood obesity prevention in order to learn how we can better prevent childhood obesity. Challenges have been identified that exist within the different steps of health promotion programme development and implementation. Important steps forward include studying behaviours and determinants of behaviours as clusters, upgrading the importance of distal environmental factors in modelling determinants and understanding determinants as a dynamic system: a complex of interacting elements. An important note is that the process of implementation and the analysis thereof should more often come before the analysis of behaviours and the determinants of behaviour. In applied research, the expertise from the 'real world' practitioners should be used in an early stage to find out whether the answers on research questions really help us in preventing childhood obesity.
Cinar, Ayse Basak
Abstract: Obesity, diabetes and oral diseases (dental cariesand periodontal diseases), largely preventable chronic diseases, are described as global pandemic due their distribution and severe consequences. WHO has called for a global action for prevention and promotion of these diseases as a vital...... the likelihood of periodontitis which is one of the most common chronic diseases worldwide, described as pandemic, and closely related to DM2. Promoting good oral health is significantly essential for prevention and reducing the negative consequences of periodontal diseases, DM2 and obesity, and to maintain good...... investment in urgent need. Diabetes and obesity, showing an increasing trend, lead to disabilities and negatively impacts on the quality of life through life course along with oral diseases. WHO projects that the prevalence of diabetes and deaths/year attrituble to diabetes complications will double...
Tetens, Inge; Alinia, Sevil
The global obesity epidemic is associated with a sedentary lifestyle and diets rich in high-fat, high-energy foods. The potential role of fruit in preventing overweight and obesity is related to their relatively low energy density, high content of dietary fibre, and associated increasing satiety...... effect. The physical disruption of fruit is of considerable importance for satiety, as shown in studies in which fruit juices were less satisfying compared to sugar-equivalent intakes of purees and whole fruits. The potential role of fruit in the prevention of overweight and obesity may be connected...... to the dietary pattern of fruit intake, and with the possibility that fruit intake may substitute for other, more energy-dense foods. The majority of human prospective cohort studies in adults suggest a preventive effect of increased fruit intake oil body weight gain; whereas a few studies have suggested...
Chriqui, Jamie F; Chaloupka, Frank J; Powell, Lisa M; Eidson, Shelby S
Obesity is a global problem. Sugar-sweetened beverages (SSB) are a leading contributor of added sugars in individual diets and thus to obesity. Governments have considered taxing SSBs to prevent obesity and generate revenue, but no 'one-size-fits-all' taxation approach exists. We describes three key considerations for governments interested in exploring beverage taxation: (i) what type of tax to apply plus how and where the tax is collected and presented to consumers; (ii) what types of beverages to tax; and (iii) the amount of tax needed to affect consumption and/or obesity prevention-related revenue generation. We offer examples of existing beverage taxes in the United States and internationally. The information will be useful to policymakers at all levels of government, as they continue to consider beverage taxation policies.
Natale, Ruby; Camejo, Stephanie; Sanders, Lee M.
Obesity is a significant public health issue affecting even our youngest children. Given that a significant amount of young children are enrolled in child care, the goal of this project was to evaluate the effectiveness of a child care facility-based obesity prevention program. Over 1,000 facilities participated in the study. The intervention…
Philip J. Morgan
Full Text Available Internationally, childhood obesity is a major public health concern. Given the established difficulties in treating obesity, designing and evaluating effective obesity prevention interventions are research priorities. As parents play a crucial role in establishing positive health behaviours in children, they are a key target for child obesity prevention programs. However, recruiting and engaging parents in such interventions can be a considerable challenge for researchers and practitioners. Members of the ‘Parenting, Child Behaviour and Well-being’ stream of the Australasian Child and Adolescent Obesity Research Network (ACAORN have considerable and varied expertise in conducting such interventions and can provide insights into addressing these challenges. This paper aims to highlight considerations regarding the design, implementation, and evaluation of obesity prevention interventions with families and provide practical insights and recommendations for researchers and practitioners conducting family-based research in this area. Case studies of three family-based interventions conducted by ACAORN members are highlighted to provide examples and contextualise the recommendations proposed.
B.C. de Vos (Bastiaan)
markdownabstractThis thesis describes the results of the first preventive randomized controlled trial worldwide in the field of knee osteoarthritis. The preventive effectiveness of a tailor-made lifestyle intervention, consisting of diet and exercise, is described in detail. Short-term results
Full Text Available Intestinal microbiota (MI imbalance affects obesity development. Strategies to treat obesity involving to restore this balance, by manipulation of the MI. The effectiveness of fecal transplantation (FT in certain pathologies, supports as an alternative therapy. The community of Pima Indians (PI are a benchmark in the study of the etiology of diabetes mellitus type II and obesity. FT was analyzed as a preventive strategy in the development of obesity in PI. To do this, scientific evidence was collected through a qualitative systematic review from 2000 to 2013. The results showed an increase of 112% in the number of scientific publications that associate health to MI. 13% relate an association of MI with obesity. No studies of the MI composition for PI were found. Regarding the FT, was found that this was the treatment less used to restore microbiota. It was concluded that there is a growing scientific interest in the study of MI and two research gaps were evident: the MI composition for PI and studies about the use of FT to determine its effectiveness as a preventive therapy of obesity.
Aguilar Cordero, María José; Sánchez López, Antonio Manuel; Madrid Baños, Nayra; Mur Villar, Norma; Expósito Ruiz, Manuela; Hermoso Rodríguez, Enrique
Breastfeeding is a recommended practice from national and international institutions due to the health benefits that it provides, both for the nursling and for the mother. Nowadays, overweight and obesity result in greater morbidity along different life periods. The goal of this systematic review is to explore the characteristics of breastfeeding in the prevention of overweight and obesity during childhood. A systematic search has been carried out and 113 papers have been selected: 20 meta-analysis and reviews, 6 original papers of clinical trials, 42 cohort or longitudinal studies, 19 correlational studies, 24 descriptive studies and 2 books. According to the analysed papers, there is a causal relationship between breastfeeding and the prevention of childhood obesity. In the various studies explored, it has been observed that the maximum benefits of breastfeeding are obtained when its duration is longer than 6 months and when it extends for two years, complemented with other foodstuffs. Other studies show that breastfeeding is effective in obesity prevention, even when its duration is limited. It is also important that complementary foods are introduced after the first six months of age, so as to reduce food allergy risk and to prevent obesity. Similarly, the weight of the mother during pregnancy has been associated with childhood obesity, as well as the weight of the child when he was born and other factors like maternal smoking and socioeconomic status. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Conroy, S; Ellis, R; Murray, C; Chaw-Kant, J
To examine successful Canadian nursing and health promotion intervention programmes for childhood obesity prevention during gestation and infancy, an integrative review was performed of the literature from 1980 to September 2005. The following databases were used: PubMed; Cochrane Database of Systematic Reviews; Cochrane Controlled Trials Register; Database of Abstracts of Reviews of Effects; ACP Journal Club; MEDLINE; EMBASE; CINAHL; Web of Science; Scopus; Sociological Abstracts; Sport Discus; PsycInfo; ERIC and HealthStar. MeSH headings included: infancy (0-24 months), gestation, gestational diabetes, nutrition, prenatal care, pregnancy, health education, pregnancy outcome, dietary services with limits of Canadian, term birth. Of 2028 articles found, six Canadian childhood obesity prevention programmes implemented during gestation and/or infancy were found; three addressed gestational diabetes with five targeting low-income Canadian urban and/or Aboriginal populations. No intervention programmes specifically aimed to prevent childhood obesity during gestation or infancy. This paucity suggests that such a programme would be innovative and much needed in an effort to stem the alarming increase in obesity in children and adults. Any attempts either to develop new approaches or to replicate interventions used with obese adults or even older children need careful evaluation and pilot testing prior to sustained use within the perinatal period.
Brownell, Kelly D; Schwartz, Marlene B; Puhl, Rebecca M; Henderson, Kathryn E; Harris, Jennifer L
Record levels of obesity in children and adolescents are predictable in light of powerful conditions that promote high consumption of calorie-dense, nutrient-poor foods and discourage physical activity. Default conditions for youth are dangerous, and include multiple and relentless forms of marketing, poor foods promoted in schools, and a variety of other conditions that undermine personal resources, individual responsibility, and parental authority. This article discusses how optimal defaults can be created using five issues as examples: framing of the obesity issue, treating versus preventing obesity, nutrition in schools, marketing, and addressing weight bias and discrimination. By adopting a public health approach that addresses the conditions causing obesity, there is hope of reversing troubling trends in prevalence.
Fader, Amanda Nickles; Arriba, Lucybeth Nieves; Frasure, Heidi E; von Gruenigen, Vivian E
Endometrial cancer is the most common gynecologic malignancy in the Western world and is strongly associated with obesity. Despite the fact that most cases are diagnosed in early, more favorable stages, endometrial cancer incidence and mortality rates are on the rise. Morbidly obese women with endometrial cancer are more likely to die of their co-morbidities and also of their cancers when compared to their leaner cohorts. Given the increasing rates of morbid obesity in the United States, it is essential to develop appropriate screening tools and guidelines to reduce cancer morbidity and death amongst this group. Through an analysis of the existing literature, we present a review of the epidemiologic trends in obesity and endometrial cancer, discuss the promising role of screening biomarker studies, review prevention efforts and modifiable risk factors, and ways in which health outcomes and quality of life for endometrial cancer survivors may be optimized.
Full Text Available Overweight in children is more prevalent than ever before. What can parents do to try to promote health and prevent obesity in their own children? The present paper reviews research related to parenting and childhood obesity. The review describes what food-related parenting practices may be helpful: modeling healthy eating behaviors, making time for family meals, making sure healthy food is available and accessible, becoming aware of appropriate portion sizes, encouraging children to eat breakfast, and limiting soda and fast food intake. The paper also discusses food-related parenting practices that may not work to help prevent obesity: pressure to eat, food rewards, restriction, permissiveness, and modeling of unhealthy eating behaviors. Additional parenting practices such as supporting and engaging in physical activity, encouraging an adequate amount of sleep, and limiting television and other screen-media may also help children to maintain healthy weights. Suggestions are also given for professionals working with youth.
Fox, Ashley M; Horowitz, Carol R
The rapidly rising rate of obesity has prompted a variety of policy responses at national, regional, and local levels. Yet, many have expressed concern that these policy responses have a limited evidence base, are overly paternalistic, and have the potential to increase rather than shrink obesity-related disparities. The purpose of this article is to evaluate obesity policies in terms of the adequacy of evidence for action and along two ethical dimensions: their potential effect on liberty and equity. To evaluate evidence, we engage in a systematic review of reviews and rate policies in terms of the sufficiency of evidence of effectiveness at combating obesity. We then apply a libertarian-paternalist framework to assess policies in terms of their impact on liberty and inverse-equity theory to assess impact on disparities. This article provides a framework to assist decision-makers in assessing best practices in obesity using a more multi-faceted set of dimensions.
Riggs, Nathaniel; Tewari, Abha; Stigler, Melissa; Rodrigues, Lindsay; Arora, Monika; Khubchandani, Jagdish; Simmons, Rob; Pentz, Mary Ann
Childhood obesity has recently been reported as a growing problem in low- and middle-income countries. One potential prevention strategy is to apply effective obesity prevention approaches from the United States and/or other Western countries into programs that can be implemented in developing countries such as India. The purpose of this study was to explore Indian students' perceptions of social-contextual factors related to obesity and whether they perceived a role for school-based obesity prevention. This study was conducted as a first step in a model to translate interventions from one culture to another. A total of 183 fourth- and fifth-grade students of middle socioeconomic status participated in focus group discussions. Analyses were guided by the essential principles of qualitative research and informed by social cognitive and social ecological theories. Results yielded five relevant themes: (a) student health behavior knowledge, (b) parental influence on health behavior, (c) school influence on health behavior, (d) media influence on health behavior, and (e) contexts for health promotion intervention. We found that students had moderate knowledge related to health behaviors (i.e., food intake and physical activity); that parents, schools, and the media are all important contributors to healthy and unhealthy behavior; and that schools can play an important role in the prevention of obesity. Results suggest that Indian middle socioeconomic status students are already moderately aware of the health benefits to nutritious food intake and physical activity, but parents, schools, and the media can influence unhealthy behaviors.
Freeman, E; Fletcher, R; Collins, C E; Morgan, P J; Burrows, T; Callister, R
To examine the long-term effects of having one overweight or obese parent on child weight status and determine whether these effects vary according to parent sex. Prospective study: Longitudinal Study of Australian Children (LSAC). Two-parent families (N=3285) from the LSAC were included if height and weight data were available for both parents and their child at the 2004 and 2008 time points. Child weight status category (healthy, overweight, obese) in 2008 when the child was aged 8-9 years. Regression modelling was used to investigate how self-reported parent weight status in 2004 influenced measured child weight status 4 years later. Parent body mass index (BMI) was significantly correlated with child BMI, but there was no evidence of sex-specific associations between parent and child BMI correlations. The results from the regression analysis showed that having an overweight or obese father, but a healthy weight mother, significantly increased the odds of child obesity (odds ratio: 4.18, 95% confidence interval (CI): 1.01-17.33 and odds ratio: 14.88, 95% CI: 2.61-84.77, respectively), but the reverse scenario (overweight or obese mother with a healthy weight father) was not a significant predictor of child overweight or obesity (odds ratio: 2.52, 95% CI: 0.38-16.71 and odds ratio: 2.56, 95% CI: 0.31-21.26, respectively). Children with overweight or obese fathers are at a higher risk of becoming obese. This suggests that interventions are urgently required to test the efficacy of treating overweight fathers as a key strategy for childhood obesity prevention and/or treatment.
Xu, Fei; Ware, Robert S.; Leslie, Eva; Tse, Lap Ah; Wang, Zhiyong; Li, Jiequan; Wang, Youfa
Background Childhood obesity has been increasing rapidly worldwide. There is limited evidence for effective lifestyle interventions to prevent childhood obesity worldwide, especially in developing countries like China. The objective of this study was to assess the effectiveness of a school-based multi-component lifestyle childhood obesity prevention program (the CLICK-Obesity study) in Mainland China. Methods A cluster randomized controlled trial was developed among grade 4 students from 8 ur...
Bonde, Ane Høstgaard; Bentsen, Peter; Hindhede, Anette Lykke
Motivational interviewing is a counseling method used to bring about behavior change; its application by school nurses for preventing obesity in children is still new. This study, based on in-depth interviews with 12 school nurses, shows how school nurses adapted motivational interviewing and integrated it into their daily practice along with…
Lindsay, Ana C.; Sussner, Katarina M.; Kim, Juhee; Gortmaker, Steven
As researchers continue to analyze the role of parenting both in the development of childhood overweight and in obesity prevention, studies of child nutrition and growth are detailing the ways in which parents affect their children's development of food- and activity-related behaviors. Ana Lindsay, Katarina Sussner, Juhee Kim, and Steven Gortmaker…
Bruss, Mozhdeh B.; Dannison, Linda; Morris, Joseph R.; Quitugua, Jackie; Palacios, Rosa T.; McGowan, Judy; Michael, Timothy
This paper presents a community-school-higher education partnership approach to the prevention of childhood obesity. Public elementary school personnel, primarily teachers, participated in the design and delivery of a curriculum targeting primary caregivers of 8-9-year-old children. Theoretical framework and methodological approaches guided the…
Shaw, Heather; Ng, Janet; Stice, Eric
Increasingly, researchers in the areas of eating disorders and obesity prevention are recognizing the benefits of collaborative efforts aimed at curbing the spectrum of eating-related disturbances. Research suggests that eating disorders and overweight tend to co-occur, and that individuals cross over from one eating-related disturbance to…
Seidell, J C
The food industry is a critical factor in any potentially successful long-term strategy to prevent obesity. By producing new products low in energy density and improving the nutritional quality (and reducing the energy content) of existing products, as well as through advances in responsible
Zach Ferraro; Adamo, Kristi B
Global increases in obesity have led public health experts to declare this disease a pandemic. Although prevalent in all ages, the dire consequences associated with maternal obesity have a pronounced impact on the long-term health of their children as a result of the intergenerational effects of developmental programming. Previously, fetal under-nutrition has been linked to the predisposition to pediatric obesity explained by the adiposity rebound and ‘catch-up’ growth that occurs when a chil...
Raine, Kim D; Nykiforuk, Candace I J; Vu-Nguyen, Karen; Nieuwendyk, Laura M; VanSpronsen, Eric; Reed, Shandy; Wild, T Cameron
As overweight and obesity is a risk factor for chronic diseases, the development of environmental and healthy public policy interventions across multiple sectors has been identified as a key strategy to address this issue. In 2009, a survey was developed to assess the attitudes and beliefs regarding health promotion principles, and the priority and acceptability of policy actions to prevent obesity and chronic diseases, among key policy influencers in Alberta and Manitoba, Canada. Surveys were mailed to 1,765 key influencers from five settings: provincial government, municipal government, school boards, print media companies, and workplaces with greater than 500 employees. A total of 236 surveys were completed with a response rate of 15.0%. Findings indicate nearly unanimous influencer support for individual-focused policy approaches and high support for some environmental policies. Restrictive environmental and economic policies received weakest support. Obesity was comparable to smoking with respect to perceptions as a societal responsibility versus a personal responsibility, boding well for the potential of environmental policy interventions for obesity prevention. This level of influencer support provides a platform for more evidence to be brokered to policy influencers about the effectiveness of environmental policy approaches to obesity prevention. © 2014 The Obesity Society.
Hendriks, Anna-Marie; Delai, Mere Y; Thow, Anne-Marie; Gubbels, Jessica S; De Vries, Nanne K; Kremers, Stef P J; Jansen, Maria W J
In Fiji and other Pacific Island countries, obesity has rapidly increased in the past decade. Therefore, several obesity prevention policies have been developed. Studies show that their development has been hampered by factors within Fiji's policy landscape such as pressure from industry. Since policymakers in the Fijian national government are primarily responsible for the development of obesity policies, it is important to understand their perspectives; we therefore interviewed 15 policymakers from nine Fijian ministries. By applying the "attractor landscape" metaphor from dynamic systems theory, we captured perceived barriers and facilitators in the policy landscape. A poor economic situation, low food self-sufficiency, power inequalities, inappropriate framing of obesity, limited policy evidence, and limited resource sharing hamper obesity policy developments in Fiji. Facilitators include policy entrepreneurs and policy brokers who were active when a window of opportunity opened and who strengthened intersectoral collaboration. Fiji's policy landscape can become more conducive to obesity policies if power inequalities are reduced. In Fiji and other Pacific Island countries, this may be achievable through increased food self-sufficiency, strengthened intersectoral collaboration, and the establishment of an explicit functional focal unit within government to monitor and forecast the health impact of policy changes in non-health sectors.
Full Text Available In Fiji and other Pacific Island countries, obesity has rapidly increased in the past decade. Therefore, several obesity prevention policies have been developed. Studies show that their development has been hampered by factors within Fiji’s policy landscape such as pressure from industry. Since policymakers in the Fijian national government are primarily responsible for the development of obesity policies, it is important to understand their perspectives; we therefore interviewed 15 policymakers from nine Fijian ministries. By applying the “attractor landscape” metaphor from dynamic systems theory, we captured perceived barriers and facilitators in the policy landscape. A poor economic situation, low food self-sufficiency, power inequalities, inappropriate framing of obesity, limited policy evidence, and limited resource sharing hamper obesity policy developments in Fiji. Facilitators include policy entrepreneurs and policy brokers who were active when a window of opportunity opened and who strengthened intersectoral collaboration. Fiji’s policy landscape can become more conducive to obesity policies if power inequalities are reduced. In Fiji and other Pacific Island countries, this may be achievable through increased food self-sufficiency, strengthened intersectoral collaboration, and the establishment of an explicit functional focal unit within government to monitor and forecast the health impact of policy changes in non-health sectors.
Williamson, Donald A; Champagne, Catherine M; Harsha, David; Han, Hongmei; Martin, Corby K; Newton, Robert; Stewart, Tiffany M; Ryan, Donna H
There is a worldwide epidemic of obesity with far-reaching consequences for the health of our nation. Prevention of obesity, especially in children, has been deemed by public health policy makers to be one of the most important objectives for our country. This prevention project, called Louisiana (LA) Health, will test whether modification of environmental and behavioral factors can prevent inappropriate weight gain in children from rural parishes of Louisiana who are enrolled in the fourth to sixth grades during Year 1. The primary aim of the LA Health project is to test the efficacy of two school-based approaches for obesity prevention: primary prevention alone and a combination of primary and secondary prevention which will be compared to a no-intervention control group using a cluster randomization research design, with 17 school clusters randomly assigned to the three treatment arms. The study will span 3 years and will provide critical tests of strategies that: 1) modify the child's environment as a primary prevention strategy and 2) provide health behavior modification via classroom instruction and internet counseling as a secondary prevention strategy. The study will also recruit a similar sample of students to measure changes in body weight relative to height, gender, and age over the same three-year period.
Zhang, Yingmei; Ren, Jun
Uncorrected obesity has been associated with cardiac hypertrophy and contractile dysfunction. Several mechanisms for this cardiomyopathy have been identified, including oxidative stress, autophagy, adrenergic and renin-angiotensin aldosterone overflow. Another process that may regulate effects of obesity is epigenetics, which refers to the heritable alterations in gene expression or cellular phenotype that are not encoded on the DNA sequence. Advances in epigenome profiling have greatly improved the understanding of the epigenome in obesity, where environmental exposures during early life result in an increased health risk later on in life. Several mechanisms, including histone modification, DNA methylation and non-coding RNAs, have been reported in obesity and can cause transcriptional suppression or activation, depending on the location within the gene, contributing to obesity-induced complications. Through epigenetic modifications, the fetus may be prone to detrimental insults, leading to cardiac sequelae later in life. Important links between epigenetics and obesity include nutrition, exercise, adiposity, inflammation, insulin sensitivity and hepatic steatosis. Genome-wide studies have identified altered DNA methylation patterns in pancreatic islets, skeletal muscle and adipose tissues from obese subjects compared with non-obese controls. In addition, aging and intrauterine environment are associated with differential DNA methylation. Given the intense research on the molecular mechanisms of the etiology of obesity and its complications, this review will provide insights into the current understanding of epigenetics and pharmacological and non-pharmacological (such as exercise) interventions targeting epigenetics as they relate to treatment of obesity and its complications. Particular focus will be on DNA methylation, histone modification and non-coding RNAs. Copyright © 2016 Elsevier Inc. All rights reserved.
Emilly Souza Marques
Full Text Available This qualitative study was performed with six nurses of a public hospital, with the objective to describe their view of the meaning of providing care to obese patients. Interviews were conducted using a semi-structured script. The data were organized under themes extracted from the subjects’ statements, after being thoroughly read. Symbolic Interactionism was adopted to interpret the findings. The results from the analysis were organized under the following themes: Being obese is excessive, it is not healthy; Providing care to the obese is a structural issue; Obese patients are troublesome, they require care, no big deal; Providing care to the obese requires teamwork. The grasped meanings can interfere in the care provided. The nurses, however, recognize the need to work as a team to deliver comprehensive care. Making positive changes to the meanings found in this study is possible, thus, contributing to providing prejudice-free nursing care to obese patients. Descriptors: Obesity; Nursing Care; Hospital Care.
Sichieri, Rosely; Souza, Rita Adriana de
Few studies on treatment or prevention of obesity have shown significant results. Theoretically, in children and adolescents as compared to adults, prevention of excessive weight gain should be easy due to the energy expended during growth, associated with more time spent in leisure-time activities. However, numerous factors that stimulate overeating and sedentary behaviors are difficult to overcome. Additionally, most intervention studies have focused on a minor portion of the many factors associated with obesity. Important aspects of the obesity epidemic such as the role of the food industry, fast food chains, advertising, and a lifestyle that limits children to sedentary activities and overeating cannot be explored by a traditional clinical trial design. At any rate, among the published interventions, those including the family in weight-reduction strategies have shown the best results, as compared to children-centered approaches. Meanwhile, studies on specific nutrient or dietary composition (such as calcium, protein, or glycemic index) related to prevention or treatment of obesity have failed to yield good results. Reducing the intake of high-sugar carbonated drinks and juices has shown promising but still inconclusive results.
The increasing prevalence of obesity or overweight at all ages, their associated morbidity and mortality associated, and the increased perception of the problem by the society have generated several hypotheses in response to the scientific and the international community. Investigate the preventive interventions in childhood obesity so far. Integrative review during the study period from April 2013 to November 2014. The MEDLINE international database was used, including PubMed, the Cochrane Library (Issue 4 2002), the national database Isooc (CSIC) national database, as well as the Internet. The review included health articles published in Spanish and English between 1990 and 2014 that focused on or included education, prevention, diagnostic, and treatment of obesity interventions. Of the 726 articles identified, 34 of most relevant (peer reviewed) were selected. It was noted that there is limited generisable evidence on interventions that could be implemented in Primary Care or referral services available, although numerous studies suggest that improvements in the overweight are possible. Despite the abundant literature and that many institutions place childhood obesity as one of the priorities of Public Health, we face the paradox that the evidence on cost-effectiveness of prevention interventions is sparse. Knowing these gaps in knowledge should lead to filling them with rigorous and well-designed studies. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
ten Have, M; de Beaufort, I D; Teixeira, P J; Mackenbach, J P; van der Heide, A
Efforts to counter the rise in overweight and obesity, such as taxes on certain foods and beverages, limits to commercial advertising, a ban on chocolate drink at schools or compulsory physical exercise for obese employees, sometimes raise questions about what is considered ethically acceptable. There are obvious ethical incentives to these initiatives, such as improving individual and public health, enabling informed choice and diminishing societal costs. Whereas we consider these positive arguments to put considerable effort in the prevention of overweight indisputable, we focus on potential ethical objections against such an effort. Our intention is to structure the ethical issues that may occur in programmes to prevent overweight and/or obesity in order to encourage further debate. We selected 60 recently reported interventions or policy proposals targeting overweight or obesity and systematically evaluated their ethically relevant aspects. Our evaluation was completed by discussing them in two expert meetings. We found that currently proposed interventions or policies to prevent overweight or obesity may (next to the benefits they strive for) include the following potentially problematic aspects: effects on physical health are uncertain or unfavourable; there are negative psychosocial consequences including uncertainty, fears and concerns, blaming and stigmatization and unjust discrimination; inequalities are aggravated; inadequate information is distributed; the social and cultural value of eating is disregarded; people's privacy is disrespected; the complexity of responsibilities regarding overweight is disregarded; and interventions infringe upon personal freedom regarding lifestyle choices and raising children, regarding freedom of private enterprise or regarding policy choices by schools and other organizations. The obvious ethical incentives to combat the overweight epidemic do not necessarily override the potential ethical constraints, and further
Melanie A. Ferris
Full Text Available Obesity is a growing issue for all children. Many experts say that preventing obesity is largely a matter of eating the right foods and getting enough physical activity. This advice doesn’t recognize the fact that First Nations, Inuit, and Métis children face unique barriers to growing up healthy and strong simply because of theiridentity. This paper discusses how the social determinants of health impact the ability of Aboriginal children to grow up free of obesity. The paper highlights results from a community-based research project conducted amongst Aboriginal parents and service providers in Ontario who wish to prevent obesity amongst their ownyoung children and clients. Research was carried out over two years to help develop a “toolkit” and training program to help service provides increase efforts to prevent obesity amongst First Nations, Inuit, and Métis children from the ages of 2 to 6 in Ontario.
Kipping, R R; Payne, C; Lawlor, D A
To determine whether a school obesity prevention project developed in the United States can be adapted for use in England. A pilot cluster randomised controlled trial and interviews with teachers were carried out in 19 primary schools in South West England. Participants included 679 children in year 5 (age 9-10). Baseline and follow-up assessments were completed for 323 children (screen viewing) and 472 children (body mass index). Sixteen lessons on healthy eating, physical activity and reducing TV viewing were taught over 5 months by teachers. Main outcome measures were hours of screen activities, body mass index, mode of transport to school and teachers' views of the intervention. Children from intervention schools spent less time on screen-viewing activities after the intervention but these differences were imprecisely estimated: mean difference in minutes spent on screen viewing at the end of the intervention (intervention schools minus control schools) adjusted for baseline levels and clustering within schools was -11.6 (95% CI -42.7 to 19.4) for a week day and was -15.4 (95% CI -57.5 to 26.8) for a Saturday. There was no difference in mean body mass index or the odds of obesity. It is feasible to transfer this US school-based intervention to UK schools, and it may be effective in reducing the time children spend on screen-based activities. The study has provided information for a full-scale trial, which would require 50 schools ( approximately 1250 pupils) to detect effects on screen viewing and body mass index over 2 years of follow-up.
Full Text Available African American girls are at a greater risk of obesity than their nonminority peers. Parents have the primary control over the home environment and play an important role in the child obesity prevention. Obesity prevention programs to help parents develop an obesity-preventive home environment are needed. The purpose of this study was to collect formative research from parents of 8–10-year old African American girls about perceptions, expectations, and content for a text messaging based program. Mothers (n = 30 participated in surveys and interviews to inform message development and content. A professional expert panel (n = 10 reviewed draft text messages via a survey. All the mothers reported owning a cellphone with an unlimited texting plan, and they used their cellphones for texting (90.0% and accessing the Internet (100.0%. The majority were interested in receiving text messages about healthy eating and physical activity (86.7%. Interviews confirmed survey findings. One hundred and seven text messages promoting an obesity-preventive home environment were developed. The expert panel and parents reported positive reactions to draft text messages. This research provides evidence that mobile health (mHealth interventions appeal to parents of African American girls and they have ready access to the technology with which to support this approach.
Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana
Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention. PMID:27649218
Full Text Available Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention.
Donaldson, Elisabeth A; Cohen, Joanna E; Villanti, Andrea C; Kanarek, Norma F; Barry, Colleen L; Rutkow, Lainie
This study examined bill- and state-level factors associated with enactment of adult obesity prevention legislation in US states. A review of bills in the Rudd Center for Food Policy and Obesity's legislative database identified 487 adult obesity prevention bills, or proposed legislation, introduced between 2010 and 2013. Multilevel models were constructed to examine bill- and state-level characteristics associated with enactment. From 2010 to 2013, 81 (17%) of obesity prevention bills introduced were enacted across 35 states and the District of Columbia. Bills introduced in 2010 were more likely to be enacted than in 2013 (OR=9.49; 95% CI: 2.61-34.5). Bills focused on access to healthy food, physical activity, general and educational programs, as well as modifying rules and procedures (e.g., preemption) had greater odds of enactment relative to food and beverage taxes (OR=8.18; 95% CI: 2.85-23.4 healthy food; OR=17.3; 95% CI: 4.55-65.7 physical activity; OR=15.2; 95% CI: 4.80-47.9 general; OR=13.7; 95% CI: 3.07-61.5 rules). The year of bill introduction and overall bill enactment rate were related to adult obesity prevention legislation enactment in states. This study highlights the importance of a bill's topic area for enactment and provides insights for advocates and policymakers trying to address enactment barriers. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Childhood obesity has been increasing rapidly worldwide. There is limited evidence for effective lifestyle interventions to prevent childhood obesity worldwide, especially in developing countries like China. The objective of this study was to assess the effectiveness of a school-based multi-component lifestyle childhood obesity prevention program (the CLICK-Obesity study in Mainland China.A cluster randomized controlled trial was developed among grade 4 students from 8 urban primary schools (638 students in intervention, 544 as control in Nanjing City, China. Students were randomly allocated to the control or intervention group at school-level. A one-year multi-component intervention program (classroom curriculum, school environment support, family involvement and fun programs/events together with routine health education was provided to the intervention group, while the control group received routine health education only. The main outcome variables assessed were changes in body mass index, obesity occurrence, obesity-related lifestyle behaviors and knowledge.Overall, 1108 (93.7% of the 1182 enrolled students completed the intervention study. The intervention group had a larger marginal reduction than did the control group in overall mean BMI value (-0.32±1.36 vs. -0.29±1.40, p = 0.09, although this was not significant. Compared with the control group, the intervention group was more likely to decrease their BMI (OR = 1.44, 95%CI = 1.10, 1.87 by 0.5 kg/m2 or above, increase the frequency of jogging/running (OR = 1.55, 95%CI = 1.18, 2.02, decrease the frequency of TV/computer use (OR = 1.41, 95%CI = 1.09, 1.84 and of red meat consumption (OR = 1.50, 95%CI = 1.15, 1.95, change commuting mode to/from school from sedentary to active mode (OR = 2.24, 95%CI = 1.47, 3.40, and be aware of the harm of selected obesity risk factors.The school-based lifestyle intervention program was practical and effective in improving health behaviors and obesity
Goodman, Harold S; Manski, Marion C; Williams, John N; Manski, Richard J
Understanding preventive dental visit utilization patterns facilitates planning of the dental health services delivery system. The authors examine these patterns by analyzing the receipt of preventive dental services in the United States by type of dental provider. The authors analyzed data from the 1996 Medical Expenditure Panel Survey (MEPS) for the U.S. community-based population. They developed national estimates for the population with preventive dental visits by provider type, including the population with a preventive dental visit and mean number of preventive dental visits per person for socioeconomic and demographic categories. Respondents who are white, are older, are female, have dental insurance, are from higher income and education backgrounds, and reside in small metropolitan areas were more likely (P output of all services rendered in their practices, including preventive services.
Petrin, Christine; Kahan, Scott; Turner, Monique; Gallagher, Christine; Dietz, William H
Relatively few patients receive obesity counselling consistent with the USPSTF guidelines, and many health care professionals (HCPs) are biased in their attitudes towards obesity management. A national sample of family physicians, internists, OB/GYN physicians, and nurse practitioners (NPs) completed a web-based survey of beliefs, practice, and knowledge regarding obesity management. A majority of HCPs believe that it is both the patient's and the provider's responsibility to ensure that the patient is counselled about obesity. Obesity (77%), obesity-related diseases (79%), or obesity-related risk factors (71%) prompt HCPs to offer obesity counselling; 59% of HCPs wait for the patient to broach the subject of their weight. Increased blood pressure (89%) and heart disease risks (90%) are the most common themes in counselling. Across all HCPs except NPs "exercise" is discussed more frequently than "physical activity" (85% vs 81%), "diet" more frequently than "eating habits" (77% vs 75%), and "obesity" more frequently than "unhealthy weight" (60% vs 45%). NPs are more likely to discuss physical activity, eating habits, and unhealthy weight instead. To improve counselling for obesity, HCPs reported needing more time (70%), training in obesity management (53%), improved reimbursement (53%), and better tools to help patients recognise obesity risks (50%). Obesity-related diseases, risk factors, or obesity alone predict obesity counselling amongst HCPs. Better training in weight management and tools to help patients recognise risks appear to be key elements in helping patients compare the risks of what they may consider invasive therapy against the risks of continued obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Hung, Ling-Shen; Tidwell, Diane K; Hall, Michael E; Lee, Michelle L; Briley, Chiquita A; Hunt, Barry P
Childhood obesity is a global concern. The objectives of this meta-analytical study were to evaluate the effectiveness of school-based childhood obesity prevention programs, and to examine program components (moderators). The methods included searching databases (PubMed, Google Scholar, and the university's EBSCOhost Web service) as well as handsearching reference lists of articles published in English. Selection criteria for studies to be included in the meta-analysis were limited to studies that reported body mass index (BMI) or skinfold thickness as outcome measures and were school-based obesity prevention interventions; cross-sectional design studies were excluded. We hypothesized the meta-analysis would yield a summary effect size of magnitude which would indicate that school-based interventions have been effective in improving children's BMI or skinfold thickness values. A total of 26 114 children from 27 school-based childhood obesity prevention programs provided 54 effect sizes. A random-effects model calculated a small summary effect size of 0.039 (95% confidence interval -0.013 to 0.092). Heterogeneity among studies was observed which disappeared after pooling studies that used a randomized controlled trial design with one program moderator (physical activity or nutrition). We failed to accept our hypothesis and concluded that overall, school-based interventions have not been effective for improving body mass index or skinfold thickness to curb childhood obesity; however, randomized controlled trials that focused on physical activity or nutrition appeared to produce promising results. Copyright © 2015 Elsevier Inc. All rights reserved.
Solomon, Jeffrey L; Gifford, Allen L; Asch, Steven M; Meuller, Nora; Thomas, Colin M; Stevens, John M; Bokhour, Barbara G
Preventive care is an essential element of comprehensive primary care medicine, yet many providers do not address the full range of recommended preventive care services. There is little understanding of how, during time-constrained clinical encounters, providers prioritize preventive care services. To identify and compare how Department of Veterans Affairs (VA) primary care providers (PCPs) prioritized general preventive care services, including HIV testing. A semistructured, qualitative interview design. We conducted semistructured phone interviews with 31 PCPs across 2 urban VA facilities. Interviews entailed questions about the most common preventive care services in primary care, how decisions are made to address some preventive care services but not others, and the role of clinical reminders (CRs) in prioritizing care. Interviews were audio-recorded and transcribed verbatim. We conducted an iterative thematic analysis of interview transcripts, utilizing NVivo 8, a qualitative data management and coding software. Most PCPs indicated they did not utilize CRs as a primary means of prioritizing general preventive care. Instead, PCPs prioritized general preventive care by attending to patients' individual needs and/or keeping in mind influential clinical training experiences. Prioritizing HIV testing included 1 or a combination of the following strategies: being attuned to HIV risk factors prior to the appearance of the CR, being prompted by the CR, and having a positive attitude toward CR design. Prioritizing preventive care can be accomplished using various strategies, including CRs. Healthcare systems might benefit from encouraging PCPs to use a range of strategies.
Alexandre Paulo Machado
Full Text Available Summary Objective: The main goal of this work was to produce a review of educational strategies to prevent diabetes, hypertension, and obesity. Method: PubMed database was consulted using combined descriptors such as [Prevention], [Educational Activities], [Diabetes], [Hypertension], and [Obesity]. Data from randomized trials published between 2002 and 2014 were included in spreadsheets for analysis in duplicate by the reviewers. Results: A total of 8,908 articles were found, of which 1,539 were selected about diabetes mellitus (DM, n=369, arterial systemic hypertension (ASH, n=200, and obesity (OBES, n=970. The number of free full text articles available was 1,075 (DM = 276, ASH = 118 and OBES = 681. In most of these studies, demographic characteristics such as gender and age were randomized, and the population mainly composed by students, ethnic groups, family members, pregnant, health or education professionals, patients with chronic diseases (DM, ASH, OBES or other comorbidities. Group dynamics, physical activity practices, nutritional education, questionnaires, interviews, employment of new technologies, people training and workshops were the main intervention strategies used. Conclusion: The most efficient interventions occurred at community level, whenever the intervention was permanent or maintained for long periods, and relied on the continuous education of community health workers that had a constant interference inside the population covered. Many studies focused their actions in children and adolescents, especially on students, because they were more influenced by educational activities of prevention, and the knowledge acquired by them would spread more easily to their family and to society.
Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study.
Hoelscher, Deanna M; Butte, Nancy F; Barlow, Sarah; Vandewater, Elizabeth A; Sharma, Shreela V; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O; Durand, Casey; Li, Linlin; Kelder, Steven H
There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity.
Incorporating Primary and Secondary Prevention Approaches To Address Childhood Obesity Prevention and Treatment in a Low-Income, Ethnically Diverse Population: Study Design and Demographic Data from the Texas Childhood Obesity Research Demonstration (TX CORD) Study
Butte, Nancy F.; Barlow, Sarah; Vandewater, Elizabeth A.; Sharma, Shreela V.; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O.; Durand, Casey; Li, Linlin; Kelder, Steven H.
Abstract Background: There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2–12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Methods: Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Results: Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3–83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Conclusions: Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity. PMID:25555188
Full Text Available Jean Rankin,1 Lynsay Matthews,2 Stephen Cobley,3 Ahreum Han,3 Ross Sanders,3 Huw D Wiltshire,4 Julien S Baker5 1Department of Maternal and Child Health, University of the West of Scotland, Paisley, 2MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland; 3Department of Exercise and Sport Science, University of Sydney, Sydney, Australia; 4Cardiff School of Sport/Ysgol Chwaraeon Caerdydd, Cardiff Metropolitan University, Cardiff, UK; 5School of Science and Sport, Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, Scotland Abstract: Childhood obesity is one of the most serious public health challenges of the 21st century with far-reaching and enduring adverse consequences for health outcomes. Over 42 million children <5 years worldwide are estimated to be overweight (OW or obese (OB, and if current trends continue, then an estimated 70 million children will be OW or OB by 2025. The purpose of this review was to focus on psychiatric, psychological, and psychosocial consequences of childhood obesity (OBy to include a broad range of international studies. The aim was to establish what has recently changed in relation to the common psychological consequences associated with childhood OBy. A systematic search was conducted in MEDLINE, Web of Science, and the Cochrane Library for articles presenting information on the identification or prevention of psychiatric morbidity in childhood obesity. Relevant data were extracted and narratively reviewed. Findings established childhood OW/OBy was negatively associated with psychological comorbidities, such as depression, poorer perceived lower scores on health-related quality of life, emotional and behavioral disorders, and self-esteem during childhood. Evidence related to the association between attention-deficit/hyperactivity disorder (ADHD and OBy remains unconvincing because of various findings
Rankin, Jean; Matthews, Lynsay; Cobley, Stephen; Han, Ahreum; Sanders, Ross; Wiltshire, Huw D; Baker, Julien S
Childhood obesity is one of the most serious public health challenges of the 21st century with far-reaching and enduring adverse consequences for health outcomes. Over 42 million children childhood obesity (OBy) to include a broad range of international studies. The aim was to establish what has recently changed in relation to the common psychological consequences associated with childhood OBy. A systematic search was conducted in MEDLINE, Web of Science, and the Cochrane Library for articles presenting information on the identification or prevention of psychiatric morbidity in childhood obesity. Relevant data were extracted and narratively reviewed. Findings established childhood OW/OBy was negatively associated with psychological comorbidities, such as depression, poorer perceived lower scores on health-related quality of life, emotional and behavioral disorders, and self-esteem during childhood. Evidence related to the association between attention-deficit/hyperactivity disorder (ADHD) and OBy remains unconvincing because of various findings from studies. OW children were more likely to experience multiple associated psychosocial problems than their healthy-weight peers, which may be adversely influenced by OBy stigma, teasing, and bullying. OBy stigma, teasing, and bullying are pervasive and can have serious consequences for emotional and physical health and performance. It remains unclear as to whether psychiatric disorders and psychological problems are a cause or a consequence of childhood obesity or whether common factors promote both obesity and psychiatric disturbances in susceptible children and adolescents. A cohesive and strategic approach to tackle this current obesity epidemic is necessary to combat this increasing trend which is compromising the health and well-being of the young generation and seriously impinging on resources and economic costs.
Wacker, Julia; Bosley, Eric; Bolling, Christopher
As childhood obesity rates continue to rise, increasing numbers of pediatric providers are advocating for healthier environments outside clinic walls. Understanding the role of the pediatrician in childhood obesity advocacy within the context of the socioecological model helps ground engagement efforts. Once a project is underway, applying evidence-based obesity clinical care principles to community-focused work creates a template for engaging with partners and developing an intervention. In addition to content expertise, providers can guide community partners through the project development process, particularly in setting realistic goals and determining relevant, attainable health outcomes. Capitalizing on existing advocacy resources designed for busy pediatricians, specifically those available through national and state chapters of the American Academy of Pediatrics, aids in initiating or continuing any community-engaged effort. Copyright 2014, SLACK Incorporated.
Reifsnider, Elizabeth; McCormick, David P; Cullen, Karen W; Szalacha, Laura; Moramarco, Michael W; Diaz, Abigail; Reyna, Lucy
Early and rapid growth in Infants is strongly associated with early development and persistence of obesity in young children. Substantial research has linked child obesity/overweight to increased risks for serious health outcomes, which include adverse physical, psychological, behavioral, or social consequences. The goal of this study is to compare the effectiveness of structured Community Health Worker (CHW)--provided home visits, using an intervention created through community-based participatory research, to standard care received through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) office visits in preventing the development of overweight (weight/length ≥ 85th percentile) and obesity (weight/length ≥ 95th percentile) in infants during their first 3 years of life. One hundred forty pregnant women in their third trimester (30-36 weeks) will be recruited and randomly assigned to the intervention or control group. This study will provide prospective data on the effects of an intervention to prevent childhood obesity in children at high risk for obesity due to ethnicity, income, and maternal body mass index (BMI). It will have wide-ranging applicability and the potential for rapid dissemination through the WIC program, and will demonstrate the effectiveness of a community approach though employing CHWs in preventing obesity during the first 3 years of life. This easy-to-implement obesity prevention intervention can be adapted for many locales and diverse communities and can provide evidence for policy change to influence health throughout life. Clinical Trials Number: NCT01905072.
Margaret A. Allman-Farinelli
Full Text Available Young adulthood is a vulnerable period for weight gain and the health consequences of becoming obese during this life-stage of serious concern. Some unhealthy dietary habits are typical of young adults in many developed nations encountering the obesity epidemic. These include high sugar-sweetened beverage consumption, lower vegetable intake and greater consumption of foods prepared outside the home including fast foods. Each of these dietary behaviours may place young adults at increased risk for overweight and obesity. Evidence suggests many young adults with unhealthy nutrition behaviours are not considering nor preparing to make changes. To improve their nutrition and health as they progress through the lifecycle requires approaches specifically targeted to this age group. Strategies and programs should include both individual level and population approaches. The evidence base for prevention of weight gain and halting overweight and obesity in young adulthood is currently small with few studies of high quality. Studies modifying food environments in colleges and universities are also of limited quality, but sufficiently promising to conduct further research employing better, more sophisticated, study designs and additionally to include health outcome measures. More research into programs tailored to the needs of young adults is warranted with several studies already underway.
This chapter surveys two segments of the economic literature on pediatric obesity: first, research regarding the impact of childhood obesity on health care expenditure, and second, research evaluating the cost-effectiveness of programs to prevent pediatric obesity. Evidence in support of the hypothesis that obese children and adolescents have higher health care costs than their otherwise similar healthy-weight peers has been found for female adolescents. Studies trying to calculate the complete lifetime health care costs attributable to childhood obesity are missing. Only a small number of studies assessing the cost-effectiveness of preventive obesity interventions among children have been published until now. The results call for the inclusion of nutrition behavior as an intervention target. There is some evidence that childhood obesity prevention might be successful in combining health gains with cost savings. However, it is not possible to rank the interventions according to their cost-effectiveness or to assess the generalizability of their results. Cost-effectiveness increasingly will be a major consideration in public reimbursement decisions. Therefore, evaluation research has to pay more attention to the economic aspects of new health technologies. Without providing good value for money, those technologies probably will not turn from inventions to innovations in health care. Moreover, future research should address various methodological and conceptual challenges and limitations which economic evaluations of preventive interventions into childhood obesity are faced with. Copyright © 2010 S. Karger AG, Basel.
Kain, Juliana; Concha, Fernando; Moreno, Lorena; Leyton, Bárbara
To evaluate the effectiveness of a 12-month multicomponent obesity prevention intervention. Setting. 9 elementary schools in Santiago, Chile. Subjects. 6-8 y old low-income children (N = 1474). Randomized controlled study; 5 intervention/4 control schools. We trained teachers to deliver nutrition contents and improve the quality of PE classes. We determined % healthy snacks brought from home, children's nutrition knowledge, nutritional status, duration of PE classes, and % time in moderate/vigorous activity (MVA). Effectiveness was determined by comparing Δ BMI Z between intervention and control children using PROCMIXED. % obesity increased in boys from both types of schools and in girls from control schools, while decreasing in girls from intervention schools (all nonsignificant). % class time in MVA declined (24.5-16.2) while remaining unchanged (24.8-23.7%) in classes conducted by untrained and trained teachers, respectively. In boys, BMI Z declined (1.33-1.24) and increased (1.22-1.35) in intervention and control schools, respectively. In girls, BMI Z remained unchanged in intervention schools, while increasing significantly in control schools (0.91-1.06, P = 0.024). Interaction group ∗ time was significant for boys (P < 0.0001) and girls (P = 0.004). This intervention was effective in controlling obesity, but not preventing it. Even though impact was small, results showed that when no intervention is implemented, obesity increases.
Full Text Available Objective. To evaluate the effectiveness of a 12-month multicomponent obesity prevention intervention. Setting. 9 elementary schools in Santiago, Chile. Subjects. 6–8 y old low-income children (N=1474. Design. Randomized controlled study; 5 intervention/4 control schools. We trained teachers to deliver nutrition contents and improve the quality of PE classes. We determined % healthy snacks brought from home, children’s nutrition knowledge, nutritional status, duration of PE classes, and % time in moderate/vigorous activity (MVA. Effectiveness was determined by comparing Δ BMI Z between intervention and control children using PROCMIXED. Results. % obesity increased in boys from both types of schools and in girls from control schools, while decreasing in girls from intervention schools (all nonsignificant. % class time in MVA declined (24.5–16.2 while remaining unchanged (24.8–23.7% in classes conducted by untrained and trained teachers, respectively. In boys, BMI Z declined (1.33–1.24 and increased (1.22–1.35 in intervention and control schools, respectively. In girls, BMI Z remained unchanged in intervention schools, while increasing significantly in control schools (0.91–1.06, P=0.024. Interaction group * time was significant for boys (P<0.0001 and girls (P=0.004. Conclusions. This intervention was effective in controlling obesity, but not preventing it. Even though impact was small, results showed that when no intervention is implemented, obesity increases.
Background Social marketing integrates communication campaigns with behavioural and environmental change strategies. Childhood obesity programs could benefit significantly from social marketing but communication campaigns on this issue tend to be stand-alone. Methods A large-scale multi-setting child obesity prevention program was implemented in the Hunter New England (HNE) region of New South Wales (NSW), Australia from 2005–2010. The program included a series of communication campaigns promoting the program and its key messages: drinking water; getting physically active and; eating more vegetables and fruit. Pre-post telephone surveys (n = 9) were undertaken to evaluate awareness of the campaigns among parents of children aged 2–15 years using repeat cross-sections of randomly selected cohorts. A total of 1,367 parents (HNE = 748, NSW = 619) participated. Results At each survey post baseline, HNE parents were significantly more likely to have seen, read or heard about the program and its messages in the media than parents in the remainder of the state (p communication campaigns increased and maintained awareness of childhood obesity prevention messages. Moreover, messages were delivered equitably to diverse socio-demographic groups within the region. PMID:24090174
Full Text Available A dramatic increase in childhood overweight/obesity has been recognized globally over the past 50 years. This observed increase may reflect genetic, as well as psychological, environmental, and socio-cultural influences. In the first part of this review we present an updated summary of the psychosocial factors associated with this change and discuss possible ways in which they operate. Among these factors , lower socio economic status (in both industrialized and non-industrialized countries, being female, belonging to a minority group, and being exposed to adverse life events may all be associated with a greater risk of childhood overweight/obesity. These influences may be mediated via a variety of mechanisms, in particular above average food intake of low nutritional quality, and reduction in physical activity. Other important psychosocial mediators include the influence of the family and peer environment, and exposure to the media.In the second part of the review we discuss the potential of psychosocial prevention programs to intervene in the processes involved in the rise of childhood overweight/obesity. Two points are emphasized. Firstly, prevention programs should be multidisciplinary, combining the knowledge of experts from different professions, and taking into consideration the important role of the family environment and relevant influential social organizations, particularly school. Secondly, effective change is unlikely to occur without large-scale programs carried out on a public policy level.
Tinanoff, Norman; Holt, Katrina
The Robert Wood Johnson Foundation (RWJF) has worked to ensure that all children have healthy weights. To promote this goal, the RWJF has supported the Healthy Futures: Engaging the Oral Health Community in Childhood Obesity Prevention National Conference, held on November 3-4, 2016, and the proceeding of this conference. The goals of the conference were to increase understanding of the science focusing on oral health and childhood obesity, increase understanding of how to prevent childhood obesity, and provide opportunities to network and plan activities to prevent childhood obesity. The papers prepared for the conference identified through systematic reviews or scoping reviews the state of the science related to preventing childhood obesity and reducing children's consumption of sugar-sweetened beverages and strategies that oral health professionals and organizations can employ prevent childhood obesity. Causes of childhood obesity are multifactorial and include genetic components, environmental and lifestyle variables, and nutritional factors. Dental caries also is caused by a combination of factors, including cariogenic diet, inadequate fluoride exposure, a susceptible host, and the presence of caries-causing bacteria in the oral cavity. One key risk factors for both obesity and caries is excessive sugar consumption. To reduce the risk of obesity and dental caries in children, health professionals and parents need to be aware of the sugar content of processed foods and beverages as well as of current daily sugar-consumption recommendations. Additionally, oral health professionals must become more engaged in identifying children who are at risk for obesity and dental caries; and provide education, screening and referral to reduce these risks. © 2017 American Association of Public Health Dentistry.
Pettigrew, Simone; Borys, Jean Michel; du Plessis, Hugues Ruault; Walter, Lea; Huang, Terry T-K; Levi, Jeffrey; Vinck, Jan
While it is acknowledged that child obesity interventions should cover multiple ecological levels (downstream, midstream and upstream) to maximize their effectiveness, there is a lack of evaluation data to guide the development and implementation of such efforts. To commence addressing this knowledge gap, the present study provides process evaluation data relating to the experiences of groups implementing the EPODE approach to child obesity prevention in various locations around the world. The aim of this exploratory study was to investigate the barriers and facilitators to program implementation in program sites around the world to assist in developing strategies to enhance program outcomes. An online survey that included open-ended questions was distributed to the 25 EPODE programs in operation at the time of the survey (May 2012). The survey items asked respondents to comment on those aspects of program implementation that they found challenging and to suggest areas for future improvement. Eighteen programs representing 14 countries responded to the request to participate in the survey, yielding a 72% response rate. The responses were analyzed via the constant comparative method using NVivo qualitative data analysis software. The main concerns of the various EPODE programs were their ability to secure ongoing funding and their access to evidence-based intervention methods and policy advice relating to relationships with third parties. These issues were in turn impacted by other factors, including (i) access to user-friendly information relating to the range of intervention strategies available and appropriate evaluation measures; (ii) assistance with building and maintaining stakeholder relationships; and (iii) assurance of the quality, independence, and transparency of policies and practices. The findings are facilitating the ongoing refinement of the EPODE approach. In particular, standardized and tailored information packages are being made available to
Kornet-van der Aa, D A; van Randeraad-van der Zee, C H; Mayer, J; Borys, J M; Chinapaw, M J M
The present study aimed to enrich the scientific evidence on obesity prevention programmes for adolescents from socio-economically disadvantaged backgrounds with practice-based experiences from both scientific and professional experts in the field of youth obesity prevention. We used the participatory method of concept mapping. Two concept mapping sessions were conducted: one with programme coordinators of national/regional obesity prevention programmes across Europe (n = 8) and one with scientists participating in European obesity prevention projects (n = 5). Five recommendations were extracted from both concept maps: (1) involve adolescents in the design and delivery of the programme, (2) invest in family/parental capacity building, (3) provide and support a healthy school food and physical activity environment, (4) regulate exposure to unhealthy messages/advertising and (5) facilitate safe and active travel. These recommendations can be used as a conceptual framework for programme development for preventing obesity in adolescents. © 2017 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.
Apovian, Caroline M; Garvey, W Timothy; Ryan, Donna H
Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient's disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. This supplement provides a topical update of obesity management, including clinical practice examples, for healthcare
Christine M.W. Totura
Conclusion: Obesity prevention strategy implementation relies on the supportiveness and structure of school climates. Barriers to prevention can impede efforts despite school commitment toward prevention, while stakeholder collaboration can enhance the likelihood that practices are in place.
Katzmarzyk, PT; Barlow, S; Bouchard, C; Catalano, PM; Hsia, DS; Inge, TH; Lovelady, C; Raynor, H; Redman, LM; Staiano, AE; Spruijt-Metz, D; Symonds, ME; Vickers, M; Wilfley, D; Yanovski, JA
The 2013 Pennington Biomedical Research Center’s Scientific Symposium focused on the treatment and management of pediatric obesity and was designed to (i) review recent scientific advances in the prevention, clinical treatment and management of pediatric obesity, (ii) integrate the latest published and unpublished findings and (iii) explore how these advances can be integrated into clinical and public health approaches. The symposium provided an overview of important new advances in the field, which led to several recommendations for incorporating the scientific evidence into practice. The science presented covered a range of topics related to pediatric obesity, including the role of genetic differences, epigenetic events influenced by in utero development, pre-pregnancy maternal obesity status, maternal nutrition and maternal weight gain on developmental programming of adiposity in offspring. Finally, the relative merits of a range of various behavioral approaches targeted at pediatric obesity were covered, together with the specific roles of pharmacotherapy and bariatric surgery in pediatric populations. In summary, pediatric obesity is a very challenging problem that is unprecedented in evolutionary terms; one which has the capacity to negate many of the health benefits that have contributed to the increased longevity observed in the developed world. PMID:24662696
Katzmarzyk, P T; Barlow, S; Bouchard, C; Catalano, P M; Hsia, D S; Inge, T H; Lovelady, C; Raynor, H; Redman, L M; Staiano, A E; Spruijt-Metz, D; Symonds, M E; Vickers, M; Wilfley, D; Yanovski, J A
The 2013 Pennington Biomedical Research Center's Scientific Symposium focused on the treatment and management of pediatric obesity and was designed to (i) review recent scientific advances in the prevention, clinical treatment and management of pediatric obesity, (ii) integrate the latest published and unpublished findings and (iii) explore how these advances can be integrated into clinical and public health approaches. The symposium provided an overview of important new advances in the field, which led to several recommendations for incorporating the scientific evidence into practice. The science presented covered a range of topics related to pediatric obesity, including the role of genetic differences, epigenetic events influenced by in utero development, pre-pregnancy maternal obesity status, maternal nutrition and maternal weight gain on developmental programming of adiposity in offspring. Finally, the relative merits of a range of various behavioral approaches targeted at pediatric obesity were covered, together with the specific roles of pharmacotherapy and bariatric surgery in pediatric populations. In summary, pediatric obesity is a very challenging problem that is unprecedented in evolutionary terms; one which has the capacity to negate many of the health benefits that have contributed to the increased longevity observed in the developed world.
Kim, Min Jeong; Sung, Eunju; Choi, Eun Young; Ju, Young-Su; Park, Eal-Whan; Cheong, Yoo-Seock; Yoo, Sunmi; Park, Kyung Hee; Choi, Hyung Jin; Kim, Seolhye
Background The prevalence of childhood obesity in South Korea has increased owing to economic improvement and the prevailing Westernized dietary pattern. As the incidence of chronic diseases caused by obesity is also expected to increase, effective interventions to prevent childhood obesity are needed. Therefore, we conducted a Delphi study to determine the priorities of a potential intervention research on childhood obesity prevention and its adequacy and feasibility. Methods The two-round D...
Full Text Available Obesity is a topical medical and social problem. Prevalence of obesity is increasing among children. The number of children under 5 years of age with overweight and obesity in the world is 44 millions. Obesity in childhood is a risk factor for the development of severe concomitant pathologies. Childhood obesity is an important prognostic factor for obesity in adults. Measures to prevent and treat childhood obesity should be directed not only to the child, but also to the whole family. To prevent obesity, excessive calorie intake should be limited. To increase the effectiveness of preventing obesity among children, we should combine reduction of energy intake with an increased physical activity. Lifestyle modification (correction of nutrition, exercise and behavioral therapy is the main method of treating children’s obesity. Introduction of school programs that increase physical activity and optimize the nutrition improve the effectiveness of treatment for childhood obesity. In case of ineffectiveness of lifestyle modification, pharmacotherapy may be prescribed. Orlistat is a medication for the treatment of obesity in children. The effectiveness of pharmacotherapy is enhanced when it is combined with integrated programs of lifestyle modification. Bariatric surgery should be used in cases of morbid obesity or failure of non-surgical treatment. Surgical treatment leads to body mass index decrease, improvement of concomitant diseases and quality of life. Bariatric surgery also has a risk of side effects, which requires continuous monitoring of complications. For the treatment and prevention of obesity, children need a multidisciplinary approach involving different specialists.
Segal, Jodi; Wu, Yang; Wilson, Renee; Wang, Youfa
OBJECTIVE: This study systematically reviewed community-based childhood obesity prevention programs in the United States and high-income countries. METHODS: We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library for relevant English-language studies. Studies were eligible if the intervention was primarily implemented in the community setting; had at least 1 year of follow-up after baseline; and compared results from an intervention to a comparison group. Two independent reviewers conducted title scans and abstract reviews and reviewed the full articles to assess eligibility. Each article received a double review for data abstraction. The second reviewer confirmed the first reviewer’s data abstraction for completeness and accuracy. RESULTS: Nine community-based studies were included; 5 randomized controlled trials and 4 non–randomized controlled trials. One study was conducted only in the community setting, 3 were conducted in the community and school setting, and 5 were conducted in the community setting in combination with at least 1 other setting such as the home. Desirable changes in BMI or BMI z-score were found in 4 of the 9 studies. Two studies reported significant improvements in behavioral outcomes (1 in physical activity and 1 in vegetable intake). CONCLUSIONS: The strength of evidence is moderate that a combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. More research and consistent methods are needed to understand the comparative effectiveness of childhood obesity prevention programs in the community setting. PMID:23753099
McIntosh, Bonnie; Daly, Amelia; Mâsse, Louise C; Collet, Jean-Paul; Higgins, Joan Wharf; Naylor, Patti-Jean; Amed, Shazhan
Childhood obesity rates are steadily rising. Sustainable Childhood Obesity Prevention Through Community Engagement (SCOPE) is a community-based participatory action research (PAR) program aimed at preventing childhood obesity. This study aimed to describe community perspectives on, and elicit feedback about, SCOPE's first phase of implementation in two pilot cities in British Columbia, Canada. A case study was implemented using interviews and questionnaires to obtain feedback about SCOPE from two groups: SCOPE coordinators and stakeholders (i.e., individuals and organizations that were a member of the community and engaged with SCOPE coordinators). Participants were recruited via email and (or) by telephone. Coordinators completed a telephone interview. Stakeholders completed a questionnaire and (or) a telephone interview. Thematic analysis was conducted. Participants included 2 coordinators and 15 stakeholders. Participants similarly interpreted SCOPE as a program focused on raising awareness about childhood obesity prevention, while engaging multiple community sectors. Overall, participants valued the program's role in facilitating networking and partnership development, providing evidence-based resources, technical expertise, and contributing funding. Participants felt that SCOPE is sustainable. However, participants felt that barriers to achieving healthy weights among children included those related to the built environment, and social, behavioral, and economic obstacles. Perspectives on factors that facilitated and acted as barriers to SCOPE's first phase of implementation were obtained from the SCOPE communities and may be used to enhance the sustainability of SCOPE and its applicability to other BC communities.
Keriann H. Uesugi
Full Text Available Interventions targeting parenting focused modifiable factors to prevent obesity and promote healthy growth in the first 1000 days of life are needed. Scale-up of interventions to global populations is necessary to reverse trends in weight status among infants and toddlers, and large scale dissemination will require understanding of effective strategies. Utilizing nutrition education theories, this paper describes the design of a digital-based nutrition guidance system targeted to first-time mothers to prevent obesity during the first two years. The multicomponent system consists of scientifically substantiated content, tools, and telephone-based professional support delivered in an anticipatory and sequential manner via the internet, email, and text messages, focusing on educational modules addressing the modifiable factors associated with childhood obesity. Digital delivery formats leverage consumer media trends and provide the opportunity for scale-up, unavailable to previous interventions reliant on resource heavy clinic and home-based counseling. Designed initially for use in the United States, this system’s core features are applicable to all contexts and constitute an approach fostering healthy growth, not just obesity prevention. The multicomponent features, combined with a global concern for optimal growth and positive trends in mobile internet use, represent this system’s future potential to affect change in nutrition practice in developing countries.
Miller Alison L
-regulation. We will also gather process data on intervention implementation, including fidelity, attendance, engagement, and satisfaction. Discussion The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children. Trial registration number Clinicaltrials.gov Identifier: NCT01398358
Miller, Alison L; Horodynski, Mildred A; Herb, Holly E Brophy; Peterson, Karen E; Contreras, Dawn; Kaciroti, Niko; Staples-Watson, Julie; Lumeng, Julie C
intervention implementation, including fidelity, attendance, engagement, and satisfaction. The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children. Clinicaltrials.gov Identifier: NCT01398358.
Boonpleng, Wannaporn; Park, Chang Gi; Gallo, Agatha M
Adiposity rebound (AR) is used as an indicator to predict obesity in adults. Previous studies about AR in the U.S. were based on local data; therefore, the generalizability of study results is limited. The purpose of this study was to identify the timing of AR for U.S. children using a national survey data set, the National Health and Nutrition Examination Survey (NHANES). Combined data of NHANES 1999-2008 were used to estimate the national level of this critical period for U.S. children developing obesity. Data of 8813 children 2 to 10 years of age were analyzed. Mean body mass index was estimated using the survey sample analysis method. Visual inspection method was employed to examine the timing of AR. Gender and race/ethnicity differences in AR were identified at an early age. AR occurred earlier in girls and in Non-Hispanic African-American children than in Non-Hispanic Caucasian children. Differences in timing for AR by gender and race/ethnicity should be considered in planning early and timely intervention efforts to prevent childhood obesity.
Maynard, Maria J
The aim of this current narrative review is to critique the scope and value of recent studies with a focus on obesity-related health promotion in faith organizations. Electronic database searches, scanning of the reference lists of identified articles, and hand searching of journals for articles written in English and published in 2013-2016 revealed 16 studies. Half of the studies involved African-Americans, in churches and with predominantly female participants. Research among other ethnic groups was more likely to be exploratory. All of the 11 studies reporting the impact of programmes on weight-related measures showed favourable outcomes. However, due to study limitations (small sample size, short duration, attrition), significant unbiased effects cannot yet be concluded for most of the interventions reviewed. Study strengths included application of theory in community engagement and detailed description of cultural tailoring. Faith organizations show promise as settings for obesity prevention among high-risk groups, particularly African-Americans. Support for progressing formative work to adequately powered, randomized controlled trials is vital. Wider involvement of diverse faith settings and targeting obesity in men and childhood would be valuable developments.
Apovian, Caroline M.; Garvey, W. Timothy; Ryan, Donna H.
Objective Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient’s disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. Design and Methods This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. Results This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. Conclusions This supplement provides a topical update of obesity management
Gucalp, Ayca; Iyengar, Neil M; Hudis, Clifford A; Dannenberg, Andrew J
The incidence of obesity, a leading modifiable risk factor for common solid tumors, is increasing. Effective interventions are needed to minimize the public health implications of obesity. Although the mechanisms linking increased adiposity to malignancy are incompletely understood, growing evidence points to complex interactions among multiple systemic and tissue-specific pathways including inflamed white adipose tissue. The metabolic and inflammatory consequences of white adipose tissue dysfunction collectively provide a plausible explanation for the link between overweight/obesity and carcinogenesis. Gaining a better understanding of these underlying molecular pathways and developing risk assessment tools that identify at-risk populations will be critical in implementing effective and novel cancer prevention and management strategies. Copyright © 2016 Elsevier Inc. All rights reserved.
Rush, Elaine; Cairncross, Carolyn; Williams, Margaret Hinepo; Tseng, Marilyn; Coppinger, Tara; McLennan, Steph; Latimer, Kasha
Prevention of childhood obesity is a global priority. The school setting offers access to large numbers of children and the ability to provide supportive environments for quality physical activity and nutrition. This article describes Project Energize, a through-school physical activity and nutrition programme that celebrated its 10-year anniversary in 2015 so that it might serve as a model for similar practices, initiatives and policies elsewhere. The programme was envisaged and financed by ...
Martin, J; Chater, A; Lorencatto, F
Rates of childhood obesity are increasing, and it is essential to identify the active components of interventions aiming to prevent and manage obesity in children. A systematic review of behaviour change interventions was conducted to find evidence of behaviour change techniques (BCTs) that are most effective in changing physical activity and/or eating behaviour for the prevention or management of childhood obesity. An electronic search was conducted for randomised controlled trials published between January 1990 and December 2009. Of 4309 titles and abstracts screened, full texts of 135 articles were assessed, of which 17 published articles were included in this review. Intervention descriptions were coded according to the behaviour-specific CALO-RE taxonomy of BCTs. BCTs were identified and compared across obesity management (n=9) vs prevention (n=8) trials. To assess the effectiveness of individual BCTs, trials were further divided into those that were effective (defined as either a group reduction of at least 0.13 body mass index (BMI) units or a significant difference in BMI between intervention and control groups at follow-up) vs non-effective (reported no significant differences between groups). We reliably identified BCTs utilised in effective and non-effective prevention and management trials. To illustrate the relative effectiveness of each BCT, effectiveness ratios were calculated as the ratio of the number of times each BCT was a component of an intervention in an effective trial divided by the number of times they were a component of all trials. Results indicated six BCTs that may be effective components of future management interventions (provide information on the consequences of behaviour to the individual, environmental restructuring, prompt practice, prompt identification as role model/position advocate, stress management/emotional control training and general communication skills training), and one that may be effective in prevention
Bell, Andrew Colin; Wolfenden, Luke; Sutherland, Rachel; Coggan, Lucy; Young, Kylie; Fitzgerald, Michael; Hodder, Rebecca; Orr, Neil; Milat, Andrew J; Wiggers, John
Social marketing integrates communication campaigns with behavioural and environmental change strategies. Childhood obesity programs could benefit significantly from social marketing but communication campaigns on this issue tend to be stand-alone. A large-scale multi-setting child obesity prevention program was implemented in the Hunter New England (HNE) region of New South Wales (NSW), Australia from 2005-2010. The program included a series of communication campaigns promoting the program and its key messages: drinking water; getting physically active and; eating more vegetables and fruit. Pre-post telephone surveys (n = 9) were undertaken to evaluate awareness of the campaigns among parents of children aged 2-15 years using repeat cross-sections of randomly selected cohorts. A total of 1,367 parents (HNE = 748, NSW = 619) participated. At each survey post baseline, HNE parents were significantly more likely to have seen, read or heard about the program and its messages in the media than parents in the remainder of the state (p < 0.001). Further, there was a significant increase in awareness of the program and each of its messages over time in HNE compared to no change over time in NSW (p < 0.001). Awareness was significantly higher (p < 0.05) in HNE compared to NSW after each specific campaign (except the vegetable one) and significantly higher awareness levels were sustained for each campaign until the end of the program. At the end of the program participants without a tertiary education were significantly more likely (p = 0.04) to be aware of the brand campaign (31%) than those with (20%) but there were no other statistically significant socio-demographic differences in awareness. The Good for Kids communication campaigns increased and maintained awareness of childhood obesity prevention messages. Moreover, messages were delivered equitably to diverse socio-demographic groups within the region.
Full Text Available Still more alarming obesity studies show in fact that it is largely due to incorrect diet and lifestyle. For suitable alternative for prevention of this disease are now considered cereal foods, mainly based on increased fiber content. The importance of dietary fiber for human organism consist primarily in its protective function before civilization diseases. It has beneficial effects on digestive physiology and it is therefore an important factor in the prevention of obesity, but also other diseases. Fiber consumption in developed countries is low and it is below the lower limit of the recommended dose. Slovaks per day take only 10-12 g of fiber, which represents only 47% of the recommended dose. Recent large-scale epidemiological studies have shown that regular consumption of wholegrain cereals can reduce the risk of heart disease and certain cancers by 30 percent. One of the factors that increase the functionality of foods is the so-called indigestible resistant starch. For its the positive impact on the physiology of digestion is referred to as prebiotics new generation of dietary fiber. The increasing availability of tasty, whole grain products rich in fiber could be health benefits. doi:10.5219/76
Mozhdeh B Bruss
Full Text Available This paper presents a community-school-higher education partnership approach to the prevention of childhood obesity. Public elementary school personnel, primarily teachers, participated in the design and delivery of a curriculum targeting primary caregivers of 8-9-year-old children. Theoretical framework and methodological approaches guided the development of a cognitive behavioral lifestyle intervention targeting childhood obesity prevention in the Commonwealth of the Northern Mariana Islands (CNMI, a U.S. commonwealth. This project demonstrated that in populations with health disparity, teachers can be a valuable and accessible resource for identifying key health issues of concern to communities and a vital partner in the development of parent and child interventions. Teachers also benefited by gaining knowledge and skills to facilitate student and parent learning and impact on personal and familial health. Successful community-school-higher education partnerships require consideration of local culture and community needs and resources. Moreover, within any community-school–higher education partnership it is essential that a time sensitive and culturally appropriate feedback loop be designed to ensure that programs are responsive to the needs and resources of all stakeholders, and that leaders and policymakers are highly engaged so they can make informed policy decisions.
Have, Marieke Ten; van der Heide, Agnes; Mackenbach, Johan P; de Beaufort, Inez D
It is important to be aware of the ethical pitfalls in programmes to prevent overweight and obesity, such as stigmatization, blaming the victim and reinforcement of health inequalities. In this article, we present an ethical framework for facilitating a structured analysis to the extent to which a programme prevents overweight or obesity is ethically acceptable. First, we made an inventory of ethical issues in programmes to prevent overweight and obesity. Secondly, we studied the available ethical frameworks that address the area of public health. Finally, we designed an ethical framework for the prevention of overweight and obesity, which was tested in two international workshops. At the heart of the framework is a list of eight questions on the morally relevant features of a programme: its effects on physical health, psychosocial well-being, informed choice, cultural values, equality, privacy, responsibility and liberty. Answering these questions provides a map of the potential ethical pitfalls of a specific programme. This mapping should be followed by a structured discussion of the arguments and their importance, and the decision whether, and if so under what conditions, the programme should be implemented. Considering the ethical aspects of the programmes to prevent obesity or overweight is extremely important in the face of the urgent and extensive health problem of overweight and obesity. Our framework is a practical tool for systematic ethical evaluation. It is applicable to a broad range of programmes in different stages of development and implementation.
Peña, Michelle-Marie; Dixon, Brittany; Taveras, Elsie M
Childhood obesity is prevalent, is of consequence, and disproportionately affects racial/ethnic minority populations. By the preschool years, racial/ethnic disparities in obesity prevalence and substantial differences in many risk factors for obesity are already present, suggesting that disparities in obesity prevalence have their origins in the earliest stages of life. The reasons for racial/ethnic variation in obesity are complex and may include differences in cultural beliefs and practices, level of acculturation, ethnicity-based differences in body image, and perceptions of media, sleep, and physical activity. In addition, racial/ethnic differences in obesity may evolve as a consequence of the socio- and environmental context in which families live. The primary care setting offers unique opportunities to intervene and alter the subsequent course of health and disease for children at risk for obesity. Regular visits during childhood allow both detection of elevated weight status and offer opportunities for prevention and treatment. Greater awareness of the behavioral, social–cultural, and environmental determinants of obesity among ethnic minority populations could assist clinicians in the treatment of obesity among diverse pediatric populations. Specific strategies include beginning prevention efforts early in life before obesity is present and recognizing and querying about ethnic- and culturally specific beliefs and practices, the role of the extended family in the household, and parents' beliefs of the causative factors related to their child's obesity. Efforts to provide culturally and linguistically appropriate care, family-based treatment programs, and support services that aim to uncouple socioeconomic factors from adverse health outcomes could improve obesity care for racial/ethnic minority children.
Sanders, Lee M; Perrin, Eliana M; Yin, H Shonna; Bronaugh, Andrea; Rothman, Russell L
Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the Greenlight Intervention Study is to assess the effectiveness of a low-literacy, primary-care intervention on the reduction of early childhood obesity. At 4 primary-care pediatric residency training sites across the US, 865 infant-parent dyads were enrolled at the 2-month well-child checkup and are being followed through the 24-month well-child checkup. Two sites were randomly assigned to the intervention, and the other sites were assigned to an attention-control arm, implementing the American Academy of Pediatrics' The Injury Prevention Program. The intervention consists of an interactive educational toolkit, including low-literacy materials designed for use during well-child visits, and a clinician-centered curriculum for providing low-literacy guidance on obesity prevention. The study is powered to detect a 10% difference in the number of children overweight (BMI > 85%) at 24 months. Other outcome measures include observed physician-parent communication, as well as parent-reported information on child dietary intake, physical activity, and injury-prevention behaviors. The study is designed to inform evidence-based standards for early childhood obesity prevention, and more generally to inform optimal approaches for low-literacy messages and health literacy training in primary preventive care. This article describes the conceptual model, study design, intervention content, and baseline characteristics of the study population. Copyright © 2014 by the American Academy of Pediatrics.
Lofton, Saria; Julion, Wrenetha A.; McNaughton, Diane B.; Bergren, Martha Dewey; Keim, Kathryn S.
Obesity and overweight prevalence in African American (AA) youth continues to be one of the highest of all major ethnic groups, which has led researchers to pursue culturally based approaches as a means to improve obesity prevention interventions. The purpose of this systematic review was to evaluate culturally adapted obesity prevention…
McDavid, Kelsey; Piedrahita, Catalina; Hashima, Patricia; Vall, Emily Anne; Kay, Christi; O'Connor, Jean
In the United States, one in three children is overweight or obese by their fifth birthday. In Georgia, 35 percent of children are overweight or obese. Contrary to popular belief, children who are overweight or obese are likely to be the same weight status as adults, making early childhood an essential time to address weight status. An estimated 380,000 Georgia children attend early care and education environments, such as licensed child care centers, Head Start, and pre-kindergarten programs, which provide an opportunity to reach large numbers of children, including those at risk for obesity and overweight. To address this opportunity, the Georgia Department of Public Health, Georgia Shape - the Governor's Initiative to prevent childhood obesity, and HealthMPowers, Inc., created the Growing Fit training and toolkit to assist early childhood educators in creating policy, systems, and environmental changes that support good nutrition and physical activity. This report, the first related to this project, describes the training and its dissemination between January and December 2015. A total of 103 early childcare educators from 39 early childcare education centers (22 individual childcare systems) from 19 counties in Georgia were trained. Fifteen systems completed a pre and post-test assessment of their system, demonstrating slight improvements. Training for an additional 125 early childcare education centers is planned for 2016. Lessons learned from the first year of the training include the need for more robust assessment of adoption and implementation of policy, systems, and environmental changes in trained centers.
Sisson, Susan B; Krampe, Megan; Anundson, Katherine; Castle, Sherri
Review peer-reviewed interventions designed to reduce obesity and improve obesogenic behaviors, including physical activity, diet, and screen time, at child care centers. Interventions components and outcomes, study design, duration, use of behavioral theory, and level of social ecological influence are detailed. Article searches were conducted from March 2014, October 2014, March 2015, January 2016 across three databases. Eligible interventions were conducted in child care settings, included 3-to-5-year-old children, included an outcome measure of obesity or obesogenic behavior, and published in English. Study design quality was assessed using Stetler's Level of Quantitative Evidence. All unique records were screened (n=4589): 237 articles were assessed for eligibility. Of these, 97 articles describing 71 interventions met inclusion criteria. Forty-four articles included multi-level interventions. Twenty-nine interventions included an outcome measure of obesity. Forty-one interventions included physical activity. Forty-five included diet. Eight included screen time. Fifty-five percent of interventions were Level II (randomized controlled trials), while 37% were Level III (quasi-experimental or pre-post only study design), and 8% were Level IV (non-experimental or natural experiments). Most interventions had the intended effect on the target: obesity 48% (n=14), physical activity 73% (n=30), diet 87% (n=39), and screen time 63% (n=5). Summarizing intervention strategies and assessing their effectiveness contributes to the existing literature and may provide direction for practitioners and researchers working with young children in child care. Most interventions produced the targeted changes in obesity and obesity-associated behaviors, supporting current and future efforts to collaborate with early-care centers and professionals for obesity prevention. Copyright © 2016 Elsevier Inc. All rights reserved.
Cai, L; Wu, Y; Cheskin, L J; Wilson, R F; Wang, Y
We aimed to assess the effects of childhood obesity prevention programmes on blood lipids in high-income countries. We searched MEDLINE®, Embase, PsychInfo, CINAHL®, clinicaltrials.gov, and the Cochrane Library up to 22 April 2013 for relevant randomized controlled trials, quasi-experimental studies and natural experiments published in English. Studies were included if they implemented diet and/or physical activity intervention(s) with ≥1 year follow-up (or ≥6 months for school-based intervention studies) in 2-18-year-olds, and were excluded if they targeted only overweight/obese children, or those with a pre-existing medical condition. Seventeen studies were finally included. For total cholesterol, the pooled intervention effect was -0.97 mg dL(-1) [95% confidence interval (CI): -3.26, 1.32; P = 0.408]; for low-density lipoprotein cholesterol (LDL-C), -6.06 mg dL(-1) (95% CI: -11.09, -1.02; P = 0.018); for high-density lipoprotein cholesterol (HDL-C), 1.87 mg dL(-1) (95% CI: 0.39, 3.34; P = 0.013); and for triglycerides, -1.95 mg dL(-1) (95% CI: -4.94, 1.04; P = 0.202). Most interventions (70%) showed similar significant or no effects on adiposity- and lipids outcomes: 15% interventions improved both adiposity- and lipids outcomes; 55% had no significant effects on either. Childhood obesity prevention programmes had a significant desirable effect on LDL-C and HDL-C. Two-thirds of interventions showed similar significant or no effects in adiposity- and lipids outcomes. Assessing lipids outcomes provide additional useful information on obesity prevention programme benefits. © 2014 World Obesity.
Kominiarek, Michelle A; Gay, Franklin; Peacock, Nadine
To investigate perceptions of minority pregnant women and providers about obesity and gestational weight gain (GWG), and to explore strategies to improve management of obesity in pregnancy with an emphasis on group prenatal care. Sixteen primarily non-Hispanic black pregnant women with a body mass index ≥ 30 kg/m(2) and 19 prenatal care providers participated in focus groups. Discussion topics included GWG goals, body image, health behaviors, and group prenatal care with additional emphasis on provider training needs. Women frequently stated a GWG goal >20 lbs. Women described a body image not in line with clinical recommendations ("200 pounds is not that big."). They avoided the term "obese". They were interested in learning about nutrition and culturally-acceptable healthy cooking. Women would enjoy massage and exercise in group settings, though definitions of "exercise" varied. Family members could help, but generational differences posed challenges. Most had to "encourage myself" and "do this for me and the baby". Providers expressed discomfort discussing GWG and difficulty finding the right words for obesity, which was partially attributed to their own weight. They noted the challenges they faced during prenatal care including time constraints, cultural myths, and system issues. Providers considered a group setting with social support an ideal environment to address health behaviors in obese women. Culturally-tailored programs that use acceptable terms for obesity, provide education regarding healthy eating and safe exercise, and encourage support from social networks may be effective in addressing GWG in obese minority women. Provider training in communication skills is necessary to address obesity in pregnancy.
Washington Cole, Katie O; Gudzune, Kimberly A; Bleich, Sara N; Cheskin, Lawrence J; Bennett, Wendy L; Cooper, Lisa A; Roter, Debra L
To examine the association of women's body weight with provider communication during prenatal care. We coded audio recordings of prenatal visits between 22 providers and 117 of their patients using the Roter Interaction Analysis System. Multivariate, multilevel Poisson models were used to examine the relationship between patient pre-pregnancy body mass index and provider communication. Compared to women with normal weight, providers asked fewer lifestyle questions (IRR 0.66, 95% CI 0.44-0.99, p=0.04) and gave less lifestyle information (IRR 0.51, 95% CI 0.32-0.82, p=0.01) to women with overweight and obesity, respectively. Providers used fewer approval (IRR 0.68, 95% CI 0.51-0.91, p=0.01) and concern statements (IRR 0.68, 95% CI 0.53-0.86, p=0.002) when caring for women with overweight and fewer self-disclosure statements caring for women with obesity (IRR 0.40, 95% CI 0.19-0.84 p=0.02). Less lifestyle and rapport building communication for women with obesity may weaken patient-provider relationship during routine prenatal care. Interventions to increase use of patient-centered communication - especially for women with overweight and obesity - may improve prenatal care quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Howe, Carol J; Alexander, Gina; Stevenson, Jada
Obesity prevention efforts may be ineffective if parents lack awareness of their children's overweight status. This study examined the factors that predicted parents' underestimation of child weight status. Using a cross sectional design, researchers recruited children and parents in a local children's museum. Parents completed a demographic questionnaire, the Newest Vital Sign, and the Child Body Image Scale. Children's height and weight were measured to calculate child BMI. Random effects modeling examined the association between predictor variables (parent race/ethnicity, income, education, and health literacy, and child BMI percentile, gender, and age) and the dependent variable, parent underestimation of child weight status. Participants included 160 parents (213 children aged 7-12years) representing a racially and ethnically diverse sample who were affluent, educated, and with 36.6% of parents assessed with limited health literacy. Although 45.1% of children were overweight/obese, only 7.5% of parents chose this weight status; 80% of parents underestimated the weight of their normal weight children, 96% underestimated their overweight children, and 72% underestimated their obese children. Parents were more likely to underestimate weight of older children and those under 81st percentile of BMI. No other predictors were significant. Parent underestimation of child weight status appears to be a widespread phenomenon in this sample, regardless of race, ethnicity, income, education, and health literacy. The consistent underestimation of child weight suggests that parents' misperception of weight status represents a critical pathway for intervention. Methods to improve parents' perception of child weight need be developed and tested. Copyright © 2017 Elsevier Inc. All rights reserved.
Pratt, Charlotte A; Lemon, Stephenie C; Fernandez, Isabel Diana; Goetzel, Ron; Beresford, Shirley A; French, Simone A; Stevens, Victor J; Vogt, Thomas M; Webber, Larry S
This paper describes the design characteristics of the National Heart, Lung, and Blood Institute (NHLBI)-funded studies that are testing innovative environmental interventions for weight control and obesity prevention at worksites. Seven separate studies that have a total of 114 worksites ( approximately 48,000 employees) across studies are being conducted. The worksite settings include hotels, hospitals, manufacturing facilities, businesses, schools, and bus garages located across the U.S. Each study uses its own conceptual model drawn from the literature and includes the socio-ecological model for health promotion, the epidemiological triad, and those integrating organizational and social contexts. The interventions, which are offered to all employees, include environmental- and individual-level approaches to improve physical activity and promote healthful eating practices. Environmental strategies include reducing portion sizes, modifying cafeteria recipes to lower their fat contents, and increasing the accessibility of fitness equipment at the workplace. Across all seven studies about 48% (N = 23,000) of the population is randomly selected for measurements. The primary outcome measure is change in BMI or body weight after two years of intervention. Secondary measures include waist circumference, objective, and self-report measures of physical activity, dietary intake, changes in vending machines and cafeteria food offerings, work productivity, healthcare use, and return on investment. The results of these studies could have important implications for the design and implementation of worksite overweight and obesity control programs.
Sacks, Gary; Swinburn, Boyd A; Lawrence, Mark A
As obesity prevention becomes an increasing health priority in many countries, including Australia and New Zealand, the challenge that governments are now facing is how to adopt a systematic policy approach to increase healthy eating and regular physical activity. This article sets out a structure for systematically identifying areas for obesity prevention policy action across the food system and full range of physical activity environments. Areas amenable to policy intervention can be systematically identified by considering policy opportunities for each level of governance (local, state, national, international and organisational) in each sector of the food system (primary production, food processing, distribution, marketing, retail, catering and food service) and each sector that influences physical activity environments (infrastructure and planning, education, employment, transport, sport and recreation). Analysis grids are used to illustrate, in a structured fashion, the broad array of areas amenable to legal and regulatory intervention across all levels of governance and all relevant sectors. In the Australian context, potential regulatory policy intervention areas are widespread throughout the food system, e.g., land-use zoning (primary production within local government), food safety (food processing within state government), food labelling (retail within national government). Policy areas for influencing physical activity are predominantly local and state government responsibilities including, for example, walking and cycling environments (infrastructure and planning sector) and physical activity education in schools (education sector). The analysis structure presented in this article provides a tool to systematically identify policy gaps, barriers and opportunities for obesity prevention, as part of the process of developing and implementing a comprehensive obesity prevention strategy. It also serves to highlight the need for a coordinated approach to
Natale Ruby; Scott Stephanie Hapeman; Messiah Sarah E; Schrack Maria Mesa; Uhlhorn Susan B; Delamater Alan
Abstract Background Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. Methods/design A randomi...
Crammond, B; Van, C; Allender, S; Peeters, A; Lawrence, M; Sacks, G; Mavoa, H; Swinburn, B A; Loff, B
A complex regulatory package is likely to be necessary to effectively reduce obesity prevalence in developed countries. This study investigated the barriers and facilitators to implementing regulatory interventions to prevent obesity within the executive arm of the Australian Commonwealth Government. Policy reviews were conducted on nine government departments to understand their roles and interests in obesity. From this process we identified regulatory review carried out by the Office of Best Practice Regulation as possibly posing a barrier to law reform for obesity prevention, along with the complexity of the food policymaking structures. The policy reviews informed subsequent in-depth semi-structured interviews with senior Commonwealth government officers (n = 13) focused on refining our understanding of the barriers to enacting obesity prevention policy. In addition to the two barriers already identified, interviewees identified a lack of evidence for interventions, which would reduce obesity prevalence, and the influence of politicians on executive decisions as posing obstacles. Most interviewees believed that the barriers to regulating to prevent obesity were strong and that intervention by elected politicians would be the most likely method of implementing obesity prevention policy. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.
Thury, Chad; de Matos, Carla Valentina Melo
Childhood obesity is considered by many one of the biggest public health issues facing our country. In the U.S. almost one in three children are overweight and one in five are obese. This article aims to outline the current childhood obesity prevention measures as well as discuss programs that have had success in reducing childhood overweight and obesity. Recent literature on prevention of childhood obesity was reviewed. There was a focus on systematic reviews, random controlled trials and well-designed observational studies. Evidenced-based prevention of childhood obesity demonstrates that there is a benefit to programs that focus on a collaboration of community/school, primary health care, and home/family based interventions that involve both a physical activity and dietary component. Successful programs have more efficacy if they are longer in duration and initiated for children in middle school or younger. The most recent recommendations regarding prevention of childhood obesity focus on increased exercise and improved diet to prevent childhood obesity. Despite these clear recommendations and general consensus for them, childhood obesity continues to increase. The evidence supports a collaborative effort with multiple stakeholders to reverse the trend in childhood obesity.
Doak, C.M.; Visscher, T.L.S.; Renders, C.M.; Seidell, J.C.
Overweight and obesity are serious, large-scale, global, public health concerns requiring population-based childhood overweight and obesity prevention. The overall objective of this review is to identify aspects of successful childhood overweight prevention programmes. This objective will be met by
Doak, C M; Visscher, T L S; Renders, C M; Seidell, J C
Overweight and obesity are serious, large-scale, global, public health concerns requiring population-based childhood overweight and obesity prevention. The overall objective of this review is to identify aspects of successful childhood overweight prevention programmes. This objective will be met by
Dreisinger, Mariah L.; Boland, Elizabeth M.; Filler, Carl D.; Baker, Elizabeth A.; Hessel, Amy S.; Brownson, Ross C.
Within the realm of obesity prevention research, there have been many promising interventions to improve physical activity and nutrition among diverse target populations. However, very little information is known about the dissemination and replication of these interventions. In 2007 and 2008 as part of a larger obesity prevention initiative,…
Brown, V; Moodie, M; Mantilla Herrera, A M; Veerman, J L; Carter, R
Given the alarming prevalence of obesity worldwide and the need for interventions to halt the growing epidemic, more evidence on the role and impact of transport interventions for obesity prevention is required. This study conducts a scoping review of the current evidence of association between modes of transport (motor vehicle, walking, cycling and public transport) and obesity-related outcomes. Eleven reviews and thirty-three primary studies exploring associations between transport behaviours and obesity were identified. Cohort simulation Markov modelling was used to estimate the effects of body mass index (BMI) change on health outcomes and health care costs of diseases causally related to obesity in the Melbourne, Australia population. Results suggest that evidence for an obesity effect of transport behaviours is inconclusive (29% of published studies reported expected associations, 33% mixed associations), and any potential BMI effect is likely to be relatively small. Hypothetical scenario analyses suggest that active transport interventions may contribute small but significant obesity-related health benefits across populations (approximately 65 health adjusted life years gained per year). Therefore active transport interventions that are low cost and targeted to those most amenable to modal switch are the most likely to be effective and cost-effective from an obesity prevention perspective. The uncertain but potentially significant opportunity for health benefits warrants the collection of more and better quality evidence to fully understand the potential relationships between transport behaviours and obesity. Such evidence would contribute to the obesity prevention dialogue and inform policy across the transportation, health and environmental sectors. Copyright © 2016 Elsevier Inc. All rights reserved.
Palmer, Wendy; Henderson, Danielle; Stahnke, Barbara; Shary, Katherine; Hardy, Trisha; Welsh, Jean A
..., Children’s Healthcare of Atlanta’s Strong4Life program provided 388 WIC counselors in Georgia with a 2-hour training session on motivational interviewing, patient-centered counseling, and goal setting for obesity prevention...
Kline, L; Jones-Smith, J; Jaime Miranda, J; Pratt, M; Reis, R S; Rivera, J A; Sallis, J F; Popkin, B M
Childhood obesity rates in Latin America are among the highest in the world. This paper examines and evaluates the many efforts underway in the region to reduce and prevent further increases in obesity, identifies and discusses unique research challenges and opportunities in Latin America, and proposes a research agenda in Latin America for the prevention of childhood obesity and concomitant non-communicable diseases. Identified research gaps include biological challenges to healthy growth across the life cycle, diet and physical activity dynamics, community interventions promoting healthy child growth, and rigorous evaluation of national food and activity programs and regulatory actions. Addressing these research gaps is critical to advance the evidence-based policy and practice in childhood obesity tailored to the Latin American context that will be effective in addressing obesity. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.
Schmandt, Rosemarie E; Iglesias, David A; Co, Ngai Na; Lu, Karen H
Worldwide, obesity has become a major public health crisis. Overweight and obesity not only increase the risk of cardiovascular disease and type-2 diabetes mellitus but also are now known risk factors for a variety of cancer types...
Health risks of obesity. Obesity has major adverse medical consequences largely due to its health risks and association with hypertension and non-insulin dependent diabetes mellitus2,3. Obesity can be classified using the Body. Mass Index (BMI), Table 1. The BMI is defined as weight in kilogrammes divided by the square ...
Royall, Dawna; Brauer, Paula; Atta-Konadu, Edwoba; Dwyer, John J M; Edwards, A Michelle; Hussey, Tracy; Kates, Nick
Both providers and patients may have important insights to inform the development of obesity prevention and management services in Canadian primary care settings. In this formative study, insights for new obesity management services were sought from both providers and patients in 1 progressive citywide organization (150 physicians, team services, separate offices). Seven focus groups with interprofessional health providers (n = 56) and 4 focus groups with patients (n = 34) were conducted. Two clinical vignettes (adult, child) were used to focus discussion. Four analysts coded for descriptive content and interpretative themes on possible tools and care processes using NVivo. Participants identified numerous strategies for care processes, most of which could be categorized into 1 or more of 11 themes: 6 directed at clinical care of patients (raising awareness, screening, clinical care, skill building, ongoing support, and social/peer support) and 5 directed at the organization (coordination/collaboration, creating awareness among health professionals, adding new expertise to the team, marketing, and lobbying/advocacy). The approach was successful in generating an extensive list of diverse activities to be considered for implementation studies. Both patients and providers identified that multiple strategies and systems approaches will be needed to address obesity management in primary care.
Park, Bu Kyung; Nahm, Eun-Shim; Rogers, Valerie E; Choi, Mona; Friedmann, Erika; Wilson, Marisa; Koru, Gunes
Adolescent obesity is one of the most serious global public health challenges. Social networking sites are currently popular among adolescents. Therefore, the obesity prevention program for Korean American adolescents was developed on the most popular social networking site, Facebook. The purpose of this study was to evaluate the usability of a culturally tailored Facebook-based obesity prevention program for Korean American adolescents (Healthy Teens). An explorative descriptive design of usability testing was used. Usability testing employing one-on-one observation, the think-aloud method, audio taping, screen activity capture, and surveys was performed. Twenty participants were recruited from two Korean language schools (mean age, 15.40 ± 1.50 years). Recruitment and user testing was performed between February and April 2014. Content analysis, using the inductive coding approach, was performed by three coders to analyze transcriptions. Descriptive statistics were used to analyze quantitative data including demographic characteristics, perceived usability, eHealth literacy, and health behaviors. Testing revealed several usability issues in content, appearance, and navigation. Participants' comments regarding content were positive. Although the Facebook platform provided limited flexibility with respect to building the site, participants described the program's appearance as appropriate. Most participants did not experience difficulty in navigating the program. Our preliminary findings indicated that participants perceived the Healthy Teens program as usable and useful. This program could be used as a robust platform for the delivery of health education to adolescents. Further research is required to assess the effects of Facebook-based programs on adolescent obesity prevention. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Clark, Mary Jo; Gahagan, Sheila
Childhood obesity affects approximately 20% of US preschool children. Early prevention is needed to reduce young children’s risks for obesity, especially among Hispanic preschool children who have one of the highest rates of obesity. Vida Saludable was an early childhood obesity intervention designed to be culturally appropriate for low-income Hispanic mothers with preschool children to improve maternal physical activity and reduce children’s sugar sweetened beverage consumption. It was conducted at a large southwestern United States urban health center. Presented here are the methods and rationale employed to develop and culturally adapt Vida Saludable, followed by scoring and ranking of the intervention’s cultural adaptations. An empowered community helped design the customized, culturally relevant program via a collaborative partnership between two academic research institutions, a community health center, and stakeholders. Improved health behaviors in the participants may be attributed in part to this community-engagement approach. The intervention’s cultural adaptations were scored and received a high comprehensive rank. Post-program evaluation of the intervention indicated participant satisfaction. The information presented provides investigators with guidelines, a template, and a scoring tool for developing, implementing, and evaluating culturally adapted interventions for ethnically diverse populations. PMID:24595163
Full Text Available Zicao (Lithospermum erythrorhizon has been used in clinics as a traditional Chinese medicine for thousands of years. Acetylshikonin (AS is the main ingredient of Zicao, Xinjiang, China. The objective of this study was to investigate the anti-obesity and anti-nonalcoholic fatty liver disease (NAFLD efficacy of AS in a model of spontaneous obese db/db mice. Mice were divided into Wild Type (WT groups and db/db groups, which received no treatment or treatment with 100 mg/kg/day clenbuterol (CL hydrochloride or 540 mg/kg/day AS by oral gavage for eight weeks. The results provided the evidence that AS prevented obesity and NAFLD including reduction in body weight, food efficiency ratio, serum triglyceride (TG and free fatty acid (FFA levels in db/db mice. Administration of AS markedly suppressed the levels of hepatic alanine aminotransferase (ALT, aspartate aminotransferase (AST and pro-inflammatory cytokines in treated groups when compared with that of db/db groups. Further investigation of the lipid synthesis-related protein using Western blotting revealed that hepatic protein expression of sterol regulatory element-binding protein-1 (SREBP-1, fatty acid synthetase (FAS and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR were significantly downregulated by AS treatment. These findings suggest that AS exerts anti-obesity and anti-NAFLD effects through the regulation of lipid metabolism and anti-inflammatory effects.
Carlson, Matthew J; Thiel, Kristina W; Yang, Shujie; Leslie, Kimberly K
The lifetime risk for developing endometrial cancer, the fourth most common malignancy in women, is approximately 3%. Endometrial cancer is a hormone-driven cancer, with approximately 80% of endometrial cancers arising attributable to either an excess of estrogen or a lack of progesterone. In the normal endometrium, the proliferative effects of estrogen are normally countered by progesterone, but the absence of progesterone allows estrogen to induce oncogenesis, an effect that is amplified in situations of excess estrogen. One of the major emerging causes of the estrogen/progesterone imbalance is obesity. Obesity is associated with several hormonal derangements as well as dysregulation of insulin/insulin-like growth factor activity, which collectively contribute to hyperplasia and carcinogenesis in the endometrium. In this article, we provide an in-depth description of how obesity mechanistically promotes this hormone and growth factor imbalance. Given that endometrial cancer is clearly associated with obesity, we put forth the hypothesis that a large portion of these cancers might be prevented by treatment with progesterone.
Kading, Cherri L; Wilder, Rebecca S; Vann, William F; Curran, Alice E
Obesity is a major public health issue in the United States. Dental hygienists influence their patients' oral health by providing dietary and behavioral recommendations that encourage good oral health practices. However, it is not known if they are ready to provide behavioral counseling strategies for weight loss. This study investigates whether dental hygienists in North Carolina are confident to counsel patients who are at-risk for obesity. A questionnaire was used to survey 246 dental hygienists attending a continuing education (CE) course. It investigated self-reported confidence in providing obesity counseling, educational preparation, outcome expectations and self-efficacy. The primary outcome was confidence in providing weight loss counseling. Mantel Haenszel statistics were used to compare group of interest. Of the dental hygienists surveyed, 43% perceived an increase of overweight patients in their practices. Nearly all (95%) felt that dental hygienists have a role in helping patients improve nutrition. Over half (65%) expressed confidence in discussing obesity-related health risks. On average, the confidence in getting patients to follow weight loss advice was significantly different (p=0.02) for those with a 2 year degree and those with a 4 year degree. The findings indicate that many North Carolina dental hygienists are willing to discuss obesity with patients.
Full Text Available Background. Childhood obesity is associated with enormous health consequences and costs to society. This study aims to systematically review the studies on Cost Effectiveness Analysis (CEA of primary prevention programmes of childhood obesity, discussing the gaps and providing recommendations for future research. Methods. All the studies on the cost effectiveness evaluation of primary prevention of obesity among children were included. Studies were retrieved from MEDLINE and Google Scholar, up to 31st March 2012, with only English language papers being eligible. The quality of the retrieved studies was evaluated by using the Drummond scale.Results. Eight studies were included, five of which concerning community-based intervention programmes, while three school-based programmes. Fifty-percent of the studies, 3 school-based and 1 community-based primary prevention programme reported the intervention being cost effective. The studies were heterogeneous in terms of study design, quality, target population and outcome measures. Use of the Drummond scale showed that the eight studies were of low-medium quality. Conclusion. Although model-based studies may be considered as practical measures applicable to different type of programmes and settings, we auspicate for a convergence towards the use of homogenous clinical and outcome measures in order to properly evaluate the added value of obesity primary prevention programmes in childhood.Keywords: cost-effectiveness, childhood obesity, overweight, primary prevention, systemic review.
Sharps, P W; Koziol-McLain, J; Campbell, J; McFarlane, J; Sachs, C; Xu, X
Homicide of women (femicide) by intimate partners is the most serious form of violence against women. The purpose of this analysis of a larger multisite study was to describe health care use in the year prior to murder of women by their intimate partner in order to identify opportunities for intervention to prevent femicide. A sample of femicide cases was identified from police or medical examiner records. Participants (n = 311) were proxy informants (most often female family members) of victims of intimate partner femicide from 11 U.S. cities. Information about prior domestic abuse and use of health care and other helping agencies for victims and perpetrators was obtained during structured telephone interviews. Most victims had been abused by their partners (66%) and had used health care agencies for either injury or physical or mental health problems (41%). Among women who had been pregnant during the relationship, 23% were beaten by partners during pregnancy. Among perpetrators with fair or poor physical health, 53% had contact with physicians and 15% with fair or poor mental health had seen a doctor about their mental health problem. Among perpetrators with substance problems, 5.4% had used alcohol treatment programs and 5.7% had used drug treatment programs. Frequent contacts with helping agencies by victims and perpetrators represent opportunities for the prevention of femicide by health care providers. Copyright 2001 American Health Foundation and Academic Press.
Manios, Y.; Grammatikaki, E.; Androutsos, O.; Chin A Paw, M.J.M.; Gibson, E.L.; Buijs, G.; Iotova, V.; Socha, P.; Annemans, L.; Wildgruber, A.; Mouratidou, T.; Yngve, A.; Duvinage, K.; de Bourdeaudhuij, I.
The increasing childhood obesity epidemic calls for appropriate measures and effective policies to be applied early in life. Large-scale socioecological frameworks providing a holistic multifactorial and cost-effective approach necessary to support obesity prevention initiatives in this age are
George, Gretchen Lynn; Schneider, Constance; Kaiser, Lucia
To examine the effect of participation in a summer camp focused on nutrition and fitness among low-income youth. In 2011-2012, overweight and obese youth (n = 126) from Fresno, CA participated in a free 6-week summer program, Healthy Lifestyle Fitness Camp (HLFC), which included 3 h/wk of nutrition education provided by University of California CalFresh and 3 hours of daily physical activity through Fresno Parks and Recreation. The researchers used repeated-measures ANOVA to examine changes in weight, waist circumference, and waist-to-height ratio (WHtR) between HLFC and the comparison group (n = 29). Significant pre-post WHtR reductions were observed in HLFC: 0.64 to 0.61 (P summer camps during unstructured months of summer is integral to obesity prevention among low-income youth. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Lessard, Laura; Breck, Andrew
Current obesity rates in young children are a serious public health concern; developing and implementing obesity prevention interventions in childcare settings is a promising avenue to address this issue. In recent years, there has been increasing focus on environmental and policy change interventions for this setting. Improving access to and quality of outdoor play spaces and implementing the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) are two promising environmental change strategies in this setting. Laws at the local, state, and federal level have also been implemented; New York City and Delaware are two jurisdictions that have passed policies and provided preliminary evidence of the potential of policy interventions to change child outcomes. A combination of programmatic, environmental, and policy change strategies will likely be most effective in maximizing the potential of childcare settings to promote healthy weight in children.
Tate, Eleanor B; Spruijt-Metz, Donna; O'Reilly, Gillian; Jordan-Marsh, Maryalice; Gotsis, Marientina; Pentz, Mary Ann; Dunton, Genevieve F
Childhood obesity continues to be a significant public health issue. mHealth systems offer state-of-the-art approaches to intervention design, delivery, and diffusion of treatment and prevention efforts. Benefits include cost effectiveness, potential for real-time data collection, feedback capability, minimized participant burden, relevance to multiple types of populations, and increased dissemination capability. However, these advantages are coupled with unique challenges. This commentary discusses challenges with using mHealth strategies for child obesity prevention, such as lack of scientific evidence base describing effectiveness of commercially available applications; relatively slower speed of technology development in academic research settings as compared with industry; data security, and patient privacy; potentially adverse consequences of increased sedentary screen time, and decreased focused attention due to technology use. Implications for researchers include development of more nuanced measures of screen time and other technology-related activities, and partnering with industry for developing healthier technologies. Implications for health practitioners include monitoring, assessing, and providing feedback to child obesity program designers about users' data transfer issues, perceived security and privacy, sedentary behavior, focused attention, and maintenance of behavior change. Implications for policy makers include regulation of claims and quality of apps (especially those aimed at children), supporting standardized data encryption and secure open architecture, and resources for research-industry partnerships that improve the look and feel of technology. Partnerships between academia and industry may promote solutions, as discussed in this commentary.
Cyril, Sheila; Polonsky, Michael; Green, Julie; Agho, Kingsley; Renzaho, Andre
Objective Disadvantaged communities bear a disproportionate burden of childhood obesity and show low participation in childhood obesity prevention initiatives. This study aims to examine the level of readiness of disadvantaged communities to engage with childhood obesity prevention initiatives. Methods Using the community readiness model, 95 semi-structured interviews were conducted among communities in four disadvantaged areas of Victoria, Australia. Community readiness analysis and paired t-tests were performed to assess the readiness levels of disadvantaged communities to engage with childhood obesity prevention initiatives. Results The results showed that disadvantaged communities demonstrated low levels of readiness (readiness score=4/9, 44%) to engage with the existing childhood obesity prevention initiatives, lacked knowledge of childhood obesity and its prevention, and reported facing challenges in initiating and sustaining participation in obesity prevention initiatives. Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia. What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exist in Australia especially among communities living in disadvantaged areas, which experience poor engagement in childhood obesity prevention initiatives. Studies in the USA have found that assessing disadvantaged communities' readiness to participate in health programs is a critical initial step in reducing the disproportionate obesity burden among these communities
Full Text Available Abstract Background The first years of life are crucial to start preventive interventions that can have an impact on lifestyle and later overweight and obesity. Under the Italian National Health System (INHS, children are cared for by family pediatricians who perform health balances at regular intervals. The Italian Society of Preventive and Social Pediatrics (SIPPS has designed a randomized controlled trial (RCT to evaluate the effectiveness of family pediatricians for the prevention of childhood obesity in preschool children. We report the rationale and protocol of such trial, named the "Mi voglio bene" ("I love myself" study. Methods "Mi voglio bene" is a parallel-arm RCT. Family pediatricians willing to participate to the trial will be randomly assigned to a control group and to an experimental group. The control group will provide the usual standard of care while the experimental group will implement 10 preventive actions (promotion of breastfeeding, avoidance of solid foods, control of protein intake, avoidance of sugar-sweetened beverages, avoidance of bottle, active means of transportation, identification of early adiposity rebound, limitation of television viewing, promotion of movement, and teaching portion size at 10 time points during a 6-yr follow-up. The main outcome measures is the prevalence of overweight and obesity at 6 years of age. The experimental intervention is expected to reduce the prevalence of overweight and obesity from 25% to 20% and the study requires a total of 3610 children. Each pediatrician will enroll 30 consecutive newborns into the study so that a total of 120 pediatricians will participate to the study. Discussion "Mi voglio bene" is expected to provide important information for the INHS and possibly other institutional child care settings about the effectiveness of a pediatrician-based approach to the prevention of childhood obesity. We published this study protocol with the aim of opening a discussion with
Background The first years of life are crucial to start preventive interventions that can have an impact on lifestyle and later overweight and obesity. Under the Italian National Health System (INHS), children are cared for by family pediatricians who perform health balances at regular intervals. The Italian Society of Preventive and Social Pediatrics (SIPPS) has designed a randomized controlled trial (RCT) to evaluate the effectiveness of family pediatricians for the prevention of childhood obesity in preschool children. We report the rationale and protocol of such trial, named the "Mi voglio bene" ("I love myself") study. Methods "Mi voglio bene" is a parallel-arm RCT. Family pediatricians willing to participate to the trial will be randomly assigned to a control group and to an experimental group. The control group will provide the usual standard of care while the experimental group will implement 10 preventive actions (promotion of breastfeeding, avoidance of solid foods, control of protein intake, avoidance of sugar-sweetened beverages, avoidance of bottle, active means of transportation, identification of early adiposity rebound, limitation of television viewing, promotion of movement, and teaching portion size) at 10 time points during a 6-yr follow-up. The main outcome measures is the prevalence of overweight and obesity at 6 years of age. The experimental intervention is expected to reduce the prevalence of overweight and obesity from 25% to 20% and the study requires a total of 3610 children. Each pediatrician will enroll 30 consecutive newborns into the study so that a total of 120 pediatricians will participate to the study. Discussion "Mi voglio bene" is expected to provide important information for the INHS and possibly other institutional child care settings about the effectiveness of a pediatrician-based approach to the prevention of childhood obesity. We published this study protocol with the aim of opening a discussion with all people interested
Lemon, Stephenie C; Zapka, Jane; Li, Wenjun; Estabrook, Barbara; Rosal, Milagros; Magner, Robert; Andersen, Victoria; Borg, Amy; Hale, Janet
The worksite represents a promising venue in which to address the issue of obesity. Pair-matched, cluster-RCT. Data were collected from 2005 to 2008 and analyzed in 2008. A random sample of 806 employees was selected to represent the workforce of six hospitals in central Massachusetts. The 2-year ecologic intervention sought to prevent weight gain through changes in worksite weight-related norms using strategies targeted at the organization, interpersonal environment, and employees. The primary outcome was change in BMI at the 12- and 24-month follow-ups. Change in perceptions of organizational commitment to employee health and normative coworker behaviors were secondary outcomes. There was no impact of the intervention on change in BMI from baseline to 12 (beta=0.272; 95% CI=-0.271, 0.782) or 24 months (beta=0.276; 95% CI=-0.338, 0.890) in intention-to-treat analysis. When intervention exposure (scale=0 to 100) was used as the independent variable, there was a decrease of 0.012 BMI units (95% CI=-0.025, 0.001) for each unit increase in intervention participation at the 24-month follow-up. Employees in intervention sites reported significantly greater improvements in perceptions of organizational commitment to employee health at 12 and 24 months compared to control sites, but there was no impact on perceptions of normative coworker behaviors. The intervention had a dose-response relationship with BMI, with positive effects proportional to extent of participation. Although the intervention was able to change organizational perceptions, successfully improving changes in actual and perceived social norms may be needed to achieve population-level impact in complex worksite organizations. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Ige, Teminijesu John; DeLeon, Patrice; Nabors, Laura
After-school programs are an ideal setting for childhood obesity prevention interventions. This qualitative study examined the implementation of a training technique in the Children's Healthy Eating and Exercise Program: motivational interviewing. Participants included 19 children in Grades 3 through 5, nine coaches enrolled in university health education classes, and four parents. Nine lessons were presented during the fall session (N = 5) and eight during the spring (N = 14), with five individual coaching sessions per child. From September, 2014 through April 2015, child and coach perceptions were assessed using goal sheets, surveys, a focus group, and the analysis of the video recording of a health habit commercial created by teams of children grouped by gender. Children developed weekly eating and exercise goals with coaches and reported on their progress the following week. Following the intervention, children reported improved eating and exercise habits and coaches reported they learned more about healthy food options for themselves. Overall, children responded positively to the motivational interviewing. Involving teachers may allow for dissemination of lessons and reinforcement for healthy choices during the school day. Involving parents in training may remove roadblocks to healthy lifestyle changes for children for nonschool hours and when packing lunches.
Thompson, Debbe; Baranowski, Janice; Buday, Richard; Baranowski, Tom
Abstract Objective Stories can serve as powerful tools for health interventions. Story immersion refers to the experience of being absorbed in a story. This is among the first studies to analyze story immersion's role in health videogames among children by addressing two main questions: Will children be more immersed when the main characters are similar to them? Do increased levels of immersion relate to more positive health outcomes? Subjects and Methods Eighty-seven 10–12-year-old African-American, Caucasian, and Hispanic children from Houston, TX, played a health videogame, “Escape from Diab” (Archimage, Houston, TX), featuring a protagonist with both African-American and Hispanic phenotypic features. Children's demographic information, immersion, and health outcomes (i.e., preference, motivation, and self-efficacy) were recorded and then correlated and analyzed. Results African-American and Hispanic participants reported higher immersion scores than Caucasian participants (P=0.01). Story immersion correlated positively (P valuesvideogame characters and players enhanced immersion and several health outcomes. Effectively embedding characters with similar phenotypic features to the target population in interactive health videogame narratives may be important when motivating children to adopt obesity prevention behaviors. PMID:24066276
Obesity increases the risk of type 2 diabetes, cardiovascular diseases, and certain cancers, which are among the leading causes of death worldwide. Obesity and obesity-related metabolic diseases are characterized by specific alterations in the human gut microbiota. Experimental studies with gut microbiota transplantations in mice and in humans indicate that a specific gut microbiota composition can be the cause and not just the consequence of the obese state and metabolic disease, which suggests a potential for gut microbiota modulation in prevention and treatment of obesity-related metabolic diseases. In addition, dietary intervention studies have suggested that modulation of the gut microbiota can improve metabolic risk markers in humans, but a causal role of the gut microbiota in such studies has not yet been established. Here, we review and discuss the role of the gut microbiota in obesity-related metabolic diseases and the potential of dietary modulation of the gut microbiota in metabolic disease prevention and treatment. PMID:26773017
Messiah, S E; Lipshultz, S E; Natale, R A; Miller, T L
In the past 20 years, the prevalence of obesity in the United States increased almost 50% among adults and by 300% in children. Today, 9.7% of all U.S. infants up to 2 years old have abnormally high weight-for-recumbent length; 25% of children under age 5 are either overweight or obese; and 17% of adolescents are obese. Ethnic disparities in the rates of obesity are also large and apparent in childhood. Further, 44% of obese adolescents have metabolic syndrome. Obese children tend to become obese adults; thus, in a decade, young adults will likely have much higher risks of chronic disease, which has tremendous implications for the healthcare system. However, early childhood may be the best time to prevent obesity. Teachers' healthy eating choices are positively associated with changes in body mass index percentiles for children, for example. In addition, 8 million children attend afterschool programs, which can successfully promote health and wellness and successfully treat obesity. This childhood epidemic of obesity and its health-related consequences in adolescents should be a clinical and public health priority. However, this major public health problem cannot be managed solely in clinical settings. Rather, public health strategies must be integrated into home and family, school and community-based settings. © 2013 The Authors. Clinical Obesity © 2013 International Association for the Study of Obesity.
Virudachalam, Senbagam; Gruver, Rachel S; Gerdes, Marsha; Power, Thomas J; Magge, Sheela N; Shults, Justine; Faerber, Jennifer A; Kalra, Gurpreet K; Bishop-Gilyard, Chanelle T; Suh, Andrew W; Berkowitz, Robert I; Fiks, Alexander G
Despite many recommended strategies for obesity prevention during infancy, effectively delivering recommendations to parents in clinical settings is challenging, especially among high-risk populations. This study describes and compares mothers' and clinicians' priorities for obesity prevention during infancy, to facilitate more-effective obesity prevention messaging. A discrete choice experiment using maximum difference scaling was administered in 2013 and analyzed in 2013-2014. Twenty-nine low-income, obese mothers of infants and 30 pediatric clinicians from three urban primary care practices rated the relative importance of 16 items relevant to obesity prevention during infancy, in response to this question: Which topic would be most helpful [for new mothers] to learn about to prevent your [their] child from becoming overweight? Response options encompassed the domains of feeding, sleep, parenting (including physical activity and screen time), and maternal self-care. Mothers (all Medicaid-enrolled and black; mean age, 27 years; mean BMI, 35 kg/m(2)) and clinicians (97% female, 87% pediatricians, 13% nurse practitioners) both highly prioritized recognizing infant satiety and hunger cues, and appropriate feeding volume. Mothers rated infant physical activity and maintaining regular routines as 3.5 times more important than clinicians did (pobese, black mothers of infants highly prioritized learning about many effective obesity prevention strategies, including recognizing hunger and satiety cues, promoting infant activity, and maintaining regular routines. Clinicians may frame preventive guidance to be responsive to these priorities. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Knowledge based on science has been central to implementing community-based childhood obesity prevention interventions. The art of practitioner wisdom is equally critical to ensure locally relevant responses. In South Australia (SA), the OPAL (Obesity Prevention and Lifestyle) program has been implemented to reduce childhood obesity across 20 communities reaching nearly one quarter of the state's population. Staff from across the State come together at regular intervals to share practice challenges and insights and refine the model of practice. Over a 3-year period 12 reflective practice workshops were held with OPAL staff (n = 46). OPAL staff were guided by an external facilitator using inquiring questions to reflect on their health promotion practice within local government. Three themes were identified as central within the reflections. The first theme is shared clarity through the OPAL obesity prevention model highlighting the importance of working to a clearly articulated, holistic obesity prevention model. The second theme is practitioner skill and sensitivity required to implement the model and deal with the 'politics' of obesity prevention. The final theme is the power of relationships as intrinsic to effective community based health promotion. Insights into the daily practices and reflections from obesity prevention practitioners are shared to shed light on the skills required to contribute to individual and social change. OPAL staff co-authored this paper. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Hidalgo, Catalina González; Samur, Eduardo Atalah
Obesity is a serious global epidemic and the prevention strategies implemented have been insufficient. Numerous environmental factors have been associated with risk of obesity and their full consideration in prevention policies is important. The connection between food advertising on television and childhood obesity has been demonstrated. The large number of advertisements for unhealthy foods targeted at children through television and its possible impact on health has led some countries to legislate on this matter. However, a conceptual framework of reference enabling legislation must be internationally defined in order to achieve a real impact in preventing childhood obesity. This paper reviews scientific evidence on the relationship between food advertising and childhood obesity as a basis for developing public policies to regulate food marketing on television.
Döring, Nora; Hansson, Lena M; Andersson, Elina Scheers
: The on-going population-based PRIMROSE trial, which targets childhood obesity, is embedded in the regular national (routine) preventive child health services that are available free-of-charge to all young families in Sweden. Of the participants (n = 1369), 489 intervention and 550 control mothers (75......-day food diary. We are not aware of any previous RCT, concerned with the primary prevention of childhood obesity through sessions at CHC that addresses healthy eating habits and physical activity in the context of a routine child health services programme. TRIAL REGISTRATION: ISRCTN16991919.......BACKGROUND: Childhood obesity is a growing concern in Sweden. Children with overweight and obesity run a high risk of becoming obese as adults, and are likely to develop comorbidities. Despite the immense demand, there is still a lack of evidence-based comprehensive prevention programmes targeting...
Zhang, Wenping; Fujikawa, Takahiko; Mizuno, Kaito; Ishida, Torao; Ooi, Kazuya; Hirata, Tetsuya; Wada, Atsunori
The cortex of Eucommia ulmoides Oliver is widely used to treat kidney deficiency in traditional Chinese medicine. Its leaves have recently been reported to have anti-obesity properties in metabolic syndrome-like rat models. Due to a sharp decline in estrogen production, obesity, together with osteoporosis, are common problems in postmenopausal women. In this study, we examined the potential effect of Eucommia leaf extract (ELE) in preventing osteoporosis and obesity induced by ovariectomy (OVX). Forty-six female Wistar rats were divided into six groups: Sham-Cont, OVX-Cont, and four OVX groups administered estradiol and different concentrations of ELE 1.25%, ELE 2.5%, and ELE 5%. Treatments were administered after ovariectomy at six weeks of age and continued for 12 weeks. OVX induced a significant decrease in the bone mineral density (BMD) of the lumbar, femora, and tibiae, together with a marked increase in body mass index (BMI). The administration of 5% ELE led to a significant increase in tibial and femoral BMD, as well as significantly increased bone-strength parameters when compared with OVX-Cont rats. According to the suppressed Dpd and increased osteocalcin concentrations in ELE 5% rats, we suggest that varying proportions of bone formation and bone absorption contributed to the enhanced BMD in the femora and tibiae. In addition, significant decreases in body weight, BMI and fat tissue in 5% ELE rats were also observed. These results suggest that ELE may have curative properties for BMD and BMI in OVX rats, and could provide an alternative therapy for the prevention of both postmenopausal osteoporosis and obesity.
Johnson-Shelton, Deb; Moreno-Black, Geraldine; Evers, Cody; Zwink, Nicole
Childhood obesity is a systemic and complex, multilevel public health problem. Research approaches are needed that effectively engage communities in reversing environmental determinants of child obesity. This article discusses the Communities and Schools Together (CAST) Project and lessons learned about the project's community-based participatory research (CBPR) model. A partnership of schools, community organizations, and researchers used multiple methods to examine environmental health risks for childhood obesity and conduct school-community health programs. Action work groups structured partner involvement for designing and implementing study phases. CBPR in child obesity prevention involves engaging multiple communities with overlapping yet divergent goals. Schools are naturally situated to participate in child obesity projects, but engagement of key personnel is essential for functional partnerships. Complex societal problems require CBPR approaches that can align diverse communities and necessitate significant coordination by researchers. CBPR can provide simultaneous health promotion across multiple communities in childhood obesity prevention initiatives. Support for emergent partner activities is an essential practice for maintaining community interest and involvement in multiyear CBPR projects. Investigator-initiated CBPR partnerships can effectively organize and facilitate large, health-promoting partnerships involving multiple, diverse stakeholder communities. Lessons learned from CAST illustrate the synergy that can propel projects that are holistically linked to the agents of a community.
Shaibu, Sheila; Holsten, Joanna E.; Stettler, Nicolas; Maruapula, Segametsi D.; Jackson, Jose C.; Malete, Leapetswe; Mokone, George; Wrotniak, Brian H.; Compher, Charlene W.
The study's objectives were to gain school personnel's (1) perceptions on diet, physical activity, body size, and obesity, (2) description of school food and physical activity practices, and (3) recommendations for programs to prevent adolescent obesity. The study took place in six junior secondary schools of varying socioeconomic status in…
Full Text Available Obesity and its related metabolic abnormalities, including insulin resistance, alterations in the insulin-like growth factor-1 (IGF-1/IGF-1 receptor (IGF-1R axis, and the state of chronic inflammation, increase the risk of colorectal cancer (CRC and hepatocellular carcinoma (HCC. However, these findings also indicate that the metabolic disorders caused by obesity might be effective targets to prevent the development of CRC and HCC in obese individuals. Green tea catechins (GTCs possess anticancer and chemopreventive properties against cancer in various organs, including the colorectum and liver. GTCs have also been known to exert anti-obesity, antidiabetic, and anti-inflammatory effects, indicating that GTCs might be useful for the prevention of obesity-associated colorectal and liver carcinogenesis. Further, branched-chain amino acids (BCAA, which improve protein malnutrition and prevent progressive hepatic failure in patients with chronic liver diseases, might be also effective for the suppression of obesity-related carcinogenesis because oral supplementation with BCAA reduces the risk of HCC in obese cirrhotic patients. BCAA shows these beneficial effects because they can improve insulin resistance. Here, we review the detailed relationship between metabolic abnormalities and the development of CRC and HCC. We also review evidence, especially that based on our basic and clinical research using GTCs and BCAA, which indicates that targeting metabolic abnormalities by either pharmaceutical or nutritional intervention may be an effective strategy to prevent the development of CRC and HCC in obese individuals.
Stanhope, Kaitlyn K; Kay, Christi; Stevenson, Beth; Gazmararian, Julie A
The incidence of childhood obesity is highest among children entering kindergarten. Overweight and obesity in early childhood track through adulthood. Programs increasingly target children in early life for obesity prevention. However, the published literature lacks a review on tools available for measuring behaviour and environmental level change in child care. The objective is to describe measurement tools currently in use in evaluating obesity-prevention in preschool-aged children. Literature searches were conducted in PubMed using the keywords "early childhood obesity," "early childhood measurement," "early childhood nutrition" and "early childhood physical activity." Inclusion criteria included a discussion of: (1) obesity prevention, risk assessment or treatment in children ages 1-5 years; and (2) measurement of nutrition or physical activity. One hundred thirty-four publications were selected for analysis. Data on measurement tools, population and outcomes were abstracted into tables. Tables are divided by individual and environmental level measures and further divided into physical activity, diet and physical health outcomes. Recommendations are made for weighing advantages and disadvantages of tools. Despite rising numbers of interventions targeting obesity-prevention and treatment in preschool-aged children, there is no consensus for which tools represent a gold standard or threshold of accuracy. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Morris, Heather; Skouteris, Helen; Edwards, Susan; Rutherford, Leonie
Partnering early childhood education and care (ECEC) and the home together may be more effective in combating obesogenic risk factors in preschool children. Thus, an evaluation of ECEC obesity prevention interventions with a parental component was conducted, exploring parental engagement and its effect on obesity and healthy lifestyle outcomes. A…
Bosch, Joop; Stradmeijer, Margreet; Seidell, Jaap
A profile will be given of the psychosocial characteristics of obese children and youngsters, as well as those of their families. Then several attempts of (particularly) preventive interventions will be sketched. Differences found between clinical and non-clinical groups of obese children and
Stegelin, Dolores A.
Obesity rates for children, adolescents, and adults continue to escalate in the United States and globally. Educators, health specialists, psychologists, and sociologists are studying the complex problems related to early obesity. Like other health problems, prevention and early detection are the most effective strategies. The causes and…
P.H.M. Van Baal (Pieter); J.J. Polder (Johan); G.A. de Wit (Ardine); R.T. Hoogenveen (Rudolf); T.L. Feenstra (Talitha); H.C. Boshuizen (Hendriek); P.M. Engelfriet (Peter); W.B.F. Brouwer (Werner)
textabstractBackground: Obesity is a major cause of morbidity and mortality and is associated with high medical expenditures. It has been suggested that obesity prevention could result in cost savings. The objective of this study was to estimate the annual and lifetime medical costs attributable to
Borys, J.M.; Le Bodo, Y.; Jebb, S.A.; Seidell, J C; Summerbell, C.; Richard, D.; De Henauw, S.; Moreno, L.A.; Romon, M.; Visscher, T L S; Raffin, S.; Swinburn, B.
Childhood obesity is a complex issue and needs multi-stakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. 'Ensemble Prévenons l'Obésité Des Enfants' (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for
Haines, Jess; Neumark-Sztainer, Dianne
In response to the high prevalence of obesity, eating disorders and disordered eating behaviors among youth, researchers in both the obesity and eating disorders fields have proposed using an integrated approach to prevention that addresses the spectrum of weight-related disorders within interventions. The identification of risk factors that are…
Verrotti, A; Penta, L; Zenzeri, L; Agostinelli, S; De Feo, P
Two crucial aspects of obesity prevention are early childhood and school-based interventions. The main purpose of this systematic review wass to evaluate the efficacy and the feasibility of school-based interventions performed in primary schools. All pertinent data from the literature have been critically examined and reviewed to evaluate the efficacy and the feasibility of different strategies of interventions. In particular, many studies have been performed in school-aged children. Data from literature suggest that educational interventions toward healthy eating habits and physical activity at school could be a key strategy in the prevention of obesity, because it has been shown that is difficult to treat obesity in adults through changes in the lifestyle rather than during childhood. Recent advances in technology, especially web-based interventions, have been used to provide a specific content addressing healthy lifestyle with regard diet and exercise. These data suggest the opportunity to use web-interactive programs as a new challenging technique of communication in order to promote healthy behaviors. The early detection and treatment of obesity in children may be the best approach to prevent future increases in morbidity, as well as healthcare costs that will likely occur as overweight and obese children age.
... by William Dietz and a forward-looking 'future perspectives' conclusion by Philip James embrace an international team of authors, all with experience of the issues posed by obesity in the young. Aimed at doctors, and all health-care professionals, it will be of interest to all those concerned about the increasing prevalence of obesity in children and ...
The obesity epidemic, recognized in developed nations for decades, is now a worldwide phenomenon. All age groups are affected, including women of childbearing age, fueling concern that maternal obesity before and during pregnancy and lactation impairs developmental establishment of body weight regul...
Werner, Danilea; Teufel, James; Holtgrave, Peter L.; Brown, Stephen L.
Background: Over the last 3 decades, US obesity rates have increased dramatically as more children and more adults become obese. This study explores an innovative program, Active Generations, an intergenerational nutrition education and activity program implemented in out-of-school environments (after school and summer camps). It utilizes older…
Seidell, J.C.; Halberstadt, J.
The prevalence of obesity is increasing at an alarming rate in many parts of the world. About 2 billion people are overweight and one third of them obese. The plight of the most affected populations, like those in high-income countries in North America, Australasia and Europe, has been well
The atherosclerotic process begins in childhood and advances rapidly triggered by multiple genetic and environmental factors, including obesity. Obesity has reach epidemic proportions mainly by the consumption of junk food and a sedentary lifestyle. Our children spend long time inactive in front of the television and video games, further aggravated by the consumption of excessive calories of unhealthy food bombardment from TV commercials. The health related expenses of the obese is in average $1,500 annually higher than for persons with normal weight. The annual cost of diseases associated to obesity is estimated on $147 billion in the United States, a 10% of the national medical expenses. We must uncover strategies conducting to healthier lifestyles. School and home initiatives together with community and governmental efforts are necessary to stimulate our youngsters to live healthy lifestyles. The commitment of the food industry is critical to achieve the difficult goal of reducing childhood obesity to the prevalent 5% of the 1970's.
Lumeng, Julie C; Miller, Alison L; Horodynski, Mildred A; Brophy-Herb, Holly E; Contreras, Dawn; Lee, Hannah; Sturza, Julie; Kaciroti, Niko; Peterson, Karen E
To determine the effect of an intervention to improve emotional and behavioral self-regulation in combination with an obesity-prevention program on the prevalence of obesity and obesity-related behaviors in preschoolers. This was a cluster-randomized intervention trial in Head Start (HS) classrooms conducted in each of 4 academic years from 2011 to 2015. Participants (697 children; 49% boys; mean age: 4.1 ± 0.5 years; 48% white, 30% African American, 12% Hispanic) were randomly assigned by classroom to 1 of 3 intervention arms: (1) HS + Preschool Obesity Prevention Series (POPS) + Incredible Years Series (IYS) (HS enhanced by the POPS [program targeting evidence-based obesity-prevention behaviors] and the IYS [program to improve children's self-regulation]), (2) HS+POPS, or (3) HS. Primary outcomes were changes in prevalence of obesity, overweight/obesity, BMI z score, and teacher-reported child emotional and behavioral self-regulation; secondary outcomes were dietary intake, outdoor play, screen time, and parent nutrition knowledge and nutrition self-efficacy. HS+POPS+IYS improved teacher-reported self-regulation compared with HS+POPS ( P obesity (16.4% preintervention to 14.3% postintervention in HS+POPS+IYS versus 17.3% to 14.4% in HS+POPS [ P = .54] versus 12.2% to 13.0% in HS [ P = .33]). There was no effect of HS+POPS compared with HS alone ( P = .16). There was no effect on other outcomes except for sugar-sweetened beverage intake (HS+POPS+IYS resulted in a greater decline than HS; P = .005). An intervention for parents and children to improve HS preschoolers' emotional and behavioral self-regulation in combination with an obesity-prevention curriculum did not reduce obesity prevalence or most obesity-related behaviors. Copyright © 2017 by the American Academy of Pediatrics.
Safdie, Margarita; Cargo, Margaret; Richard, Lucie; Lévesque, Lucie
Ecological intervention programs are recommended to prevent overweight and obesity in children. The National Institute of Public Health (INSP) in Mexico implemented a successful ecological intervention program to promote healthy lifestyle behaviors in school age children. This study assessed the integration of ecological principles and Social Cognitive Theory (SCT) constructs in this effective school-based obesity prevention program implemented in 15 elementary schools in Mexico City. Two coders applied the Intervention Analysis Procedure (IAP) to "map" the program's integration of ecological principles. A checklist gauged the use of SCT theory in program activities. Thirty-two distinct intervention strategies were implemented in one setting (i.e., school) to engage four different target-groups (students, parents, school representatives, government) across two domains (Nutrition and Physical Activity). Overall, 47.5% of the strategies targeted the school infrastructure and/or personnel; 37.5% of strategies targeted a key political actor, the Public Education Secretariat while fewer strategies targeted parents (12.5%) and children (3%). More strategies were implemented in the Nutrition domain (69%) than Physical Activity (31%). The most frequently used SCT construct within both intervention domains was Reciprocal Determinism (e.g., where changes to the environment influence changes in behavior and these behavioral changes influence further changes to the environment); no significant differences were observed in the use of SCT constructs across domains. Findings provide insight into a promising combination of strategies and theoretical constructs that can be used to implement a school-based obesity prevention program. Strategies emphasized school-level infrastructure/personnel change and strong political engagement and were most commonly underpinned by Reciprocal Determinism for both Nutrition and Physical Activity.
Hill, Briony; McPhie, Skye; Moran, Lisa J; Harrison, Paul; Huang, Terry T-K; Teede, Helena; Skouteris, Helen
Maternal obesity and excessive gestational weight gain (GWG) are significant contributors to the global obesity epidemic. However, isolated lifestyle interventions to address this in pregnancy appear to have only modest benefit and responses can be variable. This paper aims to address the question of why the success of lifestyle interventions to prevent excessive GWG is suboptimal and variable. We suggest that there are inherent barriers to lifestyle change within pregnancy as a life stage, including the short window available for habit formation; the choice for women not to prioritise their weight; competing demands including physiological, financial, relationship, and social situations; and lack of self-efficacy among healthcare professionals on this topic. In order to address this problem, we propose that just like all successful public health approaches seeking to change behaviour, individual lifestyle interventions must be provided in the context of a supportive environment that enables, incentivises and rewards healthy changes. Future research should focus on a systems approach that integrates the needs of individuals with the context within which they exist. Borrowing from the social marketing principle of 'audience segmentation', we also need to truly understand the needs of individuals to design appropriately tailored interventions. This approach should also be applied to the preconception period for comprehensive prevention approaches. Additionally, relevant policy needs to reflect the changing evidence-based climate. Interventions in the clinical setting need to be integrally linked to multipronged obesity prevention efforts in the community, so that healthy weight goals are reinforced throughout the system. Copyright © 2016 Elsevier Ltd. All rights reserved.
Nelson, Toben F.; Stovitz, Steven D.; Thomas, Megan; LaVoi, Nicole M.; Bauer, Katherine W.; Neumark-Sztainer, Dianne
Sport is a promising setting for obesity prevention among youth, but little is known about whether it prevents obesity. We reviewed research comparing sport participants with non-participants on weight status, physical activity and diet. Among nineteen studies we found no clear pattern of association between body weight and sport participation. Among seventeen studies we found that sport participants are more physically active than those who do not participate. Seven studies examined the rela...
Full Text Available Abstract Background The diets, physical activity and sedentary behavior levels of both children and adults in Australia are suboptimal. The family environment, as the first ecological niche of children, exerts an important influence on the onset of children’s habits. Parent modeling is one part of this environment and a logical focus for child obesity prevention initiatives. The focus on parent’s own behaviors provides a potential opportunity to decrease obesity risk behaviors in parents as well. Objective To assess the effect of a parent-focused early childhood obesity prevention intervention on first-time mothers’ diets, physical activity and TV viewing time. Methods The Melbourne InFANT Program is a cluster-randomized controlled trial which involved 542 mothers over their newborn’s first 18 months of life. The intervention focused on parenting skills and strategies, including parental modeling, and aimed to promote development of healthy child and parent behaviors from birth, including healthy diet, increased physical activity and reduced TV viewing time. Data regarding mothers’ diet (food frequency questionnaire, physical activity and TV viewing times (self-reported questionnaire were collected using validated tools at both baseline and post-intervention. Four dietary patterns were derived at baseline using principal components analyses including frequencies of 55 food groups. Analysis of covariance was used to measure the impact of the intervention. Results The scores of both the "High-energy snack and processed foods" and the "High-fat foods" dietary patterns decreased more in the intervention group: -0.22 (−0.42;-0.02 and −0.25 (−0.50;-0.01, respectively. No other significant intervention vs. control effects were observed regarding total physical activity, TV viewing time, and the two other dietary patterns, i.e. “Fruits and vegetables” and “Cereals and sweet foods”. Conclusions These findings suggest that
Lioret, Sandrine; Campbell, Karen J; Crawford, David; Spence, Alison C; Hesketh, Kylie; McNaughton, Sarah A
The diets, physical activity and sedentary behavior levels of both children and adults in Australia are suboptimal. The family environment, as the first ecological niche of children, exerts an important influence on the onset of children's habits. Parent modeling is one part of this environment and a logical focus for child obesity prevention initiatives. The focus on parent's own behaviors provides a potential opportunity to decrease obesity risk behaviors in parents as well. To assess the effect of a parent-focused early childhood obesity prevention intervention on first-time mothers' diets, physical activity and TV viewing time. The Melbourne InFANT Program is a cluster-randomized controlled trial which involved 542 mothers over their newborn's first 18 months of life. The intervention focused on parenting skills and strategies, including parental modeling, and aimed to promote development of healthy child and parent behaviors from birth, including healthy diet, increased physical activity and reduced TV viewing time. Data regarding mothers' diet (food frequency questionnaire), physical activity and TV viewing times (self-reported questionnaire) were collected using validated tools at both baseline and post-intervention. Four dietary patterns were derived at baseline using principal components analyses including frequencies of 55 food groups. Analysis of covariance was used to measure the impact of the intervention. The scores of both the "High-energy snack and processed foods" and the "High-fat foods" dietary patterns decreased more in the intervention group: -0.22 (-0.42;-0.02) and -0.25 (-0.50;-0.01), respectively. No other significant intervention vs. control effects were observed regarding total physical activity, TV viewing time, and the two other dietary patterns, i.e. "Fruits and vegetables" and "Cereals and sweet foods". These findings suggest that supporting first-time mothers to promote healthy lifestyle behaviors in their infants impacts maternal
van Galen, Louise S; Brabrand, Mikkel; Cooksley, Tim
OBJECTIVES: Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority...
Whelan, Jillian; Love, Penny; Romanus, Anne; Pettman, Tahna; Bolton, Kristy; Smith, Erin; Gill, Tim; Coveney, John; Waters, Elizabeth; Allender, Steve
Obesity is the single biggest public health threat to developed and developing economies. In concert with healthy public policy, multi-strategy, multi-level community-based initiatives appear promising in preventing obesity, with several countries trialling this approach. In Australia, multiple levels of government have funded and facilitated a range of community-based obesity prevention initiatives (CBI), heterogeneous in their funding, timing, target audience and structure. This paper aims to present a central repository of CBI operating in Australia during 2013, to facilitate knowledge exchange and shared opportunities for learning, and to guide professional development towards best practice for CBI practitioners. A comprehensive search of government, non-government and community websites was undertaken to identify CBI in Australia in 2013. This was supplemented with data drawn from available reports, personal communication and key informant interviews. The data was translated into an interactive map for use by preventive health practitioners and other parties. We identified 259 CBI; with the majority (84%) having a dual focus on physical activity and healthy eating. Few initiatives, (n=37) adopted a four-pronged multi-strategy approach implementing policy, built environment, social marketing and/or partnership building. This comprehensive overview of Australian CBI has the potential to facilitate engagement and collaboration through knowledge exchange and information sharing amongst CBI practitioners, funders, communities and researchers. An enhanced understanding of current practice highlights areas of strengths and opportunities for improvement to maximise the impact of obesity prevention initiatives. © 2015 Public Health Association of Australia.
Ward, Dianne S; Vaughn, Amber; Story, Mary
Early childhood is a formative period for many weight-related behaviors (diet and activity), but little obesity prevention research targeting this age group has been conducted. Early care and education settings are a useful avenue for interventions targeting young children, but the limited research provides insufficient evidence upon which to base policy decisions, practice guidelines, or mobilized efforts to improve healthy eating and physical activity, and ultimately healthy weight development in these settings. In September of 2011, prominent researchers, young investigators, and leaders in early care and education came together to examine past research and to explore challenges and priorities for future research on healthy weight development in children aged 2-5 years. During this meeting, experts presented and attendees discussed key issues around measurement of diet and physical activity, policy and environment measurement, intervention approaches, policy research, and capacity development. Following the meeting, attendees were invited to participate in an online voting exercise to select top research priorities. A total of 64 research issues were identified, and voting narrowed this list to 24 issues. Highest-rated issues included: Assessment of the quality of children's meals and snacks, use of financial incentives, interventions that include healthcare providers, the role of screen time, and need for multilevel interventions. The presentations within this meeting highlighted the importance of research to address the unique challenges for those working in early care and education settings. Expert and stakeholder consensus of priorities identified significant and innovative areas where future obesity prevention research efforts should be focused.
McCall, Anthony; Raj, Ramona
As rates of obesity and type 2 diabetes continue to escalate, effective means of prevention become paramount in curbing the largest epidemic of our times. With adult obesity rates in the United States already at 34%, according to the most recent National Health and Nutrition Examination Survey (NHANES) data, preventing obesity in childhood is of increasing urgency. Exercise and lifestyle modification have been shown to be effective in adult trials for diabetes prevention, such as the Diabetes Prevention Program (DPP), Finnish Diabetes Study, and Da Qing Study. This article reviews randomized, controlled trials in children, using exercise and lifestyle modification in the prevention of insulin resistance and obesity. This review encompasses studies within the past decade from Planet Health in 1999 to the Beijing Obesity Intervention trial published in 2007 and covers both school-based and family-based approaches. A challenging task by any means, these trials have contributed valuable insight into the efficacy of various approaches toward preventing childhood obesity and insulin resistance, a pressing public health concern.
Golley, R K; McNaughton, S A; Collins, C E; Magarey, A; Garnett, S P; Campbell, K J; Mallan, K; Burrows, T
The Food and Nutrition stream of Australasian Child and Adolescent Obesity Research Network (ACAORN) aims to improve the quality of dietary methodologies and the reporting of dietary intake within Australasian child obesity research (http://www.acaorn.org.au/streams/nutrition/). With 2012 marking ACAORN's 10th anniversary, this commentary profiles a selection of child obesity nutrition research published over the last decade by Food and Nutrition Stream members. In addition, stream activities have included the development of an online selection guide to assist researchers in their selection of appropriate dietary intake methodologies (http://www.acaorn.org.au/streams/nutrition/dietary-intake/index.php). The quantity and quality of research to guide effective child obesity prevention and treatment has increased substantially over the last decade. ACAORN provides a successful case study of how research networks can provide a collegial atmosphere to foster and coordinate research efforts in an otherwise competitive environment. © 2014 The Authors. Pediatric Obesity © 2014 International Association for the Study of Obesity.
Caballero, B; Vorkoper, S; Anand, N; Rivera, J A
The increasing prevalence of childhood obesity in Latin America poses a major public health challenge to the region. In response, many countries are implementing obesity prevention programmes aimed at modifying known risk factors. However, the limited scientific evidence inhibits the development and implementation of novel, effective interventions across the region. To address these gaps, the NIH Fogarty International Center convened a workshop of researchers, policymakers, programme implementers and public health advocates who are actively engaged in the region to prevent childhood obesity. Major aims of the meeting were to define the current status of childhood obesity, identify the scientific gaps in our understanding of the epidemic, point out the barriers and opportunities for research and outline a plan for capacity building in the region in the area of childhood obesity. This series of articles reflects the key outcome of the meeting and offers an analysis of the knowledge translation needed for evidence-based policy initiatives, a review of the research agenda and an evaluation of research capacity in the region. The goal of the papers is to inform the development of multidisciplinary and multisector research collaborations, which are essential to the implementation of successful childhood obesity prevention strategies in the region. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.
Yang, N; Ginsburg, G S; Simmons, L A
The prevalence of obesity in America has reached epidemic proportions, and obesity among women is particularly concerning. Severe obesity (body mass index ≥35 kg m(-2) ) is more prevalent in women than men. Further, women have sex-specific risk factors that must be considered when developing preventive and therapeutic interventions. This review presents personalized medicine as a dynamic approach to obesity prevention, management and treatment for women. First, we review obesity as a complex health issue, with contributing sex-specific, demographic, psychosocial, behavioural, environmental, epigenetic and genetic/genomic risk factors. Second, we present personalized medicine as a rapidly advancing field of health care that seeks to quantify these complex risk factors to develop more targeted and effective strategies that can improve disease management and/or better minimize an individual's likelihood of developing obesity. Third, we discuss how personalized medicine can be applied in a clinical setting with current and emerging tools, including health risk assessments, personalized health plans, and strategies for increasing patient engagement. Finally, we discuss the need for additional research, training and policy that can enhance the practice of personalized medicine in women's obesity, including further advancements in the '-omics' sciences, physician training in personalized medicine, and additional development and standardization of innovative targeted therapies and clinical tools. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.
Minematsu, Kazuo; Kawabuchi, Ryosuke; Okazaki, Hiromi; Tomita, Hiroyuki; Tobina, Takuro; Tanigawa, Takeshi; Tsunawake, Noriaki
There is no official recommendations for physical activity level or steps for preventing and improving child obesity in Japan. Three hundred and two Japanese children aged 9-12 years were recruited wore 3-D speed sensors. Subjects were divided into two groups using the criteria for child obesity in Japan. Body composition was measured on bioelectrical impedance analysis. Physical fitness test was done to evaluate physical strength. Twenty-four hour total steps, energy expenditure, and metabolic equivalents (MET) from Monday to Sunday were consecutively measured. The cut-offs for steps and physical activity level for preventing child obesity were evaluated on receiver operating characteristic curves. Daily life-related risk factors for child obesity were assessed on logistic regression analysis. In both sexes, body volume; bodyweight, body mass index, fat mass, and percentage body fat in the obese group was significantly higher than in the normal group, but age and height were not different (P obese group were inferior to those in the normal group (P child obesity. Additionally, >2 h TV viewing per day is a significant risk factor for child obesity (OR, 3.43; 95%CI: 1.27-9.31). Cut-offs for physical activity and potential risk factors for child obesity have been identified. Recommendations for changes to daily lifestyle for school-aged Japanese children are given. © 2014 Japan Pediatric Society.
Benjamin Neelon, S E; Østbye, T; Hales, D; Vaughn, A; Ward, D S
Obesity prevention in young children is a public health priority. In the USA, nearly 10% of children less than 5 years of age are obese, and most attend some form of out-of-home child care. While a number of interventions have been conducted in early care and education settings, few have targeted the youngest children in care or the less formal types of child care like family child care homes. Additionally, only two previous studies provided recommendations to help inform future interventions. This paper presents lessons learned from two distinct intervention studies in early care and education settings to help guide researchers and public health professionals interested in implementing and evaluating similar interventions. We highlight two studies: one targeting children ages 4 to 24 months in child care centres and the other intervening in children 18 months to 4 years in family child care homes. We include lessons from our pilot studies and the ongoing larger trials. To date, our experiences suggest that an intervention should have a firm basis in behaviour change theory; an advisory group should help evaluate intervention materials and plan for delivery; and realistic recruitment goals should recognize economic challenges of the business of child care. A flexible data collection approach and realistic sample size calculations are needed because of high rates of child (and sometimes facility) turnover. An intervention that is relatively easy to implement is more likely to appeal to a wide variety of early care and education providers. Interventions to prevent obesity in early care and education have the potential to reach large numbers of children. It is important to consider the unique features and similarities of centres and family child care homes and take advantage of lessons learned from current studies in order to develop effective, evidence-based interventions. © 2016 John Wiley & Sons Ltd.
Brahe, Lena Kirchner; Astrup, Arne; Larsen, Lesli Hingstrup
microbiota transplantations in mice and in humans indicate that a specific gut microbiota composition can be the cause and not just the consequence of the obese state and metabolic disease, which suggests a potential for gut microbiota modulation in prevention and treatment of obesity-related metabolic......Obesity increases the risk of type 2 diabetes, cardiovascular diseases, and certain cancers, which are among the leading causes of death worldwide. Obesity and obesity-related metabolic diseases are characterized by specific alterations in the human gut microbiota. Experimental studies with gut...... diseases. In addition, dietary intervention studies have suggested that modulation of the gut microbiota can improve metabolic risk markers in humans, but a causal role of the gut microbiota in such studies has not yet been established. Here, we review and discuss the role of the gut microbiota in obesity...
Michele R. Sgambato
Full Text Available Abstract Background The prevalence of childhood obesity is increasing at a high rate in Brazil, making prevention a health priority. Schools are the central focus of interventions aiming the prevention and treatment of childhood obesity, however, randomized trials and cohort studies have not yet provided clear evidence of strategies to reduce prevalence of obesity. The aim of this study is to present a protocol to evaluate the efficacy of combining school and household level interventions to reduce excessive weight gain among students. Methods The intervention target fifth and sixth graders from 18 public schools (9 interventions and 9 controls in the municipality of Duque de Caxias, metropolitan area of Rio de Janeiro, Brazil. A sample size of 2500 students will be evaluated at school for their weight status and those from the intervention group who are overweight or obese will be followed monthly at home by community health agents. Demographic, socioeconomic, anthropometric, eating behavior and food consumption data will be collected at school using a standardized questionnaire programmed in personal digital assistant. At school, all students from the intervention group will be encouraged to change eating habits and food consumption and to increase physical activity and reducing sedentary behavior. Discussion This study will provide evidence whether integration of school with primary health care can prevent excessive weight gain among adolescents. Positive results will inform a sustainable strategy to be disseminated in the health care system in Brazil. Trial registration ClinicalTrials.gov, NCT02711488 . Date of registration: March 11, 2016.
Haynes, Emily; Palermo, Claire; Dianne P Reidlinger
Introduction Until now, industry and government stakeholders have dominated public discourse about policy options for obesity. While consumer involvement in health service delivery and research has been embraced, methods which engage consumers in health policy development are lacking. Conflicting priorities have generated ethical concern around obesity policy. The concept of ?intrusiveness? has been applied to policy decisions in the UK, whereby ethical implications are considered through lev...
Ness-Abramof, Rosane; Apovian, Caroline M
The obesity epidemic is best explained by global lifestyle alterations favoring weight gain in a susceptible population. The consumption of calorically dense foods, increased portion sizes, and a decrease in workplace and leisure physical activity most likely accounts for the increase in overweight and obesity worldwide. The cornerstone of overweight and obesity therapy is dietary intervention, but unfortunately most patients eventually regain the weight lost through diet alone. The search for a macronutrient composition that may enhance and help maintain weight loss has brought an abundance of fad diets into the lay literature. According to the available data, weight loss and maintenance of weight loss are dictated by total caloric intake, and not by macronutrient composition. There is epidemiologic data linking sugar-sweetened beverages to adult and childhood obesity, and an inverse relationship between dairy intake and overweight and obesity has also been observed. More research is needed to elucidate mechanisms explaining these relationships. Further research should focus on permanent lifestyle changes that may reverse this growing epidemic. This review will focus on current practices for the dietary management of obesity and to promote weight maintenance.
Hesketh, Kylie D; Campbell, Karen J
The small number and recency of the early childhood obesity-prevention literature identified in a previous review of interventions to prevent obesity, promote healthy eating, physical activity, and/or reduce sedentary behaviors in 0-5 year olds suggests this is a new and developing research area. The current review was conducted to provide an update of the rapidly emerging evidence in this area and to assess the quality of studies reported. Ten electronic databases were searched to identify literature published from January 1995 to August 2008. interventions reporting child anthropometric, diet, physical activity, or sedentary behavior outcomes and focusing on children aged 0-5 years of age. focusing on breastfeeding, eating disorders, obesity treatment, malnutrition, or school-based interventions. Two reviewers independently extracted data and assessed study quality. Twenty-three studies met all criteria. Most were conducted in preschool/childcare (n = 9) or home settings (n = 8). Approximately half targeted socioeconomically disadvantaged children (n = 12) and three quarters were published from 2003 onward (n = 17). The interventions varied widely although most were multifaceted in their approach. While study design and quality varied most studies reported their interventions were feasible and acceptable, although impact on behaviors that contribute to obesity were not achieved by all. Early childhood obesity-prevention interventions represent a rapidly growing research area. Current evidence suggests that behaviors that contribute to obesity can be positively impacted in a range of settings and provides important insights into the most effective strategies for promoting healthy weight from early childhood.
Reed, Monique; Wilbur, JoEllen; Schoeny, Michael
In the U.S., overweight/obesity among African American (AA) girls has become epidemic. Since parental factors may be associated with improved weight status, it is important to understand the empirical evidence for including parents in obesity prevention interventions with AA girls. The purpose of this integrative review was to identify effectiveness and characteristics of obesity prevention interventions for AA girls (6-17 years) and their parent. Included interventions addressed physical activity (PA), dietary/eating behaviors, and body composition. Of 708 studies published through March 2014, eight met inclusion criteria. Though effects were in the intended direction for most, statistically significant effects were found only for dietary intake and eating behavior. Interventions were characterized by exclusion of girls ages 13-17, failure to link parent involvement to child outcomes, the absence of family systems theory, and modest effects. Further research is needed to ascertain the effectiveness of daughter/parent obesity prevention interventions.
Eck, Kaitlyn; Alleman, Gayle Povis; Quick, Virginia; Martin-Biggers, Jennifer; Hongu, Nobuko; Byrd-Bredbenner, Carol
Community family educators have the opportunity to incorporate childhood obesity prevention concepts in their programming with families of young children, but often lack formal health and nutrition education. The purpose of this feasibility study was to create an online training certificate program for community family educators and assess the program's effectiveness at improving participant's knowledge, attitudes, and intended and actual behaviors related to healthy lifestyles. Community family educators (n = 68) completed an online pretest, viewed 13 brief videos (8-15 min) focused on childhood obesity related topics and took mini-knowledge self-checks after each video followed by an online posttest. At posttest, paired t tests showed participants' childhood obesity prevention related knowledge (i.e., nutrition, physical activity, screen time and sleep) improved significantly (p family meals, physical activity, screen time control and parent modeling significantly (p family educators' knowledge, attitudes, and intentions for obesity-prevention related parenting practices.
Banchonhattakit, Pannee; Tanasugarn, Chanuantong; Pradipasen, Mandhana; Miner, Kathleen R; Nityasuddhi, Dechavudh
This research was designed to test the effectiveness of a school network for childhood obesity prevention (SNOCOP) in primary schools; a program that aimed to improve student behavior in terms of knowledge, attitude, intention towards obesity prevention, and their food consumption behavior. A quasi-experimental pretest-posttest time series study was conducted. By 2-stage stratified sampling selection 180 students from 6 schools were assigned to the intervention group and 195 students from 6 schools to the control group at Saraburi Province, Thailand in 2006- 2007. In addition, thirty-one participants being school administrators, teachers, parents, and community members from six schools formed the social network initiating the intervention. The schoolchildren in the intervention group improved their eating behavior, knowledge, attitude, intention towards obesity preventive behavior. The six schools of the intervention group changed school policies and school activities aiming to reduce the proportion of obesity among their student. No such activities could be observed in the control group. These findings suggest that the School-Social Network of Childhood Obesity Prevention program is an effective means to prevent childhood obesity.
Petzke, Klaus J.; Freudenberg, Anne; Klaus, Susanne
High-protein diets have been shown to prevent the development of diet-induced obesity and can improve associated metabolic disorders in mice. Dietary leucine supplementation can partially mimic this effect. However, the molecular mechanisms triggering these preventive effects remain to be satisfactorily explained. Here we review studies showing a connection between high protein or total amino nitrogen intake and obligatory water intake. High amino nitrogen intake may possibly lower lipid storage, and prevent insulin resistance. Suggestions are made for further systematical studies to explore the relationship between water consumption, satiety, and energy expenditure. Moreover, these examinations should better distinguish between leucine-specific and unspecific effects. Research in this field can provide important information to justify dietary recommendations and strategies in promoting long-term weight loss and may help to reduce health problems associated with the comorbidities of obesity. PMID:24447927
Clarke, J; Fletcher, B; Lancashire, E; Pallan, M; Adab, P
Schools are increasingly recognized as an ideal setting for interventions to tackle childhood obesity. A better understanding of the views of key stakeholders would help to engage schools and inform the feasibility of such interventions in practice. This meta-synthesis of 18 qualitative studies explores the views of parents, school staff, school governors, school nurses and students on the role of the primary school in preventing childhood obesity. Six categories emerged: 'School as a key setting'; 'What schools should be doing to promote healthy eating (HE)'; 'What schools should be doing to promote physical activity (PA)'; 'General barriers'; 'Barriers to promoting HE at school'; and 'Barriers to promoting PA at school'. Thirty-seven finer-level themes emerged within these categories. Stakeholders agreed on the key role of the primary school as a setting for obesity prevention, the importance of schools providing and promoting opportunities for HE and PA, and the need for schools to work with parents. Some perceived barriers could be overcome at school level, e.g. using unhealthy foods as rewards/fundraisers or withholding PA for bad behaviour. Leadership and guidance from government were considered to be needed to counteract other observed barriers, particularly regarding school canteens, support for parents and time for PA. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.
Lévesque, Lise; Ozdemir, Vural; Godard, Béatrice
The goal of nutrigenomics is to develop nutritional interventions targeted to individual genetic make-up. Obesity is a prime candidate for nutrigenomics research. Personalized approaches to prevention of diseases associated with obesity may be available in the near future. Nevertheless, in the context of limited resources, access to a nutrigenomics personalized health service raises questions around equity. Using focus groups, the present qualitative research study provides empirical data on ethical concerns and values surrounding the nutrigenomics-guided personalized nutrition for obesity prevention. Eight focus groups were convened including 27 healthy individuals and 21 individuals who self-identified as obese or at risk of obesity. The transcripts of the focus group were analyzed according to the qualitative method of grounded theory. Responsibility, reciprocity, and solidarity emerged as the key ethical criteria perceived by the respondents to be significant in terms of how health professionals should determine access to personalized nutrition services. Still, exclusion of individuals from specific nutrigenomic services is likely to conflict with the imperatives of medical deontology and contemporary social consensus. The representation of equity in this paper is novel: it considers the intersection of nutrigenomics and personalized nutritional interventions specifically in the context of limited public resources for health services.
Evaluation of the overweight/obese child--practical tips for the primary health care provider: recommendations from the Childhood Obesity Task Force of the European Association for the Study of Obesity
Baker, Jennifer L; Farpour-Lambert, Nathalie J; Nowicka, Paulina
Association for the Study of Obesity (EASO). We have attempted to use an evidence-based approach while allowing flexibility for the practicing clinician in domains where evidence is currently lacking and ensuring that treating the obese child involves the entire family as well.......The prevalence of obesity among children and adolescents is on the rise. The majority of overweight or obese children are treated by primary health care providers including paediatricians, family practitioners, dieticians, nurses, and school health services - and not by specialists. The majority...... of obese children have no underlying medical disorder causing their obesity yet a significant proportion might suffer from obesity-related co-morbidities. This text is aimed at providing simple and practical tools for the identification and management of children with or at risk of overweight and obesity...
... concerned about weight-related health problems, see your doctor or health care provider. You and your provider can evaluate your health risks and discuss your weight-loss options. Although there are genetic, behavioral and hormonal influences on body weight, obesity occurs when you take ...
May, Jeanette; Buckman, Ellen
Nearly two thirds of the US population is overweight or obese and those numbers are climbing. Many organizations are beginning to recognize overweight and obesity as severe health threats and to acknowledge that treatment can serve as an important first step in addressing this epidemic. Through its Obesity with Co-morbidities Initiative, the Disease Management Association of America (DMAA) seeks to raise awareness and improve understanding of the role disease management (DM) can play in the treatment and management of obesity with comorbidities. Among the objectives of the Obesity with Co-morbidities Initiative was to develop standard definitions of obesity and obesity with comorbidities and to conduct qualitative research among key DM stakeholders. The first project undertaken and completed by the Obesity with Associated Co-morbidities Steering Committee and work group was to define the term "obesity" for consistent usage within the DM community for the purposes of population-based interventions. As part of this initiative, DMAA partnered with Synovate, a global market research firm, to conduct focus groups and in-depth interviews in order to collect qualitative data on attitudes and practices related to obesity treatment and coverage among key industry stakeholders, including health plans, disease management organizations, employers, and the business community. The findings indicated that obesity was widely recognized as a serious issue, but there remained varying opinions regarding responsibility, health and productivity costs, coverage, and best treatment methods among the participants. DMAA will continue this initiative through 2007 and will continue to develop a knowledge base of obesity guidelines and management practices, create valuable tools and resources including an online resource center, and facilitate partnerships with other organizations involved in the management and prevention of obesity.
Gupta, Nidhi; Goel, Kashish; Shah, Priyali; Misra, Anoop
Rapidly changing dietary practices and a sedentary lifestyle have led to increasing prevalence of childhood obesity (5-19 yr) in developing countries recently: 41.8% in Mexico, 22.1% in Brazil, 22.0% in India, and 19.3% in Argentina. Moreover, secular trends indicate increasing prevalence rates in these countries: 4.1 to 13.9% in Brazil during 1974-1997, 12.2 to 15.6% in Thailand during 1991-1993, and 9.8 to 11.7% in India during 2006-2009. Important determinants of childhood obesity include high socioeconomic status, residence in metropolitan cities, female gender, unawareness and false beliefs about nutrition, marketing by transnational food companies, increasing academic stress, and poor facilities for physical activity. Childhood obesity has been associated with type 2 diabetes mellitus, the early-onset metabolic syndrome, subclinical inflammation, dyslipidemia, coronary artery diseases, and adulthood obesity. Therapeutic lifestyle changes and maintenance of regular physical activity through parental initiative and social support interventions are the most important strategies in managing childhood obesity. Also, high-risk screening and effective health educational programs are urgently needed in developing countries. Copyright © 2012 by The Endocrine Society
Evaluation of the overweight/obese child--practical tips for the primary health care provider: recommendations from the Childhood Obesity Task Force of the European Association for the Study of Obesity
Baker, Jennifer L; Farpour-Lambert, Nathalie J; Nowicka, Paulina
in the primary care setting. The tips and tools provided are based on data from the recent body of work that has been published in this field, official statements of several scientific societies along with expert opinion provided by the members of the Childhood Obesity Task Force (COTF) of the European......The prevalence of obesity among children and adolescents is on the rise. The majority of overweight or obese children are treated by primary health care providers including paediatricians, family practitioners, dieticians, nurses, and school health services - and not by specialists. The majority...... of obese children have no underlying medical disorder causing their obesity yet a significant proportion might suffer from obesity-related co-morbidities. This text is aimed at providing simple and practical tools for the identification and management of children with or at risk of overweight and obesity...
Sreevatsava, Meghana; Narayan, K M Venkat; Cunningham, Solveig A
Childhood obesity is on the rise worldwide and its increasing prevalence in low and middle income countries is well-known. Obesity interventions have the potential to prevent adverse health outcomes; however, large gaps in research and knowledge about the efficacy and sustainability of such interventions remain. The objectives of this article were to review the evidence for interventions to prevent and control obesity among children and adolescents, evaluate their applicability in India, and discuss the challenges to sustain such interventions. The authors reviewed published research focusing on childhood obesity interventions, especially in India and other lower-resource countries. Nine observational and 10 interventional studies were reviewed. Most studies identified were from developed countries and took place at day-care settings, schools, and after school programs. Nineteen reported studies were grouped into categories: diet (2), physical activity (4), childcare programs (2), media-based programs (2), parental involvement (2), multi-component studies (1), and screen time (6). Most interventions were effective in reducing BMI, decreasing sedentary behaviors, and increasing physical activity. Sustainability of these interventions was not evaluated. While there is no one method or simple intervention to address obesity, multi-component approaches involving home and school environments are promising and warrant evaluation in India. Literature on obesity prevention and control in India and in lower-resource countries, however, is sparse. Existing gaps in knowledge about obesity should be addressed by conducting research in India and carrying out interventions to determine what strategies will be successful and sustainable locally.
Kobyliak, Nazarii; Conte, Caterina; Cammarota, Giovanni; Haley, Andreana P; Styriak, Igor; Gaspar, Ludovit; Fusek, Jozef; Rodrigo, Luis; Kruzliak, Peter
The worldwide prevalence of obesity more than doubled between 1980 and 2014. The obesity pandemic is tightly linked to an increase in energy availability, sedentariness and greater control of ambient temperature that have paralleled the socioeconomic development of the past decades. The most frequent cause which leads to the obesity development is a dysbalance between energy intake and energy expenditure. The gut microbiota as an environmental factor which influence whole-body metabolism by affecting energy balance but also inflammation and gut barrier function, integrate peripheral and central food intake regulatory signals and thereby increase body weight. Probiotics have physiologic functions that contribute to the health of gut microbiota, can affect food intake and appetite, body weight and composition and metabolic functions through gastrointestinal pathways and modulation of the gut bacterial community.
Torres-Fuentes, Cristina; Schellekens, Harriët; Dinan, Timothy G; Cryan, John F
Obesity and obesity-related disorders are reaching epidemic proportions worldwide. In this review, we summarize the accumulating studies that have emerged in the last few decades demonstrating that bioactives from different natural sources could potentially have anti-obesity effects. We carried out an extensive search of relevant literature from Pubmed, Web of Knowledge, and other online databases for studies where anti-obesity effects were shown by compounds from natural sources. Appetite suppression, lipid metabolism regulation, and increase of energy expenditure are the main mechanisms by which anti-obesity effects are exerted. Plants represent the most studied natural source of anti-obesity bioactives. Camellia sinensis is the most representative species exerting several anti-obesity effects. Moreover, probiotics (bacteria which bestow health benefit), such as strains of Bifidobacteria and Lactobacillus families, and certain prebiotics (non-viable food components that confers a health benefit on the host associated with modulation of the microbiota effects), such as insulin-type fructans, have also shown capability to combat obesity. Finally, compounds from animal sources, in particular bioactive peptides derived from milk-derived whey and casein protein digestion, high dietary calcium, and omega-3s polyunsaturated fatty acids (n-3 PUFA) present in fish oils, have also shown potential anti-obesity effects. Several anti-obesity effects have been observed in different natural bioactives providing an interesting and potentially safer and more desirable treatment strategy for the development of anti-obesity functional or medical foods.
Palomo Atance, E; Bahíllo Curieses, P; Bueno Lozano, G; Feliu Rovira, A; Gil-Campos, M; Lechuga-Sancho, A M; Ruiz Cano, R; Vela Desojo, A
Childhood obesity is associated with a high risk of cardiovascular disease and early mortality. This paper summarises the currently available evidence on the implications of dietary factors on the development and prevention of obesity in paediatric patients. Evidence-based recommendations are: promote the consumption of slowly absorbed carbohydrates and reduce those with a high-glycaemic-index, avoid intake of sugar-sweetened beverages. Fat may provide up to 30-35% of the daily energy intake and saturated fat should provide no more than 10% of daily energy intake; reduce cholesterol intake, avoid formula milk with a high protein content during the first year; promote higher fibre content in the diet, reduce sodium intake, and have at least four meals a day, avoiding regular consumption of fast food and snacks. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.
Frerichs, Leah; Brittin, Jeri; Stewart, Catherine; Robbins, Regina; Riggs, Cara; Mayberger, Susan; Cervantes, Alberto
Background Childhood obesity rates in minority populations continue to rise despite leveling national trends. Although interventions that address social and environmental factors exist, processes that create demand for policy and environmental change within communities have not been identified. Community Context We developed a pilot program in South Omaha, a Nebraska Latino community, based on the community readiness model (CRM), called SaludableOmaha. We used CRM to explore the potential of youth advocacy to shift individual and community norms regarding obesity prevention in South Omaha and to advocate for health-promoting community environments. Methods We used CRM to assess supply and demand for health programs, engage the community, determine the community’s baseline readiness to address childhood obesity, and guide youth advocacy program development. We conducted our project in 2 phases. In the first, we trained a cohort of youth. In the second, the youth cohort created and launched a Latino health movement, branded as SaludableOmaha. A third phase, which is currently under way, is directed at institutionalizing youth advocacy in communities. Outcome At baseline, the community studied was at a low stage of readiness for change. Our program generated infrastructure and materials to support the growth and institutionalization of youth advocacy as a means of increasing community readiness for addressing obesity prevention. Interpretation CRM is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community. Community partnerships such as SaludableOmaha can aid the adoption of obesity prevention programs. PMID:23217590
Full Text Available Introduction: The future of any nation depends on how its children's care, According to their likely future health needs of the adult population model for healthy living and wealth has increased. One of the most pressing health diet. This study is done to aimed investigate the factors influencing malnutrition in children in the past for weight loss and weight gain can be seen today. Methods and Methods: Related articles referring to achieve in the field of databases to Google scholar, Pub Med, proquest, SID, Magiran, Springer Link,… and studies until 2013 with the key words malnutrition, child, obesity and examine their English. Results: In the past, malnutrition was associated with weight loss, but for now he has to weight gain and obesity. Childhood obesity is emerging as a phenomenon caused health problems in childhood and adolescence, including hyperlipidemia, obstructive sleep apnea, early puberty, diabetes, hypertension and cardiovascular. In addition to the health problems of obese children will benefit from the social and psychological problems such as anxiety, fewer friends, loss of confidence, lower education, and fewer chances for marriage.... Overweight in children can be caused by poor eating habits and low activity, which is affected by the parents and the family environment. Conclusions: Since the patterns learned in childhood affect all life on lifestyle, understand the causes of obesity and to eliminate or reduce them and reinforce the correct patterns of feeding Through education and the incidence is somewhat reduced, especially for parents to deal with this phenomenon. Keywords: Child,Malnutrition, Obesity
Nakamura, Yuko; Ikuta, Toshikazu
There exists diversity among individuals in difficulty controlling body weight. Body weight control, or obesity prevention, requires cognitive control over ingestive behavior, which may account for the diverse ability of body weight control. The caudate nuclei, especially the dorsal area, have been shown to play critical roles in ingestive behaviors, which significantly influences body weight control. However, the practice of body weight control is dependent on the body weight status, because the current obesity status determines the need for body weight control. To elucidate the underlying neural mechanism that accounts for individual differences in obesity prevention, we aimed to isolate functional caudate connectivity responsible for the underlying tendency of obesity prevention, independent of the current obesity status, using resting state fMRI data, body mass index (BMI), and assessment of ingestive behavior from 185 individuals from the NKI-Rockland sample. The underlying tendency of obesity prevention was estimated from BMI and behavioral and cognitive components of food intake. Functional connectivities between the caudate head and the whole brain were tested as a function of the estimated tendency in a voxel-wise manner. The bilateral precuneus showed inverse association between its connectivity to the caudate and the estimated tendency. Caudate-precuneus connectivity may have significant implications to understanding personal differences that accounts for the success in body weight control.
Bourgeois, Nicole; Brauer, Paula; Simpson, Janis Randall; Kim, Susie; Haines, Jess
Preventing childhood obesity is a public health priority, and primary care is an important setting for early intervention. Authors of a recent national guideline have identified a need for effective primary care interventions for obesity prevention and that parent perspectives on interventions are notably absent from the literature. Our objective was to determine the perspectives of primary care clinicians and parents of children 2-5 years of age on the implementation of an obesity prevention intervention within team-based primary care to inform intervention implementation. We conducted focus groups with interprofessional primary care clinicians (n = 40) and interviews with parents (n = 26). Participants were asked about facilitators and barriers to, and recommendations for implementing a prevention program in primary care. Data were recorded and transcribed, and we used directed content analysis to identify major themes. Barriers existed to addressing obesity-related behaviours in this age group and included a gap in well-child primary care between ages 18 months and 4-5 years, lack of time and sensitivity of the topic. Trust and existing relationships with primary care clinicians were facilitators to program implementation. Offering separate programs for parents and children, and addressing both general parenting topics and obesity-related behaviours were identified as desirable. Despite barriers to addressing obesity-related behaviours within well-child primary care, both clinicians and parents expressed interest in interventions in primary care settings. Next steps should include pilot studies to identify feasible strategies for intervention implementation.
Howard-Drake, E J; Halliday, V
Headteachers of primary schools in England are a crucial partner for childhood obesity prevention. Understanding how this works in practice is limited by their views being underrepresented or missing from the evidence base. The aim of this study was to explore primary school headteachers' perspectives on childhood obesity and the perceived barriers and facilitators of prevention. A qualitative study with a purposive sample of 14 primary school headteachers from the Yorkshire and Humber region of England was conducted. Semi-structured interviews were audio-taped, transcribed and analysed using an inductive thematic approach. An extensive range of barriers and facilitators emerged within four key themes; understanding childhood obesity, primary school setting, the role of parents and external partners. A lack of knowledge, awareness and skills to deal with the sensitivity and complexity of childhood obesity across all school stakeholders presents the most significant barrier to effective action. Headteachers recognize primary schools are a crucial setting for childhood obesity prevention; however their school's often do not have the capability, capacity and confidence to make a meaningful and sustainable impact. To increase headteachers' ability and desire to prevent childhood obesity, schools require specialist and tailored training, resources and support from external partners such as public health teams and school nursing services. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: email@example.com.
Shirakami, Yohei; Ohnishi, Masaya; Sakai, Hiroyasu; Tanaka, Takuji; Shimizu, Masahito
Colorectal cancer is a major healthcare concern worldwide. Many experimental and clinical studies have been conducted to date to discover agents that help in the prevention of this disease. Chronic inflammation in colonic mucosa and obesity, and its related metabolic abnormalities, are considered to increase the risk of colorectal cancer. Therefore, treatments targeting these factors might be a promising strategy to prevent the development of colorectal cancer. Among a number of functional foods, various phytochemicals, including tea catechins, which have anti-inflammatory and anti-obesity properties, and medicinal agents that ameliorate metabolic disorders, might also be beneficial in the prevention of colorectal cancer. In this review article, we summarize the strategies for preventing colorectal cancer by targeting obesity-related disorders and inflammation through nutraceutical and pharmaceutical approaches, and discuss the mechanisms of several phytochemicals and medicinal drugs used in basic and clinical research, especially focusing on the effects of green tea catechins.
Qin, Huanying; Erwin, Kristin; Houston, Susan
Annually, over 350,000 persons require cardiopulmonary resuscitation (CPR), either in or outside of the hospital. With obesity a rising health issue in the United States, concerns exist regarding the efficacy of quality compressions for CPR in obese patients. The aims of this study were to determine if the compressions for three adult simulation manikins (normal, obese, and morbidly obese) met quality guidelines; to examine any differences in quality of chest compressions performed by health care providers between the three manikins; and to examine the effect of participant characteristics on the quality of chest compressions in obese and morbidly obese manikins. A randomized controlled design was used. Sixty-one health care providers performed chest compressions on the three simulation manikins. Results showed that performance on the normal-sized manikin was significantly better than that on both obese and morbidly obese manikins. Participant characteristics were significantly associated with quality of chest compressions. The effectiveness of compressions in obese and morbidly obese CPR recipients has yet to be determined. PMID:28966448
Childhood obesity is a worldwide issue, and effective methods encouraging children to adopt healthy diet and physical activity behaviors are needed. This viewpoint addresses the promise of serious video games, and why they may offer one method for helping children eat healthier and become more physi...
Miyawaki, Kazumasa; Yamada, Yuichiro; Ban, Nobuhiro
Secretion of gastric inhibitory polypeptide (GIP), a duodenal hormone, is primarily induced by absorption of ingested fat. Here we describe a novel pathway of obesity promotion via GIP. Wild-type mice fed a high-fat diet exhibited both hypersecretion of GIP and extreme visceral and subcutaneous fat...
This article explores the growing problem of childhood obesity and suggests guidelines for professionals to recommend to parents. Research has shown that an overweight child at 3 years is nearly eight times as likely to become an overweight young adult as is a typically developing 3-year-old. More of America's children are becoming overweight, and…
Peters, John C
We continue to lose ground in meeting national goals for reversing obesity. We must begin to examine the social and economic drivers of this epidemic, and we must set more realistic, immediate goals. Success will depend on mounting an effective social movement fueled by renewal of American social capital.
This project, implemented in collaboration with the Institute of Nutrition of Central America and Panama, aims to reduce obesity and micronutrient deficiencies in school-aged children in Central America through innovative food system interventions that improve the supply and demand of fruits and vegetables in public ...
Haynes, Emily; Palermo, Claire; Reidlinger, Dianne P
Until now, industry and government stakeholders have dominated public discourse about policy options for obesity. While consumer involvement in health service delivery and research has been embraced, methods which engage consumers in health policy development are lacking. Conflicting priorities have generated ethical concern around obesity policy. The concept of 'intrusiveness' has been applied to policy decisions in the UK, whereby ethical implications are considered through level of intrusiveness to choice; however, the concept has also been used to avert government regulation to address obesity. The concept of intrusiveness has not been explored from a stakeholder's perspective. The aim is to investigate the relevance of intrusiveness and autonomy to health policy development, and to explore consensus on obesity policy priorities of under-represented stakeholders. The Policy-Delphi technique will be modified using the James Lind Alliance approach to collaborative priority setting. A total of 60 participants will be recruited to represent three stakeholder groups in the Australian context: consumers, public health practitioners and policymakers. A three-round online Policy-Delphi survey will be undertaken. Participants will prioritise options informed by submissions to the 2009 Australian Government Inquiry into Obesity, and rate the intrusiveness of those proposed. An additional round will use qualitative methods in a face-to-face discussion group to explore stakeholder perceptions of the intrusiveness of options. The novelty of this methodology will redress the balance by bringing the consumer voice forward to identify ethically acceptable obesity policy options. Ethical approval was granted by the Bond University Health Research Ethics Committee. The findings will inform development of a conceptual framework for analysing and prioritising obesity policy options, which will be relevant internationally and to ethical considerations of wider public health issues
Sealy, Yvette M; Zarcadoolas, Christina; Dresser, Michelle; Wedemeyer, Laura; Short, Leslie; Silver, Lynn
This paper describes the research and development of the Obesity in Children Action Kit, a paper-based chronic disease management tool of the Public Health Detailing Program (PHD) at the New York City (NYC) Department of Health and Mental Hygiene (DOHMH). It also describes PHD's process for developing the Obesity in Children detailing campaign (targeting healthcare providers working with children aged 2-18) and its results, during which the Action Kit materials were a focal point. The campaign goals were to impact healthcare provider clinical behaviors, improve the health literacy of parents and children, instigate patient-provider-parent dialogue, and change family practices to prevent obesity. Qualitative research methods consisted of healthcare provider in-depth interviews and parent focus groups to aid campaign development. Evaluation of the Obesity in Children campaign included self-reported data on uptake and usage of clinical tools and action steps of matched assessments from 237 healthcare provider initial and follow-up visits, material stock counts, and DOHMH representative qualitative visit excerpts. Key themes identified in parent focus groups were concerns about childhood diabetes and high blood pressure, awareness of cultural pressure and our "supersize" culture, frustration with family communication around overweight and obesity, lack of knowledge about food quality and portion size, economic pressures, and the availability of healthy and nutritious foods. During the Obesity in Children campaign, six representatives reached 161 practices with 1,588 one-on-one interactions, and an additional 461 contacts were made through group presentations. After these interactions, there was a significant increase in the percentage of physicians self-reported use of key recommended practices: Use of BMI percentile-for-age to assess for overweight or obesity at every visit increased from 77% to 88% (p realistic goals increased from 64% to 86% (p goal setting posters
Cheskin, L J; Frutchey, R; McDermott, A Y; Esposito, L; Lee, B Y; Kumanyika, S
Research on the types of interventions needed for population-level prevention of childhood obesity in complex societal systems can benefit from greater use of systems-science concepts and tools. We report outcomes of a funding programme promoting incorporation of systems-science approaches into studies of imminent policy or environmental changes potentially impacting childhood obesity. Seven funding cycles over 3 years yielded 172 initial submissions from 29 US states and 25 other countries were analyzed. Submissions focused primarily on aspects of school or child-care settings, parks and recreational settings, or access to healthy food; about half reflected attention to systems perspectives. Analysis of initial submissions as well as the 15 funded projects showed some success in motivating use of systems concepts and tools but suggested the need for a more focused effort to educate and prepare the childhood obesity prevention research community for this potentially crucial type of research. © 2016 World Obesity Federation.
Croker, Helen; Beeken, Rebecca J.
Purpose of Review Obesity presents a challenge for practitioners, policy makers, researchers and for those with obesity themselves. This review focuses on psychological approaches to its management and prevention in children and adults. Recent Findings Through exploring the work of the late Professor Jane Wardle, we look at the earliest behavioural treatment approaches and how psychological theory has been used to develop more contemporary approaches, for example incorporating genetic feedbac...
Leah M Frerichs
Full Text Available Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1 to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2 to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively. Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally
Frerichs, Leah M; Araz, Ozgur M; Huang, Terry T-K
Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2) to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively). Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence) than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally, targeting adults may
Frerichs, Leah M.; Araz, Ozgur M.; Huang, Terry T. – K.
Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2) to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2–1.8% and 0.2–1.0% greater reduction when targeted at children and adults respectively). Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence) than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally, targeting adults
Morgen, Camilla Schmidt; Sørensen, Thorkild I A
A new report provides compelling evidence of the high prevalence of overweight and obesity throughout the world. The prevalence has increased since 1980, but at different rates across ages, times and locations. Studies exploring the causes of these differences could aid development of effective...
Omura, John D; Bellissimo, Moriah P; Watson, Kathleen B; Loustalot, Fleetwood; Fulton, Janet E; Carlson, Susan A
The US Preventive Services Task Force (USPSTF) recommends offering or referring adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. This study determined the proportion of primary care providers (PCPs) who discussed physical activity with most of their at-risk patients and referred them to intensive behavioral counseling, and reported barriers to counseling. Our analyses used data from DocStyles 2015, a Web-based panel survey of 1251 PCPs. Overall, 58.6% of PCPs discussed physical activity with most of their at-risk patients. Among these PCPs, the prevalence of components offered ranged from 98.5% encouraging increased physical activity to 13.9% referring to intensive behavioral counseling. Overall, only 8.1% both discussed physical activity with most at-risk patients and referred to intensive behavioral counseling. Barriers related to PCPs' attitudes and beliefs about counseling (e.g., counseling is not effective) were significantly associated with both discussing physical activity with most at-risk patients and referring them to intensive behavioral counseling (adjusted odds ratio, 1.92; 95% confidence interval, 1.15-3.20). System-level barriers (e.g., referral services not available) were not. Just over half of PCPs discussed physical activity with most of their at-risk patients, and few both discussed physical activity and referred patients to intensive behavioral counseling. Overcoming barriers related to attitudes and beliefs about physical activity counseling could help improve low levels of counseling and referrals to intensive behavioral counseling for CVD prevention. Published by Elsevier Inc.
González-Gross, Marcela; Meléndez, Agustín
The benefits of regular physical activity have been known since ancient Greek. But in the last Century the scientific knowledge around this topic has progressed enormously, starting with the early studies of JN Morris and RS Paffenberger, who demonstrated that physical activity at work reduced incidence of cardiovascular disease and mortality. In the Harvard alumni study, the lowest risk was associated with a weekly output of 1000 to 2000 kcal performing vigorous activities. Further studies in all age groups have supported these findings and have added that even moderate levels of physical activity provide considerable benefits to health, including lower prevalence of overweight and obesity at all ages. Metabolic fat oxidation rate is highest at exercise intensities between 45 and 65% of VO2max. This means that people must be active regularly and force physiological mechanisms at certain intensities. All this body of evidence has contributed to current WHO physical activity recommendations of 150 min/week of moderate to vigorous physical activity (MVPA) in adults and elderly, and 60 min/day of MVPA in children and adolescents, with additional strength training, apart from adopting an active lifestyle. In the last 50 years, occupational physical activity has been reduced for about 120 kcal/day, and sedentarism has emerged as an additional risk factor to physical inactivity. Even if less than 60 min of TV time in adults have been related to lower average BMI, there is still a need for research to determine the appropriate dose of exercise in combination with sedentary behaviours and other activities in the context of our modern lifestyle in order to prevent obesity at all ages. As public health measures have failed to stop the obesity epidemic in the last 3 decades, there is clearly a need to change the paradigm. The inclusion of sport scientists, physical education teachers and other professionals in the multidisciplinary team which should be responsible for drawing
Kim, Min Jeong; Sung, Eunju; Choi, Eun Young; Ju, Young-Su; Park, Eal-Whan; Cheong, Yoo-Seock; Yoo, Sunmi; Park, Kyung Hee; Choi, Hyung Jin; Kim, Seolhye
The prevalence of childhood obesity in South Korea has increased owing to economic improvement and the prevailing Westernized dietary pattern. As the incidence of chronic diseases caused by obesity is also expected to increase, effective interventions to prevent childhood obesity are needed. Therefore, we conducted a Delphi study to determine the priorities of a potential intervention research on childhood obesity prevention and its adequacy and feasibility. The two-round Delphi technique was used with a panel of 10 childhood obesity experts. The panelists were asked to rate "priority populations," "methods of intervention," "measurement of outcomes," "future intervention settings," and "duration of intervention" by using a structured questionnaire. Finally, a portfolio analysis was performed with the adequacy and feasibility indexes as the two axes. For priority populations, the panel favored "elementary," "preschool," and "middle and high school" students in this order. Regarding intervention settings, the panelists assigned high adequacy and feasibility to "childcare centers" and "home" for preschool children, "school" and "home" for elementary school children, and "school" for adolescents in middle and high school. As the age of the target population increased, the panelists scored increasing numbers of anthropometric, clinical, and intermediate outcomes as highly adequate and feasible for assessing the effectiveness of the intervention. According to the results of the Delphi survey, the highest-priority population for the research on childhood obesity prevention was that of elementary school students. Various settings, methods, outcome measures, and durations for the different age groups were also suggested.
Full Text Available Obesity and its related metabolic disorders are closely correlated with gut dysbiosis. Montmorillonite is a common medicine used to treat diarrhea. We have previously found that dietary lipid adsorbent-montmorillonite (DLA-M has an unexpected role in preventing obesity. The aim of this study was to further investigate whether DLA-M regulates intestinal absorption and gut microbiota to prevent obesity-related metabolic disorders. Here, we show that DLA-M absorbs free fatty acids (FFA and endotoxins in vitro and in vivo. Moreover, the combination of fluorescent tracer technique and polarized light microscopy showed that DLA-M crystals immobilized BODIPY® FL C16 and FITC-LPS, respectively, in the digestive tract in situ. HFD-fed mice treated with DLA-M showed mild changes in the composition of the gut microbiota, particularly increases in short-chain fatty acids (SCFA-producing Blautia bacteria and decreases in endotoxin-producing Desulfovibrio bacteria, these changes were positively correlated with obesity and inflammation. Our results indicated that DLA-M immobilizes FFA and endotoxins in the digestive tract via the adsorption-excretion axis and DLA-M may potentially be used as a prebiotic to prevent intestinal dysbiosis and obesity-associated metabolic disorders in obese individuals.
Goldberg, Jeanne P; Wright, Catherine M
Effective health interventions involve an understanding of the specific needs and wants of the population to be served. Lessons from more than two decades of obesity prevention can be applied to understanding how to design and implement other behaviorally-focused health interventions, including those for alcohol education. Three obesity prevention campaigns were reviewed and evaluated for elements critical to their success in achieving desired outcomes. Evaluation of the three cases studies revealed six key elements common to successful interventions. These include: specifying the desired outcome at the outset, understanding the target population, identifying a framework for the intervention, creating a campaign "identity", enlisting champions, and evaluating both outcomes and process. Successful health interventions should be behaviorally-focused and include multiple components to address the various factors that influence behavior. A clear understanding of how and why desired outcomes were achieved can inform dissemination to a wider audience and improve sustainability. Lessons learned from obesity prevention provide guidance for development of alcohol education. It must be acknowledged that there is still much to be learned to maximize success in prevention efforts. It is likely that analysis of future efforts in alcohol education can contribute to that understanding. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Background. The period surrounding pregnancy has been identified as a risk period for overweight/obesity in both mother and child because of excessive gestational weight gain (GWG. The promotion of a healthy GWG is therefore of paramount importance in the context of the prevention of obesity in the current and next generations. Objective. To provide a comprehensive overview of the effect of prenatal physical activity interventions, alone or in combination with nutritional counselling, on GWG and to address whether preventing excessive GWG decreases the incidence of infant high birth weight and/or postpartum weight retention. Method. A search of the PubMed database was conducted to identify all relevant studies. Nineteen studies were included in this review: 13 interventions combining physical activity, nutrition, and GWG counselling and 6 interventions including physical activity alone. Results. Prenatal lifestyle interventions promoting healthy eating and physical activity habits appear to be the most effective approach to prevent excessive GWG. Achievement of appropriate GWG may also decrease the incidence of high infant birth weight and postpartum weight retention. Conclusion. Healthy eating habits during pregnancy, combined with an active lifestyle, may be important elements in the prevention of long-term risk of obesity for two generations.
Full Text Available The 4-Health Project promotes healthy lifestyles for rural families with an overall goal of reducing or preventing childhood obesity. 4-Health is an integrated research and educational outreach program delivered by agents located in Montana State University Extension offices throughout the state. The collaborative project was developed to provide healthy living programs focusing on the areas of parenting and family communication, body image, food and nutrition, and physical activity to rural parents of 8-12 year old children participating in Montana’s 4-H Youth Development programs. Evaluation outcomes of the 4-Health Educational (experimental program and the Healthy Living Information (control program both showed increases in participants’ knowledge, attitudes, and behaviors related to healthy living, with those participating in the 4-Health Educational program making greater gains.
Parra, Diana C; Vorkoper, Susan; Kohl, Harold W; Caballero, Benjamin; Batis, Carolina; Jauregui, Alejandra; Mason, Jessica; Pratt, Michael
The rise of childhood obesity in Latin America calls for research capacity to understand, monitor and implement strategies, policies and programmes to address it. The objective of the study was to assess current research capacity in Latin America related to childhood obesity, nutrition and physical activity. We conducted a search of peer-reviewed articles on childhood obesity in Latin America with at least one Latin American author from 2010 to May 2015. We coded 484 published articles for author affiliation, study subjects' nationality, research topic and study design and extracted a series of networks per research topic, study design and collaborating country for each of the countries. Obesity is the most frequently explored topic. Nutrition and obesity are somewhat better developed compared with physical activity and sedentary behaviour. There are numerous observational and cross-sectional studies, indicating either a lack of capacity required for more complex research or the extent of the problem and associated factors is still unknown. The low number of intervention studies and the near absence of policy articles suggest a void in research capacity. For childhood obesity, there is a clear need to build research capacity that documents the current state of the problem and design evidence-based prevention and intervention efforts. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.
Carrillo Aguilera, Sonia
Full Text Available This paper aims to review the current worrying situation in terms of physical activity in our country and the problem that leads us to be below the European average, with the attendant problems of obesity, particularly among children, which follow from this. We analyzed the intervention programs that are being used as PIOBIN plan (The Andalusian Plan for Childhood Obesity, effective from 2007-12, based on a national strategy called Naos Strategy and how different studies support that some intrinsic motivation toward physical activity helps to create lasting habits to the practice. We also carry out an analysis of the different Motivation theories and we base our study on the Self-determination Theory of Deci and Ryan (1985, 2000
Pérez Solís, D; Díaz Martín, J J; Álvarez Caro, F; Suárez Tomás, I; Suárez Menéndez, E; Riaño Galán, I
Intervention for childhood obesity is a public health priority. The purpose of this study was to evaluate the effectiveness of an elementary school-based intervention against obesity in children. Non-randomised controlled trial was conducted on children from first to fifth grade from two public schools of Avilés (Spain). The intervention lasted for 2 school years comprising healthy diet workshops, educational chats, educational meetings, informative written material, and promotion of physical activities. Primary outcome measure was body mass index z-score. Secondary outcomes included: obesity and overweight prevalence, waist circumference, dietary habits, and physical activity. A total of 382 (177 girls, 205 boys) out of 526 pupils of both schools were included in the study. Complete anthropometric data were obtained in 340 of the 382 individuals. Compared to children in control group, those in intervention group decreased body mass index z-score from 1.14 to 1.02 (P=.017), and improved KIDMED score from 7.33 to 7.71 points (P=.045). The percentage of students who carried on an optimal diet increased from 42.6% to 52.3% (P=.021). There were no statistical differences in the prevalence of obesity and overweight, or in waist circumference between the intervention and control groups. This school-based program resulted in modest beneficial changes in body mass index and diet quality. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.
Xu, Mu; Jung, Xiaoman; Hines, O Joe; Eibl, Guido; Chen, Yijun
Currently, there are no effective preventive strategies for pancreatic cancer. Obesity has been increasingly recognized as a strong but modifiable risk factor of pancreatic cancer. In this article, we aim to review the literature regarding weight loss on prevention of pancreatic cancer. Epidemiological and laboratory studies have shown that obesity is associated with increased incidence of pancreatic cancer and potentially worse cancer outcome. Whereas the underlying pathomechanisms remain unclear, chronic inflammation, insulin resistance, and altered intestinal microbiota are all implicated in the carcinogenic effect of obesity. Weight loss, especially the durable and significant weight loss after bariatric surgery, has been shown to reduce the risks of multiple cancers and may become a good intervention for pancreatic cancer prevention.
Horst, Kyle E; Modesitt, Susan C
Endometrial cancer remains the fourth most common malignancy among US women, and hormonal contraceptives drastically reduce this risk. The study objectives were to assess the prescribing patterns, counseling practices, and knowledge of family physicians and obstetrician/gynecologists (OB/GYNs) regarding hormonal contraceptives, obesity, and cancer prevention. A 25-question survey was mailed to 4600 OB/GYNs and family practitioners licensed in Virginia to assess self-reported hormonal contraceptive prescription practices, patient evaluation and counseling, and gynecologic oncology knowledge. χ(2) and t tests were used to assess for differences across groups. P endometrial cancer risk associated with oral contraceptive pills (73.0%) and increased risk with obesity (95.3%), but only 36.7% consistently counseled patients on obesity-associated cancer risk. Compared with family physicians, OB/GYNs were more likely to cite endometrial cancer prevention as an indication for hormonal contraceptives (53.3% vs 10.9%, P obesity-related cancer risk (P = 0.003); and were more likely to correctly identify Lynch syndrome (69.4% vs 22.5%, P endometrial cancer. Endometrial or ovarian cancer prevention factored into endometrial cancer risk factors and the use of hormonal contraception for chemoprevention. This represents a significant opportunity for both specialties to optimize primary endometrial cancer prevention in their increasingly obese and at-risk female patients.
Full Text Available Growth and development are key characteristics of childhood and sensitive markers of health and adequate nutrition. The first 1000 days of life—conception through 24 months of age—represent a fundamental period for development and thus the prevention of childhood obesity and its adverse consequences is mandatory. There are many growth drivers during this complex phase of life, such as nutrition, genetic and epigenetic factors, and hormonal regulation. The challenge thus involves maximizing the potential for normal growth without increasing the risk of associated disorders. The Mediterranean Nutrition Group (MeNu Group, a group of researchers of the Mediterranean Region, in this Special Issue titled “Prevent Obesity in the First 1000 Days”, presented results that advanced the science of obesity risk factors in early life, coming both from animal model studies and studies in humans. In the future, early-life intervention designs for the prevention of pediatric obesity will need to look at different strategies, and the MeNu Group is available for guidance regarding an appropriate conceptual framework to accomplish either prevention or treatment strategies to tackle pediatric obesity.
Full Text Available Abstract The American Dietetic Association (ADA has stated that the best nutritional strategy for promoting optimal health and reducing the risk of chronic disease is to wisely choose a wide variety of foods. Seventy diets were computer analyzed from the menu of athletes or sedentary subjects seeking to improve the quality of micronutrient intake from food choices. All of these dietary analyses fell short of the recommended 100% RDA micronutrient level from food alone. Therefore, based on diets analyzed for adequacy or inadequacy of macronutrients and micronutrients, a challenging question is proposed: "Does food selection alone provide 100% of the former RDA or newer RDI micronutrient recommended daily requirement?"
Blaine, Rachel E; Pbert, Lori; Geller, Alan C; Powers, E Michael; Mitchell, Kathleen
To assess parent preferences for utilisation of a parent-focused, telephone-based coaching service, or 'FITLINE,' to prevent or manage childhood obesity. A cross-sectional survey of parents of children aged 2-12 years was conducted at a paediatric practice in Greater Boston, Massachusetts, USA, between July 2012 and May 2013. Parents received questionnaires with clinic visit paperwork and opted-in to the study by returning them to clinic staff or by mail. The anonymous pen-to-paper questionnaire assessed parents' potential FITLINE utilisation, preferences regarding educational content and logistics, and parent/child demographics. Simple logistical regression was used to assess associations between parent and child factors and FITLINE interest. Among n=114 participants, most parents reported being very likely (n=53, 48%) or somewhat likely (n=44, 40%) to use a FITLINE-promoting healthy habits for children if it was made available. Interest in a FITLINE was greatest among overweight or obese parents (OR 3.12, CI 1.17 to 8.30) and those with children aged shopping on a budget (91%) and how to meet children's physical activity needs (81%). Most parents preferred to obtain a FITLINE referral from a paediatrician or nurse (73%), instead of a school nurse (42%) or child-care provider (26%). Given strong interest among parents in a FITLINE and the urgency of the youth obesity epidemic, implementation of a pilot phone-based service should be strongly considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Swank, Melissa Farrell; Brennan, Laura K; Gentry, Daniel; Kemner, Allison L
To date, few tools assist policy makers and practitioners in understanding and conveying the implementation costs, potential impacts, and value of policy and environmental changes to address healthy eating, active living, and childhood obesity. For the Evaluation of Healthy Kids, Healthy Communities (HKHC), evaluators considered inputs (resources and investments) that generate costs and savings as well as benefits and harms related to social, economic, environmental, and health-related outcomes in their assessment of 49 HKHC community partnerships funded from 2009 to 2014. Using data collected through individual and group interviews and an online performance monitoring system, evaluators created a socioecological framework to assess investments, resources, costs, savings, benefits, and harms at the individual, organizational, community, and societal levels. Evaluators customized frameworks for 6 focal strategies: active transportation, parks and play spaces, child care physical activity standards, corner stores, farmers' markets, and child care nutrition standards. To illustrate the Value Frameworks, this brief highlights the 38 HKHC communities implementing at least 1 active transportation strategy. Evaluators populated this conceptual Value Framework with themes from the strategy-specific inputs and outputs. The range of factors corresponding to the implementation and impact of the HKHC community partnerships are highlighted along with the inputs and outputs. The Value Frameworks helped evaluators identify gaps in current analysis models (ie, benefit-cost analysis, cost-effectiveness analysis) as well as paint a more complete picture of value for potential obesity prevention strategies. These frameworks provide a comprehensive understanding of investments needed, proposed costs and savings, and potential benefits and harms associated with economic, social, environmental, and health outcomes. This framing also allowed evaluators to demonstrate the interdependence
Moulos, Ioannis; Maramis, Christos; Mourouzis, Alexandros; Maglaveras, Nicos
The recent immense diffusion of smartphones has significantly upgraded the role of mobile user interfaces in interventions that build and/or maintain healthier lifestyles. Indeed, high-quality, user-centered smartphone applications are able to serve as advanced front-ends to such interventions. These smartphone applications, coupled with portable or wearable sensors, are being employed for monitoring day to day health-related behaviors, including eating and physical activity. Some of them take one step forward by identifying unhealthy behaviors and contributing towards their modification. This work presents the design as well as the preliminary implementation of the mobile user interface of SPLENDID, a novel, sensor-oriented intervention for preventing obesity and eating disorders in young populations. This is implemented by means of an Android application, which is able to monitor the eating and physical activity behaviors of young individuals at risk for obesity and/or eating disorders, subsequently guiding them towards the modification of those behaviors that put them at risk. Behavior monitoring is based on multiple data provided by a set of communicating sensors and self-reported information, while guidance is facilitated through a feedback/encouragement provision and goal setting mechanism.
Hurt, Ryan T; Croghan, Ivana T; Schroeder, Darrell R; Hays, J Taylor; Choi, Doo-Sup; Ebbert, Jon O
Post-cessation weight gain (PCWG) is a major barrier to maintaining abstinence, especially in weight-concerned smokers. Varenicline is the most effective medication for smoking cessation but has minimal impact on PCWG. Lorcaserin is an FDA-approved medication for weight management in overweight or obese patients which also provides a noticeable benefit in treating drug dependence. We hypothesized that combining varenicline with lorcaserin may help prevent PCWG. We conducted an open-label, single arm, Phase II clinical pilot study to obtain preliminary data on the safety and effectiveness of combination varenicline and lorcaserin in preventing PCWG in overweight and obese smokers. Twenty overweight or obese (body mass index 27-40 kg/m2) cigarette smokers were enrolled. The primary outcomes were weight and waist circumference (WC) changes at 12 and 26 weeks in smokers meeting criteria for prolonged smoking abstinence. All participants received open-label varenicline (1 mg twice a day) and lorcaserin (10 mg twice a day) for 12 weeks with follow-up at 26 weeks. Ten subjects met criteria for prolonged smoking abstinence at 12 weeks (50%) and 6 at 26 weeks (30%). Among those achieving prolonged smoking abstinence at 12 weeks, WC was +0.2 ± 6.0 cm (90% CI; -2.9, +3.4) and weight gain was +1.1 ± 3.9 kg (90% CI; -0.9, +3.1). Weight gain and WC increases following prolonged smoking abstinence may be reduced among overweight and obese smokers using combination varenicline and lorcaserin. This combinatory treatment warrants further research in the obese and weight-concerned smoking population. This is the first published prospective pilot study to evaluate lorcaserin for use in reducing PCWG in overweight and obese smokers. When combined with varenicline, lorcaserin minimized PCWG and increases in WC. In addition to the benefit on PCWG reduction, lorcaserin may be a potential new pharmacological treatment for smoking cessation and warrants further larger studies.
T. L. Griffin
component was identified as the most challenging, VV the least. Median implementation score across schools was 56/75 (IQR, 51.0 - 60.8. Agreement between teacher logbooks and researcher observations was generally high, the main discrepancies occurred in session duration reporting where in some cases teachers’ estimations tended to be higher than researchers’. Conclusions The WAVES study model provides a rigorous and replicable approach to undertaking and analysing a multi-component process evaluation. Challenges to implementing school-based obesity prevention interventions have been identified which can be used to inform future trials. Trial registration ISRCTN97000586 . 19 May 2010.
Özer, Samet; Yılmaz, Resul; Özlem Kazanci, Nafia; Sönmezgöz, Ergün; Karaaslan, Erhan; Altuntaş, Buket; Emre Kuyucu, Yunus
The definition of childhood metabolic syndrome has not been described clearly. Childhood obesity is increasing gradually, and the incidence of childhood metabolic syndrome is also rising. We aimed to show metabolic syndrome components and preventive factors for metabolic syndrome in obese children Methods: In the present study, 187 obese children and adolescents 5-18 years old were investigated retrospectively. Demographic data, anthropometric measurements, body mass index, blood pressure values, insulin levels, oral glucose tolerance test results, total cholesterol, high density lipoprotein, and triglyceride levels were obtained from hospital records. A body mass index > 95th percentile was considered obese. Insulin resistance was calculated according to the oral glucose tolerance test with 1.75 g/kg glucose maximum 75 g glucose. The insulin sensitivity index and homeostatic model assessment-insulin resistance (HOMA IR) were calculated and compared. Metabolic syndrome was diagnosed according to the modified WHO criteria adapted for metabolic syndrome in children. Abnormal glucose homeostasis was detected in 53% of subjects. Dyslipidaemia was present in 45.7% and hypertension in 16.6% of the patients. Metabolic syndrome was identified in 24.6% of obese children and adolescents. High HOMA-IR values and fasting glucose levels, elevated triglycerides and lower HDL levels were an indication of metabolic syndrome. Obesity and insulin resistance are significant factors for the development of metabolic syndrome in children and adolescents. In obese children higher HDL levels are preventive factor for metabolic syndrome. Preventing obesity and insulin resistance may decrease the prevalence of metabolic syndrome. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Rerksuppaphol, Lakkana; Rerksuppaphol, Sanguansak
Internet based obesity prevention program is one approach in learning strategies to improve healthy behaviour. It has been advocated as one strategy to address the rising prevalence of childhood obesity; however, their efficacy is not seen consistently. The purpose of this study was to assess the efficacy of internet based obesity prevention program in Thai school children. Healthy children studying in public schools in one township of central Thailand were randomly assigned to either the intervention (internet based) program or the control group. Anthropometric characteristics were recorded at baseline and for the next four following months at monthly intervals. Changes in the percentage of overweight/obese children and changes in BMI at the end of study were considered as the primary and secondary outcome, respectively. A total of 217 children, mean age of 10.7 years, were included into the final analysis. Baseline anthropometric parameters and percentages of overweight/obesity were not significantly different between groups. At the end of the study, the control group had a higher percentage of overweight/obesity than the intervention group (56.6% vs. 39.6%, respectively; p-value=0.009). Children in the control group had a significantly higher increase in net BMI gains than those in the intervention group (1.24kg/m(2) vs. 0.40kg/m(2), p-value=0.027). The intervention group had no changes in BMI z-score (-0.001, 95%CI -0.19 to 0.18, p-value=0.988), contrary to those in the control group, which had significant gain of BMI z-score at the end of study (0.45, 95%CI 0.27 to 0.63, p-value<0.001). Internet the based obesity prevention program was effective in modifying anthropometric outcome and helped to address the rising prevalence of overweight and obese status in Thai children.
Full Text Available Elizabeth TeixeiraDrexel University College of Nursing and Health Professions, Philadelphia, PA, USAAbstract: Obesity is a major public health concern worldwide. The increasing prevalence of obesity in all ages, especially children and adolescents, has gained global attention and it is widely known that obesity increases the risk of many chronic conditions and illnesses, such as Type 2 Diabetes Mellitus (T2DM and cardiovascular disease (CVD. Obesity is a complex metabolic disorder, however, that is difficult to treat and manage. Therefore, despite the increased awareness about obesity-related health risks, obesity prevention and control has been a major challenge for health professionals. Lifestyle modification is easily prescribed, however, multiple barriers to implementation exist. Barriers include but are not limited to: behavioral and motivational factors, anti-fat bias, access to and reimbursement of educational programs, availability of healthy affordable foods, ongoing support systems that are culturally and community attuned, and comorbidities that limit physical activity and quality of life. Further, the current health care systems are not all designed to focus on health promotion and wellness. These contributing factors complicate weight management and control. Community-based programs are one potentially feasible approach that can assist individuals, families, and communities in developing healthy behaviors that promote and maintain weight loss. This review reports on nine worldwide current studies on the effectiveness of community-based programs in diverse populations targeting obesity. The purpose of this review is to examine evidenced-based interventions that can assist in the development of standard practices in the battle against obesity.Keywords: obesity, community, prevention, physical activity, nutrition
This 60 second Public Service Announcement (PSA) is based on the August, 2011 CDC Vital Signs report. Childhood obesity is an epidemic in the US. Breastfeeding can help prevent obesity, but one in three moms stop without hospital support. About 95% of hospitals lack policies that fully support breastfeeding moms. Hospitals need to do more to help moms start and continue breastfeeding. Created: 8/2/2011 by Centers for Disease Control and Prevention (CDC). Date Released: 8/2/2011.
Grossman, David C; Bibbins-Domingo, Kirsten; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen
Based on year 2000 Centers for Disease Control and Prevention growth charts, approximately 17% of children and adolescents aged 2 to 19 years in the United States have obesity, and almost 32% of children and adolescents are overweight or have obesity. Obesity in children and adolescents is associated with morbidity such as mental health and psychological issues, asthma, obstructive sleep apnea, orthopedic problems, and adverse cardiovascular and metabolic outcomes (eg, high blood pressure, abnormal lipid levels, and insulin resistance). Children and adolescents may also experience teasing and bullying behaviors based on their weight. Obesity in childhood and adolescence may continue into adulthood and lead to adverse cardiovascular outcomes or other obesity-related morbidity, such as type 2 diabetes. Although the overall rate of child and adolescent obesity has stabilized over the last decade after increasing steadily for 3 decades, obesity rates continue to increase in certain populations, such as African American girls and Hispanic boys. These racial/ethnic differences in obesity prevalence are likely a result of both genetic and nongenetic factors (eg, socioeconomic status, intake of sugar-sweetened beverages and fast food, and having a television in the bedroom). To update the 2010 US Preventive Services Task Force (USPSTF) recommendation on screening for obesity in children 6 years and older. The USPSTF reviewed the evidence on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. Comprehensive, intensive behavioral interventions (≥26 contact hours) in children and adolescents 6 years and older who have obesity can result in improvements in weight status for up to 12 months; there is inadequate evidence regarding the effectiveness of less intensive interventions. The harms of behavioral interventions can be bounded as small to none, and the harms of screening are minimal. Therefore, the USPSTF
Full Text Available Parental participation is a key factor in the prevention and management of childhood obesity, thus parental recognition of weight problems is essential. We estimated parental perceptions and their determinants in the Emirati population. We invited 1541 students (grade 1-12; 50% boys and their parents, but only 1440 (6-19 years and their parents consented. Of these, 945 Emirati nationals provided data for analysis. Anthropometric and demographic variables were measured by standard methods. CDC BMI percentile charts for age and sex were used to classify children's weight. Parental perception of their children's weight status (underweight, normal, and overweight/obese was recorded. Logistic regression analyses were used to identify independent predictors of parental perceptions of children's weight status. Of all parents, 33.8% misclassified their children's' weight status; underestimating (27.4% or overestimating (6.3%. Misclassification was highest among parents of overweight/obese children (63.5% and underweight (55.1% children. More importantly, parental perceptions of their children being overweight or obese, among truly overweight/obese children, i.e. correct identification of an overweight/obese child as such, were associated with the true child's BMI percentile (CDC with an OR of 1.313 (95% CI: 1.209-1.425; p<0.001 per percentile point, but not age, parental education, household income, and child's sex. We conclude that the majority of parents of overweight/obese children either overestimated or, more commonly, underestimated children's weight status. Predictors of accurate parental perception, in this population, include the true children's BMI, but not age, household income, and sex. Thus, parents having an incorrect perception of their child's weight status may ignore otherwise appropriate health messages.
Martin, J; Peeters, A; Honisett, S; Mavoa, H; Swinburn, B; de Silva-Sanigorski, A
Successful obesity prevention will require a leading role for governments, but internationally they have been slow to act. League tables of benchmark indicators of action can be a valuable advocacy and evaluation tool. To develop a benchmarking tool for government action on obesity prevention, implement it across Australian jurisdictions and to publicly award the best and worst performers. A framework was developed which encompassed nine domains, reflecting best practice government action on obesity prevention: whole-of-government approaches; marketing restrictions; access to affordable, healthy food; school food and physical activity; food in public facilities; urban design and transport; leisure and local environments; health services, and; social marketing. A scoring system was used by non-government key informants to rate the performance of their government. National rankings were generated and the results were communicated to all Premiers/Chief Ministers, the media and the national obesity research and practice community. Evaluation of the initial tool in 2010 showed it to be feasible to implement and able to discriminate the better and worse performing governments. Evaluation of the rubric in 2011 confirmed this to be a robust and useful method. In relation to government action, the best performing governments were those with whole-of-government approaches, had extended common initiatives and demonstrated innovation and strong political will. This new benchmarking tool, the Obesity Action Award, has enabled identification of leading government action on obesity prevention and the key characteristics associated with their success. We recommend this tool for other multi-state/country comparisons. Copyright © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
Amini, Maryam; Djazayery, Abolghassem; Majdzadeh, Reza; Taghdisi, Mohammad-Hossein; Sadrzadeh-Yeganeh, Haleh; Eslami-Amirabadi, Maryam
Childhood obesity is a world-wide health problem and development of interventions to prevent or control it is a priority. Obesity is prevalent and on the increase among school-students in Iran, too. As the first step for development of an intervention, the current study was designed to complete our understanding of ideas, attitudes, beliefs, and preferences of primary school children in Tehran, Iran. Twenty-seven primary school-students (11 boys, 16 girls) in grade-five, most of whom were overweight or obese, participated in four focus-group discussions (FGDs). All FGD notes were analyzed to find the main themes. Nine themes in three main categories emerged after analysis. The themes in the category of barriers of losing weight included environmental, psychological and physiological barriers. Category of intervention components included nutrition improvement, physical activity promotion, social support and education. Setting and deliverer of the intervention were included in the intervention conditions category. The children proposed a multi-component approach for development of an intervention. They mentioned nutrition and physical activity improvement, social support and education as the main elements of an effective intervention. The findings indicate that obese children need to be supported against different barriers of losing weight, mainly social barriers, especially humiliation by the community.
Full Text Available Background: Childhood obesity is a world-wide health problem and development of interventions to prevent or control it is a priority. Obesity is prevalent and on the increase among school-students in Iran, too. As the first step for development of an intervention, the current study was designed to complete our understanding of ideas, attitudes, beliefs, and preferences of primary school children in Tehran, Iran. Methods: Twenty-seven primary school-students (11 boys, 16 girls in grade-five, most of whom were overweight or obese, participated in four focus-group discussions (FGDs. All FGD notes were analyzed to find the main themes. Results: Nine themes in three main categories emerged after analysis. The themes in the category of barriers of losing weight included environmental, psychological and physiological barriers. Category of intervention components included nutrition improvement, physical activity promotion, social support and education. Setting and deliverer of the intervention were included in the intervention conditions category. The children proposed a multi-component approach for development of an intervention. They mentioned nutrition and physical activity improvement, social support and education as the main elements of an effective intervention. Conclusions: The findings indicate that obese children need to be supported against different barriers of losing weight, mainly social barriers, especially humiliation by the community.
Typically, genotype-based personalised nutrition involves genotyping for a number of susceptibility SNPs associated with the prevention, or management, of a particular disease. Dietary advice is then personalised to the individual's genotype to ensure optimal prevention or treatment outcomes. To ensure evidence-based ...
Austin, S Bryn
Public health attention to childhood obesity has increased in tandem with the growing epidemic, but despite this intense focus, successes in prevention have lagged far behind. There is a blind spot in our drive for childhood obesity prevention that prevents us from generating sufficiently broad solutions. Eating disorders and the constellation of perilous weight-control behaviors are in that blind spot. Evidence is mounting that obesity and eating disorders are linked in myriad ways, but entrenched myths about eating disorders undermine our ability to see the full range of leverage points to target in obesity preventive intervention studies. Our efforts to prevent childhood obesity can no longer afford to ignore eating disorders and the assemblage of related behaviors that persist unabated.
Brahe, Lena K; Astrup, Arne; Larsen, Lesli H
Obesity increases the risk of type 2 diabetes, cardiovascular diseases, and certain cancers, which are among the leading causes of death worldwide. Obesity and obesity-related metabolic diseases are characterized by specific alterations in the human gut microbiota. Experimental studies with gut microbiota transplantations in mice and in humans indicate that a specific gut microbiota composition can be the cause and not just the consequence of the obese state and metabolic disease, which suggests a potential for gut microbiota modulation in prevention and treatment of obesity-related metabolic diseases. In addition, dietary intervention studies have suggested that modulation of the gut microbiota can improve metabolic risk markers in humans, but a causal role of the gut microbiota in such studies has not yet been established. Here, we review and discuss the role of the gut microbiota in obesity-related metabolic diseases and the potential of dietary modulation of the gut microbiota in metabolic disease prevention and treatment. © 2016 American Society for Nutrition.
Full Text Available Abstract Background Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. Methods/design A randomized, controlled obesity prevention trial is currently being conducted over a three year period (2010-present. The sample consists of 28 low-income, ethnically diverse child care centers with 1105 children (sample is 60% Hispanic, 15% Haitian, 12% Black, 2% non-Hispanic White and 71% of caregivers were born outside of the US. The purpose is to test the efficacy of a parent and teacher role-modeling intervention on children’s nutrition and physical activity behaviors. . The Healthy Caregivers-Healthy Children (HC2 intervention arm schools received a combination of (1 implementing a daily curricula for teachers/parents (the nutritional gatekeepers; (2 implementing a daily curricula for children; (3 technical assistance with meal and snack menu modifications such as including more fresh and less canned produce; and (4 creation of a center policy for dietary requirements for meals and snacks, physical activity and screen time. Control arm schools received an attention control safety curriculum. Major outcome measures include pre-post changes in child body mass index percentile and z score, fruit and vegetable and other nutritious food intake, amount of physical activity, and parental nutrition and physical activity knowledge, attitudes, and beliefs, defined by intentions and behaviors. All measures were administered at the beginning and end of the school year for year one and year two of the study for a total of 4 longitudinal time points for assessment
Natale, Ruby; Scott, Stephanie Hapeman; Messiah, Sarah E; Schrack, Maria Mesa; Uhlhorn, Susan B; Delamater, Alan
Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. A randomized, controlled obesity prevention trial is currently being conducted over a three year period (2010-present). The sample consists of 28 low-income, ethnically diverse child care centers with 1105 children (sample is 60% Hispanic, 15% Haitian, 12% Black, 2% non-Hispanic White and 71% of caregivers were born outside of the US). The purpose is to test the efficacy of a parent and teacher role-modeling intervention on children's nutrition and physical activity behaviors. . The Healthy Caregivers-Healthy Children (HC2) intervention arm schools received a combination of (1) implementing a daily curricula for teachers/parents (the nutritional gatekeepers); (2) implementing a daily curricula for children; (3) technical assistance with meal and snack menu modifications such as including more fresh and less canned produce; and (4) creation of a center policy for dietary requirements for meals and snacks, physical activity and screen time. Control arm schools received an attention control safety curriculum. Major outcome measures include pre-post changes in child body mass index percentile and z score, fruit and vegetable and other nutritious food intake, amount of physical activity, and parental nutrition and physical activity knowledge, attitudes, and beliefs, defined by intentions and behaviors. All measures were administered at the beginning and end of the school year for year one and year two of the study for a total of 4 longitudinal time points for assessment. Although few attempts have been made to prevent obesity
Hooren, R H van; Widdershoven, G A M; Borne, H W van den; Curfs, L M G
The policy concerning care for people with intellectual disability (ID) has developed from segregation via normalization towards integration and autonomy. Today, people with ID are seen as citizens who need to be supported to achieve a normal role in society. The aim of care is to optimize quality of life and promote self-determination. The promotion of autonomy for people with ID is not easy and gives rise to ethical dilemmas. Caregivers are regularly confronted with situations in which there is a conflict between providing good care and respecting the client's autonomy. This becomes evident in the case of prevention of obesity in people with Prader-Willi syndrome (PWS). As part of a study about the ethical aspects of the prevention of obesity, in-depth qualitative interviews were conducted with the parents and professional caregivers of people with PWS. In analysing interviews with parents and formal caregivers, the present authors found that the dichotomy between respecting autonomy and securing freedom of choice on the one hand, and paternalism on the other, is too crude to do justice to the process of care. The stories indicated that caregivers see other options and act in other ways than to intervene without taking into account the wishes of the individual with PWS. The present authors elaborated these options, taking models of the physician-patient relationship as a heuristic starting point. They extended the logic of these models by focusing on the character of the process of interaction between caregiver and care receiver, and on the emotional aspects of the interactions. This approach results in more attention to processes of interpretation, deliberation and joint learning.
Aparicio, E; Canals, J; Arija, V; De Henauw, S; Michels, N
Stress and negative emotions pose a major threat to public health, by increasing the risk of obesity. Since the management process for emotions (emotion regulation; ER) is developed in childhood, we present a novel conceptual framework model for the role of ER in the prevention and treatment of childhood obesity. A narrative review of the literature by electronic database search (MEDLINE, Web of Knowledge and Scopus) was conducted of observational and interventional/experimental literature on ER and obesity and the underlying concepts. We also present an overview of ER intervention techniques. Our model indicates that childhood ER is a link between stress and obesity. Stress along with ineffective ER leads to abnormal cortisol patterns, emotional eating, sedentary lifestyle, reduction of physical activity, and sleep problems. Simultaneously, a healthy lifestyle could show benefits on ER and in developing adaptive ER strategies. In the development of obesity and ER, parents also play a role. By contrast, effective ER skills decrease obesity-related unhealthy behaviour and enhance protective factors, which boost health. The literature contains some observational studies of children but very few intervention studies, most of which are pilot or on-going studies. In conclusion, encouraging effective ER could be a useful new approach for combating and treating childhood obesity. Future ER intervention studies are needed to confirm the validity of this model in children.
Kwon, Soyang; Janz, Kathleen F; Letuchy, Elena M; Burns, Trudy L; Levy, Steven M
To test the hypothesis that individuals who are active but who decrease physical activity (PA) over time have a higher risk of becoming obese in young adulthood, when compared to individuals who are consistently active throughout childhood and adolescence. Iowa Bone Development Study cohort members (242 males and 251 females) participated in accelerometry assessments, dual-energy X-ray absorptiometry scans, and dietary questionnaire surveys at ages 5, 8, 11, 13, 15, 17, and 19 years. Group-based trajectory analyses identified distinct trajectory patterns of moderate- to vigorous-intensity PA (MVPA), percentage of body fat, and energy intake. A multivariable logistic regression model was fit to estimate the odds of "becoming obese" based on the MVPA trajectories, adjusted for mother's education, somatic maturation, and energy intake. Among males, 74.7% had a "normal" body fat pattern, 14.6% had a "becoming obese" pattern, and 10.7% had a "consistently obese" pattern, while among females, the percentages were 58.6%, 28.6%, and 12.8%, respectively. Participants who were active (≥45 min MVPA) as children but decreased MVPA with age were more likely to become obese, compared to consistently active participants (adjusted OR = 2.77; 95% CI = 1.16, 6.58). An active lifestyle throughout childhood and adolescence could prevent obesity development in young adulthood. © 2015 The Obesity Society.
Vuolteenaho, Katriina; Koskinen, Anna; Moilanen, Eeva
Osteoarthritis (OA) is the most common cause of musculoskeletal disability and pain in the world. The current drug treatment for OA is symptom relieving, and there is an urgent need for treatments that could retard, prevent or repair cartilage destruction in OA. Obesity is a major risk factor for OA. Traditionally, it has been thought to contribute to the development of OA by increasing the load on weight-bearing joints. However, this appears to be an over-simplification, because obesity is also linked to OA in the hand and finger joints. Recent studies have shown that adipocytokine leptin is a possible link between obesity and OA: Leptin levels in synovial fluid are increased in obese patients, leptin receptor (Ob-R) is expressed in cartilage, and leptin induces the production of matrix metalloproteinases (MMPs), pro-inflammatory mediators and nitric oxide (NO) in chondrocytes. Furthermore, according to the very recent findings, not only leptin levels in the joint but also leptin sensitivity in the cartilage are enhanced in obese OA patients. The findings supporting leptin as a causative link between obesity and OA offer leptin as a potential target to the development of disease-modifying drugs for osteoarthritis (DMOAD), especially for obese patients. © 2013 Nordic Pharmacological Society. Published by John Wiley & Sons Ltd.
Pérez-Escamilla, R; Lutter, C K; Rabadan-Diehl, C; Rubinstein, A; Calvillo, A; Corvalán, C; Batis, C; Jacoby, E; Vorkoper, S; Kline, L; Ewart-Pierce, E; Rivera, J A
Addressing childhood obesity in Latin America requires a package of multisectoral, evidence-based policies that enable environments conducive to healthy lifestyles. Identify and examine key elements to translating research into effective obesity policies in Latin America. We examined obesity prevention policies through case studies developed with an expert in the specific policy. Policies were selected based on their level of implementation, visibility and potential impact to reduce childhood obesity. They include: (i) excise taxes on sugar sweetened beverages and energy-dense foods; (ii) front-of-package food label legislation; (iii) trans fatty acids removal from processed foods; and (iv) Ciclovías recreativas or 'open streets'. Case studies were coded to identify components that explained successful implementation and sustainability using the Complex Adaptive Health Systems framework. The analysis identified key elements for effective and sustainable policy, including evidence justifying policy; evidence-based advocacy by civil society; political will; and legislation and skillful negotiations across government, academia, the private sector and civil society. Scientific evidence and evaluation played an important role in achieving tipping points for policies' launch and sustain effective implementation. Well-coordinated, intersectoral partnerships are needed to successfully implement evidence-based anti-obesity policies. Prospective policy research may be useful for advancing knowledge translation. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.
McLean, Rachael M; Hoek, Janet A; Buckley, Sue; Croxson, Bronwyn; Cumming, Jacqueline; Ehau, Terry H; Tanuvasa, Ausaga Fa'asalele; Johnston, Margaret; Mann, Jim I; Schofield, Grant
New Zealand rates of obesity and overweight have increased since the 1980s, particularly among indigenous Māori people, Pacific people and those living in areas of high deprivation. New Zealand's response to the obesity epidemic has been The Healthy Eating-Healthy Action: Oranga Kai - Oranga Pumau (HEHA) Strategy ('the Strategy'), launched in 2003. Because the HEHA Strategy explicitly recognises the importance of evaluation and the need to create an evidence base to support future initiatives, the Ministry of Health has commissioned a Consortium of researchers to evaluate the Strategy as a whole. This paper discusses the Consortium's approach to evaluating the HEHA Strategy. It includes an outline of the conceptual framework underpinning the evaluation, and describes the critical components of the evaluation which are: judging to what extent stakeholders were engaged in the process of the strategy implementation and to what extent their feedback was incorporated in to future iterations of the Strategy (continuous improvement), to what extent the programmes, policies, and initiatives implemented span the target populations and priority areas, whether there have been any population changes in nutrition and/or physical activity outcomes or behaviours relating to those outcomes, and to what extent HEHA Strategy and spending can be considered value for money. This paper outlines our approach to evaluating a complex national health promotion strategy. Not only does the Evaluation have the potential to identify interventions that could be adopted internationally, but also the development of the Evaluation design can inform other complex evaluations.
Encarnação, R; Lloyd-Williams, F; Bromley, H; Capewell, S
Evidence shows that one of the main causes for rising obesity rates is excessive consumption of sugar, which is due in large part to the high sugar content of most soda and juice drinks and junk foods. Worryingly, UK and global populations are consuming increasing amounts of sugary drinks and junk foods (high in salt, sugar and saturated fats). However, there is raised public awareness, and parents in particular want something to be done to curb the alarming rise in childhood obesity. Population-wide policies (i.e. taxation, regulation, legislation, reformulation) consistently achieve greater public health gains than interventions and strategies targeted at individuals. Junk food and soda taxes are supported by increasing evidence from empirical and modelling studies. The strongest evidence base is for a tax on sugar sweetened beverages, but in order to effectively reduce consumption, that taxation needs to be at least 20%. Empirical data from a number of countries which have implemented a duty on sugar or sugary drinks shows rapid, substantial benefits. In the UK, increasing evidence from recent scientific reports consistently support substantial reductions in sugar consumption through comprehensive strategies which include a tax. Furthermore, there is increasing public support for such measures. A sugar sweetened beverages tax will happen in the UK so the question is not 'If?' but 'When?' this tax will be implemented. And, crucially, which nation will get there first? England, Ireland, Scotland or Wales?
Background New Zealand rates of obesity and overweight have increased since the 1980s, particularly among indigenous Māori people, Pacific people and those living in areas of high deprivation. New Zealand's response to the obesity epidemic has been The Healthy Eating-Healthy Action: Oranga Kai - Oranga Pumau (HEHA) Strategy ('the Strategy'), launched in 2003. Because the HEHA Strategy explicitly recognises the importance of evaluation and the need to create an evidence base to support future initiatives, the Ministry of Health has commissioned a Consortium of researchers to evaluate the Strategy as a whole. Methods This paper discusses the Consortium's approach to evaluating the HEHA Strategy. It includes an outline of the conceptual framework underpinning the evaluation, and describes the critical components of the evaluation which are: judging to what extent stakeholders were engaged in the process of the strategy implementation and to what extent their feedback was incorporated in to future iterations of the Strategy (continuous improvement), to what extent the programmes, policies, and initiatives implemented span the target populations and priority areas, whether there have been any population changes in nutrition and/or physical activity outcomes or behaviours relating to those outcomes, and to what extent HEHA Strategy and spending can be considered value for money. Discussion This paper outlines our approach to evaluating a complex national health promotion strategy. Not only does the Evaluation have the potential to identify interventions that could be adopted internationally, but also the development of the Evaluation design can inform other complex evaluations. PMID:19961625
Xu, Pengfei; Wang, Jialin; Hong, Fan; Wang, Sheng; Jin, Xi; Xue, Tingting; Jia, Li; Zhai, Yonggong
Excess weight and obesity are severe public health threats worldwide. Recent evidence demonstrates that gut microbiota dysbiosis contributes to obesity and its comorbidities. The body weight-reducing and energy balancing effects of melatonin have been reported in several studies, but to date, no investigations toward examining whether the beneficial effects of melatonin are associated with gut microbiota have been carried out. In this study, we show that melatonin reduces body weight, liver steatosis, and low-grade inflammation as well as improving insulin resistance in high fat diet (HFD)-fed mice. High-throughput pyrosequencing of the 16S rRNA demonstrated that melatonin treatment significantly changed the composition of the gut microbiota in mice fed an HFD. The richness and diversity of gut microbiota were notably decreased by melatonin. HFD feeding altered 69 operational taxonomic units (OTUs) compare with a normal chow diet (NCD) group, and melatonin supplementation reversed 14 OTUs to the same configuration than those present in the NCD group, thereby impacting various functions, in particular through its ability to decrease the Firmicutes-to-Bacteroidetes ratio and increase the abundance of mucin-degrading bacteria Akkermansia, which is associated with healthy mucosa. Taken together, our results suggest that melatonin may be used as a probiotic agent to reverse HFD-induced gut microbiota dysbiosis and help us to gain a better understanding of the mechanisms governing the various melatonin beneficial effects. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Kipping, R R; Jago, R; Lawlor, D A
Little is known about the effectiveness of parent involvement in school-based obesity prevention interventions. A qualitative study with parents of children aged 9-10 years was conducted to identify possible methods to involve them in a school-based obesity prevention intervention, followed by a process evaluation of homework and school newsletters to involve parents. Qualitative study: parents supported the use of homework and school newsletters to involve them and overcome the main barriers of their work and time. Process evaluation: Ten homeworks and inserts for the school newsletter about the obesity prevention intervention were developed and delivered. The majority of homeworks were given out (73%), completed by children (84%) and recalled by parents (60-68%). The majority of homeworks were enjoyed by parents and children. All the schools put information about the project in the newsletter and this was recalled by parents. Most parents felt the homeworks were a practical way of involving them. Homeworks are routinely given to children and provide a means of engaging potentially all parents if parental support is required. Homeworks which are novel, fun and involve activities and social contact are enjoyed by parents and children and may increase awareness of healthy diet and physical activity.
Camille Dugas; Julie Perron; Michèle Kearney; Roxanne Mercier; André Tchernof; Isabelle Marc; S. John Weisnagel; Julie Robitaille
Children exposed to gestational diabetes mellitus (GDM) in utero are at high risk of developing many health problems such as obesity. There is an urgent need to find new strategies to prevent obesity development among high-risk populations such as those children. Accordingly, the aim of this review was to summarize current knowledge on the postnatal prevention of childhood obesity in offspring born from mothers with GDM. Specifically, this review addresses the impact of breastfeeding, complem...
Pigeot, I; Baranowski, T; De Henauw, S
One of the major research dimensions of the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study involved the development, implementation and evaluation of a setting-based community-oriented intervention programme for primary prevention of childhood obesity. In this supplement of Obesity Reviews, a compilation of key results of the IDEFICS intervention is packaged in a series of complementary papers. This paper describes the overall design and methods of the IDEFICS intervention in order to facilitate a comprehensive reading of the supplement. In addition, some 'best practice' examples are described. The IDEFICS intervention trial was conducted to assess whether the IDEFICS intervention prevented obesity in young children aged 2 to 9.9 years. The study was a non-randomized, quasi-experimental trial with one intervention matched to one control region in each of eight participating countries. The intervention was designed following the intervention mapping framework, using a socio-ecological theoretical approach. The intervention was designed to address several key obesity-related behaviours in children, parents, schools and community actors; the primary outcome was the prevalence of overweight/obesity according to the IOTF criteria based on body mass index. The aim was to achieve a reduction of overweight/obesity prevalence in the intervention regions. The intervention was delivered in school and community settings over a 2-year period. Data were collected in the intervention and control cohort regions at baseline and 2 years later. This paper offers an introductory framework for a comprehensive reading of this supplement on IDEFICS intervention key results. © 2015 World Obesity.
Griffin, Tania L; Clarke, Joanne L; Lancashire, Emma R; Pallan, Miranda J; Passmore, Sandra; Adab, Peymane
Objective: There has been a wealth of childhood obesity prevention studies in school-based settings. However, few have investigated the experiences of school staff charged with delivery of such programmes. This study aimed to elicit teachers' experiences of delivering a childhood obesity prevention programme for children aged 6-7 years. Design:…
Knol, Linda L.; Myers, Harriet H.; Black, Sheila; Robinson, Darlene; Awololo, Yawah; Clark, Debra; Parker, Carson L.; Douglas, Joy W.; Higginbotham, John C.
Background: Effective childhood obesity prevention programs for preschool children are limited in number and focus on changes in the child care environment rather than the home environment. Purpose: The purpose of this project was to develop and test the feasibility of a home environment obesity prevention program that incorporates mindful eating…
Nelson, Toben F; Stovitz, Steven D; Thomas, Megan; LaVoi, Nicole M; Bauer, Katherine W; Neumark-Sztainer, Dianne
Sport is a promising setting for obesity prevention among youth, but little is known about whether it prevents obesity. We reviewed research comparing sport participants with nonparticipants on weight status, physical activity, and diet. Among 19 studies, we found no clear pattern of association between body weight and sport participation. Among 17 studies, we found that sport participants are more physically active than those who do not participate. We found seven studies that compared the diet of sport participants with non-participants. These studies reported that youth involved in sport were more likely to consume fruits, vegetables, and milk, and also more likely to eat fast food and drink sugar-sweetened beverages and consume more calories overall. It is unclear from these results whether sports programs, as currently offered, protect youth from becoming overweight or obese. Additional research may foster understanding about how sport, and youth sport settings, can help promote energy balance and healthy body weight.
Abidin, Norhaslinda Zainal; Zulkepli, Jafri Hj; Zaibidi, Nerda Zura
The rise in income and population growth have increased the demand for food and induced changes in food habits, food purchasing and consumption patterns in Malaysia. With this transition, one of the plausible causes of weight gain and obesity is the frequent consumption of outside food which is synonymous with bigger portion size. Therefore, the aim of this paper is to develop a system dynamics model to analyse the effect of reducing food portion size on weight and obesity prevention. This study combines the different strands of knowledge comprise of nutrition, physical activity and body metabolism. These elements are synthesized into a system dynamics model called SIMULObese. Findings from this study suggested that changes in eating behavior should not emphasize only on limiting the food portion size consumption. The efforts should also consider other eating events such as controlling the meal frequency and limiting intake of high-calorie food in developing guidelines to prevent obesity.
Anti, Eliza; Laurent, Jennifer S; Tompkins, Connie
The purpose of this study was to explore the experience of health care providers (HCPs) in the outpatient setting as they work with fathers of children who are overweight and obese. Interpretative phenomenological analysis was used for data collection and analysis. Seven HCPs were interviewed about their experiences. Two major themes emerged from the experiences of these HCPs: "dad in the back seat" and "paternal resistance." The theme of "dad in the back seat" captured the HCPs' experiences and perceptions of parental roles and related stereotypes with respect to fathers' lack of presence in the health-care setting, family roles that relegate fathers to the back seat in dealing with this issue, and the tendency of fathers to take a passive role and defer to mothers in the management of their child's weight. "Paternal resistance" reflected the perceived tendency of the father to resist the acceptance of his child's weight as a problem and to resist change and even undermine family efforts to make healthier choices. HCPs' experiences of fathers as having a minimal role in the management of their child's overweight and obesity may lead them to neglect fathers as agents of change with regard to this important issue. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Showell, Nakiya N; Fawole, Oluwakemi; Segal, Jodi; Wilson, Renee F; Cheskin, Lawrence J; Bleich, Sara N; Wu, Yang; Lau, Brandyn; Wang, Youfa
Childhood obesity is a global epidemic. Despite emerging research about the role of the family and home on obesity risk behaviors, the evidence base for the effectiveness of home-based interventions on obesity prevention remains uncertain. The objective was to systematically review the effectiveness of home-based interventions on weight, intermediate (eg, diet and physical activity [PA]), and clinical outcomes. We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library from inception through August 11, 2012. We included experimental and natural experimental studies with ≥1-year follow-up reporting weight-related outcomes and targeting children at home. Two independent reviewers screened studies and extracted data. We graded the strength of the evidence supporting interventions targeting diet, PA, or both for obesity prevention. We identified 6 studies; 3 tested combined interventions (diet and PA), 1 used diet intervention, 1 combined intervention with primary care and consumer health informatics components, and 1 combined intervention with school and community components. Select combined interventions had beneficial effects on fruit/vegetable intake and sedentary behaviors. However, none of the 6 studies reported a significant effect on weight outcomes. Overall, the strength of evidence is low that combined home-based interventions effectively prevent obesity. The evidence is insufficient for conclusions about home-based diet interventions or interventions implemented at home in association with other settings. The strength of evidence is low to support the effectiveness of home-based child obesity prevention programs. Additional research is needed to test interventions in the home setting, particularly those incorporating parenting strategies and addressing environmental influences.
Fawole, Oluwakemi; Segal, Jodi; Wilson, Renee F.; Cheskin, Lawrence J.; Bleich, Sara N.; Wu, Yang; Lau, Brandyn; Wang, Youfa
BACKGROUND AND OBJECTIVES: Childhood obesity is a global epidemic. Despite emerging research about the role of the family and home on obesity risk behaviors, the evidence base for the effectiveness of home-based interventions on obesity prevention remains uncertain. The objective was to systematically review the effectiveness of home-based interventions on weight, intermediate (eg, diet and physical activity [PA]), and clinical outcomes. METHODS: We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library from inception through August 11, 2012. We included experimental and natural experimental studies with ≥1-year follow-up reporting weight-related outcomes and targeting children at home. Two independent reviewers screened studies and extracted data. We graded the strength of the evidence supporting interventions targeting diet, PA, or both for obesity prevention. RESULTS: We identified 6 studies; 3 tested combined interventions (diet and PA), 1 used diet intervention, 1 combined intervention with primary care and consumer health informatics components, and 1 combined intervention with school and community components. Select combined interventions had beneficial effects on fruit/vegetable intake and sedentary behaviors. However, none of the 6 studies reported a significant effect on weight outcomes. Overall, the strength of evidence is low that combined home-based interventions effectively prevent obesity. The evidence is insufficient for conclusions about home-based diet interventions or interventions implemented at home in association with other settings. CONCLUSIONS: The strength of evidence is low to support the effectiveness of home-based child obesity prevention programs. Additional research is needed to test interventions in the home setting, particularly those incorporating parenting strategies and addressing environmental influences. PMID:23753095
Aronne, L J
Recognition by the American Heart Association that obesity is a major modifiable risk factor for coronary heart disease has prompted health providers to take a more active role in obesity management. Obesity has long been known to accompany a host of chronic diseases, e.g., type II diabetes, hypertension, and dyslipidemia. We now recognize that obesity is itself a chronic disease with a complex etiology; like diabetes and hypertension, it is treatable with a similar chronic disease treatment model. Relatively modest weight loss confers disproportionate health benefits, improving a roster of risk factors. Diet, exercise, and behavior modification still compose the gold standard of treatment. If these measures fail, medication and surgery should be considered for appropriate patients. With current techniques, many patients can achieve realistic weight goals that can be maintained over the long term. Published management guidelines can now assist in integrating the practical applications of obesity-related research findings into everyday clinical practice.
Full Text Available Abstract Background New Zealand rates of obesity and overweight have increased since the 1980s, particularly among indigenous Māori people, Pacific people and those living in areas of high deprivation. New Zealand's response to the obesity epidemic has been The Healthy Eating-Healthy Action: Oranga Kai - Oranga Pumau (HEHA Strategy ('the Strategy', launched in 2003. Because the HEHA Strategy explicitly recognises the importance of evaluation and the need to create an evidence base to support future initiatives, the Ministry of Health has commissioned a Consortium of researchers to evaluate the Strategy as a whole. Methods This paper discusses the Consortium's approach to evaluating the HEHA Strategy. It includes an outline of the conceptual framework underpinning the evaluation, and describes the critical components of the evaluation which are: judging to what extent stakeholders were engaged in the process of the strategy implementation and to what extent their feedback was incorporated in to future iterations of the Strategy (continuous improvement, to what extent the programmes, policies, and initiatives implemented span the target populations and priority areas, whether there have been any population changes in nutrition and/or physical activity outcomes or behaviours relating to those outcomes, and to what extent HEHA Strategy and spending can be considered value for money. Discussion This paper outlines our approach to evaluating a complex national health promotion strategy. Not only does the Evaluation have the potential to identify interventions that could be adopted internationally, but also the development of the Evaluation design can inform other complex evaluations.
Nathan, N.; Wolfenden, L.; Williams, C. M.; Yoong, S. L.; Lecathelinais, C.; Bell, A. C.; Wyse, R.; Sutherland, R.; Wiggers, J.
Despite significant investment in many countries, the extent of schools' adoption of obesity prevention policies and practices has not been widely reported. The aims of this article are to describe Australian schools' adoption of healthy eating and physical activity policies and practices over an 8-year period and to determine if their adoption…
Wieringa, N.F.; van der Windt, H.J.; Zuiker, R.R.M.; Dijkhuizen, L.; Verkerk, M.A.; Vonk, R.J.; Swart, J.A.A.
To contribute to the social debate about the role of functional foods in the prevention of overweight and obesity using an ecological model to study the positioning of functional foods and their social implications. Positioning was conceptualized as the relative attention given to functional foods
Hardus, P.M.; Vuuren, van C.L.; Crawford, D.; Worsley, A.
OBJECTIVE: To investigate lay perceptions of the causes and prevention of obesity among primary school children. DESIGN: A cross-sectional survey of randomly selected sample of adults in a shopping centre. SUBJECTS: 315 adults in Melbourne, Australia. MEASUREMENTS: Subjects completed a
Clark, Rachel; Waters, Elizabeth; Armstrong, Rebecca; Conning, Rebecca; Allender, Steven; Swinburn, Boyd
Public health practitioners make decisions based on research evidence in combination with a variety of other influences. Evidence summaries are one of a range of knowledge translation options used to support evidence-informed decision making. The literature relevant to obesity prevention requires synthesis for it to be accessible and relevant to…
Spieker, Elena A.; Sbrocco, Tracy; Theim, Kelly R.; Maurer, Douglas; Johnson, Dawn; Bryant, Edny; Bakalar, Jennifer L.; Schvey, Natasha A.; Ress, Rachel; Seehusen, Dean; Klein, David A.; Stice, Eric; Yanovski, Jack A.; Chan, Linda; Gentry, Shari; Ellsworth, Carol; Hill, Joanne W.; Tanofsky-Kraff, Marian; Stephens, Mark B.
Obesity impacts the U.S. military by affecting the health and readiness of active duty service members and their families. Preventing Obesity in Military Communities (POMC) is a comprehensive research program within Patient Centered Medical Homes (PCMHs) in three Military Training Facilities. This paper describes three pilot randomized controlled trials that target critical high risk periods for unhealthy weight gain from birth to young adulthood: (1) pregnancy and early infancy (POMC-Mother-Baby), (2) adolescence (POMC-Adolescent), and (3) the first tour of duty after boot camp (POMC-Early Career). Each study employs a two-group randomized treatment or prevention program with follow up. POMC offers a unique opportunity to bring together research and clinical expertise in obesity prevention to develop state-of-the-art programs within PCMHs in Military Training Facilities. This research builds on existing infrastructure that is expected to have immediate clinical benefits to DoD and far-reaching potential for ongoing collaborative work. POMC may offer an economical approach for widespread obesity prevention, from conception to young adulthood, in the U.S. military as well as in civilian communities. PMID:25648176
Elena A. Spieker
Full Text Available Obesity impacts the U.S. military by affecting the health and readiness of active duty service members and their families. Preventing Obesity in Military Communities (POMC is a comprehensive research program within Patient Centered Medical Homes (PCMHs in three Military Training Facilities. This paper describes three pilot randomized controlled trials that target critical high risk periods for unhealthy weight gain from birth to young adulthood: (1 pregnancy and early infancy (POMC-Mother-Baby, (2 adolescence (POMC-Adolescent, and (3 the first tour of duty after boot camp (POMC-Early Career. Each study employs a two-group randomized treatment or prevention program with follow up. POMC offers a unique opportunity to bring together research and clinical expertise in obesity prevention to develop state-of-the-art programs within PCMHs in Military Training Facilities. This research builds on existing infrastructure that is expected to have immediate clinical benefits to DoD and far-reaching potential for ongoing collaborative work. POMC may offer an economical approach for widespread obesity prevention, from conception to young adulthood, in the U.S. military as well as in civilian communities.
Morgan, Philip J; Young, Myles D; Lloyd, Adam B; Wang, Monica L; Eather, Narelle; Miller, Andrew; Murtagh, Elaine M; Barnes, Alyce T; Pagoto, Sherry L
Despite their important influence on child health, it is assumed that fathers are less likely than mothers to participate in pediatric obesity treatment and prevention research. This review investigated the involvement of fathers in obesity treatment and prevention programs targeting children and adolescents (0-18 years). A systematic review of English, peer-reviewed articles across 7 databases. Retrieved records included at least 1 search term from 2 groups: "participants" (eg, child*, parent*) and "outcomes": (eg, obes*, diet*). Randomized controlled trials (RCTs) assessing behavioral interventions to prevent or treat obesity in pediatric samples were eligible. Parents must have "actively participated" in the study. Two authors independently extracted data using a predefined template. The search retrieved 213 eligible RCTs. Of the RCTs that limited participation to 1 parent only (n = 80), fathers represented only 6% of parents. In RCTs in which participation was open to both parents (n = 133), 92% did not report objective data on father involvement. No study characteristics moderated the level of father involvement, with fathers underrepresented across all study types. Only 4 studies (2%) suggested that a lack of fathers was a possible limitation. Two studies (1%) reported explicit attempts to increase father involvement. The review was limited to RCTs published in English peer-reviewed journals over a 10-year period. Existing pediatric obesity treatment or prevention programs with parent involvement have not engaged fathers. Innovative strategies are needed to make participation more accessible and engaging for fathers. Copyright © 2017 by the American Academy of Pediatrics.
Quelly, Susan B.
Comprehensive childhood obesity prevention (COP) strategies should include increasing school nurse involvement. This study was conducted to determine the influence of key school nurse perceptions (self-efficacy, perceived benefits, and perceived barriers) on participation in COP practices at the individual child and school level. Florida…
... Service 7 CFR Part 272 RIN 0584-AE07 Supplemental Nutrition Assistance Program: Nutrition Education and... under the Act to carry out nutrition education and obesity prevention services each fiscal year. DATES... Act removes the existing nutrition education program under section 11(f) of the Food and Nutrition Act...
Cerin, E; Baranowski, J; Baranowski, T
Abstract Obesity prevention interventions through dietary and physical activity change have generally not been effective. Limitations on possible program effectiveness are herein identified at every step in the mediating variable model, a generic conceptual framework for understanding how interventions may promote behavior change. To minimize these problems, and thereby enhance likely intervention effectiveness, four sequential types of formative studies are proposed: targeted behavior valida...
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Karanja, Njeri; Aickin, Mikel; Lutz, Tam; Mist, Scott; Jobe, Jared B.; Maupome, Gerardo; Ritenbaugh, Cheryl
Eating and physical activity behaviors associated with adult obesity have early antecedents, yet few studies have focused on obesity prevention interventions targeting very young children. Efforts to prevent obesity beginning at birth seem particularly important in populations at risk for early-onset obesity. National estimates indicate that…
Swindle, Taren M; Ward, Wendy L; Whiteside-Mansell, Leanne
This study investigated the use of Facebook to deliver health-related education materials to augment a preschool classroom-based obesity prevention curriculum. Cross-sectional, mixed methods (descriptive and interviews). Head Start classrooms administered by 2 large agencies (1 rural and 1 urban). Convenience sample of parents in 13 classrooms (cohort 1, 3 classrooms; cohort 2, 10 classrooms). Delivery of nutrition education curriculum content using social media (Facebook). Qualitative interviews assessed barriers and facilitators to Facebook use. Parent views, likes, and comments were measured to reflect parent engagement with Facebook. Content analyses (qualitative data) and descriptive statistics (quantitative data). Family access (views) and interaction (comments and likes) with the posts varied based on type and content of posts. Rural families were more active. Barriers to parental Facebook engagement included a desire to see more posts from classroom teachers, lack of time, and misunderstanding about privacy protections. Facilitators of parental Facebook engagement included perceived utility of the content and social support. Facebook was found to be a feasible platform to provide nutrition education and facilitated varying levels of parental engagement. Lessons learned and implications for prevention and intervention programming are offered. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Rush, Elaine; Cairncross, Carolyn; Williams, Margaret Hinepo; Tseng, Marilyn; Coppinger, Tara; McLennan, Steph; Latimer, Kasha
Prevention of childhood obesity is a global priority. The school setting offers access to large numbers of children and the ability to provide supportive environments for quality physical activity and nutrition. This article describes Project Energize, a through-school physical activity and nutrition programme that celebrated its 10-year anniversary in 2015 so that it might serve as a model for similar practices, initiatives and policies elsewhere. The programme was envisaged and financed by the Waikato District Health Board of New Zealand in 2004 and delivered by Sport Waikato to 124 primary schools as a randomised controlled trial from 2005 to 2006. The programme has since expanded to include all 242 primary schools in the Waikato region and 70 schools in other regions, including 53,000 children. Ongoing evaluation and development of Project Energize has shown it to be sustainable (ongoing for >10 years), both effective (lower obesity, higher physical fitness) and cost effective (one health related cost quality adjusted life year between $18,000 and $30,000) and efficient ($45/child/year) as a childhood 'health' programme. The programme's unique community-based approach is inclusive of all children, serving a population that is 42% Māori, the indigenous people of New Zealand. While the original nine healthy eating and seven quality physical activity goals have not changed, the delivery and assessment processes has been refined and the health service adapted over the 10 years of the programme existence, as well as adapted over time to other settings including early childhood education and schools in Cork in Ireland. Evaluation and research associated with the programme delivery and outcomes are ongoing. The dissemination of findings to politicians and collaboration with other service providers are both regarded as priorities.
The recent report by Barnhill and King about obesity prevention policy raises important issues for discussion and analysis. In response, this article raises four points for further consideration. First, a distinction between equality and justice needs to be made and consistently maintained. Second, different theories of justice highlight one additional important source of disagreement about the ethical propriety of the proposed obesity prevention policies. Third, another point of contention a...
Yoshiike, Nobuo; Iwabe, Maiko; Yoshioka, Yoshiko
Educational interventions for obesity prevention from early childhood is one of the important measures in health promotion policies, especially in locations where obesity and overweight in school and preschool children are prevalent, such as in the Aomori Prefecture. The Aomori Prefecture government started a new demonstration project in FY 2014 that targeted children in nursing schools for the prevention of obesity through both population approaches (nutrition/physical activity education and nutrition management in lunch programs) and individual approaches to solving overweight in children. Our study group developed a data management tool to routinely accumulate data on measured body height and weight. We also developed educational materials with growth charts for nutritional education of guardians, and summary sheets showing the distributions of degree of obesity and prevalence of overweight/obesity in age-sex groups for use in assessment in each nursing school. To promote and evaluate the demonstration project, we offered the data management tool to all nursing schools in the prefecture for nutritional education and management in the nursing schools and asked them to anonymously submit data to build a prefecture-based monitoring dataset. Around 70% (310 institutes) of the institutes responded to this request, and we developed a longitudinal dataset with about 4,000 children in each of the 3-, 4-, and 5-year-old cohorts. This first revealed the prevalence of overweight in preschool children in the entire prefecture. The dataset will be further utilized for evaluating the effectiveness of educational interventions in preschool settings in local communities.
Castro, Heriberto; Pomar, Catalina Amadora; Palou, Andreu; Picó, Catalina; Sánchez, Juana
We studied in rats whether the expected detrimental effects in offspring associated to maternal dietary obesity may be reverted by obesogenic diet removal 1 month before mating. Female rats were fed a cafeteria diet (CD) from days 10 to 100 and then a standard diet (SD) (postcafeteria rats). One month after CD removal, postcafeteria rats and a group of SD-fed female rats (controls) were mated with males. At weaning, offspring were fed SD and followed until 4 months old. CD was effective at inducing obesity in dams. Its removal led to a reduction in body weight, although, after 30 days, rats retained excess body weight and fat than controls. During lactation, postcafeteria dams showed greater body fat, and higher leptin and adiponectin levels in milk than controls. From 2 months of life, offspring of postcafeteria dams displayed lower body weight than controls, with no differences in the percentage of fat, homeostatic model assessment for insulin resistance, or circulating parameters. Removal of CD in obese rats before gestation, although without complete reversion of body weight excess, may prevent the expected detrimental effects in offspring associated to an excess fat accumulation in adulthood and the related metabolic disturbances. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Bagherniya, Mohammad; Sharma, Manoj; Mostafavi, Firoozeh; Keshavarz, Seyed Ali
The aim of this cross-sectional study was to use social cognitive theory to predict overweight and obesity behaviors in adolescent girls in Iran. Valid and reliable questionnaires about nutritional and physical activity regarding social cognitive theory constructs (self-efficacy, social support, outcome expectations, and outcome expectancies), dietary habits, and physical activity were filled by 172 overweight and obese girl adolescents. The mean age and body mass index were 13.4 ± 0.6 years and 28.2 ± 3.6 kg/m(2), respectively. Body mass index was significantly related to hours of television viewing (p = .003) and grams of junk food (p = .001). None of the social cognitive theory constructs were found to be significant predictors for servings of fruits and vegetables, grams of junk foods, minutes of physical activity, and hours of sedentary behaviors. In future, more culturally appropriate models need to be developed in Iran that can explain and predict prevention behaviors of obesity in Iranian adolescents. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Trevor J. B. Dummer
Full Text Available The obesity epidemic requires the development of prevention policy targeting individuals most likely to benefit. We used self-reported prepregnancy body weight of all women giving birth in Nova Scotia between 1988 and 2006 to define obesity and evaluated socioeconomic, demographic, and temporal trends in obesity using linear regression. There were 172,373 deliveries in this cohort of 110,743 women. Maternal body weight increased significantly by 0.5 kg per year from 1988, and lower income and rural residence were both associated significantly with increasing obesity. We estimated an additional 82,000 overweight or obese women in Nova Scotia in 2010, compared to the number that would be expected from obesity rates of just two decades ago. The critical age for weight gain was identified as being between 20 and 24 years. This age group is an important transition age between adolescence and adulthood when individuals first begin to accept responsibility for food planning, purchasing, and preparation. Policy and public health interventions must target those most at risk, namely, younger women and the socially deprived, whilst tackling the marketing of low-cost energy-dense foods at the expense of healthier options.
Lu, Amy Shirong; Kharrazi, Hadi; Gharghabi, Fardad; Thompson, Debbe
Childhood obesity is a global epidemic. Health videogames are an emerging intervention strategy to combat childhood obesity. This systematic review examined published research on the effect of health videogames on childhood obesity. Fourteen articles examining 28 health videogames published between 2005 and 2013 in English were selected from 2433 articles identified through five major search engines. Results indicated that academic interest in using health videogames for childhood obesity prevention has increased during this time. Most games were commercially available. Most studies were of short duration. Diverse player and game play patterns have been identified. Most studies involved players of both genders with slightly more boys. The majority of players were non-white. Most studies had the players play the games at home, whereas some extended the play setting to school and sports/recreational facilities. Most of the games were commercially available. Positive outcomes related to obesity were observed in about 40 percent of the studies, all of which targeted overweight or obese participants.
Barquera Cervera, Simón; Campos-Nonato, Ismael; Rojas, Rosalba; Rivera, Juan
Obesity is a major risk factor for developing type 2 diabetes, cardiovascular disease, hypertension, dyslipidemias, musculoskeletal diseases, and certain types of cancer. In Mexico the prevalence of overweight and obesity is 16.7% in preschool children, 26.2% in school children, and 30.9% in adolescents. For adults, the prevalence of overweight and obesity is 39.7 and 29.9%, respectively (ENSANUT 2006). Based on an analysis of the situation in Mexico, the need for a comprehensive, multisectoral, multilevel policy and an effective coordination policy have been clearly identified to achieve changes in eating patterns and physical activity to enable the prevention of chronic diseases and to reduce the prevalence of overweight and obesity The combination of strategies and actions of the Mexican National Agreement for Healthy Nutrition proposed by the federal government proposes among its aims for 2012: a reversal in the prevalence of overweight and obesity for children aged 2-5 years in comparison with ENSANUT to stop the increasing prevalence in this condition for school children and adolescents (aged 5-19 years), and to slow down the increasing prevalence of overweight and obesity in adults. This challenge will require important regulatory actions, efficient and adaptable implementation, and participation of all sectors of society.
Full Text Available Background: Education is one of the standard components of current nursing care. It is aimed at healthy and diseased and it aims to take responsibility for health. Constantly increasing prevalence of obesity is a global problem. As in the majority population in the Czech Republic and even serious situation of minorities. However, implemented intervention programs and strategies are targeted mainly at the majority population. The concept of social learning theory, however, offers the possibility of integrating previously neglected knowledge as it provides a social context that has a direct impact on the conduct of individuals. Objectives: The aim of this paper is to analyze the problems in the education of the Roma minority and to highlight the possibilities of using the concept of social learning theory in the development of intervention programs aimed at the prevention of overweight and obesity. Methods: This paper is based on data gathered in the implementation of qualitative research, where the research group consists of 25 Roma respondents older than eighteen years of age whose BMI was in the overweight or obese range (ie BMI ≥ 25 kg/m2. Among the respondents were 8 men and 17 women. The paper is also supported by the data obtained in the framework of the grant project aimed, inter alia, to determine the prevalence of these diagnoses among the Roma minority. Results: Culturally conditioned behavior patterns are a significant factor that can influence the effectiveness of implemented interventions. Already during the collection history with these patterns manifest themselves. Among other factors, are body image, social functions of eating, socioeconomic status and related dietary composition. Understanding the relationships between these factors and motivational elements of risk behaviors can go into nursing to bring a new dimension. Conclusions: Ethnicity is often a significant factor that affects the effectiveness of
Cai, Li; Wu, Yang; Cheskin, Lawrence J.; Wilson, Renee F.; Wang, Youfa
Summary Aim We aimed to assess the effects of childhood obesity prevention programs on blood lipids in high-income countries. Methods We searched MEDLINE®, Embase, PsychInfo, CINAHL®, clinicaltrials.gov, and the Cochrane Library up to April 22, 2013 for relevant randomized controlled trials, quasi-experimental studies, and natural experiments published in English. Studies were included if they implemented diet and/or physical activity intervention(s) with ≥ one year follow up (or ≥ six months for school-based intervention studies) in 2 to 18 years old, and were excluded if they targeted only overweight/obese children, or those with a pre-existing medical condition. Results Seventeen studies were finally included. For total cholesterol, the pooled intervention effect was −0.97 mg/dL (95% CI: −3.26, 1.32; P=0.408); for low density lipoprotein-cholesterol (LDL-C), −6.06 mg/dL (95% CI: −11.09, −1.02; P=0.018); for high density lipoprotein-cholesterol (HDL-C), 1.87 mg/dL (95% CI: 0.39, 3.34; P=0.013); and for triglycerides, −1.95 mg/dL (95% CI: −4.94, 1.04; P=0.202). Most interventions (70%) showed similar significant or no effects on adiposity- and lipids outcomes: 15% interventions improved both adiposity- and lipids outcomes; 55% had no significant effects on either. Conclusions Childhood obesity prevention programs had a significant desirable effect on LDL-C and HDL-C. Two-thirds of interventions showed similar significant or no effects in adiposity- and lipids outcomes. Assessing lipids outcomes provide additional useful information on obesity prevention program benefits. PMID:25263653
Tastesen, Hanne Sørup
mice were fed obesity‐promoting diets with protein from different sources, in different forms and at different levels to evaluate the affect on development of obesity, glucose intolerance and dyslipidemia. Results: In the present study the dietary level of protein, 16 versus 32 percent energy from...... protein, was found to be negligible in development of obesity and co‐morbidities in mice. Seafood protein with high endogenous taurine and glycine contents was found to prevent diet‐induced adiposity and dyslipidemia, both in ad libitum and pair‐fed settings. The ability of seafood proteins to prevent...... that the source and form of protein has great impact on development and prevention of diet‐induced adiposity, dyslipidemia, hyperinsulinemia and impairment of glucose tolerance through modulations of voluntary locomotor activity, energy expenditure and energy substrate metabolism in mice...
Gracia-Marco, L; Vicente-Rodríguez, G; Borys, J M; Le Bodo, Y; Pettigrew, S; Moreno, L A
To review child and adolescent obesity prevention programmes to determine whether they have included the Social Marketing Benchmark Criteria (BC). In addition, we analysed whether there was a relationship between the presence of the criteria and the effectiveness of the programme. Interventions had to be aimed at preventing obesity through behaviour changes relating to diet, physical activity, lifestyle and social support, separately or in combination. A total of 41 interventions were identified in PubMed and Embase that fulfilled the inclusion criteria. The more recent the studies, the greater the number of the BC that seem to have been used. However, regarding behaviour changes, we found the most effective period to be 1997-2002, with 100% of the interventions resulting in behaviour changes (9/9). In addition, almost all interventions resulted in improvements in body composition variables: 5 of 6 for body mass index or overweight/obesity prevalence and 6 of 6 for skin-folds. The presence of a higher number of BC does not assure higher effectiveness. Further research is required in this field. At the moment, studies aimed at preventing obesity in children and adolescents have not included social marketing aspects in their interventions in a comprehensive manner.
Anderson, Sarah E; Keim, Sarah A
This paper describes the epidemiologic evidence linking parent-child relationships, self-regulation, and weight status with a focus on early childhood. The emotional quality of parent-child interactions may influence children's risk for obesity through multiple pathways. Prospective studies linking observer ratings of young children's self-regulation, particularly inhibitory control, to future weight status are discussed. Although findings are preliminary, promoting positive relationships between parents/caregivers and young children holds promise as a component of efforts to prevent childhood obesity. Multi-disciplinary collaborations between researchers with training in developmental science and child health should be encouraged.
This podcast features Katie Arlinghaus, a doctoral student at the University of Houston and one of the winners of PCDâs 2017 Student Research Paper Contest. Katie answers questions about her winning research and what impact her study has on childhood obesity prevention and public health, particularly for the Hispanic community. Created: 10/9/2017 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 10/9/2017.
Xiao, Ting; Stamatakis, Katherine A; McVay, Allese B
Local health departments (LHDs) have an important function in controlling the growing epidemic of obesity in the United States. Data are needed to gain insight into the existence of routine functions and structures of LHDs that support and sustain obesity prevention efforts. The purpose of this study was to develop and examine the reliability of measures to assess foundational LHD organizational processes and functions specific to obesity prevention. Survey measures were developed using a stratified, random sample of US LHDs to assess supportive organizational processes and infrastructure for obesity prevention representing different domains. Data were analyzed using weighted κ and intraclass correlation coefficient for assessing test-retest reliability. Most items and summary indices in the majority of survey domains had moderate/substantial or almost perfect reliability. The overall findings support this survey instrument to be a reliable measurement tool for a large number of processes and functions that comprise obesity prevention-related capacity in LHDs.
Roman, Sonia; Ojeda-Granados, Claudia; Ramos-Lopez, Omar; Panduro, Arturo
Obesity and nonalcoholic steatohepatitis are increasing in westernized countries, regardless of their geographic location. In Latin America, most countries, including Mexico, have a heterogeneous admixture genome with Amerindian, European and African ancestries. However, certain high allelic frequencies of several nutrient-related polymorphisms may have been achieved by past gene-nutrient interactions. Such interactions may have promoted the positive selection of variants adapted to regional food sources. At present, the unbalanced diet composition of the Mexicans has led the country to a 70% prevalence rate of overweightness and obesity due to substantial changes in food habits, among other factors. International guidelines and intervention strategies may not be adequate for all populations worldwide because they do not consider disparities in genetic and environmental factors, and thus there is a need for differential prevention and management strategies. Here, we provide the rationale for an intervention strategy for the prevention and management of obesity-related diseases such as non-alcoholic steatohepatitis based on a regionalized genome-based diet. The components required to design such a diet should focus on the specific ancestry of each population around the world and the convenience of consuming traditional ethnic food.
Roman, Sonia; Ojeda-Granados, Claudia; Ramos-Lopez, Omar; Panduro, Arturo
Obesity and nonalcoholic steatohepatitis are increasing in westernized countries, regardless of their geographic location. In Latin America, most countries, including Mexico, have a heterogeneous admixture genome with Amerindian, European and African ancestries. However, certain high allelic frequencies of several nutrient-related polymorphisms may have been achieved by past gene-nutrient interactions. Such interactions may have promoted the positive selection of variants adapted to regional food sources. At present, the unbalanced diet composition of the Mexicans has led the country to a 70% prevalence rate of overweightness and obesity due to substantial changes in food habits, among other factors. International guidelines and intervention strategies may not be adequate for all populations worldwide because they do not consider disparities in genetic and environmental factors, and thus there is a need for differential prevention and management strategies. Here, we provide the rationale for an intervention strategy for the prevention and management of obesity-related diseases such as non-alcoholic steatohepatitis based on a regionalized genome-based diet. The components required to design such a diet should focus on the specific ancestry of each population around the world and the convenience of consuming traditional ethnic food. PMID:25834309
Ahrens, W; Bammann, K; de Henauw, S; Halford, J; Palou, A; Pigeot, I; Siani, A; Sjöström, M
The environment of children has drastically changed in Europe during the last decades as reflected in unhealthy dietary habits and sedentary lifestyle. Nutrition obviously plays a part in the development of overweight in childhood. However, dietary factors and physical activity are also involved in the development of metabolic syndrome, type II diabetes, cardiovascular diseases, osteoporosis, and postural deformities like scoliosis, effects related in part to excessive weight gain. To stop the resulting epidemic of diet- and lifestyle-induced morbidity, efficient evidence-based approaches are needed. These issues are the focus of IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants), a five-year project proposed under the sixth EU framework. The IDEFICS consortium comprises 25 research centres and SMEs across Europe. The planned prospective study will identify risk profile inventories for children susceptible to any of these disorders with emphasis on obesity and its co-morbid conditions. Genetic and non-genetic factors, psychosocial factors and social settings will be considered. The project will devise tailored prevention strategies that are effective, easy to implement and that account for the needs of different social groups. Population-based studies will investigate the impact of sensory perception and provide results concerning internal and external triggers of food choices and children's consumer behaviour. The ethical implications of a "right not to know" of genetic factors will be addressed. We will propose knowledge-based guidelines on dietary and lifestyle activities for health promotion and disease prevention in children for health professionals, stakeholders and consumers.
Sheri A Lippman
Full Text Available Men who have sex with men (MSM in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers' opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM.
Blanck, Heidi M.; Lee, Brian; Kocot, S. Lawrence; Seeff, Laura; McGuire, Lisa C.; Collins, Janet
Electronic information technology standards facilitate high-quality, uniform collection of data for improved delivery and measurement of health care services. Electronic information standards also aid information exchange between secure systems that link health care and public health for better coordination of patient care and better-informed population health improvement activities. We developed international data standards for healthy weight that provide common definitions for electronic information technology. The standards capture healthy weight data on the “ABCDs” of a visit to a health care provider that addresses initial obesity prevention and care: assessment, behaviors, continuity, identify resources, and set goals. The process of creating healthy weight standards consisted of identifying needs and priorities, developing and harmonizing standards, testing the exchange of data messages, and demonstrating use-cases. Healthy weight products include 2 message standards, 5 use-cases, 31 LOINC (Logical Observation Identifiers Names and Codes) question codes, 7 healthy weight value sets, 15 public–private engagements with health information technology implementers, and 2 technical guides. A logic model and action steps outline activities toward better data capture, interoperable systems, and information use. Sharing experiences and leveraging this work in the context of broader priorities can inform the development of electronic information standards for similar core conditions and guide strategic activities in electronic systems. PMID:29072985
Kahrass, Hannes; Strech, Daniel; Mertz, Marcel
Planning and conducting preventive measures against obesity for school children is beset with ethical issues which should be known to make well-informed decisions. The goal of this study was to provide a comprehensive spectrum of these ethical issues by means of a systematic review. In this context, the study also assesses the value of different search strategies for ethical literature in public health. Literature was searched in Medline, EBSCO and others. Three different search strategies with varied scopes were applied and their output was compared. Qualitative content analysis was used for extracting and categorizing ethical issues. 109 publications (published from 1995 to 2015) were finally included. The qualitative analysis resulted in 60 potentially relevant ethical issues. The three search strategies showed substantial differences regarding their search results. The presented spectrum provides an initial evidence base for dealing with ethical issues adequately. The findings of the study further suggest that a broader scope is more fruitful for systematic reviews on ethical issues in the field of public health.
Wiltz, Jennifer L; Blanck, Heidi M; Lee, Brian; Kocot, S Lawrence; Seeff, Laura; McGuire, Lisa C; Collins, Janet
Electronic information technology standards facilitate high-quality, uniform collection of data for improved delivery and measurement of health care services. Electronic information standards also aid information exchange between secure systems that link health care and public health for better coordination of patient care and better-informed population health improvement activities. We developed international data standards for healthy weight that provide common definitions for electronic information technology. The standards capture healthy weight data on the "ABCDs" of a visit to a health care provider that addresses initial obesity prevention and care: assessment, behaviors, continuity, identify resources, and set goals. The process of creating healthy weight standards consisted of identifying needs and priorities, developing and harmonizing standards, testing the exchange of data messages, and demonstrating use-cases. Healthy weight products include 2 message standards, 5 use-cases, 31 LOINC (Logical Observation Identifiers Names and Codes) question codes, 7 healthy weight value sets, 15 public-private engagements with health information technology implementers, and 2 technical guides. A logic model and action steps outline activities toward better data capture, interoperable systems, and information use. Sharing experiences and leveraging this work in the context of broader priorities can inform the development of electronic information standards for similar core conditions and guide strategic activities in electronic systems.
Croker, Helen; Beeken, Rebecca J
Obesity presents a challenge for practitioners, policy makers, researchers and for those with obesity themselves. This review focuses on psychological approaches to its management and prevention in children and adults. Through exploring the work of the late Professor Jane Wardle, we look at the earliest behavioural treatment approaches and how psychological theory has been used to develop more contemporary approaches, for example incorporating genetic feedback and habit formation theory into interventions. We also explore how Jane has challenged thinking about the causal pathways of obesity in relation to eating behaviour. Beyond academic work, Jane was an advocate of developing interventions which had real-world applications. Therefore, we discuss how she not only developed new interventions but also made these widely available and the charity that she established.
Cinar, A B; Murtomaa, H
Obesity and dental caries in childhood are among the major public health concerns described as a global pandemic because of their global distribution and severe consequences. A consensus has developed as to a recently emerging and alarming common risk factor that leads to the double burden...... of dental caries and obesity; energy-dense foods (sugar-coated cereals, high-sugar yogurt, soft drinks) are becoming very popular among children because of their dense marketing, cheaper price, increased supply and variety. Implementation of health-promoting and -supporting marketing strategies for healthy...... food can be one initial cornerstone for successful application of the common risk factor approach in prevention of obesity and dental caries, as also suggested by World Health Organization. Labelling healthy food with a 'health-friendly' logo, illustrating that the teeth and the heart are both parts...
Full Text Available Abstract Background Policies targeting obesogenic environments and behaviours are critical to counter rising obesity rates and lifestyle-related non-communicable diseases (NCDs. Policies are likely to be most effective and enduring when they are based on the best available evidence. Evidence-informed policy making is especially challenging in countries with limited resources. The Pacific TROPIC (Translational Research for Obesity Prevention in Communities project aims to implement and evaluate a tailored knowledge-brokering approach to evidence-informed policy making to address obesity in Fiji, a Pacific nation challenged by increasingly high rates of obesity and concomitant NCDs. Methods The TROPIC project draws on the concept of ‘knowledge exchange’ between policy developers (individuals; organisations and researchers to deliver a knowledge broking programme that maps policy environments, conducts workshops on evidence-informed policy making, supports the development of evidence-informed policy briefs, and embeds evidence-informed policy making into organisational culture. Recruitment of government and nongovernment organisational representatives will be based on potential to: develop policies relevant to obesity, reach broad audiences, and commit to resourcing staff and building a culture that supports evidence-informed policy development. Workshops will increase awareness of both obesity and policy cycles, as well as develop participants’ skills in accessing, assessing and applying relevant evidence to policy briefs. The knowledge-broking team will then support participants to: 1 develop evidence-informed policy briefs that are both commensurate with national and organisational plans and also informed by evidence from the Pacific Obesity Prevention in Communities project and elsewhere; and 2 collaborate with participating organisations to embed evidence-informed policy making structures and processes. This knowledge broking initiative
Buscemi, Joanna; Kanwischer, Katelyn; Becker, Adam B; Ward, Dianne S; Fitzgibbon, Marian L
The Society of Behavioral Medicine (SBM) urges policymakers to help prevent childhood obesity by improving state regulations for early care and education (ECE) settings related to child nutrition, physical activity, and screen time. More than three quarters of preschool-aged children in the USA attend ECE settings, and many spend up to 40 h per week under ECE care. ECE settings provide meals and snacks, as well as opportunities for increasing daily physical activity and reducing sedentary screen time. However, many states' current policies do not adequately address these important elements of obesity prevention. A growing number of cities and states, child health organizations, medical and early childhood associations, and academic researchers are beginning to identify specific elements of policy and regulations that could transform ECE settings into environments that contribute to obesity prevention. Let's Move! Child Care recommends a set of straightforward regulations addressing nutrition, physical activity, and screen time in ECE settings. These emerging models provide local and state leaders with concrete steps to implement obesity prevention initiatives. We provide a set of recommendations based upon these models that will help state and local policymakers to improve current policies in ECE settings.
Kilburn, Janice E.; Shapiro, Cheri J.
Strategic workforce training of organizations that provide services to families of young children with special needs can help strengthen families and prevent child maltreatment, but few curriculua are available for this purpose. One professional development curriculum, "Preventing Child Abuse and Neglect: Parent-Provider Partnerships in Child…
Thrun, Mark; Cook, Paul F.; Bradley-Springer, Lucy A.; Gardner, Lytt; Marks, Gary; Wright, Julie; Wilson, Tracey E.; Quinlivan, E. Byrd; O'Daniels, Christine; Raffanti, Stephen; Thompson, Melanie; Golin, Carol
The Centers for Disease Control and Prevention have recommended that HIV care clinics incorporate prevention into clinical practice. This report summarizes HIV care providers' attitudes and counseling practices before and after they received training to deliver a counseling intervention to patients. Providers at seven HIV clinics received training…
Murugan, Hemalatha; Spigner, Clarence; McKinney, Christy M; Wong, Christopher J
Aim The objective of this study was to seek decision-making insights on the provider level to gain understanding of the values that shape how providers deliver preventive health in the primary care setting. The primary care clinic is a core site for preventive health delivery. While many studies have identified barriers to preventive health, less is known regarding how primary care providers (PCPs) make preventive health decisions such as what services to provide, under what circumstances, and why they might choose one over another. Qualitative methods were chosen to deeply explore these issues. We conducted semi-structured, one-on-one interviews with 21 PCPs at clinics affiliated with an academic medical center. Interviews with providers were recorded and transcribed. We conducted a qualitative analysis to identify themes and develop a theoretical framework using Grounded Theory methods. Findings The following themes were revealed: longitudinal care with an established PCP-patient relationship is perceived as integral to preventive health; conflict and doubt accompany non-preventive visits; PCPs defer preventive health for pragmatic reasons; when preventive health is addressed, providers use multiple contextual factors to decide which interventions are discussed; and PCPs desired team-based preventive health delivery, but wish to maintain their role when shared decision-making is required. We present a conceptual framework called Pragmatic Deferral.
Tang, Liang; Gao, Xiaohang; Yang, Xiaoying; Liu, Chentao; Wang, Xudan; Han, Yanqi; Zhao, Xinjuan; Chi, Aiping; Sun, Lijun
Resistance exercise has been proved to be effective in improving bone quality in both animal and human studies. However, the issue about whether resistance exercise can inhibit obesity-induced bone loss has not been previously investigated. In the present study, we have evaluated the effects of ladder-climbing training, one of the resistance exercises, on bone mechanical properties and microarchitecture in high-fat (HF) diet-induced obese rats. Twenty-four rats were randomly assigned to the Control, HF + sedentary (HF-S) and HF + ladder-climbing training (HF-LCT) groups. Rats in the HF-LCT group performed ladder-climbing training for 8 weeks. The results showed that ladder-climbing training significantly reduced body and fat weight, and increased muscle mass along with a trend toward enhanced muscle strength in diet-induced obese rats. MicroCT analysis demonstrated that obesity-induced bone loss and architecture deterioration were significantly mitigated by ladder-climbing training, as evidenced by increased trabecular bone mineral density, bone volume over total volume, trabecular number and thickness, and decreased trabecular separation and structure model index. However, neither HF diet nor ladder-climbing training had an impact on femoral biomechanical properties. Moreover, ladder-climbing training significantly increased serum adiponectin, decreased serum leptin, TNF-α, IL-6 levels, and downregulated myostatin (MSTN) expression in diet-induced obese rats. Taken together, ladder-climbing training prevents bone loss and microarchitecture deterioration in diet-induced obese rats through multiple mechanisms including increasing mechanical loading on bone due to improved skeletal muscle mass and strength, regulating the levels of myokines and adipokines, and suppressing the release of pro-inflammatory cytokines. It indicates that resistance exercise may be a promising therapy for treating obesity-induced bone loss.
Kwon, Janice S; Lu, Karen H
It is unknown whether obese women would benefit from oral contraceptives or screening as endometrial cancer prevention strategies. We estimated the net health benefits and cost-effectiveness of these strategies in a hypothetical cohort of obese women. A Markov decision-analytic model evaluated 4 strategies: 1) no prevention (reference strategy); 2) oral contraceptive pills (OCPs) for 5 years; 3) annual screening with endometrial biopsy from age 30; 4) biennial screening from age 30. Net health benefit was life expectancy and primary outcome was the incremental cost-effectiveness ratio. Baseline and transition probabilities were obtained from published literature and the Surveillance Epidemiology and End Results database, and costs were from the U.S. Department of Health and Human Services and Agency for Healthcare Research and Quality. Sensitivity analyses were performed for uncertainty around various measures. Average life expectancy for all strategies ranged from 74.52 to 74.60 years. None of the strategies had an incremental cost-effectiveness ratio less than $50,000 per year of life saved relative to the next best strategy. Endometrial cancer risk in obese women had to be 13 times greater than the general population risk before OCPs were a cost-effective intervention. Oral contraceptives and current screening methods are not cost-effective endometrial cancer prevention strategies for obese women. Risk factors such as morbid obesity and longstanding anovulation may define a subgroup at highest risk of endometrial cancer for whom OCPs may be a cost-effective strategy. Interventions that reduce endometrial cancer risk further or those with additional health benefits are needed in this population. III.
Full Text Available Abstract Background Community-based interventions are a promising approach and an important component of a comprehensive response to obesity. In this paper we describe the Collaboration of COmmunity-based Obesity Prevention Sites (CO-OPS Collaboration in Australia as an example of a collaborative network to enhance the quality and quantity of obesity prevention action at the community level. The core aims of the CO-OPS Collaboration are to: identify and analyse the lessons learned from a range of community-based initiatives aimed at tackling obesity, and; to identify the elements that make community-based obesity prevention initiatives successful and share the knowledge gained with other communities. Methods Key activities of the collaboration to date have included the development of a set of Best Practice Principles and knowledge translation and exchange activities to promote the application (or use of evidence, evaluation and analysis in practice. Results The establishment of the CO-OPS Collaboration is a significant step toward strengthening action in this area, by bringing together research, practice and policy expertise to promote best practice, high quality evaluation and knowledge translation and exchange. Future development of the network should include facilitation of further evidence generation and translation drawing from process, impact and outcome evaluation of existing community-based interventions. Conclusions The lessons presented in this paper may help other networks like CO-OPS as they emerge around the globe. It is important that networks integrate with each other and share the experience of creating these networks.
Cai, Li; Wu, Yang; Wilson, Renee F; Segal, Jodi B; Kim, Miyong T; Wang, Youfa
Childhood overweight and obesity are associated with elevated blood pressure (BP). However, little is known about how childhood obesity lifestyle prevention programs affect BP. We assessed the effects of childhood obesity prevention programs on BP in children in developed countries. We searched databases up to April 22, 2013, for relevant randomized, controlled trials, quasi-experimental studies, and natural experiments. Studies were included if they applied a diet or physical activity intervention(s) and were followed for ≥ 1 year (or ≥ 6 months for school-based intervention studies); they were excluded if they targeted only overweight/obese subjects or those with a medical condition. In our meta-analysis, intervention effects were calculated for systolic BP and diastolic BP with the use of weighted random-effects models. Of the 23 included intervention studies (involving 18 925 participants), 21 involved a school setting. Our meta-analysis included 19 studies reporting on systolic BP and 18 on diastolic BP. The pooled intervention effect was -1.64 mm Hg (95% confidence interval, -2.56 to -0.71; P=0.001) for systolic BP and -1.44 mm Hg (95% confidence interval, -2.28 to -0.60; P=0.001) for diastolic BP. The combined diet and physical activity interventions led to a significantly greater reduction in both systolic BP and diastolic BP than the diet-only or physical activity-only intervention. Thirteen interventions (46%) had a similar effect on both adiposity-related outcomes and BP, whereas 11 interventions (39%) showed a significant desirable effect on BP but not on adiposity-related outcomes. Obesity prevention programs have a moderate effect on reducing BP, and those targeting both diet and physical activity seem to be more effective.
Cai, Li; Wu, Yang; Wilson, Renee F.; Segal, Jodi B.; Kim, Miyong T.; Wang, Youfa
Background Childhood overweight and obesity are associated with elevated blood pressure (BP). However, little is known about how childhood obesity lifestyle prevention programs affect BP. We assessed the effects of childhood obesity prevention programs on BP in children in developed countries. Methods and Results We searched databases up to April 22, 2013 for relevant randomized controlled trials, quasi-experimental studies, and natural experiments. Studies were included if they applied a diet and/or physical activity intervention(s) and were followed for ≥1 year (or ≥ 6 months for school-based intervention studies); they were excluded if they targeted only overweight/obese subjects or those with a medical condition. In our meta-analysis, intervention effects were calculated for systolic blood pressure (SBP) and diastolic blood pressure (DBP) using weighted random effects models. Of the 23 included intervention studies (involving 18,925 participants), 21 involved a school setting. Our meta-analysis included 19 studies reporting on SBP and 18 on DBP. The pooled intervention effect was −1.64 mmHg (95% CI: -2.56, −0.71; P=0.001) for SBP and -1.44 mmHg (95% CI: −2.28, −0.60; P=0.001) for DBP. The combined diet and physical activity interventions led to a significantly greater reduction in both SBP and DBP than the diet-only or physical activity-only intervention. Thirteen interventions (46%) had a similar effect on both adiposity-related outcomes and BP; while 11 interventions (39%) showed a significant desirable effect on BP, but not on adiposity-related outcomes. Conclusions Obesity prevention programs have a moderate effect on reducing BP and those targeting at both diet and physical activity seem to be more effective. PMID:24552832
Wagle, Madhu; Acharya, Ganesh; Basnet, Purusotam; Trovik, Tordis A
Dentists' and dental healthcare providers' professional knowledge and attitude towards the prevention of oral diseases may have an impact on the oral health of the general population. The aim of this study was to describe Nepalese dentists' competency in giving preventive education and treatment to their patients, and to assess their level of knowledge about preventive dental health. This was a cross-sectional study of 195 dentists (71 males and 124 females). Knowledge of preventive oral healthcare and self-reported aspects of preventive oral healthcare were assessed using a close-ended multiple-choice questionnaire. Statistical evaluation was done using chi-squared test, independent sample t-test and factor analysis as appropriate. More than 90% of dentists self-reported to be competent in providing preventive treatment and oral hygiene education to their patients. Female dentists reported being more competent in giving oral hygiene education than their male counterparts (p = 0.045). Dentists scored a mean of 24.06 ± 3.8 [range (15-33)] out of 56 on knowledge based on self-reported awareness of seven different aspects of preventive dentistry. More than 70% of the dentists had relatively good knowledge regarding the use of fluoride, whereas the preventive knowledge in other aspects of dental health such as frequency of sugar consumption, xylitol use, dental visits, sealant, gingival health, dental and general health was found to be limited. The majority of participating dentists reported a high level of general competency in providing preventive treatment and oral health education to their patients, whereas their knowledge was found to be limited in some aspects of preventive dentistry.
Story, Mary; Nanney, Marilyn S; Schwartz, Marlene B
Research consistently shows that the majority of American children do not consume diets that meet the recommendations of the Dietary Guidelines for Americans, nor do they achieve adequate levels of daily physical activity. As a result, more children are overweight today than at any other time in U.S. history. Schools offer many opportunities to develop strategies to prevent obesity by creating environments in which children eat healthfully and engage regularly in physical activity. This article discusses the role of schools in obesity prevention efforts. Current issues in schools' food and physical activity environments are examined, as well as federal, state, and local policies related to food and physical activity standards in schools. The article is organized around four key areas: (1) school food environments and policies, (2) school physical activity environments and policies, (3) school body mass index measurements, and (4) school wellness policies. Recommendations for accelerating change also are addressed. The article found that (1) competitive foods (foods sold outside of federally reimbursed school meals) are widely available in schools, especially secondary schools. Studies have related the availability of snacks and drinks sold in schools to students' high intake of total calories, soft drinks, total fat and saturated fat, and lower intake of fruits and vegetables; (2) physical activity can be added to the school curriculum without academic consequences and also can offer physical, emotional, and social benefits. Policy leadership has come predominantly from the districts, then the states, and, to a much lesser extent, the federal government; (3) few studies have examined the effectiveness or impact of school-based BMI measurement programs; and (4) early comparative analyses of local school wellness policies suggest that the strongest policies are found in larger school districts and districts with a greater number of students eligible for a free or
Werr, Joachim; Sydhoff, Jenny; Landström, Sofia; Forsberg, Birger
Background: Obesity is one of the leading causes of ill health and avoidable care costs worldwide, with children of particular concern. While public health campaigns have had some success, worldwide prevalence is increasing. Several risk factors including overweight parents and socioeconomic factors (education, income, living areas) influence childhood obesity prevalence.There is evidence that early preventive measures targeting children at high risk of becoming obese are effective. However, ...
Radnitz, Cynthia; Loeb, Katharine L; DiMatteo, Julie; Keller, Kathleen L.; Zucker, Nancy; Schwartz, Marlene B.
The term “optimal defaults” refers to imparting pre-selected choices which are designed to produce a desired behavior change. The concept is attractive to policymakers because it steers people toward desirable behaviors while preserving free choice through the ability to opt out. It has been found to be a powerful behavioral determinant in areas such as pension plan enrollment, organ donation, and green energy utilization. We discuss how optimal defaults can be applied to pediatric obesity prevention in several domains including public policy, institutional, private sector, and home environment. Although there are obstacles to overcome in implementing optimal defaults, it is a promising component to incorporate in a multi-level strategy for preventing pediatric obesity. PMID:25328903
Ahmad, Rabia Shabir; Butt, Masood Sadiq; Sultan, M Tauseef; Mushtaq, Zarina; Ahmad, Shakeel; Dewanjee, Saikat; De Feo, Vincenzo; Zia-Ul-Haq, Muhammad
Background During the last few years, scientific investigations have proposed diet based regimens to prevent several health ailments including obesity, hypercholesterolemia and diabetes. In this regard, a promising tool is the use of functional foods/nutraceuticals. Present research project was an attempt to explore nutraceutical worth of locally grown green tea variety (Qi-Men) against lifestyle related disorders. Methods Functional drinks (T2 and T3) were prepared by adding catechins and ep...
... out in order to investigate the preventing effect of water-extract from masson pine pollen (PWE) on obesity in mice. Materials and Methods: Sixty male KM mice (bodyweight was 19±1g) were divided randomly into six groups: normal control group (NC), high fat group (FC), positive control group (Orlistat, 0.05g/kg bw·d, PC), ...
Abidin, Norhaslinda Zainal; Zaibidi, Nerda Zura; Zulkepli, Jafri Hj
Obesity is a medical condition where an individual has an excessive amount of body fat. There are many factors contributing to obesity and one of them is the sedentary behaviour. Rapid development in industrialization and urbanization has brought changes to Malaysia's socioeconomic, especially the lifestyles of Malaysians. With this lifestyle transition, one of the impact is on weight and obesity. How does sedentary behaviour have an impact on the growth of Malaysian population's weight and obesity? What is the most effective sedentary behaviour preventing strategy to obesity? Is it through reduction in duration or frequency of sedentary behaviour? Thus, the aim of this paper is to design an intervention to analyse the effect of decreasing duration and frequency of sedentary behaviour on the population reversion trends of average weight (AW), average body mass index (ABMI), and prevalence of overweight and obesity (POVB). This study combines the different strands of sub-models comprised of nutrition, physical activity and body metabolism, and then synthesis these knowledge into a system dynamics of weight behaviour model, namely SIMULObese. Findings from this study revealed that Malaysian's adults spend a lot of time engaged in sedentary behaviour and this resulted in weight gain and obesity. Comparing between frequency and duration of sedentary behaviour, this study reported that reduced in duration or time spend in sedentary behaviour is a better preventing strategy to obesity compared to duration. As a summary, this study highlighted the importance of decreasing the frequency and duration of sedentary behaviour in developing guidelines to prevent obesity.
Daniels, Lynne Allison; Mallan, Kimberley Margaret; Nicholson, Jan Maree; Battistutta, Diana; Magarey, Anthea
The goal of this study was to evaluate outcomes of a universal intervention to promote protective feeding practices that commenced in infancy and aimed to prevent childhood obesity. The NOURISH randomized controlled trial enrolled 698 first-time mothers (mean ± SD age: 30.1 ± 5.3 years) with healthy term infants (51% female) aged 4.3 ± 1.0 months at baseline. Mothers were randomly allocated to self-directed access to usual care or to attend two 6-session interactive group education modules that provided anticipatory guidance on early feeding practices. Outcomes were assessed 6 months after completion of the second information module, 20 months from baseline and when the children were 2 years old. Maternal feeding practices were self-reported by using validated questionnaires and study-developed items. Study-measured child height and weight were used to calculate BMI z scores. Retention at follow-up was 78%. Mothers in the intervention group reported using responsive feeding more frequently on 6 of 9 subscales and 8 of 8 items (all, P ≤ .03) and overall less controlling feeding practices (P feeding practices (3 of 4 items; all, P feeding, tailored to developmental stage, increased use by first-time mothers of "protective" feeding practices that potentially support the development of healthy eating and growth patterns in young children.
Struben, Jeroen; Chan, Derek; Dubé, Laurette
This paper presents a system dynamics policy model of nutritional food market transformation, tracing over-time interactions between the nutritional quality of supply, consumer food choice, population health, and governmental policy. Applied to the Canadian context and with body mass index as the primary outcome, we examine policy portfolios for obesity prevention, including (1) industry self-regulation efforts, (2) health- and nutrition-sensitive governmental policy, and (3) efforts to foster health- and nutrition-sensitive innovation. This work provides novel theoretical and practical insights on drivers of nutritional market transformations, highlighting the importance of integrative policy portfolios to simultaneously shift food demand and supply for successful and self-sustaining nutrition and health sensitivity. We discuss model extensions for deeper and more comprehensive linkages of nutritional food market transformation with supply, demand, and policy in agrifood and health/health care. These aim toward system design and policy that can proactively, and with greater impact, scale, and resilience, address single as well as double malnutrition in varying country settings. © 2014 New York Academy of Sciences.
Steward, Wayne T; Koester, Kimberly A; Myers, Janet J; Morin, Stephen F
We examined the relationship between provider fatalism, a belief that behavior change among HIV-infected patients is unlikely, and HIV-prevention counseling in 16 publicly funded clinics. HIV-seropositive patients (N = 618) completed surveys assessing prevention counseling in the past 6 months. Additionally, 144 interviews were conducted with providers, administrators, and patients to examine beliefs about prevention counseling. We summed the number of fatalistic comments made by providers and administrators in each clinic, and assigned these counts as clinic-level fatalism scores to survey participants. Patients in high fatalism clinics were less likely to report prevention counseling than patients in low fatalism clinics. This difference remained significant even after controlling for clinic characteristics or patients' sexual risk and health status. However, clients in high fatalism clinics were more likely to be White, gay, educated, and older. Provider fatalism is a barrier that must be addressed when implementing HIV-prevention counseling in primary care settings.
González-Zapata, Laura Inés; Alvarez-Dardet, Carlos; Millstone, Erik; Clemente-Gómez, Vicente; Holdsworth, Michelle; Ortiz-Moncada, Rocio; Lobstein, Tim; Sarri, Katerina; De Marchi, Bruna; Horvath, Katalin Z
Obesity implies costs not only for the individual but also for society. The authors explore the opinions of stakeholders on the potential of taxes or subsidies, as measures for tackling obesity in Europe. Structured interviews were conducted using Multicriteria Mapping, a computer-based, decision-support tool, with 189 interviewees drawn from 21 different stakeholder categories across nine members of the EU interviews, to appraise 20 predefined policy options aimed at reducing obesity, including 'taxing obesity-promoting foods' and 'subsidising healthy foods.' A four-step approach involved selecting options, defining criteria, scoring options quantitatively and weighting criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. Compared with other policy options appraised, taxation and subsidies were not favourably received, mainly because they were considered difficult to implement. Overall, trade unions rated both options more favourably than all other stakeholder groups. As anticipated, both options received their lowest scores from representatives of the farming, food processing and advertising industries. Nutritional/obesity advisory experts and public sector caterers gave the most positive ratings to subsidies overall. Along with public health professionals, large commercial retailers were most in favour of taxation. Taxation and subsidies were poorly appraised compared with other policy measures, with stakeholders expressing reservations mainly focussed on the practicalities and cost of introducing such measures. Although applying taxes/subsidies could be useful to combat obesity, the study suggests that most stakeholders still need to be convinced of their viability and acceptability when compared with other measures.
Obesity means having too much body fat. It is different from being overweight, which means weighing too ... what's considered healthy for his or her height. Obesity happens over time when you eat more calories ...
Zhou, Yuan E; Emerson, Janice S; Levine, Robert S; Kihlberg, Courtney J; Hull, Pamela C
Childcare settings are an opportune location for early intervention programs seeking to prevent childhood obesity. This article reports on a systematic review of controlled trials of obesity prevention interventions in childcare settings. The review was limited to English language articles published in PubMed, Web of Science, and Education Resources Information Center (ERIC) between January 2000 and April 2012. childhood obesity prevention interventions in childcare settings using controlled designs that reported adiposity and behavior outcomes. no interventions, non-childcare settings, clinical weight loss programs, non-English publications. Publications were identified by key word search. Two authors reviewed eligible studies to extract study information and study results. Qualitative synthesis was conducted, including tabulation of information and a narrative summary. Fifteen studies met the eligibility criteria. Seven studies reported improvements in adiposity. Six of the 13 interventions with dietary components reported improved intake or eating behaviors. Eight of the 12 interventions with physical activity components reported improved activity levels or physical fitness. Evidence was mixed for all outcomes. Results should be interpreted cautiously given the high variability in study designs and interventions. Further research needs long-term follow-up, multistrategy interventions that include changes in the nutrition and physical activity environment, reporting of cost data, and consideration of sustainability.
White, Richard O; Thompson, Jessica R; Rothman, Russell L; McDougald Scott, Amanda M; Heerman, William J; Sommer, Evan C; Barkin, Shari L
To describe a systematic assessment of patient educational materials for the Growing Right Onto Wellness (GROW) trial, a childhood obesity prevention study targeting a low health literate population. Process included: (1) expert review of educational content, (2) assessment of the quality of materials including use of the Suitability Assessment of Materials (SAM) tool, and (3) material review and revision with target population. 12 core modules were developed and assessed in an iterative process. Average readability was at the 6th grade reading level (SMOG Index 5.63 ± 0.76, and Fry graph 6.0 ± 0.85). SAM evaluation resulted in adjustments to literacy demand, layout & typography, and learning stimulation & motivation. Cognitive interviews with target population revealed additional changes incorporated to enhance participant's perception of acceptability and feasibility for behavior change. The GROW modules are a collection of evidence-based materials appropriate for parents with low health literacy and their preschool aged children, that target the prevention of childhood overweight/obesity. Most trials addressing the treatment or prevention of childhood obesity use written materials. Due to the ubiquitous prevalence of limited health literacy, our described methods may assist researchers in ensuring their content is both understood and actionable. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Bosch, J.D.; Stradmeijer, A.M.; Seidell, J.C.
A profile will be given of the psychosocial characteristics of obese children and youngsters, as well as those of their families. Then several attempts of (particularly) preventive interventions will be sketched. Differences found between clinical and non-clinical groups of obese children and
Sisnowski, Jana; Handsley, Elizabeth; Street, Jackie M
High prevalence of overweight and obesity remains a significant international public health problem. Law has been identified as a tool for obesity prevention and selected high-profile measures have been reported. However, the nature and extent of enacted legislation internationally are unclear. This research provides an overview of regulatory approaches enacted in the United States, the European Union, and EU Member States since 2004. To this end, relevant databases of primary and secondary legislation were systematically searched to identify and explore laws addressing dietary risk factors for obesity. Across jurisdictions, current regulatory approaches to obesity prevention are limited in reach and scope. Target groups are rarely the general population, but instead sub-populations in government-supported settings. Consumer information provision is preferred over taxation and marketing restrictions other than the regulation of health and nutrition claims. In the EU in particular, product reformulation with industry consent has also emerged as a popular small-scale measure. While consistent and widespread use of law is lacking, governments have employed a range of regulatory measures in the name of obesity prevention, indicating that there is, in principle, political will. Results from this study may serve as a starting point for future research and policy development. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Wallia, S; Bhopal, R S; Douglas, A; Bhopal, R; Sharma, A; Hutchison, A; Murray, G; Gill, J; Sattar, N; Lawton, J; Tuomilehto, J; Mcknight, J; Forbes, J; Lean, M; Sheikh, A
Type 2 diabetes is extremely common in South Asians, e.g. in men from Pakistani and Indian populations it is about three times as likely as in the general population in England, despite similarities in body mass index. Lifestyle interventions reduce the incidence of diabetes. Trials in Europe and North America have not, however, reported on the impact on South Asian populations separately or provided the details of their cross-cultural adaptation processes. Prevention of diabetes and obesity in South Asians (PODOSA) is a randomized, controlled trial in Scotland of an adapted, lifestyle intervention aimed at reducing weight and increasing physical activity to reduce type 2 diabetes in Indians and Pakistanis. The trial was adapted from the Finnish Diabetes Prevention Study. We describe, reflect on and discuss the following key issues: The core adaptations to the trial design, particularly the delivery of the intervention in homes by dietitians rather than in clinics. The use of both a multilingual panel and professional translators to help translate and/or develop materials. The processes and challenges of phonetic translation. How intervention resources were adapted, modified, newly developed and translated into Urdu and Gurmukhi (written Punjabi). The insights gained in PODOSA (including time pressures on investigators, imperfections in the adaptation process, the power of verbal rather than written information, the utilization of English and the mother-tongue languages simultaneously by participants and the costs) might help the research community, given the challenge of health promotion in multi-ethnic, urban societies. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Miller, Alison L; Horodynski, Mildred A; Herb, Holly E Brophy; Peterson, Karen E; Contreras, Dawn; Kaciroti, Niko; Staples-Watson, Julie; Lumeng, Julie C
... likely to eat impulsively in response to stress. Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity...
Dixon, Helen; Scully, Maree; Durkin, Sarah; Brennan, Emily; Cotter, Trish; Maloney, Sarah; O'Hara, Blythe J; Wakefield, Melanie
Mass media communications are an important component of comprehensive interventions to address population levels of overweight and obesity, yet we have little understanding of the effective characteristics of specific advertisements (ads) on this topic. This study aimed to quantitatively test audience reactions to existing adult-focused public health television ads addressing overweight and obesity to determine which ads have the highest levels of message acceptance, argument strength, personalised perceived effectiveness and negative emotional impact. 1116 Australian adults aged 21-55 years recruited from a national online panel participated in this web-based study. Quotas were applied to achieve even numbers of males and females, those aged 21-29 years and 30-55 years, and those with a healthy weight (BMI = 18.5-24.9) and overweight/obesity (BMI = 25+). Participants were randomly assigned to view and rate four of eight ads that varied in terms of message content (health consequences, supportive/encouraging or social norms/acceptability) and execution style (graphic, simulation/animation, positive or negative testimonial, or depicted scene). Toxic fat (a graphic, health consequences ad) was the top performing ad on all four outcome measures and was significantly more likely than the other ads tested to promote strong responses in terms of message acceptance, argument strength and negative emotional impact. Measure up (a negative testimonial, health consequences ad) performed comparably on personalised perceived effectiveness. Most ads produced stronger perceptions of personalised perceived effectiveness among participants with overweight/obesity compared to participants with healthy weight. Some ads were more likely to promote strong negative emotions among participants with overweight/obesity. Findings provide preliminary evidence of the most promising content and executional styles of ads that could be pursued as part of obesity prevention campaigns. Ads
Masson, Walter; Lobo, Martín; Huerín, Melina; Molinero, Graciela; Manente, Diego; Pángaro, Mario; Vitagliano, Laura; Zylbersztejn, Horacio
Cardiovascular risk estimation in patients with overweight/obesity is not standardized. Our objectives were to stratify cardiovascular risk using different scores, to analyze use of statins, to report the prevalence of carotid atherosclerotic plaque (CAP), and to determine the optimal cut-off point (OCP) of scores that discriminate between subjects with or without CAP. Non-diabetic patients with overweight or obesity in primary prevention were enrolled. The Framingham score (FS), the European score (ES), and the score proposed by the new American guidelines (NS) were calculated, and statin indication was evaluated. Prevalence of CAP was determined by ultrasound examination. A ROC analysis was performed. A total of 474 patients (67% with overweight and 33% obese) were enrolled into the study. The FS classified the largest number of subjects as low risk. PAC prevalence was higher in obese as compared to overweight subjects (44.8% vs. 36.1%, P=.04). According to the FS, ES, and NS respectively, 26.7%, 39.1%, and 39.1% of overweight subjects and 28.6%, 39.0%, and 39.0% of obese subjects had an absolute indication for statins. All three scores were shown to acceptably discriminate between subjects with and without CAP (area under the curve>0.7). The OCPs evaluated did not agree with the risk category values. Risk stratification and use of statins varied in the overweight/obese population depending on the function used. Understanding of the relationship between scores and presence of CAP may optimize risk estimate. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.
Masson, Walter; Siniawski, Daniel; Lobo, Martín; Molinero, Graciela
Obese patients with lipid discordance (non-HDL cholesterol levels 30mg/dL above the LDL-c value) may have a greater prevalence of carotid atherosclerotic plaque (CAP). Our study objectives were: 1) To assess the prevalence of lipid discordance in a primary prevention population of obese patients; 2) To investigate the association between lipid discordance and presence of CAP. Obese subjects aged >18 years (BMI ≥30kg/m 2 ) with no cardiovascular disease, diabetes, or lipid-lowering treatment from six cardiology centers were included. Lipid discordance was defined when, regardless of the LDL-c level, the non-HDL cholesterol value exceeded the LDL-c value by 30mg/dL. Presence of CAP was identified by ultrasonography. Univariate and multivariate analyses were performed to explore the association between lipid discordance and presence of CAP. The study simple consisted of 325 obese patients (57.2% men; mean age, 52.3 years). Prevalence of lipid discordance was 57.9%. CAP was found in 38.6% of patients, but the proportion was higher in subjects with lipid discordance as compared to those without this lipid pattern (44.4% vs. 30.7%, P=.01). In both the univariate (OR: 1.80; 95% CI: 1.14-2.87; P=.01) and the multivariate analysis (OR: 2.07; 95% CI: 1.22-3.54; P=.007), presence of lipid discordance was associated to an increased probability of CAP. In these obese patients, lipid discordance was associated to greater prevalence of CAP. Evaluation of obese patients with this strategy could help identify subjects with higher residual cardiovascular risk. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.
Mandelblatt, Jeanne; van Ravesteyn, Nicolien; Schechter, Clyde; Chang, Yaojen; Huang, An-Tsun; Near, Aimee M; de Koning, Harry; Jemal, Ahmedin
US breast cancer mortality is declining, but thousands of women still die each year. Two established simulation models examine 6 strategies that include increased screening and/or treatment or elimination of obesity versus continuation of current patterns. The models use common national data on incidence and obesity prevalence, competing causes of death, mammography characteristics, treatment effects, and survival/cure. Parameters are modified based on obesity (defined as BMI ≥ 30 kg/m(2) ). Outcomes are presented for the year 2025 among women aged 25+ and include numbers of cases, deaths, mammograms and false-positives; age-adjusted incidence and mortality; breast cancer mortality reduction and deaths averted; and probability of dying of breast cancer. If current patterns continue, the models project that there would be about 50,100-57,400 (range across models) annual breast cancer deaths in 2025. If 90% of women were screened annually from ages 40 to 54 and biennially from ages 55 to 99 (or death), then 5100-6100 fewer deaths would occur versus current patterns, but incidence, mammograms, and false-positives would increase. If all women received the indicated systemic treatment (with no screening change), then 11,400-14,500 more deaths would be averted versus current patterns, but increased toxicity could occur. If 100% received screening plus indicated therapy, there would be 18,100-20,400 fewer deaths. Eliminating obesity yields 3300-5700 fewer breast cancer deaths versus continuation of current obesity levels. Maximal reductions in breast cancer deaths could be achieved through optimizing treatment use, followed by increasing screening use and obesity prevention. © 2013 American Cancer Society.
Jennifer Marks; Barnett, Lisa M.; Chad Foulkes; Penelope Hawe; Steven Allender
Introduction. Interest has grown in how systems thinking could be used in obesity prevention. Relationships between key actors, represented by social networks, are an important focus for considering intervention in systems. Method. Two long day care centers were selected in which previous obesity prevention programs had been implemented. Measures showed ways in which physical activity and dietary policy are conversations and actions transacted through social networks (interrelationships) with...
McAuley, Kirsten A; Taylor, Rachael W; Farmer, Victoria L; Hansen, Paul; Williams, Sheila M; Booker, Chris S; Mann, Jim I
Effective strategies are urgently required to reduce the prevalence of obesity during growth. Determining which strategies are most successful should also include analysis of their relative costs. To date, few obesity prevention studies in children have reported data concerning cost-effectiveness. The aim of this study was to assess the costs and health benefits of implementing the APPLE (A Pilot Program for Lifestyle and Exercise) project, a 2-year controlled community-based obesity prevention initiative utilizing activity coordinators (ACs) in schools and nutrition promotion in New Zealand children (5-12 years). The marginal costs of the project in 2006 prices were estimated and compared with the kilograms (kg) of weight-gain prevented for children in the intervention relative to the control arm. The children's health-related quality of life (HRQoL) was also measured using the Health Utilities Index (HUI). The total project cost was NZ$357,490, or NZ$1,281 per intervention child for 2 years (NZ$1 = US$0.67 = UK pound 0.35 = EUR euro 0.52). Weight z-score was reduced by 0.18 (0.13, 0.22) units at 2 years and 0.17 (0.11, 0.23) units at 4 years in intervention relative to control children. Mean HUI values did not differ between intervention and control participants. The reduction in weight z-score observed is equivalent to 2.0 kg of weight-gain prevented at 15 years of age. The relatively simple intervention approach employed by the APPLE project was successful in significantly reducing the rate of excessive weight gain in children, with implementation costs of NZ$664-1,708 per kg of weight-gain prevented over 4 years.
Wang, Y; Cai, L; Wu, Y; Wilson, R F; Weston, C; Fawole, O; Bleich, S N; Cheskin, L J; Showell, N N; Lau, B D; Chiu, D T; Zhang, A; Segal, J
Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high-income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi-experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2-18 in high-income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta-analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity-related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity-only interventions delivered in schools with home involvement or combined diet-physical activity interventions delivered in schools with both home and community components. SOE was moderate for school-based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school-based interventions
The recent report by Barnhill and King about obesity prevention policy raises important issues for discussion and analysis. In response, this article raises four points for further consideration. First, a distinction between equality and justice needs to be made and consistently maintained. Second, different theories of justice highlight one additional important source of disagreement about the ethical propriety of the proposed obesity prevention policies. Third, another point of contention arises with respect to different understandings of the principle of respect for autonomy due to its often-mistaken equation with simple, unfettered freedom. Finally, based on a more robust definition of autonomy, the key issues in obesity prevention policies can be suitably re-framed in terms of whether they advance just social conditions that enable people to realize human capabilities to the fullest extent possible.
Full Text Available The recent report by Barnhill and King about obesity prevention policy raises important issues for discussion and analysis. In response, this article raises four points for further consideration. First, a distinction between equality and justice needs to be made and consistently maintained. Second, different theories of justice highlight one additional important source of disagreement about the ethical propriety of the proposed obesity prevention policies. Third, another point of contention arises with respect to different understandings of the principle of respect for autonomy due to its often-mistaken equation with simple, unfettered freedom. Finally, based on a more robust definition of autonomy, the key issues in obesity prevention policies can be suitably re-framed in terms of whether they advance just social conditions that enable people to realize human capabilities to the fullest extent possible.
Michelle L. Lee
Full Text Available Obesity is a national health concern and the focus of many health promotion programs. The purpose of this study was to evaluate the behavioral impact of a 12-week obesity prevention program on a university campus. Participants were provided questionnaires with weights, heights, and body mass indices (BMIs determined at the pre-phase weigh-in and post-phase weigh-out. At the weigh-in, participants received pedometers and information about upcoming educational sessions to assist them with reaching their health behavior goals. A total of 247 (38.2% of 646 individuals (79.4% women completed the program. A mean weight loss of 1.8 kg caused a decrease in BMI from 29.3 at weigh-in to 28.7 at weigh-out (p = .002. Pre- and post-questionnaires indicated increases (p < 0.001 in physical activity; using pedometers; and intakes of fruits, vegetables, and water at the end of the program. The 6-month follow-up questionnaire (33.2% response rate indicated healthy habits were being maintained for fruit and vegetable consumption. Further intervention development to incorporate innovative strategies for promoting healthy behaviors among students and employees on university campuses could help decrease the prevalence of obesity.
María Matilde Socarrás Suárez
Full Text Available La obesidad es un importante problema de salud en nuestros días, por el riesgo aumentado de morbilidad y mortalidad, sobre todo por las enfermedades cardiovasculares que provoca. El objetivo de este trabajo fue actualizar los conocimientos acerca del tratamiento no farmacológico y la prevención de la enfermedad. Se expuso que en el 95 % de los casos la obesidad es de origen exógeno o nutricional, y en el 5 %, de causa genética o endocrina. En relación con los factores genéticos, las investigaciones plantean las diferentes mutaciones que se acompañan de fenotipos obesos. Se señalaron los diferentes métodos empleados para el diagnóstico de la obesidad, antropométricamente. Se afirmó que en la actualidad es muy utilizado el IMC y la relación cintura/cadera. Se concluyó que el tratamiento de la obesidad supone modificaciones dietéticas, actividad física e intervención conductual y/o psicológica y que la prevención sigue siendo la acción fundamental para evitar su aparición por lo que los esfuerzos de todos los médicos se deben dirigir hacia este problema de salud.Obesity is an important health problem at present due to the increased risk of morbidity and mortality and, mainly, to the cardiovascular diseases resulting from it. The objective of this paper was to bring up to date the knowledge about the nonpharmacological treatment and the prevention of the disease. It was explained that in 95 % of the cases, obesity has an exogenous or nutritional origin, whereas in the other 5 % its cause is genetic or endocrine. In relation to the genetic factors, the investigations state the different mutations that are accompanied by obese phenotypes.The different anthropometric methods used to diagnose obesity were described. It was confirmed that nowadays the BMI and the waist/hip relationship are widely used. It was concluded that the obesity treatment pressuposes diet modifications, physical activity and behavioral and/or psychological
Full Text Available Jyu-Lin Chen,1 Mary Ellen Wilkosz2 1Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA, 2Nursing Department, Sonoma State University, Rohnert Park, CA, USA Abstract: About one third of adolescents in the USA are overweight and/or obese. Obesity during the adolescent years is associated with many adverse health consequences, including type 2 diabetes, hypertension, hyperlipidemia, and psychosocial problems. Because of substantial advances in technologies and wide acceptance by adolescents, it is now possible to use technology for healthy weight management and prevention of obesity. This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and aimed to evaluate the existing literature reported on the effectiveness of technology-based intervention (web-based, e-learning, and active video games in preventing obesity in adolescents. The primary aim of this review was to explore if components of specific interventions were associated with a reduction in body mass index. Research articles obtained from CINAHL, Embase, PubMed, PsycInfo, and the Cochrane database from1990 to 2014 were reviewed. A total of 131 published articles were identified, and 14 met the inclusion criteria of a randomized or nonrandomized clinical study with body mass index as primary outcome and/or secondary outcomes of diet/physical activity and/or psychosocial function, tested lifestyle interventions to prevent obesity, used technology, and studied adolescents (aged 12–18 years. The results indicated that six of 14 studies found body mass index and/or body fat decreased at short-term (less than 12 months follow-up. Six of eleven studies that examined physical activity or physical activity-related outcomes found an improved physical activity outcome (time playing active video games and increase in physical activity time, while five of seven studies which assessed dietary
Ramirez, Amelie G; Gallion, Kipling J; Despres, Cliff; Aguilar, Rosalie P; Adeigbe, Rebecca T; Seidel, Sarah E; McAlister, Alfred L
Salud America! is a national network created to engage Latino researchers, health professionals and community leaders in actions to reduce Latino childhood obesity. An online survey of 148 Salud America! network members investigated relationships between (1) their levels of engagement with the network, (2) self- and collective-efficacy, and (3) behavioral intentions to engage in advocacy for policies that can help reduce Latino childhood obesity. Analyses of these data found that higher levels of Salud America! engagement was associated with collective-advocacy efficacy-greater confidence in organized group advocacy as a way of advancing policies to reduce Latino childhood obesity. A multiple regression analysis found that this sense of collective-efficacy moderately predicted intentions to engage in advocacy behaviors. Salud America! engagement levels were less strongly associated with members' confidence in their personal ability to be an effective advocate, yet this sense of self-efficacy was a very strong predictor of a behavioral intention to advocate. Based on these findings, new online applications aimed at increasing self- and collective-efficacy through peer modeling are being developed for Salud America! in order to help individuals interested in Latino childhood obesity prevention to connect with each other and with opportunities for concerted local actions in their communities. © 2015 Society for Public Health Education.
Full Text Available The discovery of a form of chronic, low-grade systemic inflammation (“metaflammation” linked with obesity, but also associated with several lifestyle-related behaviours not necessarily causing obesity, suggests a re-consideration of obesity as a direct cause of chronic disease and a search for the main drivers—or cause of causes. Factors contributing to this are considered here within an environmental context, leading to the conclusion that humans have an immune reaction to aspects of the modern techno-industrial environment, to which they have not fully adapted. It is suggested that economic growth—beyond a point—leads to increases in chronic diseases and climate change and that obesity is a signal of these problems. This is supported by data from Sweden over 200 years, as well as “natural” experiments in disrupted economies like Cuba and Nauru, which have shown a positive health effect with economic downturns. The effect is reflected both in human health and environmental problems such as climate change, thus pointing to the need for greater cross-disciplinary communication and a concept shift in thinking on prevention if economic growth is to continue to benefit human health and well-being.
Gittelsohn, Joel; Trude, Angela
Innovative approaches are needed to impact obesity and other diet-related chronic diseases, including interventions at the environmental and policy levels. Such interventions are promising due to their wide reach. This article reports on 10 multilevel community trials that the present authors either led (n = 8) or played a substantial role in developing (n = 2) in low-income minority settings in the United States and other countries that test interventions to improve the food environment, support policy, and reduce the risk for developing obesity and other diet-related chronic diseases. All studies examined change from pre- to postintervention and included a comparison group. The results show the trials had consistent positive effects on consumer psychosocial factors, food purchasing, food preparation, and diet, and, in some instances, obesity. Recently, a multilevel, multicomponent intervention was implemented in the city of Baltimore that promises to impact obesity in children, and, potentially, diabetes and related chronic diseases among adults. Based on the results of these trials, this article offers a series of recommendations to contribute to the prevention of chronic disease in Mexico. Further work is needed to disseminate, expand, and sustain these initiatives at the city, state, and federal levels. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: email@example.com.
Bray, George A.; Home, Philip D.; Garvey, W. Timothy; Klein, Samuel; Pi-Sunyer, F. Xavier; Hu, Frank B.; Raz, Itamar; Van Gaal, Luc; Wolfe, Bruce M.; Ryan, Donna H.
As obesity rates increase, so too do the risks of type 2 diabetes, cardiovascular disease, and numerous other detrimental conditions. The prevalence of obesity in U.S. adults more than doubled between 1980 and 2010, from 15.0 to 36.1%. Although this trend may be leveling off, obesity and its individual, societal, and economic costs remain of grave concern. In June 2014, a Diabetes Care Editors’ Expert Forum convened to review the state of obesity research and discuss the latest prevention initiatives and behavioral, medical, and surgical therapies. This article, an outgrowth of the forum, offers an expansive view of the obesity epidemic, beginning with a discussion of its root causes. Recent insights into the genetic and physiological factors that influence body weight are reviewed, as are the pathophysiology of obesity-related metabolic dysfunction and the concept of metabolically healthy obesity. The authors address the crucial question of how much weight loss is necessary to yield meaningful benefits. They describe the challenges of behavioral modification and predictors of its success. The effects of diabetes pharmacotherapies on body weight are reviewed, including potential weight-neutral combination therapies. The authors also summarize the evidence for safety and efficacy of pharmacotherapeutic and surgical obesity treatments. The article concludes with an impassioned call for researchers, clinicians, governmental agencies, health policymakers, and health-related industries to collectively embrace the urgent mandate to improve prevention and treatment and for society at large to acknowledge and manage obesity as a serious disease. PMID:26421334
Menez, Steven; Cheskin, Lawrence; Geller, Gail
Objective: To determine and compare the perspectives of the general public and health care providers (HCPs) on obesity and its treatment in rural West Virginia (WV) and Baltimore, MD. Method: Surveys were completed in both locations by the general public (WV: "n" = 200; Baltimore: "n" = 171) and HCPs (WV: "n" = 25;…
Full Text Available Background: The Obesity Prevention and Lifestyle (OPAL intervention program targets families and communities to improve children’s eating and physical activity patterns. We outline the quantitative evaluation design and recruitment results for baseline data collection. Methods: A longitudinal quasi-experimental design, with baseline data collection and five-year follow-up. Participants targeted are children, parents, and school principals/directors from primary, secondary/R-12 schools, pre-schools, childcare and out-of-school-hours-care (OSHC centers in 20 selected communities across South Australia (SA, and one in the Northern Territory (NT. A total of 277 (262 SA, 15 NT schools participated; 4860 9-11 year olds and 1164 12-16 year olds completed a questionnaire. Anthropometric measures were taken from 5531 students; 6552 parents, 276 pre/school/childcare directors, 139 OSHC directors and 237 principals completed questionnaires. Data include measurements of child participants’ weight/height/waist circumference; paper-based/online surveys of informants in early childhood, primary/secondary school and community settings; and secondary growth check data for 4-5 year old children. Serial cross-sectional analyses will compare intervention to matched comparison communities. Results: Overall school response rate was 50%. Student response rates were 20-22% and 11-13% (questionnaires and measurements respectively; 14-21% of parents, 49-55% of directors, and 26-44% of principals completed and returned questionnaires. Changes to child weight status; eating practices; sleep, physical activity/sedentary behaviors; physical environments; community capacity; and economic evaluation (Quality Adjusted Life year gain will examine program effectiveness. Conclusions: As the most significant program of its kind in Australia, OPAL will contribute to obesity prevention efforts on an international scale.
Gabriele, Jeanne M.; Stewart, Tiffany M.; Sample, Alicia; Davis, Allison B.; Allen, Ray; Martin, Corby K.; Newton, Robert L.; Williamson, Donald A.
Background Childhood obesity is a growing problem, particularly in rural, Louisiana school children. Traditionally, school-based obesity prevention programs have used a primary prevention approach. Finding methods to deliver secondary prevention programs to large numbers of students without singling out overweight students has been a challenge. An innovative approach to achieving this goal is through use of an Internet intervention targeted toward a student's weight status. This article describes the Louisiana (LA) Health Internet intervention, including the student Web site, the Internet counselor Web site, and the Internet counseling process. Method The LA Health Internet intervention had separate interfaces for students and Internet counselors. The main features of the student site were behavioral weight loss lessons, lesson activities, chat with an Internet counselor, and email. The Internet counselor site contained these same features, plus a student directory and various means of obtaining student information to guide counseling. Based on their baseline weight status, students received lessons and counseling that promoted either weight loss or weight maintenance. Intervention was delivered during class time, and teachers scheduled Internet counseling sessions with intervention personnel. Results The LA Health Internet intervention was initially implemented within 14 schools; 773 students were granted access to the site. From Fall 2007 to Spring 2009, 1174 hours of Internet counselor coverage was needed to implement the Internet counseling component of this intervention Conclusion The LA Health Internet intervention is an innovative and feasible method of delivering a secondary prevention program within a school setting to large numbers of students. PMID:20513340
Larson, Nicole; Davey, Cynthia S; Caspi, Caitlin E; Kubik, Martha Y; Nanney, Marilyn S
The promotion of healthy eating and physical activity within school settings is an important component of population-based strategies to prevent obesity; however, adolescents may be vulnerable to weight-related messages, as rapid development during this life stage often leads to preoccupation with body size and shape. This study examines secular trends in secondary school curricula topics relevant to the prevention of unhealthy weight-control behaviors; describes cross-sectional associations between weight-related curricula content and students' use of weight-control behaviors; and assesses whether implementation of school-based obesity-prevention policies/practices is longitudinally related to students' weight-control behaviors. The Minnesota School Health Profiles and Minnesota Student Survey (grades 9 and 12) data were used along with National Center for Education Statistics data to examine secular trends, cross-sectional associations (n=141 schools), and longitudinal associations (n=42 schools). Students self-reported their height and weight along with past-year use of healthy (eg, exercise), unhealthy (eg, fasting), and extreme (eg, use laxatives) weight-control behaviors. Descriptive statistics, generalized estimating equations, and generalized linear regression models accounting for school-level demographics. There was no observable pattern during the years 2008 to 2014 in the mean number of curricula topics addressing unhealthy weight-control behaviors, despite an increase in the prevalence of curricula addressing acceptance of body-size differences. Including three vs fewer weight-control topics and specifically including the topic of eating disorders in the curricula was related to a lower school-level percent of students using any extreme weight-control behaviors. In contrast, an overall measure of implementing school-based obesity-prevention policies/practices (eg, prohibited advertising) was unrelated to use of unhealthy or extreme behaviors
Turner-McGrievy, Gabrielle; Mandes, Trisha; Crimarco, Anthony
The goal of this paper is to review the evidence related to the effect of plant-based dietary patterns on obesity and weight loss, including both observational and intervention trials. Literature from plant-based diets (PBDs) epidemiological and clinical trial research was used to inform this review. In addition, data on dietary quality, adherence, and acceptability were evaluated and are presented. Both clinical trials and observational research indicate an advantage to adoption of PBDs for preventing overweight and obesity and promoting weight loss. PBDs may also confer higher levels of diet quality than are observed with other therapeutic diet approaches, with similar levels of adherence and acceptability. Future studies should utilize health behavior theory to inform intervention development and delivery of PBDs studies and new technologies to bring interventions to scale for greater public health impact. Research examining PBDs and weight loss is also needed with more diverse populations, including older adults. Based on the available evidence, PBDs should be considered a viable option for the treatment and prevention of overweight and obesity.
Shin, Hee-Sung; Valente, Thomas W; Riggs, Nathaniel R; Huh, Jimi; Spruijt-Metz, Donna; Chou, Chih-Ping; Ann Pentz, Mary
Social network analysis was used to examine whether peer influence from one's social networks moderates obesity prevention program effects on obesity-related behaviors: healthful and unhealthful. Participants included 557 children residing in Southern California. The survey assessed health-promoting behaviors (i.e., physical activity at school, physical activity outside of school, and fruit and vegetable intake), as well as unhealthful behaviors (high-calorie, low-nutrient intake and sedentary activity), and peer exposure calculated from social network nominations as indicators of peer influence. Multilevel models were conducted separately on outcomes predicted by program participation, peer exposure, and program participation by peer exposure. Results indicated that peer exposure was positively associated with one's own healthful and unhealthful behaviors. Program participation effects were moderated by peer influence, but only when unhealthful peer influence was present. Results suggest that peer influence can diminish or amplify prevention programs Future interventions should consider peer-led components to promote healthful influence of peers on healthful and unhealthful behaviors, and programs should be mindful that their effects are moderated by social networks. Copyright © 2014 The Obesity Society.
Whittemore, Robin; Chao, Ariana; Popick, Rachel; Grey, Margaret
In response to the childhood obesity epidemic, numerous studies on school-based Internet obesity prevention interventions have been conducted. The purpose of this systematic review is to describe, synthesize, and evaluate the research on school-based Internet obesity prevention programs for adolescents. Medline, CINAHL, and PsycInfo were searched from January 1995 to August 2012 to locate relevant studies. Ninety-one reports were initially identified, with 12 meeting the inclusion criteria. Studies had variable control groups, program content, and sample characteristics. Though few authors reported on implementation processes or body mass index (BMI) outcomes, the majority of studies were effective in improving health behaviors in the short term. Most studies were judged to have a high or unclear risk of bias in at least two domains, thus the quality of evidence for this body of literature is moderate. Further research is needed to examine programs of longer duration, optimal dose and timing of programs, cost-effectiveness, and mediators and moderators of intervention outcomes.
Natale, Ruby A; Messiah, Sarah E; Asfour, Lila S; Uhlhorn, Susan B; Englebert, Nicole E; Arheart, Kristopher L
To assess the impact of an early childhood obesity prevention intervention "Healthy Caregivers-Healthy Children" (HC2) on dietary patterns and body mass index percentile (PBMI) over 2 school years. Randomized controlled trial. Childcare centers. Low-income families. Intervention centers (N = 12) received HC2 which consisted of (1) menu modifications, (2) a healthy eating and physical activity curriculum for children, and (3) a parent curriculum for healthy meal preparation, reinforced through a role-modeling curriculum. Control centers (N = 16) received an injury prevention/safety intervention. Child PBMI and parent report of child's consumption of fruits/vegetables and unhealthy food. Confirmatory factor analysis verified the psychometric properties of factor scores for children's consumption of fruits/vegetables and unhealthy food. Growth curve analysis assessed the impact of HC2 on change in consumption of fruits/vegetables and unhealthy food and PBMI over 2 school years. Children in the intervention group (n = 754) had a negative slope (β = -1.95, standard error [SE] = 0.97, P = .04), indicating less increase in PBMI versus control children (n = 457). Stratified analyses showed that obese children in the intervention arm had a significantly higher increase in fruit/vegetable consumption versus control group obese children (β = 0.24, SE = 0.08, P = .003). The HC2 intervention resulted in the maintenance of healthy PBMI over 2 preschool years among low-income multiethnic children. These findings support efforts to implement healthy weight programs in the childcare setting.
Rush, Elaine; Simmons, David
There is strong evidence that increased physical activity is beneficial for blood glucose homeostasis and the prevention of obesity and type 2 diabetes mellitus. This chapter takes a life course approach with an emphasis on the intrauterine and childhood stages of life. Firstly, growth and development at critical periods with a focus on skeletal muscle and adipose tissue; then, obesity and type 2 diabetes mellitus are considered in relation to physical activity and sedentary behaviour. The importance of the development of fundamental movement skills in early childhood for both physical fitness and also growth and development is emphasised. Physical activity guidelines in westernised countries are examined for commonalities. Finally, the effective translation of the evidence base for the benefits of physical activity into randomised controlled trials and then into real-world public health services that are sustainable is addressed with a case study from New Zealand of Project Energize--a through-school physical activity and nutrition intervention. Physical activity, alongside a 'healthy diet' is arguably the best preventive measure and treatment for both obesity and type 2 diabetes. It is an essential and normal activity of daily life, and all aspects of the life course and the environment should support physical activity.
Fitzgibbon, Marian L; Stolley, Melinda R; Schiffer, Linda A; Braunschweig, Carol L; Gomez, Sandra L; Van Horn, Linda; Dyer, Alan R
The preschool years offer an opportunity to interrupt the trajectory toward obesity in black children. The Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial was a group-randomized controlled trial assessing the feasibility and effectiveness of a teacher-delivered weight control intervention for black preschool children. The 618 participating children were enrolled in 18 schools administered by the Chicago Public Schools. Children enrolled in the nine schools randomized to the intervention group received a 14-week weight control intervention delivered by their classroom teachers. Children in the nine control schools received a general health intervention. Height and weight, physical activity, screen time, and diet data were collected at baseline and postintervention. At postintervention, children in the intervention schools engaged in more moderate-to-vigorous physical activity (MVPA) than children in the control schools (difference between adjusted group means = 7.46 min/day, P = 0.02). Also, children in the intervention group had less total screen time (-27.8 min/day, P = 0.05). There were no significant differences in BMI, BMI Z score, or dietary intake. It is feasible to adapt an obesity prevention program to be taught by classroom teachers. The intervention showed positive influences on physical activity and screen time, but not on diet. Measuring diet and physical activity in preschool children remains a challenge, and interventions delivered by classroom teachers require both intensive initial training and ongoing individualized supervision.
Fitzgibbon, M. L.; Stolley, M. R.; Schiffer, L.; Braunschweig, C. L.; Gomez, S. L.; Van Horn, L.; Dyer, A.
The preschool years offer an opportunity to interrupt the trajectory toward obesity in black children. The Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial was a group-randomized controlled trial assessing the feasibility and effectiveness of a teacher-delivered weight control intervention for black preschool children. The 618 participating children were enrolled in 18 schools administered by the Chicago Public Schools. Children enrolled in the 9 schools randomized to the intervention group received a 14-week weight control intervention delivered by their classroom teachers. Children in the 9 control schools received a general health intervention. Height and weight, physical activity, screen time, and diet data were collected at baseline and post-intervention. At post-intervention, children in the intervention schools engaged in more moderate-to vigorous physical activity than children in the control schools (difference between adjusted group means=7.46 min/day, p=.02). Also, children in the intervention group had less total screen time (−27.8 min/day, p=.05). There were no significant differences in BMI, BMI Z score, or dietary intake. It is feasible to adapt an obesity prevention program to be taught by classroom teachers. The intervention showed positive influences on physical activity and screen time, but not diet. Measuring diet and physical activity in preschool children remains a challenge, and interventions delivered by classroom teachers require both intensive initial training and ongoing individualized supervision. PMID:21193852
Ash, Tayla; Agaronov, Alen; Young, Ta'Loria; Aftosmes-Tobio, Alyssa; Davison, Kirsten K
A wide range of interventions has been implemented and tested to prevent obesity in children. Given parents' influence and control over children's energy-balance behaviors, including diet, physical activity, media use, and sleep, family interventions are a key strategy in this effort. The objective of this study was to profile the field of recent family-based childhood obesity prevention interventions by employing systematic review and quantitative content analysis methods to identify gaps in the knowledge base. Using a comprehensive search strategy, we searched the PubMed, PsycIFO, and CINAHL databases to identify eligible interventions aimed at preventing childhood obesity with an active family component published between 2008 and 2015. Characteristics of study design, behavioral domains targeted, and sample demographics were extracted from eligible articles using a comprehensive codebook. More than 90% of the 119 eligible interventions were based in the United States, Europe, or Australia. Most interventions targeted children 2-5 years of age (43%) or 6-10 years of age (35%), with few studies targeting the prenatal period (8%) or children 14-17 years of age (7%). The home (28%), primary health care (27%), and community (33%) were the most common intervention settings. Diet (90%) and physical activity (82%) were more frequently targeted in interventions than media use (55%) and sleep (20%). Only 16% of interventions targeted all four behavioral domains. In addition to studies in developing countries, racial minorities and non-traditional families were also underrepresented. Hispanic/Latino and families of low socioeconomic status were highly represented. The limited number of interventions targeting diverse populations and obesity risk behaviors beyond diet and physical activity inhibit the development of comprehensive, tailored interventions. To ensure a broad evidence base, more interventions implemented in developing countries and targeting racial
Ahmad, Rabia Shabir; Butt, Masood Sadiq; Sultan, M Tauseef; Mushtaq, Zarina; Ahmad, Shakeel; Dewanjee, Saikat; De Feo, Vincenzo; Zia-Ul-Haq, Muhammad
During the last few years, scientific investigations have proposed diet based regimens to prevent several health ailments including obesity, hypercholesterolemia and diabetes. In this regard, a promising tool is the use of functional foods/nutraceuticals. Present research project was an attempt to explore nutraceutical worth of locally grown green tea variety (Qi-Men) against lifestyle related disorders. Functional drinks (T2 and T3) were prepared by adding catechins and epigallocatechin gallate (EGCG) @ 550 mg/500 mL and compared with control (T1). These functional drinks were tested in experimental rats modeling (Sprague Dawley). Based on diets, four studies were conducted i.e. trial-I (normal diet), trial-II (high cholesterol diet), trial-III (high sucrose diet), trial-IV (high cholesterol + high sucrose diet). Rats were monitored daily for their feed and drink intake while body weight was measured on weekly basis. After period of 56 days rats were sacrificed and evaluated their serum lipid (cholesterol, LDL and HDL), glucose and insulin levels. Results for feed consumption by rats revealed that highest feed intake was recorded in group provided control drink than other groups. However, non significant differences were noted among all groups for drink consumption. Functional drinks resulted in significant reduction in body weight with maximum lowering noted in trial-II and III i.e. 10.73 to 8.49% and 10.12 to 10.49%, respectively. Likewise, cholesterol and LDL were substantially reduced with 14.42% decrease observed in trial-IV and 30.43% in trial-II, respectively. Furthermore, serum glucose and insulin levels were also lowered significantly in the trial-III and IV while in trial-I and II differences were non-significant. In contrast to lipid profile, experimental drink containing EGCG reduced the trait better than catechins based functional drink. The drinks supplemented with catechins and EGCG are effective against obesity, hypercholesterolemia and
de Silva-Sanigorski, Andrea; Prosser, Lauren; Carpenter, Lauren; Honisett, Suzy; Gibbs, Lisa; Moodie, Marj; Sheppard, Lauren; Swinburn, Boyd; Waters, Elizabeth
Kids--'Go for your life' (K-GFYL) is an award-based health promotion program being implemented across Victoria, Australia. The program aims to reduce the risk of childhood obesity by improving the socio-cultural, policy and physical environments in children's care and educational settings. Membership of the K-GFYL program is open to all primary and pre-schools and early childhood services across the State. Once in the program, member schools and services are centrally supported to undertake the health promotion (intervention) activities. Once the K-GFYL program 'criteria' are reached the school/service is assessed and 'awarded'. This paper describes the design of the evaluation of the statewide K-GFYL intervention program. The evaluation is mixed method and cross sectional and aims to: 1) Determine if K-GFYL award status is associated with more health promoting environments in schools/services compared to those who are members only; 2) Determine if children attending K-GFYL award schools/services have higher levels of healthy eating and physical activity-related behaviors compared to those who are members only; 3) Examine the barriers to implementing and achieving the K-GFYL award; and 4) Determine the economic cost of implementing K-GFYL in primary schools. Parent surveys will capture information about the home environment and child dietary and physical activity-related behaviors. Environmental questionnaires in early childhood settings and schools will capture information on the physical activity and nutrition environment and current health promotion activities. Lunchbox surveys and a set of open-ended questions for kindergarten parents will provide additional data. Resource use associated with the intervention activities will be collected from primary schools for cost analysis. The K-GFYL award program is a community-wide intervention that requires a comprehensive, multi-level evaluation. The evaluation design is constrained by the lack of a non-K-GFYL control
Background Kids - 'Go for your life' (K-GFYL) is an award-based health promotion program being implemented across Victoria, Australia. The program aims to reduce the risk of childhood obesity by improving the socio-cultural, policy and physical environments in children's care and educational settings. Membership of the K-GFYL program is open to all primary and pre-schools and early childhood services across the State. Once in the program, member schools and services are centrally supported to undertake the health promotion (intervention) activities. Once the K-GFYL program 'criteria' are reached the school/service is assessed and 'awarded'. This paper describes the design of the evaluation of the statewide K-GFYL intervention program. Methods/Design The evaluation is mixed method and cross sectional and aims to: 1) Determine if K-GFYL award status is associated with more health promoting environments in schools/services compared to those who are members only; 2) Determine if children attending K-GFYL award schools/services have higher levels of healthy eating and physical activity-related behaviors compared to those who are members only; 3) Examine the barriers to implementing and achieving the K-GFYL award; and 4) Determine the economic cost of implementing K-GFYL in primary schools Parent surveys will capture information about the home environment and child dietary and physical activity-related behaviors. Environmental questionnaires in early childhood settings and schools will capture information on the physical activity and nutrition environment and current health promotion activities. Lunchbox surveys and a set of open-ended questions for kindergarten parents will provide additional data. Resource use associated with the intervention activities will be collected from primary schools for cost analysis. Discussion The K-GFYL award program is a community-wide intervention that requires a comprehensive, multi-level evaluation. The evaluation design is constrained
Full Text Available Abstract Background Kids - 'Go for your life' (K-GFYL is an award-based health promotion program being implemented across Victoria, Australia. The program aims to reduce the risk of childhood obesity by improving the socio-cultural, policy and physical environments in children's care and educational settings. Membership of the K-GFYL program is open to all primary and pre-schools and early childhood services across the State. Once in the program, member schools and services are centrally supported to undertake the health promotion (intervention activities. Once the K-GFYL program 'criteria' are reached the school/service is assessed and 'awarded'. This paper describes the design of the evaluation of the statewide K-GFYL intervention program. Methods/Design The evaluation is mixed method and cross sectional and aims to: 1 Determine if K-GFYL award status is associated with more health promoting environments in schools/services compared to those who are members only; 2 Determine if children attending K-GFYL award schools/services have higher levels of healthy eating and physical activity-related behaviors compared to those who are members only; 3 Examine the barriers to implementing and achieving the K-GFYL award; and 4 Determine the economic cost of implementing K-GFYL in primary schools Parent surveys will capture information about the home environment and child dietary and physical activity-related behaviors. Environmental questionnaires in early childhood settings and schools will capture information on the physical activity and nutrition environment and current health promotion activities. Lunchbox surveys and a set of open-ended questions for kindergarten parents will provide additional data. Resource use associated with the intervention activities will be collected from primary schools for cost analysis. Discussion The K-GFYL award program is a community-wide intervention that requires a comprehensive, multi-level evaluation. The evaluation