Pediatric Obesity and Ear, Nose, and Throat Disorders

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... Marketplace Find an ENT Doctor Near You Pediatric Obesity and Ear, Nose, and Throat Disorders Pediatric Obesity ... self-esteem, and isolation from their peers. Pediatric obesity and otolaryngic problems Otolaryngologists, or ear, nose, and ...

Do pediatric gastroenterology doctors address pediatric obesity?

OpenAIRE

Batra, Suruchi; Yee, Caitlin; Diez, Bernadette; Nguyen, Nicholas; Sheridan, Michael J; Tufano, Mark; Sikka, Natalie; Townsend, Stacie; Hourigan, Suchitra

2017-01-01

Objectives: To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits. Methods: A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher?s exact tests were used to examine statistical associatio...

Researchers? perspectives on pediatric obesity research participant recruitment

OpenAIRE

Parikh, Yasha; Mason, Maryann; Williams, Karen

2016-01-01

Background Childhood obesity prevalence has tripled over the last three decades. Pediatric obesity has important implications for both adult health as well as the United States economy. In order to combat pediatric obesity, exploratory studies are necessary to create effective interventions. Recruitment is an essential part of any study, and it has been challenging for all studies, especially pediatric obesity studies. The objective of this study was to understand barriers to pediatric obesit...

Obesity in pediatric trauma.

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Witt, Cordelie E; Arbabi, Saman; Nathens, Avery B; Vavilala, Monica S; Rivara, Frederick P

2017-04-01

The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters. Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values Obese children also had significantly longer lengths of stay and more frequent ventilator requirement. Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications. Level III; prognosis study. Copyright © 2017 Elsevier Inc. All rights reserved.

Obesity in pediatric ALL survivors: a meta-analysis.

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Zhang, Fang Fang; Kelly, Michael J; Saltzman, Edward; Must, Aviva; Roberts, Susan B; Parsons, Susan K

2014-03-01

Previous studies of survivors of pediatric acute lymphoblastic leukemia (ALL) have drawn heterogeneous conclusions regarding the prevalence of obesity and risk factors for developing obesity in pediatric ALL survivors. We sought to determine the prevalence of obesity in pediatric ALL survivors and examine risk factors for obesity through a systematic review and meta-analysis. A MEDLINE search was performed from its inception through 2013. Studies met the inclusion criteria if they (1) included at least 10 survivors of pediatric ALL; (2) assessed the prevalence or indicators of obesity; and (3) compared obesity among ALL survivors to a reference population or external control group. Extracted data included patient and treatment characteristics, study design, population used for comparison, and prevalence of obesity. Forty-seven studies met the inclusion criteria. Despite significant heterogeneity among the studies (I(2) = 96%), the mean BMI z score in 1742 pediatric ALL survivors was 0.83 (95% confidence interval: 0.60-1.06), which corresponds to the 80th BMI percentile, indicating a significantly higher BMI in pediatric ALL survivors than the reference population. Subgroup analyses found a high prevalence of obesity in ALL survivors regardless of survivors' receipt of cranial irradiation, gender, or age at diagnosis. Obesity is prevalent in pediatric ALL survivors and is independent of patient- and treatment-related characteristics. Clinicians need to screen for obesity and its associated health conditions early in survivorship.

Where are family theories in family-based obesity treatment?: conceptualizing the study of families in pediatric weight management

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Skelton, JA; Buehler, C; Irby, MB; Grzywacz, JG

2014-01-01

Family-based approaches to pediatric obesity treatment are considered the ‘gold-standard,’ and are recommended for facilitating behavior change to improve child weight status and health. If family-based approaches are to be truly rooted in the family, clinicians and researchers must consider family process and function in designing effective interventions. To bring a better understanding of family complexities to family-based treatment, two relevant reviews were conducted and are presented: (1) a review of prominent and established theories of the family that may provide a more comprehensive and in-depth approach for addressing pediatric obesity; and (2) a systematic review of the literature to identify the use of prominent family theories in pediatric obesity research, which found little use of theories in intervention studies. Overlapping concepts across theories include: families are a system, with interdependence of units; the idea that families are goal-directed and seek balance; and the physical and social environment imposes demands on families. Family-focused theories provide valuable insight into the complexities of families. Increased use of these theories in both research and practice may identify key leverage points in family process and function to prevent the development of or more effectively treat obesity. The field of family studies provides an innovative approach to the difficult problem of pediatric obesity, building on the long-established approach of family-based treatment. PMID:22531090

A Values-Based Motivational Interviewing (MI) Intervention for Pediatric Obesity: Study Design and Methods for MI Values

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Bean, Melanie K.; Mazzeo, Suzanne E.; Stern, Marilyn; Bowen, Deborah; Ingersoll, Karen

2011-01-01

To reduce pediatric obesity in clinical settings, multidisciplinary behaviorally-based treatment programs are recommended. High attrition and poor compliance are two difficulties frequently encountered in such programs. A brief, empathic and directive clinical intervention, Motivational Interviewing (MI), might help address these motivational and behavioral issues, ultimately resulting in more positive health outcomes. The efficacy of MI as an adjunct in the treatment of pediatric obesity rem...

School-Based Interventions for Overweight and Obesity in Minority School Children

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Johnson, Teresa; Weed, L. Diane; Touger-Decker, Riva

2012-01-01

The prevalence of childhood overweight and obesity in the United States has resulted in a number of school-based health interventions. This article provides a review of research that addressed childhood overweight and obesity in minority, U.S. elementary schools. All studies reported some benefits in health behaviors and/or anthropometric…

Pediatric Obesity: It's Time for Prevention before Conception Can Maternal Obesity Program Pediatric Obesity?

Directory of Open Access Journals (Sweden)

Zach Ferraro

2008-01-01

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.

[Focus of childhood obesity from pediatrics].

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Hurtado-López, Erika F; Macías-Rosales, Rocío

2014-01-01

The prevalences of overweight and obesity have increased dramatically in the last two decades in the adult and children population. The Organization for Cooperation and Economic Development reported in 2010 that Mexico ranks first worldwide in childhood obesity. The 2006 National Health and Nutrition Survey reported that one of every three teenagers are overweight and obese. In the last decades, pediatric hospitals in different parts of the world reported the prevalence of secondary malnutrition, since in those days overweight and obesity did not represent health problems. Currently, the prevalence of overweight and obesity has been scarcely studied in pediatric hospitals. In the Hospital de Pediatría (Children's Hospital) of the Instituto Mexicano del Seguro Social's Centro Médico Nacional de Occidente it is reported a prevalence of overweight of 15.4 % and obesity of 12.2 %, which reflects a nutritional transition.Due to the high prevalence of overweight and obesity in this pediatric hospital of reference, one could conclude that the pediatrician should be able to make a correct evaluation of the nutritional state, because, if he does not detect these problems, we will be condemning children to suffer from a chronic disease for the rest of their lives, and with all the implications in the short, medium and long term.

Pharmacological management of obesity in pediatric patients.

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Boland, Cassie L; Harris, John Brock; Harris, Kira B

2015-02-01

To review current evidence of pharmacological options for managing pediatric obesity and provide potential areas for future research. A MEDLINE search (1966 to October 2014) was conducted using the following keywords: exenatide, liraglutide, lorcaserin, metformin, obesity, orlistat, pediatric, phentermine, pramlintide, topiramate, weight loss, and zonisamide. Identified articles were evaluated for inclusion, with priority given to randomized controlled trials with orlistat, metformin, glucagon-like peptide-1 agonists, topiramate, and zonisamide in human subjects and articles written in English. References were also reviewed for additional trials. Whereas lifestyle modification is considered first-line therapy for obese pediatric patients, severe obesity may benefit from pharmacotherapy. Orlistat is the only Food and Drug Administration (FDA)-approved medication for pediatric obesity and reduced body mass index (BMI) by 0.5 to 4 kg/m(2), but gastrointestinal (GI) adverse effects may limit use. Metformin has demonstrated BMI reductions of 0.17 to 1.8 kg/m(2), with mild GI adverse effects usually managed with dose titration. Exenatide reduced BMI by 1.1 to 1.7 kg/m(2) and was well-tolerated with mostly transient or mild GI adverse effects. Topiramate and zonisamide reduced weight when used in the treatment of epilepsy. Future studies should examine efficacy and safety of pharmacological agents in addition to lifestyle modifications for pediatric obesity. Lifestyle interventions remain the treatment of choice in pediatric obesity, but concomitant pharmacotherapy may be beneficial in some patients. Orlistat should be considered as second-line therapy for pediatric obesity. Evidence suggests that other diabetes and antiepileptic medications may also provide weight-loss benefits, but safety should be further evaluated. © The Author(s) 2014.

Pediatric obesity. An introduction ☆

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Yanovski, Jack A.

2015-01-01

The prevalence of child and adolescent obesity in the United States increased dramatically between 1970 and 2000, and there are few indications that the rates of childhood obesity are decreasing. Obesity is associated with myriad medical, psychological, and neurocognitive abnormalities that impact children’s health and quality of life. Genotypic variation is important in determining the susceptibility of individual children to undue gains in adiposity; however, the rapid increase in pediatric obesity prevalence suggests that changes to children’s environments and/or to their learned behaviors may dramatically affect body weight regulation. This paper presents an overview of the epidemiology, consequences, and etiopathogenesis of pediatric obesity, serving as a general introduction to the subsequent papers in this Special Issue that address aspects of childhood obesity and cognition in detail. PMID:25836737

Postnatal BMI changes in children with different birthweights: A trial study for detecting early predictive factors for pediatric obesity

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Nakagawa, Yuichi; Nakanishi, Toshiki; Satake, Eiichiro; Matsushita, Rie; Saegusa, Hirokazu; Kubota, Akira; Natsume, Hiromune; Shibata, Yukinobu; Fujisawa, Yasuko

2018-01-01

Abstract. The purpose of this study was to clarify the degree of early postnatal growth by birthweight and detect early predictive factors for pediatric obesity. Body mass index (BMI) and degree of obesity were examined in children in the fourth year of elementary school and second year of junior high school. Their BMI at birth and three years of age were also examined. Based on birthweight, participants were divided into three groups: low ( 3500 g). Furthermore, according to the degree of obesity, they were divided into two groups: obese (20% ≤) and non-obese (20% >). The change of BMI from birth to three years of age (ΔBMI) showed a strong inverse relationship with birthweight and was significantly different among the three birthweight groups (low > middle > high). The ΔBMI and BMI at three years of age were higher in obese than in non-obese children and showed significant positive correlations with the degree of obesity. Early postnatal growth might be determined by birthweight and was higher in obese than in non-obese children. The ΔBMI from birth to three years of age and BMI at age of three years could be predictive factors for pediatric obesity. PMID:29403153

Pediatric Obesity and Ear, Nose, and Throat Disorders

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... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Obesity and Ear, Nose, and Throat Disorders Pediatric ... of self-esteem, and isolation from their peers. Pediatric obesity and otolaryngic problems Otolaryngologists, or ear, nose, ...

The Role of Social Support for Promoting Quality of Life among Persistently Obese Adolescents: Importance of Support in Schools

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Wu, Yelena P.; Reiter-Purtill, Jennifer; Zeller, Meg H.

2014-01-01

Background: Despite school-based and other interventions for pediatric obesity, many obese youth of the present generation will persist in their obesity into adolescence and adulthood. Thus, understanding not only how better to tailor weight interventions but how to promote overall adjustment for persistently obese youth is of utmost importance.…

Neighborhoods, Schools and Obesity: The Potential for Place-Based Approaches to Reduce Childhood Obesity.

Directory of Open Access Journals (Sweden)

Brian Elbel

Full Text Available A common policy approach to reducing childhood obesity aims to shape the environment in which children spend most of their time: neighborhoods and schools. This paper uses richly detailed data on the body mass index (BMI of all New York City public school students in grades K-8 to assess the potential for place-based approaches to reduce child obesity. We document variation in the prevalence of obesity across NYC public schools and census tracts, and then estimate the extent to which this variation can be explained by differences in individual-level predictors (such as race and household income. Both unadjusted and adjusted variability across neighborhoods and schools suggest place-based policies have the potential to meaningfully reduce child obesity, but under most realistic scenarios the improvement would be modest.

Neighborhoods, Schools and Obesity: The Potential for Place-Based Approaches to Reduce Childhood Obesity

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Elbel, Brian; Corcoran, Sean P.; Schwartz, Amy Ellen

2016-01-01

A common policy approach to reducing childhood obesity aims to shape the environment in which children spend most of their time: neighborhoods and schools. This paper uses richly detailed data on the body mass index (BMI) of all New York City public school students in grades K-8 to assess the potential for place-based approaches to reduce child obesity. We document variation in the prevalence of obesity across NYC public schools and census tracts, and then estimate the extent to which this variation can be explained by differences in individual-level predictors (such as race and household income). Both unadjusted and adjusted variability across neighborhoods and schools suggest place-based policies have the potential to meaningfully reduce child obesity, but under most realistic scenarios the improvement would be modest. PMID:27309533

Pediatric Obesity: It's Time for Prevention before Conception Can Maternal Obesity Program Pediatric Obesity?

OpenAIRE

Zach Ferraro; Kristi B. Adamo

2008-01-01

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...

Global school-based childhood obesity interventions: a review.

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Ickes, Melinda J; McMullen, Jennifer; Haider, Taj; Sharma, Manoj

2014-08-28

The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and (7) studies that reported outcome data. A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.

Global School-Based Childhood Obesity Interventions: A Review

Directory of Open Access Journals (Sweden)

Melinda J. Ickes

2014-08-01

Full Text Available Background: The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. Methods: A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1 primary research; (2 overweight or obesity prevention interventions; (3 school-based; (4 studies published between 1 January 2002 through 31 December 2013; (5 published in the English language; (6 child-based interventions, which could include parents; and (7 studies that reported outcome data. Results: A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Discussion: Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.

Genetics of pediatric obesity.

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Manco, Melania; Dallapiccola, Bruno

2012-07-01

Onset of obesity has been anticipated at earlier ages, and prevalence has dramatically increased worldwide over the past decades. Epidemic obesity is mainly attributable to modern lifestyle, but family studies prove the significant role of genes in the individual's predisposition to obesity. Advances in genotyping technologies have raised great hope and expectations that genetic testing will pave the way to personalized medicine and that complex traits such as obesity will be prevented even before birth. In the presence of the pressing offer of direct-to-consumer genetic testing services from private companies to estimate the individual's risk for complex phenotypes including obesity, the present review offers pediatricians an update of the state of the art on genomics obesity in childhood. Discrepancies with respect to genomics of adult obesity are discussed. After an appraisal of findings from genome-wide association studies in pediatric populations, the rare variant-common disease hypothesis, the theoretical soil for next-generation sequencing techniques, is discussed as opposite to the common disease-common variant hypothesis. Next-generation sequencing techniques are expected to fill the gap of "missing heritability" of obesity, identifying rare variants associated with the trait and clarifying the role of epigenetics in its heritability. Pediatric obesity emerges as a complex phenotype, modulated by unique gene-environment interactions that occur in periods of life and are "permissive" for the programming of adult obesity. With the advent of next-generation sequencing techniques and advances in the field of exposomics, sensitive and specific tools to predict the obesity risk as early as possible are the challenge for the next decade.

Pediatric obesity community programs: barriers & facilitators toward sustainability.

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Po'e, Eli K; Gesell, Sabina B; Lynne Caples, T; Escarfuller, Juan; Barkin, Shari L

2010-08-01

Our current generation of young people could become the first generation to live shorter lives than their parents. Families need resources in their community to address this issue. Identifying barriers and facilitators of community organizations to offer obesity-related services is a first step in understanding sustainable community programs. The objective of this study is to identify common barriers and facilitators in community organizational programs designed to prevent or reduce pediatric obesity. We conducted an exploratory qualitative research study based on grounded theory. Thirty-six community organizations were identified based on self-descriptions of goals involving pediatric obesity. Semi-structured, systematic, face-to-face interviews among program directors (n = 24) were recorded, transcribed, and coded for recurrent themes. Relevant themes were abstracted from interviews by a standardized iterative process by two independent reviewers between December 2007 and November 2008. Theme discordance was reconciled by a third reviewer. Seventy percent of organizations indicated that obesity prevention/treatment was their explicit goal with remaining groups indicating healthy lifestyles as a more general goal. Facilitators to provision of these programs included: programmatic enhancements such as improved curriculums (73%), community involvement such as volunteers (62.5%), and partnerships with other programs (54.2%). Barriers that threatened sustainability included lack of consistent funding (43.8%), lack of consistent participation from the target population (41.7%) and lack of support staff (20.8%). New approaches in fostering partnerships between organizations need to be developed. Building coalitions and engaging community members in developing community based programs may be a helpful strategy to strengthen community-based programs to address the pediatric obesity epidemic.

The safety of pharmacologic treatment for pediatric obesity.

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Chao, Ariana M; Wadden, Thomas A; Berkowitz, Robert I

2018-04-01

Pediatric obesity is a serious public health concern. Five medications have been approved by the Food and Drug Administration (FDA) for chronic weight management in adults with obesity, when used as an adjunct to lifestyle modification. Orlistat is the only FDA-approved medication for pediatric patients aged 12 years and above. Areas covered: This paper summarizes safety and efficacy data from clinical trials of weight loss medications conducted among pediatric samples. Relevant studies were identified through searches in PubMed. Expert opinion: Orlistat, as an adjunct to lifestyle modification, results in modest weight losses and may be beneficial for some pediatric patients with obesity. However, gastrointestinal side effects are common and may limit use. In adults taking orlistat, rare but severe adverse events, including liver and renal events, have been reported. Recent pediatric pharmacokinetic studies of liraglutide have demonstrated similar safety and tolerability profiles as found in adults, with gastrointestinal disorders being the most common adverse events. Clinical trials are needed of liraglutide, as well as other medications for obesity, that systematically evaluate their risks and benefits in pediatric patients.

Obesity after pediatric liver transplantation: prevalence and risk factors.

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Sundaram, Shikha S; Alonso, Estella M; Zeitler, Phil; Yin, Wanron; Anand, Ravinder

2012-12-01

Pediatric obesity has become a significant public health concern. The historical focus in pediatric liver transplant (LT) has been undernutrition, with limited knowledge regarding obesity. Therefore, we sought to determine the prevalence of obesity in pediatric LT, compare it to National Health and Nutrition Examination Surveys (NHANES) data, and identify risk factors for obesity in pediatric LT. SPLIT, which collects pediatric LT data at 39 centers, was queried for subjects ages 2 to 18 years at follow-up, LT between 1995 and 2007, and with at least 1 body mass index measured 1 to 5 years after LT. Of 1706 individuals included, 44% had biliary atresia (47% boys, 58% white, mean age at LT 4.6 years). Of these individuals, 19% were obese at 1 year and 18% at 3 years, higher than in the general pediatric population reported by 2003-2004 NHANES, whereas 11% obesity at 5 years after LT was similar to NHANES data. Using logistic regression, Hispanic ethnicity (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.19-2.23), steroid use at follow-up (OR 1.48, 95% CI 1.23-1.77), overweight (OR 4.34, 95% CI 2.91-6.68), and obesity (OR 10.62, 95% CI 5.9-19.65) at LT independently predicted post-LT obesity. These findings suggest a need to broaden standard care to include obesity assessment and intervention in routine pre- and posttransplant care.

Pediatric Obesity Empowerment Model Group Medical Visits (POEM-GMV) as Treatment for Pediatric Obesity in an Underserved Community.

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Geller, Jeffrey S; Dube, Eileen T; Cruz, Glavielinys A; Stevens, Jason; Keating Bench, Kara

2015-10-01

This is a retrospective cohort study to evaluate a novel group medical visit (GMV) program using an empowerment curriculum as treatment for pediatric obesity in a federally qualified community health center. Biometric and self-reported data were reviewed from 417 overweight or obese children ages 5-18 attending the pediatric obesity empowerment model GMV program (POEM-GMV) at least twice during a 3-year period. Variables were evaluated using paired means t-test. Pearson's correlation test was used to evaluate variables and the BMI z-score. Subanalysis by gender was performed. The average participant was 10.48 ± 2.53 years old and participated for 301 ± 287 days. BMI z-score reduced from 2.99 ± 0.96 to 2.88 ± 0.88 (p pediatric obesity in an underserved community. There were statistically significantly improved outcomes in obesity, especially for boys. Significant improvement was observed in many lifestyle factors associated with obesity. Weight loss most closely correlated with reduced stress levels and sugary beverage consumption. Additional studies are needed to further evaluate the efficacy of POEM-GMV.

The Pediatric Obesity Initiative: development, implementation, and evaluation.

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Sample, Denise A; Carroll, Heather L; Barksdale, Debra J; Jessup, Ann

2013-09-01

Pediatric obesity rates have nearly tripled over the past three decades contributing to increased morbidity and mortality in the United States and around the world. Pediatric obesity is most prevalent in developed countries and affects all races, ethnicities, cultures, and age groups. To combat this epidemic locally, a team of dedicated providers developed a comprehensive evidenced-based toolkit and training program for clinical practices providing primary care services to children in a North Carolina county. The toolkit and training program were developed using the most current treatment guidelines for pediatric obesity and included resources developed by Healthy Carolinians. One unique feature of the training was a demonstration of motivational interviewing with additional resources included in the toolkit. Staff and providers in three pediatric practices and the local Health Department received the training. In a 3 months follow-up survey after the training, the providers indicated that the toolkit and training program were useful but that they still did not consistently use the guidelines or tools. Ensuring the use of available guidelines and resources by providers remains a challenge. Further study is needed on how to improve implementation of guidelines in primary care settings. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Establishment of the Pediatric Obesity Weight Evaluation Registry: A National Research Collaborative for Identifying the Optimal Assessment and Treatment of Pediatric Obesity.

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Kirk, Shelley; Armstrong, Sarah; King, Eileen; Trapp, Christine; Grow, Mollie; Tucker, Jared; Joseph, Madeline; Liu, Lenna; Weedn, Ashley; Sweeney, Brooke; Fox, Claudia; Fathima, Samreen; Williams, Ronald; Kim, Roy; Stratbucker, William

2017-02-01

Prospective patient registries have been successfully utilized in several disease states with a goal of improving treatment approaches through multi-institutional collaboration. The prevalence of youth with severe obesity is at a historic high in the United States, yet evidence to guide effective weight management is limited. The Pediatric Obesity Weight Evaluation Registry (POWER) was established in 2013 to identify and promote effective intervention strategies for pediatric obesity. Sites in POWER provide multicomponent pediatric weight management (PWM) care for youth with obesity and collect a defined set of demographic and clinical parameters, which they regularly submit to the POWER Data Coordinating Center. A program profile survey was completed by sites to describe characteristics of the respective PWM programs. From January 2014 through December 2015, 26 US sites were enrolled in POWER and had submitted data on 3643 youth with obesity. Ninety-five percent were 6-18 years of age, 54% female, 32% nonwhite, 32% Hispanic, and 59% publicly insured. Over two-thirds had severe obesity. All sites included a medical provider and used weight status in their referral criteria. Other program characteristics varied widely between sites. POWER is an established national registry representing a diverse sample of youth with obesity participating in multicomponent PWM programs across the United States. Using high-quality data collection and a collaborative research infrastructure, POWER aims to contribute to the development of evidence-based guidelines for multicomponent PWM programs.

Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

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Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

2017-07-01

To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

Pediatric obesity: Causes, symptoms, prevention and treatment.

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Xu, Shumei; Xue, Ying

2016-01-01

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, hypertension, hyperlipidemia, liver and kidney diseases and causes reproductive dysfunction in adults. Obesity in children is a major health concern of the developed world. The National Health and Nutrition Examination Survey has reported that the prevalence of obesity is on the increase in all the pediatric age groups, in males and females, and in various ethnic and racial groups. Factors, such as eating habits, genetics, environment, metabolism, and lifestyle play an important role in the development of obesity. Over 90% of obesity cases are idiopathic and less than 10% are associated with genetic and hormonal causes. Obesity occurs when the body consumes more calories than it burns, through overeating and underexercising. The symptoms of obesity include breathing disorders, sleep apnea, chronic obstructive pulmonary disease, certain types of cancer such as prostate, bowel, breast and uterine, coronary heart disease, diabetes (type 2 in children), depression, liver and gallbladder problems, gastro-esophageal reflux disease, high blood pressure, high cholesterol, stroke, and joint diseases such as osteoarthritis, pain in knees and lower back. Environmental, behavioral such as consumption of convenience foods, genetic, and family factors contribute to pediatric obesity. Obesity can be countered through lower calorie consumption, weight loss and diet programs, as well as increased physical activity. A number of endogenous molecules including leptin, hypothalamic melanocortin 4 receptor

Impact Evaluation of Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial

Science.gov (United States)

Knowlden, Adam P.; Sharma, Manoj; Cottrell, Randall R.; Wilson, Bradley R. A.; Johnson, Marcus Lee

2015-01-01

Background. The family and home environment is an influential antecedent of childhood obesity. The purpose of this study was to pilot test The Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) intervention; a newly developed, theory-based, online program for prevention of childhood…

Pediatric obesity & type 2 diabetes.

Science.gov (United States)

Dea, Tara L

2011-01-01

This article focuses on (a) identifying obesity and other risk factors for developing type 2 diabetes, (b) differentiating between pediatric type 1 diabetes and type 2 diabetes, and (c) treating pediatric type 2 diabetes. Obesity has significant implications on a child's health, including an increased risk for insulin resistance and progression to type 2 diabetes. Type 2 diabetes in children, characterized by insulin resistance and relative pancreatic b-cell failure due to the increased demand for insulin production, has now reached epidemic proportions. Longitudinal research on pediatric type 2 diabetes, however, is lacking because this epidemic is relatively new. Treatment of type 2 diabetes in children is focused on lifestyle modification with weight management/increased physical activity, and pharmacological management through oral medication or insulin therapy. Because children with type 2 diabetes are at risk for developing diabetes-related complications earlier in life, they need to be closely monitored for comorbidities.

Comanagement of Pediatric Depression and Obesity: A Clear Need for Evidence.

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Mihalopoulos, Nicole L; Spigarelli, Michael G

2015-09-01

The purpose of this article is to provide a review of the existing literature for the comanagement of depression and obesity in the pediatric population. A review of the current literature was conducted using EBSCOhost and EMBASE to identify evidence and recommendations for the comanagement of depression and obesity among children and adolescents (aged 2-18 years). Additional search criteria included peer-reviewed, English language-only full-text articles published before August 2015. Multiple factors contribute to and influence the interplay of obesity and depression in the pediatric population. These 2 chronic conditions are affected by multiple factors, including the roles of the family, school, health care practitioners, and access to health care. In addition, there are no formal recommendations for the treatment of depression in the setting of obesity for pediatric or adult populations, and there is only medication approved by the Food and Drug Administration (orlistat) for the treatment of obesity in the adolescent population. Bariatric surgery may play a role in some adolescents, but larger and long-term clinical studies with the use of therapeutic agents in conjunction with lifestyle modification need to be conducted to support this. The interrelatedness of these 2 separate diseases is not well understood; the presence of 1 of the diseases clearly contributes to the manifestation of the other and likely to the ability to treat the other disease. Current focus is on modifying behavior to decrease weight. Weight loss is associated with improvement in depressive symptoms but may not be adequate to treat depression. Copyright © 2015. Published by Elsevier Inc.

Provider Training to Screen and Initiate Evidence-Based Pediatric Obesity Treatment in Routine Practice Settings: A Randomized Pilot Trial.

Science.gov (United States)

Kolko, Rachel P; Kass, Andrea E; Hayes, Jacqueline F; Levine, Michele D; Garbutt, Jane M; Proctor, Enola K; Wilfley, Denise E

This randomized pilot trial evaluated two training modalities for first-line, evidence-based pediatric obesity services (screening and goal setting) among nursing students. Participants (N = 63) were randomized to live interactive training or Web-facilitated self-study training. Pretraining, post-training, and 1-month follow-up assessments evaluated training feasibility, acceptability, and impact (knowledge and skill via simulation). Moderator (previous experience) and predictor (content engagement) analyses were conducted. Nearly all participants (98%) completed assessments. Both types of training were acceptable, with higher ratings for live training and participants with previous experience (ps pediatric obesity services. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Indian students' perspectives on obesity and school-based obesity prevention: a qualitative examination.

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Riggs, Nathaniel; Tewari, Abha; Stigler, Melissa; Rodrigues, Lindsay; Arora, Monika; Khubchandani, Jagdish; Simmons, Rob; Pentz, Mary Ann

2013-11-01

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.

Pediatric obesity: could metabolomics be a useful tool?

OpenAIRE

Angelica Dessì; Vassilios Fanos

2013-01-01

Pediatric obesity represents an important health issue. In recent years applications of metabolomics have led to evaluation of responses to the various nutrients (nutrigenomics), in particular to lipids, in diseases such as obesity and diabetes. The experimental data and the studies in pediatrics  that evaluated the metabolic condition in infant obesity are presented. It is thus to be hoped that future progress in connection with this new technique, together with a metabolomic study of mother...

Pediatric obesity: Current concepts.

Science.gov (United States)

Greydanus, Donald E; Agana, Marisha; Kamboj, Manmohan K; Shebrain, Saad; Soares, Neelkamal; Eke, Ransome; Patel, Dilip R

2018-04-01

This discussion reflects on concepts of obesity in children and adolescents in the early 21st century. It includes reflections on its history, definition, epidemiology, diagnostic perspectives, psychosocial considerations, musculoskeletal complications, endocrine complications and principles of management. In addition to emphasis on diet and exercise, research and clinical applications in the second decade of the 21 st century emphasize the increasing use of pharmacotherapy and bariatric surgery for adolescent and adult populations with critical problems of overweight and obesity. We conclude with a discussion of future directions in pediatric obesity management. Copyright © 2018 Mosby, Inc. All rights reserved.

Telemedicine and Pediatric Obesity Treatment: Review of the literature and lessons learned

OpenAIRE

Cohen, Gail M.; Irby, Megan B.; Boles, Katie; Jordan, Christine; Skelton, Joseph A.

2012-01-01

Pediatric obesity is more prevalent in rural areas, yet rural families may not have access to pediatric obesity treatment programs. Use of new technologies, particularly telemedicine, has proven effective in other behavioral fields, such as psychiatry. This paper reviews the literature on the use of telemedicine in pediatric obesity treatment, and describes one tertiary-care pediatric obesity telemedicine program. We performed a systematic review of the literature from 1990–2011 using the fol...

The Role of Ethnicity in School-Based Obesity Intervention for School-Aged Children: A Pilot Evaluation

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Karczewski, Sabrina A.; Carter, Jocelyn S.; DeCator, Draycen D.

2016-01-01

Background: Rates of obesity have risen disproportionately for ethnic minority youth in the United States. School-based programs may be the most comprehensive and cost-effective way to implement primary prevention in children. In this study we evaluated the effect of a school-based obesity prevention on the outcome of body mass index percentile…

Pediatric obesity: Causes, symptoms, prevention and treatment

OpenAIRE

XU, SHUMEI; XUE, YING

2015-01-01

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...

Obesity and outcomes following burns in the pediatric population.

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Ross, Evan; Burris, Agnes; Murphy, Joseph T

2014-03-01

While obesity is associated with increased mortality and decreased functional outcomes in adult burn patients, the ramifications of larger than average body size in the pediatric burn population are less well understood. The present study examines whether obesity was associated with poor outcomes following pediatric burn injuries. Thermal injury data for patients ≤ 18 years of age admitted to a Level III burn center over ten years (n=536) was analyzed. Obesity was defined as ≥ 95 th percentile of weight for height according to the WHO growth charts (obese (n=154) and non-obese (n=382) children. All data was collected in accordance with IRB regulations. Obese and non-obese thermally-injured children did not differ in TBSA, percentage of full thickness burn, or overall mortality. However, these groups were significantly different with respect to age (obese=7.16 ± 0.46 years, non-obese=9.38 ± 0.32 years, pobese=4.89 ± 1.3 days, non-obese=2.67 ± 0.49 days, pobese (n=46) and non-obese (n=129) did not differ significantly with respect to age, TBSA, percentage of full thickness burn or other outcome measures. However, significant differences between these groups were noted for ICU LOS (obese=18.59 ± 5.18 days, non-obese=9.51 ± 1.82 days, pobese=11.65 ± 3.91 days, non-obese=3.92 ± 0.85 days, pobese pediatric patients required longer and more intensive medical support in the form of BICU care and respiratory intervention. Counter to findings in adult populations, differences in mortality were not observed. Collectively, these findings suggest obesity as a risk factor for increased morbidity in the pediatric burn population. © 2014 Elsevier Inc. All rights reserved.

Media, social networking, and pediatric obesity.

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Vandewater, Elizabeth A; Denis, Laurence M

2011-12-01

The 5 years leading up to 2011 witnessed unprecedented transformations in the technology and media available to American consumers. These changes have led to major paradigmatic shifts in the way people think about media, how they use it, and the role they expect it to play in their lives. This article discusses the new media landscape and summarizes the evidence regarding media influences on pediatric obesity. Various effects on pediatric obesity are discussed and some conclusions and implications are provided, including possibilities and future directions for clinical practice and research. Copyright © 2011. Published by Elsevier Inc.

School-based obesity policy, social capital, and gender differences in weight control behaviors.

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Zhu, Ling; Thomas, Breanca

2013-06-01

We examined the associations among school-based obesity policies, social capital, and adolescents' self-reported weight control behaviors, focusing on how the collective roles of community and adopted policies affect gender groups differently. We estimated state-level ecologic models using 1-way random effects seemingly unrelated regressions derived from panel data for 43 states from 1991 to 2009, which we obtained from the Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System. We used multiplicative interaction terms to assess how social capital moderates the effects of school-based obesity policies. School-based obesity policies in active communities were mixed in improving weight control behaviors. They increased both healthy and unhealthy weight control behaviors among boys but did not increase healthy weight control behaviors among girls. Social capital is an important contextual factor that conditions policy effectiveness in large contexts. Heterogeneous behavioral responses are associated with both school-based obesity policies and social capital. Building social capital and developing policy programs to balance outcomes for both gender groups may be challenging in managing childhood obesity.

Assessment of obese children and adolescents: a survey of pediatric obesity-management programs.

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Eisenmann, Joey C

2011-09-01

This article provides descriptive information on the assessments conducted in stage 3 or 4 pediatric obesity-management programs associated with National Association of Children's Hospital and Related Institutions hospitals enrolled in FOCUS on a Fitter Future. Eighteen institutions completed a survey that considered the following assessments: patient/family medical history; physical examination; blood pressure; body size and composition; blood chemistry; aerobic fitness; resting metabolic rate; muscle strength and flexibility; gross motor function; spirometry; sedentary behavior and physical activity; dietary behavior and nutrition; and psychological assessments. Frequency distributions were determined for each question. Overall, the results indicate that most programs that participated in this survey were following 2007 Expert Committee assessment recommendations; however, a variety of measurement tools were used. The variation in assessment tools, protocols, etc is partially caused by the program diversity dictated by personnel, both in terms of number and duties. It also shows the challenges in standardizing methodologies across clinics if we hope to establish a national registry for pediatric obesity clinics. In addition to providing a better understanding of the current assessment practices in pediatric obesity-management programs, the results provided herein should assist other clinics/hospitals that are developing pediatric obesity programs.

The Influence of Organizational Culture on School-Based Obesity Prevention Interventions: A Systematic Review of the Literature.

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Fair, Kayla N; Solari Williams, Kayce D; Warren, Judith; McKyer, E Lisako Jones; Ory, Marcia G

2018-06-01

Although the influence of organizational culture has been examined on a variety of student outcomes, few studies consider the influence that culture may have on school-based obesity prevention interventions. We present a systematic review of the literature to examine how elements of organizational culture may affect the adoption, implementation, and sustainability of school-based obesity prevention interventions. Fourteen studies examining the impact of organizational-level characteristics on school-based obesity prevention interventions were identified through the online databases EBSCO (CINAHL, ERIC, Agricola), Web of Science, Medline (PubMed), and Scopus. Five themes were identified as elements of organizational culture that influence the adoption, implementation, and sustainability of school-based obesity prevention interventions: organizational response to limited resources, value placed on staff training and professional development, internal support, organizational values, and school climate. Organizational culture can greatly influence the success of school-based obesity interventions. The collection of data related to organizational-level factors may be used to identify strategies for creating and sustaining a supportive environment for obesity prevention interventions in the school setting. © 2018, American School Health Association.

An evolving scientific basis for the prevention and treatment of pediatric obesity.

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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

2014-07-01

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.

An update in prevention and treatment of pediatric obesity.

Science.gov (United States)

Moya, Manuel

2008-08-01

Obesity prevalence is growing as well as its severity with increasing morbidity and mortality. This "globesity" also affects developing countries where under nutrition and stunting frequently coexist with overweight and obesity. One third of obese adults began to be so in the pediatric ages. There are two main types of prevention: general one representing greater actions from health authorities and the individual one carried out by the pediatrician and the patient at risk. Once the state of obesity is reached (relative body mass index, rBMI >121%) the longer lasting care becomes more complex and frequently unsuccessful. The treatment of obesity is aimed to care for the present and silent disorders and for preventing its further tracking to adulthood. Identification of pediatric population at risk which is the one with an rBMI of 111%-120% plus other risk factors. Specific individual actions include reduction of food intake, increase of energy expenditure, involvement of parents, and the child-adolescent himself in the prevention. Therapy is based on some principles plus the important medical and emotional approach. A Cochrane study based on only 10 appropriate studies showed a predominant poor efficacy of the undergone preventive action. Treatment guides are presented after our own experience with a group of 400 kids with an average follow-up of 7 years and other individual prevention studies. Involving motivated pediatricians with a minimum of time for visits and better follow-up in the frame of a general national preventive programme could be a rational outcome. Treatment of obesity should never be postponed whatever the clinical care is.

Metabolic evaluation of urolithiasis and obesity in a midwestern pediatric population.

Science.gov (United States)

Roddy, John T; Ghousheh, Anas I; Christensen, Melissa A; Durkee, Charles T

2014-03-01

The incidence of urolithiasis has been proved to be increasing in the adult population, and evidence to date suggests that the same holds true for the pediatric population. While adult urolithiasis is clearly linked to obesity, studies of pediatric patients have been less conclusive. We hypothesized that a population of otherwise healthy children with stones would have an increased body mass index compared to a control population, and that obese pediatric stone formers would have results on metabolic assessment that are distinct from nonobese stone formers. We retrospectively reviewed the charts of all patients 10 to 17 years old with upper tract urolithiasis without comorbidities treated between 2006 and 2011. Mean body mass index of our population was compared to state data, and 24-hour urine collection results were compared between obese and nonobese patients with stones. The obesity rate in 117 patients with urolithiasis did not differ significantly from the obesity rate derived from the 2007 National Survey of Children's Health (observed/expected ratio 1.11, 95% CI 0.54-1.95). Using t-test and chi-square comparisons, overall 24-hour urine collection data did not show statistically significant differences. Our results do not confirm obesity as a risk factor for pediatric urolithiasis in otherwise healthy patients. We also found no substantial metabolic differences between healthy nonobese stone formers and obese patients. While the pediatric literature is mixed, our study supports the majority of published series that have failed to establish a link between pediatric urolithiasis and obesity. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

School-based programs aimed at the prevention and treatment of obesity: evidence-based interventions for youth in Latin America.

Science.gov (United States)

Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K; Nagle, Brian J; Arredondo, Elva M; Barquera, Simón; Elder, John P

2013-09-01

Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be gathered from such interventions. We performed a systematic review of papers published between 1965 and December 2010. Interventions were considered eligible if they had a school-based component, were done in Latin America, evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z-score), and compared youth exposed vs not exposed. Ten studies were identified as having a school-based component. Most interventions had a sample of normal and overweight children. The most successful interventions focused on prevention rather than treatment, had longer follow-ups, a multidisciplinary team, and fewer limitations in execution. Three prevention and 2 treatment interventions found sufficient improvements in obesity-related outcomes. We found sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America. Evidence-based interventions in the school setting should be promoted as an important component for integrated programs, policies, and monitoring frameworks designed to reverse the childhood obesity in the region. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Support for school-based obesity prevention efforts: attitudes among administrators at nationally representative samples of US elementary schools.

Science.gov (United States)

Turner, Lindsey; Slater, Sandy J; Chaloupka, Frank J

2013-08-01

With the continued threat of childhood obesity, many public health intervention efforts focus on school settings. The current study sought to document administrator attitudes regarding obesity and interest in improving relevant school practices (i.e., nutrition and physical activity) in elementary schools. Mail-back surveys were used to gather data from public and private elementary schools during the 2006-2007, 2007-2008, 2008-2009, and 2010-2011 school years. In each year, a different set of items pertaining to administrator attitudes was included. Numbers of responding schools annually ranged from 259 to 336 private schools, and from 578 to 748 public schools. The vast majority of elementary school administrators (>90%) agreed that schools can play a role in addressing childhood obesity, physical education improves a variety of academic outcomes, and they were interested in improving practices at their school. Concern about childhood obesity and perceiving that schools can play a role in addressing obesity were both associated with more interest in improving school practices. However, only one-third of administrators agreed that parents were interested in participating in improving nutrition and physical activity practices, suggesting opportunities for efforts to improve collaboration. Administrators are generally very supportive of school-based efforts to improve nutrition and physical activity practices and see the value in doing so. Given the amount of time children spend in school, schools are an essential venue for efforts to address childhood obesity.

From Bench to Bedside: Understanding Stress-Obesity Research Within the Context of Translation to Improve Pediatric Behavioral Weight Management.

Science.gov (United States)

Sato, Amy F; Fahrenkamp, Amy J

2016-06-01

A growing body of literature suggests that stress, including chronic stress and acute physiologic stress reactivity, is one contributor to the development and maintenance of obesity in youth. Little has been done to apply the literature on stress and obesity risk to inform the development of pediatric behavioral weight control (BWC) interventions. The aims of this review are to (1) discuss research linking stress and pediatric obesity, (2) provide examples of the implications of the stress-obesity research for pediatric BWC development, and (3) propose that a mindfulness-based approach may be useful in targeting stress reduction within pediatric BWC. Copyright © 2016 Elsevier Inc. All rights reserved.

Pediatric Obesity-Related Asthma: The Role of Metabolic Dysregulation.

Science.gov (United States)

Vijayakanthi, Nandini; Greally, John M; Rastogi, Deepa

2016-05-01

The burden of obesity-related asthma among children, particularly among ethnic minorities, necessitates an improved understanding of the underlying disease mechanisms. Although obesity is an independent risk factor for asthma, not all obese children develop asthma. Several recent studies have elucidated mechanisms, including the role of diet, sedentary lifestyle, mechanical fat load, and adiposity-mediated inflammation that may underlie the obese asthma pathophysiology. Here, we review these recent studies and emerging scientific evidence that suggest metabolic dysregulation may play a role in pediatric obesity-related asthma. We also review the genetic and epigenetic factors that may underlie susceptibility to metabolic dysregulation and associated pulmonary morbidity among children. Lastly, we identify knowledge gaps that need further exploration to better define pathways that will allow development of primary preventive strategies for obesity-related asthma in children. Copyright © 2016 by the American Academy of Pediatrics.

Neural correlates of pediatric obesity.

Science.gov (United States)

Bruce, Amanda S; Martin, Laura E; Savage, Cary R

2011-06-01

Childhood obesity rates have increased over the last 40 years and have a detrimental impact on public health. While the causes of the obesity epidemic are complex, obesity ultimately arises from chronic imbalances between energy intake and expenditure. An emerging area of research in obesity has focused on the role of the brain in evaluating the rewarding properties of food and making decisions about what and how much to eat. This article reviews recent scientific literature regarding the brain's role in pediatric food motivation and childhood obesity. The article will begin by reviewing some of the recent literature discussing challenges associated with neuroimaging in children and the relevant developmental brain changes that occur in childhood and adolescence. The article will then review studies regarding neural mechanisms of food motivation and the ability to delay gratification in children and how these responses differ in obese compared to healthy weight children. Increasing our understanding about how brain function and behavior may differ in children will inform future research, obesity prevention, and interventions targeting childhood obesity. Copyright © 2011. Published by Elsevier Inc.

Pediatric metabolic outcome comparisons based on a spectrum of obesity and asthmatic symptoms.

Science.gov (United States)

Perdue, Ashley D; Cottrell, Lesley A; Lilly, Christa L; Gower, William A; Ely, Brian A; Foringer, Brad; Wright, Melvin L; Neal, William A

2018-04-20

Asthma and obesity are two of the most prevalent public health issues for children in the U.S. Trajectories of both have roughly paralleled one another over the past several decades causing many to explore their connection to one another and to other associated health issues such as diabetes and dyslipidemia. Earlier models have commonly designated obesity as the central hub of these associations; however, more recent models have argued connections between pediatric asthma and other obesity-related metabolic conditions regardless of children's obesity risk. To examine the relationships between asthma, obesity, and abnormal metabolic indices. We conducted a cross-sectional study of 179 children ages 7 to 12 years recruited from a rural, Appalachian region. Our model controlled for children's smoke exposure, body mass index percentile, and gender to examine the association between children's asthma (based on pulmonary function tests, medical history, medications, and parent report of severity), lipids (fasting lipid profile), and measures of altered glucose metabolism (glycosylated hemoglobin and homeostatic model assessment 2-insulin resistance). Our findings revealed a statistically significant model for low density lipids, high density lipids, log triglyceride, and homeostatic model assessment 2-insulin resistance; however, a statistically significant main effect for asthma was found for triglycerides. We also found an asthma-obesity interaction effect on children's glycosylated hemoglobin with asthmatic obese children revealing significantly higher glycosylated hemoglobin values than non-asthmatic obese children. Our findings support a connection between asthma and children's glycosylated hemoglobin values; however, this association remains entwined with obesity factors.

Exercise-Based School Obesity Prevention Programs: An Overview

Science.gov (United States)

Yetter, Georgette

2009-01-01

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…

The Status of Billing and Reimbursement in Pediatric Obesity Treatment Programs

Science.gov (United States)

Gray, Jane Simpson; Filigno, Stephanie Spear; Santos, Melissa; Ward, Wendy L.; Davis, Ann M.

2014-01-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service. PMID:23224661

The status of billing and reimbursement in pediatric obesity treatment programs.

Science.gov (United States)

Gray, Jane Simpson; Spear Filigno, Stephanie; Santos, Melissa; Ward, Wendy L; Davis, Ann M

2013-07-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service.

Using Intervention Mapping to develop the Parents as Agents of Change (PAC©) intervention for managing pediatric obesity.

Science.gov (United States)

Ball, Geoff D C; Mushquash, Aislin R; Keaschuk, Rachel A; Ambler, Kathryn A; Newton, Amanda S

2017-01-13

Pediatric obesity has become increasingly prevalent over recent decades. In view of the psychosocial and physical health risks, and the high likelihood that children with obesity will grow to become adults with obesity, there is a clear need to develop evidence-based interventions that can be delivered in the health care system to optimize the health and well-being of children with obesity and their families. The aim of this paper is to describe the development, implementation, and planned evaluation of a parent-based weight management intervention designed for parents of 8-12 year olds with obesity. The principles of Intervention Mapping (IM) were used to develop an intervention called Parents as Agents of Change (PAC © ). From 2006 to 2009, an environmental scan plus qualitative (individual interviews with parents and children), quantitative (medical record reviews), and literature review data were collected to gain broad insight into family factors related to pediatric obesity and its management. Theoretical frameworks and empirical evidence guided curriculum development, which was founded primarily on the tenets of family systems theory and cognitive behavioral theory. PAC was developed as a manualized, 16-session, group-based, health care professional-led intervention for parents to address individual, family, and environmental factors related to the management of pediatric obesity. The intervention was refined based on feedback from local and international experts, and has been implemented successfully in a multi-disciplinary weight management centre in a children's hospital. IM provided a practical framework to guide the systematic development of a pediatric weight management intervention for parents of children with obesity. This logical, step-by-step process blends theory and practice and is broadly applicable in the context of obesity management intervention development and evaluation. Following intervention development, the PAC intervention was

A values-based Motivational Interviewing (MI) intervention for pediatric obesity: study design and methods for MI Values.

Science.gov (United States)

Bean, Melanie K; Mazzeo, Suzanne E; Stern, Marilyn; Bowen, Deborah; Ingersoll, Karen

2011-09-01

To reduce pediatric obesity in clinical settings, multidisciplinary behaviorally-based treatment programs are recommended. High attrition and poor compliance are two difficulties frequently encountered in such programs. A brief, empathic and directive clinical intervention, Motivational Interviewing (MI), might help address these motivational and behavioral issues, ultimately resulting in more positive health outcomes. The efficacy of MI as an adjunct in the treatment of pediatric obesity remains relatively understudied. MI Values was developed to implement within an existing multidisciplinary treatment program for obese, ethnically diverse adolescents, the T.E.E.N.S. Program (Teaching, Encouragement, Exercise, Nutrition, Support). T.E.E.N.S. participants who consent to MI Values are randomized to either MI or an education control condition. At weeks 1 and 10 of T.E.E.N.S. participation, the subset of participants assigned to the MI condition engages in individual MI sessions and control participants view health education videos. All MI sessions are audiotaped and coded to monitor treatment fidelity, which has been satisfactory thus far. Participants complete comprehensive assessments at baseline, 3- and 6-month follow-ups. We hypothesize that MI participants will demonstrate greater reductions in Body Mass Index (BMI) percentile, improved diet and physical activity behaviors, better compliance with T.E.E.N.S., and lower attrition than participants in the control group. We present study design and methods for MI Values as well as data on feasibility of recruitment methods and treatment integrity. At study completion, findings will contribute to the emerging literature examining the efficacy of MI in the treatment of pediatric obesity. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparison between a pediatric health promotion center and a pediatric obesity clinic in detecting metabolic syndrome and non-alcoholic fatty liver disease in children.

Science.gov (United States)

Yang, Hye Ran; Yi, Dae Yong; Choi, Hyoung Soo

2014-12-01

This study was done to evaluate the efficacy of health check-ups in children in detecting metabolic syndrome and non-alcoholic fatty liver disease (NAFLD) by comparing the pediatric health promotion center with the pediatric obesity clinic. Children who visited a pediatric health promotion center (n=218) or a pediatric obesity clinic (n=178) were included. Anthropometric data, blood pressure, laboratory tests, and abdominal ultrasonography were evaluated. Two different criteria were applied to diagnose metabolic syndrome. The prevalence of metabolic syndrome in the 2 units was 3.2%-3.7% in a pediatric health promotion center and 23%-33.2% in a pediatric obesity clinic. Significant differences were observed in the prevalence of each component of metabolic syndrome between the 2 units including abdominal adiposity, blood pressure, serum triglycerides, and fasting blood glucose (Pobesity clinic targeting obese children than that among patients visiting the health promotion center offering routine check-ups. An obesity-oriented approach is required to prevent obesity-related health problems in children.

Assessing attitudes and actions of pediatric dentists toward childhood obesity and sugar-sweetened beverages.

Science.gov (United States)

Wright, Robin; Casamassimo, Paul S

2017-06-01

Childhood obesity is a major US health concern, and oral health professionals have opportunities to participate in an interprofessional effort to intervene owing to their access to young patients and their abilities in addressing obesity-related dietary habits like consumption of sugar-sweetened beverages (SSBs). This study determined attitudes, behaviors, future intentions, and perceived barriers of pediatric dentists regarding efforts to prevent childhood obesity and reduce children's consumption of SSBs. The American Academy of Pediatric Dentistry conducted an online electronic survey with a convenience sample of approximately 7,450 pediatric dentists and pediatric dental residents during spring 2016. Over 17 percent of pediatric dentists offer childhood obesity interventions. Of those not providing interventions, 67 percent were interested in offering obesity-prevention services. Nearly 94 percent of pediatric dentists offer information or other interventions on consumption of SSBs. Statistically significant barriers to providing healthy weight interventions were fear of offending parents, appearing judgmental, or creating parent dissatisfaction and a lack of parental acceptance of guidance about weight management from a dentist. Significant barriers to SSB interventions were sufficient time and health professional education. More pediatric dentists stated they offer childhood obesity interventions than in previous surveys reporting 6 percent, but respondents suggested that a child's weight is seen as a medical rather than dental issue. Most pediatric dentists provide interventions related to consumption of SSBs, perceiving the issue as integral to their care of children. © 2017 American Association of Public Health Dentistry.

School-Based Obesity-Prevention Policies and Practices and Weight-Control Behaviors among Adolescents.

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Larson, Nicole; Davey, Cynthia S; Caspi, Caitlin E; Kubik, Martha Y; Nanney, Marilyn S

2017-02-01

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

School sociodemographic characteristics and obesity in schoolchildren: does the obesity definition matter?

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Bel-Serrat, Silvia; Heinen, Mirjam M; Mehegan, John; O'Brien, Sarah; Eldin, Nazih; Murrin, Celine M; Kelleher, Cecily C

2018-03-09

Existing evidence on the role of sociodemographic variables as risk factors for overweight and obesity in school-aged children is inconsistent. Furthermore, findings seem to be influenced by the obesity definition applied. Therefore, this study aimed to investigate if school sociodemographic indicators were associated with weight status in Irish primary schoolchildren and whether this association was sensitive to different obesity classification systems. A nationally representative cross-sectional sample of 7542 Irish children (53.9% girls), mean age 10.4 (±1.2SD) years, participating in the Childhood Obesity Surveillance Initiative in the 2010, 2012/2013 or 2015/2016 waves were included. Height, weight and waist circumference were objectively measured. Five definitions of obesity were employed using different approaches for either body mass index (BMI) or abdominal obesity. Associations between overweight and obesity and sociodemographic variables were investigated using adjusted multilevel logistic regression analyses. Children attending disadvantaged schools were more likely to be overweight and obese than their peers attending non-disadvantaged schools, regardless of the obesity classification system used. Associations remained significant for the BMI-based obesity definitions when the sample was stratified by sex and age group, except for boys aged 8-10.5 years. Only boys aged ≥10.5 years in disadvantaged schools had higher odds of abdominal obesity (UK 1990 waist circumference growth charts: OR = 1.56, 95%CI = 1.09-2.24; waist-to-height ratio: OR = 1.78, 95%CI = 1.14-2.79) than those in non-disadvantaged schools. No associations were observed for school urbanisation level. School socioeconomic status was a strong determinant of overweight and obesity in Irish schoolchildren, and these associations were age- and sex-dependent. School location was not associated with overweight or obesity. There remains a need to intervene with school

An adaptive community-based participatory approach to formative assessment with high schools for obesity intervention*.

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Kong, Alberta S; Farnsworth, Seth; Canaca, Jose A; Harris, Amanda; Palley, Gabriel; Sussman, Andrew L

2012-03-01

In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles to conduct formative research in identifying acceptable and potentially sustainable obesity intervention strategies in 8 New Mexico school communities. We collected formative data from 8 high schools on areas of community interest for school health improvement through collaboration with local School Health Advisory Councils (SHACs) and interviews with students and parents. A survey based on formative results was created to assess acceptability of specific intervention strategies and was provided to SHACs. Quantitative data were analyzed using descriptive statistics while qualitative data were evaluated using an iterative analytic process for thematic identification. Key themes identified through the formative process included lack of healthy food options, infrequent curricular/extracurricular physical activity opportunities, and inadequate exposure to health/nutritional information. Key strategies identified as most acceptable by SHAC members included healthier food options and preparation, a healthy foods marketing campaign, yearly taste tests, an after-school noncompetitive physical activity program, and community linkages to physical activity opportunities. An adaptive CBPR approach for formative assessment can be used to identify obesity intervention strategies that address community school health concerns. Eight high school SHACs identified 6 school-based strategies to address parental and student concerns related to obesity. © 2012, American School Health Association.

The impact of obesity on 30-day complications in pediatric surgery.

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Train, A T; Cairo, S B; Meyers, H A; Harmon, C M; Rothstein, D H

2017-11-01

To examine the effects of obesity on specialty-specific surgical outcomes in children. Retrospective cohort study using the National Surgical Quality Improvement Program, Pediatric, 2012-2014. Patients included those aged 2-17 years who underwent a surgical procedure in one of six specialties. Obesity was the primary patient variable of interest. Outcomes of interest were postoperative complications and operative times. Odds ratios for development of postoperative complications were calculated using stepwise multivariate regression analysis. Obesity was associated with a significantly greater risk of wound complications (OR 1.24, 95% CI 1.13-1.36), but decreased risk of non-wound complications (OR 0.68, 95% CI 0.63-0.73) and morbidity (OR 0.79, 95% CI 0.75-0.84). Obesity was not a significant factor in predicting postoperative complications in patients undergoing otolaryngology or plastic surgery procedures. Anesthesia times and operative times were significantly longer for obese patients undergoing most types of pediatric surgical procedures. Obesity confers an increased risk of wound complications in some pediatric surgical specialties and is associated with overall decreased non-wound complications and morbidity. These findings suggest that the relationship between obesity and postoperative complications is complex and may be more dependent on underlying procedure- or specialty-related factors than previously suspected.

Practical approaches to the treatment of severe pediatric obesity.

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Lenders, C M; Gorman, K; Lim-Miller, A; Puklin, S; Pratt, J

2011-12-01

Pediatric obesity is a major public health threat. Obese children and adolescents are at increased risk for many medical and surgical conditions. These conditions may affect their quality of life and life expectancy. The rapidly progressive nature of type 2 diabetes mellitus within the first 5 years of obesity diagnosis is particularly concerning. Because health risk increases with degree of obesity, adolescents who may be eligible for more aggressive obesity treatment should be identified and counseled. Published by Elsevier Inc.

Association of pediatric obstructive sleep apnea with poor academic performance: A school-based study from India

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Abhishek Goyal; Abhijit P Pakhare; Girish C Bhatt; Bharat Choudhary; Rajesh Patil

2018-01-01

Background: Pediatric obstructive sleep apnea (OSA) is a highly prevalent but often neglected disorder. There is paucity of reports on the prevalence of pediatric OSA from India. This study was done to estimate the prevalence of OSA in school children aged 5–10 years and its association with academic performance. Methodology: This school-based cross-sectional epidemiological study was conducted from July 2015 to November 2015. A questionnaire seeking information on sociodemographic variables,...

Trimming the fat: identification of risk factors associated with obesity in a pediatric emergency department.

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Thundiyil, Josef G; Christiano-Smith, Danielle; Greenberger, Sarah; Cramm, Kelly; Latimer-Pierson, Janese; Modica, Renee F

2010-10-01

The purpose of this study was to assess which knowledge deficits and dietary habits in an urban pediatric emergency department (ED) population are risk factors for obesity. This cross-sectional study in an urban pediatric ED used a modified version of the Diet and Health Knowledge Survey, an in-person interview questionnaire, to collect data on demographics, dietary knowledge, and practices. All patients aged 2 to 17 years were enrolled in the study over a 4-month period. Subjects were excluded if they were in extremis, pregnant, incarcerated, institutionalized, considered an emancipated minor, or consumed only a modified consistency diet. One hundred seventy-nine subjects were enrolled in this study. Based on body mass index, the prevalence of obesity in our study population was 24%. Parents with obese children answered a mean of 62.9% (95% confidence interval, 60.4%-65.5%) of knowledge questions correctly, whereas all others scored 60.3% (95% confidence interval, 58.3%-62.3%) correctly. Based on the univariate analysis, 10 predictors met inclusion criteria into logistic regression analysis: screen time (P = 0.03), race (P = 0.08), sex (P = 0.04), parental education (P = 0.08), parental estimation that child is overweight (P obesity were independently associated with obesity. Knowledge deficiencies regarding healthy nutrition among parents in an urban pediatric ED population were not significantly associated with having obese children; however, specific habits were. Emergency physicians may provide a valuable role in identification and brief behavioral intervention in high-risk populations during the current epidemic of childhood obesity.

School-Based Programs Aimed at the Prevention and Treatment of Obesity: Evidence-Based Interventions for Youth in Latin America

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Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K.; Nagle, Brian J.; Arredondo, Elva M.; Barquera, Simon; Elder, John P.

2013-01-01

Background: Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be…

Current Approaches to the Management of Pediatric Overweight and Obesity

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Ridolfi, Danielle R.; Hayes, Jacqueline F.; St Paul, Michelle; Wilfley, Denise E.

2015-01-01

Opinion Statement Family-based behavioral intervention has been demonstrated to be an effective and safe treatment for childhood obesity and should be considered a first-line treatment option. However, access to such intensive evidence-based treatment is limited and, currently, obesity care is dominated by high intensity behavioral treatment implemented in specialty clinics or less effective, low intensity treatments implemented in primary care. However, capitalizing on the established and ongoing relationship between primary care providers and families, primary care providers hold an invaluable role in early identification of overweight and obesity, and subsequent referral to an evidence-based treatment. key aspects of effective treatment include: early intervention, moderate- to high-intensity intervention of sufficient duration, multi-component intervention targeting dietary modification, physical activity and behavioral strategies, family involvement and goals targeting family members, and follow-up contact during maintenance. The purpose of this review is to present the current empirically supported treatment options for pediatric obesity including primary care-based interventions and diagnostic tools, multi-component behavioral intervention with a focus on family-based behavioral intervention, immersion treatment, and pharmacologic and surgical management. PMID:25205083

Beyond Parenting Practices: Family Context and the Treatment of Pediatric Obesity

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Kitzmann, Katherine M.; Dalton, William T., III; Buscemi, Joanna

2008-01-01

Many family-based treatments for pediatric obesity teach specific parenting practices related to weight management. Although youth in these programs show increases in positive health behaviors and reductions in the extent to which they are overweight, most remain overweight after treatment. A recent trend is to create tailored programs for…

School-based internet obesity prevention programs for adolescents: a systematic literature review.

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Whittemore, Robin; Chao, Ariana; Popick, Rachel; Grey, Margaret

2013-03-01

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.

The characteristics of the pediatric model for counteracting obesity in Serbia

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Banićević Miloš

2012-01-01

Full Text Available Basic data on the establishment, features and results of the health care system for children and adolescents in the Republic of Serbia during the period 1950-1990 are given in the introductory remarks. Enormous pressure for the change of the health sector ownership and the profile of physicians in the primary pediatric care in the last decade of 20th century and at the beginning of 21st century is also emphasized. The destructive consequences of the sanctions of international community (1992-1995, NATO aggression (1999 and the change of the political system in Serbia (2000 caused the huge loss of gross domestic product, increase of the unemployment and poverty rates, and the decrease of the health expenditure rate to unsustainable levels (200-300 USD per capita. In spite of all misfortunes, Pediatric Association of Serbia, in response to the global obesity epidemic, offered in 2007 to the Ministry of health and the National Institute for health insurance the Project 'The prevention and treatment of obesity in children and adolescents in Serbia', as the pediatric chapter for future National strategy for counteracting obesity. The Project, ie the pediatric model for counteracting obesity is funded on the features of the health care system for children and adolescents in our country. The solidarity of the society and the continuous education of health care workers, adolescents and their parents about the significance of obesity epidemic are, in our conviction, key factors for the strengthening of adolescent's conscience on individual responsibility for own health as the prerequisite for successful control of obesity epidemic in adolescents.

School-Based Obesity Prevention Intervention in Chilean Children: Effective in Controlling, but not Reducing Obesity

Directory of Open Access Journals (Sweden)

Juliana Kain

2014-01-01

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.

Parental Feeding Style and Pediatric Obesity in Latino Families.

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Maliszewski, Genevieve; Gillette, Meredith Dreyer; Brown, Chris; Cowden, John D

2017-06-01

Pediatric obesity has become an epidemic in the United States. Previous research has shown that parenting factors related to feeding style affect child weight and that Latino families are especially at risk for pediatric obesity. The goal of the current study was to evaluate the relationship between parental feeding style and child body mass index (BMI) in Latino families. Latino parents of children between the ages of 2 and 8 ( N = 124) completed a survey on parental feeding styles, acculturation, and demographics. The outcome variable was child BMI. Among respondents, 89% were mothers, 72% were overweight or obese, and 40% reported an indulgent feeding style. Children had a mean age of 59 months ( SD = 23.8) and a mean BMI z score of 0.77 ( SD = 1.14). A demanding parental feeding style was associated with lower child BMI z score, r = -.179, p parents' feeding behaviors. Future research is warranted in the area of ethnic variations of parenting and how these affect feeding and obesity in this highly vulnerable population.

Obesity related factors in school-aged children.

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Soltani, Parvaneh Reza; Ghanbari, Atefeh; Rad, Afagh Hasanzadeh

2013-05-01

Overweight and obesity is becoming an increasingly prevalent problem in both developed and developing world, and is one of the most serious public health challenges of the 21(st) century. Although various studies demonstrated pediatric obesity-related factors, but, due to its ongoing hazardous effects, researchers aimed to assess obesity-related factors in school-aged children in Rasht, Iran. This was a case-control study which was performed in eight primary schools of Rasht. A cluster sampling method was used to select 320 students including 80 in case (BMI ≥85(th) percentile for age and gender) and 240 in control group (BMI = 5(th)-85(th) percentile for age and gender). Data were collected by a scale, a tape meter, and a form which consisted of obesity-related factors, and were analyzed by Chi-square, Mann-Whitney, and stepwise multivariate regression tests in SPSS 19. Findings showed that the mean and standard deviation of birth weight (g) in case and control groups were 3671 ± 5.64 and 190 ± 5.46, respectively (P = 0.000). 82.5% of case and 92.9% of control group had exclusive breastfeeding for 4-6 months (P = 0.024). Also, multivariate regression analysis indicated that birth weight, age, exclusive breastfeeding, and frequency of meals have significant effects on body mass index (BMI). It seems that more accurate interventions for primordial prevention are essential to reduce childhood obesity risk factors, including promotion of pre-pregnancy and prenatal care to have neonates who are appropriate for gestational age and also improving exclusive breastfeeding in the first 6 months of life. In addition, identifying children at risk for adolescent obesity provides physicians and midwives with an opportunity for earlier intervention with the goal of limiting the progression of abnormal weight gain.

Ultrasound Accuracy in Diagnosing Appendicitis in Obese Pediatric Patients.

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Love, Bryan E; Camelo, Monica; Nouri, Sarvenaz; Kriger, Diego; Ludi, Daniel; Nguyen, Henry

2017-10-01

The use of ultrasound to diagnose appendicitis in pediatric patients has been growing with the improvement of ultrasound technology and operator skills, but its utility in the increasingly obese pediatric population has not been thoroughly investigated. A retrospective review of all pediatric (≤18 years old) patients with appendicitis who were admitted at a single hospital from 2014 to 2016 was conducted. Patients were stratified into body mass index (BMI) percentile categories based on the centers for disease control guidelines. Comparisons were then made. There were 231 patients with an average BMI percentile of 72.6; 99 (42.9%) who had an ultrasound, of which 54 (54.5%) were positive for acute appendicitis, whereas 43 (43.4%) were nondiagnostic. In patients who had a nondiagnostic ultrasound, 37 had a CT demonstrating acute appendicitis. These were compared with 123 patients who had CT alone demonstrating acute appendicitis. The CT-only group was older (12 vs 9, P appendicitis.

National Institutes of Health Update: Translating Basic Behavioral Science into New Pediatric Obesity Interventions.

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Czajkowski, Susan M

2016-06-01

Pediatric obesity increases the risk of later-life obesity and chronic diseases. Basic research to better understand factors associated with excessive weight gain in early life and studies translating research findings into preventive and therapeutic strategies are essential to our ability to better prevent and treat childhood obesity. This overview describes several National Institutes of Health efforts designed to stimulate basic and translational research in childhood obesity prevention and treatment. These examples demonstrate the value of research in early phase translational pediatric obesity research and highlight some promising directions for this important area of research. Published by Elsevier Inc.

A School-Based Program for Overweight and Obese Adolescents: A Randomized Controlled Trial

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Pbert, Lori; Druker, Susan; Barton, Bruce; Schneider, Kristin L.; Olendzki, Barbara; Gapinski, Mary A.; Kurtz, Stephen; Osganian, Stavroula

2016-01-01

Background: Given the dramatic increase in adolescent overweight and obesity, models are needed for implementing weight management treatment through readily accessible venues. We evaluated the acceptability and efficacy of a school-based intervention consisting of school nurse-delivered counseling and an afterschool exercise program in improving…

A systematic review of pediatric obesity and family communication through the lens of addiction literature.

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Mogul, Ashley; Irby, Megan B; Skelton, Joseph A

2014-06-01

Both treatment of addiction and treatment of pediatric obesity often integrate the family unit. Thus, addiction therapies may provide a model to guide treatment of pediatric obesity, particularly issues of family communication, weight, and weight-related behaviors. The aim of this systematic review is to assess what knowledge in the field of addiction treatment can be translated to pediatric weight management, particularly in relation to family-based approaches and communication. A systematic review of family communication and food addiction in obese children was conducted using MEDLINE and other databases, including all English-language studies published after 1990 meeting search criteria and related to family factors or family communication, and addiction treatment strategies used in obesity interventions. Three reviews, two survey studies, and two observational studies were included. Most focused on family communication; less-healthy communication patterns and parental restriction were related to maladaptive eating behaviors in children and attrition from weight management programs. A few studies suggested family communication interventions to improve unhealthy eating patterns in children, using therapies common in family treatment of addiction (e.g., motivational interviewing and cognitive behavioral therapy). No studies presented concrete suggestions to aid family communication around issues of food and weight management. Potential contributions of addiction therapies are discussed. Though the addictive properties of food have not been fully delineated and obesity is not classified as a disease of addiction, the field of addiction offers many approaches that may prove useful in the treatment of obesity.

Geographic distribution of childhood diabetes and obesity relative to the supply of pediatric endocrinologists in the United States.

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Lee, Joyce M; Davis, Matthew M; Menon, Ram K; Freed, Gary L

2008-03-01

To determine the geographic distribution of childhood diabetes and obesity relative to the supply of US pediatric endocrinologists. Estimation of observed and "index" ratios of children with diabetes (by region and division) and obesity (body mass index >/=95th % for age and sex) (by region and state) to board-certified pediatric endocrinologists. At the national level, the ratio of children with diabetes to pediatric endocrinologists is 290:1, and the ratio of obese children to pediatric endocrinologists is 17,741:1. Ratios of children with diabetes to pediatric endocrinologists in the Midwest (370:1), South (335:1), and West (367:1) are twice as high as in the Northeast (144:1). Across states, there is up to a 19-fold difference in the observed ratios of obese children to pediatric endocrinologists. Under conditions of equitably distributed endocrinologist supply, variation across states would be mitigated considerably. The distribution of children with diabetes and obesity does not parallel the distribution of pediatric endocrinologists in the United States, due largely to geographic disparities in endocrinologist supply. Given the large burden of obese children to endocrinologists, multidisciplinary models of care delivery are essential for the US health care system to address the needs of children with diabetes and obesity.

A systematic review of satisfaction and pediatric obesity treatment: new avenues for addressing attrition.

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Skelton, Joseph A; Irby, Megan Bennett; Geiger, Ann M

2014-01-01

Pediatric obesity treatment programs report high attrition rates, but it is unknown if family experience and satisfaction contributes. This review surveys the literature regarding satisfaction in pediatric obesity and questions used in measurement. A systematic review of the literature was conducted using Medline, PsychINFO, and CINAHL. Studies of satisfaction in pediatric weight management were reviewed, and related studies of obesity were included. Satisfaction survey questions were obtained from the articles or from the authors. Eighteen studies were included; 14 quantitative and 4 qualitative. Only one study linked satisfaction to attrition, and none investigated the association of satisfaction and weight outcomes. Most investigations included satisfaction as a secondary aim or used single-item questions of overall satisfaction; only one assessed satisfaction in noncompleters. Overall, participants expressed high levels of satisfaction with obesity treatment or prevention programs. Surveys focused predominantly on overall satisfaction or specific components of the program. Few in-depth studies of satisfaction with pediatric obesity treatment have been conducted. Increased focus on family satisfaction with obesity treatment may provide an avenue to lower attrition rates and improve outcomes. Enhancing measurement of satisfaction to yield actionable responses could positively influence outcomes, and a framework, via patient-centered care principles, is provided. © 2013 National Association for Healthcare Quality.

Obesity: from the agricultural revolution to the contemporary pediatric epidemic.

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Lopez, Keila N; Knudson, Jarrod D

2012-01-01

Obesity is pandemic in Western society. Currently, approximately 100 million Americans are overweight (body mass index > 25 kg/m2) or obese (body mass index > 30 kg/m2). The pandemic is largely attributable to the relatively recent (from an evolutionary perspective) adoption of a sedentary lifestyle, coupled with the high availability of foods with high caloric content in Western cultures. These factors superimposed on dated genotypes have given rise to the global obesity epidemic. Over the past two decades, the discovery of leptin and other new molecules (e.g., adiponectin, resistin, ghrelin) has shed significant light on the pathophysiologic mechanisms of obesity-related morbidities, many of which became apparent through human epidemiologic studies during the last half of the 20th century. Of high concern for modern Western societies is the pediatric obesity epidemic, which stands to cripple Western cultures, both literally and financially in terms of health care costs and exhaustion of finite medical resources. The prevalence of childhood obesity has more than tripled since the 1960s, and 12.5 million (~17%) of children and teenagers are obese in the United States today. The rate of increasing prevalence of childhood obesity is staggering, and the collective efforts of the pediatric medical community and scientists are essential for battling the epidemic. © 2012 Wiley Periodicals, Inc.

Small steps to health: building sustainable partnerships in pediatric obesity care.

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Pomietto, Mo; Docter, Alicia Dixon; Van Borkulo, Nicole; Alfonsi, Lorrie; Krieger, James; Liu, Lenna L

2009-06-01

Given the prevalence of childhood obesity and the limited support for preventing and managing obesity in primary care settings, the Seattle Children's Hospital's Children's Obesity Action Team has partnered with Steps to Health King County to develop a pediatric obesity quality-improvement project. Primary care clinics joined year-long quality-improvement collaboratives to integrate obesity prevention and management into the clinic setting by using the chronic-disease model. Sustainability was enhanced through integration at multiple levels by emphasizing small, consistent behavior changes and self-regulation of eating/feeding practices with children, teenagers, and families; building local community partnerships; and encouraging broader advocacy and policy change. Cultural competency and attention to disparities were integrated into quality-improvement efforts. . Participating clinics were able to increase BMI measurement and weight classification; integrate management of overweight/obese children and family and self-management support; and grow community collaborations. Over the course of 4 years, this project grew from a local effort involving 3 clinics to a statewide program recently adopted by the Washington State Department of Health. This model can be used by other states/regions to develop pediatric obesity quality-improvement programs to support the assessment, prevention, and management of childhood obesity. Furthermore, these health care efforts can be integrated into broader community-wide childhood-obesity action plans.

Obesity prevention in English primary schools: headteacher perspectives.

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Clarke, J L; Pallan, M J; Lancashire, E R; Adab, P

2017-06-01

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: journals.permissions@oup.com.

An Evaluation of the Identification and Management of Overweight and Obesity in a Pediatric Clinic.

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Reyes, Imelda

2015-01-01

With the rise in overweight and obesity in children, it is imperative for health care providers to routinely address appropriate body mass index for children during primary care visits. The purposes of this project were to determine if overweight and obese children are accurately being identified and to evaluate provider adherence to American Academy of Pediatrics guidelines for the management of obesity. A retrospective chart review was completed for all children ages 2, 6, and 10 years who presented for a well-child visit from January 1, 2011, through June 30, 2011. Based on a review of 255 charts, 21.6% of patients were overweight and 18.4% were obese according to standards of the Centers for Disease Control and Prevention. Of these children, 34% were properly documented as being either overweight or obese, and documentation was lacking for the remaining 66%. Of the children correctly identified as being overweight or obese, only 11% and 26%, respectively, were counseled on therapeutic lifestyle changes, including diet and exercise. This review provides evidence that providers have opportunities to intervene early with well-child examinations and that providers have great room for improvement on counseling overweight and obese children. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

[Diagnosis of insulin resistance by indirect methods in obese school children].

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Angulo, Nerkis; de Szarvas, Sobeida Barbella; Mathison, Yaira; Hadad, Erika; González, Dora; Hernández, Ana; Guevara, Harold

2013-06-01

Obesity leads to a deterioration of glucose tolerance and the action of insulin. The purpose of this study was to determine insulin resistance (IR) by indirect methods, and its correlation with clinical, anthropometric and biochemical variables in obese normoglycemic school children. This was a descriptive-correlational study of 72 school prepubescent children, who attended the ambulatory "El Concejo" of the University of Carabobo (UC) and at the Gastroenterology and Pediatric Nutrition service of the city hospital "Enrique Tejera" (CHET), in Valencia, Venezuela, between January-April 2011. exogenous obesity. We assessed personal and family history, presence of Acanthosis Nigricans and nutritional and biochemical status. We found a higher percentage of IR, through the use of the QUICKI method (66.7%), followed by the HOMA (55.6%) and basal insulin (45.9%). The mean (chi) indexes of body mass and waist circumference were significantly greater (p method detected significant differences (p methods. In conclusion, the evaluated techniques, QUICKI, HOMA and basal insulin indexes, were most effective for detecting the IR.

One-Year Efficacy Testing of Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial

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Knowlden, Adam; Sharma, Manoj

2016-01-01

Background: The purpose of this study was to evaluate the efficacy of the Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) intervention at 1-year, postintervention follow-up. Method: A mixed between-within subjects design was used to evaluate the trial. Independent variables included a…

Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors.

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Wolff, Margaret S; Rhodes, Erinn T; Ludwig, David S

2010-02-17

Information about the availability and effectiveness of childhood obesity training during residency is limited. We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds), and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs. The response rate was 42.2% (299/709) and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%), diagnosis (N = 282, 94.3%), diagnosis of complications (N = 249, 83.3%), and treatment (N = 242, 80.9%). However, only 18.1% (N = 54) of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p obesity training was competing curricular demands (58.5%). While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children.

The Effectiveness of School-Based Nutritional Education Program among Obese Adolescents: A Randomized Controlled Study

OpenAIRE

In-Iw, Supinya; Saetae, Tridsanun; Manaboriboon, Boonying

2012-01-01

The purpose of the study was to determine the change in body weight and body mass index (BMI), as well as diet behaviors at 4 months after intervention between obese adolescent girls who participated in the school-based nutritional education program, addressed by pediatrician, compared to those who attended regular nutritional class. Methods. 49 obese girls were recruited from a secondary school. Those, were randomized into 2 groups of intervention and control. The intensive interactive nutri...

Prevalence of Overweight and Obesity in 4 Schools of South Mumbai.

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Pawar, Sunil V; Choksey, Ajay S; Jain, Samit S; Surude, Ravindra G; Rathi, Pravin M

2016-03-01

The paediatric obesity is on the rise so as the complications of obesity like cardiovascular diseases, liver diseases, dyslipidaemia are increasing. The changing dietary habits and less of outdoor activities are risk factors for obesity. The study was conducted to find out prevalence of overweight and obesity among students in four schools of the Mumbai and compare with studies from rest of the country. It is school based, cross-sectional study conducted in four Schools from class of 5(th) to 10(th). The anthropometric measurements of height, weight were taken of each student. The body mass index was calculated based on the age based Cole et al., criteria (International) as well as Khadilkar et al., criteria which are specially develop for Indian children. The data was analysed with chi-square test. Total 1828 students were screened from 4 schools. Out of which 590 were girls and 1238 were boys. The prevalence of overweight and obesity by Cole et al., criteria were 11.3% and 3.3% and by Khadilkar et al., criteria were 17.5% and 7.8 % respectively. It shows significant difference in obesity between boys and girls and also between government and private schools. There is overall decrease in prevalence of overweight and obesity as age increases. The overweight and obesity among these schools in Mumbai is comparable with the rest of the studies from India.

Position of the Academy of Nutrition and Dietetics: interventions for the prevention and treatment of pediatric overweight and obesity.

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Hoelscher, Deanna M; Kirk, Shelley; Ritchie, Lorrene; Cunningham-Sabo, Leslie

2013-10-01

It is the position of the Academy of Nutrition and Dietetics that prevention and treatment of pediatric overweight and obesity require systems-level approaches that include the skills of registered dietitians, as well as consistent and integrated messages and environmental support across all sectors of society to achieve sustained dietary and physical-activity behavior change. This position paper provides guidance and recommendations for levels of intervention targeting overweight and obesity prevention and treatment from preschool age through adolescence. Methods included a review of the literature from 2009 to April 2012, including the Academy's 2009 evidence analysis school-based reviews. Multicomponent interventions show the greatest impact for primary prevention; thus, early childhood and school-based interventions should integrate behavioral and environmental approaches that focus on dietary intake and physical activity using a systems-level approach targeting the multilevel structure of the socioecological model as well as interactions and relationships between levels. Secondary prevention and tertiary prevention/treatment should emphasize sustained family-based, developmentally appropriate approaches that include nutrition education, dietary counseling, parenting skills, behavioral strategies, and physical-activity promotion. For obese youth with concomitant serious comorbidities, structured dietary approaches and pharmacologic agents should be considered, and weight-loss surgery can be considered for severely obese adolescents. Policy and environmental interventions are recommended as feasible and sustainable ways to support healthful lifestyles for children and families. The Academy supports commitment of resources for interventions, policies, and research that promote healthful eating and physical-activity behaviors to ensure that all youth have the opportunity to achieve and maintain a weight that is optimal for health. Copyright © 2013 Academy of

Pediatric obesity pharmacotherapy: current state of the field, review of the literature and clinical trial considerations.

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Kelly, A S; Fox, C K; Rudser, K D; Gross, A C; Ryder, J R

2016-07-01

Despite the increasing number of medications recently approved to treat obesity among adults, few agents have been formally evaluated in children or adolescents for this indication. Moreover, there is a paucity of guidance in the literature addressing best practices with regard to pediatric obesity pharmacotherapy clinical trial design, and only general recommendations have been offered by regulatory agencies on this topic. The purposes of this article are to (1) offer a background of the current state of the field of pediatric obesity medicine, (2) provide a brief review of the literature summarizing pediatric obesity pharmacotherapy clinical trials, and (3) highlight and discuss some of the unique aspects that should be considered when designing and conducting high-quality clinical trials evaluating the safety and efficacy of obesity medications in children and adolescents. Suggestions are offered in the areas of target population and eligibility criteria, clinical trial end-point selection, trial duration, implementation of lifestyle modification therapy and recruitment and retention of participants. Efforts should be made to design and conduct trials appropriately to ensure that high-quality evidence is generated on the safety and efficacy of various medications used to treat pediatric obesity.

Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors

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Rhodes Erinn T

2010-02-01

Full Text Available Abstract Background Information about the availability and effectiveness of childhood obesity training during residency is limited. Methods We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds, and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs. Results The response rate was 42.2% (299/709 and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%, diagnosis (N = 282, 94.3%, diagnosis of complications (N = 249, 83.3%, and treatment (N = 242, 80.9%. However, only 18.1% (N = 54 of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p Conclusions While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children.

The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States.

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Okubo, Yusuke; Nochioka, Kotaro; Testa, Marcia A

2018-04-01

Obesity is the most common public health problem and is a clinically complicating risk factor among hospitalized children. The impact of pediatric obesity on the severity and morbidity of lower respiratory tract infections remains unclear. We conducted a retrospective cohort study of bronchitis and pneumonia among children aged 2-20 years using hospital discharge records. The data were obtained from the Kid's Inpatient Database in 2003, 2006, 2009, and 2012, and were weighted to estimate the number of hospitalizations in the United States. We used the International Classification of Diseases, Ninth Revision, Clinical Modification code (278.0×) to classify whether the patient was obese or not. We investigated the associations between pediatric obesity and use of mechanical ventilation using multivariable logistic regression model. In addition, we ascertained the relationships between pediatric obesity, comorbid blood stream infections, mean healthcare cost, and length of hospital stay. We estimated a total of 133 602 hospitalizations with pneumonia and bronchitis among children aged between 2 and 20 years. Obesity was significantly associated with use of mechanical ventilation (adjusted OR 2.90, 95% CI 2.15-3.90), comorbid bacteremia or septicemia (adjusted OR 1.58, 95% CI 1.03-2.44), elevated healthcare costs (adjusted difference $383, 95%CI $276-$476), and prolonged length of hospital stay (difference 0.32 days, 95%CI 0.23-0.40 days), after adjusting for patient and hospital characteristics using multivariable logistic regression models. Pediatric obesity is an independent risk factor for severity and morbidity among pediatric patients with lower respiratory tract infections. These findings suggest the importance of obesity prevention for pediatric populations. © 2017 John Wiley & Sons Ltd.

An ecological and theoretical deconstruction of a school-based obesity prevention program in Mexico.

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Safdie, Margarita; Cargo, Margaret; Richard, Lucie; Lévesque, Lucie

2014-08-10

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.

Prevalence of obesity among Arab school children in Nazareth, Israel: comparison with national (Jewish) and international data.

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Ram, E; Marcus, O; Joubran, S; Abdo, B; Asal, N R

2013-12-01

Lack of published data. Absence of Ethnic specific data. Lack of focus on obesity prevention in Arab schools. First set of data on obesity for Arab children. Data will be used as reference data. Alert health/school official for intervention. Objective The objective is to produce the first set of obesity prevalence data and use the data as reference values of body mass index (BMI) trends for Arab children in Israel and compare with Jewish and international data. Methods A prevalence study was carried out in 2009 in which 4130 children aged 6-12, were selected from eight Arab sector schools representing the Nazareth Municipality. Height, weight and BMI measurements were obtained and presented by age, mean age, size, weight, gender and percentile. Appropriate epidemiological and statistical methods used for comparison. Results The obesity and overweight prevalence rates in Arab children by age ranges from 0% to 2.6% and 0% to 11.2%, respectively. Comparison with international and Jewish data revealed differences in almost all age groups but higher rates in Arabs, especially boys. Discussion The higher rates/trends in Arab children may be explained by more Arab women entering the workforce, increase in single-parent families and changes in food and physical activity environments. Conclusion Based on our data, we recommend either an ethnic-specific BMI reference curves and/or inclusion of Arab data in the Israeli data system. Research need to focus on reasons for the increase and interventions to reverse/slow the trend. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Is obesity associated with school dropout? Key developmental and ethnic differences

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Lanza, H. Isabella; Huang, David Y.C.

2015-01-01

Background We aimed to expand the literature on child obesity and school outcomes by examining associations between obesity and high school dropout, including the role of obesity onset and duration as well as ethnicity. Methods Data on 5066 children obtained between 1986 and 2010 from the child cohort of the 1979 National Longitudinal Study of Youth (NLSY79) were analyzed. Group-based trajectory analysis identified obesity trajectories from 6-18 years. School completion information from age 14 into young adulthood was used to calculate school dropout. Chi-square and pairwise comparison tests were used to identify significant associations between obesity trajectories and school dropout. Results Adolescents belonging to an increasing trajectory (adolescent-onset obesity) had a higher likelihood of dropping out of high school compared to those belonging to chronic, decreasing (childhood-only obesity), and non-obese trajectories. This association was particularly salient among white adolescents. Conclusions Obesity onset during early adolescence increased risk of high school dropout. White adolescents were particularly vulnerable. Given that early adolescence is marked by significant biological and social changes, future research should seek to identify the underlying processes linking adolescent-obesity and school dropout to decrease school dropout risk among this vulnerable population. PMID:26331748

Obesity research based on the Copenhagen School Health Records Register

DEFF Research Database (Denmark)

Baker, Jennifer L; Sørensen, Thorkild I A

2011-01-01

INTRODUCTION: To summarise key findings from research performed using data from the Copenhagen School Health Records Register over the last 30 years with a main focus on obesity-related research. The register contains computerised anthropometric information on 372,636 schoolchildren from the capi......INTRODUCTION: To summarise key findings from research performed using data from the Copenhagen School Health Records Register over the last 30 years with a main focus on obesity-related research. The register contains computerised anthropometric information on 372,636 schoolchildren from...... the capital city of Denmark. Additional information on the cohort members has been obtained via linkages with population studies and national registers. RESEARCH TOPICS: Studies using data from the register have made important contributions in the areas of the aetiology of obesity, the development...... of the obesity epidemic, and the long-term health consequences of birth weight as well as body size and growth in childhood. CONCLUSION: Research using this unique register is ongoing, and its contributions to the study of obesity as well as other topics will continue for years to come....

The impact of obesity on pediatric procedural sedation-related outcomes: results from the Pediatric Sedation Research Consortium.

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Scherrer, Patricia D; Mallory, Michael D; Cravero, Joseph P; Lowrie, Lia; Hertzog, James H; Berkenbosch, John W

2015-07-01

To evaluate the impact of obesity on adverse events and required interventions during pediatric procedural sedation. The Pediatric Sedation Research Consortium database of prospectively collected procedural sedation encounters was queried to identify patients for whom body mass index (BMI) could be calculated. Obesity was defined as BMI ≥95th percentile for age and gender. Sedation-related outcomes, adverse events, and therapeutic interventions were compared between obese and nonobese patients. For analysis, 28,792 records were eligible. A total of 5,153 patients (17.9%) were obese; they were predominantly male and older and had a higher median American Society of Anesthesiologists Physical Status classification (P obese patients (odds ratio [OR] 1.49, 95% confidence interval [1.31, 1.70]). Respiratory events (airway obstruction OR 1.94 [1.54, 2.44], oxygen desaturation OR 1.99 [1.50, 2.63], secretions OR 1.48 [1.01, 2.15], laryngospasm OR 2.30 [1.30, 4.05]), inability to complete the associated procedure (OR 1.96 [1.16, 3.30]), and prolonged recovery (OR 2.66 [1.26, 5.59]) were increased in obese patients. Obese patients more frequently required airway intervention including repositioning, suctioning, jaw thrust, airway adjuncts, and bag-valve-mask ventilation. Multivariate regression analysis demonstrated obesity to be independently associated with minor and moderate but not major adverse events. Obesity is an independent risk factor for adverse respiratory events during procedural sedation and is associated with an increased frequency of airway interventions, suggesting that additional vigilance and expertise are required when sedating these patients. © 2015 John Wiley & Sons Ltd.

Relation of diet and physical activity to obesity in children in elementary schools

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Senka Dinarević

2011-04-01

Full Text Available Introduction: The prevalence of pediatric obesity is increasing. Finding the most effective preventive measures for the development of obesity in each country requires accurate epidemiological data on the number of obese children and adolescents, and their habits regarding nutrition and activity. The objective of this study was evaluate diet and physical activity in primary school students in relation to the occurrence of obesity, to determine the prevalence of overweight, mark the basic causes of this phenomenon and to establish measures for treatment and prevention.Methods: pupils 1-8. grades of primary schools were surveyed in written forms in terms of nutrition and physical activity, and measured height and weight, body mass index (BMI-body mass index was calculated by whichwas estimated the level of nourishment: BMI> p (percentile 5-malnutrition, p 5-85 proper body weight, p 85-95 over-nutrition, p> 95 obesity.Results: The study comprised 2329 pupils from 10 primary schools in the Canton of Sarajevo. Number of respondents by age and gender was balanced: I-IV 1077, V-VIII 1252; M-1226 and -1103 W. Obese and overweight was 22.46%, 62.53% of normal weight and 15 underweight, 01%. Most children eat a sandwich from school 34.63%, and food from the bakery 23.36% and 23.64% a sandwich from home. Still-dense juices are mostly drunk, even 22.34% of the students, a maximum of 52.8% water. Daily candy had taken 53.21% of all primary school students. 33.80% of the students were active on physical activity lessons and daily only 28.27%.Conclusions: The overweight problem in relation to the way of nutrition and physical activity is evident. The most important factors in] uencing the development of obesity undernutrition of children in school, the high frequency of intake of sweets and thick juice, an inadequate level ofphysical activity and sedanteran way of life.

Comparing Active Pediatric Obesity Treatments Using Meta-Analysis

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Gilles, Allyson; Cassano, Michael; Shepherd, Elizabeth J.; Higgins, Diana; Hecker, Jeffrey E.; Nangle, Douglas W.

2008-01-01

The current meta-analysis reviews research on the treatment of pediatric obesity focusing on studies that have been published since 1994. Eleven studies (22 comparisons, 115 effect sizes, N = 447) were included in the present meta-analysis. Results indicated that comprehensive behavioral interventions may be improved in at least two ways:…

Sensitivity and specificity of obesity diagnosis in pediatric ambulatory care in the United States.

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Walsh, Carolyn O; Milliren, Carly E; Feldman, Henry A; Taveras, Elsie M

2013-09-01

We examined the sensitivity and specificity of an obesity diagnosis in a nationally representative sample of pediatric outpatient visits. We used the 2005 to 2009 National Ambulatory Medical Care and National Hospital Ambulatory Medical Care surveys. We included visits with children 2 to 18 years, yielding a sample of 48 145 database visits. We determined 3 methods of identifying obesity: documented body mass index (BMI) ≥95th percentile; International Classification of Diseases, Ninth Revision (ICD-9) code; and positive answer to the question, "Does the patient now have obesity?" Using BMI as the gold standard, we calculated the sensitivity and specificity of a clinical obesity diagnosis. Among the 19.5% of children who were obese by BMI, 7.0% had an ICD-9 code and 15.2% had a positive response to questioning. The sensitivity of an obesity diagnosis was 15.4%, and the specificity was 99.2%. The sensitivity of the obesity diagnosis in pediatric ambulatory visits is low. Efforts are needed to increase identification of obese children.

School-Based Interventions to Reduce Obesity Risk in Children in High- and Middle-Income Countries.

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Evans, Charlotte E L; Albar, Salwa Ali; Vargas-Garcia, Elisa J; Xu, Fei

2015-01-01

School-based interventions are relatively new and were first introduced in the United States in the 1990s. Early programs were mainly education based with many of the findings now embedded in school policy in the form of a healthy eating curriculum. More recent school programs have taken education outside the classroom and attempted to engage parents as well as teachers. Environmental changes such as improving the quality of foods available at lunchtime and at other times during the school day are now common. Reviews of evaluations of school-based programs have demonstrated that they are effective and successfully improve dietary quality such as increasing fruit and vegetable intake and decreasing sweet and savory snacks and sweetened drinks; not just in school but over the whole day and particularly in younger school children. School-based interventions are also effective at reducing obesity if components to increase physical activity and reduce sedentary behaviors are also targeted but not if only dietary behaviors are tackled. Most of the high-quality evaluation studies using randomized controlled trials have been carried out in high-income countries as they are costly to run. However, middle-income countries have benefitted from the information available from these evaluation studies and many are now starting to fund and evaluate school-based programs themselves, resulting in unique problems such as concomitant under- and overnutrition being addressed. Action for the future demands more focus on populations most at risk of poor dietary quality and obesity in order to reduce inequalities in health and on adolescents who have not benefited as much as younger children from school-based interventions. This will involve innovative solutions within schools as well as targeting the food environment outside schools such as reducing the density of fast-food outlets and marketing of sweet and savory snacks and drinks. © 2015 Elsevier Inc. All rights reserved.

Pediatric cognitive rehabilitation: effective treatments in a school-based environment.

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Shaw, Dorothy R

2014-01-01

Many studies have investigated the impact of pediatric Cognitive Rehabilitation Therapy (CRT) upon intellectual functioning after traumatic brain injury; however, relatively few have identified efficacious treatment in a school setting. The purpose is to present a variety of CRT strategies that would be useful to a teacher or therapist working with students who are learning disabled or who have who have had a traumatic brain injury (TBI). This article investigates the particular challenges in learning which result from impaired cognition, and suggests techniques for improving memory and executive functioning. Students who are learning disabled or who have TBI face social and emotional issues that impact their learning. Special therapeutic interventions are necessary to assist with orienting to their setting, integrating with peers, and coping with distressing emotions. Students with TBI can adapt and flourish in a school based setting provided that therapies and learned strategies are targeted to their specific needs.

Childhood obesity in secondary care: national prospective audit of Australian pediatric practice.

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Campbell, Michele; Bryson, Hannah E; Price, Anna M H; Wake, Melissa

2013-01-01

In many countries, pediatricians offer skilled secondary care for children with conditions more challenging than can readily be managed in the primary care sector, but the extent to which this sector engages with the detection and management of obesity remains largely unexplored. This study aimed to audit the prevalence, diagnosis, patient, and consultation characteristics of obesity in Australian pediatric practices. This was a national prospective patient audit in Australia. During the course of 2 weeks, members of the Australian Paediatric Research Network prospectively recorded consecutive outpatient consultations by using a brief standardized data collection form. Measures included height, weight, demographics, child and parent health ratings, diagnoses, referrals, investigations, and consultation characteristics. We compared the prevalence of pediatrician-diagnosed and measured obesity (body mass index ≥95th percentile) and top-ranked diagnoses, patient, and consultation characteristics in (a) obese and nonobese children, and (b) obese children with and without a diagnosis. A total of 198 pediatricians recorded 5466 consultations with 2-17 year olds, with body mass index z-scores calculated for 3436 (62.9%). Of the 12.6% obese children, only one-third received an "overweight/obese" diagnosis. Obese children diagnosed as overweight/obese were heavier, older, and in poorer health than those not diagnosed and incurred more Medicare (government-funded health system) cost and referrals. Obesity is infrequently clinically diagnosed by Australian pediatricians and measurement practices vary widely. Further research could focus on supporting and normalizing clinical obesity activities from which pediatricians and parents could see clear benefits. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The Effectiveness of School-Based Nutritional Education Program among Obese Adolescents: A Randomized Controlled Study

Directory of Open Access Journals (Sweden)

Supinya In-Iw

2012-01-01

Full Text Available The purpose of the study was to determine the change in body weight and body mass index (BMI, as well as diet behaviors at 4 months after intervention between obese adolescent girls who participated in the school-based nutritional education program, addressed by pediatrician, compared to those who attended regular nutritional class. Methods. 49 obese girls were recruited from a secondary school. Those, were randomized into 2 groups of intervention and control. The intensive interactive nutritional program was provided to the intervention group. Weight and height, dietary record and % fat consumption, as well as self-administered questionnaires on healthy diet attitudes were collected at baseline and 4-month follow-up, and then compared between two groups. Results. There was a statistically significant change of BMI in the intervention group by  kg/m2 ( compared to the control group ( kg/m2, but no significant change in calorie and % fat consumption between groups. The attitudes on healthy eating behaviors in the intervention group were shown improving significantly (. Conclusions. Interactive and intensive nutritional education program as shown in the study was one of the most successful school-based interventions for obese adolescents.

Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities.

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Ryder, Justin R; Fox, Claudia K; Kelly, Aaron S

2018-06-01

Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies. At present, there are three treatment options for youth with severe obesity: lifestyle modification therapy, pharmacotherapy, and bariatric surgery. Lifestyle modification therapy can be useful for improving many chronic disease risk factors and comorbid conditions but often fails to achieve clinically meaningful and sustainable weight loss. Pharmacotherapy holds promise as an effective adjunctive treatment but remains in the primordial stages of development in the pediatric population. Bariatric surgery provides robust weight loss and risk factor/comorbidity improvements but is accompanied by higher risks and lower uptake compared to lifestyle modification therapy and pharmacotherapy. New areas worth pursuing include combination pharmacotherapy, device therapy, identification of predictors of response aimed at precision treatment, and interventions in the postbariatric surgical setting to improve long-term outcomes. Treating pediatric severe obesity effectively and safely is extremely challenging. Some progress has been made, but substantially more effort and innovation are needed in the future to combat this serious and ongoing medical and public health issue. © 2018 The Obesity Society.

Childhood obesity management shifting from health care system to school system: intervention study of school-based weight management programme.

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Lee, Albert; Ho, Mandy; Keung, Vera M W; Kwong, Amy C M

2014-11-03

Home and school environments conducive for unhealthy eating and physical inactivity are precursors of obesity. The aim of this study is evaluation of the effectiveness of a multi-component school-based weight management programme for overweight and obese primary school children via a home-school joint venture. This study made use of variety of behavioural modification strategies integrating into the Health Promoting School approach to promote healthy lifestyles. The participants were overweight and obese students aged between 8 and 12 from six participating schools. The interventions involved students attending ten 75 minutes after-school sessions and one 3-hour week-end session of practical interactive and fun activities on healthy eating and exercise, and meal plan together with parents and printed tailor-made management advices. Parents received an introductory seminar with 2 sets of specially designed exercise for their overweight children. The tools to measure bodyweight and fat percentage and standing height were bio-impedance body fat scale and a portable stadiometer. Self-administered questionnaire was used to measure knowledge, attitudes and behaviours. McNemar test was utilized to compare the proportions of behaviour changes within the same group to assess for the trends of changes. BMI z-score and body fat percentage of intervention participants at baseline, 4 month and 8 month were compared pair-wisely using tests of within subject contrasts in repeated measures ANOVA to assess for programme sustainability. Those students in the intervention group reduced their BMI z-score (-0.21, 95% CI -0.34 to -0.07, P = 0.003) and body fat (-2.67%, 95% CI -5.12 to -0.22, P = 0.033) compared to wait list control group with statistical significant, and the intervention group also had a significant reduction in BMI z-score (-0.06, 95% CI -0.11, -0.007, P = 0.028) and body fat (-1.71%, 95% CI, -3.44 to 0.02, P = 0.052) after a 4 month maintenance period. Improvement of

The impact of morbid obesity on solid organ injury in children using the ATOMAC protocol at a pediatric level I trauma center.

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Vaughan, Nathan; Tweed, Jeff; Greenwell, Cynthia; Notrica, David M; Langlais, Crystal S; Peter, Shawn D St; Leys, Charles M; Ostlie, Daniel J; Maxson, R Todd; Ponsky, Todd; Tuggle, David W; Eubanks, James W; Bhatia, Amina; Greenwell, Cynthia; Garcia, Nilda M; Lawson, Karla A; Motghare, Prasenjeet; Letton, Robert W; Alder, Adam C

2017-02-01

Obesity is an epidemic in the pediatric population. Childhood obesity in trauma has been associated with increased incidence of long-bone fractures, longer ICU stays, and decreased closed head injuries. We investigated for differences in the likelihood of failure of non-operative management (NOM), and injury grade using a subset of a multi-institutional, prospective database of pediatric patients with solid organ injury (SOI). We prospectively collected data on all pediatric patients (hepatic injury (36.8% versus 15.3%, P=0.048) but not a significant difference in likelihood of severe (grade 4 or 5) splenic injury (15.3% versus 10.5%, P=0.736). Obese patients had a higher mean ISS (22.5 versus 16.1, P=0.021) and mean abdominal AIS (3.5 versus 2.9, P=0.024). Obesity is a risk factor for more severe abdominal injury, specifically liver injury, but without an associated increase in failure of NOM. This may be explained by the presence of hepatic steatosis making the liver more vulnerable to injury. A protocol based upon physiologic parameters was associated with a low rate of failure regardless of the pediatric obesity status. Level II prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of the Healthy Schools Program on prevalence of overweight and obesity in California schools, 2006-2012.

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Madsen, Kristine A; Cotterman, Carolyn; Crawford, Pat; Stevelos, JoAnn; Archibald, Abbie

2015-05-21

The Alliance for a Healthier Generation's Healthy Schools Program (HSP) is a national evidence-based obesity-prevention initiative aimed at providing the schools in greatest need with onsite training and technical assistance (TTA) and consultation with national experts (HSP national advisors) to create sustainable healthy change in schools' nutrition and physical activity environments. The objective of this study was to evaluate the impact of HSP on the prevalence of overweight and obesity in California schools, from HSP's inception in 2006 through 2012. We used statewide body mass index (BMI) data collected annually from 5th-, 7th-, and 9th-grade students to determine whether enrolling in the HSP's onsite intervention reduced the prevalence of overweight and obesity in intervention schools (n = 281) versus propensity-score matched control schools (n = 709) and whether increasing exposure to the program (TTA and contact with HSP national advisors) was associated with reductions in the prevalence of overweight and obesity. Analyses showed no difference between HSP schools and control schools in overweight or obesity prevalence. However, program exposure varied widely among participating schools, and each additional contact with TTA or HSP national advisors was associated with a 0.3% decline in overweight and obesity prevalence (P schools in reducing obesity. Although participation in HSP alone was not sufficient to improve weight status in California schools, there was a clear dose-response relationship to the program. HSP serves as an effective model for addressing childhood obesity among engaged schools.

Obesity and Hypertension among School-going Adolescents in Peru.

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Nam, Eun Woo; Sharma, Bimala; Kim, Ha Yun; Paja, Doris Jackeline Vasquez; Yoon, Young Min; Lee, Sun Ha; Kim, Eun Hwan; Oh, Chung Hyeon; Kim, Yun Seop; Song, Chang Hoon; Kim, Jong Koo

2015-09-01

Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.

Psychometric characteristics of process evaluation measures for a school-based childhood obesity prevention study: Louisiana Health

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Process evaluations of large-scale school based programs are necessary to aid in the interpretation of the outcome data. The Louisiana Health (LA Health) study is a multi-component childhood obesity prevention study for middle school children. The Physical Education (PEQ), Intervention (IQ), and F...

Organization of school health education in obesity in children

Directory of Open Access Journals (Sweden)

Joanna Woźniak-Holecka

2013-12-01

Full Text Available Abnormal body weight poses a risk of the development of various health disorders, having a negative impact on the quality and length of life. The prevalence of overweight and obesity among European children is estimated to be 10–20%. In Poland this figure reaches 18%. A war on the epidemic obesity waged from the youngest age of the child is a strategy that brings long-term health benefits for the entire population. Apart from the family, the school is the second important educational environment responsible for conducting health education activities among children and teenagers. School health education programs should be implementing by teachers in collaboration with other school staff, parents and the broadly understood local community. Comprehensive health education aiming at combating obesity should cover the entire population of school children and teenagers, with special attention given to high risk groups. The school, undertaking health education activities aimed at preventing abnormal body weight, should implement nationwide programs for the prevention of obesity, and should also pursue its own health education program based on its curriculum. In most cases, development of obesity at children results from improper eating habits and insufficient physical activity, and therefore school health education programs aimed at the prevention of overweight and obesity should focus on these two most important modifiable risk factors of abnormal body weight.

Description of the Design and Implementation of a School-Based Obesity Prevention Program Addressing Needs of Middle School Students

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Ward-Begnoche, Wendy L.; Gance-Cleveland, Bonnie; Harris, Margaret M.; Dean, Janice

2008-01-01

This article describes the design and implementation of a school-based obesity prevention program, the successes associated with its implementation, and challenges with development and application of the program's curriculum base. The program is described, including purpose and goals, content and structure of the curriculum, type and training of…

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review.

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Armstrong, Sarah; Lazorick, Suzanne; Hampl, Sarah; Skelton, Joseph A; Wood, Charles; Collier, David; Perrin, Eliana M

2016-02-01

Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits. Copyright © 2016 by the American Academy of Pediatrics.

School-Based Health Centers and Childhood Obesity: "An Ideal Location to Address a Complex Issue"

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National Assembly on School-Based Health Care, 2010

2010-01-01

One of today's most pressing public health problems is the rise in childhood overweight and obesity. School-based health centers (SBHCs)--the convergence of public health, primary care, and mental health in schools--represent an important element in the public health toolbox for combating the challenging epidemic. When working side-by-side in a…

Prevalence of obesity in elementary school children and its association with dental caries

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Farsi, Deema J.; Elkhodary, Heba M.; Merdad, Leena A.; Farsi, Najat M.A.; Alaki, Sumer M.; Alamoudi, Najlaa M.; Bakhaidar, Haneen A.; Alolayyan, Mohammed A.

2016-01-01

Objectives To investigate the prevalence of obesity among elementary school children and to examine the association between obesity and caries activity in the mixed dentition stage. Methods This cross-sectional study was conducted in King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between September 2014 and June 2015 using a multi-stage stratified sample of 915 elementary school children (482 boys, 433 girls) in Jeddah, Saudi Arabia. Anthropometric measurements, consisting of height, weight, body mass index (BMI), and waist circumference (WC), were obtained. Children were classified as underweight/healthy, overweight, or obese and as non-obese or obese according to their BMI and WC, respectively. Each child’s caries experience was assessed using the decay score in the primary and permanent teeth. Results Based on BMI, 18% of children were obese, 18% were overweight, and 64% were underweight/normal. Based on WC, 16% of children were obese, and 84% were non-obese. Girls had a significantly higher prevalence of obesity based on WC measurements (p<0.001), but not BMI. Children enrolled in private schools had a significantly higher prevalence of obesity (p<0.05) than those in public schools. For primary and permanent teeth combined, children with higher BMI and WC had a lower prevalence of caries (p<0.05). Conclusion The prevalence of obesity was high among male and female elementary school children. Overall caries activity was inversely proportional to BMI and WC. PMID:27874156

Prevalence of obesity in elementary school children and its association with dental caries.

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Farsi, Deema J; Elkhodary, Heba M; Merdad, Leena A; Farsi, Najat M A; Alaki, Sumer M; Alamoudi, Najlaa M; Bakhaidar, Haneen A; Alolayyan, Mohammed A

2016-12-01

To investigate the prevalence of obesity among elementary school children and to examine the association between obesity and caries activity in the mixed dentition stage. Methods: This cross-sectional study was conducted in King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between September 2014 and June 2015 using a multi-stage stratified sample of 915 elementary school children (482 boys, 433 girls) in Jeddah, Saudi Arabia. Anthropometric measurements, consisting of height, weight, body mass index (BMI), and waist circumference (WC), were obtained. Children were classified as underweight/healthy, overweight, or obese and as non-obese or obese according to their BMI and WC, respectively. Each child's caries experience was assessed using the decay score in the primary and permanent teeth. Results: Based on BMI, 18% of children were obese, 18% were overweight, and 64% were underweight/normal. Based on WC, 16% of children were obese, and 84% were non-obese. Girls had a significantly higher prevalence of obesity based on WC measurements (p less than 0.001), but not BMI. Children enrolled in private schools had a significantly higher prevalence of obesity (p less than 0.05) than those in public schools. For primary and permanent teeth combined, children with higher BMI and WC had a lower prevalence of caries (p less than 0.05). Conclusion: The prevalence of obesity was high among male and female elementary school children. Overall caries activity was inversely proportional to BMI and WC.

Involvement of Fathers in Pediatric Obesity Treatment and Prevention Trials: A Systematic Review.

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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

2017-02-01

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.

The readiness and motivation interview for families (RMI-Family) managing pediatric obesity: study protocol.

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Ball, Geoff D C; Spence, Nicholas D; Browne, Nadia E; O'Connor, Kathleen; Srikameswaran, Suja; Zelichowska, Joanna; Ho, Josephine; Gokiert, Rebecca; Mâsse, Louise C; Carson, Valerie; Morrison, Katherine M; Kuk, Jennifer L; Holt, Nicholas L; Kebbe, Maryam; Gehring, Nicole D; Cesar, Melody; Virtanen, Heidi; Geller, Josie

2017-04-11

Experts recommend that clinicians assess motivational factors before initiating care for pediatric obesity. Currently, there are no well-established clinical tools available for assessing motivation in youth with obesity or their families. This represents an important gap in knowledge since motivation-related information may shed light on which patients might fail to complete treatment programs. Our study was designed to evaluate the measurement properties and utility of the Readiness and Motivational Interview for Families (RMI-Family), a structured interview that utilizes a motivational interviewing approach to (i) assess motivational factors in youth and their parents, and (ii) examine the degree to which motivation and motivation-related concordance between youth and parents are related to making changes to lifestyle habits for managing obesity in youth. From 2016 to 2020, this prospective study will include youth with obesity (body mass index [BMI] ≥97th percentile; 13-17 years old; n = 250) and their parents (n = 250). The study will be conducted at two primary-level, multidisciplinary obesity management clinics based at children's hospitals in Alberta, Canada. Participants will be recruited and enrolled after referral to these clinics, but prior to initiating clinical care. Each youth and their parent will complete the RMI-Family (~1.5 h) at baseline, and 6- and 12-months post-baseline. Individual (i.e., youth or parent) and family-level (i.e., across youth and parent) responses to interview questions will be scored, as will aspects of interview administration (e.g., fidelity to motivational interviewing tenets). The RMI-Family will also be examined for test-retest reliability. Youth data collected at each time point will include demography, anthropometry, lifestyle habits, psychosocial functioning, and health services utilization. Cross-sectional and longitudinal associations between individual and family-level interview scores on the RMI

Undergraduate Teaching in Geriatrics and Pediatrics in Portuguese Medical Schools: An Observational Study.

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Amaral, Mariana; Matias, Filipa; Massena, Lígia; Cardoso, Nuno

2016-12-30

Motivated by the contracting nature of the Portuguese age pyramid, and thereby the ever increasing geriatric population, the aim of this study was to compare the number of European Credit Transfer and Accumulation System Credits dedicated to Geriatrics with Pediatrics in Portuguese Medical Schools. An observational, descriptive and cross-sectional study was conducted and included six Portuguese Medical Schools that have six years of training and a total of 360 credits. The study plans were obtained from the medical schools' websites or requested. Schools were grouped in modular/classic teaching methodology and the courses were categorized in mandatory/optional and specific/related. The credits of Geriatrics and Pediatrics were compared. Four schools had classical methodology and two had a modular one. Overall, they had more credits dedicated to Pediatrics than Geriatrics. Three schools offered mandatory courses specifically oriented to Geriatrics (1.5 - 8 credits) compared to all schools mandatory courses courses on Pediatrics (5.7 - 26.5 credits). The ratio of averages of mandatory specific courses (Pediatrics/Geriatrics) was 12.4 in the classical and 1.5 in the modular group. Pediatrics teaching has revealed to be superior to Geriatrics in all categories. Based on our results, we consider the Portuguese Geriatrics' undergraduate teaching sub-optimal. Nowadays, geriatric population is quantitatively similar to pediatric population. Efforts should be made to adequate Geriatrics teaching to our reality in order to provide a more adequate health care to this age group.

Obesity Prevention Interventions in US Public Schools: Are Schools Using Programs That Promote Weight Stigma?

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Kenney, Erica L; Wintner, Suzanne; Lee, Rebekka M; Austin, S Bryn

2017-12-28

Despite substantial research on school-based obesity prevention programs, it is unclear how widely they are disseminated. It is also unknown whether schools use obesity programs that inadvertently promote weight stigma or disordered weight-control behaviors. In spring 2016, we distributed an online survey about school wellness programming to a simple random sample of US public school administrators (N = 247 respondents; 10.3% response rate). We analyzed survey responses and conducted immersion/crystallization analysis of written open-ended responses. Slightly less than half (n = 117, 47.4%) of schools offered any obesity prevention program. Only 17 (6.9%) reported using a predeveloped program, and 7 (2.8%) reported using a program with evidence for effectiveness. Thirty-seven schools (15.0%) reported developing intervention programs that focused primarily on individual students' or staff members' weight rather than nutrition or physical activity; 28 schools (11.3% of overall) used staff weight-loss competitions. School administrators who reported implementing a program were more likely to describe having a program champion and adequate buy-in from staff, families, and students. Lack of funding, training, and time were widely reported as barriers to implementation. Few administrators used educational (n = 12, 10.3%) or scientific (n = 6, 5.1%) literature for wellness program decision making. Evidence-based obesity prevention programs appear to be rarely implemented in US schools. Schools may be implementing programs lacking evidence and programs that may unintentionally exacerbate student weight stigma by focusing on student weight rather than healthy habits. Public health practitioners and researchers should focus on improving support for schools to implement evidence-based programs.

Challenges and successes of a multidisciplinary pediatric obesity treatment program.

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Walsh, Stephanie M; Palmer, Wendy; Welsh, Jean A; Vos, Miriam B

2014-12-01

Despite the well-documented need for multidisciplinary pediatric obesity treatment programs, few programs exist and best practices are not clearly defined. We describe the design and initial quality-related outcomes of the Strong4Life multidisciplinary pediatric obesity treatment program along with some challenges and solutions implemented over the first 2 years. The purpose of this report is to inform others interested in designing similar programs. The Strong4Life Clinic obesity program was designed to provide children with the medical care, as well as the behavior change guidance and support needed to reverse their obesity and/or minimize the related health risks. This low-intensity program is designed to provide approximately 6 hours of care over 12 months from a medical provider, psychologist, registered dietitian nutritionist, exercise physiologist, and nurse. Between August 2011 and February 2014, the Strong4Life clinic served 781 high-risk (mean sex- and age-adjusted body mass index [BMI] percentile 98.8) and racially/ethnically diverse (45% non-Hispanic black and 24% Hispanic) patients. Of the 781 patients seen, 66% returned for at least 1 visit. Nearly all returning Strong4Life patients stabilized or improved their BMI (90% of those who participated 6 months, but longer follow-up and assessment of comorbidities are needed. © 2014 American Society for Parenteral and Enteral Nutrition.

Assessing implementation of evidence-based childhood obesity prevention strategies in schools

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Christine M.W. Totura

2015-01-01

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.

SWITCH: rationale, design, and implementation of a community, school, and family-based intervention to modify behaviors related to childhood obesity

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Callahan Randi

2008-06-01

Full Text Available Abstract Background Although several previous projects have attempted to address the issue of child obesity through school-based interventions, the overall effectiveness of school-based programs on health-related outcomes in youth has been poor. Thus, it has been suggested that multi-level interventions that aim to influence healthy lifestyle behaviors at the community, school and family levels may prove more successful in the prevention of childhood obesity. Methods/Design This paper describes the rationale, design, and implementation of a community-, school-, and family-based intervention aimed at modifying key behaviors (physical activity, screen time (Internet, television, video games, and nutrition related to childhood obesity among third through fifth graders in two mid-western cities. The intervention involves a randomized study of 10 schools (5 intervention and 5 control schools. The intervention is being conducted during the duration of the academic year – approximately 9 months – and includes baseline and post-intervention measurements of physical activity, dietary intake, screen time and body composition. Discussion We hope this report will be useful to researchers, public health professionals, and school administrators and health professionals (nurses and physical/health educators seeking to develop similar prevention programs. It is obvious that more collaborative, inter-disciplinary, multi-level work is needed before a proven, effective intervention package to modify behaviors related to childhood obesity can be generally recommended. It is our hope that SWITCH is a step in that direction. Trial Registration ClinicalTrials.gov NCT00685555

Obesity prevention, screening, and treatment: practices of pediatric providers since the 2007 expert committee recommendations.

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Rausch, John Conrad; Perito, Emily Rothbaum; Hametz, Patricia

2011-05-01

This study surveyed pediatric primary care providers at a major academic center regarding their attitudes and practices of obesity screening, prevention, and treatment. The authors compared the care providers' reported practices to the 2007 American Medical Association and Centers for Disease Control and Prevention Expert Committee Recommendations to evaluate their adherence to the guidelines and differences based on level of training and specialty. Of 96 providers surveyed, less than half used the currently recommended criteria for identifying children who are overweight (24.7%) and obese (34.4%), with attendings more likely to use the correct criteria than residents (P obesity, the majority felt their counseling was not effective. There was considerable variability in reported practices of lab screening and referral patterns of overweight and obese children. More efforts are needed to standardize providers' approach to overweight and obese children.

Feasibility of a Friendship Network-Based Pediatric Obesity Intervention.

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Giannini, Courtney M; Irby, Megan B; Skelton, Joseph A; Gesell, Sabina B

2017-02-01

There is growing evidence supporting social network-based interventions for adolescents with obesity. This study's aim was to determine the feasibility of a social network-based intervention by assessing adolescents' friendship networks, willingness to involve friends in treatment, and how these factors influence enjoyment. Adolescents (N = 42) were recruited from a tertiary care obesity clinic. Participants gave a list of closest friends, friendship characteristics, and which of their friends they would involve in treatment. A subset (N = 14) participated in group treatment, were encouraged to bring friends, and invited to a second interview. Participants nominated a mean of 4.0 (standard deviation [SD] = 1.6) friends and were more likely to nominate closer friends (p = 0.003). Friends who attended group sessions were more likely to have multiple friendships in common with the participant's own network (p = 0.04). Involving friends in treatment is feasible and desired by adolescents and may be a novel approach for augmenting obesity treatment outcomes.

Do School Lunches Contribute to Childhood Obesity?

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Schanzenbach, Diane Whitmore

2009-01-01

This paper assesses whether school lunches contribute to childhood obesity. I employ two methods to isolate the causal impact of school lunches on obesity. First, using panel data, I ?nd that children who consume school lunches are more likely to be obese than those who brown bag their lunches even though they enter kindergarten with the same…

Effectiveness of a Randomized Controlled Lifestyle Intervention to Prevent Obesity among Chinese Primary School Students: CLICK-Obesity Study.

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Fei Xu

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

Overweight and Obesity among Adolescents, A Comparative Study Between Government and Private Schools.

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Patnaik, Lipilekha; Pattanaik, Sumitra; Sahu, Trilochan; Rao, E Venkata

2015-09-01

To compare prevalence of overweight/obesity among adolescent school children of government and private schools. A school-based cross-sectional study was conducted in 1800 children aged 10-16 years. Body mass index (BMI), Waist circumference (WC), Hip circumference (HC), and Neck circumference (NC) were measured using standard guidelines. The prevalence of overweight obesity was 27.8% (private schools 45.2%, government schools 10.5%). BMI, WC, NC, and Waist-hip ratio were significantly higher among private school students. A differential strategic plan may be needed to prevent and control obesity among adolescent school children.

Treating Rural Pediatric Obesity through Telemedicine: Baseline Data from a Randomized Controlled Trial

OpenAIRE

Gallagher, Katherine Steiger; Davis, Ann McGrath; Malone, Brett; Landrum, Yasuko; Black, William

2011-01-01

Objective To describe baseline characteristics of participants in a pediatric obesity intervention tailored specifically to rural families delivered via telemedicine. Methods Randomized-control trial comparing a family-based behavioral intervention to a usual care condition. Participants Fifty-eight first through fifth graders and their parents from the rural Midwest. Measures Demographic, body mass index (BMI), Actigraph activity monitor information, 24-h dietary recalls, Child Behavior Chec...

Are Graduating Pediatric Residents Prepared to Engage in Obesity Prevention and Treatment?

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Frintner, Mary Pat; Liebhart, Janice L; Lindros, Jeanne; Baker, Alison; Hassink, Sandra G

2016-01-01

Little information is available to gauge residents' perceived receipt of comprehensive training and preparedness to manage children with obesity in practice. A national, random sample of 1000 graduating pediatric residents were surveyed in 2013 on childhood overweight/obesity and preparedness to prevent and treat obesity. A composite training measure was created by summing the number of areas (10 possible) where training on overweight/obesity was received. Multivariable logistic regression explored relationships of resident and training characteristics to residents' belief that their own counseling on prevention and treatment of overweight/obesity is very effective (vs somewhat/slightly/not effective). Of 625 survey respondents (63% response), most (68-92%) reported receipt of training in each of 10 assessed areas on overweight/obesity prevention, assessment, and treatment. Most residents did not desire more training in the assessed areas; however, 54% wanted more training in motivational interviewing. About one-fourth believed that their own counseling on the prevention of overweight/obesity (26%) and treatment of obesity (22%) was very effective. Residents who rated their ability to use motivational interviewing as very good/excellent were more likely to rate their counseling on both the prevention and treatment of overweight/obesity as very effective (adjusted odds ratio [aOR] 4.33, 95% confidence interval [CI] 2.63-7.13; and aOR 4.69, 95% CI 2.72-8.07, respectively). Residents who received training in all 10 assessed areas were also more likely to rate their counseling on both prevention and treatment as very effective (aOR 2.58, 95% CI 1.61-4.14; aOR 2.41, 95% CI 1.46-3.97, respectively). Comprehensive training on overweight/obesity and inclusion of training in motivational interviewing may help residents feel better prepared to care for children with overweight/obesity. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights

Association between obesity and behavioral/emotional disorders in primary school-aged children: a cross-sectional study

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Clarissa J. Aditya

2017-05-01

Full Text Available Background: Obesity in children can increase the risks of various chronic diseases. Mental disorders associated with obesity in children include: depression, anxiety, low self-esteem, hyperkinetic disorders, and increased aggressiveness. This relationship is estimated due to vulnerable genetic expressions in obese individuals. This study aimed to find the association between obesity and behavioral/emotional disorder in primary school-aged children.Methods: This cross-sectional study was conducted on 384 children at Menteng 1 Elementary School, Jakarta from July to September 2015. The study was conducted to find the association between the children’s nutritional status and behavioral/emotional disorders screened by the 17-item Pediatric Symptom Checklist (PSC-17. Chi square analysis was applied in this study.Results: The prevalence of obese children at Menteng 1 Elementary School, Jakarta reached 23.2%, which is higher than Jakarta’s prevalence (14%. 8.7% of the subjects were obese and 13.6% of them were having behavioral/emotional disorders. 20.0% of the obese subjects had behavioral/emotional disorders. The prevalence was higher for internalizing sub-scale, which was consistent with other studies. Association between obesity and behavioral/emotional disorders was significant for externalizing sub-scale (p=0.036. Externalizing problems caused by obesity might be affected by the social stigma of their peer group. However, obesity in children did not have a statistically significant relationship in internalization sub-scale, attention, and PSC-17 total score (p>0.05. No significant associations towards those sub-scales were thought to be influenced by other factors, playing a role in causing mental disorders in children.Conclusion: In general, obesity was not associated with behavioral and emotional disorders in children, but obesity was related to externalizing behavioral/emotional disorders.

Exploring the contribution of maternal antibiotics and breastfeeding to development of the infant microbiome and pediatric obesity.

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Lemas, Dominick J; Yee, Shanique; Cacho, Nicole; Miller, Darci; Cardel, Michelle; Gurka, Matthew; Janicke, David; Shenkman, Elizabeth

2016-12-01

Pediatric obesity, a significant public health concern, has been associated with adult premature mortality and the development of type 2 diabetes and cardiovascular disease. Evidence has suggested that the gut microbiota is associated with pediatric obesity. Establishment of the infant gut microbiome is dependent on a dynamic maternal-infant microbiota exchange during early life. The objective of this review is to describe maternal factors such as feeding practices and antibiotic use that may influence the infant gut microbiome and risk for obesity. The complex components in human milk have many nutritional benefits to the infant; however, the microbiome in human milk may be an important factor to help regulate the infant's weight. We discuss maternal antibiotics and the effects on breast milk as critical exposures that alter the infant's gut microbiome and influence the risk of pediatric obesity. Copyright © 2016 Elsevier Ltd. All rights reserved.

How can primary care providers manage pediatric obesity in the real world?

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Hopkins, Kristy F; Decristofaro, Claire; Elliott, Lydia

2011-06-01

To provide information regarding evidence-based interventions and clinical practice guidelines as a basis for a clinical toolkit utilizing a step management approach for the primary care provider in managing childhood obesity. Evidence-based literature including original clinical trials, literature reviews, and clinical practice guidelines. Interventions can be stratified based on initial screening of children and adolescents so that selection of treatment options is optimized. For all treatments, lifestyle modifications include attention to diet and activity level. Levels of initial success, as well as maintenance of target body mass index, may be related to the intensity and duration of interventions; involvement of family may increase success rates. For failed lifestyle interventions, or for patients with extreme obesity and/or certain comorbidities, pharmacologic or surgical options should be considered. Many intensive programs have shown success, but the resources required for these approaches may be unavailable to the typical community provider and family. However, using current guidelines, the primary care provider can initiate and manage ongoing interventions in pediatric obesity. A toolkit for primary care implementation and maintenance interventions is provided. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

Adaptive and maladaptive cortisol responses to pediatric obesity.

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Soros, Arlette; Zadik, Zvi; Chalew, Stuart

2008-09-01

The recent unprecedented increase of childhood obesity has led to an alarming rise in type 2 diabetes mellitus (T2D) among these children. The process underlying the progression from simple obesity to T2D is not well understood. Cortisol is a candidate factor in the pathogenesis of T2D, as it can exacerbate insulin resistance and provoke other disturbances of the metabolic syndrome. The 24-h integrated concentration (IC) of cortisol is suppressed in non-diabetic obese children compared to lean children. This difference in IC-cortisol is not due to changes in cortisol binding globulin or plasma cortisol to cortisone ratio between groups. In obese individuals, IC-cortisol suppression disappears with age after adolescence, which corresponds with increasing occurrence of T2D and other metabolic disorders of obesity. We consider the IC-cortisol levels of lean insulin sensitive children to be metabolically inappropriate for obese insulin resistant children. Thus, we hypothesize that suppression of IC-cortisol is an important adaptive response to obesity (cortisol adaptive suppression) in childhood that prevents pediatric T2D while failure to suppress IC-cortisol (cortisol suppression failure) exacerbates insulin resistance and contributes to the development of T2D. In further support of this hypothesis is early pilot data suggesting that cortisol suppression failure occurs in obese children with impaired fasting glucose levels. The mechanism(s) underlying cortisol adaptive suppression, how and why these mechanism(s) fail are unknown. Elucidation of these mechanisms may lead to interventions to prevent the development of T2D and its complications in obese individuals.

Life course impact of school-based promotion of healthy eating and active living to prevent childhood obesity.

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Bach Xuan Tran

Full Text Available The Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools is a comprehensive school health program that is proven feasible and effective in preventing obesity among school aged children. To support decision making on expanding this program, evidence on its long-term health and economic impacts is particularly critical. In the present study we estimate the life course impact of the APPLE Schools programs in terms of future body weights and avoided health care costs.We modeled growth rates of body mass index (BMI using longitudinal data from the National Population Health Survey collected between 1996-2008. These growth rate characteristics were used to project BMI trajectories for students that attended APPLE Schools and for students who attended control schools (141 randomly selected schools in the Canadian province of Alberta.Throughout the life course, the prevalence of overweight (including obesity was 1.2% to 2.8% (1.7 on average less among students attending APPLE Schools relative to their peers attending control schools. The life course prevalence of obesity was 0.4% to 1.4% (0.8% on average less among APPLE Schools students. If the APPLE Schools program were to be scaled up, the potential cost savings would be $33 to 82 million per year for the province of Alberta, or $150 to 330 million per year for Canada.These projected health and economic benefits seem to support broader implementation of school-based health promotion programs.

Parent Interest in a School-Based, School Nurse-Led Weight Management Program

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Kubik, Martha Y.; Lee, Jiwoo

2014-01-01

Because one in three children is already overweight or obese, school-based interventions targeting secondary obesity prevention merit consideration. This study assessed parent interest in participating in a school-based, school nurse-led weight management program for young school-aged children. A random sample of parents ("n" = 122) of…

Junk Food in Schools and Childhood Obesity.

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Datar, Ashlesha; Nicosia, Nancy

2012-01-01

Despite limited empirical evidence, there is growing concern that junk food availability in schools has contributed to the childhood obesity epidemic. In this paper, we estimate the effects of junk food availability on BMI, obesity, and related outcomes among a national sample of fifth-graders. Unlike previous studies, we address the endogeneity of the school food environment by controlling for children's BMI at school entry and estimating instrumental variables regressions that leverage variation in the school's grade span. Our main finding is that junk food availability does not significantly increase BMI or obesity among this fifth grade cohort despite the increased likelihood of in-school junk food purchases. The results are robust to alternate measures of junk food availability including school administrator reports of sales during school hours, school administrator reports of competitive food outlets, and children's reports of junk food availability. Moreover, the absence of any effects on overall food consumption and physical activity further support the null findings for BMI and obesity.

Altered insulin response to an acute bout of exercise in pediatric obesity.

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Tran, Brian D; Leu, Szu-Yun; Oliver, Stacy; Graf, Scott; Vigil, Diana; Galassetti, Pietro

2014-11-01

Pediatric obesity typically induces insulin resistance, often later evolving into type 2 diabetes. While exercise, enhancing insulin sensitivity, is broadly used to prevent this transition, it is unknown whether alterations in the exercise insulin response pattern occur in obese children. Therefore, we measured exercise insulin responses in 57 healthy weight (NW), 20 overweight (OW), and 56 obese (Ob) children. Blood samples were drawn before and after 30 min of intermittent (2 min on, 1 min off) cycling at ~80% VO2max. In a smaller group (14 NW, 6 OW, 15 Ob), a high-fat meal was ingested 45 min preexercise. Baseline glycemia was similar and increased slightly and similarly in all groups during exercise. Basal insulin (pmol/L) was significantly higher in Ob vs. other groups; postexercise, insulin increased in NW (+7± 3) and OW (+5 ± 8), but decreased in Ob (-15±5, p feeding caused a rapid rise in insulin, promptly corrected by exercise. In Ob, however, insulin rose again 30 min postexercise. Our data indicates a distinct pattern of exercise-induced insulin modulation in pediatric obesity, possibly modulated by basal insulin concentrations.

Process evaluation of the Enabling Mothers toPrevent Pediatric Obesity Through Web-Based Learning and Reciprocal Determinism (EMPOWER) randomized control trial.

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Knowlden, Adam P; Sharma, Manoj

2014-09-01

Family-and-home-based interventions are an important vehicle for preventing childhood obesity. Systematic process evaluations have not been routinely conducted in assessment of these interventions. The purpose of this study was to plan and conduct a process evaluation of the Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Learning and Reciprocal Determinism (EMPOWER) randomized control trial. The trial was composed of two web-based, mother-centered interventions for prevention of obesity in children between 4 and 6 years of age. Process evaluation used the components of program fidelity, dose delivered, dose received, context, reach, and recruitment. Categorical process evaluation data (program fidelity, dose delivered, dose exposure, and context) were assessed using Program Implementation Index (PII) values. Continuous process evaluation variables (dose satisfaction and recruitment) were assessed using ANOVA tests to evaluate mean differences between groups (experimental and control) and sessions (sessions 1 through 5). Process evaluation results found that both groups (experimental and control) were equivalent, and interventions were administered as planned. Analysis of web-based intervention process objectives requires tailoring of process evaluation models for online delivery. Dissemination of process evaluation results can advance best practices for implementing effective online health promotion programs. © 2014 Society for Public Health Education.

Putting the Barker Theory into the Future: Time to Act on Preventing Pediatric Obesity.

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Pietrobelli, Angelo; Agosti, Massimo; Zuccotti, Gianvincenzo

2016-11-17

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.

Edmonton obesity staging system among pediatric patients: a validation and obesogenic risk factor analysis.

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Grammatikopoulou, M G; Chourdakis, M; Gkiouras, K; Roumeli, P; Poulimeneas, D; Apostolidou, E; Chountalas, I; Tirodimos, I; Filippou, O; Papadakou-Lagogianni, S; Dardavessis, T

2018-01-08

The Edmonton Obesity Staging System for Pediatrics (EOSS-P) is a useful tool, delineating different obesity severity tiers associated with distinct treatment barriers. The aim of the study was to apply the EOSS-P on a Greek pediatric cohort and assess risk factors associated with each stage, compared to normal weight controls. A total of 361 children (2-14 years old), outpatients of an Athenian hospital, participated in this case-control study by forming two groups: the obese (n = 203) and the normoweight controls (n = 158). Anthropometry, blood pressure, blood and biochemical markers, comorbidities and obesogenic lifestyle parameters were recorded and the EOSS-P was applied. Validation of EOSS-P stages was conducted by juxtaposing them with IOTF-defined weight status. Obesogenic risk factors' analysis was conducted by constructing gender-and-age-adjusted (GA) and multivariate logistic models. The majority of obese children were stratified at stage 1 (46.0%), 17.0% were on stage 0, and 37.0% on stage 2. The validation analysis revealed that EOSS-P stages greater than 0 were associated with diastolic blood pressure and levels of glucose, cholesterol, LDL and ALT. Reduced obesity odds were observed among children playing outdoors and increased odds for every screen time hour, both in the GA and in the multivariate analyses (all P  2 times/week was associated with reduced obesity odds in the GA analysis (OR = 0.57, 95% CI = 0.33-0.98, P linear = 0.047), it lost its significance in the multivariate analysis (P linear = 0.145). Analogous results were recorded in the analyses of the abovementioned physical activity risk factors for the EOSS-P stages. Linear relationships were observed for fast-food consumption and IOTF-defined obesity and higher than 0 EOSS-P stages. Parental obesity status was associated with all EOSS-P stages and IOTF-defined obesity status. Few outpatients were healthy obese (stage 0), while the majority exhibited several comorbidities

Effect of the Healthy Schools Program on Prevalence of Overweight and Obesity in California Schools, 2006–2012

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Cotterman, Carolyn; Crawford, Pat; Stevelos, JoAnn; Archibald, Abbie

2015-01-01

Introduction The Alliance for a Healthier Generation’s Healthy Schools Program (HSP) is a national evidence-based obesity-prevention initiative aimed at providing the schools in greatest need with onsite training and technical assistance (TTA) and consultation with national experts (HSP national advisors) to create sustainable healthy change in schools’ nutrition and physical activity environments. The objective of this study was to evaluate the impact of HSP on the prevalence of overweight and obesity in California schools, from HSP’s inception in 2006 through 2012. Methods We used statewide body mass index (BMI) data collected annually from 5th-, 7th-, and 9th-grade students to determine whether enrolling in the HSP’s onsite intervention reduced the prevalence of overweight and obesity in intervention schools (n = 281) versus propensity-score matched control schools (n = 709) and whether increasing exposure to the program (TTA and contact with HSP national advisors) was associated with reductions in the prevalence of overweight and obesity. Results Analyses showed no difference between HSP schools and control schools in overweight or obesity prevalence. However, program exposure varied widely among participating schools, and each additional contact with TTA or HSP national advisors was associated with a 0.3% decline in overweight and obesity prevalence (P schools in reducing obesity. Although participation in HSP alone was not sufficient to improve weight status in California schools, there was a clear dose–response relationship to the program. HSP serves as an effective model for addressing childhood obesity among engaged schools. PMID:25996984

A systematic review of the effectiveness of school-based obesity prevention programmes for First Nations, Inuit and Métis youth in Canada.

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Godin, K; Leatherdale, S T; Elton-Marshall, T

2015-06-01

First Nations, Inuit and Métis (FNIM) youth are disproportionately affected by obesity and represent known a high-risk group in Canada. School-based prevention programmes may have the potential to effectively influence obesity-related health behaviours (i.e. healthy eating and physical activity) among this population. We conducted a systematic review of nine electronic databases (2003-2014) to identify studies that describe school-based programmes that have been developed to improve obesity-related health behaviours and outcomes among FNIM youth in Canada. The objectives of this review were to identify and evaluate the effectiveness of these programmes and assess the strength of the methodologies used to evaluate them. Fifteen studies, representing seven distinct interventions, met our inclusion criteria. The majority of these programmes did not result in significant improvements in outcomes related to obesity, healthy eating, or physical activity among FNIM youth. The studies varied in design rigour and use of evaluation activities. The lack of literature on effective school-based programmes for FNIM youth in Canada that target obesity-related outcomes highlights a priority area for future intervention development, evaluation and dissemination within the peer-reviewed literature. Further research is needed on interventions involving Métis and Inuit youth, secondary school-aged FNIM youth and FNIM youth living in urban settings. © 2015 World Obesity.

Initial Steps for Quality Improvement of Obesity Care Across Divisions at a Tertiary Care Pediatric Hospital

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Sheila Z. Chang

2014-09-01

Full Text Available Background: Pediatric subspecialists can participate in the care of obese children. Objective: To describe steps to help subspecialty providers initiate quality improvement efforts in obesity care. Methods: An anonymous patient data download, provider surveys and interviews assessed subspecialty providers’ identification and perspectives of childhood obesity and gathered information on perceived roles and care strategies. Participating divisions received summary analyses of quantitative and qualitative data and met with study leaders to develop visions for division/service-specific care improvement. Results: Among 13 divisions/services, subspecialists’ perceived role varied by specialty; many expressed the need for cross-collaboration. All survey informants agreed that identification was the first step, and expressed interest in obtaining additional resources to improve care. Conclusions: Subspecialists were interested in improving the quality and coordination of obesity care for patients across our tertiary care setting. Developing quality improvement projects to achieve greater pediatric obesity care goals starts with engagement of providers toward better identifying and managing childhood obesity.

Prevalence of ''obesity disease'' and ''metabolic syndrome'' in obese pediatric outpatients at the University Hospital of Occupational and Environmental Health, Japan

International Nuclear Information System (INIS)

Araki, Shunsuke; Dobashi, Kazushige; Kubo, Kazuyasu; Kawagoe, Rinko; Yamamoto, Yukiyo; Kawada, Yasusada; Shirahata, Akira; Asayama, Kohtaro

2008-01-01

'Obesity Disease for Japanese Children' was defined in 2002, and very recently 'Metabolic Syndrome (MS) for Japanese Children' was also defined. We therefore aimed to determine the prevalence of these two among the obese pediatric outpatients at our university hospital. The subjects were 97 children, 58 boys and 39 girls, ranging in age from 5 to 15 years. A child was considered to be obese when the body weight exceeded 120% of the standard body weight. All the subjects exceeded 120% overweight, and 58 children (35 boys and 23 girls) were over 150% overweight. Eighty five children (53 boys and 32 girls) were diagnosed with obesity disease (87.6%). Sixteen children (12 boys and 4 girls) were diagnosed with metabolic syndrome, which was 16.5% of all the subjects and 18.8% of the children with obesity disease. Fourteen of the 16 children with MS were over 10 years old. Obesity disease is diagnosed when the child has an obesity disease score of more than 6. The obesity disease score was significantly correlated with the waist circumference and the visceral adipose tissue area measured by computed tomography. The mean score of the children with MS was significantly higher than that of the non-MS group (30.2 vs. 12.3 points). In this study, it was clear that about 90% of our clinic patients are in the obesity disease group, and need therapeutic interventions. The prevalence of MS in the pediatric age is very low compared with that of adults, but MS is a high-risk category of obesity disease. (author)

The Relationship between School-Level Characteristics and Implementation Fidelity of a Coordinated School Health Childhood Obesity Prevention Intervention

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Lederer, Alyssa M.; King, Mindy H.; Sovinski, Danielle; Seo, Dong-Chul; Kim, Nayoung

2015-01-01

Background: Curtailing childhood obesity is a public health imperative. Although multicomponent school-based programs reduce obesity among children, less is known about the implementation fidelity of these interventions. This study examines process evaluation findings for the Healthy, Energetic Ready, Outstanding, Enthusiastic, Schools (HEROES)…

Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting

DEFF Research Database (Denmark)

2015-01-01

Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children...... circumference, growth, pubertal stage, blood pressure, neurology and skin and provide comprehensive paraclinical investigations for obesity and obesity related conditions. Treatment of obesity in children and adolescents is fully dependent on the combined effort of the entire family. This cannot...... as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI...

Obesity and Student Performance at School

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Taras, Howard; Potts-Datema, William

2005-01-01

To review the state of research on the association between obesity among school-aged children and academic outcomes, the authors reviewed published studies investigating obesity, school performance, and rates of student absenteeism. A table with brief descriptions of each study's research methodology and outcomes is included. Research demonstrates…

Association of pediatric obstructive sleep apnea with poor academic performance: A school-based study from India.

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Goyal, Abhishek; Pakhare, Abhijit P; Bhatt, Girish C; Choudhary, Bharat; Patil, Rajesh

2018-01-01

Pediatric obstructive sleep apnea (OSA) is a highly prevalent but often neglected disorder. There is paucity of reports on the prevalence of pediatric OSA from India. This study was done to estimate the prevalence of OSA in school children aged 5-10 years and its association with academic performance. This school-based cross-sectional epidemiological study was conducted from July 2015 to November 2015. A questionnaire seeking information on sociodemographic variables, school performance, sleeping pattern, and a validated 22-item pediatrics sleep-related breathing disorder (SRBD) scale was distributed to 1820 pupils in three primary schools. The prevalence of OSA (defined as SRBD score >33%) was reported as proportion and its 95% confidence interval (CI). We received 1520 questionnaires out of 1820 distributed and of which 1346 were complete and were analyzed. The prevalence of OSA among children in our study was 9.6% (95% CI: 8.1%-11.7%). On multivariate analysis, working mother (adjusted odds ratio [OR]: 1.8; 95% CI: 1.2-2.7), sleep bruxism (adjusted OR: 1.7; 95% CI: 1.1-2.6), and sleep talking (adjusted OR: 3.0; 95% CI: 1.9-4.7) were found to be independently associated with OSA. Students with positive SRBD were more prone to nocturnal enuresis (NE) (OR 3.48; 95% CI 2.27-5.26) and poor academic performance in all subjects. OSA is highly prevalent (9.6%) in Indian children. OSA is associated with NE and poor academic performance in all subjects. This study found association of maternal occupation and OSA which needs to be confirmed in larger studies.

Association of pediatric obstructive sleep apnea with poor academic performance: A school-based study from India

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Abhishek Goyal

2018-01-01

Full Text Available Background: Pediatric obstructive sleep apnea (OSA is a highly prevalent but often neglected disorder. There is paucity of reports on the prevalence of pediatric OSA from India. This study was done to estimate the prevalence of OSA in school children aged 5–10 years and its association with academic performance. Methodology: This school-based cross-sectional epidemiological study was conducted from July 2015 to November 2015. A questionnaire seeking information on sociodemographic variables, school performance, sleeping pattern, and a validated 22-item pediatrics sleep-related breathing disorder (SRBD scale was distributed to 1820 pupils in three primary schools. The prevalence of OSA (defined as SRBD score >33% was reported as proportion and its 95% confidence interval (CI. Results: We received 1520 questionnaires out of 1820 distributed and of which 1346 were complete and were analyzed. The prevalence of OSA among children in our study was 9.6% (95% CI: 8.1%–11.7%. On multivariate analysis, working mother (adjusted odds ratio [OR]: 1.8; 95% CI: 1.2–2.7, sleep bruxism (adjusted OR: 1.7; 95% CI: 1.1–2.6, and sleep talking (adjusted OR: 3.0; 95% CI: 1.9–4.7 were found to be independently associated with OSA. Students with positive SRBD were more prone to nocturnal enuresis (NE (OR 3.48; 95% CI 2.27–5.26 and poor academic performance in all subjects. Conclusion: OSA is highly prevalent (9.6% in Indian children. OSA is associated with NE and poor academic performance in all subjects. This study found association of maternal occupation and OSA which needs to be confirmed in larger studies.

Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan.

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Shih, Shu-Fang; Liu, Chieh-Hsing; Liao, Li-Ling; Osborne, Richard H

2016-03-22

Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children. Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p 1.10, p obese. This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic

Putting the Barker Theory into the Future: Time to Act on Preventing Pediatric Obesity

Directory of Open Access Journals (Sweden)

Angelo Pietrobelli

2016-11-01

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.

Relationships between pediatric obesity and maternal emotional states and attitudes.

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Akay, Aynur Pekcanlar; Ozturk, Yesim; Avcil, Sibel Nur; Kavurma, Canem; Tufan, Evren

2015-01-01

The goal of this study was to investigate depression and anxiety levels of mothers whose child (7-11 years) and adolescent (12-18 years) offspring had obesity, as well as those mothers' attitudes toward their children and their family relationships. This is a cross-sectional, case-control study of 100 dyads. All mothers completed the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Parental Attitude Research Instrument, and the Family Assessment Device. Maternal state anxiety in the group with obesity was significantly higher than controls (p = 0.03). As measured by Family Assessment Device, affective involvement (p = 0.05) and behavior control (p = 0.00) scores were significantly higher for those with obesity. Obesity and adolescence have independent effects on maternal state anxiety; affective involvement domain of family function is affected by both obesity and its interaction with adolescence, while behavior control domain is singularly affected by obesity. Our results may demonstrate that, for the mothers of children who have obesity, this condition may have an adverse effect on their lives and their family relationships. Pediatric obesity and developmental stage of offspring may have different effects on maternally reported psychometric variables. Cross-sectional design may hinder causal explanations. Further studies with longitudinal designs are needed. © The Author(s) 2015.

Changes in Body Mass Index During a 3-Year Elementary School-Based Obesity Prevention Program for American Indian and White Rural Students.

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Vogeltanz-Holm, Nancy; Holm, Jeffrey

2018-04-01

Childhood obesity is a significant but largely modifiable health risk, disproportionately affecting socioeconomically disadvantaged, racial/ethnic minority, and rural children. Elementary school-aged children typically experience the greatest increases in excess weight gain and therefore are important targets for reducing adolescent and adult obesity while improving children's health. Our study evaluated outcomes of a 3-year elementary school-based program for reducing obesity in American Indian and White students attending eight rural schools in the U.S. upper Midwest. Researchers measured body mass indexes (BMI) and other health indicators and behaviors of 308 beginning third-grade students and then again at the end of students' third, fourth, and fifth grades. The primary focus of this study is a mixed multilevel longitudinal model testing changes in age- and gender-adjusted BMI z scores ( zBMI). There was a significant decrease in zBMI across the 3-year study period. Ethnicity analyses showed that White students had overall decreases in zBMI whereas American Indian students' zBMIs remained stable across the program. Comparisons with children from an age- and cohort-matched national sample provided support for the effectiveness of the school program in reducing BMI and obesity during the study period. An elementary school-based health program that addresses a range of students' obesity-related health behaviors, the school health environment, and that involves educators and parents is an effective intervention for reducing or stabilizing BMI in rural White and American Indian students. School health programs for students living in rural communities may be especially effective due to greater school and community cohesiveness, and valuing of the school's primary role in improving community health.

In Preparation of the Nationwide Dissemination of the School-Based Obesity Prevention Program DOiT: Stepwise Development Applying the Intervention Mapping Protocol

NARCIS (Netherlands)

van Nassau, F.; Singh, A.S.; van Mechelen, W.; Brug, J.; Chin A Paw, M.J.M.

2014-01-01

BACKGROUND: The school-based Dutch Obesity Intervention in Teenagers (DOiT) program is an evidence-based obesity prevention program. In preparation for dissemination throughout the Netherlands, this study aimed to adapt the initial program and to develop an implementation strategy and materials.

A school-based comprehensive lifestyle intervention among chinese kids against obesity (CLICK-Obesity: rationale, design and methodology of a randomized controlled trial in Nanjing city, China

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Xu Fei

2012-06-01

Full Text Available Abstract Background The prevalence of childhood obesity among adolescents has been rapidly rising in Mainland China in recent decades, especially in urban and rich areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited data regarding adolescent overweight prevention in China are available. Thus, we developed a school-based intervention with the aim of reducing excess body weight in children. This report described the study design. Methods/design We designed a cluster randomized controlled trial in 8 randomly selected urban primary schools between May 2010 and December 2013. Each school was randomly assigned to either the intervention or control group (four schools in each group. Participants were the 4th graders in each participating school. The multi-component program was implemented within the intervention group, while students in the control group followed their usual health and physical education curriculum with no additional intervention program. The intervention consisted of four components: a classroom curriculum, (including physical education and healthy diet education, b school environment support, c family involvement, and d fun programs/events. The primary study outcome was body composition, and secondary outcomes were behaviour and behavioural determinants. Discussion The intervention was designed with due consideration of Chinese cultural and familial tradition, social convention, and current primary education and exam system in Mainland China. We did our best to gain good support from educational authorities, school administrators, teachers and parents, and to integrate intervention components into schools’ regular academic programs. The results of and lesson learned from this study will help guide future school-based childhood obesity prevention programs in Mainland China. Trial registration Registration number: ChiCTR-ERC-11001819

An Adaptive Community-Based Participatory Approach to Formative Assessment with High Schools for Obesity Intervention

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Kong, Alberta S.; Farnsworth, Seth; Canaca, Jose A.; Harris, Amanda; Palley, Gabriel; Sussman, Andrew L.

2012-01-01

Background: In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles…

Implementation of a School Nurse-led Intervention for Children With Severe Obesity in New York City Schools.

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Schroeder, Krista; Jia, Haomiao; Wang, Y Claire; Smaldone, Arlene

The Healthy Options and Physical Activity Program (HOP) is a school nurse-led intervention for children with severe obesity. HOP was developed by experts at the New York City Department of Health and Mental Hygiene and implemented in New York City schools beginning in 2012. The purpose of this study was to evaluate HOP implementation with the goal of informing HOP refinement and potential future HOP dissemination. This study entailed a retrospective analysis of secondary data. Analytic methods included descriptive statistics, Wilcoxon rank sum and Chi square tests, and multivariate logistic regression. During the 2012-2013 school year, 20,518 children were eligible for HOP. Of these, 1054 (5.1%) were enrolled in the program. On average, enrolled children attended one HOP session during the school year. Parent participation was low (3.2% of HOP sessions). Low nurse workload, low school poverty, higher grade level, higher BMI percentile, and chronic illness diagnosis were associated with student enrollment in HOP. As currently delivered, HOP is not likely to be efficacious. Lessons learned from this evaluation are applicable to future nurse-led obesity interventions. Prior to implementing a school nurse-led obesity intervention, nursing workload and available support must be carefully considered. Interventions should be designed to facilitate (and possibly require) parent involvement. Nurses who deliver obesity interventions may require additional training in obesity treatment. With attention to these lessons learned, evidence-based school nurse-led obesity interventions can be developed. Copyright © 2017 Elsevier Inc. All rights reserved.

Exploring facilitating factors and barriers to the nationwide dissemination of a Dutch school-based obesity prevention program "DOiT": a study protocol

NARCIS (Netherlands)

van Nassau, F.; Singh, A.S.; van Mechelen, W.; Paulussen, T.G.; Brug, J.; Chinapaw, M.J.

2013-01-01

Background: The evidence-based Dutch Obesity Intervention in Teenagers (DOiT) program is a school-based obesity prevention program for 12 to 14-year olds attending the first two years of prevocational education. This paper describes the study protocol applied to evaluate (a) the nationwide

A multicomponent, school-initiated obesity intervention to promote healthy lifestyles in children.

Science.gov (United States)

Morano, Milena; Rutigliano, Irene; Rago, Alfonso; Pettoello-Mantovani, Massimo; Campanozzi, Angelo

2016-10-01

In the context of a 6-mo obesity program, incorporating school- and family-based components, nutritional education, fun-type skill-learning physical activities, and exercise training, this study examined relationships among changes in nutritional status, physical fitness, and some psychosocial and behavioral treatment-related outcomes, using a before and after comparison. Eighteen obese and overweight children ages 10 to 12 y were assessed with respect to body weight, height, circumferences, skinfold thickness, and fat mass. Health-related fitness tests, and self-reported physical activity enjoyment and perceived physical ability also were administered. Health-related quality of life (HRQoL) was evaluated using the Pediatric Quality of Life Inventory; dietary habits were collected using a 7-d food diary. The WinFood software was used for the estimation of nutrient and caloric intake. After treatment, children showed decreases in body mass index z-score (P = 0.001), body fat percentage (P children, and place emphasis on directing such interventions toward improving perceived physical competence that could lead to increased exercise adherence and promotion of the health benefits associated with it. Copyright © 2016 Elsevier Inc. All rights reserved.

School Breakfast Receipt and Obesity among American Fifth- and Eighth-Graders.

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Sudharsanan, Nikkil; Romano, Sebastian; Cunningham, Solveig A

2016-04-01

School breakfast consumption can improve children's nutrition, but the implications of breakfast at school for children's weight remains unclear. The aim of this study was to determine whether receiving breakfast at school is related to changes in children's weight between the fifth and eighth grades, and whether the relationship between school breakfasts and obesity varies for children of different socioeconomic backgrounds. This was a longitudinal study of children observed in the fifth and eighth grades. Data are from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99, a nationally representative prospective cohort of children in the United States. The analytic sample consisted of 6,495 children interviewed in the fifth and eighth grades. Standard thresholds from the Centers for Disease Control and Prevention were used to classify children as not obese or obese based on direct-measured height and weight. Difference-in-difference propensity score matching and fixed-effect logistic regression models were used to estimate the relationship between receipt of school breakfast and change in obesity between the fifth and eighth grades, adjusting for child, household, and school characteristics. School breakfast receipt was not associated with a change in obesity status between the fifth and eighth grades for children overall (odds ratio=1.31; P=0.129). In the propensity score model, receiving school breakfasts more than doubled the odds of becoming obese (odds ratio=2.31; P=0.0108) for children from families below the federal poverty line compared with children of similar socioeconomic backgrounds who did not regularly receive school breakfasts. School breakfast receipt was not independently related to obesity for most children. Receiving school breakfasts in the fifth grade may be associated with weight gain between the fifth and eighth grades for children from families below the federal poverty line compared with children of similar socioeconomic

Urinary Metabolomics in Pediatric Obesity and NAFLD Identifies Metabolic Pathways/Metabolites Related to Dietary Habits and Gut-Liver Axis Perturbations

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Jacopo Troisi

2017-05-01

Full Text Available To get insight into still elusive pathomechanisms of pediatric obesity and non-alcoholic fatty liver disease (NAFLD we explored the interplay among GC-MS studied urinary metabolomic signature, gut liver axis (GLA abnormalities, and food preferences (Kid-Med. Intestinal permeability (IP, small intestinal bacterial overgrowth (SIBO, and homeostatic model assessment-insulin resistance were investigated in forty children (mean age 9.8 years categorized as normal weight (NW or obese (body mass index <85th or >95th percentile, respectively ± ultrasonographic bright liver and hypertransaminasemia (NAFLD. SIBO was increased in all obese children (p = 0.0022, IP preferentially in those with NAFLD (p = 0.0002. The partial least-square discriminant analysis of urinary metabolome correctly allocated children based on their obesity, NAFLD, visceral fat, pathological IP and SIBO. Compared to NW, obese children had (1 higher levels of glucose/1-methylhistidine, the latter more markedly in NAFLD patients; and (2 lower levels of xylitol, phenyl acetic acid and hydroquinone, the latter especially in children without NAFLD. The metabolic pathways of BCAA and/or their metabolites correlated with excess of visceral fat centimeters (leucine/oxo-valerate, and more deranged IP and SIBO (valine metabolites. Urinary metabolome analysis contributes to define a metabolic fingerprint of pediatric obesity and related NAFLD, by identifying metabolic pathways/metabolites reflecting typical obesity dietary habits and GLA perturbations.

Exercise, adipokines and pediatric obesity: a meta-analysis of randomized controlled trials.

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García-Hermoso, A; Ceballos-Ceballos, R J M; Poblete-Aro, C E; Hackney, A C; Mota, J; Ramírez-Vélez, R

2017-04-01

Adipokines are involved in the etiology of diabetes, insulin resistance, and the development of atherosclerosis and other latent-onset complications. The objective of this meta-analysis was to determine the effectiveness of exercise interventions on adipokines in pediatric obesity. A computerized search was made using three databases. The analysis was restricted to studies that examined the effect of exercise interventions on adipokines (adiponectin, leptin, resistin and visfatin) in pediatric obesity (6-18 years old). Fourteen randomized controlled trials (347 youths) were included. Weighted mean difference (WMD) and 95% confidence intervals were calculated. Exercise was associated with a significant increase in adiponectin (WMD=0.882 μg ml -1 , 95% CI, 0.271-1.493) but did not alter leptin and resistin level. Likewise, exercise intensity and change in body fat; as well as total exercise program duration, duration of the sessions, and change in body fat all significantly influenced the effect of exercise on adiponectin and leptin, respectively. Exercise seems to increase adiponectin levels in childhood obesity. Our results also suggested that exercise on its own, without the concomitant presence of changes in body composition levels, does not affect leptin levels.

Pediatric Obesity: Pharmacokinetic Alterations and Effects on Antimicrobial Dosing.

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Natale, Stephanie; Bradley, John; Nguyen, William Huy; Tran, Tri; Ny, Pamela; La, Kirsten; Vivian, Eva; Le, Jennifer

2017-03-01

Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic (PK) alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacillin-tazobactam, tobramycin, vancomycin, and voriconazole is presented. PubMed (1966-July 2015) and Cochrane Library searches were performed using these key terms: children, pharmacokinetic, obesity, overweight, body mass index, ideal body weight, lean body weight, body composition, and specific antimicrobial drugs. PK studies in obese children and, if necessary, data from adult studies were summarized. Knowledge of PK alterations stemming from physiologic changes that occur with age from the neonate to adolescent, as well as those that result from increased body fat, become an essential first step toward optimizing drug dosing in obese children. Excessive amounts of adipose tissue contribute significantly to body size, total body water content, and organ size and function that may modify drug distribution and clearance. PK studies that evaluated antimicrobial dosing primarily used total (or actual) body weight (TBW) for loading doses and TBW or adjusted body weight for maintenance doses, depending on the drugs' properties and dosing units. PK studies in obese children are imperative to elucidate drug distribution, clearance, and, consequently, the dose required for effective therapy in these children. Future studies should evaluate the effects of both age and obesity on drug dosing because the incidence of obesity is increasing in pediatric patients. © 2017 Pharmacotherapy Publications, Inc.

VIVA LA SALUD INFANTILE: Pediatric obesity treatment in an underserved Hispanic community

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Pediatric obesity in the US disproportionately impacts minority populations who face socioeconomic and cultural barriers to weight management programs. The specific aim of this pilot study was to test the effectiveness of diet behavior modification or diet behavior modification plus structured aerob...

Prevalence and Predictors of Overweight and Obesity Among a Multiethnic Population of Pediatric Acute Lymphoblastic Leukemia Survivors: A Cross-Sectional Assessment.

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Brown, Austin L; Lupo, Philip J; Danysh, Heather E; Okcu, Mehmet F; Scheurer, Michael E; Kamdar, Kala Y

2016-08-01

As previous studies of obesity in survivors of pediatric acute lymphoblastic leukemia (ALL) have primarily been conducted among non-Hispanic white survivors or children treated on older protocols, our objective was to describe the prevalence and correlates of overweight status among an ethnically diverse population of pediatric ALL survivors, largely treated with more contemporary therapies. We evaluated the overweight/obesity status of pediatric ALL survivors (n=406) followed in the Texas Children's Cancer Center between 2004 and 2014. Survivors were classified as underweight, normal weight, overweight, or obese on the basis of their body mass index at their most current follow-up visit. Our results showed that Hispanic ethnicity (39% of the subjects) was associated with being overweight (adjusted odds ratio=1.88; 95% confidence interval, 1.13-3.14) or obese (adjusted odds ratio=2.84; 95% confidence interval, 1.59-5.06) at follow-up, even after adjusting for cranial radiotherapy (CRT) exposure. Body mass index z-score at diagnosis was also associated with overweight/obesity at follow-up. In addition, there was a statistically significant interaction between younger age at diagnosis and CRT, indicating that younger age at diagnosis was associated with obesity among patients who received CRT. These findings may help identify pediatric ALL patients that are at increased risk of being overweight or obese after treatment.

FitKids360: Design, Conduct, and Outcomes of a Stage 2 Pediatric Obesity Program

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Jared M. Tucker

2014-01-01

Full Text Available This paper describes FitKids360, a stage 2 pediatric weight management program. FitKids360 is a physician-referred, multicomponent, low-cost healthy lifestyle program for overweight and obese youth 5–16 years of age and their families. FitKids360 provides an evidence-based approach to the treatment of pediatric overweight by targeting patients’ physical activity, screen time, and dietary behaviors using a family-centered approach. The intervention begins with a two-hour orientation and assessment period followed by six weekly sessions. Assessments include lifestyle behaviors, anthropometry, and the Family Nutrition and Physical Activity (FNPA survey, which screens for obesogenic risk factors in the home environment. Outcomes are presented from 258 patients who completed one of 33 FitKids360 classes. After completing FitKids360, patients increased moderate to vigorous physical activity by 14 minutes (P=0.019, reduced screen time by 44 minutes (P<0.001, and improved key dietary behaviors. Overall, FNPA scores increased by 9% (P<0.001 and 69% of patients with “high risk” FNPA scores at baseline dropped below the “high risk” range by followup. Patients also lowered BMIs (P=0.011 and age- and sex-adjusted BMI z-scores (P<0.001 after completing the 7-week program. We hope this report will be useful to medical and public health professionals seeking to develop stage 2 pediatric obesity programs.

Does maternal obesity have an influence on feeding behavior of obese children?

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Cebeci, A N; Guven, A

2015-12-01

Although the pathogenesis of childhood obesity is multi factorial, maternal obesity and parenting have major roles. The aim of this study was to evaluate the influence of maternal obesity on feeding practices toward their obese school children. Obese children and adolescents referred to the pediatric endocrinology department were enrolled consecutively. Height and weight of all children and their mothers were measured. Maternal feeding practices were measured using an adapted version of the Child Feeding Questionnaire (CFQ). Answers were compared between obese (Body Mass Index [BMI] ≥ 30 kg/m2) and non-obese mothers. A total of 491 obese subjects (292 girls, mean age 12.0 ± 2.8 years) and their mothers participated in this study. A direct correlation between children's BMI and their mothers' BMI was found (Pobese in the study, only half of them consider themselves as obese. No difference were found in the scores of the subscales "perceived responsibility", "restriction", "concern for child's weight" and "monitoring" between obese and non-obese mothers. Child's BMI-SDS positively correlated with mothers' personal weight perception, concern for child's weight and restriction after adjustment for child's age (P obesity increases mothers' concern and food restriction behavior. While mothers of obese children have a high prevalence of obesity, maternal obesity was found to have no significant influence on feeding behavior of obese school children.

Relationships between the Family Environment and School-Based Obesity Prevention Efforts: Can School Programs Help Adolescents Who Are Most in Need?

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Bauer, K. W.; Neumark-Sztainer, D.; Hannan, P. J.; Fulkerson, J. A.; Story, M.

2011-01-01

Identifying factors that contribute to students' behavior and weight improvements during school-based obesity prevention interventions is critical for the development of effective programs. The current study aims to determine whether the support and resources that adolescent girls received from their families were associated with improvements in…

Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan

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Shu-Fang Shih

2016-03-01

Full Text Available Abstract Background Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people’s control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan’s sixth grade school children. Methods Using a population-based survey, 162,209 sixth grade (11–12 years old school children were assessed. The response rate at school level was 83 %, with 70 % of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. Results The sample consisted of 48.9 % girls, 3.8 % were indigenous and the mean BMI was 19.55 (SD = 3.93. About 6 % of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32. The overall proportion of obese children was 15.2 %. Children in the highest health literacy quartile were less likely to be obese (12.4 % compared with the lowest quartile (17.4 %. After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR = 0.94, p  1.10, p < 0.0001 were more likely to report being overweight or obese. Conclusions This study demonstrates strong links between health literacy and obesity, even after

Obesity among secondary school students in Bahrain.

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Musaiger, A O; Matter, A M; Alekri, S A; Mahdi, A R

1993-01-01

The aim of this study is to estimate the prevalence of obesity and factors associated with it in Bahraini secondary school students. A cross-sectional study involving a sample of 825 students (417 boys and 408 girls) aged 15 to 21 years was obtained from secondary schools. Obesity was determined using body mass index (BMI = Wt/Ht2). The findings revealed that 15.6% of boys and 17.4% of girls were either overweight or obese (BMI > or = 25). Family size, parents education, and family history of obesity were significantly associated with obesity among boys, while family history was the only socio-economic factors statistically associated with obesity among girls. Meal patterns such as eating between meals, number of meals per day, and method of eating were not associated with obesity in students. Boys who ate alone were 3 times more likely to be obese than those who ate with family members (odd ratio = 3.4). Measures to prevent and control obesity among children are suggested.

Nutrition and physical activity related school environment/policy factors and child obesity in China: a nationally representative study of 8573 students in 110 middle schools.

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Li, M; Xue, H; Wen, M; Wang, W; Wang, Y

2017-12-01

Obesity is a serious threat to global health. School is a key setting for obesity intervention. Research on school risk factors for child obesity is limited in developing countries. To examine regional variations in obesity and school environments/policies and their associations among students in China. Analyses were based on the first nationally representative sample of 8573 9 th graders in 110 middle schools from 28 regions across China. Multilevel models tested associations between school factors and child self-reported weight outcomes and by school urbanicity setting (urban, rural). Overweight/obesity rate is higher among boys and in urban areas. Schools in rural areas, or less developed regions, promote longer on-campus life, as is indicated by the presence of school cafeterias, night study sessions and longer class hours. Multilevel models show that (i) school cafeterias (OR = 2.53, 95% CI = 1.35-4.75) and internet bars close to school (OR = 1.63, 95% CI = 1.15-2.30) are associated with increased overweight/obesity risk in rural areas, especially for boys; (ii) school night study sessions are associated with lower overweight/obesity risk (OR = 0.69, 95% CI = 0.50-0.96) in rural areas. China has large regional disparities in school environment/policies related to nutrition and physical activity. Some school factors are associated with students' weight status, which vary across gender and areas. Future school-based interventions should attend to diverse regional contexts. © 2016 World Obesity Federation.

Implementing a pediatric obesity care guideline in a freestanding children's hospital to improve child safety and hospital preparedness.

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Porter, Renee M; Thrasher, Jodi; Krebs, Nancy F

2012-12-01

Medical and surgical care of children with severe obesity is complicated and requires recognition of the problem, appropriate equipment, and safe management. There is little literature describing patient, provider, and institutional needs for the severely obese pediatric patient. Nonetheless, the limited data suggest 3 broad categories of needs unique to this population: (a) airway management, (b) drug dosing and pharmacology, and (c) equipment and infrastructure. We describe an opportunity at the Children's Hospital Colorado to better prepare and optimize care for this patient population by creation of a Pediatric Obesity Care Guideline that focused on key areas of quality and safety. Copyright © 2012 Elsevier Inc. All rights reserved.

School Nurses' Experiences with Motivational Interviewing for Preventing Childhood Obesity

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Bonde, Ane Høstgaard; Bentsen, Peter; Hindhede, Anette Lykke

2014-01-01

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…

Metabolic Syndrome Components After Pediatric Liver Transplantation: Prevalence and the Impact of Obesity and Immunosuppression.

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Perito, E R; Lustig, R H; Rosenthal, P

2016-06-01

Metabolic syndrome is associated with long-term morbidity and mortality after adult liver transplantation (LT). Whether pediatric LT recipients have a higher prevalence of metabolic syndrome remains controversial. In a cross-sectional study, we evaluated pediatric LT recipients aged 8-30 years using National Health and Nutrition Examination Survey (NHANES) protocols. LT recipients were matched by gender, race/ethnicity, and age with controls from NHANES. Pediatric LT recipients (n = 83), after adjusting for overweight/obesity and glucocorticoid use, had increased prevalence of prehypertension and hypertension, impaired glucose tolerance (IGT; 2-h glucose after oral glucose tolerance test ≥140 mg/dL), and low high-density lipoprotein compared to matched NHANES controls (n = 235) despite a lower prevalence of overweight/obesity. Among LT recipients, the adjusted odds of IGT doubled for every 7.5 years taking calcineurin inhibitors (odds ratio = 2.10, 95% confidence interval 1.06-4.17 per 7.5 years taking calcineurin inhibitors, p = 0.03). Among all subjects with IGT, LT recipients had a lower prevalence of overweight/obesity and less insulin resistance (homeostatic model assessment of insulin resistance) than did controls with IGT. Among normal weight subjects, LT recipients were significantly more likely than controls to have prehypertension/hypertension, IGT, low high-density lipoprotein, and metabolic syndrome. Pediatric LT recipients have unique metabolic syndrome profiles and risk factors and will require tailored screening and management protocols. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

In Preparation of the Nationwide Dissemination of the School-Based Obesity Prevention Program DOiT: Stepwise Development Applying the Intervention Mapping Protocol

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van Nassau, Femke; Singh, Amika S.; van Mechelen, Willem; Brug, Johannes; Chin A. Paw, Mai J. M.

2014-01-01

Background: The school-based Dutch Obesity Intervention in Teenagers (DOiT) program is an evidence-based obesity prevention program. In preparation for dissemination throughout the Netherlands, this study aimed to adapt the initial program and to develop an implementation strategy and materials. Methods: We revisited the Intervention Mapping (IM)…

Obesity Prevention Practices of Elementary School Nurses in Minnesota: Findings from Interviews with Licensed School Nurses

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Morrison-Sandberg, Leslie F.; Kubik, Martha Y.; Johnson, Karen E.

2011-01-01

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…

Overweight and obesity: overrepresentation in the pediatric reconstructive burn population.

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Mayes, Theresa; Gottschlich, Michele M; Allgeier, Chris; Khoury, Jane; Kagan, Richard J

2010-01-01

Pediatric burn patients are predisposed to excessive weight gain in the reconstructive period, but the cause is unclear. An overweight (OW) or obese (OB) condition is associated with numerous health risks, decreased physical function, and increased morbidity. The purpose of this study was to compare the frequency of OW status in reconstructive, pediatric burn patients with the prevalence in the US population. The authors reviewed the records of 1533 pediatric patients, >1 year from acute burn, admitted for an elective reconstructive procedure. Body mass index between 85th and 95th percentile, according to the National Center for Health Statistics for 2000 growth charts, was classified as OW, and body mass index >95th percentile was classified as OB. Frequency of OW and OB and racial disparity was calculated as a percentage of total patients and compared with pediatric data from National Health and Nutrition Examination Survey for 1999 to 2006, a nationally representative sample. The rate of OW and OB was 16.3 and 24.1%, respectively, in the authors' pediatric burn population. White patients had OW and OB rates of 15.9 and 23.6%, respectively, compared with 18.2 and 30.2%, respectively, in black patients. All OW and OB rates were outside the 95% confidence interval of the nationally representative National Health and Nutrition Examination Survey population. The rates of OW and OB in pediatric reconstructive burn patients exceed the US population standard across age and race stratifications. The prevention and treatment of excessive weight gain should be a component of rehabilitation in pediatric burns.

Perceptions of middle school educators in Hawai'i about school-based gardening and child health.

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Ahmed, Ameena T; Oshiro, Caryn E; Loharuka, Sheila; Novotny, Rachel

2011-07-01

Childhood obesity prevention is a national priority. School-based gardening has been proposed as an innovative obesity prevention intervention. Little is known about the perceptions of educators about school-based gardening for child health. As the success of a school-based intervention depends on the support of educators, we investigated perceptions of educators about the benefits of gardening programs to child health. Semi-structured interviews of 9 middle school educators at a school with a garden program in rural Hawai'i were conducted. Data were analyzed using a grounded theory approach. Perceived benefits of school-based gardening included improving children's diet, engaging children in physical activity, creating a link to local tradition, mitigating hunger, and improving social skills. Poverty was cited as a barrier to adoption of healthy eating habits. Opinions about obesity were contradictory; obesity was considered both a health risk, as well as a cultural standard of beauty and strength. Few respondents framed benefits of gardening in terms of health. In order to be effective at obesity prevention, school-based gardening programs in Hawai'i should be framed as improving diet, addressing hunger, and teaching local tradition. Explicit messages about obesity prevention are likely to alienate the population, as these are in conflict with local standards of beauty. Health researchers and advocates need to further inform educators regarding the potential connections between gardening and health.

School-Based Health Promotion Intervention: Parent and School Staff Perspectives

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Patino-Fernandez, Anna M.; Hernandez, Jennifer; Villa, Manuela; Delamater, Alan

2013-01-01

Background: The prevalence of childhood obesity is high, particularly among minority youth. The objective of this article was to evaluate parent and school staff perspectives of childhood health and weight qualitatively to guide the development of a school-based obesity prevention program for minority youth. Methods: Hispanic parents (N?=?9) of…

A Call to Action: Addressing the Childhood Obesity Epidemic through Comprehensive School Counseling Programs

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Belser, Christopher T.; Morris, Jessica A.; Hasselbeck, Jennifer M.

2012-01-01

The need for school-based interventions targeting the childhood obesity epidemic has been well documented. The risk factors associated with childhood obesity are physical, mental, psychosocial, academic, and economic. With training in developing comprehensive programs and interventions, professional school counselors are positioned to assist…

[Breastfeeding as a protective factor against overweight and obesity among pre-school children].

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Jarpa, M Catalina; Cerda, L Jaime; Terrazas, M Claudia; Cano, C Carmen

2015-01-01

The rates of overweight and obesity among children have significantly increased in Chile. To assess the benefits of breastfeeding in preventing malnutrition by excessive intake of foods in Chilean pre-school children. A case-control study was conducted in 2011 on pediatric patients treated in a private Chilean healthcare center (San Joaquin Medical Center, Catholic University). Gender, age, weight, height, nutritional diagnosis, type of feeding during the first 6 months of life, socioeconomic status, parental education and obesity, television viewing, and kindergarten attendance were analyzed. A total of 209 patients were included in the study, 53.1% of whom were male, and 60.3% were predominantly breastfed for the first 6 months of life. More than half (51.7%) were eutrophic, 29.7% were overweight, and 18.6% obese. The patients were between the ages of 2 and 3 years 11 months. The crude Odds Ratio of breast-feeding versus formula during the first 6 months of life in patients with normal weight versus overweight children was 0.442 (95% CI 0.204-0.961). It was found that predominantly breastfeeding during the first 6 months of life acted as a protective factor against malnutrition by excessive intake of foods in Chilean pre-school children treated in this private medical center. Copyright © 2015. Publicado por Elsevier España, S.L.U.

The school food environment and adolescent obesity: qualitative insights from high school principals and food service personnel

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Ellerbeck Edward F

2007-05-01

Full Text Available Abstract Objectives To examine high school personnel's perceptions of the school environment, its impact on obesity, and the potential impact of legislation regulating schools' food/beverage offerings. Methods Semi-structured interviews were conducted with the principal (n = 8 and dietitian/food service manager (n = 7 at 8 schools (4 rural, 4 suburban participating in a larger study examining the relationship between the school environment and adolescent health behavior patterns. Results Principal themes included: 1 Obesity is a problem in general, but not at their school, 2 Schools have been unfairly targeted above more salient factors (e.g., community and home environment, 3 Attempts at change should start before high school, 4 Student health is one priority area among multiple competing demands; academic achievement is the top priority, 5 Legislation should be informed by educators and better incorporate the school's perspective. Food service themes included: 1 Obesity is not a problem at their school; school food service is not the cause, 2 Food offerings are based largely on the importance of preparing students for the real world by providing choice and the need to maintain high participation rates; both healthy and unhealthy options are available, 3 A la carte keeps lunch participation high and prices low but should be used as a supplement, not a replacement, to the main meal, 4 Vending provides school's additional revenue; vending is not part of food service and is appropriate if it does not interfere with the lunch program. Conclusion Discrepancies exist between government/public health officials and school personnel that may inhibit collaborative efforts to address obesity through modifications to the school environment. Future policy initiatives may be enhanced by seeking the input of school personnel, providing recommendations firmly grounded in evidence-based practice, framing initiatives in terms of their potential impact on the

Effectiveness of school network for childhood obesity prevention (SNOCOP) in primary schools of Saraburi Province, Thailand.

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Banchonhattakit, Pannee; Tanasugarn, Chanuantong; Pradipasen, Mandhana; Miner, Kathleen R; Nityasuddhi, Dechavudh

2009-07-01

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.

Junk Food in Schools and Childhood Obesity

OpenAIRE

Datar, Ashlesha; Nicosia, Nancy

2012-01-01

Despite limited empirical evidence, there is growing concern that junk food availability in schools has contributed to the childhood obesity epidemic. In this paper, we estimate the effects of junk food availability on BMI, obesity, and related outcomes among a national sample of fifth-graders. Unlike previous studies, we address the endogeneity of the school food environment by controlling for children’s BMI at school entry and estimating instrumental variables regressions that leverage vari...

Obesity and Aerobic Fitness among Urban Public School Students in Elementary, Middle, and High School.

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B Ruth Clark

Full Text Available To assess the prevalence of cardiovascular disease risk among urban public school students through a collaborative school district and university partnership.Children and adolescents in grades K-12 from 24 urban public schools participated in measurements of height, weight, and other health metrics during the 2009-2010 school year. Body mass index (BMI percentiles and z-scores were computed for 4673 students. President's Challenge 1-mile endurance run was completed by 1075 students ages 9-19 years. Maximal oxygen consumption (⩒O2max was predicted using an age-, sex-, and BMI-specific formula to determine health-related fitness. Resting blood pressure (BP was assessed in 1467 students. Regression analyses were used to compare BMI z-scores, fitness, and age- and sex-specific BP percentiles across grade levels. Chi-square tests were used to explore the effect of sex and grade-level on health-related outcomes.Based on BMI, 19.8% were categorized as overweight and 24.4% were obese. Included in the obese category were 454 students (9.7% of sample classified with severe obesity. Using FITNESSGRAM criteria, 50.2% of students did not achieve the Healthy Fitness Zone (HFZ; the proportion of students in the Needs Improvement categories increased from elementary to middle school to high school. Male students demonstrated higher fitness than female students, with 61.4% of boys and only 35.4% of girls meeting HFZ standards. Elevated BP was observed among 24% of 1467 students assessed. Systolic and diastolic BP z-scores revealed low correlation with BMI z-scores.A community-university collaboration identified obesity, severe obesity, overweight, and low aerobic fitness to be common risk factors among urban public school students.

Identification, Prevention, and Management of Childhood Overweight and Obesity in a Pediatric Primary Care Center.

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Reed, Monique; Cygan, Heide; Lui, Karen; Mullen, Mary

2016-08-01

Background In the United States, overweight/obesity among youth has reached epidemic proportions. The purpose of this project was to (1) examine primary care provider adherence to American Academy of Pediatrics guidelines; (2) compare adherence based on patients' weight classification, age, race, and gender; and (3) identify areas for improvement in health care delivery. Methods A retrospective chart audit and feedback quality improvement project was conducted with a stratified random sample of 175 charts of 6- to 19-year-olds seen for well-child visits. Frequencies of provider adherence were reported. χ(2) Analyses of weight classification, age, race, or gender influence on adherence was calculated. Results After discussion with the primary care providers, 5 areas were identified as priorities for change (diagnosis based on BMI, parental history of obesity, sleep assessment, endocrine assessment, and attendance of patients at the follow-up visit). Conclusion Cost-efficient, feasible strategies to improve provider adherence to recommendations for identification, prevention and management of childhood overweight and obesity were identified. © The Author(s) 2015.

Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting

DEFF Research Database (Denmark)

Johansen, Anders; Holm, Jens-Christian; Pearson, Seija

2015-01-01

as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI......Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children...... and adolescents a chronic illness, which is in line with the American Medical Society. We summarize the evidence for the efficacy of a combination of diet, physical activity and behavior-focused interventions in a family-based setting. The present guidelines propose a multidisciplinary service implemented...

Guided self-help for the treatment of pediatric obesity.

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Boutelle, Kerri N; Norman, Gregory J; Rock, Cheryl L; Rhee, Kyung E; Crow, Scott J

2013-05-01

Clinic-based programs for childhood obesity are not available to a large proportion of the population. The purpose of this study was to evaluate the efficacy of a guided self-help treatment of pediatric obesity (GSH-PO) compared with a delayed treatment control and to evaluate the impact of GSH-PO 6-months posttreatment. Fifty overweight or obese 8- to 12-year-old children and their parents were randomly assigned to immediate treatment or to delayed treatment. The GSH-PO includes 12 visits over 5 months and addresses key components included in more intensive clinic-based programs. Children and parents in the immediate treatment arm were assessed at time 1 (T1), participated in GSH-PO between T1 and T2, and completed their 6-month posttreatment assessment at T3. Children and parents in the delayed treatment arm were assessed at T1, participated in GSH-PO between T2 and T3, and completed their 6-month posttreatment assessment at T4. The main outcome measures were BMI, BMI z score, and percentage overweight (%OW). Children in the immediate treatment GSH-PO arm decreased their BMI significantly more than did the delayed treatment arm (BMI group × time = -1.39; P < .001). Similar results were found for BMI z score and %OW. At the 6-month posttreatment assessment, changes resulting from GSH-PO were maintained for BMI z score and %OW but not BMI (BMI time effect = -0.06, not significant; BMI z score time effect = -0.10, P < .001; %OW time effect = -4.86, P < .05). The GSH-PO showed initial efficacy in decreasing BMI for children in this study. Additional efficacy and translational studies are needed to additionally evaluate GSH-PO.

Perceptions of Middle School Educators in Hawai‘i about School-based Gardening and Child Health

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Oshiro, Caryn E; Loharuka, Sheila; Novotny, Rachel

2011-01-01

Background Childhood obesity prevention is a national priority. School-based gardening has been proposed as an innovative obesity prevention intervention. Little is known about the perceptions of educators about school-based gardening for child health. As the success of a school-based intervention depends on the support of educators, we investigated perceptions of educators about the benefits of gardening programs to child health. Methods Semi-structured interviews of 9 middle school educators at a school with a garden program in rural Hawai‘i were conducted. Data were analyzed using a grounded theory approach. Results Perceived benefits of school-based gardening included improving children's diet, engaging children in physical activity, creating a link to local tradition, mitigating hunger, and improving social skills. Poverty was cited as a barrier to adoption of healthy eating habits. Opinions about obesity were contradictory; obesity was considered both a health risk, as well as a cultural standard of beauty and strength. Few respondents framed benefits of gardening in terms of health. Conclusions In order to be effective at obesity prevention, school-based gardening programs in Hawai‘i should be framed as improving diet, addressing hunger, and teaching local tradition. Explicit messages about obesity prevention are likely to alienate the population, as these are in conflict with local standards of beauty. Health researchers and advocates need to further inform educators regarding the potential connections between gardening and health. PMID:21886287

Pediatric refugees in Rhode Island: increases in BMI percentile, overweight, and obesity following resettlement.

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Heney, Jessica H; Dimock, Camia C; Friedman, Jennifer F; Lewis, Carol

2014-01-05

To evaluate BMI change among pediatric refugees resettling in Providence, RI. Retrospective chart review of pediatric refugees from the initial evaluation to year 3 post-resettlement at Hasbro Children's Hospital. Primary outcome of interest was within person change in BMI percentile at each time point. From 2007-2012, 181 children visited the clinic. Initial prevalence of overweight and obesity was 14.1% and 3.2% versus 22.8% and 12.6% at year 3. From visit 1 and years 1-3, there was a positive mean within person change in BMI percentile of 12.9% (95% CI 6.3-19.6%s), 16.6% (95% CI 11.2-21.9%), and 14.4% (95% CI 9.1-19.7%). The prevalence of overweight and obesity increased from 17.3% at initial intake to 35.4% at 3 years post-resettlement to surpass that of American children (31.7-31.8% for 2007-2012). Refugee children have additional risk factors for obesity; multidisciplinary interventions must be designed to address nutrition at each visit.

A controlled, class-based multicomponent intervention to promote healthy lifestyle and to reduce the burden of childhood obesity.

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Centis, E; Marzocchi, R; Di Luzio, R; Moscatiello, S; Salardi, S; Villanova, N; Marchesini, G

2012-12-01

Overweight and obesity prevention in childhood and adolescence represent a priority for public health; school is a privileged place for health promotion interventions. The study aimed to test the effectiveness of a multicomponent 5-month intervention on the habits of primary school children, making the families aware of the importance of healthy choices. Two hundred nine children attending the fourth class of primary school, divided into interventional (n = 103) and control arm (n = 106) were included in the study. In the intervention group, parents and teachers received more intense lifestyle counseling, associated with weekly motivational telephone calls to families to motivate further their lifestyle changes. Standard deviation score (SDS) body mass index (BMI) was the primary outcome measure; on open-air games and TV watching were secondary outcomes. At baseline, no differences were observed between groups. At 8-month follow-up, mean SDS BMI had decreased by 0.06 units in the intervention arm and increased by 0.12 in controls (time × treatment anova, P < 0.002). Outdoor activities increased from 6.23 h week(-1) to 9.93 in the intervention group (P < 0.001), not in controls. This change was associated differences in TV watching from baseline (intervention, -0.96 h week(-1); P = 0.037; controls, +1.33 h week(-1); P = 0.031). A multicomponent school-based intervention addressing the needs of children, teachers and families produced a significant and favourable short-term effect on overweight/obese schoolchildren. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

Social Determinants of Overweight and Obesity Rates by Elementary School in a Predominantly Hispanic School District.

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Santos, Richard; Huerta, Gabriel; Karki, Menuka; Cantarero, Andrea

This study analyzes the social determinants associated with the overweight or obesity prevalence of 85 elementary schools during the 2010-11 academic year in a predominantly Hispanic school district. A binomial logistic regression is used to analyze the aggregate overweight or obesity rate of a school by the percent of Hispanic students in each school, selected school and neighborhood characteristics, and its geographical location. The proportion of Hispanic enrollment more readily explains a school's aggregate overweight or obesity rate than social determinants or spatial location. Number of fast food establishments and the academic ranking of a school appear to slightly impact the aggregate prevalence rate. Spatial location of school is not a significant factor, controlling for other determinants. An elementary school's overall overweight or obesity rate provides a valuable health indicator to study the social determinants of obesity among Hispanics and other students within a local neighborhood. Copyright © 2017 Elsevier Inc. All rights reserved.

Obesity Prevention Opinions of School Stakeholders: A Qualitative Study

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Della Torre, Sophie Bucher; Akre, Christina; Suris, Joan-Carles

2010-01-01

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…

Gender-specific relationships between socioeconomic disadvantage and obesity in elementary school students.

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Zahnd, Whitney E; Rogers, Valerie; Smith, Tracey; Ryherd, Susan J; Botchway, Albert; Steward, David E

2015-12-01

To assess the gender-specific effect of socioeconomic disadvantage on obesity in elementary school students. We evaluated body mass index (BMI) data from 2,648 first- and fourth-grade students (1,377 male and 1,271 female students) in eight elementary schools in Springfield, Illinois, between 2012 and 2014. Other factors considered in analysis were grade level, year of data collection, school, race/ethnicity, gender, and socioeconomic disadvantage (SD). Students were considered SD if they were eligible for free/reduced price lunch, a school-based poverty measure. We performed Fisher's exact test or chi-square analysis to assess differences in gender and obesity prevalence by the other factors and gender-stratified logistic regression analysis to determine if SD contributed to increased odds of obesity. A higher proportion of SD female students (20.8%) were obese compared to their non-SD peers (15.2%) (p=0.01). Unadjusted and adjusted logistic regression analysis indicated no difference in obesity in SD and non-SD male students. However, in both unadjusted and adjusted analyses, SD female students had higher odds of obesity than their peers. Even after controlling for grade level, school, year of data collection, and race/ethnicity, SD female students had 49% higher odds of obesity than their non-SD classmates (odds ratio:1.49; 95% confidence interval: 1.09-2.04). Obesity was elevated in SD female students, even after controlling for factors such as race/ethnicity, but such an association was not seen in male students. Further study is warranted to determine the cause of this disparity, and interventions should be developed to target SD female students. Copyright © 2015 Elsevier Inc. All rights reserved.

Baby steps in the prevention of childhood obesity: IOM guidelines for pediatric practice.

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Gaffney, Kathleen F; Kitsantas, Panagiota; Brito, Albert; Kastello, Jennifer

2014-01-01

The aim of this paper is to present an overview of the infancy-related guidelines from the Institute of Medicine (IOM, 2011) report “Early Childhood Obesity Prevention Policies” and highlight research studies that support their implementation in pediatric practice. Findings from recent studies of infant growth monitoring, feeding, sleep, and physical activity are presented. Research strategies that may be applied to today's clinical assessments and interventions are specified. Participation by pediatric nurses in the development of future multi-component interventions to prevent rapid infant weight gain is recommended.

Exploring primary school headteachers' perspectives on the barriers and facilitators of preventing childhood obesity.

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Howard-Drake, E J; Halliday, V

2016-03-01

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: journals.permissions@oup.com.

School-based systems change for obesity prevention in adolescents: outcomes of the Australian Capital Territory 'It's Your Move!'

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Malakellis, Mary; Hoare, Erin; Sanigorski, Andrew; Crooks, Nicholas; Allender, Steven; Nichols, Melanie; Swinburn, Boyd; Chikwendu, Cal; Kelly, Paul M; Petersen, Solveig; Millar, Lynne

2017-10-01

The Australian Capital Territory 'It's Your Move!' (ACT-IYM) was a three-year (2012-2014) systems intervention to prevent obesity among adolescents. The ACT-IYM project involved three intervention schools and three comparison schools and targeted secondary students aged 12-16 years. The intervention consisted of multiple initiatives at individual, community, and school policy level to support healthier nutrition and physical activity. Intervention school-specific objectives related to increasing active transport, increasing time spent physically active at school, and supporting mental wellbeing. Data were collected in 2012 and 2014 from 656 students. Anthropometric data were objectively measured and behavioural data self-reported. Proportions of overweight or obesity were similar over time within the intervention (24.5% baseline and 22.8% follow-up) and comparison groups (31.8% baseline and 30.6% follow-up). Within schools, two of three the intervention schools showed a significant decrease in the prevalence of overweight and obesity (pobesity among adolescents. Implications for public health: The incorporation of systems thinking has been touted as the next stage in obesity prevention and public health more broadly. These findings demonstrate that the use of systems methods can be effective on a small scale. © 2017 The Authors.

What Barriers and Facilitators Do School Nurses Experience When Implementing an Obesity Intervention?

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Schroeder, Krista; Smaldone, Arlene

2017-12-01

A recent evaluation of a school nurse-led obesity intervention demonstrated a 5% implementation rate. The purpose of this study was to explore school nurses' perceived barriers to and facilitators of the intervention in order to understand reasons for the low implementation rate. Methods included semi-structured individual interviews with school nurses. Data were analyzed using content analysis and heat mapping. Nineteen nurses participated and eight themes were identified. Parental and administrative gatekeeping, heavy nurse workload, obesogenic environments, and concerns about obesity stigma were barriers to implementation. Teamwork with parents and school staff was a key facilitator of implementation. Nurses also noted the importance of cultural considerations and highlighted the need to tailor the intervention to the unique needs of their school environment and student population. These findings suggest that for school nurses to play a key role in school-based obesity interventions, barriers must be identified and addressed prior to program implementation.

Smartphone Interventions for Weight Treatment and Behavioral Change in Pediatric Obesity: A Systematic Review.

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Chaplais, Elodie; Naughton, Geraldine; Thivel, David; Courteix, Daniel; Greene, David

2015-10-01

Traditional approaches for treating or managing children and adolescents with overweight or obesity have limited effectiveness. Current advances in smartphone technology may improve the attractiveness and accessibility of weight management support for children and adolescents with overweight or obesity. This systematic review aimed to provide a comparative evaluation of the effectiveness of using smartphones in the multidisciplinary treatment of child and adolescent overweight or obesity, with a specific interest in behavior change. The databases of Medline complete, OVID, CINAHL, EMBASE, and PubMed were searched for randomized controlled trial (RCT) studies addressing behavioral change using smartphone technology, plus nutrition and/or physical activity, to treat or manage child and adolescent obesity. Only two RCTs have described the effectiveness of smartphone devices in pediatric overweight or obesity treatment. Within the limitation of the two studies, electronic contact (e-contact) appeared unsuccessful in achieving weight loss. However, smartphone usage was linked to improved engagement and reduced dropout rates during important sustainability phases of these long-term interventions. Smartphone technologies allow users to accomplish tasks anywhere and anytime and, as such, provide researchers with additional and generationally appropriate capacities to deliver health promotion. E-contact should be used for its significant capacity to prolong engagement and decrease withdrawal during sustainability phases that follow intensive intervention for weight management in young populations. Despite increasing popularity in published protocols of weight management trials, the effectiveness of the impact of smartphone technology in pediatric programs remains equivocal.

The Prevalence of Obesity in School Children of Zahedan-Iran; Double Burden of Weight Disorders

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Soheilipour

2015-08-01

Full Text Available Background Obesity has a permanent effect on childrens’ health and acts as a major risk factor for chronic diseases. Therefore considering children BMI is a vital parameter at each visit. Objectives This study was performed to assess the prevalence of obesity and its determinants in school children of Zahedan in Iran. Zahedan is the capital of Sistan-and-Balouchestan province known to have the highest prevalence of underweight in Iranian children. Patients and Methods This cross-sectional study was performed on 3582 school children, among which 1786 were girls and 1796 boys in 2012. The students aged 6 to 13 years old and selected based on a stratified random method. The body mass index (BMI was measured for each student and being overweight/obesity was determined based on CDC 2000 definitions. Prevalence proportions were estimated by weighing the sample. The study was performed at primary and guidance schools of Zahedan. Samples were stratified from two geographic regions of Zahedan (Zone 1 and 2. Results In the sample, 78.9% were under 85th percentile, 11.8% were overweight (85th - 95th percentile and 9.3% were obese (> 95th percentile. Weighted estimate for the prevalence of obesity/overweight in girls, boys and all 6 - 13 years old students were 16.2%, 18.4% and 17.4%, respectively. Presence of overweight/obesity was related to school type (private to public schools OR = 2.13, 1.80 - 2.52 and increasing age (OR = 1.12, 1.04 - 1.20. Conclusions A high prevalence of obesity was found in Zahedan students. Concurrent high prevalence of obesity/overweight and underweight demonstrates amplitude of weight problems in school children. There is an urgent need for special health programs to conduct proper diagnosis and management of obesity in Zahedan.

Practitioner Review: Bridging the Gap between Research and Clinical Practice in Pediatric Obesity

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Jelalian, Elissa; Wember, Yana Markov; Bungeroth, Heidi; Birmaher, Vered

2007-01-01

Background: Pediatric obesity is a significant public health concern, with rising prevalence rates in both developed and developing countries. This is of particular significance given that overweight children and adolescents are at increased risk for multiple medical comorbidities, as well as psychosocial and behavioral difficulties. The current…

Why did soft drink consumption decrease but screen time not? Mediating mechanisms in a school-based obesity prevention program

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Chin A Paw, M.J.M.; Singh, A.S.; Brug, J.; Mechelen, van, W.

2008-01-01

Abstract Objectives This paper aims to identify the mediating mechanisms of a school-based obesity prevention program (DOiT). Methods The DOiT-program was implemented in Dutch prevocational secondary schools and evaluated using a controlled, cluster-randomised trial (September 2003 to May 2004). We examined mediators of effects regarding (1) consumption of sugar containing beverages (SCB); (2) consumption of high caloric snacks; (3) screen-viewing behaviour; and (4) active commuting to school...

Obesity in elementary school children after the Great East Japan Earthquake.

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Moriyama, Hidenori; Fuchimukai, Toru; Kondo, Naoki; Takayama, John I

2018-03-01

Rikuzentakata was one of the cities most devastated by the Great East Japan Earthquake on 11 March 2011. Many buildings were swept away or destroyed and affected families were placed into temporary housing. The aim of this study was to determine the impact of long-term temporary housing on the body mass index (BMI) of elementary school children living in Rikuzentakata City. A retrospective cohort study of was carried out of students attending 1st-3rd grade in 2010, and 4th-6th grade in 2013, in eight elementary schools in Rikuzentakata City. Height and weight were measured annually. We compared changes in BMI between children in temporary housing and those in permanent housing. Separately, parents of students attending one of the elementary schools were surveyed in 2013. Of 526 children in the present study, 32% were living in temporary housing. The prevalence of obesity climbed from 5.3% in 2010 to 7.8% in 2013 in the temporary housing group, and from 7.6% to 7.8% in the permanent housing group. BMI z-score in the temporary housing group increased by 0.102 points between 2010 and 2013 (P comic books and their walking commute time had decreased by 2 min compared with before the disaster. Obesity prevalence and BMI z-score increased in children in temporary housing compared with permanent housing. A more sedentary lifestyle may explain this trend. It is important for policy makers and health-care providers to recognize potential consequences of long-term residence in temporary housing. © 2017 Japan Pediatric Society.

Association between impaired fasting glycaemia in pediatric obesity and type 2 diabetes in young adulthood.

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Hagman, E; Danielsson, P; Brandt, L; Ekbom, A; Marcus, C

2016-08-22

In adults, impaired fasting glycemia (IFG) increases the risk for type 2 diabetes mellitus (T2DM). This study aimed to investigate to which extent children with obesity develop T2DM during early adulthood, and to determine whether IFG and elevated hemoglobin A1c (HbA1c) in obese children are risk markers for early development of T2DM. In this prospective cohort study, 1620 subjects from the Swedish Childhood Obesity Treatment Registry - BORIS who were ⩾18 years at follow-up and 8046 individuals in a population-based comparison group, matched on gender age and living area, were included. IFG was defined according to both ADA (cut-off 5.6 mmol l(-1)) and WHO (6.1 mmol l(-1)). Elevated HbA1c was defined according to ADA (cut-off 39 mmol l(-1)). Main outcome was T2DM medication, as a proxy for T2DM. Data on medications were retrieved from a national registry. The childhood obesity cohort were 24 times more likely to receive T2DM medications in early adulthood compared with the comparison group (95% confidence interval (CI): 12.52-46). WHO-defined IFG predicted future use of T2DM medication with an adjusted hazard ratio (HR) of 3.73 (95% CI: 1.87-7.45) compared with those who had fasting glucose levels fasting glucose level of 5.6-6.0 mmol l(-1), that is, the IFG-interval added by American Diabetes Association (ADA), did not increase the use of T2DM medication more than pediatric obesity itself, adjusted HR=1.72 (0.84-3.52). Elevated levels of HbA1c resulted in an adjusted HR=3.12 (1.50-6.52). More severe degree of obesity also increased the future T2DM risk. IFG according to WHO and elevated HbA1c (39-48 mmol l(-1)), but not the additional fasting glucose interval added by ADA (5.6-6.0 mmol l(-1)), can be considered as prediabetes in the obese pediatric population in Sweden.

Providers as weight coaches: using practice guides and motivational interview to treat obesity in the pediatric office.

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Tripp, Sandy Blizzard; Perry, Joan Templeton; Romney, Sharon; Blood-Siegfried, Jane

2011-10-01

Motivational interview techniques combined with an evidence-based guideline provide valuable tools for the treatment of childhood obesity. The National Association of Pediatric Nurse Practitioners' Healthy Eating and Activity Together guidelines were adopted in a rural pediatric office. After a 6-month pilot, effectiveness of treatment was evaluated with a retrospective chart review. The results suggest that children were motivated for healthy lifestyle changes but had difficulty maintaining motivation and compliance with healthy change choices after 1-2 months; however, with consistent use of motivational interviewing techniques combined with diet and exercise counseling, there was a trend toward lowered body mass index and waist measurements. Copyright © 2011 Elsevier Inc. All rights reserved.

Overweight and obesity in youth in schools-the role of the school nurse: position statement.

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2014-05-01

It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as the school nurse) has the knowledge and expertise to promote the prevention of overweight and obesity and address the needs of overweight and obese youth in schools. The school nurse collaborates with students, families, school personnel, and health care providers to promote healthy weight and identify overweight and obese youth who may be at risk for health problems. The school nurse can refer and follow up with students who may need to see a health care provider. The school nurse also educates and advocates for changes in school and district policies that promote a healthy lifestyle for all students.

A STUDY ON PREVALENCE OF OBESITY IN SCHOOL CHILDREN IN A RURAL POPULATION IN SOUTH KERALA

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Nesamony Maneksh Kumar

2017-05-01

Full Text Available BACKGROUND Obesity is defined as having excess body fat due to ‘calorie imbalance’ -too few calories expended for the amount of calories consumed. Childhood obesity has both immediate and long-term effects on health and well-being. This study is aimed to highlight the burden of obesity among school children. The objectives of this study are to find the prevalence of obesity among school children aged 11-15 years and to compare prevalence of obesity among school children of government and private schools. MATERIALS AND METHODS School-based cross-sectional study conducted in 2 private and 2 government schools of a rural area in Trivandrum district. Total 800 students (200 from each school aged 11-15 years in 6 th to 10 th standards were selected by systematic random sampling and consent were obtained. Height (cm and weight (kg were measured using stadiometer and standardised weighing machine, respectively. Body Mass Index (BMI was calculated and categorised as underweight, normal, overweight and obese. The prevalence is expressed in percentages. RESULTS In this study, the total prevalence of overweight and obesity among the total 800 school children is found to be 4% and 1%, respectively. An alarming incidental finding is that the underweight prevalence is 61%, which is significantly high and should be addressed. The overall prevalence of overweight and obesity is 4.25% and 1.75%, respectively in private schools, whereas it is 3.5% and 1%, respectively, in government schools. There is not a significant difference between private and government school children. This may be due to the awareness about problems of obesity and its effects among school children and also timely health checkups in the schools. CONCLUSION This study done in a rural area found that there is a significant prevalence of obesity and overweight as well as a very high prevalence of underweight. It indicates that childhood obesity is an emerging health problem in rural areas

Design of the FRESH study: A randomized controlled trial of a parent-only and parent-child family-based treatment for childhood obesity.

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Boutelle, Kerri N; Braden, Abby; Douglas, Jennifer M; Rhee, Kyung E; Strong, David; Rock, Cheryl L; Wilfley, Denise E; Epstein, Leonard; Crow, Scott

2015-11-01

Approximately 1 out of 3 children in the United States is overweight or obese. Family-based treatment (FBT) is considered the gold-standard treatment for childhood obesity, but FBT is both staff and cost intensive. Therefore, we developed the FRESH (Family, Responsibility, Education, Support, & Health) study to evaluate the effectiveness of intervening with parents, without child involvement, to facilitate and improve the child's weight status. Targeting parents directly in the treatment of childhood obesity could be a promising approach that is developmentally appropriate for grade-school age children, highly scalable, and may be more cost effective to administer. The current paper describes the FRESH study which was designed to compare the effectiveness of parent-based therapy for pediatric obesity (PBT) to a parent and child (FBT) program for childhood obesity. We assessed weight, diet, physical activity, and parenting, as well as cost-effectiveness, at baseline, post-treatment, and at 6- and 18-month follow-ups. Currently, all participants have been recruited and completed assessment visits, and the initial stages of data analysis are underway. Ultimately, by evaluating a PBT model, we hope to optimize available child obesity treatments and improve their translation into clinical settings. Copyright © 2015 Elsevier Inc. All rights reserved.

History matters: childhood weight trajectories as a basis for planning community-based obesity prevention to adolescents.

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Ekberg, J; Angbratt, M; Valter, L; Nordvall, M; Timpka, T

2012-04-01

To use epidemiological data and a standardized economic model to compare projected costs for obesity prevention in late adolescence accrued using a cross-sectional weight classification for selecting adolescents at age 15 years compared with a longitudinal classification. All children born in a Swedish county (population 440 000) in 1991 who participated in all regular measurements of height and weight at ages 5, 10 and 15 years (n=4312) were included in the study. The selection strategies were compared by calculating the projected financial load resulting from supply of obesity prevention services from providers at all levels in the health care system. The difference in marginal cost per 1000 children was used as the primary end point for the analyses. Using the cross-sectional selection strategy, 3.8% of adolescents at age 15 years were selected for evaluation by a pediatric specialist, and 96.2% were chosen for population-based interventions. In the trajectory-based strategy, 2.4% of the adolescents were selected for intensive pediatric care, 1.4% for individual clinical interventions in primary health care, 14.0% for individual primary obesity prevention using the Internet and 82.1% for population-based interventions. Costs for the cross-sectional selection strategy were projected to USD463 581 per 1000 adolescents and for the trajectory-based strategy were USD 302 016 per 1000 adolescents. Using projections from epidemiological data, we found that by basing the selection of adolescents for obesity prevention on weight trajectories, the load on highly specialized pediatric care can be reduced by one-third and total health service costs for obesity management among adolescents reduced by one-third. Before use in policies and prevention program planning, our findings warrant confirmation in prospective cost-benefit studies.

Psychometric characteristics of process evaluation measures for a rural school-based childhood obesity prevention study: Louisiana Health.

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Newton, Robert L; Thomson, Jessica L; Rau, Kristi K; Ragusa, Shelly A; Sample, Alicia D; Singleton, Nakisha N; Anton, Stephen D; Webber, Larry S; Williamson, Donald A

2011-01-01

To evaluate the implementation of intervention components of the Louisiana Health study, which was a multicomponent childhood obesity prevention program conducted in rural schools. Content analysis. Process evaluation assessed implementation in classrooms, gym classes, and cafeterias. Classroom teachers (n  =  232), physical education teachers (n  =  53), food service managers (n  =  33), and trained observers (n  =  9). Five process evaluation measures were created: Physical Education Questionnaire (PEQ), Intervention Questionnaire (IQ), Food Service Manager Questionnaire (FSMQ), Classroom Observation (CO), and School Nutrition Environment Observation (SNEO). Interrater reliability and internal consistency were assessed on all measures. Analysis of variance and χ(2) were used to compare differences across study groups on questionnaires and observations. The PEQ and one subscale from the FSMQ were eliminated because their reliability coefficients fell below acceptable standards. The subscale internal consistencies for the IQ, FSMQ, CO, and SNEO (all Cronbach α > .60) were acceptable. After the initial 4 months of intervention, there was evidence that the Louisiana Health intervention was being implemented as it was designed. In summary, four process evaluation measures were found to be sufficiently reliable and valid for assessing the delivery of various aspects of a school-based obesity prevention program. These process measures could be modified to evaluate the delivery of other similar school-based interventions.

School environment and policies, child eating behavior and overweight/obesity in urban China: the childhood obesity study in China megacities.

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Jia, P; Li, M; Xue, H; Lu, L; Xu, F; Wang, Y

2017-05-01

Childhood obesity is rising rapidly in China, especially in urban areas. Knowledge about how school environment and policies (SEPs) may have contributed to the epidemic remains limited. We examined SEP and their associations with students' eating behaviors and overweight/obesity in urban China. Data were collected from 1648 students (plus their parents and schools) in 16 primary and middle schools (4 schools per city) in four megacities across China: Beijing, Shanghai, Nanjing and Xi'an. We examined nutrition-related SEP such as unhealthy food restriction, healthy food promotion, price control and nutrition guideline in school cafeterias (SCs), campus food stores (CFS), school vicinity food stalls (SVFS); SEP on physical activity, physical education (PE) and physical examination. Cluster robust regression models were fit to assess associations of SEP with child eating behaviors and overweight/obesity (defined based on body mass index, from measured weight and height). All 16 schools had regular PE classes and annual physical examination. Most schools (n=12; 75%) had food policies in SC; few had policies on CFS (n=1; 6.25%) or SVFS (n=4; 25%). Local governments had a major role in regulating food prices, setting nutrition guidelines and regulating SVFS. Policies on CFS and SVFS were associated with less frequent intake of sugary beverage (odds ratio (OR)=0.54 (0.47-0.61); OR=0.70 (0.61-0.80)), snack (OR=0.84 (0.74-0.95); OR=0.78 (0.67-0.92)) and fast food (OR=0.58 (0.42-0.81); OR=0.56 (0.39-0.80)). The associations were stronger for boys. Policies on SC, CFS and SVFS were associated with lower likelihood for overweight/obesity (OR=0.60 (0.46-0.79); OR=0.74 (0.62-0.90); OR=0.51 (0.35-0.73)) and central obesity (OR=0.79 (0.70-0.89); OR=0.67 (0.48-0.92); OR=0.63 (0.48-0.84)) in boys. Policies on SC were associated with lower overweight/obesity odds (OR=0.48 (0.28-0.82)) for girls. SEP are heterogeneous in the four Chinese megacities, high-income areas. They affect

Structured Dietary Interventions in the Treatment of Severe Pediatric Obesity: A Pilot Study.

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Kalarchian, Melissa A; Levine, Michele D; Marcus, Marsha D

2013-06-01

Structured dietary interventions have been associated with improved outcomes in adult weight-control programs, but virtually no research has focused on children. Thus, we conducted an uncontrolled pilot study to determine the potential utility of structured approaches to enhance the dietary component of family-based treatment of severe pediatric obesity (body mass index [BMI] >97th percentile for age and sex). Children aged 8-12 years participated with a parent or guardian. Individualized menu plans were provided (MENU, n =12) alone, or along with meals and snacks for the child (MENU+MEAL, n =6). All families received up to $30/week reimbursement for foods included in the menus. Median BMI change was -1.2 kg/m 2 for MENU ( n =12), and -1.8 kg/m 2 for MENU+MEAL ( n =6). Both approaches were associated with significant reductions in BMI ( p obesity are acceptable to families and warrant further development.

The effectiveness of web-based programs on the reduction of childhood obesity in school-aged children: A systematic review.

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Antwi, Flora; Fazylova, Natalya; Garcon, Marie-Carmel; Lopez, Liliana; Rubiano, Rosagna; Slyer, Jason T

The objective of this review is to synthesise the best available evidence on the effectiveness of web-based programs on the reduction of childhood obesity in school age children. Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low- and middle-income countries, particularly in urban settings.[1] The prevalence has increased at an alarming rate globally.[2] The International Association for the Study of Obesity; estimates that up to 200 million school aged children are either overweight or obese, of those 40-50 million are classified as obese. Obesity has negative health impact in childhood, as well as in the long term.Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity. It is defined as a person's weight in kilograms divided by the square of his/her height in meters (kg/m). The World Health Organization defines overweight as BMI greater than or equal to 25 and BMI greater than or equal to 30 as obesity. Children two years of age or older with a BMI between the 85 and 94 percentile on age-growth charts are considered overweight; children with a BMI greater than the 95 percentile are considered obese. BMI provides the most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages worldwide. Measures of central obesity such as the waist:hip ratio and waist circumference can provide more robust indices of overall obesity-related health risk than BMI alone. A BMI z-score is a quantitative measure of the deviation of a specific BMI percentile from the mean of that population. A positive z-score indicates a child is heavier than the mean and a negative z-score indicates a child is lighter than the mean. Thus, a z-score compares the BMI of a given child to the BMI

The Downstart Program: a hospital-based pediatric healthy lifestyle program for obese and morbidly obese minority youth.

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Sternberg, Alex; Muzumdar, Hiren; Dinkevich, Eugene; Quintos, Jose Bernardo; Austin-Leon, Galia; Owens, Terrel; Murphy, Cheryl; Dapul, Geraldine; Rao, Madu

2006-12-01

Although obesity affects all cultures, ethnic groups and social strata, this disorder affects African Americans, Hispanics and the poor at a disproportionate rate. The Downstart Pediatric Healthy Lifestyle Program was developed to provide a multi-disciplinary behavioral modification program for inner city families in Brooklyn, New York interested in leading a healthier, more active lifestyle. The Downstart Program uses a four-pronged approach of medical evaluation, exercise, nutritional education and lifestyle modification. A psychological evaluation is performed to determine the individual's ability and readiness to participate in group activities. Baseline physical fitness, flexibility and muscle strength are measured, followed by a twice-weekly karate/martial arts/dance program, incorporating principles established by the President's Council on Exercise. Nutritional and behavioral modification aspects of the program consist of weekly education about food groups, portion control, goal setting and appropriate rewards for attaining goals. Our preliminary results indicate that the Downstart Program may be a viable intervention for weight loss. Further study is needed to improve strategies for motivating patients and means and criteria for assessing long-term effects on health and lifestyle.

Evidence, theory and context - using intervention mapping to develop a school-based intervention to prevent obesity in children

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Greaves Colin J

2011-07-01

Full Text Available Abstract Background Only limited data are available on the development and feasibility piloting of school-based interventions to prevent and reduce obesity in children. Clear documentation of the rationale, process of development and content of such interventions is essential to enable other researchers to understand why interventions succeed or fail. Methods This paper describes the development of the Healthy Lifestyles Programme (HeLP, a school-based intervention to prevent obesity in children, through the first 4 steps of the Intervention Mapping protocol (IM. The intervention focuses on the following health behaviours, i reduction of the consumption of sweetened fizzy drinks, ii increase in the proportion of healthy snacks consumed and iii reduction of TV viewing and other screen-based activities, within the context of a wider attempt to improve diet and increase physical activity. Results Two phases of pilot work demonstrated that the intervention was acceptable and feasible for schools, children and their families and suggested areas for further refinement. Feedback from the first pilot phase suggested that the 9-10 year olds were both receptive to the messages and more able and willing to translate them into possible behaviour changes than older or younger children and engaged their families to the greatest extent. Performance objectives were mapped onto 3 three broad domains of behaviour change objectives - establish motivation, take action and stay motivated - in order to create an intervention that supports and enables behaviour change. Activities include whole school assemblies, parents evenings, sport/dance workshops, classroom based education lessons, interactive drama workshops and goal setting and runs over three school terms. Conclusion The Intervention Mapping protocol was a useful tool in developing a feasible, theory based intervention aimed at motivating children and their families to make small sustainable changes to their

Evidence, theory and context - using intervention mapping to develop a school-based intervention to prevent obesity in children

Science.gov (United States)

2011-01-01

Background Only limited data are available on the development and feasibility piloting of school-based interventions to prevent and reduce obesity in children. Clear documentation of the rationale, process of development and content of such interventions is essential to enable other researchers to understand why interventions succeed or fail. Methods This paper describes the development of the Healthy Lifestyles Programme (HeLP), a school-based intervention to prevent obesity in children, through the first 4 steps of the Intervention Mapping protocol (IM). The intervention focuses on the following health behaviours, i) reduction of the consumption of sweetened fizzy drinks, ii) increase in the proportion of healthy snacks consumed and iii) reduction of TV viewing and other screen-based activities, within the context of a wider attempt to improve diet and increase physical activity. Results Two phases of pilot work demonstrated that the intervention was acceptable and feasible for schools, children and their families and suggested areas for further refinement. Feedback from the first pilot phase suggested that the 9-10 year olds were both receptive to the messages and more able and willing to translate them into possible behaviour changes than older or younger children and engaged their families to the greatest extent. Performance objectives were mapped onto 3 three broad domains of behaviour change objectives - establish motivation, take action and stay motivated - in order to create an intervention that supports and enables behaviour change. Activities include whole school assemblies, parents evenings, sport/dance workshops, classroom based education lessons, interactive drama workshops and goal setting and runs over three school terms. Conclusion The Intervention Mapping protocol was a useful tool in developing a feasible, theory based intervention aimed at motivating children and their families to make small sustainable changes to their eating and activity

Evidence, theory and context--using intervention mapping to develop a school-based intervention to prevent obesity in children.

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Lloyd, Jennifer J; Logan, Stuart; Greaves, Colin J; Wyatt, Katrina M

2011-07-13

Only limited data are available on the development and feasibility piloting of school-based interventions to prevent and reduce obesity in children. Clear documentation of the rationale, process of development and content of such interventions is essential to enable other researchers to understand why interventions succeed or fail. This paper describes the development of the Healthy Lifestyles Programme (HeLP), a school-based intervention to prevent obesity in children, through the first 4 steps of the Intervention Mapping protocol (IM). The intervention focuses on the following health behaviours, i) reduction of the consumption of sweetened fizzy drinks, ii) increase in the proportion of healthy snacks consumed and iii) reduction of TV viewing and other screen-based activities, within the context of a wider attempt to improve diet and increase physical activity. Two phases of pilot work demonstrated that the intervention was acceptable and feasible for schools, children and their families and suggested areas for further refinement. Feedback from the first pilot phase suggested that the 9-10 year olds were both receptive to the messages and more able and willing to translate them into possible behaviour changes than older or younger children and engaged their families to the greatest extent. Performance objectives were mapped onto 3 three broad domains of behaviour change objectives--establish motivation, take action and stay motivated--in order to create an intervention that supports and enables behaviour change. Activities include whole school assemblies, parents evenings, sport/dance workshops, classroom based education lessons, interactive drama workshops and goal setting and runs over three school terms. The Intervention Mapping protocol was a useful tool in developing a feasible, theory based intervention aimed at motivating children and their families to make small sustainable changes to their eating and activity behaviours. Although the process was time

Determinants of overweight and obesity in the middle school students of Pakdasht city, Tehran province

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Azam Mahmudi

2014-09-01

Full Text Available Background: In recent years, overweight and obesity have dramatically increased in many countries, and this trend is also visible among children. Childhood obesity will increase the chance of obesity and its associated diseases in adulthood. This study was aimed to investigate the prevalence and determinants of overweight and obesity in middle school students of Pakdasht. Methods: In this cross-sectional study, 995 female students were selected from all middle schools of Pakdasht city, Tehran Province by stratified random sampling method. The required information on demographic variables, social determinants of health, type of entertainment, daily physical activity and eating habits was collected and Body Mass Index (BMI was calculated. Results: The mean age of students was 12.6 years. Finally, 9.1% and 15.1% of the students were obese and overweight, respectively. The results of univariate analysis showed that overweight and obesity were significantly associated with age, type of transportation to school, time of computer use, first-degree family history of obesity and daily physical activity. Overweight and obesity were also independently related to type of transportation to school, time of computer use, first-degree family history of obesity, birth weight and daily physical activity based on the results of multivariate analysis. Conclusion: Considering the relatively high prevalence of overweight and obesity in middle school students, it is necessary to design and implement ongoing interventional and multidimensional programms in order to declin or eliminate the mentioned risk factors.

School-based obesity-prevention interventions in low- and middle-income countries: Do they really work?

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Obesity is the most common nutrition-related health problem around the world, especially among children. Hundreds of studies have been conducted to test approaches to prevent obesity, and many were in children in schools. Most of these studies were conducted in higher-income countries. An article in...

A Facebook-Based Obesity Prevention Program for Korean American Adolescents: Usability Evaluation.

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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.

Using a community-based participatory research approach to develop a faith-based obesity intervention for African American children.

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Davis, Dawnavan S; Goldmon, Moses V; Coker-Appiah, Dionne S

2011-11-01

Childhood obesity is a major epidemic, with African American (AA) children aged 6 to 11 years experiencing increased burden. The AA faith community has numerous assets that point to the need for the intersection of faith and health to address obesity-related racial disparities. The purpose of the Our Bodies, God's Temples (OBGT) study was to examine diet, physical activity, and body image behaviors among AA children aged 6 to 11 years; receptivity to a faith-based obesity intervention among AA children, parents, and church leaders; and strengths and barriers of implementing a faith-based obesity curriculum in the Sunday school setting. A community-based participatory research approach was used to develop an obesity intervention to be integrated into the church Sunday school setting for AA children. A Community Advisory Network worked with researchers to develop a 12-week culturally appropriate faith-based obesity intervention. Future work will test the effectiveness of the newly created curriculum on obesity-related outcomes in AA children.

Vascular risks and management of obesity in children and adolescents

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Courtney J Jolliffe

2006-06-01

Full Text Available Courtney J Jolliffe1, Ian Janssen1,21School of Physical and Health Education, 2Department of Community Health and Epidemiology, Queen’s University, Kingston, Ontario, CanadaAbstract: Childhood obesity has reached epidemic proportions in many countries. Pediatric obesity is associated with the development of cardiovascular (CV risk factors including type 2 diabetes, hypertension, dyslipidemia, and the metabolic syndrome. It is also associated with an increased risk of CV disease (CVD in adulthood. Moreover, obesity and CVD risk factors in obese youth tend to track into adulthood, further increasing the risk of adult CVD. Consequently, the treatment and prevention of childhood overweight and obesity has become a public health priority. Proper nutrition and increased physical activity are the main focus of these efforts; however, few studies have shown positive results. Treatment options for obesity in youth also include pharmacotherapy and surgery. While pharmacotherapy appears promising, additional evidence is needed, especially with respect to the long-term impact, before it becomes a widespread treatment option in the pediatric population.Keywords: childhood, obesity, overweight, cardiovascular risk factors, prevention, treatment

A Meta-Analytic Review of Obesity Prevention in the Schools: 1997-2008

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Cook-Cottone, Catherine; Casey, Carolyn M.; Feeley, Thomas Hugh; Baran, Jennifer

2009-01-01

A meta-analysis was conducted on school-based interventions to reduce obesity in children. Sixty-six (k = 66, N = 31,059) comparisons from 40 published studies from 1997 through 2008 were included in analyses. Results indicated a significant effect for school-based interventions with an overall weighted effect size of r = 0.05. Several moderating…

Adequacy of patient pools to support predoctoral students' achievement of competence in pediatric dentistry in U.S. dental schools.

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Casamassimo, Paul S; Seale, N Sue

2015-06-01

The aim of this study was to characterize the current status of predoctoral pediatric dentistry patient pools in U.S. dental schools and compare their status to that in 2001. A 2014 survey of school clinic-based and community-based dental patient pools was developed, piloted, and sent to pediatric predoctoral program directors in 57 U.S. dental schools via SurveyMonkey. Two follow-up contacts were made to increase the response rate. A total of 49 surveys were returned for a response rate of 86%. The responding program directors reported that their programs' patient pools had declined in number and had changed in character with more diversity and fewer procedures. They attributed the changes to competition, cost, and location of the dental school. The respondents reported that community-based dental education clinical sites continued to provide additional service experiences for dental students, with contributions varying by the nature of the site. A large number of the respondents felt that their graduates lacked some basic pediatric dentistry clinical skills and were not ready for independent practice with children. The results of this study suggest that the predoctoral pediatric dentistry patient pool has changed and general dentists may be graduating with inadequate experiences to practice dentistry for children.

Overweight and Obesity in Youth in Schools--The Role of the School Nurse. Position Statement. Revised

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Mehrley, Melissa; Leibold, Nancyruth

2011-01-01

It is the position of the National Association of School Nurses that school nurses have the knowledge and expertise to promote the prevention of overweight and obesity and address the needs of overweight and obese youth in schools. The school nurse collaborates with students, families, school personnel, and health care providers to promote healthy…

Increasing inequality in childhood obesity in primary schools in a northern English town.

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Black, M; Joseph, V; Mott, L; Maheswaran, R

2018-05-01

To undertake an analysis of National Child Measurement Programme (NCMP) data to quantify the obesity prevalence gap over time between children in primary schools in the most and least deprived areas of Doncaster. The research design for this study was retrospective quantitative analysis of secondary data. The study undertook secondary analysis of NCMP data on obesity prevalence in children in Reception Year and Year 6 in primary schools in Doncaster for the period 2006-2007 to 2014-2015. Data were combined into three 3-year periods (2006-2007 to 2008-2009; 2009-2010 to 2011-2012; and 2012-2013 to 2014-2015), and schools were grouped by deprivation based on the national Indices of Multiple Deprivation 2015. Analysis was undertaken to assess whether there is a difference in obesity prevalence for Reception Year and Year 6 children in schools in the most deprived areas compared with the least deprived (prevalence gap), over time. The difference in obesity prevalence between children attending schools in the most and least deprived areas has increased over time. For Reception Year children, the prevalence gap has widened from a difference of 1.01% higher in the most deprived schools in 2006-2007 to 2008-2009 to 3.64% higher in 2012-2013 to 2014-2015. In the same time periods, for Year 6 children, the obesity prevalence gap has also increased over time from 2.82% to 5.08%. There is inequality in relation to obesity in primary school children in Doncaster with those in schools in the most deprived areas carrying the greatest burden. Research is needed to understand why the plateau seen nationally is not reaching the most deprived children. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Pilot Study of a Computer-Based Parental Questionnaire and Visual Profile of Obesity Risk in Healthy Preschoolers.

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Davies, Marilyn A; Terhorst, Lauren; Zhang, Peng; Nakonechny, Amanda J; Nowalk, Mary Patricia

2015-01-01

This group field-tested a computer-based, parental questionnaire entitled the Childhood Obesity Risk Questionnaire 2-5 (CORQ 2-5) designed to assess obesity risk in healthy preschoolers. COR 2-5 generates a profile of seven obesity risk factors. Field studies provided good internal reliability data and evidence of discriminant validity for the CORQ 2-5. Pediatric nurse clinicians found the CORQ 2-5 profile to be clinically relevant. The CORQ 2-5 is a promising measure of obesity risk in preschoolers who attend community-based health centers for their wellchild visits and who are not yet obese. CORQ 2-5 is intended to guide provider-parental obesity risk discussions. Copyright © 2015 Elsevier Inc. All rights reserved.

Rationale and study protocol for the 'active teen leaders avoiding screen-time' (ATLAS) group randomized controlled trial: an obesity prevention intervention for adolescent boys from schools in low-income communities.

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Smith, Jordan J; Morgan, Philip J; Plotnikoff, Ronald C; Dally, Kerry A; Salmon, Jo; Okely, Anthony D; Finn, Tara L; Babic, Mark J; Skinner, Geoff; Lubans, David R

2014-01-01

The negative consequences of unhealthy weight gain and the high likelihood of pediatric obesity tracking into adulthood highlight the importance of targeting youth who are 'at risk' of obesity. The aim of this paper is to report the rationale and study protocol for the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention intervention for adolescent boys living in low-income communities. The ATLAS intervention will be evaluated using a cluster randomized controlled trial in 14 secondary schools in the state of New South Wales (NSW), Australia (2012 to 2014). ATLAS is an 8-month multi-component, school-based program informed by self-determination theory and social cognitive theory. The intervention consists of teacher professional development, enhanced school-sport sessions, researcher-led seminars, lunch-time physical activity mentoring sessions, pedometers for self-monitoring, provision of equipment to schools, parental newsletters, and a smartphone application and website. Assessments were conducted at baseline and will be completed again at 9- and 18-months from baseline. Primary outcomes are body mass index (BMI) and waist circumference. Secondary outcomes include BMI z-scores, body fat (bioelectrical impedance analysis), physical activity (accelerometers), muscular fitness (grip strength and push-ups), screen-time, sugar-sweetened beverage consumption, resistance training skill competency, daytime sleepiness, subjective well-being, physical self-perception, pathological video gaming, and aggression. Hypothesized mediators of behavior change will also be explored. ATLAS is an innovative school-based intervention designed to improve the health behaviors and related outcomes of adolescent males in low-income communities. Copyright © 2013 Elsevier Inc. All rights reserved.

The pediatric daytime sleepiness scale (PDSS): sleep habits and school outcomes in middle-school children.

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Drake, Christopher; Nickel, Chelsea; Burduvali, Eleni; Roth, Thomas; Jefferson, Catherine; Pietro, Badia

2003-06-15

To develop a measure of daytime sleepiness suitable for middle-school children and examine the relationship between daytime sleepiness and school-related outcomes. Self-report questionnaire. Four hundred fifty, 11- to 15-year-old students, from grades 6, 7, and 8 of a public middle school in Dayton, Ohio. A pediatric daytime sleepiness questionnaire was developed using factor analysis of questions regarding sleep-related behaviors. Results of the sleepiness questionnaire were then compared across other variables, including daily sleep patterns, school achievement, mood, and extracurricular activities. Factor analysis on the 13 questions related to daytime sleepiness yielded 1 primary factor ("pediatric daytime sleepiness"; 32% of variance). Only items with factor loadings above .4 were included in the final sleepiness scale. Internal consistency (Chronbach's alpha) for the final 8-item scale was .80. Separate one-way analyses of variance and trend analyses were performed comparing pediatric daytime sleepiness scores at the 5 different levels of total sleep time and academic achievement. Participants who reported low school achievement, high rates of absenteeism, low school enjoyment, low total sleep time, and frequent illness reported significantly higher levels of daytime sleepiness compared to children with better school-related outcomes. The self-report scale developed in the present work is suitable for middle-school-age children and may be useful in future research given its ease of administration and robust psychometric properties. Daytime sleepiness is related to reduced educational achievement and other negative school-related outcomes.

The Role of School Counselors in the Childhood Obesity Epidemic

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Larrier, Yvonne I.; Bakerson, Michelle A.; Linton, Jeremy M.; Walker, Lynne R.; Woolford, Susan J.

2011-01-01

Childhood obesity is a significant public health concern. Since 1960, the prevalence of childhood obesity in the United States increased dramatically from 5% to 16.9%. To date many interventions to address obesity in schools have focused on healthy changes to the content of vending machines, school lunches, and the addition of after school…

Predictors of Short- and Long-Term Attrition From the Parents as Agents of Change Randomized Controlled Trial for Managing Pediatric Obesity.

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Spence, Nicholas D; Newton, Amanda S; Keaschuk, Rachel A; Ambler, Kathryn A; Jetha, Mary M; Holt, Nicholas L; Rosychuk, Rhonda J; Spence, John C; Sharma, Arya M; Ball, Geoff D C

Attrition in pediatric weight management is a substantial problem. This study examined factors associated with short- and long-term attrition from a lifestyle and behavioral intervention for parents of children with overweight or obesity. Fifty-two families with children ages 6 to 12 years old and body mass index at or above the 85th percentile participated in a randomized controlled trial focused on parents, comparing parent-based cognitive behavioral therapy with parent-based psychoeducation for pediatric weight management. We examined program attrition using two clinical phases of the intervention: short-term and long-term attrition, modeled using the general linear model. Predictors included intervention type, child/parent weight status, sociodemographic factors, and health of the family system. Higher self-assessed health of the family system was associated with lower short-term attrition; higher percentage of intervention sessions attended by parents was associated with lower long-term attrition. Different variables were significant in our short- and long-term models. Attrition might best be conceptualized based on short- and long-term phases of clinical, parent-based interventions for pediatric weight management. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Childhood obesity prevention through a community-based cluster randomized controlled physical activity intervention among schools in china: the health legacy project of the 2nd world summer youth olympic Games (YOG-Obesity study).

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Wang, Z; Xu, F; Ye, Q; Tse, L A; Xue, H; Tan, Z; Leslie, E; Owen, N; Wang, Y

2018-04-01

Childhood obesity has been becoming a worldwide public health problem. We conducted a community-based physical activity (PA) intervention program aiming at childhood obesity prevention in general student population in Nanjing of China, the host city of the 2nd World Summer Youth Olympic Games (YOG-Obesity study). This was a cluster randomized controlled intervention study. Participants were the 4th (mean age±s.e.: 9.0±0.01) and 7th (mean age±s.e.: 12.0±0.01) grade students (mean age±s.e.: 10.5±0.02) from 48 schools and randomly allocated (1:1) to intervention or control groups at school level. Routine health education was provided to all schools, whereas the intervention schools additionally received an 1-year tailored multi-component PA intervention program, including classroom curricula, school environment support, family involvement and fun programs/events. The primary outcome measures were changes in body mass index, obesity occurrence and PA. Overall, 9858 (97.7%) of the 10091 enrolled students completed the follow-up survey. Compared with the baseline, PA level increased by 33.13 min per week (s.e. 10.86) in the intervention group but decreased by 1.76 min per week (s.e. 11.53) in the control group (P=0.028). After adjustment for potential confounders, compared with the control group, the intervention group were more likely to have increased time of PA (adj. Odds ratio=1.15, 95% confidence interval=1.06-1.25), but had a smaller increase in mean body mass index (BMI) (0.22 (s.e. 0.02) vs 0.46 (0.02), P=0.01) and BMI z-score (0.07 (0.01) vs 0.16 (0.01), P=0.01), and were less likely to be obese (adj. Odds ratio=0.7, 95% confidence interval=0.6, 0.9) at study end. The intervention group had fewer new events of obesity/overweight but a larger proportion of formerly overweight/obese students having normal weight by study end. This large community-based PA intervention was feasible and effective in promoting PA and preventing obesity among the general

Childhood Obesity and Schools: Evidence from the National Survey of Children's Health

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Li, Ji; Hooker, Neal H.

2010-01-01

Background: The international prevalence of childhood obesity and obesity-related diseases has received increasing attention. Applying data from the Centers for Disease Control and Prevention, we explore relationships between childhood obesity and school type, National School Lunch Program (NSLP) and School Breakfast Program (SBP) eligibility,…

Association of energy intake and expenditure with obesity: A cross-sectional study of 150 pediatric patients following treatment for leukemia.

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Srivastava, Richa; Batra, Atul; Dhawan, Deepa; Bakhshi, Sameer

2017-02-01

Increased obesity in leukemia survivors has been attributed to chemotherapy and radiation. Data on total energy intake (TEI) and total energy expenditure (TEE) are lacking in obese childhood leukemia patients after completion of therapy from India. We conducted a cross-sectional study in pediatric acute leukemia patients after completion of therapy wherein energy intake was assessed by 24-hour recall method. TEE was calculated using Harris-Benedict equation, by assessing the physical activity level using Physical Activity Questionnaire for children and basal metabolic rate by World Health Organization equation. Indian Academy of Pediatrics 2015 guidelines for BMI were used for defining overweight and obesity. Nutritional status was assessed in 150 leukemia patients after completion of therapy. Twenty-five percent of leukemia patients after completion of therapy were overweight and obese versus 11% of healthy controls (p = 0.042). The mean ratio of TEI/required energy intake (REI), TEE/required energy expenditure (REE), and (TEI:REI)/(TEE:REE) were significantly higher in overweight and obese group versus nonobese survivors (p obesity. Obesity in leukemia patients after completion of therapy is associated with increased energy intake, causing imbalance between energy intake and TEE in these patients.

Obesity increases metabolic syndrome risk factors in school-aged children from an urban school in Mexico city.

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Perichart-Perera, Otilia; Balas-Nakash, Margie; Schiffman-Selechnik, Esther; Barbato-Dosal, Annarella; Vadillo-Ortega, Felipe

2007-01-01

To characterize the nutritional status of school-aged children from an urban public school in Mexico City, Mexico, and to assess the influence of obesity on health status in a subgroup of these children. Cross-sectional descriptive study. A nutrition screening was done for all children, including anthropometric (ie, weight, height, and waist circumference) and blood pressure assessment. In the subgroup of children, complementary dietary and biochemical assessment (ie, glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, insulin, albumin, hemoglobin, and hematocrit levels) was done. Children from an urban school in Mexico City (N=561) aged 6 to 13 years. The representative subgroup (n=88) was selected based on age (9 to 12 years) and weight status (ie, normal, overweight, or obese). Descriptive statistics, correlations, mean differences tests (analysis of variance, Kruskal-Wallis and Mann-Whitney U), and chi(2) tests (categorical variables) were done with SPSS version 13 (2005, SPSS Inc, Chicago, IL). In the whole school, overweight and obesity prevalence were 27.1% and 21.4%, respectively. High systolic blood pressure was seen in 8.4% of children and 6.2% of children had prehypertension. Higher hypertension risk was seen in children with body mass index > or =95th percentile and waist circumference > or =90th percentile (88 cm). Significantly higher waist circumference, systolic blood pressure, insulin resistance indexes, and triglyceride levels were found among the obese when compared with normal-weight children. Childhood obesity prevalence is high in Mexico and it is having an influence on children's health. It is urgent to design, implement, and evaluate specific childhood obesity prevention programs.

Risk Factors of Overweight and Obesity among High School Students in Bahir Dar City, North West Ethiopia: School Based Cross-Sectional Study

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Zelalem Alamrew Anteneh

2015-01-01

Full Text Available Background. Overweight and obesity are risk factors for diet-related noncommunicable diseases. These diseases are the fifth leading risks for global deaths. Virtually, all age groups are affected from consequences of overweight and obesity. Methods. Cross-sectional study was conducted among 431 school adolescents. Data were collected using self-administered questionnaire and physical measurements. The sex and age specific BMI was computed using WHO Anthroplus software and the data were analyzed using bivariate and multivariable logistic regression analysis. Results. The magnitudes of overweight and obesity were 12.3% and 4.4%, respectively, and the combined prevalence of overweight and obesity together was 16.7%. Three-fourths of the respondents (74.7% had healthy body mass index; however, 8.6% were underweight. Sex, frequency of eating food out of home, school type, family monthly income, family having vehicle, vigorous physical activity, and frequency of vigorous physical activity were statistically significant predictors of overweight and obesity. Conclusion. The problems of overweight and obesity are taking place while students are still under the risk of underweight. Several factors were correlated with overweight and obesity. Therefore, interventions targeting gender, frequency of eating food out of home, vigorous activities, and frequency of doing vigorous physical activity are recommended.

Risk Factors of Overweight and Obesity among High School Students in Bahir Dar City, North West Ethiopia: School Based Cross-Sectional Study

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Anteneh, Zelalem Alamrew; Gedefaw, Molla; Tekletsadek, Kidist Nigatu; Tsegaye, Meseret; Alemu, Dagmawi

2015-01-01

Background. Overweight and obesity are risk factors for diet-related noncommunicable diseases. These diseases are the fifth leading risks for global deaths. Virtually, all age groups are affected from consequences of overweight and obesity. Methods. Cross-sectional study was conducted among 431 school adolescents. Data were collected using self-administered questionnaire and physical measurements. The sex and age specific BMI was computed using WHO Anthroplus software and the data were analyzed using bivariate and multivariable logistic regression analysis. Results. The magnitudes of overweight and obesity were 12.3% and 4.4%, respectively, and the combined prevalence of overweight and obesity together was 16.7%. Three-fourths of the respondents (74.7%) had healthy body mass index; however, 8.6% were underweight. Sex, frequency of eating food out of home, school type, family monthly income, family having vehicle, vigorous physical activity, and frequency of vigorous physical activity were statistically significant predictors of overweight and obesity. Conclusion. The problems of overweight and obesity are taking place while students are still under the risk of underweight. Several factors were correlated with overweight and obesity. Therefore, interventions targeting gender, frequency of eating food out of home, vigorous activities, and frequency of doing vigorous physical activity are recommended. PMID:26697231

Evaluation of a Coordinated School-Based Obesity Prevention Program in a Hispanic Community: Choosing Healthy and Active Lifestyles for Kids/healthy Schools Healthy Families

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Berger-Jenkins, Evelyn; Rausch, John; Okah, Ebiere; Tsao, Daisy; Nieto, Andres; Lyda, Elizabeth; Meyer, Dodi; McCord, Mary

2014-01-01

Background: Obesity is a public health concern that disproportionately affects underserved and minority communities. Purpose: To evaluate whether a comprehensive obesity prevention program that targets children and school staff in an underserved Hispanic community affects obesity related knowledge, attitudes, and behaviors among both students and…

Assessing the sustained impact of a school-based obesity prevention program for adolescent boys: the ATLAS cluster randomized controlled trial.

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Lubans, David R; Smith, Jordan J; Plotnikoff, Ronald C; Dally, Kerry A; Okely, Anthony D; Salmon, Jo; Morgan, Philip J

2016-08-20

Obesity prevention interventions targeting 'at-risk' adolescents are urgently needed. The aim of this study is to evaluate the sustained impact of the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention program. Cluster RCT in 14 secondary schools in low-income communities of New South Wales, Australia. Participants were 361 adolescent boys (aged 12-14 years) 'at risk' of obesity. The intervention was based on Self-Determination Theory and Social Cognitive Theory and involved: professional development, fitness equipment for schools, teacher-delivered physical activity sessions, lunch-time activity sessions, researcher-led seminars, a smartphone application, and parental strategies. Assessments for the primary (body mass index [BMI], waist circumference) and secondary outcomes were conducted at baseline, 8- (post-intervention) and 18-months (follow-up). Analyses followed the intention-to-treat principle using linear mixed models. After 18-months, there were no intervention effects for BMI or waist circumference. Sustained effects were found for screen-time, resistance training skill competency, and motivational regulations for school sport. There were no clinically meaningful intervention effects for the adiposity outcomes. However, the intervention resulted in sustained effects for secondary outcomes. Interventions that more intensively target the home environment, as well as other socio-ecological determinants of obesity may be needed to prevent unhealthy weight gain in adolescents from low-income communities. Australian Clinical Trial Registry ACTRN12612000978864.

Impact of obesity on the risk of venous thromboembolism in an inpatient pediatric population.

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Stokes, Sean; Breheny, Patrick; Radulescu, Aurelia; Radulescu, Vlad Calin

2014-08-01

The incidence of venous thromboembolism in children has increased significantly over the past 20 years. Over the same period of time, there was an increase in the prevalence of obesity in the pediatric population. Obesity is a known risk factor for VTE in adults, but little information is available in children. This study evaluates the relation between obesity and VTE using a retrospective, case-control design, comparing the body mass index (BMI) of patients admitted with a diagnosis of VTE versus patients admitted with other diagnoses, at a single institution, between 2007 and 2011. We studied 48 inpatients diagnosed with deep venous thrombosis or pulmonary embolism and a control group of 274 age and gender matched patients admitted with other diagnoses. We found obese patients (BMI > 95th percentile) to have significantly higher risk of VTE (odds ratio 2.1, with 95% CI 1.1-4.2) than patients of normal weight (BMI obesity and VTE in a group of hospitalized children, showing a risk for VTE in obese children similar to the one described in much larger adult cohorts.

School-Based Nutrition Education Intervention Using Social Cognitive Theory for Overweight and Obese Iranian Adolescent Girls: A Cluster Randomized Controlled Trial.

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Bagherniya, Mohammad; Sharma, Manoj; Mostafavi Darani, Firoozeh; Maracy, Mohammad Reza; Safarian, Mohammad; Allipour Birgani, Ramesh; Bitarafan, Vida; Keshavarz, Seyed Ali

2017-10-01

Background Nowadays childhood obesity has become one the most challenging issue which is considered as a principle public health problem all around the world. This study was conducted with the aim of evaluating the impact of a 7-month school-based nutrition education intervention using social cognitive theory (SCT) to prevent obesity among overweight and obese adolescent girls. Method In this cluster randomized community trial after choosing schools, a total of 172 overweight and obese girl students participated in the study (87 in the intervention and 85 in the control group). A 7-month intervention based on SCT for students, their parents, and teachers was conducted. At baseline and end of the study, body mass index (BMI), waist circumstances (WCs), dietary intake, and psychological questionnaires regarding the SCT constructs were obtained. Results After 7 months, the mean of BMI and WCs reduced in the intervention group from 29.47 (4.05) to 28.5 (4.35) and from 89.65 (8.15) to 86.54 (9.76), respectively, but in comparison to the control group, they were not statistically significant ( p values .127 and .504, respectively). In the intervention group, nutritional behaviors and most of the psychological variables (self-efficacy, social support, intention, and situation) were improved in favor of the study and they were significant in comparison to the control group ( p < .05). Conclusion Although school-based nutrition education intervention using SCT did not change significantly BMI and WCs among the targeted population in this study, dietary habits as well as psychological factors improved significantly in the intervention group. This trial was registered in Iranian Registry of Clinical Trials, www.irct.ir (IRCT2013103115211N1).

Proximity of fast-food restaurants to schools and adolescent obesity.

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Davis, Brennan; Carpenter, Christopher

2009-03-01

We examined the relationship between fast-food restaurants near schools and obesity among middle and high school students in California. We used geocoded data (obtained from the 2002-2005 California Healthy Kids Survey) on over 500,000 youths and multivariate regression models to estimate associations between adolescent obesity and proximity of fast-food restaurants to schools. We found that students with fast-food restaurants near (within one half mile of) their schools (1) consumed fewer servings of fruits and vegetables, (2) consumed more servings of soda, and (3) were more likely to be overweight (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02, 1.10) or obese (OR = 1.07; 95% CI = 1.02, 1.12) than were youths whose schools were not near fast-food restaurants, after we controlled for student- and school-level characteristics. The result was unique to eating at fast-food restaurants (compared with other nearby establishments) and was not observed for another risky behavior (smoking). Exposure to poor-quality food environments has important effects on adolescent eating patterns and overweight. Policy interventions limiting the proximity of fast-food restaurants to schools could help reduce adolescent obesity.

Quality of life improves in children and adolescents during a community-based overweight and obesity treatment

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Mollerup, Pernille M; Nielsen, Tenna R H; Bøjsøe, Christine

2017-01-01

PURPOSE: The quality of life is compromised in children and adolescents with overweight or obesity. The aim of this study was to evaluate whether the quality of life improves during a community-based overweight and obesity treatment, and whether improvements depend on reductions in the degree...... of obesity. METHODS: Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 in children and adolescents aged 3-18 years with overweight or obesity [body mass index (BMI) ≥85th percentile] upon entry into a community-based chronic care overweight and obesity treatment based...... upon The Children's Obesity Clinic's Treatment protocol, and upon follow-up after 10-30 months of treatment. Height and weight were measured at each consultation and converted into a BMI standard deviation score (SDS). RESULTS: Upon entry, 477 children (212 boys) completed a PedsQL, and 317 (143 boys...

Effectiveness of social marketing strategies to reduce youth obesity in European school-based interventions: a systematic review and meta-analysis.

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Aceves-Martins, Magaly; Llauradó, Elisabet; Tarro, Lucia; Moreno-García, Carlos Francisco; Trujillo Escobar, Tamy Goretty; Solà, Rosa; Giralt, Montse

2016-05-01

The use of social marketing to modify lifestyle choices could be helpful in reducing youth obesity. Some or all of the 8 domains of the National Social Marketing Centre's social marketing benchmark criteria (SMBC) are often used but not always defined in intervention studies. The aim of this review is to assess the effectiveness of European school-based interventions to prevent obesity relative to the inclusion of SMBC domains in the intervention. The PubMed, Cochrane, and ERIC databases were used. Nonrandomized and randomized controlled trials conducted from 1990 to April 2014 in participants aged 5 to 17 years were included. After the study selection, the 8 domains of the SMBC were assessed in each included study. Thirty-eight publications were included in the systematic review. For the meta-analysis, randomized controlled trials (RCTs) reporting body mass index or prevalence of overweight and obesity were considered. Eighteen RCTs with a total of 8681 participants included at least 5 SMBC. The meta-analysis showed a small standardized mean difference in body mass index of -0.25 (95%CI, -0.45 to -0.04) and a prevalence of overweight and obesity odds ratio of 0.72 (95%CI, 0.5-0.97). Current evidence indicates that the inclusion of at least 5 SMBC domains in school-based interventions could benefit efforts to prevent obesity in young people. PROSPERO registration number: CRD42014007297. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute.

Best Practice Updates for Pediatric/Adolescent Weight Loss Surgery

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Pratt, Janey S.A.; Lenders, Carine M.; Dionne, Emily A.; Hoppin, Alison G.; Hsu, George L.K.; Inge, Thomas H.; Lawlor, David F.; Marino, Margaret F.; Meyers, Alan F.; Rosenblum, Jennifer L.; Sanchez, Vivian M.

2011-01-01

The objective of this study is to update evidence-based best practice guidelines for pediatric/adolescent weight loss surgery (WLS). We performed a systematic search of English-language literature on WLS and pediatric, adolescent, gastric bypass, laparoscopic gastric banding, and extreme obesity published between April 2004 and May 2007 in PubMed, MEDLINE, and the Cochrane Library. Keywords were used to narrow the search for a selective review of abstracts, retrieval of full articles, and grading of evidence according to systems used in established evidence-based models. In light of evidence on the natural history of obesity and on outcomes of WLS in adolescents, guidelines for surgical treatment of obesity in this age group need to be updated. We recommend modification of selection criteria to include adolescents with BMI ≥ 35 and specific obesity-related comorbidities for which there is clear evidence of important short-term morbidity (i.e., type 2 diabetes, severe steatohepatitis, pseudotumor cerebri, and moderate-to-severe obstructive sleep apnea). In addition, WLS should be considered for adolescents with extreme obesity (BMI ≥ 40) and other comorbidities associated with long-term risks. We identified >1,085 papers; 186 of the most relevant were reviewed in detail. Regular updates of evidence-based recommendations for best practices in pediatric/adolescent WLS are required to address advances in technology and the growing evidence base in pediatric WLS. Key considerations in patient safety include carefully designed criteria for patient selection, multidisciplinary evaluation, choice of appropriate procedure, thorough screening and management of comorbidities, optimization of long-term compliance, and age-appropriate fully informed consent. PMID:19396070

A coordinated school health approach to obesity prevention among Appalachian youth: the Winning with Wellness Pilot Project.

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Schetzina, Karen E; Dalton, William T; Lowe, Elizabeth F; Azzazy, Nora; VonWerssowetz, Katrina M; Givens, Connie; Pfortmiller, Deborah T; Stern, H Patrick

2009-01-01

Childhood obesity has been an increasing problem in the United States, especially in rural areas. Effective prevention approaches are needed. This article describes the development, implementation, effectiveness, feasibility, and sustainability of a school-based obesity prevention pilot project, Winning with Wellness. The program was based on the coordinated school health model and included a community-based participatory research approach aimed at promoting healthy eating and physical activity in a rural Appalachian elementary school. Findings from this preliminary project revealed improvements in nutrition offerings and increased physical activity during the school day. In addition, the program was found to be acceptable to teachers, successfully implemented utilizing both existing and newly developed resources, and sustainable as evidenced in continued practice and expansion to other area schools.

Is Obesity Associated with School Dropout? Key Developmental and Ethnic Differences

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Lanza, H. Isabella; Huang, David Y. C.

2015-01-01

Background: We aimed to expand the literature on child obesity and school outcomes by examining associations between obesity and high school dropout, including the role of obesity onset and duration as well as ethnicity. Methods: Data on 5066 children obtained between 1986 and 2010 from the child cohort of the 1979 National Longitudinal Study of…

Comparative effectiveness of childhood obesity interventions in pediatric primary care: a cluster-randomized clinical trial.

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Taveras, Elsie M; Marshall, Richard; Kleinman, Ken P; Gillman, Matthew W; Hacker, Karen; Horan, Christine M; Smith, Renata L; Price, Sarah; Sharifi, Mona; Rifas-Shiman, Sheryl L; Simon, Steven R

2015-06-01

Evidence of effective treatment of childhood obesity in primary care settings is limited. To examine the extent to which computerized clinical decision support (CDS) delivered to pediatric clinicians at the point of care of obese children, with or without individualized family coaching, improved body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and quality of care. We conducted a cluster-randomized, 3-arm clinical trial. We enrolled 549 children aged 6 to 12 years with a BMI at the 95% percentile or higher from 14 primary care practices in Massachusetts from October 1, 2011, through June 30, 2012. Patients were followed up for 1 year (last follow-up, August 30, 2013). In intent-to-treat analyses, we used linear mixed-effects models to account for clustering by practice and within each person. In 5 practices randomized to CDS, pediatric clinicians received decision support on obesity management, and patients and their families received an intervention for self-guided behavior change. In 5 practices randomized to CDS + coaching, decision support was augmented by individualized family coaching. The remaining 4 practices were randomized to usual care. Smaller age-associated change in BMI and the Healthcare Effectiveness Data and Information Set (HEDIS) performance measures for obesity during the 1-year follow-up. At baseline, mean (SD) patient age and BMI were 9.8 (1.9) years and 25.8 (4.3), respectively. At 1 year, we obtained BMI from 518 children (94.4%) and HEDIS measures from 491 visits (89.4%). The 3 randomization arms had different effects on BMI over time (P = .04). Compared with the usual care arm, BMI increased less in children in the CDS arm during 1 year (-0.51 [95% CI, -0.91 to -0.11]). The CDS + coaching arm had a smaller magnitude of effect (-0.34 [95% CI, -0.75 to 0.07]). We found substantially greater achievement of childhood obesity HEDIS measures in the CDS arm (adjusted odds ratio, 2.28 [95% CI, 1

Teacher Experiences of Delivering an Obesity Prevention Programme (The WAVES Study Intervention) in a Primary School Setting

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Griffin, Tania L; Clarke, Joanne L; Lancashire, Emma R; Pallan, Miranda J; Passmore, Sandra; Adab, Peymane

2015-01-01

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:…

The Effect of School-Based Exercise Practices of 9-11 Year Old Girls Students on Obesity and Health-Related Quality of Life

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Demirci, Nevzat; Demirci, Pervin Toptas; Demirci, Erdal

2017-01-01

This study was planned to determine the effects of school-based exercise practices (SBEP) on obesity and health-related quality of life (HRQL) in 9-11 year old girls. Participants consist of girls students from 9-11 years old in two state schools in Kars. Intervention Group (n: 85) courses of games and physical activities (CGPA) and SBEP…

Prevalence of overweight and obesity among school children and adolescents in Chennai.

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Jagadesan, Sonya; Harish, Ranjani; Miranda, Priya; Unnikrishnan, Ranjit; Anjana, Ranjit Mohan; Mohan, Viswanathan

2014-07-01

To determine the prevalence of overweight and obesity among children and adolescents in Chennai, India, using national and international age- and sex- specific body mass index (BMI) cut-off points. The Obesity Reduction and Awareness and Screening of Non communicable diseases through Group Education in Children and Adolescents (ORANGE) project is a cross-sectional study carried out on 18,955 children (age 6-11 years) and adolescents (age 12-17 years) across 51 schools (31 private and 20 government) of Chennai. Overweight and obesity was classified by the International Obesity Task Force (IOTF 2000) and Khadilkars criteria (2012), and Hypertension by the IDF criteria (in children ≥10 years and adolescents). The prevalence of overweight/obesity was significantly higher in private compared to government schools both by the IOTF criteria [private schools: 21.4%, government schools: 3.6%, (OR: 7.4, 95% CI:6.3-8.6; POverweight/obesity was higher among girls (IOTF: 18%, Khadilkar: 21.3%) compared to boys (IOTF: 16.2%, Khadilkar: 20.7%) and higher among adolescents (IOTF: 18.1%, Khadilkar: 21.2%) compared to children (IOTF: 15.5%, Khadilkar: 20.7%). Prevalence of hypertension was 20.4% among obese/overweight and 5.2% among non-obese (OR 4.7, 95%CI: 4.2-5.3, Poverweight and obesity is high among private schools in Chennai, and hypertension is also common.

Protocol for systematic review of school-based interventions to prevent and control obesity in African learners.

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Adom, Theodosia; Puoane, Thandi; De Villiers, Anniza; Kengne, André Pascal

2017-03-27

The increasing prevalence of obesity and overweight in childhood in developing countries is a public health concern to many governments. Schools play a significant role in the obesity epidemic as well as provide favourable environments for change in behaviours in childhood which can be carried on into adulthood. There is dearth of information on intervention studies in poor-resource settings. This review will summarise the available evidence on school-based interventions that focused on promoting healthy eating and physical activity among learners aged 6-15 years in Africa and to identify factors that lead to successful interventions or potential barriers to success of these programmes within the African context. This protocol is developed following the guidelines of PRIMSA-P 2015. Relevant search terms and keywords generated from the subject headings and the African search filter will be used to conduct a comprehensive search of MEDLINE (PubMed), MEDLINE (EbscoHost), CINAHL (EbscoHost), Register Academic Search Complete (EbscoHost) and ISI Web of Science (Science Citation Index) for published literature on school-based interventions to prevent and control obesity in learners in Africa. Grey literature will be also be obtained. The searches will cover 1 January 2000 to 30 June 2016. No language limitations will be applied. Full-text articles of eligible studies will be screened. Risk of bias and quality of reporting will be assessed. Data will be extracted, synthesised and presented by country and major regional groupings. Meta-analysis will be conducted for identical variables across studies, where data allow. This protocol is developed following the guidelines of PRISMA-P 2015. No primary data will be collected hence ethics is not a requirement. The findings will be submitted for publication in peer-reviewed journals, in conferences and in policy documents for decision-making, where needed. Published by the BMJ Publishing Group Limited. For permission to use

Junk Food in Schools and Childhood Obesity

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Datar, Ashlesha; Nicosia, Nancy

2012-01-01

Despite limited empirical evidence, there is growing concern that junk food availability in schools has contributed to the childhood obesity epidemic. In this paper, we estimate the effects of junk food availability on body mass index (BMI), obesity, and related outcomes among a national sample of fifth graders. Unlike previous studies, we address…

Danish clinical guidelines for examination and treatment of overweight and obese children and adolescents in a pediatric setting.

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Johansen, Anders; Holm, Jens-Christian; Pearson, Seija; Kjærsgaard, Mimi; Larsen, Lone Marie; Højgaard, Birgitte; Cortes, Dina

2015-05-01

Overweight children are at an increased risk of becoming obese adults, which may lead to shorter life expectancies in the current generation of children as compared to their parents. Furthermore, being an overweight child has a negative psycho-social impact. We consider obesity in children and adolescents a chronic illness, which is in line with the American Medical Society. We summarize the evidence for the efficacy of a combination of diet, physical activity and behavior-focused interventions in a family-based setting. The present guidelines propose a multidisciplinary service implemented as a "chronic care model" based on "best clinical practice" inspired by an American expert committee and the daily practice of The Children's Obesity Clinic at Copenhagen University Hospital Holbaek. Children and adolescents should be referred for examination and treatment in a pediatric setting when BMI corresponds to an isoBMI of minimum 30 or BMI corresponds to an isoBMI of 25 and complex obesity is suspected. Obtaining a thorough medical history is pivotal. We propose a structured interview to ensure collection of all relevant information. We recommend physical examination focused on BMI, waist circumference, growth, pubertal stage, blood pressure, neurology and skin and provide comprehensive paraclinical investigations for obesity and obesity related conditions. Treatment of obesity in children and adolescents is fully dependent on the combined effort of the entire family. This cannot be overemphasized! The main principle of the treatment is developing an individual detailed plan for every patient to reduce caloric intake whilst increasing physical activity, leaving no ambiguity with the recommendations.

OBESITY: health prevention strategies in school environments

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Pâmela Ferreira Todendi

2013-04-01

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.

An Innovative Model of Integrated Behavioral Health: School Psychologists in Pediatric Primary Care Settings

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Adams, Carolyn D.; Hinojosa, Sara; Armstrong, Kathleen; Takagishi, Jennifer; Dabrow, Sharon

2016-01-01

This article discusses an innovative example of integrated care in which doctoral level school psychology interns and residents worked alongside pediatric residents and pediatricians in the primary care settings to jointly provide services to patients. School psychologists specializing in pediatric health are uniquely trained to recognize and…

Prevalence of obesity and its correlates in school going adolescents of Haldwani, Nainital, Uttarakhand, India

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Shantanu Aggarwal

2016-07-01

Full Text Available Background: With a rising trend of Non-Communicable Diseases (NCDs in the present world, overweight and obesity has gained importance as it is not only a disease in itself but also risk factor for majority of other NCDs. A dramatic increase in overweight and obesity among children and adolescent has raised the concern of various public health physicians especially in developing country like India. Aims & Objective: To study the prevalence of overweight and obesity & its correlates among school going adolescents of Haldwani block. Material & Methods: School based cross sectional study was done among the adolescents of 8th to 12th standard. To calculate the maximum sample size prevalence of obesity was assumed to be 50%, taking absolute error of 5%, design effect of 2 and 10% non-response rate the sample was calculated to be 880, rounded off to 900. Samples were collected from 30 clusters/schools using simple random sampling. Data was collected using a pre-designed, semi-structured and pre-tested questionnaire and analyzed by using SPSS version 22. Results: Prevalence of overweight and obesity was 13% (CI = 10.8 - 15.2%. Overweight and obesity was found to be significantly associated with urban area, private school, Socio-economic class I, non-vegetarian diet, physical inactivity and playing videogames, working on laptops and computer on univariate analysis. On applying binary logistic regression factors like private schools, socioeconomic class I, non-vegetarian diet and physical inactivity were again found to be significantly associated with overweight and obesity. Conclusion: Prevalence of obesity was found to be more in adolescents having modifiable risk factors. 

School nurse perceptions and knowledge of pediatric toileting.

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Arlen, Angela M; Boyt, Margaret A; Cooper, Christopher S

2012-04-01

We surveyed school nurses on toileting conditions in schools, their level of understanding related to normal toileting patterns in school-age children, and whether they are in need of additional resources to promote healthy toilet habits for their students. An Institutional Review Board approved web-based survey with 34 questions was employed; 562 nurses completed the survey and 97% were currently employed as school nurses. Participants were invited via email blasts through national school nursing associations and the Iowa Department of Education. Only 48% and 33% of respondents suspected an underlying health problem in children with frequent urination and bladder or bowel accidents, respectively. Despite 61% reporting never receiving information about children's normal elimination patterns, 43% had been asked to provide such information to teachers. Only 42% felt they had adequate resources to respond to such requests. School nurses requested information about treatment of dysfunctional elimination (67%), health effects of childhood toileting habits (65%), fluid intake guidelines (44%) and improvement of bathroom facilities (39%); 70% were unaware of local providers specially trained to treat children with these problems. Our survey results suggest that school nurses need additional information and resources in order to promote healthy elimination patterns in school children. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Convenience Sampling of Children Presenting to Hospital-Based Outpatient Clinics to Estimate Childhood Obesity Levels in Local Surroundings.

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Gilliland, Jason; Clark, Andrew F; Kobrzynski, Marta; Filler, Guido

2015-07-01

Childhood obesity is a critical public health matter associated with numerous pediatric comorbidities. Local-level data are required to monitor obesity and to help administer prevention efforts when and where they are most needed. We hypothesized that samples of children visiting hospital clinics could provide representative local population estimates of childhood obesity using data from 2007 to 2013. Such data might provide more accurate, timely, and cost-effective obesity estimates than national surveys. Results revealed that our hospital-based sample could not serve as a population surrogate. Further research is needed to confirm this finding.

Overweight and Obesity and Associated Factors among School-Aged Adolescents in Ghana and Uganda

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Karl Peltzer

2011-09-01

Full Text Available The aim of this study was to assess overweight and obesity and associated factors in school-going adolescents in low income African countries (Ghana, Uganda. The total sample included 5,613 school children aged 13 to 15 years from nationally representative samples from two African countries. Bivariate and multivariable analyses were conducted to assess the relationship between dietary behavior, substance use, physical activity, psychosocial factors and overweight or obesity. The prevalence of overweight and obesity was determined based on self-reported height and weight and the international child body mass index standards. Results indicate a prevalence of overweight or obesity of 10.4% among girls and 3.2% among boys, and 0.9% and 0.5% obesity only among girls and boys, respectively. Among girls smoking cigarettes and loneliness and among boys smoking cigarettes were found to be associated with overweight or obesity in multivariable analysis. Overweight status was not associated with the intake of fruits, vegetables, and sedentary behavior. Low prevalence rates of overweight or obesity were found in Ghana and Uganda. Smoking cessation and social programs could be integrated into strategies to prevent and treat overweight and obesity in youth.

Addressing Pediatric Obesity in Ambulatory Care: Where Are We and Where Are We Going?

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Lenders, Carine M; Manders, Aaron J; Perdomo, Joanna E; Ireland, Kathy A; Barlow, Sarah E

2016-06-01

Since the "2007 summary report of child and adolescent overweight and obesity treatment" published by Barlow, many obesity intervention studies have been conducted in pediatric ambulatory care. Although several meta-analyses have been published in the interim, many studies were excluded because of the focus and criteria of these meta-analyses. Therefore, the primary goal of this article was to identify randomized case-control trials conducted in the primary care setting and to report on treatment approaches, challenges, and successes. We have developed four themes for our discussion and provide a brief summary of our findings. Finally, we identified major gaps and potential solutions and describe several urgent key action items.

Dietary Factors Associated To Obesity In Ahwaz Primary School Pupils

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Dorosty A.R; Tabatabaei M

2005-05-01

Full Text Available Background: Increase in obesity prevalence in recent years are associated to genetics as well environmental and behavioral factors. Change in dietary patterns including fatty and high density energy foods consumption have been reported to be very important. This study aimed to determine dietary factors (daily energy and macronutrient intakes, energy percentage of macronutrient, energy and macronutrient intakes per kilogram body weight, frequency of cola, natural fruit juice drinking, dairy products except cheese, tomato chips, puff, chocolate and fast food consumption and eating speed associated to obesity in Ahwaz primary school pupils. Materials and Methods: Using two stage cluster sampling from 35 Ahwaz primary schools, all 10-11y students who had a BMI 95th percentile of Hosseini et al. (1999 reference, were identified as obese (n=150 and 150 same age and gender pupils (having BMI0.05. macronutrient intakes per kilogram body weight were significantly lower in obese group (p0.05. Obese students used to eat faster (p<0.05. Conclusion: In conclusion, high intakes of energy, protein, carbohydrate, tomato chips and puff and high eating speed were associated to obesity in Ahwaz primary school pupils.

A primary-school-based study to reduce the prevalence of childhood obesity--the EdAl (Educació en Alimentació) study: a randomized controlled trial.

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Tarro, Lucia; Llauradó, Elisabet; Albaladejo, Rosa; Moriña, David; Arija, Victoria; Solà, Rosa; Giralt, Montse

2014-02-14

Obesity is one of the main determinants of avoidable disease burden.To implement a program by university students acting as "health promoting agents" (HPAs) and to evaluate the effects on obesity prevalence of the primary-school-based program that promotes healthy lifestyle, including dietary and physical activity recommendations over 28 months. Two school clusters were randomly assigned to intervention (24 schools, 1,222 pupils) or control (14 schools, 717 pupils); 78% of pupils were Western European. Mean age (±SD) was 8.4±0.6 years (49.9% females) at baseline. Generalized linear mixed models were used to analyze differences in primary outcome between both groups. Data collected included body mass index (BMI) every year. Dietary habits and lifestyle questionnaires were filled in by the parents at baseline and at the end of the study. The interventions focused on eight lifestyle topics covered in 12 activities (1 hour/activity/session) implemented by HPAs over 3 school academic years. At 28 months, obesity prevalence in boys was decreased -2.36% in the intervention group (from 9.59% to 7.23%) and increased 2.03% (from 7.40% to 9.43%) in the control group; the difference was 4.39% (95% CI 3.48 to 5.30; P=0.01). The boys in the intervention group had an effective reduction of -0.24 units in the change of BMI z-score (from 0.01 to -0.04), compared to control (from -0.10 to 0.09); 5.1% more intervention pupils undertook physical activity>5 hours/week than control pupils (P=0.02).Fish consumption was a protector (odds ratio 0.39; 95% CI 0.23 to 0.67) while "fast-food" consumption was a risk factor for childhood obesity (odds ratio: 2.27; 95% CI 1.08 to 4.77). Our school-based program, conducted by HPA students, successfully reduced childhood obesity prevalence in boys. International Standard Randomized Controlled Trial Number: ISRCTN29247645.

Overweight and obesity at school entry among migrant and German children: a cross-sectional study

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Zeeb Hajo

2005-05-01

Full Text Available Abstract Background Overweight and obesity have become a global epidemic and are increasing rapidly in both childhood and adolescence. Obesity is linked both to socioeconomic status and to ethnicity among adults. It is unclear whether similar associations exist in childhood. The aim of the present study was to assess differences in overweight and obesity in migrant and German children at school entry. Methods The body mass index (BMI was calculated for 525 children attending the 2002 compulsory pre-school medical examinations in 12 schools in Bielefeld, Germany. We applied international BMI cut off points for overweight and obesity by sex and age. The migration status of children was based on sociodemographic data obtained from parents who were interviewed separately. Results The overall prevalence of overweight in children aged 6–7 was 11.9% (overweight incl. obesity, the obesity prevalence was 2.5%. The prevalence of overweight and obesity was higher for migrant children (14.7% and 3.1% than for German children (9.1% and 1.9%. When stratified by parental social status, migrant children had a significantly higher prevalence of overweight than German children in the highest social class. (27.6% vs. 10.0%, p = 0.032 Regression models including country/region and socioeconomic status as independent variables indicated similar results. The patterns of overweight among migrant children differed only slightly depending on duration of stay of their family in Germany. Conclusion Our data indicate that children from ethnic minorities in Germany are more frequently overweight or obese than German children. Social class as well as family duration of stay after immigration influence the pattern of overweight and obesity in children at school entry.

WHO European Childhood Obesity Surveillance Initiative in Serbia: a prevalence of overweight and obesity among 6-9-year-old school children.

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Djordjic, Visnja; Radisavljevic, Snezana; Milanovic, Ivana; Bozic, Predrag; Grbic, Miljana; Jorga, Jagoda; Ostojic, Sergej M

2016-09-01

The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) is a public health program established in order to understand the progress of the obesity epidemic in young populations and gain inter-country comparisons within the European region, yet the data from a number of East European countries, including Serbia, were not available then. Therefore, the main aim of this cross-sectional study was to collect data about the prevalence of overweight and obesity among 6-9-year-old school children in Serbia according to the standardized protocol during the Fourth COSI Implementation Round. From September 2015 to November 2015, 5102 first- and second-grade primary-school children (age 7.7±0.6 years) were assessed for weight, height, and body mass index (BMI) in 14 Serbian school districts. The prevalence rates of obesity, as calculated using the International Obesity Task Force (IOTF) cut-off points, vary across different age groups, with the lowest obesity rates reported in 7-year-old boys (6.2%), while the highest obesity prevalence rates were observed in 6-year-old boys (9.7%). In addition, being overweight was strongly associated with poor local community development and lower level of urbanization. The overall prevalence of overweight (23.1%, including obesity) and obesity (6.9%) in Serbian primary-school children seem to be comparable to rather high rates previously reported in other countries participating in the COSI program, indicating an obesity epidemic in Serbian children. This surveillance system should be regularly implemented throughout Europe, providing comparable data on rates of overweight/obesity in primary schools that might drive prudent actions to reverse the pandemic trend of childhood obesity.

Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the Philadelphia, Pennsylvania, School District, 2006–2010

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Robbins, Jessica M.; Mallya, Giridhar; Polansky, Marcia; Schwarz, Donald F.

2012-01-01

Introduction Epidemic increases in obesity negatively affect the health of US children, individually and at the population level. Although surveillance of childhood obesity at the local level is challenging, height and weight data routinely collected by school districts are valuable and often underused public health resources. Methods We analyzed data from the School District of Philadelphia for 4 school years (2006–2007 through 2009–2010) to assess the prevalence of and trends in obesity and...

Prevalence of obesity and its correlates in school going adolescents of Haldwani, Nainital, Uttarakhand, India

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Shantanu Aggarwal

2016-06-01

Full Text Available Background: With a rising trend of Non-Communicable Diseases (NCDs in the present world, overweight and obesity has gained importance as it is not only a disease in itself but also risk factor for majority of other NCDs. A dramatic increase in overweight and obesity among children and adolescent has raised the concern of various public health physicians especially in developing country like India. Aims & Objective: To study the prevalence of overweight and obesity & its correlates among school going adolescents of Haldwani block. Material & Methods: School based cross sectional study was done among the adolescents of 8th to 12th standard. To calculate the maximum sample size prevalence of obesity was assumed to be 50%, taking absolute error of 5%, design effect of 2 and 10% non-response rate the sample was calculated to be 880, rounded off to 900. Samples were collected from 30 clusters/schools using simple random sampling. Data was collected using a pre-designed, semi-structured and pre-tested questionnaire and analyzed by using SPSS version 22. Results: Prevalence of overweight and obesity was 13% (CI = 10.8 - 15.2%. Overweight and obesity was found to be significantly associated with urban area, private school, Socio-economic class I, non-vegetarian diet, physical inactivity and playing videogames, working on laptops and computer on univariate analysis. On applying binary logistic regression factors like private schools, socioeconomic class I, non-vegetarian diet and physical inactivity were again found to be significantly associated with overweight and obesity. Conclusion: Prevalence of obesity was found to be more in adolescents having modifiable risk factors.  

Campus-Based, Community-Based, and Philanthropic Contributions to Predoctoral Pediatric Dental Clinical Education: Two Years of Experiences at One Dental College.

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Spiritoso, Stephen; Gross, Erin; Bean, Canise Y; Casamassimo, Paul S; Levings, Kevin; Lloyd, Patrick

2015-08-01

The aim of this study was to investigate the contribution of a tiered predoctoral pediatric dentistry clinical education model to competency achievement by dental students over a two-year clinical education. Retrospective data were obtained for academic years 2012-13 and 2013-14 from three sources: a campus-based, dental school-housed clinic; division-directed clinics in community-based pediatric and special needs clinics (DDC); and clinics affiliated with the dental college's community-based dental education (CBDE) program, the OHIO Project (OP). A fourth dataset was obtained for the same two-year period from a biannual clinic event held at the college in conjunction with Give Kids a Smile Day (GKAS). Procedures considered essential to the care of children were sorted by 12 dental codes from all services for patients 18 years of age and younger. The dental school clinic provided 11,060 procedures; the DDC, 28,462; the OP, 17,863; and GKAS, 2,028. The two-year total was 59,433 procedures. Numbers of diagnostic and preventive procedures were 19,441, restorative procedures were 13,958, and pulp and surgical procedures were 7,392. Site contribution ranged from 52.2 to 144.9 procedures per attending student, with the DDC yielding the highest per student average for each year (126.4 and 144.9) and the dental school clinic the lowest (52.2 and 53.1). This study found that a combination of school-based, community-based, and philanthropic pediatric dental experiences offered a large number of essential pediatric dentistry experiences for predoctoral dental students, with CBDE opportunities offering the largest contribution.

Large reductions in child overweight and obesity in intervention and comparison communities 3 years after a community project.

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Swinburn, B; Malakellis, M; Moodie, M; Waters, E; Gibbs, L; Millar, L; Herbert, J; Virgo-Milton, M; Mavoa, H; Kremer, P; de Silva-Sanigorski, A

2014-12-01

comparison schools increased from a very low base to over 66 000 AUD per school per year in 2009. The 8%-point reduction in overweight/obesity in both areas over 6 years from baseline to 3 years post-intervention was substantial. While the benefits of BAEW increased in the intervention community in the long term, the surrounding communities appeared to have more than caught up in programme investments and health gains, suggesting a possible 'viral spread' of obesity prevention actions across the wider region. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

A cluster randomised school-based lifestyle intervention programme for the prevention of childhood obesity and related early cardiovascular disease (JuvenTUM 3

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Haller Bernhard

2011-04-01

Full Text Available Abstract Background Childhood obesity is not only associated with adult obesity but also with increased risk of adult onset of type 2 diabetes and subsequent coronary heart disease. The potential effects of school-based health intervention programmes on cardiovascular risk and surrogate markers are unclear, as only few studies have attempted to investigate a complete risk profile including a detailed laboratory analysis or micro- and macrovascular function. In this study a comprehensive school-based randomized intervention programme will be investigated in 10-14-year old children addressing the influence of lifestyle intervention on inactivity, cardiometabolic risk factors and early signs of vascular disease. Methods/Design 15 secondary schools in Southern Germany are randomly assigned to intervention or control schools. Children in the fifth grade (10-11 years will be observed over four years. The study combines a school-based with a home-based approach, aiming at children, teachers and parents. The main components are weekly lifestyle-lessons for children, taught by regular classroom teachers to increase physical activity in- and outside of school, to improve eating patterns at school and at home, to reduce media consumption and to amplify well-being. In 4-6 annual meetings, teachers receive information about health-related topics with worksheets for children and supporting equipment, accounting for school-specific needs and strategies. Parents' trainings are provided on a regular basis. All examinations are performed at the beginning and at the end of every school year. Anthropometry includes measurements of BMI, waist and upper arm circumferences, skinfold thickness as well as peripheral blood pressure. Blood sampling includes lipid parameters, insulin, glucose, hsCRP, adiponectin, and IL-6 as well as testosteron and estrogen to determine maturation status. Vascular function is non-invasively assessed by measuring arterial stiffness in large

Technology Components as Adjuncts to Family-Based Pediatric Obesity Treatment in Low-Income Minority Youth.

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Tripicchio, Gina L; Ammerman, Alice S; Neshteruk, Cody; Faith, Myles S; Dean, Kelsey; Befort, Christie; Ward, Dianne S; Truesdale, Kimberly P; Burger, Kyle S; Davis, Ann

2017-12-01

Strategies to treat pediatric obesity are needed, especially among high-need populations. Technology is an innovative approach; however, data on technology as adjuncts to in-person treatment programs are limited. A total of 64 children [body mass index (BMI) ≥85th percentile, mean age = 9.6 ± 3.1 years, 32.8% female, 84.4% Hispanic] were recruited to participate in one of three cohorts of a family-based behavioral group (FBBG) treatment program: FBBG only, TECH1, and TECH2. Rolling, nonrandomized recruitment was used to enroll participants into three cohorts from May 2014 to February 2015. FBBG began in May 2014 and received the standard, in-person 12-week treatment only (n = 21); TECH1 began in September 2014 and received FBBG plus a digital tablet equipped with a fitness app (FITNET) (n = 20); TECH2 began in February 2015 and received FBBG and FITNET, plus five individually tailored TeleMed health-coaching sessions delivered via Skype (n = 23). Child BMI z-score (BMI-z) was assessed at baseline and postintervention. Secondary aims examined weekly FBBG attendance, feasibility/acceptability of FITNET and Skype, and the effect of technology engagement on BMI-z. FBBG and TECH1 participants did not show significant reductions in BMI-z postintervention [FBBG: β = -0.05(0.04), p = 0.25; TECH1: β = -0.006(0.06), p = 0.92], but TECH2 participants did [β = -0.09(0.02), p < 0.001] and TeleMed session participation was significantly associated with BMI-z reduction [β = -0.04(0.01), p = 0.01]. FITNET use and FBBG attendance were not associated with BMI-z in any cohort. Overall, participants rated the technology as highly acceptable. Technology adjuncts are feasible, used by hard-to-reach participants, and show promise for improving child weight status in obesity treatment programs.

Pediatric Obesity Management in Rural Clinics in California and the Role of Telehealth in Distance Education

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Shaikh, Ulfat; Nettiksimmons, Jasmine; Romano, Patrick

2011-01-01

Objective: To determine health care provider needs related to pediatric obesity management in rural California and to explore strategies to improve care through telehealth. Methods: Cross-sectional survey of health care providers who treated children and adolescents at 41 rural clinics with existing telehealth connectivity. Results: Most of the…

A Systematised Review of Primary School Whole Class Child Obesity Interventions: Effectiveness, Characteristics, and Strategies

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Elise C. Brown

2016-01-01

Full Text Available Background. A systematised review was conducted to examine the effectiveness of school-based interventions that focus on changing dietary intake and physical activity levels to reduce childhood obesity. Methods. Multiple databases were searched for randomised and nonrandomised interventions from 2007 to 2016 in full-time elementary schools, which were delivered to the whole class, included dietary and physical activity components, involved both sexes, were written in English, and used body mass index (BMI as an outcome. Results. The database search produced 8,866 titles from which 78 were deemed relevant and assessed for inclusion resulting in 15 studies meeting all inclusion criteria. From these 15 studies, 9 yielded a reduction or stabilisation in BMI or BMI z-score in the entire intervention group and/or subgroups. Programmes lasting between 6 and 12 months that involve multiple environmental, educational, and physical strategies appear to be most likely to result in BMI or BMI z-score improvement. Moderators most likely influencing an improvement in BMI included increased physical activity, decreased sugar sweetened beverages intake, and increased fruit intake. Conclusions. School-based interventions may be an effective means for child obesity prevention. The identification of consistent elements used in school-based interventions that have demonstrated effectiveness may aid in preventing child obesity.

Association between state school nutrition laws and subsequent child obesity.

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Palakshappa, Deepak; Fiks, Alexander G; Faerber, Jennifer A; Feudtner, Chris

2016-09-01

Many states have enacted laws to improve school nutrition. We tested whether stronger state nutrition laws are associated with subsequently decreased obesity. We conducted a retrospective national multi-year panel data study (analyzed 2014-2016 at the Children's Hospital of Philadelphia). The predictors were 2010 laws regarding 9 nutrition categories from the Classification of Laws Associated with School Students, which grades the strength of state laws (none, weak, or strong). The outcome was weight status (healthy weight, overweight, or obese) in elementary, middle, and high school from the 2011/2012 National Survey of Children's Health. We tested the association between the strength of laws and weight using multinomial logistic regression. To further evaluate our main results, we conducted state-level longitudinal analyses testing the association between competitive food and beverage laws on the change in obesity from 2003-2011. In main analyses of 40,177 children ages 10-17years, we found strong state laws restricting the sale of competitive food and beverages in elementary school (OR: 0.68; 95% CI: 0.48, 0.96) and strong advertising laws across all grades (OR: 0.63; 95% CI: 0.46, 0.86) were associated with reduced odds of obesity. In longitudinal analyses, states with strong competitive food and beverage laws from 2003-2010 had small but significant decreases in obesity, compared to states with no laws. Although further research is needed to determine the causal effect of these laws, this study suggests that strong state laws limiting the sale and advertising of unhealthy foods and beverages in schools are associated with decreased obesity rates. Copyright © 2016 Elsevier Inc. All rights reserved.

Obesity counseling by pediatric health professionals: an assessment using nationally representative data.

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Liang, Lan; Meyerhoefer, Chad; Wang, Justin

2012-07-01

Examine the rate of screening for adolescent overweight and obesity by pediatric health care professionals and the provision of advice on healthy eating and physical activity. Our sample contains adolescents 11 to 17 years old (6911 girls and 6970 boys) from the 2001-2007 Medical Expenditure Panel Survey who reported having at least 1 health provider visit in the previous 12 months. Using logistic regression, we investigated factors associated with whether parents reported that their children were weighed and measured and whether they or their children received counseling on their eating habits and physical activity. All models were estimated separately by gender. Forty-seven percent of girls and 44% of boys who visited a health provider were advised to eat healthy, and 36% of boys and girls were advised to exercise more. Obese boys and girls were both more likely to be advised to eat healthy (odds ratio [OR] = 2.10, P obese. Adolescents who were more likely to receive such advice lived in the northeast, were from higher-income households, had parents with at least some college education, and had a usual source of medical care. Greater efforts should be made to incorporate guidelines on childhood obesity screening and counseling into clinical practice.

Are Changes in Consumption of “Healthy” Foods Related to Changes in Consumption of “Unhealthy” Foods During Pediatric Obesity Treatment?

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Hollie A. Raynor

2012-04-01

Full Text Available Increasing fruits and vegetables (FVs, a dietary recommendation for pediatric weight management, is theorized to reduce energy intake by reducing intake of more energy-dense foods, such as snack foods (SFs. This study examined the relationship between changes in FV, SF, and energy intake in children enrolled in a 6-month, family-based behavioral pediatric weight management trial. Secondary data analyses examined dietary intake in 80 overweight ( ≥ 85th to < 95th percentile for body mass index [BMI] and obese ( ≥ 95th percentile for BMI children (7.2 ± 1.7 years with complete dietary records at 0 and 6 months. Participants were randomized to one of three treatment conditions: (1 increased growth monitoring with feedback; (2 decrease SFs and sugar sweetened beverages; or (3 increase FVs and low-fat dairy. With treatment condition controlled in all analyses, FV intake significantly increased, while SF and energy intake decreased, but not significantly, from 0 to 6 months. Change in FV intake was not significantly associated with change in SF consumption. Additionally, change in FV intake was not significantly related to change in energy intake. However, reduction in SF intake was significantly related to reduction in energy intake. Changing only FVs, as compared to changing other dietary behaviors, during a pediatric obesity intervention may not assist with reducing energy intake.

5-4-3-2-1 go! Coordinating pediatric resident education and community health promotion to address the obesity epidemic in children and youth.

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Stahl, Christiane Ellen; Necheles, Jonathan Wolf; Mayefsky, Jay Hirsh; Wright, Lydia Katherine; Rankin, Kristin Michele

2011-03-01

This study investigated the feasibility and effectiveness of training pediatric residents to conduct a brief clinic-based behavioral intervention in coordination with community dissemination of a health promotion message developed by the Consortium for Lowering Obesity in Chicago Children. A total of 113 residents completed a short (obesity rates: increased intake of fruits and vegetables (28% vs 16%, P < .01), increased intake of water (30% vs 19%, P < .01), increased physical activity (40% vs 29%, P < .03), and decreased television time (36% vs 24%, P < .01). Brief training using the 5-4-3-2-1-Go! message seems to be feasible and effective.

From birth to adolescence: Vienna 2005 European Childhood Obesity Group International Workshop.

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Pietrobelli, A; Flodmark, C E; Lissau, I; Moreno, L A; Widhalm, K

2005-09-01

In the last 15 y there has been a tremendous increase in the number of studies on pediatric obesity looking at epidemiology, health-related risks, etiology, methodology and treatment. During the early 1990s, the European Childhood Obesity Group (ECOG) was born as a group of scientists' expert in the field of pediatric obesity. ECOG this year celebrates the approach to early maturity with an excited and omni-comprehensive program developing through eight different tracks. Comments on different 'key' papers in each of the eight tracks. The eight tracks were (1) Nutrition requirements and food habits, (2) physical activity, (3) prevention and political actions/strategies, (4) diabetes, (5) metabolism, (6) psychology, (7) pathology, and (8) treatment with emphasis on drugs. Looking at the overall picture of the ECOG workshop we could conclude that despite the fact that childhood obesity is a crisis facing worldwide youth, it is necessary that action to control it must be taken now. All the six relevant levels (ie, family, schools, health professionals, government, industry and media) could be involved in prevention of child and adolescent obesity.

Obesity and food security in Yazd primary school students

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Karam soltani Z

2007-09-01

Full Text Available Background: Food security is defined as access, for all people at all times, to enough food for an active and healthy life. Food security includes: 1 the ready availability of nutritionally-adequate and safe food, and 2 an assured ability to acquire acceptable foods in socially acceptable ways. The increase in childhood as well as adulthood obesity and food insecurity has caused many recent investigations on obesity, food insecurity and some associated factors. However, there appears to be a lack of published information regarding some factors affecting obesity and food insecurity. This study aimed to determine the prevalence obesity and food insecurity and some associated factors among Yazd province primary school students in Iran.Methods: Using two-stage cluster sampling, a total of 3245 students (1587 boys and 1658 girls, aged 9-11 years, were randomly selected from primary school pupils in Yazd, Iran. From these, 187 students having BMIs ≥95th percentile, as defined by Hosseini et al. (1999, were identified as obese and 187 pupils of the same age and gender having BMIs between the 15th and 85th percentiles were selected as controls. Data were collected using 24-hour food-recall and USDA food insecurity questionnaires.Results: We found that the prevalence of obesity among students aged 9-11 years was 13.3%, and the prevalence of food insecurity was 30.5%. Daily energy intakes, compared to those recommended by the RDA, carbohydrate intake and energy percentages from proteins and carbohydrates were higher in obese children, and all macronutrient intakes per kilogram of body weight were significantly higher. An association between obesity and food insecurity was observed with adjusted fat intake.Conclusion: In conclusion, the prevalence of obesity and food insecurity is high among Yazd primary school students, and high-level intakes of energy, protein, carbohydrate are associated with obesity. Furthermore, variation in the rate of fat intake

Factors affecting subspecialty referrals by pediatric primary care providers for children with obesity-related comorbidities.

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Walsh, Carolyn O; Milliren, Carly E; Feldman, Henry A; Taveras, Elsie M

2013-08-01

To determine referral patterns from pediatric primary care to subspecialists for overweight/obesity and related comorbidities. We used the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to identify overweight/obesity and 5 related comorbidities in primary care visits between 2005 and 2009 by children 6 to 18 years. The primary outcome was whether the visit ended in referral. We used multivariable analysis to examine factors associated with referral. We identified 34,225 database visits. A total of 17.1% were with overweight (body mass index=85th to 94th percentile) or obese (body mass index≥95th percentile) patients. A total of 7.1% of primary care visits with overweight/obese children ended in referral. Referral was more likely when obesity was the reason for visit (odds ratio=2.83; 95% confidence interval=1.61-4.97) but was not associated with presence of a comorbidity (odds ratio=1.35; 95% confidence interval=0.75-2.44). Most overweight or obese children are not referred, regardless of comorbidity status. One reason may be low levels of appropriate diagnosis.

The Nutrition and Enjoyable Activity for Teen Girls (NEAT girls) randomized controlled trial for adolescent girls from disadvantaged secondary schools: rationale, study protocol, and baseline results

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Okely Anthony D; Plotnikoff Ronald C; Collins Clare E; Dewar Deborah; Morgan Philip J; Lubans David R; Batterham Marijka J; Finn Tara; Callister Robin

2010-01-01

Abstract Background Child and adolescent obesity predisposes individuals to an increased risk of morbidity and mortality from a range of lifestyle diseases. Although there is some evidence to suggest that rates of pediatric obesity have leveled off in recent years, this has not been the case among youth from low socioeconomic backgrounds. The purpose of this paper is to report the rationale, study design and baseline findings of a school-based obesity prevention program for low-active adolesc...

Limitations of studies on school-based nutrition education interventions for obesity in China: a systematic review and meta-analysis.

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Kong, Kaimeng; Liu, Jie; Tao, Yexuan

2016-01-01

School-based nutrition education has been widely implemented in recent years to fight the increasing prevalence of childhood obesity in China. A comprehensive literature search was performed using six databases to identify studies of school-based nutrition education interventions in China. The methodological quality and the risk of bias of selected literature were evaluated. Stratified analysis was performed to identify whether different methodologies influenced the estimated effect of the intervention. Seventeen articles were included in the analysis. Several of the included studies had inadequate intervention duration, inappropriate randomization methods, selection bias, unbalanced baseline characteristics between control and intervention groups, and absent sample size calculation. Overall, the studies showed no significant impact of nutrition education on obesity (OR=0.76; 95% CI=0.55-1.05; p=0.09). This can be compared with an OR of 0.68 for interventions aimed at preventing malnutrition and an OR of 0.49 for interventions aimed at preventing iron-deficiency anemia. When studies with unbalanced baseline characteristics between groups and selection bias in the study subjects were excluded, the impact of nutrition education on obesity was significant (OR=0.73; 95% CI=0.55-0.98; p=0.003). An analysis stratified according to the duration of intervention revealed that the intervention was effective only when it lasted for more than 2 years (OR=0.49, 95% CI=0.42-0.58; pnutrition education programs in China have some important limitations that might affect the estimated effectiveness of the intervention.

The association of obesity and school absenteeism attributed to illness or injury among adolescents in the United States, 2009.

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Pan, Liping; Sherry, Bettylou; Park, Sohyun; Blanck, Heidi M

2013-01-01

School attendance can impact academic performance. Childhood obesity-related physical and psychosocial consequences are potentially associated with school absenteeism. Thus, we examined the association between school absenteeism attributed to illness or injury and obesity among adolescents aged 12-17 years. We used a weighted sample of 3,470 U.S. adolescents from the 2009 National Health Interview Survey. School absenteeism was measured from the parent-reported number of sick days taken in the preceding 12 months. Body mass index was calculated from parent-reported weight and height. Weight status was classified based on the sex-specific body mass index-for-age percentile defined by the CDC growth charts. Poisson regression was conducted to examine the association between school absenteeism and weight status, controlling for selected sociodemographic characteristics and disease status. The mean number of annual sick days was 3.9 days overall; 3.4 days among normal-weight, 4.4 days among overweight, and 4.5 days among obese adolescents. Obese adolescents had a higher proportion of missing ≥4 days of school per year than adolescents of normal weight. Our multivariate analyses found that compared with adolescents of normal weight, overweight and obese adolescents had greater than one-third more sick days annually (rate ratio = 1.36 for overweight and 1.37 for obese adolescents). Overweight and obese adolescents had 36% and 37% more sick days, respectively, than adolescents of normal weight. The results suggest another potential aspect of obesity prevention and reduction efforts among children and families is to improve children's school attendance. Published by Elsevier Inc.

Lifestyle intervention for improving school achievement in overweight or obese children and adolescents.

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Martin, Anne; Saunders, David H; Shenkin, Susan D; Sproule, John

2014-03-14

to resolve discrepancies when required. Authors were contacted to obtain further study details and were asked to provide data on the overweight and obese study population when they were not reported separately. Of 529 screened full-text articles, we included in the review six studies (14 articles) of 674 overweight and obese children and adolescents, comprising four studies with multicomponent lifestyle interventions and two studies with physical activity only interventions. We conducted a meta-analysis when possible and a sensitivity analysis to consider the impact of cluster-randomised controlled trials and/or studies at 'high risk' of attrition bias on the intervention effect. We prioritised reporting of the sensitivity analysis when risk of bias and differences in intervention type and duration were suspected to have influenced the findings substantially. Analysis of a single study indicated that school-based healthy lifestyle education combined with nutrition interventions can produce small improvements in overall school achievement (mean difference (MD) 1.78 points on a scale of zero to 100, 95% confidence interval (CI) 0.8 to 2.76; P obesity treatment trials, evidence regarding their impact on school achievement and cognitive abilities is lacking. Existing studies have a range of methodological issues affecting the quality of evidence. Multicomponent interventions targeting physical activity and healthy diet could benefit general school achievement, whereas a physical activity intervention delivered for childhood weight management could benefit mathematics achievement, executive function and working memory. Although the effects are small, a very large number of children and adolescents could benefit from these interventions. Therefore health policy makers may wish to consider these potential additional benefits when promoting physical activity and healthy eating in schools. Future obesity treatment trials are needed to examine overweight or obese children and

Prevalence and socioeconomic correlates of overweight and obesity among Pakistani primary school children

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Shahid Ubeera

2011-09-01

Full Text Available Abstract Background Childhood obesity is becoming an equally challenging, yet under-recognized, problem in developing countries including Pakistan. Children and adolescents are worst affected with an estimated 10% of the world's school-going children being overweight and one quarter of these being obese. The study aimed to assess prevalence and socioeconomic correlates of overweight and obesity, and trend in prevalence statistics, among Pakistani primary school children. Methods A population-based cross-sectional study was conducted with a representative multistage cluster sample of 1860 children aged 5-12 years in Lahore, Pakistan. Overweight (> + 1SD and obesity (> + 2SD were defined using the World Health Organization child growth reference 2007. Chi-square test was used as the test of trend. Linear regression was used to examine the predictive power of independent variables in relation to BMI. Logistic regression was used to quantify the independent predictors for overweight and adjusted odds ratios (aOR with 95% confidence intervals (CI were obtained. All regression analyses were controlled for age and gender and statistical significance was considered at P Results Seventeen percent (95% CI 15.4-18.8 children were overweight and 7.5% (95% CI 6.5-8.7 were obese. Higher prevalence of obesity was observed among boys than girls (P = 0.028, however, there was no gender disparity in overweight prevalence. Prevalence of overweight showed a significantly increasing trend with grade (P Conclusion Alarmingly rapid rise in overweight and obesity among Pakistani primary school children was observed, especially among the affluent urban population. The findings support the urgent need for National preventive strategy for childhood obesity and targeted interventions tailored to local circumstances with meaningful involvement of communities.

Comparison of ICD code-based diagnosis of obesity with measured obesity in children and the implications for health care cost estimates.

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Kuhle, Stefan; Kirk, Sara F L; Ohinmaa, Arto; Veugelers, Paul J

2011-12-21

Administrative health databases are a valuable research tool to assess health care utilization at the population level. However, their use in obesity research limited due to the lack of data on body weight. A potential workaround is to use the ICD code of obesity to identify obese individuals. The objective of the current study was to investigate the sensitivity and specificity of an ICD code-based diagnosis of obesity from administrative health data relative to the gold standard measured BMI. Linkage of a population-based survey with anthropometric measures in elementary school children in 2003 with longitudinal administrative health data (physician visits and hospital discharges 1992-2006) from the Canadian province of Nova Scotia. Measured obesity was defined based on the CDC cut-offs applied to the measured BMI. An ICD code-based diagnosis obesity was defined as one or more ICD-9 (278) or ICD-10 code (E66-E68) of obesity from a physician visit or a hospital stay. Sensitivity and specificity were calculated and health care cost estimates based on measured obesity and ICD-based obesity were compared. The sensitivity of an ICD code-based obesity diagnosis was 7.4% using ICD codes between 2002 and 2004. Those correctly identified had a higher BMI and had higher health care utilization and costs. An ICD diagnosis of obesity in Canadian administrative health data grossly underestimates the true prevalence of childhood obesity and overestimates the health care cost differential between obese and non-obese children.

Overweight and obesity among school-going children of Lucknow city.

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Vohra, Rajaat; Bhardwaj, Pankaj; Srivastava, Jyoti P; Srivastava, Shekhar; Vohra, Anusha

2011-05-01

Childhood obesity is increasingly being observed with changing lifestyles of families. The magnitude of overweight ranges from 9% to 27.5% and obesity ranges from 1% to 12.9% among Indian children. The present study was undertaken to study the magnitude of overweight/obesity and its determinants among children in Lucknow city. A list of government and private school was procured from Office of Basic Shiksha Adhikari. Three government and three private schools were selected by Simple Random Sampling. Students of 5th to 12th grades available at the time of study were included as study unit. Predesigned and pretested questionnaire was used to elicit the information on family characteristics and individual characteristics. Height and weight were measured and BMI was calculated. Children with BMI of 25 and above were considered overweight and children with BMI more than 30 were considered obese. Overweight and obesity was found to be 4.17% and 0.73%, respectively; they together constitute 4.91% for overweight/obesity. The study revealed that the important correlates of overweight/obesity were father's education, father's occupation, class, children playing outdoor games for less than 30 min, and those consuming fast foods. Children of higher classes (above 8th standard) belonging to higher socioeconomic group with less outdoor activities and consuming fast foods were more predisposed to overweight/obesity. As a preventive strategy, there is a need to apply health and nutritional education programs for inculcating healthy life styles, and incorporating more outdoor activities in Physical Education Department of school curriculum.

[Prevention of overweight and obesity in children and adolescents in European countries].

Science.gov (United States)

Drewa, Aleksandra; Zorena, Katarzyna

2017-01-01

In the 21st century the occurrence of overweight and obesity in children and adolescents reaches the size of a global epidemic. It is recommended to promote a healthy lifestyle and, above all, to educate children, adolescents and adults about the dangerous consequences of being overweight or obese. It is crucial for prevention programs to comprise educational activities so that the participants are encouraged to change their lifestyle for better. However, it must be borne in mind that the overall effectiveness of such activities is determined by the commitment of both the obese child and the environment - the school or kindergarten and the media. Only integrated efforts can increase patients' awareness and reverse the growing trend in incidence of obesity around the world. This work discusses the current knowledge of overweight and obesity in children and adolescents, as well as the methods of prevention applied in various European countries. The analysis was based on up-to-date epidemiological data available in PubMed, Scopus, and Google Scholar databases. © Polish Society for Pediatric Endocrinology and Diabetology.

Examining social norm impacts on obesity and eating behaviors among US school children based on agent-based model.

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Wang, Youfa; Xue, Hong; Chen, Hsin-jen; Igusa, Takeru

2014-09-06

Although the importance of social norms in affecting health behaviors is widely recognized, the current understanding of the social norm effects on obesity is limited due to data and methodology limitations. This study aims to use nontraditional innovative systems methods to examine: a) the effects of social norms on school children's BMI growth and fruit and vegetable (FV) consumption, and b) the effects of misperceptions of social norms on US children's BMI growth. We built an agent-based model (ABM) in a utility maximization framework and parameterized the model based on empirical longitudinal data collected in a US nationally representative study, the Early Childhood Longitudinal Study - Kindergarten Cohort (ECLS-K), to test potential mechanisms of social norm affecting children's BMI growth and FV consumption. Intraclass correlation coefficients (ICC) for BMI were 0.064-0.065, suggesting that children's BMI were similar within each school. The correlation between observed and ABM-predicted BMI was 0.87, indicating the validity of our ABM. Our simulations suggested the follow-the-average social norm acts as an endogenous stabilizer, which automatically adjusts positive and negative deviance of an individual's BMI from the group mean of a social network. One unit of BMI below the social average may lead to 0.025 unit increase in BMI per year for each child; asymmetrically, one unit of BMI above the social average, may only cause 0.015 unit of BMI reduction. Gender difference was apparent. Social norms have less impact on weight reduction among girls, and a greater impact promoting weight increase among boys. Our simulation also showed misperception of the social norm would push up the mean BMI and cause the distribution to be more skewed to the left. Our simulation results did not provide strong support for the role of social norms on FV consumption. Social norm influences US children's BMI growth. High obesity prevalence will lead to a continuous increase in

Indicator for success of obesity reduction programs in adolescents: Body composition or body mass index? evaluating a school-based health promotion project after 12 weeks of intervention

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Naser Kalantari

2017-01-01

Full Text Available Background: Obesity in adolescence is the strongest risk factor for obesity in adulthood. This study aimed to evaluate the effects of a comprehensive lifestyle intervention on different anthropometric indices in 12–16-year-old boy adolescents after 12 Weeks of Intervention. Methods: A total of 96 male adolescents from two schools participated in this study. The schools were randomly assigned to intervention (53 students and control school (43 students. Height and weight of students were measured and their body mass index (BMI was calculated. Body fat percent (BF and body muscle percent (BM was assessed using a bioimpedance analyzer considering the age, gender, and height of students at baseline and after intervention. The obesity reduction intervention was implemented in the intervention school based on the Ottawa charter for health promotion. Results: Twelve weeks of intervention decreased BF percent in the intervention group in comparison with the control group (decreased by 1.81% in the intervention group and increased by 0.39% in the control group, P < 0.01. However, weight, BMI, and BM did not change significantly. Conclusions: The result of this study showed that a comprehensive lifestyle intervention decreased the body fat percent in obese adolescents, although these changes was not reflected in the BMI. It is possible that BMI is not a good indicator in assessment of the success of obesity management intervention.

Evaluating School Wellness Policy in Curbing Childhood Obesity in Anchorage, Alaska

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Parsons, Wendy G.; Garcia, Gabriel M.; Hoffman, Pamela K.

2014-01-01

In 2006, the Anchorage School District implemented a school wellness policy to address the problem of obesity among its elementary-aged students. We assessed whether the addition of this policy is effective in protecting or preventing students from becoming overweight/obese over time. The methods involved following two cohorts of students for 5…

Quality of evidence-based pediatric guidelines

NARCIS (Netherlands)

Boluyt, Nicole; Lincke, Carsten R.; Offringa, Martin

2005-01-01

Objective. To identify evidence-based pediatric guidelines and to assess their quality. Methods. We searched Medline, Embase, and relevant Web sites of guideline development programs and national pediatric societies to identify evidence-based pediatric guidelines. A list with titles of identified

Randomized Trial of a Family-based, Automated, Conversational Obesity Treatment Program for Underserved Populations

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Wright, J. A.; Phillips, B.D.; Watson, B.L.; Newby, P.K.; Norman, G. J.; Adams, W.G.

2013-01-01

Objective To evaluate the acceptability and feasibility of a scalable obesity treatment program integrated with pediatric primary care and delivered using interactive voice technology (IVR) to families from underserved populations. Design and Methods Fifty parent-child dyads (child 9–12 yrs, BMI >95th percentile) were recruited from a pediatric primary care clinic and randomized to either an IVR or a wait-list control (WLC) group. The majority were lower-income, African-American (72%) families. Dyads received IVR calls for 12 weeks. Call content was informed by two evidenced-based interventions. Anthropometric and behavioral variables were assessed at baseline and 3 mo follow-up. Results Forty-three dyads completed the study. IVR parents ate 1 cup more fruit than WLC (p 75% agreed that the calls were useful, made for people like them, credible, and helped them eat healthy foods. Conclusion An obesity treatment program delivered via IVR may be an acceptable and feasible resource for families from underserved populations. PMID:23512915

Hypertension and its association with overweight and obesity among adolescents: a school-based survey

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Rafael Vieira Martins

2013-07-01

Full Text Available This study aimed to investigate the association of overweight and obesity with hypertension in adolescents from public schools in Curitiba, southern Brazil.The sample comprised 1,549 randomly selected adolescents aged 12 to 18 years (744 males. Body mass index (BMI was calculated and classified according to Conde and Monteiro (2006. Blood pressure was measured by the auscultation method on two occasions (different days and was classified according to the fourth report of the National High Blood Pressure Education Program (NHBPEP. Prevalence ratio was used as a measure of association. Overweight and obesity were observed in 23% and 5.8% of boys, respectively. Among girls, 18.8% were overweight and 5.6% were obese. After two measurements, 7% of boys had prehypertension and 10.5% had hypertension. Pre hypertension and hypertension were observed in 5.2% and 9.9% of girls, respectively. Obesity was significantly associated with high blood pressure among boys (PR = 1.19, 95% CI= 1.07-1.32. Overweight (PR = 1.11, 95% CI = 1.04-1.17 and obese (PR = 1.26,95% CI = 1.13-1.40 girls were more likely to have high blood pressure levelsin comparison to normal weight adolescents. These results showed alarming estimates of hypertension among young people and that the reduction of obesity during adolescence should be focused on public policies for hypertensionprevention in the population.

Associations between obesity and developmental functioning in pre-school children: a population-based study.

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Mond, J M; Stich, H; Hay, P J; Kraemer, A; Baune, B T

2007-07-01

To examine associations between obesity and impairment in developmental functioning in a general population sample of pre-school children. Standardized medical examinations were conducted in nine consecutive cohorts of male and female children (n=9415) aged between 4.4 and 8.6 years (mean=6.0, s.d.=0.37) residing in the Lower Bavaria region of Germany. Tests designed to assess performance in subdivisions representing four broad developmental domains, namely, motor development, speech development, cognitive development and psycho-social development, were completed by all participants. Boys had significantly higher rates of impairment than girls. The prevalence of obesity in boys was 2.4%, whereas in girls it was 4.3% (chi (2)=21.51, Pmotor skills was higher among obese male children than normal-weight male children (adjusted odds ratio=1.76, 95% confidence interval (CI)=1.02, 3.01, Pability to focus attention was higher in obese female children than normal-weight female children (adjusted odds ratio=1.86, 95% CI=1.00, 3.44, Pobesity and impairment in specific aspects of developmental functioning may be evident in younger children.

Screening and treatment of obesity in school health care - the gap between clinical guidelines and reality.

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Häkkänen, Paula; Ketola, Eeva; Laatikainen, Tiina

2018-05-06

School health care offers a natural setting for childhood obesity interventions. Earlier studies reveal inadequate screening and treatment in primary care. However, longitudinal studies in unselected populations are lacking. We aimed to examine how school nurses and physicians identified obesity, diagnosed it and offered interventions over primary school. We compared the results with Finnish recommendations. From our cohort of 2000 primary school sixth graders (aged 12-14), 172 were obese at least once during primary school. We manually collected retrospective electronic health record (EHR) data of these 'ever-obese' children. Of the ever-obese children, 96% attended annual nurse assessments more than twice. School physicians met 53% of the ever-obese children at health checks at first grade and 93% at fifth grade. Of overweight-related extra visits to school nurses, 94% took place without parents. Parents were present in 48% of extra school physician visits. Only 29% of the 157 who became obese during the first five school grades received an obesity diagnosis. However, school physicians mentioned weight problems in EHR for 90% of the children and, similarly, school nurses for 99%. The majority received a treatment plan at least once. For 78%, at least one plan was made with the parents. Still, 28% missed nutrition plans, 31% exercise plans and 90% lacked recorded weight development targets. The gap between clinical guidelines and reality in school health care could be narrowed by improving diagnosing and parent collaboration. Obstacles in parent involvement and work methods in school health care need further study. © 2018 Nordic College of Caring Science.

Current Government Actions and Potential Policy Options for Reducing Obesity in Queensland Schools

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Naser A. Alsharairi

2018-01-01

Full Text Available School nutrition policies provide promising avenues towards the improvement of children’s eating habits and the prevention of obesity. Childhood obesity rates and related chronic diseases are increasing in Queensland, in part as a result of unhealthy eating habits and lack of physical activity. There is a very high investment by the Queensland government in maintaining healthy weight and promoting nutrition and physical activity among schoolchildren through delivering a range of initiatives across the state. However, there is a lack of evidence concerning the effectiveness of nutrition/physical education and parental involvement programs addressing obesity delivered in Queensland schools. This paper can be used to guide government and policy-makers regarding the most effective policy options that will promote healthy eating and physical activity among Queensland schoolchildren. The aim of this paper is to: (i summarize current evidence on Queensland government responses to obesity; and (ii discuss potential policy options that could support healthy eating and regular physical activity, and examine the evidence base for each option and suggest new areas for future research.

State school nutrition and physical activity policy environments and youth obesity.

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Nanney, Marilyn S; Nelson, Toben; Wall, Melanie; Haddad, Tarek; Kubik, Martha; Laska, Melissa Nelson; Story, Mary

2010-01-01

With the epidemic of childhood obesity, there is national interest in state-level school policies related to nutrition and physical activity, policies adopted by states, and relationships to youth obesity. This study develops a comprehensive state-level approach to characterize the overall obesity prevention policy environment for schools and links the policy environments to youth obesity for each state. Using 2006 School Health Policies and Programs Study (SHPPS) state data, qualitative and quantitative methods were used (2008-2009) to construct domains of state-level school obesity prevention policies and practices, establish the validity and reliability of the domain scales, and examine their associations with state-level obesity prevalence among youth aged 10-17 years from the 2003 National Survey of Children's Health. Nearly 250 state-level obesity prevention-policy questions were identified from the SHPPS. Three broad policy topic areas containing 100 food service and nutrition (FSN) questionnaire items; 146 physical activity and education (PAE) items; and two weight assessment (WA) items were selected. Principal components analysis and content validity assessment were used to further categorize the items into six FSN, ten PAE, and one WA domain. Using a proportional scaled score to summarize the number of policies adopted by states, it was found that on average states adopted about half of the FSN (49%), 38% of the PAE, and 17% of the WA policies examined. After adjusting for state-level measures of ethnicity and income, the average proportion of FSN policies adopted by states was correlated with the prevalence of youth obesity at r =0.35 (p=0.01). However, no correlation was found between either PAE or WA policies and youth obesity (PAE policies at r =0.02 [p=0.53] and WA policies at r =0.16 [p=0.40]). States appear to be doing a better job adopting FSN policies than PA or WA policies, and adoption of policies is correlated with youth obesity. Continued

Effectiveness of a school-based multicomponent intervention on children nutritional status among primary school children in bangkok, thailand

International Nuclear Information System (INIS)

Chawla, N.; Panza, A.; Kumar, R.

2017-01-01

Childhood obesity has become a major public health issue today. The prevalence of obesity and overweight is increasing in both adult and children. Childhood obesity in Thailand has more than doubled since the 1960s and a recent study reported that overweight and obesity in Thai is the 5th highest in Asia. The present study objective is to evaluate the effectiveness of a life skills multicomponent school-based intervention on children's nutritional status. Methods: A quasi-experimental design was conducted in two-groups (control and intervention schools) on 453 students attending grade levels 4-5 in Bangkok. Two schools were selected for control, and two schools for intervention groups. The intervention included education, dietary, physical activity, food-environment, school built-environment, and life skills components. Outcomes were measured at baseline and post-treatment measured after 6 months. Results: The intervention group had significant improvements in healthier practice (+1.5 mean difference, p=0.048) on dietary habits and physical activity, lowered cholesterol levels (-2.43 mean, p=0.019), and higher HDL levels (+4.06 p=0.028) as compared to control. A higher reduction of overweight individuals among the intervention group over the intervention period was observed. Physical activity and consumption of vegetable increased while consumption of high-caloric snacks and fasts food decreased in children after the intervention. Conclusion: Childhood overweight and obesity is a serious public health problem based on its increasing rates and the associated health risks. This study indicated that multidisciplinary approach on school-based interventions is likely most effective to prevent children becoming overweight in long term. More research should be conducted on school-based intervention with longer intervention periods with higher sustainability. (author)

Overweight and obesity among school-going children of Lucknow city

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Rajaat Vohra

2011-01-01

Full Text Available Background: Childhood obesity is increasingly being observed with changing lifestyles of families. The magnitude of overweight ranges from 9% to 27.5% and obesity ranges from 1% to 12.9% among Indian children. Objectives: The present study was undertaken to study the magnitude of overweight/obesity and its determinants among children in Lucknow city. Materials and Methods: A list of government and private school was procured from Office of Basic Shiksha Adhikari. Three government and three private schools were selected by Simple Random Sampling. Students of 5th to 12th grades available at the time of study were included as study unit. Predesigned and pretested questionnaire was used to elicit the information on family characteristics and individual characteristics. Height and weight were measured and BMI was calculated. Children with BMI of 25 and above were considered overweight and children with BMI more than 30 were considered obese. Results: Overweight and obesity was found to be 4.17% and 0.73%, respectively; they together constitute 4.91% for overweight/obesity. The study revealed that the important correlates of overweight/obesity were father′s education, father′s occupation, class, children playing outdoor games for less than 30 min, and those consuming fast foods. Conclusions : Children of higher classes (above 8th standard belonging to higher socioeconomic group with less outdoor activities and consuming fast foods were more predisposed to overweight/obesity. As a preventive strategy, there is a need to apply health and nutritional education programs for inculcating healthy life styles, and incorporating more outdoor activities in Physical Education Department of school curriculum.

Obesity Prevention among Latino Youth: School Counselors' Role in Promoting Healthy Lifestyles

Science.gov (United States)

Cook, Amy L.; Hayden, Laura A.

2012-01-01

Given the burgeoning obesity problem among Latino youth and concomitant health problems (Spiotta & Luma, 2008), school counselors have begun to recognize the need for culturally sensitive programming to promote healthy lifestyles. More theoretical, evidence-based programs are needed, however, to ensure Latino youth receive appropriate…

A primary-school-based study to reduce prevalence of childhood obesity in Catalunya (Spain)--EDAL-Educació en alimentació: study protocol for a randomised controlled trial.

Science.gov (United States)

Giralt, Montse; Albaladejo, Rosa; Tarro, Lucia; Moriña, David; Arija, Victoria; Solà, Rosa

2011-02-27

The EdAL (Educació en Alimentació) study is a long-term, nutrition educational, primary-school-based program designed to prevent obesity by promoting a healthy lifestyle that includes dietary recommendations and physical activity.The aims are: 1) to evaluate the effects of a 3-year school-based life-style improvement program on the prevalence of obesity in an area of north-west Mediterranean 2) To design a health-promotion program to be implemented by health-promoter agents (university students) in primary schools. 1) The intervention study is a randomised, controlled, school-based program performed by university-student health-promoter agents. Initial pupil enrolment was in 2006 and continued for 3 years. We considered two clusters (designated as cluster A and cluster B) as the units for randomisation. The first cluster involved 24 schools from Reus and the second involved 14 schools from surrounding towns Cambrils, Salou and Vilaseca combined in order to obtain comparable groups. There are very good communications between schools in each town, and to avoid cross influence of the programs resulting from inter-school dialogue, the towns themselves were the unit for randomisation. Data collected included name, gender, date and place of birth at the start of the program and, subsequently, weight, height, body mass index (BMI) and waist circumference every year for 3 years. Questionnaires on eating and physical activity habits are filled-in by the parents at the start and end of the study and, providing that informed consent is given, the data are analysed on the intention-to-treat basis.The interventions are based on 8 nutritional and physical activity objectives. They are implemented by university students as part of the university curriculum in training health-promoter agents. These 8 objectives are developed in 4 educational activities/year for 3 years (a total of 12 activities; 1 h/activity) performed by the health-promoter agents in primary schools. Control

Obesity problem students from Secondary School No 32 in Bydgoszcz

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Magdalena Wittbrodt

2017-02-01

Full Text Available The aim of this study was to determine the level of youth obesity from School No. 32 in Bydgoszcz, how their nutrition and to provide existing eating habits. The study included 60 girls and 40 boys. The method used in the study is a diagnostic survey. Conclusions from the study are as follows: (1 young people eat irregular meals, (2 favorite snack between meals is a candy and soft drinks, (3 a sedentary lifestyle conducive to the development of obesity and overweight, (4 parents should set a good example for their children, (5 good sports facilities, schools can have an impact on the level of obesity amongst schoolchildren.

Prevalence of the metabolic syndrome among North Indian adolescents using Adult Treatment Panel III and pediatric International Diabetic Federation definitions

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Riyaz Ahmad Bhat

2015-01-01

Full Text Available Background and Objective: Childhood obesity is an important risk factor for the development of metabolic syndrome (MS in children and adolescent. Because of high prevalence of insulin resistance and MS in Indian adult population, studies are needed to identify the prevalence of these metabolic abnormalities in the adolescent population. The objective of this study was to estimate the prevalence of MS using pediatric International Diabetic Federation (IDF definition and compare it with estimates of Adult Treatment Panel III (ATP III definition among adolescents in Northern India. Materials and Methods: At a total of 899 adolescents attending school (aged 10-18 years participated in this population-based prospective study. All the clinical and biochemical assessment were done after proper consent. The MS was determined by the National Cholesterol Education Program ATP III definition modified for age and pediatric IDF definition. Results: The prevalence of MS was 3.5% according to ATP III criteria and 1.5% based on IDF criteria. No significant gender difference was observed in the distribution of MS. Hypertriglyceridemia was the most common and abdominal obesity the least common constituent of MS. Conclusion: This study provides the first estimates of MS using pediatric IDF definition in the adolescent population from Northern India.

Interrelation between Obesity, Oral Health, and Life-Style Factors among Turkish School Children

DEFF Research Database (Denmark)

Cinar, Ayse Basak; Murtomaa, Heikki

2011-01-01

Obesity, dental caries, and periodontal diseases are among major public health concerns which may affect children's growth and development. This study seeks any clustering between obesity, oral health, and life-style factors among school children in Istanbul, Turkey. A cross-sectional study...... (BMI), and life-style factors (tooth-brushing frequency, milk consumption at breakfast and bedtimes on school nights) of children were examined. Data analysis included factor analysis, Student's t-test, and Chi-square tests by cross-tabulation. Public school children were more dentally diseased...... but less obese than were those in private school (P calculus (62%) and reported non-recommended tooth-brushing (68%) than did those in private school (37%, 56), (P

Knowledge and attitudes towards obesity among primary school children in Dar es Salaam, Tanzania.

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Njelekela, Marina A; Muhihi, Alfa; Mpembeni, Rose N M; Anaeli, Amani; Chillo, Omary; Kubhoja, Sulende; Lujani, Benjamin; Ngarashi, Davis; Maghembe, Mwanamkuu

2015-01-01

Childhood obesity has increased over the past two decades. Child obesity is likely to persist through adulthood and increases the risk of non-communicable diseases (NCDs) later in life. This study assessed knowledge and attitudes towards obesity among primary school children in Dar es Salaam, Tanzania. A cross-sectional study was conducted in randomly selected primary schools in Dar es Salaam. A structured questionnaire was used to assess the knowledge and attitudes. Anthropometric and blood pressure measurements were taken using standard procedures. A total of 446 children were included in the analysis. The mean age of the participants was 11.1 ± 2.0 years. The mean body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 16.6 ± 4.0 kg/m(2), 103.9 ± 10.3 mmHg and 65.6 ± 8.2 mmHg, respectively. Prevalence of obesity (defined as BMI >95(th) percentile for age and sex) was 5.2%. Half of the children (51.1%) had heard about obesity from teachers at school (20%), radio (19.4%) and books/newspaper (17.3%). Less than half (45.4%) had knowledge about the risk factors for childhood obesity and correctly defined obesity (44.6%). However, a good number of the children (72.1%) were aware that they can be affected by obesity. Majority of them had negative attitude towards obesity and various factors leading to or resulting from childhood obesity. Knowledge about childhood obesity among primary school children is moderate and have negative attitude towards obesity. Integrating educational programs early in primary schools may be an effective strategy to impact knowledge about obesity and other non-communicable diseases early in childhood.

The management of pediatric systemic lupus erythematosus.

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Ardoin, Stacy P; Schanberg, Laura E

2005-12-01

Most children and adolescents with systemic lupus erythematosus (SLE) now survive into adulthood, leading the pediatric rheumatology community to focus on preventing long-term complications of SLE, including atherosclerosis, obesity, and osteoporosis, and their treatment. Unfortunately, because of the paucity of data in pediatric SLE, little is known about epidemiology, long-term outcome, and optimal treatment. Most research focuses on adults with SLE, but pediatric SLE differs significantly from adult SLE in many aspects, including disease expression, approaches to pharmacologic intervention, management of treatment toxicity, and psychosocial issues. Children and adolescents with SLE require specialized, multidisciplinary care. Treatment can be optimized by early recognition of disease flares and complications, minimizing medication toxicity, educating families about prevention, promoting school performance, addressing concerns about reproductive health, and negotiating the transition to adult-centered medical care. Developmentally appropriate concerns about pain, appearance, and peers often affect treatment adherence and must be addressed by the health-care team. Research in pediatric SLE is desperately needed and provides a unique opportunity to understand how developmental immunology and the hormonal changes associated with puberty affect the pathophysiology of SLE.

School Nutrition Programs and the Incidence of Childhood Obesity

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Millimet, Daniel L.; Tchernis, Rusty; Husain, Muna

2010-01-01

Given the recent rise in childhood obesity, the School Breakfast Program (SBP) and National School Lunch Program (NSLP) have received renewed attention. Using panel data on more than 13,500 primary school students, we assess the relationship between SBP and NSLP participation and (relatively) long-run measures of child weight. After documenting a…

Association of childhood and teen school performance and obesity in young adulthood in the US National Longitudinal Survey of Youth.

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Sobol-Goldberg, Shira; Rabinowitz, Jonathan

2016-08-01

The literature suggests an association between poor school performance and obesity. However, little is known about academic achievement and behavior as possible risk factors for future obesity. The analysis was based on data from 3172 participants aged 6 to 25years from the US National Longitudinal Survey conducted 1986 to 2010. Academic achievement, behavior problems and body mass index (BMI) were assessed at childhood (6-9) and teenhood (10-14). Height and weight were self-reported at pre-young adulthood (15-18) and young adulthood (19-25). Based on logistic regression stratified by sex and race/ethnicity, academic and behavioral deficiencies during childhood and teenhood were risk factors for young adult obesity with some sex and ethnic/racial differences. The highest prevalence rates of obesity by race/ethnicity and sex are as follows: black/Hispanic females, those in the lowest quartile of teen reading and math (32.8%); black/Hispanic males, those in lowest quartile of teen reading (26.1%); white males, those in the highest quartile of behavioral problems (21.9%); and white females, those in the lowest quartile teen math (23.2%). Poor school performance in childhood and teenhood is associated with an increased risk of adult obesity. Prospective studies should further examine the association of school performance and adult obesity and whether programs directed at improving school performance may have secondary gains in preventing obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

School Accountability and Youth Obesity: Can Physical Education Mandates Make a Difference?

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Helen Schneider

2013-01-01

Full Text Available This paper explores the effect of accountability laws under No Child Left Behind Act (NCLB on obesity rates among school-aged children in the United States. Our results show that pressures due to school closures for poor performance, rewards for good performance, and assistance to schools that lag behind lead to lower levels of vigorous physical activity. This effect is significant for high school children only. We find no significant impact of school accountability laws on children in grades 3 through 8 after state characteristics such as state obesity rate are taken into account. We also find that state physical education mandates increase physical activity for children in grades 3 through 8 and mitigate the negative effect of accountability pressures on physical activity at the high school level where accountability pressures are most effective at decreasing physical activity and increasing obesity. The study shows that physical education mandates play an important role in promoting physical activity for all grades in our sample.

Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

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John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

2014-04-01

Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

Stigma Experienced by Children and Adolescents With Obesity.

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Pont, Stephen J; Puhl, Rebecca; Cook, Stephen R; Slusser, Wendelin

2017-12-01

The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth. Health care professionals continue to seek effective strategies and resources to address the obesity epidemic; however, they also frequently exhibit weight bias and stigmatizing behaviors. This policy statement seeks to raise awareness regarding the prevalence and negative effects of weight stigma on pediatric patients and their families and provides 6 clinical practice and 4 advocacy recommendations regarding the role of pediatricians in addressing weight stigma. In summary, these recommendations include improving the clinical setting by modeling best practices for nonbiased behaviors and language; using empathetic and empowering counseling techniques, such as motivational interviewing, and addressing weight stigma and bullying in the clinic visit; advocating for inclusion of training and education about weight stigma in medical schools, residency programs, and continuing medical education programs; and empowering families to be advocates to address weight stigma in the home environment and school setting. Copyright © 2017 by the American Academy of Pediatrics.

Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

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Um SS

2011-12-01

Full Text Available Scott S Um1, Wendelin Slusser2, Daniel A DeUgarte11Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; 2Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USAAbstract: Adolescent obesity is a growing health concern that can have immense physical and psychological impact. Treatment of morbidly obese adolescents should include a multidisciplinary team to address medical comorbidities, diet, physical activity, mental health, and behavior modification. Anti-obesity pharmacologic agents have a limited role in the treatment of adolescents because of concerns with side effects, safety, and efficacy. Orlistat (GlaxoSmithKline, Moon Township, PA is the only approved medication for weight-loss in adolescents. However, it is associated with gastrointestinal side effects and its long-term efficacy is unknown. Bariatric surgery is the most effective therapy to treat morbid obesity. However, adolescents must meet rigorous criteria and have appropriate cognitive, psychological, and social clearance before being considered for surgical intervention. Gastric bypass remains the gold standard bariatric operation. The adjustable gastric band is not FDA-approved for use in patients under 18 years of age. Sleeve gastrectomy is a promising procedure for adolescents because it avoids an intestinal bypass and the implantation of a foreign body. Prospective longitudinal assessment of bariatric surgery procedures is required to determine long-term outcomes. In this manuscript, we review the treatment options, efficacy, and impact on quality of life for morbidly obese adolescents.Keywords: bariatric surgery, morbid obesity, weight loss, adolescent

Obesity in School Children with Intellectual Disabilities in France

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Salaun, Laureline; Berthouze-Aranda, Sophie

2011-01-01

Background: The aims of this study were to assess the prevalence of obesity in school children with intellectual disabilities and to determine the most appropriate indicators of obesity measurement. Materials and Methods: The weight, height, body mass index (BMI), waist circumference, waist-to-height ratio and body fat percentage as measured by…

Implementing the Obesity Care Model at a Community Health Center in Hawaii to Address Childhood Obesity

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Okihiro, May; Pillen, Michelle; Ancog, Cristeta; Inda, Christy; Sehgal, Vija

2013-01-01

Obesity, the most common chronic disease of childhood, is prevalent among economically disadvantaged children. The Chronic Care and Obesity Care Models are comprehensive health care strategies to improve outcomes by linking primary care best practices and community-based programs. Pediatric providers and community health centers are well positioned to design and implement coordinated and synergistic programs to address childhood health disparities. This article describes a comprehensive proje...

Are K-12 school environments harming students with obesity? A qualitative study of classroom teachers.

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Kenney, Erica L; Redman, Morgan T; Criss, Shaniece; Sonneville, Kendrin R; Austin, S Bryn

2017-03-01

Weight bias can negatively impact health, and schools may be risky environments for students with obesity. We aimed to explore teachers' perceptions of the school experiences and academic challenges of students with obesity. We conducted interviews with 22 teachers in the Northeast, mid-Atlantic, and Midwest in July-August 2014. All interviews were transcribed verbatim, coded, and analyzed for important themes by two researchers using the immersion/crystallization approach. Most teachers felt that students with obesity were more likely to have academic difficulties. Two main perceptions of the reasons for these difficulties emerged: (1) obesity led to lower self-esteem that caused students to participate less, and (2) poorer nutrition, increased screen time, and reduced physical activity were simultaneously causing obesity and poorer academic performance. A few teachers described colleagues who felt students with obesity were not as motivated to work hard in school as their peers. Many teachers described school health promotion efforts focused on weight reduction that could exacerbate weight stigma and risk of disordered eating. Students with obesity, particularly girls, may be at risk for negative social and academic experiences in K-12 schools and may be perceived as struggling academically by their teachers.

Gender differences and a school-based obesity prevention program in Argentina: a randomized trial.

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Rausch Herscovici, Cecile; Kovalskys, Irina; De Gregorio, María José

2013-08-01

To evaluate the impact of a school-based obesity prevention program that seeks to change food intake among students at schools in Rosario, Argentina. This was a prospective study involving 405 children 9-11 years of age at six schools in the poor areas of Rosario, Argentina, in May-October 2008. After matching for socioeconomic status, schools were selected by simple randomization; participants were assessed at baseline (T1) and again 6 months later, after completion of the intervention (T2). The program focused on increasing the children's knowledge of healthy nutrition and exercise through four workshops; educating the parents/caregivers; and offering healthy options at the school snack bar. The main outcome measures were the children's intake of healthy and unhealthy foods (assessed with a weekly food frequency questionnaire) and their body mass index (BMI). Of the 387 children assessed at T1, 369 were reassessed at T2 (205 intervention; 164 control). Girls at the schools where the intervention occurred increased their intake of three of the five healthy food items promoted by the program (fruits, vegetables, low-sugar cereals). Statistical significance was reached for skim milk (P = 0.03) and for pure orange juice (P = 0.05). Boys of both the intervention and control groups failed to improve their intake of healthy foods, but those of the intervention arm significantly reduced their intake of hamburgers and hot dogs (P = 0.001). Girls were more amenable to improving their dietary intake. Overall, the program was more likely to increase consumption of healthy food than to decrease intake of unhealthy foods. Gender differences should be taken into account when designing preventive interventions.

Effects of a pediatric weight management program with and without active video games a randomized trial.

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Trost, Stewart G; Sundal, Deborah; Foster, Gary D; Lent, Michelle R; Vojta, Deneen

2014-05-01

Active video games may offer an effective strategy to increase physical activity in overweight and obese children. However, the specific effects of active gaming when delivered within the context of a pediatric weight management program are unknown. To evaluate the effects of active video gaming on physical activity and weight loss in children participating in an evidence-based weight management program delivered in the community. Group-randomized clinical trial conducted during a 16-week period in YMCAs and schools located in Massachusetts, Rhode Island, and Texas. Seventy-five overweight or obese children (41 girls [55%], 34 whites [45%], 20 Hispanics [27%], and 17 blacks [23%]) enrolled in a community-based pediatric weight management program. Mean (SD) age of the participants was 10.0 (1.7) years; body mass index (BMI) z score, 2.15 (0.40); and percentage overweight from the median BMI for age and sex, 64.3% (19.9%). All participants received a comprehensive family-based pediatric weight management program (JOIN for ME). Participants in the program and active gaming group received hardware consisting of a game console and motion capture device and 1 active game at their second treatment session and a second game in week 9 of the program. Participants in the program-only group were given the hardware and 2 games at the completion of the 16-week program. Objectively measured daily moderate-to-vigorous and vigorous physical activity, percentage overweight, and BMI z score. Participants in the program and active gaming group exhibited significant increases in moderate-to-vigorous (mean [SD], 7.4 [2.7] min/d) and vigorous (2.8 [0.9] min/d) physical activity at week 16 (P video gaming into an evidence-based pediatric weight management program has positive effects on physical activity and relative weight. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01757925.

Effectiveness Of A School-Based Multicomponent Intervention On Nutritional Status Among Primary School Children In Bangkok, Thailand.

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Chawla, Nattapon; Panza, Alessio; Sirikulchayanonta, Chutima; Kumar, Ramesh; Taneepanichskul, Surasak

2017-01-01

Childhood obesity has become a major public health issue today. The prevalence of obesity and overweight is increasing in both adults and children. Childhood obesity in Thailand has more than doubled since the 1960s and a recent study reported that overweight and obesity in Thais is the 5th highest in Asia. The present study objective was to evaluate the effectiveness of a life-skills, multicomponent, school-based intervention on child nutritional status. A quasi-experimental design was conducted in two-groups (control and intervention schools) on 453 students attending grade levels 4-5 in Bangkok. Two schools were selected for control, and two schools for intervention groups. The interventions included education, diet, physical activity (PA), food-environment, school builtenvironment, and life-skills components. Subjects were measured at baseline and at 6 months post-treatment. The intervention group had significant differences in overall healthy practices (+1.5 mean difference, p=0.048), dietary habits, physical activity, lower total cholesterol (TC) levels (-2.43 mean, p=0.019) and higher high density lipoprotein cholesterol (HDL-C) levels (+4.06 p=0.028) as compared to the control. A higher reduction of overweight individuals among the intervention group over the intervention period was observed. Physical activity and consumption of vegetables increased while consumption of high-caloric snacks and fast foods decreased in children after the intervention. This study indicated that a multidisciplinary approach in school-based interventions is most likely to be effective in preventing children from becoming overweight in the long term. More research should be conducted on school-based interventions with longer intervention periods and higher sustainability.

Educational software and improvement of first grade school students' knowledge about prevention of overweight and obesity

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Luana Santos Vital Alves Coelho

Full Text Available Objective.To evaluate the effects of educational software to improve first grade school students' knowledge about prevention of overweight and obesity. Methods. This non-controlled trial with a before-and-after evaluation was carried out in an school located in the municipality of Divinópolis (Brazil among 71 students aged 6 to 10 years. The educational software about prevention of overweight and obesity was designed and then validated. The educational intervention comprised the use of the software. Before and after of the intervention we applied a questionnaire based on the Ten Steps to Healthy Eating for Children, proposed by the Brazilian Ministry of Health. Results. Comparing the times before and after application of the educational software, we observed statistically significant differences in proportion of questions answered correctly by first grade school students, mainly concerning daily eating of healthy and unhealthy food, adequate preparation of food and importance of exercise. Conclusion. This study highlights the importance of educational actions using software to build knowledge of first grade school students about prevention of overweight and obesity.

Pediatric Psychology: Applications to the Schools Needs of Children with Health Disorders.

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Perry, Joseph D.; Flanagan, William K.

1986-01-01

A review of pediatric psychology considers interventions by school personnel to promote the school adjustment of children with serious medical illness. Psychosocial and educational impacts of cancer, spina bifida, enuresis, and encopresis are discussed; and suggestions for managing children with chronic health disorders, serious illness, and…

A web- and mobile phone-based intervention to prevent obesity in 4-year-olds (MINISTOP): a population-based randomized controlled trial.

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Delisle, Christine; Sandin, Sven; Forsum, Elisabet; Henriksson, Hanna; Trolle-Lagerros, Ylva; Larsson, Christel; Maddison, Ralph; Ortega, Francisco B; Ruiz, Jonatan R; Silfvernagel, Kristin; Timpka, Toomas; Löf, Marie

2015-02-07

Childhood obesity is an increasing health problem globally. Overweight and obesity may be established as early as 2-5 years of age, highlighting the need for evidence-based effective prevention and treatment programs early in life. In adults, mobile phone based interventions for weight management (mHealth) have demonstrated positive effects on body mass, however, their use in child populations has yet to be examined. The aim of this paper is to report the study design and methodology of the MINSTOP (Mobile-based Intervention Intended to Stop Obesity in Preschoolers) trial. A two-arm, parallel design randomized controlled trial in 300 healthy Swedish 4-year-olds is conducted. After baseline measures, parents are allocated to either an intervention- or control group. The 6- month mHealth intervention consists of a web-based application (the MINSTOP app) to help parents promote healthy eating and physical activity in children. MINISTOP is based on the Social Cognitive Theory and involves the delivery of a comprehensive, personalized program of information and text messages based on existing guidelines for a healthy diet and active lifestyle in pre-school children. Parents also register physical activity and intakes of candy, soft drinks, vegetables as well as fruits of their child and receive feedback through the application. Primary outcomes include body fatness and energy intake, while secondary outcomes are time spent in sedentary, moderate, and vigorous physical activity, physical fitness and intakes of fruits and vegetables, snacks, soft drinks and candy. Food and energy intake (Tool for Energy balance in Children, TECH), body fatness (pediatric option for BodPod), physical activity (Actigraph wGT3x-BT) and physical fitness (the PREFIT battery of five fitness tests) are measured at baseline, after the intervention (six months after baseline) and at follow-up (12 months after baseline). This novel study will evaluate the effectiveness of a mHealth program for

A primary-school-based study to reduce prevalence of childhood obesity in Catalunya (Spain - EDAL-Educació en alimentació: study protocol for a randomised controlled trial

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Moriña David

2011-02-01

Full Text Available Abstract Background The EdAL (Educació en Alimentació study is a long-term, nutrition educational, primary-school-based program designed to prevent obesity by promoting a healthy lifestyle that includes dietary recommendations and physical activity. The aims are: 1 to evaluate the effects of a 3-year school-based life-style improvement program on the prevalence of obesity in an area of north-west Mediterranean 2 To design a health-promotion program to be implemented by health-promoter agents (university students in primary schools. Methods/Design 1 The intervention study is a randomised, controlled, school-based program performed by university-student health-promoter agents. Initial pupil enrolment was in 2006 and continued for 3 years. We considered two clusters (designated as cluster A and cluster B as the units for randomisation. The first cluster involved 24 schools from Reus and the second involved 14 schools from surrounding towns Cambrils, Salou and Vilaseca combined in order to obtain comparable groups. There are very good communications between schools in each town, and to avoid cross influence of the programs resulting from inter-school dialogue, the towns themselves were the unit for randomisation. Data collected included name, gender, date and place of birth at the start of the program and, subsequently, weight, height, body mass index (BMI and waist circumference every year for 3 years. Questionnaires on eating and physical activity habits are filled-in by the parents at the start and end of the study and, providing that informed consent is given, the data are analysed on the intention-to-treat basis. The interventions are based on 8 nutritional and physical activity objectives. They are implemented by university students as part of the university curriculum in training health-promoter agents. These 8 objectives are developed in 4 educational activities/year for 3 years (a total of 12 activities; 1 h/activity performed by the

Development of overweight and obesity among primary school children-a longitudinal cohort study.

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Häkkänen, Paula; Ketola, Eeva; Laatikainen, Tiina

2016-08-01

School health care is crucial for obesity prevention. Data on constancy of childhood obesity are still scarce, but highly necessary for risk evaluation. We examined from electronic health records (EHRs) the continuity of obesity during primary school and searched for social and behavioural characteristics associated with childhood obesity. From randomly selected 2000 Finnish sixth graders (aged 12-14), we identified 402 'ever overweight' and 172 'ever obese' children who were overweight or obese at least once since their first grade. These cohort data of growth measurements and the content of all pre-seventh grade health checks were retrospectively analysed from EHRs. Of the ever obese and ever overweight children, 69.3% (95% CI: 65.2-73.4%) continued to be overweight or obese in sixth grade. Of the ever obese children, nearly 40% were obese in first grade and 56% were obese or overweight in all six grades. Furthermore, 80% were obese or overweight already before school age. Obese children had experienced more bullying than overweight children (43.6% versus 30.8%, P = 0.003), had more frequently special needs for studying (25.6% versus 14.7%, P = 0.002) or had undergone a serious family crisis (20.3% versus 11.4%, P = 0.005). Electronic data on children's growth and psychosocial characteristics are potentially useful when aiming for early action to counter obesity. Such routinely collected data appear to be underutilized and should be further exploited both in individual and population level to develop screening and treatment processes. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Dietary patterns of obese high school girls: snack consumption and energy intake

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Yoon, Jin-Sook; Lee, Nan-Jo

2010-01-01

In order to develop an obesity management program for teenagers, we compared obese and non-obese girls attending high schools in terms of their dietary practices related to snack consumption. Dietary records were collected for 7 days. No significant differences were found for the average daily energy intake between obese and non-obese girls. However, the highest energy intake was greater for obese girls while not much difference was found for the lowest amount of energy intake. Obese girls ha...

The Role of Youth Sports in Promoting Children's Physical Activity and Preventing Pediatric Obesity: A Systematic Review.

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Lee, Jung Eun; Pope, Zachary; Gao, Zan

2018-01-01

Youth sport participation plays an important role in promoting physical activity among children and may be a possible venue for the prevention of pediatric obesity. To design effective physical activity interventions, it is imperative to understand how different aspects of sport participation influence physical activity (PA). The purpose of this article is to present a comprehensive review of the impact of youth sport participation on children's PA and obesity status. A total of 44 studies published up to January 2014 concerning youth sport participation, PA, and obesity status were identified. Inclusion criteria were studies comparing PA levels of sport participants to nonparticipants or those comparing PA levels in different sport types and settings. Studies with the outcome variables of obesity status (e.g., body mass index, fat percentage, waist circumference) were also included. Participation in youth sport was positively associated with children's PA levels, and youth participating in sports were more likely to persist in their PA. However, the relationship between youth sport participation and obesity status was inconclusive. Educators and sports professionals should find ways to involve children in various sports settings and policies and help obese children engage more in sports.

[Gene-gene interaction on central obesity in school-aged children in China].

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Fu, L W; Zhang, M X; Wu, L J; Gao, L W; Mi, J

2017-07-10

Objective: To investigate possible effect of 6 obesity-associated SNPs in contribution to central obesity and examine whether there is an interaction in the 6 SNPs in the cause of central obesity in school-aged children in China. Methods: A total of 3 502 school-aged children who were included in Beijing Child and Adolescent Metabolic Syndrome (BCAMS) Study were selected, and based on the age and sex specific waist circumference (WC) standards in the BCAMS study, 1 196 central obese cases and 2 306 controls were identified. Genomic DNA was extracted from peripheral blood white cells using the salt fractionation method. A total of 6 single nucleotide polymorphisms ( FTO rs9939609, MC4R rs17782313, BDNF rs6265, PCSK1 rs6235, SH2B1 rs4788102, and CSK rs1378942) were genotyped by TaqMan allelic discrimination assays with the GeneAmp 7900 sequence detection system (Applied Biosystems, Foster City, CA, USA). Logistic regression model was used to investigate the association between 6 SNPs and central obesity. Gene-gene interactions among 6 polymorphic loci were analyzed by using the Generalized Multifactor Dimensionality Reduction (GMDR) method, and then logistic regression model was constructed to confirm the best combination of loci identified in the GMDR. Results: After adjusting gender, age, Tanner stage, physical activity and family history of obesity, the FTO rs9939609-A, MC4R rs17782313-C and BDNF rs6265-G alleles were associated with central obesity under additive genetic model ( OR =1.24, 95 %CI : 1.06-1.45, P =0.008; OR =1.26, 95 %CI : 1.11-1.43, P =2.98×10(-4); OR =1.18, 95 % CI : 1.06-1.32, P =0.003). GMDR analysis showed a significant gene-gene interaction between MC4R rs17782313 and BDNF rs6265 ( P =0.001). The best two-locus combination showed the cross-validation consistency of 10/10 and testing accuracy of 0.539. This interaction showed the maximum consistency and minimum prediction error among all gene-gene interaction models evaluated. Moreover, the

The Association of Pediatric Obesity With Nocturnal Non-Dipping on 24-Hour Ambulatory Blood Pressure Monitoring.

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Macumber, Ian R; Weiss, Noel S; Halbach, Susan M; Hanevold, Coral D; Flynn, Joseph T

2016-05-01

Obesity has been linked with abnormal nocturnal dipping of blood pressure (BP) in adults, which in turn is associated with poor cardiovascular outcomes. There are few data regarding abnormal dipping status in the obese pediatric population. The goal of this study was to further describe the relationship between obesity and non-dipping status on ambulatory blood pressure monitor (ABPM) in children. We conducted a cross-sectional study using a database of patients aged 5-21 years who had undergone 24-hour ABPM at Seattle Children's Hospital from January 2008 through May 2014. Subjects were grouped by body mass index (BMI) into lean (BMI 15th-85th percentile) and obese (BMI >95th percentile) groups. Compared to lean subjects (n = 161), obese subjects (n = 247) had a prevalence ratio (PR) for non-dipping of 2.15, adjusted for race (95% confidence interval (CI) = 1.25-3.42). Increasing severity of obesity was not further associated with nocturnal non-dipping. Nocturnal non-dipping was not associated with left ventricular hypertrophy (PR = 1.01, 95% CI = 0.71-1.44). These results suggest that in children, just as in adults, obesity is related to a relatively decreased dipping in nocturnal BP. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PREVALENCE OF OBESITY & HYPERTENSION IN ADOLESCENT SCHOOL GOING CHILDREN OF BERHAMPUR, ODISHA, INDIA.

OpenAIRE

Satyajit Bagudai; Pranati Nanda; Satyanath Reddy Kodidala

2014-01-01

Background: In the prevailing era of adult hypertension, limited data are available regarding the profile of childhood obesity & hypertension from India. We examined & studied the prevalence of childhood obesity & hypertension in a representative sample of school children from Berhampur, Odisha & tried to find out if any relationship is there or not between obesity & hypertension in those study population. Methods: In a cross sectional study we select the children from different schools o...

Association of Sleep Duration with Obesity among US High School Students

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Richard Lowry

2012-01-01

Full Text Available Increasing attention is being focused on sleep duration as a potential modifiable risk factor associated with obesity in children and adolescents. We analyzed data from the national Youth Risk Behavior Survey to describe the association of obesity (self-report BMI ≥95th percentile with self-reported sleep duration on an average school night, among a representative sample of US high school students. Using logistic regression to control for demographic and behavioral confounders, among female students, compared to 7 hours of sleep, both shortened (≤4 hours of sleep; adjusted odds ratio (95% confidence interval, AOR = 1.50 (1.05–2.15 and prolonged (≥9 hours of sleep; AOR = 1.54 (1.13–2.10 sleep durations were associated with increased likelihood of obesity. Among male students, there was no significant association between obesity and sleep duration. Better understanding of factors underlying the association between sleep duration and obesity is needed before recommending alteration of sleep time as a means of addressing the obesity epidemic among adolescents.

Fast food intake and prevalence of obesity in school children in Riyadh City.

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Almuhanna, Monira Abdulrahman; Alsaif, Mohammed; Alsaadi, Muslim; Almajwal, Ali

2014-01-01

Childhood obesity has become a new challenge for healthcare providers. The issue is not limited to certain parts of the world; its prevalence is increasing worldwide. The causes of obesity are poorly understood and continue to be debated and studied. It is a multifactorial disorder which involves dietary, behavioral, environmental as well as genetic factors. The increased consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity, have led to high obesity rates among children. The aim of this study was to assess the effect of dietary intake on the occurrence of childhood obesity, and study other associated factors including the education, occupation and income of parents and the living status. Normal healthy school girls (n =196) and school boys (n = 85) between the age of 6- 15 were recruited for the study. We found that obesity among children in Riyadh City was significantly associated with fast food intake (p = 0.0280). It was also observed that 72.5% of the overweight or obese students consumed fast food at least 4 times/week, and the other 15.9% were taking fast food 1- 3 times/week, while only 11.6% of the same overweight or obese group did not consume any fast food/ week. Father's and mother's occupations were not significantly correlated to their children's body weight. The prevalence of childhood obesity is changing and increasing yearly and is attributed to the nutritional risk factors for the Saudi school-age children. It is interesting to know that most of overweight or obese school students belonged to the families of highincome. Parents must take necessary precautions for the diet of their children and should adopt healthy life style in order to prevent or manage obesity of their children.

Association of Sleep Duration with Obesity among US High School Students