Article

Reversing the obesity epidemic in young people: Building up the physical activity side of energy balance

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... P hysical inactivity is pandemic, with over 30% of adults worldwide not meeting the sufficiency threshold [29,31]. In spite of studies indicating an increase in leisuretime physical activity (PA) in high-income countries, the modern lifestyle in these countries is reducing physical energy expenditure in occupational, household, and transport domains. ...
... This can be referred to as a sedentary lifestyle syndrome [4]. The result is an increase in overweight and obesity, which has already exceeded 50% in the adult population, 32% in children, with over 30% of adults being obese and 10-12% of children in obese children [8,31]. Obesity is one of the basic medical and social problems of today's world. ...
... Epidemiological studies over the past 50 years have unanimously shown that low PA and PF are associated with high risk of cardiovascular and total mortality. Recent data also suggest that low PA and PF are followed by an increased incidence of diabetes mellitus and nonfatal cardiovascular diseases, an increase in mental illness, a deterioration in lifestyle [15,31]. For seniors, a higher level of PA and thus increased PF significantly affect the quality and progression of aging -we are speaking about the antiaging effect [4,7,32]. ...
Article
Full-text available
Abstract Introduction. The health benefits of PA are well established and include a lower risk of cardiovascular disease, hypertension, diabetes, and breast and colon cancer. Additionally, PA has positive effects on mental health, delays the onset of dementia, and can help the maintenance of a healthy body mass. Aim of Study. The aim of the study is to summarize the results of the application of appropriate PA based on walking on PF and health in non-trained Czech population differing in age. Material and Methods. The energy output on the level 950 to 2000 kcal (3971-8360 kJ) per week was respected by construction of individual moving programs for seniors, adults and children of both genders. The moving programs consisted of aerobic walking (min 80% of whole exercise) or cycling (min 10% of total exercise) at the level of 50 to 70% VO2max. The duration of exercise session ranged from 20 to 50 min, and training was performed 3-5 times a week during 5 months. The functional variables were assessed on treadmill, body composition with help of bioimpedance analysis. The data were collected in children (142 boys and 124 girls; age 12.6 ± 2.3 years, BM = 36.9 ± 3.0 kg, height = 136.5 ± 2.6 cm, VO2peak = 43.2 ± 3.1 ml·kg–1·min–1) in both men (n = 154) and women (138) of middle age (45.2 ± 7.0, 74.3 ± 3.9, 172.5 ± 2.6, 31.2 ± 3.9), and in seniors of both genders (men n = 71, women n = 112; 71.6 ± 3.6, 77.1 ± 4.1, 171.5 ± 2.9, 26.1 ± 3.1). Results. Interventions with an energy content of 2000 kcal in children, 1500 kcal in adults and 950 kcal in seniors can reduce body mass (about 10%), improve VO2peak (~17%) and motor performance (~15%), reduce the systolic blood pressure (~7 mmHg) regardless of gender, starting values and age. It is also possible to significantly affect the amount of muscle mass (~8%). Conclusions. Reasonable PA is a prerequisite for quality lifestyle and active aging. For seniors, a higher level of PA and thus increased PF significantly affect the quality and progression of aging.
... To increase the likelihood of an effect, school-based interventions that are multi-component and socio-ecologically framed are recommended. 11,12 Systematic reviews of school-based physical activity interventions have also recommended that interventions address educational, curricular and environmental changes in the school. 13,14 The 'Physical Activity 4 Everyone' (PA4E1) cluster randomised controlled trial (RCT) was designed based on these recommendations and aimed to reduce the decline in physical activity typically observed during adolescence. ...
... 16 The PA4E1 intervention was a multi-component and socio-ecologically framed school-based intervention, key elements of which have been recommended to increase physical activity and reduce the prevalence of obesity during adolescence. 11,12 The intervention addressed educational, curricular and environmental changes in the school, supported by evidence from recent systematic reviews of school-based interventions. 13,14 A 'change agent', who was a trained PE teacher, visited each of the intervention schools 1 day per week for the duration of the intervention to support the school and PE teachers in implementing the strategies (the change agent did not deliver any classes). ...
Article
Full-text available
Background/objectives: Obesity prevention during adolescence is a health priority. The 'Physical Activity 4 Everyone' (PA4E1) study tested a multi-component physical activity intervention in 10 secondary schools from socio-economically disadvantaged communities. This paper aimed to report the secondary outcomes of the study; to determine whether the intervention impacted on adiposity outcomes (weight, body mass index (BMI), BMI z-score), and whether any effect was moderated by sex, baseline BMI and baseline physical activity level, at 12 and 24 months. Subjects/methods: A cluster randomised controlled trial was conducted in New South Wales, Australia. The school-based intervention included seven physical activity strategies targeting the following: curriculum (strategies to maximise physical activity in physical education, student physical activity plans, an enhanced school sport programme); school environment (physical activity during school breaks, modification of school policy); and parents and the community (parent engagement, links with community physical activity providers). Students' weight (kg), BMI and BMI z-score, were collected at baseline (Grade 7), 12 and 24 months. Linear Mixed Models were used to assess between-group mean difference from baseline to 12 and 24 months. Exploratory sub-analyses were undertaken according to three moderators of energy balance. Results: A total of 1150 students (mean age=12 years) provided outcome data at baseline, 1051 (91%) at 12 months and 985 (86%) at 24 months. At 12 months, there were group-by-time effects for weight (mean difference=-0.90 kg (95% confidence interval (CI)=-1.50, -0.30), P<0.01) and BMI (-0.28 kg m-2 (-0.50, -0.06), P=0.01) in favour of the intervention group, but not for BMI z-score (-0.05 (-0.11; 0.01), P=0.13). These findings were consistent for weight (-0.62 kg (-1.21, 0.03), P=0.01) and BMI (-0.28 kg m-2 (-0.49, -0.06), P=0.01) at 24 months, with group-by-time effects also found for BMI z-score (-0.08 (-0.14; -0.02), P=0.02) favouring the intervention group. Conclusion: The PA4E1 school-based intervention achieved moderate reductions in adiposity among adolescents from socio-economically disadvantaged communities. Multi-component interventions that increase adolescents' engagement in moderate-to-vigorous physical activity (MVPA) may assist in preventing unhealthy weight gain.
... Energy intake is balanced by food intake and energy expenditure, which is affected by several factors, including basal metabolism rate (Blundell et al., 2012), physical activity (Sallis and Hinckson, 2014), body weight, life span (Speakman, 2005), and thermogenesis (Rosen and Spiegelman, 2006). Disturbances of either central (Avena and Bocarsly, 2012) or peripheral (Izzo et al., 2009) signals lead to a state of obesity or anorexia. ...
Chapter
Full-text available
Gum Arabic (GA) is a soluble fiber obtained from Acacia senegal and Acacia seyal trees grown in sub-Saharan Africa, particularly Sudan. It is one of the most important medicinal plants used in traditional, or alternative, medicine. The main purpose of writing this chapter is to view recent and updated information about GA, which is promising as a medicinal plant and has short- and long-term health potentiality that can be developed as future phytopharmaceuticals to manage and/or treat panoply of various diseases. Pharmacologically, GA has been confirmed to have several therapeutic actions, such as being hypoglycemic, antidiabetic, antioxidant, immunomodulatory, and antiulcer. GA is used by local communities to protect against hepatic, renal, and cardiac complications in diabetic and chronic renal failure patients. The studies on the effects of GA on lipid metabolism in experimental animals are also documented. Ingestion of GA can decrease plasma cholesterol concentrations both in human and animals.
... Obesity is a state of increased abdominal fat deposition consequential from chronic nutrient intake, where energy intake exceeds energy expenditure [1]. Energy expenditure was influenced by basal metabolism rate [2], physical activity [3], body size and lifespan [4], and thermogenesis [5]. Disturbances of central [6] and peripheral [7] signals may lead to obesity and anorexia. ...
... 1 However, physical activity drops sharply in adolescence, 2,3 and about four-fifths of the world's adolescent population does not meet minimum recommended levels. 4 This is a major contributor to rising overweight and obesity, 5,6 which significantly increases risk for a range of adverse health outcomes in children and adolescents, including early onset of type 2 diabetes, cardiovascular disease, nonalcoholic fatty liver disease, and poor mental health. [7][8][9] Reviews of the research indicate that low physical activity levels in youth track into adulthood. ...
Article
Objectives: To understand perceived benefits, facilitators, disadvantages and barriers for physical activity amongst South Asian adolescents in India and Canada. Methods: 13 focus group discussions with South Asian (origin) adolescent boys and girls of different nutritional status and socioeconomic status in rural and urban India and urban Canada. Results: Across the groups, fitness and 'energy' were perceived to be major benefits of physical activity. In India, better academic performance was highlighted, while health benefits were well detailed in Canadian groups. Universally, friends, family and teachers were perceived as facilitators of and/or barriers to physical activity. Lack of a safe space to play was a major concern for urban adolescents, while academic pressures and preference for other sedentary recreational activities were common barriers across all groups. Girls were less likely than boys to be interested in physical activity, with girls' participation in India further limited by societal restrictions. Conclusion: The study suggests key areas for promotion of physical activity amongst South Asian adolescents: balance between academic pressure and opportunities for physical activity, especially in India; urban planning for a built environment conducive to physical activity; and, gender sensitive programming to promote girls' activity which also addresses culture-specific barriers.
Article
Objective: to conduct an analysis and synthesis of scientific literature and modern recommendations regarding the criteria for diagnosing overweight and obesity in children, international and national statistical databaseson the prevalence of overweight among children,legalactson the diagnosis of obesity and the detection of overweight in children in Ukraine. Methods. bibliosemantic, epidemiological, contentanalysis. Results. The international statistical data bases,results of the cross-national studies of WHO, current recommendations and strategies of prevention of obesity of children have been studied. According to the data of the official branch statistics the current scope of spreading of obesity among children’s population of Ukraine. The analysis of the normative documents regulating the order of organization and main components of the obligatory preventive medical examinations of children in Ukraine, the scheme of their periodicity, criteria of evaluation of physical development of children and record of results of medical examination of a child with evaluation of his/ her physical condition have been conducted. Figured out the disadvantages of the existing system of prevention of obesity of children: discrepancies between branchstandardsthatregulateapproachestotheevaluationofharmonyofphysicaldevelopmentofachildanddocumentsthatregulatestoringofresultsofthepreventivemedicalexaminations of children which is the reason for absence of statistics of obesity of children in Ukraine; lowlevel of diagnostics of obesity of children and identification of the excessbody weight that is conditioned by the lowlevel of knowledge a mongprimary medical caredoctors, providing medical careto children,of indicators of excess body weight of children. Conclusions. A conceptual solution to this problem can be achieved by organizing a continuous, systematic process of detection and registration of children with overweight and obesity, analysis of the environment where the child is from the standpoint of social characteristics and behavioral characteristics.
Article
Background Nowadays non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in children. Our recent clinical trial demonstrated that dietary and VSL#3-based interventions may improve fatty liver by ultrasound and body mass index (BMI) after 4 months.Objectives As in this short-term trial, as in others, it is impracticable to monitor response to therapy or treatment by liver biopsy, we aimed to identify a panel of potential non-invasive metabolic biomarkers by a urinary metabolic profiling.Methods Urine samples from a group of 31 pediatric NAFLD patients, enrolled in a VSL#3 clinical trial, were analyzed by high-resolution proton nuclear magnetic resonance ((1)H-NMR) spectroscopy in combination with ANOVA-Simultaneous Component Analysis (ASCA) model and multivariate data analyses. Urinary metabolic profiles were interpreted in term of clinical patient feature, treatment and chronology pattern correlations.ResultsVSL#3 treatment induced changes in NAFLD urinary metabolic phenotype mainly at level of host amino acid metabolism (i.e., valine, tyrosine, 3-amino-isobutyrate or β-aminoisobutyric acid [BAIBA]), nucleic acid degradation (pseudouridine, psi), creatinine metabolism (methylguanidine [MG]) and secondarily at level of gut microbial amino acid metabolism (i.e., 2-hydroxyisobutyrate [2-HIB] from valine degradation). Furthermore, some of these metabolites correlated with clinical primary and secondary trial endpoints after VSL#3 treatment: tyrosine and the organic acid U4 positively with ALT (R=0.399, P=0.026) and BMI (R=0.36, P=0.045); BAIBA and tyrosine negatively with active GLP-1 (R=-0.51, P=0.003; R=-0.41, P=0.021, respectively).ConclusionsVSL#3-treatment dependent urinary metabotypes of NAFLD children may be considered as non-invasive effective biomarkers to evaluate the response to treatment.International Journal of Obesity accepted article preview online, 26 March 2015. doi:10.1038/ijo.2015.40.
Article
Full-text available
Identifying neighborhood environment attributes related to childhood obesity can inform environmental changes for obesity prevention. To evaluate child and parent weight status across neighborhoods in King County (Seattle metropolitan area) and San Diego County differing in GIS-defined physical activity environment (PAE) and nutrition environment (NE) characteristics. Neighborhoods were selected to represent high (favorable) versus low (unfavorable) on the two measures, forming four neighborhood types (low on both measures, low PAE/high NE, high PAE/low NE, and high on both measures). Weight and height of children aged 6-11 years and one parent (n=730) from selected neighborhoods were assessed in 2007-2009. Differences in child and parent overweight and obesity by neighborhood type were examined, adjusting for neighborhood-, family-, and individual-level demographics. Children from neighborhoods high on both environment measures were less likely to be obese (7.7% vs 15.9%, OR=0.44, p=0.02) and marginally less likely to be overweight (23.7% vs 31.7%, OR=0.67, p=0.08) than children from neighborhoods low on both measures. In models adjusted for parent weight status and demographic factors, neighborhood environment type remained related to child obesity (high vs low on both measures, OR=0.41, p<0.03). Parents in neighborhoods high on both measures (versus low on both) were marginally less likely to be obese (20.1% vs 27.7%, OR=0.66, p=0.08), although parent overweight did not differ by neighborhood environment. The lower odds of parent obesity in neighborhoods with environments supportive of physical activity and healthy eating remained in models adjusted for demographics (high vs low on the environment measures, OR=0.57, p=0.053). Findings support the proposed GIS-based definitions of obesogenic neighborhoods for children and parents that consider both physical activity and nutrition environment features.
Article
Full-text available
Until quite recently, there has been a widespread belief in the popular media and scientific literature that the prevalence of childhood obesity is rapidly increasing. However, high quality evidence has emerged from several countries suggesting that the rise in the prevalence has slowed appreciably, or even plateaued. This review brings together such data from nine countries (Australia, China, England, France, Netherlands, New Zealand, Sweden, Switzerland and USA), with data from 467,294 children aged 2-19 years. The mean unweighted rate of change in prevalence of overweight and obesity was +0.00 (0.49)% per year across all age ×sex groups and all countries between 1995 and 2008. For overweight alone, the figure was +0.01 (0.56)%, and for obesity alone -0.01 (0.24)%. Rates of change differed by sex, age, socioeconomic status and ethnicity. While the prevalence of overweight and obesity appears to be stabilizing at different levels in different countries, it remains high, and a significant public health issue. Possible reasons for the apparent flattening are hypothesised.
Article
Full-text available
Childhood obesity is associated with serious health problems and the risk of premature illness and death later in life. Monitoring related trends is important. The objective was to quantify the worldwide prevalence and trends of overweight and obesity among preschool children on the basis of the new World Health Organization standards. A total of 450 nationally representative cross-sectional surveys from 144 countries were analyzed. Overweight and obesity were defined as the proportion of preschool children with values >2 SDs and >3 SDs, respectively, from the World Health Organization growth standard median. Being "at risk of overweight" was defined as the proportion with values >1 SD and ≤2 SDs, respectively. Linear mixed-effects modeling was used to estimate the rates and numbers of affected children. In 2010, 43 million children (35 million in developing countries) were estimated to be overweight and obese; 92 million were at risk of overweight. The worldwide prevalence of childhood overweight and obesity increased from 4.2% (95% CI: 3.2%, 5.2%) in 1990 to 6.7% (95% CI: 5.6%, 7.7%) in 2010. This trend is expected to reach 9.1% (95% CI: 7.3%, 10.9%), or ≈60 million, in 2020. The estimated prevalence of childhood overweight and obesity in Africa in 2010 was 8.5% (95% CI: 7.4%, 9.5%) and is expected to reach 12.7% (95% CI: 10.6%, 14.8%) in 2020. The prevalence is lower in Asia than in Africa (4.9% in 2010), but the number of affected children (18 million) is higher in Asia. Childhood overweight and obesity have increased dramatically since 1990. These findings confirm the need for effective interventions starting as early as infancy to reverse anticipated trends.
Article
Full-text available
Obesity has risen dramatically in the past few decades. However, the relative contribution of energy intake and energy expenditure to rising obesity is not known. Moreover, the extent to which social and economic factors tip the energy balance is not well understood. This exploratory study estimates the relative contribution of increased caloric intake and reduced physical activity to obesity in developed countries using two methods of energy accounting. Results show that rising obesity is primarily the result of consuming more calories. We estimate multivariate regression models and use simulation analysis to explore technological and sociodemographic determinants of this dietary excess. Results indicate that the increase in caloric intake is associated with technological innovations as well as changing sociodemographic factors. This review offers useful insights to future research concerned with the etiology of obesity and suggests that obesity-related policies should focus on encouraging lower caloric intake.
Article
The childhood obesity epidemic reflects the daily accumulation of an "energy gap"-excess calories consumed over calories expended. Population-level interventions to reverse the epidemic can be assessed by the degree to which they increase energy expenditure and/or reduce caloric intake. However, no common metric exists for such comparative assessment. To develop a common metric, the Average Caloric Impact (ACI), for estimating and comparing population-level effect sizes of a range of childhood obesity interventions. An iterative, collaborative process was used to review literature from 1996 to 2012 and select illustrative interventions showing effects on youth diet and/or activity levels, energy balance, and weight. The ACIs of physical activity interventions were estimated based on program reach, frequency, duration, and intensity and mean body weight of the targeted age and gender group from the 2009-2010 National Health and Nutrition Examination Survey. ACIs of dietary interventions were based on reach and changes in foods and/or beverages consumed. Fifteen interventions informed by 29 studies were included, ranging from individual behavioral to population-level policies. A web tool, the Caloric Calculator, was developed to allow researchers and policymakers to estimate the ACIs of interventions on target populations with reference to energy gap reductions required to reach the nation's Healthy People childhood obesity goals. The Caloric Calculator and ACIs provide researchers and policymakers with a common metric for estimating the potential effect sizes of various interventions for reducing childhood obesity, providing a platform for evidence-based dialogues on new program or policy approaches as data emerge.
Article
To implement effective non-communicable disease prevention programmes, policy makers need data for physical activity levels and trends. In this report, we describe physical activity levels worldwide with data for adults (15 years or older) from 122 countries and for adolescents (13-15-years-old) from 105 countries. Worldwide, 31·1% (95% CI 30·9-31·2) of adults are physically inactive, with proportions ranging from 17·0% (16·8-17·2) in southeast Asia to about 43% in the Americas and the eastern Mediterranean. Inactivity rises with age, is higher in women than in men, and is increased in high-income countries. The proportion of 13-15-year-olds doing fewer than 60 min of physical activity of moderate to vigorous intensity per day is 80·3% (80·1-80·5); boys are more active than are girls. Continued improvement in monitoring of physical activity would help to guide development of policies and programmes to increase activity levels and to reduce the burden of non-communicable diseases.
Article
The purpose of this study was to examine differences in cardiovascular disease (CVD) risk factors across four cross-tabulated groups of cardiorespiratory fitness and body fatness in youth. Subjects included 860 males and 755 females aged 9-15 yr from the Australian Schools Health and Fitness Survey. Participants were cross-tabulated into four groups using percent body fat and estimated maximal oxygen consumption (VO2max) to split the groups. CVD risk factors included blood pressure, triglycerides (TG), fasting total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and TC:HDL-C. In males, significant differences across groups were observed for blood pressure, TG, HDL-C, LDL-C, and TC:HDL-C (P < 0.05). In females, significant group differences were observed for blood pressure and HDL-C (P < 0.05). In females, a significant difference was also evident between those in the high-fat/high-fitness group compared with the high-fat/low-fitness group for all blood pressure measures. A general trend of lower blood pressure values for both males and females in the low-fat group compared with the high-fat group was also observed. This same trend was found for males in the blood lipids. There was a linear relationship across groups for the CVD risk score for both genders. There were also significant differences between the low- and high-fat subgroups within a fitness group for both genders. The results provide evidence for the consideration of both fatness and fitness when interpreting CVD risk factors in youth, particularly among high-fat youth.