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Childhood obesity: Current literature, policy and implications for practice
Abstract
In most of the industrialized world, a childhood obesity epidemic is evident, with the numbers rising each year.
To discuss the current literature in relation to childhood obesity and to provide health practitioners, especially nurses, with the fundamental knowledge that is imperative in the recognition of children who are at risk and thereby tailor appropriate interventions.
Databases that were accessed for current literature included CINAHL, Science Direct and ProQuest. Keywords used in the search included obesity, childhood, health, relevant national statistics, policy and health risks. The literature was confined to the past 10 years with emphasis on the past 5 years. The 50 most pertinent papers from a variety of countries were chosen, and 35 papers that represented key areas of relevance were selected as the basis of this article. This selection of papers dictated the key areas of discussion such as the acknowledged factors in childhood obesity.
Although childhood obesity may be related to specific cultural and national circumstances, universal themes emerged from the literature review. These include social factors, exercise, advertising, public policy and the importance of partnerships in policy.
Any country that has a high rate or increasing rate of childhood obesity must acknowledge core factors that contribute to this serious health problem. Furthermore, public policy and community partnerships that include all health professionals have a responsibility in the prevention of childhood obesity. This can be implemented through education, research and advocacy of all nurses involved with children and families.
... 1,5 Once obesity is established, it is difficult to treat, and the rapidly rising rates of cases each year has created an urgent need for successful strategies and policies to address and reverse trends in weight gain, sedentary lifestyle, and unhealthy nutritional and life habits, especially in youth. [6][7][8][9] Motivating individuals to make healthy personal lifestyle choices is critical, although determining the best method to achieve this goal is a challenge. 6,9,10 A social marketing strategy based on influencing voluntary behavior to improve personal welfare is one possible tool with which to reduce youth obesity. ...
... Thus, it is important to review the effectiveness of social marketing as a methodology for school-based interventions aimed at reducing youth obesity, because the establishment of healthy habits by changing behaviors in school-aged children is a great challenge for health professionals. 8,9,20 School environments provide a strong, ideal setting for implementing a range of different school-based activities to improve dietary behaviors and increase physical activity to promote healthy lifestyles. The school setting represents an important channel for facilitating behavioral change because of the broad access to large, similar, nonselected populations; moreover, beneficially altered behaviors of children and adolescents can persist into adulthood. ...
... The school setting represents an important channel for facilitating behavioral change because of the broad access to large, similar, nonselected populations; moreover, beneficially altered behaviors of children and adolescents can persist into adulthood. 8,[21][22][23] Social marketing could represent a methodological challenge in determining whether greater SMBC inclusion improves the effectiveness of school-based interventions to reduce obesity. Thus, the hypothesis here is that, if school-based interventions include more of the SMBC domains, they will be more effective in preventing youth obesity. ...
Context: 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. Objective: 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. Data Sources: The PubMed, Cochrane, and ERIC databases were used. Study Selection: Nonrandomized and randomized controlled trials conducted from 1990 to April 2014 in participants aged 5 to 17 years were included. Data Extraction: After the study selection, the 8 domains of the SMBC were assessed in each included study. Results: 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). Conclusion: 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.
... For instance, the child can develop a negative body image, lower self-esteem and self-doubt that can create awkwardness in children; labeled "social insecurity". This social insecurity may result in children shunning public encounters; including but not limited to missing school days that can further impede academic progress [9][10][11]. Additionally, students reported unkind or nonhelping nature of fellow students and lesser involvement of parents in routine life within the past month and these factors were associated with being overweight. ...
... Additionally, students reported unkind or nonhelping nature of fellow students and lesser involvement of parents in routine life within the past month and these factors were associated with being overweight. Previous research has indicated the presence of neglect, stigma, bias, and discrimination against overweight/obese children, which can culminate into pervasive victimization, teasing, and bullying [10][11][12]. Reports of depression, anxiety, and suicidal thoughts have also been associated with abnormal weight in adolescents in western countries [10][11][12][13]. ...
... Previous research has indicated the presence of neglect, stigma, bias, and discrimination against overweight/obese children, which can culminate into pervasive victimization, teasing, and bullying [10][11][12]. Reports of depression, anxiety, and suicidal thoughts have also been associated with abnormal weight in adolescents in western countries [10][11][12][13]. ...
To examine the association between overweight status and psycho-social risk factors in Indian children.
Data from India's nationally-representative Global School-based Student Health Survey were analyzed using SPSS for all participating students (n=8130, 58% males).
The likelihood of being overweight was significantly higher for children with fewer friends (OR=1.16, 95%CI=1.13-1.18) or friends who were not kind or helpful, children with symptoms of depression (OR=1.20, 95%CI=1.03-1.39) and anxiety (OR=1.09, 95%CI=1.07-1.15), children with little parental involvement (OR=1.06, 95%CI=1.02-1.10), and children who felt lonely or missed school days without permission.
Psychosocial distress in overweight Indian children warrants comprehensive interventions for screening and treatment of pediatric obesity.
... It plays potential roles in normal and diseased cells as regulatory, immunologic, or antioxidant factors, particularly as cofactors or essential components in the structures of cellular enzymes [10]. In obesity, trace elements are shown to be associated with the severity of the disease and its associated complications, such as peroxidation, inflammation, and metabolic disturbances [11,12]. ...
... In obese people, the metabolic disturbances are decompensated. Although overweight is a preclinical condition, obesity is a clinically manifested metabolic disorder, including mineral imbalances [12], which could play a potential role in the pathogenesis of intellectual disabilities (ID). ...
Background
Patients with intellectual disabilities are shown to have a limited capacity for cooperation, communication,and other biological consequences, which significantly require a specialized interest in healthcare professionals worldwide.
Aim
In this respect, the present study was designed to evaluate the levels mineral elements, and their correlation with oxidative stress markers and adiposity markers; leptin (L), adiponectin (A), and L/A ratio in adolescents with intellectual disabilities.
Methods
A total of 350 schoolchildren aged (12–18 years) were randomly invited to participate in this prospective, observational study. Only 300 participants agreed to participate in this study. According to Intelligence quotients scores (IQ) measured by WISC-III, the participants were classified into two groups; the healthy control group (no = 180; IQ = 90–114); and the moderate intellectual disability (MID) group (no = 120; IQ = 35–49). Adiposity markers; body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), physical activity scores, adipokines biomarkers; leptin, adiponectin, L/A ratio, oxidative stress, and plasma mineral elements were evaluated by prevalidated questionnaires, inductively coupled plasma-mass spectrometry (ICP-MS), colorimetric, and immunoassay techniques.
Results
Intellectual disability of moderate type was reported in 40% of the studied populations most of them are men aged 12–18 years (66.6% for men vs. 33.3 for females). Obesity was shown to be associated with the degree of intellectual disability of the students. There was a significant (P = 0.001) increase in the BMI, WHR, and WHtR scores as obesity markers with poor physical activity (P = 0.01) in students with poor disability compared to healthy controls (HC). The levels of leptin (P = 0.001), adiponectin (P = 0.01), and L/A ratio (P = 0.01) as adiposity biomarkers were significantly increased in students with MID compared to healthy controls. Also, oxidative stress measured by malondialdehyde (MDA) (P = 0.01) and total antioxidant capacity (TAC) (P = 0.01) were significantly increased in students with MID compared to healthy control subjects. In addition, mineral elements were shown to be linked with intellectual disability. The data showed that the levels of Fe, Mn, Zn, Hg, Pb, Ca, Cr, Mg, and Ni significantly (P = 0.001) increased, and the levels of Al, Na, K, Cu, and Zn/Cu ratio significantly (P = 0.001) decreased in subjects with MID compared to healthy controls. Correlation analysis concluded that changes in mineral elements significantly correlated with adiposity markers, oxidative stress, and the scores of intellectual disability (WISC III-IQ score).
Conclusion
The intellectual disability of moderate type (MID) was associated with abnormal changes in the levels of essential mineral elements and adipokines and increased levels of cellular oxidative stress. Thus, evaluating plasma mineral elements and adipokines levels could be a potential diagnostic parameter for diagnosing MID.
... Cholesterol rich high fat diet tends to increase adipose tissue at various parts of body and activates innate immune system [108]. Generally, it has been shown that, such diet not only associated with obesity but also causes altered endocrine and metabolic regulations like diabetes, dyslipidemias, cardiovascular diseases, hepatic steatosis and cancer [109][110][111][112][113][114][115][116]. In case of T2DM, diet mediate increase of white adipose tissue and related immune response contributes to the cornerstone effect in disease pathology [108,112]. ...
... Generally, it has been shown that, such diet not only associated with obesity but also causes altered endocrine and metabolic regulations like diabetes, dyslipidemias, cardiovascular diseases, hepatic steatosis and cancer [109][110][111][112][113][114][115][116]. In case of T2DM, diet mediate increase of white adipose tissue and related immune response contributes to the cornerstone effect in disease pathology [108,112]. Association between diabetes mellitus and hypercholesterolemia, which is regarded as one of the most important factors involved in the acceleration of atherosclerosis in diabetic patients [117]. Researchers in this field have observed that plasma cholesterol levels in diabetic rats are notably high compared with non-diabetic animals [118]. ...
Type-2-diabetes mellitus (T2DM) is a global non-communicable disease with dietary causes. This chronic disease is escalating to epidemic proportion. Medication expenditure puts additional burden on the nations already deprived of economy due to loss in terms of disability adjusted life years. Since there is no permanent cure as yet, dietary prevention and management remains the best mitigation strategy. Hyperglycemia is the characteristic symptom of T2DM. The glycaemic propensity of the food/diet is regulated at bio-accessibility, bio-availability and metabolic levels and is determined by the nutrient content and composition. Though qualitative information of certain dietary components on glycaemic regulation of the foods has been documented, studies pertaining to their effect and mechanisms have been fragmentary across several reports over the period of many years. Therefore, the present review has been conducted to interpret individual and synergistic effects of the most relevant nutritional components on the glucose propensity, insulin secretion and insulin sensitivity. This review identifies and enlists some of the most relevant nutrients to T2DM; provides various dietary sources along with their content in the context of their glycaemic indices and tracks the physiological participation of amino acid, fatty acids, cholesterol and dietary fiber. The pertinence of the nutritional components to different aspects of diabetic pathophysiology has been categorized. This study is of significance in formulations of diet and food supplements, meal planning as well as nutrition policy and regulation. Some of the identified nutrients may also function as metabolic biomarkers for prognosis and as potential therapeutic agents.
... Cholesterol rich high fat diet tends to increase adipose tissue at various parts of body and activates innate immune system [108]. Generally, it has been shown that, such diet not only associated with obesity but also causes altered endocrine and metabolic regulations like diabetes, dyslipidemias, cardiovascular diseases, hepatic steatosis and cancer [109][110][111][112][113][114][115][116]. In case of T2DM, diet mediate increase of white adipose tissue and related immune response contributes to the cornerstone effect in disease pathology [108,112]. ...
... Generally, it has been shown that, such diet not only associated with obesity but also causes altered endocrine and metabolic regulations like diabetes, dyslipidemias, cardiovascular diseases, hepatic steatosis and cancer [109][110][111][112][113][114][115][116]. In case of T2DM, diet mediate increase of white adipose tissue and related immune response contributes to the cornerstone effect in disease pathology [108,112]. Association between diabetes mellitus and hypercholesterolemia, which is regarded as one of the most important factors involved in the acceleration of atherosclerosis in diabetic patients [117]. Researchers in this field have observed that plasma cholesterol levels in diabetic rats are notably high compared with non-diabetic animals [118]. ...
Type-2-diabetes mellitus (T2DM) is a global non-communicable disease with dietary causes. This chronic disease is escalating to epidemic proportion. Medication xpenditure puts additional burden on the nations already deprived of economy due to loss in terms of disability adjusted life years. Since there is no permanent cure as yet, dietary prevention and management remains the best mitigation strategy. Hyperglycemia is the haracteristic symptom of T2DM. The glycaemic propensity of the food/diet is regulated at bio-ccessibility, bio-availability and metabolic levels and is determined by the nutrient content
and composition. Though qualitative information of certain dietary components on glycaemic regulation of the foods has been documented, studies pertaining to their effect and mechanisms have been fragmentary across several reports over the period of many years. Therefore, the present review has been conducted to interpret individual and synergistic effects of the most relevant nutritional components on the glucose propensity, insulin secretion and insulin sensitivity. This review identifies and enlists some of the most relevant nutrients to T2DM; provides various dietary sources along with their content in the context of their glycaemic indices and tracks the physiological participation of amino acid, fatty acids, cholesterol and dietary fiber. The pertinence of the nutritional components to different aspects of diabetic pathophysiology has been categorized. This study is of significance in formulations of diet and food supplements, meal planning as well as nutrition policy and regulation. Some of the identified nutrients may also function as metabolic biomarkers for prognosis and as potential therapeutic agents.
... Obesity has been said to constitute a global "crisis" [1][2][3][4][5]this is increasingly the case among children and young people [6][7][8][9][10]. In the U.S. for instance, 32.6% of boys aged 12 to 19 years, and 29.9% of girls within this age cohort have a high body mass index (BMI), at or above the 85th percentile [11]. ...
... The aforesaid health and mental health issues among children and young people can have considerable social implications. These include the oft-cited burden of care among family members [30][31][32][33][34], limited educational opportunities [35] and fewer employment prospects [9]. This paper explores the obesity "epidemic" [6] among Australian young people. ...
In Australia, as in many other developed economies, the prevalence of obesity has risen significantly in all age groups and especially in young males and females over the past decade. Using data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, this paper investigates the influence of economic, personality and social factor demographics on the incidence of obesity in Australian youths. The study uses two random parameters logit models, including one that allows for gender-specific differences in the conditioning variables. The models reveal notable differences between the most important variables affecting the incidence of obesity amongst females compared to males. These differences are notable to consider for policy and intervention programs aimed at reducing the problem of obesity.
... Nurses compose one category of health professionals who can be important agents in promoting health (4)(5)(6)(7)(8), as they represent a large number of total patient/health-care-worker interactions. However, studies show that nurses do not sufficiently practice health promotion (9,10). ...
... Research has found impediments to implementing reforms in European nursing education concerning health promotion (26), and difficulties have also arisen in interpreting nurses' role in health promotion (10). However, it is important that all nursing education take WHO's call seriously and incorporate health promotion in the education, as the role nurses should play in health promotion is evident (4)(5)(6)(7)(8). ...
Aim:
The aim of this study was to compare Italian and Swedish nursing students' attitudes towards health promotion practice on matriculation to nursing school and after a three-year nursing education, and to explore whether attitudes towards health promotion practice correlate with BMI and smoking.
Method:
The study involved students who started their nursing education in autumn 2009 (n =240). Data were collected via a questionnaire.
Results:
The results show that the Swedish students had a more positive stance on health promotion than Italian students did. After completion of a three-year nursing education programme, Italian students' attitudes on health promotion had improved, while no such development was seen in Sweden. Further, no correlation between lifestyle issues and attitudes to health promotion was found.
Conclusion:
Health promotion in nursing education may have important influence on students' attitudes and thereby on the quantity and quality of future health promotion practice.
... 17 Hemşire yaş ve cinse göre gerekli miktarda besin alımını içeren yeni bir yaşam stili kurulmasına destek olmalıdır. 6 Beslenme eğitiminde özellikle çocuk için gerekli olan besinler üzerine odaklanılmalıdır. Çocuklara verilecek besinler normal büyüme ve gelişmeyi sağlayacak yeterli kalori ve esansiyel besinleri içeren, protein, karbonhidrat ve yağ içeriği bakımından dengeli olmalıdır. ...
... ay), ek besinlerin uygun kalite ve miktarda olmasına dikkat etmesi, besinlere tuz ve şeker eklememesi, ek besinleri verirken kaşık kullanması, bebeği hazır bebek mamaları (formül süt) ile besliyorsa mamayı tarife göre hazırlaması ve biberondaki mamanın miktarının bebeğin ayına uygun olması, mamayı hazırlarken su yerine süt kullanmaması, ek besin olarak unlu-şekerli (muhallebi) tercih etmemesi, hazır bebek mamalarına bisküvi, ekmek, un, şeker, yağ eklememesi gerektiği üzerinde durmalıdır. 2,27,38Çocukluk ve adolesan döneminde ise hemşire beslenme eğitimini yapmadan önce ebeveynlerin çocuk besleme tutum ve davranışlarını, evde sağlıklı ve sağlıksız bulunan besinleri ve çocukların bunlara ulaşılabilirliğini ve ebeveynlerin sergiledikleri beslenme davranışlarını bilmelidir.[5][6]29 Öncelikle obezite gelişiminde rol oynayan hatalı beslenme davranışının düzeltilmesi gereklidir. ...
... The pre-school age (2-6 years) has been indicated as the most critical growth period for adult overweight (De Kroon et al., 2010). Treatment has been shown to have poor results for children and adolescents already suffering from obesity (Ben-Sefer et al., 2009). Early prevention is therefore essential to effectively counteract the obesity epidemic . ...
... De leeftijd voordat kinderen naar school gaan (2-6 jaar) is aangeduid als de meest belangrijke groeiperiode voor de ontwikkeling van toekomstig overgewicht (De Kroon et al., 2010). Behandelingen laten vaak slechte resultaten zien bij kinderen en adolescenten die al te dik zijn (Ben-Sefer et al., 2009). Vroege preventie is daarom essentieel om effectief de obesitas epidemie tegen te kunnen gaan . ...
... The ndings of this article reveal that though childhood obesity may be associated with speci c cultural and national situations, universal themes appeared in the literature review. These consist of social factors, exercise, advertising, public policy and the signi cance of partnerships in the policy [21]. As per WHO, a set of recommendations on the marketing of foods and non-alcoholic beverages to children concludes that advertising and other forms of food and beverage marketing to children are extensive and primarily concern products with a high content of fat, sugar or salt. ...
The objective of this paper is to study the trend and pattern of advertising content for child health drinks in India. A detailed analysis of the advertisement content of 5 child health drink brands for 6 years has been undertaken in this study. The majority of the brand's core focus area was growth. The most highlighted nutrient among the brand was protein. Maximum brands have highlighted more than one nutrient in their advertisements. Most of the brands have displayed scientific information and 100% of the brands have shown health benefits in their ads. The celebrity or HCP was present in most of the brand’s advertisements. Regarding location, it was found that in the majority of the brand's advertisements there was a combination of location i.e., home, leisure & shop. All the brands have used rational and emotional appeals in their advertisements. In the majority of the brands' advertisements, the lead voice was female. In child-parent interaction, most of the brands have shown the mother in the parents’ position. However, in the advertisement content, there was no verbal mention of a balanced diet, RDA, and calories which are very important from a child’s health point of view. As there are several studies that suggest the rise in childhood obesity and the association of television advertisements with it. The policymakers also need to closely look into the advertising content and act for the benefit of the child’s health.
... The following hypothesis is tested at the significance level of 0.05 H 1 : There will be a significant association between knowledge level of adolescent girls on prevention and management of obesity with their selected personal variables [2]. ...
Background of the Study: Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in metres). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight. Obesity result from increased caloric intake that consistently exceeds caloric requirements. Change in life style practices including increasing consumption of oily, junk food, decreased physical activities, watching and playing video games for prolonged duration etc. are the most important factors in causing childhood obesity. Aim and Objectives: The aim of the study is to assess the knowledge of adolescent girls on prevention and management of obesity in selected schools. Approach and Design: The descriptive study approach was used. Sampling and Sampling Criteria: Simple Random Probabality sampling technique was used to select 120 adolescent girls from selected schools at Mysuru. Tools and Technique: Structured knowledge questionnaire was used to collect the data. The data was analyzed using descriptive and inferential statistics. Result: Result revealed that majority 50(41.66%) adolescent girls had average knowledge, 40(33.33%) girls had good knowledge and 30(25%) girls had poor knowledge. Chi-square analysis revealed that the knowledge and personal variables are not significantly associated with their selected personal variables like age, class of studying, source of information and familial history of obesity. Conclusion: It was concluded that, adolescent girls have average knowledge; hence the knowledge was reinforced by providing information pamphlet to the adolescent girls that contains essential information regarding the causes, consequences, prevention and management of obesity.
... For instance, parents clearly play a critical role in infant feeding. Similarly midwives and childcare providers were important for inclusion due to their potential role in childhood obesity intervention delivery [31,32]. Participants were invited to participate via emails to individuals from each stakeholder group, and to the mailing lists of national and international professional organisations and networks; parents were recruited via online national and international parenting forums and social media. ...
Background:
Standardisation of outcomes measured and reported in trials of infant-feeding interventions to prevent childhood obesity is essential to evaluate and synthesise intervention effects. The aim of this study is to develop an infant-feeding core outcome set for use in randomised trials of infant-feeding interventions, with children ≤1 year old, to prevent childhood obesity.
Methods: Core outcome set development followed four stages: (1) systematic review of outcomes reported in the extant literature; (2) meeting with national and international stakeholders to discuss and clarify identified outcomes; (3) e-Delphi study with national and international stakeholders to prioritise outcomes; (4) meeting with national and international stakeholders to reach consensus on outcomes. Stakeholders in stages 2–4 were paediatricians, general practitioners, nurses, midwives, non-clinician researchers, parents, dieticians, nutritionists, and childcare providers.
Results: Twenty-six outcomes were identified for inclusion in the core outcome set. These were grouped in nine outcome domains: ‘breastfeeding and formula feeding’, ‘introduction of solids’, ‘parent feeding practices and styles’, ‘parent knowledge and beliefs’, ‘practical feeding’, ‘food environment’, ‘dietary intake’, ‘perceptions of infant behaviour and preferences’, and ‘child weight’.
Conclusions: The core outcome set identified in this study is the minimum that should be measured and reported in trials of infant-feeding interventions to prevent childhood obesity. This standardisation of outcomes will enable more comprehensive examination and synthesis of the effects of infant-feeding interventions to prevent childhood obesity.
... It is a complex disease caused by various factors including genetic, diet, lifestyle and environmental factors [11]. The danger of obesity is very fearful throughout the world because it occurs in people of almost all aged, even in children and adolescents [12,13]. It has been considered as one of the serious global health problems which have close association with various types of diseases including cardiovascular disease, type 2 diabetes, hypertension, dyslipidemia, liver disease and also several types of cancer [14][15][16][17][18]. Recent data indicates that some forms of obesity are commonly associated with chronic low-grade inflammation, also [19]. ...
Once considered a problem of developed countries, obesity and obesity-related complications are rapidly spreading around the globe. Increased body mass index and obesity are strongly associated with metabolic dysfunction. The purpose of this study was to review and explain the role of different dietary supplements, medicinal plants, and beverages in reducing obesity. The drug used in treating obesity has so many adverse effects, including drug abuse and drug resistance. This evidence based review article suggested that several dietary supplements including Chitosan, Prolibra, Phosphorus supplementation, Vitamin D3 supplementation and beverages like Yerba Mate, Green coffee bean extract, Green tea extract may be more effective for treating obese individuals.
... In South Korea, the prevalence of childhood obesity steadily increased from 11.6% to 16.5% between 2006 and 2016 [3]. To tackle these trends in childhood obesity, unhealthy eating behaviors including individual, familial and environmental risk factors are considered the key modifiable factors [4]. Dietary modification and nutritional education are essential elements of nutrition interventions [5]. ...
Diet-related behavioral modification for healthy eating and lifestyle is required to improve childhood obesity. The present study aimed to develop customized nutritional intervention protocol and education program to find barriers to adhere healthy diet and lifestyle for moderate to severe obese children and adolescents and their families. Theoretical framework approaches can be used to change behavior and achieve goals. Previous studies that described the relationship between behavioral modification and nutrition education theory were reviewed. The social cognitive theory and transtheoretical model were employed with behavioral changes to target a healthful diet and lifestyle. The nutrition care process (NCP) model was adopted to customize nutrition care for the participants. Customized nutritional intervention protocol was developed following as the four steps of the NCP. Firstly, nutrition status of the participants was assessed by the nutrition expert. Nutrition problems were described as "inadequate energy intake," "overweight/obesity," or "food and nutrition-related knowledge deficit." All nutrition sessions were designed for nutrition intervention to give nutritional knowledge and a practical mission in real life for individual goal setting and self-control. Meal planning, portion control, healthy snack selection and cooking with fruits and vegetables were consisted of five components of the nutrition education session. During each session, the participants and their families were interviewed by a nutrition expert for monitoring and evaluating diet-related goal setting and achievement. A theoretical and evidence-based nutritional intervention was developed for the secondary to tertiary prevention of childhood obesity. This nutrition intervention protocol and program might be helpful for the further research on childhood obesity.
Trial registration:
Clinical Research Information Service Identifier: KCT0002111.
... It is a complex disease caused by various factors including genetic, diet, lifestyle and environmental factors [17]. The danger of obesity is very fearful throughout the world because it occurs in people of almost all aged, even in children and adolescents [18,19]. ...
Background and objectives:
Obesity is associated with metabolic dysfunction and over nutrition. Increased body mass index and obesity are strongly amalgamated with changes in the physiological function of adipose tissue, leading to altered secretion of adipocytokines, inflammatory mediators release as well as chronic inflammation and insulin resistance. The purposes of this study were to review the evidence of how obesity and inflammation may lead to insulin resistance and cancer.
Summary:
Recent findings suggested that increased level of inflammatory mediators in obesity, plays an introductory and cabalistic role in the development of different types of inflammatory disorders including type 2 diabetes mellitus. Link between elevated body mass index and type 2 diabetes mellitus (T2DM). Several of the factors-such as increased levels of leptin, plasminogen activator inhibitor-1, decreased levels of adiponectin, insulin resistance, chronic inflammation etc. consequently result in carcinogenesis and carcinogenic progression too.
Conclusion:
This review summarizes how cytokine production in adipose tissue of obese subject creates a chronic inflammatory environment that favors tumor cell motility and invasion to enhance the metastatic potential of tumor cells. High levels of cytokine in the circulation of affected individuals have been associated with a significantly worse outcome. This article also reconnoiters the mechanisms that link obesity to numerous disorders such as inflammation, diabetes, cancers and most specifically combine these processes in a single image. Understanding these mechanisms may assist to understand the consequences of obesity.
... Milteer, Ginsburg, & Mulligan, 2012). Internationally, increased prevalence in overweight and obesity underpins attention to modifiable lifestyle factors including children's low levels of physical activity (Ben-Sefer, Ben-Natan, & Ehrenfeld, 2009;Murphy & Demaio, 2018;Waters & Baur, 2003). Recent findings of vitamin D deficiencies have also drawn attention to the amount of time spent indoors (Greer et al., 2007;Munns et al., 2006;Voortman et al., 2015). ...
As part of a cluster randomized controlled trial (Bundy et al., 2017), the after school-hours activities of 5-7 year old children were recorded by parents and other adult carers on four consecutive weekdays between 3:30pm-7:00pm. Records of time use showed most time was spent indoors in activities involving low levels of physical activity. The most-frequently-recorded activity was screen time, accounting for approximately one quarter of all activities. Higher levels of physical activity were reported when children were outdoors (19.5% of time) and/or with peers (9.58%). If an adult was present, highest activity levels of children occurred when the child was with a teacher/carer (6.07%). Although concern is frequently raised about children spending too much time in organized activities, these structured forms of out-of-school choices accounted for only 8.09% of recordings. The results of the current study strengthen the evidence base, supporting the need to optimise out-of-school times with more developmentally important social and physical contexts. We discuss ways in which context may support or inhibit opportunities physical activity in after school-hours activities.
... Milteer, Ginsburg, & Mulligan, 2012). Internationally, increased prevalence in overweight and obesity underpins attention to modifiable lifestyle factors including children's low levels of physical activity (Ben-Sefer, Ben-Natan, & Ehrenfeld, 2009;Murphy & Demaio, 2018;Waters & Baur, 2003). Recent findings of vitamin D deficiencies have also drawn attention to the amount of time spent indoors ( Greer et al., 2007;Munns et al., 2006;Voortman et al., 2015). ...
As part of a cluster randomized controlled trial (Bundy et al., 2017), the after school-hours activities of 5-7 year old children were recorded by parents and other adult carers on four consecutive weekdays between 3:30pm-7:00pm. Records of time use showed most time was spent indoors in activities involving low levels of physical activity. The most-frequently-recorded activity was screen time, accounting for approximately one quarter of all activities. Higher levels of physical activity were reported when children were outdoors (19.5% of time) and/or with peers (9.58%). If an adult was present, highest activity levels of children occurred when the child was with a teacher/carer (6.07%). Although concern is frequently raised about children spending too much time in organized activities, these structured forms of out-of-school choices accounted for only 8.09% of recordings. The results of the current study strengthen the evidence base, supporting the need to optimise out-of-school times with more developmentally important social and physical contexts. We discuss ways in which context may support or inhibit opportunities physical activity in after school-hours activities.
... Amerikan Ulusal Sağlık ve Beslenme Araştırma Anketi 2011-2012 verisine göre Amerika'da çocuklarda obezite prevalansını %31,8 olarak belirlemiştir (5). Avrupa ülkelerinde ise tüm çocukların yaklaşık %30'unun ve 7-11 yaş arası çocukların da %25'inin aşırı kilolu ve obez olduğu bildirilmektedir (6). Türkiye'de okul çağındaki çocuklarda obezite prevalansını araştıran, ülke genelini yansıtan geniş tabanlı çalışmalar olmasa da bölgesel yapılan çalışmalarda obezite prevalansı %9 ile %27 arasında bildirilmiştir (7). ...
Childhood obesity is an important public health problem worldwide with an increasing incidence and prevalance. This increase in the obesity rates can lead to many other health problems. Obesity shows early symptoms in childhood like other chronic diseases such as dental caries and gingivitis, and it will be an important step to prevent their adverse effects at early ages in terms of improving the general wellbeing of the societies. The aim of this review is to point out childhood obesity and its potential risks, and put forward its consequences in terms of oral health as well as offering solutions.
... Department of Health and Human Services [USDHHS], 2009). As such, childhood obesity has evolved from a relatively uncommon societal problem to a national public health crisis (Ben-Sefer, Ben-Natan, & Ehrenfeld, 2009;Brescoll, Kersh, & Brownell, 2008;Handy, Cao, & Mokhtarian, 2006;Levi, Segal, Laurent, Lang, & Rayburn, 2009;Rosenthal & Chang, 2004;USDHHS, 2009). This epidemic disproportionately affects Black, Hispanic, and low-income children. ...
Scholars suggest that children’s built and social environments play key roles in their physical activity (PA) levels and subsequent propensity toward obesity. This study examines the associations between neighborhood constructs and the race and income disparities in PA and health among children ages 10–17 years in the United States. Using the 2011–2012 National Survey of Children’s Health and a series of logistic and ordinary least squares regressions, this study compares obesity and PA levels of Black, Hispanic, and low-income children with their White and more affluent counterparts, interacting demographic and neighborhood characteristics with one another. Findings reveal that non-White respondents report having more amenities and more detractions; low-income respondents report having fewer amenities and more detractions; and non-White and low-income respondents report having less social cohesion. Additionally, though amenities and cohesion improve PA and health and detractions have the reverse effect, these effects are opposite for Black, Hispanic, and low-income children. Black children with more cohesion and Hispanic children with more amenities and fewer detractions have greater odds of being obese. Findings underscore the need for improved physical and social environments in non-White and low-income communities, as well as targeted initiatives to educate parents and children on obesity and healthful activities.
... A considerable proportion of children in the UK (United Kingdom) are severely overweight. The scale of the current problem is such that experts are referring to it as a 'childhood obesity crisis' (Ben-Sefer, Ben-Natan, & Ehrenfeld, 2009). Approximately 10% of reception class children (aged 4-5 years) are obese, and this proportion rises to 20% of children in year 6 (aged 10-11) (National Statistics, 2012 ). ...
Childhood obesity is a serious problem in the UK, with around 20% of children aged 10-11 being overweight or obese. Lifestyle interventions can be effective, but there is limited evidence of their effectiveness in delivering sustained weight loss. The present research explored potential of web-based, 3-dimensional virtual worlds (VWs) for facilitation of weight-management, well-being and patient and public involvement (PPI) for young people. Attendees of a weight management camp took part in induction sessions for use of the VW of Second Life. All participants successfully learned how to interact with one another and navigate the virtual environment. Participant appraisals of Second Life were varied. Some found it complicated and difficult to use, and some found it fun and the majority stated that they would choose to use VWs again. There is considerable potential for use of VWs to promote weight management, and Second Life or a similar VW could be used to deliver this. Potential barriers include members of the target sample having limited access to computers with necessary system requirements for running VWs, and that some may find VW-based educational experiences unappealing or challenging to navigate. For some however, VWs may provide a useful mode for provision of education, PPI and support relating to weight management.
... Until recently, childhood and adolescents overweight and obesity were mostly associated with affluence and the developed world [1,2]. These conditions have however significantly increased in low and middle income countries (LMICs) over time [3]. ...
Aims: To evaluate the prevalence and pattern of malnutrition among adolescents in public
secondary schools in a rural community.
Study Design: A school based cross-sectional descriptive study.
Place and Duration of Study: Public secondary schools in Gokana Local Government Area,
Rivers State, Nigeria between August and October, 2016.
Methodology: A total of 300 adolescents between 10 and 18 years were recruited from students
attending public secondary schools in Gokana Local Government Area of Rivers State using a two
staged simple random sampling technique. Information from respondents was obtained using a
pretested semi-structured interviewer administered questionnaire. The respondents’ weights and
heights were measured and used to calculate their body mass index (BMI). BMI was used to
classify them into stunted, underweight, normal and overweight/obese adolescents using the 2007
World Health Organisation’s reference population. Data analysis was done using the Statistical
Package for Social Sciences (SPSS) version 20.
Results: The prevalence of stunting, underweight and overweight/obesity in this study were 14.3%,
15.6% and 0.0% respectively. Male and older adolescents were more likely to be underweight and
stunted compared to female and younger adolescents.
Conclusion: Acute and chronic under-nutrition is still a major problem among adolescents in rural
communities in Rivers State unlike overweight / obesity. Our findings have implications for
intensified nutrition programmes generally and specifically for adolescents at all levels of
government.
Keywords: Adolescents; malnutrition; public schools; rural; Rivers State.
associated
... However, behavioural modifiable factors, such as unhealthy eating habits, physical inactivity, and a sedentary lifestyle, play crucial roles in the rising prevalence of childhood obesity worldwide. 9 To tackle the rising prevalence of obesity, early behavioural modification is needed to sustain behavioural changes. Adolescence is a time of major physical and cognitive changes, when independence is established and overweightness-and obesity-related behaviours, such as dietary and activity patterns, may be adopted. ...
Background and objectives:
Social cognitive theory provides the opportunity for program development to enhance healthy personal behvioural characteristics. We devised study to employ social cognitive theory to reduce snacking habits and sedentary activity among overweight adolescents .
Methods and study design:
Eight junior high schools in Makassar city were randomly assigned as intervention and control schools. A total of 238 overweight students aged 11-15 years (BMI z-score >=1 SD, according to a 2007 report from the WHO) were recruited. Adolescents from the intervention schools attended 12 weekly 75-min nutrition education group sessions, which focused on behavioural modification assisted by trained facilitators; furthermore, their parents received weekly nutrition education leaflets. Adolescents from the control schools, but not their parents, received leaflets on evidenced-based nutrition information. The BMI z-scores, waist circumference, snacking habits, sedentary activity, and the adolescents' self-efficacy data were assessed prior to and after 3 months of intervention. The outcomes were analysed on an intent-to-treat basis.
Results:
Compared with the control group, the intervention group showed a higher reduction in BMI z-scores (-0.08; p<0.05) and waist circumference (-1.5; p<0.05) at 3 months. Significant between-group differences were also observed for decreased snacking habits, but not for sedentary activity. Additionally, the programme improved self-efficacy for reducing these behaviours. Mean compliance and satisfaction with the programme were 95% and 92%, respectively.
Conclusions:
These high reduction rates suggest that the programme is promising and may address the problem of overweightness in adolescents. Additional studies are required to develop the programme in community settings.
... Apart from the above-mentioned chronic diseases, the findings from one study have indicated a significant increase in the psychosocial consequences of childhood obesity (Centers for Disease Control and Prevention 2009). For example, children who are obese have a negative body image, which leads to lower self-esteem, and reflects negatively on their academic and social progress (Ben-Sefer et al. 2009). The complications caused by childhood obesity are severe, and could continue to affect the health of a child, even in adulthood (Centers for Disease Control and Prevention 2009). ...
Background:
The rapid increase in childhood obesity is a serious public health problem, and has led to the development of many interventions. However, no intervention has emphasized whole grains as a strategy to manage childhood obesity. Therefore, this article describes the protocol of a 12-week multi-component, family-based intervention on whole grain, using a healthy balanced diet for managing childhood obesity.
Methods:
The GReat-Child trial utilize a quasi-experimental method in which two schools in Kuala Lumpur are assigned to intervention and control groups. The eligibility criteria are overweight/obese children, aged 9 through 11 years, who has no serious co-morbidities. The children who report consuming whole-grain foods in their 3-day diet-recall during the screening will be excluded. The study sample is characterized by anthropometric measurements (weight, height, percentage of body fat and waist circumference), whole grain and nutrient intakes (3-day 24-h diet recalls), and their knowledge, attitudes and practices towards whole grain. The 12-week intervention is comprised of three components addressing behaviour, personal and environmental factors, based on social cognitive theory: (1) individual diet counselling for the parents; (2) six 30-min nutrition education classes and (3) school delivery of whole-grain foods; The control school does not receive any interventions, however, for ethical purposes, a health talk is conducted after the entire GReat-Child Trial is completed.
Conclusion:
The GReat-Child trial represents a novel approach to examining the effectiveness of the intervention of whole grain in a healthy balanced diet on managing childhood obesity. We anticipate that this trial will reveal not only whether whole grain intervention will be effective in managing childhood obesity, but also provide greater insights into the acceptance of whole grain among Malaysian children.
... The psychological mechanisms by which the influence of marketing works is widely accepted as well as the favorable results of interventions aimed at prohibition on food advertisements during daytime, pointing at the importance of governmental policies and strategies (54,55). In some countries bans on "unhealthy" advertisements have now been established (56,57). ...
The worldwide obesity epidemic is a complex problem, resulting from the interaction of individual metabolic, genetic, and psychological factors with meso-and macro environmental factors. Adolescents, with their rapid changes in body composition, together with their shift in orientation from the direct family to the peer-related environment, are particularly vulnerable to unhealthy changes in lifestyle and peers seem to play an important role in shaping the behavior of adolescents. Adolescents tend to mimic their peers' behavior related to both food choices as well as to physical activity. This influence of peers depends on environmental circumstances such as availability of snacks, and it is affected by individual psychological and demographic factors as well as by macro-environmental factors such as cultural and social norms, legislation, food distribution, and media and advertising. Rapidly expanding sources of influence on health behavior are media such as television, the internet, and smartphones. These media may enhance overweight and a sedentary lifestyle. However, potentially these media could be used to monitor and influence snacking behavior and physical activity for the better. An example of the use of new technology to enhance health behavior is the 'Wii' home video game. Using insights from social psychology, thoughtful choice architecture can be established to nudge adolescents to choose what is best for them without restricting freedom of choice and to help them with really implementing healthy intentions. A challenge for the coming decade is to develop 'Apps' aimed to decrease adolescent obesity while making use of social networks.
... The report on the health state of inhabitants from 2004 says about the increase since 1998 in overweight and obesity in men by 3.3%, while in women a decrease by 4.9% has been recorded since 1993 (Jurkovičová, 2005). Ben-Sefer, Ben-Natan M. & Ehrenfeld, (2009) in their contribution underline the differences in the incidence of overweight and obesity in different countries of Europe and the world. The change of living conditions, for which reduction of physical effort, sedentary behaviour at work and at home (working with PC, watching Tv and video programmes) are characteristic, reduces the share of physical activity in the daily regime of children. ...
The article presents the results of a survey of incidence of obesity in children and adults during a 5-year-long research period. The objects of the research were 1118 children and adults aged 6-23 years. Questionnaires contained basic information on their health state, amount of performed activity, methods of nutrition, and interest in performing physical activity. Basic somatic data on each person involved were obtained: body weight and height, waist circumference, hips circumference. By means of Body analyser device the amount of fat, muscle mass and water was analysed. The measurement results obtained at the beginning of our research mostly complied with the ones publicized by the Public Health Bureau in SR, where up to 12.5 % of the Slovak population suffers from overweight and 6.7% from obesity. However, an increasing number of overweight population (up to 19%), but a lower incidence of people suffering from obesity (5%) were recorded After the application of the programme of exercises in the selected experimental groups the percentage of population suffering from overweight decreased to 17% and overweight people to 4.5%. In all observed individuals, in spite of the non-significant reduction of weight (increasing muscle mass) all circumferential measures decreased. We can assume that our programmes of exercises positively impacted obesity consequences.
... The psychological mechanisms by which the influence of marketing works is widely accepted as well as the favorable results of interventions aimed at prohibition on food advertisements during daytime, pointing at the importance of governmental policies and strategies (Harris, Pomeranz, Lobstein, & Brownell, 2009;Jones, Mannino, & Green, 2010). In some countries bans on "unhealthy" advertisements have now been established (Ben-Sefer, Ben-Natan, & Ehrenfeld, 2009;Strasburger, 2011). ...
The worldwide obesity epidemic is a major and complex problem, resulting from theinteraction of individual metabolic, genetic, and psychological factors with meso- andmacro environmental factors. Adolescents, with their rapid changes in body composition,together with their shift in orientation from the direct family to the peer-relatedenvironment, are particularly vulnerable to unhealthy changes in life style. Habits withrespect to food and physical activity tend to change substantially in this period ascompared to earlier childhood, and peers seem to play an important role in shaping thebehavior of adolescents. Adolescents tend to mimic their peers' behavior related to bothhealthy and unhealthy food choices as well as to physical activity and sportsparticipation. This influence of peers depends on environmental circumstances such asavailability of snacks, and is affected by individual psychological and demographicfactors, and by macro-environmental factors such as cultural and social norms,legislation, food distribution, and media and advertising. A rapidly expanding source ofinfluence on health behavior are media such as television, the internet (e.g., Facebook,twitter), and smartphones. These media may enhance overweight and reduce physicalstrength by reinforcing a sedentary life. However, potentially these media could be usedto monitor and influence snacking behavior and physical activity for the better. Anexample of the use of new technology to enhance health behavior is the 'Wii' home videogame. Using insights from social psychology, thoughtful choice architecture can beestablished to nudge adolescents to choose what is best for them without restrictingfreedom of choice and to help them with really implementing healthy intentions. Achallenge for the coming decade is to develop 'Apps' aimed to decrease adolescentobesity while making use of social networks.
... Once obesity is established, it is difficult to treat, highlighting the urgent need for successful strategies and policies to revert trends in weight gain, sedentary lifestyles and inadequate nutritional habits, especially in vulnerable youth populations [6][7][8]. ...
The encouragement of healthy lifestyles for obesity prevention in young people is a public health priority. The European Youth Tackling Obesity (EYTO) project is a multicentric intervention project with participation from the United Kingdom, Portugal, the Czech Republic and Spain. The general aim of the EYTO project is to improve lifestyles, including nutritional habits and physical activity practice, and to prevent obesity in socioeconomically disadvantaged and vulnerable adolescents. The EYTO project works through a peer-led social marketing intervention that is designed and implemented by the adolescents of each participating country. Each country involved in the project acts independently. This paper describes the "Som la Pera" intervention Spanish study that is part of the EYTO project.
In Spain, the research team performed a cluster randomised controlled intervention over 2 academic years (2013-2015) in which 2 high-schools were designated as the control group and 2 high-schools were designated as the intervention group, with a minimum of 121 schoolchildren per group. From the intervention group, 5 adolescents with leadership characteristics, called "Adolescent Challenge Creators" (ACCs), were recruited. These 5 ACCs received an initial 4 h training session about social marketing principles and healthy lifestyle theory, followed by 24 sessions (1.30 h/session) divided in two academic years to design and implement activities presented as challenges to encourage healthy lifestyles among their peers, the approximately 180-200 high-school students in the intervention group. During the design of the intervention, it was essential that the ACCs used the 8 social marketing criteria (customer orientation, behaviour, theory, insight, exchange, competition, segmentation and methods mix). The expected primary outcomes from the Spanish intervention will be as follows: increases in the consumption of fruits and vegetables and physical activity practice along with reductions in TV/computer/game console use. The secondary outcomes will be as follows: increased breakfast consumption, engagement with local recreation and reduced obesity prevalence. The outcomes will be measured by the Health Behaviour in School-aged Children Study (HBSC) survey at baseline and at the end of the intervention. In the control group, no intervention was implemented, but the outcome measurements were collected in parallel with the intervention group.
This study described a new methodology to improve lifestyles and to address adolescent obesity.
ClinicalTrials.gov: NCT02157402 . Registered 03 June 2014.
... Non-communicable diseases have been among the leading causes of death since the end of the 1990s[2]. Child obesity perpetuated into adolescence and adult ages leads to a serious condition associated to changes in food culture and transformations of a social nature such as physical activity giving way to sedentarism[3]. Many countries in the Americas, have seen a rise in the prevalence of overweight and obesity[4]for several years[5]. Unfortunately there is no more information available to be related nor compared in the same scheme. ...
The lack of population-level data on growth and development of children and adolescents in Ecuador, and the existence of previous data suggesting an alarming increase in the numbers of children presenting overweight or obesity justifies the present cohort study which includes all pupils of municipal schools of Quito aged 9 to 17 years. Follow-up will continue for a minimum of 7 years. This will allow determining the evolution of prevalence of these phenomena and their trends as well as other indices, both physiological and family-related customs, in order to plan appropriate preventive interventions. The present cross-sectional study includes 21 municipal schools, grouped into four health zones, each of which depends on a health centre, also municipal, and which are responsible for the health of pupils in these schools. Of the 6964 pupils studied, 18.7% suffer overweight and 7.9% obesity: 19.3% and 9.7% respectively in boys, compared to 18.2% and 5.4% in girls. The study also assesses family characteristics, degree of sedentarism and nutritional habits: 62.3% declared living in a nuclear family, and 60.5% declared their families to be in the “adolescent” life-cycle stage; 91.9% of pupils were sedentary while 5.4% (CI95% 4.87 - 5.94) reported not eating breakfast every day.
... Until recently, childhood and adolescent overweight and obesity were mostly associated with affluence [1,2] and the developed world [3][4][5]. These conditions have however significantly increased in low and middle income countries (LMICs) over time [6][7][8]. ...
Background
The burden caused by the coexistence of obesity and underweight in Low and Middle Income Countries is a challenge to public health. While prevalence of underweight among youth has been well documented in these countries, overweight, obesity and their associated risk factors are not well understood unlike in high income countries.
Methods
Cross-sectional data from the Global School-based Student Health Survey (GSHS) conducted in seven African countries were used for this study. The survey used a clustered design to obtain a representative sample (n = 23496) from randomly selected schools. 53.6% of the sample was male, and participants ranged in age from 11-17 years old. Body Mass Index (BMI) was calculated using age and sex adjusted self-reported heights and weights. Classification of weight status was based on the 2007 World Health Organization growth charts (BMI-for-age and sex). Multivariable Logistic Regression reporting Odds Ratios was used to assess potential risk factors on BMI, adjusting for age, sex, and country. Statistical analyses were performed with Stata with an alpha of 0.05 and reporting 95% confidence intervals.
Results
Unadjusted rates of being underweight varied from 12.6% (Egypt) to 31.9% (Djibouti), while being overweight ranged from 8.7% (Ghana) to 31.4% (Egypt). Obesity rates ranged from 0.6% (Benin) to 9.3% (Egypt). Females had a higher overweight prevalence for every age group in five of the countries, exceptions being Egypt and Malawi. Overall, being overweight was more prevalent among younger (≤12) adolescents and decreased with age. Males had a higher prevalence of being underweight than females for every country. There was a tendency for the prevalence of being underweight to increase starting in the early teens and decrease between ages 15 and 16. Most of the potential risk factors captured by the GSHS were not significantly associated with weight status.
Conclusions
The prevalence of both overweight and underweight was relatively high, demonstrating the existence of the double burden of malnutrition among adolescents in developing countries. Several factors were not associated with weight status suggesting the need to explore other potential risk factors for overweight and underweight, including genetic factors and socioeconomic status.
... I n recent decades, the prevalence of overweight and obesity among children has risen dramatically in the Western world, now reaching crisis proportions. 1 Obesity is associated with health problems in childhood and is a significant early risk factor for adult morbidity and mortality. It also affects self-esteem and influences social and cognitive development. ...
Childhood overweight and obesity have increased in recent decades, reaching alarming proportions. Children with a migrant background seem to be particularly at risk of developing overweight and obesity. This article provides an overview of the prevalence of overweight or obesity among North African (NA) children living in their own countries or as immigrants in Europe. The aim is to show the effect of the migration process on this trend and to discuss its possible contributing factors. Publications were identified by a systematic search of PubMed and the existing literature. Original longitudinal or cross-sectional studies on the prevalence of childhood and adolescent overweight and obesity and of physical activity among ethnic groups from North Africa compared with the native population were reviewed. The results confirmed that children of NA origin in Europe have higher levels of overweight and obesity than the native ones, especially girls. However, this trend can also be detected in urban areas of NA countries. Important factors contributing to the increase of overweight and obesity among children and adolescents are discussed, in particular the westernization of eating habits, the level of physical activity and body image perception. The review shows that factors linked to acculturation in the host society and others maintained from the country of origin come into play in determining childhood overweight and obesity among NA immigrants in Europe. The importance of health promotion targeting the groups most at risk of childhood overweight and obesity, i.e. aspects of a healthy diet and the benefits of physical activity, is underlined.
... Dynamic physical activities, but not static tasks or sedentary lifestyles, lead to a marked increase of regional cerebral blood flow [34][35][36][37]. Lack of physical activity, especially among children, is a major cause for obesity and the early onset of many diseases and consecutive aggravation in adult life, e.g., cardiovascular or metabolic [31,38]. However, there is substantial evidence mounting up that suggests exercise not only to be highly recommendable for keeping and enhancing physical health, but also to improve academic and mental performance, i.e., 'running makes smart' [31][32][33]39]. ...
Stress can facilitate disease processes and causes strain on the health care budgets. It is responsible or involved in many human ailments of our time, such as cardiovascular illnesses, particularly related to the psychosocial stressors of daily life, including work. Besides pharmacological or clinical medical treatment options, behavioral stress reduction is much-needed. These latter approaches rely on an endogenous healing potential via life-style modification. Hence, research has suggested different ways and approaches to self-treat stress or buffer against stressors and their impacts. These self-care-centred approaches are sometimes referred to as mind-body medicine or multi-factorial stress management strategies. They consist of various cognitive behavioral techniques, as well as relaxation exercises and nutritional counselling. However, a critical and consistent element of modern effective stress reduction strategies are exercise practices. With regard to underlying neurobiological mechanisms of stress relief, reward and motivation circuitries that are imbedded in the limbic regions of the brain are responsible for the autoregulatory and endogenous processing of stress. Exercise techniques clearly have an impact upon these systems. Thereby, physical activities have a potential to increase mood, i.e., decrease psychological distress by pleasure induction. For doing so, neurobiological signalling molecules such as endogenous morphine and coupled nitric oxide pathways get activated and finely tuned. Evolutionarily, the various activities and autoregulatory pathways are linked together, which can also be demonstrated by the fact that dopamine is endogenously converted into morphine which itself leads to enhanced nitric oxide release by activation of constitutive nitric oxide synthase enzymes. These molecules and mechanisms are clearly stress-reducing.
... Yet, focusing intervention efforts on caregiver acts of commission or omission alone may overlook the complex interrelationship of factors that are theorized to induce obesity and, in turn, must be considered in efforts to prevent and/or treat it (see Ben-Sefer, Ben-Natan, & Ehrenfeld, 2009, for a review). Our review of these multiple and interactive factors is not meant to be original or exhaustive; rather, we briefly sum- marize and present information reviewed elsewhere. ...
Given the lasting effects on adolescent and adult health, childhood obesity is a major public health issue. The relatively slow progress toward the prevention and treatment of childhood obesity, however, has prompted leaders in both academic and practice sectors to advocate for what may be considered a radical intervention approach, to conceptualize extreme child obesity as an issue of child maltreatment. Advocates of this approach suggest that this conceptualization affords a new angle for intervention-the involvement of child protective services (CPS) in mandating family-focused lifestyle changes aimed at reducing child overweight and, in the most extreme cases, the removal of the obese child from the home. However, surprisingly little research has been conducted to inform policies or practices consistent with this recommendation, which is already being implemented in some states. This article aims to provide an overview of the challenges to the prevention and treatment of childhood obesity that have motivated the call for CPS involvement in extreme cases and to review the existing research related to this approach. Given that relatively little data are currently available to support or refute the merits of CPS involvement, recommendations for future research that would better inform public policy and decision making regarding this and other intervention strategies are also highlighted.
... Every dynamic physical activity, but not static tasks or sedentary lifestyles, leads to a marked increase of regional cerebral blood flow [Herholz et al. 1987; Hollmann & Strueder, 1996; Hollmann & Strueder, 2000a; Hollmann & Strueder, 2000b]. Lack of physical activity, especially among children, is a major cause of obesity and the early onset, and consecutive aggravation in adult life, of many diseases, e.g., cardiovascular or metabolic [Ben-Sefer, 2009; Hillmann et al. 2008]. However, there is substantial evidence mounting up that suggests exercise not only to be highly recommendable for keeping and enhancing physical health, but also to improve academic and mental performance – 'running makes smart' [Hillmann et al. 2008; Stroth et al. 2009; van Praag et al. 2005; Voelcker-Rehage et al. 2006]. ...
Stress is natural and belongs to life itself. To sustain it and even grow with it biology invented different mechanisms, since stress resistance is obligatory. These pathways, we surmise, can be activated and learned intentionally, through professional stress management training or 'mind-body medicine', or endogenously and automatically through autoregulation. Since the primary goal of various stress-reducing approaches is corresponding, we expect to find an overlapping physiology and neurobiological principle of stress reduction. These common pathways, as we speculate, involve some of the very same signalling molecules and structures.
METHODS:
Concepts of stress and stress management are described and then associated with underlying molecular and neurobiological pathways. Evidence is gathered from different sources to substantiate the hypothesis of an overlapping neurobiological principle in stress autoregulation.
RESULTS:
Stress describes the capacity and mechanisms to sustain and adjust to externally or internally challenging situations. Therefore, organisms can rely on the endogenous ability to self-regulate stress and stressors, i.e., autoregulatory stress management. Stress management usually consists of one to all of the following instruments and activities: behavioral or cognitive, exercise, relaxation and nutritional or food interventions (BERN), including social support and spirituality. These columns can be analyzed for their underlying neurobiological and autoregulatory pathways, thereby revealing a close connection to the brain's pleasure, reward and motivation circuits that are particularly bound to limbic structures and to endogenous dopamine, morphine, and nitric oxide (NO) signalling. Within this work, we demonstrate the existence of opioid, opiate, dopamine and related pathways for each of the selected stress management columns.
DISCUSSION:
Stress management techniques may possess specific and distinct physiological effects. However, beneficial behaviors and strategies to overcome stress are, as a more general principle, neurobiologically rewarded by pleasure induction, yet positively and physiologically amplified and reinforced, and this seems to work via dopamine, endorphin and morphine release, apart from other messenger molecules. These latter effects are unspecific, however, down-regulatory and clearly stress-reducing by their nature.
CONCLUSIONS:
There seems to exist a common neurobiological mechanism, i.e., limbic autoregulation, that involves dopamine, morphine and other endogenous signalling molecules, e.g., other opioid receptor agonists, endocannabinoids, oxytocin or serotonin, many of which act via NO release, and this share seems to be of critical importance for the self-regulation and management of stress: stress management is an endogenous potential.
... Dynamic physical activities, but not static tasks or sedentary lifestyles, lead to a marked increase of regional cerebral blood flow [34][35][36][37]. Lack of physical activity, especially among children, is a major cause for obesity and the early onset of many diseases and consecutive aggravation in adult life, e.g., cardiovascular or metabolic [31,38]. However, there is substantial evidence mounting up that suggests exercise not only to be highly recommendable for keeping and enhancing physical health, but also to improve academic and mental performance, i.e., 'running makes smart' [31][32][33]39]. ...
A b s t r a c t
Stress can facilitate disease processes and causes strain on the health care budgets. It is responsible or involved in many human ailments of our time, such as cardiovascular illnesses, particularly related to the psychosocial stressors of daily life, including work. Besides pharmacological or clinical medical treatment options, behavioral stress reduction is much-needed. These latter approaches rely on an endogenous healing potential via life-style modification. Hence, research has suggested different ways and approaches to self-treat stress or buffer against stressors and their impacts. These self-care-centred approachesare sometimes referred to as mind-body medicine or multi-factorial stressmanagement strategies. They consist of various cognitive behavioral techniques,as well as relaxation exercises and nutritional counselling. However, a critical
and consistent element of modern effective stress reduction strategies are exercise practices. With regard to underlying neurobiological mechanisms ofstress relief, reward and motivation circuitries that are imbedded in the limbicregions of the brain are responsible for the autoregulatory and endogenousprocessing of stress. Exercise techniques clearly have an impact upon thesesystems. Thereby, physical activities have a potential to increase mood, i.e.,decrease psychological distress by pleasure induction. For doing so,neurobiological signalling molecules such as endogenous morphine and coupled nitric oxide pathways get activated and finely tuned. Evolutionarily, the various activities and autoregulatory pathways are linked together, which can also be demonstrated by the fact that dopamine is endogenously converted into morphine which itself leads to enhanced nitric oxide release by activation of constitutive nitric oxide synthase enzymes. These molecules and mechanisms are clearly stress-reducing.
Key words: nitric oxide, morphine, dopamine, pleasure, motivation, neurobiology, autoregulation, health, running, mind-body medicine.
The objective of this paper is to study the trend and pattern of advertising content for child health drinks in India. A detailed analysis of the advertisement content of 5 child health drink brands for 6 years has been undertaken in this study. The majority of the brand's core focus area was growth. The most highlighted nutrient among the brand was protein. Maximum brands have highlighted more than one nutrient in their advertisements. Most of the brands have displayed scientific information and 100% of the brands have shown health benefits in their ads. The celebrity or HCP was present in most of the brand’s advertisements. Regarding location, it was found that in the majority of the brand's advertisements there was a combination of location i.e., home, leisure & shop. All the brands have used rational and emotional appeals in their advertisements. In the majority of the brands' advertisements, the lead voice was female. In child-parent interaction, most of the brands have shown the mother in the parents’ position. However, in the advertisement content, there was no verbal mention of a balanced diet, RDA, and calories which are very important from a child’s health point of view. As there are several studies that suggest the rise in childhood obesity and the association of television advertisements with it. The policymakers also need to closely look into the advertising content and act for the benefit of the child’s health.
Capillary liver hemangioma is a frequent finding during routine ultrasound examination, while hemangioma
with focal cirrhosis, in a form of isolated liver tumor is rather rare. The finding of pedunculated liver tumor morphologically
defined as a combination of cirrhotic liver tissue surrounding capillary hemangioma, is a unique case in our clinical
practice.
A case of 44-years-old female patient, with left liver lobe tumor incidentally found by ultrasound, is presented.
The unexpected microscopic finding of cirrhotic tissue in the tumor specimen obtained with fine needle biopsy under
ultrasound control, was confirmed by second biopsy. Because etiological, clinical and biochemical findings supporting
the diagnosis of cirrhosis were absent, another fine needle biopsy of the right liver lobe was performed, revealing a
normal liver histology. Since contrast enhanced Computed Tomography (CT) confirmed the presence of pendulous
tumor, the patient underwent abdominal surgery and tumor resection. Histological analysis of surgical specimen
revealed the presence of capillary hemangioma surrounded by cirrhotic liver tissue.
The presence of liver tumors can be easily detected by “imaging methods” such as ultrasound and contrast�enhanced CT, but only biopsy specimen can determine the real nature of the lesion. Microscopic finding obtained from
operative specimen compared to histological finding of specimen obtained by percutaneous fine needle biopsy is
superior in determining the diagnosis of focal liver lesions.
Key words: liver tumor, focal cirrhosis, FNH, capillary hemangioma, histology
Purpose:
This study aimed at gaining insight into parents' perceptions towards health behaviour in parenting and the impact of the school environment. Healthcare professionals experience barriers to discuss health behaviour in families where levels of overweight and obesity are elevated. There is a need to understand parents' perception and perceived significance of health behaviour.
Design and methods:
Sixty-three semi-structured interviews were conducted with parents of children from three primary schools located in two different neighbourhoods in Zwolle, the Netherlands. Parents were asked to formulate their top three priority goals in parenting, additionally supplemented with 15 predetermined goals, including a health behaviour related goal. Parents ranked the goals in order of importance and gave an explanation. Finally, parents shared their opinions regarding the school environment in promoting health behaviour, according to the EnrG framework.
Results:
In 8 out of 63 interviews, health was reported in the top three self-formulated goals. Other goals considered important were happiness and being respectful to others. When health was ranked as less important in parenting, routine of health behaviour, own beliefs and religion were given as explanations. The physical school environment and teachers were mentioned as important factors in promoting health behaviour.
Conclusions:
Parents indicate health behaviour as a key-element in parenting, even when health behaviour is not considered as the most important priority.
Practice implications:
Since school is perceived as a logical and powerful environment, healthcare professionals should collaborate with school staff to empower their own, teachers' and parents' roles to address health promotion.
Background:
Circulating microRNAs (miRNAs) as valuable biomarkers yielded important insights into the pathogenesis of obesity.
Aim:
This study aimed to describe the circulating miRNA profile for adolescences and its association with the circulating levels leptin and adiponectin according to specific degree of obesity.
Methods:
RT-PCR and immunoassy analysis were used to study circulating miRNA profile, adipokines; adiponectin (A), leptin (L), and L/A ratio as well as other factors of metabolic syndrome (MS) in 250 adolescents with severe obesity.
Results:
In morbidly obese adolescents, we identified at least 10 circulating miRNAs, including increased concentrations of miRNAS; miR-142-3p, miR-140-5p, miR-222 miR-143, miR-130, and decreased concentrations of miR-532-5p, miR-423-5p, miR-520c-3p, miR-146a, and miR-15a, which were strongly linked to measures of BMI, WHtR, adipokines; adiponectin, leptin, L/A ratio, and other MS related biomarkers such as FBS, insulin, HOMA-IR, C-peptide, and circulated plasma lipids such as TG, HDL-C, and LDL-C.
Conclusion:
Circulating miRNAs showed significant association with plasma levels of adipokines; adiponectin, leptin, and L/A ratios in adolescents with severe obesity. The study provides that regulation of miRNAs expression is associated with adipokines, and other related MS metabolic factors. Thus, early detection of any changes in circulating miRNAs profiles may play a promising role in identifying obese children or adolescents who may suffer from severe metabolic syndrome.
Introduction: Major causes of depression and metabolic syndrome share overlapping psychosocial and patho-physiological etiologies. Recent studies focused on the role of adiponectin for development of metabolic syndrome (MS) and depression. An association between MS and depression has also been observed by many researchers. Therefore it is interesting to reveal the association between these two disorders and the level of adiponectin.
Objective: To review the association between adiponectin, metabolic syndrome and depression from the reported research outcome.
Method: By searching indexed journals for research papers and reviews as well as authentic websites.
Results: Several studies identify the mechanism underlying the link between adiponectin, one of the platinum biomarkers of metabolic syndrome, and depression. Some studies have been conducted to examine the status of these biomarkers in patients with depression, but the results are intriguing.
Conclusion and recommendation: This paper reviews the association between adiponectin, depression and MS. From the available reports it may be concluded that there is a strong possibility of adiponectin deregulation in MS associated depression which has become one of the most emerging areas of research.
Ensuring optimal health for school children is a fundamental concern shared by families, teachers and the wider community. Medical practitioners, allied health professionals, educators and policymakers regularly collaborate in the first stage of attaining this goal-in the early detection of childhood diseases and disorders through school health screenings. The value of this inter-professional practice is well recognized on a global scale, with school health screenings having a long history in all industrialized countries. Each year, millions of school children are screened for a wide variety of potential disorders, and many children are treated for disorders that might otherwise have gone undetected. This book is an important new text that examines elementary school screening programs from a number of perspectives. The history of school screenings and the ethical principles surrounding them are outlined, in addition to the methods by which screening program performance can be gauged. The common health disorders associated with young school children are comprehensively reviewed. Detailed chapters, written by international experts, are dedicated to specific school screening programs currently in place in developed nations, with each chapter signposting future directions for the field. For example, the chapters on school hearing screenings, dental health screenings and speech pathologist screening assessments provide in-depth descriptions of the individual screening programs, screening tests, result interpretation, personnel and equipment requirements and directions for system improvements. Topical issues that are currently of concern for all school health professionals-optimal communication of screening test results to families and the need for integrated, non-discipline specific, data systems-are discussed in the final section of this book. For those working in the area of elementary school health screening, this book provides comprehensive information on school-based screening programs in a single up-to-date volume. This book will enable education and health professionals to better understand the whole school screening process and the role of other professionals in this highly worthwhile process.
Background:
Mexico is a developing country with one of the highest youth obesity rates worldwide; >34% of children and adolescents between 5 and 19 years of age are overweight or obese.
Objectives:
The current review seeks to compile, describe, and analyze dietary conditions, physical activity, socioeconomic status, and cultural factors that create and exacerbate an obesogenic environment among Mexican youth.
Design:
A narrative review was performed using PubMed and the Cochrane Library databases, as well as grey literature data from the Mexican government, academics, and statistical reports from nongovernmental organizations, included in electronic formats.
Results:
The recent socioeconomic and nutritional transition has resulted in reduced healthy meal options at public schools, high rates of sedentary lifestyles among adolescents, lack of open spaces and playgrounds, socioeconomic deprivation, false or misunderstood sociocultural traditional beliefs, misconceptions about health, a high percentage of overweight or obese adults, and low rates of maternal breastfeeding. Some of the factors identified are exacerbating the obesity problem in this population. Current evidence also shows that more policies and health programs are needed for prevention of childhood and adolescent obesity. Mexico presents alarming obesity levels, which need to be curtailed and urgently reversed.
Conclusions:
The present narrative review presents an overview of dietary, physical activity, societal and cultural preconceptions that are potentially modifiable obesity-promoting factors in Mexican youth. Measures to control these factors need to be implemented in all similar developing countries by governments, policy makers, stakeholders, and health care professionals to tackle obesity in children and young people.
Excess bodyweight is the sixth most important risk factor contributing to the overall burden of disease worldwide; 1.1 billion adults and 10% of children are now classified as overweight or obese. Average life expectancy is already diminished; the main adverse consequences are cardiovascular disease, type 2 diabetes, and several cancers. Obesity is a leading preventable cause of death worldwide, with increasing rates in adults and children. Are there any descriptions of obese characters in the Bible? Who were the characters afflicted?
The biblical texts were examined and characters who were afflicted by obesity were studied closely. This study also examines the historical, cultural and social aspects of obesity, its prevalence of obesity, military and childhood obesity, health effects, mortality, obesity and falling, risk factors for fall, sarcopenic obesity, bone fractures, and the approach towards obesity.
The purpose of this study was to develop an understanding of the leisure experiences of children who are overweight and obese aged between 6 and 12 years. Guided by a social–ecological framework, interviews were conducted with 15 parents with children who were overweight or obese. Leisure education sessions with parent–child pairs followed and case notes from these sessions also formed the data set. Findings indicated children’s physical activity skill levels and abilities, being victimized in recreation and sport settings and having developed of mastery and competence with sedentary pursuits influenced children’s leisure experiences and behaviours. The opportunities available in children’s communities, parents’ ability and willingness to be coparticipants and care providers’ efforts to support active leisure also influenced children’s experiences. The findings highlight the importance of safe environments and helping children develop and improve physically active leisure skills and set the stage for positive first experiences with activities.
For over a century school health services have provided children with an important safety net-identifying those with disorders that may not be readily apparent to parents or teachers, or to the children themselves. These services became more sophisticated over time, with formal screening of targeted age groups of school children for specific disorders replacing the general medical checks of earlier years. Screening tests now are standard procedures in all school health services and tests cover a wide range of disorders. Growth and development, hearing and vision, speech and language, and dental problems are some of the many health issues handled by school health screening systems. Health screening has developed ethical principles that apply to school-based testing and that aid the qualitative evaluation of screening programs. The history of school health screening and the principles that guide school health screening systems are outlined in this chapter. In addition, procedures can be rigorously evaluated using quantitative methodologies that are often specific to the practice of screening. This chapter details these methods and includes examples of screening programs that have been appraised using quantitative techniques. School screening systems have a valued place within both the health care and education sectors. Systems that are constantly reflected upon and critically evaluated will continue to serve our children well, far into the future.
Obesity is strongly associated with the prevalence of nonalcoholic fatty liver disease (NAFLD) in adult and pediatric populations. Nutrition, physical activity, and behavioral modifications are critical components of the treatment regimen for all obese patients with NAFLD. Bariatric surgeries that affect or restrict the flow of food through the gastrointestinal tract may improve liver histology in morbidly obese patients with nonalcoholic steatohepatitis (NASH), although randomized clinical trials and quasi-randomized clinical studies are lacking. Early detection of NASH and hepatic fibrosis using noninvasive biochemical and imaging markers that may replace liver biopsy is the current challenge.
Overweight and obesity affects approximately 20% of Australian pre-schoolers. The general practice nurse (PN) workforce has increased in recent years; however, little is known of PN capacity and potential to provide routine advice for the prevention of child obesity. This mixed methods pilot study aims to explore the current practices, attitudes, confidence and training needs of Australian PNs surrounding child obesity prevention in the general practice setting.
PNs from three Divisions of General Practice in New South Wales were invited to complete a questionnaire investigating PN roles, attitudes and practices in preventive care with a focus on child obesity. A total of 59 questionnaires were returned (response rate 22%). Semi-structured qualitative interviews were also conducted with a subsample of PNs (n = 10).
Questionnaire respondent demographics were similar to that of national PN data. PNs described preventive work as enjoyable despite some perceived barriers including lack of confidence. Number of years working in general practice did not appear to strongly influence nurses' perceived barriers. Seventy per cent of PNs were interested in being more involved in conducting child health checks in practice, and 85% expressed an interest in taking part in child obesity prevention training.
Findings from this pilot study suggest that PNs are interested in prevention of child obesity despite barriers to practice and low confidence levels. More research is needed to determine the effect of training on PN confidence and behaviours in providing routine healthy life-style messages for the prevention of child obesity.
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