Improvement of body composition in 8- to 11-year-old schoolboys: effects of a 6-months lifestyle intervention A retrospective evaluation of the “EDDY-Kids” prevention study

The Coronavirus disease (COVID-19) pandemic has brought about drastic measures that have significantly altered the norms of daily living. These measures have affected human behaviors in disparate ways. This study seeks to understand the impact of the pandemic on physical activity and dietary behavior among adults living in Kuwait. A cross-sectional survey was conducted between 18 June and 15 July 2020, using a questionnaire disseminated through social media, including WhatsApp and Facebook. The target population was individuals aged 21 years or older living in the State of Kuwait. The study included 679 respondents; 57.9% were females, and 67.7% were Kuwaiti nationals. Both genders reported an increased consumption of vegetables, fruits, and carbohydrates, and a decreased consumption of fish and sugary drinks. Compared to males, females reported eating more during the outbreak than their pre-pandemic eating behaviors (32.3% vs. 35.9%, p < 0.05). Approximately one-third of respondents (33.1%) reported performing less than 30 min of physical activity or exercise in a week, and 36.4% of respondents rated their quality of sleep as ‘poor’ or ‘very poor’. The rate of smoking cigarettes among males was significantly higher than in females (40.6% vs. 5.3%, p < 0.001). Physical activity was positively correlated with vegetable consumption and quality of sleep. Quality of sleep was negatively correlated with the consumption of sweets and snacks, just as the consumption of vegetables was negatively correlated with the consumption of sugary drinks. The overall negative impact of the COVID-19 pandemic in Kuwait necessitates the development of health promotion interventions to support positive physical activity and dietary behaviors using alternative coping strategies among the residents of Kuwait.

Aging, in conjunction with decreasing physical activity, is associated with a range of health problems. Simple, low-maintenance, population-based means of promoting activity to counteract the age-associated decline are required. We therefore assessed the effect of pedometry and buddy support to increase physical activity. We undertook a clustered randomized trial (HKCTR-346) of 24 community centers involving 399 older Chinese participants (≥ 60 yr). Centers were randomly allocated to 1) pedometry and buddy, 2) pedometry and no buddy, 3) no pedometry and buddy, and 4) no pedometry and no buddy with a 2 × 2 factorial design. The trial simultaneously tested the individual and combined effects of the interventions. The intervention groups also received monthly organized group activities to provide encouragement and support. Outcome measures were assessed at 6 and 12 months, including physical fitness and activity and cardiovascular disease risk factors (anthropometry and blood pressure). From the 24 centers, 356 volunteers (89.2%) completed the study. Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 (95% confidence interval (CI) = 1360-2290) and 1260 (95% CI = 780-1740) MET·min·wk(-1), respectively relative to the decrease in the control groups. The buddy peer support intervention significantly improved mean aerobic fitness (12% [95% CI = 4%-21%]) and reduced both body fat (-0.6% [95% CI = -1.1% to 0.0%]) and time to complete the 2.5-m get-up-and-go test (-0.27 [95% CI = -0.53 to -0.01] s). No other improvements in the cardiovascular disease risk factors were observed. The combination of motivational tools was no better than the individual interventions. Both motivational interventions increased physical activity levels, and the buddy style improved fitness. These tools could be useful adjuncts in the prevention of obesity and age-related complications.

Effect of healthy and unhealthy habits on obesity: a multicentric study.

BackgroundLittle is known about how adolescents and their parents interact and talk about some of the key lifestyle behaviors that are associated with overweight and obesity, such as screen time (ST) and sugary drink (SD) consumption. This qualitative study aimed to explore adolescents' and parents' perceptions, attitudes, and interactions in regards to these topics.MethodsUsing an exploratory approach, semi-structured focus groups were conducted separately with adolescents and (unrelated) parents. Participants were recruited from low and middle socio-economic areas in the Sydney metropolitan area and a regional area of New South Wales, Australia. Transcripts were analysed using thematic analysis for each of the four content areas (adolescent-ST, adolescent-SD consumption, parents' views on adolescents' ST and parents' views on adolescents' SD consumption).ResultsNine focus groups, with a total of 63 participants, were conducted. Broad themes spanned all groups: patterns of behavior; attitudes and concerns; adolescent-parent interactions; strategies for behavior change; and awareness of ST guidelines. While parents and adolescents described similar patterns of behaviour in relation to adolescents' SD consumption and ST, there were marked differences in their attitudes to these two behaviours which were also evident in the adolescent-parent interactions in the home that they described. Parents felt able to limit adolescents' access to SDs, but felt unable to control their adolescents' screen time.ConclusionThis study offers unique insights regarding topics rarely explored with parents or adolescents, yet which are part of everyday family life, are known to be linked to risk of weight gain, and are potentially amenable to change.

Background The objective was to assess the associations between the consumption of sugary drinks (sugar sweetened beverages and 100% fruit juices), artificially sweetened beverages and cancer risk. Methods Overall, 101,257 participants aged ≥18y (mean age: 42.2) from the French NutriNet-Santé cohort (2009-2017) were included. Consumptions of sugary drinks and artificially sweetened beverages were assessed using repeated 24h-dietary records, designed to register participants’ usual consumption for 3,300 different food and beverage items. Associations between beverage consumption and the risk of overall, breast, prostate and colorectal cancer were assessed by multi-adjusted Fine&amp;Gray Hazard models, accounting for competing risks. Results The consumption of sugary drinks was significantly associated with overall cancer risk (n = 2,193 cases, sHRfor a 100mL/d increase=1.18, 95% confidence interval 1.10 to 1.27, P&amp;lt;.0001) and breast cancer risk (n = 693 cases, sHRfor a 100mL/d increase=1.22, 95% confidence interval 1.07 to 1.39, P = 0.004). The consumption of artificially sweetened beverages was not associated with cancer risk. In specific sub-analyses, the consumption of 100% fruit juice was significantly associated with overall cancer risk (n = 2,193 cases, sHRfor a 100mL/d increase =1.12, 95% confidence interval 1.03 to 1.23, P = 0.007). Conclusions In this large prospective study, the consumption of sugary drinks was positively associated with overall and breast cancer risks. Of note, 100% fruit juices were also positively associated with overall cancer risk. These results need replication in other large-scale prospective studies. They suggest that sugary drinks, which are massively consumed in Western countries, may potentially represent a modifiable risk factor for cancer prevention. Key messages In this large prospective study (n = 101,257), the consumption of sugary drinks (including 100% fruit juice) was associated with an increase in overall and breast cancer risk. In specific sub-analyses, 100% fruit juices were also associated with an increased risk of overall cancers. The consumption of artificially sweetened beverages was not associated with cancer risk.

To assess the effectiveness of the 'Weet wat je eet' ('Know what you eat') school-based nutrition education programme on behavioural determinants and behaviour among students aged 12-15 years. A quasi-experimental study design was used, collecting data at baseline and after implementing the programme in both an intervention and control group (in total 611 students) across the Netherlands. Students from eighteen Dutch secondary education schools completed two consecutive questionnaires, assessing knowledge, self-efficacy, attitude, subjective norm, intention, and behaviours related to healthy, safe, and sustainable nutrition. Multilevel regression analyses were conducted corrected for gender, grade, education level, and school location. The intervention group showed a significant higher increase in self-efficacy, attitude, intention to drink water (all three P < 0.01), and a significant higher decrease in the consumption of sugary drinks, snacks, and meat (all P < 0.05) than the control group. Both the groups scored significantly higher on knowledge during the post-test (both P < 0.05), although the intervention group not significantly higher than the control group (P = 0.14). No significant effects were observed for subjective norm, intention, and fruit, vegetable, and whole grain bread consumption. The results of this study showed positive effects of the 'Weet wat je eet' school-based nutrition education programme on self-efficacy and attitude towards healthy, safe and sustainable nutrition, intention to drink more water, and various healthy eating behaviours among secondary school students. Further research is necessary to assess the long-term sustainability of these results.

Physical activity in the prevention and treatment of obesity and its comorbidities: evidence report of independent panel to assess the role of physical activity in the treatment of obesity and its comorbidities.

When attempts to lose body fat mass frequently fail, breath acetone (BA) monitoring may assist fat mass loss during a low-carbohydrate diet as it can provide real-time body fat oxidation levels. This randomized controlled study aimed to evaluate the effectiveness of monitoring BA levels and providing feedback on fat oxidation during a three-week low-carbohydrate diet intervention. Forty-seven participants (mean age = 27.8 ± 4.4 years, 53.3% females, body mass index = 24.1 ± 3.4 kg m−2) were randomly assigned to three groups (1:1:1 ratio): daily BA assessment with a low-carbohydrate diet, body weight assessment (body scale (BS)) with a low-carbohydrate diet, and low-carbohydrate diet only. Primary outcome was the change in fat mass and secondary outcomes were the changes in body weight and body composition. Forty-five participants completed the study (compliance rate: 95.7%). Fat mass was significantly reduced in all three groups (all P < 0.05); however, the greatest reduction in fat mass was observed in the BA group compared to the BS (differences in changes in fat mass, −1.1 kg; 95% confidence interval: −2.3, −0.2; P = 0.040) and control (differences in changes in fat mass, −1.3 kg; 95% confidence interval: −2.1, −0.4; P = 0.013) groups. The BA group showed significantly greater reductions in body weight and visceral fat mass than the BS and control groups (all P < 0.05). In addition, the percent body fat and skeletal muscle mass were significantly reduced in both BA and BS groups (all P < 0.05). However, no significant differences were found in changes in body fat percentage and skeletal muscle mass between the study groups. Monitoring BA levels, which could have motivated participants to adhere more closely to the low-carbohydrate diet, to assess body fat oxidation rates may be an effective intervention for reducing body fat mass (compared to body weight assessment or control conditions). This approach could be beneficial for individuals seeking to manage body fat and prevent obesity.

ABSTRACTOBJECTIVE To evaluate the influence of family habits and household characteristics on the consumption of sugary drinks by Brazilian children under two years old.METHODS This was a cross-sectional study that used secondary data generated by the National Health Survey (PNS) in 2013. We studied 4,839 pairs of children under two years old and adults living in the same house. We estimated the prevalence of the indicator of sugary drinks consumption for the total sample of children and according to family and household variables. We applied multiple logistic regression analysis to evaluate the influence of family habits and household characteristics on the consumption of sugary drinks by the children.RESULTS The consumption of sugary drinks was identified in 32% of the studied children (95%CI 30.6-33.3) and was independently associated with the following family and household characteristics: regular consumption of sugary drinks by the adult living in the house (OR = 1.78; 95%CI 1.51-2.10), watching TV for more than three hours per day (OR = 1.22; 95%CI 1.03-1.45), older age (OR = 3.10; 95%CI 1.54-6.26), greater education level (OR = 0.70; 95%CI 0.53-0.91), house located in the Northeast region (OR = 0.65; 95%CI 1.54-6.26), and number of family members (OR = 1.05; 95%CI 1.00-1.09).CONCLUSIONS Our findings indicate the high prevalence of sugary drinks consumption by Brazilian children under two years old and show that sociodemographic characteristics and family habits affect this feeding practice not recommended in childhood.

ObjectiveTo assess the associations between the consumption of sugary drinks (such as sugar sweetened beverages and 100% fruit juices), artificially sweetened beverages, and the risk of cancer.DesignPopulation based prospective cohort...

Excess sugary drink (SD) consumption is associated with childhood obesity and development of cardiometabolic disease. In addition to having high added sugar content, many SDs also contain caffeine, which may further encourage excess SD consumption among children. The objective of this study was to develop a conceptual framework of children's caffeinated SD consumption using group concept mapping, an applied social research multimethodology that collectively harnesses qualitative and quantitative data from participants to generate a visual representation of their ideas and input. Children, 8–14 years old, who reported consuming ≥12 ounces of caffeinated SDs (e.g., sodas, sweet teas) per day were recruited throughout Washington, D.C. and invited to participate. Concept mapping included three participant-driven activities: (1) brainstorming (n = 51), during which children reported reasons for their SD consumption, from which 58 unique reasons were identified; (2) sorting (n = 70), during which children sorted each of the reported reasons into categories and named each category; and (3) rating (n = 74), during which children rated the influence of each reason on their own caffeinated SD consumption. Similarity matrices, multidimensional scaling, and hierarchical cluster analysis were used to generate concept maps (hereafter “SODA MAPS”), which display the 58 reasons organized within eight overarching clusters. Among these eight clusters, Taste and Feel, Something to Do, and Energy were rated as particularly influential. Children's caffeinated SD consumption is encouraged not only by the palatable taste and reported preferences for these beverages (e.g., Taste and Feel), but also by psychological (e.g., Mood and Focus), biological (e.g., Energy), social (e.g., Something to Do) and environmental reasons (e.g., Nothing Better Available). Thus, the SODA MAPS can inform the development of tailored, multi-level SD reduction interventions that incorporate strategies to address important and currently overlooked reasons for caffeinated SD consumption among children.

Objective To determine the effects of a health management program based on WeChat platform of overweight and obese diabetic high-risk population and to provide the basis for developing a scientific and effective weight loss program. Methods A total of 123 overweight and obese diabetic cases were identified during health examinations and were randomly divided into intervention (n= 62) and control (n= 61) groups. In the control group, traditional health lectures once a week for 3 months were conducted. In the intervention group, based on the control group using a micro-classroom setting to give diet and exercise interventions, diabetes information and intervention programs were uploaded to the WeChat learning platform, arranged at a fixed time with the patient online learning exchange, and with complete follow-up services. Low-energy intake therapy was used for diet intervention program, the daily calorie intake decreased by 15% to 40%; aerobic exercise combined with appropriate strength training were used as part of the exercise intervention program. Both groups were followed up for 1 year, measuring the dietary, exercise compliance, body mass index (BMI), body fat, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and fasting blood glucose (FBG) levels. Blood lipids, blood glucose, and weight loss were analyzed using an independent sample t-test and χ2 test. Results The difference in the educational participation rate between the intervention (81.0%, 583/720) and control (72.9%, (516/708) groups was statistically significant (χ2=13.18, P<0.05). The reasonable proportions of carbohydrate, protein, fat, and salt were 85.0%, 70.0%, 73.0%, and 75.0%, respectively, in the intervention group, which were significantly higher than those in the control group (66.0%, 47.6%, 49.2%, and 52.5%, respectively), The difference was statistically significant (χ2=5.76, 6.24, 7.34, 6.50, all P<0.05). To compare the daily effective exercise time, the intervention group (22.8±2.1) min was significantly longer than the control group (16.2±1.8) min, with a statistically significant difference (t=18.33, P<0.01). The TC, TG, LDL-C, and FBG levels in the intervention group [(4.9±0.4) mmol/L, (1.5±0.2) mmol/L, (2.7±0.3) mmol/L, and (4.9±0.6) mmol/L, respectively] were significantly lower than those in the control group [(5.6±0.4) mmol/L, (2.1±0.2) mmol/L, (3.9±0.3) mmol/L, and (5.8±0.6) mmol/L, respectively]. The BMI in the intervention group (24.3±2.8) kg/m² was significantly lower than that in the control group (27.8±2.9) kg/m². Moreover, the mean level of body fat in the intervention group (19.6±1.9) kg was lower than that in the control group (22.6±2.1) kg, with a statistically significant difference (t=9.54, 15.93, 22.56, 8.54, 6.72, 8.22, all P<0.01). The effective rate of weight loss and fat loss was 65.0% and 60.0% in the intervention group, which were significantly higher than those in the control group (35.6% and 32.2%, respectively), with a statistically significant difference (χ2=10.29, 9.25, all P<0.05). Conclusion The health management program based on a micro-letter platform can improve the participation in the intervention and reasonable diet and exercise compliance and effectively reduce the weight and blood lipid and glucose levels of overweight and obese diabetic patients. Key words: Diabetes; Overweight; Obesity; Health management; WeChat platform

A weight-management camp followed by weekly after-school lifestyle education sessions as an obesity intervention for Qatari children: a prospective cohort study

Dental caries is a multifactorial disease, and a sugary diet can generate an acidic plaque environment that advances its development. However, the specific effect of sugary drinks on the subsequent oral health of schoolchildren with mixed dentition is unclear. In this study, we investigated the association between the consumption of sugary drinks and 1year incidence rate of caries in permanent teeth among Taiwanese schoolchildren with mixed dentition. A longitudinal 1year follow-up study was conducted among Taiwanese schoolchildren aged 8-9years. A questionnaire collected information regarding the parents' oral health status and their children's demographic background, oral health-related behaviours and consumption habits of sugary drinks, including handmade drinks (specifically bubble tea and pearl milk tea) and carbonated drinks. Dental caries was recorded through standardized oral examinations. The number of dental services received was retrieved from the Taiwan National Health Insurance Research Database. Multivariate Cox proportional hazards models and zero-inflated negative binomial models were used to estimate the association between the consumption of sugary drinks and the incidence rate of caries in permanent teeth after 1year. The study involved 494 children. During the 1year follow-up period, 117 children developed new dental caries in their permanent teeth, yielding a caries incidence rate of 0.183 per person-year. After adjustments for confounding factors, children who preferred having sugar-rich beverages were associated with having a 4.3 times higher (95% confidence interval [CI]=1.2-15.7) risk of developing caries than did those who preferred nonsugary drinks (P<.05). Additionally, children who often consumed handmade drinks were associated with having a 1.7 times higher (95% CI=1.1-2.9) risk of developing caries than those who seldom consumed (P<.05). The findings suggest that the consumption of sugary drinks during the mixed dentition stage might be a major etiological factor for caries in permanent teeth. These findings could be valuable to paediatricians, dentists, nutritionists and policymakers.

Objective. The purpose was to study associations between tooth brushing frequency, use of fluoride lozenges and consumption of sugary drinks at 1.5 years of age and having caries experience at 5 years of age. Methods. This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and by the Public Dental Services. A total of 1095 children were followed from pregnancy to the age of 5 years. Questionnaires regarding oral health behavior were completed by the parents at 1.5 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. Results. In multiple logistic regression, having caries experience at 5 years of age was associated with; at 1.5 years of age having the teeth brushed less than twice daily (OR = 2.1, CI = 1.3–3.6) and being offered sugary drinks at least once a week (OR = 1.8, CI = 1.1–2.9) when controlled for family characteristics and oral health behavior at 5 years of age. Conclusions. Tooth brushing frequency and consumption of sugary drinks in early childhood were related to caries development during pre-school age, independent of family characteristics and oral health behavior at 5 years of age. The results indicate that early established habits regarding tooth brushing and consumption of sugary drinks have long-term effects on caries development. Parents encountering difficulties in establishing favorable oral health behavior in children’s first years of life should receive special attention from health personnel.