Determinants Of Childhood Obesity Research Articles

The Biological and Social Determinants of Childhood Obesity: Comparison of 2 Cohorts 50 Years Apart

To determine whether the same relationships between early-life risk factors and socioeconomic status (SES) with childhood body mass index (BMI) are observed in a modern cohort (2000) compared with a historic cohort (1947). The relationships between early-life factors and SES with childhood BMI were examined in 2 prospective birth cohorts from the same region, born 50years apart: 711 children in the 1947 Newcastle Thousand Families Study (NTFS) and 475 from the 2000 Gateshead Millennium Study (GMS). The associations between birth weight, breastfeeding, rapid infancy growth (0-12months), early-life adversity (0-12months), and parental SES (birth and childhood) with childhood BMI z-scores and whether overweight/obese (BMI >91st percentile using UK 1990 reference) aged 9years were examined using linear regression, path analyses, and logistic regression. In the NTFS, the most advantaged children were taller than the least (+0.91 height z-score, P=.001), whereas in GMS they had lower odds of overweight/obese than the least (0.35 [95% CI 0.14-0.86]). Rapid infancy growth was associated with increased BMI z-scores in both cohorts, and with increased likelihood of overweight/obese in GMS. This study suggests that children exposed to socioeconomic disadvantage or who have rapid infancy growth in modern environments are now at lower risk of growth restriction but greater risk of overweight.

26.A. Workshop: Assessing the role of policies and actions to address childhood obesity

Abstract Childhood obesity has grown to become one of the most dramatic features of the global obesity epidemic, with long-term consequences. The spread of obesity has been fueled by changes in social norms and living environments that have shaped individual behaviours making them conducive to excessive and imbalanced nutrition, sedentary lifestyles, and ultimately obesity and associated diseases. The STOP project will aim to generate scientifically sound, novel and policy-relevant evidence on the factors that have contributed to the spread of childhood obesity in European countries and on the effects of alternative technological and organisational solutions and policy options available to address the problem. STOP will translate the evidence gathered and generated into indicators and measurements, policy briefs and toolkits and multi-stakeholder frameworks. A special focus of STOP is understanding the stakeholders' networks and drivers of stakeholders' action. STOP will establish new ways for policy-relevant evidence to be generated, made available and used in the design and implementation of effective and sustainable solutions for childhood obesity at the EU, national and local levels. Each of the policy work packages will: Produce evidence syntheses and impact simulations for different policy approaches;Assess selected policy approaches and actions in children cohorts and other relevant settings;Devise policy toolkits and policy guidance to support the adoption and implementation of specific actions by relevant actors;Establish a country-based European accountability and monitoring framework in each policy area. The workshop aims to: Showcase the impact of different policy options evaluated throughout the STOP project;Increase participants' understanding and awareness of the opportunities and challenges associated with the implementation of selected policies;Increase awareness of public health professionals of the importance of overcoming siloes in identifying and implementing public health policies;Increase the understanding of multi-stakeholder engagement. The discussion will explore the role of stakeholders across different policy areas. We will explore the different definitions of “stakeholders” and “multi-stakeholders” engagement. This will also be an opportunity to explore some of the benefits, risks and challenges around stakeholder engagement, and explore what are the different types of stakeholders involved in these policies as well as their roles. The workshop will offer an opportunity to: Inform participants about existing physical activity, regulatory and fiscal policies to address childhood obesity;Inform participants about new, innovative EU-level projects that aim to address childhood obesity;Outline preliminary findings of the STOP project with regards to the effectiveness of the evaluated policies;Identify some of the gaps and limitations of existing policies and discuss some of the steps to ensure successful policy implementation. Key messages Present new evidence on what policy approaches work in addressing key determinants of childhood obesity. Showcase findings on the attitudes of different stakeholders towards obesity policies, and debate the benefits, risks and challenges of multi-stakeholder engagement.

Timing of rapid weight gain and its effect on subsequent overweight or obesity in childhood: findings from a longitudinal birth cohort study

BackgroundRapid weight gain (RWG) has been recognized as an important determinant of childhood obesity. This study aims to explore the RWG distribution among children at six-month intervals from birth to two years old and to examine the association of RWG in each interval with overweight or obesity development in preschool- and school-aged children.MethodsData were obtained from the Taiwan Birth Cohort Study, which is a nationally representative sample of 24,200 children who participated in a face-to-face survey. A total of 17,002 children had complete data both for weight and height at each of the five measurement time periods. Multivariable logistic regression models quantified the relationship between RWG and childhood overweight or obesity.ResultsA total of 17.5% of children experienced rapid weight gain in the first six months of age, compared to only 1.8% of children from 18-24 months. RWG was significantly associated with an increased risk of developing overweight or obesity at 36 months (RWG birth-6 months: OR = 2.6, 95% CI: 2.3–2.8; RWG 18–24 months: OR = 3.7, 95% CI: 2.9–4.6), 66 months (RWG birth-6 months: OR = 2.2, 95% CI: 2.0–2.4; RWG 18–24 months: OR = 2.3, 95% CI: 1.8–2.8), and 8 years of age (RWG birth-6 months: OR = 1.7, 95% CI: 1.6–1.9; RWG 18–24 months: OR = 2.4, 95% CI: 2.0–3.0).ConclusionsChildhood RWG increased the risk of subsequent overweight or obesity, regardless of the specific time interval at which RWG occurred before the age of two years. The results reinforce the importance of monitoring childhood RWG continuously and show the risks of childhood RWG with respect to the development of overweight or obesity at preschool and school ages.

The Extent and Nature of Food and Beverage Company Sponsorship of Children's Sports Clubs in Canada: A Pilot Study.

Food and beverage marketing is considered a determinant of childhood obesity. Sponsorship is a marketing technique used by the food industry to target young people when they are engaged in sports. The purpose of this study was to document the frequency and nature of food company sponsorship of children’s sports clubs in Ottawa, Canada. Using national data on sports participation, the five most popular sports among Canadian children aged 4–15 years were first selected for inclusion in the study and relevant sports clubs located in Ottawa (Canada) were then identified. Sports club websites were reviewed between September and December 2018 for evidence of club sponsorship. Food company sponsors were identified and classified by food category. Of the 67 sports clubs identified, 40% received some form of food company sponsorship. Overall, sports clubs had 312 commercial and noncommercial sponsors. Food companies constituted 16% of total sponsors and were the second most frequent type of sponsor after sports-related goods, services, and retailers (25%). Fast food restaurants and other restaurants accounted for 45% and 41% of food company sponsors, respectively. Food company sponsorship of children’s sports clubs is frequent with some promoting companies or brands associated with unhealthy foods. Policymakers should consider restricting the sponsorship of children’s sports clubs by food companies that largely sell or promote unhealthy foods.

Body mass index and potential correlates among elementary school children in Jordan.

Childhood obesity and overweight are on the rise worldwide, and Jordanian children are no exception to this rule. Childhood Obesity has major implications on the physical and mental health of individuals, and it can often develop into adult obesity. Obesity/overweight correlates have not been researched extensively in the Middle East region, where Jordan is central. This region is undergoing tremendous changes because of wars, globalization, and the influx of refugees. The cultural and eating habits of the people are changing along with demographical changes. Thus, timely research is required to assess the current health state of this dynamic society. The main goal of this study is to understand the environmental and cultural factors that are associated with Body Mass Index (BMI) z score in elementary school children in Jordan. A total of 1260 children enrolled in this descriptive, cross-sectional study. The study used a parental self-reporting questionnaire that contains possible factors associated with BMI, zBMI, demographics, and other pertinent information. Several factors have been associated with higher zBMI among elementary school children: if a child owns a smartphone (p = 0.0037), uses electronics to play ([Formula: see text]), uses electronics for longer hours ([Formula: see text]), eats food while using electronics or watching TV ([Formula: see text] and [Formula: see text], respectively), sleeps less hours in weekends ([Formula: see text]), was breastfed for lower number of months ([Formula: see text]), lives in rural areas ([Formula: see text]), goes to a private school ([Formula: see text]) and is a male ([Formula: see text]). Investigating characteristics and environmental determinants of childhood obesity play an essential role in establishing effective intervention program and reduce future risks of morbidity. Level V, descriptive (cross-sectional) study.

Path Analysis on Determinants of Childhood Obesity and Associated Risk Factors of Cardiovascular, Renal, and Hepatic Diseases: The CASPIAN-V Study

AbstractThe interaction between several lifestyle and obesogenic environmental factors is considered as the main underlying factor for the escalating trend of childhood obesity and its adverse consequences. In this study, we assessed the mutual influence of lifestyle habits and body mass index (BMI) as well as risk factors for cardiometabolic, hepatic, and renal disorders to define the causality power of each item. This nationwide cross-sectional study was conducted as the fifth round of a school-based surveillance program. Overall, 14,800 students living in Iran were studied, and blood samples were obtained from 4,200 of them. Demographic factors, anthropometric and biochemical measures were used to define lifestyle-related latent variables as well as cardiac, renal, and hepatic risk indicators. Total, direct, and indirect effects between factors were analyzed using the standardized regression weights for each pathway. Data from 14,274 students (participation rate of 99%) and 3,843 blood samples were included. All of the latent variables had a significant direct effect on BMI, with the most potent effect of unhealthy nutrition (β ≅ 0.63) in boys and girls. BMI has significant direct effects on risk indicators of cardiovascular, renal, and hepatic diseases with the most powerful effect on cardiovascular risk factors (β ≅ − 0.08). The most important predisposing factor for obesity was unhealthy nutrition, whereas increased activity, adequate sleep, and better hygiene had protective roles. BMI shows the strongest association with indicator of cardiovascular diseases. These findings underscore the importance of implementing public health programs for the prevention of chronic noncommunicable diseases.

Prevalence and Factors Associated with Overweight and Obesity among Primary School Children (9-14 Years) in a Selected Area of Dhaka, Bangladesh: A Cross-Sectional Study.

Introduction:Childhood obesity is a threat worldwide; notably, some Asian nations are experiencing a shift toward obesity at a younger age. The context of overweight/obesity remains unexplored, more among younger age groups in Bangladesh. This study assessed prevalence and factors associated with overweight/obesity among 9–14-year-old school-going children studying in public and private primary schools in a selected area of Dhaka, Bangladesh.Materials and Methods:This descriptive cross-sectional study involved 150 children recruited from four purposively selected primary schools, following simple random sampling technique. Body mass index was assessed to classify children following the Centers for Disease Control and Prevention age and sex-specific cutoff points. Data were analyzed using SPSS, version 20, and Chi-square/Fisher's exact test was done to determine association.Results:A higher prevalence of overweight/obesity was observed among boys (67.1%) compared to girls, and the mean age was 11.6 years. Overweight and obesity were prevalent among girls (35.7% and 17.9%, respectively) in public schools and boys (38.8% and 32.7%, respectively) in private schools. The magnitude was higher (>80.0%) among those not participating in sports at school (P = 0.002) or outside school (P < 0.001). They exposed (97.5%) to sedentary behaviors (P < 0.001) and preferred fast food (60.8%) as regular meals (P = 0.001). Their dietary chart lacked an adequate serving of vegetables and fruits in a week.Conclusions:Overweight/obesity is prevalent among 9–14-year-old school-going children, and behavior factors are major determinants of childhood obesity. Effective public health interventions are required to address this emerging health problem.

Factors Influencing Parents' and Children's Misperception of Children's Weight Status: a Systematic Review of Current Research.

Misperception of children's weight status is prevalent among parents and children themselves and may impact parents' and children's health behaviors. This study was conducted in order to provide a descriptive systematic review of research on factors influencing parents' and children's misperceptions of children's weight status published in the past 5 years. Factors studied most often in relation to parents' and children's misperception included children's weight status, gender, and age, as well as parents' weight status, parental education levels and socioeconomic status, and ethnicity. Most determinants that were found to have a significant influence on misperception in parents also did in children. The literature on misperception of children's weight status is extensive. Most determinants assessed in included studies were known determinants of childhood obesity. Further research should be directed toward better understanding the impact of weight status perception (whether it is accurate or not) on health behaviors and weight gain over time.

Characterizing Micro-scale Disparities in Childhood Obesity: Examining the Influence of Multilevel Factors on 4-Year Changes in BMI, Healthy Eating, and Physical Activity, Among a Cohort of Children Residing in Disadvantaged Urban Enclaves.

The childhood obesity epidemic in the United States disproportionately affects minority, low-income populations. Hispanics have one of the highest childhood obesity rates, and are the fastest growing population subgroup in the country. Past research has examined disparities in the occurrence of obesity, healthy eating, and physical activity at a macro-geographic level, with less emphasis on examining the multilevel, micro-scale determinants of childhood obesity in disadvantaged urban ethnic enclaves. The aim of our study was to identify child-, parental-, familial-, community-, and neighborhood-level factors associated with differences in 4-year changes in BMI, healthy eating, and physical activity, among children residing in low-income, predominantly Hispanic urban enclaves in Austin, Texas. This analysis used data from the Go Austin! Vamos Austin! (GAVA) Evaluation study, a cohort with 4 years of follow-up from 313 child-caregiver dyads. The dependent variables were change categories denoting 4-year increase, decrease, or no change in Body Mass Index (BMI) percentile, fruit and vegetable intake, and physical activity, among child participants. The independent variables were factors at multiple levels of the socio-ecological model: child, parental, familial, community, and environmental. Multinomial logistic regression models were used to estimate the odds of children being in the “increasing” or “decreasing” categories for the three dependent variables (vs. “no change”), in association with the studied independent variables. The results showed that among children residing in this low-income, predominantly Hispanic urban enclave, weight gain prevention and weight loss have different determinants. We identified relevant micro-scale disparities, and micro-level factors of influence on child BMI and its related health behaviors, at all levels of the socio-ecological model. Our results revealed evidence, through the characterization of positive deviance cases (children for whom decreases in BMI, increases in fruit and vegetable intake, or increases in physical activity were observed) which could potentially help mitigate established unhealthy habits among high need populations. Factors associated with positive deviance for BMI (decreases in child BMI) included male child sex (OR: 0.33, 95% CI: 0.12–0.83) and living in a food-insecure household (OR: 0.24, 95% CI: 0.13–0.79). Our findings may inform the design of obesity prevention interventions in these types of disadvantaged urban Hispanic enclaves.

Ranked Importance of Childhood Obesity Determinants: Parents' Views across Ethnicities in New Zealand.

Māori, Pacific, Indian, and New Zealand European pre-school children’s caregivers’ views on determinants of childhood obesity are needed to inform strategies that will reduce disparities in prevalence. Nineteen focus groups were conducted to explore the relative influence of factors contributing to body weight in children. Predetermined and participant-suggested factors were ranked. Discussion data were inductively analysed. The cost of healthy foods was the highest ranked factor across all groups. Ranked similarly were ease of access to takeaways and lack of time for food preparation. Cultural factors followed by screen time induced sedentariness in children and lack of time to ensure children exercised was next. Participant-raised factors included lack of familial, social, and health promotion support, and others’ behaviour and attitudes negatively impacting what children ate. All groups rejected stereotyping that blamed culture for higher obesity rates. Compared to the Māori and NZ European groups, the Pacific Island and Indian participants spoke of losing culture, missing extended family support, and not having access to culturally appropriate nutrition education or social support and services. Public health policies need to mitigate the negative effects of economic deprivation on food insecurity. Complementary interventions that increase access to healthier meal choices more often are needed.

Prevalence and Determinants of Childhood Obesity in Dhaka City

Background: Obesity amongst the children is increasing worldwide at an alarming rate in both developed and developing countries. Obese children are at higher risk of developing coronary heart disease, non-insulin dependent diabetes, respiratory disease etc.&#x0D; Methods: A case-control study, preceded by a cross sectional survey was conducted, aimed to estimate the prevalence rate and to identify the factors associated with the development of childhood obesity in Dhaka city. A multi stage probability proportionate to size (PPS) cluster sampling method was used to obtain the sample. To identify the obese children, a pre-tested questionnaire was used to collect data on age, weight and height among the randomly selected 5000 children of 2-10 years age group from 12 government primary and 23 private elementary schools, 4 hospitals, 8 health centres and 12 immunisation centres (on National Immunisation Days) from all the 12 thanas (civil administrative sub-districts) of Dhaka city. Survey included a medical history and physical examination to assess the eligibility of the subjects for the study.&#x0D; Results: Of 5000 children, 380 (7.6%) were identified as obese using the criterion of weight for height &gt;120% as a cut-off point. Obesity was positively correlated with the increase of age in both sexes (r = 0.76). Of all obese children, 216 (56.8%) were boys and 164 (43.2%) were girls. Prevalence of obesity was significantly higher among the boys than girls (p=0.007). The study was conducted among the 220 cases of 380 obese children (Wt/Ht&gt; 120%) and 220 randomly selected controls, matching age and sex, using a semi-structured questionnaire for identifying the factors associated with the development of childhood obesity. Information also collected from parents of both cases and controls. Family income (p&lt;0.001) and expenditure on food (p&lt;0.001) were significantly higher among the cases. Data showed that parental obesity was significantly associated with the obesity in children. There was an association between obesity of the children and parents’ educational status (p&lt;0.001). There was no difference in the working hours of parents outside households between the cases and controls. Energy balance was significantly higher among the cases. Dose response of energy balance shows, the estimated relative risk of obesity increases with higher levels of energy balance up to a maximum of odds ratio 3.41 (p&lt;0.001). A significant difference (p&lt;0.001) was found in hours of television-video viewing between the cases and controls.&#x0D; Conclusion: Findings of this study show that the obesity among the children is caused by a positive energy balance over a considerable period, is related to environmental factors including energy intake, energy expenditure and other behavioural aspects. Appropriate interventions like behavioural change regarding energy intake and physical activity are thus recommended to address the childhood obesity- an emerging public health problem in Dhaka city.&#x0D; Bangladesh Med Res Counc Bull 2019; 45: 68-80

Describing studies on childhood obesity determinants by Socio-Ecological Model level: a scoping review to identify gaps and provide guidance for future research.

Childhood obesity is increasing worldwide and is a major public health concern once children with obesity are at higher risk for several diseases and are often stigmatized. Children with obesity are more likely to become adults with obesity with greater needs of healthcare. Determinants of childhood obesity might be grouped in five levels according to the Socio-Ecological Model (SEM): individual, interpersonal, institutional, community and policies. This scoping review emerged from the need to identify which determinants of childhood obesity have been more frequently studied (and how) and which require more investigation. The main objectives were to quantify studies on the determinants of childhood obesity by SEM level addressed, to identify gaps in the literature regarding the studied SEM level(s), to describe the studies' characteristics and to provide guidance for SEM levels that need further investigation. This scoping review follows the five-stage protocol methodology proposed by Arksey and O'Malley in 2005. PubMed database was systematically searched, and hand-searches also took place. The search yielded 975 results from which 552 were excluded after title and abstract reading. The remaining 423 results were fully read and information about methodologic aspects, namely study design, sample size, sample constitution (children, dyads or/and parents) and children's age as well as the SEM level determinants addressed was retrieved. Despite the consensus about the appropriateness of SEM as a framework to comprehensively examine childhood obesity determinants, studies addressing all SEM levels determinants jointly or the policies level determinants alone were not found. Other gaps shown were: the small number of studies that included the policies level determinants alongside determinants from other levels (N = 10) and studies using cohorts study design (ranging from 2 to 28 per SEM level). These gaps should be considered when planning future research.

From conception to infancy - early risk factors for childhood obesity.

Maternal lifestyle during pregnancy, as well as early nutrition and the environment infants are raised in, are considered relevant factors for the prevention of childhood obesity. Several models are available for the prediction of childhood overweight and obesity, yet most have not been externally validated. Moreover, the factors considered in the models differ among studies as the outcomes manifest after birth and depend on maturation processes that vary between individuals. The current Review examines and interprets data on the early determinants of childhood obesity to provide relevant strategies for daily clinical work. We evaluate a selection of prenatal and postnatal factors associated with child adiposity. Actions to be considered for preventing childhood obesity include the promotion of healthy maternal nutrition and weight status at reproductive age and during pregnancy, as well as careful monitoring of infant growth to detect early excessive weight gain. Paediatricians and other health-care professionals should provide scientifically validated, individual nutritional advice to families to counteract excessive adiposity in children. Based on systematic reviews, original papers and scientific reports, we provide information to help with setting up public health strategies to prevent overweight and obesity in childhood.

Medical Students and Childhood Obesity: Health Disparity and Implication for Education.

This study aimed at examining the relationship between medical students’ perceptions about health disparity and childhood obesity care. A cross-sectional survey (n = 163) was used to examine medical students’ characteristics and perceptions related to health disparity and childhood obesity. Multiple mixed effects regression models with Tukey’s tests were used to examine participants’ perceived importance of different roles (e.g., parents) and topics to discuss with child patients and their parents. Separate models were used to examine whether health disparity perception was associated with participants’ perceived importance of different roles and topics to discuss with child patients and their parents. Despite acknowledging that low-income families might lack resources to change health behaviors, many medical students still reported patients and parents being primarily responsible for childhood obesity condition. Participants perceived that the most important topic to discuss was patient’s behaviors, followed by access to safe environments and school-based interventions. Participants’ perception about health disparity was significantly associated with their perceived importance of different roles and topics to discuss with parents. The current study implies disconnection in linking health disparity with childhood obesity among medical students and confirms the importance of sensitizing medical students about the socio-environmental determinants of childhood obesity.

Prenatal determinants of childhood obesity: a review of risk factors 1.

Childhood obesity is a predictor of adult obesity and has its roots in the pre-pregnancy or pregnancy period. This review presents an overview of the prenatal risk factors for childhood obesity, which were categorized into 2 groups: biological risk factors (maternal pre-pregnancy body mass index, gestational weight gain, diabetes in pregnancy, and caesarean section), and environmental and behavioural risk factors (maternal smoking and exposure to obesogens, maternal dietary patterns, maternal intestinal microbiome and antibiotics exposure, and maternal psychosocial stress). Identifying modifiable predisposing prenatal factors for obesity will inform further development of inventions to prevent obesity over the life course, and future directions for research and intervention are discussed.

The association of parental obesity with physical activity and sedentary behaviors of their children: the CASPIAN‐V study

ObjectiveLow physical activity and sedentary behaviors, two important determinants of childhood obesity, may be influenced by parental lifestyle and weight status. This study aims to determine the association of parental weight status with children's physical activity and screen time. MethodsThis study was conducted on 14,440 Iranian schools students, aged 7–18 years, and one of their parents, who participated in the large national school‐based surveillance program. The children's screen‐based and physical activities were evaluated based on the World Health Organization's Global School Student Health Survey. Children and parental height, weight, and waist circumference were measured using standardized methods. ResultsOverall, 14,274 students and one of their parents completed the survey (participation rate: 99%). Mean (standard deviation) age of students was 12.3 (3.2) years, and the prevalence of low physical activity and high screen time was 58.2% and 17.7%, respectively. In multivariate model, the parental general obesity and abdominal obesity increased the odds of children having low physical activity, by 21% and 13%, respectively. Parental overweight, general obesity, and abdominal obesity increased the odds of the combination of low physical activity/high screen time in children by 33%, 26%, and 20%, respectively. ConclusionsThis study showed that parental obesity was associated with increased screen‐based activities and low physical activity in children. Focus on parental weight status, as an important factor influenced by their lifestyle, can be helpful for preventing sedentary behaviors in their children.

The effectiveness of the food and beverage industry\u2019s self-established uniform nutrition criteria at improving the healthfulness of food advertising viewed by Canadian children on television

BackgroundFood and beverage marketing has been identified as an environmental determinant of childhood obesity. The purpose of this study is to assess whether the Uniform Nutrition Criteria established and implemented by companies participating in the self-regulatory Canadian Children’s Food and Beverage Advertising Initiative (CAI) had an impact on the healthfulness of food and beverage advertising during television programming with a high share of children in the viewing audience.MethodsData on food advertising were licensed from Numeris for 27 television stations for Toronto for May 2013 and May 2016 (i.e. before and after the implementation of the nutrition criteria). First, television programs that had a child audience share of ≥35% (when the nutrition criteria applied) were identified. Ten percent of these programs were randomly selected and included in the study. After identifying the food and beverage ads that aired during these programs, the nutritional information of advertised products was collected and their healthfulness was assessed using the Pan-American Health Organization (PAHO) and UK Nutrient Profile Models (NPM). The healthfulness of CAI products advertised in May 2013 and 2016 was compared using Chi-square tests.ResultsAlthough in May 2016, products advertised by CAI companies were more likely to be categorized as healthier by the UK NPM (21.5% versus 6.7%, χ2(1) = 12.1,p = 000) compared to those advertised in May 2013, the frequency of advertised products considered less healthy in May 2016 remained very high (78.5%) and comparable to that of products advertised by companies not participating in the CAI (80.0% categorized as less healthy). Furthermore, in both May 2013 and May 2016, 99–100% of CAI advertisements featured products deemed excessive in either fat (total, saturated, trans), sodium or free sugars according to the PAHO NPM.ConclusionsDespite modest improvements noted after the implementation of the CAI’s Uniform Nutrition Criteria, the healthfulness of most products advertised during programs with a high share of children in the viewing audience remains poor. Mandatory regulations are needed.

The obesogenic environment around elementary schools: food and beverage marketing to children in two Mexican cities

BackgroundUnhealthy environments and food advertisements are major determinants of childhood obesity. Recent regulation has banned unhealthy foods from schools in Mexico. However, currently there is no regulation limiting exposure to food marketing around schools. Thus, our objective was to analyze the characteristics of food advertising practices around 60 elementary schools in two cities and to evaluate compliance with the Pan American Health Organization (PAHO) recommendations and the local food industry self-regulatory marketing code.MethodsData were collected during the period of October 2012 to March 2013. A random sample of elementary schools was selected from two Mexican cities. Using geographic information systems, we drew a 100-m-diameter buffer around each school. Trained personnel obtained photographs to assess the locations and types of food advertisements. Our results were stratified by school type and by indicators of compliance with the PAHO and industry recommendations. We developed a multivariate negative binomial regression model to determine factors predicting the number of advertisements around schools.ResultsThe number of advertisements was significantly higher around public schools than around private schools (6.5 ± 5.6 vs. 2.4 ± 3.5, p < 0.05). Printed posters were the most common type of marketing medium (97%), showing mostly sugar-sweetened beverages, sweet breads, candies, and bottled water. Promotions, such as special prices or gifts, were included on 30% of printed posters. Food advertising practices were often in compliance with industry recommendations (83%) but not with those from the PAHO (32%) (p < 0.001).ConclusionOur results support the importance of monitoring the obesogenic environment and identifying policy tools to protect children from food marketing not only inside schools but also around them, particularly in lower income communities.

The association of parental obesity with physical activity and sedentary behaviors of their children: the CASPIAN-V study

ObjectiveLow physical activity and sedentary behaviors, two important determinants of childhood obesity, may be influenced by parental lifestyle and weight status. This study aims to determine the association of parental weight status with children's physical activity and screen time. MethodsThis study was conducted on 14,440 Iranian schools students, aged 7–18 years, and one of their parents, who participated in the large national school-based surveillance program. The children's screen-based and physical activities were evaluated based on the World Health Organization's Global School Student Health Survey. Children and parental height, weight, and waist circumference were measured using standardized methods. ResultsOverall, 14,274 students and one of their parents completed the survey (participation rate: 99%). Mean (standard deviation) age of students was 12.3 (3.2) years, and the prevalence of low physical activity and high screen time was 58.2% and 17.7%, respectively. In multivariate model, the parental general obesity and abdominal obesity increased the odds of children having low physical activity, by 21% and 13%, respectively. Parental overweight, general obesity, and abdominal obesity increased the odds of the combination of low physical activity/high screen time in children by 33%, 26%, and 20%, respectively. ConclusionsThis study showed that parental obesity was associated with increased screen-based activities and low physical activity in children. Focus on parental weight status, as an important factor influenced by their lifestyle, can be helpful for preventing sedentary behaviors in their children.

Body mass index associations between mother and offspring from birth to age 18: the Fels Longitudinal Study.

SummaryBackgroundParental obesity is a known determinant of childhood obesity. Previous research has shown a strong maternal influence on body mass index (BMI) during infancy and early childhood.ObjectivesThe purpose of this research was to investigate the BMI associations between mother and offspring from birth to age 18 years.MethodsParticipants were selected from the Fels Longitudinal Study. The current study sample includes 427 (215 mother/son and 212 mother/daughter) mother/child pairs. These pairs are repeatedly measured at multiple age groups in children, resulting in a total of 6,263 (3,215 mother/son, 3,048 mother/daughter) observations for data analysis. Inclusion criteria were children with measured height and weight for BMI collected at ages 0 to 18 years and their mother with BMI data. Maternal influences of BMI on offspring BMI from birth to early adulthood were analyzed by Spearman correlations and linear regression analyses.ResultsMother/son BMI correlations became statistically significant (p ≤ 0.05) at age 5–6 years and were significant through puberty and into early adulthood at age 18 years. Mother/daughter correlations became significant at age 1.5 years and also continued through adolescence, puberty and early adulthood at age 18 years. Associations persisted after the study sample was grouped into life stages and adjusted for decade of birth and parity.ConclusionsThe mother/daughter relationship was more strongly correlated than the mother/son relationship and also became statistically significant at an earlier age than boys.