Excess Weight In Children Research Articles

Prevention of overweight and obesity in early life.

Childhood obesity is a serious challenge for public health. The problem begins early with most excess childhood weight gained before starting school. In 2016, the WHO estimated that 41 million children under 5 were overweight or obese. Once established, obesity is difficult to reverse, likely to persist into adult life and is associated with increased risk of CVD, type 2 diabetes and certain cancers. Preventing obesity is therefore of high importance. However, its development is multi-factorial and prevention is a complex challenge. Modifiable lifestyle behaviours such as diet and physical activity are the most well-known determinants of obesity. More recently, early-life factors have emerged as key influencers of obesity in childhood. Understanding risk factors and how they interact is important to inform interventions that aim to prevent obesity in early childhood. Available evidence supports multi-component interventions as effective in obesity prevention. However, relatively few interventions are available in the UK and only one, TrimTots, has been evaluated in randomised controlled trials and shown to be effective at reducing obesity risk in preschool children (age 1-5 years). BMI was lower in children immediately after completing TrimTots compared with waiting list controls and this effect was sustained at long-term follow-up, 2 years after completion. Developing and evaluating complex interventions for obesity prevention is a challenge for clinicians and researchers. In addition, parents encounter barriers engaging with interventions. This review considers early-life risk factors for obesity, highlights evidence for preventative interventions and discusses barriers and facilitators to their success.

An Exploration of How Fathers Attempt to Prevent Childhood Obesity in Their Families

ObjectiveTo understand how fathers of preschool-aged children define overweight and obesity in children, investigate how fathers influence or attempt to influence their child's nutrition and physical activity behavior, and explore the father's perceived role in making decisions regarding his child's weight status. MethodsExplorative study using an online survey, with 9 open-ended questions. Content analysis using constant comparative method was applied to data. A total of 117 US fathers (35.6 ± 5.55 years, 85% white; 82% had a 4-year degree or more) of preschoolers were included in the final analysis. ResultsFour themes emerged from the responses: (1) causes of childhood obesity, (2) prevention and/or treatment strategies, (3) recognition of child excess weight, and (4) barriers to changing behavior. Conclusions and ImplicationsAlthough qualitative studies with a more representative sample are needed, practitioners could engage both fathers and mothers in interventions aimed at improving a child's health.

Cardiometabolic risk and variation of fat/adipose content according to body mass index in children from six to nine years old

Introduction: child excess weight has been associated with obesity in adulthood and, as a consequence, increased risk of death due to cardiometabolic factors. Objective: to identify whether BMI reflects changes in the content and distribution of fat/adipose tissue and the cardiometabolic risk in children between six and nine years old. Material and methods: participants were 537 children (59.8% women) randomly selected. BMI, waist circumference (WC), waist-height index (WHI), body composition, nutritional status and cardiometabolic risk were determined. Student's t-test, one-way ANOVA, Pearson's correlation, Chi-square and diagnostic concordance were applied. An alpha ≤ 0.05 was considered. Results: direct and significant correlations between nutritional status and the anthropometric parameters studied are shown, except for the percentage of adiposity. There were significant variations (p < 0.05) in the percentage of fat and adiposity according to nutritional status of the sample. In addition, there was consistency between the variation of the nutritional status with the cardiometabolic risk evaluated trough WC and WHI. Conclusion: BMI identifies the differences in the amount of fat/adipose tissue in the children between six and nine years old when categorized according to nutritional status. In addition, it reflects direct association with cardiometabolic risk.

Individual development and potential determinants of excess weight in children and adolescents: a longitudinal study.

Excess body weight is a major public health concern already at a young age. The aim of this study was to track weight status among pupils aged 6-14 years in the City of Zurich, to examine the association between sociodemographic and environmental factors and excess weight at school entry and excess weight gain thereafter. Longitudinal study. Data were from the medical examinations routinely performed at public schools in Zurich, the largest city in Switzerland. Weight and height were measured in kindergarten (mean age: 5.9 years), grade 1 (7.2 years), grade 4 (10.1 years) and grade 8 (14.2 years). The study included 7145 children who enrolled in kindergarten in 2003/04 or 2004/05 and had more than one measurement of weight and height. Body weight and height were measured by physicians or nurses during the medical examinations at schools. For each measurement point, body mass index (BMI) was calculated and converted to the age- and sex-specific BMI z-scores and BMI percentiles. The stability of children's weight status categories, sociodemographic and environmental factors associated with excess weight gain and with overweight/obesity at school entry were investigated using multiple linear and logistic regression models. The prevalence of overweight/obesity increased between kindergarten and grade 8 (from 17.6 to 26.0%). Overall, 86.2% of the children remained in the same weight category; 10.8% shifted to a higher and 3% to a lower category. There was a strong correlation between migration background and overweight/obesity at school entry (odds ratios between 1.62 and 3.42, all p <0.05). In addition, boys with Southern/Eastern European background (+2.29 BMI percentile, p = 0.023) and girls in lower level school type (+12.98 BMI percentile, p <0.001) had the highest risk for excess weight gain over a school period. Overweight/obesity developed prior to school entry and mostly persisted through childhood. In order to better exploit obesity prevention potential, measures to prevent the development of the excess weight need to be implemented at a very early stage in life.

Parental and Child Factors Associated with Under-Estimation of Children with Excess Weight in Spain

Objective Understanding obesity misperception and associated factors can improve strategies to increase obesity identification and intervention. We investigate underestimation of child excess weight with a broader perspective, incorporating perceptions, views, and psychosocial aspects associated with obesity. Methods This study used cross-sectional data from the Spanish National Health Survey in 2011-2012 for children aged 2-14years who are overweight or obese. Percentages of parental misperceived excess weight were calculated. Crude and adjusted analyses were performed for both child and parental factors analyzing associations with underestimation. Results Two-five year olds have the highest prevalence of misperceived overweight or obesity around 90%. In the 10-14year old age group approximately 63% of overweight teens were misperceived as normal weight and 35.7 and 40% of obese males and females. Child gender did not affect underestimation, whereas a younger age did. Aspects of child social and mental health were associated with under-estimation, as was short sleep duration. Exercise, weekend TV and videogames, and food habits had no effect on underestimation. Fathers were more likely to misperceive their child´s weight status; however parent's age had no effect. Smokers and parents with excess weight were less likely to misperceive their child´s weight status. Parents being on a diet also decreased odds of underestimation. Conclusions for practice This study identifies some characteristics of both parents and children which are associated with under-estimation of child excess weight. These characteristics can be used for consideration in primary care, prevention strategies and for further research.

Association between maternal depressive symptoms with child malnutrition or child excess weight

Abstract Objectives: to verify associations between maternal depressive symptoms with child malnutrition or child excess weight. Methods: prospective study with data from the BRISA prenatal cohort in São Luís, Brazil, obtained from the 22nd to the 25th week of gestation (in 2009 and 2010) and, later, when children were aged 12 to 32 months (in 2010 and 2012). Maternal depressive symptoms were identified using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Edinburgh Postnatal Depression Scale (EPDS). For the excess weight evaluation, BMI z-score for age &gt; +2 was used. For measuring child malnutrition, height z-score for age &lt; -2 was used. The confounding factors were identified using a directed acyclic graph in DAGitty software. Results: we did not find associations between maternal depressive symptoms with child malnutrition or child excess weight. The prevalence of maternal depressive symptoms was 27.6% during gestation and 19.8% in the second or third year of the child's life. The malnutrition rate was 6% and the excess weight rate was 10.9%. Conclusions: no associations between maternal depressive symptoms in prenatal or in the second or third year of the child's life and child malnutrition or excess weight were detected.

BMI and recommended levels of physical activity in school children

BackgroundPhysical activity (PA) and its health benefits are a continuous point of discussion. Recommendations for children’s daily PA vary between guidelines. To better define the amount of PA necessary to prevent overweight and obesity in children, further research is needed. The present study investigates children’s compliance to physical activity guidelines (PAGs) and the association between objectively measured PA and body mass index (BMI).MethodsParticipating children were 11 years old (n = 419) and part of the European CHOP trial, which was conducted in Germany, Belgium, Poland, Spain, Italy. At least 2 days of PA measurements were collected from each child using a SenseWear™ armband. BMI was calculated from children’s height and weight. Thresholds of min·day−1 in PA needed to differentiate between normal and excess weight (overweight/obesity) were determined with Receiver Operator Characteristics (ROC) analysis. Additionally, adjusted linear and logistic regressions models were calculated for group differences and effects of a 5, 15 and 60 min·day−1 increases in PA on BMI.ResultsMedian time spent in total PA was 462 min·day−1 (25th percentile; 75th percentile: 389; 534) and 75 min·day−1 (41; 115) in moderate to vigorous PA (MVPA). Girls spent 36 min·day−1 less in MVPA than boys and overweight/obese children 24 min·day−1 less than normal weight children (linear regression, p < 0.001). 63.2% of the children met PAGs of 60 min·day−1 in MVPA. The optimal threshold for min·day−1 in MVPA determined with ROC analysis was 46 min·day−1. Comparing 5, 15 and 60 min·day−1 increases in PA revealed that an additional 15 min·day−1 of vigorous PA had the same effect as 60 min·day−1 of MVPA. Sedentary time and light PA showed contrary associations to one another, with light PA being negatively and sedentary time being positively associated with excessive weight.ConclusionsCurrent PAGs are met by 2/3 of children and seem appropriate to prevent excess weight in children. An official recommendation of daily 15–20 min of vigorous PA and further reduction of sedentary time could help to fight youth overweight and thus be of potential public health importance.Trial registrationClinicalTrials.gov Identifier: NCT00338689. Registered: June 19, 2006 (retrospectively registered).

Barriers to addressing childhood weight issues in acute care settings and how to overcome them.

Excess weight and obesity in childhood is a global problem, with UK prevalence unfavourably high. Despite national policy recommendations and professional guidelines that nurses should address the issue, research shows that practice is not consistent. This literature review identifies barriers nurses face in addressing childhood weight issues with families in acute healthcare settings. Three interlinked themes are identified: parental receptiveness; knowledge, education and resource constraints; and time, priority and continuity constraints. Senior managers, particularly those working in acute settings, must prioritise measures to tackle childhood obesity and excessive weight to enable nurses to address the issue. Additionally, further UK-specific research is needed to explore the barriers perceived by nurses and how these affect local practices. Children's nursing education and practice should include obesity recognition and prevention to increase nurses' confidence and abilities in tackling childhood obesity, despite perceived parental barriers.

Excess weight and factors associated in preschool of southwest of Bahia

Abstract Objectives: this study aimed to evaluate the environmental factors associated with excess weight in preschool children. Methods: a cross-sectional study involving 664 full-time preschoolers enrolled in public childcare centers in Vitória da Conquista (BA). The excess weight status has been defined according to the BMI/Age index and score Z above +2. The independent variables were grouped into maternal characteristics, socioeconomic, related to children and child care. We conducted multiple logistic regression to assess the association between excess weight and the variables studied. Results: a prevalence of excess weight was 5.7 %; 3.9% were overweight and 1.8% were obese. The factors associated with excess weight in children were cesarean delivery (OR: 2.59; IC95%: 1.11; 6.01); being singletons (OR: 3.32; IC95%: 1.44; 7.67); and exclusive breastfeeding of less than 4 months (OR: 2.59; IC95%: 1.12; 5.99). Conclusions: the results show that interventions to reduce and/or prevent excess weight should begin prenatally, with promotion of exclusive breastfeeding and natural birth, as well as nutritional advice for mothers with singletons.

The implications of family lack of concern and perception of obesity in childhood in the city of Curitiba, State of Paraná, Brazil

The scope of this study was to relate child obesity with the family's perception of the child's silhouette's and concern with excess weight in childhood A cross-sectional study was conducted among children aged between 20 and 48 months who frequent Health Units or are preschoolers in the city of Curitiba from June to December 2014. A questionnaire was used to collect data relating to family income, weight, height, perception of child silhouette's and assess concern about obesity by parents. Overweight and obesity was not correctly perceived by relations (kappa = 0,11) and the vast majority of parents did not know the child's height and weight and were not even concerned with childhood obesity. In the population studied, children from lower income family were more likely to suffer from overweight in childhood (p = 0,02). It is necessary to invest in the sensitization of families, since it is extremely important to pay attention to obesity from childhood onwards, thus preventing new cases and avoiding problems in adult life.

Childhood Excess Weight in Spain From 2006 to 2012. Determinants and Parental Misperception

Introduction and objectivesDue to the high prevalence of childhood obesity in Spain, we analyzed changes in its prevalence from 2006 to 2007 and from 2011 to 2012, as well as diet, sleep, and sedentary habits in 5- to 14-year-olds and parental misperceptions about their children's excess weight. MethodsThe sample was from the Spanish National Health Surveys for 2006 to 2007 (n=5590) and for 2011 to 2012 (n=3601). Data were collected by trained personnel through telephone interviews with parents/guardians. Weight and height were self-reported and the International Obesity Task Force cutpoints were used to define overweight and obesity. ResultsThe prevalence of childhood excess weight was 30.1% from 2006 to 2007 and 29.7% from 2011 to 2012, while that of childhood obesity was 9.6% and 9%, respectively. Parental misperception of childhood excess weight increased from 60.8% to 71.4% (P<.001). Daily consumption of vegetables increased by 7.8%, while that of soft drinks and snacks decreased. This decrease was greatest in children from families with a low socioeconomic status, who also decreased their consumption of sweets and fast food. Adherence to sleep recommendations decreased by 5%, but adherence to recommended sedentary time did not change. ConclusionsHigh childhood overweight and obesity rates remained stable in Spain from 2006 to 2007 and from 2011 to 2012, but there was an increase in parental misperception of childhood excess weight. Despite reduced consumption of soft drinks and snacks, there was low adherence to dietary recommendations, hours of sleep, and sedentary habits.

Excess weight in preschool children: The role of food intake

ABSTRACT Objective: The study aimed to compare the food intake of overweight/obese and normal weight preschoolers and to verify whether excess weight is associated with low birth weight, catch-up growth, early weaning, and physical activity/inactivity Methods: This case-control study was conducted in family healthcare units of the city of Olinda, Pernambuco, from May to August 2014 Results: A total of 253 children were studied, 84 with 'excess weight' and 164 with 'normal weight'. In the 'overweight/obese' and 'normal weight' groups, 77% and 43% of the children, respectively, had high calorie intake. The 'overweight/obese' group had lower fruit intake, higher maternal education level, higher family income, higher maternal excess weight, and presence of catch-up growth and inactivity Conclusion: The results suggest that food intake has an important role, but that other variables contribute to excess weight in children. Recognition of the problem's many causes should guide the public policies directed at this age group to prevent this nutritional disorder.

Joint association of screen time and physical activity with anthropometric measures in Iranian children and adolescents: the weight disorders survey of the CASPIAN-IV study.

This study aims to assess the joint association of screen time (ST) and physical activity (PA) with anthropometric indices among Iranian children and adolescents. In this national study, 23,183 school students, aged 6-18 years, were studied. By using a multi-stage cluster sampling method, they were selected from rural and urban areas of 30 provinces of Iran. ST and PA were assessed by self-administered validated questionnaires. Height, weight, hip and waist circumferences (WC) were measured according to standard protocols, and body mass index (BMI) was calculated. ST of <2 h per day was categorized as "low" and ≥2 h per day as "high". PA levels were obtained by a 7-day recall of sports or activities that made participants sweat or make their legs feel tired, or games that made them breathe heavily. Using this questionnaire, the score of 1-1.9 was categorized as "low" and scores between 2 and 5 as "high" PA. Logistic regression analyses were used to evaluate the joint association of PA and ST categories with odds of anthropometric measures. In both genders, those students categorized as "Low PA & High ST" had the highest levels of BMI z-scores (boys: 0.15±1.12, girls: 0.17±1.08), WC (boys: 69.93±13.89 cm, girls: 67.30±11.26 cm), and hip circumference (boys: 82.41±13.90 cm, girls: 84.05±13.7 cm), as well as the highest prevalence of overweight (boys: 15.32%, girls: 14.04%) (p<0.001 in all comparisons). In linear multivariate model, students with "High PA & High ST" had significant increased levels of z-scores for BMI, WC and hip circumference (p<0.05). The current findings underscore the importance of reducing ST along with increasing PA for prevention and control of excess weight in children and adolescents.

Maternal excess weight and nutritional status of preschool children

Introduction: The increasing prevalence and early occurrence of excess weight in childhood suggests an association with the habits and nutritional status of the parents, as preschool aged children are still strongly influenced by the home environment.&#x0D; Objective: This study sought to evaluate the association between excess weight in parents and the nutritional status of preschool aged children.&#x0D; Methods: Using a cross-sectional study, the nutritional status of 224 children aged two-six from seven private schools in São Paulo city was classified into two categories: a low or appropriate body mass index (BMI) group called ‘normal weight’ and an overweight or obese group, called ‘excess weight’ according to the World Health Organization. The independent variables were: maternal and paternal nutritional status, sex of the child, family income, maternal education, duration of breastfeeding, age of mother and father and weight and length of the child at birth. A multiple generalised linear regression examined the relation between the independent variables and child excess weight.&#x0D; Results: Mothers with excess weight presented a prevalence ratio of 1.3 (CI90%: 1.08 to 1.59) of children with excess weight compared to normal weight mothers, but not for fathers. Breastfeeding duration of over 12 months was a protective factor against excess weight of the child, 0.71 (CI90%: 0.51 to 0.99).&#x0D; Conclusion: The interpretation of the results, even considering the possible limitations, demonstrates that there is an association between excess weight of preschool age children and maternal excess weight, but not with father’s excess weight.

Exceso de peso infantil en España 2006-2012. Determinantes y error de percepción parental

Introduction and objectivesDue to the high prevalence of childhood obesity in Spain, we analyzed changes in its prevalence from 2006 to 2007 and from 2011 to 2012, as well as diet, sleep and sedentary habits in 5- to 14-year-olds, and parental misperceptions about their children's excess weight. MethodsThe sample was from the Spanish National Health Surveys for 2006 to 2007 (n = 5590) and for 2011 to 2012 (n = 3601). Data were collected by trained personnel through telephone interviews with parents/guardians. Weight and height were self-reported and the International Obesity Task Force cutpoints were used to define overweight and obesity. ResultsChildhood excess weight was 30.1% from 2006 to 2007 and 29.7% from 2011 to 2012, while that of obesity was 9.6% and 9%, respectively. Parental misperception of childhood excess weight increased from 60.8% to 71.4% (P < .001). Daily consumption of vegetables increased by 7.8%, while that of soft drinks and snacks decreased. This decrease was greatest in children from families with a low socioeconomic status, who also decreased their consumption of sweets and fast food. Adherence to sleep recommendations decreased by 5%, but adherence to recommended sedentary time did not change. ConclusionsHigh childhood overweight and obesity rates remained stable in Spain from 2006 to 2007 and from 2011 to 2012, but there was an increase in parental misperception of childhood excess weight. Despite reduced consumption of soft drinks and snacks, there was low adherence to dietary recommendations, hours of sleep and sedentary habits.Full English text available from: www.revespcardiol.org/en

Microbiota and Obesity.

Obesity is globally the most prevalent nutritional disorder. Multifaceted therapeutic approaches are called for to halt the cascade from neonatal adiposity/high birth weight to childhood excessive weight gain/adult obesity with comorbidities. Recent experimental and clinical data provide one new target for interventions aiming to close this vicious circle: the microbiota. An aberrant gut microbiota, dysbiosis, induces immune and metabolic disturbances both locally and, consequent upon impaired gut barrier function, also systemic low-grade inflammation, which is causally linked to insulin resistance. The gut microecology could thus fill the gap between energy intake and expenditure by processing nutrients and regulating their access to and storage in the body, producing chemicals of hormonal nature and controlling the secretion of proinflammatory mediators locally and systemically. Conversely, being highly sensitive to environmental impacts, particularly to early feeding, the compositional development of the gut microbiota may prove the target of choice in efforts to reduce the risk of obesity. It has been demonstrated that a lower number of bifidobacteria precedes the development of obesity, and a dearth of butyrate-producing bacteria and an overall richness of bacteria increase the risk of metabolic disease; moreover, recognition that practices known to disrupt the early gut microbiota, e.g., cesarean section delivery and antibiotic exposure, contribute to obesity, encourages to pursue this line of research.

Beyond Oblivobesity: Seven Myths About Parental Misperception of Children's Weight.

[Author Affiliation]Arnaldo Perez. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.Geoff D.C. Ball. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.Address correspondence to: Geoff D.C. Ball, PhD, RD, Department of Pediatrics, University of Alberta, 4-515 Edmonton Clinic Health Academy, 11405m 87th Avenue, Edmonton, Alberta, Canada T6G IC9, E-mail: gdball@ualberta.caTo the Editor:In a recent editorial in Childhood Obesity, Katz commented on the phenomenon of parents' misperception of children's excess weight.1 Although the editorial focused on engaging children and their families in obesity management, he challenged a common belief in the weight misperception literature, which is to combat misperception of excess weight with objective information. Upon review of the misperception literature, we believe there is value in going beyond oblivobesity to consider a number of misunderstandings related to the conceptualization, interpretation, and attempt to address the discrepancy between perceived and actual weight status of children.1. Parents are unaware of their children's obesity. Most studies on parental weight misperception have relied on anthropometric measures (e.g., BMI) to determine children's weight status.2 Given that these metrics only provide an indirect estimate of obesity, parental unawareness of child obesity can only ever be estimated indirectly as well. Further, unawareness is just one aspect of weight misperception; the latter not only implies that parents are unaware of their children's actual weight status, but also that they assign to their children a weight status other than the actual status. Compared to unawareness, misperception may exert a greater influence on whether parents choose to accept objective data (e.g., BMI plotted on a growth chart) showing that their children meet the clinical definition for obesity.2. Parents fail to recognize their children's weight problem. Conceptually, it is important to differentiate between misclassifying the identity of a condition (which is the main focus of studies on perceived weight status) and being concerned about a condition (perceiving it as a problem). Health concern in general, and weight concern in particular, depend on (1) the severity attached to the consequences of the condition and (2) the perceived personal susceptibility to those consequences. In this regard, accurate recognition of excess weight is necessary, but not sufficient, to be concerned about obesity. For instance, both Genovesi and colleagues3 and Jain and colleagues4 found that most parents in their studies were aware of, but not concerned about, their children's excess weight.3. Parents will not take preventive actions to address obesity unless a weight problem is recognized. Compared to parents who failed to recognize their children's excess weight, Neumark-Sztainer and colleagues5 found that those who recognized it correctly were not more likely to promote healthier lifestyle behaviors for their children. Qualitative evidence has shown that children's psychosocial well-being and quality of life were more common reasons for parents to engage in pediatric weight management versus concerns about children's weight and physical health.6,7 It is sometimes forgotten in the dominant discourse about nutrition, physical activity, and obesity that individuals may perform healthy lifestyle behaviors not because a problem exists or because one is expected, but for the simple sake of living a healthy and enjoyable life.4. Parents who do not recognize their children's obesity are in denial. Given that children's excess weight is visually apparent, it is often assumed that parents should recognize it unless they are in denial. As a defense or coping mechanism, 8 denial denotes a causal attribution to account for weight misperception that cannot be demonstrated by simply comparing the perceived and actual weight status. …

ASSOCIATIONS BETWEEN ENERGY AND FAT INTAKES WITH ADIPOSITY IN SCHOOLCHILDREN - THE CUENCA STUDY.

the relationship between changes in energy intake (EI) over the last few decades and the trends towards of excess weight in children is still debated. to examine the relationship between energy and macronutrient intakes with adipostity in children, controlling for cardiorespiratory fitness (CRF) as a surrogate measure of physical activity. we conducted a cross-sectional study of 320 schoolchildren aged 9-11 years (54.5% girls). We collected data on socio-demographic variables, and measured weight, height, waist circumference (WC), and fat mass percentage by bioimpedance analysis. Fat mass index (FMI) was calculated as fat mass (kg) divided by height (m) squared, to adjust for body size. Energy (kcal) and macronutrient intake (percentages) were measured by two non-consecutive 24-h recalls (weekday and weekend day), using the Young Adolescents' Nutrition Assessment on Computer (YANA-C) software program; CRF was measured by the 20-m shuttle run test. boys in the 4th quartile of the WC distribution had lower fat intake (34.9%) than boys in the 1st (42.4%; p = 0.019) and 2nd quartiles (41.6%; p = 0.022). Children in the 1st quartile of the FMI distribution had higher daily EIs than children in the 4th quartile (1762.3 kcal vs. 1496.8 kcal; p = 0.023). All macronutrient intakes relative to weight were lower in children in the more adipose categories for weight status, WC and FMI (p < 0.001). adiposity was inversely related to energy and fat intakes. Excessive EI and high EI from fats not appears to be directly associated with the current obesity epidemic among schoolchildren living in Cuenca (Spain).

Moving Focus from Weight to Health. What Are the Components Used in Interventions to Improve Cardiovascular Health in Children?

IntroductionObesity in childhood impacts on many areas of the child’s current and future health, including their cardiovascular health. To date many attempts have been made to design interventions to tackle excess childhood weight but with limited success. We aimed to establish the components common to interventions in children that improve cardiovascular health parameters.MethodsWe searched the following databases: EMBASE 1974-week 3 November 2014, Ovid Medline 1946 Present, and PsychINFO 1967-Present for studies reporting interventions in healthy young people under the age of 18. Included interventions had to contain an education component and have been carried out in a community, school, or clinical setting. Papers had to report on at least one of the pre-specified CVD risk parameters and at least one non-biological outcome from knowledge, attitudes or behaviours.ResultsWe retrieved 2451 papers, from which 12 studies (18 papers) of 3046 participants were included. From the selected papers we identified four component themes; Health Behaviours, Self-Concept, Practical and Cognitive Tools, and Intervention Characteristics. The subcomponents that made up these themes were fairly consistent across the studies analysed although the studies varied in their duration, settings and children with which they were carried out. Nine of the studies were able to bring about positive change in at least one biological and one non-biological aspect of child cardiovascular health.ConclusionThe component themes identified here were common to intervention studies that had success in improving parameters of cardiovascular health. We suggest that the focus of childhood health interventions be moved from weight onto cardiovascular health parameters and that future interventions use the lessons learned by their predecessors to incorporate those components that are associated with successful interventions.

Factores socioeconómicos, demográficos, institucionales y familiares asociados con exceso de peso en niños de 2 a 5 años asistentes a los jardines infantiles de Envigado-Colombia, 2014-2015

Introduction : Overweight and obesity affect public health on a global level and its increase is due to multiple factors. Objective : To determine socioeconomic, demographic, familial, and institutional factors associated with excess weight in daycare children aged 2-5 years in Envigado, Colombia from 2014-2015 in order to strengthen childhood overweight and obesity prevention strategies. Materials and methods: An observational, descriptive, cross-sectional study with a sample of 278 children, selected by probability sampling. Anthropometric evaluation was conducted along with parental and teacher surveys. Bi-variate and multi-variate statistical analyses were completed using SPSS. Results : 28.8% presented with excess weight (9.7% obesity and 19.1% overweight); 48.6% were aged 5 years, and 47.8% were female. Factors associated with excess weight included: not attending the growth and development program (OR 4.1; CI;1.2-14.1), preference for television watching and use of video games during free time (OR 4.4; CI:1.10-17.7), not eating whole grains and root vegetables for snack (OR 5.5; CI:1.2-26.1), and incidence of overweight or obesity in the family or direct caregiver (OR 3.8; CI:1.1-13.3). Conclusion : Factors that most influence excess weight in children are familiar factors such as incidence of overweight and obesity and caregiving practices in the family.