Healthy Physical Activity Research Articles

Impact of COVID-19 Pandemic on Dietary Patterns and Physical Activity in Overweight and Obese Adolescents Based on Body Fat Percentages

Background: Obese and overweight adolescents have a high risk of COVID-19 susceptibility and severity compared to normal nutritional status. Although a healthy dietary pattern and physical activity do not entirely prevent infection, they play a substantial role in the host's response to infectious agents. The purpose of this study is to analyze the changes in dietary patterns and physical activity during the COVID-19 pandemic in overweight and obese adolescents based on body fat percentages (BFP). Method: A cross-sectional study using purposive sampling was conducted on 159 adolescents from selected high schools in West Lampung, Indonesia. Data collection was assessed using a body composition scale and Food Frequency Questionnaire (FFQ). Data analysis was performed using SPSS. The Wilcoxon signed-rank test was used to analyze the differences between the two adolescent groups. Result: The overweight and obese adolescents group increased the consumption of unhealthy foods and beverages compared to the normal group (p<0.05). Both groups significantly increased the fruit rich in vitamin C consumption (p<0.05), but no significant difference in vegetable consumption (p>0.05). Both groups were found to have no significant difference in physical activity, both before and during the COVID-19 pandemic (p>0.05). Conclusion: Adolescents with normal body fat percentages (BFP) tend to have better dietary patterns, in contrast to overweight and obese adolescents with a high BFP who tend to have a decrease in the quality of their dietary patterns. Then, both groups were found to have a significant decrease in the frequency of physical activity during the COVID-19 pandemic.

An Experiential Learning Program to Promote Healthy Eating and Physical Activity at an Australian Children’s Museum: Formative Research with Caregivers and Staff

ABSTRACT Background Healthy eating (HE) and physical activity (PA) are essential for children’s health and well-being. Innovative approaches, informed by formative research, are crucial to promoting these behaviors. Experiential learning, involving active, hands-on approaches, may be an effective way to encourage healthy behaviors in children. Children’s museums could contribute to health education by providing a variety of educational opportunities. Purpose To inform the design of an experiential learning Healthy Living program for children at an Australian children’s museum. Methods A qualitative study involving focus group discussions with 23 caregivers and in-depth interviews with 6 staff were conducted to explore perceptions of caregivers and staff working in an Australian children’s museum (Discovery Space) relating to potentially effective experiential learning strategies for promoting children’s healthy behaviors. Data were transcribed verbatim and thematically analyzed in NVivo 12. Results Key considerations for promoting HE and PA children through experiential learning activities include involving caregivers, engaging children through processes such as providing choice and stimulating curiosity, and selecting appropriate activity types such as simple, engaging, fun, hands-on, sensory play, and music-based activities. Translation to Health Education Practice Experiential learning activities that address these key considerations can promote HE and PA in children and should be studied in future studies. Competencies and sub-competencies in two areas of responsibility, (I) Assessment of Needs and Capacity and (V) Advocacy, were addressed.

Double burden of malnutrition and its associated factors among women in low and middle income countries: findings from 52 nationally representative data

BackgroundDouble burden of malnutrition (DBM) is an emerging global public health problem. The United Nations member states adopted eradicating all forms of malnutrition as an integral component of the global agenda. However, there is evidence of a high burden of undernutrition among women and rising rates of overweight and obesity, especially in low and middle income countries (LMICs). Therefore, this study aimed to investigate the prevalence and associated factors of underweight, overweight, and obesity among women of reproductive age in LMICs.MethodsData for the study were drawn from a recent 52 Demographic and Health Surveys (DHS) conducted in LMICS. We included a sample of 1,099,187 women of reproductive age. A multilevel multinomial logistic regression model was used to identify factors associated with DBM. Adjusted relative risk ratio (RRR) with a 95% Confidence Interval (CI) was reported to show an association.ResultsThe prevalence of underweight, overweight, and obesity in LMICs among women of reproductive age was 15.2% (95% CI: 15.1–15.3), 19.0% (95% CI: 18.9- 19.1), and 9.1% (95% CI: 9.0–9.2), respectively. This study found that women aged 24–34 years, aged ≥ 35 years, with primary, secondary, and above educational level, from wealthy households, using modern contraceptives, exposed to media (radio and television), and with high parity (more than one birth) were more likely to have overweight and obesity and less likely to have underweight. Moreover, the risk of having obesity (RRR = 0.59; 95% CI = 0.58–0.60 and overweight (RRR = 0.78; 95% CI = 0.77–0.79) were lower among rural women, while the risk of being underweight was (RRR = 1.13; 95% CI = 1.11–1.15) higher among rural women compared to urban women.ConclusionThe prevalence of underweight, overweight, and obesity was high among women of reproductive age in LMICs. Underweight, overweight, and obesity are influenced by sociodemographic, socioeconomic, and behavioral-related factors. This study shows that, in order to achieve Sustainable Development Goal 2, a multifaceted intervention approach should be considered to prevent both forms of malnutrition in women of reproductive age. This can be achieved by raising awareness and promoting healthy behaviors such as healthy eating and physical activity, especially among educated women, women from wealthy households, and women exposed to the media.

An SMS Text Message-Based Type 2 Diabetes Prevention Program for Hispanic Adolescents With Obesity: Qualitative Co-Design Process.

SMS text message-based interventions are a promising approach for reaching and engaging high-risk youths, such as Hispanic adolescents with obesity, in health promotion and disease prevention opportunities. This is particularly relevant, given that SMS text messaging is widely accessible and available and that adolescents are frequent texters. Including youths in the development of SMS text message content can lead to more acceptable and relevant messaging; however, few studies include this group as cocollaborators. This study aimed to use a co-design process to inform the development of SMS text messages that promote healthy physical activity (PA) and sleep behaviors among Hispanic adolescents with obesity. The co-design framework uses multiple methods across several phases. Self-determination theory and a literature review of SMS text message-based interventions guided the background and research phases. In the co-design phase, Hispanic adolescents (n=20) completed in-depth interviews to identify barriers and facilitators of PA and sleep, preferences for ways to emphasize key self-determination theory constructs (autonomy, competence, and relatedness), and suggestions for making SMS text message content engaging. In the design and content phase, interview findings were used to develop initial SMS text messages, which were then evaluated in the early evaluation phase by experts (n=6) and adolescents (n=6). Feedback from these panels was integrated into the SMS text message content during refinement. The background phase revealed that few SMS text message-based interventions have included Hispanic adolescents. Common barriers and facilitators of activity and sleep as well as preferences for ways in which SMS text messages could provide autonomy, competence, and relatedness support were identified in the co-design phase. The youths also wanted feedback about goal attainment. Suggestions to make SMS text messages more engaging included using emojis, GIFs, and media. This information informed an initial bank of SMS text messages (N=116). Expert review indicated that all (116/116, 100%) SMS text messages were age and culturally appropriate; however, some (21/116, 18.1%) did not adequately address youth-identified barriers and facilitators of PA and sleep, whereas others (30/116, 25.9%) were not theoretically adherent. Adolescents reported that SMS text messages were easy to understand (116/116, 100%), provided the support needed for behavior change (103/116, 88.8%), and used mostly acceptable language (84/116, 72.4%). Feedback was used to refine and develop the final bank of 125 unique text messages. Using a co-design process, a theoretically grounded, appealing, and relevant bank of SMS text messages promoting healthy PA and sleep behaviors to adolescents was developed. The SMS text messages will be further evaluated in a pilot study to assess feasibility, acceptability, and preliminary efficacy. The co-design process used in this study provides a framework for future studies aimed at developing SMS text message-based strategies among high-risk adolescents. RR2-10.1016/j.cct.2023.107117.

ХРАНИ СЕ ЗДРАВОСЛОВНО – ЖИВЕЙ ЗДРАВОСЛОВНО!

Creating an environment that promotes children’s health and well-being from an early age has an effect on their ability and desire to learn and develop. The goals of the project are related to activities such as healthy eating, physical activity and emotional well-being. This symbiosis prepares the child for entering the modern world. If we want children to be healthy, we need to introduce them to discussions about the importance of nutrition. Especially in times of various conflicts, it is important to teach both different cultures and traditions, as well as ways of eating, in order to raise open-minded and tolerant people. The goals of the topics related to physical activity are familiarization with one’s own body and its development through movement and sports and fair play with friends. Focusing on mental well-being is all about stress of the role of empathic communication with others. This can boost children’s self-esteem and tolerance. All these project ideas are crucial for preparing children for their future roles as adults in a democratic European society. We must not forget that the future begins today and future adults acquire important skills among peers in kindergarten, learning love, friendship, tolerance and healthy living.

The Effects of the Jump-In Whole-School Intervention on the Weight Development of Children in Amsterdam, the Netherlands.

This study assessed the effects of the "Jump-in" whole-school intervention in Amsterdam, the Netherlands, on children's weight development by comparing children exposed to the intervention and controls from 3 other large Dutch cities. Jump-in is a comprehensive intervention that aims to stimulate healthy nutrition and physical activity in children at primary schools in Amsterdam. In addition, the relationship between the intervention's implementation degree and its effectiveness was studied. Demographic and anthropometric data, collected by youth health care professionals via routine health checks at T0 (2014) and T1 (2019), were used to analyze possible intervention effects by comparing the weight development of children exposed to the Jump-in intervention versus unexposed controls. Implementation logs from health promotion professionals were used to determine intervention effects per implementation degree. Multilevel regression analyses were used for all analyses. In total, 4299 children were included mean age ± 5.5 years (T0), 10.6 years (T1), and ≈50% boys/girls at both times. Receiving the fully implemented intervention resulted in a decline in standardized body-mass index (zBMI) compared to the controls (-0.23, confidence interval [CI] -0.33, -0.13). It also led to higher odds to move into a healthier weight category over time (odds ratio [OR] 1.36, CI 1.06, 1.74), yet no statistically significant shift towards a healthy weight was found. Relative to the controls, children exposed to the intervention showed positive zBMI developments, with stronger effects when the implementation degree was higher. Despite positive results, creating more impact might require the further integration of school-based programs into whole-systems approaches that include other energy-balance behaviors.

Differences in obesity-related health behaviors and health outcomes by rural and Appalachian residency

PurposeObesity and health behaviors are the major modifiable contributors to cancer and health disparities. We examined the differences in obesity-related health behaviors, and health outcomes by rural and Appalachian residency in Ohio.MethodsCross-sectional survey data from the 2011–2019 Behavioral Risk Factor Surveillance System were obtained from the Ohio Department of Health. County-level identifiers were used to classify urban non-Appalachian, urban Appalachian, rural non-Appalachian, and rural Appalachian residency. Self-reported weight, height, health behaviors, and health conditions were used. Logistic regression was used to assess the difference in health behaviors and health outcomes by rural and Appalachian residency. All analyses incorporated with sample weights.ResultsAmong Ohio residents, compared to urban non-Appalachian residents, urban Appalachian and rural Appalachian residents had a higher prevalence of obesity, hypertension, high cholesterol, and cardiovascular diseases, as well as lower rates of healthy diet and physical activity. No difference was found in trends of obesity and obesity-related health outcomes in 2011–2019 by rural and Appalachian residency. However, rural Appalachian residents had a greater increase in obesity, hypertension, and diabetes, whereas rural non-Appalachian had favorable changes in obesity-related health behaviors. Additionally, associations between health behaviors and obesity-related health outcomes differed by rural and Appalachian residency.ConclusionsFindings underscore the importance of distinguishing between urban non-Appalachian, urban Appalachian, rural non-Appalachian, and rural Appalachian populations when assessing health disparities. While the trends of obesity and obesity-related health outcomes did not differ, the association between health behaviors and obesity-related outcomes differed by rural and Appalachian residency.

Sedentary Behavior and Lack of Physical Activity among Children in Indonesia.

Sedentary behavior and lack of physical activity among children in Indonesia is an important issue that needs to be addressed. It is estimated that 57% of children in Indonesia have insufficient physical activity. Studies have shown that children who engage in sedentary behaviors are at an increased risk for various negative health outcomes, including obesity, type 2 diabetes, cardiovascular disease, and poor mental health, compared to physically active ones. This article aims to provide recommendations to increase physical activity and reduce passive behavior in children in Indonesia. This is a commentary article developed from observing the recent progress of sedentary behavior and lack of physical activity among children in Indonesia and the potential consequences. The level of inactive behavior in children in Indonesia is relatively high. Factors that contribute to sedentary behavior and lack of physical activity among children in Indonesia are the increasing use of electronic devices and screen time, the lack of safe and accessible places to be physically active, the COVID-19 pandemic, as well as cultural and social norms that prioritize academic achievement over physical activity. To address sedentary lifestyles among children, there is a need for a comprehensive approach that addresses both the individual and societal factors contributing to the problem. This might include increasing access to healthy food options, promoting physical activity, and implementing education programs to raise awareness about the importance of healthy eating and physical activity, as well as limiting screen time.

Diabetes associated complicated disorders and its treatment a review article

Type 2 diabetes mellitus is increasingly prevalent in the worldwide and is associated with significant morbidity, mortality, and rising health care costs. Microvascular and, to a lesser extent, macrovascular complications are recognized to result from uncontrolled hyperglycemia. However, intensive therapy to achieve normal glucose levels is not without risk, as demonstrated by increased rates of hypoglycemia, weight gain, and all-cause mortality rates in the intensive treatment arm of the ACCORD trial. In addition, observational studies indicate that the presence of diabetes increases the risk of other comorbidities such as fracture and certain cancers, and treatment choice may affect risk. Thus, in an effort to maintain glucose control, the clinician encounters a complex interplay of primary disease management while simultaneously seeking to avoid complications associated with glucose lowering. The chronic nature of diabetes management, efficacy must be balanced against side effects to achieve a tolerable long-term regimen. The goal of this concept is to identify complications of non-insulin treatment of diabetes. The major classes of medication should be reviewed with special attention given to patient considerations, mechanism of action, effect on weight, and cardiovascular outcomes, and additional class-specific side effects including effects on bone. In addition, effects on β-cell function are rectified. It is possible to identify diabetes mellitus risk years or decades in advance on the basis of numerous personal, historic, and laboratory measures and user-friendly clinical decision-support tool to estimate absolute risk for individuals. The patient families, communities, and health organizations should encourage healthy eating and physical activity and should focus the most intensive diabetes mellitus prevention efforts on those at highest risk for progression to diabetes mellitus.

Healthy eating and physical activity: Analysing Soweto's young adults' perspectives with an intersectionality lens.

Non-communicable diseases (NCDs) are taking a toll on Africa's youth at younger ages than in other regions. These are attributed to risk factors that usually advance in adolescence, such as unhealthy diets and reduced physical activity. Young adults in South Africa, particularly women, tend to be sedentary, consume energy-dense diets low in micronutrients, and are more likely to develop NCDs much earlier in life than those in high-income countries. With an intersectionality perspective, this study explored young adults' barriers and solutions to addressing these risk factors in Soweto. Soweto, Johannesburg, South Africa, is one of the most well-known historically disadvantaged townships known for its established communities, and socioeconomic and cultural diversity. Design: A qualitative investigation utilising focus group discussions (FGDs) with a topic guide. FGDs were transcribed verbatim and thematically analysed using a combination of deductive and inductive approaches. 15 Men and 15 women 18-24 years of age living in Soweto (n = 30). Results: South African young adults have a basic understanding of the significance of nutrition, exercise, and their ties to health. However, numerous barriers (like taste, affordability and crime) to such behaviours were reported, arising from the participants' personal, domestic, social, and local community levels. Young women experienced sexism and had safety concerns while exercising in the streets, while young men tended to describe themselves as lazy to engage in exercise as they find it boring. Young adults face a multitude of intersecting barriers, making it difficult to adopt or sustain health-promoting behaviours. It is important that potential solutions focus on the intersections of barriers to healthy eating and physical activity in order to provide more realistic support for such behaviours.

Exploring Restrictions to use of community greenways for physical activity through structural equation modeling.

Public health problems caused by rapid urbanization have attracted increasing amounts of attention. Existing studies show that improving the frequency and duration of physical activity among urban residents can effectively reduce their disease risk. A community greenway, as a green space for public activity directly serving community residents, is one of the best spatial place for bringing health benefits to people. Although the scale and scope of greenway construction have been increasing in recent years, the utilization rate of some greenways is not high for various reasons, restricting the extent to which people engage in healthy physical activities in greenway spaces. In this study, the greenway of Nancheng Community in Wenjiang District, Chengdu city, China was selected as the object of study, and structural equation modeling was conducted to explore the objective environmental factors and individual characteristics acting as barriers to use of the community greenway by the population for physical activity. The results show that user experience, the greenway landscape, and safety and accessibility are important factors that restrict people's willingness engage in physical activity in the community greenway environment. The results of this study provide a direction for further consideration of ways to enhance people's willingness to make use of greenways for physical activity, and further provide a theoretical basis for the healthy design and transformation of community greenway spaces.

School Health Education Program in Pakistan (SHEPP): findings from a feasibility trial in pre-adolescent school children from a lower middle-income country

BackgroundThe school environment plays an essential role in promoting health education and physical activity for children and adolescents. We aim to assess the feasibility of threefold health education program in children and its potential efficacy on physical activity and diet and cardiometabolic risk factors including blood pressure, body mass index (BMI), and waist circumference.MethodsThe SHEPP was a parallel group feasibility intervention trial conducted in two schools over 23 months. All children aged 9–11 years enrolled in the schools were included. The SHEPP intervention comprised of health education on healthy lifestyle and physical activity sessions for children, training of teachers, and awareness sessions for parents conducted over 10 months. One school received the intervention of SHEPP while the other school continued routine activity. The primary outcome was the feasibility of SHEPP in terms of recruitment, retention, and treatment fidelity. Secondary outcomes were physical activity levels, dietary intake (of fruits and vegetables), and cardiometabolic risk factors (blood pressure, BMI, and waist circumference (WC)).ResultsA total of 1280 preadolescent children were assessed for eligibility and 1191 were found eligible. The overall recruitment n (%) was 982/1191(82.5%) with 505(51.4) from SHEPP intervention school and 477(48.6) in routine activity school. The overall retention rate n (%) at 10-month follow-up was 912/982(92.8), with 465/505(92) in SHEPP intervention school and 447/477(93.7) in routine activity school. In treatment fidelity, 132/144(92) %). Physical activity sessions and all (100%) health education sessions were conducted for each of the twelve classes. Mean (SD) Seven-day Physical activity increased by 134 (196) min in the SHEPP intervention school v 29.8(177) in the routine activity school (P value < 0.001) from baseline to follow-up. Overall, there was an increase in vegetable intake (> 3 serving /day) in SHEPP intervention school of 5.5 to 21.4% from baseline to follow-up compared to 7.5 to 14.9% in routine activity school. The mean change (SD) in systolic blood pressure was 1.3(12) mmHg, 2.2(19.0) mm Hg in in diastolic blood pressure, − 0.09(5.4) kg/m2 in BMI and 6.2 cm in waist circumference in the intervention arm versus − 3.4(11.1) mm Hg in SBP, − 4.3(9.9) mm Hg in DBP, − 0.04((4.6) kg/m2 in BMI, and 3.8 cm in WC in the control arm.ConclusionWe found that intervention using SHEPP is feasible in schools and may help children to adopt a healthy lifestyle as they age by increasing physical activity. However, the potentially beneficial effect on diet, MI, and BP needs further exploration and a longer follow-up, more specifically at the juncture of teenage and adulthood.Trial registrationNCT03303287.

Cardiometabolic risk management: insights from a European Society of Cardiology Cardiovascular Round Table.

Metabolic comorbidities are common in patients with cardiorenal disease; they can cause atherosclerotic cardiovascular disease (ASCVD), speed progression, and adversely affect prognosis. Common comorbidities are Type 2 diabetes mellitus (T2DM), obesity/overweight, chronic kidney disease (CKD), and chronic liver disease. The cardiovascular system, kidneys, and liver are linked to many of the same risk factors (e.g. dyslipidaemia, hypertension, tobacco use, diabetes, and central/truncal obesity), and shared metabolic and functional abnormalities lead to damage throughout these organs via overlapping pathophysiological pathways. The COVID-19 pandemic has further complicated the management of cardiometabolic diseases. Obesity, T2DM, CKD, and liver disease are associated with increased risk of poor outcomes of COVID-19 infection, and conversely, COVID-19 can lead to worsening of pre-existing ASCVD. The high rates of these comorbidities highlight the need to improve recognition and treatment of ASCVD in patients with obesity, insulin resistance or T2DM, chronic liver diseases, and CKD and equally, to improve recognition and treatment of these diseases in patients with ASCVD. Strategies to prevent and manage cardiometabolic diseases include lifestyle modification, pharmacotherapy, and surgery. There is a need for more programmes at the societal level to encourage a healthy diet and physical activity. Many pharmacotherapies offer mechanism-based approaches that can target multiple pathophysiological pathways across diseases. These include sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, selective mineralocorticoid receptor antagonists, and combined glucose-dependent insulinotropic peptide/glucagon-like peptide-1 receptor agonist. Non-surgical and surgical weight loss strategies can improve cardiometabolic disorders in individuals living with obesity. New biomarkers under investigation may help in the early identification of individuals at risk and reveal new treatment targets.

The Lived Experience of Young Adult Cancer Survivors after Treatment: A Qualitative Study.

The purpose of this qualitative study was to compare the lived experiences among extended (one year or less post-treatment) and long-term (three years or more post-treatment) young adult (YA) cancer survivors (ages 18-39 years old). Two trained researchers conducted semi-structured interviews inquiring about the overall lived experience of N = 24 YA cancer survivors (n = 12 extended and n = 12 long-term). The same two researchers independently completed line-by-line coding and thematic content analysis. Interviews lasted an average of 41 min and revealed common themes of symptoms, psychosocial concerns, coping, and changes in health behaviors (e.g., nutrition and physical activity). All participants discussed symptoms impairing their quality of life and affecting their fear of recurrence. Specific psychosocial concerns among extended survivors were appearance-related (e.g., hair loss, weight gain) whereas concerns among long-term survivors included job loss, fertility, and financial stress. Coping strategies described by extended survivors were often distraction-based (e.g., watching television to "escape"), while long-term survivors described more active coping strategies (e.g., yoga, meditation, and seeking support from family and friends). Most survivors reflected on limited physical activity or unhealthy eating during treatment; however, nearly all declared healthy eating and physical activity post-treatment to improve well-being. YA cancer survivors report differing symptoms, psychosocial concerns, and coping strategies across time since treatment. While survivors reported challenges with physical activity and nutrition during treatment, nearly all emphasized the importance of these health behaviors post-treatment. Thus, health behavior interventions could represent a preferred approach to address post-treatment challenges and improve quality of life for YA survivors.

OR07-02-23 Feasibility and Acceptability of a Self-Monitoring, Online Behavior Change Intervention To Promote Healthy Diets and Physical Activity of Young Adults

OR07-02-23 Feasibility and Acceptability of a Self-Monitoring, Online Behavior Change Intervention To Promote Healthy Diets and Physical Activity of Young Adults

P24-091-23 Parent Preferences for a Digital Healthy Eating and Physical Activity Intervention

P24-091-23 Parent Preferences for a Digital Healthy Eating and Physical Activity Intervention

Understanding Obesity Among Latinx Families of Children With Intellectual &amp; Developmental Disabilities: The Role of OT

Abstract Date Presented 04/22/2023 Research on obesity prevention for Latinx children with disabilities is limited. OTs can play an essential role in supporting families’ health behaviors, including promoting healthy eating and physical activity routines. Primary Author and Speaker: Yolanda Suarez-Balcazar Contributing Authors: Jasmine Brown, Mansha Mirza

Prevalence of Obesity among Students in Private and Public high Schools in Sulaimani City

Background: There is an increasing concern about obesity among children and adolescents worldwide as they constitute 20% of the world population. Several predisposing factors are contributing to the obesity that can be monitored, particularly healthy diet and physical activities. Addressing those factors among children and adolescents lead to decreasing health related conditions.&#x0D; Objective: To investigate the prevalence rate of obesity, sociodemographic, dietary habits, lifestyle and knowledge factors among adolescents attending private and public schools in Sulaimani city, Iraq.&#x0D; Patients and Methods: Through a school-based cross-sectional study from October 2021 to April 2022, a total of 576 students in high schools located in Sulaimani city, Kurdistan Region, Iraq were studied. A structured questionnaire was used to collect information on students’ sociodemographic characteristics, physical activities, dietary habits and knowledge. Body mass index was measured based on WHO Growth Reference for 5 to 19 years of age.&#x0D; Results: The obesity prevalence rate in private schools (36.11%) was higher than public schools (31.6%) (P=0.5890) however, the difference was not statistically significant. The majority of students in private schools exercised more frequently and for a longer duration; however, they ate more red meat, less dairy produce and had a higher fast food intake.&#x0D; Conclusion: The prevalence of obesity is slightly higher among students in private schools than the students in public schools.

Altitude and metabolic syndrome in China: Beneficial effects of healthy diet and physical activity.

The correlation between altitude and metabolic syndrome has not been extensively studied, and the mediation effects of diet and physical activity remain unclear. We evaluated the cross-sectional correlations between altitude and metabolic syndrome and the possible mediation effects of diet and physical activity in China. We included 89 485 participants from the China Multi-Ethnic Cohort. We extracted their altitude information from their residential addresses and determined if they had metabolic syndrome by the presence of three or more of the following components: abdominal obesity, reduced high-density lipoprotein cholesterol (HDL-C), elevated triglycerides, elevated glucose, and high blood pressure at recruitment. We conducted multivariable logistic regression and mediation analyses for all and separately for Han ethnic participants. The participants had a mean age of 51.67 years and 60.56% were female. The risk difference of metabolic syndrome was -3.54% (95% confidence interval (CI) = -4.24, -2.86) between middle and low altitudes, -1.53% (95%CI = -2.53, -0.46) between high and low altitudes, and 2.01% (95% CI = 0.92, 3.09) between high and middle altitudes. Of the total estimated effect between middle and low altitude, the effect mediated by increased physical activity was -0.94% (95% CI = -1.04, -0.86). Compared to low altitude, the effects mediated by a healthier diet were -0.40% (95% CI = -0.47, -0.32) for middle altitude and -0.72% (95% CI = -0.87, -0.58) for high altitude. Estimates were similar in the Han ethnic group. Living at middle and high altitudes was significantly associated with lower risk of metabolic syndrome compared to low altitude, with middle altitude having the lowest risk. We found mediation effects of diet and physical activity.

Prevalence of Obesity among Students in Private and Public high Schools in Sulaimani City

Background: There is an increasing concern about obesity among children and adolescents worldwide as they constitute 20% of the world population. Several predisposing factors are contributing to the obesity that can be monitored, particularly healthy diet and physical activities. Addressing those factors among children and adolescents lead to decreasing health related conditions. Objective: To investigate the prevalence rate of obesity, sociodemographic, dietary habits, lifestyle and knowledge factors among adolescents attending private and public schools in Sulaimani city, Iraq. Patients and Methods: Through a school-based cross-sectional study from October 2021 to April 2022, a total of 576 students in high schools located in Sulaimani city, Kurdistan Region, Iraq were studied. A structured questionnaire was used to collect information on students’ sociodemographic characteristics, physical activities, dietary habits and knowledge. Body mass index was measured based on WHO Growth Reference for 5 to 19 years of age. Results: The obesity prevalence rate in private schools (36.11%) was higher than public schools (31.6%) (P=0.5890) however, the difference was not statistically significant. The majority of students in private schools exercised more frequently and for a longer duration; however, they ate more red meat, less dairy produce and had a higher fast food intake. Conclusion: The prevalence of obesity is slightly higher among students in private schools than the students in public schools. Keywords: Obesity, private, public, high schools, Sulaimani city