Obesogenic Behaviors Research Articles

Impact of the COVID-19 pandemic on elementary schoolers' physical activity, sleep, screen time and diet: A quasi-experimental interrupted time series study.

SummaryBackgroundCOVID‐19 school closures pose a threat to children's wellbeing, but no COVID‐19‐related studies have assessed children's behaviours over multiple years .ObjectiveTo examine children's obesogenic behaviours during spring and summer of the COVID‐19 pandemic compared to previous data collected from the same children during the same calendar period in the 2 years prior.MethodsPhysical activity and sleep data were collected via Fitbit Charge‐2 in 231 children (7–12 years) over 6 weeks during spring and summer over 3 years. Parents reported their child's screen time and dietary intake via a survey on 2–3 random days/week.ResultsChildren's behaviours worsened at a greater rate following the pandemic onset compared to pre‐pandemic trends. During pandemic spring, sedentary behaviour increased (+79 min; 95% CI = 60.6, 97.1) and MVPA decreased (−10 min, 95% CI = −18.2, −1.1) compared to change in previous springs (2018–2019). Sleep timing shifted later (+124 min; 95% CI = 112.9, 135.5). Screen time (+97 min, 95% CI = 79.0, 115.4) and dietary intake increased (healthy: +0.3 foods, 95% CI = 0.2, 0.5; unhealthy: +1.2 foods, 95% CI = 1.0, 1.5). Similar patterns were observed during summer.ConclusionsCompared to pre‐pandemic measures, children's PA, sedentary behaviour, sleep, screen time, and diet were adversely altered during the COVID‐19 pandemic. This may ultimately exacerbate childhood obesity.

Prospective relations between maternal emotional eating, feeding to soothe, and infant appetitive behaviors

BackgroundInfant obesogenic appetitive behaviors are associated with greater infant weight and child obesity, yet little is known about maternal influences on infant appetitive behaviors. This study examines the relations between maternal eating behaviors, feeding to soothe, and infant appetitive behaviors in a longitudinal sample of United States mothers.MethodsPregnant women were recruited in the first trimester (< 12 weeks) and followed through 1 year postpartum. Mothers reported their own eating behaviors (eating competence, restrained, emotional, and external eating) in pregnancy; feeding to soothe their infant at 2, 6, and 12 months postpartum; and their infants’ appetitive behaviors (enjoyment of food, food responsiveness, slowness in eating, and satiety responsiveness) at 6 months. Three path models were estimated to examine the direct relations of maternal eating behaviors with infant appetitive behaviors, the indirect relations of maternal eating behaviors with infant appetitive behaviors through feeding to soothe, and the longitudinal relations between feeding to soothe and infant appetitive behaviors.ResultsMaternal eating behaviors and infant appetitive behaviors were directly and indirectly related in all three models. Greater maternal eating competence was related to greater enjoyment of food but was not related to feeding to soothe. Greater maternal restrained and external eating were not directly related to infant appetitive behaviors but were indirectly related to greater infant responsiveness to food through more frequent feeding to soothe. Additionally, several longitudinal relations between feeding to soothe behaviors and infant appetitive behaviors were present. More frequent feeding to soothe at 2 months was related to greater responsiveness to food at 6 months, which was then related to more frequent feeding to soothe at 6 months. Furthermore, greater satiety responsiveness, faster eating speed, and greater responsiveness to food at 6 months were related to more frequent feeding to soothe at 12 months.ConclusionsMaternal eating behaviors were related to infant appetitive behaviors directly and indirectly through feeding to soothe. Additionally, results suggest feeding to soothe and infant appetitive behaviors may be bidirectionally linked. These results underscore the need to examine how parental feeding behaviors are influenced both by parental eating behaviors and child appetitive behaviors throughout infancy.Trial registrationClinicaltrials.gov. Registration ID – NCT02217462. Date of registration – August 13, 2014.

Disparities in Adolescents' Obesogenic Behaviors, 2005-2017.

Objectives: Given the increasing national-level efforts to reduce disparities in obesogenic behaviors in youth, in this paper, we assessed the change in disparities in meeting guidelines for fruits and vegetables intake (FV), physical activity (PA), and sedentary behavior (SB) among adolescents in the United States in the last 13 years. Methods: Using the Youth Risk Behavior Surveillance System (2005-2017), overall and characteristic-specific (sex, age, race/ethnicity) disparities ratios for meeting FV, PA, and SB guidelines were calculated using the Extended Gastwirth Index Method. Linear regressions, one-way analysis of variance, and posthoc tests assessed change in characteristic-specific disparities over the years. Linear and quadratic trends assessed change in characteristic-specific contributions to overall disparities. Results: Sex-specific and age-specific disparities increased for meeting FV and PA and decreased for meeting SB guidelines. Race/ethnicity-specific disparities decreased for meeting FV and SB guidelines. Characteristics-specific contributions to overall disparities for each behavior changed over the years. Conclusions: Disparities in obesogenic behaviors are still an ongoing concern despite national-level efforts to improve adolescents' behaviors. The methodology allowed for meaningful disparities ratios that facilitated comparison of categorical demographic characteristics across the years and identifying targetable intervention groups to reduce disparities.

Exploring Associations Between Children's Obesogenic Behaviors and the Local Environment Using Big Data: Development and Evaluation of the Obesity Prevention Dashboard.

BackgroundObesity is a major public health problem globally and in Europe. The prevalence of childhood obesity is also soaring. Several parameters of the living environment are contributing to this increase, such as the density of fast food retailers, and thus, preventive health policies against childhood obesity must focus on the environment to which children are exposed. Currently, there are no systems in place to objectively measure the effect of living environment parameters on obesogenic behaviors and obesity. The H2020 project “BigO: Big Data Against Childhood Obesity” aims to tackle childhood obesity by creating new sources of evidence based on big data.ObjectiveThis paper introduces the Obesity Prevention dashboard (OPdashboard), implemented in the context of BigO, which offers an interactive data platform for the exploration of objective obesity-related behaviors and local environments based on the data recorded using the BigO mHealth (mobile health) app.MethodsThe OPdashboard, which can be accessed on the web, allows for (1) the real-time monitoring of children’s obesogenic behaviors in a city area, (2) the extraction of associations between these behaviors and the local environment, and (3) the evaluation of interventions over time. More than 3700 children from 33 schools and 2 clinics in 5 European cities have been monitored using a custom-made mobile app created to extract behavioral patterns by capturing accelerometer and geolocation data. Online databases were assessed in order to obtain a description of the environment. The dashboard’s functionality was evaluated during a focus group discussion with public health experts.ResultsThe preliminary association outcomes in 2 European cities, namely Thessaloniki, Greece, and Stockholm, Sweden, indicated a correlation between children’s eating and physical activity behaviors and the availability of food-related places or sports facilities close to schools. In addition, the OPdashboard was used to assess changes to children’s physical activity levels as a result of the health policies implemented to decelerate the COVID-19 outbreak. The preliminary outcomes of the analysis revealed that in urban areas the decrease in physical activity was statistically significant, while a slight increase was observed in the suburbs. These findings indicate the importance of the availability of open spaces for behavioral change in children. Discussions with public health experts outlined the dashboard’s potential to aid in a better understanding of the interplay between children’s obesogenic behaviors and the environment, and improvements were suggested.ConclusionsOur analyses serve as an initial investigation using the OPdashboard. Additional factors must be incorporated in order to optimize its use and obtain a clearer understanding of the results. The unique big data that are available through the OPdashboard can lead to the implementation of models that are able to predict population behavior. The OPdashboard can be considered as a tool that will increase our understanding of the underlying factors in childhood obesity and inform the design of regional interventions both for prevention and treatment.

Transitioning to an obese India: Demographic and structural determinants of the rapid rise in overweight incidence

India, which has long suffered from undernutrition, has seen a rapid rise in overweight incidence in the last decade and a half. These changes are characterized by significant within-country differences in overweight incidence that vary by gender and regional development levels. In this paper, we provide an integrative framework, linking the income-gradient hypothesis of obesity with biological, obesogenic, and environmental factors to provide an explanation on the emergence of within-country differences in overweight patterns. We utilize measured body mass index (BMI), along with individual- and household-level data of over 800,000 men and women surveyed in the National Family Health Surveys of 2005–06 and 2015–16 to identify correlates of within-country differences in overweight incidence. A decomposition analysis reveals that among women, in addition to increasing access to obesogenic technologies, biological factors are associated with overweight incidence. Among men, obesogenic factors related to technology use and health behaviors are associated with the rise in overweight incidence, but biological factors are not. At lower levels of regional development, overweight incidence is associated with greater access to obesogenic technology such as motorized transport, which reduces physical activity among men at higher rates than women. At higher levels of economic development, obesogenic behaviors, such as watching more television and reducing smoking, are associated with overweight incidence. Our results corroborate the call by public health experts for group-specific policies to stem the rise of overweight incidence in developing countries.

Abstract 2962: Investigation of the relationship between obesity, weight cycling, and tumor progression in a murine myeloma model

Abstract Background: The purpose of this study was to investigate physiologic effects of body weight regulation patterns and myeloma progression in vivo. Obesity and obesogenic behaviors are positively associated with both monoclonal gammopathy of unknown significance and multiple myeloma (MM). As the only known modifiable risk factor, this association has emerged as an optimal target for MM prevention, but little is known about the mechanistic relationship of weight patterns with MM progression. In two large prospective cohorts, we have reported an association of episodes of weight cycling (WC), e.g., intentional weight loss followed by unintentional weight gain, with increased MM risk compared to weight-stable individuals (Marinac et al. JNCI Cancer Spectrum, 2019). Experimental Procedures: We used two murine MM models (C57BL/6J Vk*Myc and SCID-Beige MM.1Sluc+ xenograft); male mice were fed a control diet (CD; 10% kcal from fat), high fat diet (HFD; 60% kcal from fat), or a diet cycling regimen (DC; 4 weeks on CD then 4 weeks on HFD) for 16 weeks and thereafter injected them intravenously with tumor cells (1x106 Vk*Myc or 2x106 MM.1S). Body composition was assessed via PIXIMUS-DEXA (SCID-Beige) or NMR (C57BL/6J). Tumor burden was assessed via CD138+ FACS (Vk*Myc) or in vivo bioluminescent imaging (IVIS; MM.1S). Results: The C57BL/6J mice (n=20) on HFD consistently gained weight and sustained the gains throughout the study duration; mice on the DC regimen exhibited dramatic weight cycling responses to diet switching. We observed significant differences in body fat (%) between HFD and CD mice, as assessed by NMR (p&amp;lt;= 0.0001), while body fat fluctuated with diet in the DC mice. At the time of tumor cell injection, HFD mice had higher body weights versus CD (p&amp;lt;0.000001) and DC (p&amp;lt;0.000001) mice; however, weights of DC mice were comparable to CD despite weight fluctuation throughout the study. Three weeks after MM inoculation, we detected elevated tumor burden in DC mice vs. CD mice (n-10, p=0.0061) and a trend toward elevated tumor burden in HFD mice (p=0.145). C57BL/6J mice on the DC regimen also had greater Vk*Myc tumor burden (p=0.0413) within the bone marrow (BM), specifically. In the SCID-Beige MM.1Sluc+ model (n=10), we observed similar trends for weight gain and cycling, and greater early tumor burden in both the HFD (p&amp;lt;0.0001) and DC (p=0.0214) groups compared to CD. Tumor burden was also elevated (p=0.0004) in the heaviest mice (vs. the lightest), regardless of diet, later in the SCID-Beige study. Conclusions: Combined, these results suggest that HFD and WC may contribute to MM risk via changes in the BM microenvironment that affect MM cell homing, engraftment and early expansion. This study lays the groundwork for the future characterization of the relationship between weight patterns, the BM, and MM pathogenesis, which may affect MM prevention and treatment strategies. Citation Format: Heather Fairfield, Catherine Marinac, Mariah Farrell, Brenda Birmann, Michaela Ruth Reagan. Investigation of the relationship between obesity, weight cycling, and tumor progression in a murine myeloma model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2962.

The mediating role of emotional eating in the relationship between perceived stress and dietary intake quality in Hispanic/Latino adolescents

Obesity rates have steadily increased over the past three decades, and large racial/ethnic disparities in childhood obesity rates—specifically for Hispanic/Latino youth—highlight the major need for identifying and examining key mechanisms of obesogenic behaviors for this at-risk population. This study investigates the relationship between stress and dietary quality in Hispanic/Latino adolescents and seeks to determine the mediating role of emotional eating as a behavioral mechanism. Baseline data from 169 adolescents enrolled in the Imagine HEALTH trial were used to investigate these relationships. Perceived stress and emotional eating were assessed with age-validated questionnaires, and dietary quality was measured via 24-hour recall dietary assessments (later calculated as individual Healthy Eating Index-2015 scores). Nonparametric bootstrapping was used to test the primary hypothesis that emotional eating partially or fully mediates the relationship between perceived stress and dietary quality in this sample, and to test the significance of the mediating effect. Results indicate that emotional eating partially mediates the relationship between perceived stress and dietary quality. The total effect of perceived stress scores on dietary quality scores was −0.24 (p = .006); the direct effect of perceived stress scores on dietary quality scores (controlling for emotional eating scores) was −0.16 (p = .107), and the mediating (indirect) effect of emotional eating was −0.09 (p = .001). The proportion of mediation was 0.36 (36%) (p = .008). This study identifies an important mechanism of obesogenic behavior and can be used to inform future obesity prevention and intervention strategies tailored for the Hispanic/Latino adolescent population.

Obesogenic Behaviors of Rural Children on School and Nonschool Days.

Background: Children living in rural areas are at increased risk of overweight and obesity compared with their urban-dwelling counterparts. The purpose of this study was to provide preliminary evidence of rural children's obesogenic behaviors (e.g., activity, sedentary behaviors, sleep, and diet) during school days, nonschool weekdays, and weekend days. Methods: A repeated measures 14-day observational study was conducted early March 2020. Children (n = 54, 92% 6-11 years old; 66% female; 98% non-Hispanic white; 22% overweight or obese) wore accelerometers on the nondominant wrist for 24 hours/day for 14 consecutive days to capture moderate-to-vigorous physical activity (MVPA), sedentary time, and sleep. Parents completed diaries to report daily activities, diet, and screen time of their child each day. Mixed effect models compared behaviors between school days, nonschool weekdays, and weekend days. Results: Children accumulated +16 additional minutes/day of MVPA (95% confidence interval, CI: +10 to +23 minutes/day), reduced sedentary time (-68 minutes/day, 95% CI: -84 to -51 minutes/day), and reduced screen time (-99 minutes/day; 95% CI: -117 to -81 minutes/day) on school days vs. nonschool weekdays. Similar patterns were observed on school weekdays days vs. weekend days, and on nonschool days when children attended a structured program vs. days they did not attend. Minimal differences were observed in reported consumption of food groups across different days. Conclusions: Preliminary evidence suggests rural children display multiple unfavorable obesogenic behaviors on days when they do not attend school or other structured programs. Future interventions targeting obesogenic behaviors of rural children may want to target times when rural children are not engaged in school and "school-like" environments.

Differences in ​the proportion of children meeting behavior guidelines ​between summer​and schoolby socioeconomic status and race.

ObjectiveChildren who fail to meet activity, sleep, and screen‐time guidelines are at increased risk for obesity. Further, children who are Black are more likely to have obesity when compared to children who are White, and children from low‐income households are at increased risk for obesity when compared to children from higher‐income households. The objective of this study was to evaluate the proportion of days meeting obesogenic behavior guidelines during the school year compared to summer vacation by race and free/reduced priced lunch (FRPL) eligibility.MethodsMixed‐effects linear and logistic regressions estimated the proportion of days participants met activity, sleep, and screen‐time guidelines during summer and school by race and FRPL eligibility within an observational cohort sample.ResultsChildren (n = 268, grades = K − 4, 44.1%FRPL, 59.0% Black) attending three schools participated. Children's activity, sleep, and screen‐time were collected during an average of 23 school days and 16 days during summer vacation. During school, both children who were White and eligible for FRPL met activity, sleep, and screen‐time guidelines on a greater proportion of days when compared to their Black and non‐eligible counterparts. Significant differences in changes from school to summer in the proportion of days children met activity (−6.2%, 95CI = −10.1%, −2.3%; OR = 0.7, 95CI = 0.6, 0.9) and sleep (7.6%, 95CI = 2.9%, 12.4%; OR = 2.1, 95CI = 1.4, 3.0) guidelines between children who were Black and White were observed. Differences in changes in activity (−8.5%, 95CI = −4.9%, −12.1%; OR = 1.5, 95CI = 1.3, 1.8) were observed between children eligible versus uneligible for FRPL.ConclusionsSummer vacation may be an important time for targeting activity and screen‐time of children who are Black and/or eligible for FRPL.

Importance of Family Connection for Healthy Weight Behaviors Amid Adverse Family Experiences and Behavioral Difficulties.

Adverse family experiences (AFEs), including parent divorce and domestic violence, negatively affect obesogenic behaviors and engagement in healthy weight behaviors (HWBs). The current study used a moderated mediation model to investigate the role of family connection in the relationship between AFEs and HWBs for children with behavioral difficulties. Youth (6-17 years old; n = 13,921) from the 2016 National Survey of Children's Health data set were included in the study. Family connection mediated the relationship between AFEs and each HWB. The models of physical activity and screen time had significant direct effects. Behavioral difficulties moderated the direct effect of AFEs and screen time and physical activity. Family connection mediated the relationships between each HWB and AFEs. The findings suggest that for children without behavioral difficulties, family connection was a stronger protective factor for adequate physical activity and decreased screen time.

Prevalence of and Trends in the Co-Existence of Obesogenic Behaviors in Adolescents From 15 Countries.

Background: The global epidemic of pediatric obesity is well-known, but data on co-existence of obesogenic behaviors are limited. We aim to report the prevalence of and trends in the co-existence of obesogenic behaviors in adolescents from 15 countries.Methods: This study was based on the Global School-based Student Health Survey 2003–2017 and included 121,963 adolescents aged 12–15 years from 15 countries where at least 2 cross-sectional surveys were conducted. We used sampling weights and calculated the country-level prevalence of and trends in the co-existence of obesogenic behaviors (low fruit and vegetable intake, anxiety-induced insomnia, no physical activity, and sedentary behavior) during survey years. Pooled prevalence and trend estimates were calculated with random-effects models.Results: Pooled prevalence of exposure ≥ 1, ≥2, and ≥3 obesogenic behaviors was 88.2, 44.9, and 9.8% in the first survey and 88.4, 46.4, and 10.2% in the last survey, respectively. Plateauing, increasing, and decreasing trends in the co-existence of obesogenic behaviors were observed in different countries. Specifically, we identified a plateauing pooled trend in the exposure ≥ 1, ≥2, and ≥3 obesogenic behaviors [odds ratios (95% confidence intervals): 1.03 (0.93, 1.14), 1.05 (0.97, 1.13), and 1.06 (0.95, 1.18), respectively].Conclusion: Trends in the prevalence of the co-existence of obesogenic behaviors varied significantly across different countries, but the prevalence remained high in most countries. These findings suggest the need for behavioral interventions to mitigate obesogenic behaviors in adolescents for overweight and obesity prevention.

Eating behaviour, physical activity, TV exposure and sleeping habits in five year olds: a latent class analysis

BackgroundDiet, physical activity, sedentary behaviours, and sleep time are considered major contributory factors of the increased prevalence of childhood overweight and obesity. The aims of this study were to (1) identify behavioural clusters of 5 year old children based on lifestyle behaviours, (2) explore potential determinants of class membership, and (3) to determine if class membership was associated with body measure outcomes at 5 years of age.MethodsData on eating behaviour, engagement in active play, TV watching, and sleep duration in 1229 5 year old children from the Cork BASELINE birth cohort study was obtained through in-person interviews with parent. Latent class analysis was used to identify behavioural clusters. Potential determinants of cluster membership were investigated using multinomial logistic regression. Associations between the identified classes and cardio metabolic body measures were examined using multivariate logistic and linear regression, with cluster membership used as the independent variable.Results51% of children belonged to a normative class, while 28% of children were in a class characterised by high scores on food avoidance scales in combination with low enjoyment of food, and 20% experienced high scores on the food approach scales. Children in both these classes had lower conditional probabilities of engaging in active play for at least 1 hour per day and sleeping for a minimum of 10 h, and higher probability of watching TV for 2 hours or more, compared to the normative class. Low socioeconomic index (SEI) and no breastfeeding at 2 months were found to be associated with membership of the class associated with high scores on the food avoidance scale, while lower maternal education was associated with the class defined by high food approach scores. Children in the class with high scores on the food approach scales had higher fat mass index (FMI), lean mass index (LMI), and waist-to-height ratio (WtHR) compared to the normative class, and were at greater risk of overweight and obesity.ConclusionFindings suggest that eating behaviour appeared to influence overweight and obesity risk to a greater degree than activity levels at 5 years old. Further research of how potentially obesogenic behaviours in early life track over time and influence adiposity and other cardio metabolic outcomes is crucial to inform the timing of interventions.

Management of Childhood Obesity-Time to Shift from Generalized to Personalized Intervention Strategies.

As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.

Brief parental self-efficacy scales for promoting healthy eating and physical activity in children: a validation study

BackgroundBrief scales to measure parental self-efficacy (PSE) in relation to children’s obesogenic behaviours have not been developed and validated using more rigorous methodology such as invariance testing, limiting their generalisability to sub-groups.This study aimed to assess the construct validity and measurement invariance of brief PSE scales for children’s intake of vegetables, soft drinks, and sweets, and physical activity.MethodsParents (n = 242) of five-to-seven-year-old children in disadvantaged and culturally diverse settings in Sweden responded to a questionnaire in Swedish with 12 items assessing PSE in relation to healthy and unhealthy behaviours. Construct validity was assessed with confirmatory factor analysis, invariance testing compared the scales by groups of parental sex, education, and child weight status. Criterion validity was evaluated using objective measures of children’s physical activity and semi-objective measures of diet.ResultsTwo-factor models showed moderate to excellent fit to the data. Invariance was supported across all groups for healthy behaviour scales. Unhealthy behaviour scales were invariant for all groups except parental education where partial metric invariance was supported. Scales were significantly correlated with physical activity and diet.ConclusionThis study provides preliminary evidence for the validity of brief PSE scales and invariance across groups suggesting their utility for research and clinical management of weight-related behaviours.

A practical approach to obesity prevention: Healthy home habits.

Families have the potential to foster a healthy home environment aimed at reducing the risk of overweight and obesity. Establishing habits associated with reduced risk of obesity and overweight early in childhood can have lasting effects into adulthood. Nurse practitioners can encourage families to participate in healthy habits by addressing areas of growth for obesity prevention within the home. A review of the most recent literature, approximately over the past decade, was used to provide a consolidated source of reference for healthy home habits for the nurse practitioner. The search included terms such as "obesity," "overweight," "healthy habits," "physical activity," "obesogenic behaviors," "family meals," "screen time," "depression," "sugary beverages," and "portion sizes." The information was synthesized into three content areas: nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and obesity. Nurse practitioners can serve a vital role in the prevention of pediatric, adolescent, and adult obesity. Equipped with the unique role of assisting those from a diverse patient base, nurse practitioners can inform patients how to improve healthy habits to decrease the likelihood of obesity or overweight. Encouraging behavior change related to the healthy habits associated with the prevention of overweight and obesity can have a long-term impact on the health of an entire family.

Late eating is associated with cardiometabolic risk traits, obesogenic behaviors, and impaired weight loss

There is a paucity of evidence regarding the role of food timing on cardiometabolic health and weight loss in adults. To determine whether late eating is cross-sectionally associated with obesity and cardiometabolic risk factors at baseline; and whether late eating is associated with weight loss rate and success following a weight loss intervention protocol. Also, to identify obesogenic behaviors and weight loss barriers associated with late eating. Participants were recruited from a weight-loss program in Spain. Upon recruitment, the midpoint of meal intake was determined by calculating the midway point between breakfast and dinner times, and dietary composition was determined from diet recall. Population median for the midpoint of meal intake was used to stratify participants into early (before 14:54) and late (after 14:54) eaters. Cardiometabolic and satiety hormonal profiles were determined from fasting blood samples collected prior to intervention. Weekly weight loss and barriers were evaluated during the ∼19-wk program. Linear and logistic regression models were used to assess differences between late and early eaters in cardiometabolic traits, satiety hormones, obesogenic behaviors, and weight loss, adjusted for age, sex, clinic site, year of recruitment, and baseline BMI. A total of 3362 adults [mean (SD): age: 41 (14) y; 79.2% women, BMI: 31.05 (5.58) kg/m2] were enrolled. At baseline, no differences were observed in energy intake or physical activity levels between early and late eaters (P>0.05). Late eaters had higher BMI, higher concentrations of triglycerides, and lower insulin sensitivity compared with early eaters (all P<0.05) prior to intervention. In addition, late eaters had higher concentrations of the satiety hormone leptin in the morning (P=0.001). On average, late eaters had an average 80 g lower weekly rate of weight loss [early, 585 (667) g/wk; late, 505 (467) g/wk; P=0.008], higher odds of having weight-loss barriers [OR (95% CI): 1.22 (1.03, 1.46); P=0.025], and lower odds of motivation for weight loss [0.81 (0.66, 0.99); P=0.044] compared with early eaters. Our results suggest that late eating is associated with cardiometabolic risk factors and reduced efficacy of a weight-loss intervention. Insights into the characteristics and behaviors related to late eating may be useful in the development of future interventions aimed at advancing the timing of food intake.

Hassle Exposure and Reactivity Links with Obesogenic Health Behaviors.

Objectives: In this study, we explored associations between daily "hassles" (irritating inconveniences) and obesogenic health behaviors of college students. Methods: Students (N = 406, 62% female) completed a survey including the 5-point Brief College Student Hassle Scale which quantifies hassles experienced in the last month in 9 domains (eg, preparing meals, exercising, adequate sleep) and hassle reactivity (ie, upset from hassles), with scores categorized as low (< 2.5), moderate (≥ 2.5 to ≤ 3.5), or high (> 3.5). Results: Females had significantly (p < .05) greater hassles in all domains than males, except for work, personal relationships, and living environment. ANOVA revealed both sexes in the high hassle exposure groups tended to have poorer eating behaviors than the low hassle exposure group. Additionally, high hassle exposure females and males slept less, and had poorer sleep quality, satisfaction with life, and physical and mental health than lower hassle exposure groups. Multiple linear regression analyses examining associations of hassle exposures and hassle reactivity with each health behavior, adjusted for sex and body mass index, revealed all models were statistically significant, except fruit and vegetable intake. Conclusions: Lower hassle during college is associated with healthier weight-related behaviors and better health status. Future nutrition interventions targeting college students may be strengthened by incorporating strategies for effectively coping with daily hassles.

Engaging fathers in the first 1000 days to improve perinatal outcomes and prevent obesity: Rationale and design of the First Heroes randomized trial

BackgroundEarly pregnancy through the first year of life represents an important period for family health promotion and obesity prevention. Overall, preventive interventions in pregnancy and infancy have insufficiently engaged fathers. We describe the rationale and design of First Heroes, an intervention to improve perinatal and obesity-related outcomes among mother-father-infant triads beginning in pregnancy. Methods/designFirst Heroes is a hybrid type 1 effectiveness-implementation randomized trial of mother-father-infant triads recruited in the second trimester of pregnancy from a large Obstetric practice in eastern Massachusetts and continuing through 12 months of infant age. Triads are randomized to the intervention arm or to an enhanced safety education control group. Triads randomized to the intervention arm receive three virtual visits with a health educator, in the 3rd trimester of pregnancy, at 3–4 weeks, and 3–4 months postpartum, and receive continuous multimedia education through text messaging, print material, and videos. The educational curriculum addresses parent health behaviors, family relationships, social determinants of health, and infant feeding, sleep, and development. The primary outcome is prevalence of rapid infant weight gain from birth to 6 months of age. Secondary outcomes include parent anthropometrics, parent obesogenic behaviors, family functioning, and infant behaviors. DiscussionFirst Heroes will evaluate the extent to which intentional mother-father dyad engagement, coaching on adoption of early life health behaviors, and addressing social determinants of health, influence obesogenic behaviors and outcomes in the first year of life. Findings from this work will inform future obesity prevention efforts, especially those focused on whole family inclusion.

Parent Perspectives on Implementing Health Behavior Recommendations for Their Infants

Little is known about the influence of parental values, preferences, and child achievement and health expectations on parent choices for their child’s rearing practices. We aimed to explore parents’ perceptions of immediate and future impact of health behavior decisions for their child and to understand factors associated with child-specific health behavior decisions. This pilot study included interviews with 25 parents of 9–24-month-old children attending well child care visits at a primary care practice. Questions assessed parental perceptions and attitudes in making health behavior changes now for their child’s future health. Themes suggest parents perceive many factors are involved, and intricately connected, in health behavior decision-making. Although almost all parents believed there is a connection between the foods they feed their child and achieving their goals, only half are willing to make a change. In addition, parents failed to consider the impact of the health practices they currently have with their children to influence the future acquisition of life skills and of healthy versus obesogenic behaviors. Our results add to the understanding of the process of health behavior change through anticipatory guidance. Study findings will be used to guide next steps towards refining our understanding of health and lifestyle change decisions made by parents.

Factors influencing obesogenic behaviours of adolescent girls and women in low- and middle-income countries: A qualitative evidence synthesis.

SummaryThis systematic review synthesized the qualitative evidence on factors influencing obesogenic behaviours in adolescent girls and women of reproductive age in low‐ and middle‐income countries (LMICs). This qualitative evidence synthesis followed the framework synthesis approach to extract, analyse and synthesize data. Electronic searches were conducted in the Web of Science, SCOPUS, CABI s, MEDLINE, PsycINFO and Google Scholar. Studies were eligible if they were conducted in LMICs, of qualitative nature, and reported obesogenic behaviours of female adolescents (10–19 years of age) or women of reproductive age (15–49 years of age). The review resulted in 71 included studies from 27 different countries. Thirty‐two studies focused on dietary behaviours, 17 on physical activity and 22 on both behaviours. Gender norms and failures to recognize the importance of healthy behaviours across the life cycle were important factors. The abundance and promotion of affordable but unhealthy food, food safety concerns, taste preferences and social desirability of foods drive consumption of unhealthy foods. Busy lives and limited exercise spaces keep girls and women from being physically active. Obesogenic behaviours of adolescent girls and women of reproductive age are influenced by factors at individual, social, physical and environmental levels and require diverse solutions to address these factors in LMICs.