Overweight Adolescents Research Articles

Using a mobile health app in a weight management program for overweight and obese adolescents and young adults with spina bifida

Context: Adolescents and young adults (AYA) with spina bifida (SB) are more susceptible to obesity due to impaired mobility. There is limited access to physical activity for this population. Objective: The primary aim of this study was to evaluate the feasibility of a mobile health app in a weight management program for AYA with SB. This was determined by measuring program adherence, active use of the app (defined as ≥3 uses per week), and user rating of the Pt Pal™ mobile app. Secondary outcomes were changes in BMI, quality of life, and health behavior, and the number of active participants over time. Methods: Patients from the SB Clinic of a large metropolitan hospital between the ages of 11–21 years and overweight were invited to participate. The program consisted of group nutrition sessions and an individualized exercise plan using a mobile app with coaching. Outcome measures were program adherence, changes in BMI, and validated survey responses. Descriptive statistical analysis was performed. Results: Fifteen participants enrolled, and ten participants completed the program. Five of the ten participants attended the nutrition sessions. The number of active app users declined after the first week. Seventy percent of participants decreased their BMI. Most participants reported the program improved their ability to exercise regularly, eat a healthier diet and feel more self-confident. Peds QL™ psychosocial health domains increased postintervention. The YRBS showed increased physical activity and less sedentary time postintervention. Conclusions: This mobile app-based weight management program with coaching implemented may not be feasible for adoption in the general population of AYA with SB; however, it was well received by some, and further testing is needed to determine how to improve feasibility. This study provides useful information to guide future programs utilizing digital health and coaching.

The Relationship between Dietary Intake and Adiposity in South African Female Adolescents: A Systematic Review

The prevalence of obesity has increased significantly in developing nations over the past decade, particularly among adolescent girls. To assess the scale of this epidemic among female adolescents in South Africa, a systematic review was undertaken to investigate the connection between diet and obesity. Multiple databases (Google Scholar, Science Direct, Cochrane Library, PubMed, and Web of Science) were searched to identify studies investigating the associations between diet and various adiposity indices as outcomes. Of the 56 studies identified, 7 met the inclusion criteria. The age range of participants spanned from 11 to 21 years. Tabulation was used to report the data, study by study. The consumption of nutrients from animal sources exhibited a positive correlation with higher BMI-for-age Z scores (p = 0.02). Eating habits such as sporadic family meals (p ≤ 0.02), irregular breakfast consumption (p ≤ 0.05), and a high energy intake derived from fat were linked to an increased risk of adiposity. Additionally, factors such as socioeconomic status and residential location revealed associations with certain dietary intakes and adiposity. As more studies identify the causative role of diet in obesity, there is an urgent need for policy intervention and strategies to address the growing non-communicable disease burden in South Africa.

Prevalence and risk factors associated with dysglycemia among overweight and obese Palestinian adolescents in the Hebron governorate

Background: The prevalence of dysglycemia among adolescents and younger children has been rising, yet health professionals are still unaware of the significance of this problem. According to the Palestinian Ministry of Health (MOH) records, most diabetic children under the age of 20 in Palestine are classified as type 1; nonetheless, very limited data are available for policymakers to frame cost-effective screening programs. This study aims to determine the prevalence of dysglycemia in a sample of obese and overweight Palestinian adolescents, identify risk factors associated with dysglycemia, and examine risk factors variance by gender. Methods: A cross-sectional sample of observed obese and overweight adolescents was selected from public schools in the Hebron governorate. Informed consent, physical examination, anthropometric, and laboratory tests (Random Blood Glucose Level (BGL) and fasting BGL ) were performed on a sample of 511 students (44.6% boys and 55.4% girls) aged 13–18-years (13-15 years =46.2% and 16-18 years =53.8%). Results: The prevalence of confirmed overweight and obese cases was 73.2%, and dysglycemia prevalence among the confirmed cases was 3.7% (5.3% boys and 2.5% girls). The BMI classifications of the dysglycemic children indicated that 42.1% were overweight and 31.1% were obese. Furthermore, 64.6% reported high systolic and/or diastolic blood pressure readings. Conclusions: The results of this study provide valuable information about the rising problem of dysglycemia among Palestinian adolescents and underlines the need for rapid screening programs and protocols for early detection and classification of the disease, leading to initiation of early prevention and treatment plans.

Anxiety level in overweight and obese children

Purpose - to evaluate personal and situational anxiety levels in overweight and obese children. Materials and methods. 153 children (72 girls and 81 boys) aged 12-17 were involved in the study at the Odesa Regional Children’s Clinical Hospital. Anthropometric indicators (weight, height, body mass index (BMI)) were assessed taking into account the sex and age of children. Based on BMI values, 3 groups were selected: 1 - children with a body weight corresponding to age and gender - 47 persons (Control); 2 - children with excessive body weight - 50 persons (Overweight); 3 - children with obesity - 56 persons (Obesity). The state of personal and situational anxiety was determined using the Spielberger-Khanin questionnaire. Statistical data analysis was carried out using packages STATISTICA 12.0, MedCalc 20.0, Microsoft EXCEL 2003. Results. In children with obesity, the most common comorbidities were biliary dyskinesia (14.28%), arterial hypertension (10.52%), skin infections 4% and obstructive sleep apnea syndrome 2%. In the studied groups of children, the level of anxiety increased in proportion to the degree of increase in body weight. Personal anxiety in children with obesity compared to control was noted at a higher level - 50.1±1.04 and 30.27±0.98, respectively (χ2=49.9, p=0.0001). Situational anxiety also increased in children with obesity, but the differences were expressed to a lesser extent - 38.94±0.74 and 33.91±0.93 (χ2=5.49, p=0.019). Conclusions. The obtained results indicate the feasibility of further study and monitoring of the psycho-emotional state and quality of life of overweight and obese children and adolescents for individual psychological support and correction of psycho-emotional disorders. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

Efficacy of body appreciation training on body image concerns in overweight adolescents

Body image concern is one of the important issues in the field of overweight and the factors of failure in losing weight which is necessary to undergo intervention to increase the efficiency of sports and nutrition programs. This study aimed to analyze the efficacy of body appreciation training on body image concerns in overweight adolescents. It was a semi-experimental method with a pre-test and post-test design with a control group). The research community consisted of overweight girl adolescents who were referred to weight control and weight loss centers in Isfahan City in 2021. From the mentioned society, 30 adolescents were selected by targeted sampling method and assigned to two groups of 15 people, experiment and control. The experimental group received 9 sessions of 90-min body appreciation training. The control group was on the waiting list during this time. The research tool was the body image concern questionnaire of Littleton et al. (2005). Data analysis was done using SPSS-24 software and the covariance analysis method. The results showed that there is a significant difference between the two groups in the variable of concerns related to body image (P < 0.001); Also, the results showed that there is a significant difference between the two groups in the variables of dissatisfaction with appearance and interference in social functioning (P < 0.001). In this way, based on the results of this research, body appreciation training can be used to reduce concerns related to body image in overweight adolescents.

The effectiveness of e-booklet and lectures to increase overweight adolescents’ nutritional knowledge

Overweight adolescents’ low knowledge of balanced nutrition is a problem that needs attention. If such a problem is left unchecked, overweight adolescents have a higher risk of suffering from various health problems. Efforts are needed to increase overweight adolescents’ nutrition knowledge, including through the provision of nutrition education using educational media. The purpose of this study was to analyze differences in knowledge after being given nutrition education using e-booklets and lectures. This study was conducted at SMAN 4 and SMAN 7 Banjarmasin in September 2022. This study was an experimental research with a quasi-experimental design with pre-test – post-test control group. The sample in this study was selected by purposive sampling technique, namely 64 overweight students divided into two groups, namely nutrition education with e-booklets accompanied by lectures and nutrition education with lectures only. The intervention was carried out 4 times in one month and each meeting took 55 minutes. Data on differences between pretest and posstest were analysed by paired T Test and data on differences between education groups were analysed by Independent T Test. Results, there were differences in pretest and posttest nutritional knowledge in groups given nutrition education with e-booklet media and lectures (p=0,000) and there are differences in groups given nutrition education with lectures only (p=0,001). There was a significant difference effect between the provision of nutrition education in both education groups (p=0,002). In conclusion, providing nutrition education with e-booklet media combined with lectures can improve knowledge about balanced nutrition for overweight adolescents more effectively than lectures.

Frequency of breakfast consumption and its associations with food consumption by degree of industrial processing and with indicators of overweight in Brazilian adolescents (EVA-JF Study)

ObjectiveThe aim of this study was to investigate the frequency of breakfast consumption and estimate its associations with the consumption of food at different degrees of industrial processing and with overweight indicators in Brazilian adolescents. MethodsThis cross-sectional study involved a probabilistic sample of 14- to 19-y-old adolescents enrolled in 29 public schools in the municipality of Juiz de Fora, MG, Southeast Brazil (n = 805). The frequency of breakfast consumption was evaluated via a questionnaire (classified into "do not consume", "sometimes consume", and "regularly consume"). The evaluation of food consumption involved two 24-h dietary recalls, the items of which were analyzed according to the NOVA classification system. Overweight indicators (waist circumference, body mass index for age (BMI-for-age), and body fat percentage) were evaluated according to a standard protocol. Linear regression models were performed, first without and then with adjustments for sociodemographic characteristics. ResultsWe found that 20% of adolescents skipped breakfast, and ∼46% of the caloric intake came from ultra-processed foods. Breakfast omission was associated with a mean increase of 3.02% (95% confidence interval [CI], 0.52–5.53) in energy intake from ultra-processed foods, in addition to a mean increase of 0.28 z-score (95% CI, 0.05– 0.52) of BMI-for-age and of 1.64% (95% CI, 0.21–3.08) in body fat. ConclusionsWe verified that the omission of breakfast was associated with higher consumption of ultra-processed foods, as well as a higher BMI-for-age and higher percentage of body fat, reinforcing the importance of actions to encourage the consumption of this meal and the adoption of healthy eating practices in adolescents.

Differences in the absolute muscle strength and power of children and adolescents with overweight or obesity: a systematic review

This study aimed to describe absolute muscle strength and power in children and adolescents with obesity, overweight and normal weight, and the assessment tests and tools used. We retrieved observational studies from MEDLINE (PubMed), TripDataBase, Epistemonikos, EBSCO essentials, NICE, SCOPUS, and LILACs up to February 2023. In addition, we recovered data from studies with at least three comparison groups (obesity, overweight, normal weight) and with a description of the absolute muscle strength and power and the assessment tests and instruments used. The methodologic quality of the studies was assessed with the Joanna Briggs checklist, and the review was carried out using the PRISMA 2020 methodology. Eleven studies with 13,451 participants from 6 to 18 years of age were once included, finding that the absolute muscle strength of their upper extremities was greater when they were overweight or obese; however, in the same groups, absolute muscle strength was lower when they carried their body weight. In addition, lower limb absolute muscle strength was significantly lower in obese participants than in normal weight, regardless of age and gender. The most used tools to measure the absolute muscle strength of the upper limbs were the grip dynamometers and push-up exercises. In contrast, different jump tests were used to measure the power of the lower limbs. There are great differences in muscle strength and power between overweight or obese children and adolescents and those with normal weight. Therefore, it is recommended to use validated tests, preferably that assess strength through the load of the patient’s body weight, either of the upper or lower limbs, for greater evaluation objectivity that facilitates the management of these children and adolescents.

The Relationship Between Fast Food Consumption, Pocket Money, And Quality Of Sleep With Over Nutrition In Adolescents

Background: Adolescents with obese nutritional status are at risk of experiencing degenerative diseases, which can reduce the quality of life of adolescents. The healthy rate of overweight and obesity is closely related to food intake and lifestyle. Consuming fast food has become a lifestyle for teenagers. This is also influenced by the amount of pocket money, making it easy for teenagers to get fast food. Another lifestyle factor that is related to obesity in adolescents is the quality of sleep. This study aims to determine the relationship between fast food consumption, pocket money, and sleep quality with the incidence of overweight in adolescents at SMA Negeri 1 Telukjambe Timur Karawang. Research Methods: This research was conducted at SMAN 1 Telukjambe Karawang. The respondents were grade 10 and 11 students aged 16-18 years. The sampling technique used purposive sampling with a total sample of 103 respondents. The method used is quantitative research with survey techniques utilizing a cross-sectional approach. Data analysis was performed with the chi-square test. The instruments used in this study were the Food Frequency Questionnaire (FFQ), the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the pocket money questionnaire. Research Result: Analysis of statistical test data using spearman rank. The results of the study showed that the majority of respondents aged 16 years were 74 people (71.8%), non-overnutrition were 76 people (73.8%), rarely consumed fast food as many as 59 people (57.3%), sleep quality 76 people (73.8%) have insufficient income, and 74 people (71.8%) have low pocket money. Conclusion: The conclusion in this study is that there is a relationship between the frequency of fast food consumption and the quality of sleep with the incidence of overweight, and there is no relationship between pocket money and the incidence of overweight and the fast food consumption habits of adolescents.

Modigiz Application as an Educational Media for Overweight Teenagers

Background: Android mobile applications about nutrition and health are starting to be developed, but only a few develop mobile applications with a discussion of overweight adolescents. Android media with exciting features can be an alternative to increase adolescents' awareness of the problem of obesity.Research Methods: Development of an Android mobile application named "Modigiz," which stands for mobile obesity diet nutrition. The application is developed using the agile software development method and uses its development technology, namely Android Studio, Android SDK, Kotlin, Android Jetpack Library, Github, Figma, and Canva.Research Result: The Modigiz application implements the principle of quick feedback for application users. Users can find nutritional status information about each feature display, and there is feedback for consultations between users and the team via WhatsApp no.Conclusion: The Modigiz application was developed for overweight adolescents to monitor their nutritional status and manage their diet independently. In addition, this application also provides nutrition and health information for users, so it is hoped that it can encourage healthy behavior habits and implement balanced nutrition.

Obesity in Adolescents: Can it be affected by the use of the Technological Media?

One of the most important problems, which public health is called to face, is obesity. The World Health Organization (WHO) underlines that worldwide more than 380 million of overweight or obese children and adolescents exist.

Epidemiological Impact of Metabolic Syndrome in Overweight and Obese European Children and Adolescents: A Systematic Literature Review.

The prevalence of overweight and obesity is continuously increasing, both in the adult and pediatric populations, posing a substantial challenge to public health. Understanding the epidemiological burden of metabolic syndrome (MetS) among children, particularly regarding its complications and long-term effects in adulthood, is crucial for identifying effective preventive measures and enhancing the clinical care of obese children. Therefore, by searching two databases, a systematic review was conducted in order to evaluate studies that specifically addressed the epidemiological MetS impact among overweight/obese European children and adolescents. Overall, 15 studies were considered. The epidemiological data concerning the MetS impact were contingent on the diagnostic criteria used and varied across countries, resulting in a prevalence range of 1.44% to 55.8%. Spanish studies were the most numerous (34%), revealing a country prevalence rate ranging from 2.5% to 19.6%. Males (prevalence range: 1.4-55.8%) and subjects with overweight/obesity (prevalence range: 12.9-55.8%) were mainly affected. Obesity emerged as the main risk factor in the MetS development and the consequent onset of cardiovascular complications and diabetes. Knowing the MetS burden and its risk factors could improve their prevention, detection, and treatment, and guide the development of targeted public health interventions to appropriately address the health needs of younger patients.

Overweight and obesity in children and adolescents with endocrine disorders.

Obesity has become a serious medical condition where many factors can contribute to excess weight gain. The most common type of childhood obesity is simple obesity, which is due to gene-obesogenic environment interaction. Only a minority are due to pathological causes. Secondary causes of obesity, while less common, include these: genetic syndromes, drug-related obesity, as well as endocrine disorders (hypothyroidism, Cushing's syndrome, growth hormone deficiency, hypogonadism, pseudohypoparathyroidism type Ia, insulinoma, hypothalamic obesity and polycystic ovary syndrome). Given that some conditions may be treatable, physicians must be aware of obesity due to endocrinopathies and distinguish them from simple obesity, and treat them properly. Although rare among children, early detection of the endocrine cause of obesity leads to reduced morbidity and, in some cases, reduced mortality in these individuals. The aim of this review is to summarize the current findings on obesity-related endocrinopathies in children (illustrated by clinical examples), highlighting aspects of pathogenetic mechanisms, genetics, the clinical diagnosis, growth, body mass index and possible therapeutic approaches. Early detection and correction of endocrine obesity is of paramount importance for obese children who could benefit from timely diagnosis and an improved management of obesity as many disturbances related to obesity can be reversed at the early stage, if weight loss is achieved.

Evidence Base Update on Behavioral Treatments for Overweight and Obesity in Children and Adolescents

ABSTRACT Objective This review provides an update to a previous Evidence Base Update addressing behavioral treatments for overweight and obesity in children and adolescents. Method Articles were identified through a systematic search of the biomedical literature in PubMed/MEDLINE (1946-), Elsevier EMBASE (1947-), SCOPUS (1823-), Clarivate Web of Science Core Collection (WOS, 1900-), PsycINFO (1800-), The Cochrane Library and Clinicaltrials.gov published between June 2014 and August 2022. Results Family-based treatment (FBT) remains a well-established treatment for overweight and obesity in children and is now well-established in adolescents and toddlers. Parent-only behavioral treatment remains well-established in children and is now well-established among adolescents and children. Possibly effective treatments continue to include FBT-parent only for adolescents, and behavioral weight loss (BWL) with a family component for adolescents, children, and toddlers. Several variations of FBT and BWL can now be considered possibly effective including FBT+motivational interviewing, FBT+social facilitation maintenance, group-based FBT, low-dose FBT, BWL+stress management, and camp-based BWL. Cognitive behavioral treatment (CBT) for adolescents also met criteria for possibly effective treatments. Current research has also established that behavioral treatments can be effectively delivered in alternative settings (e.g. primary care) and through alternative mediums (e.g. telehealth). Conclusions Research continues to support the use of multicomponent lifestyle interventions in accordance with recent recommendations from the American Academy of Pediatrics, the American Psychological Association, and the United State Preventative Services Task Force. However, more work is needed to ensure appropriate access for children with comorbid medical and psychiatric disorders and children from socially, politically, and economically marginalized groups.

Exploring Gut Microbiota and the Influence of Physical Activity Interventions on Overweight and Obese Children and Adolescents: A Systematic Review.

The recognition that the gut microbiota of obese children differs from lean children has grown, and some studies suggest that physical activity positively influences the gut microbiota. This systematic review explores the changes in the gut microbiota composition of obese and non-obese children and adolescents and provides an understanding of the effects of physical activity interventions in modulating their microbiota. The PRISMA protocol was used across PubMed, Scopus, and Web of Science. Overall, twenty-four research papers were included in accordance with the chosen inclusion and exclusion criteria, eighteen studies compared the gut microbiota of obese and normal-weight children and adolescents, and six studies explored the effect of physical activity interventions on the gut microbiota. The analysis indicated that obese gut microbiota is reduced in Bacteroidetes, Bifidobacterium and alpha diversity but enriched in Proteobacteria and Lactobacillus. Interventions with physical activity seem to improve the alpha diversity and beneficial bacteria linked to body weight loss in children and adolescents. The gut microbiota of obese children exhibited a remarkably individual variation. More interventions are needed to clearly and accurately explore the relationships between child obesity, gut microbiota, and physical activity and to develop approaches to decrease the incidence of paediatric obesity.

Integrative Korean Medicine Treatment for Obesity and Overweight in Children and Adolescents: A Multicenter Retrospective Chart Review Study.

Integrative Korean medicine treatment (IKM), including herbal medicine (HM) and acupuncture, has been widely used for obesity and overweight in children and adolescents in South Korea. We investigated the real-world usage status and the potential effect of the IKM for obesity and overweight in children and adolescents. Multicenter medical charts were retrospectively reviewed of obese and overweight children and adolescents who visited Korean medicine institutions with the goal of weight control for the first time and received IKM, to analyze the usage status and effect of IKM. We defined IKM responders as those with an improved obesity grade on the body mass index (BMI) percentile and analyzed their characteristics. Medical charts of 209 patients (183 obese and 26 overweight) with a mean age of 11.45 years were examined. Patients visited the institution a mean of 5.95 times, and HM alone and HM plus acupuncture were frequently used IKM. HM was prescribed to 205 patients, 167 of whom received an HM prescription containing Ephedrae Herba. An HM of the decoction type was prescribed to 189 patients, and the average treatment duration was 76.54 days. After IKM, the percentile and z-score of BMI and weight significantly declined and height percentile and z-score were significantly enhanced, without serious adverse events. In the IKM responders, age, and the proportion of girls and overweight were significantly higher, and the percentile and z-score of height, weight, and BMI were significantly lower. This is the first study to examine the real-world usage of IKM for obesity and overweight in children and adolescents. A significant improvement in obesity-related outcome measures after IKM, illustrated the potential effect of IKM.

Unhealthy Dietary Patterns and Their Associations with Sociodemographic Factors as Predictors among Underweight and Overweight Adolescents in Southern Thailand.

(1) Background: Adolescence is a critical developmental phase; dietary intake and nutritional status significantly impact health outcomes. (2) Objective: This cross-sectional study investigated dietary patterns (DPs) and the association between sociodemographic factors and unhealthy DPs among adolescents in Thailand. (3) Methods: A multi-stage sampling selected 1480 participants from three public high schools in Nakhon Si Thammarat province. A food frequency questionnaire assessed dietary habits, and principal component analysis was used to identify DPs. Multinomial logistic regression examined the association between sociodemographic factors and DPs. (4) Results: The findings show that 25.9% of adolescents were underweight, 14.7% were overweight, and 5.8% were obese. Three DPs were identified: a healthy 'protein and vegetables' pattern and two unhealthy patterns: 'snacks' and 'processed foods', which explained 12.49%, 10.37%, and 7.07% of the dietary variance, respectively. Among underweight adolescents, higher snack consumption was associated with being younger (odds ratio (OR) = 3.24) and receiving a higher daily allowance (OR = 3.43). Additionally, female adolescents who engaged in frequent exercise had a 2.15 times higher intake of processed foods. Among overweight adolescents, higher snack intake was linked to being younger (OR = 8.65) and having larger families (OR = 6.37). Moreover, an increased daily allowance was associated with higher consumption of processed foods (OR = 11.47). (5) Conclusion: This study underscores the socio-demographic influence on unhealthy DPs. Insights can guide targeted interventions to foster healthier dietary habits during adolescence.

Individualized Implementation of Youth Quality of Life Instrument-Research Version (YQOL-R) Among Chinese Adolescents with Different Weight Status.

This study implemented the individualized Youth Quality of Life Instrument-Research Version (YQOL-R) to estimate the quality of life (QoL) among Chinese adolescents with three different Body Mass Index (BMI) levels. The study aims to explore and provide a reference for developing individualized QoL (IQoL) measurements in China. The sample consisted of 822 aged 11-18 from nine schools. The data collection included all participants' primary characters (age, sex, annual household income, parental education, and recruitment community) and their self-report QoL. Precisely, based on the generic measurement of YQOL-R, we developed IQoL measurements by asking adolescents' perceived five most important things to them (IQOLimportance) and the aspects they most want to change (IQOLchange) from 19 facets, respectively. The one-way analysis of variance (ANOVA) was applied to compare total and subscale scores of IQOLimportance, IQOLchange, and YQOL-R among adolescents with three different weight status. Also, the data analysis used multivariable linear regression modeling to test the effects on scores of IQOLimportance and IQOLchange. Overall, the obese adolescents identified "Having good physical health" as the most important (54.03%) and most like-to-change (42.65%); in contrast, the normal-weight group ranked "Being myself" as the top facet of IQOLimportance (52.42%) and "Having good friends" as the top facet of IQOLchange (43.12%). The obese adolescents' reported IQOLimportance scores are significantly lower than those of the normal-weight group (P=0.039). However, there is no significant difference in IQOLchange score among the three weight-status groups. The multivariable linear regression models indicated that adolescents who are girls (P=0.035), have higher educated fathers (P=0.049), and are overweight/obese (P=0.041) self-reported worse IQOLimportance score; yet, the girls (P=0.023) and older adolescents (P=0.004) answered lower IQOLchange scores. In addition, adolescents who had higher educated mothers (P=0.047; 0.023) and responded with higher total YQOL-R scores (P<0.001; <0.001) reported higher IQOLimportance and IQOLchange scores. In the current study, although the self-reported YQOL-R scores from different weight status did not present a significant difference, the obese group reported a statistical trend towards lower IQOLimportance scores than the normal-weight and overweight adolescents. These findings emphasize that IQOLimportance and IQOLchange could capture adolescents' perspectives with different weight statuses about their lives, which are unique as complementary health outcomes accompanying YQOL-R in health surveys and interventions among Chinese adolescents.

Understanding the dynamics emerging from the interplay among poor mental wellbeing, energy balance-related behaviors, and obesity prevalence in adolescents: A simulation-based study.

Both obesity and poor mental wellbeing have a high prevalence in European youth. Adolescents in six countries identified mental wellbeing factors as main drivers of youth obesity through systems mapping. This study sought to (1) explore the dynamics of the interplay between poor mental wellbeing, energy balance-related behaviors, and adolescent overweight and obesity prevalence and (2) test the effect of intervention point scenarios to reduce adolescent obesity. Drawing on the youth-generated systems maps and a literature synthesis, we built a simulation model that represents the links from major feedback pathways for poor mental wellbeing to changes in dietary, physical activity, and sleep behaviors. The model was calibrated using survey data from Norway, expert input, and literature and shows a good fit between simulated behavior and available statistical data. The simulations indicate that adolescent mental wellbeing is harmed by socio-cultural pressures and stressors, which trigger reinforcing feedback mechanisms related to emotional/binge eating, lack of motivation to engage in physical activity, and sleep difficulty. Targeting a combination of intervention points that support a 25% reduction of pressure on body image and psychosocial stress showed potentially favorable effects on mental wellbeing-doubling on average for boys and girls and decreasing obesity prevalence by over 4%.

An examination of the relationships between the neighborhood social environment, adiposity, and cardiometabolic disease risk in adolescence: a cross-sectional study

BackgroundDisadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years.MethodsThis cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey five-year block group estimates, 2012–2016. Multilevel linear regression models were used to examine whether neighborhood concentrated disadvantage index and perceived neighborhood disorder were associated with body mass index, waist circumference, body fat, adipose tissue, blood pressure, and lipids. We performed multilevel logistic regression to determine the odds of elevated adiposity and cardiometabolic disease risk for adolescents living in neighborhoods with varying levels of neighborhood concentrated disadvantage and disorder.ResultsAdolescents living in neighborhoods with higher disadvantage or disorder had greater waist circumference and total percent body fat compared to those in less disadvantaged and disordered neighborhoods (p for trend < 0.05). Neighborhood disadvantage was also positively associated with percentage of the 95th Body Mass Index percentile and visceral abdominal adipose tissue mass while greater perceived neighborhood disorder was related to higher trunk fat mass and diastolic blood pressure (p for trend < 0.05). Living in the most disadvantaged was associated with greater odds of obesity (OR: 2.9, 95% CI:1.3, 6.5) and being in the top tertile of body fat mass (OR: 3.0, 95% CI: 1.4, 6.6). Similar results were found with neighborhood disorder for odds of obesity (OR: 2.1, 95% CI:1.1, 4.2) and top tertile of body fat mass (OR: 2.1, 95% CI:1.04, 4.1).ConclusionsNeighborhood social environment measures of chronic stress exposure were associated with excess adiposity during adolescence, and relationships were most consistently identified among adolescents living in the most disadvantaged and disordered neighborhoods. Future studies should account for the influences of the neighborhood environment to stimulate equitable improvements in adolescent health.Clinical Trials Registration# NCT02784509.