Overweight Parents Research Articles

Leveraging Text Messaging and Mobile Technology to Support Pediatric Obesity-Related Behavior Change: A Qualitative Study Using Parent Focus Groups and Interviews

BackgroundText messaging (short message service, SMS) is a widely accessible and potentially cost-effective medium for encouraging behavior change. Few studies have examined text messaging interventions to influence child health behaviors or explored parental perceptions of mobile technologies to support behavior change among children.ObjectiveOur aim was to examine parental acceptability and preferences for text messaging to support pediatric obesity-related behavior change.MethodsWe conducted focus groups and follow-up interviews with parents of overweight and obese children, aged 6-12 years, seen for “well-child” care in eastern Massachusetts. A professional moderator used a semistructured discussion guide and sample text messages to catalyze group discussions. Seven participants then received 3 weeks of text messages before a follow-up one-on-one telephone interview. All focus groups and interviews were recorded and transcribed verbatim. Using a framework analysis approach, we systematically coded and analyzed group and interview data to identify salient and convergent themes.ResultsWe reached thematic saturation after five focus groups and seven follow-up interviews with a total of 31 parents of diverse race/ethnicity and education levels. Parents were generally enthusiastic about receiving text messages to support healthy behaviors for their children and preferred them to paper or email communication because they are brief and difficult to ignore. Participants anticipated high responsiveness to messaging endorsed by their child’s doctor and indicated they would appreciate messages 2-3 times/week or more as long as content remains relevant. Suggestions for maintaining message relevance included providing specific strategies for implementation and personalizing information. Most felt the negative features of text messaging (eg, limited message size) could be overcome by providing links within messages to other media including email or websites.ConclusionsText messaging is a promising medium for supporting pediatric obesity-related behavior change. Parent perspectives could assist in the design of text-based interventions.Trial RegistrationClinicaltrials.gov NCT01565161; http://clinicaltrials.gov/show/NCT01565161 (Archived by WebCite at http://www.webcitation.org/6LSaqFyPP).

Long-Term Impact of Preterm Birth on Exercise Capacity in Healthy Young Men: A National Population-Based Cohort Study

BackgroundIncreasing numbers of survivors of preterm birth are growing into adulthood today. Long-term health-effects of prematurity are still poorly understood, but include increased risk for diabetes, obesity and cardiovascular diseases in adult life. To test if reduced physical fitness may be a link in the causal chain of preterm birth and diseases in later life, the association of preterm birth and adult exercise capacity was investigated. The hypothesis was that preterm birth contributes independently of other risk factors to lower physical fitness in adulthood.Methods and FindingsPopulation-based national cohort study of all males conscripting for military service in 1993–2001 and born in Sweden 1973–1983, n = 218,820. Data were retrieved from the Swedish Conscript Register, the Medical Birth Register and the Population and Housing Census 1990. Primary outcome was the results from maximal exercise test (Wmax in Watt) performed at conscription. Association to perinatal and socioeconomic risk factors, other co-variates and confounders were analysed. General linear modelling showed that preterm birth predicted low Wmax in a dose-response related pattern, with 25 Watt reduction in Wmax for the lowest gestational ages, those born ≤27 weeks. Low birth weight for gestational age also independently predicted low Wmax compared to normal and high birth weight (32 Watt reduction for those with a birth weight Standard Deviation Score <2). Low parental education was significantly associated with reduced Wmax (range 17 Watt), as well as both low and high current BMI, with severe obesity resulting in a 16 Watt deficit compared to Wmax top performance.ConclusionBeing born preterm as well as being born small for gestational age predicts low exercise capacity in otherwise healthy young men. The effect size of being born preterm equal or exceed that of other known risk factors for unfitness in adults, such as low parental education and overweight.

Ethnic Background and Overweight among 5-Year-Old Children: The “Be Active, Eat Right” Study

Introduction. This study investigates the association between ethnic background and overweight (obesity included) among 5 year olds. Methods. We used baseline data from 5 year olds (n = 7801) and their parents collected for the “Be active, eat right” study. A child was considered to be of non-Dutch ethnic background when at least one of the parents was born abroad. Odds ratios (ORs) were adjusted for sociodemographic characteristics. Results. Compared to children of Dutch ethnic background, for children with a Moroccan ethnic background the OR for being overweight (obesity included) was 2.27 (95% CI 1.48–3.47), for Turkish children the OR was 3.63 (95% confidence interval (CI) 2.46–5.35), for Antillean children the OR was 1.97 (95% CI 1.01–3.86), and for Surinamese children the OR was 0.47 (95% CI 0.20–1.06). Addition of parental overweight decreased the ORs for Moroccan and Turkish children by 10.2% and 12.5%, and addition of watching TV and having breakfast by the child decreased the ORs by 7.9% and 12.2%. Conclusion. Already at a young age, children of Moroccan and Turkish ethnic background are at increased risk for being overweight compared to Dutch children. Parental overweight, watching TV, and not having breakfast by the child are contributing factors in this association.

A population-based study of overweight and obesity in expectant parents: socio-demographic patterns and within-couple associations

BackgroundOverweight and obesity in pregnancy increase the risk of several adverse pregnancy outcomes. However, both mothers’ and fathers’ health play an important role for long-term health outcomes in offspring. While aspects of health and lifestyle of pregnant women have been reported, the health of expectant fathers and correlations of health variables within couples have received less attention. This study aimed to explore the prevalence and socio-demographic patterns of overweight and obesity in Swedish expectant parents, and to assess within-couple associations.MethodsThis population-based, cross-sectional study investigated self-reported data from 4352 pregnant women and 3949 expectant fathers, comprising 3356 identified couples. Data were collected in antenatal care clinics between January 2008 and December 2011. Descriptive, correlation and logistic regression analyses were performed.ResultsThe self-reported prevalence of overweight (BMI 25.0-29.99) and obesity (BMI ≥30.0) was 29% among women (pre-pregnancy) and 53% among expectant fathers. In a majority of couples (62%), at least one partner was overweight or obese. The odds of being overweight or obese increased relative to partner’s overweight or obesity, and women’s odds of being obese were more than six times higher if their partners were also obese in comparison with women whose partners were of normal weight (OR 6.2, CI 4.2-9.3). A socio-demographic gradient was found in both genders in relation to education, occupation and area of residence, with higher odds of being obese further down the social ladder. The cumulative influence of these factors showed a substantial increase in the odds of obesity for the least compared to the most privileged (OR 6.5, CI 3.6-11.8).ConclusionsThe prevalence of overweight and obesity in expectant parents was high, with a clear social gradient, and a minority of couples reported both partners with a healthy weight at the onset of pregnancy. Partner influence on health and health behaviours, and the role both mothers and fathers play in health outcomes of their offspring, underpin the need for a more holistic and gender inclusive approach to the delivery of pregnancy care and postnatal and child health services, with active measures employed to involve fathers.

Workplace weight management programme: Does it promote weight reduction?

Introduction: This cross sectional study was conducted to assess the quality of life (QoL) of primary school children in Kuala Lumpur. Method: As much as 124 children (75 normal weight, 23 overweight and 26 obese) aged between 8 and 11 years old were participated in this study. Result: Mean for physical characteristics of the subjects were 35.5± 12.8 kg for body weight, 134.8± 9.1 cm for height, 19.2± 5.1 kg/m2 for BMI and 1.2± 2.1 for BMI z-score. QoL was assessed using the Pediatric Quality of Life Inventory version 4.0. It was self-administered and completed by both parent-proxy and child self-report. This questionnaire assessed physical, emotional, social, and school functioning from which total, physical and psychosocial health summary scores were derived. There was no significant difference (p > 0.05) in QoL mean score of normal weight, overweight and obese children in all domains including physical health, psychosocial health and total score either for child self report or parent-proxy report. However, this study found that overall children self-report QoL mean score was higher among normal weight children (71.2± 12.9) than overweight (69.9± 11.0) and obese children (66.7± 10.9). For parent-proxy, parents of obese children reported higher QoL (69.7± 15.7) than normal weight (68.6± 14.1) and overweight children parents (63.9± 16.0). This study indicated that higher BMI associated with lower quality of life (r =−0.13, p > 0.05 for total score) reported by the children. Conclusion: Higher BMI contributes to lower quality of life and the trend shows that the overweight and obese children have lower quality of life.

What Factors Influence Uptake into Family-Based Obesity Treatment after Weight Screening?

To determine what factors drive participation in a family-based weight management program for 4- to 8-year-old children following screening for overweight or obesity. Children (n = 1093) attended a comprehensive screening appointment where parents completed questionnaires on demographics, motivation for healthy lifestyles, feeding practices, and beliefs about child size, prior to feedback about the child's weight. Parents of overweight or obese children (body mass index ≥85th percentile) attended a follow-up interview to assess reactions to feedback and willingness to participate in a 2-year intervention. A total of 271 (24.8%) children were overweight or obese with 197 (72.7%) agreeing to the intervention. Socioeconomic status differed in intervention participants (n = 197) compared with non-participants (n = 74), whereas no differences were observed in parental feeding practices, ineffective parenting practices, or self-determined forms of motivation. However, fewer non-participating parents believed their child to be overweight (23% vs 49%, P < .001) or were concerned about it (16% vs 43%, P < .001), despite children having an average body mass index approximating the 95th percentile. Non-participating parents did not expect their child to be overweight (P = .002) and rated receiving this information as less useful (P = .008) than participating parents. Preconceptions about child weight and reactions to feedback determined intervention uptake more than parenting or motivation for health. Many parents agreed to participate in the intervention despite not viewing their child as overweight.

Risk factors for childhood overweight: a 30-month longitudinal study of 3- to 6-year-old children.

The increasing prevalence of childhood overweight is an important health issue. There is a need for longitudinal research among children in order to identify risk factors for childhood overweight. The objective of the present research was to identify potential sociodemographic and behavioural risk factors for development of childhood overweight among 3- to 6-year-old children. Longitudinal study. Sixteen pre-primary and primary schools. BMI Z-scores at baseline and two follow-up measurements were calculated for 568 children. Sociodemographic, parental adiposity, familial composition, child's diet, physical activity and sedentary behavioural data were collected through questionnaires. Several risk factors for the development of childhood overweight were found. Being an only child, lower maternal educational level, maternal and paternal overweight, more than 1 h screen time on weekdays and high soft drinks consumption were shown to be positively associated with the development of childhood overweight. Although behavioural factors are important, our findings support the thesis that interventions on the prevention of childhood overweight should focus on high-risk groups, i.e. children from low socio-economic background or with high parental BMI. Interventions should address the whole family and take into account their lifestyle and structure.

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When Parents Focus on Weight, Kids’ Eating Disorder Risk Rises

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessWhen Parents Focus on Weight, Kids’ Eating Disorder Risk RisesJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:8 Aug 2013https://doi.org/10.1176/appi.pn.2013.8b3AbstractParents need to be careful in discussing weight issues with their children in light of findings suggesting that such discussions can increase the risk of developing an eating disorder.Jaimie Duplass/Shutterstock At a workshop concerned with binge eating last year, Chevese Turner, the founder and chief executive officer of the Binge Eating Disorder Association, said that when she was little, her mother had anorexia nervosa and talked a lot about dieting. Both factors encouraged Turner to start binge eating, she believes (Psychiatric News, June 1, 2012).Now a new study reinforces Turner’s assumption. It has found a link between parents’ discussion of weight with their adolescents and the adolescents engaging in unhealthy eating behaviors such as dieting, laxative use, and binge eating.The study, headed by Jerica Berge, Ph.D., an assistant professor of family medicine and community health at the University of Minnesota, was published online June 24 in JAMA Pediatrics.Berge and her colleagues first surveyed approximately 2,400 adolescents from 20 public middle schools and high schools in the Minneapolis/St. Paul area to determine whether they were overweight and whether they engaged in unhealthy eating behaviors. The adolescents came from diverse racial and ethnic backgrounds and were mostly from low, low-middle, and middle socioeconomic backgrounds.The researchers then surveyed about 3,500 parents of the adolescents—50 percent of the adolescents had both parents surveyed—to learn whether the parents discussed weight or healthful eating with their youngsters and to see if there were any associations between parental conversations on these topics and adolescents engaging in unhealthy eating behaviors.They found that such a relationship did exist.For example, adolescents who were not overweight and whose mothers talked about healthful eating were significantly less likely to diet than were nonoverweight adolescents whose mothers talked about weight (27 percent versus 35 percent).Similarly, overweight adolescents whose mothers talked about healthful eating were significantly less likely to diet than were overweight youngsters whose mothers talked about weight (40 percent versus 53 percent).When their fathers talked about weight, nonoverweight adolescents were significantly more likely to diet than when their fathers did not discuss weight (33 percent versus 22 percent). The findings were comparable for overweight youngsters. When their fathers talked about weight, 64 percent dieted, whereas when fathers talked about healthy eating, only 49 percent did.As for the prevalence of binge eating, it was significantly lower among nonoverweight adolescents whose mothers didn’t discuss weight than among nonoverweight adolescents whose mothers did discuss it (4 percent versus 8 percent). Similar findings emerged for overweight adolescents. The prevalence of binge eating was 9 percent in youngsters whose mothers didn’t discuss weight, but 13 percent in youngsters whose mothers did.“These findings suggest that parents should avoid conversations that focus on weight or losing weight and instead engage in conversations that focus on healthful eating, without reference to weight issues,” Berge and her team concluded. “This approach may be particularly important for parents of overweight or obese adolescents.”Psychiatrists can also “use the results of this study to guide their conversations with parents and adolescents about eating behaviors,” Berge suggested in an interview with Psychiatric News.“I think these are important findings,” Michael Devlin, M.D., codirector of eating disorders research at the New York State Psychiatric Institute, told Psychiatric News. “They support the idea that despite our concerns about obesity and its comorbidities, the most useful health-promotion messages relate to lifestyle and not weight and that weight-related messaging—particularly messages that evoke shame or contribute to stigma—can be counterproductive. The next step would be to examine this cohort, or some similar cohort, over time to examine the longer-term ‘hard outcomes’ of medical risk factors, such as blood pressure, insulin sensitivity, blood lipids, and others, and the quality of life in groups exposed to weight versus lifestyle-related messages.”The study was funded by the National Institutes of Health. ■An abstract of “Parent Conversations About Healthful Eating and Weight” is posted at http://archpedi.jamanetwork.com/article.aspx?articleid=1700514. ISSUES NewArchived

Family and Neighbourhood Socioeconomic Inequalities in Childhood Trajectories of BMI and Overweight: Longitudinal Study of Australian Children

BackgroundSocioeconomic inequalities in longitudinal patterning of childhood overweight could cause marked differentials in total burden by adulthood. This study aims to determine timing and strength of the association between socioeconomic status (SES) and children’s body mass index (BMI) in the pre- and primary school years, and to examine socioeconomic differences in overweight trajectories across childhood.MethodsParticipants were 4949 children from the Longitudinal Study of Australian Children. BMI was measured at four biennial waves starting at age 4–5 years in 2004. Developmental trajectories of childhood overweight were identified with latent class analyses. Composite variables of family and neighbourhood SES were used.ResultsSocioeconomic differences in mean BMI z-scores already present at age 4–5 more than doubled by age 10–11 years, reflecting decreasing mean BMI among advantaged rather than increasing means among disadvantaged children. Latent class analysis identified children with ‘stable normal weight’ (68%), and with ‘persistent’ (15%), ‘late-onset’ (14%), and ‘resolving’ overweight (3%). Risks of persistent and late-onset childhood overweight were highest among low SES families (e.g. most disadvantaged quintile: ORpersistent = 2.51, 95%CI: 1.83–3.43), and only partly explained by birth weight and parental overweight. Relationships with neighbourhood SES were weaker and attenuated fully on adjustment for family SES. No socioeconomic gradient was observed for resolving overweight.ConclusionsChildhood has become the critical period when socioeconomic inequalities in overweight emerge and strengthen. Although targeting disadvantaged children with early overweight must be a top priority, the presence of childhood overweight even among less-disadvantaged families suggests only whole-society approaches will eliminate overweight-associated morbidity.

Hispanic Parents of Overweight and Obese Children and Their Outcome Expectations for Children’s Television Viewing: A Qualitative Study

Explore parental outcome expectations (OE) regarding children's television (TV) viewing among parents of overweight or obese children. Qualitative study using semi-structured interviews with 20 parents of 5- to 8-year-old overweight or obese children. Parent's positive OE for allowing TV viewing were the convenience of using TV for entertainment or as a babysitter. Hispanic parents would limit children's TV viewing to improve their children's health, restrict content, and promote other activities. Negative OE such as children misbehavior and the loss of positive OE for allowing TV emerged as reasons parents may not limit TV. Although Hispanic parents expected to improve their child's health by limiting TV, the negative OE may prevent them from doing so. Interventions targeting children's TV viewing, as a strategy to fight childhood obesity, may be more effective if they promote parent's positive OE and address parent's negative OE for children's TV viewing.

An Exploratory Study of 2 Parenting Styles and Family Health Behaviors

To examine the relationships between 2 parenting styles and family nutrition and physical activity. Parents of elementary/primary school children in the southeastern United States (N = 145) completed surveys regarding family relationships and health behaviors. Parents exhibiting a laissez-faire parenting style reported lower levels of family nutrition and physical activity. In addition, parent BMI moderated the relationship between laissez-faire parenting and these health behaviors. This study indicates that family-oriented nutrition and physical activity programs may benefit from including a focus on decreasing laissez-faire parenting, as well as helping overweight parents reduce their BMIs.

The relationship between family and child weight status by household structure in South Korea: 2007–2010

Objective:Parental obesity has been identified as a predominant risk factor for childhood overweight and obesity. We investigated the relationship between parent and child obesity in South Korea, particularly linked with varying family structures.Subjects and methods:Data for households with children aged 2–18 years were taken from the pooled data of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007–2010 conducted by the Korea Centers for Disease Control and Prevention (KCDC). The sample consisted of 17 453 individuals (7879 children and 9574 adults) from 5048 households with children for this study. Children's overweight and obesity prevalence was compared using both International Obesity Taskforce (IOTF) and KCDC cutoff points according to parental weight status and household structure. Logistic regression analysis was used.Results:Significantly greater odds of overweight and obesity existed among children living with both parents (odds ratio (OR)=3.5, 95% confidence interval (CI): 2.71, 4.65) or one parent (mother: OR=1.6, 95% CI: 1.22, 2.12; father: OR=1.7, 95% CI: 1.37, 1.99). The adjusted ORs for overweight and obesity among children living with overweight mother only or overweight grandparent only were approximately double that of children living with normal-weight mother (OR=2.2, 95% CI: 1.22–3.82) or normal-weight grandparent (OR=2.1, 95% CI: 1.06–4.05).Conclusion:Children living with overweight parent(s) or grandparent(s) were positively correlated with the risk for childhood overweight and obesity. Socioeconomic status did not affect the observed relationships in this population, whereas the role of genetic, dietary and activity patterns requires further exploration.

Higher Protein Diets Consumed Ad Libitum Improve Cardiovascular Risk Markers in Children of Overweight Parents from Eight European Countries

Dietary strategies to improve early cardiovascular markers in overweight children are needed. We investigated the effect of dietary protein and glycemic index (GI) on cardiovascular markers and metabolic syndrome (MetS) scores in 5- to 18-y-old children of overweight/obese parents from 8 European centers. Families were randomized to 1 of 5 diets consumed ad libitum: high protein (HP) or low protein (LP) combined with high GI (HGI) or low GI (LGI), or a control diet. At 6 centers, families received dietary instruction (instruction centers); at 2 centers, free foods were also provided (supermarket centers). Diet, anthropometry, blood pressure, and serum cardiovascular markers (lipid profile, glucose regulation, and inflammation) were measured in 253 children at baseline, 1 mo, and/or 6 mo. Protein intake was higher in the HP groups (19.9 ± 1.3% energy) than in the LP groups at 6 mo (16.8 ± 1.2% energy) (P = 0.001). The GI was 4.0 points lower (95% CI: 2.1, 6.1) in the LGI compared with the HGI groups (P < 0.001). In the supermarket centers, the HP and LP groups differed more in protein intake than did the groups in the instruction centers (P = 0.009), indicating better compliance. The HP diets evoked a 2.7-cm (95% CI: 0.9, 5.1) smaller waist circumference and a 0.25-mmol/L (95% CI: 0.09, 0.41) lower serum LDL cholesterol compared with the LP diets at 6 mo (P < 0.007). In a separate supermarket center analysis, the HP compared with LP diets reduced waist circumference (P = 0.004), blood pressure (P < 0.01), serum insulin (P = 0.013), and homeostasis model of assessment-insulin resistance (P = 0.016). In the instruction centers, the HP compared with the LP diets reduced LDL cholesterol (P = 0.004). No consistent effect of GI was seen and the MetS scores were not affected. In conclusion, increased protein intake improved cardiovascular markers in high-risk children, particularly in those undergoing most intensive intervention.

Population-Based Childhood Overweight Prevention: Outcomes of the ‘Be Active, Eat Right’ Study

ObjectiveAn overweight prevention protocol was used in the ‘Be active, eat right’ study; parents of overweight children (5 years) were offered healthy lifestyle counseling by youth health care professionals. Effects of the protocol on child BMI and waist circumference at age 7 years were evaluated.MethodsA cluster RCT was conducted among nine youth health care centers in the Netherlands. Parents of overweight, not obese, children received lifestyle counseling and motivational interviewing according to the overweight prevention protocol in the intervention condition (n = 349) and usual care in the control condition (n = 288). Measurements were made of child height, weight and waist circumference at baseline and at a two-year follow-up; parents completed questionnaires regarding demographic characteristics. Linear mixed models were applied; interaction terms were explored.ResultsThe analyzed population consisted of 38.1% boys; mean age 5.7 [sd: 0.4] years; mean BMI 18.1 [sd: 0.6], the median number of counseling sessions in the intervention condition was 2. The regression model showed no significant difference in BMI increase between the research conditions at follow-up (beta −0.16; 95% CI:−0.60 to 0.27; p = 0.463). There was a significant interaction between baseline BMI and research condition; children with a baseline BMI of 17.25 and 17.50 had a smaller increase in BMI at follow-up when allocated to the intervention condition compared to control condition (estimated adjusted mean difference −0.67 [se: 0.30] and −0.52 [se: 0.36]).ConclusionMildly overweight children (baseline BMI 17.25 and 17.50) in the intervention condition showed a significantly smaller increase in BMI at follow-up compared to the control condition; there was no overall difference between intervention and control condition. Future research may explore and evaluate improvements of the prevention protocol.Trial RegistrationCurrent Controlled Trials ISRCTN04965410

Effects of providing personalized feedback of child's obesity risk on mothers' food choices using a virtual reality buffet.

Providing personalized genetic-risk feedback of a child's susceptibility to adult-onset health conditions is a topic of considerable debate. Family health history (FHH), specifically parental overweight/obesity status, is a useful assessment for evaluating a child's genetic and environmental risk of becoming obese. It is unclear whether such risk information may influence parents' efforts to reduce their child's risk of obesity. To evaluate whether telling mothers the magnitude of their child's risk of becoming obese based on personal FHH influenced food choices for their young child from a virtual reality-based buffet restaurant. Overweight/obese mothers of a child aged 4-5 years who met eligibility criteria (N=221) were randomly assigned to one of three experimental arms, which emphasized different health information: arm 1, food safety control (Control); arm 2, behavioral-risk information (BRI) alone or arm 3, behavioral-risk information plus personal FHH-based risk assessment (BRI+FHH). Mothers donned a head-mounted display to be immersed in a virtual restaurant buffet, where they selected virtual food and beverages as a lunch for their child. Mothers who were randomized to BRI+FHH filled the index child's plate with an average of 45 fewer calories than those in the Control arm (P<0.05); those in the BRI arm filled the plate with 35 fewer calories than the Control arm, a non-significant difference. Calorie restriction was greatest among mothers in the BRI+FHH arm who received the weaker-risk message (that is, only one overweight parent). The influence of communicating a child's inherited risk of obesity on mothers' feeding practices may vary by the risk level conveyed. High-risk messages may best be coupled with strategies to increase mother's perceptions that efforts can be undertaken to reduce risk and build requisite behavioral skills to reduce risk.

Risk factors associated with overweight and obesity among urban school children and adolescents in Bangladesh: a case–control study

BackgroundChildhood obesity has become an emerging urban health problem in urban cities in Bangladesh, particularly in affluent families. Risk factors for obesity in this context have not been explored yet. The objective of this study was to identify the risk factors associated with overweight and obesity among school children and adolescents in Dhaka, Bangladesh.MethodsFrom October through November 2007, we conducted a case–control study among children aged 10–15 years in seven schools in Dhaka. We assessed body mass index (weight in kg/height in sq. meter) to identify the cases (overweight/obese) and controls (healthy/normal weight) following the Centers for Disease Control and Prevention age and sex specific growth chart. We used a structured questionnaire to collect demographic information and respondent’s exposure to several risk factors such as daily physical activity at home and in school, hours spent on computer games and television watching, maternal education level and parents’ weight and height.ResultsWe enrolled 198 children: 99 cases, 99 controls. Multiple logistic regression analysis revealed that having at least one overweight parent (OR = 2.8, p = 0.001) and engaging in sedentary activities for >4 hours a day (OR = 2.0, p = 0.02) were independent risk factors for childhood overweight and/or obesity while exercising ≥ 30 minutes a day at home was a protective factor (OR = 0.4, p = 0.02). There were no significant associations between childhood overweight and sex, maternal education or physical activity at school.ConclusionHaving overweight parents along with limited exercise and high levels of sedentary activities lead to obesity among school children in urban cities in Bangladesh. Public health programs are needed to increase awareness on risk factors for overweight and obesity among children and adolescents in order to reduce the future burden of obesity-associated chronic diseases.

Comparison of total energy expenditure between school and summer months

Childhood obesity has increased 3 to 4 fold. Some children gain excess weight in summer. Total energy expenditure increases almost linearly with fat-free mass. A lower total energy expenditure was not detected in summer. Recent data report that the youth experience greater weight gain during summer than during school months. We tested the hypothesis that a difference in total energy expenditure (TEE) between school and summer months exists and may contribute to summer weight gain. A secondary analysis was performed on cross-sectional TEE data from school-age, sedentary African-American and Caucasian youth based in or near the District of Columbia who were at-risk for adult obesity because they had body mass index (BMI) ≥ 85th percentile or had overweight parents. TEE was estimated from 18-O and deuterium measurements during 1-week intervals using urine samples collected after ingestion of doubly labelled water. Differences in summer- and school-time TEE were assessed using analysis of covariance. The data were adjusted for fat-free mass (FFM) as determined by deuterium dilution to adjust for the effect of body size on TEE. Data were collected from 162 youth (average age 10 ± 2 years, BMI 28 ± 8 kg m(-2) and BMI z-score 1.96 + 0.96). Of these, 96 youth had TEE measured during the school year (September-June); 66 different youths had TEE measured during summer months (June-August). After adjustment for FFM, average summertime TEE was 2450 ± 270 kcal d(-1) and average school-time TEE was 2510 ± 350 kcal d(-1) (P = 0.26). No difference in TEE was detected between the school year and the summer months. These data suggest that seasonal differences in youth weight gain are not necessarily due to differences in energy expenditures.

Food-Related Parenting Practices and Adolescent Weight Status: A Population-Based Study

To examine food-related parenting practices (pressure-to-eat and food restriction) among mothers and fathers of adolescents and associations with adolescent weight status within a large population-based sample of racially/ethnically and socioeconomically diverse parent-adolescent pairs. Adolescents (N = 2231; 14.4 years old [SD = 2.0]) and their parents (N = 3431) participated in 2 coordinated population-based studies designed to examine factors associated with weight status and weight-related behaviors in adolescents. Adolescents completed anthropometric measurements and surveys at school. Parents (or other caregivers) completed questionnaires via mail or phone. Findings suggest that the use of controlling food-related parenting practices, including pressure-to-eat and restriction, is common among parents of adolescents. Mean restriction levels were significantly higher among parents of overweight and obese adolescents compared with nonoverweight adolescents. However, levels of pressure-to-eat were significantly higher among nonoverweight adolescents. Results indicate that fathers are more likely than mothers to engage in pressure-to-eat behaviors and boys are more likely than girls to be on the receiving end of parental pressure-to-eat. Parental report of restriction did not differ significantly by parent or adolescent gender. No significant interactions by race/ethnicity or socioeconomic status were seen in the relationship between restriction or pressure-to-eat and adolescent weight status. Given that there is accumulating evidence for the detrimental effects of controlling feeding practices on children's ability to self-regulate energy intake, these findings suggest that parents should be educated and empowered through anticipatory guidance to encourage moderation rather than overconsumption and emphasize healthful food choices rather than restrictive eating patterns.

Reliability and validity of the Parent Efficacy for Child Healthy Weight Behaviour (PECHWB) scale

Interventions for childhood overweight and obesity that target parents as the agents of change by increasing parent self-efficacy for facilitating their child's healthy weight behaviours require a reliable and valid tool to measure parent self-efficacy before and after interventions. Nelson and Davis developed the Parent Efficacy for Child Healthy Weight Behaviour (PECHWB) scale with good preliminary evidence of reliability and validity. The aim of this research was to provide further psychometric evidence from an independent Australian sample. Data were provided by a convenience sample of 261 primary caregivers of children aged 4-17 years via an online survey. PECHWB scores were correlated with scores on other self-report measures of parenting efficacy and 2- to 4-week test-retest reliability of the PECHWB was assessed. The results of the study confirmed the four-factor structure of the PECHWB (Fat and Sugar, Sedentary Behaviours, Physical Activity, and Fruit and Vegetables) and provided strong evidence of internal consistency and test-retest reliability, as well as good evidence of convergent validity. Future research should investigate the properties of the PECHWB in a sample of parents of overweight or obese children, including measures of child weight and actual child healthy weight behaviours to provide evidence of the concurrent and predictive validity of PECHWB scores.