Prevention Of Pediatric Obesity Research Articles

The Impact of a Community-Based Activity and Nutrition Program for Children

There is consensus that community-wide integration of programs targeting pediatric obesity prevention is needed. The present article describes the growth, acceptability, and impact of a school- and community-based kids' marathon program targeting physical activity and nutrition. Youth in the program are encouraged to incrementally walk/run/jog a marathon and improve their diet through nutrition challenges. Participants track mileage and healthy eating over approximately 6 months, and complete a final marathon mile at the program's culminating event. Across 21 schools, 404 students between kindergarten and 8th grade reported on their experiences in the program. Also, 19 school coordinators rated their perceptions of the program's impact. While the data is preliminary and retrospective, it indicates that participants are highly engaged and that the program has potential to improve physical activity and other healthy lifestyle behaviors in many children. Strengths of the program, implications for obesity prevention, and future directions are also discussed.

Effectiveness of a Novel Pediatric Obesity Prevention Program on Endurance and Flexibility of Preschool Participants

A not-for-profit community hospital in the Southeast seeks to prevent and treat childhood obesity by observational learning and active participation in the context of a simulated home environment, the Healthy House. A Wellness Fitness, Awareness & Nutrition (FAN) program was developed, emphasizing energy balance, towards this goal. The fitness component utilizes active play to engage preschoolers in expending energy through fun indoor and outdoor activities. PURPOSE: This study was designed to determine the effect of a preschool fitness program on cardiovascular endurance and flexibility. METHODS: Subjects (N=116) were recruited through the local Head Start program whose faculty transported 3-5 yr old children to the Healthy House. Children participated in 45-min FAN sessions (9) in consecutive months over the academic year. The 15-min fitness protocol/session included aerobic and muscular strengthening exercises, sports and balance skills and stretching. Initial and ending BMI, 6-inch step test (no. steps/30 sec) and sit-n-reach test measurements were collected. RESULTS: African American (AA), Hispanic and Caucasian children comprised 95% of subjects. Female (48.3%) and male subjects' mean age was 4 yrs, 3.8 mos. Population mean BMI increased (16.63 to 16.78) significantly (p=.032) over the study period. However, BMI analyses by ethnicity and gender revealed a significant increase only among AA (p=.018) and females (p=.001). Baseline endurance was 14.45 steps on average for preschool subjects. A significant improvement in endurance was observed at academic year end when the mean 6-inch step value was 17.75 (p<.001). Participants showed an overall decrease in flexibility as measured by the sit-n-reach. While this decrease was not significant for males, females, Hispanic or Caucasian subjects, the decrease observed in the AA preschoolers was statistically significant (p=.005). CONCLUSION: The FAN program emphasizes active play over stretching, which correlates with the study findings of improved endurance and flexibility loss. In adults, obesity and co-morbidities are greater for African Americans than for either Hispanics or Caucasians. This research may suggest the pattern for obesity has already been set in motion by preschool age. Supported by Kate B. Reynolds Charitable Trust Grant.

Correlates of Participation in a Pediatric Primary Care‐Based Obesity Prevention Intervention

The purpose of this study was to examine the correlates of participation in a childhood obesity prevention trial. We sampled parents of children recruited to participate in a randomized controlled trial. Eligible children were 2.0-6.9 years with BMI ≥ 95th percentile or 85th to <95th percentile if at least one parent was overweight. We attempted contact with parents of children who were potentially eligible. We recruited 475 parents via telephone following an introductory letter. We also interviewed 329 parents who refused participation. Parents who refused participation (n = 329) did not differ from those who participated (n = 475) by number of children at home (OR 0.94 per child; 95% CI: 0.77-1.15) or by child age (OR 1.07 per year; 95% CI: 0.95-1.20) or sex (OR 1.06 for females vs. males; 95% CI: 0.80-1.41). After multivariate adjustment, parents who were college graduates vs. <college graduates were less likely to participate (OR 0.62; 95% CI: 0.46-0.83). In addition, parents were less likely (OR 0.41; 95% CI: 0.31-0.56) to participate if their child was overweight vs. obese. Among the 115 refusers with obese children, 21% cited as a reason for refusal that their children did not have a weight problem, vs. 30% among the 214 refusers with overweight children. In conclusion, parents of preschool-age children with a BMI 85-95th%ile are less likely to have their children participate in an obesity prevention trial than parents of children with BMI > 95th%ile. One reason appears to be that they less frequently consider their children to have a weight problem.

Commentary on The Role of Physical Therapists in Pediatric Health Promotion and Obesity Prevention

Commentary on The Role of Physical Therapists in Pediatric Health Promotion and Obesity Prevention

Pediatric Obesity Prevention Initiatives

Pediatric Obesity Prevention Initiatives

Improving the Prevention, Early Recognition, and Treatment of Pediatric Obesity by Primary Care Physicians

To determine if participation in a learning collaborative (LC) would improve care processes for prevention, early recognition, and treatment of childhood obesity by primary care physicians (PCP), the authors conducted pre-post evaluations of the use of obesity related care processes by 18 primary care practices following participation in a 9-month LC based on the Model for Improvement. Prior to the LC, chart audits revealed that 55% of patients had a BMI recorded; this rose to 97% of patients at its conclusion. Following the LC, 11 practices had implemented systematic prevention advice to parents of infants compared with 3 prior to the LC. All practices developed plans for evaluation and management of children with an elevated BMI. Participation in an LC increased the number of primary care practices that provided anticipatory guidance regarding obesity prevention and that identified and treated overweight or obese children.

Diet vs exercise for the prevention of pediatric obesity: the role of exercise

As pediatric obesity is commonly viewed as the result of an excessively positive energy balance, preventive efforts typically emphasize reduction of energy intake, with increases in physical activity (PA) having a supporting role. However, recent research that has focused on body composition rather than weight has found that PA stimulates development of lean tissue rather than fat tissue. Preventive interventions that emphasize vigorous PA rather than restriction of energy intake can help youths to develop lean bodies, at the same time that they ingest sufficient amounts of the energy and accompanying nutrients needed for healthy growth.

Implementation of Intensive Behavioral Strategies (Guided Goal Setting) in an EFNEP Intervention: Educator Feasibility

As obesity rates for young children in the United States continue to increase, development of interventions targeting pediatric obesity prevention is recommended for low-income families with preschool children. The purpose of this study was to test the feasibility of such an intervention with nutrition educators.

Effects of a school‐based pediatric obesity prevention program

The purpose of the current study was to evaluate a school‐based pediatric obesity program for elementary children. Children (n = 782) were between the ages of 7 and 9 and in the 2nd grade. A total of 323 (189 males) children who exceeded the 85th percentile for BMI were randomized into an integrated health curriculum (IHC) or treatment as usual (TAU) condition. The IHC condition (n= 187) received nutrition education that included lifestyle change techniques provided by their classroom teacher. The teacher was provided with a trained instructor to assist with the integration of health materials into their classes. The TAU condition (n= 136) received a typical health and physical education class. Repeated Measures ANOVA was used to evaluate weight changes between the groups using standardized BMIs from baseline to 2 years. Children in the IHC condition significantly reduced their BMI zscore when compared to the children in the TAU condition as demonstrated by a significant time by condition interaction effect (F = 8.08, p = .005). This study suggests that an integrated health program supported by trained professionals is a promising approach for school‐based pediatric obesity prevention. This project was funded by a grant from the Oliver Foundation.

Measuring dietary intake in children and adolescents in the context of overweight and obesity

Dietary intake throughout childhood is a key determinant of growth and development and has an important role in both the prevention and treatment of childhood overweight and obesity. Although dietary intake assessment is fraught with challenges and limitations, reporting intake remains an important research outcome if dietary recommendations to promote healthy weight are to be refined. The aims of this paper are to review current dietary intake assessment methodologies for children, to identify their biases and provide guidance on how these can be addressed to improve reporting of dietary intakes of overweight children in the literature and to identify future research priorities. Knowledge of the methodological aspects of studies examining dietary intake a priori in the context of obesity will assist researchers in improving the quality of dietary data collected and reported and facilitate publication of both dietary intake and nutrition outcomes in the context of body weight. This will help to develop a strong evidence base against which to evaluate the effectiveness of nutrition interventions for both the prevention and treatment of pediatric obesity.

Circumventing Communication Barriers With Spanish-speaking Patients Regarding Pediatric Obesity

In 2005, the Journal of Pediatric Health Care published an article citing the importance of educational material in the treatment and prevention of pediatric obesity, including handouts that could be copied for use (Ward-Begnoche & Gance-Cleveland, 2005). With the increased clinical use of these educational handouts, the need for Hispanic versions of the handouts to use with Spanishspeaking patients and families has become clear. This article reviews the need for language-specific educational material, and includes the Spanish versions of the handouts on Metabolism, Nutrition for Kids, Healthy Snacks, Portion Sizes, Fitness for Children and Adolescents, Behavioral Recommendations for Overweight Children and Adolescents, and Exercise Activities for Kids. Concerns for culturally appropriate treatment approaches also are reviewed. In addition, a list of online resources and books is provided to assist in behavioral change for overweight Hispanic youth. Research suggests that there is an ethnic disparity in risk for pediatric obesity, with Hispanic youth being at highest risk (Ogden et al., 2006), suggesting the need to target this population with prevention and intervention efforts. Yet youth (including Hispanic youth) report rarely receiving preventive counseling regarding specific recommendations for nutritional intake or physical activity changes during routine primary care visits (Taveras et al., 2007). Taveras and colleagues suggest that social class disparities should be included in the design of prevention counseling and treatment. Most of the literature on pediatric obesity has focused on White, middle-class samples, thus telling us little about how best to deliver chronic disease self-management interventions to low-income, Wendy L. Ward-Begnoche, Associate Professor of Pediatrics, Department of Pediatrics,UniversityofArkansas forMedical Sciences,CollegeofMedicine,andArkansas Children’s Hospital, Little Rock, AR.

Psychological Determinants of Emotional Eating in Adolescence

Emotional eating is conceptualized as eating in response to negative affect. Data from a larger study of physical activity was employed to examine the associations among specific emotions/moods and emotional eating in an adolescent sample. Six-hundred and sixty-six students of diverse backgrounds from 7 middle schools in Los Angeles County participated. Cross-sectional analysis revealed no gender differences in emotional eating, and showed that perceived stress and worries were associated with emotional eating in the total sample. Gender stratified analyses revealed significant associations of perceived stress, worries and tension/anxiety to emotional eating for girls, while only confused mood was related to emotional eating in boys. These findings bear potential implications for the treatment and prevention of pediatric obesity and eating disorders because they suggest that interventions would benefit from incorporation of stress-reduction techniques and promotion of positive mood.

Prevention and treatment of pediatric obesity: An Endocrine Society Clinical Practice Guideline Based on Expert Opinion

与1963～1970年的调查相比,1999～2000年的肥胖患病率在6～11岁儿童中增加了4倍,在12～19岁青少年中增加了3倍.于1976～1980年间,婴幼儿(0～23个月)的肥胖患病率从7.2%增至11.6%,2～5岁儿童从5%增至13.9%.儿童肥胖的总患病率为17.1%.同期,6岁以上儿童中的超重发生率增加了 2.5倍,达37.2%.……

Patient Guide to the Prevention and Management of Pediatric Obesity

Patient Guide to the Prevention and Management of Pediatric Obesity

Child Obesity Can Be Reduced With Vigorous Activity Rather Than Restriction of Energy Intake

Child Obesity Can Be Reduced With Vigorous Activity Rather Than Restriction of Energy Intake

An update in prevention and treatment of pediatric obesity

Obesity prevalence is growing as well as its severity with increasing morbidity and mortality. This "globesity" also affects developing countries where under nutrition and stunting frequently coexist with overweight and obesity. One third of obese adults began to be so in the pediatric ages. There are two main types of prevention: general one representing greater actions from health authorities and the individual one carried out by the pediatrician and the patient at risk. Once the state of obesity is reached (relative body mass index, rBMI >121%) the longer lasting care becomes more complex and frequently unsuccessful. The treatment of obesity is aimed to care for the present and silent disorders and for preventing its further tracking to adulthood. Identification of pediatric population at risk which is the one with an rBMI of 111%-120% plus other risk factors. Specific individual actions include reduction of food intake, increase of energy expenditure, involvement of parents, and the child-adolescent himself in the prevention. Therapy is based on some principles plus the important medical and emotional approach. A Cochrane study based on only 10 appropriate studies showed a predominant poor efficacy of the undergone preventive action. Treatment guides are presented after our own experience with a group of 400 kids with an average follow-up of 7 years and other individual prevention studies. Involving motivated pediatricians with a minimum of time for visits and better follow-up in the frame of a general national preventive programme could be a rational outcome. Treatment of obesity should never be postponed whatever the clinical care is.

Childhood Obesity: Looking Into the Future

A major concern related to childhood obesity is that obese children tend to become obese adults, with all the risks/ comorbidities associated (ie, diabetes, cardiovascular diseases among many others). The challenges of childhood obesity are not limited to one country but confront most nations around the world. Efforts to manage and to prevent childhood obesity involve education, research, and intervention. Research could drive new directions in prevention and could develop public policy that might help manage the problem. Additionally, research is needed to test these issues. Looking into the future, 6 relevant levels may be involved in the prevention and treatment of pediatric obesity, and each of these needs investigation: family, schools, health care, government, industry, and media. Together, these 6 levels could promote childhood obesity as a high research priority and put it as the first point in the international public agenda.

Prevention Of Childhood Obesity: The New Search For The Holy Grail?

Dramatic increases in the prevalence of child and adolescent obesity have occurred recently across the developed and much of the developing world. Trends predict further marked increases in the prevalence of pediatric obesity. The pediatric obesity epidemic will have substantial adverse health and economic impacts. This article summarizes recent trends in pediatric obesity, and their likely impact for future cardiovascular disease. The evidence on preventive interventions is summarized, with a critique of why most preventive interventions have been unsuccessful. A rationale for designing improved, more radical interventions for the prevention of pediatric obesity is presented.

New International Measuring Stick for Defining Obesity in Non-Europeans

Body mass index (BMI) is a useful way of classifying the degree of excess weight in an individual. Defining BMI cut points at which adverse cardiovascular outcomes, diabetes mellitus, and other comorbidities are more likely to occur affords clinically relevant guidelines for patient care. Expert panels from both the National Institutes of Health and the World Health Organization1–3 have developed such cut points, which define overweight as a BMI (weight [in kilograms]/height [in meters squared]) of 25.0 to 29.9 kg/m2, mild or grade I obesity as a BMI of 30 to 34.9 kg/m2, grade II or more severe obesity as a BMI of 35 to 39.9 kg/m2, and extreme or grade III obesity as a BMI ≥40 kg/m2. Epidemiological studies focusing on persons of European descent have verified that these cut points are, indeed, associated with incremental risk for cardiovascular events and all-cause death.4–6 An awareness that appropriate BMI cut points for Asians may differ from those of Europeans has been largely based on observations that cardiovascular and metabolic risk in Asians occur at a lower BMI than in Europeans. For example, there is increasing evidence of a high prevalence of type 2 diabetes mellitus and elevated cardiovascular risk in certain Asian countries, despite an average BMI in these countries that is <25 kg/m2.7,8 Even for Asian-Americans, the prevalence of diabetes mellitus after adjustment for BMI is 60% higher than in their European counterparts.9 Article p 2111 The definition of clinically useful BMI cut points in Asian populations has been difficult, at least in part because of the limitations of previously used methodologies. Two general methodological approaches have been taken in the past to derive these BMI cut points in Asians: (1) recalculation of BMI cut …

AAP Publications Retired or Reaffirmed, October 2006

Policy Statement: School Bus Transportation of Children With Special Health Care Needs. Pediatrics. 2001;108:516–518Policy Statement: Injuries Associated With Infant Walkers. Pediatrics. 2001;108:790–792Policy Statement: Bicycle Helmets. Pediatrics. 2001;108:1030–1032Policy Statement: Measles Immunization in HIV-Infected Children. Pediatrics. 1999;103:1057–1060Policy Statement: Fetal Therapy—Ethical Considerations. Pediatrics. 1999;103:1061–1063Policy Statement: Issues Related to Human Immunodeficiency Virus Transmission in Schools, Child Care, Medical Settings, the Home, and Community. Pediatrics. 1999;104:318–324Policy Statement: Evaluation of the Newborn With Developmental Anomalies of the External Genitalia. Pediatrics. 2000;106:138–142Policy Statement: When Inflicted Injuries Constitute Child Abuse. Pediatrics. 2002;110:644–645Policy Statement: Revised Indications for the Use of Palivizumab and Respiratory Syncytial Virus Immune Globulin Intravenous for the Prevention of Respiratory Syncytial Virus Infection. Pediatrics. 2003;112:1442–1446Policy Statement: Clioquinol (Iodochlorhydroxyquin, Vioform) and Iodoquinol (Diiodohydroxyquin): Blindness and Neuropathy. Pediatrics. 1990;86:797–798Policy Statement: Infants With Anencephaly as Organ Sources: Ethical Considerations. Pediatrics. 1992;89:1116–1119Policy Statement: Informed Consent, Parental Permission, and Assent in Pediatric Practice. Pediatrics. 1995;95:314–317Policy Statement: Religious Objections to Medical Care. Pediatrics. 1997;99:279–281Policy Statement: Use of Codeine- and Dextromethorphan-Containing Cough Remedies in Children. Pediatrics. 1997;99:918–920Policy Statement: Sterilization of Minors With Developmental Disabilities. Pediatrics. 1999;104:337–340Policy Statement: Education of Children With Human Immunodeficiency Virus Infection. Pediatrics. 2000;105:1358–1360Policy Statement: Palliative Care for Children. Pediatrics. 2000;106:351–357Policy Statement: Forgoing Life-Sustaining Medical Treatment in Abused Children. Pediatrics. 2000;106:1151–1153Policy Statement: The Use and Misuse of Fruit Juice in Pediatrics. Pediatrics. 2001;107:1210–1213Clinical Report: Selecting Appropriate Toys for Young Children: The Pediatrician's Role. Pediatrics. 2003;111:911–913Policy Statement: Prevention of Pediatric Overweight and Obesity. Pediatrics. 2003;112:424–430