Primary Prevention Of Obesity Research Articles

Gene and lncRNA Profiling of ω3/ω6 Polyunsaturated Fatty Acid-Exposed Human Visceral Adipocytes Uncovers Different Responses in Healthy Lean, Obese and Colorectal Cancer-Affected Individuals.

Colorectal cancer (CRC) is a major life-threatening disease, being the third most common cancer and a leading cause of death worldwide. Enhanced adiposity, particularly visceral fat, is a major risk factor for CRC, and obesity-associated alterations in metabolic, inflammatory and immune profiles in visceral adipose tissue (VAT) strongly contribute to promoting or sustaining intestinal carcinogenesis. The role of diet and nutrition in obesity and CRC has been extensively demonstrated, and AT represents the main place where diet-induced signals are integrated. Among the factors introduced with diet and processed or enriched in AT, ω3/ω6 polyunsaturated fatty acids (PUFAs) are endowed with pro- or anti-inflammatory properties and have been shown to exert either promoting or protective roles in CRC. In this study, we investigated the impact of ex vivo exposure to the ω3 and ω6 PUFAs docosahexaenoic and arachidonic acids on VAT adipocyte whole transcription in healthy lean, obese and CRC-affected individuals. High-throughput sequencing of protein-coding and long non-coding RNAs allowed us to identify specific pathways and regulatory circuits controlled by PUFAs and highlighted an impaired responsiveness of obese and CRC-affected individuals as compared to the strong response observed in healthy lean subjects. This further supports the role of healthy diets and balanced ω3/ω6 PUFA intake in the primary prevention of obesity and cancer.

Motivational interviewing to promote healthy behaviors for obesity prevention in young adults (MOTIVATE): a pilot randomized controlled trial protocol

BackgroundObesity is a chronic disease and is an established risk factor for other chronic diseases and mortality. Young adulthood is a period when people may be highly amenable to healthy behavior change, develop lifelong healthy behaviors, and when primary prevention of obesity may be feasible. Interventions in early adulthood have the potential for primary or primordial prevention (i.e., preventing risk factors before disease onset). The primary objective of this study is to determine the feasibility of a 6-month behavioral and educational intervention to promote healthy behaviors for obesity prevention among young adults.MethodsThis is the study protocol for a pilot randomized controlled trial. Young adults (age 18–29) attending McMaster University, Hamilton, Canada, will be recruited and randomized to either the intervention or control. The intervention will include individual motivational interviewing sessions (online or in-person) with a trained interviewer plus educational materials (based on Canada’s food guide and physical activity recommendations). The control group will receive educational materials only. The primary feasibility outcomes that will be evaluated as part of this pilot study include enrollment, retention (≥ 80%), data completion (≥ 80% of weights measured, and surveys completed), and participant satisfaction. Secondary clinical outcomes will include body mass index (BMI) change from baseline to 6 months, physical activity, nutrition risk, health-related quality of life mental health, and economic outcomes. Outcomes will be measured remotely using activity trackers, and online questionnaires at baseline and every 2 months. Risk stratification will be applied at baseline to identify participants at high risk of obesity (e.g., due to family or personal history). Exit questionnaires will collect data on how participants felt about the study and cost analysis will be conducted.DiscussionOur pilot randomized controlled trial will evaluate the feasibility of an obesity prevention intervention in early adulthood and will inform future larger studies for obesity prevention. The results of this study have the potential to directly contribute to the primary prevention of several types of cancer by testing an intervention that could be scalable to public health, post-secondary education, or primary care settings.Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT05264740. Registered on March 3, 2022.

A clinician's guide to obesity prevention in the UK

Across the UK, people's lives are being cut short because of obesity, and the lives of the most deprived members of our communities are being cut the most. The role of the medical professional in managing overweight and obesity is extensive, but, for many patients, maintaining a healthy weight needs to be supported by creating environments that help people to stay healthy in the first place. The building blocks of health are the environmental, commercial, economic and social factors that largely determine our health and wellbeing and impact our capability, opportunity and motivation to maintain healthy-weight behaviours. Although the role of the healthcare professional generally is to focus on the individual patient, clinicians can still influence these building blocks. Clinicians have the skills to create change, they often hold power in organisations with local to international impact and there are actions, big or small, that every clinician can take to improve obesity prevention. Here, we outline an environmental-behavioural framework for the primary prevention of obesity and consider the role of clinicians in catalysing change.

The Nutritional Needs of Mothers and Babies: A Review

The aim is to assess the importance of measuring healthy habits by pregnant women, that enhance different factors of mother and fetus health. We evaluate the change and variations in dietary recommendations. A female went through a lot of physical and mental changes in different stages of pregnancy and there are some common symptoms such as vomiting, fatigue, nausea, frequent urination, dizziness, etc. Certain hormonal changes are there to balance the body’s fatigue, tiredness, and hormones, few dietary recommendations are mentioned and it has been concluded that diet plays an important role during pregnancy, and meeting all the nutrition needs is an essential factor in planning the diet. Many diseases/deficiencies are there such as goiter, iodine deficiency, folate deficiency, gestational diabetes mellitus, gestational weight gain, Neural tube defects, and much more. A detailed view is mentioned below in the following paper: On average, pregnancy lasts 40 to 42 weeks (Nine months). On average, weight gain for a pregnant woman is 12 to 14 kg, thus weight gain can lower the risk of complications during labor and also lower the risk of LBW (low birth weight). Low GWG increases the risk of having an LBW infant. The average weight of the baby should be 2.5–3 kg. A baby having this much body weight should be considered a healthy infant. We provide up-to-date advice for achieving optimal nutrition before conception, throughout breastfeeding, in the first two years of life, and for preschoolers, with an eye on long-term health benefits. These guidelines are intended to aid in the primary prevention of obesity and the non-communicable diseases it is linked to among economically privileged groups, such as European women and children. Medical professionals should be incentivized and educated to promote and advise patients on preconception nutrition, which includes enhancing adolescent nutrition and health. Women who are physically active, eat healthily, don’t smoke, don’t drink excessively, and have a good body mass index (BMI) have a higher chance of having a safe pregnancy. Women of childbearing age should have their consumption and status of specific micronutrients closely monitored, especially folate. Women at risk for insufficient dietary intake of certain micronutrients may benefit from taking dietary supplements containing iron, vitamin D, vitamin B12, iodine, and maybe others. Smoke and alcohol should be strictly eliminated from the diet. Yes, diet plays an important role during pregnancy but staying physically active is equally important for the mother and the baby to promote general health and well-being. Exercise and stretching can reduce the risk of excessive maternal weight gain or gestational weight gain(Obesity). A long walk can greatly help a pregnant woman after lunch or in the morning.

Associations between parental adherence to healthy lifestyles and risk of obesity in offspring: a prospective cohort study in China

BackgroundMaternal adherence to a healthy lifestyle has been associated with a lower risk of obesity in offspring. However, little is known about the potential effect of an overall healthy parental lifestyle on the development of obesity in children. We aimed to investigate the prospective association of parental adherence to a combination of healthy lifestyle factors with the risk of obesity in offspring. MethodsParticipants in the China Family Panel Studies, without obesity at baseline, were enrolled between April and September, 2010; between July, 2012, and March, 2013; and between July, 2014, and June, 2015; and followed up until the end of 2020. Parental healthy lifestyle score (ranged 0–5) was characterised by five modifiable lifestyle factors: smoking, alcohol consumption, exercise, diet, and BMI. The first occurrence of offspring obesity during the study follow-up period was defined by age-specific and sex-specific cutoff values of BMI. We used multivariable-adjusted Cox proportional hazard models to examine the associations between parental healthy lifestyle scores and risk of obesity in children. FindingsWe included 5881 participants aged 6–15 years; median follow-up was 6 years (IQR 4–8). A total of 597 (10·2%) participants developed obesity during follow-up. Compared with those in the lowest tertile of parental healthy lifestyle scores, participants in the top tertile had a 42% lower risk of obesity (multivariable-adjusted hazard ratio [HR] 0·58 [95% CI 0·45–0·74]). The association persisted in sensitivity analyses and was similar across major subgroups. Both maternal (HR 0·75 [95% CI 0·61–0·92]) and paternal (0·73 [0·60–0·89]) healthy lifestyle scores were independently associated with lower risks of obesity in offspring, with significant contributions observed for paternal diverse diet and healthy BMI. InterpretationAdherence to an overall parental healthier lifestyle was associated with a substantially lower risk of obesity in childhood and adolescence. This finding highlights the potential benefits of promoting a healthy lifestyle among parents for the primary prevention of obesity in offspring. FundingSpecial Foundation for National Science and Technology Basic Research Program of China (grant reference 2019FY101002) and National Natural Science Foundation of China (grant reference 42271433).

Improving the health of adolescents: the Nordic countries can help fill the evidence gap.

While in the Nordic countries we have well-developed welfare policies and several structural, statutory measures in place aiming to promote public health, studies from these countries are often absent from systematic reviews of research literature assessing the effects of policy measures designed to promote health. Using adolescent health promotion and efforts related to primary prevention of obesity as an example, this short commentary aims to illustrate the paucity of well-designed studies investigating the effects of public health policies affecting adolescents. This paper argues that the Nordic research community is in a good position to help fill this gap, and to contribute more widely to the international literature on evaluation of policy interventions.

Experiences of nurses and coordinators in a childhood obesity prevention trial based on motivational interviewing within Swedish child health services

ABSTRACT Purpose To explore the experiences of nurses and coordinators in the PRIMROSE childhood obesity prevention trial, and to understand the factors that might help to improve the outcome of future primary prevention of obesity. Methods Using a qualitative approach, data were obtained by interviewing nine intervention nurses and three regional study coordinators. All participants were female. The interviews were transcribed and analysed using content analysis. Results Two themes emerged: The nurses experienced that it was rewarding to participate in the trial, but challenging to combine the intervention with regular work; and The study coordinators experienced that they were in a difficult position handling the conflicting needs of the research group and the nurses’ commitment to usual child health care services. The importance of support, encouragement, briefer and simpler intervention, and adaptation of the training in motivational interviewing to the setting was emphasized. Stress and lack of time were major barriers to deliver the intervention as intended. Conclusions Although the PRIMROSE intervention was developed in collaboration with representatives from the child health services, and additional research funding was provided to compensate for time spent working with the trial, nurses experienced stress and time constraints. .

Cost effectiveness analysis of childhood obesity primary prevention programmes: a systematic review

Background. Childhood obesity is associated with enormous health consequences and costs to society. This study aims to systematically review the studies on Cost Effectiveness Analysis (CEA) of primary prevention programmes of childhood obesity, discussing the gaps and providing recommendations for future research. 
 Methods. All the studies on the cost effectiveness evaluation of primary prevention of obesity among children were included. Studies were retrieved from MEDLINE and Google Scholar, up to 31st March 2012, with only English language papers being eligible. The quality of the retrieved studies was evaluated by using the Drummond scale.
 Results. Eight studies were included, five of which concerning community-based intervention programmes, while three school-based programmes. Fifty-percent of the studies, 3 school-based and 1 community-based primary prevention programme reported the intervention being cost effective. The studies were heterogeneous in terms of study design, quality, target population and outcome measures. Use of the Drummond scale showed that the eight studies were of low-medium quality. 
 Conclusion. Although model-based studies may be considered as practical measures applicable to different type of programmes and settings, we auspicate for a convergence towards the use of homogenous clinical and outcome measures in order to properly evaluate the added value of obesity primary prevention programmes in childhood

A mixed methods study of siblings’ roles in maternal feeding practices in early childhood: an application of the learning from experience process

BackgroundFirstborn children have higher rates of obesity compared to secondborns, perhaps due, in part, to differential feeding practices. Despite the centrality of siblings in family life and potential for influence, almost nothing is known about the role of siblings in parent feeding practices in early childhood.MethodsParticipants (n = 117) were mothers of consecutively born siblings. Firstborns participated in an RCT that compared a responsive parenting intervention designed for primary prevention of obesity against a safety control. Secondborns participated in an observational cohort. Multilevel models tested whether and how firstborn characteristics (temperament, appetite, rapid weight gain) at 16 weeks and 1 year were associated maternal feeding practices of secondborns in infancy at 16 weeks, 28 weeks, and 1 year (food to soothe) and at ages 1, 2, and 3 years (structure-and control-based feeding practices). A purposive subsample (n = 30) of mothers also participated in semi-structured interviews to further illuminate potential sibling influences on maternal feeding practices during infancy and toddlerhood.ResultsFirstborn characteristics did not predict secondborn feeding in infancy (all ps > 0.05). Firstborn negative affect, however, predicted mothers’ less consistent mealtime routines (b (SE) = − 0.27 (0.09); p = 0.005) and more pressure (b (SE) = 0.38 (0.12); p = 0.001). Firstborn appetite predicted mothers’ less frequent use of food to soothe (b (SE) = − 0.16 (0.07); p = 0.02) when secondborns were toddlers. Firstborn surgency, regulation, and rapid weight gain, however, did not predict secondborn feeding practices during toddlerhood (all ps > 0.05). Interviews with mothers revealed three ways that maternal experiences with firstborns informed feeding practices of secondborns: 1) Use of feeding practices with secondborn that worked for the firstborn; 2) Confidence came from firstborn feeding experiences making secondborn feeding less anxiety-provoking; and 3) Additional experiences with firstborn and other factors that contributed to secondborn feeding practices.ConclusionsSome firstborn characteristics and maternal experiences with firstborns as well as maternal psychosocial factors may have implications for mothers’ feeding practices with secondborns. Together, these mixed methods findings may inform future research and family-based interventions focused on maternal feeding of siblings in early childhood.

A comparative study of efficacy of DIPSI and O’Sullivan’s method of screening for GDM in a high risk tertiary referral hospital

There is an increasing trend of making Diabetes one of the most common non-communicable diseases globally. Gestational Diabetes Mellitus (GDM) is defined as “carbohydrate intolerance variable severity that is first diagnosed during present pregnancy, regardless of the need for insulin or persistence of the diabetic state after delivery”. Diabetes Mellitus is the most common disorder of pregnancy, although the prevalence is usually reported as 2 to 5% of pregnant women, it can be as high as 14% in high risk groups. To note the Foetal Outcome of pregnancy with impaired and abnormal glucose tolerance detected with DIPSI.Total of 200 patients was included in the study from Vanivilas hospital for 1 year. A detailed history from antenatal patients was taken to reveal all risk factors. The procedure of the study was explained and required consent for the study was taken. Examination of the patients was done and all relevant data was obtained. Fasting blood glucose was taken of all antenatal patients at their first visit. Pregnant women at 24-28 weeks were tested with 50g oral glucose load or 75g oral glucose load, at random. Patients were give 50g glucose irrespective of the meal and 1 hour venous blood sample was collected. Patients of 75 g of oral glucose were asked to come in fasting state, 75g of glucose was given, and following which 2 hour venous sample was collected. Blood glucose was tested by GOD-POD method. Diagnosis of GDM was made when the plasma glucose of >140mg/dL and impaired glucose tolerance diagnosis was made when plasma glucose was between 120-140mg/dl. High prevalence rate of GDM was obtained in our study, GDM has adverse maternal and fetal outcome. GDM when identification early and treatment initiated for mothers, maternal and fetal complications can be reduced. In conclusion, intensive care of GDM mothers can help primary prevention of obesity, impaired glucose tolerance and diabetes in the offspring.

Risk factors of overweight/obesity-related lifestyles in university students: Results from the EHU12/24 study.

This paper investigates the prevalence and interaction of overweight/obesity-related lifestyles (specifically, examining whether subjects meet the recommended criteria), in a representative sample of university students. This study is part of the project EHU12/24, an observational cross-sectional study, designed to assess the prevalence of excess body fat (BF) and major risk of developing overweight/obesity, according to a standardised protocol. In a cohort of 603 students, aged between 18 and 28 years, of the University of the Basque Country, information about meal patterns, diet quality, physical activity, sitting time, sleeping time, toxic habits and anthropometric measurements were collected. Sampling took place from February 2014 to May 2017. Binary logistic regression models adjusted for the covariates were utilised to test the association between lifestyles and risk of excess adiposity. The prevalence of overweight/obesity, according to BF percentage, was 14·4 %. The variables analysed related to meal pattern were associated with diet quality, and less healthy food habits were associated with other less health-related behaviours. Among men, moderate/low physical activity, breakfast skipping, non-adequate breakfast duration, number of eating occasions and eating breakfast alone/depending on the occasion were associated with excess BF, while among women, low MedDietScore, moderate/high alcohol consumption, non-adequate sleep duration, eating breakfast and lunch alone/depending on the occasion. Results suggest that certain unhealthy lifestyle behaviours coexist, interact with one another and increase the risk of overweight/obesity in this population. Sex-specific differences in risk factors of obesity have implications for interventions for primary prevention of obesity within this environment.

Adiposity Phenotypes and Subclinical Atherosclerosis in Adults from Sub-Saharan Africa: An H3Africa AWI-Gen Study.

Background:Obesity and adipose tissue distribution contribute to an increased risk of cardiovascular disease (CVD) by promoting atherosclerosis. This association has been poorly studied in sub–Saharan Africa (SSA) despite the rising prevalence of cardiovascular disease.Objectives:We determined the association between various adiposity phenotypes and carotid intima–media thickness (CIMT), a proxy of subclinical atherosclerosis, in a large SSA population.Methods:A population–based cross–sectional study was performed from 2013–2016 in Burkina Faso, Ghana, Kenya and South Africa. Body mass index (BMI), waist (WC), hip circumferences (HC), visceral (VAT) and subcutaneous adipose tissue (SCAT) using B-mode ultrasound were measured. Ultrasonography of left and right far wall CIMT of the common carotid artery was used as an indicator of subclinical atherosclerosis. Individual participant data meta–analyses were used to determine the associations between adiposity phenotypes and CIMT in the pooled sample while adjusted multivariable linear regression analyses were used for site specific analyses.Results:Data were obtained from 9,010 adults (50.3% women and a mean age of 50± 6years). Men had higher levels of visceral fat than women while women had higher BMI, waist and hip circumference and subcutaneous fat than men at all sites except Burkina Faso. In the pooled analyses, BMI (β–value [95% CIs]: 19.5 [16.8, 22.3] μm) showed the strongest relationship with CIMT followed by VAT (5.86 [4.65, 7.07] μm), SCAT (5.00 [2.85, 7.15] μm), WC (1.27 [1.09, 1.44] μm) and HC (1.23 [1.04, 1.42] μm). Stronger associations were observed in men than in women.Conclusion:Obesity within SSA will likely result in higher levels of atherosclerosis and promote the occurrence of cardio- and cerebrovascular events, especially in males, unless addressed through primary prevention of obesity in both rural and urban communities across Africa. The inverse association of VAT with CIMT in Burkina Faso and Ghana requires further investigation.HighlightsAll adiposity phenotypes were positively associated with common carotid intima–media thickness (CIMT) in the entire cohort (pooled analyses).BMI had the strongest association with CIMT compared to other phenotypes.The magnitude of association between adiposity phenotypes and CIMT was higher in men than in women.Subcutaneous adipose tissue was inversely associated with CIMT only in women.An unexpected finding was the inverse association of visceral adipose tissue with CIMT in Burkina Faso and Ghana.

Comparative effectiveness of school-based interventions targeting physical activity, physical fitness or sedentary behaviour on obesity prevention in 6- to 12-year-old children: A systematic review and meta-analysis.

A systematic search of the literature was performed to compare the effects of interventions that targeted sedentary behaviours or physical activity (PA) or physical fitness on primary prevention of obesity in 6- to 12-year-old children. The search identified 146 reports that provided relevant data for meta-analysis. Point estimates in % body fat were higher for fitness interventions compared with PA interventions (standardized mean difference = -0.11%; 95% CI = -0.26 to 0.04, and -0.04%; 95% CI = -0.15 to 0.06, respectively). Including sedentary behaviour to a PA- or fitness-oriented intervention was not accompanied by an increase in intervention effectiveness, as the point estimates were slightly smaller compared with those for PA- or fitness-only interventions. Overall, the effects tended to be larger in girls than in boys, especially for PA + sedentary behaviour interventions. There was some evidence for inequality, as the effects on body mass index were seen when interventions were delivered in the general population (standardized mean difference = -0.05, 95% CI = -0.07 to -0.02), but not in groups of disadvantaged children (standardized mean difference = -0.01, 95% CI = -0.29 to 0.19). In conclusion, school-based PA interventions appear to be an effective strategy in the primary prevention of childhood obesity among 6- to 12-year-old children, but targeting sedentary behaviour in addition to PA or fitness does not increase the effectiveness of the intervention.

Influence of early-life body mass index and systolic blood pressure on left ventricle in adulthood – the Cardiovascular Risk in Young Finns Study

Background Increased left ventricular mass (LVM) predicts cardiovascular events and mortality. The objective of this study was to determine whether early-life exposures to body mass index (BMI) and systolic blood pressure (SPB) affects the left ventricular structure in adulthood. Methods We used longitudinal data from a 31-year follow-up to examine the associations between early-life (between ages 6–18) BMI and SPB on LVM in an adult population (N = 1864, aged 34–49). The burden of early-life BMI and SBP was defined as area under the curve. Results After accounting for contemporary adult determinants of LVM, early-life BMI burden associated significantly with LVM (3.61 g/SD increase in early-life BMI; [1.94 − 5.28], p < 0.001). Overweight in early-life (age- and sex-specific BMI values corresponding to adult BMI > 25 kg/m2) associated with 4.7% (2.5–6.9%, p < 0.0001) higher LVM regardless of BMI status in adulthood. Overweight in early-life combined with obesity in adulthood (BMI > 30kg/m2) resulted in a 21% (17.3–32.9%, p < 0.0001) increase in LVM. Higher early-life BMI was associated with a risk of developing eccentric hypertrophy. The burden of early-life SPB was not associated with adult LVM or left ventricular remodeling. Conclusions High BMI in early-life confers a sustained effect on LVM and the risk for eccentric hypertrophy independently of adulthood risk factors. KEY MESSAGES Excess in BMI in early-life has an independent effect on LVM and the risk of developing eccentric hypertrophy regardless of overweight status in adulthood. Systolic blood pressure levels in early-life did not have an independent effect on LVM or LV remodeling. The clinical implication of this study is that primary prevention of obesity in early-life may prevent the development of high LVM and eccentric hypertrophy.

Overweight and obesity among preschool children attending a rural family health unit in Menoufia governorate

Abstract Background: Obesity in preschool children is a growing problem as it is a predictor of adulthood obesity, morbidity and mortality. Objectives: assess prevalence of overweight and obesity and identify risk factors associated with them among preschool children. Methods: A cross sectional study was conducted on 248 preschool children of both sexes, aged between 2-5 years in rural area in Menoufia Governorate. Sociodemographic data of the studied children and their eating practices were collected. Weight and height were measured and body mass index (BMI) was calculated. Egyptian practice guidelines were used for cut-off values of BMI-for-age, and percentiles were used to determine the prevalence of overweight and obesity. Results: The overall prevalence of combined overweight and obesity was 21% )15% for overweight and 6% for obesity). Higher prevalence was found among those aged from 3-4 years old (46.7%) and among males (80%). Mothers’ education, frequency of junk food and fried food were significantly associated with overweight and obesity (p < 0.05). Also, BMI was significantly affected by mothers’ feeding behavior such as allowing the child to eat alone, offering him sweets regularly, using sweets as a reward, mothers’ concern about overweight and keeping food out of reach. Conclusion: Prevalence of preschool obesity increases with multiple risk factors, such as mother’s education, frequency of eating junk food and fried food. BMI was affected by mothers’ feeding behavior. So, the first five years of life are the best period for primary prevention of obesity.

Primary prevention of fat and weight gain among obesity susceptible healthy weight preschool children. Main results from the "Healthy Start" randomized controlled intervention.

A vital public health challenge lies in understanding the primary drivers behind excessive weight gain among healthy weight individuals. To examine if excessive weight and fat gain can be prevented among healthy weight, obesity susceptible children aged 2 to 6 years. Eligible children were identified based on information on either a high birth weight, maternal pre-pregnancy obesity or maternal low educational level from national registries, and randomized into an intervention group, a control group and a shadow control group. All children with overweight at baseline were excluded from subsequent analysis (n = 196), while healthy weight children were included (n = 926). The intervention was designed to deliver improvements in diet and physical activity habits, optimization of sleep quantity and quality, and reduction of family stress. The average intervention period was 1.3 years. Intention-to-treat analyses indicated a lower gain in percentage fat mass and a higher gain in fat-free mass in the intervention group compared with the control group. However, the results should be interpreted with caution, as they were clinically small and borderline significant, only. This primary prevention intervention among young healthy weight children with susceptibility to future obesity had clinically small effects on growth and body composition. More interventions, conducting primary obesity prevention, are urgently needed.

Prediction of the Influential Factors on Eating Behaviors: A Hybrid Model of Structural Equation Modelling-Artificial Neural Networks.

The importance of eating behavior risk factors in the primary prevention of obesity has been established. Researchers mostly use the linear model to determine associations among these risk factors. However, in reality, the presence of nonlinearity among these factors causes a bias in the prediction models. The aim of this study was to explore the potential of a hybrid model to predict the eating behaviors. The hybrid model of structural equation modelling (SEM) and artificial neural networks (ANN) was applied to evaluate the prediction model. The SEM analysis was used to check the relationship of the emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) and their effect on different categories of eating behavior patterns (EBP). In the second step, the input and output required for ANN analysis were obtained from SEM analysis and were applied in the neural network model. 340 university students participated in this study. The hybrid model (SEM-ANN) was conducted using multilayer perceptron (MLP) with feed-forward network topology. Moreover, Levenberg–Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The tangent/sigmoid function was used for the input layer, while the linear function was applied for the output layer. The coefficient of determination (R2) and mean square error (MSE) were calculated. Using the hybrid model, the optimal network happened at MLP 3-17-8. It was proved that the hybrid model was superior to SEM methods because the R2 of the model was increased by 27%, while the MSE was decreased by 9.6%. Moreover, it was found that BSC, BAS, and EES significantly affected healthy and unhealthy eating behavior patterns. Thus, a hybrid approach could be suggested as a significant methodological contribution from a machine learning standpoint, and it can be implemented as software to predict models with the highest accuracy.

AB001. Obesity in children and adolescents

: Obesity is a global public health problem. The prevalence of obesity and the risk of obesity is rising both in childhood and in adolescence throughout the world and also in Croatia. Although obesity causes short-term and long-term, direct and indirect effects on the health of an individual and the population, parents usually do not recognise it as their child's health problem. Obesity may be primary or secondary, the causes endogenic and exogenic. Obesity most often occurs as a result of an imbalance between excessive intake and reduced consumption of energy. The clinical challenges are the relatively long, asymptomatic course, the objective diagnostics of obesity and obesity-associated diseases, and the most often frustrating results of treatment. Due to the very limited possibilities of treatment in childhood, prevention is the foundation of intervention. Prevention of obesity begins with the prenatal formation or correction of incorrect dietary and lifestyle habits. Primary prevention of obesity is aimed at anthropometric monitoring and education of the healthy population. Secondary and tertiary prevention of obesity comprises specific interventions through clinical and laboratory supervision of the population at risk of developing obesity, specifically adjusted to the individual needs of the obese child. Multi-discipline, continuous and professionally coordinated preventive programmes are the foundation for resolution of the problem of obesity in childhood and adolescence, which require the engagement and cooperation of families, the health and education systems, and the support of the media and the social community.

Primary Prevention of Obesity: Moving Towards an Active Learning Model

The current review focuses on the importance of primary prevention of obesity in youth. In several elementary school programs such as Texas I-Can and the Physical Activity Across the Curriculum initiatives, physical activities are integrated into the academic lessons to help offset sedentary time during seated learning while also increasing academic performance. The purpose of such programs is to attenuate gains in body mass index and adiposity while increasing physical activity levels. In some cases, increases in physical activity were translated to after-school and weekend activities. In other cases, improvements in time on task and academic courses were also observed. In schools monitoring BMI, those increasing physical activity levels > 75 min/wk evidenced significant decreases in BMI. At the middle school level, programs such as Planet Health and another novel middle school curriculum in the sciences, resulted in beneficial changes in health behaviors and metabolic risk factors. These changes were accompanied by decreases in adiposity, particularly in girls. In the most recent translational health in nutrition and kinesiology (THINK) program, a stand-alone curriculum featuring hands-on clinical experiences rooted in STEM education, resulted in significant gains in physical fitness and curricular-based knowledge with favorable but non-significant decreases in adiposity. These studies illustrate the importance of implementing innovative programs that may increase academic performance while also empowering students to increase physical activity and improve metabolic health, both of which are often accompanied by favorable reductions in adiposity. Physically active interventions that are integrated into the academic curriculum may be the best direction to take in the primary prevention of obesity. More randomized clinical trials are needed to determine the extent to which such active interventions significantly reduce adiposity in youth.

Child-Centred Health Dialogue for primary prevention of obesity in Child Health Services - a feasibility study.

Aims: The aim of this study was to test a Child-Centred Health Dialogue model for primary prevention of obesity for 4-year-old children in Child Health Services, for its feasibility and the responsiveness of its outcomes. Methods: A feasibility study was set up with a non-randomised quasi-experimental cluster design comparing usual care with a structured multicomponent Child-Centred Health Dialogue consisting of two parts: (1) a universal part directed to all children and (2) a targeted part for families where the child is identified with overweight. Results: In total, 203 children participated in Child-Centred Health Dialogue while 582 children received usual care. Nurses trained in the model were able to execute both the universal health dialogue and the targeted part of the intervention. Tutorship enabled the nurses to reflect on and discuss their experiences, which strengthened their confidence and security. One year after the intervention fewer normal-weight 4-year-olds in the intervention group had developed overweight at the age of five compared with the control group, and none had developed obesity. The difference in overweight prevalence at follow-up did not reach statistical significance. Conclusions: This study demonstrates that a child-centred, multicomponent, interactive intervention for the promotion of healthy lifestyles and primary prevention of obesity for all 4-year-old children participating in Child Health Services is feasible on a small scale. As almost all caregivers make use of Child Health Services in Sweden, the findings should be confirmed in a randomised controlled trial before the intervention can be implemented on a larger scale.