Longitudinal relationships among overweight, life satisfaction, and aspirations in young women

Objective: This study investigated associations of overweight status and changes in overweight status over time with life satisfaction and future aspirations among a community sample of young women.
Research Methods and Procedures: A total of 7865 young women, initially 18 to 23 years of age, completed two surveys that were 4 years apart. These women provided data on their future life aspirations in the areas of further education, work/career, marital status, and children, as well as their satisfaction with achievements to date in a number of life domains. Women reported their height and weight and their sociodemographic characteristics, including current socioeconomic status (occupation).
Results: Young women's aspirations were cross-sectionally related to BMI category, such that obese women were less likely to aspire to further education, although this relationship seemed explained largely by current occupation. Even after adjusting for current occupation, young women who were obese were more dissatisfied with work/career/study, family relationships, partner relationships, and social activities. Weight status was also longitudinally associated with aspirations and life satisfaction. Women who were overweight or obese at both surveys were more likely than other women to aspire to "other" types of employment (including self-employed and unpaid work in the home) as opposed to full-time employment. They were also less likely to be satisfied with study or partner relationships. Women who resolved their overweight/obesity status were more likely to aspire to being childless than other women.
Discussion: These results suggest that being overweight/obese may have a lasting effect on young women's life satisfaction and their future life aspirations.

How feasible are healthy eating and physical activity for young women?

Objective: This study investigated young women’s perceptions of the feasibility of physical activity and healthy eating behaviours, and how these vary by socioeconomic status, domestic characteristics and weight status. Design: This population-based study used a mailed questionnaire to investigate perceptions of the feasibility of commonly recommended healthy eating and physical activity behaviours among a sample of young women. The feasibility of 29 physical activity behaviours (e.g. relating to frequency, intensity, duration, domain/setting) and 15 healthy eating behaviours (e.g. relating to location/setting, fruit and vegetable intake, fat/sugar intake) was assessed. Height, weight and sociodemographic details were also obtained. Setting: Nation-wide community-based survey. Subjects: A total of 445 women aged 18–32 years selected randomly from the Australian electoral roll. Results: Most women reported that they either were already engaged in many of the healthy eating behaviours or saw these as highly feasible. Many physical activity behaviours, on the other hand, were perceived as less feasible, particularly among women with children and women who were overweight. Conclusions: Health promotion messages and strategies aimed at increasing physical activity and healthy eating are unlikely to succeed unless they take into account perceptions that these behaviours are not feasible. For young women, this may involve promoting more time-effective, flexible ways of achieving recommended physical activity. Messages specifically targeted to women with children, and women who are overweight, are required.

Perceptions of local neighbourhood environments and their relationship to childhood overweight and obesity

OBJECTIVES: To examine associations between parent and child perceptions of the local neighbourhood and overweight/obesity among children aged 5–6 and 10–12 y. DESIGN: Cross-sectional survey. SUBJECTS: In total, 291 families of 5–6-y-old and 919 families of 10–12-y-old children. MEASURES: Parent's perceptions of local neighbourhood and perceived child access to eight local destinations within walking distance of home; 10–12-y-old children's perception of local neighbourhood; socio-demographic characteristics (survey). Children's height and weight (measured). RESULTS: No perceptions of the local neighbourhood were associated with weight status among 5–6-y-old children. Among 10–12-y-old children, those whose parents agreed that there was heavy traffic in their local streets were more likely to be overweight or obese (OR=1.4, 95% CI=1.0–1.8), and those whose parents agreed that road safety was a concern were more likely to be obese (OR=3.9, 95% CI=1.0–15.2), compared to those whose parents disagreed with these statements. CONCLUSIONS: This study suggests that parental perceptions of heavy traffic on local streets and concern about road safety may be indirect influences on overweight and obesity among 10–12-y-old children. Future work should also consider perceptions of the neighbourhood related to food choice.

Personal, family, social, and environmental correlates of active commuting to school

Background: Active commuting to school may be an important opportunity for children to accumulate adequate physical activity for improved cardiovascular risk factors, enhanced bone health, and psychosocial well-being. The purpose of this study was to examine personal, family, social, and environmental correlates of active commuting to school among children. Methods: Cross-sectional study of 235 children aged 5 to 6 years and 677 children aged 10 to 12 years from 19 elementary schools in Melbourne, Australia. Self-administered questionnaires were completed by parents, and the older children. The shortest possible routes to school were examined using a geographic information system. Results: Among both age groups, negative correlates of active commuting to school included parental perception of few other children in the neighborhood and no lights or crossings for their child to use, and an objectively assessed busy road barrier en route to school. In younger children, an objectively assessed steep incline en route to school was negatively associated with walking or cycling to school. Good connectivity en route to school was negatively associated with walking or cycling to school among older children. Among both age groups, children were more likely to actively commute to school if their route was <800 meters. There were no associations with perceived energy levels or enjoyment of physical activity, weight status, or family factors. Conclusions: For children, creating child-friendly communities and providing skills to safely negotiate the environment may be important. Environmental correlates of active transport in children and adults may differ and warrant further investigation.

Stability of television viewing and electronic game/computer use in a prospective cohort study of Australian children: relationship with body mass index

Background
While much cross-sectional data is available, there have been few longitudinal investigations of patterns of electronic media use in children. Further, the possibility of a bi-directional relationship between electronic media use and body mass index in children has not been considered. This study aimed to describe longitudinal patterns of television viewing and electronic game/computer use, and investigate relationships with body mass index (BMI).
Methods
This prospective cohort study was conducted in elementary schools in Victoria, Australia. 1278 children aged 5–10 years at baseline and 8–13 years at follow-up had their BMI calculated, from measured height and weight, and transformed to z-scores based on US 2000 growth data. Weight status (non-overweight, overweight and obese) was based on international BMI cut-off points. Weekly television viewing and electronic game/computer use were reported by parents, these were summed to generate total weekly screen time. Children were classified as meeting electronic media use guidelines if their total screen time was ≤14 hrs/wk.
Results
Electronic media use increased over the course of the study; 40% met guidelines at baseline but only 18% three years later. Television viewing and electronic game/computer use tracked moderately and total screen time was positively associated with adiposity cross-sectionally. While weaker relationships with adiposity were observed longitudinally, baseline z-BMI and weight status were positively associated with follow-up screen time and baseline screen time was positively associated with z-BMI and weight status at follow-up. Children who did not meet guidelines at baseline had significantly higher z-BMI and were more likely to be classified as overweight/obese at follow-up.

Conclusion
Electronic media use in Australian elementary school children is high, increases with age and tracks over time. There appears to be a bi-directional association suggesting that interventions targeting reductions in either screen time or adiposity may have a positive effect on both screen time and adiposity.

Association of key foods and beverages with obesity in Australian schoolchildren

Objective: To examine the pattern of intake of key foods and beverages of children aged 4–12 years and the association with weight status.
Design and setting: A computer-assisted telephone interview was used to determine the intake of fruit, vegetables, packaged snacks, fast foods and sweetened drinks ‘yesterday’ and ‘usually’ as reported by parents/guardians of a representative sample of 2184 children from the Barwon South-Western region of Victoria, Australia.
Results: Children who consumed .2–3, .3–4 and .4 servings of fruit juice/drinks ‘yesterday’ were, respectively, 1.7 (95% confidence interval (CI) 1.2–2.2), 1.7 (95% CI 1.2–2.5) and 2.1 (95% CI 1.5–2.9) times more likely to be overweight/obese compared with those who had no servings of fruit juice/drink ‘yesterday’, adjusted for age, gender and socio-economic status (SES). Further, children who had $3 servings
of soft drink ‘yesterday’ were 2.2 (95% CI 1.3–3.9) times more likely to be
overweight/obese compared with those who had no servings of soft drink ‘yesterday’, adjusted for age, gender and SES. In addition, children who ‘usually’ drank fruit juice/drinks twice or more per day were 1.7 (95% CI 1.2–2.4) times more likely to be overweight/obese compared with those who drank these beverages once or less per week, adjusted for age, gender and SES. Although fast foods and packaged snacks were regularly eaten, there were no associations between weight status and
consumption of these foods.
Conclusions: Intake of sweetened beverages was associated with overweight and obesity in this population of Australian schoolchildren and should be a target for intervention programmes aimed at preventing unhealthy weight gain in children.

Association between the family environment and television viewing in Australian children

Aim: To describe the time children spend watching television (TV) and to assess associations between TV viewing time, the family environment and weight status.

Methods: Parents reported the amount of time children watched TV/video both for ‘the previous school day’ and ‘usually’ and described aspects of the family environment influencing TV access as part of a large cross-sectional study in the Barwon South-western region of Victoria, Australia. Child weight status was  based on measured height and weight. All data were collected in 2003/2004.

Results: A total of 1926 children aged 4–12 years participated. Parent-reported mean ± SE TV time for the previous school day was 83 ± 1.5 min. Children who lived in a family with tight rules governing TV viewing time (22%), or who never watched TV during dinner (33%), or had only one TV in the household (23%) or had no TV in their bedroom (81%) had significantly less TV time than their  counterparts. Overweight or obese children had more TV time than healthy weight children 88 ± 2.9 versus 82 ± 1.7 min per day (P = 0.04). They were also more likely to live in a household where children had a TV in their bedroom than healthy weight children (25% vs. 17%, P < 0.001).

Conclusion: Strategies to reduce TV time should be included as part of broader strategies to prevent childhood obesity. They should include messages to parents about not having a TV in children’s bedrooms, encouraging family rules restricting TV viewing, and not having the TV on during dinner.

New techniques and issues in assessing walking behavior and its contexts

In the first section of this article, we discuss the metabolic responses to walking by describing the economy of walking during different locomotion velocities. Gender, weight status, and growth effects on metabolic responses to walking are reviewed. In the second section, we examine the use of technology to assess walking patterns and behavior in the community. We use an engineering approach for understanding how to measure objects that move, and these methods are used to assess walking used in transportation. In the third part of the paper, we summarize self-report methods that have been used to assess walking behavior and highlight the strengths and weaknesses of these methods. We illustrate how self-report methods are used to quantify walking behavior in the surveillance systems that are now widely used to ascertain walking prevalence and temporal changes in different populations. In the final section, we discuss ways of measuring the walkability of neighborhoods and the community to understand the influence of the built environment on walking behavior.

Double disadvantage : the influence of ethnicity over socioeconomic position on childhood overweight and obesity: findings from an inner urban population of primary school children

Objective: To examine the relationship between overweight/obesity in children, socioeconomic status and ethnicity/cultural background.

Design: Cross-sectional survey of children aged 4–13 years.

Setting: A total of 23 primary (elementary) schools in an inner urban municipality of Melbourne, Australia.

Participants: A total of 2685 children aged 4–13 years and their parents.

Main exposure measures: Ethnicity/cultural background – maternal region of birth; socioeconomic position (SEP) indicators – maternal and paternal educational attainment, family employment status, possession of a healthcare card, ability to buy food, indicator of disadvantage (Socioeconomic Index for Areas, SEIFA) score for school; parental weight status.

Main outcome measure: Prevalence of overweight/obesity.

Results: Prevalence of overweight/obesity approached 1 in 3 (31%) in this sample. Prevalence of overweight/obesity was greater for children of both North Africa and Middle Eastern background and children of Southern, South Eastern and Eastern European background compared with children of Australian background. This difference remained after adjusting for age, sex, height, clustering by school, SEP indicators and parental weight status; odds ratio, OR=1.57 (95% confidence interval, CI 1.12–2.19) and 1.88 (95%CI 1.24–2.85), respectively.

Conclusions: There is a clear independent effect of ethnicity above and beyond the effect of socioeconomic status on overweight and obesity in children. Further research is required to explore the mediators of this gradient.

Taste sensitivity to NaCl is associated with liking of salty foods and BMI

Background – It is widely acknowledged that sodium is consumed in excess in most developed countries. Sodium (Na) consumption has been a target of public health interventions in recent years due to its link to numerous adverse health affects such as hypertension and cardiovascular disease. While much of the current research is directed at strategies to reduce sodium in foods and the diet, little is known about the factors which determine salt consumption and preference. Currently, there is no research relating NaCl taste sensitivity and liking of food, or if NaCl taste sensitivity may manifest in changes in BMI.
Objective – Establish whether a relationship exists between NaCl taste sensitivity, preference for salty foods and BMI.
Design – Taste sensitivity to NaCl was determined for 119 subjects (104 female) according to the procedure laid out by “ISO 3972:1991 – Method of investigating sensitivity of taste”. In a separate session subjects rated their liking of generic biscuit with 2 levels of added NaCl [low (2.9g/100g) & high (19.1g/100g)] using the 9-point hedonic scale. BMI was calculated from self reported height and weight data collected. Spearman’s rank order correlation was used to determine whether an association existed between NaCl taste sensitivity, preference for salty foods and BMI.
Outcomes – A significant positive correlation was found between BMI and NaCl taste sensitivity (r=0.204, p<0.05). In addition there was a significant positive correlation between BMI and liking of low NaCl biscuits (r=0.267, p<0.01). No significant associations were identified between the high NaCl cracker and NaCl taste sensitivity or BMI. A paired t-test showed there was no significant difference in liking of the low and commercial NaCl crackers (p=0.078).
Conclusion – This study revealed that individuals with a higher BMI have a greater liking of low NaCl biscuits, and this may be due to their increased NaCl taste sensitivity. The results suggest that NaCl taste sensitivity may be a factor in foods consumed by an individual which in turn may influence weight status.

A prospective study of overweight, physical activity and depressive symptoms in young women

This study examined the prospective associations of BMI, physical activity (PA), changes in BMI, and changes in PA, with depressive symptoms. Self-reported data on height, weight, PA, selected sociodemographic and health variables and depressive symptoms (CESD-10) were provided in 2000 and 2003 by 6,67 young adult women (22–27 years in 2000) participating in the Australian Longitudinal Study on Women's Health (ALSWH). Results of logistic regression analyses showed that the odds of developing depressive symptoms at follow-up (2003) were higher in women who were overweight or obese in 2000 than in healthy weight women, and lower in women who were active in 2000 than in sedentary women. Changes in BMI were significantly associated with increased odds of depressive symptoms at follow-up. Sedentary women who increased their activity had lower odds of depressive symptoms at follow-up than those who remained sedentary. Increases in activity among initially sedentary young women were protective against depressive symptoms even after adjusting for BMI changes. These findings indicate that overweight and obese young women are at risk of developing depressive symptoms. PA appears to be protective against the development of depressive symptoms, but does not attenuate the depressive symptoms associated with weight gain. However, among initially sedentary young women, even small increases in PA over time may reduce the odds of depressive symptoms, regardless of weight status.

Dose-response associations between screen time and overweight among youth

Objective. To examine dose-response associations between screen time and overweight, independent of physical activity and dietary intake.

Methods. Participants were 580 Dutch youth (13 years; 48% boys). Body mass index, waist circumference and skinfold thickness at four sites determined weight status. Questionnaires examined television viewing and computer use, participation in organized sport and high caloric snack and sugar-containing beverage consumption.

Results. There were no significant associations among boys. Compared with girls spending less than two hours/day in screen time, those who spent three to four hours/day were more likely to be classified as overweight by waist circumference (odds ratio [OR]=3.4; 95% confidence intervals [CI]=1.1-10.7; p=0.03), and this likelihood increased substantially among those spending more than four hours/day (OR=5.5; 95% CI=2.1-14.1; p≤0.0001).

Conclusions. Girls who spend three or more hours/day in screen time are at increased risk of being classified as overweight by waist circumference.

Colac's Be Active Eat Well program outcomes

The high baseline prevalence of overweight highlighted the pressing need for interventions like Be Active Eat Well (BAEW). The mid-intervention survey found that change was underway. The impact on weight status, behaviours and environments is presented.

Scaling up community-based obesity prevention in Australia : background and evaluation design of the health promoting communities : being active eating well initiative

Background : There is only limited evidence available on how best to prevent childhood obesity and community-based interventions hold promise, as several successful interventions have now been published. The Victorian Government has recently funded six disadvantaged communities across Victoria, Australia for three years to promote healthy eating and physical activity for children, families, and adults in a community-based participatory manner. Five of these intervention communities are situated in Primary Care Partnerships and are the subject of this paper. The interventions will comprise a mixture of capacity-building, environmental, and whole-of-community approaches with targeted and population-level interventions. The specific intervention activities will be determined locally within each community through stakeholder and community consultation. Implementation of the interventions will occur through funded positions in primary care and local government. This paper describes the design of the evaluation of the five primary care partnership-based initiatives in the 'Go for your life' Health Promoting Communities: Being Active Eating Well (HPC:BAEW) initiative.

Methods/Design : A mixed method and multi-level evaluation of the HPC:BAEW initiative will capture process, impact and outcome data and involve both local and state-wide evaluators. There will be a combined analysis across the five community intervention projects with outcomes compared to a comparison group using a cross-sectional, quasi-experimental design. The evaluation will capture process, weight status, socio-demographic, obesity-related behavioral and environmental data in intervention and comparison areas. This will be achieved using document analysis, paper-based questionnaires, interviews and direct measures of weight, height and waist circumference from participants (children, adolescents and adults).

Discussion : This study will add significant evidence on how to prevent obesity at a population level in disadvantaged and ethnically diverse communities. The outcomes will have direct influence on policy and practice and guide the development and implementation of future obesity prevention efforts in Australia and internationally.

Reliability and validity of the system for observing children's activity and relationships during play (SOCARP)

Background: Children frequently engage in diverse activities that are broadly defined as play, but little research has documented children’s activity levels during play and how they are influenced by social contexts. Assessing potentially modifiable conditions that influence play behavior is needed to design optimal physical activity interventions.

Methods: System for Observing Children’s Activity and Relationships during Play (SOCARP) was developed to simultaneously assess children’s physical activity, social group sizes, activity type, and social behavior during play. One hundred and fourteen children (48 boys, 66 girls; 42% overweight) from 8 elementary schools were observed during recess over 24 days, with 12 days videotaped for reliability purposes. Ninety-nine children wore a uni-axial accelerometer during their observation period.

Results: Estimated energy expenditure rates from SOCARP observations and mean accelerometer counts were significantly correlated (r = .67; P < .01), and interobserver reliabilities (ie, percentage agreement) for activity level (89%), group size (88%), activity type (90%) and interactions (88%) met acceptable criteria. Both physical activity and social interactions were influenced by group size, activity type, and child gender and body weight status.

Conclusions: SOCARP is a valid and reliable observation system for assessing physical activity and play behavior in a recess context.