Weight status and gender-related differences in motor skills and in child care - based physical activity in young children.

Over the last decades, a decline in motor skills and in physical activity and an increase in obesity has been observed in children. However, there is a lack of data in young children. We tested if differences in motor skills and in physical activity according to weight or gender were already present in 2- to 4-year-old children. Fifty-eight child care centers in the French part of Switzerland were randomly selected for the Youp'là bouge study. Motor skills were assessed by an obstacle course including 5 motor skills, derived from the Zurich Neuromotor Assessment test. Physical activity was measured with accelerometers (GT1M, Actigraph, Florida, USA) using age-adapted cut-offs. Weight status was assessed using the International Obesity Task Force criteria (healthy weight vs overweight) for body mass index (BMI). Of the 529 children (49% girls, 3.4 ± 0.6 years, BMI 16.2 ± 1.2 kg/m2), 13% were overweight. There were no significant weight status-related differences in the single skills of the obstacle course, but there was a trend (p = 0.059) for a lower performance of overweight children in the overall motor skills score. No significant weight status-related differences in child care-based physical activity were observed. No gender-related differences were found in the overall motor skills score, but boys performed better than girls in 2 of the 5 motor skills (p ≤ 0.04). Total physical activity as well as time spent in moderate-vigorous and in vigorous activity during child care were 12-25% higher and sedentary activity 5% lower in boys compared to girls (all p < 0.01). At this early age, there were no significant weight status- or gender-related differences in global motor skills. However, in accordance to data in older children, child care-based physical activity was higher in boys compared to girls. These results are important to consider when establishing physical activity recommendations or targeting health promotion interventions in young children.

SOCIAL, ATTITUDINAL AND BEHAVIORAL CORRELATES OF WEIGHT CHANGE AMONG MEXICAN AMERICAN WOMEN (OBESITY, DIET, TEXAS)

In industrialized countries the prevalence of obesity among women decreases with increasing socioeconomic status. While this relation has been amply documented, its explanation and implications for other causal factors of obesity has received much less attention. Differences in childbearing patterns, norms and attitudes about fatness, dietary behaviors and physical activity are some of the factors that have been proposed to explain the inverse relation.^ The objectives of this investigation were to (1) examine the associations among social characteristics and weight-related attitudes and behaviors, and (2) examine the relations of these factors to weight change and obesity. Information on social characteristics, weight-related attitudes, dietary behaviors, physical activity and childbearing were collected from 304 Mexican American women aged 19 to 50 living in Starr County, Texas, who were at high risk for developing diabetes. Their weights were recorded both at an initial physical examination and at a follow-up interview one to two and one-half years later, permitting the computation of current Body Mass Index (weight/height('2)) and weight change during the interval for each subject. Path analysis was used to examine direct and indirect relations among the variables.^ The major findings were: (1) After controlling for age, childbearing was not an independent predictor of weight change or Body Mass Index. (2) Neither planned exercise nor total daily physical activity were independent predictors of weight change. (3) Women with higher social characteristics scores reported less frequent meals and less use of calorically dense foods, factors associated with lower risk for weight gain. (4) Dietary intake measures were not significantly related to Body Mass Index. However, dietary behaviors (frequency of meals and snacks, use of high and low caloric density foods, eating restraint and disinhibition of restraint) did explain a significant portion (17.4 percent) of the variance in weight change, indicating the importance of using dynamic measures of weight status in studies of the development of obesity. This study highlights factors amenable to intervention to reverse or to prevent weight gain in this population, and thereby reduce the prevalence of diabetes and its sequelae. ^

Impact of weight loss on oxidative stress and inflammatory cytokines in obese type 2 diabetic patients.

Background: Type 2 diabetes mellitus is associated with abnormal markers of inflammatory cytokines and oxidative stress markers. Although, these abnormalities could be modulated with weight reduction; there is limitation in clinical studies that have addressed the beneficial effects of weight reduction in modulating biomarkers of inflammatory cytokines and oxidative stress for obesity associated with type 2 diabetes mellitus. Objective: This study was designed to detect the effects of weight loss on the inflammatory cytokines, oxidative stress markers in obese type 2 diabetic patients. Material and Methods: Eighty obese patients with type 2 diabetes mellitus, their age ranged from 35-57 years and their body mass index ranged from 31-35 kg/m2 were equally assigned into 2 groups: the weight reduction group received aerobic exercises, diet regimen, where as the control group received medical treatment only for 12 weeks. Results: The mean values of body mass index (BMI), tumor necrosis factor–alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (sCRP), conjugated dienes (CD) and malondialdehyde (MDA) were significantly decreased, while the mean values of glutathione peroxidase (GPx), superoxide dismutase (SOD) and glutathione (GSH) were significantly increased in patients of group (A), while changes were not significant in group (B). Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study. Conclusion: Weight loss ameliorates inflammatory cytokines and oxidative stress markers in obese type 2 diabetic patients.

A systematic review of studies on socioeconomic inequalities in dietary intakes associated with weight gain and overweight/obesity conducted among European adults

This Review examined socioeconomic inequalities in intakes of dietary factors associated with weight gain, overweight/obesity among adults in Europe. Literature searches of studies published between 1990 and 2007 examining socioeconomic position (SEP) and the consumption of energy, fat, fibre, fruit, vegetables, energy-rich drinks and meal patterns were conducted. Forty-seven articles met the inclusion criteria. The direction of associations between SEP and energy intakes were inconsistent. Approximately half the associations examined between SEP and fat intakes showed higher total fat intakes among socioeconomically disadvantaged groups. There was some evidence that these groups consume a diet lower in fibre. The most consistent evidence of dietary inequalities was for fruit and vegetable consumption; lower socioeconomic groups were less likely to consume fruit and vegetables. Differences in energy, fat and fibre intakes (when found) were small-to-moderate in magnitude; however, differences were moderate-to-large for fruit and vegetable intakes. Socioeconomic inequalities in the consumption of energy-rich drinks and meal patterns were relatively under-studied compared with other dietary factors. There were no regional or gender differences in the direction and magnitude of the inequalities in the dietary factors examined. The findings suggest that dietary behaviours may contribute to socioeconomic inequalities in overweight/obesity in Europe. However, there is only consistent evidence that fruit and vegetables may make an important contribution to inequalities in weight status across European regions.

Weight status and perception barriers to healthy physical activity and diet behavior

Background : Physical inactivity and insufficient fruit and vegetable consumption are key risk factors for obesity and noncommunicable diseases. Weight perceptions may affect physical activity and diet behaviors. We report current prevalence estimates of Australian adults meeting recommended levels of leisure-time physical activity (LTPA) (150 min/week or more of at least moderate-intensity physical activity (including walking) on 5 days/week) and fruit (2 servings/day) and vegetable (5 servings/day) consumption for health benefits, by weight status and perceptions.
Methods : We conducted a cross-sectional survey analysis of data for 16 314 adults from the Australian National Health Survey 2004–2005. All variables were collected by self-report. Weighted estimates were age- and gender-specific, and data were analyzed using logistic regression with acceptable weight referent categories, adjusting for covariates.
Results : Among acceptable, overweight and obese adults, the prevalence of LTPA was 26.8, 26.1 and 19.3% for men, and 27.7, 23.7 and 19.7% for women, respectively. Approximately 55 and 15% of adults consumed sufficient fruit servings/day and vegetable servings/day, respectively, and less than 5% of adults met combined LTPA and diet guidelines. Overweight decreased the odds ratio for LTPA among women but not men, and obesity decreased the odds ratio for LTPA among both men and women. Overweight perception conferred odds ratios of 0.83 (95% CI 0.70–0.97, P=0.021) for overweight men, and of 0.74 (95% CI 0.62–0.88, P=0.001) and 0.69 (95% CI 0.59–0.80, P<0.001) for obese men and women, respectively; for LTPA, whereas no significant associations were found for acceptable weight perception. No consistent associations between weight status or perceptions and diet behaviors were found.
Conclusions : Overweight perception may be another barrier to physical activity participation among men and women with excess body weight. Public health strategies might need to focus on overcoming weight perception as well as weight status barriers to adopting healthy physical activity behaviors.

Childhood overweight and obesity: paternal influences on preschool aged children's eating and weight status

This thesis explored the role of paternal parenting styles, paternal child feeding practices, and father-child interactions in the development of preschool aged children’s eating behaviours and weight. Fathers parenting style and feeding practices were not directly associated with child BMI. However, fathers parenting style was predictive of child eating behaviours over time, and children's eating behaviours were associated with higher BMI, which suggests that there may be an indirect effect of parenting style on child BMI via child eating behaviour.

Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9

Background: Parental obesity is a predominant risk factor for childhood obesity. Family factors including socio-economic status (SES) play a role in determining parent weight. It is essential to unpick how shared family factors impact on child weight. This study aims to investigate the association between measured parent weight status, familial socio-economic factors and the risk of childhood obesity at age 9. Methodology/Principal Findings: Cross sectional analysis of the first wave (2008) of the Growing Up in Ireland (GUI) study. GUI is a nationally representative study of 9-year-old children (N = 8,568). Schools were selected from the national total (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Children and their parents had height and weight measurements taken using standard methods. Data were reweighted to account for the sampling design. Childhood overweight and obesity prevalence were calculated using International Obesity Taskforce definitions. Multinomial logistic regression examined the association between parent weight status, indicators of SES and child weight. Overall, 25% of children were either overweight (19.3%) or obese (6.6%). Parental obesity was a significant predictor of child obesity. Of children with normal weight parents, 14.4% were overweight or obese whereas 46.2% of children with obese parents were overweight or obese. Maternal education and household class were more consistently associated with a child being in a higher body mass index category than household income. Adjusted regression indicated that female gender, one parent family type, lower maternal education, lower household class and a heavier parent weight status significantly increased the odds of childhood obesity. Conclusions/Significance: Parental weight appears to be the most influential factor driving the childhood obesity epidemic in Ireland and is an independent predictor of child obesity across SES groups. Due to the high prevalence of obesity in parents and children, population based interventions are required.

Accuracy of mothers’ perceptions of their child’s weight status

The study examined the accuracy of maternal perceived child weight. Urban-affluent mothers with 111 children aged 2-5 years were recruited. Nearly a quarter of mothers overestimated their underweight child as healthyweight and all overweight/obese children were perceived as healthyweight. Mothers therefore were unable to recognize their child’s true weight status.

Analysis of dietary pattern impact on weight status for personalised nutrition through on-line advice: the Food4Me Spanish cohort

Obesity prevalence is increasing. The management of this condition requires a detailed analysis of the global risk factors in order to develop personalised advice. This study is aimed to identify current dietary patterns and habits in Spanish population interested in personalised nutrition and investigate associations with weight status. Self-reported dietary and anthropometrical data from the Spanish participants in the Food4Me study, were used in a multidimensional exploratory analysis to define specific dietary profiles. Two opposing factors were obtained according to food groups’ intake: Factor 1 characterised by a more frequent consumption of traditionally considered unhealthy foods; and Factor 2, where the consumption of “Mediterranean diet” foods was prevalent. Factor 1 showed a direct relationship with BMI (β = 0.226; r2 = 0.259; p < 0.001), while the association with Factor 2 was inverse (β = −0.037; r2 = 0.230; p = 0.348). A total of four categories were defined (Prudent, Healthy, Western, and Compensatory) through classification of the sample in higher or lower adherence to each factor and combining the possibilities. Western and Compensatory dietary patterns, which were characterized by high-density foods consumption, showed positive associations with overweight prevalence. Further analysis showed that prevention of overweight must focus on limiting the intake of known deleterious foods rather than exclusively enhance healthy products.

Which aspects of socioeconomic status are related to obesity among men and women?

OBJECTIVE: This study aimed to investigate the relationships between body weight and fat distribution, and four empirically derived domains of socioeconomic status: employment, housing, migration status and family unit.

DESIGN: A population-based study was used.

PARTICIPANTS: A total of 8667 randomly-selected adults (4167 men; 4500 women) who participated in the 1995 Australian National Health and Nutrition Surveys provided data on a range of health factors including objective height, weight and body fat distribution, and a range of sociodemographic indicators.

RESULTS: Results demonstrated associations for women, after controlling for age, between the employment domain, and body mass index and waist-to-hip ratio. Low status employed women were 1.4 times as likely to be overweight as high status employed women. There were less consistent relationships observed among these factors for men. Relationships between family unit and indicators of body weight and body fat distribution were observed for both men and women, with those who were married, particularly men (OR=1.6, 95% CI 1.4-2.0), at higher risk of overweight. The migration and housing socioeconomic status domains were not consistently associated with body mass index or waist-to-hip ratio.

CONCLUSIONS: These findings indicate that different components of socioeconomic status may be important in predicting obesity, and thus should be examined separately. Future research would benefit from investigating the underlying mechanisms governing the relationships between socioeconomic status domains further, particularly those related to employment and family unit and obesity

Trends in children`s physical activity and weight status in high and low socio-economic status areas of Melbourne, Victoria, 1985-2001

Objective:
To examine trends in active transport to and from school, in school sport and physical education (PE), and in weight status among children from high and low socio-economic status (SES) areas in Melbourne, Victoria, between 1985 and 2001.

Methods:
Cross-sectional survey data and measured height and weight from 1985 (n=557) and 2001 (n=926) were compared for children aged between 9–13 years within high and low SES areas.

Results:
From 1985 to 2001, the frequency of walking to or from school declined (4.38±4.3 vs. 3.61 ± 3.8 trips/wk, p<0.001), cycling to or from school also declined (1.22±2.9 vs. 0.36±1.5 trips/wk, p<0.001), and the frequency of PE lessons declined (1.64±1.1 vs. 1.18±0.9 lessons/wk, p<0.001). However, the frequency of school sport increased (0.9±1.22 vs. 1.24±0.8 sessions/wk, p<0.001). In 1985, 11.7% of children were overweight or obese compared with 28.7% in 2001 (p<0.001). Apart from walking to school and school sport, there were greater relative declines in cycling to school and PE, and increases in overweight and obesity among children attending schools in low SES areas compared with those attending schools in high SES areas.

Conclusions:
Declines in active school transport and PE have occurred at the same time as increases in overweight and obesity among Australian children.

Implications:
Promoting active school transport and maintaining school sport and PE should be important public health priorities in Australia. Current inequities in school sport and PE and in prevalence of overweight and obesity by area-level SES also need to be addressed.

Associations between family circumstance and weight status of Australian children

To examine associations between weight status and multiple indicators of family circumstance in Australian elementary school children. Data were combined from the 2001 Children's Leisure Activities Study (CLAS Study) and 2002/3 Health, Eating and Play Study (HEAP Study), involving 2520 children in Grades Prep (mean age 6 years) and 5-6 (mean age 11 years) in Melbourne, Australia. Children's body mass index (BMI) was calculated from measured height and weight. Weight status (non-overweight or overweight) was determined according to International Obesity Taskforce cut-off points and BMI was transformed to z-scores based on the 2000 US growth chart data. Parents reported family circumstance (number of parents in the home, marital status, presence of siblings, parental education, parental employment status, parental work hours [HEAP Study only]) and parental BMI. Regression analyses were conducted for the sample overall and separately for young girls, young boys, older girls and older boys. Children in single-parent homes, those without siblings, and those with less educated mothers and fathers tended to have higher z-BMIs (p=0.002, p=0.003, p<0.001 and p<0.001, respectively) and were more likely to be overweight (p=0.003, p<0.001, p<0.001 and p=0.02, respectively). Associations were stronger for older children. Parental employment and work hours were not consistently associated with child weight status. The multivariable models did not demonstrate a cumulative explanatory effect (R2=0.02), except when maternal BMI was included (R2=0.07). Individual measures of family circumstance were differentially associated with child weight status and appeared to be largely independent of other measures of family circumstance. Childhood overweight interventions may need to be tailored based on the age, gender, maternal BMI and family circumstances of the target group.

Weight and place: a multilevel cross-sectional survey of area-level social disadvantage and overweight/obesity in Australia

Objective: To estimate variation between small areas in adult body mass index (BMI), and assess the importance of area level socioeconomic disadvantage in predicting BMI.

Methods: We identified all census collector districts (CCDs) in the 20 innermost Local Government Areas in metropolitan Melbourne, Australia, and ranked them by the percentage of low income households (<$400/week). In all, 50 CCDs were randomly selected from the least, middle and most disadvantaged septiles of the ranked list and 4913 residents (61.4% participation rate) completed one of two surveys. Multilevel linear regression was used to estimate area level variance in BMI and the importance of area level socioeconomic disadvantage in predicting BMI.

Results: There were significant variations in BMI between CCDs for women, even after adjustment for individual and area SES (P=0.012); significant area variation was not found for men. Living in the most versus least disadvantaged areas was associated with an average difference in BMI of 1.08 kg/m² (95% CI: 0.48–1.68 kg/m²) for women, and of 0.93 kg/m² (95% CI: 0.32–1.55 kg/m²) for men. Living in the mid versus least disadvantaged areas were associated with an average difference in BMI of 0.67 kg/m² (95% CI: 0.09–1.26 kg/m²) for women, and 0.43 kg/m² for men (95% CI: -0.16–1.01).

Conclusion: These findings suggest that area disadvantage is an important predictor of adult BMI, and support the need to focus on improving local environments to reduce socioeconomic inequalities in overweight and obesity.

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.