No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Potential Factors Related to Waist Circumference in Urban South Indian Children
Abstract
To identify important factors (linked to lifestyle, eating and sedentary behaviors) relating to waist circumference among urban South Indian children aged 3 to 16 years.
Cross sectional.
Urban schools of Bangalore, from August 2008 to January 2010.
8444 children; 4707 children aged 3-10 years and 3737 children aged 10-16 years.
Data were collected on the frequency of consumption of certain foods, physical activity patterns, sedentary habits at home, sleep duration and behaviors such as habits of snacking, skipping breakfast, eating in front of television and frequency of eating out. Simple linear regression analysis of waist circumference on various food items, physical activity, behavior and parental BMI were performed. A path model was developed to identify potential causal pathways to increase in waist circumference.
Increased consumption of bakery items, non vegetarian foods, increased television viewing, decreased sleep duration, eating while watching television, snacking between meals, family meals, skipping breakfast (in older children), and parental BMI were found to be related to waist circumference. Older children possibly under-reported their intake of unhealthy foods, but not behaviors.
This study identified potential behaviors related to waist circumference in urban school children in India. Longitudinal studies with better measures of morbidity and adiposity are warranted in order to derive casual relationships between various determinants and waist circumference.
... Kuriyan et al. 39 Outcome not evaluated. ...
... Three studies evaluated markers of body adiposity, blood pressure, and glycemic and lipid profile 41,56,60 , one evaluated markers of body adiposity, lipid profile, and blood pressure 49 ; two assessed markers of body adiposity and glycemic profile 29,58 ; one article evaluated only lipid profile 12 ; one only blood pressure 31 and thirty-five articles evaluated only markers of body adiposity (body mass index (BMI), waist circumference (WC), body fat %, and waist-height ratio (WHR)) 11,16,[21][22][23][24][25][26][27][28]30,[32][33][34][35][36][37][38][39][40][42][43][44][45][46][47][48][50][51][52][53][54][55]57,59 . ...
... Timlin et al. 21 Wang et al. 16 Cayres et al. 22 Wu et al. 11 Harding et al. 25 Maddah 26 Sánchez et al. 28 Alexander et al. 29 Croezen et al. 30 Maddah et al. 32 Sun et al. 33 Deshmukh-Taskar et al. 34 Kapantais et al. 35 Maddah and Nikooyeh 36 Thompson-McCormick et al. 37 Kuriyan et al. 39 Vaezghasemi et al. 40 Shafiee et al. 41 Boričic et al. 42 Díez-Navarro et al. 43 Faizi et al. 44 Garcia-Continente et al. 45 Gokler et al. 47 Talat and Shahat 48 Cayres et al. 49 Badr et al. 51 Frayon et al. 52 De Cnop et al. 54 Khan et al. 55 Tee et al. 57 Werneck et al. 58 Forkert et al. 59 Mustafa et al. 60 -Hassan et al. 23 Hassan et al. 24 Mota et al. 27 Kim and So 38 Garg et al. 46 Morales and Montilva 50 Zalewska et al. 53 Silva et al. 56 Positive association (C) a Quality of evidence (GRADE system) of breakfast skipping (sometimes or always vs. rarely 25 , 0 to 7 days 30,37 and 5, 6, and 7 times/week 50 ). Seven articles used the "skip yes/no" option 11,27,39,46,52,53,59 and nine defined skipping according to breakfast consumption: yes/no 28,31 , regular/non-regular 36,54 , presence/absence 43,47,56 and whether study participants did not report food or drink consumption in the R24h 29,34 ( Table 1). ...
Objective:
To systematically review the results of the association between breakfast skipping and cardiometabolic risk factors in adolescents.
Methods:
The articles were searched in May 2020 from PubMed, Virtual Health Library, Scopus, Web of Science and Scientific Electronic Library Online (SciELO). The review included observational studies conducted with adolescents (10-19 years old), which estimated the association of breakfast skipping with at least one outcome (markers of body adiposity, blood pressure, serum lipid and glucose levels). Regarding the risk of bias, the articles were evaluated using the Research Triangle Institute (RTI) Item Bank on bias risk and accuracy of observational studies. The quality of the evidence was assessed by the Grade rating.
Results:
A total of 43 articles involving 192,262 participants met the inclusion criteria and were considered in this review. The prevalence of breakfast skipping ranged from 0.7% to 94% and 60.5% of studies were classified with low risk of bias. The significant association between breakfast skipping and cardiometabolic risk factors was found in twenty-nine cross-sectional articles (n = 106,031) and four longitudinal articles (n = 5,162) for excess adiposity, in three articles (n = 8,511) for high total cholesterol levels, low-density lipoprotein and triglycerides, and in three studies (n = 6,303) for high blood pressure levels. However, there was no significant association between breakfast skipping and glycemic profile. According to the Grade rating, all the associations had low quality of evidence.
Conclusion:
The results of this review suggest that breakfast skipping is associated with cardiometabolic risk factors in adolescents aged 10 to 19 years. However, considering the low quality of the evidence, the present results should be interpreted carefully. In addition, our findings highlight the importance of standardizing the definition of breakfast skipping and that more prospective studies are needed to determine how skipping breakfast can affect cardiometabolic risk factors in the long time.
... interventional studies) (n = 6). Twenty relevant articles (4,5,(10)(11)(12)(13)(14)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)31) were identified for the systematic review, of which eight articles (5,10,12,13,20,25,26,31) reported OR for overweight/ obesity and were therefore included in the meta-analysis. Only one of the eight articles (5) assessed obesity as an outcome; we therefore included overweight in the meta-analysis. ...
... Only one of the eight articles (5) assessed obesity as an outcome; we therefore included overweight in the meta-analysis. (4,5,10,12,13,17,18,20,21,25,26,31), and four articles used abdominal obesity or waist circumferences as the primary outcome measure (19,22,23,26). Nine articles examined the relationship between eating any meal (did not specified the meal) (4,11,12,19,21,23,26,27,31) while TVV, while nine articles specified breakfast, lunch or dinner ( Table 2). ...
... (4,5,10,12,13,17,18,20,21,25,26,31), and four articles used abdominal obesity or waist circumferences as the primary outcome measure (19,22,23,26). Nine articles examined the relationship between eating any meal (did not specified the meal) (4,11,12,19,21,23,26,27,31) while TVV, while nine articles specified breakfast, lunch or dinner ( Table 2). The majority of studies (75%) found positive associations between eating meals while TVV and body composition outcomes. ...
The objective of this systematic review and meta-analysis was to examine the association between eating while television viewing (TVV) and overweight or obesity in children (<18 years). A systematic search of PubMed, Scopus, Web of science, PreQuest and Embase was conducted up to April 2017; pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated using a random effects model. Of 4,357 articles identified, 20 observational studies met inclusion criteria (n = 84,825) and 8 of these 20 (n = 41,617) reported OR. Eating while TVV was positively associated with obesity-related anthropometric measurements in 15 studies (75%). The meta-analysis revealed that eating while TVV was positively associated with being overweight (OR = 1.28; 95% CI: 1.17, 1.39). Subgroup analyses showed similar positive associations in both girls and boys, as well as in children who ate dinner while TVV. There was no evidence of publication bias. The present systematic review and meta-analysis suggests that eating while TVV could be a risk factor for being overweight or obese in childhood and adolescents.
... Among food types, daily fruit and vegetable consumption is protective, while a lower frequency of fruit and vegetable intake may lead to obesity [23,24]. High calorie food items such as sweets/sugar, fatty/fried and fast/junk food may contribute to obesity in this population [9,15,16,18,[23][24][25][26][27][28][29][30][31][32]. Adding extra salt to food as a taste enhancer, is also known to contribute towards overweight/obesity [9]. ...
... In contrast, having supper with family is reported as a protective factor for overweight/obesity in children [33]. Eating while watching TV may also contribute to overweight/obesity [27,33]. Seven studies have shown that missing meals (breakfast/lunch) is associated with overweight/obesity, while three regular meals per day has a protective effect [9,23,27,33,[35][36][37]. ...
... Eating while watching TV may also contribute to overweight/obesity [27,33]. Seven studies have shown that missing meals (breakfast/lunch) is associated with overweight/obesity, while three regular meals per day has a protective effect [9,23,27,33,[35][36][37]. In contrast, one study from Pakistan noted that taking lunch regularly is associated with a higher incidence of overweight/obesity [38]. ...
Introduction Obesity among teenagers/adolescents and young adults is associated with significant adverse short and longer-term effects on health. To date, no narrative reviews have evaluated nutrition transition and its contribution to the obesity epidemic among adolescents and young adults in the South Asian (SA) region. Methods Data were retrieved by a four-stage systematic search process. A search of the online PubMed/Medline, SciVerse Scopus and Web of Science databases was performed. The age groups were defined as follows; teenage:13-19 years, adolescence:10-18 years and young adult:19-24 years. Results Among teenagers/adolescents, the prevalence of overweight ranged from 11.0% (Sri Lanka) to 19.0% (India), while obesity ranged from 2.4% (Sri Lanka) to 11.0% (Pakistan). In young adults, prevalence of overweight ranged between 7.9% (Nepal) to 15.0% (Pakistan), while obesity showed a much wider variation (0.005%[Nepal] – 22.8%[India]). Nutritional risk factors associated with overweight/obesity among SAs of this age group included reduced fruit and vegetable consumption, a total vegetarian diet, consumption of fast food and soft drinks, and skipping breakfast. Other contributing factors identified were: adding extra salt to meals, eating meals outside of the home, frequently visiting restaurants and eating while watching television. Daily milk/yoghurt consumption and a family supper have shown a protective effect against overweight/obesity. Conclusions Overweight and obesity are common amongst teenagers/adolescents and young adults of the SA region. Several food types and habits were identified as being associated with overweight/obesity in this population. Identifying common protective and contributory factors is very important for the development of a shared regional preventive strategy.
... The remaining 9 studies for screen time, 13 studies for TV viewing, and 1 study for total sedentary behaviour reported null findings. Within 19 studies, significant associations with body composition were not observed across all sex groups (Dupuy et al. 2011;Hardy et al. 2012;Ismailov and Leatherdale 2010;Jones et al. 2010;Mejia et al. 2013;Nigg et al. 2011;Rey-Lopez et al. 2012;Sigmundova et al. 2014;Suglia et al. 2013;Vaezghasemi et al. 2012), ethnic groups (Saab et al. 2011), age groups (de Jong et al. 2013;Seo and Niu 2014;Zhang et al. 2012), geographical locations (Taber et al. 2012;Tambalis et al. 2013), days of the week (Liou et al. 2010), or measures of body composition (Kuriyan et al. 2012;Sluyter et al. 2013). Inconsistent findings were observed for doing homework and reading and primarily null findings were observed for accelerometer-derived sedentary time, breaks, and bouts as well as computer use, and video game use with body composition. ...
... f Includes 5 case-control studies (Xi et al. 2011;Zurriaga et al. 2011;Yi et al. 2012;Al-Ghamdi 2013;Huang et al. 2013). g Includes 125 cross-sectional studies (Beets and Foley 2010;Bishwalata et al. 2010;Brown et al. 2010;Ferrar and Olds 2010;Hong et al. 2010;Ismailov and Leatherdale 2010;Jones et al. 2010;Kuhle et al. 2010;Legnani et al. 2010;Liou et al. 2010;Melkevik et al. 2010;Olds et al. 2010;Pitrou et al. 2010;Rivera et al. 2010;Ruiz et al. 2010;Shan et al. 2010;Thibault et al. 2010;Wilkosz et al. 2010;Yen et al. 2010;Zhang et al. 2010;Al-Hazzaa et al. 2011;Allender et al. 2011;Bener et al. 2011;Brown et al. 2011;Carson and Janssen 2011;Chen et al. 2011;Dupuy et al. 2011;Fernandes et al. 2011;Goyal et al. 2011;Hsu and Johnson 2011;Kimbro et al. 2011;Leatherdale and Papadakis 2011;Martinez-Gomez et al. 2011a;McConley et al. 2011;Mushtaq et al. 2011;Nigg et al. 2011;Peart et al. 2011;Peltzer and Pengpid 2011;Rajmil et al. 2011;Saab et al. 2011;Sisson et al. 2011;Al-Hazzaa et al. 2012;Al-Nakeeb et al. 2012;Carson and Janssen 2012;Casiano and Kinley 2012;Chaput et al. 2012;Colley et al. 2012;Drake et al. 2012;Dundar and Oz 2012;Ercan et al. 2012;Gregori et al. 2012;Grydeland et al. 2012;Hajian-Tilaki and Heidari 2012;Hardy et al. 2012;Hay et al. 2012;Inanc et al. 2012;Jahns et al. 2012;Kuriyan et al. 2012;Lissner et al. 2012;Machado-Rodrigues et al. 2012;Masse et al. 2012;Morley et al. 2012;Rey-Lopez et al. 2012;Taber et al. 2012;Tin et al. 2012;Vaezghasemi et al. 2012;Wang et al. 2012;Zhang et al. 2012;Atkin et al. 2013;Badawi et al. 2013;Bingham et al. 2013;Bracale et al. 2013;Braithwaite et al. 2013;Busch et al. 2013;Cameron et al. 2013;Carriere et al. 2013;Chahal et al. 2013;Colley et al. 2013;de Jong et al. 2013;Ekstedt et al. 2013;Fernandez-Alvira et al. 2013;Ghavamzadeh et al. 2013;Giussani et al. 2013;Gonzalez Montero de Espinosa et al. 2013;Govindan et al. 2013;Graff et al. 2013;Kettner et al. 2013;Kristiansen et al. 2013;Magee et al. 2013;Mejia et al. 2013;Mungrue et al. 2013;Perez et al. 2013;Rani and Sathiyasekaran 2013;Saunders et al. 2013;Sluyter et al. 2013;Stamatakis et al. 2013a;Stroebele et al. 2013;Suglia et al. 2013;Tambalis et al. 2013;Thibault et al. 2013;Wang et al. 2013;Yako et al. 2013;Bozza et al. 2014;Carson et al. 2014;Chaput et al. 2014b;Chinapaw et al. 2014;Decelis et al. 2014;Drenowatz et al. 2014;Farajian et al. 2014;Garmy et al. 2014;Hatami et al. 2014;Herman et al. 2014 bouts (≥5 min), computer use, video game use, and total sedentary behaviour with a clustered cardiometabolic risk score. Higher duration of TV viewing (5/8 studies) was associated with higher blood pressure (Berendes et al. 2013;Gopinath et al. 2012;Stamatakis et al. 2013b;Vaisto et al. 2014;Yoshinaga et al. 2011). ...
... Out of 108 studies that used a subjective measure of sedentary behaviour, only 33 studies mentioned psychometric properties for the sedentary behaviour items(Barnett et al. 2010;Ferrar and Olds 2010;Liou et al. 2010;Melkevik et al. 2010;Olds et al. 2010;Hands et al. 2011;Peart et al. 2011;Xi et al. 2011;Al-Nakeeb et al. 2012; Carson and Janssen 2012; Grydeland et al. 2012; Lissner et al. 2012; Masse et al. 2012; Rey-Lopez et al. 2012; Veitch et al. 2012; Yi et al. 2012; Al-Ghamdi 2013; Cameron et al. 2013; Falbe et al. 2013; Fernandez-Alvira et al. 2013; Ghavamzadeh et al. 2013; Graff et al. 2013; Huang et al. 2013; Mitchell et al. 2013b; Tambalis et al. 2013; Thibault et al. 2013; Bozza et al. 2014; Chen et al. 2014; Garmy et al. 2014; Lin et al. 2014; Marques and Gaspar De Matos 2014; Tucker et al. 2014; Katzmarzyk et al. 2015a).i A gradient for higher TV, video games, sedentary bouts, sedentary breaks, screen time, and studying with unfavourable body composition was observed in 30 studies(Hong et al. 2010;Kuhle et al. 2010;Pitrou et al. 2010;Carson and Janssen 2011;Kimbro et al. 2011;Leatherdale and Papadakis 2011;Mushtaq et al. 2011;Sisson et al. 2011;Carson and Janssen 2012;Drake et al. 2012;Kuriyan et al. 2012;Masse et al. 2012;Rey-Lopez et al. 2012;Taber et al. 2012;Tin et al. 2012;Zhang et al. 2012;Braithwaite et al. 2013;Cameron et al. 2013;Colley et al. 2013;Gonzalez Montero de Espinosa et al. 2013;Graff et al. 2013;Mejia et al. 2013;Perez et al. 2013;Saunders et al. 2013;Sluyter et al. 2013;Stamatakis et al. 2013a;Carson et al. 2014;Hatami et al. 2014;Lane et al. 2014;Lee et al. 2014). ...
This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5-17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a prioridetermined population (apparently healthy children and youth, mean age: 5-17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.
... Nonetheless, while evidence supports the daily consumption of breakfast, studies have found conflicting results to substantiate this evidence. Some studies have shown a null association between breakfast consumption and weight management while others have found a positive association [26][27][28][29][30]. Potential reasons for the conflicting findings could be attributed to the quality of foods consumed at breakfast and/or the influence of breakfast on the overall diet. ...
... Similar to the results in this study, other recent studies have shown null or positive associations between breakfast consumption and obesity prevalence [26][27][28][29][30]. Fayet-Moore et al. showed breakfast consumption to be associated with lower overweight and obesity prevalence in children [13]. ...
Breakfast consumption is associated with lower obesity prevalence and cardiometabolic risk and higher dietary quality (DQ) in children. Low-income, Hispanic populations are disproportionately affected by obesity and cardiometabolic risks. This study examined the relationship between breakfast consumption groups (BCG) on anthropometric, metabolic, and dietary parameters in predominately low-income, Hispanic children from 16 Texas schools. Cross-sectional data were from TX Sprouts, a school-based gardening, nutrition, and cooking randomized controlled trial. Anthropometric measurements included height, weight, body mass index, body fat percent via bioelectrical impedance, waist circumference, and blood pressure. Metabolic parameters included fasting plasma glucose, insulin, glycated hemoglobin, cholesterol, and triglycerides. DQ and BCG were assessed via two 24-h dietary recalls. Multivariate multiple regression examined relationships between BCG and anthropometric, metabolic, and dietary parameters. This study included 671 students (mean age 9 years, 58% Hispanic, 54% female, 66% free/reduced lunch, 17% breakfast skippers). No relationships were observed between BCG and anthropometric or metabolic parameters. BCG had higher DQ; higher daily protein, total sugar, and added sugar intake; and lower daily fat intake. Skipping breakfast was associated with lower DQ; higher daily fat intake; and lower daily protein intake. Longitudinal research examining breakfast quality on cardiometabolic outcomes in low-income, Hispanic children is warranted.
... 7 Urban middle class children in India were found to have higher waist circumference when compared to age-and-sex matched British children, suggesting an early leaning towards the adult South Asian phenotype. [7][8][9] The pathogenesis of childhood obesity is multifactorial, combining genetic pre-disposition and environmental factors. Many studies have examined dietary habits, lifestyle behaviors, family-based factors and their association with childhood obesity in developed country populations. ...
... Parental BMI, especially maternal BMI was a significant contributor to increased WC in south Indian children. 8 A study in Delhi on urban Bania populations showed the heritability of waist circumference to be approximately 45%, demonstrating the importance of the genetic factors. 12 Our study identified individual factors such as increased fast food and bakery consumption along with decreased sleep to be significantly associated with abdominal adiposity in the younger sibling. ...
Background and objectives:
Childhood obesity is increasing in urban India. This study aimed to examine the associations of younger siblings abdominal adiposity with individual, familial and environmental factors, in urban school aged siblings.
Methods and study design:
Weight, height and waist circumference of 2906 siblings aged 3-16 years were measured along with details on demographics, diet, lifestyle, behavior and reported parental anthropometrics. Abdominal adiposity was classified as waist circumference above the age and sex specific 75th percentile value. The associations of various factors with abdominal adiposity in the younger siblings were examined through logistic regression analyses.
Results:
Sibling, familial factors and environmental factors had significant associations with abdominal adiposity. The odds of a younger sibling having abdominal adiposity was greatest (OR=3.16, 95% confidence interval (95% CI): 2.27 to 4.42), when the older sibling had abdominal adiposity, followed by the odds ratio of both parents being overweight (OR=1.63, 95% CI: 1.33 to 1.99) compared to neither being overweight. The influence of abdominal adiposity of the older sibling was greater when the siblings were of the same sex (OR=3.55, 95% CI: 2.24 to 5.65) than when they were of different sex (OR=2.73, 95% CI: 1.67 to 4.46); the odds ratio being highest when both siblings were males.
Conclusions:
The younger sibling's abdominal adiposity is associated with that of his/her sibling and parental obesity, in addition to other known risk factors in urban south Indian families. Interventions to prevent childhood obesity need to also consider the sibling effect along with the other known factors.
... Sin embargo, la mayoría coincide en usar el percentil 90° como punto de corte para establecer el riesgo de presentar trastornos metabólicos (15) . Aún más, otros estudios en escolares de otros países muestran asociación entre la medida de CC y dislipidemias, resistencia a la insulina e incremento de la presión arterial sistólica en edades tempranas, incluso con una medida por encima del percentil 75 (28) . ...
... Como resultados el factor que tuvo mayor asociación positiva con la CC fue el consumo de bebidas azucaradas a diferencia de la asociación negativa que mostró el consumo de frutas y verduras y también la adecuada práctica de actividad física(50) .Una investigación posterior, realizada por Kuriyan y colaboradores en el 2012, identificó las conductas potencialmente relacionadas con la circunferencia de cintura en escolares de la India. Conductas como el saltarse el desayuno, consumo de productos de pastelería o bebidas azucaradas, incremento en el tiempo de ver TV y el bajo consumo de verduras, estuvieron principalmente relacionadas(28) .Por todo ello la determinación de la circunferencia de cintura es muy importante y debe ser considerada rutinaria ya que además es un buen predictor de complicaciones metabólicas y de riesgo cardiovascular a cualquier edad(51) .En el Perú, información sobre la prevalencia de obesidad abdominal en la población escolar aún es escasa, más aún los factores que pueden tener mayor relación a la presencia de ésta. Por ello, el presente estudio aportará información necesaria para ...
Introduction: The causes of abdominal obesity are well documented in adults, however, there are few studies regarding modifiable factors such as: physical activity, sedentary lifestyle, consumption of fruits and vegetables, sweets, sugary drinks and unhealthy preparations, in childhood. Objectives: To determine the association between the consumption of unhealthy foods, the consumption of fruits and vegetables, the practice of physical exercises and sedentary behaviors with abdominal obesity. Design: Descriptive of crossed, transversal and prospective association. Place: State educational institutions of the primary level, Cercado de Lima. Participants: 350 school children from 8 to 10 years old from ten schools. Interventions: The waist circumference was measured. A measure> 90p was classified as abdominal obesity according to Bustamante´s Peruvian references (2015). Questionnaires were used to collect information about the practice of physical exercises and food consumption. The Chi square test was carried out, with an alpha of 0.05, and calculation of Odds Ratio. Main outcome measures: Prevalence of abdominal obesity and risk factors. Results: The prevalence of abdominal obesity was 37.4%. Seventy six percent of evaluated children consumed sweets and 41% sugary drinks daily. Only 43% complied with the recommendation of three or more fruits per day, and 37.7% with the practice of 1h/day of exercises as well. Thirty two percent watched TV or used the computer for more than 2 hours. The OR for abdominal obesity in schoolchildren with a high consumption of unhealthy foods was 7.2 (4.3 - 12.1), for sedentary behaviors it was 3.61 (2.2 - 5.7). The practice of physical exercises and the consumption of vegetables in salads were protective factors, with an OR of 0.19 (0.1 - 0.3) and 0.28 (0.2 - 0.4) respectively. Conclusion: The consumption of sweets, unhealthy foods and sedentary behaviors were strongly related to the presence of abdominal obesity. The practice of physical exercises and the consumption of vegetable salads were protective factors. Fruit consumption didn’t show association.
... Sin embargo, la mayoría coincide en usar el percentil 90° como punto de corte para establecer el riesgo de presentar trastornos metabólicos (15) . Aún más, otros estudios en escolares de otros países muestran asociación entre la medida de CC y dislipidemias, resistencia a la insulina e incremento de la presión arterial sistólica en edades tempranas, incluso con una medida por encima del percentil 75 (28) . ...
... Como resultados el factor que tuvo mayor asociación positiva con la CC fue el consumo de bebidas azucaradas a diferencia de la asociación negativa que mostró el consumo de frutas y verduras y también la adecuada práctica de actividad física(50) .Una investigación posterior, realizada por Kuriyan y colaboradores en el 2012, identificó las conductas potencialmente relacionadas con la circunferencia de cintura en escolares de la India. Conductas como el saltarse el desayuno, consumo de productos de pastelería o bebidas azucaradas, incremento en el tiempo de ver TV y el bajo consumo de verduras, estuvieron principalmente relacionadas(28) .Por todo ello la determinación de la circunferencia de cintura es muy importante y debe ser considerada rutinaria ya que además es un buen predictor de complicaciones metabólicas y de riesgo cardiovascular a cualquier edad(51) .En el Perú, información sobre la prevalencia de obesidad abdominal en la población escolar aún es escasa, más aún los factores que pueden tener mayor relación a la presencia de ésta. Por ello, el presente estudio aportará información necesaria para ...
Introduction: The causes of abdominal obesity are well documented in adults, however, there are few studies regarding modifiable factors such as: physical activity, sedentary lifestyle, consumption of fruits and vegetables, sweets, sugary drinks and unhealthy preparations, in childhood. Objectives: To determine the association between the consumption of unhealthy foods, the consumption of fruits and vegetables, the practice of physical exercises and sedentary behaviors with abdominal obesity. Design: Descriptive of crossed, transversal and prospective association. Place: State educational institutions of the primary level, Cercado de Lima. Participants: 350 school children from 8 to 10 years old from ten schools. Interventions: The waist circumference was measured. A measure> 90p was classified as abdominal obesity according to Bustamante´s Peruvian references (2015). Questionnaires were used to collect information about the practice of physical exercises and food consumption. The Chi square test was carried out, with an alpha of 0.05, and calculation of Odds Ratio. Main outcome measures: Prevalence of abdominal obesity and risk factors. Results: The prevalence of abdominal obesity was 37.4%. Seventy six percent of evaluated children consumed sweets and 41% sugary drinks daily. Only 43% complied with the recommendation of three or more fruits per day, and 37.7% with the practice of 1h/day of exercises as well. Thirty two percent watched TV or used the computer for more than 2 hours. The OR for abdominal obesity in schoolchildren with a high consumption of unhealthy foods was 7.2 (4.3 - 12.1), for sedentary behaviors it was 3.61 (2.2 - 5.7). The practice of physical exercises and the consumption of vegetables in salads were protective factors, with an OR of 0.19 (0.1 - 0.3) and 0.28 (0.2 - 0.4) respectively. Conclusion: The consumption of sweets, unhealthy foods and sedentary behaviors were strongly related to the presence of abdominal obesity. The practice of physical exercises and the consumption of vegetable salads were protective factors. Fruit consumption didn’t show association.
... Although data in children are limited in South Asia [9], physical activity patterns and the risks associated with various forms of physical inactivity (motorized transport to school, long TV viewing, no outdoor games etc.) have been reported in children and adolescents in some urban settings [1,3,[9][10][11][12][13][14][15][16][17][18][19]. Across the various regions of urban South Asia a high prevalence of physical inactivity (18.3 to 67.4 %) have been reported among children [1,9]. ...
... Although the prevalence of over-weight or obesity in rural children aged 6-18 years has been reported at 2.2-9.7 % from two populations of India [39,40], the association of physical activity patterns and weight outcomes is rarely reported from these rural regions [35]. In our rural children we found TV watching (49.3 %) as the main sedentary activity followed by reading (43.9 %), which is similar (i.e., long TV viewing) to what is reported in urban children and adolescents of India and Bangladesh [3,[11][12][13][14][15][16][17][18]. Although significant associations of weight-related outcomes and physical activity have been reported in urban children, similar data is distinctly lacking among rural South Asian children. ...
Background
We report the prevalence of recommended physical activity levels (RPALs) and examine the correlates of achieving RPALs in rural South Asian children and analyse its association with anthropometric outcomes.
Methods
This analysis on rural South Asian children aged 5–14 years (n = 564) is a part of the Chronic Disease Risk Factor study conducted at three sites in India (Chennai n = 146; Goa n = 218) and Bangladesh (Matlab; n = 200). Data on socio-demographic and lifestyle factors (physical activity (PA); diet) were collected using an interviewer-administered questionnaires, along with objective anthropometric measurements. Multivariate logistic regression models were used to examine whether RPALs (active travel to school (yes/no); leisure-time PA ≥ 1 h/day; sedentary-activity ≤ 2 h/day) were associated with socio-demographic factors, diet and other forms of PA. Multivariate linear regression models were used to investigate associations between RPALs and anthropometrics (BMI- and waist z-scores).
Results
The majority of children (71.8 %) belonged to households where a parent had at least a secondary education. Two-thirds (66.7 %) actively travelled to school; 74.6 % reported ≥1 h/day of leisure-time PA and 55.7 % had ≤2 h/day of sedentary-activity; 25.2 % of children reported RPALs in all three dimensions. Older (10–14 years, OR = 2.0; 95 % CI: 1.3, 3.0) and female (OR = 1.7; 95 % CI: 1.1, 2.5) children were more likely to travel actively to school. Leisure-time PA ≥ 1 h/day was more common among boys (OR = 2.5; 95 % CI: 1.5, 4.0), children in Matlab, Bangladesh (OR = 3.0; 95 % CI: 1.6, 5.5), and those with higher processed-food consumption (OR = 2.3; 95 % CI: 1.2, 4.1). Sedentary activity ≤ 2 h/day was associated with younger children (5–9 years, OR = 1.6; 95 % CI: 1.1, 2.4), children of Goa (OR = 3.5; 95 % CI: 2.1, 6.1) and Chennai (OR = 2.5; 95 % CI: 1.5, 4.3) and low household education (OR = 2.1; 95 % CI: 1.1, 4.1). In multivariate analyses, sedentary activity ≤ 2 h/day was associated with lower BMI-z-scores (β = −0.3; 95 % CI: −0.5, −0.08) and lower waist-z-scores (β = −1.1; 95 % CI: −2.2, −0.07).
Conclusion
Only one quarter of children in these rural areas achieved RPAL in active travel, leisure and sedentary activity. Improved understanding of RPAL in rural South Asian children is important due to rapid socio-economic transition.
... Factors affecting abdominal obesity comprise biological elements, including parental obesity, maternal nutrition at pregnancy, child's birth weight and breast-feeding (Psarra et al., 2005;Ortega et al., 2007;Vale et al., 2011;Kuriyan et al., 2011); behavioural ones, including child's dietary habits, sleep duration, physical activity or sedentary behaviours (Klein-Platat et al., 2005;Ortega et al., 2007;Hitze et al., 2009;Lazarou & Soteriades, 2010;Vale et al., 2011;Kuriyan et al., 2011;Lehto et al., 2011); and socioeconomic factors, including educational level, social class and occupation (Shrewsbury & Wardle, 2008;Vale et al., 2011). Certainly, these factors are close to those that determine general obesity, but nevertheless working out programmes to fight abdominal-type obesity connected with the accumulation of subcutaneous and visceral fat requires precise identification of its detailed determinants, which are often characteristic for a given population. ...
... Factors affecting abdominal obesity comprise biological elements, including parental obesity, maternal nutrition at pregnancy, child's birth weight and breast-feeding (Psarra et al., 2005;Ortega et al., 2007;Vale et al., 2011;Kuriyan et al., 2011); behavioural ones, including child's dietary habits, sleep duration, physical activity or sedentary behaviours (Klein-Platat et al., 2005;Ortega et al., 2007;Hitze et al., 2009;Lazarou & Soteriades, 2010;Vale et al., 2011;Kuriyan et al., 2011;Lehto et al., 2011); and socioeconomic factors, including educational level, social class and occupation (Shrewsbury & Wardle, 2008;Vale et al., 2011). Certainly, these factors are close to those that determine general obesity, but nevertheless working out programmes to fight abdominal-type obesity connected with the accumulation of subcutaneous and visceral fat requires precise identification of its detailed determinants, which are often characteristic for a given population. ...
Summary The aim of this study was to determine abdominal obesity risk factors in two successive cohorts of children and adolescents aged 4-18 from Cracow, Poland, examined during the years of political transformation. The influence of biological, socio-demographic and lifestyle factors on abdominal obesity was analysed by calculating odds ratios and 95% confidence intervals using logistic regression analysis. It was found that for girls obesity in both parents (OR=4.31; 95% CI 1.73-20.70) and high birth weight (OR=1.78; 95% CI 1.12-2.82) were significant risk factors for abdominal obesity in the 1983 cohort. In the 2000 cohort obesity in both parents for boys and girls (boys: OR=5.85; 95% CI 1.36-25.10; girls: OR=4.82; 95% CI 1.17-19.77), low level of parental education in girls (OR=2.06; 95% CI 1.15-3.69), having only one son (OR=1.96; 95% CI 1.36-3.40), parents' smoking habits in girls (OR=2.94; 95% CI 1.46-5.91) and lack of undertaking physical activity in sport clubs in boys (OR=6.11; 95% CI 1.46-25.47) were significant abdominal obesity risk factors. Higher number of hours of leisure time physical activity (OR=0.89; 95% CI 0.81-0.97) significantly lowered the risk of abdominal obesity in boys in the 2000 cohort. The greater differentiation of abdominal obesity risk factors in the 2000 cohort in comparison to the 1983 cohort may have resulted from the social and economic changes taking place in Poland at the end of the 20th century.
... Children with BMI equal to or exceeding the age, gender specific 95th percentile are defined obese. Those with BMI equal to or exceeding 85 th but are below 95th percentile are defined overweight and are at risk for obesity related comorbidities 3 . Obesity index that predicts metabolic syndrome Includes BMI, Waist circumference, waist hip ratio, and waist height ratio and so on 4 . ...
Introduction: World-wide obesity trends are causing serious public health concern and in many countriesthreatening the viability of basic health care delivery. Waist circumference as a screening measure of centralobesity in children where obesity is a global phenomenon affecting all socio-economic groups, irrespective of age,sex or ethnicity.Aims and Objectives: Waist circumference Reference values are in percentiles for children with 5-15 years of agein Karimnagar city. To screen over weight and obese children using waist circumference and in comparison withthat of BMI (reference values)Material and Methods: The study was prospective case control observational study included for 5-15 years of 1000school going children in Karimnagar city from January 2021 to October 2022 For each group children – Height,weight, waist circumference and BP were recorded and BMI was calculated according to their (formula) wt/(ht)2.Results: There was good correlation with waist circumference and BMI in each age group.1. The reference values for each age group were constructed for WC, BMI, SBP and DBP.2. The study population was observed over weight (OW) and obesity with their reference values i.e. OW between85th and 95th percentile and obese over 95th percentile for both WC and BMI. There was good correlation betweenBMI and waist circumference for age groups and both the sexes and screening results of OW and obese raising WCand BMI were almost similar. This indirect WC alone can be used to screen over weight and obesity.Conclusion: Reference values for both waist circumference and BMI, age wise and gender wise were constructed.Reference values for BMI and Waist Circumference with cutoff points of 75th, 85th and 95th percentiles wereconstructed. The reference values were developed both in percentiles and mean with standard deviation. Usingthese reference values, children were screened for overweight, obesity using both BMI and WC. Children at risk(“action point” >75th percentile of WC) for metabolic syndrome were identified. There is good correlation betweenBMI and Waist Circumference. WC measurement alone on regular basis during school health checkup can help toscreen, intervene and monitor Overweight and obese children.
... Anak yang terbiasa sarapan lebih cenderung memiliki asupan gizi yang baik termasuk asupan serat dan karbohidrat total yang lebih tinggi, dan menurunkan kadar lemak total dan kolesterol (Deshmukh-Taskar et al., 2010). Peningkatan konsumsi roti, ngemil di antara waktu makan dan melewatkan sarapan pada anak ditemukan terkait dengan lingkar pinggang (Kuriyan et al., 2012). Pengaruh sarapan terhadap status kesehatan dari waktu ke waktu sangat bermanfaat untuk anak yang memiliki asupan makanan harian yang hampir tidak mencukupi (Huang, Hu, Fan, Liao, & Tsai, 2010). ...
Pendahuluan & Tujuan: Salah satu isi pesan dari 13 PUGS adalah biasakan sarapan pagi. Namun, masih banyak penduduk Indonesia yang tidak sarapan. Kampanye sarapan sehat harus dilaksanakan oleh semua pihak. Penelitian ini bertujuan untuk melihat gambaran tingkat pengetahuan sarapan dan gambaran penerapan prinsip gizi seimbang pada susunan menu sarapan pada orang tua siswa SDIT Al-Fahmi Palu. Bahan dan Metode: Bahan menggunakan piring tiruan yang terbuat dari kertas, kertas karton dan double tip. Desain penelitian adalah deskriptif. Penelitian dilaksanakan di SDIT Al-Fahmi Kota Palu pada tanggal 5 September 2017. Responden yang mengikuti penelitian sebanyak 51 orang. Jenis data yang digunakan dalam penelitian berupa data frekuensi tingkat pengetahuan sarapan responden, frekuensi responden yang menjawab benar kuesioner pengetahuan sarapan, dan penerapan prinsip gizi seimbang pada susunan menu sarapan selama tiga hari menggunakan media piring tiruan. Hasil: Keseluruhan (100%) responden memiliki tingkat pengetahuan baik. Namun sebaliknya, ketika dilakukan praktik penyusunan menu diperoleh pada hari ke-1, dari 12 kelompok hanya 1 kelompok (8,3%) yang sudah menerapkan prinsip gizi seimbang dalam praktik menyusun menu sarapan, pada hari ke-2 hanya 2 kelompok (16,7%) yang sudah menerapkan prinsip gizi seimbang dalam praktik menyusun menu sarapan, dan pada hari ke-3 tidak ada satupun kelompok yang sudah menerapkan prinsip gizi seimbang dalam praktik menyusun menu sarapan. Kesimpulan: Keseluruhan responden telah memiliki tingkat pengetahuan baik, namun pada praktinya hampir keseluruhan dari 12 kelompok responden yang belum menerapkan prinsip gizi seimbang dalam praktik menyusun menu sarapan.
... Children were investigated on OPD basis with demographic data, and anthropometric measurements like Height and Weight were measured and BMI was calculated. BMI values were plotted in the World Health Organization growth charts to differentiate from overweight, and obese from normal [8]. All subjects underwent general and physical examination. ...
Background: Type 2 diabetes mellitus (T2DM) once considered an adult disease is now being reported in children and adolescents all over the world due to a parallel increase in obesity. Prediabetes is an intermediate stage between no diabetes and diagnosis of DM. Objective: To screen at risk asymptomatic adolescent children for prediabetes state. Methods: A prospective descriptive study was conducted in the outpatient department of a tertiary care hospital in South India. All adolescent children between the age group of 10 and 18 years with evidence of overweight as per the World Health Organization age and sex specific centile charts for body mass index (BMI) were enrolled. The study period was 18-month. Anthropometric and demographic data were collected among these subjects and investigated for oral glucose tolerance test (OGTT), fasting blood glucose (FBG), and glycosylated hemoglobin (HbA1c) as per the designed protocol. Results: Prediabetes was diagnosed in 13% of the study population with a combination of OGTT, FBG, and HbA1c tests. Prediction of prediabetes by OGTT was 10%, HbA1c 5% and by FBS was 3%. Combination of impaired glucose tolerance test with HbA1c had high sensitivity (92%) and specificity (100%). Conclusions: Our study had 13% population with increasing risk of developing T2DM. Further longitudinal studies are required to screen at risk asymptomatic adolescent children for prediabetes.
... Eating out of home in adolescents can be related to anthropometric measures. As in research conducted in India which stated that Among the younger children there was a mediated effect of behaviours such as "number of eat-outs, "snacks between meals" and "eating in front of TV" through increase consumption of snacks/fried foods, bakery and nonvegetarian, on an increase in Waist Circumference (Kuriyan et al., 2012). Contrary to research conducted in Vietnam which states that Compared with normal BMI adolescents, underweight and overweight adolescents did not significantly eat out more often (P = 0.39 and P = 0.24, respectively) (Lachat et al., 2011). ...
Background: Over the past few years, eating outside the home (OH) has become a common activity for family to do and is also done by adolescents. Adolescence is seen as an important period for youth as they transition to adulthood. Subjects and Methods: We have identified some factors that are associated with eating out. We conducted a systematic review of the article that published in the last 10 years. There were 9 articles that met the criteria and were included in this review. Results: Foods consumed outside the home are important sources of energy in all age groups and their energy contribution increases in adolescents and young adults. Eating outside of home was associated with anthropometry measurement such as waist circumference and body mass index. In addition, eating out of home is also associated with gender and physical activities. There were some studies showed that eating out is also associated with food security such as the quality of foods. Conclusion: From the factors that we found, it can be concluded that eating out is associated with health status and some individual characteristics in adolescents.
... has not yet been established if such displacement translates into micronutrient deficiencies or growth faltering (Gibson, 2007 (Kuriyan et al., 2012). A positive association between SSB consumption and overweight/obesity among preschoolers in the United States has also been noted (Welsh, 2005), whereas another U.S. study found an association between SSB consumption and growth faltering among preschoolers (Dennison, Rockwell, & Baker, 1997). ...
Although snacks can provide important nutrients for young children during the complementary feeding period, the increasing availability of snack foods and sugar‐sweetened beverages (SSB), often energy‐dense and nutrient‐poor, in low‐ and middle‐income countries (LMIC) is a concern. Such foods may displace consumption of nutritious foods in contexts where diets are often nutritionally inadequate and the burden of childhood malnutrition is high. This systematic review summarizes literature on the contribution of snack food/SSB consumption to total energy intakes (TEI) of children below 23 months of age in LMIC and associations between this consumption and nutritional outcomes. It also identifies areas where further research is needed. A systematic search of Embase, Global Health, and MEDLINE for literature published in January 1990–July 2018 was conducted. This search yielded 8,299 studies, 13 of which met inclusion criteria: Nine studies assessed % TEI from snack foods/SSB, and four studies assessed associations between snack food/SSB consumption and nutritional outcomes. Average % TEI from snack foods/SSB ranged from 13% to 38%. Findings regarding associations with growth were inconclusive, and no studies assessed associations with nutrient intakes. Variation in measurement of consumption and definitions of snack foods and SSB limited study comparisons. Further research is needed to understand how consumption of energy‐dense, nutrient‐poor snack foods and SSB influences undernutrition and overnutrition among young children during the complementary feeding period in settings that are experiencing dietary transitions and the double burden of malnutrition.
... Anak yang terbiasa sarapan lebih cenderung memiliki asupan gizi yang baik termasuk asupan serat dan karbohidrat total yang lebih tinggi, dan menurunkan kadar lemak total dan kolesterol (Deshmukh-Taskar et al., 2010). Peningkatan konsumsi roti, ngemil di antara waktu makan dan melewatkan sarapan pada anak ditemukan terkait dengan lingkar pinggang (Kuriyan et al., 2012). Pengaruh sarapan terhadap status kesehatan dari waktu ke waktu sangat bermanfaat untuk anak yang memiliki asupan makanan harian yang hampir tidak mencukupi (Huang, Hu, Fan, Liao, & Tsai, 2010). ...
Background & Objective: One of the messages from the 13 General Messages of Nutrition is get used to breakfast. However, there are still many Indonesians who do not have breakfast. This study aimed to see the description of knowledge level of breakfast and the description of the application of balanced nutrition principle on the breakfast menu in the parents of SDIT Al-Fahmi Palu students. Materials and Methods: Material used artificial plates, paperboard and double tip. The research design was cross sectional, was conducted at SDIT Al-Fahmi Palu on September 5, 2017 witth respondents who followed the research were 51. Types of data used were frequency of knowledge level, frequency of respondents who correctly answered the knowledge questionnaire, and the application of balanced nutrition principle on the breakfast menu then analyzed desctriptively. Results: Overall of respondents had a good knowledge. It appears that the most answered questions was “how it can be done to overcome a child with difficulty eating breakfast” (47.1%). In contrast, when the practice of menu preparation was obtained on the first day, from 12 groups only 1 group who had applied the principle of balanced nutrition in composing menu, on the 2nd day only 2 groups (16,7%) who have applied, and on the third day none of the groups who have applied. Conclusion: It is found that all respondents had a good level of knowledge, but in practice the whole of the groups who have not applied balanced nutrition principle in composing menu
... An earlier study done by Rebecca kuriyan et al showed eating in front of TV as a significant risk factor for obesity. 14 Higher percentage of sedentary life style habits was seen in obese children compared to control group a finding similar to an earlier study done by Keerthan kumar et al in south Indian children. 3 All anthropometric parameters including BMI (which was natural as per diagnostic criteria), skin fold thickness and abdominal circumference were higher in obese children compared to control group. These observations were consistent to earlier studies done by Nageswar Rao et al and Dubey et al. 13,15 Both systolic and diastolic blood pressures were high in obese children compared to control group. ...
Background: We compared clinical and biochemical parameters of obese children aged 6 to 18 years with normal controls visiting to outpatient department in a tertiary care hospital. It was a prospective case control study.Methods: Obese children with Body Mass Index > 2 standard deviation according to WHO chart were included. Endocrinological and syndromic obese children were excluded. We described risk factors for obesity and compared clinical and biochemical parameters between cases and controls. Student’s t test, Chi-square test and ANOVA (analysis of variance) were used for statistical analysis.Results: We noted higher prevalence of intake of junk food and sedentary lifestyle in obese group. Anthropometric parameters including BMI, skin fold thickness and abdominal circumference were higher in obese children compared to control group. Both systolic and diastolic blood pressures were high in obese children compared to control group. We observed higher prevalence of insulin resistance and dyslipidaemia among obese children.Conclusions: This study reemphasises that junk foods and sedentary lifestyle are important risk factors for obesity. Always screen for glucose intolerance, hypertension, insulin resistance and dyslipidaemia in obese children.
... These factors might be responsible for an overall high lipid profile and BMI/WC in this group. Thus, BMI/WC could be an indicator of the extent of sedentary lifestyle ( Nathan et al. 2007;Kuriyan et al. 2012) in this group. However, it is interesting to note that despite the high/comparable overweight status and sedentary lifestyle of the LV group, there is a significant lower prevalence of diabetes than among those practicing an NV diet. ...
Rising burden of diabetes in India requires quick intervention that integrates policies and programs for effective prevention and control of disease. This retrospective cross-sectional study was conducted to observe effect of diet in two Indian communities practicing sedentary lifestyle. Fasting blood samples were analyzed for blood sugar, glycated-hemoglobin (HbA1C), and lipid profile. Body mass index (BMI) and waist circumference (WC) measurements were recorded. Diabetes incidence was lower in lacto-vegetarian (1.7%) than in non-vegetarian group (5.3%) despite similar lipid profiles and BMI/WC between the groups. Fasting blood sugar (FBS) was positively correlated with LDL and VLDL levels and negatively correlated with HDL, only in lacto-vegetarian group. Study suggests: (1) Indian lacto-vegetarian diet has beneficial effects on diabetes incidence irrespective of high body weight and sedentary lifestyle; (2) intervention to reduce body lipids, such as lipid-lowering drugs and exercise, may have greater effect in reducing FBS levels in this lacto-vegetarian group.
... Children who skipped breakfast in these settings had increased waist circumference (Song et al., 2005). Similar observations were reported in developing countries among the higher socio-economic status (Arora et al., 2012;Kuriyan et al., 2012). On the contrary, in developing countries nutrient inadequacy in the first meal, followed by inability to compensate in the subsequent meals results in undernutrition (Sethi and Dangwal, 2001). ...
Background:
Breakfast is considered the first and most important meal of the day. Missing the first meal may result in significant nutritional deficits, if not compensated in subsequent meals.
Aim:
To describe the nutrient intake through breakfast and to study its association with nutritional indicators among adolescent girls.
Methods:
A cross-sectional study among adolescent girls ( n = 565) 16-18 years was carried out in urban slums of Pune, Maharashtra, India. Haemoglobin was assessed by cyanmethemoglobin method. Nutritional status was assessed through anthropometry and three 24-hours diet recall. Z scores, independent sample test, and linear logistic regression were used to assess undernutrition, to compare means of nutrient intake and to associate nutrient intake with nutritional status, respectively.
Results:
Almost 50% did not consume solid food for breakfast and 99% of the participants consumed inadequate breakfast (<610 kcal). Two types of breakfast emerged: I (bakery products + beverage) and II (traditional breakfast + beverage). Although the mean energy intake of type II breakfast (235±100.55 kcal) and the mean micronutrient intake was significantly higher than type I (micronutrients: vitamin C and folate ( p = 0.001), iron ( p = 0.01)) it did not meet the adequacy norms for breakfast. Among nutritional indicators breakfast intake was not directly associated with body mass index. However, mean intake of nutrients such as energy, protein and iron through the day were significantly lesser ( p = 0.001, p = 0.01 and p = 0.01 respectively) among anaemic adolescents. Linear regression showed significant association between energy, fat intake and BAZ scores.
Conclusions:
Compensating dietary deficits that arise in the first meal would directly address the day's nutrient deficit. The results highlight the need for a food-based approach to address undernutrition among adolescent girls in resource-poor settings.
... Breakfast skipping was associated with being overweight (Gajre, 2008). A prospective study also found that skipping breakfast was associated with weight gain (Kuriyan, 2011). ...
Breakfast is considered as the most important meal of the day, yet many people skip breakfast. Studies indicate that school age children who regularly skip breakfast are not likely to concentrate in class, thus affecting school performance. Present study aims at studying the effect of breakfast skipping on the nutritional status and cognition of school going children. An exploratory cross sectional study was undertaken to assess and compare the nutritional status of school going children eating breakfast and those skipping it. Questionnaires were used to collect information on background characteristics and breakfast consumption habits. The 24-hour dietary recall method was used to obtain information on the children’s food intake. The total sample size was 195 school going students aged 10-16 years old from the selected schools in Batticaloa district. Chi-square test and t-test were used for statistical analysis using SPSS software. According to the results of the current study, the prevalence of breakfast skipping among school going children of age 10-16 years old is 23.50% in selected areas of Udupi district. More number of breakfast skippers were found to be overweight than breakfast non-skippers (p =0.992). However intakes of fat (p<0.05) and miscellaneous foods (p<0.05) like junk food that are high in saturated fat were significantly high in breakfast skippers than breakfast non-skippers. A significant difference was also seen in a no. of parameters like memory (p<0.01), concentration (p<0.01), grades obtained (p<0.01), attendance (p<0.01) etc. between breakfast skippers and breakfast non-skippers. The study indicates that skipping breakfast affects both the nutritional status as well as the school performance of the students. The study strongly favours breakfast plays an important role for adequate nutrition of school children and has a major impact on cognition.
... The data from India therefore highlight the generic dilemma generated by the differential growth rates of specific parts of the body in response to antagonistic nutritional trends. The epidemic of overweight is associated with the efforts of diverse commercial companies targeting India as an 'emerging market' nation, and driving trends in dietary intake and behavioral activity (Kuriyan et al., 2012;Wells, 2013). Urban Indian populations are increasingly characterized by elevated metabolic load superimposed on nutritional constraint in early life, ie the double-burden of malnutrition within individuals, and these traits are strongly implicated in the epidemics of diabetes and cardiovascular disease (Misra and Khurana, 2008). ...
Many modernizing countries are characterized by a dual nutritional burden—the simultaneous presence of undernutrition and obesity within populations, households, or even individuals. The dual burden is a primary risk factor for the epidemic of chronic degenerative diseases affecting such populations, and may benefit from an evolutionary perspective. Evolving in environments of ecological instability, the genus Homo developed a complex life history profile with multiple “nodes of flexibility” whereby the magnitude and rate of growth are sensitive to diverse ecological stresses. Through such plasticity, preagricultural populations could tolerate ecological instability, through time-lagged physiological sensitivity to fluctuating energy availability. This plasticity now renders contemporary populations vulnerable to new sources of nutritional instability, emerging from the role played by capitalist economics in the global supply and distribution of food. Chronic diseases emerge when rapid economic growth elevates metabolic load (adiposity, high-energy diet, sedentary behavior) over short-time scales in the absence of complementary effects on homeostatic capacity. An evolutionary perspective emphasizes the sensitivity of human metabolism to politico-economic factors driving nutritional trends. Successful prevention of chronic diseases is unlikely to occur without efforts to alter the power structures that characterize the contemporary food-industrial complex, restoring individual agency over diet and activity behavior.
... †Means adjusted for birth weight, duration of exclusive breast-feeding, total duration of breast-feeding, age at initiation of complementary feeding and total family income. assessment, surveys carried out in Indian urban low-to middle-income groups have shown an increase in the consumption of energy-dense foods among children (42)(43)(44)(45) . Bentley et al. (45) found that in informal settlements of Mumbai, the diets of children under 5 years of age were marked by consumption of unhealthy snacks. ...
Objective
To compare the BMI, body fat and waist-to-height ratio (WHtR) of stunted and non-stunted children following different growth trajectories from low socio-economic strata in Mumbai, India.
Design
Cross-sectional, case–control study. Weight, height, skinfold thicknesses and waist circumference were measured. Information regarding the duration of breast-feeding, age at initiation of complementary feeding and income was obtained. Birth weight was obtained from records. BMI, body fat, WHtR and change in weight sd were calculated.
Setting
Children who were beneficiaries of anganwadis, Mumbai city, India.
Subjects
Three hundred and thirty children aged 2–4 years were selected in each of the stunted and non-stunted groups after matching for age and sex.
Results
After adjusting for birth weight, change in weight sd, duration of breast-feeding, age at complementary feeding initiation and income, stunted children had significantly higher body fat, WHtR and BMI than the non-stunted (P<0·01). The stunted and non-stunted children were classified based on their change in weight sd. Stunted children with no change in weight sd had higher mean body fat, BMI (P<0·01) and WHtR (P<0·05) than their non-stunted counterparts. In the catch-up growth group, stunted children had higher BMI and WHtR than the non-stunted (both P<0·001). In the catch-down growth group, stunted children had higher BMI than the non-stunted (P<0·001).
Conclusions
Stunting was seen to increase the tendency of conserving body fat in young children. Such a tendency, if continued during later childhood and adolescence, can increase the risk of obesity and non-communicable diseases.
... On average, American children consume between two and three snacks a day, which account for more than a quarter of their daily energy intake. 1 Children's snacks often consist of foods high in sugar, fat, and sodium. 1 Snacking or eating outside the standard three daily meals (breakfast, lunch, and dinner) 2,3 is frequently implicated as a cause of excessive energy intake and a contributor to an unhealthy weight status. 4 However, observational studies and randomized controlled trials have been unable to establish a consistent association between snacking and weight gain or obesity. 4,5 Some studies, such as the Bogalusa Heart Study, report a positive association between snacking and overweight status in children, 2,3,6-11 whereas other studies have demonstrated an inverse association [12][13][14][15][16] or no relationship at all. ...
Objective: To examine the impact of adherence to a healthy snacking component of a 6 month school-based intervention program for overweight and obese children.
Design: Randomized controlled intervention trial
Methods: Mexican American children who were ≥ 85th percentile for body mass index (BMI) were recruited between 2005-2012 from three Houston schools. Children participated in a 12-week instructor led intensive intervention program that included nutrition education, physical activity, and a snacking component which consisted of a daily choice of peanuts and/or peanut butter snacks. Children (12±0.6 years) (n= 257) were divided into either low or high snacking adherence groups based on their responses on a peanut food frequency questionnaire. The low adherence group reported consuming peanuts or peanut butter ≤ once per week and the high adherence group > once per week over 6 months. Change of BMI, standardized BMI (zBMI), triceps skinfold, and weight were compared at six months of children reporting high and low levels of adherence to the snacking component.
Analysis: T-tests were performed with SPSS version 22 with level of significance set at P
... †Means adjusted for birth weight, duration of exclusive breast-feeding, total duration of breast-feeding, age at initiation of complementary feeding and total family income. assessment, surveys carried out in Indian urban low-to middle-income groups have shown an increase in the consumption of energy-dense foods among children (42)(43)(44)(45) . Bentley et al. (45) found that in informal settlements of Mumbai, the diets of children under 5 years of age were marked by consumption of unhealthy snacks. ...
Introduction: India has a high prevalence of stunting among children below five years of age. Stunting in early life has been associated with increased risk of morbidity and cognitive deficits. Recent literature suggests that stunted individuals are likely to have an altered body composition, lipid profile and glycemic control. Adiposity has been implicated in the pathogenesis of metabolic syndrome. Therefore, we conducted this study to examine the differences in the body fat indices of stunted and non-stunted children residing in low socioeconomic area of Mumbai city.
Methodology: In this cross-sectional study, we recruited 947 children aged between 2 to 4 years and born with normal birth weight (≥ 2.5 kg) from anganwadis across Mumbai city. Weight, height, MUAC, waist circumference and skinfold thicknesses were measured. Z scores were computed for the anthropometric indices using WHO Anthro software. Slaughter’s equation (1988) was used to derive the percent body fat. BMI and waist-height ratio (WHtR) was calculated. Birth weight was obtained from the records. Based on the height-for-age Z score (HAZ), children were classified as stunted (≤ -2.0 SD) or non-stunted (> -2.0 SD). One-way ANOVA was carried out to study the differences between the stunted and non-stunted children.
Results: Overall, 31.9% (302) children were stunted while 68.1% (645) were non-stunted. The stunted children were significantly lighter and had lower MUAC than the non-stunted children (p < 0.001). No differences were noted in the mean BMI and body fat (%) of the stunted and the non-stunted children. Waist circumference and WHtR are indicators of central adiposity. There was no difference in the mean waist circumference of the stunted and the non-stunted children. The mean WHtR of the stunted children was significantly higher than that of their non-stunted counterparts (p = 0.001).
Conclusion: In spite of being undernourished, stunted children exhibited a tendency to conserve body fat at a young age of 2 to 4 years. In the long-term, such a tendency may elevate the risk of obesity and related metabolic risks.
... Qualitative aspects of the dietary intake was noted and the data on food habits is reported in Table 2 [4] . ...
... Significant association between obesity and television viewing was found in a study conducted in urban and semi urban south Indian children [11]. Study done in urban south Indian children in Bangalore found increased consumption of bakery items, increased television viewing, decreased sleep duration and eating while watching television, significantly related to waist circumference [12]. ...
Food marketing directed to children is an issue of concern in the present day society. Revolution in food industry, increasing globalization and boom in information technology has introduced various types of food products and the way they are placed in front of likely consumers. This has resulted in rising trend of obesity and switch from communicable to non-communicable diseases, which is not cost effective for nation as a whole. Multinational companies have targeted children as a naïve audience to boost their sales. In-ethical practice of misleading claims in the advertisements is instrumental in many cases. Food marketing to children has been assumed a public health threat since times of yore. World Health Organization has resolutions and recommendations on this subject. Member countries, including India are a signatory to this declaration. However, much needs to be done to counter these multinational food giants. Regulations and policies need to be enforced at national and institutional levels. Parents must be educated; schools and social organizations to be made proactive on this aspect.
... However, good eating habits, a balanced diet and regular physical activity, are also critical elements to prevent childhood obesity. [6][7][8] Historically, most interventions that aim to prevent childhood obesity have focused on individual-level behavioral determinants. 9,10 However, these interventions find only low to modest effects on behaviors among children and have little effects on their weight. ...
In China, childhood obesity is a growing health issue. Eating behaviors among children can be influenced by both the family and school environment. We examine the association between these environments and eating habits among children.
A total of 11 270 fourth to sixth grade school children, 11 270 of their fathers or mothers, and 1348 teachers from 48 schools were sampled using a multistage cluster random sampling method. Questionnaires collected information on eating behaviors among children, non-communicable chronic disease (NCD)-related health knowledge and behaviors among teachers, and education levels among parents. Mixed effect logistic regression models were used to describe the key associations between eating behaviors among children and teacher and parental characteristics.
Health awareness, positive health attitudes, never-smoking and regular-exercise among teachers was positively associated with healthy eating behaviors among their students (having breakfast, vegetables and dairy products every day; P < 0.05), and negatively associated with the unhealthy behaviors (daily intake of fried foods and desserts and sugary beverages; P < 0.05). More than one parent having a high school level or above was positively related to healthy eating behaviors among their children (P < 0.05), but its associations with high-calorie eating habits were negative in urban and positive in rural areas (P < 0.05).
School-based interventions which target health-related awareness, attitude and behaviors among school teachers may help improve school-aged children's eating behaviors. Parental education levels may help guide efforts to target children at higher risk of unhealthy eating habits.
Lifestyle changes cause imbalance in energy intake and expenditure which leads to obesity. This study aimed to determine the relationship between anthropometry, physical activity, and nutritional knowledge with energy and macronutrient intake in adolescents. This cross-sectional study was conducted from June 2011 to June 2013 in one of the medical schools in Jakarta. A number of 75 students enrolled in this study. Body height, weight, and skinfold were measured by staturemeter microtoise, SECA scale, and skinfold calliper. Physical activity and nutritional knowledge were assessed by B3D questionnare and open ended questions. The mean age was 17,7±0,6 years. The mean intake of energy, carbohydrates, proteins, and fats were 2.443 (761-5.109) kcal, 316 (106-734) grams, 84,3 (25,2-224) grams, dan 82 (14,8-211,3) grams respectively. Body mass index, skinfold thickness, waist circumferences, and nutritional knowledge levels. Moderate and high physical activity levels were related with better energy (p=0.007) and fat intake (p=0.005). Proteins and fats had no correlation with activity levels. Therefore, modification in physical exertion may affect energy and fat intake. Keywords:energy intake, macro nutrient intake, knowledge of nutrition, physical activity levels, body mass index, thick folds of skin, adolescents, obesity.
Background:
Snacking (i.e., eating in between meals) is common among U.S. preschool children, but associations with weight status are unclear.
Objective:
This research evaluated associations of snack frequency, size, and energy-density as well as the percent of daily energy from snacking with weight status and sociodemographic characteristics among U.S. children aged 2 to 5 years.
Design:
Cross-sectional analysis of 2007-2018 National Health and Nutrition Examination Survey (NHANES) data using two, caregiver proxy 24-hour dietary recalls.
Participants/setting:
U.S. children aged 2 to 5 years (n=3313) with at least one snack occasion over two days of intake.
Main outcome measures/statistical analyses:
Snacking parameters included frequency (number of occasions/day), size (kcal/occasion), and energy-density (kcal/g/occasion) as well as percent of daily energy from snacking. Generalized linear regression models evaluated associations of snacking with child weight status (normal weight (NW), and overweight (OW)/obesity (OB)), adjusting for survey weights, energy misreporting, mean meal size, and sociodemographic covariates.
Results:
Children with OW/OB consumed more frequent snacks (2.8 (0.06) vs 2.5 (0.03) snacks/day, respectively; p<0.001), larger snacks (188 (4) vs. 162 (23) kcal/occasion, respectively; p<0.001), and a greater percent of daily energy from snacking (29.80 (1.00) vs 26.09 (0.40) %, respectively; p<0.001) than children with NW. Mean snack frequency and size as well as percentage of daily energy from snacking varied with child age, gender, and head of household education. Associations of snacking with child race/ethnicity were less consistent.
Conclusion:
These nationally representative findings provide evidence that the consumption of larger, more frequent snacks is associated with OW/OB among U.S. children 2 to 5 years of age and snacking varies by sociodemographic characteristics.
Background:
Breakfast consumption is often associated with improving cardiometabolic parameters and diet quality. However, literature evaluating breakfast consumption with these outcomes between the school and home environments is limited.
Objective:
This study examined relationships between breakfast consumption locations (home versus school) and cardiometabolic parameters, breakfast dietary intake, and daily dietary intake.
Design:
This cross-sectional study used baseline data from TX Sprouts, a one-year school-based gardening, nutrition, and cooking cluster-randomized trial, implemented in 16 elementary schools in Austin, TX, in 2016-2019.
Participants/setting:
Analysis included 383 low-income, multi-racial/ethnic elementary school-aged children (mean age 9.2 years; 60.6% Hispanic; 70.5% free/reduced lunch; 58.5% home breakfast consumers).
Main outcome measures:
Cardiometabolic parameters were obtained via fasting blood draws, and dietary intake was assessed using one 24-hour dietary recall conducted on a random, unannounced weekday. Cardiometabolic and dietary parameters (i.e., energy intake, macronutrients, and food group servings) for breakfast and for the day were evaluated.
Statistical analyses performed:
Multivariate analysis of covariance was performed to examine cardiometabolic parameters and dietary intake between school and home breakfasts.
Results:
School breakfast consumers (SBC) had lower fasting triglyceride levels than home breakfast consumers (HBC) (89.0 mg/dL vs. 95.7 mg/dL; P = 0.03). SBC had lower total fat for the day (P = 0.02) and lower total and saturated fat, sodium, and refined grains at breakfast (P ≤ 0.01) than HBC. However, SBC had lower protein at breakfast (P = 0.01) and higher carbohydrates, total sugar, and added sugar for the day and at breakfast (P ≤ 0.03) than HBC.
Conclusion:
SBC compared to HBC had lower fat intake, which may have contributed to the lower triglyceride level observed in SBC, but also had lower protein intake at breakfast and higher added sugar intake for the day and at breakfast. These results suggest dietary intake differed between the home and school environments, but more research is needed to evaluate if such differences are due to the School Breakfast Program guidelines.
The incidence of skipping breakfast in pediatric subjects is rising, and a relationship with overweight (OW) and obesity (OB) has been shown. Associations with cardiovascular outcomes and skipping breakfast in adults have been reported. The purpose of this systematic review was to summarize the association of skipping breakfast with body weight and metabolic outcomes in the pediatric population. We searched relevant databases (2008–2018) and identified 56 articles, of which 39 were suitable to be included, basing on inclusion criteria (observational; defined breakfast skipping; weight and/or metabolic outcomes). Overall, 286,804 children and adolescents living in 33 countries were included. The definitions of OW/OB, skipping breakfast, and the nutrient assessment were highly heterogeneous. Confounding factors were reported infrequently. The prevalence of skipping breakfast ranged 10–30%, with an increasing trend in adolescents, mainly in girls. Skipping breakfast was associated with OW/OB in the 94.7% of the subjects. The lack of association was shown mainly in infants. Moreover, 16,130 subjects were investigated for cardiometabolic outcomes. Skipping breakfast was associated with a worse lipid profile, blood pressure levels, insulin-resistance, and metabolic syndrome. Five studies reported a lower quality dietary intake in breakfast skippers. This review supports skipping breakfast as an easy marker of the risk of OW/OB and metabolic diseases, whether or not it is directly involved in causality. We encourage intervention studies using standardized and generalizable indicators. Data on confounders, time of fasting, chronotypes, and nutrition quality are needed to establish the best practice for using it as a tool for assessing obesity risk.
Background: There has been an increase in the consumption of energy drinks and dietary supplements in India. However, the benefit of regular consumption of multivitamin and mineral supplements still remains questionable. Objectives: The study was conducted with an aim to obtain data about the type of nutritional supplements and energy drinks consumed by adolescents, reasons for their consumption, with particular emphasis on the effect of consumption on body mass index. Methods: A cross-sectional study was conducted among 120 adolescents of the age group 14–19 years. Data was collected with the aid of a semi-structured questionnaire. Questions pertaining to diet were asked using a 24-hour dietary recall method and their physical activity was also determined by the questionnaire. The height and weight of the subjects were measured, and BMI was calculated. Data was analyzed using SPSS-17. The Institutional Ethical Committee (IEC) permission was obtained. Results: In this study, the use of energy/sports drinks over last two weeks period was reported to be 55% and 43% of the respondents reported the consumption of one or the other type of vitamin and/or mineral supplement (s) without assessing any need or consulting any physician. The most commonly consumed vitamins without prescription were Vitamin C (5%) and D (5%), while in terms of minerals, iron (6%) and calcium (5%) were being used by the study subjects without prescription. Some of the reasons for using energy/sports drinks were curiosity followed by peer pressure, whereas students those reported to be consuming reported perceived short-term health benefits and supply by the parents as the common cause. The body mass index has also been found to be associated statistically significant with the consumption of the energy and sports drinks. Conclusions: Thus, health education programs should incorporate the perceptions, aspirations and motivations of young people into the planning of interventions and activities in order to make them most relevant and effective.
Methods:
This cross-sectional study of 829 adolescents derived sleep duration, efficiency and moderate-to-vigorous physical activity from >5 days of wrist actigraphy recording for >10 hours/day. The main outcome was a metabolic risk score (mean of 5 sex-specific z-scores for waist circumference, systolic blood pressure, high-density lipoprotein cholesterol scaled inversely, and log-transformed triglycerides and homeostatic model assessment of insulin resistance), for which higher scores indicate greater metabolic risk. Secondary outcomes included score components and dual-energy radiograph absorptiometry fat mass. We measured socioeconomic status, race and/or ethnicity, pubertal status, and obesity-related behaviors (television-viewing and fast food and sugar-sweetened beverage consumption) using questionnaires.
Results:
The sample was 51.5% girls; mean (SD) age 13.2 (0.9) years, median (interquartile range) sleep duration was 441.1 (54.8) minutes per day and sleep efficiency was 84.0% (6.3). Longer sleep duration was associated with lower metabolic risk scores (-0.11 points; 95% CI: -0.19 to -0.02, per interquartile range). Associations with sleep efficiency were similar and persisted after adjustment for BMI z score and physical activity, television-viewing, and diet quality. Longer sleep duration and greater sleep efficiency were also favorably associated with waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, and fat mass.
Conclusions:
Longer sleep duration and higher sleep efficiency were associated with a more favorable cardiometabolic profile in early adolescence, independent of other obesity-related behaviors. These results support the need to assess the role of sleep quantity and quality interventions as strategies for improving cardiovascular risk profiles of adolescents.
Objective: This study was conducted to review the trends observed in studies concerning the associations of family meal practices with health status and dietary intake.
Methods: A literature review was carried out using MEDLINE (PubMed) and Eric databases. Relevant articles published between 2001 and 2011 were identified using the following search terms: “family meals” or “family meal” or “family dinner” or “family mealtime.” Additional articles were retrieved from the references of three systematic reviews on family meal practice. After screening titles, abstracts, and full texts, 50 articles were included in this review.
Results: Of the 43 measures used to assess family meal practices, 30 were related to “family meal frequency (FMF)” using one question. Many of them were asked about the frequency of a meal with all or most of the family within a week. Twenty-four cross-sectional and six longitudinal studies examined the association between FMF and health or nutrition status among young children through adolescents. Ten cross-sectional and three longitudinal studies reported FMF and food or nutrient intake among children. Children with high FMF were more likely to have a lower score of depression symptoms, higher intake of fruits and vegetables, and higher score of diet quality. The association of obesity and FMF yielded mixed results. Studies that targeted adults were limited to four cross-sectional studies.
Conclusion: This study implied that children and adolescents who have frequent family meals have a better dietary intake, such as a higher intake of fruits and vegetables.
Abstract
Objective: To study the effect of breakfast skipping on
the nutritional status and cognition of school going
children. Design: A descriptive cross sectional study.
Setting: selected schools in Batticaloa district.
Participants / Subjects: 195 school going students aged
13-16 years old from the selected schools in Batticaloa
district. Method: Questionnaires were used to collect
information on breakfast consumption habits. The 24-
hour dietary recall method was used to obtain
information on the children’s food intake. Data were
analyzed using SPSS software. Results: The prevalence
of breakfast skipping among school going children of age
11-16 years old is 23.50% in selected areas of Batticaloa
district. More number of breakfast skippers were found
to be overweight than breakfast non-skippers However,
intakes of fat and miscellaneous foods like junk food that
are high in saturated fat were significantly high in
breakfast skippers than breakfast non-skippers. A
significant difference was also seen in a no. of
parameters like memory, concentration, grades obtained,
attendance, etc. between breakfast skippers and breakfast
non-skippers. Conclusion: The study indicates that
skipping breakfast affects both the nutritional status as
well as the school performance of the students. The study
strongly favours breakfast plays an important role for
adequate nutrition of school children.
Television has traversed a long path in India as an educational tool. After opening up the economy for liberalization, radio and television were laid open to private players. From the days of the solitary few soaps and televised mythological dramas when millions of viewers stayed glued to their sets to today’s television mills that cater to a growingly information hungry nation, India’s television has seen a sea change. After over five decades, India’s television industry has broadcasters constantly facing the three Rs—revenue, relevance and reach. With changing technology the screen no doubt are slimming but TVs are blamed in part for bulging girth of India’s upwardly mobile population. Juxtaposing this scenario with the changing health policies, this chapter analyzes the role of television in promoting health and the influence it has had on various social, economic and political processes that have been revolutionizing the health landscape in India. Furthermore, the chapter also analyzes various social processes that include health consumerism, urban modelling, ‘health food’ advertising and its impact on nutrition, restructuring of human relationships, hegemony in health messaging and the emergence of a confused information cacophony. Some see these processes as positive, yet others view them as negative developments. These are looked at with specific reference to changing nutrition scenario in India.
The evidence for a link between sleep and cardiometabolic risk factors in children and adolescents is accumulating; however, the literature has not yet been reviewed. Seventy-five studies investigating associations between sleep variables and measures of abdominal adiposity, glucose homeostasis, blood lipids, blood pressure (BP), and inflammatory markers were included in the present review. The current evidence indicates that inadequate sleep may play a role in cardiometabolic risk at a later age for children and adolescents. Most compelling is the evidence for an association between inadequate sleep and abdominal adiposity, decreased insulin sensitivity as well as high BP, whereas the evidence for potential links between sleep and blood lipids as well as inflammatory markers is less convincing. It should, however, be noted that the majority of studies linking sleep with cardiometabolic outcomes are cross-sectional in nature, and sleep is often assessed using parent or self-report. We suggest that future studies should investigate longitudinal associations between sleep and cardiometabolic risk factors with the use of objective sleep measurements conducted for several days, including weekdays and weekend days, at multiple time points over time. Meanwhile, based on the available evidence, we recommend that children and adolescents get adequate amounts of good sleep in a regular pattern.
Visceral adiposity poses significant consequences for long-term health and it is important to identify methods that can be used to prevent fat deposition in visceral adipose tissue.
To identify the factors contributing to differential fat distribution in overweight/obese children.
Demographic, dietary and lifestyle factors potentially associated with increased visceral adipose tissue in overweight and obese South-Indian children aged 3 to 16 years. The diagnosis of visceral obesity was based on the waist-to-height ratio (WHtR) cut-off value of 0.5.
Exposure variables with statistically different distributions in the two WHtR categories, when examined by Mann–Whitney and chi-square tests, were used to develop a binary logistic regression model of visceral adiposity. Increased birthweight and higher sleep duration were significant predictors of having a healthy WHtR, with odds ratios of 1.30 and 1.26 respectively.
Early programming effects associated with low birthweight and current sleep deprivation could promote the storage of excess fat as visceral adipose tissue in overweight and obese children.
Abstract Given the growing contribution of snacks to dietary intake and the need for effective strategies to reduce obesity, it is important to consider whether snacking behaviors contribute to high BMI in childhood. This review summarizes US research that has addressed trends in snacking behavior and its contribution to dietary intake, as well as research describing snack food availability in settings where youth spend their time. In addition, it comprehensively reviews studies conducted in the United States and internationally that have examined associations of snacking behavior with weight. Research published between January, 2000, and December, 2011, was identified by searching PubMed and MEDLINE databases, and by examining bibliographies of relevant studies. Recent analyses of trends in dietary intake have shown there were significant increases in the contribution of energy-dense, nutrient-poor foods to snacking kilocalories over the past few decades. Although snacks can contribute to intake of key nutrients, frequent snacking has been associated with higher intake of total energy and energy from added and total sugars. Assessments in schools and retail stores have further indicated that energy-dense, nutrient-poor snacks are widely available in settings where youth spend their time. The majority of studies either found no evidence of a relationship between snacking behavior and weight status or found evidence indicating that young people who consumed more snacks were less likely to be obese; however, additional research is needed to address various methodological limitations. Recommendations for future research are provided to address knowledge gaps and inform the development of interventions.
Energy balance is influenced by understudied genetic, social and other environmental factors. The frequency of family meals (FFM) may be one of these factors since it is associated with a healthier dietary pattern in children and adolescents. The objective of this review is to evaluate the scientific evidence on the association between FFM and the risk of childhood and adolescent overweight. The electronic literature search identified 394 articles published during 2005-2012. Of these, 15 studies gave precise information of the studied association, of which four were longitudinal. We found great variability regarding the measurement of FFM. Six out of 11 cross-sectional studies and 1 out of 4 longitudinal studies found statistically significant inverse associations between FFM and being overweight, mainly in children, with odds ratios ranging from 0.11 to 0.93. Of those, only one adjusted for all the potential confounding factors considering socio-demographic, physical activity- and diet-related variables. Therefore, this review found inconsistent and weak evidence of an inverse association between FFM and risk of childhood overweight. In conclusion, further research is needed to establish whether family meals have an effect on childhood overweight. These studies ideally should have longitudinal or experimental designs, a clear and standardized definition of the exposure under study, a measure of the exposure based on direct observation or validated questionnaires and an adequate adjustment for potential confounders.
To develop age and gender specific waist circumference references for urban Indian children aged 3 -16 years.
Cross-sectional study.
Urban preschools and schools of Bangalore.
9060 children (5172 boys and 3888 girls) in the age group of 3-16 years.
Weight, height, and waist circumference were measured using standard anthropometric methodology. Percentiles for waist circumference and Waist/height ratio (W/Ht) for each age and gender were constructed and smoothed using the LMS method.
Mean waist circumference increased with age for both girls and boys. The upper end of curve in boys continued to increase, whereas in the girls it tended to plateau at 14 years. The waist circumference of the Indian children from the present study was higher than age and sex matched European children. The proportion of children with W/Ht ratio greater than 0.5 decreased as their age increased.
These curves represent the first waist and waist height ratio percentiles for Indian children and could be used as reference values for urban Indian children. We suggest that for a start, the 75th percentile of waist circumference from this study be used as an action point for Indian children to identify obesity (as a tautological argument), while retaining the cut-off of 0.5 for the W/Ht ratio; however this underlines the need to derive biologically rational cut-offs that would relate to different levels of risk for adult cardiovascular disease.
The accuracy of dietary energy assessment tools is critical to understanding the role of diet in the increasing rate of obesity.
The purposes of our study in overweight adolescent boys and girls were 1) to assess the energy reporting bias of diet records against the referent of total energy expenditure (TEE) and 2) to compare the methods of determining energy needs by using measured metabolizable energy intake (MEI) and TEE.
Twenty girls [12-15 y, body mass index (in kg/m2) = 33.0 +/- 5] and 14 boys (12-14 y, body mass index = 27.4 +/- 4) participated in 2- to 3-wk metabolic balance studies. TEE was measured by using doubly labeled water (TEE(DLW)), and MEI was measured by bomb calorimetry of composite daily diet, urine, and fecal collections. Food records were collected before each study.
Food records underreported TEE(DLW) by 35 +/- 20%. Underreporting of energy intake was correlated with all macronutrient intake concentrations (g or kcal) (P < 0.0001). A multiple regression model showed that 86.4% of the variance in underreporting error was explained by dietary fat (g), BMI, and sex. The intrasubject CV was 3.9% for TEE(DLW) and 9.9% for MEI. MEI for weight stability (MEI(wtstb)) averaged 99 +/- 11% of TEE.
The increased underreporting of dietary intake with increasing body weight in teens may explain in part previous reports noting that there has been an increased incidence of obesity, although energy intakes have not appeared to increase. MEI(wtstb) and TEE(DLW) gave similar estimates of energy needs. This trial was registered at clinicaltrials.gov as NCT 00592137.
Although body fat patterning has been related to adverse health outcomes in adults, its importance in children and adolescents is less certain.
We examined the relation of circumference (waist and hip) and skinfold-thickness (subscapular and triceps) measurements to lipid and insulin concentrations among 2996 children and adolescents aged 5-17 y.
This was a community-based, cross-sectional study conducted in 1992-1994.
A central or abdominal distribution of body fat was related to adverse concentrations of triacylglycerol, LDL cholesterol, HDL cholesterol, and insulin; these associations were independent of race, sex, age, weight, and height. These associations were observed whether fat patterning was characterized by using 1) waist circumference alone (after adjustment for weight and height), 2) waist-to-hip ratio, or 3) principal components analysis. Compared with a child at the 10th percentile of waist circumference, a child at the 90th percentile was estimated to have, on average, higher concentrations of LDL cholesterol (0.17 mmol/L), triacylglycerol (0.11 mmol/L), and insulin (6 pmol/L) and lower concentrations of HDL cholesterol (-0.07 mmol/L). These differences, which were independent of weight and height, were significant at the 0.001 level and were consistent across race-sex groups.
These findings emphasize the importance of obtaining information on body fat distribution, waist circumference in particular, in children. Waist circumference, which is relatively easy to measure, may help to identify children likely to have adverse concentrations of lipids and insulin.
To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points.
International survey of six large nationally representative cross sectional growth studies.
Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States.
97 876 males and 94 851 females from birth to 25 years of age.
Body mass index (weight/height(2)).
For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m(2) for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years.
The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
We provide an updated version of the Compendium of Physical Activities, a coding scheme that classifies specific physical activity (PA) by rate of energy expenditure. It was developed to enhance the comparability of results across studies using self-reports of PA. The Compendium coding scheme links a five-digit code that describes physical activities by major headings (e.g., occupation, transportation, etc.) and specific activities within each major heading with its intensity, defined as the ratio of work metabolic rate to a standard resting metabolic rate (MET). Energy expenditure in MET-minutes, MET-hours, kcal, or kcal per kilogram body weight can be estimated for specific activities by type or MET intensity. Additions to the Compendium were obtained from studies describing daily PA patterns of adults and studies measuring the energy cost of specific physical activities in field settings. The updated version includes two new major headings of volunteer and religious activities, extends the number of specific activities from 477 to 605, and provides updated MET intensity levels for selected activities.
Rates of overweight have increased dramatically among children in the United States. Although an increase in consumption of food prepared away from home has paralleled overweight trends, few data exist relating food prepared away from home to change in BMI in children. The goals of this study were to (1) examine the cross-sectional and longitudinal associations between consumption of fried foods away from home (FFA) and BMI and (2) examine the cross-sectional associations between intake of FFA and several measures of diet quality.
We studied a cohort of 7745 girls and 6610 boys, aged 9 to 14 years, at baseline in 1996. We obtained BMI from self-reported height and weight, measures of diet quality from a food frequency questionnaire, and weekly servings of FFA during the previous year. We performed linear regression analyses to assess the longitudinal associations between change in consumption of FFA on change in BMI, using data from three 1-year periods from 1996 through 1999. We also related consumption of FFA with intake of selected foods and nutrients at baseline.
In cross-sectional analyses, adjusting for potential confounders, mean (SE) BMI was 19.1 (0.13) among children who ate FFA "never or <1/week," 19.2 (0.13) among those who responded "1 to 3 times/week," and 19.3 (0.18) among those who responded "4 to 7 times/week." In longitudinal multivariate models, increasing (over 1 year) consumption of FFA "never or <1/week" to "4 to 7/week" was associated with increasing BMI (beta = 0.21 kg/m2; 95% confidence interval: 0.03-0.39) compared with those with low consumption of FFA at baseline and 1 year later. At baseline, frequency of eating FFA was associated with greater intakes of total energy, sugar-sweetened beverages, and trans fat, as well as lower consumption of low-fat dairy foods and fruits and vegetables.
These data suggest that older children who consume greater quantities of FFA are heavier, have greater total energy intakes, and have poorer diet quality. Furthermore, increasing consumption of FFA over time may lead to excess weight gain.
The need has never been greater to support healthy eating and physical activity in children and youth; the numbers of overweight and obese children have doubled and tripled, respectively, over the past 3 decades. Poor eating habits, including inadequate intake of vegetables, fruit, and milk, and eating too many high-calorie snacks, play a role in childhood obesity. Grain products provide the highest percentage (31%) of daily calories, followed by "other foods," which have limited nutritional value (22% of daily calories). Snacks account for 27% of total daily calories, which is more than the calories consumed at breakfast (18%) and lunch (24%), but not dinner (31%). For Canadians older than 4 years of age, more than 41% of daily snack calories come from other foods, such as chips, chocolate bars, soft drinks, fruit drinks, sugars, syrup, preserves, fats, and oils. Habits that protect against childhood obesity include eating more vegetables and fruit, eating meals with family, and being physically active. Children's food habits and choices are influenced by family, caregivers, friends, schools, marketing, and the media. Successful interventions for preventing childhood obesity combine family- and school-based programs, nutrition education, dietary change, physical activity, family participation, and counseling.
Objective
To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points.
Design
International survey of six large nationally representative cross sectional growth studies.
Setting
Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States
Subjects
97 876 males and 94 851 females from birth to 25 years of age
Main outcome measure
Body mass index (weight/height2).
Results
For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m2 for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years.
Conclusions
The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
To assess the ability of simple definitions of BMI to successfully screen for children with high body fatness.
We determined the sensitivity and specificity of the body mass index (BMI) by testing its ability to correctly identify children with high body fat percentage. Receiver operator characteristic (ROC) analyses were carried out using the top 5% of body fat percentage to define children as obese (true positives).
Representative sample of 4175 7 y-old (88-92 month-old) children (2120 boys; 2055 girls) participating in the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC).
The current obesity definition based on BMI (95th centile) had moderately high sensitivity (88%) and high specificity (94%). Sensitivity and specificity did not differ significantly between boys and girls. The ROC analysis showed that lower cut-offs applied to the BMI improved sensitivity with no marked loss of specificity: the optimum combination of sensitivity (92%) and specificity (92%) was at a BMI cut-off equivalent to the 92nd centile. Sensitivity of BMI using the new International Obesity Task Force (IOTF) cut-off for obesity was much lower, and differed significantly (P < 0.001) between boys (46%) and girls (72%).
Screening for childhood obesity using the BMI is specific, and can have moderately high sensitivity if an appropriate cut-off is chosen. New recommendations based on the IOTF approach to defining childhood obesity are associated with lower sensitivity, and sensitivity differs between boys and girls.
To develop waist circumference percentile curves for British children and to compare these curves with those from other countries.
Cross-sectional study.
School-aged population.
A representative sample of school children from the geographical regions of Great Britain, approximately in proportion to their age distribution. The sample population consisted of 8355 children (3585 males, 4770 females) with ages ranging between 5.0 and 16.9 y.
Waist circumferences were measured with a flexible non-elastic tape and waist circumference percentiles were constructed and smoothed using the LMS method.
Smoothed waist circumference percentile curves.
Mean waist circumference increased with age in both boys and girls. For girls, curves began to plateau after the age of 13 y whereas, for boys, waist percentile curves continued to increase more sharply after this age. However, these curves mainly reflect the patterns of waist circumference in Caucasian children.
These curves represent the first waist circumference percentiles for British children and could be used provisionally for both clinical and possibly epidemiological use, although they should be validated against equivalent longitudinal data.
This project has been sponsored by UNL Diversity and Development Fund.
The impact of television (TV) advertisements (commercials) on children's eating behaviour and health is of critical interest. In a preliminary study we examined lean, over weight and obese children's ability to recognise eight food and eight non-food related adverts in a repeated measures design. Their consumption of sweet and savoury, high and low fat snack foods were measured after both sessions. Whilst there was no significant difference in the number of non-food adverts recognised between the lean and obese children, the obese children did recognise significantly more of the food adverts. The ability to recognise the food adverts significantly correlated with the amount of food eaten after exposure to them. The overall snack food intake of the obese and overweight children was significantly higher than the lean children in the control (non-food advert) condition. The consumption of all the food offered increased post food advert with the exception of the low-fat savoury snack. These data demonstrate obese children's heightened alertness to food related cues. Moreover, exposure to such cues induce increased food intake in all children. As suggested the relationship between TV viewing and childhood obesity appears not merely a matter of excessive sedentary activity. Exposure to food adverts promotes consumption.
To ascertain risk factors for the development of overweight in children at 9.5 years of age.
This was a prospective study of 150 children from birth to 9.5 years of age, with assessment of multiple hypothesized risk factors drawn from research reports.
Five independent risk factors for childhood overweight were found. The strongest was parent overweight, which was mediated by child temperament. The remaining risk factors were low parent concerns about their child's thinness, persistent child tantrums over food, and less sleep time in childhood. Possible mechanisms by which each of these factors influence weight gain are outlined. Two different pathways to childhood overweight/obesity were found, depending on degree of parental overweight.
There is evidence of considerable interaction between parent and child characteristics in the development of overweight. Several of the identified risk factors are amenable to intervention possibly leading to the development of early prevention programs.
Increases in childhood overweight and obesity have become an important public health problem in industrialized nations. Preventive public health action is required, but more research of risk factors is required before evidence-based initiatives can be developed and targeted effectively. We investigated the association between childhood overweight and obesity and risk factors relating to dietary habits, activities, parents and schools.
In 2003 we surveyed grade 5 students and their parents and school principals in Nova Scotia. We measured height and weight and assessed dietary habits (using Harvard's Youth/Adolescent Food Frequency Questionnaire), physical and sedentary activities, and parental and school-based risk factors. We estimated neighbourhood income by averaging, per school, the postal-code level means of household income of residential addresses of children attending that school. We used multilevel logistic regression to evaluate the significance of these risk factors for overweight and obesity.
On the basis of measurements taken of 4298 grade 5 students, we estimated the provincial prevalence of overweight to be 32.9% and of obesity to be 9.9%. Children who bought lunch at school were at increased risk of overweight (fully adjusted odds ratio [OR] 1.39, 95% confidence interval [CI] 1.16-1.67), whereas those who ate supper together with their family 3 or more times a week were at decreased risk (OR 0.68, 95% CI 0.52-0.88). Physical education classes 2 or more times a week at school were associated with a decreased risk of overweight (OR 0.61, 95% CI 0.43-0.87) and obesity (OR 0.54, 95% CI 0.33-0.88). Children in high-income neighbourhoods were half as likely to be obese as their peers living in low-income neighbourhoods (OR 0.50, 95% CI 0.36-0.70).
Parents and schools provide important opportunities for public health initiatives for reducing childhood overweight and obesity. Children and schools in low-income neighbourhoods should receive priority in public health initiatives to reduce future socioeconomic inequalities in health.
Prevailing dietary patterns and their association with nutritional outcomes are poorly understood, particularly for children in Korea. Our purposes were to identify major dietary patterns and to examine their associations with overweight among young children in Korea. For 1441 preschool children, usual diet was assessed by a FFQ, from which thirty-three food groups were created and entered into a factor analysis. We identified three dietary patterns by relative intake frequency of (1) vegetables, seaweeds, beans, fruits, milk and dairy products (Korean healthy pattern); (2) beef, pork, poultry, fish and fast foods (animal foods pattern); and (3) ice cream, soda, chocolate, cookies and candies (sweets pattern). The Korean healthy pattern was associated with better health status. As compared with the lowest quintile, the multivariate-adjusted OR of the highest quintile for health status inferior or similar to their peers was 0.59 (95 % CI 0.42, 0.84). Likelihood of being overweight was higher among those in the highest quintile (OR 1.77 (95 % CI 1.06, 2.94)) v. the lowest quintile regarding the animal foods pattern. These findings suggest that major dietary patterns are predictors of overweight and health status in Korean preschool children.
Obesity in children has become a major global public health concern. The prevention of obesity must start from early childhood in order to establish sound lifestyle habits and promote healthy adulthood. In this study, we evaluated factors associated with the prevention of obesity and the development of healthy lifestyle habits in children. A cross-sectional, questionnaire-based survey was performed in elementary and junior high school students in Tokushima Prefecture, Japan, during the summer of 2004. The questionnaire consisted of 30 items such as physique, sleep, eating habits, diet, exercise, free time, and attending after-school lessons. Our study revealed that eating meals as a family every day is associated with a lower rate of obesity as well as getting good lifestyle habits such as eating balanced meals and getting enough sleep. Of the 3,291 students who responded to the questionnaire, 2,688 (81.7%) reported that they eat meals with their family every day. The percentage of students who eat meals with their family every day decreased with increasing school grade, with the lowest percent in the junior high school students. However, the results regarding female junior high school students revealed a marked association between eating meals with the family every day and good lifestyle habits. We recommend that parents and school teaching staff encourage the establishment of sound, healthy lifestyle habits in children from early childhood as an effective measure for the prevention of obesity.
Skinfold thickness and measurement technique
- Harrison Gg Er Buskirk
- Carter Jel Fe Johnston
- Tg Lohman
- Pollock
- Ml
Harrison GG, Buskirk ER, Carter JEL, Johnston FE, Lohman TG, Pollock ML, et al. Skinfold thickness and measurement technique. In: Lohman TG, Roche AF, Martorell R, editors. Anthropometric Standardization Reference Manual. Illinois: Human Kinetics Book; 1988. p. 55-71.
Avon Longitudinal Study of Pregnancy and Childhood Study Team. Identification of the obese child: adequacy of the body mass index for clinical practice and epidemiology
- Reilly Jj Dorosty
- Ar
- Emmett
- Pm
Reilly JJ, Dorosty AR, Emmett PM, Avon Longitudinal Study of Pregnancy and Childhood Study Team. Identification of the obese child: adequacy of the body mass index for clinical practice and epidemiology. Int J Obes Relat Metab Disord. 2000;24:1623-7.
Skinfold thickness and measurement technique Anthropometric Standardization Reference Manual. Illinois: Human Kinetics Book
- Gg Harrison
- Er Buskirk
- Jel Carter
- Fe Johnston
- Tg Lohman
- Ml Pollock
Anthropometric Standardization Reference Manual. Illinois: Human Kinetics Book
- G G Harrison
- E R Buskirk
- Jel Carter
- F E Johnston
- T G Lohman
- M L Pollock
- G.G. Harrison
Harrison GG, Buskirk ER, Carter JEL, Johnston FE,
Lohman TG, Pollock ML, et al. Skinfold thickness and
measurement technique. In: Lohman TG, Roche AF,
Martorell R, editors. Anthropometric Standardization
Reference Manual. Illinois: Human Kinetics Book; 1988.
p. 55-71.