The purpose of this review was to examine the factors that predict the development of excessive fatness in children and adolescents. Medline, Web of Science and PubMed were searched to identify prospective cohort studies that evaluated the association between several variables (e.g. physical activity, sedentary behaviour, dietary intake and genetic, physiological, social cognitive, family and peer, school and community factors) and the development of excessive fatness in children and adolescents (5-18 years). Sixty-one studies met the eligibility criteria and were included. There is evidence to support the association between genetic factors and low physical activity with excessive fatness in children and adolescents. Current studies yielded mixed evidence for the contribution of sedentary behaviour, dietary intake, physiological biomarkers, family factors and the community physical activity environment. No conclusions could be drawn about social cognitive factors, peer factors, school nutrition and physical activity environments, and the community nutrition environment. There is a dearth of longitudinal evidence that examines specific factors contributing to the development of excessive fatness in childhood and adolescence. Given that childhood obesity is a worldwide public health concern, the field can benefit from large-scale, long-term prospective studies that use state-of-the-art measures in a diverse sample of children and adolescents.
BackgroundLatino preschool children have higher rates of obesity than preschool children from other racial/ethnic groups; however, few effective, culturally appropriate interventions exist targeting this group. The purpose of this study was to test the feasibility of a 10-week, promotora-mediated, home-based intervention to promote a healthy weight in Latino preschool children.MethodsTrained promotoras (community health workers) delivered 10, 90-min weekly interactive and tailored sessions to Latino families living in Allegheny County. Participants were recruited through promotoras’ own social networks and community gatherings, flyers, and word of mouth. Primary outcome measures included child body mass index (BMI) z-score and percentile. Secondary outcome measures included child objectively measured physical activity and dietary intake, and the home social and physical environment (e.g., parent health behaviors, parent self-efficacy, parental support, physical activity equipment in the home). The final analysis sample included 49 of 51 participants who completed both baseline and follow-up assessments.ResultsParticipants included mothers (33.5 ± 6.1 years old) and their preschool-aged children who were primarily 1st generation immigrants from Mexico (65%). The primary analyses of BMI percentile and z-score showed no change post-intervention. However, there was a significant decrease in child BMI percentile for overweight and obese children from baseline to follow-up (p < .05). We also saw significant pre/post increases in child daily fruit and vegetable intake, and parent moderate-to-vigorous physical activity, fruit and vegetable servings per day, and self-efficacy; and significant decreases in child saturated fat and added-sugar intake, and child and parent screen time (p’s < .05).ConclusionsDespite the short duration of the intervention and follow-up, this pilot study showed promising effects of a promotora-mediated intervention to promote a healthy weight in Latino preschool children.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5266-3) contains supplementary material, which is available to authorized users.
There was a significant reallocation of time by mothers from PA (eg, housework) to SED (eg, watching television) between 1965 and 2010. Given the essential role of PA for health and the potential for the intergenerational transmission of obesity and obesogenic behaviors, these results suggest that maternal inactivity may be an important target for the primary prevention of chronic noncommunicable diseases and obesity.
Purpose Nearly 70% of adult Americans are overweight or obese, but the associations between physical activity, diet quality, and weight status have not been examined in a representative sample of U.S. adults. The purpose of this study was to examine the associations among moderate-to-vigorous physical activity (MVPA), diet quality, and weight status within and across age groups in U.S. adults. Methods Participants included 2,587 men and 2,412 women ages 20 to ≥70 years from the National Health and Nutrition Examination Survey (NHANES) 2003–2004 and 2005–2006. Physical activity was measured by accelerometry. Diet quality was assessed with overall Healthy Eating Index-2005 scores. Measures of weight status, BMI and waist circumference, were assessed using standard NHANES protocols. Results Across age groups, MVPA was lower in the older age groups for both men and women while diet quality was higher (P<.001). BMI and waist circumference were also higher in the older age groups (P<0.05). Within age groups, MVPA was inversely associated with BMI and waist circumference for men and women in nearly every age group (P<0.05). Diet quality was inversely associated with the weight status variables only in men ages 30–39, 40–49 (BMI only), and 50–59 years, and women ages 50–59 years (P<0.05). Conclusions We observed clear age-related trends for measures of weight status, physical activity, and diet quality in U.S. men and women. MVPA was very consistently related to weight status in both genders. The relationship between diet quality and weight status was less consistent. These findings provide support for public health efforts to prevent obesity by promoting increased physical activity in adult Americans.
Obesity prevention is a public health priority and intervention strategies have focused primarily on healthy eating and physical activity in children and adults. To date, no review has systematically compiled and synthesised the scientific evidence from published review articles to determine whether there is clear consensus on the causes of obesity. A systematic review of the literature was conducted searching PubMed/Medline for narrative and systematic review articles published between January 1990 and October 2014 that examined the causes of obesity. In total, 12 of 65 articles met the inclusion criteria; 7 reviews focused on adults (1 systematic, 6 narrative) and 5 reviews on children (2 systematic, 3 narrative). The most popular cause of obesity identified in reviews of adult studies was "combined physical activity and diet" (3 of 7 studies), whereas the most popular cause specified in reviews of child studies was deemed "inconclusive" (2 of 5 studies). While a number of reviews have examined the causes of obesity, the methodology and conclusions varied widely, and few were conducted systematically. Currently, no consensus exists across published literature reviews regarding the primary cause of the obesity epidemic, and more research, particularly prospective studies using state-of-the-art measures, is warranted.
Purpose Youth physical activity (PA) levels differ by race/ethnicity and socioeconomic status (SES). It is well established that various multi-level factors may influence changes in PA. The current study examined whether the association between the change in individual, interpersonal, and environmental factors and the change in PA is modified by race/ethnicity or SES. Methods This study followed 643 youth and their parents from suburban and rural South Carolina participating in the Transitions and Activity Changes in Kids (TRACK) Study in 2008–09 and 2010–11. We assessed total PA in youth using accelerometry and categorized youth and parent survey data into blocks based on the socioecological model. Multivariate regression growth curve models evaluated whether the association between change in independent variables and change in PA was modified by race/ethnicity or SES. Results PA declined from 5th to 7th grade among all racial/ethnic and SES groups. Associations between the range of variables and change in PA were modified by race/ethnicity, but not SES. Blacks did not share any common predictors of change in PA with Whites or Hispanics. However, child-reported number of active friends was associated with total PA, and enjoyment of PA was associated with change in PA among both Whites and Hispanics. Significant interactions by time varied by racial/ethnic group. Conclusions Factors that influence changes in youth PA vary by race/ethnicity but not SES. These findings reinforce the complex nature of addressing PA behavior in diverse samples and further support the need for culturally-appropriate interventions to promote PA in youth.
SummaryBackgroundThe purpose of this study was to examine weight loss, physical activity, fitness and diet changes in response to a standard behavioral weight loss intervention in adults with self‐reported juvenile onset (n = 61) or adult onset (n = 116) obesity.MethodsParticipants (n = 177; 43.0 ± 8.6 years; body mass index [BMI] = 33.0 ± 3.4 kg m−2) engaged in an 18‐month standard behavioral weight loss intervention. Participants were randomized into three different intervention groups as part of the larger parent trial. BMI, physical activity, fitness and diet were assessed at baseline, 6, 12 and 18 months. Separate adjusted mixed models were constructed using SAS version 9.4 (SAS Institute, Cary, NC).ResultsThere was significant weight loss, increased physical activity, improved fitness and reduced caloric intake over time (p < 0.001). There were no significant differences in these outcome variables by obesity onset group. However, there was a significant group by time interaction for fitness (p = 0.001), with the adult onset making significantly greater gains in fitness from baseline to 6 months (p < 0.001); however, this difference was no longer present at 12 or 18 months.ConclusionsWith the exception of fitness at 6 months, weight loss, physical activity and diet did not differ between juvenile onset and adult onset participants, suggesting that those with juvenile onset obesity are equally responsive to a standard behavioral weight loss intervention in adulthood.
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