Environment and Obesity in the National Children's Study

Trasande, Leonardo; Cronk, Chris; Durkin, Maureen S.; Weiss, Marianne; Schoeller, Dale A.; Gall, Elizabeth A.; Hewitt, Jeanne Beauchamp; Carrel, Aaron L.; Landrigan, Philip J.; Gillman, Matthew W.

doi:10.1590/s1413-81232010000100025

Cited by 17 publications

(9 citation statements)

References 99 publications

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“…Effective interventions to prevent childhood obesity still remain elusive (25), in large part because obesity represents an interplay among individual behaviors; community structure, lifestyle and the “built environment;” and environmental factors that may have the capacity to disrupt energy balance (26). Although prevention programs may be more expensive than the immediate costs saved, the long‐term benefits obtained through prevention of adult cardiovascular disease, diabetes, stroke, and possibly cancer are likely much greater than the costs we identified in this analysis.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Obesity on Health Service Utilization and Costs in Childhood

Trasande

Chatterjee

2009

Obesity

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252

174

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Most studies of the economic costs of childhood obesity have focused upon hospitalization for comorbidities of obesity, whereas increased expenditures may also be the result of additional outpatient/emergency room visits or prescription drug expenditures. To quantify the magnitude of increased health‐care utilization and expenditures among overweight and obese children, we performed descriptive, bivariate, and multivariable analyses on data from 6‐ to 19‐year olds in the 2002–2005 Medical Expenditure Panel Survey (MEPS), a national probability survey of the noninstitutionalized civilian population in the United States. Compared with normal/underweight children, we found that children who were obese during both years of the MEPS had $194 higher outpatient visit expenditures, $114 higher prescription drug expenditures, and $12 higher emergency room expenditures. Children who were overweight during both years, or overweight in one year and obese in the other had $79 higher outpatient visit expenditures, $64 higher prescription drug expenditures, and $25 higher emergency room expenditures than normal/underweight children. Significantly, increased utilization was noted for outpatient visits, prescription drug use, and emergency room visits. Increased costs and utilization were concentrated among adolescents, though 6–11‐year‐old children who were obese in both years did have more outpatient visits and expenditures than other children. Extrapolated to the nation, elevated BMI in childhood was associated with $14.1 billion in additional prescription drug, emergency room, and outpatient visit costs annually. Although further research is needed to identify effective interventions, the immediate economic consequences of childhood obesity are much greater than previously realized, and further reinforce efforts to prevent this major comorbidity are needed.

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Section: Discussionmentioning

confidence: 99%

The Impact of Obesity on Health Service Utilization and Costs in Childhood

Trasande

Chatterjee

2009

Obesity

Self Cite

252

174

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“…It is increasingly clear that environmental chemical exposures early in life contribute to the explosive increase in the incidence of obesity and diabetes [28,47]. These likely include exposures to some of the most commonly-used pesticides [25,35].…”

Section: Introductionmentioning

confidence: 99%

Neonatal exposure to parathion alters lipid metabolism in adulthood: Interactions with dietary fat intake and implications for neurodevelopmental deficits

Lassiter

Ryde

Levin

et al. 2010

Brain Research Bulletin

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Organophosphates are developmental neurotoxicants but recent evidence also points to metabolic dysfunction. We determined whether neonatal parathion exposure in rats has long-term effects on regulation of adipokines and lipid peroxidation. We also assessed the interaction of these effects with increased fat intake. Rats were given parathion on postnatal days 1-4 using doses (0.1 or 0.2 mg/kg/ day) that straddle the threshold for barely detectable cholinesterase inhibition and the first signs of systemic toxicity. In adulthood, animals were either maintained on standard chow or switched to a high-fat diet for seven weeks. We assessed serum leptin and adiponectin, tumor necrosis factor-α (TNFα) in adipose tissues, and thiobarbituric acid reactive species (TBARS) in peripheral tissues and brain regions. Neonatal parathion exposure uncoupled serum leptin levels from their dependence on body weight, suppressed adiponectin and elevated TNFα in white adipose tissue. Some of the effects were offset by a high-fat diet. Parathion reduced TBARS in the adipose tissues, skeletal muscle and temporal/occipital cortex but not in heart, liver, kidney or frontal/parietal cortex; it elevated TBARS in the cerebellum; the high-fat diet again reversed many of the effects. Neonatal parathion exposure disrupts the regulation of adipokines that communicate metabolic status between adipose Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. tissues and the brain, while also evoking an inflammatory adipose response. Our results are consistent with impaired fat utilization and prediabetes, as well as exposing a potential relationship between effects on fat metabolism and on synaptic function in the brain. Conflict of Interest NIH Public Access

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“…However, rural youth perceive higher levels of neighborhood trust (i.e., I can ask my neighbor for help) and safety (it is safe for kids to play alone outside) than urban youth (Eriksson, Hochwälder, & Sellström, 2011). Understanding these and other differences in community-, school-, and home-based physical activity supports and barriers across urbanization is imperative to the development of an approach to promote physical activity and prevent obesity in these underserved populations (Trasande et al, 2008).…”

Section: )mentioning

confidence: 99%

Test-Retest Reliability and Validity Results of the Youth Physical Activity Supports Questionnaire

et al. 2015

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As youth obesity rates remain at unacceptably high levels, particularly across underserved populations, the promotion of physical activity has become a focus of youth obesity prevention across the United States. Thus, the purpose of this study was to develop and test the reliability and validity of a self-reported questionnaire on home, school, and neighborhood physical activity environments for youth located in low-income urban minority neighborhoods and rural areas. Third-, fourth-, and fifth-grade students and their parents were recruited from six purposively selected elementary schools (three urban and three rural). A total of 205 parent/child dyads completed two waves of a 160-item take-home survey. Test-retest reliability was calculated for the student survey and validity was determined through a combination of parental and school administrator responses, and environmental audits. The majority (90%) of measures had good reliability and validity (74%; defined as ≥70% agreement). These measures collected information on the presence of electronic and play equipment in youth participants’ bedrooms and homes, and outdoor play equipment at schools, as well as who youth are active with, and what people close to them think about being active. Measures that consistently had poor reliability and validity (≤70% agreement) were weekly activities youth participated in and household rules. Principal components analysis was also used to identify 11 sub-scales. This survey can be used to help identify opportunities and develop strategies to encourage underserved youth to be more physically active.

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Environment and Obesity in the National Children's Study

Cited by 17 publications

References 99 publications

The Impact of Obesity on Health Service Utilization and Costs in Childhood

The Impact of Obesity on Health Service Utilization and Costs in Childhood

Neonatal exposure to parathion alters lipid metabolism in adulthood: Interactions with dietary fat intake and implications for neurodevelopmental deficits

Test-Retest Reliability and Validity Results of the Youth Physical Activity Supports Questionnaire

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