Behavioral science at the crossroads in public health: Extending horizons, envisioning the future

Objective: To estimate the association strength of dietary behaviour and sedentary habits in relation to childhood obesity in Spain. Design: A matched case-control study was carried out using data collected by sentinel network paediatricians in general practices. Setting: Five Spanish autonomous communities. Subjects: Cases were 437 children (2-14 years old) with BMI .95th percentile according to Spanish reference tables. Controls were 751 children (2-14 years old; two paired per case) with BMI ,84th percentile. Data were collected in two phases: individual (questionnaires filled in by sentinel paediatricians) and family (self-administered questionnaires filled in a family environment). Crude OR and adjusted OR (ORc and adj OR) for the given variables were calculated using a simple and multiple conditional logistic regression analysis. Results: The factors with the greatest effect on obesity were family history of obesity: both parents (adj OR 5 11?2), mother but not father (adj OR 5 9?1), father but not mother (adj OR 5 6?1), siblings (adj OR 5 2?7); and eating between meals (adj OR 5 2?5) and consumption of sweets and soft drinks .2 times/week (adj OR 5 2?0). The highest protection effect was found for five meals per day (adj OR 5 0?5), the regular consumption of breakfast (adj OR 5 0?5) and for eating fruit for dessert (adj OR 5 0?6). Factors related to sedentary habits did not appear as noteworthy. Conclusions: We have determined the association between certain dietary behaviour and family history with childhood obesity in several Spanish regions.

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“…Social and cultural factors appear to play an important role in shaping the closest behavioural patterns that give rise to body weight gain (1) .…”

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confidence: 99%

Factors associated with childhood obesity in Spain. The OBICE study: a case–control study based on sentinel networks

Zurriaga

Pérez-Panadés

Izquierdo

et al. 2011

Public Health Nutr.

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“…2 Viewing the system more broadly a walkable built environment may be seen as a risk regulator, offering the opportunity for walking, which may then result a healthier population than might be found in a non-walkable neighborhood, even if individual residents are not greatly influenced by the change. 26 One view of how this relationship might look is shown in Figure 2. The main feedback loop, marked "A" at the center, shows that healthier people walk more through a selective effect, which makes this population increasingly healthy through a protective effect.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have found mixed results, without systematic development of a better understanding of why given metrics might correlate in one area and not in others. 16 Glass and McAtee 26 proposed a conceptual framework which describes the interaction of society, behavior, and biology through time. A new type of variable, a "risk regulator," is proposed to capture aspects of social structure, such as the built environment, which influence action.…”

Section: Introduction Importance and Objectivementioning

confidence: 99%

“…Risk regulators impose constraints and provide opportunities which "shape, channel, motivate, and induce behavioral risk factors that cause disease, and the salutary factors that protect agains exposure and delay disease progression". 26 The regulators function as control parameters that operate at a system level to up-or down-regulate the likelihood of key risk factors, such as physical inactivity and poor diet. Neighborhood characteristics, such as the presence of sidewalks or of other walkers, may act as risk regulators to contribute to the likelihood of residents walking for transportation.…”

Section: Introduction Importance and Objectivementioning

confidence: 99%

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Complexity in Built Environment, Health, and Destination Walking: A Neighborhood-Scale Analysis

et al. 2012

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This study investigates the relationships between the built environment, the physical attributes of the neighborhood, and the residents' perceptions of those attributes. It focuses on destination walking and self-reported health, and does so at the neighborhood scale. The built environment, in particular sidewalks, road connectivity, and proximity of local destinations, correlates with destination walking, and similarly destination walking correlates with physical health. It was found, however, that the built environment and health metrics may not be simply, directly correlated but rather may be correlated through a series of feedback loops that may regulate risk in different ways in different contexts. In particular, evidence for a feedback loop between physical health and destination walking is observed, as well as separate feedback loops between destination walking and objective metrics of the built environment, and destination walking and perception of the built environment. These feedback loops affect the ability to observe how the built environment correlates with residents' physical health. Previous studies have investigated pieces of these associations, but are potentially missing the more complex relationships present. This study proposes a conceptual model describing complex feedback relationships between destination walking and public health, with the built environment expected to increase or decrease the strength of the feedback loop. Evidence supporting these feedback relationships is presented.

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“…They rarely cited the physical environment or social support as factors in their inability to lose weight. Yet, the wide availability of high-calorie foods and surroundings that discourage physical activity create an obesogenic environment [33][34][35]. Specific aspects of the physical environment associated with obesity include suburban location (vs urban), disorderly surroundings (e.g., litter, graffiti, vandalism), lack of destinations within a 10-min walk from home, lack of interesting things to look at, and limited access to physical activity or recreational facilities [36,37].…”

Section: Discussionmentioning

confidence: 99%

Explanations for Unsuccessful Weight Loss Among Bariatric Surgery Candidates

Hwang¹,

Childs²,

Goodrick

et al. 2008

OBES SURG

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Behavioral science at the crossroads in public health: Extending horizons, envisioning the future

Cited by 663 publications

References 166 publications

Factors associated with childhood obesity in Spain. The OBICE study: a case–control study based on sentinel networks

Factors associated with childhood obesity in Spain. The OBICE study: a case–control study based on sentinel networks

Complexity in Built Environment, Health, and Destination Walking: A Neighborhood-Scale Analysis

Explanations for Unsuccessful Weight Loss Among Bariatric Surgery Candidates

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