Influence of individual- and area-level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in Canadian adolescents

Janssen, Ian; Boyce, William; Simpson, K. M.; Pickett, William

doi:10.1093/ajcn/83.1.139

Cited by 357 publications

(325 citation statements)

References 22 publications

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“…It is reasonable therefore, to assume that the mechanisms linking obesity and area level deprivation reflect the underlying effects of deprivation on dietary habits and physical activity status. Evidence suggests that the deprivation of an area is associated with characteristics of the food (43)(44)(45)(46)(47) and physical activity environment (43,45,(48)(49)(50), with more deprived areas thought to be more obesogenic (51). Of further interest is that fact that the relationship between obesity and SES is stronger, and in many cases only shown to be statistically significant in girls.…”

Section: Discussionmentioning

confidence: 99%

Area-level deprivation and adiposity in children: is the relationship linear?

2013

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Objective: It has been suggested that childhood obesity is inversely associated with deprivation, such that the prevalence is higher in more deprived groups. However, comparatively few studies actually use an area level measure of deprivation limiting the scope to assess trends in the association with obesity for this indicator. Furthermore, most assume a linear relationship. Therefore, the aim of this study was to investigate associations between area level deprivation and three measures of adiposity: body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in children.Design: Cross sectional study, data collected on 3 occasions a year apart (2005 -2007) Subjects: Data was available for 13333 children, typically aged 11-12 years from 37 schools and 542 Lower Super Output Areas (LSOAs).Measures: Stature, mass and WC. Obesity was defined as a BMI and WC exceeding the 95 th centile according to British reference data. WHtR exceeding 0.5 defined obesity. The Index of Multiple Deprivation affecting children (IDACI) was used to determine area level deprivation.Results: Considerable differences in the prevalence of obesity exist between the three different measures. However, for all measures of adiposity the highest probability of being classified obese is in the middle of the IDACI range. This relationship is more marked in girls, such that the probability of being obese for girls living in areas at the two extremes of deprivation is around half that at the peak, occurring in the middle. Conclusion:These data confirm the high prevalence of obesity in children and suggest that the relationship between obesity and residential area level deprivation is not linear. This is contrary to the 'deprivation theory' and questions the current understanding and interpretation of the relationship between obesity and deprivation in children. These results could help make informed decisions at the local level.

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Section: Discussionmentioning

confidence: 99%

Area-level deprivation and adiposity in children: is the relationship linear?

2013

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“…The observation that the basic strategy (EPIPOI-1) is effective in children from kindergartens in underprivileged areas, a proxy for lower SES is important because overweight and obesity are more prevalent in low SES groups [27][28][29][30][31] and because children of low SES are at a greater risk of becoming obese in adulthood compared with children of higher SES. 32 It is likely that the families of children in the underprivileged areas were more sensitive to interventions addressed to their children because they may be generally less exposed to information on overweight prevention, and may less utilize the health-care system.…”

Section: Discussionmentioning

confidence: 99%

Prevention of overweight in preschool children: results of kindergarten-based interventions

et al. 2009

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Objective: Given the increasing prevalence of pediatric obesity, we evaluated two kindergarten-based strategies for reducing overweight in preschool children in the Haute-Garonne Department in France. Methods: Kindergartens (n ¼ 79) were randomly assigned to one of the two strategies and followed for 2 years. In the first group (Epidémiologie et prévention de l'obésité infantile, EPIPOI-1), parents and teachers received basic information on overweight and health, and children underwent screening to identify those with overweight (body mass index (BMI) X90th percentile) or at risk for overweight (BMI between 75 and 90th percentile), who were then followed up by their physicians. EPIPOI-2 children, in addition, received kindergarten-based education to promote healthy practices related to nutrition, physical activity and sedentary behaviors. Data on control children from non-intervention kindergartens (n ¼ 40) were retrieved from medical records at the Division of School Health. Results: At baseline, groups differed significantly on age and school area (underprivileged/ not). Owing to a significant interaction between school area and group, analyses were stratified by school area. At baseline, groups did not differ on overweight prevalence and BMI z-scores for any school area. After intervention, prevalence of overweight, BMI z-score and change in BMI z-score were significantly lower in intervention groups compared with controls in underprivileged areas. Using multilevel analysis adjusted for potential confounders, a significant effect on overweight prevalence at the end of the study was noted for EPIPOI-1 in underprivileged areas only (odds ratio and 95% confidence interval: 0.18 (0.07-0.51). In nonunderprivileged areas, the gain in BMI z-score was lower in EPIPOI-2 group compared with control and EPIPOI-1. Conclusion: Our results suggest that simple measures involving increasing awareness on overweight and health, and periodic monitoring of weight and height with follow-up care when indicated, could be useful to reduce overweight in young children from underprivileged areas. A reinforced strategy with an education component, in addition, may be indicated in children in non-underprivileged areas.

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“…8,9 Inactivity appears more prevalent in higher income countries (e.g., 80% of British and 90% of American adults 10,11 ), particularly among the less wealthy, who also comprise the majority of these populations. 12,13 Global health statistics highlight 'physical inactivity' as a top 10 risk factor for poor health, 14 associated with an increased risk of premature cardiovascular and cerebrovascular mortality. [15][16][17][18] Therefore, to better harness its health benefits, we need to more effectively establish the underlying mechanisms, and therefore the role of each exercise parameter (intensity, frequency, mode, and duration) in optimizing health and well-being.…”

Section: Introductionmentioning

confidence: 99%

High-Intensity Interval Exercise and Cerebrovascular Health: Curiosity, Cause, and Consequence

Lucas

Cotter

Brassard

et al. 2015

J Cereb Blood Flow Metab

157

179

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Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases.

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Influence of individual- and area-level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in Canadian adolescents

Abstract: Individual- and area-level SES measures were independently related to obesity, which suggests that both individual and environmental approaches may be required to curtail adolescent obesity.

Cited by 357 publications

References 22 publications

Area-level deprivation and adiposity in children: is the relationship linear?

Area-level deprivation and adiposity in children: is the relationship linear?

Prevention of overweight in preschool children: results of kindergarten-based interventions

High-Intensity Interval Exercise and Cerebrovascular Health: Curiosity, Cause, and Consequence

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