Multilevel Correlates of Healthy BMI Maintenance and Return to a Healthy BMI among Children in Massachusetts

Fiechtner, Lauren; López, Gabriel; Sharifi, Mona; Taveras, Elsie M.

doi:10.1089/chi.2016.0261

Cited by 12 publications

(11 citation statements)

References 38 publications

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“…By T2, the overweight and obesity rate in these most favorable neighborhoods was nearly half that of two of the three less favorable neighborhood types and approximately half the national prevalence for childhood overweight and obesity . Present findings are consistent with other longitudinal findings regarding neighborhood environment and child weight status trajectories .…”

Section: Discussionsupporting

confidence: 88%

Two‐Year Changes in Child Weight Status, Diet, and Activity by Neighborhood Nutrition and Physical Activity Environment

Saelens

Glanz

Frank

et al. 2018

Obesity

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Section: Discussionsupporting

confidence: 88%

Two‐Year Changes in Child Weight Status, Diet, and Activity by Neighborhood Nutrition and Physical Activity Environment

Saelens

Glanz

Frank

et al. 2018

Obesity

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“…Our abdominal obesity findings indicate that by providing access to a particularly vulnerable age group (children and adolescents from the general population), the school setting offers a valuable opportunity to begin early health promotion and obesity prevention. Some studies have reported that interventions targeting middle or high school pupils are more effective than those focused on elementary schools [34,46,59], while other authors have suggested that interventions targeting children aged 2-5 years may have a greater effect on obesity prevention and management [60]. However, our findings indicate a beneficial impact across all ages evaluated.…”

Section: Discussioncontrasting

confidence: 74%

Effects of Nutritional Education Interventions on Metabolic Risk in Children and Adolescents: A Systematic Review of Controlled Trials

et al. 2019

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Childhood obesity is a global public health issue and is linked to metabolic syndrome, which increases the risk of comorbidities such as type 2 diabetes, cardiovascular diseases and cancer. Social, economic and cultural factors influence changes in nutrition and lifestyle characterized by poorer diets and reduced physical activity. This systematic review summarizes the evidence for nutritional education interventions to improve metabolic risks in children and adolescents. Systematic searches of the databases Medline (via PubMed) and Scopus were conducted following PRISMA guidelines. The risk of bias for each study was assessed following the methodology of the Cochrane Collaboration. Ten case-controlled and randomized controlled studies testing nutritional educational interventions targeting children and adolescents from the general population were eligible for inclusion. The sample size was 3915 and the age range was 7-20 years. The duration of intervention ranged from 12 weeks to 20 years. All the studies that provided data on abdominal obesity reported differences in favour of the intervention. However, data on the effects on the remaining components of metabolic syndrome remain inconclusive. These results support the role of nutritional education interventions as a strategy to reduce central adiposity and its possible unhealthy consequences in children and adolescents.

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“…Some previous studies have assumed a linear relationship between BMI change and determinants of BMI, i.e., they assume that whatever is positively associated with increases in BMI is automatically related to potential decreases in BMI if used as an intervention tool (30–32). Our results contrast with such previous approaches, by showing virtually no overlapping weight gain risk factors as also being weight reduction promotion factors, suggest that such an interpretation oversimplifies the complexities of weight maintenance and weight loss (33).…”

Section: Discussioncontrasting

confidence: 98%

Characterizing Micro-scale Disparities in Childhood Obesity: Examining the Influence of Multilevel Factors on 4-Year Changes in BMI, Healthy Eating, and Physical Activity, Among a Cohort of Children Residing in Disadvantaged Urban Enclaves

Salvo

Ranjit²,

Nielsen³

et al. 2019

Front. Public Health

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The childhood obesity epidemic in the United States disproportionately affects minority, low-income populations. Hispanics have one of the highest childhood obesity rates, and are the fastest growing population subgroup in the country. Past research has examined disparities in the occurrence of obesity, healthy eating, and physical activity at a macro-geographic level, with less emphasis on examining the multilevel, micro-scale determinants of childhood obesity in disadvantaged urban ethnic enclaves. The aim of our study was to identify child-, parental-, familial-, community-, and neighborhood-level factors associated with differences in 4-year changes in BMI, healthy eating, and physical activity, among children residing in low-income, predominantly Hispanic urban enclaves in Austin, Texas. This analysis used data from the Go Austin! Vamos Austin! (GAVA) Evaluation study, a cohort with 4 years of follow-up from 313 child-caregiver dyads. The dependent variables were change categories denoting 4-year increase, decrease, or no change in Body Mass Index (BMI) percentile, fruit and vegetable intake, and physical activity, among child participants. The independent variables were factors at multiple levels of the socio-ecological model: child, parental, familial, community, and environmental. Multinomial logistic regression models were used to estimate the odds of children being in the “increasing” or “decreasing” categories for the three dependent variables (vs. “no change”), in association with the studied independent variables. The results showed that among children residing in this low-income, predominantly Hispanic urban enclave, weight gain prevention and weight loss have different determinants. We identified relevant micro-scale disparities, and micro-level factors of influence on child BMI and its related health behaviors, at all levels of the socio-ecological model. Our results revealed evidence, through the characterization of positive deviance cases (children for whom decreases in BMI, increases in fruit and vegetable intake, or increases in physical activity were observed) which could potentially help mitigate established unhealthy habits among high need populations. Factors associated with positive deviance for BMI (decreases in child BMI) included male child sex (OR: 0.33, 95% CI: 0.12–0.83) and living in a food-insecure household (OR: 0.24, 95% CI: 0.13–0.79). Our findings may inform the design of obesity prevention interventions in these types of disadvantaged urban Hispanic enclaves.

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Multilevel Correlates of Healthy BMI Maintenance and Return to a Healthy BMI among Children in Massachusetts

Abstract: Early childhood interventions and efforts to create health-promoting neighborhoods including improving access to supermarkets and open recreational space could have important effects on obesity prevention and management.

Cited by 12 publications

References 38 publications

Two‐Year Changes in Child Weight Status, Diet, and Activity by Neighborhood Nutrition and Physical Activity Environment

Two‐Year Changes in Child Weight Status, Diet, and Activity by Neighborhood Nutrition and Physical Activity Environment

Effects of Nutritional Education Interventions on Metabolic Risk in Children and Adolescents: A Systematic Review of Controlled Trials

Characterizing Micro-scale Disparities in Childhood Obesity: Examining the Influence of Multilevel Factors on 4-Year Changes in BMI, Healthy Eating, and Physical Activity, Among a Cohort of Children Residing in Disadvantaged Urban Enclaves

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