AIM: To examine associations of prenatal maternal smoking and second-hand smoke (SHS) exposure with the development of adolescent obesity. METHODS: Longitudinal data (1991-2007) from National Institute of Child Health and Human Development Study of Early Child Care and Youth Development involving mothers that smoked and or exposed to SHS during the year before birth were analysed. Adolescent obesity in ages 12.0-15.9 years was defined as a BMI ≥ 95th percentile. Generalised estimating equations (GEE) were used for the analyses. RESULTS: Obesity was more prevalent among adolescents whose mothers smoked or had SHS exposure than those that did not smoke or exposed to SHS. After adjusting for maternal and child factors, GEE models showed that odds of adolescent obesity increased with prenatal maternal smoking (OR = 1.57, 95% CI = 1.03-2.39) and SHS exposure (OR = 1.53, 95% CI = 1.04-2.27). The odds for obesity increased more than two times among adolescents exposed to both maternal smoking and SHS (OR = 2.10, 95% CI = 1.24, 3.56) compared with those without exposure. Additionally, not breastfeeding, maternal obesity, and longer screen viewing hours per day were associated with increased odds of obesity. CONCLUSIONS: There is possibly a long-term joint effect of prenatal maternal smoke (smoking and SHS) exposure on obesity among adolescent offspring, and the effect is independent of birthweight. These findings suggest that adolescent obesity could possibly be curtailed with the development and promotion of smoking cessation programmes for families during the year before birth.

The local food environment plays an important role in the health of adolescents, especially in rural areas. Often, rural areas lack the accessibility and availability of healthy food choices, making a healthy lifestyle difficult to achieve. This study presents a cross-sectional survey of rural adolescents in 8 counties in Kentucky and North Carolina to determine the association between food store choice, body mass index (BMI), and key dietary outcomes. Although BMI had no association with food store choice, those who infrequently shopped at gas stations, convenience stores, and fast food restaurants consumed significantly less added sugar (p < 0.05) than those who shopped at those stores more regularly. Increasing the availability and accessibility of food venues with healthy food options such as supermarkets may decrease added sugar intake among rural adolescents.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 4 uppsatser.

Background: The rate of overweight and obesity among adolescents aged 12-19 years has quadrupled since 1980. Reducing obesity is a key public health priority, as obesity is associated with individual and population-level health and economic consequences. Afterschool-based obesity prevention programs that aim to develop nutrition and culinary self-efficacy have shown promise. However, the level of aptitude among program instructors is directly correlated with student success, suggesting the importance of effective train-the-trainer (TTT) mechanisms for implementing and scaling up these strategies. Pink and Dude Chefs (PDC) is an afterschool nutrition education and culinary skills program for middle-school adolescents aged between 11-14 years. The PDC online TTT platform trains lay instructors on program content and preparation, lesson delivery, and classroom and kitchen safety. Trained instructors deliver PDC lessons on topics ranging from macronutrients and USDA MyPlate to knife skills and food preparation. The literature on online TTT models and instructor impact on student outcomes is limited and the PDC online training mechanism has not been evaluated. The current project sought to address these critical gaps with the aim of creating the most effective intervention model. Methods: This project was implemented in Santa Maria, Guadalupe, and New Cuyama, California from Fall 2015 to Spring 2016. Eleven instructors and 68 middle school students participated and comprehensive surveys were used to evaluate instructor and student outcomes. Results: Instructors’ performance on all three domains (food and kitchen safety, program knowledge, and overall knowledge) increased following training (45%, 63%, and 53%, respectively), all p≤0.01. Students outcomes (food and kitchen safety, nutrition knowledge, and overall knowledge) also improved following participation (14%, 33%, and 23%, respectively), all p≤0.001. Impact analyses revealed that students with instructors who scored high in overall knowledge performed better than students with low-scoring instructors (p=0.01). Conclusion: If obesity prevention programs that incorporate online TTT mechanisms, such as PDC, continue to show promising outcomes for both instructors and adolescents, larger scale efforts may contribute to decreasing the public health and economic burdens associated with obesity.

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Thesis advisor: Arthur Lewbel / This thesis consists of two chapters. In Chapter 1, I studied the consumption inequalities between men and women, as well as boys and girls, within the households in Sierra Leone. Through a collective household model, I found that women on average experience lower levels of consumption than men, with the inequality concentrated in households that are large or consist of more women than men. Moreover, there is little evidence of overall consumption inequality by gender for children, while both boys and girls have very high poverty rates. In addition, I developed a new strategy for understanding who is perceived as a child vs. an adult in a household, which improved the estimation. In Chapter 2, I studied the associations between sugar-sweetened beverage (SSB) taxes and adolescent obesity in the US. I found that the taxes were associated with a lower body mass index and a lower probability of being overweight or obese. I found that SSBs and milk consumption had mediating roles, as tax increases were associated with decreases in SSB consumption and increases in milk consumption. Given the limited implementation and recent preemption of SSB taxes across the US, these results would help in understanding the potential benefits of implementing SSB taxes on a larger scale. / Thesis (PhD) — Boston College, 2023. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Economics.

The epidemic of adolescent obesity has become one of the greatest public health concerns in the United States. Approximately 20.5% of adolescents of both sexes aged 12-19 years are considered obese. Higher rates of obesity are evident in ethnic minority and lower income status children with the highest prevalence among Hispanic/Latino and Black populations. The causes for obesity are multifactorial in nature and highlight disparities nationwide. These factors include socioeconomic status, education, environment, availability and access to fresh fruits and vegetables, and behavior patterns. Successful intervention methods that have reduced the impact of adolescent obesity have incorporated nutrition knowledge and culinary skill building into afterschool programs. Pink and Dude Chefs, a 12-lesson nutrition education and culinary skills afterschool program targeted toward middle school students, aims to improve nutrition knowledge and dietary behavior in low income and minority populations. Based off of evidence-based curriculum, the program focuses on culinary fundamentals while incorporating nutrition lessons about macronutrients, micronutrients, label reading, kitchen safety, and USDA guidelines. Research assistants from California Polytechnic State University, San Luis Obispo and Vanderbilt University in Tennessee, were trained to implement each lesson. The program took place at Mesa Middle School in Arroyo Grande, CA; Shandon, CA; and two sites in Nashville, TN from Spring 2014 to Fall 2014. Thirty-two middle school students participated in the study aged 11-14 years. Questionnaires were used to measure fruit and vegetables preferences, nutrition knowledge, and fruit and vegetable intake. Results indicate that participants’ fruit and vegetable preferences, nutrition knowledge and fruit and vegetable intake all increased. However, statistical significance was only achieved with nutrition knowledge, likely due to small sample size. If programs such as Pink and Dude Chefs show promise for decreasing risk for obesity, the public health impact could improve long-term health outcomes for adolescents and mitigate obesity related consequences.

L’obésité de l’enfant et de l’adolescent constitue un problème de santé publique important auquel sont confrontés depuis les années 1970 tous les pays industrialisés. Son origine multifactorielle, l’absence de médicaments présentant une balance bénéfice/risque favorable et l’absence de recommandations quant à la chirurgie bariatrique en font un problème thérapeutique complexe. Ceci a induit une grande variété de prises en charge thérapeutiques dont la comparaison reste difficile en absence de critère permettant de juger de leur efficacité. Ce travail avait pour but de déterminer l’efficacité d’une prise en charge multidisciplinaire dans le Centre « Les Oiseaux » pendant 8 mois, en hospitalisation complète. Une étude rétrospective incluant 1063 patients entre 1991 et 2007 a été réalisée. 746 sujets ont retourné le questionnaire 2 ans après leur sortie et 185 sujets, 5 ans après. Parmi eux plus de 75 % ont maintenu durablement au moins la moitié de leur perte de poids.Dans le but de retrouver des marqueurs précoces d’efficacité thérapeutique, nous avons aussi suivi une cohorte de 16 adolescentes et mis en place un programme de monitorage de 895 variables, données cliniques, psychologiques et biologiques ainsi que des données de pratique d’activité physique. Chaque variable a été testée pour son caractère discriminant et sa faisabilité. Une approche de métabolomique par empreintes a été mise en place sur des échantillons urinaires. Par analyse multivariée, nous avons pu montrer que le maintien 6 mois après la sortie, de la perte de poids était positivement corrélé avec la prise en charge psychologique, l’implication familiale et la capacité de conserver une activité physique suffisante, elle même sous-tendue par l’amélioration de l’estime de soi. / Obesity in childhood must be considered as a major issue in Public Health. Since the 1970s, all developed countries must have faced an increasing prevalence of this metabolic disorder. However since the epidemic of obesity has multifactorial causes, and without the availability of a positive benefit/risk balance for chemical drugs and clear-cut indications for bariatric surgery, it is easy to understand that obesity is a complex issue. This complexity induced different schemes of care the comparison of which is made difficult by the absence of clear criteria for judging therapeutic efficacy. This work was aimed to determine the efficacy of a 8-months residential treatment program performed by a multidisciplinary team in the Care Centre “Les Oiseaux”. In order to demonstrate whether the treatment was of benefit for the patients, 1063 of those treated between 1991 and 2007 have been included in a retrospective study. 746 patients returned the questionnaire after 2 years and 185 patients, 5 years later. Among these patients 75 % were actually able to control their weight since they maintained at least half their weight loss. To unveil early parameters of therapeutic efficacy, we have set up a monitoring record of more than 895 clinical, psychological, and biological parameters as well as an accurate recording of the physical activity of adolescents during their stay in the Care Centre. In addition a metabolic profiling of urine samples has been performed. Each parameter was tested for its discrepancy power as well as its practical aspects. Sixteen female adolescents have then been followed for the duration of their stay according to our monitoring program. By multivariate analysis, we deduced that the maintaining of their weight loss was positively correlated with the psychological care, the family involvement, as well as the ability to keep a sufficient physical activity, which was sustained by the recovery of their self-esteem.

abstract: Objectives: Although childhood obesity has received growing attention, parents still fail to recognize overweight and obesity in their children. Accurate identification of overweight or obesity in their child is associated with the parent's responsiveness to interventions aimed at preventing weight-related health issues. Recent research shows that a child's age and gender are associated with parental misperception of their child's weight status, but little is known about the interaction of these factors across various age groups. This study examined the association between a wide range of parent, child, and household factors and the accuracy of parental perception of their child's body weight status compared to parent-measured body weight status. Methods: Data were collected from a random-digit-dial telephone survey of 1708 households located in five low-income New Jersey cities with large minority populations. A subset of 548 children whose parents completed the survey and returned a worksheet of parent-measured heights and weights were the focus of the analysis. Bivariate and multivariate analyses were performed to determine the factors significantly associated with parental perception of their child's body weight status. Results: Based on parent-measure heights and weights, 36% of the children were overweight or obese (OWOB). Only 21% of OWOB children were perceived by their parents as OWOB. Child gender, child body mass index (BMI) and parent BMI were significant independent predictors of parents' accuracy at perceiving their child's body weight status. Conclusion: Boys, OWOB children, and children of OWOB parents had significantly greater odds of parental underestimation of their body weight status. Parents had better recognition of OWOB in their daughters, especially older daughters, than in their sons, suggesting parental gender bias in identifying OWOB in children. Further research is needed regarding parental gender bias and its implications in OWOB identification in children. / Dissertation/Thesis / M.S. Nutrition 2013