There is limited study of the prevalence of childhood obesity and being overweight in 6 to 9 year old children living in Saskatchewan and Canada using the international standards and measured data. Limited data exists of the prevalence of obesity in rural and small urban communities. In 2000, a cross-sectional survey of children was conducted that primarily assessed the respiratory health of children in two southern Saskatchewan communities. Anthropometric measurements (height and weight) as well as child and familial data were available for 1241 children ages 6 to 9 years. Using data from this study and applying international standards for obesity and overweight developed by Cole and colleagues (2000) an analysis was undertaken to describe and compare the prevalence of overweight and obesity between communities and identify associated risk factors. Although the mean body mass index (BMI) differed statistically between communities, no differences in overweight and obesity were identified once the international standards were applied. The overall prevalence was 19.2% for being overweight and 5.2% for obesity. More girls than boys were overweight and obese at age 9. After adjusting for age, sex and community, maternal smoking during pregnancy and current gastrointestinal symptoms of nausea and/or diarrhea were associated with overweight and obesity. Lower physical activity in free time was associated with being overweight as a child. Children who were not consistently participating in physical education and sports in school were more likely to be overweight and obese. This research provides important new information regarding the prevalence and associated risk factors for overweight and obesity in school aged children in Saskatchewan. Although results concur with international prevalence rates of childhood obesity, children in this study were not as overweight or obese as previously reported data has shown for similar Canadian populations. Less physical activity, both in school and at home, may be important for the development and continuation of childhood obesity. Further research is necessary to explore reasons why obese and overweight children are experiencing significant digestive related health concerns.

There is limited study of the prevalence of childhood obesity and being overweight in 6 to 9 year old children living in Saskatchewan and Canada using the international standards and measured data. Limited data exists of the prevalence of obesity in rural and small urban communities. In 2000, a cross-sectional survey of children was conducted that primarily assessed the respiratory health of children in two southern Saskatchewan communities. Anthropometric measurements (height and weight) as well as child and familial data were available for 1241 children ages 6 to 9 years. Using data from this study and applying international standards for obesity and overweight developed by Cole and colleagues (2000) an analysis was undertaken to describe and compare the prevalence of overweight and obesity between communities and identify associated risk factors. Although the mean body mass index (BMI) differed statistically between communities, no differences in overweight and obesity were identified once the international standards were applied. The overall prevalence was 19.2% for being overweight and 5.2% for obesity. More girls than boys were overweight and obese at age 9. After adjusting for age, sex and community, maternal smoking during pregnancy and current gastrointestinal symptoms of nausea and/or diarrhea were associated with overweight and obesity. Lower physical activity in free time was associated with being overweight as a child. Children who were not consistently participating in physical education and sports in school were more likely to be overweight and obese. This research provides important new information regarding the prevalence and associated risk factors for overweight and obesity in school aged children in Saskatchewan. Although results concur with international prevalence rates of childhood obesity, children in this study were not as overweight or obese as previously reported data has shown for similar Canadian populations. Less physical activity, both in school and at home, may be important for the development and continuation of childhood obesity. Further research is necessary to explore reasons why obese and overweight children are experiencing significant digestive related health concerns.

OBJECTIVE: High prepregnancy maternal body mass index (BMI) is associated with an increased risk in childhood overweight and obesity. This study sought to expand upon the research of this phenomenon/trend by examining the role of placental weight in inter-generational obesity risk. METHODS: This prospective birth cohort study was conducted at Boston Medical Center in Boston, Massachusetts. Between 1998 and 2016, the study recruited and tracked 1,025 mother-infant pairs who have been followed from birth prospectively up to age 19 and who had data on placental pathology along with pre-, peri-, and post-natal variables, including maternal and child BMI. This study analyzed 6 Groups defined by placental weight tertiles and maternal overweight and obesity (BMI ≥ 25 kg/m2) (binary). Group 0 includes lowest placental tertile and maternal not overweight and obesity. Group 1 includes lowest placental tertile and maternal overweight and obesity. Group 2 includes middle placental tertile and maternal not overweight. Group 3 includes middle placental tertile and maternal overweight and obesity. Group 4 includes highest placental tertile and maternal not overweight. Group 5 includes highest placental tertile and maternal overweight and obesity. MAIN OUTCOMES AND MEASURES: Child BMI z-score was calculated according to United States reference data for specific age and sex. Childhood overweight and obesity was defined as an BMI in the 85th percentile or greater for age and sex. Maternal overweight and obesity was defined as a BMI of 25kg/m2 or greater, and placental weight was classified into tertiles based on sex- and gestational age. RESULTS: The mean (SD) maternal age at delivery was 28.7 (6.6) years and the mean (SD) child age at last visit was 9.5 (4.9) years. Among 1,025 mothers, 54.15% were overweight with an average BMI of 27.0 kg/m2. 68.98% of mothers were black, 76.5% never smoked, and 62.73% had less than a high school education. Among 1,025 children 447 (43.61%) were overweight. As expected, maternal overweight and obesity was associated with the highest risk for childhood overweight and obesity, with an odds ratio of 3.752 (95% CI, 2.137-6.588) as well as the largest increase in child BMI z-score. The strong association remained after adjusting for placental weight and other covariables, including birth weight. When maternal overweight and obesity and placental weight were analyzed in combined groups (0-5), they jointly increased the risk of child overweight or obesity. Using group 0 as reference, the group 5 had the highest risk of child overweight or obese and the largest increase in child BMI z-score. CONCLUSIONS: In this urban low-income prospective birth cohort, we observed a strong inter-generational link of overweight or obesity. Furthermore, there was an additive effect of maternal overweight and obesity and placental weight on child risk of overweight and obesity. Additional studies are warranted to replicate our findings and further investigate the biological pathways underlying the inter-generational obesity risk. / 2021-06-17T00:00:00Z

We examined the relationship between cesarean section (C-section) and the risk of overweight and obesity in children in grade 6 (mean age, 11.92 years; standard deviation = 0.34). Data from phase I through phase III of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development were used. Children with complete data from 1991 through 2004 were included in this study (n = 917). Multiple logistic regression analyses were used to adjust for potential confounding and to evaluate the association of C-section and childhood overweight and obesity. Compared to children delivered vaginally, children delivered by C-section had approximately twice the likelihood of being overweight (odds ratio (OR) = 1.86, 95 % confidence interval (CI) = 1.27–2.73) or obese (OR = 1.87, 95 % CI = 1.19–2.95). However, when examined according to sex, males delivered by C-section had an increased risk for being overweight (OR = 1.78, 95 % CI = 1.01–3.12) and obese (OR = 2.58, 95 % CI = 1.36–4.88), while females had an increased risk only for being overweight (OR = 1.99, 95 % CI = 1.17–3.39). Conclusion: C-section was associated with an increased risk of overweight and obesity in children in grade 6, but the relationship differed according to gender. Further longitudinal studies are warranted to examine the long-term effect of delivery mode on the risk of childhood overweight.

Mothers play a vital role in providing healthy food choices for their preschool children. This role has become more complex in the present obesity-producing environment that has contributed to the increasing prevalence of childhood overweight and obesity in Canada. Childhood overweight and obesity is a significant public health issue in Nova Scotia where the percentage is higher than the national average. The purpose of this study was to generate a theoretical understanding of the process in which 18 mothers living within the Cape Breton Regional Municipality engaged while making food choices for their preschool children. Constructivist grounded theory methodology informed by sensitising constructs from symbolic interaction and the socio-environmental health promotion perspective facilitated a multilevel exploration of the factors that affect mothers’ food choice practices for their preschoolers. Data collection took place over 16 months. Thirty-five interviews were completed. Grounded theory methods were used to analyze the data and a substantive theory of how mothers made food choices for their preschool children was co-constructed with the participants. The substantive theory, Persistent Optimizing, consists of three main integrated conceptual categories. In the first conceptual category, Acknowledging Contextual Constraints, mothers acknowledged various individual, interpersonal, and socio-environmental contextual factors that hindered their ability to make intended, healthier food choices for their children. In the second conceptual category, Stretching Boundaries, mothers developed and enacted moderating strategies to lessen the impact of contextual constraints, thereby increasing the number of food choices available to them. In the third conceptual category, Strategic Positioning, mothers developed and enacted a variety of optimizing strategies to get them closer to making the optimal food choice for their children in a given situation. Mothers in this study struggled continuously with varying degrees of success to provide the foods they believed their children needed. The findings suggest that in practice, policy, research, and education, community health nurses must work independently and collaboratively at all levels of influence to facilitate, mediate, and advocate for social, economic, and physical environments that improve mothers’ ability to make food choices that promote their children’s health and reduce their risk of becoming overweight and obese.

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Over the past 20 years there has been a clear shift in Peru’s mortality profile towards non-communicable diseases. As part of this transition, childhood overweight and obesity (O&O) has become a growing public health concern. In order to address this challenge, context-specific information is needed concerning prevalence, associated factors and culturally appropriate interventions. To this end, I conducted a mixed methods study using a socio-ecological framework to investigate childhood overweight and obesity in Peru. This study found a prevalence of 19.2% overweight and 8.6% obesity among children aged seven to eight in a pro-poor cohort in Peru. Factors associated with being overweight in this cohort included: a high socioeconomic status, living in metropolitan Lima, an O&O mother, being male and being an only child or having only one sibling. The quantitative analysis highlighted the prevalence in O&O in this population and revealed a number of relationships explored in more depth via interviews and focus group discussions. The qualitative component of this research explored these associations amongst a sub-sample of children, parents and teachers in three distinct geographical regions in Peru. My qualitative research showed that parents, teachers and children are aware of the health implications of childhood overweight and obesity and that they have a sophisticated understanding of the many factors that influence its aetiology. Participants also had many suggestions for ways to address this issue in their community. This information was complemented by a systematic review and meta-analysis of the evidence of childhood O&O interventions that took place in Latin America published between 1990 and 2011. A combination of diet, physical activity and pharmaceutical strategies have shown modest effect on BMI reduction in O&O children, but more evidence is needed for effective population-level prevention strategies. The findings highlight the need for comprehensive, multi-level interventions. Notable intervention components include: kiosco reform, junk food taxation, creation of recreational space and enhancement of school-based physical activity programmes. To accomplish this, communities need to be mobilised and work together with school administration, municipal and national government.

Children’s risk for overweight and obesity is particularly high in rural areas of the United States. Many health, psychosocial, and economic consequences are associated with childhood overweight and obesity, which concerns health researchers and professionals. But how and why might rural children be more at risk for being overweight and obese? This dissertation investigates childhood overweight and obesity in rural settings through three separate studies. First, a systematic literature review was conducted to identify determinants and mechanisms of childhood obesity-related behaviors that are specific to rural locations. The findings from the review show that lack of health resources and poverty within the rural environment may impact children’s social environment and individual factors. However, results are inconclusive and there continues to be a lack of studies focusing on linking environmental influence with individual factors. Second, a meta-analysis of current research evidence was conducted to assess the efficacy of rural interventions designed to reduce childhood overweight and obesity. Results showed that interventions have been efficacious yet modest, with a mean effect size of 0.18. Moderating variables were also examined. Mean intervention effect size was moderated by children’s age and intervention duration. Last, secondary data were used to examine the association between rural food stores and availability and affordability of fresh fruits and vegetables. A multilevel analytical approach was used to determine if rural location was associated with availability and affordability of fresh fruits and vegetables. After controlling for other variables, results showed that rural location was not associated with fruit and vegetable availability and affordability. The findings from this dissertation suggest that the area of rural childhood overweight and obesity remains understudied. More research is needed in order to understand the mechanisms of social ecological influences on diet, physical activity, and childhood overweight and obesity. This area of research, however, is rife with opportunities for public health education and promotion. Public health educators can help promote and advocate for environmental conditions that support healthy lifestyles.

Children’s lifestyle has changed significantly during the recent decades, with an increasing prevalence of obesity as one outcome. Parents are usually the most influential people in young children’s lives. The overall aim of this thesis was to investigate parental perspectives on factors associated with 3-6 year-old children’s lifestyle, regarding eating habits and physical activity. Another objective was to compare different approaches to conducting postal questionnaires in terms of response rate, time consumption and cost-efficiency. The samples in the four studies were parents of 6-year-olds (n=158), parents of 3-year-olds (n=873), parents of 4-year-olds (n=30) and parents of 3-year-olds (n=353). In the first study, a questionnaire regarding practices and attitudes towards their child’s lifestyle, perceived obstacles and desired support was used. The second study included the Swedish Parenthood Stress Questionnaire (SPSQ), the Relationship Questionnaire (RQ) and the CFQ (Child Feeding Questionnaire). Parents also reported their child’s TV-viewing habits. The child’s measured height, weight and BMI were obtained from a register, BASTA. In the third study, focus group interviews were performed. The fourth study investigated three types of consent given for participation in a survey. The results showed that parents’ attitudes towards children’s lifestyle, in general, were “healthier” than their reports of their child’s daily practices. The practices differed depending on the parents’ educational background. Significant and dose-dependant associations were found between perceived maternal stress and children’s overweight, but also underweight. Parents felt that they were mainly responsible for their preschool child’s lifestyle. However, parents described challenges that limited and obstructed them from providing their child with a healthy lifestyle, citing the need to receive professional and peer support, while also requesting support from society. Allowing respondents to actively decline participation yielded a higher response rate and proved to be the most cost-efficient method for conducting a postal questionnaire.

Background: Overweight and obesity among children under the age of 5 have become a public health problem. The worldwide prevalence is 4.9% and 6.0%, whereas in Peru it is 7.4% and 1.9%, respectively. The causes of these problems are multifactorial and must be studied to prevent the multiple consequences on children's health. Methods: Secondary data analysis of the 2016 Demographic and Family Health Survey (DHS). The sample size was 7935 children and their mothers. The dependent variable was childhood overweight/obesity, measured according to the Z-score of the BMI >2 standard deviation (SD), while the main independent variable consisted of the maternal depressive symptoms (DS) (Patient Health Questionnaire-9 score >10 points). The software STATA/MP 14.0 was used for statistical analysis. Results: The prevalence of overweight/obesity among children aged 0-5 years was 4.5% and the prevalence of moderate and severe maternal DS was 7.1%. No maternal depressive symptoms were found to be associated with the outcome [adjusted PR = 1.36 95% confidence interval (CI) = 0.59-3.09 p = 0.47]. An association was found between socioeconomic status (SES) Q3 (adjusted PR = 3.86 95% CI = 1.9-7.6 p < 0.0001), Q4 (adjusted PR = 5.53 95% CI = 2.76-11.1 p < 0.0001), Q5 (adjusted PR = 6.9 95% CI = 3.24-14.7 p = < 0.0001), maternal BMI (adjusted PR = 1.06 95% CI = 1.03-1.08 p < 0.0001), and cesarean delivery (adjusted PR = 1.42 95% CI = 1.01-1.99 p = 0.042). Conclusions: No association was found between maternal depressive symptoms and overweight/obesity among children aged 0-5 years. The upper SES quintiles, maternal BMI, and cesarean delivery were associated with the outcome. / Revisión por pares