Licentiatavhandling (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 2 uppsatser.

Background and Aims Many low- and middle-income countries are undergoing epidemiological and health transitions. South Africa has one of the highest prevalences of overweight and obesity in Sub-Saharan Africa. This research examined neighbourhood and household socio-economic influences on the risk of overweight and obesity in terms of anthropometric status and dietary intake among urban South African adolescents. A further aim was to conduct a qualitative study on the potential for religious groups such as Churches to be used as community-based organisations for obesity intervention. Methods A secondary analysis of neighbourhood and household socio-economic status (SES), anthropometric and dietary data was carried out on adolescents aged 17-19 years from the Birth to Twenty Plus cohort study in Johannesburg-Soweto. Qualitative data were collected through focus groups discussions and a community readiness survey with church leaders. Results No significant associations were observed between SES (household and neighbourhood) and energy, protein, fat, or carbohydrate intakes in males. Some significant associations were found between SES and dietary intake in females. Females had a higher prevalence of overweight and obesity than males (26.2% vs. 8.2%, p<0.0001). In males, poor household SES was associated with lower odds of overweight, fatness and high waist-to-height ratio (WHTR). For females, household SES was not significantly associated with overweight, fatness and high WHTR. The qualitative research showed that there was a very low level of community readiness among church leaders for obesity prevention programmes. Conclusions The dietary results suggest that the diet of these adolescents is transitioning to that seen in high income countries. It also highlights that even within the same relatively small urban area, nutrition transition does not affect different groups in uniform ways. The qualitative results indicate that programmes should focus around raising awareness of the problem of overweight/obesity in this community.

Made available in DSpace on 2016-03-22T17:26:26Z (GMT). No. of bitstreams: 1 ros.pdf: 724884 bytes, checksum: adc234b9f6395116f8a14b43f0028667 (MD5) Previous issue date: 2010-12-06 / Objectives: to determine the prevalence of overweight among under-five-year-old children in Brazil and investigate its associations with sociodemographic characteristics, exclusive breastfeeding, number of siblings and birth weight. Methods: cross sectional population based study, conducted in the five geopolitical regions of Brazil, with a sample of 6,397 children. The nutritional classification was done using the 2006 WHO growth curves. Were considered overweight the children with a z-score higher than two standard deviations above the weight for height median. Results: the prevalence of overweight among under-five-year-old children in Brazil was 12%. The outcome was 22% higher in males (RP=1,22; IC95% 1,02-1,47; p=0,030). There was a linear inverse association: the younger the child, the higher the prevalence of overweight (p=0,032). The white children had a prevalence of overweight 22% higher than the non-white ones. The higher the birth weight, the higher the prevalences of overweight (p=0,000). Children who were breastfed up to 120 days had a prevalence of overweight 34% higher compared to the ones who were breastfed for more than 120 days. Conclusions: the prevalence of overweight was higher in males, in under-one-year-old, white, with a birth weight of less than 3,500 grams, exclusively breastfed up to 120 days children / Objetivos: Verificar a prevalência de excesso de peso em crianças menores de cinco anos no Brasil e investigar suas associações com características sociodemográficas, aleitamento materno exclusivo, número de irmãos e peso de nascimento. Métodos: Estudo transversal de base populacional realizado nas cinco regiões geopolíticas do Brasil com uma amostra de 6.397 crianças. A classificação nutricional foi realizada utilizando as curvas de crescimento da OMS de 2006. Foram consideradas com excesso de peso crianças com escore-z maior que dois desvios-padrão acima da mediana de referência de peso para a altura. Resultados: A prevalência de excesso de peso em crianças menores de cinco anos no Brasil foi de 12%. O desfecho foi 22% maior no sexo masculino (RP=1,22; IC95% 1,02-1,47; p= 0,030). Observou-se uma associação linear inversa: quanto menor a idade da criança, maiores as prevalências de excesso de peso (p= 0,032). As crianças brancas apresentaram uma prevalência de excesso de peso 22% maior do que as não brancas. Quanto maior o peso de nascimento, maiores as prevalências de excesso de peso (p=0,000). Crianças que foram amamentadas até 120 dias apresentaram uma prevalência 34% maior de excesso de peso quando comparadas às que mamaram mais de 120 dias. Conclusões: A prevalência de excesso de peso foi maior no sexo masculino, em crianças menores de um ano, brancas, com peso de nascimento maior que 3.500 gramas, que foram amamentadas exclusivamente até 120 dias

Background and objectives: The current and projected burden of cardiometabolic diseases in Asia is high, with a notable and rapidly increasing prevalence of associated risk factors among children in this region. Comprehensive evidence on cardiometabolic disease risk factors among children in Asia is required to ensure well-informed strategies to address the future burden of disease in this region. This thesis aims to increase the current understanding of cardiometabolic disease risk factors among children in Asia. Methods: Using previously collected data on 6903 children and 17 656 adults participating in the South East Asia Community Observatory health and demographic surveillance system (SEACO HDSS) in Malaysia, the characterisation, prevalence and sociodemographic determinants of key child risk factors were examined. Furthermore, a feasibility study building upon the SEACO framework (N = 203) was designed and implemented to explore the possibility of increasing the range of cardiometabolic measures obtained from children through the collection and analysis of biological samples from individuals in the HDSS. Results: There was a high burden of cardiometabolic disease risk factors among both adults and children in this population. Among children, prevalence estimates for the four key risk factors (overweight, obesity, underweight and stunting) differed considerably depending upon the anthropometric reference used to classify these measures, but were notable regardless of reference. Nutritional and household environmental indices, including child underweight and household sanitation facilities, were strongly associated with stunting risk in this population. Furthermore, children with parents who were obese or centrally obese had an approximately twofold increased risk of being obese. There was no clear evidence of association between measures of socioeconomic position and cardiometabolic disease risk factors among children. Finally, effective procedures were established for the collection, analysis and storage of biological samples from children and their family members in the HDSS, with implications for potential scale-up to facilitate more detailed characterisation of cardiometabolic disease risk. Conclusions: This work indicates a high burden of cardiometabolic disease risk factors among children in this population, identifies modifiable sociodemographic influences on these risk factors, highlights opportunities to more comprehensively characterise child cardiometabolic disease risk in this population, and hence informs future directions for research and strategies to address the growing burden of risk factors among children in this region.

Bakgrund: Övervikt och fetma är ett ökande problem i Sverige och stora delar av världen, för både vuxna och barn. Övervikt och fetma hos modern innan och under graviditeten ökar risken för övervikt och fetma hos barnet. Risken för fetma hos barn ökar i proportion med föräldrarnas fetma. Fetma vid 4 års ålder ökar riskerna för fetma senare i livet. Ett överviktigt/obest barn har generellt sämre livskvalité och är oftare deprimerade, fetma orsakar också sjukdomar som t.ex. högt blodtryck och diabetes. Att amma sitt barn främjar dess aptitreglering och förebygger övervikt. Syfte: Syftet med denna studie var att undersöka om utökade interventioner inom ramen för ordinarie basprogram under graviditet och småbarnstid hos kvinnor med BMI över 25 påverkade viktutveckling/ISOBMI och amningslängd hos barnet fram till fyra års ålder. Metod: Interventionsstudie omfattande 182 barn indelade i en interventionsgrupp (94) och en jämförelsegrupp (88). Enkäter rörande barnets vikt, längd och matvanor samlades in och analyserades när barnet var 10 månader, 2,5 år och 4 år gammalt Resultat: En signifikant skillnad sågs mellan grupperna vid fyra års ålder, då fler var överviktiga och feta i jämförelsegruppen. Medelvikten skilde ett kg. En trend sågs i alla viktkategorier där jämförelsegruppen vägde mer än interventionsgruppen. Det sågs ingen signifikant skillnad i amningslängd mellan grupperna.Slutsats: Överviktiga/feta kvinnor får i större utsträckning överviktiga/feta barn. Vår studie visar att små interventioner gör skillnad. / Background: Obesity is an increasing problem in Sweden and large parts of the world, for both adults and children. Overweight and obesity in the mother before and during pregnancy increases the risk of overweight and obesity in the child. The risk of childhood obesity is increasing in proportion with parental obesity. Obesity at age four increases the risk of obesity later in life. An overweight / obese child generally have worse quality of life and are more often depressed, obesity also causes diseases such as hypertension, and diabetes. To breastfeed the child promotes its appetite control and prevents obesity. Purpose: The purpose of this study was to investigate whether enhanced interventions within the framework of regular base program during pregnancy and under the children’s first four years in women with a BMI over 25 affects weight gain / ISOBMI and lactation length. Method: The intervention study of 182children divided into an intervention group (94) and a comparison group (88). Surveys regarding the child's weight, height and dietary habits were collected and analyzed when the child was 10 months, 2.5 years and 4 years old Results: A significant difference was seen between the groups at age four, when more were overweight and obese in the comparison group. The average weight differed one kg. A trend was seen in all weight categories in which the control group weighed more than the intervention group. There was no significant difference in breastfeeding duration between the groups. Conclusion: Overweight / obese women have a greater degree of overweight / obese children. Our study shows that small interventions make a difference.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 138-153). Online version available via ProQuest Digital Dissertations.

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There is significant research evidence to demonstrate that physical activity can produce weight loss, weight maintenance and positive health effects in the overweight and obese. However, it can be difficult to get this population sufficiently active to achieve these benefits. This thesis reports on a series of studies that explore physical activity used alone and in conjunction with other weight management strategies. The primary aim was to gain a greater understanding about how weight loss and continued long term weight maintenance could be achieved. The first study was a systematic review on the dose of physical activity associated with weight loss and weight maintenance, it investigated if the current treatment dose was appropriate. The findings correlated with the recently published new CDC guidelines. In the second study, semi-structured interviews were employed to explore the attitudes and experiences of overweight and obese individuals towards weight loss and health. It was reported by participants that they prefer autonomy and personalisation to tailor weight loss and health strategies to their own lifestyles. It was also found that their knowledge base was confused and outdated. In the final study, a sample of overweight and obese adults took part in participatory action research with the aim to design and assess their own weight management programme. A multi-strategy weight management programme emerged that could be tailored to individual lifestyle. Tips and ideas were also devised to aid weight maintenance. This thesis found that the overweight and obese appeared to favour a multi-strategy weight management intervention that could be incorporated, personalised and tailored to their everyday lives. Physical activity (that was enjoyable, lifestyle or accomplished through accumulated bouts), dietary changes, education/improved knowledge base, support and weight monitoring all appeared to be important factors to aid weight management.

Background: Risk factors for childhood obesity include unhealthy diet, physical inactivity and lack of knowledge about nutrition and health. The purpose of this study was to investigate the potential associations between socio-economic determinants, dietary intake, self-perception, weight control behaviours and childhood overweight and obesity.   Methods: Cross-sectional data from the National Health and Nutrition Examination Survey 2013-2014 in the United States was examined. The sample included participants age 2-19, whose measured BMI indicated ‘normal weight’ or ‘overweight or obese’. The relationship between socio-economic determinants and dietary intake with BMI status was analysed using multiple logistic regression. Differences in self-perception of weight and associated weight control behaviours in relation to BMI status were examined in a sub-sample of youth age 8-15.   Results: School age (6-11 years) and adolescence (12-19 years); Mexican American, Other Hispanic and Black ethnicity; and household size of maximum two persons were significantly associated with increased odds of childhood overweight/obesity, while Asian ethnicity and above-mean household income (&gt;$64,999) showed a protective effect. There was no statistically significant relationship between dietary intake patterns and BMI status. Only 39% of overweight youth age 8-15 identified their weight status correctly. Weight-loss attempts were common among youth, 62% had tried to lose weight in the past year.   Conclusion: Significant associations between children’s BMI status and the socio-economic determinants age, ethnicity, household size and income highlight the importance of tailored prevention efforts. Incorrect self-perception of weight and weight control behaviours were common among children and adolescents.