Yu Chung Wah. / "August 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 260-296). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Hui Lai Ling. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 180-204). / Abstracts in English and Chinese. / acknowledgements --- p.I / contents --- p.II / list of abbreviation --- p.IX / list of tables --- p.X / LIST OF FIGURES --- p.XII / abstract --- p.XIII / Chapter chapter 1 --- introduction --- p.1 / Chapter 1.1 --- Overview --- p.1 / Chapter 1.2 --- Objectives & Hypotheses --- p.2 / Chapter chapter 2 --- literature review --- p.6 / Chapter 2.1 --- Definition of obesity --- p.6 / Chapter 2.1.1 --- Densitometric measurement --- p.6 / Chapter 2.1.2 --- Anthropometric measurement --- p.6 / Chapter 2.1.2.1 --- Body circumferences --- p.7 / Chapter 2.1.2.2 --- Skinfold thickness --- p.8 / Chapter 2.1.2.3 --- Weight and height ratios --- p.8 / Chapter 2.1.3 --- Body Mass Index to define obesity --- p.9 / Chapter 2.1.3.1 --- In adults --- p.9 / Chapter 2.1.3.2 --- In children & Adolescents --- p.9 / Chapter 2.2 --- Epidemic of obesity --- p.13 / Chapter 2.2.1 --- Worldwide prevalence & trends of obesity --- p.13 / Chapter 2.2.2 --- Obesity rates in Hong Kong --- p.16 / Chapter 2.3 --- Consequences of obesity --- p.17 / Chapter 2.3.1 --- Health consequences --- p.77 / Chapter 2.3.1.1 --- Adulthood obesity --- p.17 / Chapter 2.3.1.2 --- Childhood & adolescent obesity --- p.19 / Chapter 2.3.1.3 --- Controversy of health risk studies --- p.20 / Chapter 2.3.2 --- Quality of life --- p.21 / Chapter 2.3.3 --- Economic consequences of obesity --- p.21 / Chapter 2.3.4 --- Persistence of childhood obesity into adulthood --- p.22 / Chapter 2.5 --- Risk factors for childhood obesity --- p.24 / Chapter 2.5.1 --- Genetic factors --- p.24 / Chapter 2.5.1.1 --- Parental weight status --- p.24 / Chapter 2.5.1.2 --- Birth weight --- p.28 / Chapter 2.5.2 --- Demographic factors --- p.30 / Chapter 2.5.2.1 --- Socio-economic Status --- p.30 / Chapter 2.5.2.2 --- Family environment --- p.31 / Chapter 2.5.3 --- Dietary factors --- p.33 / Chapter 2.5.3.1 --- Infancy diet --- p.33 / Chapter 2.5.3.2 --- Dietary intake --- p.34 / Chapter 2.5.3.3 --- Eating behaviour --- p.39 / Chapter 2.5.4 --- Physical activity factors --- p.42 / Chapter 2.5.4.1 --- Inactivity --- p.42 / Chapter 2.5.4.2 --- Determinants of physical activity level --- p.44 / Chapter 2.5.4.3 --- Television-watching --- p.46 / Chapter 2.5.5 --- Other risk factors --- p.47 / Chapter 2.6 --- Management of childhood obesity --- p.49 / Chapter 2.6.1 --- Goals & Difficulties in childhood obesity treatment --- p.49 / Chapter 2.6.2 --- Dietary approach --- p.50 / Chapter 2.6.2.1 --- General healthy eating --- p.50 / Chapter 2.6.2.2 --- Decrease fat intake --- p.51 / Chapter 2.6.2.3 --- Increase fibre intake --- p.52 / Chapter 2.6.2.4 --- Reducing meal Glycaemic Index --- p.53 / Chapter 2.6.3 --- Increase activity level --- p.56 / Chapter 2.6.3.1 --- Reinforce active behaviour --- p.56 / Chapter 2.6.3.2 --- Decrease sedentary lifestyle --- p.57 / Chapter 2.6.4 --- Roles of parents and schools in obesity managements --- p.58 / Chapter CHAPTER 3 --- METHODOLOGY --- p.59 / Chapter 3.1 --- Overview --- p.59 / Chapter 3.2 --- Study population --- p.59 / Chapter 3.2.1 --- Reason for selecting 6-7 years old children --- p.59 / Chapter 3.2.2 --- Classification of case and control groups --- p.60 / Chapter 3.2.3 --- Reasons for using BMI --- p.62 / Chapter 3.2.4 --- Development of BMI cut-offs --- p.63 / Chapter 3.3 --- Estimation of sample size --- p.64 / Chapter 3.4 --- Subject recruitment --- p.65 / Chapter 3.4.1 --- Sample Source --- p.65 / Chapter 3.4.2 --- Inclusion criteria --- p.61 / Chapter 3.4.3 --- Recruitment --- p.67 / Chapter 3.4.4 --- Pilot Testing --- p.70 / Chapter 3.5 --- Data collection --- p.70 / Chapter 3.5.1 --- Overview --- p.70 / Chapter 3.5.2 --- Lifestyle data --- p.77 / Chapter 3.5.2.1 --- Scope of data --- p.71 / Chapter 3.5.2.2 --- References for questionnaire design --- p.71 / Chapter 3.5.2.3 --- Questionnaire content --- p.72 / Chapter 3.5.2.4 --- Data validity --- p.73 / Chapter 3.5.3 --- Dietary data --- p.76 / Chapter 3.5.3.1 --- The assessment method --- p.76 / Chapter 3.5.3.2 --- Data validity --- p.76 / Chapter 3.6 --- Data entry & analyses --- p.77 / Chapter 3.6.1 --- Data entry --- p.77 / Chapter 3.6.2 --- Dietary data analyses --- p.78 / Chapter 3.6.2.1 --- Nutrient intake --- p.78 / Chapter 3.6.2.2 --- Meal Glycaemic response --- p.78 / Chapter 3.6.3 --- Risk factor analyses --- p.79 / Chapter 3.6.3.1 --- Univariate analyses --- p.79 / Chapter 3.6.3.2 --- Multivariate analyses --- p.79 / Chapter 3.6.3.3 --- Further analyses --- p.80 / Chapter 3.6.4 --- Childhood lifestyle descriptive analyses --- p.80 / Chapter CHAPTER 4 --- RESULTS --- p.81 / Chapter 4.1 --- Overview --- p.81 / Chapter 4.2 --- Descriptive analyses --- p.82 / Chapter 4.2.1 --- Sample Size & sample source --- p.82 / Chapter 4.2.2 --- Sample Characteristics --- p.83 / Chapter 4.2.3 --- Demographic background --- p.86 / Chapter 4.3 --- Risk factors identification --- p.90 / Chapter 4.3.1 --- Overview --- p.90 / Chapter 4.3.2 --- Univariate analyses --- p.90 / Chapter 4.3.3 --- Multivariate analyses --- p.90 / Chapter 4.3.3.1 --- Variable selection --- p.90 / Chapter 4.3.3.2 --- Test for Multicollinearity --- p.91 / Chapter 4.3.3.3 --- Logistic regression results --- p.91 / Chapter 4.3.4 --- Further analyses --- p.98 / Chapter 4.3.4.1 --- Purposes --- p.98 / Chapter 4.3.4.2 --- Parental BMI --- p.99 / Chapter 4.3.4.3 --- Child's birth weight --- p.102 / Chapter 4.3.4.4 --- Eating Behaviour --- p.105 / Chapter 4.3.4.5 --- Dietary intake --- p.108 / Chapter 4.3.4.6 --- Physical activity --- p.109 / Chapter 4.3.4.7 --- Parental smoking --- p.110 / Chapter 4.3.4.8 --- Socio-economic status --- p.111 / Chapter 4.4 --- Children lifestyle descriptive analyses --- p.113 / Chapter 4.4.1 --- Inactivity in young children --- p.113 / Chapter 4.4.1.1 --- Exercise time and frequency --- p.113 / Chapter 4.4.1.2 --- Exercise preference & encouragement --- p.115 / Chapter 4.4.1.3 --- Determinants of exercise time --- p.117 / Chapter 4.4.2 --- Weight beliefs & Nutrition knowledge --- p.118 / Chapter 4.4.2.1 --- Weight and health beliefs --- p.118 / Chapter 4.4.2.2 --- Nutrition knowledge --- p.121 / Chapter 4.4.3 --- Dietary habits & Nutrient intake --- p.123 / Chapter 4.4.3.1 --- Dietary practice --- p.123 / Chapter 4.4.3.2 --- Nutrient intake --- p.129 / Chapter CHAPTER 5 --- DISCUSSION --- p.137 / Chapter 5.1 --- Risk factors for childhood overweight development --- p.137 / Chapter 5.1.1 --- Overview --- p.137 / Chapter 5.1.2 --- Genetic factors --- p.138 / Chapter 5.1.2.1 --- Parental BMI --- p.138 / Chapter 5.1.2.2 --- Birth weight --- p.142 / Chapter 5.1.3 --- Dietary factors --- p.144 / Chapter 5.1.3.1 --- Eating behaviours --- p.144 / Chapter 5.1.3.2 --- Infancy diet --- p.150 / Chapter 5.1.3.3 --- Current dietary intake --- p.151 / Chapter 5.1.4 --- Physical activity --- p.154 / Chapter 5.1.4.1 --- Exercise --- p.154 / Chapter 5.1.4.2 --- Sedentary activities --- p.155 / Chapter 5.1.5 --- Family environment --- p.157 / Chapter 5.1.5.1 --- Social class & Custody --- p.157 / Chapter 5.1.5.2 --- Parental smoking --- p.159 / Chapter 5.2 --- Lifestyle in Hong Kong young children --- p.161 / Chapter 5.2.1 --- Childhood inactivity --- p.161 / Chapter 5.2.2 --- Weight perception & Nutrition knowledge --- p.163 / Chapter 5.2.3 --- Dietary habits & Nutrient intake --- p.165 / Chapter 5.3 --- Limitations --- p.169 / Chapter 5.3.1 --- Study sample --- p.169 / Chapter 5.3.2 --- Study method --- p.171 / Chapter 5.4 --- Implication of the study results --- p.173 / Chapter 5.4.1 --- Overview --- p.173 / Chapter 5.4.2 --- Strategies on obesity treatments and prevention --- p.173 / Chapter 5.4.3 --- Conclusion --- p.775 / Chapter 5.5 --- Suggestions for further study --- p.176 / CONCLUSION --- p.178 / REFERENCES --- p.180 / APPENDICES --- p.205 / Chapter A. --- Communications for sample recruitment / Appendix A1 Invitation to Parents --- p.A-l / Appendix A2 Contact Details Form --- p.A-3 / Appendix A3 Letter of thanks to SHSC Nurses --- p.A-4 / Appendix A4 Second letter to parents --- p.A-12 / Appendix A5 Written consent from parents --- p.A-14 / Chapter B --- Study Tools / Appendix B1 The Questionnaire --- p.B-l / Appendix B2 3-day dietary record --- p.B-49 / Chapter C --- Childhood overweight risk factors - univariate analyses / Appendix C1 Genetic factors --- p.C-1 / Appendix C2 Demographic factors --- p.C-2 / Appendix C3 Custody & Home environments --- p.C-3 / Appendix C4 Infant feeding factors --- p.C-4 / Appendix C5 Dietary manipulation & Eating desire --- p.C-5 / Appendix C6 Eating habits & Food preference --- p.C-6 / Appendix C7 Physical activity factors --- p.C-7 / Appendix C8 Factors influencing physical activity --- p.C-8 / Appendix C9 Nutrition knowledge & weight perception --- p.C-9 / Appendix C10 Nutrients factors --- p.C-10 / Appendix C11 School life & unclassified factors --- p.C-11 / Chapter D --- Miscellaneous / Appendix D1 Research questions and related questions in the questionnaire --- p.D-l / Appendix D2 Food GI estimation list --- p.D-3

Zur Therapie von Adipositas als weltweit wachsendes Gesundheitsproblem ist ein kaum zu überblickender Markt an Maßnahmen entstanden. Die unterschiedlichen Möglichkeiten rücken mehr in öffentliche Diskussion - auch aufgrund begrenzter finanzieller Ressourcen des Gesundheitssystems. In der vorliegenden Arbeit werden Studien aufgeführt, die sich mit der Einstellung der Allgemeinbevölkerung, medizinischen Personals sowie betroffenen Patienten bezüglich Therapiemöglichkeiten von Adipositas beschäftigen. Ergänzend dazu werden im Anschluss die Ergebnisse der Studie zur Wirksamkeitserwartung und Empfehlungsbereitschaft der deutschen Allgemeinbevölkerung bezüglich Gewichtsreduktionsmaßnahmen bei Adipositas vorgestellt. Als wirksamste Maßnahmen gelten weniger Essen und mehr Bewegung (Zustimmung 82% bzw. 98%). Die Mehrheit (57%) befindet operative Methoden, als wirksame Maßnahmen, doch nur 22% würden bariatrische Chirurgie weiterempfehlen bzw. selbst als Behandlung wählen. Die Zurückhaltung lässt sich erklären durch die allgemeine Sorge um Risiken und Komplikationen oder Unklarheit über die Kostenübernahme. Medikamente werden mit 12,5% am wenigsten als wirksam bewertet. Bei Überprüfung möglicher Einflussfaktoren zeigt die Kausalattribution signifikante Auswirkungen. Bei angenommenen internalen Ursachen erhöht sich die Wirksamkeitserwartung für konservative Maßnahmen; ein positiver Einfluss zeig sich bei operativen und medikamentösen Interventionen, wenn als Ursache von Adipositas eher genetische Faktoren vermutet werden. Wie wahrgenommene Wirksamkeit einer Maßnahme deren Akzeptanz determiniert und damit die Behandlungsentscheidung von Patienten und Ärzten beeinflussen kann, sollte Fokus weiterer Studien sein.:Tabellenverzeichnis VI Abbildungsverzeichnis VII Abkürzungsverzeichnis VII Bibliographische Beschreibung VIII 1 Einleitung 1 2 Theoretischer Hintergrund 3 2.1 Einführung in die Therapiemöglichkeiten von Adipositas 3 2.1.1 Definition und Klassifikation von Übergewicht und Adipositas 3 2.1.2 Indikationen und Therapieziele 3 2.1.3 Therapiemethoden 4 2.2 Stand der Forschung zur Einstellung der allgemeinen Bevölkerung, medizinischen Personals sowie betroffenen Patienten zur Behandlung von Adipositas 6 2.2.1 Systematik der Recherche 6 2.2.2 Ergebnisse 7 2.2.3 Diskussion und Zusammenfassung 24 3 Fragestellung 32 4 Methodik 33 4.1 Stichprobenbeziehung und Teilnehmer 33 4.2 Instrumente 34 4.2.1 Soziodemographische Erhebungen 34 4.2.2 Kausalattribution 34 4.2.3 Maßnahmen zur Gewichtsreduktion 35 4.3 Datenanalyse 35 5 Ergebnisse 37 5.1 Soziodemographische Merkmale 37 5.2 Häufigkeitsverteilung zur Wirksamkeitserwartung und Empfehlungsbereitschaft 39 5.3 Weitere bekannte Maßnahmen 40 5.4 Bivariate Analysen 40 5.5 Multivariate Analysen 42 6 Diskussion 47 7 Fazit 55 Literaturverzeichnis 57 A Materialien 61 B Statistischer Anhang 64 C Eigenständigkeitserklärung 78 D Lebenslauf 79 E Danksagung 81

No description available.

This Thesis deals with the problem of excess weight and obesity in the child age. The problem of child obesity is described in detail and subsequently divided. The work deals with the causes of origins of excess weight and obesity in children; subsequently it describes the diagnostics of excess weight or obesity in children. Further, it describes various types of obesity, treatment and obesity prevention. The methodical part was elaborated with the help of the quantitative research. The data collection technique was utilized in the questionnaires for the primary school children from 4th till 9th classes. The aim set for the Thesis purposes was to map the problem of excess weight and obesity of primary school pupils both in the town and the country in 4th till 9th classes; mainly their eating habits and movement activities. This aim was fulfilled. In accordance with the aim hypotheses were set. The hypothesis 1 was: Excess weight will increasingly grow in children with bad eating habits. On the basis of the research this hypothesis was disconfirmed. The children with the considered problem have almost the same eating habits as the children with normal weight. The hypothesis 2 was: Excess weight will increasingly grow in children with low movement activities. On the basis of the research this hypothesis was partially confirmed. The children with the considered problem take part in sport bees 20% less frequently. In the remaining questions regarding movement activities, the evaluated results are almost the same for both categories of children. The obesity problem is not avoiding even the present time, either. Obesity has become a serious problem in all developed countries where the Czech Republic belongs as well. This problem does not involve the adult population only. Recently, we can meet with excess weight or obesity in children more often. Number of children with excess weight in this country keeps growing. This thesis of experts is confirmed even by the survey performed for this Thesis purposes. It is quite clear from the results that no fewer than 140 children, which equals 20 % from the sample surveyed, have the problem with excess weight or obesity. The allocation of excess weight and obesity problem was as follows. The highest obesity occurrence was within the age category of the 12-year-old, where 14 % recorded the excess weight. Within the age category of the 15-year-old 12 % recorded obesity. Of the total number with excess weight the total 38 % boys live with excessive weight and 25 % suffer obesity. As for girls, 18 % suffered excess weight and 19 % of them were obese. When comparing children with excessive weight in the country and the town it is obvious that in villages there are considerably more children having the problem of increased weight. 68.5 % village children with obesity or excessive weight against 31.5 % children from towns. Obesity of children is a problem of societies in a lot of countries. However it is just unsuitable eating, life style, in particular lack of movement which in the absolute majority bear their shares in the redundant kilograms. Therefore prevention is very important. Such prevention should be aimed at children and their parents from the babyhood.