Overweight and obesity, one of the most common public health problems in affluent societies, have become epidemic not only in Canada but also throughout the world. Obesity is also a major contributor to the global burden of chronic disease and disability such as diabetes, hypertension, and cardiovascular disorders. <p>Studies have demonstrated clearly that higher intake of cholesterol and saturated fats and generally higher intake of energy-dense food are a key determinant of increasing levels of obesity and overweight in children. Physical activity is also recognized as a major factor in preventing obesity among children. Environmental factorsby which we mean both social (such as social support, social networks) and physical environment (such as access to physical activity amenities, roads and trails, grocery stores)in generally believed to have a powerful influence on either limiting or enhancing the effects of fundamental determinants (diet and physical activity) of obesity in children. This thesis focuses on one of the key determinants, physical activity, and in turn examines factors that are related to changing physical activity in children. <p>This research was designed to examine two major questions: (1) How do physical activity and overweigh/obesity change over time in a cohort of adolescents in Saskatoon? Are there differences in the patterns of change in overweight/obesity and physical activity between boys and girls? (2) What are the effects of family/friends and physical environments on the changing patterns of physical activity in this sample? <p>The data used in this study was taken from the in motion studies longitudinal data. Study participants include 837 adolescents from12-18 years of age from two high schools and five elementary schools from two diverse geographic areas in Saskatoon (low and high socioeconomic status). Physical activity patterns of adolescents were investigated over a five-month period (e.g., type, frequency, and duration). Participants were also asked to respond to questions on demographics, social support, perceived benefits and barriers of physical activity, and health practices. <p>The results of this study indicated that overweight/obesity increased with age, while physical activity decreased with age for both boys and girls. Boys overall were more likely to be physically active than were girls. Adolescents who received greater direct support from family members were 21% more likely to sustain their physical activity levels (relative odds 1.21; 95% CI 1.17, 1.24); in contrast, the more the familys indirect support the 5.4% less sustaining were the adolescents physical activity (relative odds 0.94; 95% CI 0.91, 0.98). Home environments which were rich in resources relevant to physical activity had 4% greater influence on adolescents physical activity levels, and this relationship was stronger than that of the influence of living in certain neighbourhoods (relative odds 1.04; 95% CI 1.03, 1.05). <p>This research shed some greater understanding of the impact of familys support and physical environment factors on adolescents continued physical activity levels. The implications of results for further research, targeted programs, and social policy is discussed in the thesis.

Overweight and obesity, one of the most common public health problems in affluent societies, have become epidemic not only in Canada but also throughout the world. Obesity is also a major contributor to the global burden of chronic disease and disability such as diabetes, hypertension, and cardiovascular disorders. <p>Studies have demonstrated clearly that higher intake of cholesterol and saturated fats and generally higher intake of energy-dense food are a key determinant of increasing levels of obesity and overweight in children. Physical activity is also recognized as a major factor in preventing obesity among children. Environmental factorsby which we mean both social (such as social support, social networks) and physical environment (such as access to physical activity amenities, roads and trails, grocery stores)in generally believed to have a powerful influence on either limiting or enhancing the effects of fundamental determinants (diet and physical activity) of obesity in children. This thesis focuses on one of the key determinants, physical activity, and in turn examines factors that are related to changing physical activity in children. <p>This research was designed to examine two major questions: (1) How do physical activity and overweigh/obesity change over time in a cohort of adolescents in Saskatoon? Are there differences in the patterns of change in overweight/obesity and physical activity between boys and girls? (2) What are the effects of family/friends and physical environments on the changing patterns of physical activity in this sample? <p>The data used in this study was taken from the in motion studies longitudinal data. Study participants include 837 adolescents from12-18 years of age from two high schools and five elementary schools from two diverse geographic areas in Saskatoon (low and high socioeconomic status). Physical activity patterns of adolescents were investigated over a five-month period (e.g., type, frequency, and duration). Participants were also asked to respond to questions on demographics, social support, perceived benefits and barriers of physical activity, and health practices. <p>The results of this study indicated that overweight/obesity increased with age, while physical activity decreased with age for both boys and girls. Boys overall were more likely to be physically active than were girls. Adolescents who received greater direct support from family members were 21% more likely to sustain their physical activity levels (relative odds 1.21; 95% CI 1.17, 1.24); in contrast, the more the familys indirect support the 5.4% less sustaining were the adolescents physical activity (relative odds 0.94; 95% CI 0.91, 0.98). Home environments which were rich in resources relevant to physical activity had 4% greater influence on adolescents physical activity levels, and this relationship was stronger than that of the influence of living in certain neighbourhoods (relative odds 1.04; 95% CI 1.03, 1.05). <p>This research shed some greater understanding of the impact of familys support and physical environment factors on adolescents continued physical activity levels. The implications of results for further research, targeted programs, and social policy is discussed in the thesis.

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

acase@tulane.edu / Recent research has suggested a strong link between attention-deficit/hyperactivity disorder (ADHD) and obesity in youth. Both ADHD and obesity have high prevalence and are associated with an enormous personal, family, and social burden. Approximately 5% of children worldwide are currently diagnosed with ADHD, and the prevalence of obesity is estimated to increase relatively by 40% in children with ADHD. Thus, it is imperative to examine potential behavioral mechanisms that underlie comorbid ADHD and obesity, one of which may be abnormal eating behaviors. These behaviors compounded by ADHD symptomology contribute to weight gain in this population. Despite evidence that frequently sharing family meals may protect against abnormal eating behaviors, health-adverse behaviors, and overweight/obesity in youth, only half of families in the United States eat dinner together 6-7 nights per week. This study examines whether United States youth ages 10-17 who present with ADHD are more likely to be overweight/obese than those without ADHD and whether the frequency of shared family meals moderates this comorbidity. Data were obtained from the 2011/2012 National Survey of Children’s Health (NSCH). Using an ordinal regression analysis with moderation, the current study found that youth with ADHD are more likely to be overweight/obese. Frequency of shared family meals was not found to moderate the relationship between ADHD and weight status in the current study sample. Implications of the findings and suggestions for future research are discussed. / 1 / Emma Clare Lewis

Overweight and obesity are two of the most important emerging public health issues in our time and regarded by the World Health Organisation [WHO] (1998) as a worldwide epidemic. The prevalence of obesity in the USA is the highest in the world, and Australian obesity rates fall into second place. Currently, about 60% of Australian adults are overweight (BMI „d 25kg/m2). The socio-demographic factors associated with overweight and/or obesity have been well demonstrated, but many of the existing studies only examined these relationships at one point of time, and did not examine whether significant relationships changed over time. Furthermore, only limited previous research has examined the issue of the relationship between perception of weight status and actual weight status, as well as factors that may impact on people¡¦s perception of their body weight status. Aims: The aims of the proposed research are to analyse the discrepancy between perceptions of weight status and actual weight status in Australian adults; to examine if there are trends in perceptions of weight status in adults between 1995 to 2004/5; and to propose a range of health promotion strategies and furth er research that may be useful in managing physical activity, healthy diet, and weight reduction. Hypotheses: Four alternate hypotheses are examined by the research: (1) there are associations between independent variables (e.g. socio -demographic factors, physical activity and dietary habits) and overweight and/or obesity; (2) there are associations between the same independent variables and the perception of overweight; (3) there are associations between the same independent variables and the discrepancy between weight status and perception of weight status; and (4) there are trends in overweight and/or obesity, perception of overweight, and the discrepancy in Australian adults from 1995 to 2004/5. Conceptual Framework and Methods: A conceptual framework is developed that shows the associations identified among socio -demographic factors, physical activity and dietary habits with actual weight status, as well as examining perception of weight status. The three latest National Health Survey data bases (1995 , 2001 and 2004/5) were used as the primary data sources. A total of 74,114 Australian adults aged 20 years and over were recruited from these databases. Descriptive statistics, bivariate analyses (One -Way ANOVA tests, unpaired t-tests and Pearson chi-square tests), and multinomial logistic regression modelling were used to analyse the data. Findings: This research reveals that gender, main language spoken at home, occupation status, household structure, private health insurance status, and exercise are related to the discrepancy between actual weight status and perception of weight status, but only gender and exercise are related to the discrepancy across the three time point s. The current research provides more knowledge about perception of weight status independently. Factors which affect perception of overweight are gender, age, language spoken at home, private health insurance status, and diet ary habits. The study also finds that many factors that impact overweight and/or obesity also have an effect on perception of overweight, such as age, language spoken at home, household structure, and exercise. However, some factors (i.e. private health insurance status and milk consumption) only impact on perception of overweight. Furthermore, factors that are rel ated to people’s overweight are not totally related to people’s underestimation of their body weight status in the study results. Thus, there are unknown factors which can affect people’s underestimation of their body weight status. Conclusions: Health promotion and education activities should provide education about population health education and promotion and education for particular at risk sub -groups. Further research should take the form of a longitudinal study design ed to examine the causal relationship between overweight and/or obesity and underestimation of body weight status, it should also place more attention on the relationships between overweight and/or obesity and dietary habits, with a more comprehensive representation of SES. Moreover, further research that deals with identification of characteristics about perception of weight status, in particular the underestimation of body weight status should be undertaken.

<p>Overweight and obesity in children is an extensive and accelerating </p><p> problem in the western world. The risk factors for overweight are well-</p><p> known and well-documented. Focus should lie in the prophylactic work </p><p> in order to prevent overweight and obesity in preschool children.</p><p> The aim of our study has been to highlight the role of the district</p><p> nurse in her/his work to prevent overweight and obesity in preschool </p><p> children. The study was carried out through studies as a literature </p><p> review. In order to support the parents and taking their circumstances </p><p> and conditions into consideration, it was considered very important that </p><p> the district nurse paid attention to the view of the parents on the weight </p><p> of their child. Parents were considered to have an important role in </p><p> giving their children healthy eating habits. The attitude of the district </p><p> nurse was relevant as to how she/he treated the overweight and how </p><p> she/he tackled the preventive work. Professional practice and training </p><p> within the field were important factors in making the district nurse </p><p> succeed in her/his work to prevent overweight and obesity in children. </p><p> Lack of time and lack of parental commitment and attitude were the </p><p> main reasons for limiting the district nurse in her work to prevent </p><p> overweight and obesity in children. Personnel within the primary care </p><p> should supervise and coordinate health promoting measures in order to </p><p> prevent overweight and obesity in children. The district nurse plays a </p><p> unique part in influencing the parents very early on in their children’s </p><p> life by arranging regular and repeated visits to the child welfare center. </p><p> The basis for a successful work by the district nurse is training and the </p><p> fact that she is made aware of her own attitudes towards overweight. </p><p> More research is imperative to support and develop guidelines for </p><p> preventing overweight and obesity in children.</p>

Overweight and obesity in children is an extensive and accelerating problem in the western world. The risk factors for overweight are well- known and well-documented. Focus should lie in the prophylactic work in order to prevent overweight and obesity in preschool children. The aim of our study has been to highlight the role of the district nurse in her/his work to prevent overweight and obesity in preschool children. The study was carried out through studies as a literature review. In order to support the parents and taking their circumstances and conditions into consideration, it was considered very important that the district nurse paid attention to the view of the parents on the weight of their child. Parents were considered to have an important role in giving their children healthy eating habits. The attitude of the district nurse was relevant as to how she/he treated the overweight and how she/he tackled the preventive work. Professional practice and training within the field were important factors in making the district nurse succeed in her/his work to prevent overweight and obesity in children. Lack of time and lack of parental commitment and attitude were the main reasons for limiting the district nurse in her work to prevent overweight and obesity in children. Personnel within the primary care should supervise and coordinate health promoting measures in order to prevent overweight and obesity in children. The district nurse plays a unique part in influencing the parents very early on in their children’s life by arranging regular and repeated visits to the child welfare center. The basis for a successful work by the district nurse is training and the fact that she is made aware of her own attitudes towards overweight. More research is imperative to support and develop guidelines for preventing overweight and obesity in children.

The growing prevalence of overweight and obesity among United States (U.S.) elderly people today is a health concern. Higher incidences of obesity and obesity-related health conditions and mortality exist in the southern area of the U.S. Understanding obesity in relation to obesity-related factors in this population is crucial. The purpose of this study was to identify regional differences and associations between obesity and obesity-related factors in Southern U.S. elderly people, as defined by the U.S. Census Bureau, using data from the 2005 Behavioral Risk Factor Surveillance System (BRFSS), an existing telephone health survey administered by the Centers for Disease Control and Prevention (CDC). Through frequency tests, chi-square tests, and a multinomial logistic regression, the results revealed no regional difference in weight status among U.S. elderly people. However, multinomial logistic regression indicated some consistent associations with weight status among Southern U.S. elderly people. Males, Blacks and married elderly people, along with those diagnosed with high cholesterol, diabetes, and hypertension were associated with both overweight and obesity. Associations found between Southern U.S. elderly people who were overweight or obese and obesity-related factors support the need to continue to encourage elderly people living in the South to control their weight.

This thesis is an investigation into women’s experiences of repeatedly attempting to lose weight and maintain a weight they find acceptable, and the implications of this for health education. This was an interpretivist inquiry which generated data through narrative interviews. The data was analysed using three different strategies to enable deeper understanding of the participants’ experiences. To set the context health education resources relating to body weight, healthy eating and activity were collected from local community and health settings. A former local practice nurse was also interviewed about her role in assisting women with weight loss. A literature review revealed an emphasis on research and policy that focuses on the dangers of overweight and obesity, prioritising individual behaviour and energy-deficit approaches to losing weight. A qualitative method was used to collect data from a convenience sample of five women. Data from interviews and autobiographical writing were recorded, transcribed and analysed within a narrative analysis framework. Analysis of the findings using three interpretive lenses are presented first as re-storied accounts of the women’s narratives, and secondly thematic analysis addressing issues of control, pleasure and pain, and embodiment and alienation. Finally a relational analysis reveals the ways in which participants position themselves in relation to themselves, other characters and the interviewer in order to build their desired identities. The data shows that the participants had followed a wide and diverse range of diets, eating and exercise plans, none of which had been successful in both reducing their weight and maintaining it at a level they were happy with, even after repeated attempts. Whilst biomedical literature suggests a dividing line between pathological eating disorders such as anorexia nervosa/bulimia and normality, the disordered eating and emotional difficulties described by the participants supports the view that a broad range of eating and body-image problems may be more culturally normative than is generally recognised. Dieting and weight cycling were common experiences. The findings of the thesis suggest that contrary to current public policy, the views of these women who are unhappy with their body weight are complex, idiosyncratic and demonstrate resistance to health messages that target individual responsibility for weight management. Their views are developed from personal experiences - the findings suggest that these women are stigmatised. However, one response to this can be to stigmatise other people whom they see as more overweight than themselves. Normative femininity is increasingly centred on appearance and women who do not comply with the requirements risk alienation and pain. The identities that the women construct are relevant for health education but not taken into account when national policy and strategies are developed to address overweight and obesity. The risks to health of weight cycling are also not addressed by policy. The implications of the thesis are discussed in relation to the embodied experiences and gendered roles of women, the role of health education and its relationship with biomedicine.

Obesity results from a complex interaction between diet, physical activity, and the environment. The purposes of this study were to identify behaviors associated with resilience to childhood obesity, and to compare the sensitivity of the Figure Rating Scales (FRS) in reflecting Body Mass Index (BMI). Fifty health professionals in nutrition and 35 low-income, parent-and-child pairs completed the study. Children aged 6-11, perceived as “normal-weight” by their parents, were recruited. Five children had a measured BMI above the 85th percentile. Using a picture-sort method, each participant responded to a series of questions about 13 childhood obesity-related messages. Results included comparison between health professionals, parents, and children about 1) familiarity toward each message, 2) frequency in following the recommendation, 3) perception of ease for others to follow, and 4) perception of effectiveness to help prevent childhood obesity. Health professionals and parents had similar familiarity regarding all 13 messages. However, in terms of practicality, health professionals and parents differed significantly in eight messages that they reported “always taught/followed,” seven messages that they “sometimes taught/followed,” and two messages that they “seldom or never taught/followed.” In most messages, children’s observation about what the family followed differed from what parents reported following. In terms of ease for others to follow “Watch portion sizes” and “Tell children to eat all of the meal before getting dessert,” health professionals and parental perception differed significantly. In terms of effectiveness in childhood obesity prevention, health professionals and parents agreed on 12 of 13 messages. Health professionals did not find message “Tell children to eat all of the meal before getting dessert” to be effective in preventing childhood obesity, whereas parents did. FRS and measured BMI were significantly correlated among health professionals (r=0.75), parents (r=0.72), and children (r=0.53 for children ages 8-11, r=0.64 when a mother selected a silhouette for her child). For different subgroups, parent-and-child silhouette selection was closely correlated (r= 0.84). However, correlation between child’s BMI percentile and silhouette was nonsignificant in most subgroups (r= 0.47). In conclusion, FRS was effective among adults and older children (aged ≥8) in reflecting BMI but not among younger children (aged 6-7).