Despite growing school lunch availability in Germany, its utilization is still low, and students resort to unhealthy alternatives. We investigated predictors of school lunch participation and reasons for nonparticipation in 1215 schoolchildren. Children reported meal habits, parents provided family-related information (like socioeconomic status), and anthropometry was conducted on-site in schools. Associations between school lunch participation and family-related predictors were estimated using logistic regression controlling for age and gender if necessary. School was added as a random effect. School lunch participation was primarily associated with family factors. While having breakfast on schooldays was positively associated with school lunch participation (ORadj = 2.20, p = 0.002), lower secondary schools (ORadj = 0.52, p < 0.001) and low SES (ORadj = 0.25, p < 0.001) were negatively associated. The main reasons for nonparticipation were school- and lunch-related factors (taste, time constraints, pricing). Parents reported pricing as crucial a reason as an unpleasant taste for nonparticipation. Nonparticipants bought sandwiches and energy drinks significantly more often on school days, whereas participants were less often affected by overweight (OR = 0.66, p = 0.043). Our data stress school- and lunch-related factors as an important opportunity to foster school lunch utilization.

No description available.

Thesis (Ed. D.)--State University of New York at Binghamton, School of Education, 2008. / Includes bibliographical references.

Thesis (Ph. D.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0911. Includes bibliographical references.

Background: Obesity is a chronic and complex metabolic disease with associated comorbidities. The prevalence of excess body weight has risen substantially in both affluent developed countries and in developing countries worldwide. In 2008 it was estimated that 43 million children under the age of five were overweight, with developing countries accounting for 75 percent of these rates. Furthermore, with 75 percent of these children developing adulthood obesity, mortality rates due to obesity will continue to increase unless preventative interventions are implemented. Objective: To identify the prevalence of obesity and overweight among urban seven to 10 years old children in Quintile five English-medium schools in the Nelson Mandela Metropolitan municipality in the Eastern Cape, South Africa. Design and Methods: A quantitative descriptive one-way cross-sectional research design utilising random sampling was used. A total of 713 children participated in the study. A onceoff survey consisted of anthropometrical assessment of height, weight and waist circumference. To classify children into weight categories, the International Obesity Task Force cut-off values were used. A validated physical activity – related behaviour questionnaire was completed to explore and identify the daily level of physical activity expressed in MET values. Using one-way ANOVA’s and Chi-squared tests, significance between variables was analysed. Results: Overweight prevalence was 20.9 percent and obesity prevalence was 9.8 percent. A significant relationship was found between obesity and overweight levels for gender, age, ethnicity and culture. No significant relationship was found for obesity and overweight prevalence and physical activity. Conclusion: Results highlight the rising prevalence of obesity and overweight amongst urban children from affluent primary schools and the necessity for further research to explore sociocultural factors that impact on obesogenic behaviour in South African youth.

Bakgrund: Inom barnhälsovården (BHV) arbetar specialistsjuksköterskor hälsofrämjande och förebyggande. Tidig uppmärksammad ohälsosam tillväxt kan åtgärdertidigtimplementeras för att förebygga följdsjukdomar som hjärt- och kärlsjukdomar och diabetes.  Syftet: Att beskriva hur specialistsjuksköterskor på barnhälsovården arbetar hälsofrämjande, förebyggande och evidensbaserat med familjer där barnet har en övervikt. Metod: En kvalitativ forskningsdesign med induktiv ansats har använts. Individuella intervjuer har genomförts och analyserats med hjälp av en kvalitativ innehållsanalys.  Resultat: BHV-sjuksköterskorna upplevde att en längre och regelbunden kontakt med familjen ökar samarbetet och förbättrar relationen. I kontakten med familjen är det viktigt med ett empatiskt bemötande. Det är viktigt att erbjuda familjen kunskap inom kost, rörelse och begränsning av skärmtid för att främja en sund viktutveckling hos barnet. Olika informationsblad om övervikt användes. Fortbildning inom ämnet övervikt och fetma ökar BHV-sjuksköterskans trovärdighet och den evidensbaserad vården. Samverkan med olika instanser och professioner är helt nödvändigt för att kunna erbjuda familjen rätt hjälp.  Slutsats:BHV-sjuksköterskans förhållningssätt och kunskap i ämnet ökade familjens motivation. I ett nära samarbete kunde de tillsammans hitta rutiner och verktyg förtillfredsställande tillväxt. / Background: In the Child Health Care (CHC), specialist nurses work on health promotion and prevention. Early identification of unhealthy growth can be implemented early to prevent sequelae such as cardiovascular diseases and diabetes.    The purpose: To describe how the specialist nurses in the child health care work to promote health and prevention with families whose children are overweight and how the evidence is based on the care they provide.   Method:A qualitative research design with an inductive approach has been used. Individual interview has been carried out and analyzed using a qualitative analysis.   Result:The CHC-nurse’s experienced that a regular contact with the family improved the cooperation and relationship. In contact with the family, an empathetic approach is important. It is important to offer the family knowledge in diet, physical activity and limited screen-time to promote healthy weight-development. Various information sheets were used. Continuing education in the subject of overweight and obesity increases the CHC-nurse's credibility and evidence-based care. Collaboration with various departments and professions is necessary to offer the family the right help   Conclusion: The CHC-nurse's approach and knowledge increased the parents' awareness and motivation. In a close collaboration between the CHC-nurse and the family, they could find good routines that could lead to a satisfactory growth.

The purpose of this study was to determine if a relationship existed between body mass index and school absence. The research was a retrospective study of school nurse height and weight reports and attendance reports for 2nd grade Hispanic students at an elementary school in Riverside, California.

Cardiovascular disease secondary to atherosclerosis is the most common cause of human morbidity and mortality. An early and fundamental event in the development of atherosclerosis is abnormal vascular endothelial and smooth muscle function. This can be measured by flow mediated dilatation and glyceryl trinitrate mediated dilatation in children at risk of atherosclerosis. Folic acid improves endothelial function (flow mediated dilatation) in adults with coronary artery disease. No studies have previously investigated the effects of folic acid on vascular function in at risk children with diabetes or obesity. In a cross sectional study an evaluation of vascular endothelial and smooth muscle function and their determinants was performed in 159 children with type 1 diabetes, 58 children with obesity, and 53 healthy children. Children with type 1 diabetes and children with mild to moderate obesity had comparable and severe vascular dysfunction but different determinants. Vascular function in healthy and obese children related to both body mass index and weight (adjusted for age and sex), and blood glucose. Children with obesity had lower folate levels and higher homocysteine levels than children with type 1 diabetes, an abnormal lipid profile and raised inflammatory markers. A randomised double blind placebo controlled cross over trial of 8 weeks of folic acid supplementation was performed in 38 children with type 1 diabetes. In these children, folic acid improved endothelial function with a sustained increase in folate levels but independent of homocysteine levels. Folic acid did not improve smooth muscle function. A randomised double blind placebo controlled parallel trial of 8 weeks folic acid supplementation was performed including 53 obese children. Folic acid did not improve vascular function in obese children in spite of sustained increase in folate levels, and a decrease in homocysteine levels. It was concluded that children with type 1 diabetes and obesity have comparable and severe endothelial and smooth muscle function. Determinants of vascular function in children, including weight and glucose, represent a continuum effect. Folic acid supplementation improved endothelial function in children with type 1 diabetes but not in children with obesity, whose metabolic changes causing endothelial dysfunction differ from children with diabetes. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1317003 / Thesis (Ph.D.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008

Aim: To determine whether the tuck shop purchasing habits of Grade 4 learners were contributing towards the development of childhood overweight and obesity. Objectives: To assess the nutritional quality of the food and beverages available for learners to purchase; items regularly purchased from the tuck shop as well as factors influencing the learner’s decision to purchase these items; the anthropometric and socio-demographic characteristics of grade 4 learners as well as their nutrition knowledge related to the tuck shop items purchased. Method: A survey administered to 11 tuck shop managers, a questionnaire administered to 311 Grade 4 learners and two single-sex focus groups of 5 learners each were conducted. Results: Fifty six percent of the sample were female (n=173) and 44% were male (n=138). Twenty seven percent of the study sample was overweight (n = 83) and 27% were obese (n = 85). Eighty six percent of learners (n = 266) claimed to buy from their school tuck shop. Twenty two percent of learners purchased from their tuck shop at least three times per week (n =58). Learners who purchased from the tuck shop had a significantly higher BMI than those who did not (p = 0.020). Learners who purchased from the tuck shop spent on average R8,38 per day with a minimum of R1 and a maximum of R40 (standard deviation R5.39). The most popular reasons for visiting the tuck shop included “this is my favourite thing to eat or drink” (66.5%, n = 177) and “I only have enough money to buy this item” (47.0%, n = 125). Savoury pies were the most popular "lunch" item for all learners for both food breaks (45%, n = 5 schools and 27.3%, n = 3 schools) selling the most number of units (43) per day at eight of the eleven schools (72.7%). Iced popsicles were sold at almost every school, ranked as the cheapest beverage and also sold the most number of units (40.7). Healthy beverages sold included canned fruit juice and water, while healthy snacks consisted of dried fruit, fruit salad, bananas, yoghurt and health muffins. The average healthy snack contained almost half the kilojoules of its unhealthy counterpart (465kJ vs 806kJ). Nutritional analyses of the healthy lunch options revealed total fat contents that exceeded the DRI and South African recommended limit. Perceived barriers to stocking healthy items included cost and refrigeration restrictions. The average score for the food groups was only 33% indicating that learners were not familiar with the Food Based Dietary Guidelines (FBDG). Further analyses showed that the total knowledge scores of those learners that reported to buy from the tuck shop frequently, was significantly lower when compared to the total knowledge scores of those learners who bought from the tuck shop less frequently (13.0 ± 3.9 and 11.6 ± 3.1, respectively; p < 0.05). Logistic regression analysis confirmed that the total knowledge of a learner could be used to predict whether he or she is more likely to make purchases from the tuck shop (significance = 0.017). Focus group results revealed that learners are aware of “healthy” and “unhealthy” tuck shop items. Most learners stated that they would continue to purchase items from their tuck shop if all “unhealthy” items were removed. Conclusion: Primary school tuck shops of well resourced schools in Pietermaritzburg are contributing to childhood overweight and obesity through a combination of factors. These include the poor nutritional quality of the items stocked at the tuck shop as well as the poor tuck shop purchasing practices. Much consultation is required amongst dieticians, school principals and privatised tuck shop managers to overcome barriers to stocking healthy items. School management and government have an important role to play in imposing restrictions on the sale of unhealthy items; along with improving the quality of the nutrition education curriculum to ensure that learners are able to translate their knowledge into healthier purchasing practices. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

Cardiovascular disease secondary to atherosclerosis is the most common cause of human morbidity and mortality. An early and fundamental event in the development of atherosclerosis is abnormal vascular endothelial and smooth muscle function. This can be measured by flow mediated dilatation and glyceryl trinitrate mediated dilatation in children at risk of atherosclerosis. Folic acid improves endothelial function (flow mediated dilatation) in adults with coronary artery disease. No studies have previously investigated the effects of folic acid on vascular function in at risk children with diabetes or obesity. In a cross sectional study an evaluation of vascular endothelial and smooth muscle function and their determinants was performed in 159 children with type 1 diabetes, 58 children with obesity, and 53 healthy children. Children with type 1 diabetes and children with mild to moderate obesity had comparable and severe vascular dysfunction but different determinants. Vascular function in healthy and obese children related to both body mass index and weight (adjusted for age and sex), and blood glucose. Children with obesity had lower folate levels and higher homocysteine levels than children with type 1 diabetes, an abnormal lipid profile and raised inflammatory markers. A randomised double blind placebo controlled cross over trial of 8 weeks of folic acid supplementation was performed in 38 children with type 1 diabetes. In these children, folic acid improved endothelial function with a sustained increase in folate levels but independent of homocysteine levels. Folic acid did not improve smooth muscle function. A randomised double blind placebo controlled parallel trial of 8 weeks folic acid supplementation was performed including 53 obese children. Folic acid did not improve vascular function in obese children in spite of sustained increase in folate levels, and a decrease in homocysteine levels. It was concluded that children with type 1 diabetes and obesity have comparable and severe endothelial and smooth muscle function. Determinants of vascular function in children, including weight and glucose, represent a continuum effect. Folic acid supplementation improved endothelial function in children with type 1 diabetes but not in children with obesity, whose metabolic changes causing endothelial dysfunction differ from children with diabetes. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1317003 / Thesis (Ph.D.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008