Childhood Obesity最新文献

Background: The objective of this study was to test the association of Pro-Inflammatory/Anti-Inflammatory Food Intake Score (PAIFIS) and inflammatory biomarkers: C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 levels in a sample of Brazilian children. Methods: This cross-sectional study included children aged 5-8 years. Levels of inflammatory biomarkers and habitual food intake were measured using a quantitative food frequency questionnaire (FFQ) to estimate PAIFIS and anthropometric and socioeconomic data. The Mann-Whitney test, Spearman's correlation test, and nonparametric regression models with Kernel effects were used for analysis. Results: PAIFIS showed an association with increased TNF-α in the univariate analysis [β = 0.53, 95% confidence interval (CI) 0.05-1.15] and the multivariate analysis adjusted for the sum of skinfolds (ΣSF) and income (β = 0.31, 95% CI 0.00-1.11). ΣSF was associated with an increase in TNF-α (β = 15.0, 95% CI 3.16-36.1) and CRP (β = 0.013, 95% CI 0.004-0.022). Conclusions: The PAIFIS shows a positive association with TNF-α. Adiposity was also identified as an important risk factor for inflammation.

Background: Family style meal service is a nationally endorsed best practice. However, implementation in family child care homes (FCCHs) is low because child care providers are worried that it could increase plate waste. To examine this perceived barrier, the study aims to investigate the association between family style meal service and plate waste in FCCHs in Nebraska. Methods: In this cross-sectional study, the participants included FCCH providers (n = 46) in Nebraska and 3-5-year-old children attending these FCCH settings (n = 146). Providers were given a family style meal service score using 11 items from the Mealtime Observation in Child Care tool. Children's plate waste data over the observed lunchtime were collected using the Dietary Observation in Child Care method. We conducted multivariate, multilevel regression analyses in SAS (v9.4) to assess the relationship between family style meal service score and children's plate waste, while controlling for child-level characteristics and accounting for FCCH setting-level effects (ICCs 11.3%-31.2%). Results: Increase in family style meal service score was associated with a decrease in vegetable waste (B = -4.7, p = 0.03), fruit waste (B = -3.6, p = 0.03), and protein waste (B = -4.2, p = 0.02). Dairy and grain waste were not associated with family style meal service score. Conclusions: A higher family style meal service score was associated with a 3%-5% reduction in plate waste for three food groups. These findings warrant further research examining the effect of interventions promoting family style meal service in child care on improving children's dietary intake and reducing plate waste.

Background: Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have occurred mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity. Methods: This cluster randomized controlled feasibility trial included an online program designed to improve diet and PA along with administration of prebiotic fiber for 12 weeks in 123 4th and 5th grade students where 98% were eligible for free or reduced fee lunch. Of these 56% were male; 71% Latinx; 15% African American; and 14% Other. Results: A decrease in body fat (BF) was associated with higher pre-test BF. Lower BMI was associated with a decrease in fecal Tenericutes and an increase in Actinobacteria. Conclusion: Prebiotic fiber was evaluated in additional studies. Determining those most responsive to prebiotic fiber can also permit individual recommendations for greater inclusion in usual diet choices.

Background: Although racial, ethnic minorities, and immigrants are more likely to have poor diet-related health outcomes, few studies have compared children's dietary quality across diverse households, which is the formative step to designing targeted interventions. The current study evaluates and compares the dietary quality of young children from diverse racial, ethnic, and immigrant households in Nebraska. Methods: Cross-sectional survey data were collected from adults living in Nebraska with at least one 2-6-year-old child residing in their household via an online survey regarding their federal assistance program participation and dietary quality of child(ren) residing in their household, measured using the short Healthy Eating Index (sHEI). Results: With nearly two-third participating in a federal assistance program, the sample includes respondents from diverse households (n = 1,277) including first-generation immigrant (n = 61), non-immigrant Hispanic (n = 538), non-immigrant non-Hispanic White (n = 509), non-immigrant non-Hispanic Black or African American (n = 120), and non-Hispanic American Indian or Native Hawaiian (n = 49). Based on analysis of covariance controlling for demographic variables, children from immigrant households had lower mean sHEI score 43.9 as compared to non-immigrant Hispanic 46.4, non-immigrant non-Hispanic White 47.1, non-immigrant non-Hispanic Black or African American 50.2, and non-Hispanic American Indian or Native Hawaiian 48.9. Racial/ethnic/immigrant household group differences were also observed for some sHEI component scores. Conclusions: Children from immigrant and non-immigrant Hispanic households had significantly lower sHEI scores on some subcomponents compared with other groups. Findings emphasize the need for additional research and culturally responsive multilevel nutrition interventions.

Background: Head Start (HS) is the largest federally funded early childhood education program in the United States. It prepares children socially, emotionally, and academically and sets the foundation for school readiness and academic success. In 2024, the Head Start Program Performance Standards were updated to provide enhanced support and workforce stability, including improvements in health and wellness. This study assessed the availability, participation, satisfaction, and interest in Workplace Wellness Programs (WWPs) for HS educators. Methods: An electronic survey was sent to nearly 74,000 HS grantees and educators; 2,611 complete surveys were included in the analysis. Descriptive analyses examined the availability, participation, satisfaction, and interest in WWPs, and multivariate regression analyses identified factors associated with WWP participation. Results: Approximately 71% of HS educators reported access to at least one WWP. The most common programs available were health education and promotion (51%), stress management (25%), and healthy lunch and snack options (20%). Participation rates for available programs ranged from 6% to 93%, and interest in unavailable programs ranged from 40% to 93%. Job dissatisfaction was associated with lower odds of participating in any WWP or in health education and wellness programs. Receipt of community food assistance was associated with lower odds of participating in nutrition and stress management programs. Conclusions: There is considerable variability in availability, participation, and interest in WWPs among HS educators. Research is needed to understand if expression of interest would translate into take-up of WWPs, identify strategies to reduce barriers, and increase participation.

Background: Child overweight and obesity is a critical global health issue with substantial individual and societal impacts necessitating early intervention to establish healthy habits. Health promoting early childhood education (ECE) settings are important as most young children attend ECEs in high- and middle-income countries. Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) is an evidence-based approach to support improvements to ECE environment for improving child health. While adapting proven child obesity prevention interventions from other countries offers efficiency, the process is frequently underreported and insufficiently documented. Methods: Guided by the ADAPT framework, this article describes the adaptation of NAPSACC in the United States (US), Australia (AU), and the United Kingdom (UK) from 2012 to 2023. Contextual differences in ECE systems in the US, AU, and UK and reflections on the process of adaptation were explored. Results: NAPSACC was successfully adapted, maintaining core theoretical components while allowing for implementation flexibility to meet varying contexts. The iterative adaptation process revealed that a flexible dynamic approach was essential for maintaining the relevance and effectiveness of the NAPSACC intervention in different contexts. Conclusions: Our experience highlights the importance of ongoing iteration, international collaboration, research, and responsiveness to evolving circumstances in adaptation processes. Strong and flexible leadership, such as that demonstrated by NAPSACC's founder, Dr. Dianne S. Ward, facilitates successful adaptation and continuous improvement of public health programs. Trial registration: This paper includes multiple registered trials - NCT02889198, ACTRN12619001158156, ISRCTN16287377, and ISRCTN33134697.

Background: Early childhood interventions that support the development of healthy lifestyle behaviors are key to ensuring equitable health outcomes later in life. The aim of this article is to assess the extent to which early care and education (ECE) sites adopt best practices to support healthy diet and physical activity (PA) behaviors and whether adoption differs between centers and family child care homes (FCCHs). Methods: The study is a cross-sectional analysis of best practices at Supplemental Nutrition Assistance Program-Education (SNAP-Ed)-eligible child care centers (n = 76) and FCCHs (n = 47) in California. Generalized linear models were used to estimate associations of facility type with eight best practice index measures in the following three areas: dietary intake (nutrition education, food and beverage quality, staff training in nutrition), PA (quantity of PA opportunities, quality of PA opportunities, environmental support for PA), and parent engagement and wellness policies (comprehensive, active parent engagement and support for wellness policy implementation, monitoring, and feedback). Results: Overall, ECE sites scored an average of 64.8% of maximum points possible for best practices to improve dietary intake, 81.7% for best practices to improve PA, and 51.8% in comprehensive parent engagement and wellness policies. FCCHs adhered to fewer best practices for robust nutrition education, relative to centers (β = -0.41, 95% CI [-0.70, -0.12]). Differences were also observed in individual practices between settings. Conclusion: This study highlights opportunities for programs such as SNAP-Ed to support ECE providers in implementing nutrition and PA best practices to help children ages 0-5 develop healthy habits.

Background: Enhancing the quality of Family Child Care Home (FCCH) meals is an opportunity to impact children's diet and health. The purpose of this study is to assess Happy Healthy Homes (HHH) randomized controlled trial impact on health-related foods and nutrients served to and consumed by young children and achievement of Child and Adult Care Food Program (CACFP) requirements and best practices. Methods: Forty-five CACFP participating FCCHs in a moderately sized midwestern city were recruited in 2017-2018 and randomized to nutrition intervention (NUT n = 24) or control (CON n = 21). Participants received two in-home, individual 90-minute education sessions, one 3-hour small group class, and a 15-minute check-in phone call over 3 months. Outcomes include 3- and 12-month served and consumed fiber, sugar, grains, vegetables, and fruit and achievement of CACFP Best Practices. Primary analyses at 12 months used a mixed model under an intent-to-treat paradigm to account for repeated measures on participants with 3-month outcomes. Sensitivity analyses were completed on those with complete 12-month measures. Results: There were no statistically significant group-by-time effects for foods served, consumed, or CACFP Best Practices score in the primary analysis. However, in sensitivity analysis, the CACFP Best Practice score (out of 18) increased in NUT +0.5 from 8.9 ± 1.5 at baseline at 12 months and decreased -0.9 in CON from 9.9 ± 1.7 at baseline, group by time p = 0.05. Conclusions: The HHH intervention did improve the CACFP Best Practices score for lunches served. The study's effect may have been limited due to sample size and attrition. Trial Registration: Clinicaltrials.gov, NCT03560050. Retrospectively registered on 23 May 2018. First participant enrolled October 2017.

Background: Amblyopia is the most common cause of vision loss in children. Amblyopia has been associated with impaired depth perception but little attention has been paid to the extent to which amblyopia increases the risk of obesity. Methods: Public-use data from the 1999-2008 National Health and Nutrition Examination Survey were used. Analyses were limited to children aged 12-18, who had a visual examination, and a best corrected visual acuity (BCVA) of at least 20/40 in the better-seeing eye. Amblyopia was defined as two or more-line interocular difference in BCVA. Obesity was defined as Body Mass Index (BMI) or body fat percentage (BFP) ≥95th percentile for age and gender. Sedentary lifestyle was defined as cardiovascular fitness level (CFL) rating of "low." We used Mantel-Haenszel odds ratios (ORs) to examine the relative prevalence of obesity in children with/without amblyopia. Results: Adolescents with amblyopia (n = 360) were more likely than those without (n = 7935) to have a high BMI [OR = 1.56; 95% confidence interval (CI): 1.24-1.98; p < 0.001]. The associations with either high BFP (OR = 1.20; 95% CI: 0.86-1.56, p = 0.167) or low CFL (OR = 1.15; 95% CI: 0.83-1.57; p = 0.267) were not statistically significant but in the direction of a priori hypotheses. Conclusions: This analysis of population-based data suggests that adolescents with amblyopia may be at higher risk of having obesity. Given the high prevalence of amblyopia and the range of morbidities associated with childhood obesity, targeted interventions to reduce the risk of obesity among children with amblyopia could be warranted.