Introduction to the Active Living Research Reference List 2007


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T. L. LaRowe, D. P. Wubben, K. A. Cronin, S. M. Vannatter and A. K. Adams. (2007). Development of a culturally appropriate, home-based nutrition and physical activity curriculum for Wisconsin American Indian families. Preventing Chronic Disease.

We designed an obesity prevention intervention for American Indian families called Healthy Children, Strong Families using a participatory approach involving three Wisconsin tribes. Healthy Children, Strong Families promotes healthy eating and physical activity for preschool children and their caregivers while respecting each community's cultural and structural framework. Academic researchers, tribal wellness staff, and American Indian community mentors participated in development of the Healthy Children, Strong Families educational curriculum. The curriculum is based on social cognitive and family systems theories as well as on community eating and activity patterns with adaptation to American Indian cultural values. The curricular materials, which were delivered through a home-based mentoring model, have been successfully received and are being modified so that they can be tailored to individual family needs. The curriculum can serve as a nutrition and physical activity model for health educators that can be adapted for other American Indian preschool children and their families or as a model for development of a culturally specific curriculum.

P. W. Lau, A. Lee and L. Ransdell. (2007). Parenting style and cultural influences on overweight children's attraction to physical activity. Obesity (Silver Spring).

OBJECTIVE: To investigate the associations among parenting style, gender, Chinese culture, and overweight children's attraction to physical activity. RESEARCH METHODS AND PROCEDURES: A total of 104 parents with overweight children were recruited from six primary schools in Hong Kong, China. Only overweight children in grades 3 through 6 (8 to 12 years of age) were invited to participate. Overweight children were defined and identified using the international cut-off points stratified by sex and age. Questionnaires were used to assess Children's Attraction to Physical Activity (CAPA), perceived competence, and parental socialization influences. RESULTS: Parental influence, especially father's role modeling, was significantly related to attraction to physical activity in overweight Chinese children. Perceived physical competence was also an important correlate of an overweight child's attraction to physical activity. Gender differences in CAPA were not significant among the Chinese overweight children. However, gender differences were observed in the relationship between parent physical activity orientation and CAPA. DISCUSSION: In addition to a child's perceived competence, father's role modeling can provide additional and significant influence with regard to overweight children's attraction to physical activity. Differences in cultural orientation toward body weight should be considered when explaining overweight children's physical activity.

R. Lazenby, S. Angus, T. Galloway and H. Huynh. (2007). Social determinants and childhood overweight and obesity in elementary school children. American Journal Of Human Biology.
G. Leduc, M. E. Jalbert, H. Venables, M. Blouin and N. Almeras. (2007). Children's family environment: impact on body mass index and waist circumference. International Journal Of Obesity.
C. Y. Lee, S. Y. Hwang and O. K. Ham. (2007). Factors associated with physical inactivity among korean men and women. American Journal of Health Behavior.

OBJECTIVES: To identify the independently associating factors on physical inactivity in Korean men and women. METHODS: The data of 5554 men and women (18-74 years) were analyzed using national health and nutritional examination survey data that included questionnaires and physical examinations. RESULTS: Multiple logistic regression analyses showed that significant factors were low monthly income, low education, current smoking, increased waist-to-hip ratio, and low health concern among men; living in rural areas, low monthly income, low education, perceived poor health status, low health concern, and emotional stress among women. CONCLUSIONS: Health care providers should focus on education and counseling regarding the factors that influence physical inactivity.

N. Lien, B. N. Kumar, G. Holmboe-Ottesen, K. I. Klepp and M. Wandel. (2007). Assessing social differences in overweight among 15- to 16-year-old ethnic Norwegians from Oslo by register data and adolescent self-reported measures of socio-economic status. International Journal of Obesity (London).

OBJECTIVE: To determine to what extent self-reported and objective data on socio-economic status (SES) are associated with overweight/obesity among 15 to 16-year-old ethnic Norwegians. DESIGN: A cross-sectional questionnaire study on health and health-related behaviors. SUBJECTS: All school children aged 15-16 years old in 2000 and 2001 in Oslo, Norway. Response rate 88% (n=7343). This article is based on the data from the 5498 ethnic Norwegians. MEASUREMENTS: Self-reported height and weight were used to measure overweight (including obesity) as defined by the International Obesity Task Force cutoffs at the nearest half-year intervals. SES was determined by register data from Statistics Norway on residential area, parental education and income and by adolescent self-reported measures on parental occupation and adolescents' educational plans. RESULTS: The prevalence of overweight/obesity was low, but higher among boys (11%) than among girls (6%). Parental education (four levels) showed the clearest inverse gradients with overweight/obesity (boys: 18, 13, 10 and 7%; girls: 11, 6, 6 and 4%). Parental education remained significantly associated with overweight/obesity when adding occupation and income to the model for the boys, whereas there were no significant associations in the final model for the girls. Overweight/obesity was associated with a lower odds ratio of planning for higher education (college/university) among boys only. CONCLUSION: For the boys, parental education was most strongly associated with overweight/obesity, and the association between overweight/obesity and educational plans appears to imply downward social mobility. The relationships between the various SES measures and overweight/obesity appeared more interrelated for the girls.

S. Macintyre. (2007). Deprivation amplification revisited; or, is it always true that poorer places have poorer access to resources for healthy diets and physical activity? International Journal of Behavioral Nutrition and Physical Activity.

In this debate paper I suggest that it may not always be true that poorer neighbourhoods are more likely to lack health promoting resources, and to be exposed to more health damaging resources. The spatial distribution of environmental resources by area socioeconomic status may vary between types of resource, countries, and time periods. It may also be that the presence or absence of resources is less important than their quality, their social meaning, or local perceptions of their accessibility and relevance.

R. Maddison, Mhurchu, C.N., Jull, A., Jiang, Y., Prapavessis, H., Rodgers, A. (2007). Energy expended playing video console games: an opportunity to increase children's physical activity? Pediatric Exercise Science.

This study sought to quantify the energy expenditure and physical activity associated with playing the "new generation" active and nonactive console-based video games in 21 children ages 10-14 years. Energy expenditure (kcal) derived from oxygen consumption was continuously assessed while children played nonactive console video games. Physical activity was assessed continuously using the Actigraph accelerometer. Significant (p<.001) increases from baseline were found for energy expenditure (129-400%), heart rate (43-84%), and activity counts (122-1,288 versus 0-23) when playing the active console video games. Playing active console video games over short periods of time is similar in intensity to light to moderate traditional physical activities such as walking, skipping, and jogging.

B. Marion and M. W. Horner. (2007). Comparison of socioeconomic and demographic profiles of extreme commuters in several US metropolitan statistical areas. Transportation Research Record.

Extreme commuting denotes a one-way commute time of 90 min or more to work. Research into why individuals make such unusually long commutes is limited. In this paper, regression analyses by the use of Microdata files from the Bureau of the Census reveal the demographic and socioeconomic characteristics that increase an individual's odds of extreme commuting. Commuters in four metropolitan areas (Atlanta, Georgia; Baltimore, Maryland; Houston, Texas; and Tampa, Florida) were examined. The model results are consistent with the findings in the literature that define lengthy commutes as a constrained, rather than optimized, choice behavior.

K. Maximova, J. O'Loughlin, Y. Tan and K. Gray-Donald. (2007). Obesity and related lifestyle risk factors across family origin among adults in multiethnic, low-income, urban neighborhoods. International Journal Of Obesity.
N. C. McDonald. (2007). Travel and the social environment: Evidence from Alameda County, California. Transportation Research Part D-Transport And Environment.

The relationship between travel and the environment has been the subject of much study but the focus has mainly been on the physical and built environment. This ignores a large body of research in sociology showing that social processes are spatially embedded and affect individual behavior. This analysis asks whether the neighborhood social environment-in addition to the built environment-influences children's decision to walk to school in Alameda County, California. The results show that social factors, particularly neighborhood cohesion, do influence the decision to walk particularly when children face trips of less than 1.6 km. These findings provide initial evidence for transportation analysts to broaden their definition of the environment to include social factors. (c) 2006 Elsevier Ltd. All rights reserved.

A. T. Merchant, M. Dehghan, D. Behnke-Cook and S. S. Anand. (2007). Diet, physical activity, and adiposity in children in poor and rich neighbourhoods: a cross-sectional comparison. Nutrition journal.

BACKGROUND: Obesity in Canadian children increased three-fold in twenty years. Children living in low-income neighborhoods exercise less and are more overweight than those living in more affluent neighborhoods after accounting for family socio-economic status. Strategies to prevent obesity in children have focused on personal habits, ignoring neighborhood characteristics. It is essential to evaluate diet and physical activity patterns in relation to socio-economic conditions to understand the determinants of obesity. The objective of this pilot study was to compare diet, physical activity, and the built environment in two Hamilton area elementary schools serving socio-economically different communities. METHODS: We conducted a cross-sectional study (November 2005-March 2006) in two public elementary schools in Hamilton, Ontario, School A and School B, located in low and high socioeconomic areas respectively. We assessed dietary intake, physical activity, dietary restraint, and anthropometric measures in consenting children in grades 1 and higher. From their parents we assessed family characteristics and walkability of the built environment. RESULTS: 160 children (n = 48, School A and n = 112, School B), and 156 parents (n = 43, School A and n = 113, School B) participated in this study. The parents with children at School A were less educated and had lower incomes than those at School B. The School A neighborhood was perceived to be less walkable than the School B neighborhood. Children at School A consumed more baked foods, chips, sodas, gelatin desserts, and candies and less low fat dairy, and dark bread than those at School B. Children at School A watched more television and spent more time in front of the computer than children studying at School B, but reported spending less time sitting on weekdays and weekends. Children at both schools were overweight but there was no difference in their mean BMI z-scores (School A = 0.65 versus School B = 0.81, p-value = 0.38). CONCLUSION: The determinants of overweight in children may be more complex than imagined. In future intervention programs researchers may consider addressing environmental factors, and customizing lifestyle interventions so that they are closer to community needs.

K. L. Monda, L. S. Adair, F. Zhai and B. M. Popkin. (2007). Longitudinal relationships between occupational and domestic physical activity patterns and body weight in China. European Journal Of Clinical Nutrition.

Objectives:To examine the longitudinal relationship between occupational and domestic sources of physical activity and body weight in a sample of Chinese adults.Methods:Population-based longitudinal observational study of Chinese adults (4697 women and 4708 men) aged 18-55 from the 1991, 1993, 1997, and 2000 waves of the China Health and Nutrition Survey. Measured height and weight and detailed self-reported energy expenditure from multiple occupational and domestic sources were assessed over a 9-year period. Longitudinal relationships were modeled using linear random effects models.Results:Increased occupational physical activity resulted in overall lower body weight for both men and women (beta-coefficients (95% confidence interval (CI)) for high levels: -0.46 (-0.76, -0.15) for men, -0.36 (-0.62, -0.10) for women, and increased domestic physical activity resulted in overall lower body weight in men (beta-coefficient (95% CI): -0.40 (-0.62, -0.18)).Conclusions:Physical activity that occurs in the occupational and domestic sectors is often overlooked; yet our research suggests they have important effects on body weight in Chinese adults. As China continues to urbanize, energy expenditure from these sources is decreasing, and our results point out the need to explore these types of physical activity more broadly across the world as potential sources of weight gain.European Journal of Clinical Nutrition advance online publication, 18 July 2007; doi:10.1038/sj.ejcn.1602849.

C. A. Monteiro, W. L. Conde and B. M. Popkin. (2007). Income-specific trends in obesity in Brazil: 1975-2003. American Journal of Public Health.

OBJECTIVES: We sought to update income-specific secular trends in obesity in Brazil to assess the hypothesis that the disease burden is shifting toward the poor. METHODS: We compared overall and income-specific obesity prevalence rates estimated for Brazilian men and women from national surveys conducted in 1975, 1989, and 2003. We calculated age-adjusted prevalence ratios to assess time trends. RESULTS: In the first 14-year period examined (1975-1989), obesity rates among men and women increased by 92% and 63%, respectively, and increases were relatively higher among individuals in lower income groups. In the second 14-year period (1989-2003), there were further increases in obesity among men, and again increases were larger among the poor. In this second period, the obesity rate remained virtually stable in the overall female population, but it increased by 26% among women in the 2 lower income quintiles and decreased by 10% among women in the 3 higher income quintiles. CONCLUSIONS: The burden of obesity is shifting toward the poor and can no longer be considered a disease of the socioeconomic elite. Policymakers need to design policy and programs that reach all members of society, but especially the poor.

J. Moore and N. Harre. (2007). Eating and activity: the importance of family and environment. Health Promotion Journal of Australia.

ISSUE ADDRESSED: The aim of this paper was to examine the eating behaviours, physical exercise and television viewing of secondary school students, and to investigate their relationship with parental monitoring and family cohesion. METHOD: The study was conducted at a secondary school in Auckland, New Zealand, in 2005. Questionnaires were administered to 433 students aged 13-16 years, spanning Years 9, 10 and 11. Descriptive statistics, ANOVA and correlational analyses were used. RESULTS: Overall, boys and younger students reported eating more 'unhealthy' foods. Frequency of buying own food (which 59.5% did at least twice a week) was strongly correlated with eating 'unhealthy food' (r=0.50). Parental monitoring (PM) and family cohesion (FC) were significantly positively related to participants' reports of eating breakfast and eating healthy foods, and significantly negatively related to reports of buying own food and eating unhealthy foods. Most (65.5%) reported exercising at least three times a week, boys more than girls. Exercise rates were moderately correlated with eating healthy food and weakly related to PM and FC. Television viewing was related to eating unhealthy food. CONCLUSIONS: Adolescents who buy their own food make many 'unhealthy' food choices. Healthy eating and, to a lesser extent, exercise and reduced television viewing are related to increased levels of parental monitoring and family cohesion.

J. Mota, Gomes, H., Almeida, M., Ribeiro, J.C., Santos, M.P. (2007). Leisure Time Physical Activity, Screen Time, Social Background, and Environmental Variables in Adolescents. Pediatric Exercise Science.

This study analyzes the relationships between leisure time physical activity (LTPA), sedentary behaviors, socioeconomic status, and perceived environmental variables. The sample comprised 815 girls and 746 boys. In girls, non-LTPA participants reported significantly more screen time. Girls with safety concerns were more likely to be in the non-LTPA group (OR = 0.60) and those who agreed with the importance of aesthetics were more likely to be in the active-LTPA group (OR = 1.59). In girls, an increase of 1 hr of TV watching was a significant predictor of non-LTPA (OR = 0.38). LTPA for girls, but not for boys, seems to be influenced by certain modifiable factors of the built environment, as well as by time watching TV.

W. K. Mummery, W. Lauder, G. Schofield and C. Caperchione. (2007). Associations between physical inactivity and a measure of social capital in a sample of Queensland adults. Journal of Science and Medicine in Sport.

How social capital is related to an increasingly important disease risk-physical inactivity has not yet been investigated. In the present study the associations between social capital and physical inactivity were investigated in a sample of Queensland (Australia) adults. Data was collected from 1278 persons by means of a computer-assisted-telephone-interview survey. The association between the social capital variables and physical inactivity was studied using logistical regression. Multivariate analysis adjusted for the effects of selected socio-demographic factors in the investigation of the association between physical inactivity and quartile groupings of social capital scores. Physical inactivity was negatively associated with the measure of social capital. Individuals in the top two quartiles of social capital were significantly less likely to be physically inactive than those in the two lowest quartiles. In summary, low social capital was associated with physical inactivity. The results offer implications for health promotion programs aimed at increasing levels of physical activity at the community or population level.

M. Naissides, D. Kerr, D. Cross, A. McManus and C. Pollard. (2007). Investigating the determinants of weight gain in young adult living in disadvantaged Australian communities. Annals Of Nutrition And Metabolism.
J. Navarro, J. L. G. Sanz, J. M. del Castillo, A. C. Izquierdo and M. M. Rodriguez. (2007). Motivational factors and physician advice for physical activity in older urban adults. Journal Of Aging And Physical Activity.

This study aimed to ascertain by means of a new scale older adults' motives for engaging in physical activity, in a probability and representative sample of an older urban population. The sample size was 630 older adults, ranging from 65 to 94 years in age, randomly selected using multistage sampling. The participants completed a 17-item questionnaire, as well as answering questions on demographic variables, type of demand for physical activity, and physician's recommendation. A principal-component analysis was performed. The relationships among the four factors (physical health, social relationships, competence, and physician's advice) show a clearly motivational structure. Significant relationships have also been found between physician's recommendation and type of demand. The findings suggest that programs promoting physical activity in older adults should have different characteristics from those aimed at general adult populations.

C. S. Olivares, Z. N. Bustos, M. L. Lera and M. E. Zelada. (2007). [Nutritional status, food consumption and physical activity in female school children of different socioeconomic levels from Santiago, Chile.]. Rev Med Chil.

Background: A high prevalence of obesity is the main public health problem in Chilean school children. Aim: To compare the nutritional status, consumption of selected foods and extracurricular physical activity (PA) habits in school children of different socioeconomic levels as a baseline for developing effective educational interventions. Material and methods: Cross-sectional study that determined the body mass index, food consumption and physical activity with previously validated instruments in 202 and 358 girls from 3rd to 8th grade in schools of medium-high and low socioeconomic level (SEL) from Santiago, Chile, respectively. Results: Compared to their counterparts of low socioeconomic level (SEL), the prevalence of obesity was significantly lower in 8-9 year-old girls of medium high SEL (19% and 9%, respectively, p =0.012) and 12-13 year-old (12% and 2.5% respectively, p =0.008). Also median daily intake of dairy products was higher in girls of medium high SEL (250 and 470 ml/day, respectively). The intake of fruits and vegetables was similar (200 g/d); and the intake of bread was lower (230 and 70 g/day, respectively, p <0.01). Consumption of energy-dense foods was lower in 10-13 year-old girls of medium high SEL (80 and 50 g/day, respectively, p <0.01). 45% of 8-9 year-old girls and 35% of 12-13 year-old girls of both SEL engaged in PA four or more times per week (NS). Conclusions: Although the prevalence of obesity in girls of medium-high SEL was not as high as in those from low SEL, it is still high. There is a need for educational interventions to improve their food and PA habits and to promote an environment that enhances healthy behaviors.

A. M. Oliveira, A. C. Oliveira, M. S. Almeida, N. Oliveira and L. Adan. (2007). Influence of the family nucleus on obesity in children from northeastern Brazil: a cross-sectional study. BMC Public Health.

BACKGROUND: Obesity is considered to be caused by a combination of heredity and environmental factors with typical onset during childhood. The aim of this study was to identify family risk factors for the development of obesity in children from Brazil. METHODS: Cross-sectional study with 699 children, randomly and proportionally selected, ranging from 5 to 9 years of age, from public and private schools in Feira de Santana-BA. Overweight and obesity were defined using IOTF standards. Analyses of the interviews with the children's guardians were used to determine the influence of the family nucleus on obesity. RESULTS: The children were classified into four groups based on weight percentiles (underweight, normal, overweight and obese). Significant differences between the groups in relation to ethnicity, social and economical status (rho = 000.0 for all) were found. The following variables were associated with the development of childhood obesity: fathers' obesity (rho = 0.001), mothers' (rho = 0.021) and both parents' (rho = 0.000). There was no significant statistical difference between fathers and mothers who did (rho = 0.81) or did not work out (rho = 0.15). Obesity (rho = 0.07) tended to be less prevalent in the child whose parents were separated. Family history of obesity (OR = 3.3; IC = 2.0 - 5.5; rho = 0.000) and high social class (OR = 3.0; IC = 1.1 - 7.7; rho = 0.020) were predictive and independent associated factors. CONCLUSION: This study confirms the influence of genetic and/or behavioral factors on the origin of childhood obesity. Thus, effective intervention strategies must be focused not only on the children but on the entire family nucleus.

J. O'Loughlin, K. Maximova, Y. Tan and K. Gray-Donald. (2007). Lifestyle risk factors for chronic disease across family origin among adults in multiethnic, low-income, urban neighborhoods. Ethnicity and Disease.

OBJECTIVES: To describe the prevalence and co-occurrence of lifestyle risk factors for chronic disease by family origin. DESIGN: Cross-sectional analysis. SETTING: Multiethnic, low-income, urban neighborhoods in Montreal, Canada. PARTICIPANTS: 2033 adults (42.2% male), mean age 39.7 (standard deviation 6.4) years OUTCOME MEASURES: Smoking, level of physical activity, dietary habits, body mass index. METHODS: Subjects completed self-report questionnaires on sociodemographic characteristics, height, weight, and lifestyle behaviors. We tested family origin (based on language first learned in childhood and country of birth) as an independent correlate of co-occurrence (having at least two lifestyle risk factors) in multivariate logistic regression analyses. RESULTS: The prevalence of smoking and poor diet was highest among participants of French Canadian family origin. Although physical inactivity was uniformly high across family origins, it was highest among participants of Portuguese, Italian, and Haitian family origin. Obesity was highest among Europeans. The prevalence of smoking was lowest among Haitians; poor diet was lowest among South Asians; and physical inactivity was lowest among Eastern Europeans. Obesity was lowest among Asians, with the exception that 55.9% of South Asians were overweight or obese. Relative to French Canadians, adults in all other family-origin groups had a lower risk of co-occurrence of lifestyle risk factors. Adults of Asian family origin had the lowest prevalence of co-occurrence of lifestyle risk factors. CONCLUSION: Variation in the distribution of lifestyle risk factors may explain in part differences in chronic disease morbidity and mortality across ethnic groups. Prevention programs should take differential distribution of lifestyle risk factors by ethnicity into account.

C. M. Olson, C. F. Bove and E. O. Miller. (2007). Growing up poor: long-term implications for eating patterns and body weight. Appetite.

This study aimed to understand how poverty-associated food deprivation in childhood contributes to the well-known relationship between low socioeconomic status (SES) in childhood and obesity in the adult years. Thirty low-income, rural women with at least one child were followed for over three years with annual semi-structured interviews collecting quantitative and qualitative data. For the quantitative portion, the measures of interest were body mass index (BMI), food insecurity, eating patterns, and SES. For the qualitative portion, text from the interviews was analyzed using the constant comparative method. Growing up in a poor household was associated with increased risk of overweight and obesity in adulthood. Experiences of poverty-associated food deprivation in childhood appeared to super-motivate some women to actively avoid food insecurity in adulthood. It also influenced the women's current food preferences. Tremendous excitement accompanied the availability of food after periods of deprivation in both the women and their children. Some women had used food to meet emotional needs in childhood and overeating had become a generalized response to negative emotional states in the adult years. Food deprivation in childhood and associated attitudes and behaviors towards food are one possible mechanism for explaining the association between childhood poverty and adult obesity.

R. M. Page, F. Ihasz, J. Simonek, R. Klarova and I. Hantiu. (2007). Friendships and physical activity: investigating the connection in Central-Eastern European adolescents. International Journal of Adolescent Medicine and Health.

Studies investigating physical activity among adolescents living in post-communistic Central-European countries are sparse, particularly in light of the fact that some research has identified that adults in these countries exercise less frequently than western counterparts. The purpose of this study was to investigate whether physical activity participation is associated with certain friendship factors, the ability to make friends, level of involvement with friends, and perceived friends' involvement in physical activity, among 1,886 Central-Eastern European high schools students. The results of this study corroborated previous research in other adolescent populations in which it has been found that overall participation in physical activity was lowest among adolescents who said that making friends was difficult, who were less involved with friends, and who reported that making friends was difficult. The association of these friendship factors and physical activity participation has important implications for health education. Friendship factors should be given serious consideration in health education strategies and research efforts designed to increase youth physical activity.

J. R. Palmer, S. Krishnan, L. A. Wise, L. L. Adams-Campbell and L. Rosenberg. (2007). Neighborhood socioeconomic characteristics and weight gain in US black women. American Journal Of Epidemiology.
R. Pawlinska-Chmara, I. Wronka, E. Suliga and K. Broczek. (2007). Socio-economic factors and prevalence of underweight and overweight among female students in Poland. Homo-Journal Of Comparative Human Biology.

The aim of the work was to assess the prevalence of underweight among young women and to analyse factors contributing to this phenomenon. The study group consisted of 718 female students aged 18-24 years. Underweight, overweight and obesity was classified according to BMI and WHO criteria. To assess the socio-economic status (SES), place of residence before entering the university and education of parents were used. Variables characterising lifestyle such as sports activity, cigarette smoking and alcohol drinking were also taken into account. In the studied group, the prevalence of underweight was much higher than the prevalence of overweight and obesity (15.3% and 3.5%, respectively). Low BMI was more frequent among persons with higher SES. Moreover, it was noted that 70% of women having normal weight (BMI=18.50-24.99 kg/m2) wanted to have slimmer figure. No correlation was found between prevalence of very low body mass and lifestyle variables.

K. E. Peterson, T. Dubowitz, A. M. Stoddard, P. J. Troped, G. Sorensen and K. M. Emmons. (2007). Social context of physical activity and weight status in working-class populations. Journal of Physical Activity and Health.

BACKGROUND: Persistent disparities suggest that multiple aspects of social context may influence leisure-time physical activity levels and weight status in multiethnic, working-class populations. METHODS: Among participants in two randomized, controlled intervention trials (n = 1,969 in 10 health centers; n = 1545 in 26 manufacturing businesses) we used general linear mixed models to examine the relationship of variables posited by a social-contextual framework for behavior change with h/wk of self-reported leisure-time physical activity and with body mass index (BMI; weight [kg]/[height (m)2]) at baseline, adjusting for clustering within study site. RESULTS: Age, sex, race/ethnicity, and socioeconomic position were independently associated with leisure-time physical activity in both settings; multivariable models explained 15% of the variance in health centers and 11% in small businesses. Leisure-time physical activity and motivation to change lifestyle behaviors were inversely associated with BMI, adjusting for individual, interpersonal, and neighborhood factors. Models explained 12% of the variance in BMI in health centers and 10% in small businesses. CONCLUSIONS: A social-contextual framework highlights the contribution of social class and race/ethnicity in the variance in leisure-time physical activity and weight status but suggests other behavioral influences vary in multiethnic, working-class populations.

G. Petronyte and A. Zaborskis. (2007). From research to policy and practise: are parents related to adolescents' physical activity in Lithuanian families? European Journal Of Public Health.
L. C. Pichon, E. M. Arredondo, S. Roesch, J. F. Sallis, G. X. Ayala and J. P. Elder. (2007). The relation of acculturation to Latinas' perceived neighborhood safety and physical activity: a structural equation analysis. Annals of behavioral medicine.

BACKGROUND: Physical activity rates are low for adult Latinas. In the United States, only 7.8% of adult Latinas met Centers for Disease Control and Prevention recommendations for weekly vigorous leisure-time physical activity. PURPOSE: The purpose of this study is to test a theoretical model examining the direct and indirect influence of individual factors (demographic factors and acculturation) and the direct influence of built environmental variables (perceived neighborhood safety/aesthetics) on Latinas' physical activity in a U.S. border region. METHODS: Acculturation, perceived neighborhood safety/aesthetics, sociodemographic variables, and minutes of physical activity a week were collected from 526 Latinas using standardized survey measures. RESULTS: Only 30% of the Latinas reported meeting International Physical Activity Questionnaire's vigorous physical activity criteria, 8.6% met moderate, and 46.4% met walking. Findings from the structural equation modeling indicated that acculturation was positively associated with Latinas' vigorous and moderate physical activity, with no significant relation to walking. There were no direct associations of perceived neighborhood safety/aesthetics on any of the three measures of physical activity. CONCLUSIONS: Data suggest that acculturating to the U.S. mainstream culture may have positive effects on Latinas' reported physical activity. Contrary to studies of other populations, the perceived neighborhood environment was not related to Latinas' physical activity. Culturally appropriate interventions are needed for Latinas who are less acculturated into the United States.

F. Popham and R. Mitchell. (2007). Relation of employment status to socioeconomic position and physical activity types. Preventive Medicine.

OBJECTIVE: To investigate further associations between socioeconomic position and overall physical activity levels and specific types of physical activity. To investigate the role of employment status and health in these associations. METHODS: Cross-sectional analysis of self-reported physical activity of 2346 men and 2941 women aged 25 to 64 interviewed for the 2003 Scottish Health Survey. Poisson regression was used to generate prevalence ratios in multivariate analysis. RESULTS: Accumulated socioeconomic disadvantage was associated with doing little or no overall physical activity (19 and 16% of most advantaged men and women vs. 44 and 40% for most disadvantaged, age adjusted prevalence ratio: 2.02, 95% CI 1.60,2.56 and 2.21, 95% CI 1.81,2.71 for men and women). The association was attenuated by accounting for employment status and health (prevalence ratio 1.15, 95% CI 0.90,1.47 and 1.50, 95% CI 1.22,1.84 for men and women). Despite occupational activity being associated with lower socioeconomic position, the most disadvantaged did not have the highest rates because they were most likely to be out of employment. CONCLUSION: Comparing only those achieving the recommended level of physical activity to all others may obscure clear socioeconomic differences in physical activity. Policies to increase physical activity participation for the most disadvantaged are needed.

K. I. Proper, E. Cerin, W. J. Brown and N. Owen. (2007). Sitting time and socio-economic differences in overweight and obesity. International Journal Of Obesity.

Objectives: To examine (1) the inter-relationships between socio-economic status (SES), physical activity, three different domains of sitting time (weekday, weekend day and leisure-time sitting), and being overweight or obese (body mass index >= 25 kg/m(2)); and (2) the potential mediation effects of sitting time in the relationship between socio-economic factors and being overweight or obese in working Australian adults. Design: Observational epidemiological study. Subjects: One thousand forty eight working adults. Using a multistage sampling design on neighbourhood SES, participants were from high and low SES neighbourhoods of an Australian capital city. Measurements: Neighbourhood SES was assessed using census data; individual SES was based on self-reported educational attainment and household income. There were three sitting time variables: sitting time on weekdays, weekend days and in leisure time. Overweight and obesity were determined using self-reported body weight and height. Results: Gender, age, neighbourhood SES, education, working hours and physical activity were independently associated with weekday, weekend day and leisure-related sitting time. With the exception of education and working hours, these variables were also independently associated with being overweight or obese. Leisure-time sitting was found to be a mediator in the relationships between gender, education and being overweight or obese. Conclusion: Strategies to promote less sitting in leisure time are required to combat overweight and obesity in Australian adults, especially among those from low SES neighbourhoods, and among those with high levels of education and income who work long hours.

D. L. Reas, J. F. Nygard, E. Svensson, T. Sorensen and I. Sandanger. (2007). Changes in body mass index by age, gender, and socio-economic status among a cohort of Norwegian men and women (1990-2001). BMC Public Health.

BACKGROUND: Consistent with global trends, the prevalence of obesity is increasing among Norwegian adults. This study aimed to investigate individual trends in BMI (kg/m2) by age, gender, and socio-economic status over an 11-year period. METHODS: A cohort of 1169 adults (n = 581 men; n = 588 women) self-reported BMI during a general health interview twice administered in two regions in Norway. RESULTS: Average BMI increased significantly from 23.7 (SD = 3.4) to 25.4 (SD = 3.8), with equivalent increases for both genders. Proportion of obesity (BMI > or = 30) increased from 4% to 11% for women and 5% to 13% for men. Of those already classified as overweight or obese in 1990, 68% had gained additional weight 10 years later, by an average increase of 2.6 BMI units. The greatest amount of weight gain occurred for the youngest adults (aged 20-29 years). Age-adjusted general linear models revealed that in 1990, women with a lower level of education had a significantly greater BMI than more educated women. In both 1990 and 2001, rural men with the highest level of household income had a greater BMI than rural men earning less income. Weight gain occurred across all education and income brackets, with no differential associations between SES strata and changes in BMI for either gender or region. CONCLUSION: Results demonstrated significant yet gender-equivalent increases in BMI over an 11-year period within this cohort of Norwegian adults. Whereas socio-economic status exerted minimal influence on changes in BMI over time, young adulthood appeared to be a critical time period at which accelerated weight gain occurred.

S. Regber, K. Berg-Kelly and S. Marild. (2007). Parenting styles and treatment of adolescents with obesity. Pediatric nursing.

Professional caregivers have an important task in building a trusting relationship with parents and adolescents and in supporting parents in their parental roles. Our clinical experience of some 300 adolescents with obesity between 9 and 18 years of age and their parents has convinced us that consideration of parenting styles is fundamental in the treatment of children and adolescents with obesity. Typical case situations supporting the significance of parenting styles and illustrating the relationships between parents and adolescents with obesity can be identified. Group sessions with parents are the preferred mode for discussing typical parenting issues in the management of obese adolescents. The purpose of this paper is to describe different parenting styles, and to present a set of typical case situations and treatment strategies for nurses working with adolescents with obesity.

R. Richards and C. Smith. (2007). Environmental, parental, and personal influences on food choice, access, and overweight status among homeless children. Social Science & Medicine.

In-depth interviews were conducted with homeless children (n = 56, aged 6-13 years) in an urban center in Minnesota, USA, to determine factors influencing food choice, food access, and weight status, with interview questions developed using the Social Cognitive Theory. Interview transcripts were coded and then evaluated both collectively and by weight status (< 85th percentile = normal weight vs. >= 85th percentile = overweight). Forty-five percent of children were overweight. Environmental, parental, and personal factors emerged as common themes influencing food access and choice. Despite children's personal food preferences, homelessness and the shelter environment created restrictive conditions that influenced food choice and access. Shelter rules, lack of adequate storage and cooking facilities, and limited food stores near the shelter, impacted the type and quality of food choices, ultimately affecting hunger, weight status, and perceived health. (c) 2007 Elsevier Ltd. All rights reserved.

E. C. Rush, J. H. Goedecke, C. Jennings, L. Micklesfield, L. Dugas, E. V. Lambert and L. D. Plank. (2007). BMI, fat and muscle differences in urban women of five ethnicities from two countries. International Journal of Obesity (London).

OBJECTIVE: To investigate body composition differences, especially the relationship between body mass index (BMI) and percent body fat (%BF), among five ethnic groups. DESIGN: Cross-sectional. SUBJECTS: Seven hundred and twenty-one apparently healthy women aged 18-60 years (BMI: 17.4-54.0 kg/m(2)) from South Africa (SA, 201 black, 94 European) and New Zealand (NZ, 173 European, 76 Maori, 84 Pacific, 93 Asian Indian). MEASUREMENTS: Anthropometry, including waist circumference, and total, central and peripheral body fat, bone mineral content and total appendicular skeletal muscle mass (ASMM) derived from dual X-ray absorptiometry. RESULTS: Regression analysis determined that at a BMI of 30 kg/m(2), SA European women had a %BF of 39%, which corresponded to a BMI of 29 for SA black women. For a BMI of 30 kg/m(2) in NZ Europeans, equivalent to 43% body fat, the corresponding BMIs for NZ Maori, Pacific and Asian Indian women were 34, 36 and 26 kg/m(2), respectively. Central fat mass was lower in black SA than in European SA women (P<0.001). In NZ, Pacific women had the lowest central fat mass and highest ASMM, whereas Asian Indian women had the highest central fat mass, but lowest ASMM and bone mineral content. CONCLUSIONS: The relationship between %BF and BMI varies with ethnicity and may be due, in part, to differences in central fatness and muscularity. Use of universal BMI or waist cut-points may not be appropriate for comparison of obesity prevalence among differing ethnic groups, as they do not provide a consistent reflection of adiposity and fat distribution across ethnic groups.

J. M. Saavedra, S. Torres, B. Caro, Y. Escalante, E. D. la Cruz, M. J. Duran and F. A. Rodriguez. (2007). Relationship between health-related fitness and educational and income levels in Spanish women. Public Health.

OBJECTIVES: The aim of this study was to determine whether a relationship exists between health-related fitness, taken as an indicator of regular physical activity, and educational and income levels in adult Spanish women. STUDY DESIGN: Descriptive, correlation, cross-sectional study. METHODS: A stepwise stratification procedure according to population size, age and level of physical activity according to a previous epidemiological survey was used for sampling. Two thousand and thirty-eight women gave their written consent to participate (62.8% of those invited). The final sample consisted of 1709 healthy women (aged 18-88 years). Subjects were categorized into high, medium and low level groups for education and income. All participants were assessed for morphological and physical health-related fitness. Three-way MANCOVA (age as covariate) and Bonferroni's post hoc test were used to determine the differences between groups. RESULTS: No significant relationships were found between age-adjusted educational and income levels. The lowest values for health-related fitness were found in the lowest educational and income groups (P<0.001). The higher the level of education and income, the better the values for all fitness variables (P<0.001), except anterior trunk flexibility. CONCLUSIONS: A positive relationship was found between health-related fitness and educational and income levels, which appeared to be most evident in the lowest educational and income groups. This implies that health-related promotion policies in Spain should stress the importance of regular physical activity in social classes with low levels of education and income.

S. J. Salvy, J. S. Coelho, E. Kieffer and L. H. Epstein. (2007). Effects of social contexts on overweight and normal-weight children's food intake. Physiology & Behavior.

This study investigates the effects of peer influence on the food intake of overweight and normal-weight children. A mixed factorial design was employed, with children's weight status (overweight vs. normal-weight) as a between-subjects factor, and social context (alone vs. group) as a within-subjects factor. A total of 32 children (n=17 overweight and n=15 normal-weight) between the ages of 6-10 years participated in this study. Findings from the random regression model indicated that overweight children ate more when with others than when alone, while in contrast normal-weight ate more with others than they did when alone. Therefore, social context differentially impacts the eating behavior of overweight and normal-weight children. This study underscores differences in responses to the social environment between overweight and non-overweight youths, and suggests that social involvement may be an important tool in treatment and prevention programs for overweight and obesity.

A. M. Sanigorski, A. C. Bell, P. J. Kremer and B. A. Swinburn. (2007). High childhood obesity in an Australian population. Obesity (Silver Spring).

OBJECTIVE: The objective was to determine the prevalences of overweight and obesity in regional Australian children and to examine the association between BMI and indicators of socioeconomic status (SES). RESEARCH METHODS AND PROCEDURES: Regionally representative cross-sectional survey of 2184 children, 4 to 12 years of age, was conducted, and the socio-demographic characteristics of their parents from regional Victoria, Australia, 2003 to 2004, were obtained. RESULTS: The prevalences of overweight and obesity were 19.3 +/- 0.8% (proportion +/- standard error) and 7.6 +/- 0.6%, respectively, using international criteria, and the proportion of overweight/obese girls was significantly higher than that of boys (29.6 +/- 1.4% vs. 23.9 +/- 1.3%, chi2 = 9.01, p = 0.003). Children from households of lower SES had higher odds of being overweight/obese; lower SES was defined by lower paternal education (adjusted odds ratio, 1.18; 95% confidence interval, 1.08 to 1.30) and lower area-level SES (adjusted odds ratio, 1.13; 95% confidence interval, 1.02 to 1.25), adjusted for age, gender, height, and clustering by school. DISCUSSION: The prevalences of overweight and obesity are increasing in Australian children by about one percentage point per year. This equates to approximately 40,000 more overweight children each year, placing Australian children among those at highest risk around the world. In addition, girls are more likely to be overweight, and there is a general trend for children of lower SES to be at even greater risk of overweight and obesity.

C. Schroeter, J. Lusk and W. Tyner. (2008). Determining the impact of food price and income changes on body weight. Journal of Health Economics.

We develop a theoretical model to identify conditions under which price and income changes are most likely to change weight. Although it is intuitive that raising the price of high-calorie food will decrease consumption of such goods; it is not clear that such an outcome will actually reduce weight. Our empirical analysis demonstrates a case where a tax on food away from home, a food intake category blamed for much of the rise in obesity, could lead to an increase in body weight; a finding which emphasizes the need to employ economic modeling when developing public policy to reduce obesity.

M. Shishehbor, M. S. Lauer, P. Gordon-Larson, C. I. Kiefe and D. Litaker. (2007). Association of neighborhood socioeconomic status with physical fitness in healthy young adults: The CARDIA study. Journal Of The American College Of Cardiology.
J. S. Son, D. L. Kerstetter, C. M. Yarnal and B. L. Baker. (2007). Promoting older women's health and well-being through social leisure environments: What we have learned from the red hat society (R). Journal Of Women & Aging.

The purpose of this study was to describe the ways that participation in a leisure organization contributed to the health and wellbeing of middle-aged and older women. We analyzed 1,693 members' responses to a query about meaningful experiences garnered through participation in the Red Hat Society Results suggested that older women's lives have been enriched and changed by their experiences, with the women in this study citing multiple psychosocial health benefits from their participation in the Red Hat Society (R). Main themes encapsulating these health benefits were creating happy moments, responding to transitions and negative events, and enhancing the self. These findings are related to research on positive psychology, social support and coping, transformative leisure processes, and social identity formation. We conclude by providing Suggestions for applying these findings to leisure and health promotion programming to enhance women's health and well-being in later life.

O. Sonia, N. Bustos, L. Lera and M. E. Zelada. (2007). Nutritional status, food consumption and physical activity in female school children of different socioeconomic levels from Santiago, Chile. Revista Medica De Chile.

Background A high prevalence of obesity is the main public health problem in Chilean school children. Aim: To compare the nutritional status, consumption of selected foods and extracurricular physical activity (PA) habits in school children of different socioeconomic levels as a baseline for developing effective educational interventions. Material and methods: Cross-sectional study that determined the body mass index, food consumption and physical activity with previously validated instruments in 202 and 358 girls from 3(rd) to 8(th) grade in schools of medium-high and low socioeconomic level (SEL) from Santiago, Chile, respectively. Results: Compared to their counterparts of low socioeconomic level (SEL), the prevalence of obesity was significantly lower in 8-9 year-old girls of medium high SEL (19% and 9%, respectively, p =0.012) and 12-13 year=old (12% and 2.5% respectively, p =0.008). Also median daily intake of dairy products was higher in girls of medium high SEL (250 and 470 ml/day, respectively). The intake of fruits and vegetables was similar (200 g/d); and the intake of bread was lower (230 and 70 g/day, respectively, p <0.01). Consumption of energy-dense foods was lower in 10-13 year-old girls of medium high SEL (80 and 50 g/day, respectively, p <0.01). 45% of 8-9 year-old girls and 35% of 12-13 year-old girls of both SEL engaged in PA four or more times per week (NS). Conclusions: Although the prevalence of obesity in girls of medium-high SEL was not as high as in those from low SEL, it is still high. There is a need for educational interventions to improve their food and PA habits and to promote an environment that enhances healthy behaviors.

J. P. Stimpson, A. C. Nash, H. Ju and K. Eschbach. (2007). Neighborhood Deprivation is associated with lower levels of serum carotenoids among adults participating in the Third National Health and Nutrition Examination Survey. Journal of the American Dietetic Association.

OBJECTIVE: This study tested the hypothesis that neighborhood deprivation will be associated with lower levels of serum carotenoids in comparison with wealthy residential areas. DESIGN: Cross-sectional, nationally representative survey data were used to assess the relationship between neighborhood level socioeconomic status and serum carotenoids. SUBJECTS: Seventeen thousand two participants aged 17 years and older from the Third National Health and Nutrition Examination Survey were linked with 1990 census data. MAIN OUTCOME MEASURES: Serum levels of lycopene, beta-carotene, alpha-carotene, lutein/zeaxanthin, and beta-cryptoxanthin. STATISTICAL ANALYSIS: Multivariate linear regression was used to model the association of serum carotenoids and neighborhood deprivation, which is a summary index of 11 indicators for tract level socioeconomic status. Adjustments are made for individual level age, sex, years of education, household income, employment, race/ethnicity, body mass index, serum cotinine, alcohol use, physical activity, and serum cholesterol. RESULTS: Multivariate analysis revealed a negative and statistically significant association between high levels of neighborhood deprivation and beta-carotene (beta=-2.98 microg/dL [-0.06 micromol/L], P=0.00), alpha-carotene (beta=-1.28 microg/dL [-0.02 micromol/L], P=<0.0001), lutein/zeaxanthin (-1.69 microg/dL [-0.03 micromol/L], P=0.00, beta-cryptoxanthin (beta=-1.34 microg/dL [-0.02 micromol/L], P<0.0001), and total carotenoids (beta=-8.20 microg/dL, P=<0.0001). Lycopene was not related to neighborhood deprivation. Adjusted mean levels of carotenoids for high deprivation neighborhoods were lower than neighborhoods with low deprivation: beta-carotene=8.72 microg/dL [0.16 micromol/L] vs 20.64 microg/dL [0.38 micromol/L], alpha-carotene=0.44 microg/dL [0.008 micromol/L] vs 5.56 microg/dL [0.10 micromol/L], lutein/zeaxanthin=13.79 microg/dL [0.24 micromol/L] vs 20.55 microg/dL [0.36 micromol/L], beta-cryptoxanthin=4.57 microg/dL [0.08 micromol/L] vs 9.93 microg/dL [0.18 micromol/L], lycopene=22.07 microg/dL [0.41 micromol/L] vs 25.63 microg/dL [0.48 micromol/L], and total=49.56 microg/dL vs 82.36 microg/dL. CONCLUSIONS: Neighborhood deprivation was associated with lower serum levels of carotenoids. There was a substantial disparity between low deprivation and high deprivation residential areas with respect to fruit and vegetable intake.

J. L. Styles, A. Meier, L. A. Sutherland and M. K. Campbell. (2007). Parents' and caregivers' concerns about obesity in young children: a qualitative study. Family and Community Health.

To address the childhood obesity epidemic, it is necessary to understand parents' and caregivers' concerns and beliefs regarding their children's weight problems and best practices for addressing those concerns. Formative research methods were used to identify obesity-related concerns of Hispanic, Black, and White parents of young children (5-8 years old) in North Carolina. Participants identified challenges at multiple levels of influence. In all groups, participants reported that they had trouble finding enough time to help their children develop healthy lifestyles. Conflicting family priorities and needs often made it difficult to ensure that their children had healthy diets. Children's own diet and activity preferences and their parent or caregiver's inability to adequately guide their choices also contributed to obesigenic behaviors. In addition, many thought that physician and community support for their efforts to manage their children's eating habits was inadequate. Findings from these focus groups suggest that participants would be receptive to positive, multilevel prevention approaches to help their children attain and maintain healthy weights.

A. Sujoldzic and A. De Lucia. (2007). A cross-cultural study of adolescents--BMI, body image and psychological well-being. Collegium antropologicum.

Physical, psychological and social changes that occur during adolescence can markedly affect dietary habits and nutritional health. Physical changes including rapid growth place extra nutritional requirements on adolescents, while culture and society require adjustments in all of the aspects of daily living, including psychosocial well-being. Adolescents become focused on the physical appearance and any deviation from the ideal figure can result in negative dieting behavior, social withdrawal, poor self-esteem and increased health vulnerability. The paper presents some of the results of an international comparative study on risk and protective factors of adolescent health and well being, related to BMI, dieting behavior and body image and their relationship to psychosocial well-being (somatic stress, anxiety, depression, life satisfaction and self-esteem). Within an ecological cultural framework, it looks at group-specific differences of Albanian and Bosnian adolescents within different socio-cultural contexts across six European countries: two EU members (Italy and Austria) and four communities in the state of socioeconomic and political transition (Croatia, Bosnia and Herzegovina, Albania and Kosovo). The survey collected data from 2000 adolescents between 15 and 18 years of age. The study demonstrated a strong relationship between BMI and body dissatisfaction, between body image and dietary habits, and strong effects of body image on all indicators of psychosocial health. In addition to expected marked gender differences in all countries, the obtained results indicate significant intracultural variations related to socioeconomic status as well as considerable intercultural variations due to variable influence specific social and cultural contexts.

N. S. The and P. Gordon-Larsen. (2007). Shared household environment and marriage, cohabitation, and dating: Living together increases the likelihood of obesity. Faseb Journal.

C. Tudor-Locke, B. E. Ainsworth, L. S. Adair, S. Du, N. Lee and B. M. Popkin. (2007). Cross-sectional comparison of physical activity and inactivity patterns in Chinese and Filipino youth. Child Care Health Development.

BACKGROUND: To compare and contrast youth physical activity (PA) and inactivity patterns in two developing Asian countries: the Philippines and China. METHODS: Comparative analysis of 1997-1999 Cebu Longitudinal Health and Nutrition Survey and the 1997 China Health and Nutrition Survey, large-scale surveys that included questions on type, frequency and duration of: commuting mode to school, sports/exercise in and outside of school, select sedentary activities and chores. RESULTS: Filipino data included 760 males and 872 females aged 14-16 years. The comparable Chinese sample consisted of 202 males and 197 females. Active commuting is proportionately high in both countries (70-71% in the Philippines vs. 77-90% in China), although commuting by bicycling is rare in the Philippines (<1%) vs. China (approximately 35%). Patterns of school sport/exercise participation differ between countries by gender; more Filipino males report school sport/exercise than females (63 vs. 49%) vs. China, where more females participate than males (75 vs. 69%). Sport/exercise outside of school is proportionately low (6-12%) for youth from both countries with a single exception: 74% of Filipino males participate in extra-curricular sport/exercise. Although a higher percentage of Filipino youth report watching television >4 h/day (<10%) vs. Chinese youth (<1%), both are lower than comparable US reports. CONCLUSION: In the Philippines, continued modernization augurs a decrease in local primary PA sources (chores and active commuting). In China, where youth already are not expected to perform chores, shifts to more passive commuting modes (i.e. increased motorized transportation) are anticipated.

M. van Zutphen, A. C. Bell, P. J. Kremer and B. A. Swinburn. (2007). Association between the family environment and television viewing in Australian children. Journal Of Paediatrics And Child Health.

Aim: To describe the time children spend watching television (TV) and to assess associations between TV viewing time, the family environment and weight status. Methods: Parents reported the amount of time children watched TV/video both for 'the previous school day' and 'usually' and described aspects of the family environment influencing TV access as part of a large cross-sectional study in the Barwon South-western region of Victoria, Australia. Child weight status was based on measured height and weight. All data were collected in 2003/2004. Results: A total of 1926 children aged 4-12 years participated. Parent-reported mean +/- SE TV time for the previous school day was 83 +/- 1.5 min. Children who lived in a family with tight rules governing TV viewing time (22%), or who never watched TV during dinner (33%), or had only one TV in the household (23%) or had no TV in their bedroom (81%) had significantly less TV time than their counterparts. Overweight or obese children had more TV time than healthy weight children 88 +/- 2.9 versus 82 +/- 1.7 min per day (P = 0.04). They were also more likely to live in a household where children had a TV in their bedroom than healthy weight children (25% vs. 17%, P < 0.001). Conclusion: Strategies to reduce TV time should be included as part of broader strategies to prevent childhood obesity. They should include messages to parents about not having a TV in children's bedrooms, encouraging family rules restricting TV viewing, and not having the TV on during dinner.

V. R. Vieweg, C. H. Johnston, J. O. Lanier, A. Fernandez and A. K. Pandurangi. (2007). Correlation between high risk obesity groups and low socioeconomic status in school children. The Southern medical journal.

OBJECTIVE: Obesity is a major health problem among children and adolescents which is potentially affected by socioeconomic status (SES). The high risk group (HRG) comprises those youths with a body mass index (BMI) between the 85th and 95th percentile (at risk for overweight) and > or = 95th percentile (overweight). We sought a potential link between the HRG and SES. METHODS: Public schools in Chesterfield County, Virginia measured BMI among students in kindergarten and third, seventh, and tenth grades. We assessed SES based on eligibility for the National School Lunch Program and the percentage of the school-age population living in poverty based on per capita income from the 2000 Census. RESULTS: From 28 to 38% of children and adolescents were in the high risk group. Low SES had robust and highly significant correlations with HRG status with r-values ranging from 0.565 to 0.842, P < 0.0001. CONCLUSIONS: Low SES appears to be an important factor in childhood and adolescent obesity.

Y. Wang, H. Liang, L. Tussing, C. Braunschweig, B. Caballero and B. Flay. (2007). Obesity and related risk factors among low socio-economic status minority students in Chicago. Public Health Nutrition.

OBJECTIVES: To assess overweight and related risk factors among urban low socio-economic status (SES) African-American adolescents in an attempt to study the underlying causes of ethnicity and gender disparities in overweight. METHODS: Cross-sectional data collected on anthropometric measures, diet, physical activity and family characteristics from 498 students in grades 5-7 in four Chicago public schools were analysed to study the risk factors for overweight using stepwise regression analysis. RESULTS: Only 37.2% of the students lived with two parents. Nearly 90% had a television (TV) in their bedroom, and had cable TV and a video game system at home. Overall. 21.8% (17.7% boys versus 25.1% girls) were overweight (body mass index (BMI) >/= 95th percentile); and 39.8% had a BMI >/= 85th percentile. Compared with national recommendations, they had inadequate physical activity and less than desirable eating patterns. Only 66.1% reported having at least 20 min vigorous exercise or 30 min of light exercise in >/= 5 days over the past 7 days; 62.1% spent >3 h days- 1 watching TV/playing video games/computer, while 33.1% spent >/= 5 h days- 1. Their vegetable and fruit consumption was low, and they consumed too many fried foods and soft drinks: 55.1% consumed fried food twice or more daily and 19.5% four times or more daily; 70.3% consumed soft drinks twice or more daily and 22.0% four times or more daily on average. Gender, physical activity and pocket money were significant predictors of overweight (P < 0.05). CONCLUSIONS: Several factors in the students' behaviours, school and family environments may increase overweight risk among this population. There is a great need for health promotion programmes with a focus on healthy weight and lifestyle, and targeting urban low-SES minority communities.

M. C. Wang, S. Kim, A. A. Gonzalez, K. E. MacLeod and M. A. Winkleby. (2007). Socioeconomic and food-related physical characteristics of the neighbourhood environment are associated with body mass index. Journal of Epidemiological Community Health.

OBJECTIVE: To determine whether socioeconomic and food-related physical characteristics of the neighbourhood are associated with body mass index (BMI; kg/m(2)) independently of individual-level sociodemographic and behavioural characteristics. Design and METHODS: Observational study using (1) individual-level data previously gathered in five cross-sectional surveys conducted by the Stanford Heart Disease Prevention Program between 1979 and 1990 and (2) neighbourhood-level data from (a) the census to describe socioeconomic characteristics and (b) data obtained from government and commercial sources to describe exposure to different types of retail food stores as measured by store proximity, and count of stores per square mile. Data were analysed using multilevel modelling procedures. The setting was 82 neighbourhoods in agricultural regions of California. PARTICIPANTS: 7595 adults, aged 25-74 years. RESULTS: After adjusting for age, gender, ethnicity, individual-level socioeconomic status, smoking, physical activity and nutrition knowledge, it was found that (1) adults who lived in low socioeconomic neighbourhoods had a higher mean BMI than adults who lived in high socioeconomic neighbourhoods; (2) higher neighbourhood density of small grocery stores was associated with higher BMI among women; and (3) closer proximity to chain supermarkets was associated with higher BMI among women. CONCLUSION: Living in low socioeconomic neighbourhoods, and in environments where healthy food is not readily available, is found to be associated with increased obesity risk. Unlike other studies which examined populations in other parts of the US, a positive association between living close to supermarkets and reduced obesity risk was not found in this study. A better understanding of the mechanisms by which neighbourhood physical characteristics influence obesity risk is needed.

J. Wardle and S. Carnell. (2007). Parental feeding practices and children's weight. Acta Paediatrica Supplementum.

Global increases in childhood obesity rates demand that we tackle the problem from many directions. One promising avenue is to explore the impact of parental feeding practices, particularly those related to parental control over children's intake. In this paper, we review studies of parent feeding and child adiposity covering a range of research methodologies (case-control studies, high risk studies, cross-sectional community studies and longitudinal cohort studies). We also present results from a cross-sectional community study of pre-schoolers (n = 439) and a longitudinal study of twins from ages of 4 to 7 years (n = 3175 pairs). We conclude that parents are more likely to encourage leaner than heavier children to eat, but relationships between adiposity and other parental feeding strategies are unclear. We suggest that future research should: (i) explore the impact of a comprehensive range of authoritative and authoritarian parental feeding behaviours, preferably using the same validated scales consistently across studies; (ii) test the generalisation of existing findings to diverse socio-economic and ethnic groups and (iii) utilise experimental, prospective and genetic methodologies to explore the causal relationships between parental feeding and child weight. We describe current projects in our own group that are designed to take forward these recommendations.

C. A. Warms, B. L. Belza and J. D. Whitney. (2007). Correlates of physical activity in adults with mobility limitations. Family and Community Health.

This study identified the correlates of objectively and subjectively measured physical activity in adult wheelchair users. Fifty participants wore an activity monitor for a week and completed a questionnaire about factors associated with physical activity. Objectively measured activity correlated significantly with body mass index. Subjectively measured activity correlated significantly with age, stage of change, health, healthcare providers discussing exercise, and social support for exercise. Research on the effect of body mass index on activity in this population is needed. Intervention planners should plan programs that place emphasis on modifying the social environment (including healthcare providers) and removing attitudinal barriers.

D. R. Weiss, O'Loughlin, J.L., Platt, R.W., Paradis, G. (2007). Five-year predictors of physical activity decline among adults in low-income communities: a prospective study. International Journal of Behavioral Nutrition and Physical Activity.


Obesity in North America is now endemic, and increased understanding of the determinants of physical inactivity is critical. This analysis identified predictors of declines in physical activity over 5 years among adults in low-income, inner-city neighbourhoods.


Data on leisure time physical activity were collected in telephone interviews in 1992 and 1997 from 765 adults (47% of baseline respondents), as part of the evaluation of a community-based cardiovascular disease risk reduction program.


One-third of 527 participants who were physically active at baseline, were inactive in 1997. Predictors of becoming inactive included female sex (OR = 1.63 95% CI (1.09, 2.43)), older age (1.02 (1.01, 1.04)), higher BMI (1.57 (1.03, 2.40)), poor self-rated health (1.39 (1.05, 1.84)), lower self-efficacy for physical activity (1.46 (1.00, 2.14)), and not using a neighborhood facility for physical activity (1.61 (1.02, 2.14)).


These results highlight the fact that a variety of variables play a role in determining activity level, from demographic variables such as age and sex, to psychosocial and environmental variables. In addition, these results highlight the important role that other health-related variables may play in predicting physical activity level, in particular the observed association between baseline BMI and the increased risk of becoming inactive over time. Lastly, these results demonstrate the need for multi-component interventions in low-income communities, which target a range of issues, from psychosocial factors, to features of the physical environment.

M. Wen, C. R. Browning and K. A. Cagney. (2007). Neighbourhood deprivation, social capital and regular exerciSEuring adulthood: A multilevel study in Chicago. Urban Studies.

This multilevel research examines the contextual effects of neighbourhood SES and social capital indicators on physical activity over and above individual socio-demographic background. Using 1990 census data and two social surveys, the hypotheses are tested among 907 Chicagoans in 242 neighbourhoods in 1996. Significant interaction effects are found with gender and both neighbourhood SES and social capital; women's physical activity level is more responsive to neighbourhood context. Controlling for socio-demographic factors at the individual level and the interaction effects between neighbourhood variables and gender, social capital and neighbourhood SES appear to be significant correlates of individual physical activity. Moreover, contrary to most findings in the neighbourhood effects research on health, the data show that the effects of neighbourhood SES are stronger than the effects of household income. Interventions promoting physical activity should incorporate local environmental features into their designs.

B. Xie, C. P. Chou, D. Spruijt-Metz, K. Reynolds, F. Clark, P. H. Palmer, P. Gallaher, P. Sun, Q. Guo and C. A. Johnson. (2007). Socio-demographic and economic correlates of overweight status in Chinese adolescents. American Journal of Health Behavior.

OBJECTIVE: To investigate over-weight prevalence and socio-demographic and economic correlates in Chinese adolescents. METHODs: Weight, height, waist circumference, and socio-demo-graphic and economic variables of 6863 middle and high school students were measured. RESULTS: 10% of girls and 17% of boys were overweight. Waist circumference and overweight risk were significantly associated with pubertal status (P<0.05). High levels of parental education and family income were significant risk factors for overweight (P<0.05). DISCUSSION: Our findings underscore the need for development of evidence-based and culturally appropriate public health programs to prevent and treat pediatric obesity in China.

S. Yilmaz and Z. Bulut. (2007). Analysis of user's characteristics of three different playgrounds in districts with different socio-econornical conditions. Building And Environment.

During childhood, playgrounds have a great impact on development of children. Not only do well designed playgrounds help children fast problem solving ability but also increase their social interactive relationships. User surveys are sources of data to aid for planning, designing and management processing of playgrounds. The aim of this study was to investigate the characteristics of the playground users in districts which have different socio-economical structures in Erzurum. The study focuses on users of three different playgrounds, who belong to poor-middle-high income family groups. To identify the characteristics of playground users of three districts, a questionnaire survey was performed. Results were evaluated using Chi Square (chi 2) Correlation Test. Socio-economic conditions of the users were defined according to their incomes. From the outcomes, it was determined that among the playgrounds present in the districts where socio-economic conditions of the families differ user characteristics (gender, age and education level), family characteristics, problems and requirements were also significantly different. In the district where families are in the low income groups, the playgrounds (80%) are used by boys in majority (80%) and all the children (100%) in this district find the playgrounds inefficient. In the district where families are in the high income groups, again majority of the children interviewed (70%) reported they play in these areas with fear of falling down. As a consequence, it was clearly seen that more efficient playgrounds where children can play securely must be constructed. (C) 2007 Elsevier Ltd. All rights reserved.

M. F. Zabinski, G. J. Norman, J. F. Sallis, K. J. Calfas and K. Patrick. (2007). Patterns of sedentary behavior among adolescents. Health Psychology.

OBJECTIVE: Reducing certain sedentary behaviors (e.g., watching television, using a computer) can be an effective weight loss strategy for youth. Knowledge about whether behaviors cluster together could inform interventions. STUDY DESIGN: Estimates of time spent in 6 sedentary behaviors (watching television, talking on the telephone, using a computer, listening to music, doing homework, reading) were cluster analyzed for a sample of 878 adolescents (52% girls, mean age = 12.7 years, 58% Caucasian). MAIN OUTCOME MEASURES: The clusters were based on the sedentary behaviors listed above and compared on environmental variables (e.g., household rules), psychosocial variables (e.g., self-efficacy, enjoyment), and health behaviors (e.g., physical activity, diet). RESULTS: Four clusters emerged: low sedentary, medium sedentary, selective high sedentary, and high sedentary. Analyses revealed significant cluster differences for gender (p <.002), age (p <.002), body mass index (p <.001), physical activity (p <.01), and fiber intake (p <.01). CONCLUSIONS: Results suggest a limited number of distinct sedentary behavior patterns. Further study is needed to determine how interventions may use cluster membership to target segments of the adolescent population.

(2007). Prevalence of fruit and vegetable consumption and physical activity by race/ethnicity--United States, 2005. Morbidity and Mortality Weekly Report.

Diets high in fruits and vegetables and participation in regular physical activity are associated with a lower risk for several chronic diseases and conditions. The National Cholesterol Education Program and the American Cancer Society both emphasize lifestyle modifications that include diet and physical activity to reduce disease risk. These are also two of the strategies implemented by states participating in CDC's Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases. To examine the combined prevalence of 1) consumption of fruits and vegetables five or more times per day and 2) regular physical activity among U.S. adults by race/ethnicity, CDC analyzed self-reported data from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). This report describes the results of that analysis, which indicated that the combined prevalence of these two behavioral strategies was higher among men of multiple/other races (16.5%) compared with non-Hispanic white men (12.6%). In addition, only 12.6% of non-Hispanic black women and 14.8% of Hispanic women, compared with 17.4% of non-Hispanic white women, engaged in these two behavioral strategies. These results underscore the need to promote diets high in fruits and vegetables and regular physical activity among all populations in the United States and among racial and ethnic minority communities in particular.

T. K. Richmond, A. E. Field and M. Rich. (2007). Can neighborhoods explain racial/ethnic differences in adolescent inactivity? International Journal Of Pediatric Obesity.

Objective. To determine if neighborhoods and their attributes contribute to racial/ethnic disparities in adolescent inactivity. Methods. We undertook a cross-sectional analysis of the National Longitudinal Study of Adolescent Health (n = 17 007), a nationally representative school-based study in the United States. Stratifying by gender, we used multivariate linear regression and multi-level modeling to determine whether neighborhood of residence may partially explain racial/ethnic disparities in adolescent physical inactivity, defined as hours viewing television or videos/DVDs and/or playing computer/video games each week. Results. Participants lived in largely segregated communities. Black and Hispanic adolescent girls reported higher levels of inactivity than White adolescent girls (21 vs. 15 vs. 13 hours/week, respectively, p < 0.001). Similar patterns were seen in adolescent boys, with Black adolescent males reporting a mean of 26 hours/week; Hispanic boys a mean of 20 hours/week; and White boys a mean of 17 hours/week of inactivity (p < 0.001). After accounting for between-neighborhood variation, there were no residual within-neighborhood differences in inactivity between Hispanic and White adolescent girls (gamma = -0.06, p = 0.93); when living in the same neighborhood Hispanic and White girls had similar levels of inactivity. Black adolescent girls and boys were found to have higher levels of inactivity no matter where they lived (gamma = 7.00, p < 0.001 for girls, gamma=6.96, p < 0.001 for boys). Hispanic boys had similar patterns of inactivity to White boys (gamma = -1.57, p=0.12). In both males and females, the reported rate of violent crime in the neighborhood was associated with inactivity, despite the individual's perception of his/her neighborhood as safe not being predictive. Conclusions. Although inactivity varies by race/ethnicity and gender, only in Hispanic adolescent girls does neighborhood fully explain the differential use. Our findings suggest that approaches other than changing neighborhood characteristics are needed to eliminate racial/ethnic disparities in adolescent inactivity.

M. Brabec, R. Godoy, V. Reyes-Garcia and W. R. Leonard. (2007). BMI, income, and social capital in a native Amazonian Society: Interaction between relative and community variables. American Journal Of Human Biology.

Researchers have shown interest in the relation between (a) social capital and individual income and (b) the individual health of people of industrial nations. The socioeconomic complexity of industrial nations makes it difficult to arrive at firm conclusions. We circumvent the obstacle by using data from a small-scale rural society of foragers-farmers in the Bolivian Amazon (Tsimane'). We examine the interactions between the outcome (BMI) and relative income, relative social capital, village income, and village social capital. We test three hypotheses: people in villages with more social capital should have higher BMI, the positive association between social capital and BMI will be more marked among the less well-off, and better-off people who display generosity will have higher BMI than better-off people who do not. On the methodological side we show the importance of: focusing on relative measures of income and social capital, estimating interaction between community and relative measures of income and social capital, and showing results through contour plots that summarize the relation between BMI and pairs of explanatory variables. On the substantive side we find evidence that village social capital and village income complement each other and are associated with higher BMI, the rich who are stingy have lower BMI than the rich who display generosity, and increase in village income might reduce individual incentives to invest in social capital. We explore interactions between explanatory variables and their influence on BMI, and end by recommending the use of an experimental research design to obtain unbiased estimates of causal effects.

S. L. Martin, Lee, S.M., Lowry, R. (2007). National Prevalence and Correlates of Walking and Bicycling to School. American Journal of Preventive Medicine.

Active travel to school provides youth with an opportunity to accumulate minutes of physical activity toward meeting recommended levels.

More than a third of youth aged 9 to 15 years live within a mile of school, but less than half of these students walk or bike to school even 1 day per week. The lowest proportions of active travelers among the independent correlates include students in the South, students living in rural areas, and students of parents with an advanced degree.
A. Peters, E. Iverson, V. Ruelas, M. Kipke and F. Kaufman. (2007). Adult and childhood obesity and diabetes in underserved communities. Diabetes.
J. Utter, R. Scragg, C. N. Mhurchu and D. Schaaf. (2007). At-home breakfast consumption among New Zealand children: associations with body mass index and related nutrition behaviors. Journal of the American Dietetic Association.

OBJECTIVE: The evidence supporting the relationship between breakfast consumption and body weight is growing, but the mechanisms to explain this relationship are less understood. This study aims to describe the relationship between breakfast consumption and body mass index (BMI) and relevant nutrition behaviors. DESIGN: Cross-section design using the New Zealand's 2002 National Children's Nutrition Survey. Participants were interviewed about their food habits and physical activity, completed a food frequency questionnaire, and were weighed and measured for height. SUBJECTS/SETTING: A nationally representative sample of 3,275 children aged 5 to 14 years. MAIN OUTCOME MEASURES: Breakfast consumption, BMI, and nutrition behaviors. STATISTICAL ANALYSES PERFORMED: The demographic characteristics of children by breakfast consumption were generated by cross-tabulations. Regression models were used to examine the relationships between breakfast consumption and BMI and nutrition behaviors. RESULTS: Breakfast consumption was most frequent among boys, children aged 5 to 6 years, children aged 7 to 10 years, New Zealand European children, and children from more affluent neighborhoods. Age differences in breakfast consumption increased with socioeconomic deprivation; older children experiencing the most socioeconomic deprivation were the least likely to eat breakfast. Skipping breakfast was associated with a higher BMI (P=0.002). Children who missed breakfast were significantly less likely to meet recommendations for fruit and vegetable consumption (P=0.005) and more likely to be frequent consumers of unhealthy snack foods. No relationship was found between breakfast consumption and physical activity. DISCUSSION: Results from our study suggest that efforts to increase breakfast consumption should be prioritized for older children from more deprived backgrounds. Increasing at home breakfast consumption may limit the amount of unhealthful snack foods children consume later in the day. Schools also have the potential to make a reasonable nutritional impact by providing healthful and affordable breakfast options for children who do not eat breakfast at home.

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