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PubMed2006

Peer victimization, psychosocial adjustment, and physical activity in overweight and at-risk-for-overweight youth.

OBJECTIVE: To examine the relationship between peer victimization and child and parent reports of psychosocial adjustment and physical activity in a clinical sample of at-risk-for-overweight and overweight children and adolescents. METHODS: The Schwartz Peer Victimization Scale, Children's Depression Inventory-Short Form, Multidimensional Anxiety Scale for Children, Social Physique Anxiety Scale, PACE+ Adolescent Physical Activity Measure, and Asher Loneliness Scale were administered to 92 children and adolescents (54 females) aged 8-18 years. The youth's parent/guardian completed the Child Behavior Checklist. RESULTS: Peer victimization was positively related to child-reported depression, anxiety, social physique anxiety, and loneliness, and parent-reported internalizing and externalizing symptoms. Peer victimization was negatively related to physical activity. Depressive symptoms and loneliness mediated the relations between peer victimization and physical activity. CONCLUSION: Recognition of the magnitude of the problem and the means of evaluating for peer victimization is important for clinicians who work with overweight youth. Assessing peer experiences may assist in understanding rates of physical activity and/or past nonadherence to clinician recommendations.

Adolescent↗

PubMed2006

Prevalence of overweight and risk of overweight among 3- to 5-year-old Chicago children, 2002-2003.

This article reports the first estimates of overweight prevalence in Chicago children entering school (aged 3-5 years). Chicago data are compared with those from the National Health and Nutrition Examination Survey (NHANES) and the Early Childhood Longitudinal Study (ECLS). Data were from 2 separate convenience samples of children aged 3-5 years attending either 18 Chicago Public Schools or 10 Chicago Catholic School pre-K programs (n = 1517). Data were taken from students' Certificate of Child Health Examination (CCHE), completed by a health professional. Overall, the prevalence of overweight subjects (body mass index >or=95th percentile) was 24%, more than twice that of the national prevalence of 10% for 2- to 5-year olds documented by NHANES (1999-2002) and 3 times that of the 1998-1999 ECLS prevalence estimate of 8% for 5- to 7-year olds in the Midwest region. The data reported here document that nearly one quarter of children entering school in Chicago are already overweight. This clearly establishes a need for local schools to develop protocols and procedures to support the physical and mental health needs of affected and at-risk children. The findings also make it plain that ongoing weight status monitoring is needed and that current plans to implement this should go forward.

Chicago↗

PubMed2000

Improving health professionals' management and the organisation of care for overweight and obese people.

BACKGROUND: Obesity is increasing throughout the industrialised world. If left unchecked it will have major implications for both population health and costs to health services. Health professionals have a key role to play in tackling the obesity problem, but little is known about how they may be encouraged to work more effectively with overweight and obese people. OBJECTIVES: The main objective was to determine whether health professionals' management or the organisation of care for overweight and obese people could be improved. SEARCH STRATEGY: We searched the specialised registers of the Cochrane Effective Practice and Organisation of Care Group (May 1997), the Cochrane Depression, Anxiety and Neurosis Group (August 1997), the Cochrane Diabetes Group (August 1997), the Cochrane Controlled Trials Register (September 1997), MEDLINE to January 1998, EMBASE to December 1997, Cinahl (1982 to November 1997), PsycLit (1974 to December 1997), Sigle (1980 to November 1997), Sociofile (1974 to October 1997), Dissertation Abstracts (1861 to January 1998), Conference Papers Index (1973 to January 1998), Resource Database in Continuing Medical Education. We also hand searched seven key journals and contacted experts in the field. SELECTION CRITERIA: Randomised trials, controlled before-and-after studies and interrupted time series analyses of providers' management of obesity or the organisation of care to improve provider practice or patient outcomes. We addressed three a priori comparisons and a fourth post hoc comparison. 1. Interventions aimed at improving health professionals' management or the delivery of health care for overweight/obese patients are more effective than usual care. 2. Interventions aimed at redressing negative attitudes and related practices towards overweight/obese patients are more effective than usual care. 3. Organisational interventions designed to change the structure of services for overweight/obese people are more effective than educational or behavioural interventions for health professionals. 4. Comparisons of different organisational interventions. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Twelve studies were included involving more than 393 providers and 3392 patients. Four studies were identified for comparison 1. Three were professional-oriented interventions (the use of reminders and training) and the fourth was a study of professional and organisational interventions of shared care. No studies were identified for comparisons 2 or 3. Eight studies were identified for post hoc comparison 4. These compared either the deliverer of weight loss interventions or the setting of interventions. The included studies were heterogeneous and of generally poor quality. REVIEWER'S CONCLUSIONS: At present, decisions about improving provision of services must be based on the evidence of patient interventions and good clinical judgement. Further research is needed to identify cost effective strategies for improving the management of obesity.

Body Weight↗

PubMed2003

[Overweight and risk of overweight in schoolchildren aged 6-17 years old in Galicia (Spain)].

BACKGROUND: Overweight and obesity currently represent one of the most important public health problems in industrialized countries and are also linked to cardiovascular disease and sleep apnea, as well as to orthopaedic and other complications. OBJECTIVES: To examine overweight and the risk of overweight in the school-aged population in Galicia in comparison with the nationally representative survey in the US population: the first National Health and Nutrition Examination Survey (NHANES-1). METHODS: We performed a cross sectional study including a sample of 1105 boys and girls (50 % from a rural environment and 50 % from urban areas) in Galicia, northwest Spain. RESULTS: The 50th percentile for boys and girls in Galicia was higher than the corresponding percentile in the NHANES-1 for all the ages studied. In general, the 85th and 95th percentiles for children's body mass index in Galicia were higher in the group aged 6-14 years. CONCLUSIONS: In Galicia body mass index values in the 50th, 85th and 95th percentiles were higher in girls than in boys. For the 50th percentile, both boys and girls in Galicia had higher values than those of the NHANES-1 for all ages. In areas with risk of excess weight (85th percentile) and prevailing excess weight (95th percentile) the same was true in the 6 to 13-14 age group for both sexes.

Adolescent↗

PubMed2005

Prevalence, characteristics, and correlates of teasing experiences among overweight children vs. non-overweight peers.

OBJECTIVE: Information regarding the prevalence, nature, sources, and psychosocial correlates of teasing was obtained for overweight (OV) children (10 to 14 years of age) vs. non-overweight (non-OV) peers. It was hypothesized that weight-related teasing would be negatively correlated with self-esteem in specific domains and with enjoyment of physical/social activities and positively correlated with loneliness, bulimic behaviors, body dissatisfaction, and enjoyment of sedentary/isolative activities. RESEARCH METHODS AND PROCEDURES: Teasing experiences and psychosocial correlates were assessed among OV children from a fitness camp and a demographically similar school sample of non-OV children. RESULTS: Among the OV children, appearance-related teasing was more prevalent, frequent, and upsetting, involved disparaging nicknames focusing more on weight rather than less stigmatized aspects of appearance, and more often perpetrated by peers in general rather than a specific peer. Degree of teasing within the full sample was significantly associated with higher weight concerns, more loneliness, poorer self-perception of one's physical appearance, higher preference for sedentary/isolative activities, and lower preference for active/social activities, all but the latter association holding up above and beyond actual weight status and demographics. Among OV children, teasing was associated with bulimic behaviors. Associations with type of teasing showed specificity, with weight-related teasing predicting weight and appearance variables and competency-related teasing related to social domain factors. DISCUSSION: When frequency, intensity, emotional impact, and stigmatized content are examined, findings indicate that teasing is more severe for OV children. Effective interventions are needed to help victims cope with and prevent further weight-related teasing, which may improve peer functioning, enhance weight control efforts, and reduce risk for future eating disturbance.

Adolescent↗

PubMed2006

Evaluation of the energy cost of playing a dance simulation video game in overweight and non-overweight children and adolescents.

The purpose of this study was to determine if there were any differences in the submaximal energy cost of movement between overweight (OW) and non-overweight (NO) children while playing a dance simulation video game, Dance Dance Revolution (DDR) and to determine if the cardiorespiratory measures obtained while playing the game met the American College of Sports Medicine (ACSM) recommendations for developing and maintaining cardiorespiratory fitness. Twenty-two children and adolescents (10 OW vs. 12 NO) participated in the study. Cardiorespiratory measurements were taken both during a maximal treadmill walking test and during a 12-minute Dance Dance Revolution protocol. The average absolute VO2 (OW: 917.1 +/- 257.1 vs. 590.6 +/- 147.9 mL . min (-1)) sustained over the DDR protocol was significantly higher in the OW group compared to the NO group. There was no significant difference in the average energy cost of movement when VO2 was normalized to fat-free mass (OW: 17.7 +/- 5.1 vs. NO: 17.3 +/- 3.9 mL . kgFFM (-1) . min (-1)). Both groups were above the minimal ACSM recommended heart rate intensity for developing and maintaining cardiorespiratory fitness when participating in the DDR protocol (OW: 64.83 % +/- 7.14 vs. NO: 64.51 % +/- 7.71), VO2 reserve, however, did not meet ACSM standards for developing and maintaining cardiorespiratory fitness.

Adolescent↗

PubMed2003

Validity and reliability of a physical activity recall instrument among overweight and non-overweight men and women.

This study examined the validity and reliability of survey items measuring one-week recall of physical activity (PA) and examined differences by weight status. A sub-aim of the study was to objectively assess the intensity of activity that most closely matches self-report. A questionnaire was administered to adults twice, three days apart. It was again administered after subjects wore a MTI/CSA accelerometer for seven days (n = 118). Several metabolic equivalent (MET) thresholds were applied to the accelerometer data. Agreement between test and re-test estimates of sufficient physical activity for health benefits (150 min/week) was high (% agreement > 90%). Correlations (rho) between total reported PA (mins/day) and accelerometer data were 0.29 (p < 0.05) among men and 0.25 (p < 0.05) among women. Among men, self-reported duration of moderate PA (3-5.9 METS) and accelerometer data were significantly correlated (rho = 0.40, p < 0.01), with no differences by weight status. Among women, a significant relationship was found only for those who were not overweight (rho = 0.52, p < 0.001). A significant correlation between self-reported duration of vigorous PA (6+ METS) and accelerometer data was only found for overweight men (rho = 0.40, p < 0.05). When lower MET thresholds were applied to the accelerometer data, women's reported duration of moderate-intensity PA was most strongly correlated with moderate PA (accelerometer) defined as 2.0-5.9 METS (rho = 0.39, p < 0.01). The recall instrument provides a consistent measure of physical activity and validation coefficients were similar to those obtained for other physical activity recall questionnaires. However, the ability to measure PA by self-report may vary by weight status.

Adult↗

PubMed1998

[Overweight. II. Determinants of overweight and strategies for prevention].

High risk groups for overweight can be defined according to features such as ethnicity, pregnancy, smoking cessation, sudden changes in lifestyle and activities, low socioeconomic status and low educational level, and a positive (family) history of diabetes mellitus and obesity. Coronary heart death is to be attributed for 15-30% to overweight (body mass index (BMI) > or = 25 kg/m2) and for 4-25% to obesity (BMI > or = 30 kg/m2). For diabetes mellitus these percentages are 64-82% and 33-75%, respectively. Population-based preventive and therapeutic measurements have to be aimed at less (fatty) food, more bodily activity, less consumption of alcohol, and better education and income. This requires policy changes at the ministries involved.

Adolescent↗

PubMed2005