RESUMEN
PURPOSE: To distinguish the origins of higher weight status and determine when and why intra- and interracial/ethnic disparities emerge. DESIGN: The study used a longitudinal analysis of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B). SETTING: The study was conducted in the United States. SUBJECTS: Participants were children of non-Hispanic white mothers and children of U.S.- and foreign-born mothers of Mexican origin from a nationally representative sample of children born in the year 2001 (N ≈ 3700). MEASURES: The Centers for Disease Control and Prevention growth charts determined sex- and age-specific weight status. Covariates were obtained from birth certificate records and parent interviews. ANALYSIS: Frequencies, growth curve trajectories, and ordinary least squares regression examined body mass index (BMI) and obesity across survey waves. RESULTS: Compared to their peers with non-Hispanic white mothers, children of Mexican-heritage mothers have higher average BMI and greater rates of obesity. The BMI of boys with Mexican-born mothers is higher relative to whites and children of U.S.-born Mexican mothers across early childhood, increasing sharply at about age 4.5 years. This divergence is driven by increases in the BMI of boys, as girls do not show the same growth. A number of measures, including descriptors of children's nutritional intake, lifestyle factors, and acculturation, do not explain the increased obesity rates among sons of Mexican mothers. CONCLUSION: Despite favorable perinatal health and weight, Mexican-American sons of foreign-born mothers show disadvantages in BMI that emerge close to the start of kindergarten.
Asunto(s)
Índice de Masa Corporal , Emigrantes e Inmigrantes/psicología , Emigrantes e Inmigrantes/estadística & datos numéricos , Americanos Mexicanos/psicología , Obesidad/prevención & control , Obesidad/psicología , Población Blanca/psicología , Peso Corporal , Preescolar , Humanos , Estudios Longitudinales , Masculino , Americanos Mexicanos/estadística & datos numéricos , Estados Unidos , Población Blanca/estadística & datos numéricosRESUMEN
PURPOSE: To investigate pathways in the association between fear of crime and obesity. DESIGN: A cross-sectional survey was administered among residents aged 18 years and older across all Census tracts. SETTING: Genesee County, Michigan. SUBJECTS: A total of 3192 residents. MEASURES: Body mass index (BMI) was calculated by using the respondents' reported height and weight. Composite fear-of-crime and depressive symptoms scores were calculated by using several survey items. ANALYSIS . Path analysis examined the effects of fear of crime on BMI. RESULTS . Fear of crime was associated with higher BMI. Depressive symptoms mediated the relationship between fear of crime and BMI (p < .001). Moderate exercise mediated the association between depressive symptoms and BMI (p < .001). CONCLUSION: Fear of crime was associated with depressive symptoms, which in turn were associated with reduced exercise and subsequently higher BMI.
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Índice de Masa Corporal , Crimen/psicología , Depresión/complicaciones , Miedo/psicología , Obesidad/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Michigan/epidemiología , Persona de Mediana Edad , Adulto JovenRESUMEN
PURPOSE: To examine predictors for persistent overweight/obesity, deteriorated weight status, and improved weight status among students who participated in a school-based obesity prevention intervention from fall 2009 to spring 2011. DESIGN: Longitudinal assessment of a school-based cohort was conducted to determine the characteristics of students who remained overweight/obese, improved their weight status, or showed deteriorated weight status during an 18-month period. SETTING: Eleven schools in southern Indiana, northwestern Kentucky, and southeastern Illinois. SUBJECTS: N = 5309 students in 4th through 12th grade. MEASURES: Weight, height, and self-reported physical activity and nutrition behaviors of students were measured at baseline and 6, 12, and 18 months. ANALYSIS: SAS 9.3 was employed to examine predictors for the three different weight categories using logistic regression. RESULTS: Low socioeconomic status (SES) (adjusted odds ratio [AOR] = 1.56 and p < .001, AOR = 1.35 and p = .0069, respectively) and higher soda intake (AOR = 1.07 and p = .0016, AOR = 1.08 and p = .0278, respectively) increased the odds of belonging to persistent overweight/obesity (30.6%) and deteriorated weight status (6.9%), compared to the persistent nonoverweight status group. CONCLUSION: While SES is an important determinant of weight category change, students' screen time and soda consumption may be important factors. Schools and families may be able to successfully focus on these modifiable risk factors, decreasing the burden of childhood obesity.
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Bebidas Gaseosas , Obesidad/prevención & control , Factores de Riesgo , Clase Social , Estudiantes/estadística & datos numéricos , Adolescente , Niño , Femenino , Humanos , Masculino , Medio Oeste de Estados Unidos , Sobrepeso , Servicios de Salud Escolar , Aumento de Peso , Pérdida de Peso , Adulto JovenRESUMEN
PURPOSE: To assess the impact of the Choose Less, Weigh Less portion size health marketing campaign. DESIGN: A mixed-methods, cross-sectional evaluation. SETTING: A quantitative Internet panel survey was administered through an online sampling vendor and qualitative interviews were conducted by street intercept. SUBJECTS: The panel survey included 796 participants, weighted to represent Los Angeles County. Street intercept interviews were conducted with 50 other participants. INTERVENTION: The Choose Less, Weigh Less campaign included print media on transit shelters, bus and rail cars, and billboards; radio and online advertising; and Web site content and social media outreach. MEASURES: The panel survey measured self-reported campaign exposure and outcomes, including knowledge of recommended daily calorie limits, attitudes toward portion sizes, and intent to reduce calories and portion size. Intercept interviews assessed campaign appeal, clarity, and utility. ANALYSIS: Weighted survey data were analyzed using logistic regression to assess the association between campaign exposure and outcomes. Interview data were analyzed for themes. RESULTS: The campaign reached 19.7% of the Los Angeles County population. Significant differences were seen for 2 of the 10 outcomes assessed. Participants who saw the campaign were more likely than those who did not to report fast-food portion sizes as being too large (adjusted odds ratio [Adj. OR]: 1.89; 95% confidence interval [CI]: 1.16, 3.07) and intention to choose a smaller portion (Adj. OR: 1.99; 95% CI: 1.20, 3.31). Qualitative data revealed three themes about appeal, clarity, and utility. CONCLUSION: Health marketing efforts targeting portion size can have relatively broad reach and limited but positive impacts on consumer attitudes and intent to select smaller portions.
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Dieta Reductora , Promoción de la Salud , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Los Angeles , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Mercadeo Social , Encuestas y Cuestionarios , Adulto JovenRESUMEN
PURPOSE: Examine the association between soft drink consumption and risk of weight gain over 4 years. Also, determine if the relationship between soft drink intake and weight gain is a result of differences in calorie intake or physical activity (PA), or other potential mediating factors. DESIGN: Four-year prospective cohort. SETTING: Approximately 20 cities in Utah and Wyoming. SUBJECTS: One hundred seventy nonsmoking, apparently healthy women. MEASURES: At baseline, soft drink consumption and menopause status were measured using a questionnaire; calorie intake was estimated using 7-day, weighed food records; and PA was assessed using 7-day accelerometer data. Weight was assessed using an electronic scale at baseline and follow-up. ANALYSIS: Multiple regression and partial correlation. RESULTS: Four-year weight gain in participants who, at baseline, consumed sugar-sweetened soft drinks (2.7 ± 5.1 kg) was greater than in participants who consumed artificially sweetened soft drinks (-.1 ± 4.4 kg) or no soft drinks (.5 ± 5.1 kg) (F = 5.4, p = .022). Adjusting for objectively measured PA had no effect on risk of weight gain. However, controlling statistically for differences in calorie intake significantly weakened the relationship between soft drink consumption and weight gain by 28%. CONCLUSION: Consuming artificially sweetened soft drinks or no soft drinks instead of sugar-sweetened soft drinks may help to reduce risk of weight gain in women. The relationship appears to be partly a function of differences in calorie intake, but not differences in PA.
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Bebidas Gaseosas/estadística & datos numéricos , Ingestión de Energía , Ejercicio Físico , Aumento de Peso/efectos de los fármacos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Análisis de Regresión , Utah , WyomingRESUMEN
PURPOSE: The financial impact of intensive medical interventions for weight loss has not been fully studied. DESIGN: A randomized pragmatic clinical trial. SETTING: Seven primary care clinics and one research center in Louisiana. SUBJECTS: Severely obese individuals (body mass index 40-60 kg/m(2)) randomized to usual care (n = 190) or intensive medical management (n = 200). Forty-seven percent of participants completed year 2 follow-up and were included in the analyses. INTERVENTION: Physician-monitored intervention with recommendations for 12 weeks of liquid diet followed by 4 months of group behavioral therapy, structured diet, and option of pharmacotherapy, and an additional 16 months of maintenance strategies. MEASURES: Two-year preintervention and 5-year postintervention measures were computed from claims data and included (1) medical costs excluding pharmacy, (2) pharmacy costs only, (3) total medical and pharmacy costs, and (4) medical and pharmacy subcategory costs. ANALYSIS: Differential categories for preintervention and postintervention were created using total sample 75th percentiles. Chi-square tests were employed to compare the intervention groups both preintervention and postintervention with respect to the proportion of subjects above the 75th percentile for each of the cost categories. RESULTS: Medical costs excluding pharmacy did not differ between groups. The intensive medical intervention group had a significantly smaller percentage of subjects above the 75th percentile for pharmacy costs only (p = .0125), and for antidiabetic agents (p = .0464), antihypertensives (p = .0075), and dyslipidemic subcategories (p = .0197). CONCLUSION: An intensive medical intervention may reduce pharmaceutical expenditures in severely obese individuals. These results must be viewed with caution given the high attrition of study participants.
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Costos de la Atención en Salud/estadística & datos numéricos , Obesidad Mórbida/economía , Obesidad Mórbida/prevención & control , Terapia Combinada , Femenino , Humanos , Louisiana , Masculino , Persona de Mediana Edad , Atención Primaria de Salud , Proyectos de Investigación , Factores de Tiempo , Resultado del TratamientoRESUMEN
PURPOSE: To examine accuracy of children's, their guardians', and health care professionals' (HCPs') perceptions of child overweight and obesity, the degree of agreement between their perceptions, and relationships with weight loss attempts among overweight or obese children. DESIGN: Cross-sectional study using 2005-2010 National Health and Nutrition Examination Survey. SETTING: United States. SUBJECTS: Out of 4691 children and adolescents, ages 8 to 15 years, 16.4% were overweight (body mass index [BMI] percentiles 85-94.99) and 19.3% were obese (BMI percentiles ≥95). MEASURES: Age and sex-specific BMI percentiles; responses of adult proxies (guardians) on whether they considered their child overweight and whether an HCP had ever told them that their child was overweight; responses of children and adolescents on their self-perceived weight status and whether they were trying to lose weight; children's and guardians' socio-demographic characteristics. ANALYSIS: Weighted percentages; sensitivities and Cohen's kappas; adjusted prevalence ratios. RESULTS: Children, their guardians, and HCPs underestimated child's actual overweight or obesity status. Little agreement existed between overweight or obese children, their parents, and HCPs on whether these children were overweight or obese. Overweight and obese children perceived as such by themselves, their guardians, and HCPs were 88% and 32%, respectively, more likely to attempt weight loss based on multivariable analyses. CONCLUSION: Accurate and shared perceptions of adiposity in children and adolescents between children themselves, their guardians, and HCPs are positively associated with weight loss attempts among overweight or obese children in the United States.
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Padres/psicología , Obesidad Infantil/psicología , Programas de Reducción de Peso/estadística & datos numéricos , Adiposidad , Adolescente , Adulto , Factores de Edad , Índice de Masa Corporal , Niño , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Encuestas Nutricionales , Sobrepeso/psicología , Factores SexualesRESUMEN
PURPOSE: To examine relationships of sleep, eating, and exercise behaviors; work time pressures; and sociodemographic characteristics by weight status (healthy weight [body mass index or BMI < 25] vs. overweight [BMI ≥ 25]) of young adults. DESIGN: Cross-sectional. SETTING: Nine U.S. universities. SUBJECTS: Enrolled college students (N = 1252; 18-24 years; 80% white; 59% female). MEASURES: Survey included the Pittsburgh Sleep Quality Index (PSQI), Three-Factor Eating Questionnaire (TFEQ), Satter Eating Competence Inventory (ecSI), National Cancer Institute Fruit/Vegetable Screener, International Physical Activity Questionnaire, Work Time Pressure items, and sociodemographic characteristics. ANALYSIS: Chi-square and t-tests determined significant bivariate associations of sociodemographics, sleep behaviors, eating behaviors, physical activity behavior, and work time pressures with weight status (i.e., healthy vs. overweight/obese). Statistically significant bivariate associations with weight status were then entered into a multivariate logistic regression model that estimated associations with being overweight/obese. RESULTS: Sex (female), race (nonwhite), older age, higher Global PSQI score, lower ecSI total score, and higher TFEQ Emotional Eating Scale score were significantly (p < .05) associated with overweight/obesity in bivariate analyses. Multivariate logistic regression analysis showed that sex (female; odds ratio [OR] = 2.05, confidence interval [CI] = 1.54-2.74), older age (OR = 1.35, CI = 1.21-1.50), higher Global PSQI score (OR = 1.07, CI = 1.01-1.13), and lower ecSI score (OR = .96, CI = .94-.98), were significantly (p < .05) associated with overweight/obesity. CONCLUSION: Findings suggest that obesity prevention interventions for college students should include an education component to emphasize the importance of overall sleep quality and improving eating competence.
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Peso Corporal , Ejercicio Físico , Conducta Alimentaria , Sueño , Estudiantes/estadística & datos numéricos , Adolescente , Estudios Transversales , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Obesidad/epidemiología , Obesidad/etiología , Estudiantes/psicología , Estados Unidos/epidemiología , Universidades/estadística & datos numéricos , Trabajo/estadística & datos numéricos , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to examine the relationship between sleep patterns and adiposity in young adult women. DESIGN: Cross-sectional. SETTING: The study took place at two Mountain West region universities and surrounding communities. SUBJECTS: Subjects were 330 young adult women (20.2 ± 1.5 years). MEASURES: Sleep and physical activity were monitored for 7 consecutive days and nights using actigraphy. Height and weight were measured directly. Adiposity was assessed using the BOD POD. ANALYSIS: Regression analysis, between subjects analysis of variance, and structural equation modeling were used. RESULTS: Bivariate regression analysis demonstrated that sleep efficiency was negatively related to adiposity and that the 7-day standard deviations of bedtime, wake time, and sleep duration were positively related to adiposity (p < .05). Controlling for objectively measured physical activity strengthened the relationship between sleep duration and adiposity by 84% but had a statistically negligible impact on all other relationships that were analyzed. However, multivariate structural equation modeling indicated that a model including sleep efficiency, sleep pattern inconsistency (latent variable consisting of the 7-day standard deviations of bedtime, wake time, and sleep duration), and physical activity was the best for predicting percent body fat. CONCLUSION: Inconsistent sleep patterns and poor sleep efficiency are related to adiposity. Consistent sleep patterns that include sufficient sleep may be important in modifying risk of excess body fat in young adult women.