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The English National Child Measurement Programme (NCMP) is a nationally mandated public health programme. It provides data for child excess weight indicators in the Public Health Outcomes Framework, part of the government's approach to reducing childhood obesity. Drawing on a meta-ethnographic synthesis of household members' experiences of the programme, we conceptualise the NCMP as a 'technique of futuring' to generate new insights into how it (re)shapes and (re)imagines past, present, and future responsibilities and practices for overweight children, parents, and carers, in potentially harmful ways. For children categorised by the NCMP as overweight, the NCMP is an emotionally significant event, driving new bodily practices, new food practices and changed relationships with peers. This paper outlines how parents come to resist and reframe the programme and its results, to protect their children from a weight-focused future. They consider the potential risks of bullying, dysfunctional eating, and mental health consequences more important than future risks of overweight. We show how parents of children categorised as overweight preserve their claim to 'responsible' and 'good' parenting amongst peers, whilst shifting the blame for childhood obesity to other, 'irresponsible' parents, thus reproducing moralising and responsibilising discourses inherent within the 'behaviour change' messaging of the NCMP and associated research. Finally, we consider a central paradox of this programme and the use of NCMP population level monitoring data to (re)shape lives at the individual and social level – the children it sets out to help are the most likely to experience harm as a result of it. [ABSTRACT FROM AUTHOR]

The purpose of this study was to ascertain how to advertise healthy eating to adolescents in a bid to respond to global childhood obesity. Using an interpretivist research design, a three-year, bi-national study was conducted with English and Swedish participants aged 12–14. Creative research methods explored their relationship to food advertising, consumer self-perception and their own creative recommendations. By taking the adolescents' perspective, the paper reports on creative strategies likely to increase their receptiveness to healthy food advertising, e.g. use of visual statistics, branding and a departure from the healthy-versus-unhealthy dichotomy. The paper recommends additions to social cognitive theory, an underutilised theory within marketing, by infusing the model with a social marketing orientation intent upon increasing its utility when advertising healthy eating to adolescents. [ABSTRACT FROM AUTHOR]

This paper describes how eight London nurseries examined whether better use of bicycles would strengthen children's physical activity as a step to reducing child obesity. The nurseries are part of a social enterprise which offers one-third of the 4200 nursery places to children from poor and disadvantaged families/communities where rates of child obesity are high and increasing. The research was instigated because the nurseries built a partnership with Bikeworks which provided free bikes and staff wanted to ensure they were using them effectively to benefit children. Parents were involved but also asked a specific question about interest in a bike lending scheme. The paper concluded that staff became more observant of how they could enhance their practice using bikes to support children's physical and sociolinguistic development. It heightened the importance of observation of the children but also in identifying barriers such as poor cycling surface and state of bike repairs. Parents considered bikes to be a key part of their children's nursery life especially extending physical skills but were divided evenly about the value of introducing a bike lending scheme. [ABSTRACT FROM AUTHOR]

There is now a wealth of research on obesity both from biomedical and socially critical perspectives. However, less research has focused on the lived experiences of young children and particularly those who are perceived as 'sedentary'. This paper critically examines the issue of obesity as related to children's experiences of physical (in)activity, via a focus on the circulation of socio-cultural and economic discourses in the context of Spain. We report on data obtained from interviews with 13 children identified as 'sedentary'. Data were analysed using thematic content analysis and based on the analysis a collective story was constructed to represent and give voice to the children's experiences. The collective story sketches a day in the life of 'Diego' to indirectly reveal the limitations associated with assuming that sport and school physical education (PE) are pragmatic 'answers' to the presumed issue of childhood obesity. In our analysis we draw on Foucauldian notions of bio-power and governmentality to highlight how neoliberal and capitalist logics shape and constrain children's experiences and opportunities. By presenting a narrative that delves into the various domains of these children's lives, their families, friends, peers and lifestyles, we argue there is still a need to reformulate and rethink how we understand childhood wellbeing and the role of PE. We conclude by suggesting that the conflation of PE with sport and health can subtly undermine some children's views of self. [ABSTRACT FROM AUTHOR]

This Special Issue is part ofEducational Review’s Hall of Fame, comprising the journal’s most read and highly cited papers. As part of this I will be critiquing a milestone paper within the field(s) of Sport, PE and (I will extend to) PA by Professor Richard Bailey. The paper has been amongst the most-cited in the journal and I have personally cited the paper numerous times in my own work thus far. Upon its original publication (nearly 13 years ago), the article (managed to provide a very useful distinction between PE and sport (and PA), which is important given the constant slippage between the terms in many articles since. In this response article, I will try to provide a brief summary of the paper from Bailey, but at the same time examine closely the notion of social inclusion through sport and PE by summarising work that has subsequently been conducted. I will conclude by summarising that some 13 years later spurious claims about effective inclusive practices through sport abound, and we still lack clear evidence to support the rhetoric about the ways in which sport and PE can contribute to social inclusion. [ABSTRACT FROM PUBLISHER]

AbstractThe efficacy of probiotics, prebiotics, or synbiotics in children and adolescents with overweight or obesity remains uncertain. This systematic review evaluates their intervention effects through a network meta-analysis of randomized clinical trials (RCTs). Searches of 4 electronic databases until January 7, 2024, yielded 17 papers reporting on 15 RCTs involving 820 participants. Multiple-strain probiotics (MSP) showed significant efficacy in reducing BMI (Mean Difference (MD) −2.13 kg/m2, 95% credible interval (CrI) [−2.7, −1.57]), waist circumference (MD −1.34 cm, 95% CrI [−2.33, −0.35]), total cholesterol (MD −6.55 mg/dL, 95% CrI [−10.61, −2.45]), triglycerides (MD −3.71 mg/dL, 95% CrI [−5.76, −1.67]), leptin (MD −3.99 ng/mL, 95% CrI [−4.68, −3.3]), and hypersensitive C-reactive protein (Hs-CRP) (MD −1.21 mg/L, 95% CrI [−1.45, −0.97]). Synbiotics were effective in reducing BMI-z score (MD −0.07, 95% CrI [−0.10, −0.04]) and LDL-C (MD −1.54 mg/dL, 95% CrI [−1.98, −1.09]) but led to a slight increase in fasting glucose (MD 1.12 mg/dL, 95% CrI [0.75, 1.49]). Single-ingredient prebiotics and single-strain probiotics also had some beneficial effects on BMI and Hs-CRP, respectively. Moderate to low evidence suggests MSP may be a potential choice for improving BMI and reducing lipids, leptin, and Hs-CRP levels, implying that MSP could aid in managing pediatric obesity and related metabolic issues by modulating the gut microbiota. Although synbiotics show their favorable effects on body metrics and lipid control, their potential impact on blood glucose currently prevents them from being an alternative to MSP for treating pediatric obesity. Further large-scale, well-designed studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Aphasia has a great impact on children's lives, with stroke being its most common and studied etiology. However, our knowledge about this disorder is limited, the studies on this topic are sparse, and a consensus regarding its definition is lacking. In particular, the interpretation of this condition varied over time: from the rigid description of the so-called "standard doctrine" to the adoption of adult models for post-stroke aphasia. Therefore, this review provides a critical overview of childhood aphasia after stroke, focusing on its epidemiology, definition, diagnosis, and clinical manifestation. The scoping review approach was adopted, following PRISMA-ScR guidelines. PubMed, Web of Science, and PsycInfo databases were searched for related peer-review papers in English. Forty-six records were identified; the majority were single cases and case series, only a few were reviews and observational studies. Epidemiologic data are scarce; a few studies report that aphasia affects about one-third of children post-stroke. Despite terminological differences, there is an overall agreement on the definition of post-stroke aphasia in children as a language disorder acquired after the age of two. Approaches for the diagnosis and evaluation vary widely, including both assessments for developmental language disorders and tests for aphasia in adults. The clinical manifestations described in children are numerous and varied, similar to those found in adults, in contrast with the "standard doctrine." This review highlights the need for further studies to improve the knowledge of this condition, develop validated and specific assessment tools, and standardize clinical management. [ABSTRACT FROM AUTHOR]

When trying to understand childhood obesity, policymakers and healthcare professionals most often make use of behavioural sciences and biomedical perspectives. This approach assumes that fatness is unhealthy and caused by people making 'bad choices' about their diet and physical activity. Increasingly not only parents, but also children, are considered to be individually responsible for their weight, their health, and through that, for the 'obesity epidemic'. Drawing on critical obesity/weight studies and practice theory, this paper challenges the individualistic and weight-based view of health, and the heuristic of 'individual food choice', and through that such a framing of childhood obesity. It does so by focusing on the experiences of young people medically identified as overweight, who are trying to lose weight. Looking at two domains of children's lives, their family and peers, the paper demonstrates how young people experience and negotiate the individualized health advice, and what sort of consequences this has for their daily lives, and their mental and physical wellbeing. The article is based on observations of interactions between families and healthcare professionals, conversations with children and parents, as well as participant observation at youth summer weight loss camps, which were part of a larger ethnographic research project conducted in 2018–2019 in Poland. The paper concludes by proposing to reframe how we think about childhood obesity, and consider young people's knowledge and lived experiences when re-designing policy interventions and wellbeing promotion programmes, that is, to work with, and not on, children. [ABSTRACT FROM AUTHOR]

This paper explicates blame as a psychological construct in communication processes, with a focus on its underlying structure and its mediating role between message characteristics and the public's issue engagement. Data were collected from Amazon Mechanical Turk (N = 373) via a Web-based experiment, where we manipulated a news story about a child suffering an obesity-related health risk (asthma attack vs. heart attack) with different levels of preventability (high vs. low) and severity (high vs. low). Findings showed that blame should best be conceptualized and operationalized as a latent construct comprising both cognitive and affective components. Blame mediated message effects on social responses related to obesity prevention, including punitive attitudes, policy support, and intentions toward interpersonal communication and civic participatory behaviors. [ABSTRACT FROM AUTHOR]

Idiopathic intracranial hypertension (IIH) affects both children and adults. There are currently no clinical trials in IIH for those who are adolescents or children. The aims of this narrative review were to characterise the differences between pre- and post-pubertal IIH and to highlight the need to be more inclusive in clinical trial planning and recruitment. A detailed search of the scientific literature was performed using the PubMed database, from inception until 30 May 2022 using keywords. This included English language papers only. The abstracts and full texts were reviewed by two independent assessors. The literature revealed that the pre-pubertal group had a more variable presentation. The presenting features in the post-pubertal paediatric group were more akin to adults with headache as the dominant feature. They were also more likely to be female and have an increased body mass index. A clear limitation of the literature was that a number of paediatric studies had variable inclusion criteria, including secondary causes of raised intracranial pressure. Pre-pubertal children do not display the same predilection towards the female sex and obesity as post-pubertal children, who have a similar phenotype to the adult cohort. Inclusion of adolescents in clinical trials should be considered given the similar phenotype to adults. There is a lack of consistency in the definition of puberty, making the IIH literature difficult to compare. Inclusion of secondary causes of raised intracranial pressure has the potential to confound the accuracy of analysis and interpretation of the results. [ABSTRACT FROM AUTHOR]

Many physical activity (PA) interventions implemented to tackle the child obesity epidemic have shown limited effectiveness, possibly due to a lack of consideration of potential stress that accompanies behavior adaptation and the automatic perseverative cognition that exacerbates the stress (namely rumination). Purpose: The main aim of this paper is to develop and validate the PA-specific Rumination Scale for Children (PARSC) that assesses children's tendencies to engage in repeated negative thoughts about PA (Study 2). Items in the scale were derived from qualitative information about factors that inherently demotivates PA participation (intrinsic barriers) through the lived experience of UK children (Study 1). Methods: For Study 1, pedometry PA data were collected from 143 children (aged 6–10 years). Twenty-one focus groups were formed based on participants' year group, sex and PA level. For PARSC validation (Study 2), 382 children completed the questionnaire twice. Self-report PA, device-based PA, and avoidant coping were also assessed. Results: Study 1—Four overarching themes identified as intrinsic barriers were lack of competence, fear of negative experiences, external constraints and lacking a sense of purpose. Altogether, 10 higher order and lower order themes were used to construct PARSC items. Study 2—From Rasch analysis, PARSC possessed sound internal validity, internal consistency, and test–retest reliability. Self-report PA and avoidant coping were predictive of PA-specific rumination, but not device-based PA. Conclusion: PARSC is a useful tool to identify children ruminative about PA for whom interventions can be designed, with the intrinsic barriers considered, to promote PA behavior adaptation. [ABSTRACT FROM AUTHOR]

Evidence indicates that pediatric chronic health conditions (CHCs) often impair executive functioning (EF) and impaired EF undermines pediatric CHC management. This bidirectional relationship likely occurs due to biobehavioural and social-structural factors that serve to maintain this feedback loop. Specifically, biobehavioural research suggests that inflammation may sustain a feedback loop that links together increased CHC severity, challenges with EF, and lower engagement in health promoting behaviours. Experiencing social and environmental inequity also maintains pressure on this feedback loop as experiencing inequities is associated with greater inflammation, increased CHC severity, as well as challenges with EF and engagement in health promoting behaviours. Amidst this growing body of research, a model of biobehavioural and social-structural factors that centres inflammation and EF is warranted to better identify individual and structural targets to ameliorate the effects of CHCs on children, families, and society at large. This paper proposes this model, reviews relevant literature, and delineates actionable research and clinical implications. [ABSTRACT FROM AUTHOR]

From 2012 to 2014, we developed and subsequently evaluated the Healthy Eating, Active Living (HEAL) intervention—an obesity prevention and healthy lifestyle program designed for young people living in residential out-of-home care (OoHC). Based on quantitative (i.e., a randomised trial) and qualitative (i.e., semi-structured interviews) data and an iterative process of redevelopment, the program has evolved from taking a behavioural obesity prevention approach to now being underpinned by a trauma-informed care approach at a systems level. In this paper we outline the theoretical and empirical foundations of the HEALing Matters intervention that is currently being implemented at scale. In addition, we outline how our knowledge translation framework informed the iterative improvement of our intervention with a focus on stakeholder and end-user engagement, partnership, and codesign along the way. IMPLICATIONS There is a strong need for trauma-responsive health-focused programs and interventions within OoHC contexts. HEALing Matters addresses the need for trauma-informed approaches that encourage health behaviour change in young people living in OoHC. Policy, standards, and recommendations must not only acknowledge, but prioritise, the impact of trauma on health-related lifestyle behaviours in order to identify strategies to help address this impact. [ABSTRACT FROM AUTHOR]

The purpose of this mixed-method longitudinal study was to understand how health professional students' perceptions of their professional flexibility, role interdependence, and reflection on their process of working together change over time as a result of participating in an interprofessional education course. Data were collected from students enrolled in an interprofessional service-learning course each year from Fall 2014 to 2018 via online surveys at four assessment points and through qualitative reflection papers that served as course assignments. The 14-week course consisted of both didactic instruction and an experiential component whereby students conducted a service-learning activity in interprofessional teams. Quantitative findings demonstrate that students experienced a significant quadratic growth trajectory in reflection on process and a significant linear growth trajectory in professional flexibility. Students reported experiencing non-significant changes in role interdependence. Qualitative data, however, suggest student learning across all three domains. This study has implications for interprofessional educational initiatives aimed at promoting students' interprofessional competencies. [ABSTRACT FROM AUTHOR]

Obesity among Latino children in the United States is a serious health concern that poses a risk to develop other chronic illnesses such as Type 2 Diabetes, cancer, and heart disease. The following paper is focused on a 6-week health education intervention that was developed for 12- to 14-year-old Latino youth of an after -school program at a social service agency in the West Town neighborhood of Chicago. Within Chicago, childhood obesity rates in children of all ages were shown to be the second highest among Latino communities for both boys and girls. Implications from this article will provide insight into the need for public health professionals to further research and use that information to formulate ideas to create nutrition and physical activity programs that will address obesity among Latino and other ethnic youth populations—to promote and encourage them to adopt and maintain a healthy lifestyle. [ABSTRACT FROM AUTHOR]

This qualitative study investigates health care practitioners’ approaches to early childhood obesity in Denmark and their view on their own ability to initiate processes of change in affected families, and it asks the overall question of whether perceived barriers become real through practitioners’ reluctance to intervene in families labelled as ´problematic’. The paper identifies three approaches in the practitioners’ narratives: the socially oriented, the individually oriented, and the mixed. The individually oriented approach was based on a logic resembling individualistic explanatory models of behaviour change, and was related to a positive perspective on their own ability to move families towards healthier habits by health care practitioners. The socially oriented approach borrowed elements from a sociological perspective, which seemed to lead to resigned pessimism in the face of the complexity of the problem of childhood overweight and a reluctance to address early childhood overweight in some families. In practitioners of all three types, widespread cultural essentialism was found. Non-western, ethnic minority background was seen as determining family habits and making preventive action especially difficult. Based on this, the current paper discusses whether individual actions and choices are being ascribed too much explanatory power, and the health system's biased perceptions too little. [ABSTRACT FROM AUTHOR]

Objective: This paper represents an understanding of the 'usability' and 'user experience' of the TreCLifeStyle mobile app from an end-user experience in order to consider dietary food habit (e.g. Mediterranean Diet). Methods: A qualitative and quantitative approach was undertaken using the system usability scale questionnaire and semi-structured interviews in 2 phases that occurred over a period of 12 consecutive weeks. Six families (n = 12) of Trentino province, Italy, were included who have one obese child as primary inclusion criteria. Results: Incorporating three different aspects, (1) user preference, (2) usability evaluation and (3) system usability scale result; the study explains diversified end-user experiences. The outcome of the study addresses inadequate concentration of user-centered requirements from design to implementation level of a healthcare app. The users' prioritise the appB (score >68) in terms of friendly interface usability and elaborative contents. Additionally, they identify necessary technological modifications at some point to operate the app seamlessly. Conclusions: The study concludes with a strong demand for end-users' engagement to design user-friendly mHealth app interfaces where the socio-cultural needs should be considered significant. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents' perceptions of eating and culinary behaviours have important implications for their health and nutritional profiles. The purpose of the current investigation is to understand Indian adolescents' perceptions of healthy eating and meal preparation. Methods: Year nine students (n = 1026; 35% males) aged 14–16 years from nine English-speaking private secondary schools in Kolkata, India completed a paper-based, self-reported questionnaire which included questions about facilitators and barriers to healthy eating and meal preparation. Cross-tabulation analyses were performed to examine gender differences on the healthy eating measures. Results: Overall, the adolescents highlighted a number of key facilitators and barriers to healthy eating and meal preparation. The preference for water over sugar-sweetened beverages was cited as the most popular facilitator of healthy eating by adolescents (65.7%). The most commonly perceived barrier to healthy eating was the need for strong motivation to consume a healthy diet (56.1%). The importance of using fresh produce in food preparation (76.5%) emerged as the most prominent component of meal preparation. Conversely, the use of food lists was perceived as the least important aspect of healthy meal preparation (54.2%). In general, girls showed more positive attitudes towards healthy eating and meal preparation compared to boys. Conclusion: This understanding of Indian adolescents' perceptions of healthy eating and meal preparation suggests the development of skills-focussed nutrition education programmes to support young people in preparing and consuming healthy meals. [ABSTRACT FROM AUTHOR]

This paper examines the multiple ways in which health policy relating to obesity, diet and exercise is recontextualised and mediated by teachers and pupils in the context of social class in the UK. Drawing on a case study of a middle-class primary school in central England, the paper documents the complexity of the policy process, its uncertainty, its intended and unintended affects and effects on the lives and bodies of young people as they negotiate ‘health’ across a range of social contexts. Particular attention is paid to the voices of young people, whom by way of embodying imperatives found in health discourses become ‘troubled bodies’, ‘emboldened bodies’, or ‘insouciant bodies’, as such imperatives intersect with pupils' various subjectivities. It is argued that whilst all pupils appear to be affected by health policy, they are differently effected by it. The paper will outline how pupils were effected by health policy in emboldened and privileged ways and how the young people seem to not only remain unscathed by health imperatives but are also positively emboldened and privileged by them. This paper adds to understandings of social class and relationships between public health discourse and individual (e.g. pupil) subjectivity, and highlights both the complexity of the policy process itself as a product of the organisational and social relations of schooling, as well as the complex and idiosyncratic nature of young people's embodied subjectivities. [ABSTRACT FROM AUTHOR]

In this paper, I draw on the growing body of work in surveillance studies, to examine the increasing propensity in recent years towards the monitoring and collection of information about children's weight and health within school contexts. Applying Haggerty and Ericson's concept of the surveillant assemblage within school contexts, the paper examines how surveillant practices in schools are part of an assemblage constituted by a range of agencies, institutions and bodies, and socio-technological developments constituted through a complex series of rhizomatic flows. [ABSTRACT FROM AUTHOR]

This paper describes the levels of household food insecurity in the region to determine if differences exist between socio-demographics of the sample. Further, it tests if the increased prevalence of chronic diseases and obesity among food insecure households demonstrated in previous studies is true for this region. Utilizing a regional baseline survey, logistic regression models were performed to determine the relationship between household food insecurity and body mass index or chronic disease. There were significant socio-demographic differences among food insecure and food secure respondents in the region. After adjusting for covariates, food insecurity was significantly related to increased odds of hypertension (OR = 1.77, p = 0.001) and diabetes (OR = 1.51, p = 0.038), but not overweight/obesity (OR = 1.39, p = 0.067). Utilizing food assistance, like food pantries, to implement targeted interventions could help reduce both food insecurity and chronic disease in the region. [ABSTRACT FROM AUTHOR]

In this paper, we examine the emergence of what might seem an unexpected policy outcome – a large multinational corporation, frequently blamed for exacerbating childhood obesity, operating as an officially sanctioned driver of anti-obesity initiatives in primary schools across the globe. We draw on Foucault's notion of governmentality to examine the pedagogical work of two international programmes devised and funded by Coca-Cola. We demonstrate how these programmes work simultaneously as marketing campaigns and as governmental strategies to position children as responsible for their own health, conflate (ill)health with body weight and strategically employ the concept of energy balance. We argue that these programmes not only act to unite the interests of corporations, governments and schools, but also seek to use schools to reshape the very ideas of health and a ‘healthy life’. We conclude by considering two sets of ethical and political issues that come sharply as corporations like Coca-Cola continue to exploit the policy space created by the ‘obesity epidemic’. [ABSTRACT FROM AUTHOR]

Childhood obesity is a prevalent health condition, the effects of which extend to mental health, social relationships, educational performance, and long-term physical health conditions. The present study focused on an optimized student support intervention that functions in predominantly high-poverty urban locations, which recognizes students as possessing unique constellations of protective and risk factors. Participants included 5,573 K-5 students that support staff identified as being overweight through a holistic, collaborative assessment process, and evaluated how these students differed from peers not perceived as overweight. Findings indicated statistically significant differences across the groups, in terms of demographic characteristics, strengths and risks recognized (in academic, social-emotional/behavioral, family, and health/medical domains), school-related academic and thriving performance scores, and the moderating effects of specific psychosocial and familial strengths and risks on those educational areas. This study underscores the importance of considering both strengths- and risks-based assessment and intervention approaches – as well as the utility of initial identification of students – particularly in low-income, underserved environments. [ABSTRACT FROM AUTHOR]

Interpreting change in Body mass index (BMI) among youth by comparison to growth charts can be difficult because of maturation-related changes. The aim of this paper was to evaluate the utility of several alternative methods for assessing change in BMI among children. Participants included 1,615 children measured for stature and body mass in first grade and then again the following year. A total of 1,101 students were also assessed in eighth grade. Change was examined using BMI percentiles (BMI%), BMI z-scores, "Percent Over BMI" (BMI50), and the Healthy Fitness Zone continuum, also referred to as BMI85. Youth at lower BMI levels at baseline showed a positive mean change in BMI%/z-score, whereas those at higher levels at baseline showed a negative mean change in BMI%/z-score. These patterns were not seen with BMI50 or BMI85. Assessing change in weight by using BMI% may result in bias so researchers are encouraged to use BMI85 as a more appropriate approach. [ABSTRACT FROM AUTHOR]

In contemporary times, corporate philanthropy is positioned as an effective means to 'solve' a variety of social problems. Childhood obesity is one such 'problem' that has captured the interests of schools, corporations, industry groups and a number of 'not-for-profit' players. In this paper, I critically examine how the private sector uses the notion of philanthropy to shape school-based solutions to obesity and unhealthy lifestyles. By conducting a critical ethnography in two New Zealand primary schools and drawing on Foucauldian notions of government and 'practices of assemblage', I illuminate how a number of organisations officially planned to employ philanthropy as a means to govern others, as well as what actually happened when these plans met their intended targets: children, teachers and principals. Although corporations, charities and schools were assembled together through their combined 'will to give', the notion of philanthropy helped to re-assemble and re-invent private sector organisations so that they were seen to be socially responsible, healthy, and even educational. Philanthropy also worked to mask private sector players less altruistic interests: branding, public relations strategies, avoidance of stricter regulations and legislation, and the desire to profit. [ABSTRACT FROM AUTHOR]

This paper introduces the metric ‘mean duration of obesity’ to measure the average number of years lived with obesity in a population. A procedure was developed to estimate duration from periodic cross-sectional surveys. For annual cohorts born in the United States between 1925 and 1989, I estimated a logit model to derive age-cohort-specific probabilities of overweight and obesity (body mass index 25 to <30 and 30, respectively), and applied life table techniques to convert these into person-years. Duration of obesity by age 50 increased fourfold from 3.58 to 14.35 years. The rate of increase was stronger across the 1945-79 and 1980-89 cohorts than the 1925-44 cohorts. The trend was driven by increased risks of obesity among children: age groups under 20 were responsible for 31 per cent of the duration increase between the 1930 and 1960 cohorts, but 72 per cent between the 1960 and 1985 cohorts. [ABSTRACT FROM AUTHOR]

The Katalyst intervention program was piloted in fifth-grade classrooms at two Appalachian schools during the 2017–18 academic year as a potential educational resource to tackle the rising rates of obesity and chronic diseases in this region. The program consisted of four 60-minute modules, each based on a specific organ system. Each module incorporated hands-on lessons in physiology with an emphasis on preventing chronic disease through diet, nutrition, physical activity, and abstinence from drug and tobacco use. The modules were led by medical students and undergraduate volunteers who completed a two-day training. A 37-item survey assessing knowledge and perceptions regarding healthy lifestyles was administered to fifth grade participants prior to and following the intervention in order to assess the impact of the program. Additionally, educators at intervention schools were given a questionnaire post-intervention to provide feedback on the program. This paper describes the rationale, program design and execution, and conclusion of the Katalyst intervention program. It is anticipated that this program will reinforce current educational standards regarding diet, nutrition and physical activity in order to empower target students to establish healthy lifestyle behaviors and that programs modeled after the Katalyst curriculum may serve as a novel, viable option to health educators. [ABSTRACT FROM AUTHOR]

In recent years, multinational food and drink corporations and their marketing practices have been blamed for the global childhood obesity ‘crisis’. Unsurprisingly, these corporations have been quick to refute these claims and now position themselves as ‘part of the solution’ to childhood obesity. In this paper, I examine how and why corporations fund, devise and/or implement ‘healthy lifestyles education’ programmes in schools. By using a critical ethnographic research approach alongside Foucault’s notion of governmentality, I interrogate what those with the ‘will to govern’ (such as corporations) wanted to happen (e.g. fight obesity, change marketing practices and increase consumption), but also what actually happened when these corporatised education programmes met their intended targets in three New Zealand primary schools. I critically examine these programmes by focusing on the ways in which three technologies of consumption - product placement, transforming children into marketers and sponsorship - attempt to govern children to be lifelong consumers of the corporate brand image and their allegedly ‘healthy’ corporate products. Although students were not necessarily naïve and easily coerced into becoming mindless consumers of corporate products, students and their teachers readily accepted that sponsorship, product placement and marketing in schools were normal, natural, necessary and mostly harmless. Healthy lifestyles education programmes represent a new ‘brand’ of health, health education and corporation. The child-citizen is governed to become the child-consumer. Corporations’ anxieties about being blamed for childhood obesity are fused with technologies of ‘healthy consumption’: the consumption of corporate products, corporate philanthropy, the corporate brand and corporate ‘education’. [ABSTRACT FROM AUTHOR]

Despite the growing literature on childhood obesity and lifestyle intervention programmes focusing on weight loss, few studies have examined young persons’ experiences of being identified as candidates for such programmes and of participating in them. This paper does so. Juxtaposing insights from phenomenology with an approach inspired by Foucault, the paper shows how teenage girls’ bodily self-perception and bodily self-awareness are shaped in intercorporeal assemblages comprising other people and specific features or elements of the lifestyle programme. Inspired by van Manen’s hermeneutic-phenomenological approach, with its point of departure in lived experience, this paper draws on interviews with Norwegian teenage girls participating in the same lifestyle programme and identifies three core thematic aspects of the girls’ experiences: being identified as a candidate for a lifestyle programme and not wanting this; negotiating the lack of weight loss and the scales; and bodily situated agency - feeling good and being able. Permeating all three themes are two central, interrelated phenomena: agency and resistance. Furthermore, the paper shows how a combination of Foucauldian insights and a phenomenological understanding of intercorporeality can help to shed light on the power, affective, material and temporal dimensions of dys-appearance (i.e., when one’s body appears as bad or wrong), as well as those of eu-appearance (i.e., when one’s body appears as healthy or strong), and thus contribute to the understanding of the girls’ narrated lived experiences. On the basis of these findings, we argue that weight-related treatment goals are not necessarily compatible with the strengthening of adolescents’ body images and self-esteem. However, whilst being obliged to attend to their bodies while in the programme, the girls also encountered unexpected, positive bodily feelings and experiences. Such events, we suggest, offer a means of resisting the more troubling dys-appearing bodily situations our participants described so powerfully. [ABSTRACT FROM AUTHOR]

The article discusses the use of latent class trajectory analysis in child growth and obesity research. Latent class trajectory models (LCTMs) are statistical methods used to identify distinct groups of children with similar growth patterns. However, LCTMs have limitations, including providing a poor fit for longitudinal data and failing to capture individual-level growth curves. The article argues that a growth mixture model (GMM) with fewer constraints is a better alternative. The author recommends following the Guidelines for Reporting on Latent Trajectory Studies (GRoLTS) to ensure the development of a good model and accurate reporting. Overall, the article suggests caution when interpreting research that relies on LCTMs in child growth and obesity studies. [Extracted from the article]

This paper is a conceptual and methodological review of the literature on the impact of TV on preschoolers' weight status. A systematic search, of papers published between January 1995 and January 2010, identified twenty-six relevant studies. Fifteen of these were cross-sectional in design and eleven adopted a prospective design; a positive association between hours of TV and child adiposity was found in all but three studies. Although assessed in a limited number of studies, diet may mediate the relationship between TV viewing and BMI. Another likely mediator may be the content of TV programs watched; only three studies examined this association and findings were inconsistent. Our review revealed that research examining mediating effects is limited, focusing more on simple cross-sectional or prospective relationships between TV habits and child body mass index. Further investigation of the mechanisms by which TV viewing affects preschool weight gain is needed. [ABSTRACT FROM PUBLISHER]

Contemporary notions of childhood overweight and obesity have become increasingly influential in curriculum and pedagogy in school-based Health and Physical Education (HPE). Teachers' delivery of HPE subject matter and related school practices are likely to have a considerable impact on the attitudes and beliefs of the children they teach, particularly in the primary school. It thus becomes important to consider the ways of thinking about and doing health (discourse positions on health) that teachers bring to their teaching of HPE. This paper examines pre-service teachers' positions in relation to the health discourses to better understand what teachers, in this case beginning teachers, bring to their teaching of HPE and interactions with children in primary schools. It draws on a Foucauldian approach to discourse analysis to analyse pre-service teachers' qualitative survey and interview responses to questions about meanings of health. Three key positions emerged, signifying Agreement, Disagreement and Negotiated positions in relation to the dominant discourses of health and the body. [ABSTRACT FROM AUTHOR]

As one of the most important sites in and through which state agendas are articulated and disseminated, schools and teachers play critical roles in the implementation of state-driven policies and initiatives targeted at children and young people. This is especially pertinent in the current educational landscape where schools and teachers are vested with the responsibility to address a myriad of public health issues (e.g. smoking, alcohol education, etc.). The work of Basil Bernstein on pedagogic discourse is apposite to understanding how discourses external to the educational field (i.e. health promotion) become re-contextualised to serve educational purposes. Using Queensland's Eat Well Be Active (EWBA) policies as a backdrop, this paper draws on Bernstein's model of transmission context, and examines the discourses embedded within the policies. Through its focus on the classification and framing of the discourses within the EWBA policies, this paper aims to: (1) reveal the potential and expediency of Bernstein's model of transmission context in policy analysis; and (2) unmask the hegemony embedded within the policies. [ABSTRACT FROM AUTHOR]

Physical activity is essential to promote children's health and well-being. Increased sedentary behavior in children is a factor contributing to the escalation in childhood obesity in the general population. Clinical conditions, particularly physical disabilities, which reduce physical activity, may also lead to a higher risk of being overweight or obese. This paper reviews physical activity and sedentary behavior and illustrates how habitual (daily) physical activity, motor performance, and the capacity to be active are distinct and important aspects of a child's activity behavior. Positive health outcomes are linked to achieving adequate habitual levels of physical activity. This paper also highlights how pediatric therapists can promote health for those children who are already overweight or obese or are at higher risk of being overweight or obese. Physical and occupational therapists are encouraged to embrace a broad perspective of physical activity and extend children's therapeutic and health-promotion programs to include assessment of habitual level of physical activity and sedentary behavior, and promotion of recommended levels of daily physical activity. This role can also be extended beyond the area of disability. [ABSTRACT FROM AUTHOR]

Obesity is a significant problem for most industrialised nations and an emerging one for developing nations (Organisation for Economic Co-operation and Development 2005). Childhood obesity is of particular concern. This paper, using systematic review procedures, has analysed the intervention strategies used to fight the obesity battle over the past twenty years. For a number of reasons the effectiveness of many intervention strategies was found wanting whilst a minority of cases studied were sound. These cases were analysed and a set of principles developed that could deliver improved processes and outcomes to the problems encountered by planners in the complex obesogenic environment. [ABSTRACT FROM AUTHOR]

This paper examines the important contribution that teachers and other educators (including health educators, school nurses, school counselors, school psychologists, and sports coaches) have to offer in the prevention of eating disorders and child obesity. Our paper notes the important contribution of school educators whilst warning of the current need to specifically examine how teachers and school personnel may be best trained and prepared for such a preventive role, whether they currently feel willing and able to undertake such a role, and whether some groups of teachers may be personally susceptible to body image and eating problems. It is vital to understand the knowledge, behaviors, attitudes, and expectations of educators implementing prevention programs in order to ensure that they are personally and professionally capable of carrying out prevention initiatives in schools. Individuals involved in food and exercise-related careers have been identified as being at environmental and situational risk for body image and eating problems, and it may be possible that they chose their career path due to their own personal experience with eating disorders or weight issues. In such cases, specific training or assistance may be required in order to enable the educators to conduct effective preventive activities. Discussion focuses on what needs to be done in order to enable teachers and other school-based educators to perform most effectively in the implementation of school based eating disorder and child obesity prevention programs. [ABSTRACT FROM AUTHOR]

Governments and health authorities are expressing concern about increasing levels of obesity, diabetes and physical inactivity in children. In response to such concerns, it is common to adapt strategies for adults to children, and to conduct adult-focused research. This paper describes a research study commissioned by the South Australian government that sought to involve children aged younger than 12 years in defining their meanings and views about physical activity. The research is being used to plan strategies to increase children's participation in physical activity. The qualitative study combined focus groups, drawing and mapping techniques and photographic methods with 204 children aged 4-12 years in metropolitan and rural South Australia. This paper reports results from two of the research questions: What are children's theories of physical activity, play and sport? What do children want to tell adults? Results indicate that children were enthusiastic participants in the research and appreciated the opportunity to communicate their views. The terms 'physical activity' and 'exercise' had little meaning for children, who described them as terms adults use. 'Play' and 'sport' had powerful, contrasting meanings for children: with 'play' child-centred and 'sport' controlled by adults. Children had mixed views on the power of sporting heroes as role models, on computers and television as the enemy of physical activity and on links between physical activity and health status. The research demonstrates that children bring to the discourse about physical activity some ideas that challenge the views adults hold about children. It is recommended that strategies to increase children's participation in physical activity are designed using research with children. [ABSTRACT FROM AUTHOR]

In this paper, we offer a critical examination of Let's Move!, the comprehensive anti-obesity program initiated by the First Lady of the United States, Michelle Obama, that aims to solve the problem of childhood obesity within a generation. We argue that Let's Move! is not just a campaign against obesity but is emblematic of the nature of (and assumptions underpinning) the health education of children in the contemporary United States. Drawing on the concept of ‘governmentality,’ we examine how Let's Move! functions as a biopolitical strategy (a solution to the problem of childhood obesity), framed by the political rationalities of neoliberalism. In particular, we identify and explore three interrelated bio-techniques mobilized within, and through, the Let's Move! campaign. First, in an effort to ‘responsibilize’ citizens, the initiative is framed as a social movement whereby all segments of society can (and should) be empowered to take collective action against childhood obesity. Second, an array of multi-sectoral partnerships, including corporate sponsors and non-profit organizations, are being mobilized, resulting in a range of initiatives underpinned by the rhetoric of consumer choice and responsibility as well as the outsourcing of physical education to private entities. Third, the adoption of standardized fitness testing techniques based on the logic of chronic disease epidemiology, and related notions of ‘risk,’ aim to produce the disciplined child-citizen who monitors his/her health goals with the aid of Web 2.0 technologies. In contextualizing Let's Move! in this way, we illustrate how, in line with the soft authoritarian imperatives of the neoliberal enabling state, the campaign functions as a national biopedagogy, working to empower every citizen to be an ‘active partner’ in the fight against childhood obesity, so as to optimize the health of the next generation and allow them, in the words of Michelle Obama, to ‘pursue their dreams.’ [ABSTRACT FROM PUBLISHER]

Addressing concerns about unhealthy food marketing to children, food companies pledge to advertise only ‘healthier dietary choices’ in ‘child-directed media’. However, public health advocates question whether the food industry will voluntarily improve their child-targeted marketing practices in a meaningful way. In this paper, we evaluate progress made by manufacturers of one food category – ready-to-eat breakfast cereals – in promoting nutritious choices to children, and the potential role of scientific research to influence corporate behavior. Beginning in 2008, researchers at the Rudd Center for Food Policy & Obesity conducted a series of studies to evaluate child-targeted marketing by cereal companies using a variety of research methods. We aimed to understand the extent and impact of cereal marketing to children; disseminate these findings to parents, the media, the public health community, policy-makers, and industry representatives; and encourage cereal companies to shift child-targeted marketing toward the more nutritious products in their portfolios. A follow-up analysis in 2012 demonstrated some improvements in the nutritional quality and marketing of child-targeted cereals, although child-targeted cereals remain the least healthy products in company portfolios. This analysis provides a case study of the potential for success, as well as the limitations, of a public health strategy to incent food companies to voluntarily improve child-targeted marketing practices through strategic research and communications. [ABSTRACT FROM PUBLISHER]

Current concerns about a childhood obesity crisis and children's physical activity levels have combined to justify fitness lessons as a physical education practice in New Zealand primary (elementary) schools. Researchers focused on children's understandings of fitness lessons argue that they construct fitness as a quest for an ‘ideal’ (skinny or muscular) body. The conflation of fitness with thinness, however, is complex and problematic. In this paper, we draw from research conducted with a class of primary school children in New Zealand. Drawing on the theoretical tools of Foucault and utilizing a visual methods approach, we examine how children experience school fitness lessons and construct notions of fitness, health and body. The children's responses illustrated that obesity discourses and body pedagogies ‘collided’ in a way that shaped understandings of fitness lessons in ways inextricably connected with the avoidance of being fat. The children assumed that fitness lessons increased fitness and that being fit was demonstrated by a ‘correct’ corporeal appearance. We argue that body pedagogies inside and outside the school gates shape children's ideas about the body in ways which exclude other understandings of bodies, health, and physical activity. [ABSTRACT FROM PUBLISHER]

Child-care facilities that participate in the federally assisted Child and Adult Care Food Program are required to follow meal patterns that meet the nutrient needs for child growth and development. The purpose of this research is to use the U.S. Department of Agriculture (USDA) Nutrient Analysis Protocols to evaluate child-care menus in order to demonstrate their ease of use for menu planners in child-care centres. An interviewer was trained in using the USDA Nutrient Analysis Protocols to assess the menus at five child-care centres recruited for the pilot study. This paper concluded that the USDA Nutrient Analysis Protocols were fairly adaptable for use in child-care facilities. This article can be useful in demonstrating to menu planners that the USDA Nutrient Analysis Protocols are easy to use and provide a site-by-site comparison to ensure programme compliance with Dietary Reference Intakes for young children. [ABSTRACT FROM PUBLISHER]

Objective: Paternal participation and experiences in childhood weight management is an understudied studied area. Given the important role fathers play in childhood obesity prevention and treatment, the aim of this study was to explore Norwegian fathers' experiences of helping to prevent further weight gain in their children with overweight or obesity. Methods: Data were collected through semi-structured interviews with eight fathers of ten children with overweight or obesity and analysed by qualitative content analysis. Results: The analysis resulted in one overall theme: Balancing between assuming and avoiding responsibility for weight management with a desire to preserve the child's dignity, comprising two themes: 1) Alternating between concern, helplessness and responsibility, 2) Needing acknowledgement, and flexible and tailored professional support, both of which have several sub-themes. Conclusion: Fathers need guidance on how to talk to their children to prevent further weight gain, while at the same time emphasizing safeguarding the child's dignity. Healthcare professionals should address parents' own emotional barriers and include fathers to a greater extent as a resource in family-centred counselling and tailor guidance and support to help with childhood weight management. [ABSTRACT FROM AUTHOR]

This article examines how childhood has become a strategy that answers to questions concerning the (un)governability of life. The analysis is organized around the concept of 'biosocial power,' which is shown to be a particular zone of intensity within the wider field of biopolitics. To grasp this intensity it is necessary to attend to the place of imagination in staging biosocial strategies, that is the specific ways in which childhood is both an imaginary projection and a technical project, and to this end Agamben's concept of the 'anthropological machine' is used to examine how biosocial power has been assembled and deployed. The paper begins with the question of childhood as it was posed towards the end of the nineteenth century, focusing on how this positioned the figure of the child at the intersection of zoē and bios, animal and human, past and future. It ends with a discussion on how the current global obesity 'epidemic' has transformed this one-time vision of mastery into a strategy of survival. [ABSTRACT FROM AUTHOR]

Given that the health of the nation is often interpreted in and through the health of the nation's youth, the threat of the ‘childhood obesity epidemic’ garners much attention and it is hardly surprising that physical education has been recruited in the ‘war on [childhood] obesity'. This paper explores how students aged 13–15 years, at a secondary school in Toronto, Canada, make sense of, negotiate and embody the health messages embedded within the obesity-informed Health and Physical Education (HPE) curricula. A post-structural analysis of student narratives reveals the ways in which notions of biocitizenry constitute a visibly ‘healthy’, gendered, engaged, normalized body. The ‘good’ HPE student negotiates health discourse in productive and responsive ways, constructing a virtuous subjectivity and alienating the unruly or undisciplined, unhealthy body in HPE. [ABSTRACT FROM PUBLISHER]

Discourses about risk and responsibility are evident in the recent social panics surrounding childhood obesity that construct youth as necessary targets for saving. The public is not only asked to accept the problem of obesity but, often we are also asked to believe that only a highly sensationalized intervention can counter it. In this essay we argue that the obesity industry uses media to represent the ‘problem’ of obesity in ways that ultimately serve corporate interests and in ways that are antithetical to the well-being of youth. This phenomenon is made possible by the colonization of neoliberal ideologies in the social and cultural milieu of the USA. We argue that neoliberalism is a system of cruelty that gets theatrically enacted through reality television – a television subgenre that increasingly casts youth as its subjects. This paper analyzes the showJamie Oliver's Food Revolutionin an attempt to capture one manifestation of the exploitative damages of neoliberalism as well as to highlight its contradictory and harmful messages, especially as they relate to youthful bodies and their regulation. [ABSTRACT FROM AUTHOR]

Widespread concern about a childhood obesity ‘epidemic’ has focused attention on the bodies, weight and food behaviours of mothers and their children. In childhood obesity-related discourse, mothers' bodies are framed in relation to the bodies of children, most directly in claims that fat mothers produce fat babies. Drawing on data from a qualitative study involving interviews with mothers of pre-school aged children, this paper examines how the blurring of body boundaries between women and children are translated into responsibilities in feeding. We argue that in the contemporary stigmatisation of fat, the external auditing of maternal feeding and children's bodies connects the bodies of mothers and children in detrimental ways. By focusing on the ways women are held responsible for both their own and children's bodies, we draw attention to how bodily aspirations, conflict and failure, shame, self-surveillance, judgement and guilt connect women to the bodies of their children. We stress the embodied significance of mother/child relations in early childhood nutritional care and we argue that a punitive anti-fat ethic threatens positive health outcomes for mothers and children. [ABSTRACT FROM PUBLISHER]

Obesity among children has been on the rise globally for the past few decades. Previous research has centred mainly on self/parent-reported measures examining only uni-directional parental feeding styles and practices. Recent discussions in the literature have raised the importance of bi-directional parent–child interactions in influencing children's weight status. The aims of this paper are to highlight the importance of an observational approach when investigating positive bi-directional parent–child interactions during mealtimes and to outline how these interactions may be linked to positive child eating and weight outcomes. We examine the current literature on self-reported parental patterns and argue for the influential roles of responsiveness, affect and parental control dimensions within the parent–child dyad. Information about the ways in which the parent and the child can influence each other on these dimensions, as observed in parent–child interactions around food, is likely to provide greater insights into the aetiology of childhood obesity. [ABSTRACT FROM PUBLISHER]

There is increasing evidence that parenting and feeding interact to influence children's eating behaviour and weight status. Interpretation of existing research is complicated by the lack of consensus in the conceptualisation and measurement of both ‘parenting’ and ‘feeding’, particularly the distinction between ‘styles’, ‘dimensions’ and ‘practices’. In addition, the lack of validated tools to concurrently assess feeding practices in infancy limits the capacity to examine the relationships between parenting and feeding in infancy and their short- and long-term influence on weight status. In this paper, we provide an overview of the constructs examined in this emerging area of research, highlight the conceptual, definitional and measurement challenges and propose a unifying model to aid design and the interpretation of intervention studies. Progress on these methodological issues will contribute to the robust evidence required to justify investment in interventions that focus on parenting and feeding in the context of child obesity prevention. [ABSTRACT FROM PUBLISHER]

This paper describes the current prevalence and time trends of childhood obesity worldwide, and the association between childhood obesity and socio-economic status (SES). Childhood obesity has become a global public health crisis. The prevalence is highest in western and industrialized countries, but still low in some developing countries. The prevalence also varies by age and gender. The WHO Americas and eastern Mediterranean regions had higher prevalence of overweight and obesity (30-40%) than the European (20-30%), south-east Asian, western Pacific, and African regions (10-20% in the latter three). A total of 43 million children (35 million in developing countries) were estimated to be overweight or obese; 92 million were at risk of overweight in 2010. The global overweight and obesity prevalence has increased dramatically since 1990, for example in preschool-age children, from approximately 4% in 1990 to 7% in 2010. If this trend continues, the prevalence may reach 9% or 60 million people in 2020. The obesity-SES association varies by gender, age, and country. In general, SES groups with greater access to energy-dense diets (low-SES in industrialized countries and high-SES in developing countries) are at increased risk of being obese than their counterparts. [ABSTRACT FROM AUTHOR]

Health and physical education teachers have become subject to epistemological and ethical tensions associated with competing obesity and physical activity discourses. The dominating obesity discourse, underpinned by truth claims from science, encourages educators to pathologise fatness, treat exercise as a medicine and survey student activity levels. A reverse obesity discourse, however, argues that obesity concerns are socially constructed in response to a moral panic surrounding youth lifestyles and these concerns are, of themselves, harmful for health. Educators, accordingly, are drawn in different directions with respect to how to manage their governance role of student bodies and the dissemination of health and physical activity knowledge. In this paper, we discuss this dilemma and draw from Foucauldian and Derridian theorising to offer one potential educational strategy. This strategy rests on the idea that knowledge is not fixed but fluid and, therefore, critical education is less about the transmission of knowledge and more about equipping students with skills so that they can critically engage with uncertainty and negotiate the complexities of social life. [ABSTRACT FROM PUBLISHER]