Search

Many young adolescents are dissatisfied with their body due to a discrepancy between their ideal and actual body size, which can lead to weight cycling, eating disorders, depression, and obesity. The current study examined the associations of parental and peer factors with fifth-graders' body image discrepancy, physical self-worth as a mediator between parental and peer factors and body image discrepancy, and how these associations vary by child's sex. Body image discrepancy was defined as the difference between young adolescents' self-perceived body size and the size they believe a person their age should be. Data for this study came from Healthy Passages, which surveyed 5,147 fifth graders (51 % females; 34 % African American, 35 % Latino, 24 % White, and 6 % other) and their primary caregivers from the United States. Path analyses were conducted separately for boys and girls. The findings for boys suggest father nurturance and getting along with peers are related negatively to body image discrepancy; however, for girls, fear of negative evaluation by peers is related positively to body image discrepancy. For both boys and girls, getting along with peers and fear of negative evaluation by peers are related directly to physical self-worth. In addition, mother nurturance is related positively to physical self-worth for girls, and father nurturance is related positively to physical self-worth for boys. In turn, physical self-worth, for both boys and girls, is related negatively to body image discrepancy. The findings highlight the potential of parental and peer factors to reduce fifth graders' body image discrepancy.

Describes multilevel recruitment strategies for High 5 Alabama, a school-based study designed to change fourth graders' fruit and vegetable intake. The paper discusses district-, school-, teacher-, and individual-level recruitment; compares participants to nonparticipants; and presents results from teacher perception surveys. Recruitment success varied, though it was 100% effective at the district and school level. (SM)

Objectives. We investigated the association between physical and social neighborhood environments and fifth-grade students' physical activity and obesity. Methods. We collected data on 650 children and their primary caregivers during phase 1 of Healthy Passages, a multisite, community-based, cross-sectional study of health risk behaviors and health outcomes in children. We conducted independent systematic neighborhood observations to measure neighborhood physical characteristics, and we analyzed survey data on social processes. We modeled children's physical activity and obesity status with structural equation models that included latent variables for the physical and social environments. Results. After we controlled for children's sociodemographic factors, we found that a favorable social environment was positively associated with several measures of physical activity and that physical activity was negatively associated with obesity in these children. Physical environment was not significantly associated with physical activity. Conclusions. Our findings suggest that neighborhood social factors as well as the physical environment should be considered in the development of health policy and interventions to reduce childhood obesity. (Am J Public Health. 2009; 99:271-278. doi:10.2105/AJPH.2007.128702)

A randomized, clinical trial called the Program to Reduce Incontinence by Diet and Exercise (PRIDE) aims to establish the effect of a behavioral weight-reduction intervention on overweight and obese women with incontinence. Findings indicate reduced frequency of self-reported urinary-incontinence episodes among overweight and obese women after a 6-month intervention program.

Objectives. Fruit and vegetable cost is a presumed barrier to intake. We sought to determine whether fruit and vegetable cost and consumers' race and income would predict availability of fruits and vegetables in homes of schoolchildren in the Birmingham, Ala, area. Methods. Data on availability of 27 fruit and vegetable items were obtained from homes of 1355 children (32% African American) in the Birmingham area. Fruit and vegetable costs were obtained from the US Department of Agriculture. We used discrete choice analysis with the dependent variable represented as presence or absence of the fruit or vegetable item. Explanatory variables included fruit and vegetable price per serving; child's gender, race, and age; and parent's body mass index and income. Results. Higher cost was inversely related to fruit and vegetable availability. Higher income, African American race, and female gender were positively related to availability. Cost per serving was stratified into 3 categories--low, medium, and high. Relative to low-cost items, only high-cost items decreased the odds of availability significantly. Conclusions. Fruit and vegetable cost does impact availability and has the greatest impact for high-cost items. Although cost was inversely related to availability, African Americans reported higher fruit and vegetable availability than Whites. Additional studies are needed to determine whether food items of lower nutritive value and comparable cost impact availability. (Am J Public Health. 2007;97:367-372. doi:10.2105/AJPH.2005.080655)

The objective of this study was to assess the relative long-term effects of linoleic (cis, cis 18:2), linolelaidic (trans, trans 18:2), and palmitic (16:0) acids on hepatic lipoprotein production in HepG2 cells. All fatty acids increased the mass of triglycerides (TG) in the medium and the incorporation of [sup.3]H-glycerol into secreted TG; the increase was more pronounced with linoleic acid than with linolelaidic and palmitic acids. The net accumulation in the medium of apolipoprotein (apo) A-I was not affected by the fatty acids tested and moderate changes in that of apoB resulted in apoB/apoA-I mass ratios of 1.05, 1.27 and 0.86 with linoleic, linolelaidic and palmitic acids, respectively. The incorporation of [[sup.14]C]-acetate into cellular plus secreted total sterols was 9.1%, 33.6% and 17.4% of total [[sup.14]C]-labeled lipids with linoleic, linolelaidic and palmitic acids, respectively. Relative to linoleic acid, palmitic acid, and to a greater extent (P < 0.05) linolelaidic acid, increased the secretion and cellular accumulation of [[sup.14]C]-labeled free cholesterol (FC) and cholesteryl esters and decreased those of TG and phospholipids (PL). Compared with linoleic acid, linolelaidic acid increased LDL-cholesterol (C) and HDL-C by 154% (P < 0.001) and 50% (P = 0.016), respectively, whereas palmitic acid increased LDL-C by 17% (P > 0.1) and did not affect HDL-C. The LDL-C to HDL-C ratios were 0.70, 1.18 and 0.96 with linoleic, linolelaidic and palmitic acids, respectively. These differences were not due to altered LDL receptor activity. The PL to C ratios of HDL particles were 1.61, 0.40 and 0.77 with linoleic acid, linolelaidic acid and palmitic acid, respectively. These results suggest that relative to cis polyunsaturated and saturated fatty acids, trans PUFA more adversely affect the concentration and composition of apoA-I- and apoB-containing lipoproteins secreted by HepG2 cells. KEY WORDS: * cholesterol metabolism * triglyceride secretion * liver * LDL * HDL

The influence of school-based nutrition programs on 4th graders and their parents was studied. Knowledge, self-efficacy and parent consumption were found to be more important than intervention by the schools.

School-based research requires a multi-level recruitment process to ensure an adequate sample. This article describes the High 5 Alabama recruitment experience at four levels: district, school, classroom and individual. One hundred percent of 28 schools across three districts and 108 classroom teachers contacted agreed to participate. Moderate success (69%) at the individual level, which required active parental consent for the student and parent to participate, resulted in 1,698 student/parent participants. An examination of differences between participants and nonparticipants revealed under-representation of a subsample of the population in the project sample. Suggestions obtained from project staff and teachers intended to enhance future school-based recruitment strategies include enlistment of a district advocate: meeting with teachers to solicit support: using incentives with students and teachers: direct contact with parents: having teachers keep rosters of students returning consent forms: and tailoring recruitment strategies for specific subpopulations. (J Sch Health. 1997;67(10):415-421), Recruitment of subjects for school-based health research presents unique challenges for researchers because recruitment methods must be identified for four different levels: district, school, teacher, student. Subject participation must be [...]

A low-fat diet may be relatively safe for children with elevated cholesterol levels without compromising their growth. Researchers measured height, weight, body mass and nutrients in blood samples of 663 children with elevated cholesterol who were on a low-fat diet. The low-fat diet did not affect height, weight, or body mass and most of the children were receiving at least two-thirds of the recommended daily allowance of most nutrients. The diet did not adversely affect blood levels of important nutrients and vitamins., Objective. To assess the relationship between energy intake from fat and anthropometric, biochemical, and dietary measures of nutritional adequacy and safety. Design. Three-year longitudinal study of children participating in a randomized controlled trial; intervention and usual care group data pooled to assess effects of self-reported fat intake; longitudinal regression analyses of measurements at baseline, year 1, and year 3. Participants. Six hundred sixty-three children (362 boys and 301 girls), 8 to 10 years of age at baseline, with elevated low-density lipoprotein cholesterol, who are participants of the Dietary Intervention Study in Children. Measures. Energy intake from fat assessed from three 24-hour recalls at each time point was the independent variable. Outcomes were anthropometric measures (height, weight, body mass index, and sum of skinfolds), nutritional biochemical determinations (serum ferritin, zinc, retinol, albumin, [Beta] -carotene, and vitamin E, red blood cell folate, and hemoglobin), and dietary micronutrients (vitamins A, C, E, thiamin, riboflavin, niacin, vitamins B-6, B-12, folate, calcium, iron, zinc, magnesium, and phosphorus). Results. Lower fat intake was not related to anthropometric measures or serum zinc, retinol, albumin, [Beta] -carotene, or vitamin E. Lower fat intake was related to: 1) higher levels of red blood cell folate and hemoglobin, with a trend toward higher serum ferritin; 2) higher intakes of folate, vitamin C, and vitamin A, with a trend toward higher iron intake; 3) lower intakes of calcium, zinc, magnesium, phosphorus, vitamin B-12, thiamin, niacin, and riboflavin; 4) increased risk of consuming less than two-thirds of the Recommended Dietary Allowances for calcium in girls at baseline, and zinc and vitamin E in boys and girls at all visits. Conclusions. Lower fat intakes during puberty are nutritionally adequate for growth and for maintenance of normal levels of nutritional biochemical measures, and are associated with beneficial effects on blood folate and hemoglobin. Although lower fat diets were related to lower self-reported intakes of several nutrients, no adverse effects were observed on blood biochemical measures of nutritional status. Current public health recommendations for moderately lower fat intakes in children during puberty may be followed safely. Pediatrics 1997; 100:51-59; children, fat intake, nutritional status, dietary safety, low-fat diet., ABBREVIATIONS. DISC, Dietary Intervention Study in Children; LDL, low-density lipoprotein; BMI, body mass index; RDA, recommended dietary allowance; OR, odds ratio. To reduce risk of coronary heart disease, health organizations [...]

The National Heart, Lung, and Blood Institute established the Dietary Intervention Study in Children (DISC) in 1986 to evaluate the efficacy of low-fat and low-cholesterol diets in children. During its first year, DISC experienced a significantly high response rate from parents, which can be seen through the high attendance rate of its sessions. The favorable response among parents can be attributed to DISC's well-planned program which enlightened parents regarding the value of low-cholesterol diets for their children.

* Objective. - To examine whether a protein-sparing modified fast diet and a hypocaloric balanced diet are safe and effective for children in an outpatient weight reduction program. Design. - Randomization of two groups to either diet, with follow-up at 14.5 months. Setting. - Physician or parent referral to outpatient program at Children's Hospital of New Orleans, La. Participants. - Nineteen children, ranging in age from 7.5 to 16.9 years, weighing 45% to 131% more than the mean weight for age, sex, and height. Intervention. - During the first 10 weeks, 10 children were placed on a protein-sparing modified fast diet (2520 to 3360 J), and nine children and adolescents were placed on a hypocaloric balanced diet (3360 to 4200 J). Subsequently, all participants were placed on a hypocaloric diet; calories were increased from 4200 to 5040 J in a 3-month period and maintained for 1 year. Selection Procedures. - Children were assigned to one of two diets for the first 10 weeks according to their time of enrollment. Measurements/Main Results. - Both diets produced significant weight loss during the first 6 months. However, the protein-sparing modified fast diet produced significantly greater changes in the percentage of overweight at 10 weeks (-30% vs -14%) and at 6 months (-32% vs -18%). At 10 weeks, a significant loss of adipose tissue with preservation of lean body mass occurred in the protein-sparing modified fast group. A transient slowing of growth velocity was noted at 6 months in both dietary groups compared with values at 14.5 months. Growth velocity approached normal levels at 14.5 months compared with standards for North American children. When dietary groups were combined, the initial mean blood pressure decreased significantly at all points in the study. The initial mean serum cholesterol value also decreased significantly at 10 weeks. No biochemical or clinical complications were observed. Conclusions. - These hypocaloric diets appear to be safe and effective in the short-term management of pediatric obesity. However, these diets should not be used without close medical supervision. (AJDC. 1993;147:160-166), Use of a protein-sparing modified fast (PSMF) diet among obese children appears to be a safe and rapid means of losing weight. Ten obese children followed a low-calorie PSMF diet (50% protein, 40% fat, and 10% carbohydrate). Nine obese children followed a diet of slightly higher caloric intake that was 20% protein, 30% fat and 50% carbohydrate. After 10 weeks all children were placed on the same maintenance diet (20% protein, 30% fat, and 50% carbohydrate). At 10 weeks, patients on the PSMF had lost an average of 11.2 kilograms (kg) while children on the other diet had lost an average of 5.1 kg. At six months, children on the PSMF diet had lost more weight than children on the other diet. Seven of 10 children on the PMSF diet completed the 14.5 month program compared with four of nine children on the other diet. Although most children had regained the weight at 14.5 months, children on the PSMF diet had lost more weight compared to their height.