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BackgroundThis study examined the strength, shape and direction of associations of accelerometer-assessed overall, school- and non-school-based moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) with BMI among adolescents across the world. Second, we examined whether these associations differed by study site and sex.MethodsCross-sectional data from the IPEN Adolescent study, an observational multi-country study, were used. Participants wore an accelerometer for seven days, reported height and weight, and completed a socio-demographic survey. In total, 4852 adolescents (46.6% boys), aged 11-19 years (mean age = 14.6, SD = 1.7 years) were included in the analyses, using generalized additive mixed models.ResultsAdolescents accumulated on average 41.3 (SD = 22.6) min/day of MVPA and 531.8 (SD = 81.1) min/day of ST, and the prevalence of overweight and obesity was 17.2% (IOTF), but these mean values differed by country. Linear negative associations of accelerometer-based MVPA and ST with standardized BMI scores and the likelihood of being overweight/obese were found. School-based ST and non-school-based MVPA were more strongly negatively associated to the outcomes than non-school based ST and school-based MVPA. Study site moderated the associations; adolescent sex did not. No curvilinear associations were found.ConclusionsThis multi-country study confirmed the importance of MVPA as a potential protective factor against overweight/obesity in adolescents. Non-school-based MVPA seemed to be the main driver of these associations. Unexpected results were found for ST, calling for further examination in methodologically sound international studies but using inclinometers or pressure sensors to provide more precise ST measures.

IntroductionOnly international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese).Methods and analysisThe IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11-19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status.Ethics and disseminationEthical approval was received from each study site's Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.

BackgroundThe IPEN International Physical Activity and Environment Network Adolescent project was conducted using common study protocols to document the strength, shape, and generalizability of associations of perceived neighborhood environment attributes with adolescents' physical activity and overweight/obesity using data from 15 countries. Countries did not use identical versions of the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) to measure perceived neighborhood environment attributes. Therefore, this study derived a measurement model for NEWS-Y items common to all IPEN Adolescent countries and developed a scoring protocol for the IPEN Adolescent version of the NEWS-Y (NEWS-Y-IPEN) that maximizes between-country comparability of responses. Additionally, this study examined between- and within-country variability, and construct validity of the NEWS-Y-IPEN subscales in relation to neighborhood-level socio-economic status and walkability.MethodsAdolescents and one of their parents (N = 5714 dyads) were recruited from neighborhoods varying in walkability and socio-economic status. To measure perceived neighborhood environment, 14 countries administered the NEWS-Y to parents and one country to adolescents. Confirmatory factor analysis was used to derive comparable country-specific measurement models of the NEWS-Y-IPEN. Country-specific standard deviations quantified within-country variability in the NEWS-Y-IPEN subscales, while linear mixed models determined the percentage of subscale variance due to between-country differences. To examine the construct validity of NEWS-Y-IPEN subscales, we estimated their associations with the categorical measures of area-level walkability and socio-economic status.ResultsFinal country-specific measurement models of the factor-analyzable NEWS-Y-IPEN items provided acceptable levels of fit to the data and shared the same factorial structure with five latent factors (Accessibility and walking facilities; Traffic safety; Pedestrian infrastructure and safety; Safety from crime; and Aesthetics). All subscales showed sufficient levels of within-country variability. Residential density had the highest level of between-country variability. Associations between NEWS-Y-IPEN subscales and area-level walkability and socio-economic status provided strong evidence of construct validity.ConclusionsA robust measurement model and common scoring protocol of NEWS-Y for the IPEN Adolescent project (NEWS-Y-IPEN) were derived. The NEWS-Y-IPEN possesses good factorial and construct validity, and is able to capture between-country variability in perceived neighborhood environments. Future studies employing NEWS-Y-IPEN should use the proposed scoring protocol to facilitate cross-study comparisons and interpretation of findings.

The present study aimed to investigate an interaction between energy intake, physical activity and UCP2 gene variation on weight gain and adiposity changes in Indonesian adults. This is a prospective cohort study conducted in 323 healthy adults living in the city of Yogyakarta, Indonesia. Energy intake, physical activity, body weight, BMI, percentage body fat and waist:hip ratio (WHR) were measured at baseline and after 2 years while UCP2 -866G/A gene variation was determined at baseline. We reported that after 2 years subjects had a significant increment in body weight, BMI, body fat and reduction in WHR (all P < 0·05). In all subjects, total energy intake was significantly correlated with changes in body weight (β = 0·128, P = 0·023) and body fat (β = 0·123, P = 0·030). Among subjects with the GG genotype, changes in energy intake were positively correlated with changes in body weight (β = 0·232, P = 0·016) and body fat (β = 0·201, P = 0·034). These correlations were insignificant among those with AA + GA genotypes (all P > 0·05). In summary, we show that UCP2 gene variation might influence the adiposity response towards changes in energy intake. Subjects with the GG genotype of UCP2 -866G/A gene were more responsive to energy intake, thus more prone to weight gain due to overeating. [ABSTRACT FROM AUTHOR]

Background: Obesity has been associated with leptin resistance and this might be caused by genetic factors. The aim of this study was to investigate the gene-lifestyle interaction between -866G/A UCP2 (uncoupling protein 2) gene polymorphism, dietary intake and leptin in a population based study. Methods: This is a cross sectional study conducted in adults living at urban area of Yogyakarta, Indonesia. Data of adiposity, lifestyle, triglyceride, high density lipoprotein (HDL) cholesterol, leptin and UCP2 gene polymorphism were obtained in 380 men and female adults. Results: UCP2 gene polymorphism was not significantly associated with adiposity, leptin, triglyceride, HDL cholesterol, dietary intake and physical activity (all p > 0.05). Leptin was lower in overweight subjects with AA + GA genotypes than those with GG genotype counterparts (p = 0.029). In subjects with AA + GA genotypes there was a negative correlation between leptin concentration (r = -0.324; p < 0.0001) and total energy intake and this correlation was not seen in GG genotype (r = -0.111; p = 0.188). Conclusions: In summary, we showed how genetic variation in -866G/A UCP2 affected individual response to leptin production. AA + GA genotype had a better leptin sensitivity shown by its response in dietary intake and body mass index (BMI) and this explained the protective effect of A allele to obesity. [ABSTRACT FROM AUTHOR]

Background: Anemia is a major public health problem worldwide, with adverse consequences on child growth, development, and survival. This deficiency has affected approximately a quarter of the world population. This study aimed to determine the prevalence of anemia and the associated factors among preschool children in the Gaza Strip. Methods: A cross-sectional study was conducted between May and September 2012. A total of 357 preschool children were selected using multistage sampling method from Jabalya refugee camp, El Remal urban area, and Al Qarara rural area. Hemoglobin level was measured, and anemia diagnosis was confirmed at a level <11.0 g/dL. In this study, we utilized a pretested questionnaire for face to face interview with mothers. Anthropometric indicators for children were measured using the WHO guideline. Descriptive and multivariate analyses were conducted to determine the prevalence and associated factors of anemia. Results: The overall prevalence of anemia was 59.7% among preschool children in the Gaza Strip, 46.5% and 13.5% of which are mild and moderate, respectively. The mean hemoglobin level was 10.83 ± 0.86 g/dl. Children living in Jabalya refugee camp have a high risk of anemia [adjusted b= -0.55; 95% confidence interval (CI;-0.72,-0.39); p < 0.001]. Boys were more susceptible to this deficiency than girls [adjusted b = 0.17; 95% CI (0.0.01, 0.33); p = 0.031]. Hemoglobin level increased with age [adjusted b = 0.02; 95% CI (0.01, 0.03); p < 0.001]. Hemoglobin level decreased in children living in poor households [adjusted b = -0.24; 95%CI (-0.41,-0.06); p = 0.006]. Underweight children were more susceptible to anemia than normal weight children [adjusted b = - 0.22; 95% CI (-0.41, -0.03); p = 0.025]. Conclusions: The prevalence of anemia among preschool children in the Gaza Strip was higher than those reported in previous local studies, indicating that anemia is a major public health problem. In this study, we also observed mild and moderate cases among children, whereas severe anemia was not observed. Independent predictors of anemia were geographic location, sex, age, monthly income, and malnutrition. Results provided the baseline information on anemia, therefore, especial attention should be given on intervention of anemia. [ABSTRACT FROM AUTHOR]

A cross-sectional study was carried out in Kota Bharu on three groups of men with ages ranging from 18 to 44 years. The study groups included 83 athletes representing various types of sports and levels of participation (athlete group), 80 active men who exercised a minimum of 30 minutes per day at least 3 times per week (exercise group), and 80 inactive men (sedentary group). The objectives of the study were to compare the body mass indices (BMIs) and body fat statuses among the three groups with different physical activity levels. The height and weight of respondents were measured using the Seca weighing balance with height attachment. Skinfold thickness of biceps, triceps, sub scapular regions, and supra iliac regions of each respondent were measured using Harped skin fold calipers. Percentage body fat was calculated as the sum of the four measurements of skin fold thickness. The results showed that the mean (&plum; SD) BMIs in the athlete, exercise, and sedentary groups were 22.6 ± 2.9, 23.4 ± 3.5, and 24.3 ± 4.6 kg/m2, respectively. The combined prevalence of pre-obese (BMI 25.029.9) and obese (BMI³ 30.0) subjects was 21.7% in the athlete group, 29.9% in the exercise group, and 47.5% in the sedentary group. The mean (± SD) percentage of body fat in athletes was 15.7 ± 5.4%, which was lower than in the exercise (18.9 ± 5.5%) and sedentary (20.6 ± 5.8%) groups. The study revealed that individuals who are actively involved in physical activity, particularly in sport activities, have lower BMIs and percentage body fat values compared to sedentary people. Therefore, to prevent obesity, all individuals are encouraged to perform regular physical activity, particularly sports activities. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) outbreak has led to imposed movement restrictions and lockdowns to curb the spread of COVID-19 cases in the community. These lockdowns had greatly changed people's daily lives, including physical activity and sedentary behaviour. The aim of this scoping review was to establish available evidence linked to physical activity (PA) and sedentary behaviour (SB) among adults in the Asia region during the COVID-19 outbreak. This scoping review was conducted using Arksey & O'Malley's protocol with 132 studies included after full-text screening. Changes in PA were reported in 122 studies and SB in 50 studies. Most studies reported a reduction in the total level of PA and a hike in sedentary and screen time. This decrement in PA and increment in SB was related to poor mental health, body weight increase and complications in COVID-19 patients, while participants who maintained or improved their PA reported better health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Obesity, in the past was perceived to be the problem of the rich, but recent studies have reported that the problem of obesity is a worldwide problem and rural population is no less affected. Self-perceived health and weight appropriateness is an important component of weight-loss and eating behaviors and may be mediated by local, social and cultural patterning. In addition to the quality of life assessment, it should therefore be an important focal point for the design and implementation of clinical and public health policies., Methods: The present study was carried out to assess the self-perception of weight appropriateness as well as the quality of life of overweight and obese individual among the rural population particularly among housewives. A total of 421 respondents participated in the study which consisted of 36.6% in the overweight and 63.4% in the obese categories., Results: the analysis of the survey revealed that self-perception regarding obesity among respondents show common similarities, particularly in self reporting on health, dietary habit and also the concept of beauty and a beautiful body. Character and behavior are highly regarded in evaluating a person's self-worth in society. The results on the quality of life using the ORWELL 97 instrument show that the quality of life of respondents was moderate. Most of the respondents were aware of their body weight and indicated an intention to lose weight but also reported themselves as healthy or very healthy., Conclusion: The results of the survey indicated that perception on obesity did not differed very much between respondents, in fact there existed a lot of similarities in their perception about health, quality of life, personal health and self-satisfaction with own body. However, their quality of life was within the normal or moderate level based on the ORWELL 97 assessment. Even though most of the respondents were aware of their body weight and indicated an intention to lose weight they also reported themselves as healthy or very healthy, suggesting that public health messages intended for rural housewives need to be more tailored to health-related consequences of fatness.

Background: Soil-transmitted intestinal helminth infection is prevalent in rural communities of Malaysia. Risk factors contributing to helminth infections are largely unknown in the country., Aim: To determine the prevalence and risk factors of intestinal helminth infections among children in Beris Lalang, a rural Muslim community of Malaysia., Settings and Design: In this cross-sectional study, children aged 7-9 years were recruited during the mass Friday prayer at Beris Lalang mosque by trained imams (religious leaders). A standardized questionnaire was used to obtain information on socio-demographic profile, daily hygienic practices, and history of helminth infection., Results: Out of 79 samples, 29 (37%) were positive for helminthic ova, of which 24 were ova of Trichuris trichiura. Poor education of the mother (primary education or less) (P=0.015), eating raw salad (P=0.03), and no physical activities (P=0.03) were found independent risk factors for the child's helminth infections in univariate analysis. A higher proportion of children with helminth infections complained of tiredness and fatigue compared to those without such infections (36% vs. 12%, P=0.019). In a multivariate analysis of predictors of helminth infection, poor education of the mother (P=0.02) and eating raw salad (P=0.04) remained statistically significant, after controlling for several other potential risk factors., Conclusions: T. trichiura was the most prevalent intestinal helminth infection in children in rural Malaysia. Risk factors of helminth infection included mother's poor education and eating raw salad and vegetables.

Introduction: Many studies had shown that poor growth in children is associated with malnutrition. The underlying factors are diverse, multisectoral and interrelated, ranging from biological to social, cultural and economically related. Because the highest levels of under-nutrition worldwide are found in South Asia, it is essential that policymakers in the region understand the underlying determinants, in order to design effective public health intervention programs. This is especially so if public resources are limited. The purpose of this cross-sectional study was to examine causal relationships among the biological, behavioural and environmental factors related to malnutrition in children aged 5 years and under., Method: The instrument used in this study was based on a previously described conceptual framework for malnutrition in children, and tested for its psycometric component, using both qualitative and quantitative methods. As well as the use of a questionnaire, anthropometric and dietary data were collected from 295 children aged 5 years and below, randomly selected from clinics in Tumpat, Kelantan. The proposed model was tested and modified using structural equation modelling (AMOS software: ADC, Chicago, IL, USA)., Results: The modified model fitted the data adequately. The results demonstrated that an environmental construct (with factors that included total household income beta = 0.68, p <0.01; total expenditure beta = 0.67, p <0.01; number of rooms in the house beta = 0.46, p <0.01; and socioeconomic status beta = 0.71, p <0.01) had a significant effect on malnutrition. Neither the biological nor behavioural constructs had significant effects., Conclusion: These findings provide useful insights into the importance of focusing on environmental factors as the main target when designing intervention programs. This information will be useful for the prioritization of preventive programs when resources are limited, especially in a rural setting. Future studies should focus on the issues of the ability of the households to meet their basic needs, inequality in the population, and the effectiveness of intervention at both micro and macro levels. This study focused on a rural community, therefore the results can only be generalized to areas with similar characteristics.

Feeding difficulties in cleft lip and palate (CLP) infants is commonly observed and is the most traumatic experience the family has to face. These infants are undernourished and have compromised growth. The purpose of this study was to 1) assess general health and growth parameters in children with CLP and in normal children; and 2) investigate the feeding methods of CLP infants and normal infants. A total of 221 children from birth to six years of both sexes, with CLP (60 children) and normal (161 children) were selected. The CLP and normal children were divided into three subgroups by age. The practice of feeding the infants in subgroup I was assessed using standard piloted questionnaires. The assessment of growth was done at baseline and at six months in all the subgroups.The general well being of the children was assessed by noting the number of common infections. Results showed that a significantly higher percentage of mothers with normal babies (p < 0.01) had a positive attitude towards breast feeding. When compared to normal children, CLP children were more susceptible to infections (p < 0.05) and measured significantly lower on the height growth curve(p < 0.05). Hence, height can be used to monitor growth in CLP children.