Jungwon Min

Child health promotion program in South Korea in collaboration with US National Aeronautics and Space Administration: Improvement in dietary and nutrition knowledge of young children

BACKGROUND/OBJECTIVES Childhood obesity has become a global epidemic. Development of effective and sustainable programs to promote healthy behaviors from a young age is important. This study developed and tested an intervention program designed to promote healthy eating and physical activity among young children in South Korea by adaptation of the US National Aeronautics and Space Administration (NASA) Mission X (MX) Program. SUBJECTS/METHODS The intervention program consisted of 4 weeks of fitness and 2 weeks of nutrition education. A sample of 104 subjects completed pre- and post-surveys on the Childrens Nutrition Acknowledgement Test (NAT). Parents were asked for their childrens characteristics and two 24-hour dietary records, the Nutrition Quotient (NQ) at baseline and a 6-week follow-up. Child weight status was assessed using Korean body mass index (BMI) percentiles. RESULTS At baseline, 16.4% (boy: 15.4%; girl: 19.2%) of subjects were overweight or obese (based on BMI≥85%tile). Fat consumption significantly decreased in normal BMI children (48.6 ± 16.8 g at baseline to 41.9 ± 18.1 g after intervention, P < 0.05); total NQ score significantly increased from 66.4 to 67.9 (P < 0.05); total NAT score significantly improved in normal BMI children (74.3 at baseline to 81.9 after the program), children being underweight (from 71.0 to 77.0), and overweight children (77.1 at baseline vs. 88.2 after intervention, P < 0.001). CONCLUSIONS The 6-week South Korean NASA MX project is feasible and shows favorable changes in eating behaviors and nutritional knowledge among young children.

A Systematic Examination of Food Intake and Adaptation to the Food Environment by Refugees Settled in the United States

The United States is the largest refugee resettlement country in the world. Refugees may face health-related challenges after resettlement in the United States, including higher rates of chronic diseases due to problems such as language barriers and difficulty adapting to new food environments. However, reported refugee diet challenges varied, and no systematic examination has been reported. This study examined refugee food intake pre- and postresettlement in the United States and differences in intake across various refugee groups. We systematically reviewed relevant studies that reported on refugee food intake and adaptation to the US food environment. We searched PubMed for literature published between January 1985 and April 2015, including cross-sectional and prospective studies. Eighteen studies met inclusion criteria. Limited research has been conducted, and most studies were based on small convenience samples. In general, refugees increased meat and egg consumption after resettling in the United States. Changes in refugee intake of vegetables, fruits, and dairy products varied by socioeconomic status, food insecurity, past food deprivation experience, length of stay in the United States, region of origin, and age. South Asians were more likely to maintain traditional diets, and increased age was associated with more conservative and traditional diets. Despite the abundance of food in the United States, postresettlement refugees reported difficulty in finding familiar or healthy foods. More research with larger samples and follow-up data are needed to study how refugees adapt to the US food environment and what factors may influence their food- and health-related outcomes. The work could inform future interventions to promote healthy eating and living among refugees and help to reduce health disparities.

Double burden of diseases worldwide: coexistence of undernutrition and overnutrition-related non-communicable chronic diseases

This systematic examination and meta‐analysis examined the scope and variation of the worldwide double burden of diseases and identified related socio‐demographic factors.

Maternal perception of child overweight status and its association with weight-related parenting practices, their children’s health behaviours and weight change in China

OBJECTIVEnChildhood obesity has increased rapidly in China, but understanding is limited on how parents perceive their childs weight status and how this perception affects weight-related parenting practices. We examined maternal perception of her childs weight status and its association with demographics, subsequent weight-related parenting practices, the childs health behaviours and weight change. Design/Setting/Subjects Maternal perception of childs weight status and health behaviours from the China Health and Nutrition Surveys were assessed at baseline and in follow-up surveys for 816 children aged 6-18 years during 2004-2011. Associations were tested using mixed models.nnnRESULTSnOverall, maternal and child perceptions of the childs weight status were fairly consistent (κ w=0·56), 63·8 % of mothers had correct perception. While 9·6 % of mothers perceived their child as overweight, 10·9 % of children did so, and 13·6 % of children were indeed overweight. Compared with mothers who viewed their children as normal weight, mothers who thought their children were overweight were more likely to encourage their children to increase their physical activity (OR; 95 % CI: 1·8; 1·0, 3·3) and to diet (4·3; 2·3, 7·8). Children perceived as overweight by their mothers were more likely to have insufficient physical activity (2·8; 1·6, 4·7) and gain more weight during follow-up (BMI Z-score, β (se): 1·0 (0·1); P<0·01) than children perceived by their mothers as normal weight.nnnCONCLUSIONSnIn China, mothers who perceive their child as overweight are more likely to encourage their child to exercise and modify their diet for weight management, but this encouragement does not seem to improve the childs health behaviours and weight status.

A Systematic Examination of the Association between Parental and Child Obesity across Countries

Childhood obesity has become a global epidemic. Parents can have an important influence on their childrens health behaviors and weight status. Many studies have examined the association between parental and childhood weight status. However, much heterogeneity between studies exists, and the parent-child (P-C) association in obesity has varied. The purpose of this systematic examination and meta-analysis was to examine the strength and variation of the P-C association in obesity and to identify factors (e.g., demographic characteristics and countrys economic level) that may influence this association. PubMed was searched for relevant studies published between January 2000 and July 2015. Thirty-two studies from 21 countries met inclusion criteria; 27 reported ORs for the P-C obesity association and were included in a meta-analysis. The meta-analysis showed a strong P-C obesity association (pooled OR: 2.22; 95% CI: 2.09, 2.36), which varied by type of P-C pair (i.e., parents-child, father-child, and mother-child), child age, parent and child weight status, and the countrys economic level. Stronger associations were shown in older children than in younger children (β ± SE: 0.02 ± 0.01), in both parents than in father only (β ± SE: 0.51 ± 0.11) or mother only (β ± SE: 0.38 ± 0.11), in parental obesity (β ± SE: 0.26 ± 0.10) and child obesity (β ± SE: 0.28 ± 0.12) than in parental and child overweight, and in high- than in middle-income countries (β ± SE: 0.23 ± 0.08). Thus, research from multiple countries shows significant P-C associations in weight status, but this association varies by child age, type of P-C pair, weight status, and the countrys economic level. Results suggest that families and parents should be a key target for obesity intervention efforts.

Obesity, body image, and its impact on children's eating and exercise behaviors in China: A nationwide longitudinal study

Body image seems to mediate the association between obesity and health behaviors as well as weight control attempts. We examined the distribution of childrens body image by demographic characteristics and their subsequent associations with eating, exercise, and weight change. Child body image and health behaviors from the China Health National Survey 2000-2011 were assessed at baseline and in follow-up for 6- to 17-year-old children during 2000-2011 using mixed models. There was a large discrepancy between childrens actual weight status (overweight: 16.9%) vs. self-rated body image (fat: 2.4% in 2011). Less than 1% of children desired a fat body; girls were more likely to want to be thin (52.5% vs. 40.9%) than boys. About 11% of children needed to lose weight in order to be at their desired baseline. During follow-up, those needing weight loss to be as desired were more likely to attempt dieting to change their weight (OR, 95% CI=1.9, 1.1-3.5 in boys; 1.7, 1.1-2.5 in girls) and less likely to feel they had enough physical activity (OR, 95% CI=0.5, 0.4-0.7 in boys; 0.6, 0.5-0.9 in girls), although their weight gain had been significantly higher than those having consistent self and desired body images (β [SE]=0.4 [0.1] in boys; 0.2 [0.1] in girls, all p<0.05). However, no significant difference was shown in subsequent health behaviors among overweight children by body image discrepancy. The discrepancy in self vs. desired body image motivated children to change their obesity-related health behaviors among non-overweight children in China.

Longitudinal Changes and High-Risk Subgroups for Obesity and Overweight/Obesity Among Refugees in Buffalo, NY, 2004–2014

IntroductionVery few studies have been conducted on non-communicable diseases among resettled refugees. The purpose of the study was to examine longitudinal changes in obesity and overweight/obesity rates among resettled refugees and identify high-risk subgroups.MethodsLongitudinal health assessment data of 818 children (2–18xa0years) and 1055 adults (≥19xa0years) were used from a refugee clinic in Buffalo, NY, during 2004–2014. Univariate and bivariate analyses were performed. Risk factors of obesity and overweight/obesity were assessed using multivariate regression models.ResultsObesity (8.7 to 12.7%) and overweight/obesity (16.9 to 26.7%) rates increased among children over 4.5xa0years (pxa0<xa00.01). Over 3.9xa0years, overweight/obesity rates increased in men (39.6 to 58.6%, pxa0<xa00.01) and women (55.1 to 73.5%, pxa0<xa00.01), exceeding the prevalence of overweight/obesity of 65.8% in US-born women. Interestingly, longitudinal overweight/obesity rates decreased among Middle Eastern (81.4 vs 78.0%, pxa0<xa00.01) and East European (75.0 vs 70.8%, pxa0<xa00.01) women. African children had 2.31-folds (odds ratio [OR]xa0=xa02.31; 95% confidence interval [CI]xa0=xa01.46–3.67) greater overweight/obesity risk than Asians. African girls who were not overweight or obese at baseline had the highest risk of becoming obese at follow-up visits (ORxa0=xa00.21; 95%CIxa0=xa00.09–0.52). For each additional year refugees lived in the USA, overweight/obesity risk among men (ORxa0=xa01.23; 95%CIxa0=xa01.09–1.39) and women (ORxa0=xa01.18; 95%CIxa0=xa01.04–1.35) increased.ConclusionObesity and overweight/obesity rates increased among refugees, but significant variations existed. Overweight/obesity rate among refugee women surpassed the US average. African origin, baseline weight, and longer duration of stay in the USA were risk factors. Culturally tailored programs are needed to prevent obesity and reduce health disparities among refugees.

Parenting practices and overweight status of junior high school students in China: A nationally representative study of 19,487 students from 112 schools

The study aimed to examine the level of parental responsiveness and demandingness for junior high students in China and its association with child weight status; assess if it differs by student socio-demographic characteristics; and to test the association between parenting and child physical activity. Nationally representative survey data collected from 19,487 students in 112 middle schools across China in 2013-2014 academic year were analyzed in 2016. Childrens anthropometrics and perceptions of parenting practices were accessed by self-administered questionnaire. Multilevel logistic regression models were fit to test the association controlling for child age, sex, school region, and parental education. The majority of adolescents reported their parents were highly responsive in terms of emotional support and involvement (high: 64.1% vs. low: 9.2%), although more parents were not perceived as highly demanding (high: 21.4% vs. low: 35.5%). Children were more likely to be overweight or obese if their parents were highly responsive (OR=1.4 [95%CI: 1.2,1.6]) and demanding (OR=1.1 [95%CI: 1.0,1.3]) compared to those with medium parenting scores. Older children, boys, children with highly educated parents, or in urban schools had greater odds of being overweight or obese by receiving highly responsive parenting compared to their counterparts. Children with highly demanding or responsive parenting had longer physical activity duration and higher physical activity participation rates than their counterparts. High responsiveness and demandingness among Chinese parents were associated with the risk of child overweight and obesity. Further research is needed to examine the causal relationship between parenting practices and childhood obesity in China.

Association between household poverty dynamics and childhood overweight risk and health behaviours in the United States: a 8-year nationally representative longitudinal study of 16 800 children: Poverty dynamics on childhood obesity

No study has examined how the pattern of income dynamics influences both of childrens body mass index (BMI) trajectory and health behaviours.

Mismatch in Children’s Weight Assessment, Ideal Body Image, and Rapidly Increased Obesity Prevalence in China: A 10-Year, Nationwide, Longitudinal Study: Body Image Change and Obesity Epidemic

This study examined secular trends in children’s weight‐status assessment, measured weight status, and ideal body image and their associations with subsequent changes in BMI, and it explored the differences between sociodemographic groups in China.