Kimbo E. Yee

Association between the family nutrition and physical activity screening tool and cardiovascular disease risk factors in 10-year old children

OBJECTIVE To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool with cardiovascular disease (CVD) risk factors in 10-year old children. METHODS A total of 119 children were assessed for body mass index (BMI), percent body fat, waist circumference, total cholesterol, high-density lipoprotein-cholesterol (HDL), and resting blood pressure. A continuous CVD risk score was created using total cholesterol to HDL-cholesterol ratio (TC:HDL), mean arterial pressure (MAP), and waist circumference. The FNPA survey was completed by parents. RESULTS The FNPA score was significantly correlated with adiposity measures (r = ?0.35 to ?0.43) and the continuous CVD risk score (r = ?0.22) (p < 0.05) but not with TC:HDL or MAP. The prevalence of overweight and obese (43.1% vs. 14.9%) and the mean values for BMI (20.3 ? 4.3 vs. 18.0 ? 2.7 kg/m(2)) and percent body fat (24.8 ? 8.3% vs. 20.1 ? 5.7%) were significantly higher in children with a FNPA score ? 25 when compared to those with a FNPA score > 25 (median split) (p < 0.05). The continuous CVD risk score was not significantly different between these two groups. Overweight and obese children had a significantly lower mean FNPA score when compared to normal weight children. CONCLUSION Children from a high-risk, obesogenic family environment (determined using the FNPA) have a higher level of adiposity and CVD risk factor profile than children from a low-risk family environment. The FNPA screening tool can help identify children that may be at risk for overweight and adverse CVD risk factor development.

Association of the Family Nutrition and Physical Activity Screening Tool with Weight Status, Percent Body Fat, and Acanthosis Nigricans in Children from a Low Socioeconomic, Urban Community

OBJECTIVE OBJECTIVE To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool with weight status, percent body fat, and acanthosis nigricans (AN) in 6- to 13-year-old children from a low socioeconomic, urban community. METHODS Children (n=415) from four elementary schools located around Flint, Michigan were assessed for body mass index, percent body fat, and AN. The FNPA screening tool was completed by parents. Mann-Whitney U tests were used to assess differences in FNPA score by sex and presence of AN. Logistic regression was used to evaluate the association of the FNPA (tertiles) with weight status and AN. RESULTS Children with AN (13.7%) had a significantly lower FNPA score (56.3 + 7.1) compared with children without AN (61.0 + 7.1; P<.05). Children with FNPA scores in the lowest tertile (high-risk) had odds ratios of 1.74 (95% CI =1.05 - 2.91) and 2.77 (95% CI =1.22 - 6.27) compared with children with FNPA scores in the highest tertile (low-risk) for being overfat and having AN, respectively. CONCLUSION Although the FNPA screening tool did not predict risk for being overweight or obese, it was significantly associated with an increased odds of children at risk for being overfat or having AN.

Physical activity and self-efficacy in normal and over-fat children.

OBJECTIVE To examine the independent and combined association of self-efficacy and fatness with physical activity in 5(th) grade children. METHODS Participants were 281 students (10.4 ± 0.7 years). Physical activity was assessed using a self-report question. Self-efficacy to be physically active was assessed using a 5-point scale. Body fatness was assessed by bioelectrical impedance. Descriptive statistics, ANOVA, and t-tests were used. RESULTS There were no differences in reported days of physical activity between boys and girls, and normal-fat and over-fat children. However, children with high self-efficacy participated in significantly more physical activity compared to their low self-efficacy counterparts (3.4 ± 2.0 days vs. 5.4 ± 1.8 days, respectively, p < .001). CONCLUSIONS Only physical activity self-efficacy was related to physical activity, fatness was not.

Association between the Family Nutrition and Physical Activity Screening Tool and obesity severity in youth referred to weight management

BACKGROUND The Family Nutrition and Physical Activity Screening Tool (FNPA) evaluates family behavioural and environmental factors associated with pediatric obesity, but it is unknown if FNPA scores differ among youth across obesity severities. Our aim was to determine the association between the FNPA and obesity severity in youth referred to weight management. METHODS Upon initiating treatment, height, weight, and the FNPA were collected according to standard procedures. Cut-points for overweight/obesity, severe obesity (SO) class 2, and SO class 3 were calculated. FNPA scores were compared across weight status groups using analysis of covariance, and odds of SO across FNPA quartiles were evaluated with multiple logistic regression. RESULTS Participants included 564 5-18year old who initiated treatment and completed the FNPA. After adjustment, FNPA scores differed by weight status with higher/healthier scores in youth with overweight/obesity (56.6±8.5) when compared to those with SO class 2 (55.0±7.1; p=0.015) or SO class 3 (53.6±9.0; p<0.001). Compared to those in the highest FNPA quartile, youth in the 2nd quartile had 1.8 (95% CI: 1.1, 2.9) times higher odds of SO, and those in the lowest FNPA quartile had 2.1 (95% CI: 1.3, 3.4) times higher odds of SO. Youth with SO had unhealthier subscale scores among 6 of 10 constructs, including nutritional, physical activity, sedentary, and sleep behaviours. CONCLUSIONS Results suggest a consistent inverse relationship between the FNPA and adiposity among youth presenting for weight management. The FNPA is a useful metric for programs and clinicians targeting family behaviours and the home environment to combat obesity.

Changes in psychosocial health during a 7-week paediatric weight management program

Youth with obesity are at increased risk of psychosocial symptoms; however, little is known regarding the impact of paediatric weight management (PWM) on psychosocial health. The aim of the study was to investigate changes in psychosocial health among children who completed a 7‐week PWM program. Participants aged 5 to 16 years with a BMI ≥85th percentile completed a 7‐week, family‐centred PWM program focused on health behaviour education, exercise and mentored goal setting. The Paediatric Symptom Checklist (PSC) was assessed via parent report to evaluate psychosocial symptoms before and after the program, and subscales were calculated for internalizing (PSC‐IS), externalizing (PSC‐ES) and attention symptoms (PSC‐AS). At baseline, positive screen rates for psychosocial symptoms among the 317 patients included 16.1% for PSC, 14.1% for PSC‐ES, 18.6% for PSC‐IS and 12.3% for PSC‐AS. Among program completers, total PSC scores improved in those with normal (p = 0.010) and elevated p < .001 psychosocial symptoms at baseline. Youth with positive screens for elevated PSC subscales improved their subscale scores, on average, and the majority reduced scores to below elevated levels for PSC (54.2%), PSC‐ES (64.7%), PSC‐IS (78.3%) and PSC‐AS (64.7%). Improvements in PSC remained significant after adjusting for BMI changes during treatment, but BMI differed across PSC‐change groups, including BMI increases among participants with PSC deterioration (0.33 ± 0.64 kg m−2) (P = 0.035) and BMI decreases among patients with no reliable PSC change (−0.26 ± 1.04 kg m−2) (P = 0.038) or reliable PSC improvement (−0.22 ± 0.74 kg m−2) (P = 0.025). Youth with positive screens for psychosocial symptoms can improve emotional and behavioural functioning during short‐term PWM. Future research is needed to elucidate mechanisms and long‐term outcome durability.