Laura Webber

Eating behaviour and weight in children.

Objective:To test the hypothesis that quantitative variation in eating behaviour traits shows a graded association with weight in children.Design:Cross-sectional design in a community setting.Subjects:Data were from 406 families participating in the Physical Exercise and Appetite in CHildren Study (PEACHES) or the Twins Early Development Study (TEDS). Children were aged 7–9 years (PEACHES) and 9–12 years (TEDS).Measurements:Weights and heights were measured by researchers. Body mass index (BMI) s.d. scores were used to categorize participants into underweight, healthy weight, overweight and obese groups, with an additional division of the healthy weight group into higher and lower healthy weight at the 50th centile. Eating behaviour traits were assessed with the Child Eating Behaviour Questionnaire (CEBQ), completed by the parents on behalf of their child. Linear trend analyses compared CEBQ subscale scores across the five weight groups.Results:Satiety Responsiveness/Slowness in Eating and Food Fussiness showed a graded negative association with weight, whereas Food Responsiveness, Enjoyment of Food, Emotional Overeating and Desire to Drink were positively associated. All effects were maintained after controlling for age, sex, ethnicity, parental education and sample. There was no systematic association with weight for Emotional Undereating.Conclusion:These results support the idea that approach-related and avoidance-related appetitive traits are systematically (and oppositely) related to adiposity, and not exclusively associated with obesity. Early assessment of these traits could be used as indicators of susceptibility to weight gain.

Obesity prevalence in Mexico: impact on health and economic burden

OBJECTIVE Along with other countries having high and low-to-middle income, Mexico has experienced a substantial change in obesity rates. This rapid growth in obesity prevalence has led to high rates of obesity-related diseases and associated health-care costs. DESIGN Micro-simulation is used to project future BMI trends. Additionally thirteen BMI-related diseases and health-care costs are estimated. The results are simulated for three hypothetical scenarios: no BMI reduction and BMI reductions of 1 % and 5 % across the population. SETTING Mexican Health and Nutrition Surveys 1999 and 2000, and Mexican National Health and Nutrition Survey 2006. SUBJECTS Mexican adults. RESULTS In 2010, 32 % of men and 26 % of women were normal weight. By 2050, the proportion of normal weight will decrease to 12 % and 9 % for males and females respectively, and more people will be obese than overweight. It is projected that by 2050 there will be 12 million cumulative incidence cases of diabetes and 8 million cumulative incidence cases of heart disease alone. For the thirteen diseases considered, costs of

Adiposity and 'eating in the absence of hunger' in children.

US 806 million are estimated for 2010, projected to increase to

The relative reinforcing value of food predicts weight gain in a longitudinal study of 7–10-y-old children

US 1·2 billion and

The future burden of obesity-related diseases in the 53 WHO European-Region countries and the impact of effective interventions: a modelling study.

US 1·7 billion in 2030 and 2050 respectively. A 1 % reduction in BMI prevalence could save

High Rates of Obesity and Non-Communicable Diseases Predicted across Latin America

US 43 million in health-care costs in 2030 and

Screening and brief intervention for obesity in primary care: a parallel, two-arm, randomised trial.

US 85 million in 2050. CONCLUSIONS Obesity rates are leading to a large health and economic burden. The projected numbers are high and Mexico should implement strong action to tackle obesity. Results presented here will be very helpful in planning and implementing policy interventions.

MVPA Is Associated with Lower Weight Gain in 8–10 Year Old Children: A Prospective Study with 1 Year Follow-Up

Objective:To examine the association between eating in the absence of hunger (EAH) and adiposity in children.Design:Two cross-sectional studies in community settings.Subjects:For study 1, 348 children (178 girls and 170 boys) aged 7–9 years were recruited as part of the Physical Exercise and Appetite in Children Study. In study 2, participants were a subsample of children aged 9–12 years (N=316; 192 girls and 124 boys) from the Twins Early Development Study.Measurements:EAH was operationalized as intake of highly palatable sweet snacks after a mixed meal at school (study 1) or home (study 2). Weight (kg) and height (m) measurements were used to calculate the body mass index (BMI) s.d. scores. Children were grouped using the standard criteria for underweight, healthy weight, overweight and obesity. The healthy weight range was further subdivided into lower healthy weight (⩽50th centile) and higher healthy weight (>50th centile) to examine the distribution of EAH across the adiposity continuum.Results:In both studies, EAH showed a significant positive association with adiposity in boys after adjusting for covariates (P<0.001), with a linear increase in the intake across underweight, healthy weight and overweight groups. The association between EAH and adiposity was not significant in girls in either study, although in study 1, results showed a quadratic trend, with EAH increasing through the underweight and healthy weight ranges and decreasing in overweight and obese groups.Conclusion:EAH is a behavioural phenotype that is not specific to overweight children but instead shows a graded association with adiposity across the weight continuum, particularly in boys. In this study, the effect was less pronounced in girls, which may reflect social desirability pressures constraining food intake among heavier girls.

Health and economic burden of obesity in Brazil.

BACKGROUND The relative reinforcing value (RRV) of food, defined as how hard an individual is prepared to work to gain access to food rather than a nonfood alternative, has been shown to be higher in obese adults and children than in their normal-weight counterparts. However, these cross-sectional studies are unable to determine whether a high RRV of food is predictive of adiposity change or whether it is a consequence of being obese. OBJECTIVE The objective was to examine the association between the RRV of food and 1-y weight gain in children aged 7-10 y. DESIGN An observational longitudinal study design was used. The RRV of food was determined by using a questionnaire method at baseline when the children (n = 316) were aged 7-9 y. Adiposity [body mass index (BMI), BMI SD score, fat mass index, waist circumference, and waist circumference SD score] was assessed at baseline and after 1 y. RESULTS Regression analyses indicated that the RRV of food was not associated with any measure of adiposity at baseline or at the 1-y follow-up (all P > 0.58). Changes in BMI (B = 0.06, P < 0.001), BMI SD score (B = 0.03, P = 0.001), and fat mass index (B = 0.09, P = 0.001) after 1 y were significantly predicted by the RRV of food at baseline. CONCLUSIONS The RRV of food predicted the change in adiposity over a relatively short-term period of 1 y and thus may be associated with the development of obesity. The lack of association in cross-sectional analyses indicates that this behavior is a risk factor for weight gain, although weight differences may not emerge until later childhood.

Psychosocial correlates of objectively measured physical activity in children

Objective Non-communicable diseases (NCDs) are the biggest cause of death in Europe putting an unsustainable burden on already struggling health systems. Increases in obesity are a major cause of NCDs. This paper projects the future burden of coronary heart disease (CHD), stroke, type 2 diabetes and seven cancers by 2030 in 53 WHO European Region countries based on current and past body mass index (BMI) trends. It also tests the impact of obesity interventions on the future disease burden. Setting and participants Secondary data analysis of country-specific epidemiological data using a microsimulation modelling process. Interventions The effect of three hypothetical scenarios on the future burden of disease in 2030 was tested: baseline scenario, BMI trends go unchecked; intervention 1, population BMI decreases by 1%; intervention 2, BMI decreases by 5%. Primary and secondary outcome measures Quantifying the future burden of major NCDs and the impact of interventions on this future disease burden. Results By 2030 in the whole of the European region, the prevalence of diabetes, CHD and stroke and cancers was projected to reach an average of 3990, 4672 and 2046 cases/100 000, respectively. The highest prevalence of diabetes was predicted in Slovakia (10 870), CHD and stroke—in Greece (11 292) and cancers—in Finland (5615 cases/100 000). A 5% fall in population BMI was projected to significantly reduce cumulative incidence of diseases. The largest reduction in diabetes and CHD and stroke was observed in Slovakia (3054 and 3369 cases/100 000, respectively), and in cancers was predicted in Germany (331/100 000). Conclusions Modelling future disease trends is a useful tool for policymakers so that they can allocate resources effectively and implement policies to prevent NCDs. Future research will allow real policy interventions to be tested; however, better surveillance data on NCDs and their risk factors are essential for research and policy.