M. Verloigne

Family- and school-based correlates of energy balance-related behaviours in 10-12-year-old children: a systematic review within the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project

OBJECTIVEnTo identify family- and school-based correlates of specific energy balance-related behaviours (physical activity, sedentary behaviour, breakfast consumption, soft drink consumption) among 10-12-year-olds, using the EnRG framework (Environmental Research framework for weight Gain prevention).nnnDESIGNnA literature review to identify observational studies exploring at least one family- or school-based correlate of the specific behaviours, resulting in seventy-six articles.nnnSETTINGnEighteen studies were conducted in Europe, forty-one studies in North America and seventeen studies in Australasia.nnnSUBJECTSnHealthy children aged 10-12 years.nnnRESULTSnParental and maternal physical activity, doing physical activities with parents and parental logistic support were identified as the most important, positive correlates of physical activity. Parental rules was the most important correlate of sedentary behaviour and was inversely related to it. School socio-economic status was positively related to physical activity and inversely related to sedentary behaviour. The available studies suggested a positive relationship between soft drink availability at home and consumption. Soft drink availability and consumption at school were the most important school-based correlates of soft drink consumption. A permissive parenting style was related to more soft drink consumption and less breakfast consumption.nnnCONCLUSIONSnAn important role has been awarded to parents, suggesting parents should be involved in obesity prevention programmes. Despite the opportunities a school can offer, little research has been done to identify school-environmental correlates of energy balance-related behaviours in this age group. Obesity prevention programmes can focus on the most important correlates to maximize the effectiveness of the programme. Future research should aim at longitudinal studies.

Perceived social and physical environmental correlates of physical activity in older adolescents and the moderating effect of self-efficacy.

OBJECTIVEnTo determine if perceptions of the social and physical environment are associated with active transport and leisure-time sports among Belgian youth and to investigate if this relationship is moderated by self-efficacy.nnnMETHODSnIn February-May 2008, 1445 adolescents (17.4+/-0.6 yrs) were recruited in 20 randomly selected Belgian schools. Physical activity, psychosocial, and environmental factors were assessed using validated questionnaires. Moderated multilevel regression analysis was used to examine the association between physical activity and possible correlates.nnnRESULTSnSocial environmental variables (modeling and social support) were positively associated with active transportation and leisure-time sports (p<0.05). Higher land use mix diversity, higher street connectivity, more attractive environments, better access to recreational facilities, and higher emotional satisfaction with the neighborhood were associated with more active transportation (p<0.05). Higher perceived safety from traffic, better access to recreational facilities, more physical activity equipment at home, and fewer electronic devices in the bedroom were associated with more leisure-time sports (p<0.05). Lower perceived safety and poorer access to (recreational) facilities were only associated with lower active transport among youth with lower self-efficacy (p<0.05).nnnCONCLUSIONnCreating more supportive environments could have the potential to affect the physical activity levels of Belgian adolescents with both high and low self-efficacy.

Does parental involvement make a difference in school-based nutrition and physical activity interventions? A systematic review of randomized controlled trials

ObjectivesParental involvement is often advocated as important for school-based interventions, however, to date, only inconsistent evidence is available. Therefore, this study aimed at determining the impact of parental involvement in school-based obesity prevention interventions in children and adolescents.MethodsA systematic review of obesity prevention studies published from 1990 to 2010 including a comparison between school-based interventions with and without parental component was conducted. Only studies reporting effects on health behaviour-related outcomes were included.ResultsSome positive effects of parental involvement were found on children’s behaviours and behavioural determinants. Parental modules including different strategies and addressing several home-related determinants and parenting practices concerning eating and physical activity behaviours were more likely to be effective. However, no conclusive evidence could be provided concerning the added value of parent involvement, because of the paucity of studies to test this hypothesis. The few studies that are available provide inconsistent evidence.ConclusionsThere is a need for more studies comparing school-based interventions with and without a parental component, and dose, strategies and content of parental components of school-based interventions should be better reported in articles.

From sedentary time to sedentary patterns: accelerometer data reduction decisions in youth

Aim This study aims to establish evidence-based accelerometer data reduction criteria to accurately assess total sedentary time and sedentary patterns in children. Methods Participants (nu200a=u200a1057 European children; 9–13 yrs) were invited to wear an accelerometer for at least 6 consecutive days. We explored 1) non-wear time criteria; 2) minimum daily valid wear time; 3) differences between weekday and weekend day; and 4) minimum number of days of accelerometer wear by comparing the effects of commonly used data reduction decisions on total sedentary time, and duration and number of prolonged sedentary bouts. Results More than 60 consecutive minutes of zero counts was the optimal criterion for non-wear time. Increasing the definition of a valid day from 8 to 10 hours wear time hardly influenced the sedentary outcomes, while the sample size of children with more than 4 valid days increased from 69 to 81%. On weekdays, children had on average 1 hour more wear time, 50 minutes more total sedentary time, 26 minutes more sedentary time accumulated in bouts, and 1 more sedentary bout. At least 6 days of accelerometer data were needed to accurately represent weekly sedentary time and patterns. Conclusions Based on our results we recommend 1) a minimum of 60 minutes of consecutive zeros as the most realistic criterion for non-wear time; and 2) including at least six days with minimum eight valid hours to characterize childrens usual total sedentary time and patterns, preferably including one weekend day.

Family- and school-based predictors of energy balance-related behaviours in children: a 6-year longitudinal study

OBJECTIVEnTo examine family- and school-based predictors of breakfast consumption, soft drink consumption and physical activity (PA) and moderating effects of gender and socio-economic status (SES).nnnDESIGNnLongitudinal study (6-year follow-up), including a questionnaire about dietary and activity behaviour.nnnSETTINGnFifty-nine Flemish elementary schools.nnnSUBJECTSnSeven hundred and twenty-seven children (51·9 % girls, 51·9 % high SES, mean age 9·9 (sd 0·4) years at baseline).nnnRESULTSnHaving breakfast together with parents (P < 0·001) at age 10 years related to more days of eating breakfast at age 16 years. More parental soft drink consumption (P = 0·04), less soft drink availability at home (P < 0·001) and less parental permissiveness (children received soft drinks from their parents whenever they asked for it and children could take soft drinks whenever they wanted; P = 0·02 and P = 0·001, respectively) at age 10 years related to less soft drink consumption at age 16 years. A more positive parental attitude towards PA (P = 0·009), more parental encouragement (P = 0·002) and a higher rating of PAs benefit relaxing (P < 0·001) at age 10 years related to more PA at age 16 years. Gender and SES did not significantly moderate any of the associations.nnnCONCLUSIONSnOnly parental factors at age 10 years were associated with breakfast consumption, soft drink consumption and PA at age 16 years. An intervention programme at age 10 years with a strong focus on the modifiable parental factors might lead to healthy behaviour in the long term.

Associations between Family-Related Factors, Breakfast Consumption and BMI among 10- to 12-Year-Old European Children: The Cross-Sectional ENERGY-Study

Objective To investigate associations of family-related factors with children’s breakfast consumption and BMI-z-score and to examine whether children’s breakfast consumption mediates associations between family-related factors and children’s BMI-z-score. Subjects Ten- to twelve-year-old children (nu200a=u200a6374; mean ageu200a=u200a11.6±0.7 years, 53.2% girls, mean BMI-z-scoreu200a=u200a0.4±1.2) and one of their parents (nu200a=u200a6374; mean ageu200a=u200a41.4±5.3 years, 82.7% female, mean BMIu200a=u200a24.5±4.2 kg/m2) were recruited from schools in eight European countries (Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, Spain, and Switzerland). The children self-reported their breakfast frequency per week. The body weight and height of the children were objectively measured. The parents responded to items on family factors related to breakfast (automaticity, availability, encouragement, paying attention, permissiveness, negotiating, communicating health beliefs, parental self-efficacy to address children’s nagging, praising, and family breakfast frequency). Mediation analyses were performed using multi-level regression analyses (child-school-country). Results Three of the eleven family-related variables were significantly associated with children’s BMI-z-score. The family breakfast frequency was negatively associated with the BMI-z-score; permissiveness concerning skipping breakfast and negotiating about breakfast were positively associated with the BMI-z-score. Children’s breakfast consumption was found to be a mediator of the two associations. All family-related variables except for negotiating, praising and communicating health beliefs, were significantly associated with children’s breakfast consumption. Conclusions Future breakfast promotion and obesity prevention interventions should focus on family-related factors including the physical home environment and parenting practices. Nevertheless, more longitudinal research and intervention studies to support these findings between family-related factors and both children’s breakfast consumption and BMI-z-score are needed.

Mediating effects of home-related factors on fat intake from snacks in a school-based nutrition intervention among adolescents

The purpose of the present study was to investigate if the effects of the parental component of a school-based intervention on dietary fat intake from snacking were mediated by changes in home-related factors. A random sample of 10 schools with 2232 pupils aged 11-15 years was randomly assigned to one of two intervention groups [one with (n = 1226) and one without a parental component (n = 1006)]. Fat intake, home availability of low-fat foods and parental encouragement and support to eat a low-fat diet were assessed with validated self-administered questionnaires. Mediation was assessed with the product-of-coefficient test. Changes in home-related determinants were significantly related to changes in fat intake from snacks; therefore, school-based obesity programmes on adolescents should try to address these determinants. In the present study, one of the three investigated home-related factors, namely parental support, was affected by the parental component intervention. Decreases in parental support were prevented. These changes in parental support were found to mediate the parental intervention effects on changes in fat intake from snacks. Home-related factors appear to be related to changes in adolescents snacking behaviours, therefore, school-based obesity programmes should target them. Nevertheless, more research is needed concerning effectively addressing the other determinants.