Nicholas Paul Townsend

A meta-analysis of weight gain in first year university students: is freshman 15 a myth?

BackgroundObservational studies report that as students transfer from secondary school to university, there is a tendency to gain weight. This phenomenon is known as the “Freshman 15” in North America, referring to the claim that on average weight gain is 15xa0lb (6.8xa0kg) in the first year of university. Studies since 1985 have mostly found weight gains ranging from 1xa0kg to 6xa0kg. Our meta-analysis aimed to update the literature on the “Freshman 15” in the first year of university. We also aimed to explore weight gain in only those who gained weight and perform several subgroup analyses. Given adolescent weight gain is highly linked to overweight and obesity in adults, a better understanding of university student weight gain is crucial if we are to combat the rising adult obesity prevalence.MethodsWe conducted a search on six standard electronic databases (including PubMed, Embase, PsycInfo) from 1980 to 2014. Only peer reviewed articles with data from longitudinal studies were included. Screening was performed by two reviewers. The quality of papers was assessed and data extraction was done with a systematic approach.ResultsThirty two studies were included and 22 studies (5549 students) were included in a pooled mean meta-analysis as they reported standard errors. The overall pooled mean weight gain was 1.36xa0kg (3lbs) (95 % CI: 1.15 – 1.57) over an average of 5xa0months. A majority of students, 60.9xa0%, gained weight during freshman year and these on average gained 3.38xa0kg (7.5lbs) (95 % CI: 2.85 – 3.92).ConclusionFreshman weight gain is an issue with almost two thirds of students gaining weight. Students who gained weight, gained it at rates much faster than in the general population. Despite most universities having some health promotion policies, we denote a consistent weight gain in university students across several countries.

The more schools do to promote healthy eating, the healthier the dietary choices by students

Background The importance of a multifactorial whole school approach to healthy eating is gaining much recognition among policy makers; however, there is little conclusive evidence on the effectiveness of such an approach. The main aim of this study was to examine whether there is any association between the number of actions schools are taking to promote healthy eating and the dietary behaviour of schoolchildren. Methods A multilevel analysis investigated the association between school (n=64) approaches to promoting dietary choice, collected through teacher (n=289) postal surveys, and the reported dietary choices of students collected from students aged 11 to 16 (n=6693) in Wales through the 2005/2006 Health Behaviour in School-aged Children study. Results Once controlling for all student-level and school-level variables, students in schools with the most actions to promote healthy eating in place had 1.91 (CI=1.13 to 3.24) times the odds of agreeing to eat fruit for lunch, 1.54 (CI=1.07 to 2.22) times the odds of reporting to eating fruit or vegetables on a daily basis and 0.52 (CI=0.29 to 0.95) the odds of agreeing that they eat sweets for lunch, in comparison with students in schools with the lowest number of actions in place. Conclusion The number of actions that secondary schools have in place to promote healthy eating is significantly associated with healthy food choices made by students. Further research is needed to identify which specific actions are most strongly associated with students dietary behaviour, and the barriers to more widespread adoption of a whole school approach.

Age differences in the association of childhood obesity with area-level and school-level deprivation: cross-classified multilevel analysis of cross-sectional data.

Objective:Evidence suggests that area-level deprivation is associated with obesity independently of individual socioeconomic status; however, although the school may also have an impact on child health, few studies have investigated the association between school-level deprivation and the body mass index (BMI) of students. The aim of this study was to assess the relationship between the BMI for children of different ages and area-level and school-level deprivation.Subjects:BMI measurements were collected through the National Child Measurement Programme (NCMP) that samples from two school years: 396u2009171 reception year pupils (4–5-year olds) and 392u2009344 year 6 pupils (10–11-year olds) from 14u2009054 primary schools in England.Design:Cross-classified multilevel models with four levels: individual (n=788u2009525), lower super output areas corresponding to area of residence (n=29u2009606), schools (n=14u2009054) and primary care trusts (PCTs, n=143), which coordinate the collection of data within a large area, were used to study the relationship between measures of deprivation at an area and school level, and childhood BMI within England.Results:A positive association was found between the area and school measures of deprivation, and student BMI. Both the measures of deprivation explained a greater proportion of variance in BMI z-scores for year 6 students than for the reception year students, with a greater difference between the year groups found with the school-level measure of socioeconomic status than for the the area-level measure.Conclusions:Deprivation explains a greater proportion of the variance in BMI for older compared with younger children, perhaps reflecting the impact of deprivation as children age, highlighting the widening of health inequalities through childhood. The association with school-level deprivation illustrates the impact of the school on BMI status throughout the primary school years.

Implementing a social‐ecological model of health in Wales

Purpose – The purpose of this paper is to assess the implementation of the Welsh Network of Healthy School Schemes (WNHSS) at national, local and school levels, using a systems approach drawing on the Ottawa Charter.Design/methodology/approach – The approach takes the form of a single‐case study using data from a documentary analysis, interviews with Healthy Schools Co‐ordinators (n=23) and stakeholder (n∼93) discussion of interim findings at three regional workshops.Findings – There was almost universal adherence to a national framework based on Ottawa Charter principles. Substantial progress had been made with advocacy and mediation, although the framework provided less specific guidance regarding enablement. All‐Wales training for co‐ordinators, the commitment of co‐ordinators to working across administrative and professional boundaries, and support from local education and health partnerships, were important determinants of healthy school schemes growth and efficiency. Primary schools were more succe...

Improvements in the data quality of a national BMI measuring programme

Variations in data collection between collecting regions can affect the outcome measures. This study examines the impact of improvements in data collection on outcome measures in a national monitoring programme between 2007/2008 and 2010/2011. Multilevel analysis of 2007/2008 and 2010/2011 National Child Measurement Programme (NCMP) data estimated the relationship between body mass index (BMI) z-score and data collection variations within coordinating regions, while adjusting for individual-level and school-level factors. The total sample was 2u2009013u2009285 students from 17u2009279 primary schools in 152 coordinating regions in England. Data collection differences accounted for 31.2% of the regional variation in BMI z-score for Reception (aged 4–5 years) students in 2007/2008; this reduced to 12.6% in 2010/2011. For Year 6 (aged 10–11 years) students, it reduced from 5.3% in 2007/2008 to 2.4% in 2010/2011. Digit preference in the rounding of weight measurements showed the largest decreases, from 27.3 to 4.5% for Reception year pupils and from 4.2 to 1.0% for Year 6 pupils. This demonstrates that improvements in data collection variation between regions in the NCMP have led to improvements in data quality.