Adjusted population attributable fractions and preventable potential of risk factors for childhood obesity

AbstractObjectiveA number of individual risk factors for childhood obesity have been identified, but only some of these are amenable to prevention. To assess the amount of cases in a general population attributable to these risk factors, adjusted population-attributable fractions were estimated.DesignCross-sectional study.SettingObligatory school entry examination in 2001/2002 in six Bavarian communities (Germany).Subjects5472 children at age 5–6 years.MeasuresAnthropometric measures were ascertained by public health nurses, and measures concerning sociodemographics, lifestyle and child behaviour such as child's daily meal frequency were obtained with self-administered parental questionnaires. Obesity was defined according to sex- and age-specific body mass index cut-off points proposed by the International Obesity Task Force. Adjusted population-attributable fractions were calculated based on logistic regression.ResultsA combination of the risk factors low meal frequency, decreased physical activity, watching television >1 h day− 1, formula feeding and smoking in pregnancy accounted for 48.2% of obese children. This combination yielded a maximal achievable prevalence reduction of 1.5% for obesity (3.2% observed prevalence).ConclusionsA modification of five known risk factors for childhood overweight and obesity could reasonably lower obesity prevalences at school entry. These risk factors should be particularly considered in decision making on preventive measures.

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Lifestyle Risk Factors and the Population Attributable Fractions for Overweight and Obesity in Chinese Students of Zhejiang Province

Frontiers in Pediatrics ◽

10.3389/fped.2021.734013 ◽

2021 ◽

Vol 9 ◽

Author(s):

Fang Gu ◽

Siliang Zhou ◽

Ke Lou ◽

Rui Deng ◽

Xingxiu Li ◽

...

Keyword(s):

Risk Factors ◽

Chinese Students ◽

Lifestyle Factors ◽

Overweight And Obesity ◽

Zhejiang Province ◽

Lifestyle Risk Factors ◽

Population Attributable Fractions ◽

Attributable Fractions ◽

Lifestyle Risk ◽

The Relationship

Objectives: To assess the relationship between modifiable lifestyle factors and risk of overweight/obesity in Chinese students, and to evaluate the predicting prevalence of overweight if the lifestyle risk factors were removed.Methods: A cross-sectional survey was conducted among 40,141 students in grade three and above (8–24yrs) in 2019 in Zhejiang Province, China. Physical examination was performed, and a self-administered questionnaire was used to collect lifestyle information, including dietary behavior, physical activity, TV watching, sleeping, smoking, drinking, and tooth-brushing habits. Logistic regression models were performed to assess the relationship between overweight/obesity and a series of lifestyle factors. Population attributable fractions (PAFs) were used to calculate the predicting prevalence of overweight/obesity if lifestyle risk factors were removed.Results: The prevalence of overweight/obesity of participants was 25.5% (male 32.3%, female 18.1%). Overweight/obesity were associated with adverse lifestyle factors, such as watch TV ≥1 h/day (OR = 1.14, 95% CI: 1.11–1.22), insufficient sleep (OR = 1.14, 95% CI: 1.11–1.22), and irregular toothbrushing habits (OR = 1.19, 95% CI: 1.01–1.39). Based on the calculated PAFs, the predicted prevalence of overweight/obesity would decline moderately if lifestyle factors were modified, with the magnitudes of decrease vary by sex, age and residence. Generally, a larger reduction was estimated if the sleeping time was increased and TV time was reduced, with the prevalence of overweight/obesity decreased by 1.1% (95% CI: 0.7, 1.5%) and 0.9% (95% CI: 0.6, 1.2%), respectively.Conclusions: Predicted prevalence of overweight/ obesity in Chinese students may decrease if modifiable lifestyle risk factors were removed. The attributable risk for obesity of lifestyle behaviors varied in age, sex and residence groups. The findings of this study may provide insights for planning and optimizing future obesity intervention endeavors.

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Proportion of Orofacial Clefts Attributable to Recognized Risk Factors

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665618774019 ◽

2018 ◽

Vol 56 (2) ◽

pp. 151-158 ◽

Cited By ~ 5

Author(s):

Janhavi R. Raut ◽

Regina M. Simeone ◽

Sarah C. Tinker ◽

Mark A. Canfield ◽

R. Sue Day ◽

...

Keyword(s):

Risk Factors ◽

Cleft Palate ◽

Cleft Lip ◽

Population Attributable Fraction ◽

Attributable Fraction ◽

Individual Risk ◽

Orofacial Clefts ◽

Maternal Risk ◽

Population Attributable Fractions ◽

Attributable Fractions

Objective: Estimate the population attributable fraction (PAF) for a set of recognized risk factors for orofacial clefts. Design: We used data from the National Birth Defects Prevention Study. For recognized risk factors for which data were available, we estimated crude population attributable fractions (cPAFs) to account for potential confounding, average-adjusted population attributable fractions (aaPAFs). We assessed 11 modifiable and 3 nonmodifiable parental/maternal risk factors. The aaPAF for individual risk factors and the total aaPAF for the set of risk factors were calculated using a method described by Eide and Geffler. Setting: Population-based case–control study in 10 US states. Participants: Two thousand seven hundred seventy-nine cases with isolated cleft lip with or without cleft palate (CL±P), 1310 cases with isolated cleft palate (CP), and 11 692 controls with estimated dates of delivery between October 1, 1997, and December 31, 2011. Main Outcome Measures: Crude population attributable fraction and aaPAF. Results: The proportion of CL±P and CP cases attributable to the full set of examined risk factors was 50% and 43%, respectively. The modifiable factor with the largest aaPAF was smoking during the month before pregnancy or the first month of pregnancy (4.0% for CL±P and 3.4% for CP). Among nonmodifiable factors, the factor with the largest aaPAF for CL±P was male sex (27%) and for CP it was female sex (16%). Conclusions: Our results may inform research and prevention efforts. A large proportion of orofacial cleft risk is attributable to nonmodifiable factors; it is important to better understand the mechanisms involved for these factors.

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The Implementation of Childhood Obesity Related Policy Interventions in Malaysia—A Non Communicable Diseases Scorecard Project

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115950 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5950

Author(s):

Wilfred Kok Hoe Mok ◽

Noran Naqiah Hairi ◽

Caryn Mei Hsien Chan ◽

Feisul Idzwan Mustapha ◽

Thamil Arasu Saminathan ◽

...

Keyword(s):

Risk Factors ◽

Childhood Obesity ◽

Communicable Diseases ◽

Overweight And Obesity ◽

Current Status ◽

Non Communicable Diseases ◽

Modified Delphi ◽

Policy Interventions ◽

Non Governmental Organizations ◽

The Government

(1) Background: The prevalence of overweight and obesity among children has increased tremendously in the ASEAN region, including Malaysia. In Malaysia, the National Strategic Plan for Non-Communicable Diseases (2015–2025) provides the overall framework for its response to the non-communicable diseases (NCD) epidemic. Preventing childhood obesity is one of the key strategies for early intervention to prevent NCDs. The objective of this research is to examine the current status of policy interventions in addressing childhood obesity in Malaysia. (2) Methods: A panel of 22 stakeholders and experts from Malaysia, representing the government, industry, academia and non-governmental organizations, were sampled using a modified Delphi technique. Data were collected using a modified NCD scorecard under four domains (governance, risk factors, surveillance and research and health systems response). A heat map was used to measure the success of the four realms of the NCD scorecard. For each domain of the NCD scorecard, the final score was grouped in quintiles. (3) Results: A total of 22 participants responded, comprising of eight (36.4%) males and 14 (63.4%) females. All the domains measured in implementing policies related to childhood obesity were of low progress. Nine governance indicators were reported as 22.5% (low progress), four in the risk factors domain, and two in the surveillance. This shows that timely and accurate monitoring, participatory review and evaluation, and effective remedies are necessary for a country’s surveillance system. (4) Conclusion: Although Malaysia has published several key strategic documents relating to childhood obesity and implemented numerous policy interventions, we have identified several gaps that must be addressed to leverage the whole-of-government and whole-of-society approach in addressing childhood obesity in the country.

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Preventable Risk Factors for Dementia: Population Attributable Fractions in a Brazilian Population-Based Study

SSRN Electronic Journal ◽

10.2139/ssrn.3980551 ◽

2021 ◽

Author(s):

Wyllians Vendramini Borelli ◽

Vanessa Bielefeldt Leotti ◽

Matheus Zschornack Strelow ◽

Márcia Lorena Fagundes Chaves ◽

Raphael Machado Castilhos

Keyword(s):

Risk Factors ◽

Population Based ◽

Brazilian Population ◽

Population Based Study ◽

Population Attributable Fractions ◽

Attributable Fractions

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Regional variations in the economic burden attributable to excess weight, physical inactivity and tobacco smoking across British Columbia

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.36.4.02 ◽

2016 ◽

Vol 36 (4) ◽

pp. 76-86 ◽

Cited By ~ 4

Author(s):

H. Krueger ◽

J.M. Koot ◽

D.P. Rasali ◽

S. E. Gustin ◽

M. Pennock

Keyword(s):

Risk Factors ◽

British Columbia ◽

Tobacco Smoking ◽

Economic Burden ◽

Physical Inactivity ◽

Excess Weight ◽

Prevalence Rates ◽

Population Attributable Fractions ◽

Attributable Fractions ◽

Social Environmental

Introduction Prevalence rates of excess weight, tobacco smoking and physical inactivity vary substantially by geographical region within British Columbia (B.C.). The purpose of this study is to determine the potential reduction in economic burden in B.C. if all regions in the province achieved prevalence rates of these three risk factors equivalent to those of the region with the lowest rates. Methods We used a previously developed approach based on population-attributable fractions to estimate the economic burden associated with the various risk factors. Sexspecific relative risk and age/sex-specific prevalence data was used in the modelling. Results The annual economic burden attributable to the three risk factors in B.C. was about $5.6 billion in 2013, with a higher proportion of this total attributable to excess weight ($2.6 billion) than to tobacco smoking ($2.0 billion). While B.C. has lower prevalence rates of the risk factors than any other Canadian province, there is significant variation within the province. If each region in the province were to achieve the best prevalence rates for the three risk factors, then $1.4 billion (24% of the $5.6 billion) in economic burden could be avoided annually. Conclusion There are notable disparities in the prevalence of each risk factor across health regions within B.C., which were mirrored in each region’s attributable economic burden. A variety of social, environmental and economic factors likely drive some of this geographical variation and these underlying factors should be considered when developing prevention programs.

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Childhood obesity classification systems and cardiometabolic risk factors: a comparison of the Italian, World Health Organization and International Obesity Task Force references

Italian Journal of Pediatrics ◽

10.1186/s13052-017-0338-z ◽

2017 ◽

Vol 43 (1) ◽

Cited By ~ 21

Author(s):

Giuliana Valerio ◽

◽

Antonio Balsamo ◽

Marco Giorgio Baroni ◽

Claudia Brufani ◽

...

Keyword(s):

Risk Factors ◽

Childhood Obesity ◽

World Health Organization ◽

Cardiometabolic Risk ◽

Task Force ◽

Classification Systems ◽

Cardiometabolic Risk Factors ◽

World Health ◽

International Obesity Task Force ◽

Health Organization

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Sex and Age-Specific Population Attributable Fractions of CVD Risk Factors Combination from the Pooled Analysis of 85,432 Participants in Japan.

International Journal of Epidemiology ◽

10.1093/ije/dyv097.046 ◽

2015 ◽

Vol 44 (suppl_1) ◽

pp. i15-i16

Author(s):

Y. Murakami ◽

T. Okamura ◽

K. Miura ◽

H. Ueshima ◽

Keyword(s):

Risk Factors ◽

Pooled Analysis ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Specific Population ◽

Population Attributable Fractions ◽

Attributable Fractions

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Drastic increases in overweight and obesity from 1981 to 2010 and related risk factors: results from the Barbados Children’s Health and Nutrition Study

Public Health Nutrition ◽

10.1017/s1368980015002190 ◽

2015 ◽

Vol 18 (17) ◽

pp. 3070-3077 ◽

Cited By ~ 6

Author(s):

Melissa Anne Fernandez ◽

Stan Kubow ◽

Katherine Gray-Donald ◽

JaDon Knight ◽

Pamela S Gaskin

Keyword(s):

Risk Factors ◽

Task Force ◽

Sociodemographic Factors ◽

Overweight And Obesity ◽

International Obesity Task Force ◽

School Students ◽

Annual Household Income ◽

Growth Standards ◽

Prevention Programmes ◽

Potential Risk Factors

AbstractObjectiveTo examine overweight and obesity (OWOB), changes in prevalence and potential risk factors in Barbadian children.DesignA cross-section of students were weighed and measured. The WHO BMI-for-age growth references (BAZ), the International Obesity Task Force cut-offs and the US Centers for Disease Control and Prevention growth percentiles were used to determine OWOB prevalence. Harvard weight-for-height-for-age growth standards were used to estimate differences in OWOB prevalence from 1981 to 2010. Samples of parents and students were interviewed to describe correlates of OWOB.SettingBarbados.SubjectsPublic-school students (n580) in class 3.ResultsBased on WHO BAZ, the overall prevalence of OWOB was 34·8 % (95 % CI 30·9, 38·7 %). A trend of higher OWOB prevalence was seen for girls across cut-offs, with significant sex differences noted using the International Obesity Task Force cut-offs. According to Harvard growth standards, OWOB has increased dramatically, from 8·52 % to 32·5 %. Children were more likely to be OWOB when annual household income was below BBD 9000 (OR=2·69; 95 % CI 1·21, 5·99). Eating dinner with the family every night was associated with a lower prevalence of OWOB (OR=0·56; 95 % CI 0·36, 0·87).ConclusionsThe sharp increase of OWOB rates in Barbados warrants attention. Sex disparities in OWOB prevalence may emerge at a young age. Promoting family meals may be a feasible option for OWOB prevention. Understanding familial and sociodemographic factors influencing OWOB will be useful in planning successful intervention or prevention programmes in Barbados.

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Significant Decrease in Childhood Obesity and Waist Circumference over 15 Years in Switzerland: A Repeated Cross-Sectional Study

Nutrients ◽

10.3390/nu11081922 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1922

Author(s):

Isabelle Herter-Aeberli ◽

Ester Osuna ◽

Zuzana Sarnovská ◽

Michael B. Zimmermann

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Childhood Obesity ◽

Waist Circumference ◽

Parental Education ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Central Adiposity ◽

Parental Factors ◽

The Past

Despite a global increase in childhood obesity over the past decades, several countries, including Switzerland, have recently reported stabilizing trends. Using national data from school-aged children in Switzerland over the past 16 years, our study aim was to assess changes in the prevalence of overweight and obesity, central adiposity and predictors of obesity related to lifestyle and parental factors. Nationally representative samples of children aged 6–12 years were studied in 2002 (n = 2493), 2007 (n = 2218), 2012 (n = 2963), and 2017/18 (n = 2279). Height and weight, waist circumference, and multiple skinfold thicknesses were measured. Potential risk factors for overweight and obesity were determined using a self-administered questionnaire in 2017/18, collecting data on diet, physical activity, and parental factors. Prevalence (95% CI) of overweight (incl. obesity) and obesity in 2017/18 was 15.9% (14.4–17.4) and 5.3% (4.5–6.3), respectively. Binary logistic regression revealed a small but significant decrease in the prevalence of overweight (including obesity) since 2002 (OR (95% CI) = 0.988 (0.978–0.997)), while the change in obesity alone was not significant. The most important risk factors for childhood overweight/obesity in 2017/18 were low parental education, non-Swiss origin of the parents, low physical activity of the child, and male sex. In conclusion, we have shown a small but significant declining trend in the childhood overweight/obesity prevalence over the past 15 years in Switzerland. Based on the risk factor analysis, preventive action in schoolchildren might be most effective in boys, migrant populations, and families with lower education, and should emphasize physical activity.

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