Diet quality and physical activity in relation to childhood obesity

Abstract Objective: Healthy lifestyles such as being physically active and eating a healthy diet help reduce the childhood obesity risk. However, population-level studies on the relationship between lifestyles and childhood obesity typically focus on either physical activity or diet but seldom both. This study examined physical activity and diet quality in relation to obesity in a nationally representative sample of U.S. children and adolescents. Methods: The study sample of 2818 children 6–17 years old came from the National Health and Nutrition Examination Survey 2003–2006 waves. A healthy eating index (HEI)-2010 was constructed based on two nonconsecutive 24-h dietary recalls. Participants at or above the 60th percentile of the HEI-2010 score were classified as consuming a healthy diet. Participants engaging in at least 60 min of moderate-vigorous physical activity daily measured by accelerometer were classified as being physically active. Adjusted average marginal effect of diet quality and physical activity on obesity was calculated based on estimates from logistic regressions. Results: Compared with those consuming a healthy diet who are physically active, the estimated probabilities for overweight and obesity were 19.03 (95% confidence interval: 11.31, 26.74) and 15.84 (10.48, 21.21) percentage points higher among children consuming an unhealthy diet and who are physically inactive, 16.53 (7.58, 25.48) and 13.48 (5.68, 21.29) percentage points higher among children consuming a healthy diet but who are physically inactive and 3.22 (−3.43, 9.88) and 3.10 (−3.08, 9.29) percentage points higher among children consuming an unhealthy diet but physically active, respectively. Conclusion: Healthy habit formation at an early age is essential in obesity prevention.

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Long-term Diet Quality and Gut Microbiome Functionality: A Prospective, Shotgun Metagenomic Study among Urban Chinese Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzab026 ◽

2021 ◽

Vol 5 (4) ◽

Author(s):

Danxia Yu ◽

Yaohua Yang ◽

Jirong Long ◽

Wanghong Xu ◽

Qiuyin Cai ◽

...

Keyword(s):

Diet Quality ◽

Gut Microbiome ◽

Metabolic Pathways ◽

Gene Families ◽

Diet Group ◽

Healthy Diet ◽

Chinese Adults ◽

Α Diversity ◽

Unhealthy Diet

ABSTRACT Background Diet is known to affect human gut microbiome composition; yet, how diet affects gut microbiome functionality remains unclear. Objective We compared the diversity and abundance/presence of fecal microbiome metabolic pathways among individuals according to their long-term diet quality. Methods In 2 longitudinal cohorts, we assessed participants’ usual diets via repeated surveys during 1996–2011 and collected a stool sample in 2015–2018. Participants who maintained a healthy or unhealthy diet (i.e., stayed in the highest or lowest quintile of a healthy diet score throughout follow-up) were selected. Participants were excluded if they reported a history of cancer, cardiovascular disease, diabetes, or hypertension; had diarrhea or constipation in the last 7 d; or used antibiotics in the last 6 mo before stool collection. Functional profiling of shotgun metagenomics was performed using HUMAnN2. Associations of dietary variables and 420 microbial metabolic pathways were evaluated via multivariable-adjusted linear or logistic regression models. Results We included 144 adults (mean age = 64 y; 55% female); 66 had an unhealthy diet and 78 maintained a healthy diet. The healthy diet group had higher Shannon α-diversity indexes of microbial gene families and metabolic pathways (both P < 0.02), whereas β-diversity, as evaluated by Bray-Curtis distance, did not differ between groups (both P > 0.50). At P < 0.01 [false discovery rate (FDR) <0.15], the healthy diet group showed enriched pathways for vitamin and carrier biosynthesis (e.g., tetrahydrofolate, acetyl-CoA, and l-methionine) and tricarboxylic acid (TCA) cycle, and increased degradation (or reduced biosynthesis) of certain sugars [e.g., cytidine monophosphate (CMP)-legionaminate, deoxythymidine diphosphate (dTDP)-l-rhamnose, and sucrose], nucleotides, 4-aminobutanoate, methylglyoxal, sulfate, and aromatic compounds (e.g., catechol and toluene). Meanwhile, several food groups were associated with the CMP-legionaminate biosynthesis pathway at FDR <0.05. Conclusions In a small longitudinal study of generally healthy, older Chinese adults, we found long-term healthy eating was associated with increased α-diversity of microbial gene families and metabolic pathways and altered symbiotic functions relevant to human nutrition and health.

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Association between overall diet quality and postmenopausal breast cancer risk in five Finnish cohort studies

Scientific Reports ◽

10.1038/s41598-021-95773-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Satu Männistö ◽

Kennet Harald ◽

Tommi Härkänen ◽

Mirkka Maukonen ◽

Johan G. Eriksson ◽

...

Keyword(s):

Breast Cancer ◽

Diet Quality ◽

Proportional Hazards ◽

Postmenopausal Breast Cancer ◽

Healthy Eating Index ◽

Cox Proportional Hazards ◽

Healthy Diet ◽

Food Culture ◽

Alternative Healthy Eating Index

AbstractThere is limited evidence for any dietary factor, except alcohol, in breast cancer (BC) risk. Therefore, studies on a whole diet, using diet quality indices, can broaden our insight. We examined associations of the Nordic Diet (mNDI), Mediterranean diet (mMEDI) and Alternative Healthy Eating Index (mAHEI) with postmenopausal BC risk. Five Finnish cohorts were combined including 6374 postmenopausal women with dietary information. In all, 8–9 dietary components were aggregated in each index, higher total score indicating higher adherence to a healthy diet. Cox proportional hazards regression was used to estimate the combined hazard ratio (HR) and 95% confidence interval (CI) for BC risk. During an average 10-year follow-up period, 274 incident postmenopausal BC cases were diagnosed. In multivariable models, the HR for highest vs. lowest quintile of index was 0.67 (95 %CI 0.48–1.01) for mNDI, 0.88 (0.59–1.30) for mMEDI and 0.89 (0.60–1.32) for mAHEI. In this combined dataset, a borderline preventive finding of high adherence to mNDI on postmenopausal BC risk was found. Of the indices, mNDI was more based on the local food culture than the others. Although a healthy diet has beneficially been related to several chronic diseases, the link with the etiology of postmenopausal BC does not seem to be that obvious.

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“Childhood Obesity its Factors, Complications and Impact on Overall Health in Children”

10.47363/jftns/2021(3)117 ◽

2021 ◽

pp. 1-5

Author(s):

Asma Saghir Khan

Keyword(s):

Physical Activity ◽

Childhood Obesity ◽

Health Care Professionals ◽

Genetic Factors ◽

Overweight And Obesity ◽

Family Influences ◽

Childhood Overweight And Obesity ◽

Number Of Factors ◽

Obesity And Overweight

Childhood, overweight and obesity are increasingly significant problems, and ones that are likely to endure and to have long term adverse influences on the health of individuals and populations unless action is taken to reverse the trend. A number of factors have been suggested as contributing to the development of childhood obesity. These include genetic factors, decreasing levels of physical activity, increased time spent in sedentary behavior and changes in diet. In addition, lifestyle factors, including family influences, changes in society and media advertising, have been associated with the increasing incidence of obesity and overweight in childhood. To address the problem, health care professionals should incorporate appropriate screening in their child practice. Comprehensive assessment of children who are, or who are at risk of becoming, obese is also necessary

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Role of alternate healthy eating index (AHEI) in communicating the quality of diet

FOOD SCIENCE RESEARCH JOURNAL ◽

10.15740/has/fsrj/11.2/96-102 ◽

2020 ◽

Vol 11 (2) ◽

pp. 96-102

Author(s):

Krishna Mohandas ◽

L. Prema

Keyword(s):

Healthy Eating ◽

Diet Quality ◽

Dietary Habits ◽

Mean Value ◽

Healthy Eating Index ◽

Overweight And Obesity ◽

Food Groups ◽

Good Tool ◽

The Difference

The food habits of global population has been evolving in such a way that makes unhealthy foods cheaper and widely available and healthy foods costly and less available. Being surrounded by such foods and living in an environment with lesser requirement for physical activity is the primary reason for the pandemic explosion in overweight and obesity. This study is an attempt to analyze the quality of diet with an aim to study the significance of Alternate Healthy Eating Index (AHEI) in predicting the quality of dietary intake. Methodology: The study was conducted in 66 respondents (44 females and 22 males) aged 18-65 years with BMI between 23 kg/m2 to 50 kg/m2. The respondent’s data were collected using a pretested standard questionnaire. The nutrient consumption was calculated from the 24 hour recall and the AHEI scores were derived from recall and food use frequency data. The data were analysed using SAS software. Results: The intake of Energy, protein, fat and carbohydrates were more than their requirement while intake of fibre was not meeting the requirement. The AHEI scores obtained ranged from 36 to 76 with a mean value of 55.6 ± 9.54. A positive linear association for AHEI with BMI (0.0362) and energy intake (0.13) was established through Pearson’s correlation while the association was negative with BMR (-0.14). Paired t test comparing AHEI against the difference between intake and requirement of macronutrients revealed that when the diet quality was good (as indicated by AHEI>51), the difference in intake exhibited a significant linear relationship with p values <0.001 while no relation was established when the diet quality was poor. Conclusion: AHEI encompasses all nutrients and food groups relevant to metabolic health and it can be used as a good tool to assess the quality of dietary habits of overweight and obese subjects.

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Evolution of the School Breakfast Program in Northwest Mexico Evaluated in the Period 1996 to 2018 (P16-034-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz050.p16-034-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Maria Grijalva-Haro ◽

Daniela Gonzalez-Valencia ◽

María Ortéga-Vélez ◽

Martha Ballesteros-Vásquez ◽

Gloria Portillo ◽

...

Keyword(s):

Physical Activity ◽

Childhood Obesity ◽

Saturated Fat ◽

Monitoring And Evaluation ◽

Overweight And Obesity ◽

Micronutrient Deficiencies ◽

Nutritional Education ◽

School Breakfast Program ◽

Starting Point ◽

School Breakfast

Abstract Objectives To analyze the evolution of the school breakfast program (SBP) in Sonora, according to the challenges presented during the period 1996–2018. Methods This is an anthology of what has been the SBP in Sonora for twenty-two years. The results of the program (1996–2018) were analyzed and discussed, according to the different stages through which it has been developed, as well as the evaluations that constituted the starting point for the subsequent stages; published in four articles, seven master's theses and technical reports delivered to the National System for Integral Family Development (DIF) -Sonora by researchers from the Research Center for Food and Development (CIAD, A.C.) Results Follow-up studies of the SBP in Sonora included dietary evaluations and design of school breakfast menus (SB), impact on micronutrient deficiencies and the presence of overweight and obesity. The evidence showed that SB constitutes a complementary contribution of nutrients in the diet of the participants; it also did not introduce risk factors for children's health such as excessive amounts of saturated fat and cholesterol. The results of the studies on the nutritional status of children include the measurement of cognitive development, the adequacy of the diet, as well as the evaluation of anthropometric indicators, biochemical micronutrient status and cardiovascular risk for overweight and obesity, finally the inclusion of nutritional education through the implementation of programs to promote water consumption, practice of physical activity and healthy eating. The monitoring and evaluation of the SBP has allowed changes consistent with the needs of children and does not constitute a risk for the development of childhood obesity. In addition, for the benefits presented in the program such as the implementation process, sustainability, institutionalization, participation of parents and the school community and good adherence to the program has been managed to evaluate nutritional education in school and home contexts to achieve sustainable changes in dietary practices and physical activity. Conclusions The process of monitoring the program allows an adequate organizational environment for the implementation of a nutritional education program leading to the prevention of childhood obesity. The next challenge is to ensure the institutionalization of nutritional education within the SBP in Sonora. Funding Sources Sistema Integral para el Desarrollo de la Familia, DIF Sonora.

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Defining Diet Quality: A Review of Diet Metrics as Applied to the Double Burden of Malnutrition (OR17-01-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.or17-01-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Victoria Miller ◽

Patrick Webb ◽

Renata Micha ◽

Dariush Mozaffarian

Keyword(s):

Healthy Eating ◽

Diet Quality ◽

Fruits And Vegetables ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Healthy Diet ◽

Food Groups ◽

Policy Action ◽

Double Burden ◽

Meta Analyses

Abstract Objectives Meeting most of the UN Sustainable Development Goals (SGDs) will require a strong focus on tackling all forms of malnutrition─ addressing maternal and child health (MCH) as well as diet-related non-communicable diseases (NCDs). Yet, the optimal metrics to define a healthy diet remain unclear. Our aim was to comprehensively review diet metrics and assess the evidence on each metric's association with MCH and NCDs. Methods Using comprehensive searches and expert discussions, we identified metrics that i) are used in ≥3 countries to link diet to health, ii) quantify the number of foods/food groups consumed and/or iii) quantify recommended nutrient intakes. We reviewed and summarized each metric's development, components and scoring. For each identified metric, we systematically searched PubMed to identify meta-analyses or narrative reviews evaluating these metrics with nutrient adequacy and health outcomes. We assessed validity by grading the number of studies included and the consistency of the diet metric-disease relationship. Results We identified 6 MCH, 13 NCD and 0 MCH/NCD metrics. Most were developed for describing adherence to dietary guidelines or patterns, and others were developed for predicting micronutrient adequacy. On average, the metrics included 14 food groups/nutrients (range 4–45), with 10 food-group only metrics and 0 nutrient-only metrics. The most frequent metric components were grains/roots/tubers, fruits and vegetables. We identified 16 meta-analyses and 14 narrative reviews representing 102 metric-disease relationships (98 metric-NCD and 4 metric-MCH relationships, respectively). We found 5 metrics that have been consistently validated in meta-analyses and narrative reviews for NCDs, 1 metric with limited evidence for MCH, but 0 metrics for both. Of the metrics, the Alternative Healthy Eating Index (aHEI), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI), and Mediterranean Diet Score (MED) were most commonly validated, especially for all-cause mortality and cardiovascular disease (Figure 1). Conclusions Few diet metrics have been used in multiple countries to define a healthy diet. This suggests a serious gap in global analyses of diet quality relating to malnutrition in all its forms, which hinders effective policy action. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs

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Dietary and Physical Activity Behaviors in Women with Polycystic Ovary Syndrome per the New International Evidence-Based Guideline

Nutrients ◽

10.3390/nu11112711 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2711 ◽

Cited By ~ 10

Author(s):

Annie W. Lin ◽

Maryam Kazemi ◽

Brittany Y. Jarrett ◽

Heidi Vanden Brink ◽

Kathleen M. Hoeger ◽

...

Keyword(s):

Physical Activity ◽

Polycystic Ovary Syndrome ◽

Dietary Intake ◽

Diet Quality ◽

Polycystic Ovary ◽

Healthy Eating Index ◽

Evidence Based ◽

Ovary Syndrome ◽

International Evidence ◽

Evidence Based Guideline

Lifestyle modifications are recommended as first-line therapy in polycystic ovary syndrome (PCOS). However, usual dietary and physical activity (PA) behaviors of women with PCOS remain uncertain, likely owing to controversy in diagnostic criteria. Our objective was to contrast the usual dietary and PA behaviors of women with PCOS (n = 80) diagnosed by the 2018 International Evidence-based Guideline for the Assessment and Management of PCOS to that of controls (n = 44). Study outcomes were dietary intake, diet quality (Healthy Eating Index-2015), and PA (questionnaire, waist-worn accelerometers). Women with PCOS met the acceptable macronutrient distribution ranges for carbohydrate, fat, and protein, but did not meet the recommended dietary reference intakes for vitamin D (mean (95% confidence interval); 6 (5–7) μg/d), vitamin B9 (275 (252–298) μg/d), total fiber (24 (22–26) g/d), or sodium (4.0 (3.6–4.4) g/d). Women with PCOS also met the US recommendations for PA. No differences were detected in dietary intake, diet quality, or PA levels between groups (p ≥ 0.11). In conclusion, women with and without PCOS have comparable dietary and PA behaviors. A lack of unique targets for dietary or PA interventions supports the position of the new guideline to foster healthy lifestyle recommendations for the management of PCOS.

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Associations between maternal healthy lifestyle score and offspring birth outcomes and childhood obesity: results from the Lifeways Cross-Generation Cohort Study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120005467 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Pilar Navarro ◽

John Mehegan ◽

Celine Murrin ◽

Cecily Kelleher ◽

Catherine Phillips

Keyword(s):

Physical Activity ◽

Childhood Obesity ◽

Birth Outcomes ◽

Head Circumference ◽

Alcohol Intake ◽

Healthy Lifestyle ◽

Lifestyle Factors ◽

Healthy Eating Index ◽

Dietary Quality ◽

Reduced Risk

AbstractMaternal adherence to healthy lifestyle behaviours during pregnancy has been associated with reduced risk of obesity in the offspring. Our objective is to examine the association between a composite healthy lifestyle score (HLS) derived from body mass index (BMI), dietary quality, physical activity, smoking and alcohol intake, in expectant mothers and adverse offspring birth outcomes and childhood obesity. The Lifeways Cross-Generation Study comprises 1082 mother-child pairs. We defined five healthy lifestyle factors during pregnancy including: high dietary quality (top 40% of the Healthy Eating Index (HEI)-2015), moderate to vigorous physical activity (MVPA), healthy pre-pregnancy BMI (18.5–24.9 Kg/m2), never smoker, and no/moderate alcohol intake. A composite HLS was calculated (scored 0–5). Birthweight, length and head circumference were abstracted from hospital records. Waist circumference and BMI was determined when the child was 5 and 9 years. Logistic regression analyses were used to test HLS and individual HLS component associations with offspring birth and childhood outcomes. Offspring birthweight, length and head circumference were positively associated with the number of maternal healthy lifestyle factors (p < 0.001), whereas child BMI and incidence of overweight/obesity at age 5 and 9 were negatively associated with the maternal HLS (p < 0.05). In multivariable models, a lower maternal HLS (0–2 healthy lifestyle factors) was associated with increased risk of low birthweight (LBW) (OR:1.17, 95% CI:1.01–2.69, p = 0.043) and lower likelihood of macrosomia (OR:0.73, 95% CI:0.24–0.99, p = 0.034), relative to those with 5 healthy lifestyle factors. Examination of the individual HLS components revealed that, poor maternal dietary quality, smoking and alcohol intake were associated with higher risk of LBW (OR:1.61, 95%CI:1.01–7.85, p = 0.043, OR: 2.54, 95%CI:1.26–5.12, p = 0.025 and OR:2.30, 95%CI:1.01–5.26, p = 0.031, respectively). Likelihood of macrosomia and combined overweight/obesity at age 5 and 9 years was greater among mothers with a pre-pregnancy BMI in the obese range (OR:2.18, 95%CI:1.23–3.85, p = 0.042, OR:2.19, 95%CI:1.01–5.08, p = 0.03 and OR:3.89, 95%CI:1.00–10.59, p = 0.04, respectively). Smoking during pregnancy was also linked to greater risk of childhood overweight/obesity (OR:1.91, 95%CI:1.01–3.61, p = 0.04 at age 5 and OR:2.14, 95%CI:1.01–4.11, p = 0.03 at age 9). Our findings suggest that maternal adherence to a healthy lifestyle during pregnancy, in particular having a good quality diet, not smoking and no/low alcohol intake in combination with a healthy pre-pregnancy BMI, is associated with reduced risk of adverse offspring birth outcomes and childhood obesity. These findings highlight the potential benefits of implementing maternal based multifactorial interventions to improve offspring birth outcomes and combat childhood adiposity.

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Childhood obesity: food, nutrient, and eating-habit trends and influences

Applied Physiology Nutrition and Metabolism ◽

10.1139/h07-046 ◽

2007 ◽

Vol 32 (4) ◽

pp. 635-645 ◽

Cited By ~ 45

Author(s):

Lynn Roblin

Keyword(s):

Physical Activity ◽

Childhood Obesity ◽

Nutrition Education ◽

Eating Habits ◽

Fats And Oils ◽

Obese Children ◽

Physically Active ◽

School Based ◽

The Media ◽

High Calorie

The need has never been greater to support healthy eating and physical activity in children and youth; the numbers of overweight and obese children have doubled and tripled, respectively, over the past 3 decades. Poor eating habits, including inadequate intake of vegetables, fruit, and milk, and eating too many high-calorie snacks, play a role in childhood obesity. Grain products provide the highest percentage (31%) of daily calories, followed by “other foods,” which have limited nutritional value (22% of daily calories). Snacks account for 27% of total daily calories, which is more than the calories consumed at breakfast (18%) and lunch (24%), but not dinner (31%). For Canadians older than 4 years of age, more than 41% of daily snack calories come from other foods, such as chips, chocolate bars, soft drinks, fruit drinks, sugars, syrup, preserves, fats, and oils. Habits that protect against childhood obesity include eating more vegetables and fruit, eating meals with family, and being physically active. Children’s food habits and choices are influenced by family, caregivers, friends, schools, marketing, and the media. Successful interventions for preventing childhood obesity combine family- and school-based programs, nutrition education, dietary change, physical activity, family participation, and counseling.

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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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