Association of Night-Time Screen-Viewing with Adolescents’ Diet, Sleep, Weight Status, and Adiposity

Night-time screen-viewing (SV) contributes to inadequate sleep and poor diet, and subsequently excess weight. Adolescents may use many devices at night, which can provide additional night-time SV. Purpose: To identify night-time SV patterns, and describe differences in diet, sleep, weight status, and adiposity between patterns in a cross-sectional and longitudinal manner. Methods: Adolescents (10–16 y) reported devices they viewed at night and completed food recalls. Accelerometry, anthropometrics, and imaging were conducted to measure sleep, weight status, and adiposity, respectively. Latent class analysis was performed to identify night-time SV clusters. Linear regression analysis was used to examine associations between clusters with diet, sleep, weight status, and adiposity. Results: Amongst 273 adolescents (12.5 ± 1.9 y, 54% female, 59% White), four clusters were identified: no SV (36%), primarily cellphone (32%), TV and portable devices (TV+PDs, 17%), and multiple PDs (17%). Most differences in sleep and adiposity were attenuated after adjustment for covariates. The TV+PDs cluster had a higher waist circumference than the no SV cluster in cross-sectional analysis. In longitudinal analysis, the primarily cellphone cluster had less change in waist circumference compared to the no SV cluster. Conclusions: Directing efforts towards reducing night-time SV, especially TV and PDs, may promote healthy development.

Changes in Dietary Intake Patterns and Weight Status during the COVID-19 Lockdown: A Cross-Sectional Study Focusing on Young Adults in Malaysia

Introduction: The coronavirus disease 2019 (COVID-19) isolation has altered individuals’ food purchasing behaviour and dietary intake patterns. Therefore, this study aims to investigate the changes in dietary intake patterns and their impacts on the weight status of young adults in Malaysia during the COVID-19 lockdown. Methods: This cross-sectional study involved 1045 young adults in Malaysia. The changes in dietary intake patterns were assessed using the Dietary Diversity Questionnaire with slight modifications, while anthropometric measurements including body height, body weight before the pandemic and current body weight were self-reported. Results: Overall, nearly half of the respondents (48.8%) gained weight during the confinement, with an average increment of 4.06 ± 3.23 kg. Of 1045, 45.3% reported consuming more fruits and 60.2% had higher plain water intake during the pandemic. It is observed that 41.0% to 66.8% of the young adults changed their dietary intake patterns during the pandemic. Increased consumption in cereals and grains (β = 0.084, p = 0.015, 95% CI = 0.017–0.160), as well as oils and fats (β = 0.123, p = 0.001, 95% CI = 0.059–0.241), was positively associated with weight gain during the pandemic. On the contrary, an increased plain water intake was negatively associated with weight gain during the lockdown (β = −0.100, p = 0.003, 95% CI = −0.171–−0.034). Findings in the current study also suggested that cutting back cereals and grains (β = 0.156, p < 0.001, 95% CI = 0.122–0.288), as well as oils and fats (β = 0.091, p = 0.012, 95% CI = 0.022–0.183), contributed significantly to weight loss during the pandemic confinement. Conclusion: In conclusion, the enforcement of the Movement Control Order (MCO) drove up the prevalence of overweight/obesity among young adults in Malaysia. Increased consumption of cereals and grains and oils and fats contributed to weight gain in the pandemic lockdown. Nonetheless, a noticeable proportion of young adults in Malaysia shifted to a healthier food choice by increasing the consumption of fruits and vegetables.

Late-onset or chronic overweight/obesity predicts low self-esteem in early adolescence: a longitudinal cohort study

Background How weight status changes with time may affect self-esteem was seldom studied. We identified the distinct trajectories of overweight/obesity over age and assessed their associations with different domains of self-esteem in Hong Kong Chinese children. Methods Territory-wide longitudinal data of 48,558 children (girls: 50.0%; 6.3 ± 0.51 years) studying Primary 1 in the academic cohorts of 1995/96 and 1996/97 followed till Primary 6 were obtained from the Student Health Service of Hong Kong. Weight was annually measured and categorized as underweight/normal and overweight/obese and self-esteem was measured in Primary 6. Distinct trajectories of weight status were first identified using growth mixture modeling and their associations with low self-esteem were assessed by logistic regression. Results Four distinct overweight/obesity trajectories were identified: never (76.8%), late-onset (8.1%), early-onset (4.2%) and chronic (10.9%) overweight/obesity. Compared with children who were never overweight/obese, more of those in the late-onset or chronic overweight/obesity group showed low self-esteem and specific domains including general, social and academic/school-related (adjusted odds ratios: 1.20 - 1.43, all P < 0.001) except parent/home-related self-esteem (P = 0.36), whereas children being in the early-onset overweight/obesity group showed no significant difference (P ≥ 0.53) except a lower risk of low social self-esteem (adjusted odds ratio = 0.82, P = 0.03). Conclusions Late-onset or chronic overweight/obesity predicted low general, social and academic/school-related self-esteem. Children who successfully reduced weight may have equal levels of self-esteem or even better social self-esteem than those being always underweight/normal weight. Overweight/obese children had a vulnerability to self-esteem in non-domestic environments.

Maternal BMI, breastfeeding and perinatal factors that influence early childhood growth trajectories: a scoping review

Obesity rates among children are rapidly rising internationally and have been linked to noncommunicable diseases in adulthood. Individual preventive strategies have not effectively reduced global obesity rates, leading to a gap in clinical services regarding the development of early perinatal interventions. The objective of this scoping review is to explore the relationship between maternal BMI and breastfeeding behaviors on child growth trajectories to determine their relevance in developing interventions aimed at preventing childhood obesity. The scoping review was guided and informed by the Arksey and O’Malley (2005) framework. A systematic search was performed in four databases. Studies included in the final review were collated and sorted into relevant themes. A systematic search yielded a total of 5831 records (MEDLINE: 1242, EMBASE: 2629, CINAHL: 820, PubMed: 1140). Results without duplicates (n = 4190) were screened based on relevancy of which 197 relevant-full-text articles were retrieved and assessed for eligibility resulting in 14 studies meeting the inclusion criteria. Data were extracted and charted for the studies and six themes were identified: (1) healthy behaviors, lifestyle, and social economic status; (2) parental anthropometrics and perinatal weight status; (3) genetics, epigenetics, and fetal programming; (4) early infant feeding; (5) infant growth trajectories; and (6) targeted prevention and interventions. Early life risk factors for child obesity are multifactorial and potentially modifiable. Several at-risk groups were identified who would benefit from early preventative interventions targeting the importance of healthy weight gain, exclusive breastfeeding to 6 months, and healthy lifestyle behaviors.

Predictors of Post-Exercise Energy Intake in Adolescents Ranging in Weight Status from Overweight to Severe Obesity

Exercise may sensitize individuals with overweight and obesity to appetitive signals (e.g., hunger and fullness cues), overriding trait eating behaviors that contribute to overeating and obesity, such as uncontrolled eating. The objective of the current study was to measure predictors of objective ad libitum energy intake at a laboratory-based, post-exercise test-meal in adolescents ranging in weight status from overweight to severe obesity. We hypothesized that appetitive states, rather than appetitive traits, would be the strongest predictors of energy intake at a post-exercise test-meal, after controlling for body size. At Baseline, 30 adolescents (ages 10–16 years, 50% female (F), 43% non-Hispanic white (NHW), 83% with obesity (OB)) completed state and trait appetite measures and an ad libitum dinner meal following intensive exercise. Nineteen of those participants (47% F, 32% NHW, 79% OB) completed identical assessments two years later (Year 2). Energy intake (kcal) at each time point was adjusted for fat-free mass index (i.e., body size). Adjusted energy intake was reliable from Baseline to Year 2 (ICC = 0.84). Multiple pre-meal appetite ratings were associated with test-meal energy intake. In stepwise linear regression models, pre-meal prospective food consumption was the strongest and only significant predictor of test-meal energy intake at both Baseline (R2 = 0.25, p = 0.005) and Year 2 (R2 = 0.41, p = 0.003). Baseline post-exercise energy intake was associated with weight change over two years (R2 = 0.24, p = 0.04), but not with change in fat mass (p = 0.11). Appetitive traits were not associated with weight or body composition change (p > 0.22). State appetite cues were the strongest predictors of post-exercise energy intake, independent of body size. Future studies should examine whether long-term exercise programs enhance responsiveness to homeostatic appetite signals in youth with overweight and obesity, with a goal to reduce excess energy intake and risk for weight gain over time.

Validation of a Classroom Version of the Eating in the Absence of Hunger Paradigm in Preschoolers

Eating in the absence of hunger (EAH), a measure of children's propensity to eat beyond satiety in the presence of highly palatable food, has been associated with childhood obesity and later binge eating behavior. The EAH task is typically conducted in a research laboratory setting, which is resource intensive and lacks ecological validity. Assessing EAH in a group classroom setting is feasible and may be a more efficient alternative, but the validity of the classroom assessment against the traditional individually-administered paradigm has not been tested. The objective of this study was to compare EAH measured in a classroom setting to the one-on-one version of the paradigm in a sample of Head Start preschoolers. Children (n = 35) from three classrooms completed both classroom and individual EAH tasks in a random, counterbalanced order. In the group condition, children sat with peers at their classroom lunch tables; in the individual condition, children met individually with a researcher in a separate area near their classroom. In both conditions, following a meal, children were provided free access to generous portions of six snack foods (~750 kcal) and a selection of toys for 7 min. Snacks were pre- and post-weighed to calculate intake. Parents completed a survey of their child's eating behaviors, and child height and weight were measured. Paired t-tests and intraclass correlation coefficients were used to compare energy intake between conditions, and correlations between EAH intake and child BMI, eating behaviors, and parent feeding practices were examined to evaluate concurrent validity. Average intake was 63.0 ± 50.4 kcal in the classroom setting and 53.7 ± 44.6 in the individual setting, with no significant difference between settings. The intraclass correlation coefficient was 0.57, indicating moderate agreement between conditions. Overall, the EAH protocol appears to perform similarly in classroom and individual settings, suggesting the classroom protocol is a valid alternative. Future studies should further examine the role of age, sex, and weight status on eating behavior measurement paradigms.

Parental Perception of Body Weight Status of Their 8-year-old Children: Findings from the European CHOP Study

Background Maternal perception of child weight status in children with overweight or obesity has received a lot of attention but data on paternal perception of children from presumably healthy cohorts are lacking. Objective We aimed to investigate paternal and maternal perception of child weight status at the age of 8 years in a cohort of 591 children from 5 European countries. Material and Methods Included were 8-year-old children and their parents participating in the European Childhood Obesity Project (EU CHOP). Weight and height of children and parents were measured and Body Mass Index (BMI, kg/m2) was calculated. Both parents were asked to assess their perception of child weight status using Eckstein scales and their concern about child overweight. The agreement between mother and father perceptions was assessed by Cohen kappa coefficient and their relationship was analyzed by linear mixed effects models based on ordinal logistic regression, accounting for country, child gender and BMI, parental BMI, level of education, concern and type of feeding during first year of life. Results Data from children and both parents were available for 432 girls and boys. Mean BMI was comparable in boys and girls (16.7 ± 2.31 vs. 16.9 ± 2.87 kg/m2, P = 0.55). In total, 172 children (29.3%) were overweight or obese. There was a high degree of agreement between mother and father perceptions of their child’s weight status (Cohen kappa 0.77). Multivariate modelling showed that perception levels significantly increased with child BMI but were globally lower than assessed. They differed between countries, gender and types of feeding during first year of life, were influenced by education level of the father but were not related to parental BMI and concern about childhood overweight. Conclusions The study showed no overall differences between mothers and fathers in rating their child’s weight status but both parents had a propensity to underestimate their child’s actual weight, particularly in boys. The EU CHOP trial registered at clinicaltrials.gov as NCT00338689.

Energy, nutrients and food sources in snacks for adolescents and young adults

ABSTRACT Objective: To evaluate associations between snacking and energy, nutrients and food source, and to identify the contribution of snacking across age, sex, weight status and lifestyle behaviors among adolescents and young adults. Methods: A sub-sample was calculated from the population-based cross-sectional study 2015-Health Survey of São Paulo (ISA-Capital). The survey “ISA-Nutrição” used a sample of non-institutionalized individuals aged >15 years. For this study, only adolescents (12-18 years old; n=418) and young adults (19-29 years old; n=218) were included. Snacks were identified, and their contribution to energy, nutrients, and food sources were calculated. Descriptive statistics and logistic regressions were used. Results: Participants experienced an average of 2.9±0.6 snacking occasions per day. Young adults consumed more energy from morning and night snacks, and adolescents, from afternoon snacks. The top three food sources on snacking contributed to 30.5% of energy: cookies (11.8%), sugar sweetened beverages (9.4%), sweets and other desserts (9.3%). Although results were non-significant, being a female (Odds Ratio [OR] 0.93; 95% confidence interval [95%CI] 0.36-1.49), meeting the physical activity recommendations (OR 0.75; 95%CI 0.25-1.25), and scoring higher for the healthy eating index (OR 0.88; 95%C 0.24-1.52) were all factors related to increased intake of snacks. Alternatively, overweight individuals (OR -0.54; 95%CI -1.00 to -0.08) consumed less snacks. Conclusions: Improving the quality of snacks should be considered in behavior-change strategies.