Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017

Background Peru has historically experienced high rural-to-urban migration. Despite large reductions in undernutrition, overweight is increasing. Elsewhere, internal migration has been associated with differences in children’s growth and nutritional health. We investigated how child growth and nutritional status in Peru varied over time and in association with maternal internal migration. Methods Using data from Demographic & Health Surveys from 1991 to 2017, we assessed trends in child growth (height-for-age [HAZ], weight-for-age [WAZ], weight-for-height [WHZ] z scores) and nutritional health (stunting, underweight, overweight) by maternal adult internal migration (urban [UNM] or rural non-migrant [RNM], or urban-urban [UUM], rural-urban [RUM], rural-rural [RRM], or urban-rural migrant [URM]). Using 2017 data, we ran regression analyses, adjusting for confounders, to investigate associations of maternal migration with child outcomes and the maternal and child double burden of malnutrition. We further stratified by timing of migration, child timing of birth and, for urban residents, type of area of residence. Results are given as adjusted predictive margins (mean z score or %) and associated regression p-values [p]. Results In 1991–2017, child growth improved, and undernutrition decreased, but large differences by maternal migration persisted. In 2017, within urban areas, being the child of a migrant woman was associated with lower WHZ (UUM = 0.6/RUM = 0.5 vs UNM = 0.7; p = 0.009 and p < 0.001 respectively) and overweight prevalence ((RUM 7% vs UNM = 11% [p = 0.002]). Results however varied both by child timing of birth (birth after migration meant greater overweight prevalence) and type of area of residence (better linear growth in children of migrants [vs non-migrants] in capital/large cities and towns but not small cities). In rural areas, compared to RNM, children of URM had higher HAZ (− 1.0 vs − 1.2; p < 0.001) and WAZ (− 0.3 vs − 0.4; p = 0.001) and lower stunting (14% vs 21%; [p < 0.001]). There were no differences by timing of birth in rural children, nor by time since migration across all children. The mother and child double burden of malnutrition was higher in rural than urban areas but no differences were found by maternal internal migration. Conclusions Migration creates a unique profile of child nutritional health that is not explained by maternal ethnic and early life factors, but which varies depending on the pathway of migration, the child timing of birth in relation to migration and, for urban dwellers, the size of the place of destination. Interventions to improve child nutritional health should take into consideration maternal health and migration history.

Prevalence of overweight among Dutch primary school children living in JOGG and non-JOGG areas

Background One of the most influential integrated approaches towards reducing childhood obesity is EPODE, a program that has been translated to over 20 different countries worldwide. Aim The goal of this study was to explore how JOGG–the Dutch EPODE adaptation–might reduce overweight prevalence among children. Methods To compare whether overweight prevalence was different in JOGG areas vs. non-JOGG areas, in long-term JOGG areas vs. short-term JOGG areas, and in low SES JOGG areas vs. middle/high SES JOGG areas, secondary anthropometric and personal data of 209,565 Dutch children were mapped onto publicly available JOGG data. Results Findings showed that overweight prevalence decreased from 25.17% to 16.08% in JOGG-areas, and from 32.31% to 18.43% in long-term JOGG areas. However, when taking into account SES, the decrease in prevalence was mainly visible in low SES long-term JOGG areas. Conclusion JOGG appeared to be successful in targeting areas where overweight was most prevalent. Low SES areas that had implemented JOGG for a longer period of time, i.e., six years, appeared to be successful in decreasing overweight prevalence.

Overweight in the Dutch National Cohort of Long-Term Survivors of Childhood Cancer

BACKGROUND Overweight is a common problem in the general population, but occurs more frequently among childhood cancer survivors (CCS) and is regarded as a late adverse effect. However, risk factors are not fully elucidated and it is often disguised in CCS because they can have normal weight but high fat percentage (fat%) on dual-energy X-ray absorptiometry (DXA, gold standard). We aimed to assess overweight prevalence in a nationwide survivor cohort, to clarify risk factors and to identify which measurement method captures overweight best. METHODS The prevalence of overweight and obesity (body mass index (BMI) ≥25 and ≥30 kg/m 2) was assessed in the Dutch nationwide cohort of adult CCS treated between 1963 and 2002. Risk factors for overweight were analyzed using multivariable logistic regression models. In addition, overweight prevalence was calculated according to fat%, waist circumference (WC), waist/hip ratio (WHR) and waist/height ratio (WHtR). The validity of BMI, WC, WHR and WHtR for characterizing obesity, compared to fat% (expressed as false-negative percentage and in logistic regression models to identify treatment-related risk factors for disguised overweight) was studied. RESULTS A total of 2,338 (51.2% male) survivors (54.7% hematologic malignancies) participated, with mean age 35.5 (±9.3) years and 28.3 (±8.4) years follow-up. In men and women respectively, overweight prevalence was 45.9% and 43.8%, for obesity this was 11.2% and 15.5%. Risk factors for overweight included overweight at cancer diagnosis (adjusted odds ratio (aOR) 3.43, p&lt;0.001), cranial radiotherapy (CRT, aOR 3.27, p&lt;0.001) and growth hormone deficiency (GHD) (unadjusted OR 2.28, p&lt;0.001, after adjustment the effect partially disappeared, aOR 1.60, p=0.072). Previous treatment with corticosteroids was not associated with overweight. Using BMI, WC, WHR and WHtR, similar overweight prevalence was observed. However, this was 58.4% in men and even 83.7% in women when measured with DXA. Disguised overweight was more frequent after treatment with abdominal radiotherapy, high dose anthracyclines and stem cell transplantation (SCT) (aOR up to 3.37). CONCLUSIONS Overweight occurs in almost half of all long-term CCS, and risk factors include overweight at cancer diagnosis, CRT and potentially GHD. DXA identified overweight in an additional 25% of survivors. In CCS treated with abdominal irradiation, anthracyclines and SCT, overweight is more often missed with conventional methods. Hence, in these risk groups DXA needs serious consideration in surveillance, to enable early intervention and prevent complications of overweight including diabetes and atherosclerotic disease. Disclosures No relevant conflicts of interest to declare.

Prevalence and risk for overweight among employees in a leading auto-mobile industry in India

Background: Overweight is a major risk factor for the non-communicable diseases. India is home to nearly 164 million industrial workers (2017) and yet information about prevalence and risk of overweight among them is limited. Being overweight can adversely affect a person's productivity in his workplace and increase the risk of non-communicable diseases. The objective was to assess the prevalence of overweight and association between overweight and employee age, type of work and native origin.Methods: The longitudinal analysis was conducted using periodical medical examination (PME) data of employees from 2010-2018. Relevant data were collected. Year-wise prevalence of overweight was estimated along with specific prevalence by age, type of work and region.Results: The mean weight of employees increased from 68.1 kgs to 72.6 kgs (2010-2018). Overweight proportion was significantly higher in non-production departments. Overweight prevalence ranged between 15-29.8% among Karnataka regions in 2010 in production employees but reached 35-55.6% by 2018. Significant association was found between overweight with type of work and region.Conclusions: The increase in weight over time indicates the trend of overweight and weight reduction interventions are needed in workplaces to prevent the risk of NCDs.

Overweight and Obesity in Patients with Congenital Heart Disease: A Systematic Review

Background: Overweight and obesity have become a major public health concern in recent decades, particularly in patients with chronic health conditions like congenital heart disease (CHD). This systematic review elaborates on the prevalence and the longitudinal development of overweight and obesity in children and adults with CHD. Methods: A systematic literature search was conducted in PubMed, Cochrane, and Scopus from January 2010 to December 2020 on overweight and obesity prevalence in children and adults with CHD. Results: Of 30 included studies, 15 studies evaluated 5680 pediatric patients with CHD, 9 studies evaluated 6657 adults with CHD (ACHD) and 6 studies examined 9273 both pediatric patients and ACHD. Fifteen studies received the quality rating “good”, nine studies “fair”, and six studies “poor”. In children with CHD, overweight prevalence was between 9.5–31.5%, and obesity prevalence was between 9.5–26%; in ACHD, overweight prevalence was between 22–53%, and obesity was between 7–26%. The prevalence of overweight and obesity was thereby similar to the general population. Overweight and obesity have been shown to increase with age. Conclusion: The prevalence of overweight and obesity in children and adults with CHD is similar to the general population, demonstrating that the growing obesity pandemic is also affecting the CHD population.

Relationship of Overweight and Obesity with Body Self-Image Dissatisfaction in Urban Mediterranean Adolescents

The aim of this study was to analyze whether weight status has a relationship with the prevalence of body self-image dissatisfaction in Mediterranean urban teenagers. A series of 809 adolescents aged 11 to 17 years underwent anthropometric measurements according to ISAK protocols and completed the Body Shape Questionnaire (BSQ). The overall overweight prevalence according to International Obesity Task Force (IOTF) criteria was 11.5%, and 2.7% for obesity. Girls showed higher overweight prevalence than boys (18.4% vs. 12.9%; p < 0.05). At the late adolescence period (16–17 y), obesity was observed in the boys but not in the girls (8.7% vs. 0%; p < 0.01). There was a relative low prevalence of body image (BI) dissatisfaction among participants (boys 17.3%; girls 22.7%). In the late adolescence period, the girls were more often classified as being dissatisfied (31%). A weak correlation between the BSQ scores and all the anthropometric variables related to the adiposity profile was detected only in the boys. A logistic regression confirmed that female adolescents and the late pubertal period had a significant association with body dissatisfaction, regardless of their weight status. As BI are not related to weight status measured by body mass index (BMI) percentiles, other factors beyond anthropometry deserve further research to explain BI concerns specifically in girls.

Obesity as a result of food insecurity

Subject. This article examines the relationship between overweight and food insecurity. Objectives. The article aims to determine a system of factors caused by food insecurity and influencing overweight. Methods. For the study, I used analysis and synthesis, and the abstract-logical, historical, and statistical methods. Results. The article shows the relationship between food insecurity and overweight prevalence and a set of certain factors. Conclusions. Factors that lead to food insecurity are similar to the ones that contribute to the prevalence of overweight. This confirms a direct link between the two phenomena. However, there are certain key differences in how overweight is linked to food insecurity around the world.

Monitoring Information-Seeking Patterns and Obesity Prevalence in Africa With Internet Search Data: Observational Study

Background The prevalence of chronic conditions such as obesity, hypertension, and diabetes is increasing in African countries. Many chronic diseases have been linked to risk factors such as poor diet and physical inactivity. Data for these behavioral risk factors are usually obtained from surveys, which can be delayed by years. Behavioral data from digital sources, including social media and search engines, could be used for timely monitoring of behavioral risk factors. Objective The objective of our study was to propose the use of digital data from internet sources for monitoring changes in behavioral risk factors in Africa. Methods We obtained the adjusted volume of search queries submitted to Google for 108 terms related to diet, exercise, and disease from 2010 to 2016. We also obtained the obesity and overweight prevalence for 52 African countries from the World Health Organization (WHO) for the same period. Machine learning algorithms (ie, random forest, support vector machine, Bayes generalized linear model, gradient boosting, and an ensemble of the individual methods) were used to identify search terms and patterns that correlate with changes in obesity and overweight prevalence across Africa. Out-of-sample predictions were used to assess and validate the model performance. Results The study included 52 African countries. In 2016, the WHO reported an overweight prevalence ranging from 20.9% (95% credible interval [CI] 17.1%-25.0%) to 66.8% (95% CI 62.4%-71.0%) and an obesity prevalence ranging from 4.5% (95% CI 2.9%-6.5%) to 32.5% (95% CI 27.2%-38.1%) in Africa. The highest obesity and overweight prevalence were noted in the northern and southern regions. Google searches for diet-, exercise-, and obesity-related terms explained 97.3% (root-mean-square error [RMSE] 1.15) of the variation in obesity prevalence across all 52 countries. Similarly, the search data explained 96.6% (RMSE 2.26) of the variation in the overweight prevalence. The search terms yoga, exercise, and gym were most correlated with changes in obesity and overweight prevalence in countries with the highest prevalence. Conclusions Information-seeking patterns for diet- and exercise-related terms could indicate changes in attitudes toward and engagement in risk factors or healthy behaviors. These trends could capture population changes in risk factor prevalence, inform digital and physical interventions, and supplement official data from surveys.

Prevalence of overweight among Dutch primary school children living in JOGG and non-JOGG areas

Background: One of the most influential integrated approaches towards reducing childhood obesity is EPODE, a program that has been translated to over 20 different countries worldwide. Aim The goal of this study was to explore how JOGG – the Dutch EPODE adaptation – might reduce overweight prevalence among children. Methods: To compare whether overweight prevalence was different in JOGG areas vs. non-JOGG areas, in long-term JOGG areas vs. short-term JOGG areas, and in low SES JOGG areas vs. middle/high SES JOGG areas, secondary anthropometric and personal data of 209,565 Dutch children were mapped onto publicly available JOGG data. Results: Findings showed that overweight prevalence decreased from 25.17% to 16.08% in JOGG-areas, and from 32.31% to 18.43% in long-term JOGG areas. However, when taking into account SES, the decrease in prevalence was mainly visible in low SES long-term JOGG areas. Conclusion: JOGG appeared to be successful in targeting areas where overweight was most prevalent. Low SES areas that had implemented JOGG for a longer period of time, i.e., six years, appeared to be successful in decreasing overweight prevalence.