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      Influence of home/school environments on children's obesity, diet, and physical activity: the SUECO study protocol Translated title: Impacto del entorno residencial/escolar en la obesidad, la dieta y la actividad física en población infantil: protocolo del estudio SUECO

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          Abstract

          Abstract Objective The SUECO study examines the relationship between urban obesogenic environments and health outcomes among school-age children in the city of Madrid, Spain. We will study how features of the urban environment (related to the food- and the physical activity environment) associate with children's anthropometrics, eating habits, and physical activity levels. Method We describe the study protocol of this multilevel study in a representative sample of school-age children in the city of Madrid (2017; n=5,961 children ages 3-12). Main outcome variables include anthropometrics (body mass index, waist circumference, and body fat), healthy and unhealthy consumption measures, and physical activity measures. The primary explanatory variables are grouped into food environment (e.g., unhealthy food retailers' density) and physical activity environment (e.g., walkability, physical activity opportunities) variable categories. Multilevel models will be used to calculate the associations between each indicator and obesity and physical inactivity.

          Translated abstract

          Resumen Objetivo El estudio SUECO evaluará la relación entre el entorno urbano obesogénico y los resultados en salud en la población infantil escolarizada en Madrid. El estudio explorará cómo influyen las características del entorno urbano (relacionadas con la alimentación y con la actividad física) en las variables antropométricas, los hábitos alimentarios y la actividad física. Método Se presenta el protocolo de este estudio multinivel, realizado con una muestra representativa de población infantil escolarizada en la ciudad de Madrid (2017; n=5961 escolares de 3 a 12 años). Las principales variables de resultado incluyen antropometría (índice de masa corporal, circunferencia de cintura y porcentaje de grasa corporal), hábitos alimentarios (saludables y no saludables) y actividad física. Las principales variables independientes son contextuales (del entorno alimentario y del entorno de actividad física). Se utilizarán modelos de regresión multinivel para evaluar las asociaciones entre cada indicador contextual, la obesidad y la inactividad física.

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          Development of a WHO growth reference for school-aged children and adolescents

          OBJECTIVE: To construct growth curves for school-aged children and adolescents that accord with the WHO Child Growth Standards for preschool children and the body mass index (BMI) cut-offs for adults. METHODS: Data from the 1977 National Center for Health Statistics (NCHS)/WHO growth reference (1-24 years) were merged with data from the under-fives growth standards' cross-sectional sample (18-71 months) to smooth the transition between the two samples. State-of-the-art statistical methods used to construct the WHO Child Growth Standards (0-5 years), i.e. the Box-Cox power exponential (BCPE) method with appropriate diagnostic tools for the selection of best models, were applied to this combined sample. FINDINGS: The merged data sets resulted in a smooth transition at 5 years for height-for-age, weight-for-age and BMI-for-age. For BMI-for-age across all centiles the magnitude of the difference between the two curves at age 5 years is mostly 0.0 kg/m² to 0.1 kg/m². At 19 years, the new BMI values at +1 standard deviation (SD) are 25.4 kg/m² for boys and 25.0 kg/m² for girls. These values are equivalent to the overweight cut-off for adults (> 25.0 kg/m²). Similarly, the +2 SD value (29.7 kg/m² for both sexes) compares closely with the cut-off for obesity (> 30.0 kg/m²). CONCLUSION: The new curves are closely aligned with the WHO Child Growth Standards at 5 years, and the recommended adult cut-offs for overweight and obesity at 19 years. They fill the gap in growth curves and provide an appropriate reference for the 5 to 19 years age group.
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            Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity.

            The "obesogenicity" of modern environments is fueling the obesity pandemic. We describe a framework, known as ANGELO (analysis grid for environments linked to obesity), which is a conceptual model for understanding the obesogenicity of environments and a practical tool for prioritizing environmental elements for research and intervention. Development of the ANGELO framework. The basic framework is a 2 x 4 grid which dissects the environment into environmental size (micro and macro) by type: physical (what is available), economic (what are the costs), political (what are the "rules"), and sociocultural (what are the attitudes and beliefs). Within this grid, the elements which influence food intake and physical activity are characterized as obesogenic or "leptogenic" (promoting leanness). Application of the ANGELO framework. The ANGELO framework has been piloted at the population level (island communities) to prioritize the settings/sectors for intervention and at the setting level (fast food outlets) to prioritize research needs and interventions. Environmental elements were prioritized by rating their validity (evidence of impact), relevance (to the local context), and potential changeability. The ANGELO framework appears to be a flexible and robust instrument for the needs analysis and problem identification stages of reducing the obesogenicity of modern environments. Copyright 1999 American Health Foundation and Academic Press.
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              Researching health inequalities in adolescents: the development of the Health Behaviour in School-Aged Children (HBSC) family affluence scale.

              Socioeconomic inequalities in adolescent health have been little studied until recently, partly due to the lack of appropriate and agreed upon measures for this age group. The difficulties of measuring adolescent socioeconomic status (SES) are both conceptual and methodological. Conceptually, it is unclear whether parental SES should be used as a proxy, and if so, which aspect of SES is most relevant. Methodologically, parental SES information is difficult to obtain from adolescents resulting in high levels of missing data. These issues led to the development of a new measure, the Family Affluence Scale (FAS), in the context of an international study on adolescent health, the Health Behaviour in School-Aged Children (HBSC) Study. The paper reviews the evolution of the measure over the past 10 years and its utility in examining and explaining health related inequalities at national and cross-national levels in over 30 countries in Europe and North America. We present an overview of HBSC papers published to date that examine FAS-related socioeconomic inequalities in health and health behaviour, using data from the HBSC study. Findings suggest consistent inequalities in self-reported health, psychosomatic symptoms, physical activity and aspects of eating habits at both the individual and country level. FAS has recently been adopted, and in some cases adapted, by other research and policy related studies and this work is also reviewed. Finally, ongoing FAS validation work is described together with ideas for future development of the measure.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) (Barcelona, Barcelona, Spain )
                0213-9111
                February 2022
                : 36
                : 1
                : 78-81
                Affiliations
                [4] Madrid orgnameHospital Universitario Infanta Leonor orgdiv1Servicio de Medicina Preventiva Spain
                [5] A Coruña orgnameComplexo Hospitalario Universitario de A Coruña orgdiv1Servicio de Medicina Preventiva Spain
                [2] Melbourne orgnameRMIT University orgdiv1Centre for Urban Research Australia
                [7] Baltimore Maryland orgnameJohns Hopkins University orgdiv1Department of Epidemiology United States
                [1] Alcalá de Henares Madrid orgnameUniversidad de Alcalá de Henares orgdiv1School of Medicine and Health Sciences orgdiv2Public Health and Epidemiology Research Group Spain
                [6] Madrid orgnameMadrid City Council orgdiv1Public Health Institute of Madrid orgdiv2Built Environment Group Spain
                [3] Alcalá de Henares Madrid orgnameUniversidad de Alcalá de Henares orgdiv1Department of Geology, Geography and Environmental Sciences Spain
                Article
                S0213-91112022000100078 S0213-9111(22)03600100078
                10.1016/j.gaceta.2021.04.005
                34246500
                98b9b8a8-65f9-4ddb-9e91-4738d7eba0b0

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 25 April 2021
                : 24 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 4
                Product

                SciELO Spain

                Categories
                Protocols

                Schools,España,Barrios,Centros educativos,Población infantil,Índice de masa corporal,Obesidad,Spain,Neighborhoods,Children,Body mass index,Obesity

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