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Demographic determinants of obesity, and adherence to dietary and physical activity guidelines among 4 to 6-year-old children in Behbahan city, southwest Iran, 2016

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      Abstract

      Background and aim

      The world is experiencing an alarming increase in prevalence of childhood obesity. The aim of this study was to determine the demographic determinants of obesity and adherence to dietary and physical activity guidelines among children aged 4 to 6 years old in Behbahan city, southwest Iran, in 2016.

      Methods

      This cross-sectional study was conducted on 120 preschool children aged 4 to 6 years old in Behbahan city, southwest Iran, in 2016. Multi-stage random sampling was done. The weight and height of the children were measured with standard methods. The demographic and behavioral factors data were collected in self report questionnaires which were completed by the children’s mothers. The Chi-square test, Independent-samples t-tests, One-way analysis of variances and logistic regression analysis were used for data analysis. SPSS software (version 22) was employed.

      Results

      This study showed that 88.3% of the children did not meet the guideline of 5 servings per day of fruit and vegetables. Only 2.5% met the guideline of 60 minutes of structured physical activity every day. Sex and mother’s occupation status were associated with adhering to screen time guideline. This study found a significant difference in the mean of screen time between sexes. Boys were more likely to meet the screen time guideline. A significant association between adhering to physical activity guidelines and mother’s occupation status was revealed. Significant statistical relationship between demographic factors and BMI categories was not illustrated. Demographic covariates were not significantly related to adherence to dietary and physical activity guidelines.

      Conclusion

      In preventive programs of obesity among 4 to 6-year-old children key lifestyle behaviors and demographic factors need to be considered.

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      Most cited references 48

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      Development of eating behaviors among children and adolescents.

      The prevalence of obesity among children is high and is increasing. We know that obesity runs in families, with children of obese parents at greater risk of developing obesity than children of thin parents. Research on genetic factors in obesity has provided us with estimates of the proportion of the variance in a population accounted for by genetic factors. However, this research does not provide information regarding individual development. To design effective preventive interventions, research is needed to delineate how genetics and environmental factors interact in the etiology of childhood obesity. Addressing this question is especially challenging because parents provide both genes and environment for children. An enormous amount of learning about food and eating occurs during the transition from the exclusive milk diet of infancy to the omnivore's diet consumed by early childhood. This early learning is constrained by children's genetic predispositions, which include the unlearned preference for sweet tastes, salty tastes, and the rejection of sour and bitter tastes. Children also are predisposed to reject new foods and to learn associations between foods' flavors and the postingestive consequences of eating. Evidence suggests that children can respond to the energy density of the diet and that although intake at individual meals is erratic, 24-hour energy intake is relatively well regulated. There are individual differences in the regulation of energy intake as early as the preschool period. These individual differences in self-regulation are associated with differences in child-feeding practices and with children's adiposity. This suggests that child-feeding practices have the potential to affect children's energy balance via altering patterns of intake. Initial evidence indicates that imposition of stringent parental controls can potentiate preferences for high-fat, energy-dense foods, limit children's acceptance of a variety of foods, and disrupt children's regulation of energy intake by altering children's responsiveness to internal cues of hunger and satiety. This can occur when well-intended but concerned parents assume that children need help in determining what, when, and how much to eat and when parents impose child-feeding practices that provide children with few opportunities for self-control. Implications of these findings for preventive interventions are discussed.
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        Consumption patterns of sugar-sweetened beverages in the United States.

         Euna Han,  M Powell (2012)
        Few previous studies have investigated consumption distributions of sugar-sweetened beverages (SSBs) over time and individual-level associations despite recent interest in SSBs regarding obesity control. To assess consumption patterns and individual-level associations. Trend and cross-sectional analyses of 24-hour dietary recall data and demographic characteristics and socioeconomic status (SES) drawn from National Health and Nutrition Examination Survey (1999-2000, 2001-2002, 2003-2004, 2005-2006, and 2007-2008) data. Children (aged 2 to 11 years, n=8,627), adolescents (aged 12 to 19 years, n=8,922), young adults (aged 20 to 34 years, n=5,933), and middle-aged and elder adults (aged ≥35 years, n=16,456). Age-stratified regression analyses for SSBs overall and by subtypes. The prevalence of heavy total SSB consumption (≥500 kcal/day) increased among children (4% to 5%) although it decreased among adolescents (22% to 16%) and young adults (29% to 20%). Soda was the most heavily consumed SSB in all age groups except for children. Prevalence of soda consumption decreased, whereas heavy sports/energy drink consumption tripled (4% to 12%) among adolescents. Black children and adolescents showed higher odds of heavy fruit drink consumption (odds ratios 1.71 and 1.67) than whites. Low-income children had a higher odds of heavy total SSB consumption (odds ratio 1.93) and higher energy intake from total SSBs and fruit drinks (by 23 and 27 kcal/day) than high-income children. Adolescents with low- vs high-educated parents had higher odds of heavy total SSB consumption (odds ratio 1.28) and higher energy intake from total SSBs and soda (by 27 and 21 kcal/day). Low vs high SES was associated with a higher odds of heavy consumption of total SSBs, soda, and fruit drinks among adults. Prevalence of soda consumption fell, but consumption of nontraditional SSBs rose. Heterogeneity of heavy consumption by SSB types across racial/ethnic subpopulations and higher odds of heavy SSB consumption among low-SES populations should be considered in targeting policies to encourage healthful beverage consumption. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
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          Overweight and obesity in infants and pre-school children in the European Union: a review of existing data.

          The objective of this study was to synthesize available information on prevalence and time trends of overweight and obesity in pre-school children in the European Union. Retrieval and analysis or re-analysis of existing data were carried out. Data sources include WHO databases, Medline and Google, contact with authors of published and unpublished documents. Data were analysed using the International Obesity Task Force reference and cut-offs, and the WHO standard. Data were available from 18/27 countries. Comparisons were problematic because of different definitions and methods of data collection and analysis. The reported prevalence of overweight plus obesity at 4 years ranges from 11.8% in Romania (2004) to 32.3% in Spain (1998-2000). Countries in the Mediterranean region and the British islands report higher rates than those in middle, northern and eastern Europe. Rates are generally higher in girls than in boys. With the possible exception of England, there was no obvious trend towards increasing prevalence in the past 20-30 years in the five countries with data. The use of the WHO standard with cut-offs at 1, 2 and 3 standard deviations yields lower rates and removes gender differences. Data on overweight and obesity in pre-school children are scarce; their interpretation is difficult. Standard methods of surveillance, and research and policies on prevention and treatment, are urgently needed.
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            Author and article information

            Affiliations
            [1 ]Ph.D. Student of Health Education and Promotion, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
            [2 ]Ph.D. of Health Education and Promotion, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
            [3 ]Ph.D. of Health Education and Promotion, Associate Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
            [4 ]Ph.D. of Maternal and Child Health, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
            [5 ]Ph.D. of Nutrition, Professor, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
            [6 ]Ph.D. of Biostatistics, Assistant Professor, Department of Biostatistics and epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
            [7 ]M.Sc. Student of Psychometrics, Department of Assessment and Measurement, School of Psychology and Educational Sciences, Allameh Tabatabai University, Tehran, Iran
            Author notes
            Corresponding author: Professor Dr. Davood Shojaeizadeh, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98.2142933000, Email: Shojaei@ 123456tums.ac.ir
            Journal
            Electron Physician
            Electron Physician
            Electronic physician
            Electronic Physician
            Electronic physician
            2008-5842
            March 2018
            25 March 2018
            : 10
            : 3
            : 6554-6562
            5942578
            10.19082/6554
            epj-10-6554
            © 2018 The Authors

            This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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