The Effect of Obesity on Musculosceletal System

Obesity arises and persists during an excessive long-term pos- itive energy balance. Risk factors for the development of obe- sity are, in particular: ahigh-calorie diet, low physical activity; adaptation to asedentary lifestyle; irregular diet. The most commonly used criterion for assessing obesity is the Body Mass Index – BMI. The incidence of obesity in Europe is be- tween 10% to 25% in women, while more than 50% of the pop- ulation in most European countries is overweight and obese. The effect of obesity on the musculoskeletal system is demon- strable in patients who suffer its consequences during their life. Long-term overweight is the cause of excessive strain on bones, joints and muscles, which over time, due to the chronic course of obesity, affects almost every obese individual. Obesity prevention programs, the development of a healthy lifestyle, healthy eating and exercise-related activities are our common goals for preventing obesity.

Application of an Implementation Framework Using Mixed Methods in Preschool Settings

Research Findings. Application of mixed methods in a dissemination and implementation framework can give researchers a better understanding of the reach and delivery of early childhood obesity prevention programs in preschool settings, as well as potential facilitators and barriers related to implementation and sustainability. This study utilized a simultaneous, exploratory, mixed-methods design to investigate individual-, organizational-, and intervention-level factors that were related to the implementation and sustainability of policy, system, and environment (PSE) changes as part of a larger obesity prevention program in a randomly selected sample of preschool centers ( n = 20). Individual-level factors, and specifically the attitudes and skills of preschool providers, were identified in both the qualitative and quantitative data as important factors related to the sustainability of PSE changes ( r = .56, p < .01). Staff and leadership engagement and adaptability of the program were also identified as important factors related to the implementation and sustainability of PSE changes. Practice or Policy. These findings highlight the complexity of implementation success and suggest PSE obesity prevention interventions in preschool centers require the consideration of numerous, multilevel factors to ensure programming is impactful and sustained over time.

Family-focused obesity prevention program implementation in urban versus rural communities: a case study

Purpose Despite public health efforts to reduce childhood obesity, there remains an unequal distribution of obesity among rural and urban children, with higher rates in rural areas. However, few studies have compared differences in program delivery. This paper aims to describe differences between an urban and rural program delivery of a family-focused, community-based intervention program to prevent and reduce obesity among children. Methods This paper uses a case study format to provide a descriptive analysis of similar obesity prevention programs, designed by the same research team, implemented in Minnesota in different settings (i.e., an urban and rural setting) with significant community engagement in the adaptation process. The rural NU-HOME program is compared to HOME-Plus, an urban family-based obesity prevention program for school-aged children. Results Community engagement in the adaptation process of an urban program to a rural program confirmed some anticipated program content and delivery similarities while identifying key differences that were necessary for adaptation related to engagement with the community, recruitment and data collection, and intervention delivery. Discussion When adapting research-tested programs from urban to rural areas, it is important to identify the modifiable behavioral, social, and environmental factors associated with obesity to ensure the content of effective childhood obesity prevention programs is relevant. Customizing a program to meet the needs of the community may increase reach, engagement, and sustainability. In addition, long-term dissemination of a tailored program may significantly reduce childhood obesity in rural communities and be implemented in other rural settings nationally.

Social Modeling and Eating Behavior—A Narrative Review

Social modeling of eating is the adjustment of the amount of food eaten to the intake of the accompanying person. In this paper we provide a narrative review of literature on social modeling of eating with a particular focus on recent studies. Firstly, we describe the structure of a typical modeling experiment. Secondly, we present a variety of research in this field: experiments with various types of confederates, experiments aimed at the evaluation of the influence of gender, partner’s body weight, type of food, hunger, personal characteristics, etc. Thirdly, we present practical implications of this knowledge. The common conclusion is that social modeling of eating occurs in different situations and consumption is adapted to the standards established by the eating partner, but is not their direct reflection. Social influence of eating is not restricted to "artificial" laboratory situations; social modeling and social norms manipulations may be used to change people’s dietary practices, especially in children and young adults. Within the home environment parental modeling has been shown to promote children’s snacking and fruit and vegetable consumption. Social modeling may be used in nutrition interventions aimed at the improvement of children’s diet and in obesity prevention programs.

Parent/Caregiver Perceptions of Youth Health Outcomes After Participating in the WeCook: Fun With Food and Fitness Program

Many youth programs focused on improving health outcomes have not examined parent/caregiver perceptions postparticipation even though they may significantly influence youth behaviors. The primary purpose of this study was to examine changes in adult perceptions of youth- and family-related behavior after youth participated in a 12-week out-of-school time food preparation, nutrition, and physical activity program with a treatment only design. A secondary objective was to assess differences in survey responses by demographic characteristics. The program targeted fourth- and fifth-grade youth at two Title I elementary schools while also engaging families. Pre- and postprogram surveys were administered to parent/caregivers ( n = 60) across four cohorts spanning the spring 2016 school semester to fall 2017 school semester. Adult demographic characteristics and perceptions of youth- and family-related outcomes were collected. Results demonstrated a significant increase ( p value <.05) in adults’ perceptions of their youth’s ability to choose healthy snacks and decrease screen time. Additionally, lower income adults reported increased youth sedentary habits, adults using food assistance reported decreased family breakfast frequency, and adults with smaller household sizes reported decreased youth activity before school. Further research is needed on adult and family outcomes from youth cooking programs to better understand the adult and youth health relationship and encourage obesity prevention programs to increase their focus on the family component and associated assessments.

Community readiness for childhood obesity prevention programs: findings from an urban population in Iran

Summary This study aimed to examine the Iranian local communities’ readiness stage to engage with childhood obesity prevention programs for late primary school children in districts 2 and 16 of Tehran as the representatives of high and low socio-economic districts, respectively. First, a Delphi approach was conducted to assess the socio-cultural necessity/appropriateness and adequacy of the community readiness model and its dimensions as a planning basis for childhood obesity prevention program(s) in Iran. Then, the community readiness interview guide’s translation, modification, content and face validity were performed. Finally, 66 interviews with key informants were conducted and scored to assess community readiness. The socio-cultural necessity/appropriateness and adequacy of community readiness model and its dimensions were confirmed by Delphi participants and two questions were added to the interview guide. Content and face validity of the interview guide were at acceptable levels. Assessment of the community readiness based on the key informants’ perspective showed that the overall mean readiness score of targeted local communities was 4.61 ± 0.54 and 4.22 ± 0.26 in high and low socio-economic districts, respectively, corresponded to ‘preplanning stage’. The highest score was 5.00 ± 0.48 correspond to the ‘preparation stage’, which belonged to girls’ schools in district 2. Small differences were found in the readiness stage of local communities by sex and socio-economic status of schools. The results highlight the need to increase community awareness, gain their support to recognize childhood obesity as a priority, address cultural misconceptions and improve the obesity prevention programs to achieve a higher level of readiness.

Relationships among Executive Function, Cognitive Load, and Weight-related Behaviors in University Students

Objectives: College students have high risk of anxiety and weight gain. Understanding how executive function traits, especially with trait anxiety, associates with weight-related behaviors could indicate strategies for improving obesity prevention programs. In this study, we examined links between weight-related behaviors of undergraduate students and executive function traits with and without high cognitive loads in the form of trait anxiety. Methods: Participants (N = 406) completed an online survey assessing health, weight-related behaviors, executive function traits (cognitive self-control, concentration, and flexibility), and cognitive load (trait anxiety). Results: K-means cluster analysis of executive function trait scales yielded 3 homogenous groups distinctly different from each other: Cluster 1 had the lowest cognitive self-control and flexibility and moderate concentration traits, Cluster 2 had the lowest concentration and moderate self-control and flexibility traits, and Cluster 3 had the highest executive function traits. Clusters did not differ on BMI or physical health. Cluster 3 had better mental health, physical activity, sleep quality, and eating behaviors. Across clusters, those with high cognitive loads, as indicated by trait anxiety, had poorer mental health than those with low loads. High cognitive load in Clusters 2 and 3 adversely affected eating behaviors requiring cognitive concentration and self-control. Conclusions: Future research should explore the feasibility of delivering executive control improvement activities and health education simultaneously.

The Evolving Family Mealtime: Findings From Focus Group Interviews With Hispanic Mothers

Background Given the protective effects of shared family mealtimes and the importance of family in the Hispanic culture, this context should be explored further to determine how it can be leveraged and optimized for interventions. Objective This study aimed to explore contextual factors associated with family mealtimes in Mexican and Puerto Rican families. Methods A total of 63 mothers participated in 13 focus group interviews across 4 states. Thematic analysis was used to analyze transcripts. Results Seven overarching themes were identified through the thematic analysis. Themes reflected who was present at the mealtime, what occurs during mealtime, the presence of television, the influence of technology during mealtime, and how mealtimes have changed since the mothers were children. Conclusions Hispanic mothers may be adapting family mealtimes to fit their current situations and needs, keeping the television and other devices on during mealtimes, and making additional meals for multiple family members to appease everyone’s tastes. All of these are areas that can be incorporated into existing culturally tailored obesity prevention programs to help families lead healthier lives.

Practicability of Implementing a Pilot School Based Obesity Prevention Program

Unhealthy diet and lifestyle behaviours are known to increase the risk of obesity and comorbidities. This article piloted the practicability of a school-based prevention program to control weight among schoolgirls. An eight-week comprehensive program was conducted on 66 adolescent females. Food habits and lifestyle survey was completed. Student health, nutrition, and physical activity knowledge was assessed. Physical education was applied. Subjective assessment of food/beverages at the school's canteen occurred and a sample of a healthy canteen was provided. Results showed students' unhealthy patterns in food habits and lifestyle. Significant changes were noticed in their overall positive responses to pre-and post-questions (P-value=001). Nearly 70% of food/beverage items were categorised as less healthy. School-based obesity prevention programs could support students in improving their eating patterns and weight status. The program could be replicated to improve students' lives in other locations. Benefits could include health and education ministries.

Assessing the Effectiveness of an Extender Model Partnership in Implementing a Multicomponent, School-Based Nutrition Intervention

Childhood obesity continues to be a problem of national concern; school-based obesity prevention programs that incorporate nutrition education are among the efforts to address this issue. Implementation of these programs is often conducted through partner agencies like the Supplemental Nutrition Assistance Program Education (SNAP-Ed). As educators within these agencies have limited time and many schools qualify for programming, developing programs that extend reach by partnering with classroom teachers to deliver nutrition education is critical. The purpose of this article is to evaluate the effectiveness of a teacher extender model compared with direct nutrition education from trained staff using the research-tested, evidence-based Shaping Healthy Choices Program. Data collected as part of this evaluation in intervention and control groups included nutrition knowledge, body mass index percentile, and vegetable identification in youth; lesson fidelity observations and feasibility from teachers; and demographics from parents. Overall, unequal within variances did not allow for the statistical power to detect change. Generally, teachers enjoyed the program but found it too time-consuming to implement. While results were unclear, important lessons were learned regarding the implementation of extender programs warranting further research. Overall, this study aligns with others in the literature that indicate time is a major barrier to implementing nutrition education in the classroom. This study underscores the need for policy mandating nutrition education in schools.