Promotion of a Healthy Weight and Lifestyle among Children: The ‘Be Active, Eat Right’ Study

Overweight and obesity among children has become a public health issue. This thesis aimed to describe interventions promoting a healthy weight and lifestyle among children and provide insight in elements that may be related to intervention improvement. Health care has an important role in early detection of overweight and obesity among children. The prevention protocol is an intervention that can be implemented in the youth health care setting. The in this thesis described evaluation of the prevention protocol showed limited effects of the intervention on health behaviors and BMI of the children. However, the prevention protocol may be used to create awareness of the child’s overweight among parents and motivate them to change health behavior. The prevention protocol offers the opportunity to discuss potential negative health outcomes such as insecure feelings the child may be experiencing, which was shown in two studies in this thesis. Also, parents may be assisted in learning skills to promote healthy behavior of the child and to create a healthy home environment. Individual focused interventions such as the prevention protocol, should be implemented in combination with interventions targeting the general population. A study in this thesis showed that interventions among the general population of children can help decrease sedentary behavior and BMI. A local integrated approach to prevent and care for children with overweight and obesity is recommended; care providers have working arrangements with regard to detection, care and follow-up of children with overweight and obesity and all health care professionals are committed to providing local prevention and care. This integrated approach will promote sustainable health behavior change and the development of a healthy lifestyle among children and their families

Sociodemographic factors and social media use in 9-year-old children:the Generation R Study

Abstract Background We aimed to investigate the associations between sociodemographic factors and instant messaging and social network site exposure among 9-year-old children. Methods Data of 4568 children from the Generation R study, a population-based cohort study performed in Rotterdam, the Netherlands, were analyzed. Instant messaging exposure was defined as using online chat applications such as MSN, chat boxes, WhatsApp, and Ping. Social network site exposure was defined as using Hyves or Facebook. A series of multiple logistic regression analyses were performed, adjusting for covariates. Results Children of low educated mothers had a higher odds ratio (OR) for instant messaging (OR: 1.44, 95% CI: 1.12, 1.86) and social network site exposure (OR: 1.73, 95% CI: 1.13, 2.66) than their counterparts. Being a child from a single-parent family was associated with instant messaging (OR: 1.48, 95% CI: 1.16, 1.88) and social network site exposure (OR: 1.34, 95% CI: 1.01, 1.78) more often than their counterparts. Children of low educated fathers (OR: 1.48, 95% CI: 1.12, 1.95) or from families with financial difficulties (OR: 1.28, 95% CI: 1.04, 1.59) were associated with a higher OR of social network site exposure than their counterparts. Conclusion The findings suggest that several indicators of lower social position are associated with higher social network site and instant messaging exposure among 9-year-old children. More research is needed in younger children to understand the determinants and impact of social media use

Social Media Use and Health-Related Quality of Life Among Adolescents:Cross-sectional Study

BACKGROUND: Using social media is a time-consuming activity of children and adolescents. Health authorities have warned that excessive use of social media can negatively affect adolescent social, physical, and psychological health. However, scientific findings regarding associations between time spent on social media and adolescent health-related quality of life (HRQoL) are not consistent. Adolescents typically use multiple social media platforms. Whether the use of multiple social media platforms impacts adolescent health is unclear. OBJECTIVE: The aim of this study was to examine the relationship between social media use, including the number of social media platforms used and time spent on social media, and adolescent HRQoL. METHODS: We analyzed the data of 3397 children (mean age 13.5, SD 0.4 years) from the Generation R Study, a population-based cohort study in the Netherlands. Children reported the number of social media platforms used and time spent on social media during weekdays and weekends separately. Children’s HRQoL was self-reported with the EuroQol 5-dimension questionnaire–youth version. Data on social media use and HRQoL were collected from 2015 to 2019. Multiple logistic and linear regressions were applied. RESULTS: In this study, 72.6% (2466/3397) of the children used 3 or more social media platforms, and 37.7% (1234/3276) and 58.3% (1911/3277) of the children used social media at least 2 hours per day during weekdays and weekends, respectively. Children using more social media platforms (7 or more platforms) had a higher odds of reporting having some or a lot of problems on “having pain or discomfort” (OR 1.55, 95% CI 1.20 to 1.99) and “feeling worried, sad or unhappy” (OR 1.99, 95% CI 1.52 to 2.60) dimensions and reported lower self-rated health (β –3.81, 95% CI –5.54 to –2.09) compared with children who used 0 to 2 social media platforms. Both on weekdays and weekends, children spent more time on social media were more likely to report having some or a lot of problems on “doing usual activities,” “having pain or discomfort,” “feeling worried, sad or unhappy,” and report lower self-rated health (all P<.001). CONCLUSIONS: Our findings indicate that using more social media platforms and spending more time on social media were significantly related to lower HRQoL. We recommend future research to study the pathway between social media use and HRQoL among adolescents

Adolescents' Views on Seeking Help for Emotional and Behavioral Problems: A Focus Group Study

This study aimed to get insight into adolescents' views on help-seeking for emotional and behavioral problems. Fourteen focus groups were conducted. Two vignettes, depicting one healthy adolescent with few issues and one adolescent with severe psychosocial problems, were used to structure the focus groups. The focus groups were framed within a youth help-seeking model. Adolescents (mean age of 15.0 years) generally reported seeking help from friends or the internet for mild issues and from a person they trust like a parent or school mentor, for more severe problems. Adolescents correctly recognized the issues in vignette one as surmountable and the problems in vignette two as severe. A bond of trust with a help source was regarded as the main facilitator for the decision to seek help. Adolescents reported a preference for help sources who clearly displayed their expertise for the issue at hand and for informal help-sources, particularly friends

Parenting style, the home environment, and screen time of 5-year-old children; the 'be active, eat right' study

Introduction: The global increase in childhood overweight and obesity has been ascribed partly to increases in children's screen time. Parents have a large influence on their children's screen time. Studies investigating parenting and early childhood screen time are limited. In this study, we investigated associations of parenting style and the social and physical home environment on watching TV and using computers or game consoles among 5-year-old children. Methods: This study uses baseline data concerning 5-year-old children (n = 3067) collected for the 'Be active, eat right' study. Results: Children of parents with a higher score on the parenting style dimension involvement, were more likely to spend >30 min/day on computers or game consoles. Overall, families with an authoritative or authoritarian parenting style had lower percentages of children's screen time compared to families with an indulgent or neglectful style, but no significant difference in OR was found. In families with rules about screen time, children were less likely to watch TV>2 hrs/day and more likely to spend >30 min/day on computers or game consoles. The number of TVs and computers or game consoles in the household was positively associated with screen time, and children with a TV or computer or game console in their bedroom were more likely to watch TV>2 hrs/day or spend >30 min/day on computers or game consoles. Conclusion: The magnitude of the association between parenting style and screen time of 5-year-olds was found to be relatively modest. The associations found between the social and physical environment and children's screen time are independent of parenting style. Interventions to reduce children's screen time might be most effective when they support parents specifically with introducing family rules related to screen time and prevent the presence of a TV or computer or game console in the child's room

Change in neighborhood socioeconomic status and childhood weight status and body composition from birth to adolescence

Background: We aim to assess the associations between the change in neighborhood socioeconomic score (SES) between birth and 6 years and childhood weight status and body composition from 6 to 13 years.Methods: Data for 3909 children from the Generation R Study, a prospective population-based cohort in the Netherlands were analyzed. The change in neighborhood SES between birth and 6 years was defined as static-high, static-middle, static-low, upward, and downward mobility. Child body mass index (BMI), overweight and obesity (OWOB), fat mass index (FMI) and lean mass index (LMI) were measured at age 6, 10, and 13 years. The associations were explored using generalized estimating equations. The effect modification by child sex was examined. Results: In total, 19.5% and 18.1% of children were allocated to the upward mobility and downward mobility neighborhood SES group. The associations between the change in neighborhood SES and child weight status and body composition were moderated by child sex (p &lt; 0.05). Compared to girls in the static-high group, girls in the static-low group had relatively higher BMI-SDS (β, 95% confidence interval (CI): 0.24, 0.09–0.40) and higher risk of OWOB (RR, 95% CI: 1.98, 1.35–2.91), together with higher FMI-SDS (β, 95% CI: 0.27, 0.14–0.41) and LMI-SDS (β, 95% CI: 0.18, 0.03–0.33). The associations in boys were not significant. Conclusions: An increased BMI and fat mass, and higher risk of OWOB from 6 to 13 years were evident in girls living in a low-SES neighborhood or moving downward from a high- to a low-SES neighborhood. Support for children and families from low-SES neighborhoods is warranted.</p

Clustering of sedentary behaviours, physical activity, and energy-dense food intake in six-year-old children

This study examined the clustering of lifestyle behaviours in children aged six years from a prospective cohort study in the Netherlands. Additionally, we analysed the associations between socioeconomic status and the lifestyle behaviour clusters that we identified. Data of 4059 children from the Generation R Study were analysed. Socioeconomic status was measured by maternal educational level and net household income. Lifestyle behaviours including screen time, physical activity, calorie-rich snack consumption and sugar-sweetened beverages consumption were measured via a parental questionnaire. Hierarchical and non-hierarchical cluster analyses were applied. The associations between socioeconomic status and lifestyle behaviour clusters were assessed using logistic regression models. Three lifestyle clusters were identified: “relatively healthy lifestyle” cluster (n = 1444), “high screen time and physically inactive” cluster (n = 1217), and “physically active, high snacks and sugary drinks” cluster (n = 1398). Children from high educated mothers or high-income households were more likely to be allocated to the “relatively healthy lifestyle” cluster, while children from low educated mothers or from low-income households were more likely to be allocated in the “high screen time and physically inactive” cluster. Intervention development and prevention strategies may use this information to further target programs promoting healthy behaviours of children and their families

Effects of an intervention aimed at reducing the intake of sugar-sweetened beverages in primary school children: A controlled trial

Abstract Background Since sugar-sweetened beverages (SSB) may contribute to the development of overweight in children, effective interventions to reduce their consumption are needed. Here we evaluated the effect of a combined school- and community-based intervention aimed at reducing children’s SSB consumption by promoting the intake of water. Favourable intervention effects on children’s SSB consumption were hypothesized. Methods In 2011-2012, a controlled trial was conducted among four primary schools, comprising 1288 children aged 6-12 years who lived in multi-ethnic, socially deprived neighbourhoods in Rotterdam, the Netherlands. Intervention schools adopted the ‘water campaign’, an intervention developed using social marketing. Control schools continued with their regular health promotion programme. Primary outcome was children’s SSB consumption, measured using parent and child questionnaires and through observations at school, both at baseline and after one year of intervention. Results Significant positive intervention effects were found for average SSB consumption (B -0.19 litres, 95% CI -0.28;-0.10; parent report), average SSB servings (B -0.54 servings, 95% CI -0.82;-0.26; parent report) and bringing SSB to school (OR 0.51, 95% CI 0.36;0.72; observation report). Conclusions This study supports the effectiveness of the water campaign intervention in reducing children’s SSB consumption. Further studies are needed to replicate our findings. Trial registration Current Controlled Trials: NTR3400 webcit