Associations between dietary factors and obesity-related biomarkers in healthy children and adolescents - a systematic review

Background: The obesity prevalence in children and adolescents has increased worldwide during the past 30 years. Although diet has been identified as one risk factor for developing obesity in this age group, the role of specific dietary factors is still unclear. One way to gain insight into the role of these factors might be to detect biomarkers that reflect metabolic health and to identify the associations between dietary factors and these biomarkers. This would enable nutrition-related metabolic changes to be detected early in life, which might be a promising strategy to prevent childhood obesity. However, existing literature offers only inconclusive evidence for diet and some of these obesity-related biomarkers (e.g., blood lipids). We thus conducted a systematic literature review to further examine eligible studies that investigate associations between dietary factors and 12 obesity-related biomarkers in healthy children and adolescents aged 3-18 years. Methods: We searched the scientific databases PubMed/Medline and Web of Science Core Collection for potentially eligible articles. Our final literature search resulted in 2727 hits. After the selection process, we included 81 articles that reported on 1111 single observations on dietary factors and any of the obesity-related biomarkers. Results: Around 81% of the total observations showed nonsignificant results. For many biomarkers we did not find enough observations to draw clear conclusions on possible associations between a dietary factor and the respective biomarker. In cases where we identified enough observations, the results were contradictory. Since these nonsignificant and inconclusive findings may impede the development of effective strategies against childhood obesity, this article takes a closer look at possible reasons for such findings. In addition, it provides action points for future research efforts. Conclusions: In conclusion, current evidence on associations between dietary factors and obesity-related biomarkers is inconclusive. We thus provided an overview on which specific limitations may impede current research. Such knowledge is necessary to enable future research efforts to better elucidate the role of diet in the early stages of obesity development

Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: protocol for a scoping review

Introduction: Childhood and adolescence are crucial life stages for health trajectories and the development of health inequalities in later life. The relevance of schools for health and well-being of children and adolescents has long been recognised, and there is some research regarding the association of contextual and compositional characteristics of schools and classes with health, health behaviour and well-being in this population. Little is known about the role of meso-level characteristics in relation to health inequalities. The aim of this scoping review is to retrieve and synthesise evidence about the mediating or moderating role of compositional or contextual characteristics of schools for the association between students' socioeconomic position and health in primary and secondary education. Methods and analysis We will conduct a systematic search of electronic databases in PubMed/Medline, Web of Science and Education Resources Information Center. Studies must meet the following inclusion criteria: (1) The population must be students attending primary or secondary schools in developed economies. (2) The outcomes must include at least one indicator for individual health, health behaviour or well-being. (3) The study must include at least one contextual or compositional characteristic of the school context and one individual determinant of socioeconomic position. (4) The study must also examine the mediating or moderating role of the contextual or compositional characteristic of the school context for the associations between socioeconomic position and health, health behaviour or well-being. (5) The study must be published since 1 January 2000 in English or German language. We will provide a narrative synthesis of findings. Ethics and dissemination We will not collect primary data and only include secondary data derived from previously published studies. Therefore, ethical approval is not required. We intend to publish our findings in an international peer-reviewed journal and to present them at national and international conferences

Identification of starting points to promote health and wellbeing at the community level – a qualitative study

Background: As health is influenced by the social, economic and environmental conditions in which individuals live, local communities are an ideal setting to promote health and wellbeing. However, up to now various health promotion interventions at the community level have had limited success, perhaps related to an incomplete understanding of local contexts and priorities. We therefore aimed to develop a broader and deeper understanding of topics or issues that were most salient to residents of a South-West German community by exploring their perceptions of needs, challenges, barriers and existing resources related to health and well-being. Methods: As an initial step of a multi-year community-based participatory research project, we conducted semi-structured interviews with key informants (n = 30) from various community settings (e.g., child care, elderly care, businesses, non-profit organizations, village councils, and local government). The terms “health” and “wellbeing” were included in the stem of each question in the semi-structured interview guide to enable a focus on related perceived needs, challenges, barriers and existing resources. Interviews were audiotaped, transcribed verbatim and analyzed using qualitative content analysis techniques. Results: Themes emerging from our interviews appeared to center primarily in three distinct areas: natural resources and built environment, access to services, and social cohesion including subthemes on the importance of social engagement and volunteerism, sense of community, and shared identity. Conclusions: That health and wellbeing were not identified explicitly as a priority by key informants suggests that these should not be presented as the primary focus of a community-wide initiative. Instead themes with a higher priority should be addressed in ways that can lead to better health and wellbeing as a secondary goal

‘Oh God, I Have to Eat Something, But Where Can I Get Something Quickly?’—A Qualitative Interview Study on Barriers to Healthy Eating among University Students in Germany

Healthy eating can prevent individuals across all age groups from developing overweight/obesity and non-communicable diseases such as type 2 diabetes and cardiovascular disease. However, unhealthy eating habits (e.g., a high level of fast food consumption) have been found to be widespread among university students. Thus, it seems necessary to develop prevention strategies to improve students’ eating habits. However, to ensure that such strategies are successful, it is important that they fit the needs of the target population. By conducting qualitative interviews with students (n = 20), we aimed to get a deeper understanding of barriers to healthy eating. Students were asked about barriers to healthy eating and to suggest possible ideas that could improve their eating behavior in the future. Our findings revealed that students are especially affected by time-related barriers (e.g., a lack of time due to university commitment) and environmental barriers (e.g., a lack of cheap, tasty, and healthy meal options at the university canteen). Time-related barriers were also related to motivational barriers (e.g., being too lazy to cook after a busy day at university). In addition, knowledge/information-related barriers, social-support-related barriers, and transition-related barriers emerged from our interviews. The variety of barriers addressed and the different views on some of these, indicate that various strategies seem to be needed to improve the eating behavior among university students and to prevent them from gaining weight and developing non-communicable diseases in the future

Comparative physical activity as a global question to assess physical activity among university students

Background!#!To assess physical activity (PA), a comparative measurement - evaluating one's own PA compared to others - may be an appropriate method. In previous studies, the use of comparative measurements led to an effect known as unrealistic comparative optimism (UCO) - people being unrealistically optimistic about their behavior. Our aim was to use this comparative measurement in university students to quantify the prevalence of UCO at the group level and to draw conclusions on its validity.!##!Methods!#!We used data from the Nutrition and Physical Activity in Adolescence Study (NuPhA), a cross-sectional online survey that included only self-reports (n = 689). To assess PA among students, they were asked to rate their PA level compared to that of their same-aged fellow students. In addition, we used the Godin-Shephard leisure-time PA questionnaire and other questions on PA for comparisons. We used bivariate and cluster-based analyses to identify potential UCO.!##!Results!#!We found that UCO at the group level led to an uneven distribution, with a higher proportion of students who rated themselves as being more physically active than average. However, the individual assessment of PA with a single and simple comparative question seemed to be valid.!##!Discussion!#!A global single comparative question seems useful for studies where PA is measured as a covariate in university students

Loneliness at Universities: Determinants of Emotional and Social Loneliness among Students

The transition from school to university is associated with social, structural, and behavioral changes. These changes may be related to feelings of loneliness, which are in turn related to morbidity. The authors’ aim was to quantify loneliness among students and to identify its determinants and its relation to transition-related variables (e.g., changes in weight, diet, or physical activity since the transition from high school to university). Coming from across Germany, 689 students participated in the Nutrition and Physical Activity in Adolescence (NuPhA) survey (16–29 years; 69.5% female). Associations of loneliness with the above-mentioned aspects were analyzed using descriptive statistics and linear regressions. Altogether, 32.4% felt moderately lonely and 3.2%, severely lonely. Emotional loneliness was more common than social loneliness (severe loneliness: 7.7% vs. 3.2%). Both were positively associated with feelings of depression and anxiety. Being married or in a committed relationship seemed to be protective factors for emotional loneliness. Physical inactivity, an immigrant background, and studying social sciences were related to higher social loneliness. Transition-related variables produced mixed results. In conclusion, this study’s findings indicated that loneliness seemed to be prevalent in university students. The authors identified important starting points for interventions to prevent loneliness. Such interventions may help reduce the disease burden in the students’ future professional life

Students’ Motivation for Sport Activity and Participation in University Sports: A Mixed-Methods Study

Background. Physical activity among students is essential for complimenting sedentary behavior and for individuals’ future health. This study investigates reasons for sport engagement among students and addresses the utilization of university sports programs (USP) by employing a mixed-methods approach. Methods. The NuPhA-Study consists of a quantitative online survey (n=689) followed by qualitative interviews (n=20). In the survey, we assessed reasons for sport activity using a 24-item battery and USP utilization. Quantitative results were further explored using qualitative data to check for completeness of the predefined items (content validity) and to identify opportunities to improve participating in USP. Results. A factor analysis grouped the 24 items into five factors (life balance/fitness/body image/contact with others/fun). Our qualitative study explained these in more detail and revealed missing aspects. 47.6% of students participated in USP. Potential improvements for USP include program maintenance during the semester break and temporal harmonization with the classes. Discussion. The qualitative component identified additional reasons for sport activity that were not addressed by the item battery, which provides critical implications for developing item batteries for future research. Our results may help to generate a more target-group-oriented approach to increase physical activity among students, which will reduce sedentary behavior and future disease burden