Association of symptoms of attention-deficit/hyperactivity disorder with physical activity, media time, and food intake in children and adolescents.

INTRODUCTION: The aim of the study was to assess the association between attention deficit/hyperactivity disorder (ADHD) symptoms and potentially obesogenic behaviors. METHODS: Data of 11,676 German children and adolescents (6-17 years) were analyzed. Television/video exposure, physical activity, food frequency and portion size were assessed using questionnaires. A dietary quality index, energy density and volumes of consumed food, and total energy intake were calculated. The parent-rated hyperactivity/inattention subscale of the Strengths and Difficulties Questionnaire (SDQ-HI) was used as a continuous measure of ADHD symptoms. Associations were analyzed with general linear models adjusting for sex, age, socioeconomic status, migrant status, parental BMI, and parental smoking. RESULTS: SDQ-HI scores correlated positively with physical activity, average energy density of food, volume of beverages, total energy intake, and television exposure and negatively with the nutritional quality score (HuSKY) even after adjustment for parental variables (BMI, smoking, socioeconomic status, migrant status), age, sex, as well as the other SDQ subscales. The adjusted association of the SDQ-HI scores with the nutritional quality score was stronger in girls and the associations with food volume, food energy, and total energy intake was significant only in girls. CONCLUSIONS: Poor nutritional quality, high energy intake and television exposure appear to be independently associated with ADHD symptoms. The relationship between food energy intake and ADHD symptoms was especially pronounced in girls and this may help to explain the reported association of ADHD symptoms with overweight in adolescent girls

Associations of parental variables (BMI, smoking, SES, migrant status) with health behaviors adjusted for SDQ-HI, age, and sex.

<p>All parental variables were entered together. Partial eta² values for significant independent associations are listed (with negative associations in italic style).</p>§<p>N is calculated after weighting and therefore exceeds the number of participants.</p>*<p>P<0.05; **p<0.01; ***p<0.001.</p>$<p>only available n 11–16 years old participants.</p

Description of the health behaviors.

§<p>N is calculated after weighting and therefore exceeds the number of participants.</p>$<p>only available n 11–16 years old participants.</p><p>P25 = 25^th percentile; P75 = 75^th percentile.</p

Associations of SDQ-HI scores with health behaviors adjusted for age and sex only.

§<p>N is calculated after weighting and therefore exceeds the number of participants.</p>$<p>only available n 11–16 years old participants.</p

Associations of SDQ-HI scores with health behaviors adjusted for the potential parental confounders (migrant status, parental BMI, SES, and smoking), age, sex, as well as the other SDQ-subscales.

§<p>N is calculated after weighting and therefore exceeds the number of participants.</p>$<p>only available in 11–16 years old participants only.</p

Reduction of Portion Size and Eating Rate Is Associated with BMI-SDS Reduction in Overweight and Obese Children and Adolescents: Results on Eating and Nutrition Behaviour from the Observational KgAS Study

Objective: Treatment of paediatric obesity focuses on changes of nutrition and eating behaviour and physical activity. The evaluation of the patient education programme by KgAS was utilised to analyse the association of changes of portion size, eating rate and dietary habits with BMI-SDS reductions. Methods: Patients (n = 297) were examined at the beginning and at the end of treatment and after 1-year follow-up at different out-patient centres. Their parents completed questionnaires including estimation of children's portion size, eating rate and frequency of food intake. Associations of 1- and 2-year changes in BMI-SDS and behaviour were calculated for patients with complete data in BMI-SDS, portion size, eating rate, frequency of green, yellow and red food intake (n = 131) by multiple linear regression models. Results: Significant changes were found in the desired direction for BMI-SDS, portion size, eating rate and the intake of unfavourable red food items both after 1 and 2 years as well as for the consumption of favourable green food items after 1 year. Significant positive associations with BMI-SDS reduction after 1 and 2 years were detected for portion size (Cohen's f2 0.13 and 0.09) and eating rate (Cohen's f2 0.20 and 0.10), respectively. Conclusion: Reduced portion sizes and eating rates are associated with BMI-SDS reduction after 1 and 2 years. These findings suggest to focus on appropriate portion sizes and reduced eating rates in patient education programmes

Beobachtungsstudie der BZgA zur Adipositastherapie bei Kindern und Jugendlichen in Deutschland: Anthropometrie, Komorbidität und Sozialstatus

Hintergrund: Die Prävalenz von Übergewicht und Adipositas im Kindes- und Jugendalter hat über die letzten Jahre zugenommen. Zahlreiche Therapieangebote stehen betroffenen Familien zur Verfügung, jedoch sind diese heterogen strukturiert und bisher nicht ausreichend evaluiert. Patienten: Für die Auswertung der Erstuntersuchung vor Therapiebeginn wurden Daten von 1?916 Patienten im Alter von 8–16,9 Jahren analysiert. Patienten, die aktuell in der Regelversorgung behandelt werden, werden nach soziodemografischen, psychosozialen und medizinischen Gesichtspunkten beschrieben. Außerdem wird die Prozeßqualität der Behandlung bezüglich Komorbiditätsdiagnostik analysiert. Ergebnisse: Die Patienten waren bei Therapiebeginn durchschnittlich 12,6 Jahre alt. 43% waren männlich. 1?045 Patienten wurden ambulant behandelt, 871 stationär. Der durchschnittliche BMI-SDS betrug +2,43 (14% übergewichtig, 48% adipös, 37% extrem adipös). Bei 51% der Patienten konnten bereits Begleiterkrankungen diagnostiziert werden. Der Übergewichtsstatus der Eltern korrelierte mit dem kindlichen BMI. Der Sozialstatus der Studienteilnehmer lag unter dem Bundesdurchschnitt. Schlussfolgerung: Die von der BZgA (Bundeszentrale für gesundheitliche Aufklärung) initiierte multizentrische Beobachtungsstudie hat erstmals auf nationaler Ebene mit einem einheitlichen Instrumentarium für somatische und psychosoziale Variablen Patienten, die an verschiedenen Therapieprogrammen teilnehmen, miteinander verglichen. Kurz- und Langzeiteffekte der unterschiedlichen Therapieformen auf BMI-SDS, Ernährungs- und Bewegungsverhalten, Lebensqualität und Komorbidität werden im Verlauf der bis 2010 angelegten Beobachtungsstudie untersucht