Association of Breakfast Intake with Obesity, Dietary and Physical Activity Behavior Among Urban School-Aged Adolescents in Delhi, India: Results of a Cross-Sectional Study

In developed countries, regular breakfast consumption is inversely associated with excess weight and directly associated with better dietary and improved physical activity behaviors. Our objective was to describe the frequency of breakfast consumption among school-going adolescents in Delhi and evaluate its association with overweight and obesity as well as other dietary, physical activity, and sedentary behaviors. Methods: Design: Cross-sectional study. Setting: Eight schools (Private and Government) of Delhi in the year 2006. Participants: 1814 students from 8th and 10th grades; response rate was 87.2%; 55% were 8th graders, 60% were boys and 52% attended Private schools. Main outcome measures: Body mass index, self-reported breakfast consumption, diet and physical activity related behaviors, and psychosocial factors. Data analysis: Mixed effects regression models were employed, adjusting for age, gender, grade level and school type (SES). Results: Significantly more Government school (lower SES) students consumed breakfast daily as compared to Private school (higher SES) students (73.8% vs. 66.3%; p<0.01). More 8th graders consumed breakfast daily vs. 10th graders (72.3% vs. 67.0%; p<0.05). A dose-response relationship was observed such that overall prevalence of overweight and obesity among adolescents who consumed breakfast daily (14.6%) was significantly lower vs. those who only sometimes (15.2%) or never (22.9%) consumed breakfast (p<0.05 for trend). This relationship was statistically significant for boys (15.4 % vs. 16.5% vs. 26.0; p<0.05 for trend) but not for girls. Intake of dairy products, fruits and vegetables was 5.5 (95% CI 2.4-12.5), 1.7 (95% CI 1.1-2.5) and 2.2 (95% CI 1.3-3.5) times higher among those who consumed breakfast daily vs. those who never consumed breakfast. Breakfast consumption was associated with greater physical activity vs. those who never consumed breakfast. Positive values and beliefs about healthy eating; body image satisfaction; and positive peer and parental influence were positively associated with daily breakfast consumption, while depression was negatively associated. Conclusion: Daily breakfast consumption is associated with less overweight and obesity and with healthier dietary-and physical activity-related behaviors among urban Indian students. Although prospective studies should confirm the present results, intervention programs to prevent or treat childhood obesity in India should consider emphasizing regular breakfast consumption.Obesity Prevention Center, University of MinnesotaPRIME program of the University of Texas, School of Public Health (Stigler, PI)Center for Health Promotion and Disease Prevention Research in Underserved Population

Peer-Led, School-Based Nutrition Education for Young Adolescents: Feasibility and Process Evaluation of the TEENS Study

Peer education has become a popular strategy for health promotion interventions with adolescents, but it has not been used widely in school‐based nutrition education. This paper describes and reports on the feasibility of the peer leader component of school‐based nutrition intervention for young adolescents designed to increase fruit and vegetable intakes and lower-fat foods. About 1,000 seventh‐grade students in eight schools received the nutrition intervention. Of these, 272 were trained as peer leaders to assist the teacher in implementing the activities. Results from a multicomponent process evaluation based on peer leader and classroom student feedback, direct classroom observation, and teacher ratings and interviews are presented. Results show that peer‐led nutrition education approaches in schools are feasible and have high acceptability among peer leaders, classroom students, and teachers

Developing a School Functioning Index for Middle Schools

Despite widespread recognition of schools\u27 role in the healthy development of youth, surprisingly little research has examined the relationships between schools\u27 overall functioning and the health‐related behavior of students. School functioning could become an important predictor of students\u27 health‐related behavior and may be amenable to intervention. This paper describes the development and testing of the School Functioning Index (SFI) as a first step in investigating this question. The index was developed for use with middle schools and conceived as a predictor of students\u27 violent behavior, with the potential for extending research applications to additional health and social behaviors. Using social cognitive theory, social ecological theory, and social disorganization theory as guides, three domains were identified to operationalize school functioning and identify candidate SFI items: 1) resources available to the school and students; 2) stability of the school population; and 3) the schools\u27 performance as a socializing agent for students. Data for candidate SFI items were collected from public archives and directly from 16 middle schools participating in a school‐based dietary intervention study. Data collection from schools, particularly concerning student aggressive behavior and disciplinary actions, presented challenges. The final SFI comprised nine items and demonstrated good internal consistency and variability. The SFI was modestly correlated in expected directions with violence and other health behaviors. This work supports the feasibility of combining multiple school‐level indicators to create a measure of overall school functioning. Further investigation of validity and more acceptable data collection methods are warranted

Predictors of Violent Behavior in an Early Adolescent Cohort: Similarities and Differences Across Genders

The authors assessed a cohort of 2,335 students from the Minneapolis, Minnesota, area to identify predictors of violent behavior and to determine whether the predictors varied by gender. The sample was 76% White; boys and girls were equally represented. The majority lived with two parents. A measure of violent behavior collected at the end of the eighth-grade year (2000) was entered into Poisson regression against baseline data collected at the beginning of the seventh-grade year (1998). Predictors of violent behavior influencing both boys and girls included depressive symptoms, perceived invulnerability to negative future events, paternal nonauthoritative behavior, and drinking alcohol. Additional predictors of violent behavior specific to girls included both risk and protective factors

Are Differences in Exposure to a Multicomponent School-Based Intervention Associated With Varying Dietary Outcomes in Adolescents?

Multicomponent interventions are recommended for health behavior change among adolescents. However, it is difficult to disentangle the effects of multiple intervention components. This article reports outcomes associated with varying levels of exposure to a school-based nutrition intervention, Teens Eating for Energy and Nutrition at School (TEENS). Four incremental exposureswere possible: (1) control group, (2) school environment interventions only, (3) classroom plus environment interventions, and (4) peer leaders plus classroom plus environment interventions. Patterns suggesting dose response were observed, with peer leaders reporting the largest increases in fruit, vegetable, and lower fat food consumption. Students exposed to classroom plus environment interventions also improved, whereas students exposed only to school environment interventions showed trends toward choosing lower fat foods and declining fruit intake and no change in vegetable intake. Control students’ choices remained stable. Future studies may investigate mechanisms for peer leaders’ changes, maximizing curriculum effectiveness, and improving environmental interventions

Host-selected mutations converging on a global regulator drive an adaptive leap towards symbiosis in bacteria

Host immune and physical barriers protect against pathogens but also impede the establishment of essential symbiotic partnerships. To reveal mechanisms by which beneficial organisms adapt to circumvent host defenses, we experimentally evolved ecologically distinct bioluminescent Vibrio fischeri by colonization and growth within the light organs of the squid Euprymna scolopes. Serial squid passaging of bacteria produced eight distinct mutations in the binK sensor kinase gene, which conferred an exceptional selective advantage that could be demonstrated through both empirical and theoretical analysis. Squid-adaptive binK alleles promoted colonization and immune evasion that were mediated by cell-associated matrices including symbiotic polysaccharide (Syp) and cellulose. binK variation also altered quorum sensing, raising the threshold for luminescence induction. Preexisting coordinated regulation of symbiosis traits by BinK presented an efficient solution where altered BinK function was the key to unlock multiple colonization barriers. These results identify a genetic basis for microbial adaptability and underscore the importance of hosts as selective agents that shape emergent symbiont populations

School functioning and violent behavior among young adolescents: a contextual analysis

This paper examines associations between overall school functioning and the frequency of violent behaviors among young adolescents (ages 10–14). The sample included 16 middle schools participating in an unrelated intervention study (on nutrition) in Minneapolis, Minnesota. A School Functioning Index developed to characterize schools’ overall stability, performance, and demographics was constructed using data from public archives and school administrator surveys. Data on violent behaviors and other variables were collected in student surveys in fall 1998 and spring 1999. We used multilevel modeling to assess the effect of school functioning on violent behavior after adjusting for known individual-level covariates of violent behaviors. We found an interaction between school functioning (group-level variable) and expectations for future education (individual-level variable). Among students who reported expectations of completing a college degree (71% of the sample), positive school functioning was negatively associated with violent behaviors. Among students that reported expectations of completing less than a college degree, no association was found between school functioning and violent behaviors. These results support earlier work suggesting that objectively measured school characteristics are associated with students’ violent behaviors even after accounting for individual-level factors and also identify a subgroup of students for whom school detachment may be an issue

Weight-related concerns and weight-control behaviors among overweight adolescents in Delhi, India: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Obesity is emerging as a public health problem among adolescents in India. The aim of this study was to describe specific weight-related concerns among school-going youth in Delhi, India and to assess the prevalence of weight control behaviors, including healthy and unhealthy ones. Differences by weight status, gender, grade level, and school-type (a proxy for SES in this setting) are considered.</p> <p>Methods</p> <p>This study is cross-sectional by design. A sample of eighth and tenth graders (n = 1818) enrolled in Private (middle-high SES) and Government (low SES) schools (n = 8) in Delhi, India participated. All students' height and weight were measured. Students participated in a survey of weight-related concerns and weight-control behaviors, as well. Mixed-effects regression models were used to test for differences in weight-related concerns and weight-control behaviors across key factors of interest (i.e., weight status, gender, grade level, and SES).</p> <p>Results</p> <p>The combined prevalence of obesity and overweight was 16.6%, overall. Controlling one's weight was important to overweight and non-overweight youth, alike (94.2% v. 84.8%, <it>p </it>< 0.001). Significantly more overweight or obese youth reported trying to control their weight last year, compared to those who were not overweight (68.1% v. 18.0%, <it>p </it>< 0.001). Healthy weight control behaviors were more common than unhealthy or extreme practices, although the latter were still prevalent. Half of the overweight or obese students misclassified their weight status, while about 1 in 10 non-overweight youth did the same. Body dissatisfaction was highest among overweight youth and girls.</p> <p>Conclusions</p> <p>Interventions to promote healthy weight control should be pertinent to and well-received by school-going youth in India. Healthy weight control practices need to be explicitly encouraged and unhealthy practices reduced. Future interventions should address issues specific to body image, too, as body dissatisfaction was not uncommon among youth.</p

To assess the influence of tobacco use by family members, peers and role models on tobacco use status of adolescents living in urban slums of Delhi, India: Results from a longitudinal study

Objective: To assess the longitudinal relationship between tobacco use by family members, peers and role models on tobacco use behavior of adolescents living in low socio-economic communities of Delhi, India. Methods: Project ACTIVITY (Advancing Cessation of Tobacco in Vulnerable Indian Tobacco Consuming Youth), a community-based cluster-randomized trial. Adolescents (n=1720) belonging to low socio-economic status from control communities of Project ACTIVITY, including resettlement colonies and adjacent Jhuggi-Jhopris (JJs), who were non-tobacco users at baseline and participated in all the three repeated surveys (2009, 2010, 2011). The main outcome measure in the study was current tobacco use at the endline. Tobacco use by family members, friends and role models was measured at baseline. Results: The influence of tobacco use by friends on the onset of youth tobacco use was significant (OR=2.68, 95% CI=1.27-5.64) and by brother was even stronger (OR=4.36, 95% CI=1.66-11.45). Both effects were consistent across gender, age group and were also stronger than the effects of tobacco use by father (OR=1.51, 95% CI=0.70-3.23). Conclusion: Thus, study highlights the need to engage siblings and peers in efforts to prevent tobacco use and promote tobacco cessation among adolescents in resourcepoor, slum communities in India