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Engaging Coalitions in Community-Based Childhood Obesity Prevention Interventions: A Mixed Methods Assessment.
Korn, AR, Hennessy, E, Tovar, A, Finn, C, Hammond, RA, Economos, CD
Childhood obesity (Print). 2018;(8):537-552
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Abstract
BACKGROUND Childhood obesity prevention interventions have engaged coalitions in study design, implementation, and/or evaluation to improve research outcomes; yet, no systematic reviews have been conducted on this topic. This mixed methods review aims to characterize the processes and dynamics of coalition engagement in community-based childhood obesity prevention interventions. METHODS Data Sources: Studies extracted from Ovid MEDLINE, PubMed, and Web of Science; complementary original survey and interview data among researchers of included studies. Eligible Studies: Multisetting community-based obesity prevention interventions in high-income countries targeting children 0-12 years with anthropometric, behavioral, or environmental/policy outcomes. The Community-Based Participatory Research (CBPR) Conceptual Model was used as an overarching framework. RESULTS Thirteen studies met inclusion criteria. Elements of CBPR were evident across all studies with community engagement in problem identification (n = 7), design/planning (n = 11), implementation (n = 12), evaluation (n = 4), dissemination (n = 2), and sustainability (n = 10) phases. Five studies reported favorable intervention effects on anthropometric (n = 4), behavioral (n = 1), and/or policy (n = 1) outcomes; descriptive associations suggested that these studies tended to engage community members in a greater number of research phases. Researchers involved in 7 of 13 included studies completed a survey and interview. Respondents recalled the importance of group facilitation, leadership, and shared understanding to multisector coalition work. Perceived coalition impacts included community capacity building and intervention sustainability. CONCLUSIONS This review contributes to a deeper understanding of intervention processes and dynamics within communities engaged in childhood obesity prevention. Future research should more rigorously assess and report on coalition involvement to assess the influence of coalitions on multiple outcomes, including child weight status.
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Increasing CO2 threatens human nutrition.
Myers, SS, Zanobetti, A, Kloog, I, Huybers, P, Leakey, AD, Bloom, AJ, Carlisle, E, Dietterich, LH, Fitzgerald, G, Hasegawa, T, et al
Nature. 2014;(7503):139-42
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Dietary deficiencies of zinc and iron are a substantial global public health problem. An estimated two billion people suffer these deficiencies, causing a loss of 63 million life-years annually. Most of these people depend on C3 grains and legumes as their primary dietary source of zinc and iron. Here we report that C3 grains and legumes have lower concentrations of zinc and iron when grown under field conditions at the elevated atmospheric CO2 concentration predicted for the middle of this century. C3 crops other than legumes also have lower concentrations of protein, whereas C4 crops seem to be less affected. Differences between cultivars of a single crop suggest that breeding for decreased sensitivity to atmospheric CO2 concentration could partly address these new challenges to global health.
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Systematic review and meta-analysis of school-based interventions to reduce body mass index.
Lavelle, HV, Mackay, DF, Pell, JP
Journal of public health (Oxford, England). 2012;(3):360-9
Abstract
BACKGROUND Childhood obesity predisposes to adult obesity and increases the risk of many diseases. Schools provide a vehicle to deliver public health interventions to all children. METHODS Medline and Embase were used to undertake a systematic review of published studies of school-based interventions aimed at reducing the body mass index (BMI) of children ≤ 18 years. Preferred reporting items for systematic reviews and meta-analyses guidelines were followed, and eligible studies subjected to a random effects meta-analysis. RESULTS Between 1991 and 2010, 43 published studies provided 60 measurements of effect. The pooled effect was a 0.17 (95% CI: 0.08, 0.26, P < 0.001) reduction in BMI. Heterogeneity was high (I(2) = 93.4%) but there was no significant small study bias (Egger's test, P = 0.422) nor significant variation by length of follow-up. The intervention comprised physical activity only in 11 (26%) studies, education only in three (7%), and combinations of these and improved nutrition in the remaining 29 (67%). On stratified analysis, physical activity used in isolation (-0.13, 95% CI: -0.22, -0.04, P = 0.001) or combined with improved nutrition (-0.17, 95% CI: -0.29, -0.06, P < 0.001) was associated with significant improvements in BMI. Interventions targeted at overweight/obese children reduced their BMI by 0.35 (95% CI: 0.12, 0.58, P = 0.003). Those delivered to all children reduced it by 0.16 (95% CI: 0.06, 0.25, P = 0.002). CONCLUSIONS There is growing evidence that school-based interventions that contain a physical activity component may be effective in helping to reduce BMI in children.
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Evolution and variability in fitness test performance of Asian children and adolescents.
Macfarlane, DJ, Tomkinson, GR
Medicine and sport science. 2007;:143-167
Abstract
Although Asia represents well over half of the world's population, the comparative lack of resources and infrastructure in many of these countries is likely to have contributed to only sporadic data being available to examine secular changes and geographical variability in the fitness test performances of Asian children and adolescents. Given the concerns that currently exist in the development of childhood obesity including, in many Asian countries, knowledge on the secular changes in nutrition and physical fitness and activity would seem germane to developing proactive public health strategies. The aim of this study therefore was to summarize existing literature reporting explicitly on secular changes in the fitness test performance of Asian children and adolescents, and where possible, comment on the geographical variability of such performances. Using a meta-analytical strategy, this study summarizes the secular changes in power, speed and cardiovascular endurance test performance of over 23.5 million 6- to 19-year-olds from seven Asian countries, tested between 1917 and 2003. In addition, it summarizes the geographic variability in fitness test performance of Asian children and adolescents within, and outside of, Asia. There has been very little change in the power and speed test performances of Asian children and adolescents in recent decades, yet alarmingly, there have been consistent declines in cardiovascular endurance fitness performance across all studied Asian nations over the past 10-15 years. Given the association between cardiovascular endurance fitness and numerous degenerative conditions (e.g. diabetes, obesity and metabolic syndrome), recent declines in cardiovascular endurance fitness performance of Asian children and adolescents should be an issue of major concern for public health authorities throughout Asia.