Foreign-born health integration during the transition to adulthood: The case of weight

Nativity differences in youths’ health in the United States are striking—the children of foreign-born parents often have healthier outcomes than those of native-born parents. However, very little is known about how immigrant-native differences evolve within the same individuals over time, or about life cycle aspects of the health-related integration of youth with migration backgrounds. Using data from the National Longitudinal Study of Adolescent Health, I examine nativity differences in trajectories of weight gain during adolescence and early adulthood, as well as the degree to which temporal patterns are stratified by race/ethnicity and socioeconomic status. I examine whether nativity differences converge, diverge or remain stable over time, and whether patterns are socially stratified within and across nativity groups. I find that first-generation adolescents begin at a lower weight than their third generation peers and gain weight at a significantly slower pace, resulting in meaningful differences by early adulthood. More complex examination of the relationship between nativity and weight gain reveals additional differences by ethnicity: the foreign-born advantage over time does not extend as strongly to Hispanic adolescents. The findings demonstrate how the health-related integration of foreign-born youth is tied to race/ethnicity and socioeconomic circumstances, and suggest the need to examine the ways in which social circumstances and health change together.     

Childhood poverty dynamics and adulthood overweight/obesity: Unpacking the black box of childhood

Integrating several life course models, this study examines how childhood poverty dynamics shape the risk of adulthood overweight/obesity. Growth mixture models of yearly poverty data from age 0–16 from the U.S. Panel Study of Income Dynamics identify four childhood poverty trajectories: chronic poverty, early childhood poverty, downward mobility, and poverty-free. Chronic poverty and early childhood poverty groups have higher risk of adulthood overweight/obesity than the poverty-free group. Overweight/obesity risk is not significantly different between the chronic poverty group and the early childhood poverty group, suggesting that the effects of early childhood exposure persist despite subsequent upward mobility. Downward mobility in the absence of early childhood poverty does not significantly increase adulthood obesity risk, providing further evidence that early childhood is a critical period for developing risk of overweight and obesity. These findings shed new light on the timing model, social mobility model, cumulative model, and cumulative inequality theory.     

给付负担过重规则——情势变更原则具体化的一个例证

履行行为持续时间较长的合同面临情势变更的风险。当履约环境发生无法预见之重大变化,致使当事人之间的利益平衡遭受严重破坏时,立法上须建立相应的调整机制,即应当确立情势变更原则。但是,情势变更原则的抽象性使得该原则存在难以操作的弊端,所以必须把它予以具体化。出于对司法变更权加以约束的考虑,情势变更原则必须在规则的层面上实现具体化,因而,给付负担过重规则应为该原则具体化的一条有效途径。     

Barriers to and facilitators for addressing overweight and obesity before conception: A qualitative study

BackgroundObesity is a significant global health issue, especially for reproductive-aged women. Women who enter pregnancy overweight or obese are at increased risk of a range of adverse reproductive, maternal, and child health outcomes. The preconception period has been recognised as a critical time to intervene to improve health outcomes for women and their children. Despite this recognition, adequate information is significantly lacking in relation to women’s health experiences, behaviours, and information preferences to inform the development of high-quality preconception intervention strategies.AimThis study aimed to examine women’s perspectives of barriers, enablers, and strategies for addressing overweight and obesity before conception.MethodUsing a qualitative research design, twelve multiparous women, aged between 32 and 43 years, who considered themselves to be overweight or obese were interviewed. Data were analysed using thematic analysis.FindingsThree themes were identified in relation to barriers: lack of information and knowledge, time constraints, and affordability. The following four themes emerged with respect to enablers and strategies: knowledge provision, accountability and motivation, regular contact, and habit formation.ConclusionKey factors to incorporate in women-centred interventions for preconception weight loss include multi-faceted knowledge provision and practical affordable methods for supporting healthy behaviours. Interventions should integrate techniques for ensuring regular contact with support networks, to enhance accountability, motivation, and facilitate habit formation. Further research is now being conducted by our team to co-design interventions and strategies informed by these findings.     

Effect of body image on gestational weight gain in overweight and obese women

Problem or backgroundThere is little information available describing how women who are overweight or obese in pregnancy perceive their bodies, and in particular the effect of body image dissatisfaction on gestational weight gain.QuestionTo describe how women who are overweight or obese in pregnancy perceive their body, and the effect of body image on gestational weight gain.MethodsThis prospective nested cohort study evaluated self estimation of body weight, preferred body shape, dieting behavior, satisfaction with body weight and shape, and gestational weight gain in pregnant women who were overweight or obese, through self-completed questionnaire in early pregnancy in South Australia from October 2010 to February 2012.FindingsOf the 442 women who completed the questionnaire, 25.8% correctly identified their BMI, with 70.1% under-estimating and 4.1% over-estimating their BMI. Women who were obese were significantly less likely to correctly identify their BMI, as were younger women. Women who incorrectly identified their BMI were significantly more likely to have higher gestational weight gain (P < 0.001). Approximately 45% of women indicated dissatisfaction with their weight or body shape, with this being more common in women of higher parity and higher BMI. Dissatisfaction was significantly related to gestational weight gain.ConclusionWomen who report increasing dissatisfaction with their body size and shape are more likely to gain excessive weight during pregnancy. Further research should explore insights about maternal body image and diet related behaviors.     

Australian Social Work Reviewers 2010

Abstract

Children placed in out-of-home care are a particularly disadvantaged group in society, who have often been exposed to trauma and socioeconomic disadvantage. As a result, they experience poorer health outcomes than children in the general population, especially mental health outcomes. One health outcome that has yet to be researched thoroughly is overweight and obesity of children placed in out-of-home care. Hence, the overall goal of this paper was to review the extant literature over the last decade on weight-related issues for children in out-of-home care, with particular emphasis on overweight and obesity. The findings of the review revealed that there is a lack of rigorous Australian research in relation to prevalence rates of overweight and obesity in children in out-of-home care; there is a lack of strategies or interventions designed specifically to combat overweight and obesity in children in out-of-home care; and one of the major limitations of Australian research to date is the use of self-report measures to assess the weight status of children in out-of-home care. It was concluded that prevention and intervention strategies are needed that target children as they enter out-of-home care.     

Design of an educational strategy based on Intervention Mapping for nutritional health promotion in Child Care Centers

Early childhood is a critical period for instilling healthy habits to prevent overweight and obesity. This paper describes the development of an educational intervention for the promotion of healthy eating and physical activity among two-to-four-year-old children in public child care centers (CCCs) in Mexico City. Following the Intervention Mapping (IM) protocol, we developed the Bright Futures multidisciplinary intervention. First, a formative research process to identify the personal and environmental determinants of childhood overweight and obesity, behavioral outcomes and performance objectives was conducted. Then, a matrix of change objectives by intersecting the performance objectives with the determinants was integrated. Bright Futures lasted six months and included 24 weekly sessions, each composed of five phases: warm-up, theory, active movements, relaxation, and hydration. Ad hoc interactive teaching materials focused on recreational activities, and formulated plans for the adoption, implementation and process/impact evaluation of the intervention was developed. IM successfully guided the design of a theory-driven and evidence-based intervention for children in CCCs within a socio-ecological and participatory planning framework. This is one of the first studies in Mexico to use IM in the context of CCCs.     

A Demographic Analysis of the Rise in the Prevalence of the US Population Overweight and/or Obese

Using data from the National Health Interview Survey for years spanning 1976 and 2001, this paper presents an age–period–cohort analysis of weight gain throughout the life cycle. We find that while all ages experienced an increase in the prevalence of those overweight and/or obese, the prevalence among young adults has grown at a faster rate than that of older age groups. The increases in body mass index are primarily due to period effects, not cohort or age effects. From the ordered logistical regression analyses, we find that the protective influence of factors such as education, income, and age on an individual’s body mass index have decreased over time. The analyses suggest that the increase in the prevalence of those overweight or obese is a phenomenon experienced by all demographic groups in the US, albeit to differing degrees.

Breastfeeding,overweight status,and inflammation

Research documents a host of health benefits of breastfeeding for infants and children, including long-term health conditions arising from inflammation. Here, we provide new evidence about this association, focusing on the link between breastfeeding in infancy and inflammation in early adulthood. Our study is based on the National Longitudinal Study of Adolescent to Adult Health (Add Health) which allows us investigate a potentially important mediating pathway – overweight status from early adolescence into young adulthood. Results from pathway analyses in a structural equation modeling framework indicate that, in addition to a direct pathway linking breastfeeding and inflammation, an indirect pathway through overweight status across adolescence into young adulthood partially explains the association between breastfeeding and inflammation. Overweight status, moreover, links breastfeeding to inflammation not only through proximal timing of overweight status, but also through an indirect cascading process of overweight status over the life course that is evident in adolescence. Overall, this study highlights the importance of considering breastfeeding, overweight status and inflammation as dynamic life course processes that contribute to development of health inequalities.     

Overweight Korean Adolescents and Academic Achievement

The relationship between academic achievement and being overweight among South Korean high school students was examined. Data used in the regression were from the Korean Education and Employment Panel Survey. The theoretical framework that poor school performance increases the risk of adolescents’ being overweight, which, in turn, causes poor school performance, was supported. With no other direct or indirect association between weight and achievement, an overweight high school student’s poor performance in school was assumed to be a function of the psychosocial well-being variables and self-concern about weight. A simultaneous-equation regression model that endogenized the likelihood an individual is classified as overweight (a binary variable) and the performance of that individual on the College Scholastic Ability Test (CSAT) incorporates the unobserved psychosocial well-being correlated with both school grades and being overweight.