Diet, Physical Activity, and Sedentary Behaviors as Risk Factors for Childhood Obesity: An Urban and Rural Comparison

Liu, Jihong; Jones, Sonya J.; Sun, Han; Probst, Janice C.; Merchant, Anwar T.; Cavicchia, Philip

doi:10.1089/chi.2011.0090

Cited by 129 publications

(112 citation statements)

References 36 publications

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“…Obesity rates tend to be highest among children in families who function at or below the poverty threshold (2). While studies have found higher than average prevalence of obesity in urban youth (3), comparative studies indicate that children residing in rural areas also run higher than average risk of obesity (4,5) with children in rural areas having up to 30% greater chance of being overweight or obese than children in non-rural areas even after adjustments for sociodemographic, health, diet and exercise (6).…”

Section: Introductionmentioning

confidence: 94%

An Exploration of the Relationship of Body Mass Index with Motor Performance Measures and Quality of Life in Children Living in an Urban Setting

Fidler¹,

McLaughlin²,

Bubela³

et al. 2016

J Child Obes

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Section: Introductionmentioning

confidence: 94%

An Exploration of the Relationship of Body Mass Index with Motor Performance Measures and Quality of Life in Children Living in an Urban Setting

Fidler¹,

McLaughlin²,

Bubela³

et al. 2016

J Child Obes

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“…These studies have revealed mixed findings by age. For example, data from a nationally representative study showed that older rural children (12-19 years) had 30% higher odds of being overweight or obese compared to urban children, although no significant differences were observed in younger children (2-11 years) 10 . A recent meta-analysis using data of US children aged 2-19 years found that rural children compared to urban children are 26% more likely to be obese (odds ratio (OR)=1.26; 95% confidence interval (CI)=1.21-1.32)…”

mentioning

confidence: 99%

Continued development of the Rural Active Living Perceived Environmental Support Scale (RALPESS): preliminary evidence for validity among American Indians

Lilly

Umer

Cottrell

et al. 2019

Rural Remote Health

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Introduction: The prevalence of childhood cardiovascular disease (CVD) risk factors often increases in more rural geographic regions in the USA. However, research on the topic often has conflicting results. Researchers note differences in definitions of rurality and other factors that would lead to differences in inference, including appropriate use of statistical clustering analysis, representative data, and inclusion of individual-level covariates. The present study's objective was to examine CVD risk factors during childhood by geographic distribution in the US Appalachian region as a first step towards understanding the health disparities in this area. Methods: Rurality and CVD risk factors (including blood pressure, body-mass index (BMI), and cholesterol) were examined in a large, representative sample of fifth-grade students (N=73 014) from an Appalachian state in the USA. A six-category Rural-Urban Continuum Codes classification system was used to define rurality regions. Mixed modeling analysis was used to appropriately cluster individuals within 725 unique zip codes in each of these six regions, and allowed for including several individual-level socioeconomic factors as covariates. Results: Rural areas had better outcomes for certain CVD risk factors (lowest low-density lipoprotein cholesterol (LDL-C), and blood pressure (BP) and highest high-density lipoprotein cholesterol (HDL-C)) whereas mid-sized metro and town areas presented with the worst CVD risk factors (highest BMI% above ideal, mean diastolic BP, LDL-C, total cholesterol, triglyceride levels and lowest HDL-C) outcomes in children and adolescence in this Appalachian state. Conclusions: Counter to the study hypothesis, mid-sized metro areas presented with the worst CVD risk factors outcomes in children and adolescence in the Appalachian state. This data contradicts previous literature suggesting a straightforward link between rurality and cardiovascular risk factors. Future research should include a longitudinal design and explore some of the mechanisms between cardiovascular risk factors and rurality. . Data from National Health and Nutrition Examination Survey (NHANES) shows that, in the USA, 14% of adolescents had elevated BP, 22% had borderline-to-high or high low-density lipoprotein cholesterol (LDL-C), 6% had low high-density lipoprotein cholesterol (HDL-C) (NHANES: 1999(NHANES: -2008 4 and 32% children aged 2-19 years were either overweight or obese (NHANES: 2009(NHANES: -2010 5. Pediatric obesity also increases the likelihood of development of other CVD risk factors during childhood and adolescence 2 . Moreover, research shows that childhood CVD risk factors such as obesity, high BP, and abnormal lipids also track over time into adulthood 6 . Several studies have examined CVD risk factor prevalence and its contributing factors by stratified analysis of various sociodemographic characteristics (such as age, gender, racial/ethnic background and income) 4,5,[7][8][9] ; a select few have examined these differences by urban and rural geog...

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“…Consistently, rural children are more likely to be overweight or obese compared to urban children after controlling the socio-demographic characteristics, health and obesity-related behavioral factors. This significant difference is found both in boys and girls (Liu et al, 2010).…”

Section: Rural Residency As a Health Indicatormentioning

confidence: 70%

“…S. Brown et al, 2007). Further, evidence indicates that children in rural areas are more likely to be overweight or obese, and participate in unhealthy behaviors (Liu, Bennett, Harun, & Probst, 2008;Liu et al, 2010). Childhood is a crucial time when healthy behaviors are learned and adopted, and early childhood intervention programs can make a significant difference to a child's life changes (Gray & Francis, 2007).…”

Section: Need For the Studymentioning

confidence: 99%

“…Although it would be tempting to assume that rural children might have more opportunities to participate in physical activity and eat healthy food due to the more outdoor spaces and more access to the fresh foods, this is not the case (Cherry, Huggins, more fat and tended to have more sugar in their diets than urban children (Cherry et al, 2007;Liu et al, 2010). Overweight or obese rural children are reported to watch TV for more than 3 hours a day and use a computer for non-school work more often than overweight or obese urban children.…”

Section: Rural Residency As a Health Indicatormentioning

confidence: 99%

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Preliminary assessment of a school-based healthy lifestyle program among rural children.

Ling

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Diet, Physical Activity, and Sedentary Behaviors as Risk Factors for Childhood Obesity: An Urban and Rural Comparison

Cited by 129 publications

References 36 publications

An Exploration of the Relationship of Body Mass Index with Motor Performance Measures and Quality of Life in Children Living in an Urban Setting

An Exploration of the Relationship of Body Mass Index with Motor Performance Measures and Quality of Life in Children Living in an Urban Setting

Continued development of the Rural Active Living Perceived Environmental Support Scale (RALPESS): preliminary evidence for validity among American Indians

Preliminary assessment of a school-based healthy lifestyle program among rural children.

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