Preventing childhood obesity in Asia: an overview of intervention programmes

Uijtdewilligen, Léonie; Waters, Clarice N.; Müller‐Riemenschneider, Falk; Lim, Yinghao

doi:10.1111/obr.12435

Cited by 26 publications

(24 citation statements)

References 43 publications

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“…Previous systematic reviews [59,60] have highlighted the importance of engaging and supporting parents in the promotion of children's healthy behaviours, however, health promotion efforts have tended to focus on school settings. A systematic review of existing intervention studies in Asia, reported that all but one study occurred in a schoolbased setting and all targeted children at school age or above [61]. In light of our findings and previous evidence [25] with regards to the impact of detrimental parental behaviours (e.g.…”

Section: Discussionsupporting

confidence: 67%

Socio-demographic and maternal predictors of adherence to 24-hour movement guidelines in Singaporean children

Chen

Bernard

Padmapriya

et al. 2019

Int J Behav Nutr Phys Act

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Purpose: Integrated 24-Hour Movement Guidelines provide specific recommendations on screen viewing (SV), moderate-to-vigorous physical activity (MVPA) and sleep to improve health of children and youth. However, few studies have examined whether these guidelines are met in young children, particularly in Asia. We evaluated adherence to integrated and individual guidelines and its predictors in 5.5-year-old Singaporean children. Methods: Growing Up in Singapore towards Healthy Outcomes (GUSTO) is a mother-offspring birth cohort study. At age 5.5 years, child SV was reported by parents. Movement behaviours (MBs) were measured continuously using wrist-worn accelerometers over 7 consecutive days and nights. For accelerometer data including ≥3 days with ≥16 h/day we estimated mean (±SD) daily MVPA, SV and nighttime sleep duration across the week. Adherence to integrated (Canadian/Australian) guidelines was defined as meeting all individual guidelines: ≥60 min of MVPA/day, ≤2 h of screen time/day, and 9-11 h of sleep/night. Socio-demographic and maternal predictors collected at pregnancy enrolment and at 26-28 weeks' gestation were examined by multivariable logistic regression. Results: Of 864 children followed up age 5.5 years, 547 (63.3%) had both valid ActiGraph and questionnaire data (51.7% boys and 58.3% Chinese ethnicity). Children averaged 101.9 (± 88.7) min/day SV, 67.3 (± 23.7) min/day MVPA and 480.6 (± 57.2) min/night sleep. Few children met integrated guidelines. Specifically, the proportions of children who met none, SV, MVPA, sleep and integrated guidelines were 11.2, 70.2, 59.6, 13.7 and 5.5%, respectively. Multivariable analysis showed that maternal activity and television (TV) viewing were associated with meeting integrated guidelines (insufficiently vs. highly active (OR [95% CI]): 0.11 [0.01, 0.95]; 2-3 vs. ≥ 3 h TV: 3.52 [1.02, 12.22]). Examining higher adherence to individual guidelines, Chinese ethnicity, younger maternal age and lower maternal TV and sleep time were associated with greater SV; male sex, Malay ethnicity, higher birth order and higher maternal activity level were associated with greater MVPA; and older maternal age was associated with adherence to sleep guideline.

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Section: Discussionsupporting

confidence: 67%

Socio-demographic and maternal predictors of adherence to 24-hour movement guidelines in Singaporean children

Chen

Bernard

Padmapriya

et al. 2019

Int J Behav Nutr Phys Act

View full text Add to dashboard Cite

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“…The increasing prevalence of childhood adiposity has become a major global health challenge, and actions to reduce the prevalence of obesity in children and adolescents are urgently needed (4, 63, 64). Investigating risk factors associated with childhood obesity can help us to develop effective prevention interventions (65).…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Exposure in Early Life Increases Risk of Childhood Obesity: A Systematic Review and Meta-Analysis

et al. 2017

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A number of studies have previously assessed the impact of antibiotic exposure in early life on the risk of childhood obesity, but no systematic assessment is currently available. A systematic review and meta-analysis was performed to comprehensively and quantitatively elucidate the risk of childhood obesity caused by antibiotic exposure in early life. Literature search was performed in PubMed, Embase, and Web of Science. Random-effect meta-analysis was used to pool the statistical estimates. Fifteen cohort studies involving 445,880 participants were finally included, and all those studies were performed in developed countries. Antibiotic exposure in early life significantly increased risk of childhood overweight [relative risk (RR) = 1.23, 95% confidence interval (CI) 1.13–1.35, P < 0.001] and childhood obesity (RR = 1.21, 95% CI 1.13–1.30, P < 0.001). Antibiotic exposure in early life also significantly increased the z-score of childhood body mass index (mean difference: 0.07, 95% CI 0.05–0.09, P < 0.00001). Importantly, there was an obvious dose–response relationship between antibiotic exposure in early life and childhood adiposity, with a 7% increment in the risk of overweight (RR = 1.07, 95% CI 1.01–1.15, P = 0.03) and a 6% increment in the risk of obesity (RR = 1.06, 95% CI 1.02–1.09, P < 0.001) for each additional course of antibiotic exposure. In conclusion, antibiotic exposure in early life significantly increases risk of childhood obesity. Moreover, current analyses are mainly taken from developed countries, and therefore the impact of antibiotic exposure on risk of childhood obesity in vulnerable populations or developing countries still needs to be evaluated in future studies.

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“…In addition, most of these studies were conducted in Europe or the USA, 9 and the findings may not be culturally appropriate to Asian populations. 10 Previous evidence from a large-scale birth cohort study in Singapore suggests that preschool-aged children in Singapore are less active and more sedentary when compared with Western countries. 11 Longer school hours and more emphasis on children's academic performance may partly explain these differences.…”

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confidence: 99%

Understanding physical activity and sedentary behaviour among preschool-aged children in Singapore: a mixed-methods approach

et al. 2020

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ObjectivesThis study investigated physical activity (PA) and sedentary behaviour (SB) among preschool-aged children in Singapore and potential correlates at multiple levels of the socioecological model from in-school and out-of-school settings.DesignA cross-sectional study using a mixed-methods approach.ParticipantsParent–child dyads from six preschools in Singapore.MethodsPA and SB of children (n=72) were quantified using wrist-worn accelerometers for seven consecutive days. Three focus group discussions (FGDs) among 12 teachers explored diverse influences on children’s activities, and System for Observing Play and Leisure Activity in Youth (SOPLAY) assessed PA environment and children’s activity levels at preschools. Seventy-three parents completed questionnaires on home and neighbourhood factors influencing children’s PA and SB. Descriptive analyses of quantitative data and thematic analysis of FGDs were performed.ResultsBased on accelerometry, children (4.4±1.1 years) spent a median of 7.8 (IQR 6.4–9.0) hours/day in SB, and 0.5 (0.3–0.8) hours/day in moderate-to-vigorous physical activity (MVPA). MVPA was similar throughout the week, and SB was slightly higher on non-school days. In preschools, SOPLAY showed more children engaging in MVPA outdoors (34.0%) than indoors (7.7%), and absence of portable active play equipment. FGDs revealed issues that could restrict active time at preschool, including academic requirements of the central curriculum and its local implementation. The teachers had varying knowledge about PA guidelines and perceived that the children were sufficiently active. In out-of-school settings, parents reported that their children rarely used outdoor facilities for active play and spent little time in active travel. Few children (23.5%) participated in extracurricular sports, but most (94.5%) reported watching screens for 1.5 (0.5–3.0) hours/day.ConclusionMVPA was low and SB was high in preschool-aged children in an urban Asian setting. We identified diverse in-school and out-of-school correlates of PA and SB that should be taken into account in health promotion strategies.

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Preventing childhood obesity in Asia: an overview of intervention programmes

Cited by 26 publications

References 43 publications

Socio-demographic and maternal predictors of adherence to 24-hour movement guidelines in Singaporean children

Socio-demographic and maternal predictors of adherence to 24-hour movement guidelines in Singaporean children

Antibiotic Exposure in Early Life Increases Risk of Childhood Obesity: A Systematic Review and Meta-Analysis

Understanding physical activity and sedentary behaviour among preschool-aged children in Singapore: a mixed-methods approach

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