In nutritional research, the sensations of appetite have mostly been studied as a physiological phenomenon. However, in order to understand the significance of appetite for everyday eating habits, it is pertinent to include the social dimension. In a qualitative interview study, using qualitative semi-structured in-depth interviews, we investigated how appetite was experienced and handled in the context of everyday life among 20 men and women. This report examines how qualitative dimensions of appetite are experienced and conceptualised in everyday life. Achieving what was described as proper satiety was found to be of decisive importance for daily eating habits. The experience of being full up, the duration of satiety and the sensuous pleasure of eating were all found to be central dimensions of proper satiety, the definition of which varied according to different social contexts. Whether one ate one's fill in the company of others, alone, at work or in one's spare time turned out to be of decisive importance. A more elaborate understanding of the social dimensions of appetite may help to improve endeavours to prevent overweight and obesity.
Active Smarter Kids (ASK): Rationale and design of a cluster-randomized controlled trial investigating the effects of daily physical activity on children's academic performance and risk factors for non-communicable diseases.
Evidence is emerging from school-based studies that physical activity might favorably affect children's academic performance. However, there is a need for high-quality studies to support this. Therefore, the main objective of the Active Smarter Kids (ASK) study is to investigate the effect of daily physical activity on children's academic performance. Because of the complexity of the relation between physical activity and academic performance it is important to identify mediating and moderating variables such as cognitive function, fitness, adiposity, motor skills and quality of life (QoL). Further, there are global concerns regarding the high prevalence of lifestyle-related non-communicable diseases (NCDs). The best means to address this challenge could be through primary prevention. Physical activity is known to play a key role in preventing a host of NCDs. Therefore, we investigated as a secondary objective the effect of the intervention on risk factors related to NCDs. The purpose of this paper is to describe the design of the ASK study, the ASK intervention as well as the scope and details of the methods we adopted to evaluate the effect of the ASK intervention on 5 (th) grade children.
The ASK study is a cluster randomized controlled trial that includes 1145 fifth graders (aged 10 years) from 57 schools (28 intervention schools; 29 control schools) in Sogn and Fjordane County, Norway. This represents 95.3 % of total possible recruitment. Children in all 57 participating schools took part in a curriculum-prescribed physical activity intervention (90 min/week of physical education (PE) and 45 min/week physical activity, in total; 135 min/week). In addition, children from intervention schools also participated in the ASK intervention model (165 min/week), i.e. a total of 300 min/week of physical activity/PE. The ASK study was implemented over 7 months, from November 2014 to June 2015. We assessed academic performance in reading, numeracy and English using Norwegian National tests delivered by The Norwegian Directorate for Education and Training. We assessed physical activity objectively at baseline, midpoint and at the end of the intervention. All other variables were measured at baseline and post-intervention. In addition, we used qualitative methodologies to obtain an in-depth understanding of children's embodied experiences and pedagogical processes taking place during the intervention.
If successful, ASK could provide strong evidence of a relation between physical activity and academic performance that could potentially inform the process of learning in elementary schools. Schools might also be identified as effective settings for large scale public health initiatives for the prevention of NCDs.
Clinicaltrials.gov ID nr: NCT02132494 . Date of registration, 6(th) of May, 2014.
Numerous policies have been proposed to address the public health problem of obesity, resulting in a policy cacophony. The noise of so many policy options renders it difficult for policymakers to determine which policies warrant implementation. This has resulted in calls for more and better evidence to support obesity policy. However, it is not clear that evidence is the solution. This paper argues that to address the policy cacophony it is necessary to rethink the problem of obesity, and more specifically, how the problem of obesity is framed. This paper argues that the frame "obesity" be replaced by the frame "caloric overconsumption", concluding that the frame caloric overconsumption can overcome the obesity policy cacophony.
Frames are important because they influence public policy. Understood as packages that define issues, frames influence how best to approach a problem. Consequently, debates over public policy are considered battles over framing, with small shifts in how an issue is framed resulting in significant changes to the policy environment. This paper presents a rationale for reframing the problem of obesity as caloric overconsumption. The frame "obesity" contributes to the policy cacophony by including policies aimed at both energy output and energy input. However, research increasingly demonstrates that energy input is the primary cause of obesity, and that increases in energy input are largely attributable to the food environment. By focusing on policies that aim to prevent increases in energy input, the frame caloric overconsumption will reduce the noise of the obesity policy cacophony. While the proposed frame will face some challenges, particularly industry opposition, policies aimed at preventing caloric overconsumption have a clearer focus, and can be more politically palatable if caloric overconsumption is seen as an involuntary risk resulting from the food environment.
The paper concludes that policymakers will be able to make better sense of the obesity policy cacophony if the problem of obesity is reframed as caloric overconsumption. By focusing on a specific cause of obesity, energy input, the frame caloric overconsumption allows policymakers to focus on the most promising obesity prevention policies.
Recreational facilities are an important community resource for health promotion because they provide access to affordable physical activities. However, despite their health mandate, many have unhealthy food environments that may paradoxically increase the risk of childhood obesity. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are government-initiated, voluntary guidelines intended to facilitate children's access to healthy food and beverage choices in schools, childcare and recreational facilities, however few recreational facilities are using them.
We used mixed methods within an exploratory multiple case study to examine factors that influenced adoption and implementation of the ANGCY and the nature of the food environment within three cases: an adopter, a semi-adopter and a non-adopter of the ANGCY. Diffusion of Innovations theory provided the theoretical platform for the study. Qualitative data were generated through interviews, observations, and document reviews, and were analysed using directed content analysis. Set theoretic logic was used to identify factors that differentiated adopters from the non-adopter. Quantitative sales data were also collected, and the quality of the food environment was scored using four complementary tools.
The keys to adoption and implementation of nutrition guidelines in recreational facilities related to the managers' nutrition-related knowledge, beliefs and perceptions, as these shaped his decisions and actions. The manager, however, could not accomplish adoption and implementation alone. Intersectoral linkages with schools and formal, health promoting partnerships with industry were also important for adoption and implementation to occur. The food environment in facilities that had adopted the ANGCY did not appear to be superior to the food environment in facilities that had not adopted the ANGCY.
ANGCY uptake may continue to falter under the current voluntary approach, as the environmental supports for voluntary action are poor. Where ANGCY uptake does occur, changes to the food environment may be relatively minor. Stronger government measures may be needed to require recreational facilities to improve their food environments and to limit availability of unhealthy foods.
Cites: Can J Public Health. 2009 Jul-Aug;100(4):310-419722347
Cites: Milbank Q. 2004;82(4):581-62915595944
Cites: Int J Environ Res Public Health. 2010 May;7(5):2208-2120623020
Cites: Am J Public Health. 2010 Nov;100(11):2137-4520864696
Cites: Can J Diet Pract Res. 2010 Winter;71(4):180-521144134
Cites: Can J Diet Pract Res. 2010 Winter;71(4):186-9121144135
Cites: N Engl J Med. 2005 Mar 17;352(11):1138-4515784668
Cites: Qual Health Res. 2005 Nov;15(9):1277-8816204405
Cites: Health Policy Plan. 2007 Jan;22(1):28-3917237492
Cites: Health Educ Res. 2007 Apr;22(2):203-2616861362
Cites: Am J Prev Med. 2007 Apr;32(4):273-8117383558
To examine successful Canadian nursing and health promotion intervention programmes for childhood obesity prevention during gestation and infancy, an integrative review was performed of the literature from 1980 to September 2005. The following databases were used: PubMed; Cochrane Database of Systematic Reviews; Cochrane Controlled Trials Register; Database of Abstracts of Reviews of Effects; ACP Journal Club; MEDLINE; EMBASE; CINAHL; Web of Science; Scopus; Sociological Abstracts; Sport Discus; PsycInfo; ERIC and HealthStar. MeSH headings included: infancy (0-24 months), gestation, gestational diabetes, nutrition, prenatal care, pregnancy, health education, pregnancy outcome, dietary services with limits of Canadian, term birth. Of 2028 articles found, six Canadian childhood obesity prevention programmes implemented during gestation and/or infancy were found; three addressed gestational diabetes with five targeting low-income Canadian urban and/or Aboriginal populations. No intervention programmes specifically aimed to prevent childhood obesity during gestation or infancy. This paucity suggests that such a programme would be innovative and much needed in an effort to stem the alarming increase in obesity in children and adults. Any attempts either to develop new approaches or to replicate interventions used with obese adults or even older children need careful evaluation and pilot testing prior to sustained use within the perinatal period.
Rapid growth during infancy is associated with increased risk of overweight and obesity and differences in weight gain are at least partly explained by means of infant feeding. The aim was to assess the associations between infant feeding practice in early infancy and body mass index (BMI) at 6 years of age. Icelandic infants (n = 154) were prospectively followed from birth to 12 months and again at age 6 years. Birth weight and length were gathered from maternity wards, and healthcare centers provided the measurements made during infancy up to 18 months of age. Information on breastfeeding practices was documented 0-12 months and a 24-h dietary record was collected at 5 months. Changes in infant weight gain were calculated from birth to 18 months. Linear regression analyses were performed to examine associations between infant feeding practice at 5 months and body mass index (BMI) at 6 years. Infants who were formula-fed at 5 months of age grew faster, particularly between 2 and 6 months, compared to exclusively breastfed infants. At age 6 years, BMI was on average 1.1 kg/m2 (95% CI 0.2, 2.0) higher among infants who were formula fed and also receiving solid foods at 5 months of age compared to those exclusively breastfed. In a high-income country such as Iceland, early introduction of solid foods seems to further increase the risk of high childhood BMI among formula fed infants compared with exclusively breastfed infants, although further studies with greater power are needed.
Cites: BMC Pediatr. 2011;11:9922054415
Cites: Int J Obes (Lond). 2012 Apr;36(4):548-5322310472
Cites: Am J Clin Nutr. 2012 Jul;96(1):73-922592102
The aim of this study was to survey Canadian oncology practitioners' attitudes toward psychosocial concerns and issues in women with breast cancer. Surveys were mailed to 351 medical, radiation and surgical oncologists and 375 oncology nurses. Standard questionnaires assessed attitudes towards psychosocial issues in women with primary and metastatic breast cancer and evaluated the practitioners' willingness to refer women to psychosocial intervention trials in the presence and absence of competing drug trials. Responses were obtained from 74% of those surveyed. Respondents reported being aware of the common occurrence of psychosocial problems in women with metastatic breast cancer, however, physicians were less likely than nurses to offer these women psychosocial support on a prophylactic basis (p
A number of studies have shown that dieting and body dissatisfaction are highly frequent among adolescents. We here describe the relationship between dieting and body dissatisfaction in 4,952 children selected from the 11, 13 and 15 year age cohorts of the Norwegian national sample in the multinational WHO survey "Health Behavior in School Children". Body dissatisfaction was defined as the subjective experience of being a bit or much too fat and, using this definition, about 20% of the boys reported body dissatisfaction and 7% that they were on a diet. About 37% of the girls reported body dissatisfaction and 15% that they were on a diet. Within the age cohorts, respectively 22%, 30% and 32% reported body dissatisfaction, whereas about 40% overall indicated no body dissatisfaction. Being on a diet was reported by 8% of the 11-year olds, and subsequently increased to 10% (13 years) and 14% (15 years). Multiple regression analysis showed that body dissatisfaction explained 33% of the variance in dieting behaviour, and that the overall effect of gender and age was small. Dieting and body dissatisfaction should therefore be recognised as being equally important among boys, and be counteracted within the framework of a health promotion strategy aimed at the general adolescent population.