Emotional Health Predicts Changes in Body Mass Index (BMI-z) Among Black and Latino Youth Selected nutritional habits of teenagers associated with overweight and obesity Prevalence of overweight and obesity in a rural southern Italy population and relationships with total and cardiovascular mortality: the Ventimiglia di Sicilia project The Natural History of the Development of Obesity in a Cohort of Young U.S. Adults between 1981 and 1998 Obesity among outpatients with major depressive disorder. The relationship between childhood weight, dental caries and eating practices in children aged 4-8 years in Australia, 2004-2008. A three-dimensional program for the treatment of obesity. Foot structure in overweight and obese children. Hip-Hop to Health Jr., an obesity prevention program for minority preschool children: baseline characteristics of participants. Prevalence and risk factors of excess weight in school children in West Greece. The effect of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women: a systematic review protocol A cognitive behavioral therapy intervention to promote weight loss improves body composition and blood lipid profiles among overweight breast cancer survivors Bright Start: Description and main outcomes from a group-randomized obesity prevention trial in American Indian children Macronutrient intake, physical activity, serum lipids and increased body weight in primary schoolchildren in Istanbul. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Increases in morbid obesity in the USA: 2000-2005. Shared risk factors for mood-, eating-, and weight-related health outcomes. Relationships between eating quickly and weight gain in Japanese university students: a longitudinal study. The relative importance of predictors of body mass index change, overweight and obesity in adolescent girls. Associations of overweight and of weight dissatisfaction among Palestinian adolescents: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004).
Childhood obesity is a complex and multifaceted health problem linked to elevated risk for chronic diseases , such as diabetes , cancer , hypertension , and cardiovascular disease.1,2 Although research has increased dramatically in the past 2 decades , questions regarding factors driving overweight and obesity remain , particularly among youth of color who experience disproportionate rates of obesity and comorbid health conditions.3 Adolescence is a critical period in the developmental trajectory,4 in part because overweight and obese adolescents are more likely to remain overweight and /or obese in adulthood.3 Overweight and obesity have been associated with adverse symptoms and intra- and interpersonal psychological , social , and emotional issues that continue into adulthood , including depression and anxiety , social withdrawal , feeling worthless , lower self-esteem , and behavioral problems.5–7 Poor mental health may lead to increases in weight due to fluctuations in appetite , obesogenic behaviors ( eg , overeating ) to cope with negative mood , sedentary behavior , and increased isolation.8 Chronic stress or experiences of discrimination may also influence physiology and behaviors that affect weight gain.9 On the other h and , increased body mass index ( BMI ) could result in adverse emotional outcomes over time due to weight-based stigma , bullying , or poor self-esteem.5,6 The few longitudinal studies that have examined the association between emotional health and physical health outcomes have primarily taken a narrow focus of mental health symptoms ( e.g. , only examining depression)10 or behavioral concerns ( e.g. , conduct).11 Physical outcomes , including BMI , were often collected by self-report12 and /or retrospectively.13 Furthermore , they have been limited to predominantly White sample s of older adolescents or adults.12,13 Persistent racial and ethnic disparities in overweight and obesity further complicate research as well as clinical prevention and intervention efforts . Black and Latino youth experience disproportionate levels of overweight and obesity beginning as early as preschool and are more likely to remain obese as adults compared with Whites.14 Blacks and Latinos also are at disproportionate risk for multiple negative health conditions associated with overweight and obesity , such as diabetes.14,15 Reasons for such disparities remain poorly understood and understudied . Although emotional health has been associated with weight in both adults and youth,16 prior research has been limited to cross-sectional studies .17 Longitudinal , prospect i ve design s are critical to explicate the association between emotional health and BMI among Black and Latino youth . The primary objective of this study is to examine whether negative emotional symptoms prospect ively predict increases in BMI z-scores ( BMI -z ) across 2 years among a sample of predominantly Black and Latino , urban youth . We hypothesize that more negative emotional symptoms measured at baseline ( grade s 5 and 6 ) would predict increases in BMI -z scores 2 years later . Results can inform programs and interventions aim ed at reducing obesity in youth of color Introduction A balanced diet is at the heart of healthy growth and development of children and youth , whereas inappropriate eating habits considerably influence the incidence of disorders connected with nutrition , including overweight and obesity . This paper aims at study ing nutritional factors of 18-year-old secondary school youth in the urban environment and their effect on the incidence of overweight and obesity . Material s and methods The survey was conducted among 1,999 secondary school students chosen at r and om . The research tool consisted an original survey question naire . The measurements of respondents ’ height and body mass provided data for calculating the body mass index . Results and conclusion The percentage of youth with deficient body mass was estimated at 8.4 % . The percentage of normal weight students in the surveyed group was estimated at 77.6 % . Overweight and obesity characterized 14.0 % of the total number . As many as 21.8 % of overweight and obese respondents would eat one or two meals as opposed to 16.8 % of normal weight students . Three-fourths of the surveyed students would eat breakfast regardless of their nutritional habits . Lunch is eaten by 52.9 % of normal weight 18-year-olds and 46.1 % of overweight and obese students . The analysis of mealtimes suggests that overweight and obese students would have their breakfast and dinner at later hours than the rest of the surveyed . More than half of the participating students failed to eat lunch ( 53.9 % ) , and one in four students within this group resigned from supper . Girls would eat fruit and vegetables more frequently than boys several times a day . The percentage of persons in the surveyed groups who would eat fast foods on a daily basis was similar regardless of their nutritional status . Sweetened carbonated beverages would be drunk more often by overweight and obese boys ( 81.2 % ) as compared with boys with proper body mass ( 75.8 % ) . The same type of beverages would be popular with two-thirds of girls , and this result was similar regardless of their nutritional status . About 44.2 % of overweight and obese girls and 20 % of girls with proper body mass attempted to lose weight , and 5.7 % of boys tried to go on a diet . Eating limitations were declared by 16.5 % of overweight and obese boys and ca . 3 % of normal weight boys . Conclusion Within the surveyed group of youth , it was possible to indicate eating errors primarily consisting in irregular eating , too low a number of meals during the day , particularly skipping breakfast , which took place more frequently among overweight and obese students rather than normal weight ones . The survey points to the insufficient intake of vegetables and fruit as opposed to salty and sweet meals . It is essential to convey the knowledge on the causes of overweight and obesity as well as rules of a healthy diet as factors preventing civilization diseases OBJECTIVE : We investigated the prevalence of overweight and obesity and their relationships with the main cardiovascular risk factors in the population of Ventimiglia di Sicilia , a rural village in Southern Italy characterized by low cholesterol levels and by a low incidence of early coronary heart disease mortality . We related all deaths to body weight and fat distribution during an 8 y follow-up . DESIGN : Cross-sectional and prospect i ve observational study .SUBJECTS : A total of 835 free-living individuals , 363 males and 472 females , of age between 20 and 69 y. MEASUREMENTS : In all participants body weight , waist-to-hip ratio ( WHR ) , cardiovascular risk factors and plasma lipids were measured . During the follow-up , total and cardiovascular deaths were registered . RESULTS : We found a high overall prevalence of subjects with overweight or obesity ( respectively 45.0 % and 27.7 % ) , with great differences among classes of age . As expected , body weight and fat distribution were associated with diabetes , hypertension , dyslipidemia and with a worsening of lipid profile . During the follow-up we registered 37 total and 11 cardiovascular deaths . All-cause and cardiovascular mortality risks were , respectively , 1.64 ( 95 % CI 0.65–4.15 ) and 2.71 ( 95 % CI 0.29–25.26 ) in subjects with a body mass index ( BMI ) of 27–29.99 kg/m2 and 2.45 ( 95 % CI 1.03–5.87 ) and 5.36 ( 95 % CI 1.41–62.01 ) in subjects with a BMI of≥30 kg/m2 in comparison with participants with a BMI of < 27 kg/m2 , and 3.48 ( 95 % CI 1.46–8.30 ) and 4.55 ( 95 % CI 1.12–18.40 ) in subjects with a WHR higher than the median in comparison with individuals with a WHR lower than the median . CONCLUSION : The Ventimiglia di Sicilia Study highlights the great importance of overweight and obesity as a public health issue in a rural population and indicates that it is necessary to consider the impact of body weight and fat distribution on both total and CHD mortality Context Studies of the natural history of obesity have had limitations , such as cross-sectional design , short follow-up , or narrowly defined population s. Contribution Using data from a national study of Americans born between 1957 and 1964 and followed for nearly two decades , these investigators found that more than 25 % were obese by age 35 years . Obesity developed most quickly in black women , with moderate rapidity in Hispanic women , and most slowly in white women . Hispanic men developed obesity more quickly than other men . More recent birth cohorts became obese faster than earlier cohorts . Implication s Underst and ing ethnic differences in the age of onset and rate of progression of obesity may help efforts to prevent obesity . The Editors The proportion of Americans who are overweight or obese is increasing at an alarming rate . From 1960 to 1999 , the prevalence of excess weight ( body mass index [ BMI ] 25 kg/m2 ) increased from 44 % to 61 % of the adult population ( persons aged 20 to 74 years ) and the prevalence of obesity ( BMI 30 kg/m2 ) doubled from 13 % to 27 % ( 1 , 2 ) . Obesity has been linked to increased mortality and chronic morbidity from such diverse causes as hypertension , diabetes , sleep apnea , certain types of cancer , and depression . In the context of this rising prevalence , obesity is increasingly being recognized as an important medical and public health problem ( 3 - 6 ) . Treatment options are available for obesity . However , they can be expensive , often involve difficult lifestyle modifications , and pose adherence problems for many patients . In addition , weight loss , once achieved , is difficult to sustain . Because the health consequences are often long term , the costbenefit ratio of treatment may be more favorable if people who have recently become obese are targeted . Similarly , prevention should focus on those at immediate risk for becoming obese or overweight . Such approaches require a clear underst and ing of who is at highest risk for obesity , when this risk is greatest , and how excess weight develops over time . Although inactivity and high caloric intake are the primary risk factors for obesity , other risk factors have been established . Three of the most influential are age , sex , and race or ethnicity ( 1 , 7 - 9 ) . To better identify people at risk for obesity and those who might benefit from early intervention , we assessed the relationship between weight development and these influential factors . Despite the morbidity and mortality burden of obesity , its natural history has not been well characterized . Current knowledge is based largely on cross-sectional data . Although several large studies have examined weight development in adults , they have important limitations . Only a few tracked weight long enough to detect age-based trends . The first National Health and Nutrition Examination Survey ( NHANES I ) Epidemiologic Follow-up Study examined a representative group of U.S. residents but sample d only two time points , spaced 10 years apart , and had insufficient follow-up to track weight patterns in most minority groups ( 10 ) . The Coronary Artery Risk Development in Young Adults study followed weight development in a large cohort of young black and white Americans but did not provide data for other population s and was geographically restricted ( 8) . Other studies have been performed outside of the United States , but the results may not apply here ( 10 , 11 ) . We design ed our study to address the limitations described earlier . We examined data from the National Longitudinal Survey of Youth 1979 ( NLSY79 ) . This large , prospect i ve cohort study allowed longitudinal examination of weight trends over a time frame sufficient to capture the dynamics of such a slowly changing problem and of an age range during which obesity becomes prevalent . Because not all weight gain has been documented to be harmful , our analysis focused on obesity onset ( defined as the time at which a person reaches obesity ) rather than weight gain . We used the clinical definition of obesity ( BMI 30 kg/m2 ) as our end point because it reflects a point at which mortality risk increases substantially ( 12 ) . Underst and ing how obesity develops over time , who is at greatest risk , and when that risk is highest may be essential in reversing the population trend toward excess weight . Methods Study Group and Obesity Measurement We analyzed data from the NLSY79 , which was initiated by the U.S. Department of Labor , Bureau of Labor Statistics . This survey was design ed to gather information about the labor market activities and other life events of young U.S. citizens . It has been used extensively in economic and sociologic analyses , and the sample design is described elsewhere ( 13 - 16 ) . The cohort of men and women , born between 1957 and 1964 , has been followed for more than two decades . It consists of a nationally representative group , with supplemental sample s overrepresenting minority racial and ethnic groups and poor persons . We excluded a sample of military personnel because this population was removed from the study in 1985 and because physical activity requirements for these individuals could lead to atypical weight patterns . We included only persons who reported that the ethnicity with which they most closely identified was Hispanic , black , or white ( or European origin ) . Height and weight data were self-reported ; height was reported in 1981 and 1985 , and weight was reported 12 times between 1981 and 1998 . Examination of Age-Specific Body Mass Index Patterns Age-specific BMI was calculated for all participants . Height was assumed to remain constant after age 21 years . St and ard clinical definitions were used for overweight ( BMI 25 to 29.9 kg/m2 ) and obesity ( BMI 30 kg/m2 ) . Trends in age-specific BMI were examined by race or ethnicity and birth year . Cohort Differences We examined whether rates of obesity onset differed for people maturing at different times in our sample . Birth cohorts were grouped by 2-year increments . To st and ardize relative rates to age rather than calendar year , time was expressed as the number of years until a person reached obesity , starting from a st and ard age . In the cohort analysis , obesity onset was evaluated from age 24 years ( the baseline age of the oldest participants ) . The outcome of interest was obesity , and the time variable was years from age 24 years to obesity . People who were already obese at age 24 years were excluded . KaplanMeier plots visually demonstrated differences in rates of obesity onset . Cox proportional-hazards modeling estimated the ratio of rates ( hazard ratio ) between groups . For this method to be correct , the ratio of rates must be constant over time ( proportional ) . To assess this assumption , we used two methods : a statistical test of the scaled Schoenfeld residuals , with a P value greater than 0.05 implying that the rates were proportional and a visual method with parallel lines implying proportional rates . In all our analyses , results of proportional hazards testing were reported whenever the assumption was violated . Timing of Obesity Onset by Race or Ethnicity and Sex We evaluated relative rates of obesity onset in 17- and 18-year-old persons of different race or ethnicity who were not obese at the start of the study ; different models were used for men and women . Time was expressed as the number of years from age 17 years until reaching obesity . To control for birth cohort differences , models were adjusted for birth year . As before , KaplanMeier plots were examined and hazard ratios were estimated by using Cox proportional-hazards modeling . To determine relative importance of weight gain during childhood compared with adulthood in terms of the timing of obesity onset , we adjusted the models for baseline BMI at 17 or 18 years of age and examined the effect on hazard ratio estimation . Prevalence and Incidence of Obesity in Early Adulthood For this analysis , we defined early adulthood as the period from 20 to 22 years of age to 35 to 37 years of age . Persons born between 1959 and 1963 were queried about their weight one to two times during each of these age intervals . We calculated the prevalence and incidence of obesity across the early adulthood range . Logistic regression modeling predicted obesity status at age 35 to 37 years from an individual 's race or ethnicity , sex , and BMI at age 20 to 22 years . The model was adjusted in 2-year increments for year of birth . Its predictive ability was quantified by using receiver-operating characteristic ( ROC ) curves . This study was evaluated and exempted from review by the Institutional Review Board of the University of North Carolina at Chapel Hill . Role of the Funding Sources Primary funding was through the Robert Wood Johnson Clinical Scholars Program , with additional support from the National Institute of Child Health and Human Development . Neither entity had a role in the design , conduct , or reporting of this study . Results Description of the Study Sample The total sample included 9179 people : 19 % Hispanic , 31 % black , and 50 % white ( Table ) . People who did not report ethnicity ( n = 106 ) were not included . Age ( sample year minus birth year ) ranged from 17 to 24 years in 1981 to 34 to 41 years in 1998 , and participants were equally distributed across 8 years of birth . Baseline weight was 31.7 to 136.1 kg , and baseline BMI was 11.3 to 51.5 kg/m2 . Table . Sample Characteristics in 1981 Relationship of Body Mass Index to Time Mean age-specific BMI increased with time . This relationship between weight and time has two components , illustrated with data from the oldest and youngest birth cohorts of our sample ( Figure 1 ) . The first is the natural history of body weight : Average BMI increased with age throughout early adulthood . The second is a secular weight trend : Persons born in later calendar years tended to have larger age-specific BMI values . In every case in which the same age was sample d for both birth cohorts , the group born in 1957 had a lower mean BMI than the group born Studies focusing on the prevalence of obesity in Major Depressive Disorder ( MDD ) , or the impact of excess body fat on the treatment of MDD are lacking . The aim of the present work is to systematic ally study obesity in MDD out patients . A total of 369 MDD out patients enrolled in an 8-wk trial of 20 mg fluoxetine  had height and weight measured at baseline . We then examined : ( 1 ) the prevalence of being overweight or obese , ( 2 ) the relationship between obesity and a number of demographic and clinical variables , and , ( 3 ) the relationship between relative body weight and obesity with clinical response . We found that more than 50 % of patients were overweight [ body mass index ( BMI ) > or = 2 5 kg/m2 ] , while 20 % were obese ( BMI > or = 30 kg/m2 ) . Obese patients presented with worse somatic well-being scores than non-obese MDD patients , but they did not differ with respect to depression severity , anxiety , somatic complaints , hopelessness or hostility . Greater relative body weight , but not obesity , predicted non-response . In conclusion , greater relative body weight was found to place MDD out patients at risk for fluoxetine resistance OBJECTIVES The association between overweight/obesity and  dental caries in children is contentious with studies variously reporting positive or negative associations between the two conditions . Since 1995 , Australia has experienced a rise in the prevalence of both conditions in its children . This study investigated the association between child weight , diet and dental problems in a nationally representative sample . METHOD Data from 4149 children ( 51.5 % male ) participating in the Longitudinal Study of Australian Children ( LSAC ) were used . The LSAC is a longitudinal study collecting data from a large representative cohort of Australian children ; data from the first three waves were included with children aged 4 - 5 years , 6 - 7 years , and 8 - 9 years . Multivariate cross-sectional and prospect i ve analyses were conducted to determine the relationships between child weight , diet and dental problems . RESULTS Overweight/obesity was associated with sweet drink consumption and dental problems associated with consumption of fatty foods and sweet drinks . Underweight was associated with dental problems cross-sectionally , but both underweight and overweight at age 6 - 7 years predicted dental problems at age 8 - 9 years . CONCLUSIONS Dental caries and body weight are influenced by diet . Overweight children may be consuming less fatty food but appear to be consuming more sweet drinks than normal-weight children , which can lead to both increased weight and dental caries .  Dietary interventions design ed to reduce the development of dental caries may also reduce the development and maintenance of overweight Summary -Obesity is seen as a consequence of a positive balance of energy consumed over energy expended . The reduction of obesity is accordingly sought through the reduction in the amount of food eaten coupled with an increase in the rate at which energy is expended . Both the reduction in the rate of eating  and the increase in the rate of exercise  are sought through management of critical aspects of the environment . Specific recommendations are made for the behavioral treatment of obesity , with the success of the treatment seeming to depend upon the effectiveness with which environmental stimuli are brought under control rather than depending upon motivational or other personal characteristics of the overeater . Pre-test data generated by the use of this procedure , coupled with the results of several recent studies appear to indicate uniquely positive results for the behavior & control of overeating . WHETHER overweight is determined by gross body weight ( Metropolitan Life Insurance Company , 1969 ) or skin-fold measurement ( Seltzer and Mayer , 1965 ) even when differences in fat as a proportion of body weight are controlled ( Durnin and Passmore , un date d , p. 137 ) , at least one in five Americans is found to be overweight ( United States Public Health Service , un date d ) . The social and economic costs of being overwieght are staggering and are complicated by greatly increased vulnerability to a broad range of physical diseases , including cardiovascular and renal diseases , maturity-onset diabetes , cirrhosis of the liver , and gall bladder diseases , among many others ( Mayer , 1968).+ + Despite the history of concern with obesity and the magnitude of the problem , little uncontested knowledge has been accumulated with respect to its etiology and treatment . Mayer ( 1968 ) has suggested that genetic factors may contribute to the onset of a smal1 number of cases , while an additional small number of cases can be explained on the basis of injury to the hypothalamus , hormonal imbalance and other threats to normal metabolism . The exact role of genetic and physiological factors has , however , remained a mystery , and there has been little evidence to counterm and an early observation by Newburgh and Johnston ( 1930 ) that most cases of obesity are OBJECTIVE . To analyse the association between overweight and obesity and foot structure in children older than 9 years of age , whose longitudinal medial arch ( MLA ) should be practically established . DESIGN , SETTING AND SUBJECT . A cross-sectional study of 245 children ( age : 13.22±1.8 years ) from four r and omly selected schools ( Zaragoza , Spain ) .  Body mass index ( BMI ) was calculated and normal-weight , overweight and obese groups were defined . Footprints for both feet were collected . MEASUREMENTS . Foot angle ( FA ) and Chippaux-Smirak index ( CSI )  were calculated from the footprints . Height and body mass were measured to calculate the BMI . RESULTS . Mean values of FA and CSI in the normal-weight group indicated the presence of a normal MLA ; however , in the overweight they indicated an intermediary MLA and in the obese group , a low MLA . Comparison among the groups showed a decrease of FA ( p<0.01 ) and an increase of CSI ( p<0.01 ) with increasing weight associated with a lower MLA . A low but significant correlation ( p<0.0001 ) was found between the z-score BMI and footprint parameters . CONCLUSIONS . In children aged 9 to 16.5 years , the increase of body mass is related to a lower MLA . The MLA is lower in these obese children than in the younger ones studied in previous works probably due to the continuous bearing of excessive mass from childhood . A lower MLA could cause health problems . An assessment of foot structure in these children is recommended as the classification of the foot arch type can help decide if treatment to avoid these problems is necessary BACKGROUND The prevalence of obesity in the United States is a significant public health problem . Many obesity-related risk factors are more prevalent in minority population s. Given the recalcitrant nature of weight loss interventions for adults , prevention of overweight and obesity has become a high priority . The present study reports baseline data from an obesity prevention intervention developed for minority preschool children . METHODS Hip-Hop to Health Jr. is a 5-year r and omized controlled intervention that targets 3- to 5-year-old minority children enrolled in 24 Head Start programs . Our primary aim is to test the effect of the intervention on change in body mass index . Data were collected on sociodemographic , anthropometric , behavioral , and cognitive variables for the children and parents at baseline . RESULTS Participants included 416 black children , 337 black parents , 362 Latino children , and 309 Latino parents . Using body mass index for age and sex > or = the 95th percentile as the definition of overweight , 15 % of the black children and 28 % of the Latino children were overweight . More than 75 % of the parents were either overweight or obese . DISCUSSION The development of interventions to effectively prevent or control obesity early in life is crucial . These data highlight the escalating problem of weight control in minority population The present study estimated the prevalence of childhood obesity and identified risk factors in 10 - 13 year old children . A cross-sectional study was conducted , including 200 children and their parents , in seven r and omly-selected primary schools across Patras , Greece .  Height , weight , and waist circumference were measured , and self-reported information was collected via face-to-face interviews .  Body mass index was calculated for the children and their parents . The effect of risk factors on overweight and obesity was analyzed using regression analysis . The prevalence of overweight and obesity was 32 % and 10.5 % , respectively . The odds of being overweight/obese increased in children whose parents had a lower educational level and /or higher body mass index . Fewer daily meals and more time spent in front of the television  and /or on the computer were significantly associated with obesity in 10 - 13 year old children . The prevalence of excess weight in primary school children in Patras is of concern , especially for boys . Children 's nutritional habits , leisure activities , and parental characteristics influence their somatometric characteristics . These findings highlight the need for future weight loss interventions targeted at this population Review question / objective What are the effects of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women ? The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aim ed at limiting gestational weight gain and postpartum weight retention in women . The second objective of this systematic review is to investigate included intervention components with respect to effect on weight‐related outcomes . This may include , but is not limited to : length of intervention , use of face‐to‐face counselling , group or individual consultations , use of other interventions components including exercise , use of goals and use of support tools like food diaries , coaching , including email or text message support . Background Around half of all women of reproductive age are either overweight or obese,1,2,3 with women aged 25‐34 years having a greater risk of substantial weight gain compared with men of all ages.1,4 Excessive gestational weight gain ( GWG ) and postpartum weight retention ( PPWR ) may play a significant role in long term obesity . Having one child doubles the five‐ and 10‐year obesity incidence for women , with many women who gain excessive weight during pregnancy remaining obese permanently.5 Excessive GWG and /or PPWR can also significantly contribute to short‐ and long‐term adverse health outcomes for mother , baby and future pregnancies.6,7 Maternal obesity increases the risk of pregnancy related complications such as pre‐eclampsia , gestational diabetes mellitus , stillbirth and the rate of caesarean section.8 Childhood obesity is a further long term complication of maternal obesity for offspring , which may persist in to adulthood.9 Excess GWG is also a risk factor for PPWR both in the short and long‐term.10,11 Nehring et al. conducted a meta‐ analysis with over 65,000 women showing that , compared to women who gained weight within recommendations during pregnancy , women with GWG above Institute of Medicine weight gain recommendations , 12 retained an additional 3.1 kg and 4.7 kg after three and greater than or equal to 15 years postpartum , respectively.13 The health risk associated with PPWR is highlighted in a study of 151,025 Swedish women followed between 1992 and 2001.The study identified the risk of adverse pregnancy outcomes for those who gained three or more units of Body Mass Index ( kg/m2 ) between consecutive pregnancies ( an average of two years ) was much higher compared with women whose BMI changed from ‐1.0 and 0.9 units.14 Long‐term chronic disease risk may also be affected by PPWR as weight retention at the end of the first year post‐partum has been found to be a predictor of maternal overweight 15 years later.15With around 14‐20 % of women retaining 5 kg or more 12 months postpartum,16,5 the risk of developing conditions like diabetes , metabolic syndrome and cardiovascular disease may be increased.17 It becomes evident that interventions which aim to support attainment of healthy weight both in the antenatal and postpartum periods are key health priorities for women during this life stage . Lifestyle factors of overweight , having poor diet quality , and not undertaking enough moderate‐to‐vigorous physical activity are amongst the top five predictors of mortality in women.18 Additionally it is noted that , for many women , pregnancy and the postpartum period are associated with a reduction in physical activity.19 It is known that a combination of poor dietary choices , an increase in sedentary time and reduction in physical activity are all contributors to the development of overweight and obesity . With this in mind , current research has focused on lifestyle interventions to limit GWG and PPWR . Thangaratinam et al. review ed 44 r and omized controlled trials ( 7278 women ) where interventions including diet , physical activity or both were evaluated for their influence on maternal weight during  pregnancy.20 Results indicate that all were significantly effective in reducing GWG compared with the control group . More specifically , dietary interventions were the most effective in reducing weight gain , with a mean weight loss of ‐3.84 kg compared with ‐0.72 kg and ‐1.06 kg for physical activity and the mixed ( diet plus physical activity ) approach , respectively.20 This finding is supported by Hill and colleagues ' recent systematic review of theory based interventions to limit GWG.21 Included studies in this review reported an underpinning theory base and were classified as adopting a dietary , physical activity or mixed approach . Hill et al. concluded that studies which included a diet intervention were significantly more effective at limiting GWG.21 In 2011 Tanentsapf et al. review ed the effect of dietary interventions alone for reducing GWG in normal weight , overweight and obese pregnant women.22 This review analysed 13 r and omized controlled trials and quasi‐r and omized controlled trials with a dietary intervention to prevent excessive GWG in women . The review concluded that dietary interventions during pregnancy were effective in reducing GWG with an effect of ‐1.92 kg ( n=1434 ) compared with the control group.22 Tanentsapf et al. identified that trials differed in the conduct of the interventions with various diet and non‐diet related components utilised . Dietary approaches were highly variable with some trials focusing only on calorie restriction and others included additional target macronutrient distribution for intake . Some trials further provided feedback based on maternal weight gain guidelines .12 Interventions also varied in delivery method with a variety of modes used , including face‐to‐face , individual or group consultations and /or written correspondence . The frequency of communication , despite the type or mix , also changed from trial to trial with additional methods via telephone , posted material s , feedback or food diaries utilised . The inclusion of physical activity in addition to diet intervention was also common . Whilst the recent review by Tanentsapf et al.22 identified that dietary interventions are effective in reducing GWG , the review did not investigate the impact that different intervention components , delivery methods or dietary counselling approaches had on gestational weight management . It remains unclear as to which intervention components optimize GWG in women . The impact of lifestyle interventions has also been investigated in the postpartum period . The recent systematic review from van der Pligt et al. reported seven of 11 studies review ed were successful in limiting PPWR.23 As with studies aim ed at limiting GWG , interventions included in van der Pligt et al. 's review differed greatly in their conduct . Six of these seven studies included both dietary and physical activity components for the intervention , with the final successful study including a diet only intervention . Five of the successful studies recruited overweight or obese women only . Intervention time varied considerably in successful studies with some running for as little at ten days , and others up to six months . Bertz et al. demonstrated that their 12‐week behavior modification intervention which targeted diet alone or diet and exercise , including two individual sessions with a dietitian and physical therapist , provision of scales for weight self‐monitoring and bi‐weekly text messages was successful in achieving significant weight loss following the intervention , and sustained at one year.24 The diet intervention and the diet and exercise intervention  yielded significant weight loss compared to the control . Following 12 weeks a reduction of ‐8.3 + /‐ 4.2 kg for diet intervention and ‐6.9 + /‐ 3.0 kg for diet and exercise was observed . Additionally after one year , the diet intervention showed ‐10.2 + /‐ 5.7 kg reduction and ‐7.3 + /‐ 6.3 kg for the diet and exercise intervention (p<0.001).24 Colleran et al. also found significant weight change results by implementing a 16‐week intervention which consisted of weekly individual sessions with a dietitian regarding calorie restriction , two additional home visits regarding exercise , weekly food diary completion and email support.25 The intervention group had greater weight loss compared to the control group ( ‐5.8 kg + /‐ 3.5 kg vs ‐1.6 kg + /‐ 5.4 kg ) . It can be seen that various methods have been utilized in investigating the impact of diet and physical activity interventions on PPWR . The review by van der Pligt et al.23 highlights the impact successful lifestyle interventions can have on postpartum weight change . However , this review did not investigate the different intervention strategies utilized . It remains unclear as to the optimal setting , delivery method , diet strategy , contact frequency or intervention length to limit PPWR . Previous systematic review s for both GWG and PPWR have focused on the effectiveness of lifestyle interventions as a whole for weight management in pregnant and postpartum women.20,23 And despite Tanentsapf et al. 's focus on dietary interventions for GWG,22 much is still unknown about the effectiveness of differing diet interventions over the antenatal and postpartum period . Specifically , the impact of differing diet intervention strategies on maternal weight gain is not known . Firstly , this systematic review will focus on whether  weight management interventions which include a dietary component  are effective in pregnant and postpartum women . In addition to this , this review will investigate the different intervention strategies utilized and their effectiveness in maternal weight management . A search of systematic review protocol data bases has shown that there is no current review underway for this topic Overweight or obesity is an established negative prognostic factor in breast cancer . Co-morbidities associated with obesity , including cardiovascular disease ( CVD ) , may negatively impact quality of life and survival in this population . Our purpose was to determine the effect of a cognitive behavioral therapy ( CBT ) intervention for weight loss through exercise and diet modification on risk factors for recurrence of breast cancer , and risks for CVD associated with obesity . Eighty-five overweight or obese breast cancer survivors were r and omly assigned to a once weekly , 16-week intervention or wait-list control group . The intervention incorporated elements of CBT for obesity , addressing a reduction in energy intake , as well exercise , with a goal of an average of 1 h a day of moderate to vigorous activity .  Body weight , total and regional body fat ( by dual energy X-ray absorptiometry ) , waist and hip circumference , and blood lipids were assessed at baseline and following 16 weeks of intervention . Results : Seventy six women ( 89.4 % ) completed the intervention . Independent t-test to evaluate group differences at 16 weeks showed significant differences in weight , body mass index , percent fat , trunk fat , leg fat , as well as waist and hip circumference between intervention and control groups ( P ≤ 0.05 ) . Furthermore , levels of triglycerides and total cholesterol/high density lipoprotein cholesterol levels were also significantly reduced following the intervention . These results indicate that 16 weeks of a CBT program for weight management may reduce obesity and CVD risk in overweight breast cancer survivors The aim of the Bright Start study was to develop and test the effectiveness of a school environment intervention , supplemented with family involvement , to reduce excessive weight gain by increasing physical activity and healthy eating practice s among kindergarten and first grade American Indian children . Bright Start was a group-r and omized , school-based trial involving 454 children attending 14 schools on the Pine Ridge Reservation in South Dakota . Children were followed from the beginning of their kindergarten year through the end of first grade . Main outcome variables were mean BMI , mean percent body fat , and prevalence of overweight/obese children . The goals of the intervention were to : increase physical activity at school to at least 60 min/day ; modify school meals and snacks ; and involve families in making behavioral and environmental changes at home . At baseline , 32 % of boys and 25 % of girls were overweight/obese . While the intervention was not associated with statistically significant change in mean levels of BMI , BMI -Z , skinfolds or percentage body fat , the intervention was associated with a statistically significant net decrease of 10 % in the prevalence of overweight . Intervention children experienced a 13.4 % incidence of overweight , while the control children experienced a corresponding incidence of 24.8 % ; a difference of −11.4 % ( p=0.033 ) . The intervention significantly reduced parent reported mean child intakes of sugar-sweetened beverages , whole milk and chocolate milk . Changes in duration of school physical activity were not significant . Because obesity is the most daunting health challenge facing American Indian children today , more intervention research is needed to identify effective approaches BACKGROUND The aim of this cross-sectional study was to record the prevalence of underweight , overweight and obesity in primary school children living in Istanbul and to examine the relationship between increased body weight and certain cardiovascular disease ( CVD ) risk factors . METHODS A total of 510 r and omly selected children aged 12 and 13 years of age ( 257 boys , 253 girls ) were examined . Information regarding  anthropometrical indices , energy and macronutrient intake , physical activity , physical fitness and lipid profile were collected . Classification of children in overweight and obese subgroups was based on the cut-off points proposed by Cole et al. RESULTS The prevalence of underweight , overweight and obesity was found to be 15.3 % , 10.6 % and 1.6 % , respectively . Both overweight boys and girls were found to have lower physical fitness compared to their normal-weight counterparts , but no difference was observed for energy and macronutrient intake . Overweight boys were found to have higher total cholesterol ( P < 0.001 ) , low-density lipoprotein cholesterol ( P < 0.01 ) , triglycerides ( P < 0.01 ) and total cholesterol/high-density lipoprotein cholesterol ( HDL-C ) ratio ( P < 0.05 ) compared to their normal-weight counterparts , while overweight girls were found to have lower HDL-C ( P < 0.05 ) compared to their normal-weight peers . CONCLUSIONS Underweight and overweight coexisted in the current population . Increased body weight was accompanied by unfavorable lipid profiles and lower fitness levels . Consequently , there is an emergent need for early identification and underst and ing of behavioral and physiological variables related to obesity and CVD , so that appropriate interventions can be targeted to children who are at risk for adult onset of these diseases BACKGROUND To our knowledge , no single investigation concerning the long-term effects of overweight status on the risk for hypertension , hypercholesterolemia , diabetes mellitus , and cardiovascular sequelae has been reported . METHODS Relations between categories of body mass index ( BMI ) , cardiovascular disease risk factors , and vascular disease end points were examined prospect ively in Framingham Heart Study participants aged 35 to 75 years , who were followed up to 44 years . The primary outcome was new cardiovascular disease , which included angina pectoris , myocardial infa rct ion , coronary heart disease , or stroke . Analyses compared  overweight ( BMI [ calculated as weight in kilograms divided by the square of height in meters ] , 25.0 - 29.9 ) and obese persons ( BMI > or = 30 )  to a  referent group of normal-weight persons ( BMI , 18.5 - 24.9 ) . RESULTS The age-adjusted relative risk ( RR ) for new hypertension was highly associated with overweight status ( men : RR , 1.46 ; women : RR , 1.75 ) . New hypercholesterolemia and diabetes mellitus were less highly associated with excess adiposity . The age-adjusted RR ( confidence interval [ CI ] ) for cardiovascular disease was increased among those who were overweight ( men : 1.21 [ 1.05 - 1.40 ] ; women : 1.20 [ 1.03 - 1.41 ] ) and the obese ( men : 1.46 [ 1.20 - 1.77 ] ; women : 1.64 [ 1.37 - 1.98 ] ) . High population attributable risks were related to excess weight ( BMI > or = 25 ) for the outcomes hypertension ( 26 % men ; 28 % women ) , angina pectoris ( 26 % men ; 22 % women ) , and coronary heart disease ( 23 % men ; 15 % women ) . CONCLUSIONS The overweight category is associated with increased relative and population attributable risk for hypertension and cardiovascular sequelae . Interventions to reduce adiposity and avoid excess weight may have large effects on the development of risk factors and cardiovascular disease at an individual and population level BACKGROUND It is well known that citizens of developed countries are more likely to be overweight than they were 20 years ago . The most serious health problems are not associated with overweight or moderate obesity , however , but with clinical ly severe or morbid obesity ( e.g. more than 100 pounds ( 45 kg ) overweight ) . There is no reason to expect that morbid obesity trends parallel overweight or moderate obesity . If morbid obesity is a rare pathological condition that has biological causes , the more than 10-fold increase in bariatric surgery procedures over the past eight years in the USA could have even lowered the prevalence of morbid obesity- and may very well stem the problem in other countries . OBJECTIVE To estimate trends for extreme weight categories ( BMI > 40 and > 50 ) for the period between 1986 and 2005 in the USA , and to investigate whether trends have changed since 2000 . METHODS Data from The Behavioral Risk Factor Surveillance System ( a r and om-digit telephone survey of the household population of the USA ) , for the period from 1986 to 2005 , were analysed . The main outcome measure was body mass index ( BMI ) , calculated from self-reported weight and height . RESULTS From 2000 to 2005 , the prevalence of obesity ( self-reported BMI over 30 ) increased by 24 % . However , the prevalence of a ( self-reported ) BMI over 40 ( about 100 pounds ( 45 kg ) overweight ) increased by 50 % and the prevalence of a BMI over 50 increased by 75 % , two and three times faster , respectively . The heaviest BMI groups have been increasing at the fastest rates for 20 years . CONCLUSIONS The prevalence of clinical ly severe obesity is increasing at a much faster rate among adults in the USA than is the prevalence of moderate obesity . This is consistent with the public health idea that the population weight distribution is shifting , which disproportionately increases extreme weight categories . Because comorbidities and result ing service use are much higher among severely obese individuals , the widely published trends for overweight/obesity underestimate the consequences for population health . The aggressive and costly expansion of bariatric surgery in recent years has had no visible effect on containing morbid obesity rates in the USA OBJECTIVE Given the overlap among depressive symptoms , disordered eating , and overweight , identifying shared risk factors for these conditions may inform public health interventions . This study aim ed to examine cross-sectional and prospect i ve relationships among these 3 conditions , and identify potential shared eating-related and psychosocial variable risk factors ( i.e. , body dissatisfaction , dieting , teasing experiences ) . METHOD A population -based sample ( n = 1,902 ) self-reported depressive symptoms , disordered eating ( binge eating , extreme weight control behaviors ) , weight status , and several putative risk factors ( body satisfaction , dieting frequency , weight-related teasing ) at 5-year intervals spanning early/middle adolescence , middle adolescence/early young adulthood , and early/middle young adulthood . RESULTS There was moderate overlap among depressive symptoms , disordered eating , and overweight at each time point , and moderate stability in each condition over time . Body dissatisfaction and dieting were the most potent shared risk factors for later depressive symptoms , disordered eating , and overweight among males and females ( ps < .05 ) . CONCLUSIONS Depressive symptoms , disordered eating , and overweight share several risk factors , including dieting and body dissatisfaction , which may be effective targets for interventions aim ing to simultaneously prevent these 3 conditions OBJECTIVE Many cross-sectional studies have reported a relationship between overweight/obesity and eating quickly , but there have been few longitudinal studies to address this relationship in younger population s. The purpose of this prospect i ve longitudinal study was to investigate whether eating quickly was related to being overweight in Japanese university students . METHODS Of 1,396 students who underwent a general examination and completed question naires at the start of university and before graduation , 1,314 students ( 676 male and 638 female ) of normal body composition [ body mass index ( BMI ) < 25 kg m(-2 ) ] at baseline were included in the analysis . The question naires included  speed of eating and other lifestyle factors . After a 3-year follow-up , the students whose BMI s were ≥ 25 kg m(-2 ) were defined as overweight . RESULTS In this study , 38 participants ( 2.9 % ) became overweight . In the logistic regression analysis , the risk of being overweight was increased in males [ adjusted odds ratio ( OR ) : 2.77 ; 95 % confidence interval ( CI ) : 1.33 - 5.79 ; P < 0.01 ] and in those who ate quickly at baseline ( OR : 4.40 ; 95 % CI : 2.22 - 8.75 ; P < 0.001 ) . CONCLUSIONS Eating quickly may predict risk of being overweight in Japanese university students OBJECTIVE To determine the relative importance of familial , dietary , behavioral , psychological and social risk factors for predicting body mass index ( BMI ) change , and onset of  overweight and obesity among adolescent girls . METHODS Data from the NHLBI Growth and Health Study ( n = 2 150 ) , a longitudinal cohort of girls , were used to identify the most important predictors of change in BMI percentile between the ages of 9 and 19 years , and second , risk for becoming overweight and obese . Forty-one baseline predictors were assessed using a tree-based regression method ( R and om forest ) to rank the relative importance of risk factors . RESULTS The five factors that best predicted change in BMI percentile ( p < 0.05 ) were related to family socio-economic position ( income and parent education ) and drive to restrict eating and weight ( body dissatisfaction , drive for thinness and unhappiness with physical appearance ) . The factors that were statistically significant ( p < 0.05 ) predictors of both onset of overweight and obesity were income , ineffectiveness and race . CONCLUSIONS Family socio-economic position and emotion regulation appeared as the top predictors of both BMI change and onset of overweight and obesity . Our results build upon prior findings that policies to prevent the onset of obesity during adolescence be targeted towards girls from lower socio-economic position households . Our findings also suggest several novel psychological factors including ineffectiveness as predictors of obesity during adolescence . These predictive findings offer a direction for future inquiry into adolescent obesity etiology using causal methods BACKGROUND Overweight and obesity as well as weight dissatisfaction have been increasing in prevalence worldwide . Body weight dissatisfaction and fear of fatness are potential contributors to disordered eating . The present study aim ed to investigate the prevalence of self-reported overweight and weight dissatisfaction along with associations with socio-demographic characteristics , body image , health complaints , risk behaviours , physical activity and television viewing in adolescents in Palestine . METHODS The 2003/04 Palestinian Health Behaviour in School-aged Children ( HBSC ) is a cross-sectional survey of 17,817 adolescents from 405 r and omly selected schools . Students from a representative sample of grade s 6 , 8 , 10 and 12 ( aged 12 - 18 years ) self-completed a modified version of the international World Health Organization collaborative Health Behaviour in School-aged Children ( HBSC-2002 ) question naire . RESULTS Although 16.5 % of the adolescents were overweight , almost twice that number ( 32.1 % ) were dissatisfied with their weight ( i.e. dieting or perceiving a need to diet ) . Of those adolescents , two-thirds were not actually overweight ( 56.4 % boys ; 73.5 % girls ) . One-fifth of the total number of adolescents ( 16.0 % boys ; 24.0 % girls ) were not overweight but were dissatisfied with their weight . Boys reporting overweight or weight dissatisfaction were more likely to have mothers with higher education or to be from more affluent families . Among both genders , but especially among girls , weight dissatisfaction was positively associated with most of the outcome variables ( body image , health complaints , risk behaviours , and television viewing ) regardless of weight status , whereas weight status was associated with only a few of the outcome variables . CONCLUSIONS Weight dissatisfaction , independent of weight status , is associated with body image , health complaints , risk behaviours and television viewing , and represents a potential health risk factor for adolescents . Preventive interventions should focus not only on weight status , but also on body weight dissatisfaction
The results confirmed the presence of a relation between executive functions and overweight/obesity , although the directionality of this relation was not clear ; nor did any single executive function emerge as being more involved than others in this relation .
Despite this , there was evidence of a reciprocal influence between executive functions and overweight/obesity .
Conclusions : This systematic review underlines the presence of a relationship between executive functions and overweight/obesity .
Moreover , it seems to suggest a bidirectional trend in this relationship that could be the cause of the failure of interventions for weight reduction .
Background : The increasing incidence of people affected by overweight or obesity is a significant health problem .
The knowledge of the factors which influences the inappropriate eating behaviors causing excessive body fat is an essential goal for the research .
Overweight and obesity are significant risk factors for many health diseases , such as cardiovascular problems , diabetes .
Recently , many studies have focused on the relationship between body weight and cognitive processes .
Objectives : This systematic review is aim ed to investigate the existence and the nature of the relationship between excessive body weight ( overweight/obesity ) and executive functions , analyzing cross-sectional , and longitudinal studies in order to verify the evidence of a possible causality between these variables .