OBJECTIVES: The 24-hour movement behaviors, comprising physical activity, sedentary behavior, and sleep, are crucial factors affecting children's mental health. This study aims to explore the longitudinal association between 24-hour movement behaviors and psychological well-being in overweight and obese children, providing empirical evidence for mental health promotion in this population. METHODS: A total of 445 overweight and obese children were recruited via stratified cluster random sampling from a provincial capital city in China and followed up for one year. Measures included objectively assessed physical activity and sleep duration using triaxial accelerometers (ActiGraph GT3X+), parent-reported sedentary screen-based time (SST), and self-reported psychological well-being. RESULTS: After one year, the proportion of children meeting all 3 movement guidelines increased from 10.11% to 11.68%, while those meeting none increased from 11.24% to 15.06%. After adjusting for relevant covariates, children who met individual guidelines for moderate-to-vigorous physical activity (MVPA) (β=0.377, 95% CI 0.209 to 0.545), sleep (β=0.187, 95% CI 0.042 to 0.332), or guideline combinations of MVPA+SST (β=0.545, 95% CI 0.377 to 0.713) and MVPA+sleep (β=0.602, 95% CI 0.449 to 0.755) showed significant improvements in psychological well-being after one year. Additionally, an increase in the number of guidelines met was significantly associated with improved well-being (β=0.113, 95% CI 0.011 to 0.214). CONCLUSIONS Adherence to any single movement guideline, especially MVPA or sleep, and combinations such as MVPA+SST or MVPA+sleep is significantly associated with enhanced psychological well-being in overweight and obese children. Integrated behaviors may be an effective strategy to improve mental well-being in this population.
Humans ; Child ; Exercise/psychology* ; Sleep ; Sedentary Behavior ; Female ; Male ; Pediatric Obesity/psychology* ; Overweight/psychology* ; Mental Health ; China ; Accelerometry ; Psychological Well-Being

BACKGROUND: The prevalence of obesity and overweight in childhood has increased dramatically over the past decades globally. Thus, the risk factors of overweight and obesity in children and adolescents must be studied. OBJECTIVES: This study aimed to reveal the prevalence of childhood obesity and examine the relationship between socioeconomic status (SES) and z-body mass index (z-BMI) via parental obesity and dietary intake using path analysis. METHODS: Stratified cluster sampling was used to select 17,007 participants aged 6-12 years on two avenues per region in urban, suburban, and rural areas. Path analysis was conducted to examine the mediators between SES and z-BMI. RESULTS: The prevalence rates of overweight and obesity were 13.36% and 8.60%, respectively, and were positively correlated with the father's education level, family income, a birth weight > 3000g, a parental obesity history, vegetable intake and red meat intake (all P < 0.05). Four mediators (paternal obesity history, red meat intake, vegetable intake, and nutritional supplements) were observed, and the four path analyses were significant (all P < 0.05). The adjusted total effects on z-BMI were significant for income (β CONCLUSIONS The prevalence of overweight/obesity in children was notable, and the relationship between SES and z-BMI was mediated by paternal obesity history and dietary intake.
Child ; China/epidemiology* ; Cross-Sectional Studies ; Eating/psychology* ; Fathers/statistics & numerical data* ; Female ; Humans ; Male ; Obesity/psychology* ; Pediatric Obesity/etiology* ; Social Class

The risk of fracture secondary to low-impact trauma is greater in obese children, suggesting obese children are at risk of skeletal fragility. However, despite this finding, there is a lack of agreement about the impact of excessive adiposity on skeletal development. The combination of poor diet, sedentary lifestyle, greater force generated on impact through falls, and greater propensity to falls may in part explain the increased risk of fracture in obese children. To date, evidence suggests that in early childhood years, obesity confers a structural advantage to the developing skeleton. However, in time, this relationship attenuates and then reverses, such that there is a critical period during skeletal development when obesity has a detrimental effect on skeletal structure and strength. Fat mass may be important to the developing cortical and trabecular bone compartments, provided that gains in fat mass are not excessive. However, when fat accumulation reaches excessive levels, unfavorable metabolic changes may impede skeletal development. Evidence from studies examining bone microstructure suggests skeletal adaption to excessive load fails, and bone strength is relatively diminished in relation to body size in obese children. Mechanisms that may explain these changes include changes in the hormonal environment, particularly in relation to alterations in adipokines and fat distribution. Given the concomitant rise in the prevalence of childhood obesity and fractures, as well as adult osteoporosis, further work is required to understand the relationship between obesity and skeletal development.
Accidental Falls ; Adipokines ; Adiposity ; Adult ; Body Size ; Bone Density ; Child* ; Critical Period (Psychology) ; Diet ; Humans ; Obesity ; Osteoporosis ; Pediatric Obesity ; Prevalence ; Sedentary Lifestyle ; Skeleton

Understanding obesity in children is crucial because it can lead to adulthood obesity and result in fatal chronic diseases. Distinctive factors associated with obesity in adults have been described, but distinctive factors related to children remain unclear. We analyzed the correlation between the percentage of body mass index and lifestyle habits by conducting surveys on physical, nutritional, and psychological factors, and we used annual physical examination data to compare different traits among elementary school students (n = 197) and middle school students (n = 461). Our study revealed that the computing hours in elementary school students with overweight and obesity were significantly correlated with the percentage of body mass index (r = 0.29 on school days and r = 0.35 on days off, all P < 0.05). No statistically significant difference was found (all P > 0.05) in the computing hours of middle school students with overweight and obesity. Childhood obesity can cause depression and reduce children's quality of life because of their distorted body perception. In conclusion, physical factors directly affecting childhood obesity and psychological and environmental factors surrounding a child should be considered.
Adolescent ; Body Mass Index ; Child ; Diet ; Exercise ; Feeding Behavior ; Female ; Humans ; Male ; Pediatric Obesity ; epidemiology ; Physical Examination ; Quality of Life ; Republic of Korea ; epidemiology ; Students ; psychology ; Surveys and Questionnaires

Objective: To analyze the relationship between family-related factors and the status of overweight and obesity in children and adolescents aged 6-17 years in China. Methods: Data were collected from the China National Nutrition and Health Surveillance in 2010-2012 program. A sample of 6 343 subjects aged 6-17 years was selected, with matched weight, education levels, household income and other family related factors of their parents. Univariate analysis and multivariate logistic regression were used to explore the relationship between family factors and overweight and obesity in school-aged children and adolescents. Results: After adjusted for age, gender and region, results from the multivariate logistic regression showed that both the overweight and obesity of children and adolescents were associated with maternal BMI (OR=1.83, 95%CI: 1.63-2.05), paternal BMI (OR=1.74, 95%CI: 1.57-1.94), mother's educational level (OR=1.24, 95%CI: 1.12-1.37) and household income (OR=1.30, 95%CI: 1.15-1.46). Conclusion: Factors as overweight or obesity status of the parents, mother's educational level and household income were positively correlated with the prevalence of overweight and obesity in Chinese children and adolescents.
Adolescent ; Body Mass Index ; Body Weight ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Family/psychology* ; Family Characteristics ; Female ; Humans ; Male ; Obesity/psychology* ; Overweight/psychology* ; Parent-Child Relations ; Parents ; Pediatric Obesity/ethnology* ; Prevalence ; Schools

PURPOSE: The purpose of the study was to evaluate a parent involvement intervention for childhood obesity intended to increase parents' skills in managing children's weight-related behavior and to improve child-parent relationships. Many studies reported on parental influence on childhood obesity, emphasizing parent involvement in prevention and management of childhood obesity. METHODS: A randomized controlled trial was conducted. Forty-two parents of overweight/obese children were recruited from four cities and randomized to the experimental group or control group. The parental intervention was provided only to parents in the experimental group and consisted of weekly news-letters and text messages for a period of 5 weeks. Exercise classes and nutrition education were provided to all children. Lifestyle Behaviour Checklist and the Child-Parent Relationship Scale (CPRS) were used for measurement of parent outcome. For the child outcome, dietary self-efficacy, exercise frequency, and body mass index were measured. A mixed-design analysis of variance was performed with city location entered as a random effect. RESULTS: After the intervention, CPRS of parents and dietary self-efficacy of children showed an increase in the experimental group (p < .05). Intervention effects differed significantly according to the city location regarding the control efficacy of parents and dietary self-efficacy of children (p < .05). CONCLUSIONS: The results support the effectiveness of the parent involvement intervention in promoting child-parent relationship and dietary self-efficacy of children. However, a 5-week parent involvement intervention was not sufficient to produce significant changes in children's body mass index. Further research is needed to investigate effects of parent involvement intervention with long-term evaluation.
Adult ; Attitude to Health ; *Body Weight Maintenance ; Child ; Diet Therapy/*psychology ; Feeding Behavior/*psychology ; Female ; Health Promotion/*methods ; Humans ; Male ; Middle Aged ; Parent-Child Relations ; Parenting/psychology ; Parents/*psychology ; Pediatric Obesity/*prevention & control ; Republic of Korea

BACKGROUND: There is high interest in a new approach to improve children's lifestyle habits in order to prevent childhood obesity. A smartphone application (app) is a new technology platform that can be used to prevent childhood obesity. METHODS: The key messages for healthy eating habits and physical activities were selected by experts in nutrition, physical activity, and psychology and were adjusted for use in elementary school students. Gamification techniques were used to increase app user engagement. A total of 249 students in grades 4-6 were asked to rate their satisfaction for the app after 4 weeks of use. RESULTS: The main menu of "HAPPY ME" was composed of user profile, "EVERYDAY QUEST," exercise diary, diet diary, settings, and notifications. The app users were asked to complete 6-9 daily missions regarding healthy eating habits and physical activities through "EVERYDAY QUEST." The mean satisfaction scores for each variable were distributed from 3.6 to 4.0 points, and most of the students responded that they would continue to use the app (4.0 points). CONCLUSION: We developed a smartphone app (HAPPY ME) for 4th-6th grade elementary students aimed to provide educational information about healthy eating habits and physical activities in order to prevent childhood.
Child ; Diet ; Eating ; Humans ; Life Style ; Motor Activity ; Pediatric Obesity ; Psychology ; Religious Missions ; Smartphone

OBJECTIVES: To examine the relationship between health-related quality of life (HRQoL) and body mass index (BMI) of obese children. METHODS: This cross-sectional study included 387 children. HRQoL was measured with the PedsQLTM 4.0 Generic Core Scale. BMI was classified according to the World Health Organization Asia-Pacific obesity guidelines. Psychosocial factors (body image, self-esteem, and depression/anxiety) were also measured. Data were analyzed using one-way analysis of variance, Pearson's correlation and Path analysis. RESULTS: Obese participants reported lower score for physical evaluation, self-esteem, appearance evaluation component of body image, total HRQoL score, and physical/emotional/social function components of HRQoL ; they reported higher score for depression/anxiety. In addition, results indicated that as BMI increased, appearance evaluation, total HRQoL score, and social function component of HRQoL dropped. Path analysis revealed that BMI did not directly affect HRQoL ; however, BMI directly affects body image and self-esteem, indirectly mediates depression/anxiety, and thereby impacts on an individual's HRQoL. CONCLUSIONS: Body image and self-esteem, rather than BMI itself, have more influence on HRQoL. This reinforces the importance of therapeutic intervention to enhance body image and self-esteem among obese children.
Body Image ; Body Mass Index ; Child* ; Cross-Sectional Studies ; Humans ; Obesity* ; Pediatric Obesity ; Psychology ; Quality of Life* ; World Health Organization

BACKGROUND: Adolescent obesity has a high risk of developing into adult obesity and may cause many physical and psychological problems. The purpose of this study was to investigate familial environment and psychosocial factors of adolescent obesity. METHODS: A total of 1,153 students from one middle school located in suburban area were chosen as subjects. In this study, the obese group was defined to have an obesity index higher than 85 pecentile, compared to the normal weight group which ranged between 25 and 75 percentile. The questionnaires included items on familial environment and psychosocial factors, their parents' BMI, physical activity, self esteem inventory, depression self rating scale, and FACES III (family cohesion and adaptability scale III). RESULTS: Maternal BMI of the obese group was significantly higher than that of the normal weight group. The mean self esteem score of the obese group was significantly lower than that of the normal weight group. Depression self-rating score of the female obese group was significantly higher than that of the normal weight group. There was no difference in family functioning between the obese group and the normal weight group. CONCLUSION: In multivariate analysis, there were significant correlations among adolescent obesity and higher maternal BMI and lower self-esteem. It will be necessary to evaluate and support the psychosocial factors in the management of adolescent obesity.
Adolescent* ; Adult ; Depression ; Female ; Humans ; Motor Activity ; Multivariate Analysis ; Obesity ; Pediatric Obesity* ; Psychology* ; Self Concept ; Surveys and Questionnaires

BACKGROUND: The pathological significance of adolescent obesity is increasing, as research results indicate that about 80 percent of obese teenager becomes obese as adults. However, most studies on obesity have been mainly centered on the biomolecular aspect of obesity, thereby offering little solution to the clinical application and the promotion of overall health for people. This study investigates into the psychological factors of adolescent obesity, mainly that relating to stress. METHODS: After having chosen 14 third year classes from two middle schools, one from the Kang nam and the other from the Kang puk region of Seoul, I have distributed questionnaires to the total of 501 students. For calculating the degree of stress among the students, I have employed the BEPSI (Brief Encounter Psychosocial Instrument) K, transforming each 5 positive questions into 1 point, which were summed up and divided by 5 (the BEPSI K score). RESULTS: Controlling the confounding factor, the regression coefficient regarding the Body Mass Index of the BEPSI K score was 0.661, t as 3.122, and R Square as 0.05, indicating the statistical relevance of the two factors. A multiple linear regression analysis of theses data yielded the following equation: Body Mass Index=15.6+0.661 x BEPSI K score(R2=0.05) Although the R Squre, as 0.05, was relatively low, this statistical result proves that the rise in stress contributes to the increase of Body Mass Index, thereby indicating that stress functions as an important factor for adolescent obesity. CONCLUSION: For remedying and preventing adolescent obesity, one must make use of the BEPSI K examination and calculate the degree of stress among the adolescent. This study further implies that the best solution to the problems of obesity among adolescent is for the family members, the educational institutions, and the society as a whole to understand and to help the adolescent overcome frequent mental stress resulting from their daily living.
Adolescent* ; Adult ; Body Mass Index* ; Humans ; Linear Models ; Obesity ; Pediatric Obesity ; Psychology ; Seoul ; Surveys and Questionnaires