Longitudinal changes in health behaviours and body weight among Swedish school children - associations with age, gender and parental education – the SCIP school cohort

BMC Public Health

Emma Patterson¹  Zangin Zeebari¹  Nelleke Heinemans¹  Liselotte Schäfer Elinder¹ 

[1] Centre for Epidemiology and Community Medicine, Stockholm County Council, Box 1497, Solna 171 29, Sweden

关键词: Physical activity;    Socioeconomic status;    Longitudinal changes;    Gender;    Diet;    Children;    Body weight status;    BMI;   

Others  :  1129149
DOI  :  10.1186/1471-2458-14-640

 received in 2014-03-10, accepted in 2014-05-26,  发布年份 2014

【 摘 要 】

Background

In order to develop health promotion initiatives it is important to identify at what age gender and socioeconomic inequalities in health-related behaviours emerge. The aim of this longitudinal study was to analyse how health-related behaviours and weight status differed by age-group, gender, family socio-economic status and over time in three cohorts of school children.

Methods

All children in grades 2, 4 and 7 in a Swedish semi-urban municipality were invited to participate (n = 1,359) of which 813 (60%) consented. At baseline and after 2 years a health questionnaire was answered by all children. Height and weight was measured. Fourteen outcomes were analysed. The main and interaction effects of time, gender and parental educational level on the health-related behaviours, weight status and body mass index standard deviation score (BMIsds) were analysed by the Weighted Least Squares method for categorical repeated measures and Analysis of Variance.

Results

Nine of 12 health behaviours deteriorated over the two years: consumption of breakfast and lunch, vegetables and fruit, intake of sweetened drinks, TV viewing, club membership, being outdoors, and school recess activity; two behaviours were unchanged: intake of sweets, and active transport. Only sports participation increased with time. Girls consumed more vegetables, less sweetened drinks, performed less sports, were less physically active during recess, and had lower BMIsds, compared to boys. Those with more highly educated parents had more favourable or similar behaviours compared to those with less educated parents in 10 out of 12 health behaviours, the only exception being intake of sweets and being outdoors, and had lower BMIsds.

Conclusions

This study adds to our knowledge regarding the temporal development of health behaviours and weight status in school children. Differences with regard to gender and socioeconomic status were seen already at a young age. These results contribute to our understanding of several important determinants of obesity and chronic diseases and may inform future interventions regarding how to decrease gender and social inequalities in health.

【 授权许可】

   
2014 Elinder et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker-Collo S, Baxter A, Bell ML, Blore J, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan-Hancock C, Bucello C: A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013, 380:2224-2260.
• [2]Enghardt Barbieri H, Pearson M, Becker W: Riksmaten – Barn 2003. Livsmedels- och näringsintag bland barn i Sverige (Food and Nutrient Intake among Children in Sweden 2003). In Riksmaten – Barn 2003. Livsmedels- och näringsintag bland barn i Sverige (Food And Nutrient Intake among Children in Sweden 2003). Uppsala: National Food Agency; 2006. (Editor ed.^eds.)
• [3]Brug J, van Stralen MM, Te Velde SJ, Chinapaw MJ, De Bourdeaudhuij I, Lien N, Bere E, Maskini V, Singh AS, Maes L, Moreno L, Jan N, Kovacs E, Lobstein T, Manios Y: Differences in weight status and energy-balance related behaviors among schoolchildren across Europe: the ENERGY-project. PLoS One 2012, 7:e34742.
• [4]Currie C, Molcho M, Boyce W, Holstein B, Torsheim T, Richter M: Researching health inequalities in adolescents: the development of the Health Behaviour in School-Aged Children (HBSC) family affluence scale. Soc Sci Med 2008, 66:1429-1436.
• [5]Due P, Damsgaard MT, Rasmussen M, Holstein BE, Wardle J, Merlo J, Currie C, Ahluwalia N, Sorensen TI, Lynch J, Borraccino A, Borup I, Boyce W, Elgar F, Gabhainn SN, Krolner R, Svastisalee C, Matos MC, Nansel T, Al Sabbah H, Vereecken C, Valimaa R: Socioeconomic position, macroeconomic environment and overweight among adolescents in 35 countries. Int J Obes (Lond) 2009, 33:1084-1093.
• [6]Ball K, Cleland VJ, Timperio AF, Salmon J, Crawford DA: Socioeconomic position and children’s physical activity and sedentary behaviors: longitudinal findings from the CLAN study. J Phys Act Health 2009, 6:289-298.
• [7]Kantomaa MT, Tammelin TH, Nayha S, Taanila AM: Adolescents’ physical activity in relation to family income and parents’ education. Prev Med 2007, 44:410-415.
• [8]Magnusson MB, Sjoberg A, Kjellgren KI, Lissner L: Childhood obesity and prevention in different socio-economic contexts. Prev Med 2011, 53:402-407.
• [9]Sundblom E, Petzold M, Rasmussen F, Callmer E, Lissner L: Childhood overweight and obesity prevalences levelling off in Stockholm but socioeconomic differences persist. Int J Obes 2008, 32:1525-1530.
• [10]Moraeus L, Lissner L, Yngve A, Poortvliet E, Al-Ansari U, Sjoberg A: Multi-level influences on childhood obesity in Sweden: societal factors, parental determinants and child’s lifestyle. Int J Obes (Lond) 2012, 36:969-976.
• [11]Neumark-Sztainer D, Wall M, Story M, Standish AR: Dieting and unhealthy weight control behaviors during adolescence: associations with 10-year changes in body mass index. J Adolesc Health 2012, 50:80-86.
• [12]Odegaard AO, Jacobs DR Jr, Steffen LM, Van Horn L, Ludwig DS, Pereira MA: Breakfast frequency and development of metabolic risk. Diabetes Care 2013, 36:3100-3106.
• [13]Haug E, Rasmussen M, Samdal O, Iannotti R, Kelly C, Borraccino A, Vereecken C, Melkevik O, Lazzeri G, Giacchi M, Ercan O, Due P, Ravens-Sieberer U, Currie C, Morgan A, Ahluwalia N: Overweight in school-aged children and its relationship with demographic and lifestyle factors: results from the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) study. Int J Public Health 2009, 54(Suppl 2):167-179.
• [14]Basch CE: Breakfast and the achievement gap among urban minority youth. J Sch Health 2011, 81:635-640.
• [15]Bradlee ML, Singer MR, Qureshi MM, Moore LL: Food group intake and central obesity among children and adolescents in the Third National Health and Nutrition Examination Survey (NHANES III). Public Health Nutr 2010, 13:797-805.
• [16]Millar L, Rowland B, Nichols M, Swinburn B, Bennett C, Skouteris H, Allender S: Relationship between raised BMI and sugar sweetened beverage and high fat food consumption among children. Obesity (Silver Spring) 2014, 22:E96-E103.
• [17]Mitchell JA, Pate RR, Espana-Romero V, O’Neill JR, Dowda M, Nader PR: Moderate-to-vigorous physical activity is associated with decreases in body mass index from ages 9 to 15 years. Obesity (Silver Spring) 2013, 21:E280-E293.
• [18]Costigan SA, Barnett L, Plotnikoff RC, Lubans DR: The health indicators associated with screen-based sedentary behavior among adolescent girls: a systematic review. J Adolesc Health 2013, 52:382-392.
• [19]Olafsdottir S, Berg C, Eiben G, Lanfer A, Reisch L, Ahrens W, Kourides Y, Molnar D, Moreno LA, Siani A, Veidebaum T, Lissner L: Young children’s screen activities, sweet drink consumption and anthropometry: results from a prospective European study. Eur J Clin Nutr 2013, 2013:2013.
• [20]Basterfield L, Adamson AJ, Frary JK, Parkinson KN, Pearce MS, Reilly JJ: Longitudinal study of physical activity and sedentary behavior in children. Pediatrics 2011, 127:e24-e30.
• [21]Mitchell JA, Pate RR, Beets MW, Nader PR: Time spent in sedentary behavior and changes in childhood BMI: a longitudinal study from ages 9 to 15 years. Int J Obes (Lond) 2013, 37:54-60.
• [22]Nyberg GA, Nordenfelt AM, Ekelund U, Marcus C: Physical activity patterns measured by accelerometry in 6- to 10-yr-old children. Med Sci Sports Exerc 2009, 41:1842-1848.
• [23]Villard LC, Ryden L, Ohrvik J, Stahle A: Impact of time trends and increasing age on health behaviour of Swedish school children. Eur J Cardiovasc Prev Rehabil 2007, 14:326-332.
• [24]Northstone K, Smith AD, Newby PK, Emmett PM: Longitudinal comparisons of dietary patterns derived by cluster analysis in 7- to 13-year-old children. Br J Nutr 2013, 109:2050-2058.
• [25]Verloigne M, Van Lippevelde W, Maes L, Brug J, De Bourdeaudhuij I: Family- and school-based predictors of energy balance-related behaviours in children: a 6-year longitudinal study. Public Health Nutr 2013, 16:202-211.
• [26]Elinder LS, Heinemans N, Hagberg J, Quetel AK, Hagstromer M: A participatory and capacity-building approach to healthy eating and physical activity- SCIP-school: a 2-year controlled trial. Int J Behav Nutr Phys Act 2012, 9:145.
• [27]Cole TJ, Lobstein T: Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes 2012, 7(4):284-294.
• [28]Karlberg J, Luo ZC, Albertsson-Wikland K: Body mass index reference values (mean and SD) for Swedish children. Acta Paediatr 2001, 90:1427-1434.
• [29]Koch GG, Landis JR, Freeman JL, Freeman DH Jr, Lehnen RC: A general methodology for the analysis of experiments with repeated measurement of categorical data. Biometrics 1977, 33:133-158.
• [30]Liang KY, Zeger SL, Qaqish B: Multivariate Regression-Analyses for Categorical-Data. J Roy Stat Soc B Met 1992, 54:3-40.
• [31]Rokholm B, Baker JL, Sorensen TI: The levelling off of the obesity epidemic since the year 1999–a review of evidence and perspectives. Obes Rev 2010, 11:835-846.
• [32]Olds T, Maher C, Zumin S, Peneau S, Lioret S, Castetbon K, Bellisle , de Wilde J, Hohepa M, Maddison R, Lissner L, Sjoberg A, Zimmermann M, Aeberli I, Ogden C, Flegal K, Summerbell C: Evidence that the prevalence of childhood overweight is plateauing: data from nine countries. Int J Pediatr Obes 2011, 6:342-360.
• [33]Hoyland A, Dye L, Lawton CL: A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev 2009, 22:220-243.
• [34]Jones LR, Steer CD, Rogers IS, Emmett PM: Influences on child fruit and vegetable intake: sociodemographic, parental and child factors in a longitudinal cohort study. Public Health Nutr 2010, 13:1122-1130.
• [35]Bere E, Brug J, Klepp KI: Why do boys eat less fruit and vegetables than girls? Public Health Nutr 2008, 11:321-325.
• [36]Bere E, van Lenthe F, Klepp KI, Brug J: Why do parents’ education level and income affect the amount of fruits and vegetables adolescents eat? Eur J Public Health 2008, 18:611-615.
• [37]National Institute of Public Health: In Frukt- och grönsaks-konsumtion i Sverige (Fruit and Vegetable Intake in Sweden). Frukt- och grönsaks-konsumtion i Sverige (Fruit and Vegetable Intake in Sweden) 2011. (Editor ed.^eds.). City
• [38]Hu FB: Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes Rev 2013, 14:606-619.
• [39]Verloigne M, Van Lippevelde W, Maes L, Brug J, De Bourdeaudhuij I: Family- and school-based correlates of energy balance-related behaviours in 10-12-year-old children: a systematic review within the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project. Public Health Nutr 2012, 15:1380-1395.
• [40]Gordon ES, Tucker P, Burke SM, Carron AV: Effectiveness of physical activity interventions for preschoolers: a meta-analysis. Res Q Exerc Sport 2013, 84:287-294.
• [41]Soderstrom M, Boldemann C, Sahlin U, Martensson F, Raustorp A, Blennow M: The quality of the outdoor environment influences childrens health – a cross-sectional study of preschools. Acta Paediatr 2013, 102:83-91.
• [42]Lubans DR, Boreham CA, Kelly P, Foster CE: The relationship between active travel to school and health-related fitness in children and adolescents: a systematic review. Int J Behav Nutr Phys Act 2011, 8:5.
• [43]Jimenez-Pavon D, Fernandez-Alvira JM, te Velde SJ, Brug J, Bere E, Jan N, Kovacs E, Androutsos O, Manios Y, De Bourdeaudhuij I, Moreno LA: Associations of parental education and parental physical activity (PA) with children’s PA: the ENERGY cross-sectional study. Prev Med 2012, 55:310-314.
• [44]George ES, Rosenkranz RR, Kolt GS: Chronic disease and sitting time in middle-aged Australian males: findings from the 45 and Up Study. Int J Behav Nutr Phys Act 2013, 10:20.
• [45]Pearson N, Biddle SJ: Sedentary behavior and dietary intake in children, adolescents, and adults. A systematic review. Am J Prev Med 2011, 41:178-188.
• [46]Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, Goldfield G, Connor Gorber S: Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act 2011, 8:98.
• [47]Mitchell JA, Rodriguez D, Schmitz KH, Audrain-McGovern J: Greater screen time is associated with adolescent obesity: a longitudinal study of the BMI distribution from Ages 14 to 18. Obesity (Silver Spring) 2013, 21:572-575.
• [48]Mitchell JA, Pate RR, Dowda M, Mattocks C, Riddoch C, Ness AR, Blair SN: A prospective study of sedentary behavior in a large cohort of youth. Med Sci Sports Exerc 2012, 44:1081-1087.