Applied nutritional investigationRisk factors for overweight and obesity in French adolescents: Physical activity, sedentary behavior and parental characteristics
Introduction
Overweight and obesity in childhood and adolescence have dramatically increased over the past few years in developed countries [1], [2], [3] and, to some degree, in other parts of the world [4]. Their prevalence has risen three-fold in many European countries since the 1980s. Obesity is an established risk factor for several chronic diseases [5], [6], [7], [8]. In 1998, the World Health Organization recognized obesity as a major public health epidemic [9]. Obesity is a multifactorial problem, resulting from rapidly changing social, economic, and physical environments that have led to an energy imbalance in the population through a dramatic reduction in physical activity [10], [11] and changes in dietary patterns [4], [12]. Thus, principal risk factors for childhood overweight include parental obesity, socioeconomic status (SES), physical activity, sedentary behavior, and diet [2], [3], [8], [10], [13], [14], [15].
Recent French data have shown that frequencies of overweight including obesity were 15% for 3- to 14-y-old children and 18.1% for 7- to 9-y-old French children [16], [17]. These French data are comparable to those reported in other studies conducted in Western Europe [2].
The French National Program on Nutrition and Health was launched by the ministry of health in 2001. One of its main objectives is to stop the increase in the prevalence of childhood obesity in France. Various public health actions regarding the improvement of dietary habits and physical activity in children were implemented [18], [19] in the Aquitaine region (southwest France); a multidisciplinary public health program was launched in November 2004 to improve the behavior of children and teenagers regarding diet and physical activity and to stabilize the prevalence of childhood obesity. Before implementing the program, various studies were conducted to guide the intervention and to provide baseline data to evaluate its impact on dietary habits, lifestyle, overweight, and obesity.
One of these studies sought to estimate overweight and obesity prevalence and to identify factors, particularly physical activity and sedentary behavior but also social and parental factors, that might be associated with overweight and obesity in a sample of adolescents aged 11–18 y to propose adapted action. This article reports the main results of that survey.
Section snippets
Design and subjects
The study was performed in a representative sample of middle and high school students from the Aquitaine region from November 2004 to January 2005. Subjects were selected from the population of adolescents attending public middle and high schools. Schools were selected on the basis of SES of an area, rural or urban, and willingness of sports teachers to participate in the study. Thus, 49 of the 536 middle and high schools in Aquitaine were invited to participate in the study. For each school,
Results
Of the 49 middle and high schools invited to participate in the study, six declined to participate (response rate 88%). Questionnaires were filled out by 2533 students. We included 2385 adolescents aged 11–18 y (1213 boys and 1172 girls) and excluded 148 (5.8%) adolescents younger than 11 or older than 18 y to have homogeneous age groups. This sample composed of 1390 adolescents from middle schools (664 girls and 726 boys) and of 995 adolescents from high schools (508 girls and 487 boys) is
Discussion
This study shows that the prevalence of overweight and obesity in these adolescents from middle and high schools in southwest France is situated in the average range of that reported in other studies conducted in Western Europe [2], [21], [22]. Logistic regression analysis revealed associations among overweight, obesity, and specific characteristics of the subjects or their lifestyle, such as the known link with sedentary activity [13], [23]. However, we did not find any association between
Conclusion
In summary, this study of adolescents in southwest France shows that parental low SES and overweight are strong risk factors for adolescent overweight (including obesity), as is adolescents' sedentary behavior. Conversely, physical activity in parents has a protective effect against overweight in their adolescents. Thus it is clear that the implementation of interventions of programs in schools such as the present one in southwest France is essential but not sufficient [45]. Because adolescents
Acknowledgments
The authors thank the adolescents, physical education teachers, nurses, and doctors in the participating schools and the Association of Teachers of Physical Education and Sport for their collaboration. The study was conducted as part of the Program for Nutrition, Health and Prevention in Children and Adolescents in Aquitaine, which is managed by the Union Regionale des Caisses d'Assurance Maladie, Regional Union of the National Health Insurance in Aquitaine and several other partners.
References (47)
- et al.
Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia
Am J Clin Nutr
(2002) - et al.
[French national program for nutrition and health: Effects on children's health.]
Arch Pediatr
(2009) - et al.
Risk factors for childhood overweight: a prospective study from birth to 9.5 years
J Pediatr
(2004) - et al.
Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools
Am J Prev Med
(2003) - et al.
Effects of a controlled trial of a school-based exercise program on the obesity indexes of preschool children
Am J Clin Nutr
(1998) - et al.
Attitude toward physical activity in normal-weight, overweight and obese adolescents
J Adolesc Health
(2006) - et al.
After school activities, overweight, and obesity among inner city youth
J Adolesc
(2004) - et al.
Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren
Am J Clin Nutr
(2003) Extent of overweight among US children and adolescents from 1971 to 2000
Int J Obes Relat Metab Disord
(2004)- et al.
Prevalence of overweight among children in Europe
Obes Rev
(2003)
Diet, nutrition and the prevention of chronic diseases
American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee
Circulation
Impact of overweight on the risk of developing common chronic diseases during a 10-year period
Arch Intern Med
Body mass index and colon cancer mortality in a large prospective study
Am J Epidemiol
Lifetime health and economic consequences of obesity
Arch Intern Med
Obesity: preventing and managing the global epidemic. Report of a WHO consultation
The importance of physical activity in the prevention of overweight and obesity in childhood: a review and an opinion
Obes Rev
Physical activity levels and patterns of 9- and 15-yr-old European children
Med Sci Sports Exerc
Aetiology of overweight and obesity in children and adolescents
Eur J Pediatr
The influence of physical activity, socioeconomic status, and ethnicity on the weight status of adolescents
Obes Res
Childhood predictors of adult obesity: a systematic review
Int J Obes Relat Metab Disord
Television watching and soft drink consumption: associations with obesity in 11- to 13-year-old schoolchildren
Arch Pediatr Adolesc Med
Body mass index in 7–9-y-old French children: frequency of obesity, overweight and thinness
Int J Obes Relat Metab Disord
Cited by (0)
This work was supported by a grant from the French Ministry of Health, the Healthcare Insurance Fund (FNPEIS), and the National Institute for Prevention and Health Education (INPES).