Background: Low to moderate agreement between self-reported and directly measured anthropometry i... more Background: Low to moderate agreement between self-reported and directly measured anthropometry is shown in studies for adults and children. However, this issue needs further evaluation during puberty, a period marked by several transitions. We examined the correspondence of BMI status based on self-reported versus measured anthropometric data among Estonian adolescents with a specific focus on gender and age differences. Methods: Self-reported height and weight were determined in a national representative sample of Estonian schoolchildren collected within the framework of the HBSC (health behaviour of school-aged children) survey. Self-reported and directly measured height and weight were collected from 3379 students (1071 aged 11, 1133 aged 13 and 1175 aged 15 years). The standardized HBSC questionnaire was used for collecting self-reported data; direct anthropometric measures were taken after the HBSC questionnaires were completed. The accuracy of the self-reported values by age and gender groups were determined by comparing mean differences, Bland-Altman plots with limits of agreement, Kappa statistics, and by estimation of the sensitivity and positive predictive value for detecting overweight. Results: Mean self-reported weight, height and body mass index (BMI) values were significantly lower than corresponding values obtained using direct measurements. Mean differences between self-reported and directly measured weight, height and BMI were largest among 11-year-olds and smallest among students aged 15 years. Underestimation of overweight prevalence (includes obese) showed a graded trend which decreased in older age groups; the difference was greater among girls than boys in all age groups. The mean underestimation of overweight prevalence based on self-reported anthropometry was 3.6 percentage points. The positive predictive value was 72.3 % for boys and 63.4 % for girls. Conclusion: A distinct age-related pattern in underestimation of weight, height and prevalence of overweight was found; the bias decreased with increasing age. The mean underestimation of overweight prevalence based on selfreports was small, 3.6 %. Self-reported height and weight remain the method of choice in large surveys for practical and logistical reasons.
Breakfast is often considered the most important meal of the day and can benefit adolescent healt... more Breakfast is often considered the most important meal of the day and can benefit adolescent health in several ways. The aims of the present study were (1) to identify adolescents’ socio-demographic (sex, family affluence and family structure) determinants of daily breakfast consumption (DBC) and (2) to describe trends in DBC among adolescents across 23 countries. Cross-sectional surveys of nationally representative samples of adolescents (aged 11, 13, and 15 years) (n = 589,737) participating in the Health Behaviour in School-aged Children (HBSC) survey from 2002 to 2018 were used. Multilevel logistic regression analyses modeled DBC over time, adjusted for family affluence, family structure and year of survey. Four countries showed an increased trend in DBC (the Netherlands, Macedonia, Slovenia, and England). A significant decrease in DBC was observed in 15 countries (Belgium-Fr, France, Germany, Croatia, Portugal, Spain, Hungary, Poland, Russian Federation, Ukraine, Denmark, Finlan...
Objective:To examine changes in the proportions of daily, weekly and occasional consumers of suga... more Objective:To examine changes in the proportions of daily, weekly and occasional consumers of sugar-sweetened soda in six European countries that introduced/updated a tax between 2001–2002 and 2017–2018 and in neighbouring comparison countries (without a tax).Design:Repeated cross-sectional surveys.Setting:Health Behaviour in School-aged Children study, spanning five survey years (school years 2001–2002 to 2017–2018).Participants:Nationally representative samples of 13-year- and 15-year-old adolescents (n 236 623, 51·0 % girls).Results:Tax sizes (€0·02/l to €0·22/l) and pre-tax soda consumption were heterogeneous across countries. Prevalence of daily soda consumption reduced in the survey year following tax implementation in Latvia (from 17·9 to 11·9 %, P = 0·01), Finland (4·2 to 2·5 %, P = 0·001), Belgium (35·1 to 27·8 %, P < 0·001) and Portugal (17·4 to 14·9 %, P = 0·02), but not in Hungary (29·8 to 31·3 %, P = 0·47) or France (29·4 to 28·2 %, P = 0·27). However, reductions were...
The purpose of this study was to analyze changes in the prevalence of weight reduction behaviors ... more The purpose of this study was to analyze changes in the prevalence of weight reduction behaviors (WRBs) among European adolescents from 26 countries between 2001/2002 and 2017/ 2018. The impact of the perception of body weight on WLB was also analyzed, with particular attention being paid to overestimation. Methods: The data of 639,194 European adolescents aged 11, 13, and 15 years who participated in the Health Behaviour in School-aged Children survey were analyzed. Age-standardized prevalence rates of WRB were estimated separately by survey round and gender for each country, using the overall 2017/2018 Health Behaviour in School-aged Children study population as the standard. Multivariate logistic regression analyses were used to assess WRB trends over time, adjusted for survey year, body mass index, body weight misperception, and family affluence and stratified by gender and age. Results: In the 26 countries examined, the overall age-adjusted prevalence rates of WRB were 10.2% among boys and 18.0% among girls. The prevalence of WRB was higher for girls, but in the more recent surveys, gender differences in WRB decreased. There was a significant increase in the percentage of WRB among boys in most countries. Among girls, most countries did not experience IMPLICATIONS AND CONTRIBUTION This study presents changes in the prevalence of weight reduction behavior among European adolescents between 2002 and 2018. When designing public health interventions, it should be taken into account that weight reduction behavior is no longer a female phenomenon among adolescents. Conflicts of interest: There are no potential conflicts, real or perceived, for any author. Disclosure: This supplement was supported by the World Health Organization European Office and the University of Glasgow. The articles have been peer-reviewed and edited by the editorial staff of the Journal of Adolescent Health. The opinions or views expressed in this supplement are those of the authors and do not necessarily represent the official position of the funder.
Breakfast is often considered the most important meal of the day and children and adolescents can... more Breakfast is often considered the most important meal of the day and children and adolescents can benefit from breakfast consumption in several ways. The purpose of the present study was to describe trends in daily breakfast consumption (DBC) among adolescents across 31 countries participating in the HBSC survey between 2002 to 2010 and to identify socio-demographic (gender, family affluence and family structure) correlates of DBC. Cross-sectional surveys including nationally representative samples of 11-15 year olds (n = 455,391). Multilevel logistic regression analyses modeled DBC over time after adjusting for family affluence, family structure and year of survey. In all countries, children in two-parent families were more likely to report DBC compared to single parent families. In most countries (n = 19), DBC was associated with family affluence. Six countries showed an increase in DBC
Background: Low to moderate agreement between self-reported and directly measured anthropometry i... more Background: Low to moderate agreement between self-reported and directly measured anthropometry is shown in studies for adults and children. However, this issue needs further evaluation during puberty, a period marked by several transitions. We examined the correspondence of BMI status based on self-reported versus measured anthropometric data among Estonian adolescents with a specific focus on gender and age differences. Methods: Self-reported height and weight were determined in a national representative sample of Estonian schoolchildren collected within the framework of the HBSC (health behaviour of school-aged children) survey. Self-reported and directly measured height and weight were collected from 3379 students (1071 aged 11, 1133 aged 13 and 1175 aged 15 years). The standardized HBSC questionnaire was used for collecting self-reported data; direct anthropometric measures were taken after the HBSC questionnaires were completed. The accuracy of the self-reported values by age and gender groups were determined by comparing mean differences, Bland-Altman plots with limits of agreement, Kappa statistics, and by estimation of the sensitivity and positive predictive value for detecting overweight. Results: Mean self-reported weight, height and body mass index (BMI) values were significantly lower than corresponding values obtained using direct measurements. Mean differences between self-reported and directly measured weight, height and BMI were largest among 11-year-olds and smallest among students aged 15 years. Underestimation of overweight prevalence (includes obese) showed a graded trend which decreased in older age groups; the difference was greater among girls than boys in all age groups. The mean underestimation of overweight prevalence based on self-reported anthropometry was 3.6 percentage points. The positive predictive value was 72.3 % for boys and 63.4 % for girls. Conclusion: A distinct age-related pattern in underestimation of weight, height and prevalence of overweight was found; the bias decreased with increasing age. The mean underestimation of overweight prevalence based on selfreports was small, 3.6 %. Self-reported height and weight remain the method of choice in large surveys for practical and logistical reasons.
The purpose of this study was to assess recent changes in the prevalence of overweight (including... more The purpose of this study was to assess recent changes in the prevalence of overweight (including obesity) among 11-, 13- and 15-year-olds in 33 countries from 2002 to 2010. Data from 25 countries from three consecutive survey cycles (2002, 2006 and 2010) that had at least 80% response rate for self-reported height, weight and age were analysed using logistic regression analysis. Overweight prevalence increased among boys in 13 countries and among girls in 12 countries; in 10 countries, predominantly in Eastern Europe, an increase was observed for both boys and girls. Stabilization in overweight rates was noted in the remaining countries; none of the countries exhibited a decrease over the 8-year period examined. In the majority of countries (20/25) there were no age differences in trends in overweight prevalence. In over half of the countries examined overweight prevalence did not change during 2002-2010. However, increasing overweight prevalence was noted in many Eastern European ...
Fruit and vegetable consumption is linked to many positive health outcomes, nevertheless many ado... more Fruit and vegetable consumption is linked to many positive health outcomes, nevertheless many adolescents do not consume fruit and vegetables on a daily basis. Data of 488,951 adolescents, aged 11-, 13- and 15- years, from 33 mainly European and North American countries/regions participating in the cross-sectional Health Behaviour in School-aged Children surveys in 2002, 2006 and 2010, were used to investigate trends in daily fruit and vegetable consumption between 2002 and 2010. Multilevel logistic regression analyses showed an increase in daily fruit and vegetable consumption between 2002 and 2010 in the majority of countries for both genders and all three age groups. A decrease in consumption was noticed in five countries for fruit and five countries for vegetables. Overall, a positive trend was noticed, however increases in daily fruit and vegetable consumption are still indicated.
ObjectiveTo describe the prevalence of ‘graded thinness’ in children aged 11, 13 and 15 years in ... more ObjectiveTo describe the prevalence of ‘graded thinness’ in children aged 11, 13 and 15 years in eleven developed countries and to identify trends in the prevalence of ‘thinness’ (BMI < 17 kg/m2 at age 18 years) by age and gender.DesignCross-sectional study using data collected through self-reported questionnaires.SettingData were taken from the 1997/1998, 2001/2002 and 2005/2006 surveys of the Health Behaviours in School-aged Children (HBSC) Study.SubjectsChildren and adolescents from ten European countries and the USA (n 158 000).ResultsPrevalence of grades 1, 2 and 3 of thinness was higher among 11-year-old students compared with the 13- and 15-year-olds in all countries. A higher prevalence of thinness was observed in girls than in boys. Since 1998 the prevalence of thinness decreased steadily in Czech boys and girls, while it increased for French girls. In the total European sample of females, thinness decreased from 1998 to 2006 (χ2 for trend, P < 0·01). Age-adjusted log...
ObjectiveTo investigate weight concerns among adolescent boys and relationships with health indic... more ObjectiveTo investigate weight concerns among adolescent boys and relationships with health indicators and family factors.DesignAnalysis of the 2010 Health Behaviour in School-aged Children survey of 10–17-year-olds.SettingSchools in the Republic of Ireland.ResultsAmong 6187 boys, 25·1 % reported a desire to lose weight (weight ‘loss’ concern) and 7·7 % reported a desire to gain weight (weight ‘gain’ concern). Both types of weight concerns were associated with poor self-rated health, life satisfaction and happiness, and with more frequent emotional and physical symptoms. Family factors were associated with boys’ weight concerns. In adjusted analyses, the risk of weight ‘loss’ concerns decreased with daily family breakfasts (OR=0·80; 95 % CI 0·66, 0·97). The risk of weight ‘gain’ concerns decreased with frequent family evening meals (OR=0·77; 95 % CI 0·60, 0·99). Ease of communication with mother was associated with a decreased risk of weight ‘loss’ and weight ‘gain’ concerns among b...
Psychosomatic symptoms are commonly reported among young people. The potential burden of such sym... more Psychosomatic symptoms are commonly reported among young people. The potential burden of such symptoms on both young people and health services is substantial. Research from several countries indicates that psychosomatic symptoms tend to co-exist rather than occur singularly and could impose limitations on daily living and participation in school life. Objectives: The aim of this paper was to determine the weekly prevalence of somatic (headache, stomach-ache, dizziness, back ache) and psychological (feeling low, irritability/bad temper, difficulty sleeping, and nervousness) symptoms among schoolchildren in Ireland; and to explore, the influence of family material affluence on reported symptoms. Study group: 11-17 year-old school going children. Methods: Data are presented from the 2006 Irish Health Behaviour in the School-aged Children survey, comprising a nationally representative sample of schoolchildren aged 11-17 years (n = 9969). Sampling units were classes within schools with a response rate of 63% of schools and 83% of students. Results: Irritability/bad temper (43.0%) and headache (26.0%) were the most commonly reported psychological and somatic symptoms among both boys and girls. Symptom prevalence was higher among girls (range 17.8% -43.8%) than boys (range 10.7% -42.3%) and was higher among older children of both genders, except for stomachache in boys. Girls from less affluent backgrounds were significantly more likely to report frequent symptoms (55.5% vs. 50.7%). Conclusions: Multiple symptoms were inversely related to family material affluence for girls. The factors associated with psychosomatic symptoms and the consequences for schoolchildren require further investigation.
Objectives: To investigate the relationships between food poverty and food consumption, health an... more Objectives: To investigate the relationships between food poverty and food consumption, health and life satisfaction among schoolchildren. Design: Analysis of the 2002 Health Behaviour in School-aged Children (HBSC) study, a cross-sectional survey that employs a self-completion questionnaire in a nationally representative random sample of school classrooms in the Republic of Ireland. Subjects: A total of 8424 schoolchildren (aged 10-17 years) from 176 schools, with an 83% response rate from children. Results: Food poverty was found to be similarly distributed among the three social classes (15.3% in the lower social classes, 15.9% in the middle social classes and 14.8% in the higher social classes). It was also found that schoolchildren reporting food poverty are less likely to eat fruits, vegetables and brown bread, odds ratio (OR) from 0.66 (95% confidence interval (CI) 0.45-0.87) to 0.81 (95% CI 0.63 -0.99); more likely to eat crisps, fried potatoes and hamburgers, OR from 1.20 (95% CI 1.00-1.40) to 1.62 (95% CI 1.39-1.85); and more likely to miss breakfast on weekdays, OR from 1.29 (95% CI 0.33 -1.59) to 1.72 (95% CI 1.50-1.95). The risk of somatic and mental symptoms is also increased, OR from 1.48 (95% CI 1.18 -1.78) to 2.57 (95% CI 2.33-2.81); as are negative health perceptions, OR from 0.63 (95% CI 0.43-0.83) to 0.52 (95% CI 0.28-0.76) and measures of life dissatisfaction, OR from 1.88 (95% CI 1.64-2.12) to 2.25 (95% CI 2.05 -2.45). Similar results were found for life dissatisfaction in an international comparison of 32 countries. All analyses were adjusted for age and social class. Conclusions: Food poverty in schoolchildren is not restricted to those from lower social class families, is associated with a substantial risk to physical and mental health and well-being, and requires the increased attention of policy makers and practitioners.
The purpose of this study was to assess recent changes in the prevalence of overweight (including... more The purpose of this study was to assess recent changes in the prevalence of overweight (including obesity) among 11-, 13- and 15-year-olds in 33 countries from 2002 to 2010. Data from 25 countries from three consecutive survey cycles (2002, 2006 and 2010) that had at least 80% response rate for self-reported height, weight and age were analysed using logistic regression analysis. Overweight prevalence increased among boys in 13 countries and among girls in 12 countries; in 10 countries, predominantly in Eastern Europe, an increase was observed for both boys and girls. Stabilization in overweight rates was noted in the remaining countries; none of the countries exhibited a decrease over the 8-year period examined. In the majority of countries (20/25) there were no age differences in trends in overweight prevalence. In over half of the countries examined overweight prevalence did not change during 2002-2010. However, increasing overweight prevalence was noted in many Eastern European ...
Objectives: To examine overweight prevalence and its association with demographic and lifestyle f... more Objectives: To examine overweight prevalence and its association with demographic and lifestyle factors in 11-15 year olds in the HBSC 2005-2006 survey. Methods: Self-reports of height, weight, eating patterns, physical activity and sedentary behaviours were obtained from nationally representative samples in 41 countries (n=204,534 ).
Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset ... more Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset of obesity. It is considered that peers have an important role to play on adolescents' diet, however, limited research has examined the role of peers in this context. This study examined the relationship between self-efficacy for healthy eating, parent and peer support for healthy and unhealthy eating and food intake patterns. Participants were 264 boys and 219 girls (N = 483), aged 13-18 years, recruited from post-primary schools in Ireland. Self-report measures assessed self-efficacy, parent and peer support for healthy eating, and for unhealthy eating. Dietary pattern analysis, a popular alternative to traditional methods used in nutritional research, was conducted on a FFQ to derive food intake patterns. Two patterns were identified labelled 'healthy food intake' and 'unhealthy food intake'. Multi-group modelling was used to evaluate whether the hypothesized model of factors related to dietary patterns differed by gender. The multigroup model fit the data well, with only one path shown to differ by gender. Lower self-efficacy for healthy eating and higher peer support for unhealthy eating were associated with 'unhealthy food intake'. Higher self-efficacy was associated with 'healthy food intake'. Prevention programs that target self-efficacy for eating and peer support for unhealthy eating may be beneficial in improving dietary choices among adolescents. .ie (A. Fitzgerald), caroline.heary@ nuigalway.ie (C. Heary), [email protected] (C. Kelly), [email protected] (E. Nixon), [email protected] (M. Shevlin).
Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset ... more Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset of obesity. It is considered that peers have an important role to play on adolescents' diet, however, limited research has examined the role of peers in this context. This study examined the relationship between self-efficacy for healthy eating, parent and peer support for healthy and unhealthy eating and food intake patterns. Participants were 264 boys and 219 girls (N = 483), aged 13-18 years, recruited from post-primary schools in Ireland. Self-report measures assessed self-efficacy, parent and peer support for healthy eating, and for unhealthy eating. Dietary pattern analysis, a popular alternative to traditional methods used in nutritional research, was conducted on a FFQ to derive food intake patterns. Two patterns were identified labelled 'healthy food intake' and 'unhealthy food intake'. Multi-group modelling was used to evaluate whether the hypothesized model of factors related to dietary patterns differed by gender. The multigroup model fit the data well, with only one path shown to differ by gender. Lower self-efficacy for healthy eating and higher peer support for unhealthy eating were associated with 'unhealthy food intake'. Higher self-efficacy was associated with 'healthy food intake'. Prevention programs that target self-efficacy for eating and peer support for unhealthy eating may be beneficial in improving dietary choices among adolescents. .ie (A. Fitzgerald), caroline.heary@ nuigalway.ie (C. Heary), [email protected] (C. Kelly), [email protected] (E. Nixon), [email protected] (M. Shevlin).
Food choices established during childhood and adolescence tend to persist into adulthood with con... more Food choices established during childhood and adolescence tend to persist into adulthood with consequences for long-term health. Yet, to date, relatively little research has examined factors that influence the food choices of children and adolescents from their perspectives. In this article, previous research is extended by examining developmental differences between children's and adolescents' perceptions of factors influencing their food choices. Focus group discussions were conducted with 29 young people from three age groups (9-10, 13-14 and 16-18 years). An inductive thematic analysis identified three key factors as influencing food choices. These factors included intra-individual factors: the link between food preferences and awareness of healthy eating; intra-familial factors: the role of the home food environment; and extra-familial factors: eating away from the home. Findings indicate that there were developmental differences between children's and adolescents' perceptions of factors influencing food choice. Among adolescents, parental control began to diminish and adolescents exercised increased autonomy over their food choices compared with children. To develop effective nutrition interventions, it is important to gather child and adolescent input regarding factors perceived as influencing their food choices.
Background: Low to moderate agreement between self-reported and directly measured anthropometry i... more Background: Low to moderate agreement between self-reported and directly measured anthropometry is shown in studies for adults and children. However, this issue needs further evaluation during puberty, a period marked by several transitions. We examined the correspondence of BMI status based on self-reported versus measured anthropometric data among Estonian adolescents with a specific focus on gender and age differences. Methods: Self-reported height and weight were determined in a national representative sample of Estonian schoolchildren collected within the framework of the HBSC (health behaviour of school-aged children) survey. Self-reported and directly measured height and weight were collected from 3379 students (1071 aged 11, 1133 aged 13 and 1175 aged 15 years). The standardized HBSC questionnaire was used for collecting self-reported data; direct anthropometric measures were taken after the HBSC questionnaires were completed. The accuracy of the self-reported values by age and gender groups were determined by comparing mean differences, Bland-Altman plots with limits of agreement, Kappa statistics, and by estimation of the sensitivity and positive predictive value for detecting overweight. Results: Mean self-reported weight, height and body mass index (BMI) values were significantly lower than corresponding values obtained using direct measurements. Mean differences between self-reported and directly measured weight, height and BMI were largest among 11-year-olds and smallest among students aged 15 years. Underestimation of overweight prevalence (includes obese) showed a graded trend which decreased in older age groups; the difference was greater among girls than boys in all age groups. The mean underestimation of overweight prevalence based on self-reported anthropometry was 3.6 percentage points. The positive predictive value was 72.3 % for boys and 63.4 % for girls. Conclusion: A distinct age-related pattern in underestimation of weight, height and prevalence of overweight was found; the bias decreased with increasing age. The mean underestimation of overweight prevalence based on selfreports was small, 3.6 %. Self-reported height and weight remain the method of choice in large surveys for practical and logistical reasons.
Breakfast is often considered the most important meal of the day and can benefit adolescent healt... more Breakfast is often considered the most important meal of the day and can benefit adolescent health in several ways. The aims of the present study were (1) to identify adolescents’ socio-demographic (sex, family affluence and family structure) determinants of daily breakfast consumption (DBC) and (2) to describe trends in DBC among adolescents across 23 countries. Cross-sectional surveys of nationally representative samples of adolescents (aged 11, 13, and 15 years) (n = 589,737) participating in the Health Behaviour in School-aged Children (HBSC) survey from 2002 to 2018 were used. Multilevel logistic regression analyses modeled DBC over time, adjusted for family affluence, family structure and year of survey. Four countries showed an increased trend in DBC (the Netherlands, Macedonia, Slovenia, and England). A significant decrease in DBC was observed in 15 countries (Belgium-Fr, France, Germany, Croatia, Portugal, Spain, Hungary, Poland, Russian Federation, Ukraine, Denmark, Finlan...
Objective:To examine changes in the proportions of daily, weekly and occasional consumers of suga... more Objective:To examine changes in the proportions of daily, weekly and occasional consumers of sugar-sweetened soda in six European countries that introduced/updated a tax between 2001–2002 and 2017–2018 and in neighbouring comparison countries (without a tax).Design:Repeated cross-sectional surveys.Setting:Health Behaviour in School-aged Children study, spanning five survey years (school years 2001–2002 to 2017–2018).Participants:Nationally representative samples of 13-year- and 15-year-old adolescents (n 236 623, 51·0 % girls).Results:Tax sizes (€0·02/l to €0·22/l) and pre-tax soda consumption were heterogeneous across countries. Prevalence of daily soda consumption reduced in the survey year following tax implementation in Latvia (from 17·9 to 11·9 %, P = 0·01), Finland (4·2 to 2·5 %, P = 0·001), Belgium (35·1 to 27·8 %, P < 0·001) and Portugal (17·4 to 14·9 %, P = 0·02), but not in Hungary (29·8 to 31·3 %, P = 0·47) or France (29·4 to 28·2 %, P = 0·27). However, reductions were...
The purpose of this study was to analyze changes in the prevalence of weight reduction behaviors ... more The purpose of this study was to analyze changes in the prevalence of weight reduction behaviors (WRBs) among European adolescents from 26 countries between 2001/2002 and 2017/ 2018. The impact of the perception of body weight on WLB was also analyzed, with particular attention being paid to overestimation. Methods: The data of 639,194 European adolescents aged 11, 13, and 15 years who participated in the Health Behaviour in School-aged Children survey were analyzed. Age-standardized prevalence rates of WRB were estimated separately by survey round and gender for each country, using the overall 2017/2018 Health Behaviour in School-aged Children study population as the standard. Multivariate logistic regression analyses were used to assess WRB trends over time, adjusted for survey year, body mass index, body weight misperception, and family affluence and stratified by gender and age. Results: In the 26 countries examined, the overall age-adjusted prevalence rates of WRB were 10.2% among boys and 18.0% among girls. The prevalence of WRB was higher for girls, but in the more recent surveys, gender differences in WRB decreased. There was a significant increase in the percentage of WRB among boys in most countries. Among girls, most countries did not experience IMPLICATIONS AND CONTRIBUTION This study presents changes in the prevalence of weight reduction behavior among European adolescents between 2002 and 2018. When designing public health interventions, it should be taken into account that weight reduction behavior is no longer a female phenomenon among adolescents. Conflicts of interest: There are no potential conflicts, real or perceived, for any author. Disclosure: This supplement was supported by the World Health Organization European Office and the University of Glasgow. The articles have been peer-reviewed and edited by the editorial staff of the Journal of Adolescent Health. The opinions or views expressed in this supplement are those of the authors and do not necessarily represent the official position of the funder.
Breakfast is often considered the most important meal of the day and children and adolescents can... more Breakfast is often considered the most important meal of the day and children and adolescents can benefit from breakfast consumption in several ways. The purpose of the present study was to describe trends in daily breakfast consumption (DBC) among adolescents across 31 countries participating in the HBSC survey between 2002 to 2010 and to identify socio-demographic (gender, family affluence and family structure) correlates of DBC. Cross-sectional surveys including nationally representative samples of 11-15 year olds (n = 455,391). Multilevel logistic regression analyses modeled DBC over time after adjusting for family affluence, family structure and year of survey. In all countries, children in two-parent families were more likely to report DBC compared to single parent families. In most countries (n = 19), DBC was associated with family affluence. Six countries showed an increase in DBC
Background: Low to moderate agreement between self-reported and directly measured anthropometry i... more Background: Low to moderate agreement between self-reported and directly measured anthropometry is shown in studies for adults and children. However, this issue needs further evaluation during puberty, a period marked by several transitions. We examined the correspondence of BMI status based on self-reported versus measured anthropometric data among Estonian adolescents with a specific focus on gender and age differences. Methods: Self-reported height and weight were determined in a national representative sample of Estonian schoolchildren collected within the framework of the HBSC (health behaviour of school-aged children) survey. Self-reported and directly measured height and weight were collected from 3379 students (1071 aged 11, 1133 aged 13 and 1175 aged 15 years). The standardized HBSC questionnaire was used for collecting self-reported data; direct anthropometric measures were taken after the HBSC questionnaires were completed. The accuracy of the self-reported values by age and gender groups were determined by comparing mean differences, Bland-Altman plots with limits of agreement, Kappa statistics, and by estimation of the sensitivity and positive predictive value for detecting overweight. Results: Mean self-reported weight, height and body mass index (BMI) values were significantly lower than corresponding values obtained using direct measurements. Mean differences between self-reported and directly measured weight, height and BMI were largest among 11-year-olds and smallest among students aged 15 years. Underestimation of overweight prevalence (includes obese) showed a graded trend which decreased in older age groups; the difference was greater among girls than boys in all age groups. The mean underestimation of overweight prevalence based on self-reported anthropometry was 3.6 percentage points. The positive predictive value was 72.3 % for boys and 63.4 % for girls. Conclusion: A distinct age-related pattern in underestimation of weight, height and prevalence of overweight was found; the bias decreased with increasing age. The mean underestimation of overweight prevalence based on selfreports was small, 3.6 %. Self-reported height and weight remain the method of choice in large surveys for practical and logistical reasons.
The purpose of this study was to assess recent changes in the prevalence of overweight (including... more The purpose of this study was to assess recent changes in the prevalence of overweight (including obesity) among 11-, 13- and 15-year-olds in 33 countries from 2002 to 2010. Data from 25 countries from three consecutive survey cycles (2002, 2006 and 2010) that had at least 80% response rate for self-reported height, weight and age were analysed using logistic regression analysis. Overweight prevalence increased among boys in 13 countries and among girls in 12 countries; in 10 countries, predominantly in Eastern Europe, an increase was observed for both boys and girls. Stabilization in overweight rates was noted in the remaining countries; none of the countries exhibited a decrease over the 8-year period examined. In the majority of countries (20/25) there were no age differences in trends in overweight prevalence. In over half of the countries examined overweight prevalence did not change during 2002-2010. However, increasing overweight prevalence was noted in many Eastern European ...
Fruit and vegetable consumption is linked to many positive health outcomes, nevertheless many ado... more Fruit and vegetable consumption is linked to many positive health outcomes, nevertheless many adolescents do not consume fruit and vegetables on a daily basis. Data of 488,951 adolescents, aged 11-, 13- and 15- years, from 33 mainly European and North American countries/regions participating in the cross-sectional Health Behaviour in School-aged Children surveys in 2002, 2006 and 2010, were used to investigate trends in daily fruit and vegetable consumption between 2002 and 2010. Multilevel logistic regression analyses showed an increase in daily fruit and vegetable consumption between 2002 and 2010 in the majority of countries for both genders and all three age groups. A decrease in consumption was noticed in five countries for fruit and five countries for vegetables. Overall, a positive trend was noticed, however increases in daily fruit and vegetable consumption are still indicated.
ObjectiveTo describe the prevalence of ‘graded thinness’ in children aged 11, 13 and 15 years in ... more ObjectiveTo describe the prevalence of ‘graded thinness’ in children aged 11, 13 and 15 years in eleven developed countries and to identify trends in the prevalence of ‘thinness’ (BMI < 17 kg/m2 at age 18 years) by age and gender.DesignCross-sectional study using data collected through self-reported questionnaires.SettingData were taken from the 1997/1998, 2001/2002 and 2005/2006 surveys of the Health Behaviours in School-aged Children (HBSC) Study.SubjectsChildren and adolescents from ten European countries and the USA (n 158 000).ResultsPrevalence of grades 1, 2 and 3 of thinness was higher among 11-year-old students compared with the 13- and 15-year-olds in all countries. A higher prevalence of thinness was observed in girls than in boys. Since 1998 the prevalence of thinness decreased steadily in Czech boys and girls, while it increased for French girls. In the total European sample of females, thinness decreased from 1998 to 2006 (χ2 for trend, P < 0·01). Age-adjusted log...
ObjectiveTo investigate weight concerns among adolescent boys and relationships with health indic... more ObjectiveTo investigate weight concerns among adolescent boys and relationships with health indicators and family factors.DesignAnalysis of the 2010 Health Behaviour in School-aged Children survey of 10–17-year-olds.SettingSchools in the Republic of Ireland.ResultsAmong 6187 boys, 25·1 % reported a desire to lose weight (weight ‘loss’ concern) and 7·7 % reported a desire to gain weight (weight ‘gain’ concern). Both types of weight concerns were associated with poor self-rated health, life satisfaction and happiness, and with more frequent emotional and physical symptoms. Family factors were associated with boys’ weight concerns. In adjusted analyses, the risk of weight ‘loss’ concerns decreased with daily family breakfasts (OR=0·80; 95 % CI 0·66, 0·97). The risk of weight ‘gain’ concerns decreased with frequent family evening meals (OR=0·77; 95 % CI 0·60, 0·99). Ease of communication with mother was associated with a decreased risk of weight ‘loss’ and weight ‘gain’ concerns among b...
Psychosomatic symptoms are commonly reported among young people. The potential burden of such sym... more Psychosomatic symptoms are commonly reported among young people. The potential burden of such symptoms on both young people and health services is substantial. Research from several countries indicates that psychosomatic symptoms tend to co-exist rather than occur singularly and could impose limitations on daily living and participation in school life. Objectives: The aim of this paper was to determine the weekly prevalence of somatic (headache, stomach-ache, dizziness, back ache) and psychological (feeling low, irritability/bad temper, difficulty sleeping, and nervousness) symptoms among schoolchildren in Ireland; and to explore, the influence of family material affluence on reported symptoms. Study group: 11-17 year-old school going children. Methods: Data are presented from the 2006 Irish Health Behaviour in the School-aged Children survey, comprising a nationally representative sample of schoolchildren aged 11-17 years (n = 9969). Sampling units were classes within schools with a response rate of 63% of schools and 83% of students. Results: Irritability/bad temper (43.0%) and headache (26.0%) were the most commonly reported psychological and somatic symptoms among both boys and girls. Symptom prevalence was higher among girls (range 17.8% -43.8%) than boys (range 10.7% -42.3%) and was higher among older children of both genders, except for stomachache in boys. Girls from less affluent backgrounds were significantly more likely to report frequent symptoms (55.5% vs. 50.7%). Conclusions: Multiple symptoms were inversely related to family material affluence for girls. The factors associated with psychosomatic symptoms and the consequences for schoolchildren require further investigation.
Objectives: To investigate the relationships between food poverty and food consumption, health an... more Objectives: To investigate the relationships between food poverty and food consumption, health and life satisfaction among schoolchildren. Design: Analysis of the 2002 Health Behaviour in School-aged Children (HBSC) study, a cross-sectional survey that employs a self-completion questionnaire in a nationally representative random sample of school classrooms in the Republic of Ireland. Subjects: A total of 8424 schoolchildren (aged 10-17 years) from 176 schools, with an 83% response rate from children. Results: Food poverty was found to be similarly distributed among the three social classes (15.3% in the lower social classes, 15.9% in the middle social classes and 14.8% in the higher social classes). It was also found that schoolchildren reporting food poverty are less likely to eat fruits, vegetables and brown bread, odds ratio (OR) from 0.66 (95% confidence interval (CI) 0.45-0.87) to 0.81 (95% CI 0.63 -0.99); more likely to eat crisps, fried potatoes and hamburgers, OR from 1.20 (95% CI 1.00-1.40) to 1.62 (95% CI 1.39-1.85); and more likely to miss breakfast on weekdays, OR from 1.29 (95% CI 0.33 -1.59) to 1.72 (95% CI 1.50-1.95). The risk of somatic and mental symptoms is also increased, OR from 1.48 (95% CI 1.18 -1.78) to 2.57 (95% CI 2.33-2.81); as are negative health perceptions, OR from 0.63 (95% CI 0.43-0.83) to 0.52 (95% CI 0.28-0.76) and measures of life dissatisfaction, OR from 1.88 (95% CI 1.64-2.12) to 2.25 (95% CI 2.05 -2.45). Similar results were found for life dissatisfaction in an international comparison of 32 countries. All analyses were adjusted for age and social class. Conclusions: Food poverty in schoolchildren is not restricted to those from lower social class families, is associated with a substantial risk to physical and mental health and well-being, and requires the increased attention of policy makers and practitioners.
The purpose of this study was to assess recent changes in the prevalence of overweight (including... more The purpose of this study was to assess recent changes in the prevalence of overweight (including obesity) among 11-, 13- and 15-year-olds in 33 countries from 2002 to 2010. Data from 25 countries from three consecutive survey cycles (2002, 2006 and 2010) that had at least 80% response rate for self-reported height, weight and age were analysed using logistic regression analysis. Overweight prevalence increased among boys in 13 countries and among girls in 12 countries; in 10 countries, predominantly in Eastern Europe, an increase was observed for both boys and girls. Stabilization in overweight rates was noted in the remaining countries; none of the countries exhibited a decrease over the 8-year period examined. In the majority of countries (20/25) there were no age differences in trends in overweight prevalence. In over half of the countries examined overweight prevalence did not change during 2002-2010. However, increasing overweight prevalence was noted in many Eastern European ...
Objectives: To examine overweight prevalence and its association with demographic and lifestyle f... more Objectives: To examine overweight prevalence and its association with demographic and lifestyle factors in 11-15 year olds in the HBSC 2005-2006 survey. Methods: Self-reports of height, weight, eating patterns, physical activity and sedentary behaviours were obtained from nationally representative samples in 41 countries (n=204,534 ).
Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset ... more Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset of obesity. It is considered that peers have an important role to play on adolescents' diet, however, limited research has examined the role of peers in this context. This study examined the relationship between self-efficacy for healthy eating, parent and peer support for healthy and unhealthy eating and food intake patterns. Participants were 264 boys and 219 girls (N = 483), aged 13-18 years, recruited from post-primary schools in Ireland. Self-report measures assessed self-efficacy, parent and peer support for healthy eating, and for unhealthy eating. Dietary pattern analysis, a popular alternative to traditional methods used in nutritional research, was conducted on a FFQ to derive food intake patterns. Two patterns were identified labelled 'healthy food intake' and 'unhealthy food intake'. Multi-group modelling was used to evaluate whether the hypothesized model of factors related to dietary patterns differed by gender. The multigroup model fit the data well, with only one path shown to differ by gender. Lower self-efficacy for healthy eating and higher peer support for unhealthy eating were associated with 'unhealthy food intake'. Higher self-efficacy was associated with 'healthy food intake'. Prevention programs that target self-efficacy for eating and peer support for unhealthy eating may be beneficial in improving dietary choices among adolescents. .ie (A. Fitzgerald), caroline.heary@ nuigalway.ie (C. Heary), [email protected] (C. Kelly), [email protected] (E. Nixon), [email protected] (M. Shevlin).
Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset ... more Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset of obesity. It is considered that peers have an important role to play on adolescents' diet, however, limited research has examined the role of peers in this context. This study examined the relationship between self-efficacy for healthy eating, parent and peer support for healthy and unhealthy eating and food intake patterns. Participants were 264 boys and 219 girls (N = 483), aged 13-18 years, recruited from post-primary schools in Ireland. Self-report measures assessed self-efficacy, parent and peer support for healthy eating, and for unhealthy eating. Dietary pattern analysis, a popular alternative to traditional methods used in nutritional research, was conducted on a FFQ to derive food intake patterns. Two patterns were identified labelled 'healthy food intake' and 'unhealthy food intake'. Multi-group modelling was used to evaluate whether the hypothesized model of factors related to dietary patterns differed by gender. The multigroup model fit the data well, with only one path shown to differ by gender. Lower self-efficacy for healthy eating and higher peer support for unhealthy eating were associated with 'unhealthy food intake'. Higher self-efficacy was associated with 'healthy food intake'. Prevention programs that target self-efficacy for eating and peer support for unhealthy eating may be beneficial in improving dietary choices among adolescents. .ie (A. Fitzgerald), caroline.heary@ nuigalway.ie (C. Heary), [email protected] (C. Kelly), [email protected] (E. Nixon), [email protected] (M. Shevlin).
Food choices established during childhood and adolescence tend to persist into adulthood with con... more Food choices established during childhood and adolescence tend to persist into adulthood with consequences for long-term health. Yet, to date, relatively little research has examined factors that influence the food choices of children and adolescents from their perspectives. In this article, previous research is extended by examining developmental differences between children's and adolescents' perceptions of factors influencing their food choices. Focus group discussions were conducted with 29 young people from three age groups (9-10, 13-14 and 16-18 years). An inductive thematic analysis identified three key factors as influencing food choices. These factors included intra-individual factors: the link between food preferences and awareness of healthy eating; intra-familial factors: the role of the home food environment; and extra-familial factors: eating away from the home. Findings indicate that there were developmental differences between children's and adolescents' perceptions of factors influencing food choice. Among adolescents, parental control began to diminish and adolescents exercised increased autonomy over their food choices compared with children. To develop effective nutrition interventions, it is important to gather child and adolescent input regarding factors perceived as influencing their food choices.
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Papers by Colette Kelly