Search

Background Interventions promoting healthy behaviors such as physical activity are effective to prevent overweight and obesity among adolescents. Following such interventions, body satisfaction change could be discrepant with weight change (e.g. less body satisfaction while having lost weight), and decrease sustainability of behaviors in the long-term. This study aimed to describe the discrepancy between body satisfaction change and weight change among adolescents following a 2-year school-based intervention, and to identify associated sociodemographic factors. Methods Adolescents from the 2-year school-based ‘Promotion de l'Alimentation et de l'Activité Physique’ study conducted in northeastern France from 2006 to 2009 were included. Body satisfaction change was assessed using a self-administered questionnaire at the end of the study. Weight change was measured by the difference of body mass index z-score at end and start of the study. Discrepancy between body satisfaction change and weight change was described with cross-tabulations and weighted Cohen's kappa. Sociodemographic factors associated with discrepancy were determined by multivariate logistic regression models. Results Among the 3279 adolescents included (mean ± standard deviation age= 15.2±0.6 years), the proportion of discrepancy between body satisfaction change and weight change was 74.8% (pessimism= 41.6%; optimism= 33.2%). The weighted Cohen's kappa indicated high discrepancy (?= 0.09; 95% confidence interval [0.07; 0.11]). The likelihood of discrepancy, especially pessimism was higher in boys than in girls (odds ratio= 1.44, 95% confidence interval [1.19; 1.74], p= .0002), and higher in adolescents with high socioeconomic status than in those with low socioeconomic status (odds ratio= 1.82; 95% confidence interval [1.20; 2.74], p= .004) Conclusions Discrepancy between body satisfaction change and weight change was high among school-aged adolescents with increased likelihood for boys and adolescents with high socioeconomic status. Body satisfaction change should be considered in overweight and obesity prevention interventions alongside body weight change, and could be used as an indicator of long-term behavior maintenance.

Background If boys and girls are known to have different levels of quality of life (HRQoL), less is known about behavioural factors such as physical activity (PA), sedentary behaviour (SB) that can explain it. We aimed to analyse the mediation effect of PA and SB on the association of sex and HRQoL among adolescents. Methods 2448 adolescents (1378, 56.3% of Girls) from the PRALIMAP trial with 2-year follow-up were included. HRQoL (physical, mental, social and general dimension scores; range 0-100), PA (walking, moderate vigorous and total) and SB (sitting time) were assessed using the Duke Health profile and the IPAQ questionnaires, respectively. The 2-year mean PA and SB were calculated and categorized into high or low PA (? 1hour/day) or SB (2 hours/day out of school). We conducted a mediation analysis to investigate the causal mechanism of gender (reference=Girls) on HRQoL through PA and SB by estimating total effect (TE), natural direct effect (NDE), natural indirect effects (NIE) as well as proportion mediated (PM: proportion of sex-HRQoL relationship mediated by PA or SB). Results The direct relationship of gender and HRQoL (NDE) was significant whatever the HRQoL dimension. When using vigorous PA as mediator, PM was estimated at 13.7% (TE:11.0 [9.5 to 12.5]; NIE:1.5[0.9 to 2.1]), 19.4% (TE: 12.3 [10.6 to 14.1]; NIE: 2.4 [1.6 to 3.1]), 70.0% (TE:4.6 [3.1 to 6.2] ; NIE: 3.3 [2.5 to 4.0]) and 25.6% (TE: 9.3 [8.1 to 10.5]; NIE:2.4 [1.8 to 2.9]) for physical, mental, social and general HRQoL, respectively. Similar but less important mediation effect was observed for moderate and walking PA. For Total PA, PM was estimated 7.0%, 8.7%, 47.4% and 14.7% for physical, mental, social and general HRQoL while for SB, the mediation was inverse and less important (PM: -1.5%, -1.4%, -2.0% and -1.5% for physical, mental, social and general HRQoL respectively). Conclusion HRQoL is significantly higher in boys compared to girls among adolescents and this difference is shown to be partially mediated by differences in PA practice, especially vigorous PA. Additionally to the impact of adolescent PA in preventing non-communicable diseases in adulthood, it can also enhance their well-being.

Objective:To investigate clustering of risk behaviours in adolescents with excess weight.Design:Cross-sectional analysis of baseline data from the PRALIMAP-INÈS trial. Information on food frequency consumption (fruit, vegetables, sugary products and beverages), physical activity, sedentary behaviour (week and weekend days), smoking and alcohol consumption (current frequency and intoxication episodes) and socio-demographic data was collected using self-reported questionnaires. Behavioural risk factors were entered as categorical variables in a two-step clustering procedure: multiple correspondence analysis followed by hierarchical clustering. Associations between cluster membership and socio-demographic variables were investigated using multivariable multinomial logistic regression.Setting:French PRALIMAP-INÈS trial.Participants:Adolescents with excess weight.Results:A total of 1391 participants (13–18 years old, 58·2 % female) were included in the analysis, which resulted in the identification of four groups of participants, including, respectively, 543 (39·0 %), 373 (26·8 %), 246 (17·7 %) and 229 (16·5 %) participants. Clusters 1 and 4 showed associations of rather healthy behaviours (high physical activity and low consumption of sugary products; high consumption of fruit and vegetables, respectively), while clusters 2 and 3 showed associations of rather unhealthy behaviours (high sedentary behaviour and low consumption of fruit and vegetables; smoking and alcohol consumption, respectively). Both social status and family structure were associated with cluster membership.Conclusions:Risk behaviour patterns in adolescents with excess weight were clustered in both healthier and less healthy ways, with a complex interplay with socio-demographic factors.

International audience; Social differences in prevalence of overweight and obesity among adolescents, known as the weight social gradient, could be explained by differences in behaviours between social classes. This study examined the respective association of physical activity (PA), sedentary behaviour (SB) and weight status with adolescents' socioeconomic status. We used cross-sectional data for 1935 adolescents (13-18 years old) with overweight or obesity who participated in the PRALIMAP-INÉS (PRomotion de l'ALImentation et de l'Activité Physique - INÉgalités de Santé) trial conducted in northeastern France between 2012 and 2015. Adolescents completed the International Physical Activity Questionnaire for PA and SB and the Family Affluence Scale for socioeconomic status. Weight status was assessed by the body mass index (BMI) and BMI z-score. Social gradient of weight status, PA and SB were described according to the Family Affluence Scale (slopes) and evidenced by the linear trend test (p). Adolescents' socioeconomic status was positively associated with PA practice (frequency, vigorous PA and leisure-time PA), but there was no association with their SB. The results confirmed a significant weight social gradient: BMI (β = 0.37, p

International audience; BACKGROUND: A high prevalence of overweight/obesity among low socioeconomic status adolescents contributes to health inequalities. However, evidence-based interventions for reducing social inequalities in adolescent weight are lacking. We aimed to investigate whether strengthened care management for adolescents with low socioeconomic status has an equivalent effect in reducing overweight as standard care management in adolescents with high status.METHODS: PRALIMAP-INÈS was a multicentre trial including 35 state-run high and middle schools in the north-eastern France. A population-based sample of 1639 adolescents aged 13-18 years with screened and clinically confirmed overweight/obesity were proposed for inclusion and divided into two groups by the Family Affluence Scale score: advantaged (score > 5), receiving standard care management (A.S) and less-advantaged randomly assigned to two groups (1:2 ratio): standard care management (LA.S) and standard and strengthened care management (LA.S.S). Interventions were based on the proportionate universalism principle: universal standard care for all groups and proportionate care for the LA.S.S group. Main outcome was body mass index z-score (BMIz) assessed before and 1 year after inclusion.RESULTS: A total of 1419 adolescents were included and 1143 followed up at 1 year: 649 in A.S, 158 in LA.S and 336 in LA.S.S groups. BMIz decreased significantly for boys (-0.11 [95% CI, -0.13 to -0.08]; p

The aim of this study was to assess the associ- ation between smoking, food consumption, and antioxidant vita- min intake and plasma indexes of oxidative stress and antioxi- dant defenses in French adults. Food and nutrient intakes of 459 healthy men aged 23-57 y were estimated by the diet history method and analyzed by smoking status. Plasma a-tocopherol, ascorbic acid, and carotenoids were measured as antioxidants and malondialdehyde, protein Schiff bases, and autoantibodies against malondialdehyde-protein adducts as oxidative stress indexes. Smokers ate less fruit and vegetables than nonsmokers, leading to lower vitamin E, vitamin C, and carotene intakes, even after adjustment for age, education, and marital status. Unlike vitamin E, plasma ascorbic acid and b-carotene concentrations were reduced in smokers compared with nonsmokers and were inversely related to cigarette consumption. This difference remained significant after adjustment for alcohol and dietary intakes. Among the measured oxidative stress indexes, only Schiff base concentration was positively related to the number of cigarettes smoked. In our sample of French men, smoking had an adverse effect on antioxidant status; vitamin intakes were reduced in smokers and plasma antioxidant indexes were altered independently of dietary intakes. As in other countries, in France smokers require particular attention in terms of public health intervention. Am J Clin Nutr 1998;67:231-9.

The biological variation factors for cholesterol in circulating immune complexes (CIC-cholesterol) were studied in 941 unselected supposedly healthy volunteers, ages 4 to 78 years. We found a complex effect of age, including the existence of two peaks of CIC-cholesterol, one in males between 11 and 14 years and in females between 11 and 30 years, and in both sexes another peak between 41 and 60 years, and in both sexes a decrease between 31 and 40 years. By use of multiple regression analysis and after adjustment for age, CIC-cholesterol was positively related to plasma cholesterol concentration and leukocyte count, values being lower in females than in males and among subjects taking anti-inflammatory drugs. In addition, CIC-cholesterol was measured in 76 coronary angiography patients and in 100 supposedly healthy controls, ages 30 to 77 years. We noticed a significant increase (P < or = 0.05) of CIC-cholesterol when patients were affected by coronary stenosis between 20% and 50% (71.8 +/- 52.5 mumol/L vs 46.2 +/- 45.9 mumol/L in controls), but this was less pronounced in those with > 50% of obstruction (58.9 +/- 54.3 mumol/L); however, serum total cholesterol was not modified or even surprisingly slightly decreased in the coronary angiography individuals. Nevertheless, an important overlap of values in controls and patients makes questionable the usefulness of this variable in clinical practice.

Abstract —The relations between left ventricular mass (LVM) with age, gender, body size, and blood pressure were investigated in healthy adults and children from 149 nuclear families. LVM was strongly correlated with overall weight, especially in the children. Genetic analysis indicated that the segregation of LVM was compatible with an additive polygenic model, with a heritability estimate of 34% before adjustment for weight and 28% after adjustment for weight. Genetic and/or familial environmental factors played a strong role in the correlation of LVM and weight; they accounted for all of the correlation between the 2 traits in adults and 59% of the correlation in children. Spouses exhibited a strong correlation in their weight, which suggested that common family environment may contribute to the family correlations and to the observed heritability of the trait. LVM was strongly correlated with blood pressure before adjustment for weight, but this correlation could be attributed to nonfamilial environment rather than genetic factors. After adjustment for weight, the intertrait correlations between LVM and blood pressure were nonsignificant. Thus, adjustment for weight accounts for all common determinants of LVM and blood pressure.

BACKGROUND There seems to be a consensus that family influences on dietary habits are important but few studies have addressed this issue directly. The purpose of this study was to determine if and how dietary intake aggregates within families. METHODS We examined the family aggregation of energy intake and the proportion of protein, fat and carbohydrate in the diet, estimated by a 3-day food consumption diary in 387 middle-class French families. RESULTS For energy and all macronutrients, spouse-spouse and child-child correlations were higher than parent-child correlations suggesting the minor contribution of genetics and the preponderant role of cultural and residual random environment. Variance component analysis confirmed the absence of genetic component for energy and all macronutrients and underlined the important role of a cohabitational effect for parents. Cultural inheritance represented 30-40% of dietary intake variance for children. Families who shared meals together more often had a lower residual random component. With the increasing number of meals eaten together (> 45/week versus < or = 45/week), between-generation components increased by about 10% for fat and carbohydrate, while for protein intake, the between-generation component for both parents (about 27%) and children (about 37%) remained unchanged. CONCLUSIONS The general finding that dietary intake aggregates within families and that the individual behaviours are greatly influenced by characteristics within the family unit such as the number of meals eaten together provides additional justification for health promotion programmes that target the family as the unit for intervention.

The effects of alcohol consumption on serum concentrations of apolipoproteins (apo) A-I, C-III, B, and E and of lipoproteins (Lp) A-I, A-I:A-II, C-III, C-III:B, and (a) were studied in 132 healthy subjects, including 55 low drinkers of alcohol (50 g/day), and in 97 hospitalized alcoholic patients (> 100 g/day) without severe liver disease (especially functional insufficiency), before and after 21 days of withdrawal treatment. Serum concentrations of apo A-I, LpA-I, LpA-I:A-II, apo C-III, and LpC-III significantly (P

Background: Among adolescents, social differences in physical activity (PA) and sedentary behaviour (SB) are seldom explained. Proportionate universal interventions aimed at reducing social inequalities among overweight adolescents are uncommon. Objectives: To explore correlations between PA, SB, social, family and school-related factors among adolescents. Four research topics were elaborated: identifying factors associated with PA and SB, analysing socially less-advantaged overweight adolescents’ participation in a proportionate universal school intervention, analysing adolescents' perceptions of their PA practice, and evaluating the effectiveness of this intervention. Methods: This work is the result of two trials in the school setting: (PRomotion de l'ALIMentation et de l'Activité Physique) and PRALIMAP-INÈS (INÈgalité de Santé). The International PA Questionnaire (IPAQ) was used to measure PA and SB. Social status was defined according to socio-professional categories and the family affluence scale (FAS). Data on perceptions was collected from individual interviews. Individual interviews allowed data collection of perceptions. Logistic regressions were also carried out. Results: PA was dependent on social, family and school-related characteristics. Total energy expenditure was not sufficient to identify social differences in PA. The perceived barriers to PA practice were mostly individual and were different according to social status and gender. The proportionate universal intervention in schools successfully engaged these adolescents and reduced social inequalities related to PA. Conclusion: This work emphasises the importance of implementing specific activities in PA for socially less advantaged overweight adolescents, Contexte : Chez les adolescents, les différences sociales dans les pratiques d’activité physique (AP) et les comportements sédentaires restent peu expliquées. Les interventions universelles proportionnées visant la réduction des inégalités sociales chez les adolescents en situation de surpoids/obésité sont rares. Objectifs : Explorer les relations entre l’AP, la sédentarité, les facteurs sociaux, familiaux et scolaires chez les adolescents. Quatre axes de recherche ont été définis : identification des facteurs associés à l'AP et à la sédentarité, étude de la participation des adolescents en situation de surpoids/obésité socialement moins favorisés à une intervention universelle proportionnée en milieu scolaire, analyse de la perception des adolescents de leurs pratiques et évaluation de l'efficacité de l'intervention. Méthodes : Ces travaux sont issus d’essais en milieu scolaire : PRALIMAP (PRomotion de l'ALIMentation et de l'Activité Physique) et PRALIMAP-INÈS (INÈgalité de Santé). Le questionnaire international d’AP (IPAQ) a été utilisé pour mesurer l’AP et la sédentarité. Le niveau social a été défini à partir des catégories socioprofessionnelles et de l’échelle d’aisance familiale (FAS). Des entretiens individuels ont permis le recueil des perceptions. Des régressions logistiques ont été réalisées. Résultats : L'AP était dépendante des caractéristiques sociales, familiales et scolaires. La dépense énergétique totale n’était pas suffisante pour identifier les différences sociales en AP. Les freins perçus à la pratique d’AP étaient majoritairement individuels et étaient différents selon le niveau social et le sexe. Une intervention universelle proportionnée en milieu scolaire a permis la mobilisation de ces adolescents et de réduire les inégalités sociales d’AP. Conclusion : Ces travaux soulignent l’importance de la mise en œuvre en milieu scolaire d’actions spécifiques en AP pour les adolescents en situation de surpoids/obésité socialement moins favorisés