Risk factors and management of overweight in Hong Kong school children.

Hui Lai Ling.Thesis (M.Phil.)--Chinese University of Hong Kong, 2001.Includes bibliographical references (leaves 180-204).Abstracts in English and Chinese.acknowledgements --- p.Icontents --- p.IIlist of abbreviation --- p.IXlist of tables --- p.XLIST OF FIGURES --- p.XIIabstract --- p.XIIIChapter chapter 1 --- introduction --- p.1Chapter 1.1 --- Overview --- p.1Chapter 1.2 --- Objectives & Hypotheses --- p.2Chapter chapter 2 --- literature review --- p.6Chapter 2.1 --- Definition of obesity --- p.6Chapter 2.1.1 --- Densitometric measurement --- p.6Chapter 2.1.2 --- Anthropometric measurement --- p.6Chapter 2.1.2.1 --- Body circumferences --- p.7Chapter 2.1.2.2 --- Skinfold thickness --- p.8Chapter 2.1.2.3 --- Weight and height ratios --- p.8Chapter 2.1.3 --- Body Mass Index to define obesity --- p.9Chapter 2.1.3.1 --- In adults --- p.9Chapter 2.1.3.2 --- In children & Adolescents --- p.9Chapter 2.2 --- Epidemic of obesity --- p.13Chapter 2.2.1 --- Worldwide prevalence & trends of obesity --- p.13Chapter 2.2.2 --- Obesity rates in Hong Kong --- p.16Chapter 2.3 --- Consequences of obesity --- p.17Chapter 2.3.1 --- Health consequences --- p.77Chapter 2.3.1.1 --- Adulthood obesity --- p.17Chapter 2.3.1.2 --- Childhood & adolescent obesity --- p.19Chapter 2.3.1.3 --- Controversy of health risk studies --- p.20Chapter 2.3.2 --- Quality of life --- p.21Chapter 2.3.3 --- Economic consequences of obesity --- p.21Chapter 2.3.4 --- Persistence of childhood obesity into adulthood --- p.22Chapter 2.5 --- Risk factors for childhood obesity --- p.24Chapter 2.5.1 --- Genetic factors --- p.24Chapter 2.5.1.1 --- Parental weight status --- p.24Chapter 2.5.1.2 --- Birth weight --- p.28Chapter 2.5.2 --- Demographic factors --- p.30Chapter 2.5.2.1 --- Socio-economic Status --- p.30Chapter 2.5.2.2 --- Family environment --- p.31Chapter 2.5.3 --- Dietary factors --- p.33Chapter 2.5.3.1 --- Infancy diet --- p.33Chapter 2.5.3.2 --- Dietary intake --- p.34Chapter 2.5.3.3 --- Eating behaviour --- p.39Chapter 2.5.4 --- Physical activity factors --- p.42Chapter 2.5.4.1 --- Inactivity --- p.42Chapter 2.5.4.2 --- Determinants of physical activity level --- p.44Chapter 2.5.4.3 --- Television-watching --- p.46Chapter 2.5.5 --- Other risk factors --- p.47Chapter 2.6 --- Management of childhood obesity --- p.49Chapter 2.6.1 --- Goals & Difficulties in childhood obesity treatment --- p.49Chapter 2.6.2 --- Dietary approach --- p.50Chapter 2.6.2.1 --- General healthy eating --- p.50Chapter 2.6.2.2 --- Decrease fat intake --- p.51Chapter 2.6.2.3 --- Increase fibre intake --- p.52Chapter 2.6.2.4 --- Reducing meal Glycaemic Index --- p.53Chapter 2.6.3 --- Increase activity level --- p.56Chapter 2.6.3.1 --- Reinforce active behaviour --- p.56Chapter 2.6.3.2 --- Decrease sedentary lifestyle --- p.57Chapter 2.6.4 --- Roles of parents and schools in obesity managements --- p.58Chapter CHAPTER 3 --- METHODOLOGY --- p.59Chapter 3.1 --- Overview --- p.59Chapter 3.2 --- Study population --- p.59Chapter 3.2.1 --- Reason for selecting 6-7 years old children --- p.59Chapter 3.2.2 --- Classification of case and control groups --- p.60Chapter 3.2.3 --- Reasons for using BMI --- p.62Chapter 3.2.4 --- Development of BMI cut-offs --- p.63Chapter 3.3 --- Estimation of sample size --- p.64Chapter 3.4 --- Subject recruitment --- p.65Chapter 3.4.1 --- Sample Source --- p.65Chapter 3.4.2 --- Inclusion criteria --- p.61Chapter 3.4.3 --- Recruitment --- p.67Chapter 3.4.4 --- Pilot Testing --- p.70Chapter 3.5 --- Data collection --- p.70Chapter 3.5.1 --- Overview --- p.70Chapter 3.5.2 --- Lifestyle data --- p.77Chapter 3.5.2.1 --- Scope of data --- p.71Chapter 3.5.2.2 --- References for questionnaire design --- p.71Chapter 3.5.2.3 --- Questionnaire content --- p.72Chapter 3.5.2.4 --- Data validity --- p.73Chapter 3.5.3 --- Dietary data --- p.76Chapter 3.5.3.1 --- The assessment method --- p.76Chapter 3.5.3.2 --- Data validity --- p.76Chapter 3.6 --- Data entry & analyses --- p.77Chapter 3.6.1 --- Data entry --- p.77Chapter 3.6.2 --- Dietary data analyses --- p.78Chapter 3.6.2.1 --- Nutrient intake --- p.78Chapter 3.6.2.2 --- Meal Glycaemic response --- p.78Chapter 3.6.3 --- Risk factor analyses --- p.79Chapter 3.6.3.1 --- Univariate analyses --- p.79Chapter 3.6.3.2 --- Multivariate analyses --- p.79Chapter 3.6.3.3 --- Further analyses --- p.80Chapter 3.6.4 --- Childhood lifestyle descriptive analyses --- p.80Chapter CHAPTER 4 --- RESULTS --- p.81Chapter 4.1 --- Overview --- p.81Chapter 4.2 --- Descriptive analyses --- p.82Chapter 4.2.1 --- Sample Size & sample source --- p.82Chapter 4.2.2 --- Sample Characteristics --- p.83Chapter 4.2.3 --- Demographic background --- p.86Chapter 4.3 --- Risk factors identification --- p.90Chapter 4.3.1 --- Overview --- p.90Chapter 4.3.2 --- Univariate analyses --- p.90Chapter 4.3.3 --- Multivariate analyses --- p.90Chapter 4.3.3.1 --- Variable selection --- p.90Chapter 4.3.3.2 --- Test for Multicollinearity --- p.91Chapter 4.3.3.3 --- Logistic regression results --- p.91Chapter 4.3.4 --- Further analyses --- p.98Chapter 4.3.4.1 --- Purposes --- p.98Chapter 4.3.4.2 --- Parental BMI --- p.99Chapter 4.3.4.3 --- Child's birth weight --- p.102Chapter 4.3.4.4 --- Eating Behaviour --- p.105Chapter 4.3.4.5 --- Dietary intake --- p.108Chapter 4.3.4.6 --- Physical activity --- p.109Chapter 4.3.4.7 --- Parental smoking --- p.110Chapter 4.3.4.8 --- Socio-economic status --- p.111Chapter 4.4 --- Children lifestyle descriptive analyses --- p.113Chapter 4.4.1 --- Inactivity in young children --- p.113Chapter 4.4.1.1 --- Exercise time and frequency --- p.113Chapter 4.4.1.2 --- Exercise preference & encouragement --- p.115Chapter 4.4.1.3 --- Determinants of exercise time --- p.117Chapter 4.4.2 --- Weight beliefs & Nutrition knowledge --- p.118Chapter 4.4.2.1 --- Weight and health beliefs --- p.118Chapter 4.4.2.2 --- Nutrition knowledge --- p.121Chapter 4.4.3 --- Dietary habits & Nutrient intake --- p.123Chapter 4.4.3.1 --- Dietary practice --- p.123Chapter 4.4.3.2 --- Nutrient intake --- p.129Chapter CHAPTER 5 --- DISCUSSION --- p.137Chapter 5.1 --- Risk factors for childhood overweight development --- p.137Chapter 5.1.1 --- Overview --- p.137Chapter 5.1.2 --- Genetic factors --- p.138Chapter 5.1.2.1 --- Parental BMI --- p.138Chapter 5.1.2.2 --- Birth weight --- p.142Chapter 5.1.3 --- Dietary factors --- p.144Chapter 5.1.3.1 --- Eating behaviours --- p.144Chapter 5.1.3.2 --- Infancy diet --- p.150Chapter 5.1.3.3 --- Current dietary intake --- p.151Chapter 5.1.4 --- Physical activity --- p.154Chapter 5.1.4.1 --- Exercise --- p.154Chapter 5.1.4.2 --- Sedentary activities --- p.155Chapter 5.1.5 --- Family environment --- p.157Chapter 5.1.5.1 --- Social class & Custody --- p.157Chapter 5.1.5.2 --- Parental smoking --- p.159Chapter 5.2 --- Lifestyle in Hong Kong young children --- p.161Chapter 5.2.1 --- Childhood inactivity --- p.161Chapter 5.2.2 --- Weight perception & Nutrition knowledge --- p.163Chapter 5.2.3 --- Dietary habits & Nutrient intake --- p.165Chapter 5.3 --- Limitations --- p.169Chapter 5.3.1 --- Study sample --- p.169Chapter 5.3.2 --- Study method --- p.171Chapter 5.4 --- Implication of the study results --- p.173Chapter 5.4.1 --- Overview --- p.173Chapter 5.4.2 --- Strategies on obesity treatments and prevention --- p.173Chapter 5.4.3 --- Conclusion --- p.775Chapter 5.5 --- Suggestions for further study --- p.176CONCLUSION --- p.178REFERENCES --- p.180APPENDICES --- p.205Chapter A. --- Communications for sample recruitmentAppendix A1 Invitation to Parents --- p.A-lAppendix A2 Contact Details Form --- p.A-3Appendix A3 Letter of thanks to SHSC Nurses --- p.A-4Appendix A4 Second letter to parents --- p.A-12Appendix A5 Written consent from parents --- p.A-14Chapter B --- Study ToolsAppendix B1 The Questionnaire --- p.B-lAppendix B2 3-day dietary record --- p.B-49Chapter C --- Childhood overweight risk factors - univariate analysesAppendix C1 Genetic factors --- p.C-1Appendix C2 Demographic factors --- p.C-2Appendix C3 Custody & Home environments --- p.C-3Appendix C4 Infant feeding factors --- p.C-4Appendix C5 Dietary manipulation & Eating desire --- p.C-5Appendix C6 Eating habits & Food preference --- p.C-6Appendix C7 Physical activity factors --- p.C-7Appendix C8 Factors influencing physical activity --- p.C-8Appendix C9 Nutrition knowledge & weight perception --- p.C-9Appendix C10 Nutrients factors --- p.C-10Appendix C11 School life & unclassified factors --- p.C-11Chapter D --- MiscellaneousAppendix D1 Research questions and related questions in the questionnaire --- p.D-lAppendix D2 Food GI estimation list --- p.D-