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Influence des parents sur les comportements alimentaires des enfants exposés à un projet d'éducation nutritionnelle implanté dans huit écoles primaires de milieux défavorisés de Montréal : le projet Petits cuistots - Parents en réseaux (PC-PR)
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intensity. After adjusting for age, sex, Tanner stage, socioeconomic status, and parental BMI, only short-duration sleepers (<10 hours) had an increased odds of overweight/obesity (OR = 2.08, 95% CI 1.16-3.67). Addition of total energy intake and physical activity to the model did not change the association substantially (OR = 2.05, 95% CI 1.15-3.63). conclusion: The present study provides evidence that short sleep duration is an independent risk factor for overweight and obesity in children. 18 carotid artery intima-media thickness and adiposity in 8- to 10-year-old children Katerina Maximova1, Marie Lambert2, Jennifer O’Loughlin3, Gilles Paradis4, and Josée Dubois2 1 School of Public Health, University of Alberta, Edmonton, Alberta, Canada; 2Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Québec, Canada; 3 Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada, Centre de recherché de Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada; 4Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada, McGill University Health Centre Research Institute, Montréal, Québec, Canada, Public Health Institute of Québec, Montréal, Canada background: Carotid artery intima-media thickness (IMT) is a highly predictive surrogate marker of cardiovascular risk in adults. Few reports are available on IMT in population-based samples of children. We sought to describe the associations between IMT and BMI, waist circumference (WC), skinfold thickness, and measures of fat mass and central fat mass assessed by DXA in 8- to 10-year-old children. Methods: The QUALITY Study (www.etudequalitystudy.ca) follows a cohort of 632 Caucasian families (father, mother and child aged 8-10 years at cohort inception) in whom at least one biological parent was obese (BMI ≥30kg/m² and/or WC ≥102cm in men, and ≥88cm in women). This analysis is based on baseline data collected in 2005-2008. Right and left IMT was determined by ultrasound HDI 5000 (ATL, Philips, Bothwell, WA). Height, weight, WC, and skinfold thickness were measured according to standardized protocols. Measures of % fat mass (fat mass/total mass) and % central fat mass (central fat mass/total mass) were determined with DXA (Prodigy Bone Densitometer System, DF+14664, GE Lunar Corporation). results: The mean (SD) age of the sample was 9.6 (0.9) years; 45% were girls. Measures of right, left, and combined IMT did not vary by sex (p=0.47-0.91), age (p=0.10-0.27), or Tanner stage (p=0.17-0.79). Multivariate linear regression models that adjusted for age, sex, and Tanner stage, showed that right, left, and combined IMT were positively and significantly associated with BMI, WC, triceps and subscapular skinfold thickness, as well as % fat mass and % central fat mass. conclusion: IMT is already positively associated with adiposity in 8to10-year-old children. At this age, markers of total adiposity show an association with IMT similar to markers of central adiposity. Our findings suggest that excess adiposity impacts adversely on vascular health at an early age and highlight the importance of early prevention of overweight. 19 Perspectives of parents of obese children regarding physician management of childhood obesity M.Obadia1, K.M. Boydell2, E. Dettmer3, P. Parkin4, C. Birken4, and B.W. McCrindle1 1 Labbatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; 2Child Health Evaluative Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; 3Department of Psychology, The Hospital for Sick Children,
Toronto, Ontario, Canada; 4Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Both physicians and parents play a pivotal role in managing obesity in children. A qualitative study of focus groups was performed to determine, from the perspective of parents (n=42) of obese children (n=35), perceptions of current practices of primary care physicians and how physicians might better address childhood obesity. Theme 1 – Perceived physician practices: Parents perceived physicians as non-thorough, rushed, and indifferent to their child’s weight status and the health concerns that could result from it. Parents felt that physicians dismissed their child’s obesity with the assurance that the child will grow out of it. Parents initiated concern about their child’s obesity and preferred that their child would be included in the discussions. This was not perceived as common practice. Parents were happy with the information provided but were disappointed with the perceived lack of follow-up. Theme 2 – Recommendations from parents: Parents recommended that physicians talk at the child’s level in order to get their attention. It was recommended that physicians delve into life events or psychological issues that may be influencing the child’s obesity. Parents also felt that physicians should ask more open-ended questions that required the obese child to respond in more depth. This would encourage greater rapport between the child and the physicians, and enable parents to continue discussions at home. Parents’ perceptions of current practices by physicians are described as insufficient in helping them effectively manage their child’s obesity at home. Physician efforts in areas mentioned may improve the initiation and effectiveness of counseling. 20 Influence des parents sur les comportements alimentaires des enfants exposés à un projet d’éducation nutritionnelle implanté dans huit écoles primaires de milieux défavorisés de Montréal : le projet Petits cuistots - Parents en réseaux (Pc-Pr) F.B. Diallo Université de Montréal, Montréal, Québec, Canada Au cours de leur croissance, les jeunes sont exposés à des facteurs de risque de maladies associées aux habitudes de vie, notamment celles alimentaires. Les interventions scolaires mises en place en vue de modifier leurs comportements nutritionnels semblent plus efficaces lorsque les parents prennent part aux activités. Toutefois, la participation parentale est souvent définie par la fréquence d’apparition des parents à l’école; ce qui constitue une représentation réductionniste des dimensions de ce concept. De plus, ces programmes sont souvent évalués en termes d’effets sur les attitudes des élèves, peu d’attention est portée à l’influence des caractéristiques familiales. Notre objectif est d’examiner la relation entre différentes dimensions de la participation parentale et les comportements des enfants exposés au projet PC-PR, tout en identifiant l’effet modérateur de certaines caractéristiques sociodémographiques des familles sur ce lien. Cette recherche est une analyse corrélationnelle qui repose sur un échantillon de convenance composé de 502 parents. Les données sont recueillies à l’aide d’un questionnaire acheminé par la poste aux écoles participantes. Des analyses descriptives, bivariées et multivariées sont effectuées. Les résultats révèlent l’influence de diverses dimensions de la participation (connaissance du projet, présence aux activités, discussion entre parents et enfants sur les propriétés de certains aliments, réalisation à la maison des recettes du projet) sur les comportements alimentaires des jeunes. De même, des effets modérateurs de certaines variables familiales sur cette relation sont mis en évidence. Cette étude permet de mieux orienter les interventions nutritionnelles réalisées à l’école et de parfaire les connaissances scientifiques sur la participation parentale.
cANADIAN JoUrNAL oF DIAbEtEs
intensity. After adjusting for age, sex, Tanner stage, socioeconomic status, and parental BMI, only short-duration sleepers (<10 hours) had an increased odds of overweight/obesity (OR = 2.08, 95% CI 1.16-3.67). Addition of total energy intake and physical activity to the model did not change the association substantially (OR = 2.05, 95% CI 1.15-3.63). conclusion: The present study provides evidence that short sleep duration is an independent risk factor for overweight and obesity in children. 18 carotid artery intima-media thickness and adiposity in 8- to 10-year-old children Katerina Maximova1, Marie Lambert2, Jennifer O’Loughlin3, Gilles Paradis4, and Josée Dubois2 1 School of Public Health, University of Alberta, Edmonton, Alberta, Canada; 2Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Québec, Canada; 3 Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada, Centre de recherché de Centre hospitalier de l’Université de Montréal, Montréal, Québec, Canada; 4Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada, McGill University Health Centre Research Institute, Montréal, Québec, Canada, Public Health Institute of Québec, Montréal, Canada background: Carotid artery intima-media thickness (IMT) is a highly predictive surrogate marker of cardiovascular risk in adults. Few reports are available on IMT in population-based samples of children. We sought to describe the associations between IMT and BMI, waist circumference (WC), skinfold thickness, and measures of fat mass and central fat mass assessed by DXA in 8- to 10-year-old children. Methods: The QUALITY Study (www.etudequalitystudy.ca) follows a cohort of 632 Caucasian families (father, mother and child aged 8-10 years at cohort inception) in whom at least one biological parent was obese (BMI ≥30kg/m² and/or WC ≥102cm in men, and ≥88cm in women). This analysis is based on baseline data collected in 2005-2008. Right and left IMT was determined by ultrasound HDI 5000 (ATL, Philips, Bothwell, WA). Height, weight, WC, and skinfold thickness were measured according to standardized protocols. Measures of % fat mass (fat mass/total mass) and % central fat mass (central fat mass/total mass) were determined with DXA (Prodigy Bone Densitometer System, DF+14664, GE Lunar Corporation). results: The mean (SD) age of the sample was 9.6 (0.9) years; 45% were girls. Measures of right, left, and combined IMT did not vary by sex (p=0.47-0.91), age (p=0.10-0.27), or Tanner stage (p=0.17-0.79). Multivariate linear regression models that adjusted for age, sex, and Tanner stage, showed that right, left, and combined IMT were positively and significantly associated with BMI, WC, triceps and subscapular skinfold thickness, as well as % fat mass and % central fat mass. conclusion: IMT is already positively associated with adiposity in 8to10-year-old children. At this age, markers of total adiposity show an association with IMT similar to markers of central adiposity. Our findings suggest that excess adiposity impacts adversely on vascular health at an early age and highlight the importance of early prevention of overweight. 19 Perspectives of parents of obese children regarding physician management of childhood obesity M.Obadia1, K.M. Boydell2, E. Dettmer3, P. Parkin4, C. Birken4, and B.W. McCrindle1 1 Labbatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; 2Child Health Evaluative Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; 3Department of Psychology, The Hospital for Sick Children,
Toronto, Ontario, Canada; 4Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Both physicians and parents play a pivotal role in managing obesity in children. A qualitative study of focus groups was performed to determine, from the perspective of parents (n=42) of obese children (n=35), perceptions of current practices of primary care physicians and how physicians might better address childhood obesity. Theme 1 – Perceived physician practices: Parents perceived physicians as non-thorough, rushed, and indifferent to their child’s weight status and the health concerns that could result from it. Parents felt that physicians dismissed their child’s obesity with the assurance that the child will grow out of it. Parents initiated concern about their child’s obesity and preferred that their child would be included in the discussions. This was not perceived as common practice. Parents were happy with the information provided but were disappointed with the perceived lack of follow-up. Theme 2 – Recommendations from parents: Parents recommended that physicians talk at the child’s level in order to get their attention. It was recommended that physicians delve into life events or psychological issues that may be influencing the child’s obesity. Parents also felt that physicians should ask more open-ended questions that required the obese child to respond in more depth. This would encourage greater rapport between the child and the physicians, and enable parents to continue discussions at home. Parents’ perceptions of current practices by physicians are described as insufficient in helping them effectively manage their child’s obesity at home. Physician efforts in areas mentioned may improve the initiation and effectiveness of counseling. 20 Influence des parents sur les comportements alimentaires des enfants exposés à un projet d’éducation nutritionnelle implanté dans huit écoles primaires de milieux défavorisés de Montréal : le projet Petits cuistots - Parents en réseaux (Pc-Pr) F.B. Diallo Université de Montréal, Montréal, Québec, Canada Au cours de leur croissance, les jeunes sont exposés à des facteurs de risque de maladies associées aux habitudes de vie, notamment celles alimentaires. Les interventions scolaires mises en place en vue de modifier leurs comportements nutritionnels semblent plus efficaces lorsque les parents prennent part aux activités. Toutefois, la participation parentale est souvent définie par la fréquence d’apparition des parents à l’école; ce qui constitue une représentation réductionniste des dimensions de ce concept. De plus, ces programmes sont souvent évalués en termes d’effets sur les attitudes des élèves, peu d’attention est portée à l’influence des caractéristiques familiales. Notre objectif est d’examiner la relation entre différentes dimensions de la participation parentale et les comportements des enfants exposés au projet PC-PR, tout en identifiant l’effet modérateur de certaines caractéristiques sociodémographiques des familles sur ce lien. Cette recherche est une analyse corrélationnelle qui repose sur un échantillon de convenance composé de 502 parents. Les données sont recueillies à l’aide d’un questionnaire acheminé par la poste aux écoles participantes. Des analyses descriptives, bivariées et multivariées sont effectuées. Les résultats révèlent l’influence de diverses dimensions de la participation (connaissance du projet, présence aux activités, discussion entre parents et enfants sur les propriétés de certains aliments, réalisation à la maison des recettes du projet) sur les comportements alimentaires des jeunes. De même, des effets modérateurs de certaines variables familiales sur cette relation sont mis en évidence. Cette étude permet de mieux orienter les interventions nutritionnelles réalisées à l’école et de parfaire les connaissances scientifiques sur la participation parentale.