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  • Author: Sandra H. Arnold x
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Kathryn C. Nesbit, Thubi A. Kolobe, Sandra H. Arnold, Susan B. Sisson and Michael P. Anderson


The purpose of this study was to determine how proximal (home) and distal (neighborhood) environmental characteristics interact to influence obesity in early and middle adolescents.


This was a descriptive, cross-sectional study using the 2007 National Survey of Children’s Health (NCSH). Participants were 39,542 children ages 11 to 17 years. Logistic regressions were used to examine the relationship between adolescent obesity and environmental factors, the relative strength of these factors, and the influence of age and gender.


Proximal environmental factors were stronger correlates of adolescent obesity than distal environmental factors. Sedentary behavior related to TV watching time at home was the strongest correlate of adolescent obesity overall (OR 1.13, 95% CI 1.11–1.15). Parks and playgrounds (OR 0.86, 95% CI 0.08–0.92), as well as recreation centers (OR 0.91, 95% CI 0.85–0.97) were significant distal environmental factor correlates. Girls and middle adolescents were at less risk for obesity than boys and early adolescents (OR 0.51, 95% CI 0.68–0.82; OR 0.75, 95% CI 0.68–0.96).


The results of this study reveal the importance of proximal environmental characteristics on adolescent obesity relative to distal environmental characteristics. Obesity intervention strategies for adolescents should target sedentary behavior and opportunities for physical activity with a focus on early adolescents and boys.

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Chelsea L. Kracht, Susan B. Sisson, Emily Hill Guseman, Laura Hubbs-Tait, Sandra H. Arnold, Jennifer Graef and Allen Knehans

Background/Context: Children without siblings (singletons) have higher rates of obesity than do children with siblings (nonsingletons). Higher moderate to vigorous physical activity (PA) and less sedentary behavior (SB) are associated with lower childhood obesity. Purpose: To examine the difference in PA and SB between singleton and nonsingleton children. Methods: Mothers of children ages 5.0–7.9 years old who were singletons or nonsingletons with a sibling between the ages of 2.0 and 4.9 years old were recruited. Height, weight, and waist circumference of the 5.0- to 7.9-year-old children were measured, and age and sex percentiles were calculated. Accelerometry measured SB and PA, including light PA, moderate to vigorous PA, and counts per minute. Results: Fifty-six mother–child dyads (23 singletons and 33 nonsingletons) with an average child age of 5.7 (0.7) years participated. More singletons were classified as overweight or obese than were nonsingletons (49% vs 17%, P = .04). In adjusted linear models, singletons had less light PA per day (β = −38.1, SE = 19.2, P = .001) and more SB (β = 38.0, SE = 16.5, P = .02) than did nonsingletons, with no difference in moderate to vigorous PA or counts per minute. Conclusion: In this sample, singletons had higher obesity and lower light PA than did nonsingleton children. Investigation into differences in singleton/nonsingleton families, including family health behaviors, may help assess sibling influence in early behavior development.