Thursday, May 15, 2025

 

Rural preschoolers more likely to be living with overweight and abdominal obesity, and spend more time on screens, than their urban counterparts



Study links greater risk of overweight and central obesity among 3–4 year olds living in rural areas to more sedentary time and screen time.



European Association for the Study of Obesity






New research being presented at this year’s European Congress on Obesity (ECO) in Malaga, Spain (11-14 May), reveals that 3- to 4- year olds in rural areas are more likely to be living with overweight and abdominal obesity (excess fat around waist), and spend more time on screens than their urban counterparts. 

“Our findings reveal distinct patterns of how physical activity, screen time, and sleep relate to overweight and abdominal obesity in urban and rural settings, indicating that one-size-fits-all strategies to tackle overweight and obesity in early childhood are unlikely to be effective,” said lead author Doctoral researcher Karoliina Uusitalo from the Folkhälsan Research Center and the University of Helsinki in Finland.

Around 1 in 3 children in the WHO European Region is living with overweight or obesity [1], with an estimated 17 million boys and 11 million girls (aged 5-19 years) predicted to be living with obesity in Europe by 2035 [2]. Identifying those children most at risk and the environmental and geographic factors that contribute to this risk is critical to focusing prevention efforts.

Movement behaviours—insufficient physical activity, excessive sedentary behaviour (such as screen time) and poor sleep—are potential risk factors for overweight and obesity in children, but evidence in young children is inconsistent and primarily focused on body mass index (BMI), which may misrepresent true adiposity, as it fails to account for differences in body composition, such as fat distribution and muscle mass. Additionally, the effects of urbanisation on movement behaviours and adiposity in young children remain poorly understood.

To explore these issues further, researchers examined the urban-rural differences in movement behaviours (physical activity, sedentary time, screen time, and sleep) and adiposity indicators (BMI and waist-to-height ratio [WHtR]) in 1,080 3–4 year-old participants (46% girls) from the SUNRISE Finland study [3]—part of the international SUNRISE study, which aims to monitor the WHO Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years globally [4]. Researchers also examined the associations between movement behaviours and adiposity indicators separately for urban and rural areas.

In 2022−2023, participants living in both urban (57%) and rural (43%) areas of Finland wore an ActiGraph accelerometer on their waist for one week to assess different intensities of physical activity and sedentary time, and parents reported children’s sleep and screen time, as well as their consumption frequency of sugary drinks and unhealthy snacks.

Researchers measured children’s height, weight and waist circumference to calculate BMI and weight categories (normal weight [including thinness] and overweight [including obesity]) according to sex and age using Finnish reference values, with a WHtR of 0.55 or higher indicating abdominal obesity.

The results were adjusted for potentially confounding factors like age, sex, data collection area, household education, sugary drinks and unhealthy snacks (and additionally for accelerometer wear time for physical activity and sedentary time) .

The analysis revealed clear rural-urban differences in patterns of adiposity, with 24% of 3-4 year olds in rural areas living with overweight or obesity compared to 16% of those in urban areas. Similarly, around 19% of rural preschoolers had abdominal obesity compared to 13% in urban environments.

Preschoolers living in rural areas also slept more (on average 11 h 19 min vs. 11 h 11 min) and had more screen time (1 h 26 min vs. 1 h 14 min) per 24 hours than their urban counterparts.

The researchers also found that higher moderate to vigorous intensity physical activity (e.g., running and energetic play) in urban environments and higher light physical activity (e.g., low-energy play) in rural areas were linked with a higher risk of overweight (based on BMI), but not with abdominal obesity (based on WHtR).

“This finding may reflect that waist-to-height ratio is a better indicator of adiposity, whereas BMI does not distinguish between fat and muscle mass, which tends to increase with higher physical activity,” said Uusitalo.

Only in rural areas was more screen time associated with a higher risk of both overweight and abdominal obesity.

According to co-author Dr. Elina Engberg from the Folkhälsan Research Center and the University of Helsinki in Finland, “The stronger association between screen time and adiposity indicators in rural areas may be partly explained by the higher screen time observed among rural children, whereas other factors appear to play a more significant role in adiposity in urban areas.”

She continues: “The health consequences and persistence of young childhood obesity into adulthood highlight the need for efforts to improve society and family-oriented preventive strategies at the local level, which could narrow the gap in risk for young children in rural settings.”

This is a cross-sectional study, and as such, no firm conclusions can be drawn about cause. And the researchers acknowledge that reverse causality—whereby more screen time might be a consequence of overweight and abdominal obesity rather than the other way round—might explain the associations found. The study also relied on parent assessment rather than objective measures of screen time and sleep patterns. Strengths of the study include a relatively large sample of young children, the use of measured height, weight, and waist circumference, as well as device-based assessment of physical activity and sedentary time.

For interviews with article authors, please contact:

Associate professor Elina Engberg, Folkhälsan Research Center and the University of Helsinki, Helsinki, Finland E) elina.engberg@folkhalsan.fi T) + 358 (0)40566 2341

Alternative contact in the ECO Press Room: Tony Kirby T) + 44(0)7834 385827 E) tony@tonykirby.com

Notes to editors:

[1] WHO European Regional Obesity Report 2022 https://www.who.int/europe/publications/i/item/9789289057738

[2] World Obesity Federation, World Obesity Atlas 2023.
World Obesity Atlas 2023 | World Obesity Federation

[3] Engberg E et al. Sociodemographic factors, parental mental health and movement behaviours in the early years: the SUNRISE Finland study protocol. JASSB 2024. https://doi.org/10.1186/s44167-023-00042-4

[4] Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. World Health Organization 2019. https://www.who.int/publications/i/item/9789241550536


The authors declare no conflicts of interest.

This press release is based on an oral session at the European Congress on Obesity (ECO). All accepted abstracts have been extensively peer reviewed by the congress selection committee. There is no full paper at this stage, but the authors are happy to answer your questions. The research has not yet been submitted to a medical journal for publication. As it is an oral presentation there is no poster.

For full abstract click here

 

 

Half of popular TikToks about “food noise” mention medications, mainly weight-loss drugs, to manage intrusive thoughts about food


Of the TikTok videos that referenced medications to silence food noise, 92% mentioned GLP-1RA drugs like semaglutide and tirzepatide




European Association for the Study of Obesity





A new analysis being presented at this year’s European Congress on Obesity (ECO) in Malaga, Spain (11-14 May), finds that around half of the 100 top TikTok videos about food noise reference the use of medications—mainly the popular anti-obesity drugs glucagon-like peptide-1 receptor agonists (GLP-1RAs)—to manage constant and persistent thoughts about food and eating. 

“TikTok can be an incredible tool for raising awareness, but it also has a downside,” said lead author Daisuke Hayashi from the Pennsylvania State University, USA.

“The abundance of content depicting anti-obesity medications as a solution for food noise is a double-edged sword. On one hand, content creators seem to have found a community in TikTok where they can share their lived experiences about food noise, and how new medications have helped them change their health behaviours and fight intrusive thoughts about food. On the other hand, younger audiences, who make the most of TikTok’s viewership, may not understand the distinction between food noise and normal hunger and appetite. This could negatively affect their relationship with food and make them believe that they need a medication to silence normal food cravings.”

Food noise has recently emerged in media, social media, and reports from patients and clinicians to describe rumination and obsessive preoccupation about food and eating. A theoretical definition of food noise has recently been established by Hayashi and colleagues as “heightened and/or persistent manifestations of food cue reactivity, often leading to food-related intrusive thoughts and maladaptive eating behaviours” [1].

Google Trends data reveal that interest in food noise started in 2023, with an all-time high in April 2025, coinciding with the surge in popularity of anti-obesity drugs such as semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound).

Over one billion users—mostly children, teenagers, and young adults—use the online short video-sharing platform TikTok, which has become a major outlet for content creators to disseminate information on food noise, with over 3,600 videos under the hashtag #FoodNoise as of June 2024.

While these platforms have powerful potential to benefit users interested in such content, they may also help to spread misinformation. However, little is known about the content encountered by social media users around food noise.

To find out more, researchers assessed the content of the 100 top TikTok videos under the hashtag #FoodNoise retrieved on June 24th, 2024 (one duplicate video was removed).

They found that the sampled videos had an average of 1,173,324 views, 8,155 likes, 247 comments, and 583 shares. Of the videos that defined food noise (83%), almost all (94%) aligned with the current theoretical definition.

The content creators were mostly female (92%), aged 30 or older (82%), and White (86%). Notably, 1 in 5 content creators were healthcare professionals, and almost three-quarters (71%) of videos were patient testimonies.

The analysis also found that most videos (86%) depicted food noise as a negative phenomenon that causes suffering and loss of quality of life. Half of the videos mentioned medications, and often mentioned the use of drugs to manage food noise, with 92% related to GLP-1RA drugs like semaglutide and tirzepatide.

Additionally, sponsored content was disclosed in just 5% of videos. “Undisclosed sponsorship is believed to be abundant on TikTok. Some content may be posted by creators promoting products and treatments without proper disclosure, and people watching these videos may not even know they are being advertised to,” said Hayashi.He added, “Future research is needed to explore lived experiences around food noise beyond online platforms to understand more about this phenomenon, how to manage it, and how it might impact eating behaviours, health, and quality of life.”

 

 

Global survey reveals high disconnect between perceptions of obesity among people living with the disease and their doctors



International survey of people living with obesity and their physicians across Europe (including the UK), USA, and Australia examines perceptions about the causes of obesity and treatment goals




European Association for the Study of Obesity




A survey of adults living with obesity and their physicians across seven countries reveals a high disconnect between their perceptions about the causes of obesity and treatment goals. The findings being presented at this year’s European Congress on Obesity (ECO) in Malaga, Spain (11-14 May), highlight biased misconceptions about obesity which may impact patients’ access to treatment and support.

“Although the causes of weight gain and obesity are diverse and complex—and often beyond an individual’s control—many people still hold biased beliefs that frame obesity as a result of personal choices, such as healthy eating and exercise alone. These misconceptions simplify obesity into a matter of personal willpower, placing full responsibility on the individual and often leading to stigma, rather than encouraging compassionate, evidence-based chronic disease care,” said lead author Dr Ximena Ramos Salas from K&X Ramos AB, a research and consulting agency in Sweden

Although classified as a chronic, relapsing disease, obesity is often not adequately managed or prioritised in healthcare settings. Understanding of the disease among physicians and people with obesity is limited, partly due to deep-rooted weight bias and stigma. As a result, people with obesity lack access to evidence-based and person-centred care.

To understand more about physicians’ and patients’ beliefs about the causes of obesity and therapeutic goals, Dr Ramos Salas and co-authors from Eli Lilly and Company, Adelphi Real World and University of Rome Tor Vergata analysed data from the Adelphi Real World Obesity Disease Specific Programme™—a linked physician and patient cross-sectional survey with retrospective data collection which was conducted in France, Germany, Italy, Spain, the UK, the USA and Australia between October 2023 and April 2024.

Physicians provided data and answered survey questions based on the first eight consultations during the study period with adult patients (aged 18 or older) living with obesity who had a current/prior body mass index (BMI) of 30 kg/m² or higher, or a current/prior BMI of 27 kg/m² or higher, and at least one obesity-related complication. The physician survey included questions on what, in their opinion, were the main reasons for each patient’s obesity and what their treatment goals were for the patient.

Their patients with obesity were then asked to complete a voluntary questionnaire which included questions asking about their perceptions of obesity causes and therapeutic goals. The patient survey included questions on what, in their opinion, were the reasons for their current weight problems and what they were hoping for when they lost weight.

In total, 1,379 responses from patients with obesity and their physicians were analysed by body mass index (BMI) category and the Edmonton Obesity Staging System (EOSS) classification—which classifies obesity on a five-point scale according to severity and underlying health conditions.

Biased misconceptions about obesity
 

The results showed that physicians tended to report behavioural causes for their patients’ obesity—most commonly overeating (69%), followed by lack of exercise (61%), high fat diet (51%), and lack of motivation (49%; see figure 1 in notes to editors).

Notably, physicians were more likely to cite behavioural causes as their patients’ BMI and EOSS category increased. For example, three-quarters of physicians said that the primary cause of obesity in their patients with class III obesity was overeating, while two-thirds cited lack of exercise.
As Dr Ramos Salas explained, “Individuals tend to have more negative attitudes towards people with obesity if they believe that obesity is mostly a behavioural issue.”

Although the majority of people with obesity attributed their obesity to behavioural and socioeconomic causes (87%), they did so to a lesser extent than physicians (98%), reporting much higher levels of biological causes than physicians (81% vs 61%).

People with obesity also regarded genetics as third leading overall cause of their obesity, while physicians ranked genetics as 7th on the list of all causes (see figure in notes to editors).

Differing treatment goals

When asked about treatment goals for their patients with obesity, physicians tended to report health-focused outcomes—most commonly, improving quality of life (around 75%), increasing mobility (roughly 50%), and lowering blood pressure (around 45%), regardless of BMI or EOSS status (see figure 3 in notes top editors).

In contrast, when people with obesity were asked what they were hoping for when they lost weight, they tended to focus on how they would look and feel, regardless of weight loss outcomes. For example, around two-thirds reported hoping to look or feel better, to feel more confident, and be able to fit into smaller clothes sizes, objectives which reflect more psychosocial outcomes, rather than just physical health improvements.

According to Dr Ramos Salas, “Physicians play a key role in shaping treatment decisions and can offer supportive, compassionate care to patients living with obesity by focusing on improvements in overall health and psychosocial well-being, rather than just weight loss. By recognising and addressing internalised weight stigma, doctors can also help patients access additional resources that promote body acceptance, reduce self-blame, and build confidence.”

Please click here for figures 1 and 3

For full abstract click here

Dr Ramos Salas declares no conflicts of interest. Other authors are employees of Eli Lilly, the sponsor of the study.

This press release is based on a poster presentation at the European Congress on Obesity (ECO). All accepted abstracts have been extensively peer reviewed by the congress selection committee. There is no full paper at this stage, but the authors are happy to answer your questions. The research has not yet been submitted to a medical journal for publication. 

 

Physical activity + organized sports participation may ward off childhood mental ill health



ORGANIZED SPORTS ARE ABUSE AND BULLYING


But clear sex differences in protective effects, depending on condition, findings indicate

Peer-Reviewed Publication

BMJ Group





Physical activity in early childhood, especially taking part in organised sports,may ward off several mental health disorders in later childhood and adolescence, suggests research published online in the British Journal of Sports Medicine.

But there seem to be clear sex differences in the observed protective effects, depending on the condition, the findings indicate.

The prevalence of mental ill health among children and teens has risen sharply worldwide, with a heightened vulnerability to stress thought to partially explain the increase, note the researchers.

Physical activity has been suggested as crucial for helping build resilience to stress and lowering the risks of mental ill health in childhood. But it’s not clear if there are time points when it might be most beneficial.

To try and find out, the researchers drew on the ABIS Study (All Babies in Southeast Sweden), which includes nationally representative data collected from 17055 families with children born between 1 October 1997 and 1 October 1999 in Southeast Sweden. 

In all, 16,365 children were included in the study from birth, 7880 (48%) of whom were girls and 8485 (52%) of whom were boys.

The parents reported on their children’s physical activity levels, the amount of time they spent outdoors, and any participation in organised sports at the ages of 5, 8, and 11. 

One in four children experienced a traumatic event before the age of 5 and almost 30% had done so by the age of 10.

Their mental health was tracked up to the age of 18, with confirmed mental health diagnoses obtained from a national registry.  In all, 1353 participants (15%) were diagnosed with at least one mental health issue during childhood, while 4% had three or more such diagnoses.

Analysis of all the data showed that physical activity levels fell from a daily average of just over 4 hours to 2.5 hours between the ages of 5 and 11. 

The daily amount of physical activity at the age of 11 was associated with a 12% lower risk of being diagnosed with any mental disorder before the age of 18 for each additional physically active hour.

But there were sex differences in the level of associated protection afforded. For example, physical activity was associated with a 30% lower risk of any mental ill health among boys at the age of 11, but not among girls after adjusting for mothers’ education and use of mental health medication, adverse life events, and sex.  

When the incidence of specific mental health conditions was analysed in relation to daily physical activity levels, the risk of depression among girls was 18% lower, but 29% lower among boys at the age of 11. 

The effects seemed to start early—at least in boys. The risk of depression was 19% lower at the age of 5 and 23% lower at the age of 8 among boys, but not among girls. And while the risk of anxiety fell sharply at both the ages of 5 (21% lower) and 11 (39% lower) among boys, no such effects were seen among girls.

Similarly, the risk of addiction was 34% lower at the age of 8 and 35% lower at the age of 11 among boys, but not among girls. 

Time spent outdoors wasn’t influential, but taking part in organised sports at the age of 11 was strongly associated with lower risks of a first-time occurrence of any mental health disorder among both boys (23% lower) and girls (12% lower).

When stratified by specific condition, organised sports participation was associated with a 35% lower risk of depression among boys, but only an 11% lower risk among girls for every additional weekly hour engaged in it. 

Organised sports participation was also associated with a 14% lower risk of anxiety among girls and a 21% lower risk among boys, as well as a 41% lower risk of addiction among girls and a 30% lower risk among boys. It didn’t influence the risks of eating and sleep disorders.

“Physical activity may influence boys and girls in different ways, including changes mediated by different levels of sex hormones. However, these effects might be direct—for example, by influencing brain health and development, or indirect—for example, by reducing subclinical hyperactivity, which is more common among boys,” explain the researchers.

“Furthermore, there may exist differences in physiological consequences (eg, variation in intensity of physical activity) and psychological experiences that are connected to gender and cultural norms.”

Although covering an extended period, this is an observational study, thereby precluding any firm conclusions to be drawn about cause and effect. The study also relied on parental recall.

 “Our results support the hypothesis that the period just before, and during, the early stages of puberty might represent a sensitive period in which [physical activity] is key to the development of resilience and hardiness,” with the period between the ages of 10 and 12 representing a critical window of opportunity,” suggest the researchers. 

“Given the dramatic increase in the global prevalence of psychiatric disorders among children and adolescents, this study highlights the importance of promoting [physical activity], particularly through organised sports,” they conclude.

 

Long working hours may alter brain structure, preliminary findings suggest


Overwork may induce neuroadaptive changes that affect cognitive and and emotional health


EIGHT HOUR DAY

8 HOURS WORK, 8 HOURS PLAY, 8 HOURS REST



BMJ Group




Long working hours may alter the structure of the brain, particularly the areas associated with emotional regulation and executive function, such as working memory and problem solving, suggest the findings of preliminary research, published online in Occupational & Environmental Medicine.

Ultimately, overwork may induce neuroadaptive changes that might affect cognitive and emotional health, say the researchers.

Long working hours have been linked to heightened risks of cardiovascular disease, metabolic disorders, and mental health issues. And the International Labour Organisation (ILO) estimates that overwork kills more than 800,000 people every year, note the researchers.

While the behavioural and psychological consequences of overwork are reasonably well understood, the underlying neurological mechanisms and anatomical changes aren’t, they add.

To explore this further, the researchers deployed structural brain volume analysis to compare the impact of overwork on specific brain regions in healthcare workers routinely clocking up long working hours, defined as 52 or more a week.

They drew on data from the Gachon Regional Occupational Cohort Study (GROCS) and from MRI scans carried out for a research project on the effects of working conditions on brain structure. 

Participants in GROCS were asked to have an additional MRI scan, and the final analysis included 110 people after excluding those with missing data or poor MRI image quality. Most were clinicians: 32 worked excessive weekly hours (28%); 78 worked standard hours.

Those putting in long working hours every week were significantly younger, had spent less time in work and were more highly educated than those clocking up standard hours. 

Differences in brain volume were assessed using voxel-based morphometry (VBM)---a neuroimaging technique that identifies and compares regional differences in levels of grey matter—and atlas-based analysis, which uses pre-defined references to identify and label structures in images like brain scans. 

Comparative analysis of the findings showed that people who worked 52 or more hours a week displayed significant changes in brain regions associated with executive function and emotional regulation, unlike participants who worked standard hours every week. 

For example, atlas-based analysis revealed a 19% increase in the volume of the middle frontal gyrus among those clocking up long working hours compared with those working standard hours. 

This part of the brain has a major role in various cognitive functions, particularly in the frontal lobe. It's involved in attention, working memory, and language-related processing. 

VBM showed peak increases in 17 regions, including the middle frontal gyrus, the superior frontal gyrus, which is involved in attention, planning, and decision-making, and the insula. 

The insula has a key role in integrating sensory, motor, and autonomic feedback from the body. It’s involved in emotional processing, self-awareness, and understanding social context.

This is a small observational snapshot study, and as such, no firm conclusions can be drawn about cause and effect. And the researchers acknowledge that in the absence of long term data, it’s unclear whether these structural changes are a consequence of overwork or a predisposing factor.

But they nevertheless point out: “While the results should be interpreted cautiously due to the exploratory nature of this pilot study, they represent a meaningful first step in understanding the relationship between overwork and brain health.”

They add: “Notably, the increased brain volumes observed in overworked individuals may reflect neuroadaptive responses to chronic occupational stress, although the exact mechanisms remain speculative.”

They continue: “The observed changes in brain volume may provide a biological basis for the cognitive and emotional challenges often reported in overworked individuals. Future longitudinal and multi-modal neuroimaging studies are warranted to confirm these findings and elucidate the underlying mechanisms.” 

And they conclude: “The results underscore the importance of addressing overwork as an occupational health concern and highlight the need for workplace policies that mitigate excessive working hours.”

 

Recognition from colleagues helps employees cope with bad work experiences




University of East Anglia





Being appreciated by colleagues can help employees cope with negative experiences at work, according to a new study involving the University of East Anglia (UEA).

Researchers found that employees experience ‘embitterment’ - an emotional response to perceived workplace injustice - on days when they are assigned more unreasonable tasks than usual.

This negative emotion not only affects their work but also spills over into their personal lives, leading to an increase in rumination, the repetitive dwelling on negative feelings and their causes. This can result in difficulty detaching from work, ultimately preventing recovery from job-related stress.

The findings also reveal that this harmful cycle takes place mainly on days when employees receive less appreciation from their colleagues than usual.

Published today in the journal Work & Stress, the study involved researchers from UEA, in the UK, the University of Cyprus, and Aristotle University of Thessaloniki, in Greece.

The authors say it emphasises the importance of workplace recognition in mitigating the emotional toll of perceived ‘illegitimate’ tasks that are considered as unnecessary and/or unreasonable, and how this can help protect employees’ wellbeing.

Co-author George Michaelides, Professor of Work Psychology at UEA’s Norwich Business School, said: “Our findings underscore how assigning unreasonable tasks can violate employees' sense of fairness and harm their emotional wellbeing. It also emphasises the crucial role of supervisors in minimising such tasks and prioritising core responsibilities.

“Additionally, fostering a culture of appreciation among colleagues can serve as a protective factor, helping employees cope with workplace stress. Organisations can support this by equipping employees with the skills to express gratitude effectively, creating a more positive and resilient work environment.”

Lead author Dr Evie Michailidis, from the University of Cyprus, added: “The importance of appreciation for mitigating feelings of embitterment cannot be overstated. Without appreciation, unreasonable tasks foster feelings of embitterment that spill over into private lives, making it harder to mentally disconnect and recover after work."

The study highlights the dynamic nature of embitterment and suggests that unnecessary and unreasonable tasks are potential predictors of this emotion, which in turn can interfere with employees’ ability to recover from work during their time off.

Most importantly, it allowed the team to test the boundary conditions under which these relationships are stronger or weaker.

Unnecessary tasks could be those employees believe perceive as pointless and lacking relevance to their role - for example writing a report that no one will read - undermining their sense of purpose and value in the workplace.  

Unreasonable tasks are often those employees consider exceed their role, capabilities, or responsibilities - such as asking a senior employee to perform a novice’s work - generating a sense of injustice because they might violate expectations of fairness and respect in the workplace. 

Appreciation has been recognised as an important buffer to the effect of illegitimate tasks and the threat to professional identity an employee experiences when exposed to them. It refers to getting recognition for achievements and qualities by significant others at work, such as supervisors or colleagues.

The team collected data from 71 employees using daily surveys over five working days. These surveys helped the researchers track individual’s feelings of embitterment, the degree to which they had to engage with illegitimate tasks, how much appreciation they felt from their colleagues and supervisors, and how much they thought about work during their time off.

Participants worked in different industry sectors, with most in accounting and finance.

‘Daily workplace embitterment and work-related rumination during off-job time: Illegitimate tasks as antecedents and the buffering role of appreciation’, Evie Michailidis, Despoina Xanthopoulou and George Michaelides, is published in Work & Stress on May 14.