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Diet and Physical Activity in Rural vs Urban Children and Adolescents in the United States: A Narrative Review

Published:December 09, 2015DOI:https://doi.org/10.1016/j.jand.2015.10.024

      Abstract

      Current research suggests that the prevalence of obesity is higher among rural youth than urban youth. Due to the health implications that are associated with child and adolescent obesity, it is critical to understand systematic differences in diet and physical activity (PA) behaviors that may be contributing to this disparity in weight. However, varying definitions of rural and inconsistencies in study tools and methodologies may limit the generalizability of findings from research in this area. The objective of this narrative review was to synthesize and critically evaluate existing literature comparing diet and PA behaviors between rural and urban children and adolescents, providing recommendations for future research. Only five studies were found that reported on measures of diet in rural vs urban youth, whereas 16 were found that reported on measures of PA. Dietary assessment tools were generally standard and acceptable; however, differences existed in how dietary outcomes were defined. Few studies used assessment tools that objectively measured PA, and definitions for meeting PA recommendations varied among studies. Very few studies defined rural using the same criteria. Future research on the rural youth obesity disparity should focus on including a high-quality assessment of both diet and PA (as opposed to one or the other) and on using an appropriate and consistent definition of rural.

      Keywords

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      References

        • Daniels S.R.
        • Arnett D.K.
        • Eckel R.H.
        • et al.
        Overweight in children and adolescents: Pathophysiology, consequences, prevention, and treatment.
        Circulation. 2005; 111: 1999-2012
        • Dietz W.H.
        Overweight in childhood and adolescence.
        New Engl J Med. 2004; 350: 855-857
        • Freedman D.S.
        • Mei Z.
        • Srinivasan S.R.
        • Berenson G.S.
        • Dietz W.H.
        Cardiovascular risk factors and excess adiposity among overweight children and adolescents: The Bogalusa Heart Study.
        J Pediatr. 2007; 150: 12-17 e12
        • Li C.
        • Ford E.S.
        • Zhao G.
        • Mokdad A.H.
        Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005-2006.
        Diabetes Care. 2009; 32: 342-347
        • Whitaker R.C.
        • Wright J.A.
        • Pepe M.S.
        • Seidel K.D.
        • Dietz W.H.
        Predicting obesity in young adulthood from childhood and parental obesity.
        New Engl J Med. 1997; 337: 869-873
        • Freedman D.S.
        • Khan L.K.
        • Serdula M.K.
        • Dietz W.H.
        • Srinivasan S.R.
        • Berenson G.S.
        The relation of childhood BMI to adult adiposity: The Bogalusa Heart Study.
        Pediatrics. 2005; 115: 22-27
        • Guo S.S.
        • Chumlea W.C.
        Tracking of body mass index in children in relation to overweight in adulthood.
        Am J Clin Nutr. 1999; 70: 145S-148S
        • Ogden C.L.
        • Carroll M.D.
        • Kit B.K.
        • Flegal K.M.
        Prevalence of childhood and adult obesity in the United States, 2011-2012.
        JAMA. 2014; 311: 806-814
        • Johnson 3rd, J.A.
        • Johnson A.M.
        Urban-rural differences in childhood and adolescent obesity in the United States: A systematic review and meta-analysis.
        Child Obes. 2015; 11: 233-241
      1. Cromartie J, Bucholtz S. Defining the “rural” in rural America. http://www.ers.usda.gov/amber-waves/2008-june/defining-the-%E2%80%9Crural%E2%80%9D-in-rural-america.aspx#.Vb-izfntr1Y. Accessed October 30, 2012.

      2. US Census Bureau. Urban and rural classification. US Census Bureau website. https://www.census.gov/geo/reference/urban-rural.html. Revised July 27, 2015. Accessed September 18, 2015.

      3. US Census Bureau. Metropolitan and Micropolitan Statistical Areas main. US Census Bureau website. http://www.census.gov/population/metro/. Revised May 6, 2013. Accessed September 18, 2015.

      4. US Department of Agriculture Economic Research Service. Urban influence codes. http://www.ers.usda.gov/data-products/urban-influence-codes.aspx. Revised July 8, 2013. Accessed January 15, 2015.

      5. US Department of Agriculture Economic Research Service. Rural-urban continuum codes. http://www.ers.usda.gov/data-products/rural-urban-continuum-codes.aspx. Revised May 10, 2013. Accessed January 15, 2015.

      6. US Department Agriculture Economic Research Service. Rural-urban commuting area codes. http://www.ers.usda.gov/data-products/rural-urban-commuting-area-codes.aspx. Revised June 2, 2014. Accessed January 15, 2015.

        • Sandercock G.
        • Angus C.
        • Barton J.
        Physical activity levels of children living in different built environments.
        Prev Med. 2010; 50: 193-198
        • Davis A.M.
        • Bennett K.J.
        • Befort C.
        • Nollen N.
        Obesity and related health behaviors among urban and rural children in the United States: Data from the National Health And Nutrition Examination Survey 2003-2004 and 2005-2006.
        J Pediatr Psychol. 2011; 36: 669-676
        • Davis A.M.
        • Boles R.E.
        • James R.L.
        • et al.
        Health behaviors and weight status among urban and rural children.
        Rural Remote Health. 2008; 8: 810
        • Ettienne-Gittens R.
        • McKyer E.L.
        • Odum M.
        • et al.
        Rural versus urban Texas WIC participants' fruit and vegetable consumption.
        Am J Health Behav. 2013; 37: 130-140
        • Joens-Matre R.R.
        • Welk G.J.
        • Calabro M.A.
        • Russell D.W.
        • Nicklay E.
        • Hensley L.D.
        Rural-urban differences in physical activity, physical fitness, and overweight prevalence of children.
        J Rural Health. 2008; 24: 49-54
        • Johnson T.G.
        • Brusseau T.A.
        • Vincent Graser S.
        • Darst P.W.
        • Kulinna P.H.
        Step counts of 10- to 11-year-old children by ethnicity and metropolitan status.
        J Phys Act Health. 2010; 7: 355-363
        • Liu J.
        • Bennett K.J.
        • Harun N.
        • Probst J.C.
        Urban-rural differences in overweight status and physical inactivity among US children aged 10-17 years.
        J Rural Health. 2008; 24: 407-415
        • Liu J.H.
        • Jones S.J.
        • Sun H.
        • Probst J.C.
        • Merchant A.T.
        • Cavicchia P.
        Diet, physical activity, and sedentary behaviors as risk factors for childhood obesity: An urban and rural comparison.
        Child Obes. 2012; 8: 440-448
        • Lutfiyya M.N.
        • Lipsky M.S.
        • Wisdom-Behounek J.
        • Inpanbutr-Martinkus M.
        Is rural residency a risk factor for overweight and obesity for U.S. children?.
        Obesity. 2007; 15: 2348-2356
        • Moore J.B.
        • Brinkley J.
        • Crawford T.W.
        • Evenson K.R.
        • Brownson R.C.
        Association of the built environment with physical activity and adiposity in rural and urban youth.
        Prev Med. 2013; 56: 145-148
        • Nelson M.C.
        • Gordon-Larsen P.
        • Song Y.
        • Popkin B.M.
        Built and social environments associations with adolescent overweight and activity.
        Am J Prev Med. 2006; 31: 109-117
        • Springer A.E.
        • Hoelscher D.M.
        • Castrucci B.
        • Perez A.
        • Kelder S.H.
        Prevalence of physical activity and sedentary behaviors by metropolitan status in 4th-, 8th-, and 11th-grade students in Texas, 2004-2005.
        Prev Chronic Dis. 2009; 6: A21
        • Springer A.E.
        • Hoelscher D.M.
        • Kelder S.H.
        Prevalence of physical activity and sedentary behaviors in us high school students by metropolitan status and geographic region.
        J Phys Act Health. 2006; 3: 365-380
        • Carson V.
        • Iannotti R.J.
        • Pickett W.
        • Janssen I.
        Urban and rural differences in sedentary behavior among American and Canadian youth.
        Health Place. 2011; 17: 920-928
        • Kasehagen L.
        • Busacker A.
        • Kane D.
        • Rohan A.
        Associations between neighborhood characteristics and physical activity among youth within rural-urban commuting areas in the US.
        Matern Child Health J. 2012; 16: 258-267
        • Kenney M.K.
        • Wang J.
        • Iannotti R.
        Residency and racial/ethnic differences in weight status and lifestyle behaviors among US youth.
        J Rural Health. 2014; 30: 89-100
        • Powell K.E.
        • Roberts A.M.
        • Ross J.G.
        • Phillips M.A.
        • Ujamaa D.A.
        • Zhou M.
        Low physical fitness among fifth- and seventh-grade students, Georgia, 2006.
        Am J Prev Med. 2009; 36: 304-310
        • Moore J.B.
        • Beets M.W.
        • Morris S.F.
        • Kolbe M.B.
        Comparison of objectively measured physical activity levels of rural, suburban, and urban youth.
        Am J Prev Med. 2014; 46: 289-292
        • Lytle L.A.
        • Murray D.M.
        • Perry C.L.
        • Eldridge A.L.
        Validating fourth-grade students' self-report of dietary intake: Results from the 5 A Day Power Plus program.
        J Am Diet Assoc. 1998; 98: 570-572
        • Lytle L.A.
        • Nichaman M.Z.
        • Obarzanek E.
        • et al.
        Validation of 24-hour recalls assisted by food records in third-grade children. The CATCH Collaborative Group.
        J Am Diet Assoc. 1993; 93: 1431-1436
        • Kim S.A.
        • Moore L.V.
        • Galuska D.
        • et al.
        Vital signs: Fruit and vegetable intake among children - United States, 2003-2010.
        MMWR. 2014; 63: 671-676

      Biography

      L. A. McCormack is an assistant professor, Department of Health & Nutritional Sciences, South Dakota State University, Brookings.

      Biography

      J. Meendering is an associate professor, Department of Health & Nutritional Sciences, South Dakota State University, Brookings.