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Zhou M, Lalani C, Banda JA, Robinson TN. Sleep duration, timing, variability and measures of adiposity among 8- to 12-year-old children with obesity. Obes Sci Pract 2018; 4:535-544. [PMID: 30574347 PMCID: PMC6298203 DOI: 10.1002/osp4.303] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 09/23/2018] [Accepted: 09/25/2018] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Sleep disruption in laboratory studies increases adiposity and decreases glucose tolerance. However, few epidemiological studies have used objective measures of sleep. This study aims to assess associations between sleep duration, timing and regularity with measures of adiposity. METHODS This is a cross-sectional study of 188 children with obesity (age: 10.50 ± 1.39 years; body mass index: 29.24 ± 5.04 kg m-2). Nightly sleep duration, bedtime and wake time were measured by multiple-day actigraphy and parent reports. Per cent overweight (per cent over median body mass index for age and sex) was chosen as the primary measure of obesity status. Objective measures of height, weight, waist circumference, blood pressure, fasting blood lipids, glucose, insulin, glycated haemoglobin and C-reactive protein were obtained. Television screen time and total caloric intake were assessed via parent questionnaire. RESULTS Each hour later in weekday bedtime was associated with an additional 6.17 per cent overweight (95% confidence interval [CI]: 1.42-10.92). Each hour greater in day-to-day variability in weekday bedtime and weekday wake time was associated with an additional 10.20 (95% CI: 0.50-19.91) and 10.02 (95% CI: 1.55-18.50) per cent overweight, respectively. Associations were similar after controlling for other obesity-related behaviours (television screen time, total caloric intake and physical activity.). CONCLUSIONS Among children with obesity, later bedtime and greater variability in bedtime and wake time are associated with greater adiposity, independent of other obesity-related behaviours. Early bedtime and wake time and consistent day-to-day sleep timing may be strategies to reduce adiposity in high-risk children.
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Affiliation(s)
- M. Zhou
- Stanford University School of MedicineStanfordCAUSA
| | - C. Lalani
- Stanford University School of MedicineStanfordCAUSA
| | - J. A. Banda
- Department of Health and KinesiologyPurdue UniversityWest LafayetteINUSA
| | - T. N. Robinson
- Stanford Solutions Science Lab and Division of General Pediatrics, Department of Pediatrics and Stanford Prevention Research Center, Department of MedicineStanford UniversityStanfordCAUSA
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Asif M, Aslam M, Altaf S. Evaluation of anthropometric parameters of central obesity in Pakistani children aged 5-12 years, using receiver operating characteristic (ROC) analysis. J Pediatr Endocrinol Metab 2018; 31:971-977. [PMID: 30183666 DOI: 10.1515/jpem-2018-0193] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 07/30/2018] [Indexed: 01/17/2023]
Abstract
Background Different anthropometric parameters have been proposed for assessing central obesity in children, but the ability of these anthropometric parameters to correctly measure central obesity in Pakistani children is questionable and needs to be assessed. The aims of this investigation were to examine the diagnostic performance of anthropometric parameters as indicators of central obesity in Pakistani children as measured by waist circumference (WC) and to determine the sex-specific best cut-off values for these parameters that would identify obese children. Methods Anthropometric measurements - height, weight, WC, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), conicity index (CI) and neck circumference (NC) - from a cross-sectional sample of 5964 Pakistani children aged 5-12 years were analyzed. Receiver operating characteristics (ROC) analysis was used to examine the diagnostic performance and to determine the optimal cut-off point of each anthropometric parameter for identifying centrally obese children. Results It was found that WC had a significantly positive correlation with all studied anthropometric parameters. The ROC curve analysis indicated that all the parameters analyzed had good performance but WHtR had the highest value of the area under the curve (AUC). Optimal cut-off points associated with central obesity for boys and girls were, respectively, 0.47 and 0.48 for WHtR, 1.20 and 1.23 for CI, 0.96 and 0.96 for WHR and 26.36 and 26.54 cm for NC. Conclusions The sex-specific cut-off points for WHtR, CI, WHR and NC can be used to detect central obesity in Pakistani children.
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Affiliation(s)
- Muhammad Asif
- Department of Statistics, Government College, Qadirpur Raan, Multan, Pakistan
| | - Muhammad Aslam
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | - Saima Altaf
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
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Linthavong O, O'Shea TM, Allred E, Perrin E, Bauserman M, Joseph RM, Leviton A, Heeren TC, Kuban KCK. Neurocognitive and Health Correlates of Overweight and Obesity among Ten-Year-Old Children Born Extremely Preterm. J Pediatr 2018; 200:84-90.e4. [PMID: 29960765 PMCID: PMC6109604 DOI: 10.1016/j.jpeds.2018.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/10/2018] [Accepted: 05/08/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the relationship between overweight (body mass index [BMI] percentile ≥85 and <95) and obesity (BMI ≥95 percentile) and developmental and health outcomes at 10 years of age in a cohort of individuals born extremely preterm. STUDY DESIGN This was an observational cohort study of children born extremely preterm and then assessed at age 10 years for neurocognitive function and parent-reported behavior and health outcomes. Participants included 871 children aged 10 years. To describe the strength of association between overweight or obesity and outcomes, we used logistic regression models adjusting for confounders. Neurocognitive function, academic achievement, parent-reported health outcome surveys, and height and weight were measured. RESULTS BMI category at 10 years of age was not associated with differences in intelligence, language, or academic achievement. Parents of children with obesity were more likely to report their child had asthma (OR 2.2; 95% CI 1.4-3.5), fair/poor general health (OR 3.2; 95% CI 1.4-7.5), and decreased physical function (OR 1.7; 95% CI 1.1-2.9) but less likely to have physician diagnosed attention-deficit/hyperactivity disorder (OR 0.5; 95% CI 0.3-0.97) or an individualized education plan (OR 0.6; 95% CI 0.4-0.99). CONCLUSION Among children born extremely preterm, an elevated BMI, compared with normal or low BMI, is not associated with a difference in neurocognitive function. However, asthma, fair/poor general health, and decreased physical function were more prevalent among study participants with obesity, and attention-deficit/hyperactivity disorder and individualized education plan were less prevalent.
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Affiliation(s)
- Olivia Linthavong
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, NC.
| | - T Michael O'Shea
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, NC
| | | | - Eliana Perrin
- Department of Pediatrics and Duke Center for Childhood Obesity Research, Duke University, Durham, NC
| | - Melissa Bauserman
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, NC
| | - Robert M Joseph
- Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA
| | - Alan Leviton
- Department of Neurology, Harvard University, Boston, MA
| | | | - Karl C K Kuban
- Department of Child Neurology, Boston University, Boston, MA
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Comparison of Bioelectrical Impedance Analysis, Slaughter Skinfold-Thickness Equations, and Dual-Energy X-ray Absorptiometry for Estimating Body Fat Percentage in Colombian Children and Adolescents with Excess of Adiposity. Nutrients 2018; 10:nu10081086. [PMID: 30110944 PMCID: PMC6115719 DOI: 10.3390/nu10081086] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/08/2018] [Accepted: 08/13/2018] [Indexed: 01/06/2023] Open
Abstract
Dual-energy X-ray absorptiometry (DXA) has been considered a reference method for measuring body fat percentage (BF%) in children and adolescents with an excess of adiposity. However, given that the DXA technique is impractical for routine field use, there is a need to investigate other methods that can accurately determine BF%. We studied the accuracy of bioelectrical impedance analysis (BIA) technology, including foot-to-foot and hand-to-foot impedance, and Slaughter skinfold-thickness equations in the measurement of BF%, compared with DXA, in a population of Latin American children and adolescents with an excess of adiposity. A total of 127 children and adolescents (11–17 years of age; 70% girls) from the HEPAFIT (Exercise Training and Hepatic Metabolism in Overweight/Obese Adolescent) study were included in the present work. BF% was measured on the same day using two BIA analysers (Seca® 206, Allers Hamburg, Germany and Model Tanita® BC-418®, TANITA Corporation, Sportlife Tokyo, Japan), skinfold measurements (Slaughter equation), and DXA (Hologic Horizon DXA System®, Quirugil, Bogotá, Columbia). Agreement between measurements was analysed using t-tests, Bland–Altman plots, and Lin’s concordance correlation coefficient (ρc). There was a significant correlation between DXA and the other BF% measurement methods (r > 0.430). According to paired t-tests, in both sexes, BF% assessed by BIA analysers or Slaughter equations differ from BF% assessed by DXA (p < 0.001). The lower and upper limits of the differences compared with DXA were 6.3–22.9, 2.2–2.8, and −3.2–21.3 (95% CI) in boys and 2.3–14.8, 2.4–20.1, and 3.9–18.3 (95% CI) in girls for Seca® mBCA, Tanita® BC 420MA, and Slaughter equations, respectively. Concordance was poor between DXA and the other methods of measuring BF% (ρc < 0.5). BIA analysers and Slaughter equations underestimated BF% measurements compared to DXA, so they are not interchangeable methods for assessing BF% in Latin American children and adolescents with excess of adiposity.
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Kang C, Saso K, Ota K, Kawazu M, Ueda T, Okada H. JMJD2B/KDM4B inactivation in adipose tissues accelerates obesity and systemic metabolic abnormalities. Genes Cells 2018; 23:767-777. [PMID: 30073721 DOI: 10.1111/gtc.12627] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 07/01/2018] [Accepted: 07/03/2018] [Indexed: 01/09/2023]
Abstract
Obesity is a serious global health issue; however, the roles of genetics and epigenetics in the onset and progression of obesity are still not completely understood. The aim of this study was to determine the role of Kdm4b, which belongs to a subfamily of histone demethylases, in adipogenesis and fat metabolism in vivo. We established conditional Kdm4b knockout mice. Inactivation of Kdm4b in adipocytes (K4bKO) induced profound obesity in mice on a high fat diet (HFD). The HFD-fed K4bKO mice exhibited an increased volume of fat mass and higher expression levels of adipogenesis-related genes. In contrast, the genes involved in energy expenditure and mitochondrial functions were down-regulated. Supporting these findings, the energy expenditure of Kdm4b-deficient cells was markedly decreased. In addition, progression of glucose intolerance and hepatic steatosis with hepatocellular damages was observed. These data indicate that Kdm4b is a critical regulator of systemic metabolism via enhancing energy expenditure in adipocytes.
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Affiliation(s)
- Changkeun Kang
- The Campbell Family Cancer Research Institute, Ontario Cancer Institute, University Health Network, Toronto, Ontario, Canada
| | - Kayoko Saso
- The Campbell Family Cancer Research Institute, Ontario Cancer Institute, University Health Network, Toronto, Ontario, Canada
| | - Kazushige Ota
- Department of Biochemistry, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Masahito Kawazu
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Takeshi Ueda
- Department of Biochemistry, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Hitoshi Okada
- Department of Biochemistry, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
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Imran M, Khan N, Shah AA, Ahmad I. Overweight and Obesity Prevalence Pattern and Associated Risk Factors Among the People of Malakand Division, Khyber Pakhtunkhwa Pakistan. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2018. [DOI: 10.1007/s13369-018-3457-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Shafiee G, Qorbani M, Heshmat R, Djalalinia S, Motlagh ME, Arefirad T, Mahdavi Gorabi A, Najafi F, Asayesh H, Kelishadi R. Wrist circumference as a novel predictor of obesity in children and adolescents: the CASPIAN-IV study. J Pediatr Endocrinol Metab 2018; 31:717-725. [PMID: 29794252 DOI: 10.1515/jpem-2017-0206] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 04/16/2018] [Indexed: 12/22/2022]
Abstract
Background Recent studies have discussed the application of wrist circumference as an easy-to-use predictor of general and abdominal obesity. The aim of the current study is to evaluate the association of wrist circumference with generalized and abdominal obesity and to determine its sex- and age-specific optimal cutoff points in association with generalized and abdominal obesity in a national sample of pediatric population. Methods This nationwide survey was conducted among 14,880 students, aged 6-18 years, selected through a multistage, random cluster sampling method from rural and urban areas of 30 provinces in Iran from 2011 to 2012. Anthropometric indices (weight, height, wrist circumference, waist circumference [WC], hip circumference [HC]) were measured by standard protocols using calibrated instruments. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. By considering the area under the curve (AUC) of the receiver operator characteristic (ROC) curves, we evaluated the association of wrist circumference with obesity indices and determined its sex- and age-specific optimal cutoff points in association with obesity. AUC: 0.5, AUC: 0.5-0.65 and AUC: 0.65-1.0 were interpreted as equal to chance, moderately and highly accurate tests, respectively. Results Overall, 13,486 children and adolescents with a mean age of 12.47±3.36 years completed the study (participation rate of 90.6%). In both genders, wrist circumference had a significant correlation with anthropometric measures including weight, height, BMI, WC, HC and WHtR. In all age groups and both genders, wrist circumference performed relatively well in classifying individuals into overweight (AUC: 0.67-0.75, p<0.001), generalized obesity (AUC: 0.81-0.85, p<0.001) and abdominal obesity (AUC: 0.82-0.87, p<0.001). Conclusions Wrist circumference is suggested to be a useful index for assessing excess weight in the pediatric age group. Its easy measurement without the need of calculation ratios might make it as a routine measurement in daily clinical practice and in large epidemiological studies.
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Affiliation(s)
- Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran, Phone: +009821-88913543, Fax: +009821-88808082
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Tahereh Arefirad
- Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Najafi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Roya Kelishadi
- Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primary Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran, Phone: +009821-88913543, Fax: +009821-88808082
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Family TXT: Feasibility and Acceptability of a mHealth Obesity Prevention Program for Parents of Pre-Adolescent African American Girls. CHILDREN-BASEL 2018; 5:children5060081. [PMID: 29921811 PMCID: PMC6025426 DOI: 10.3390/children5060081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 01/28/2023]
Abstract
Obesity prevalence is greater in African American girls than their non-Hispanic white peers. Obesity prevention programs are needed to help parents create an obesity-preventive home environment. This paper reports the feasibility and acceptability of a mHealth child obesity prevention program consisting of self-determination theory-grounded text messages promoting a healthy home food and activity environment to parents of 8–10-year-old African American girls. A one-group design with baseline and immediate post-intervention assessments was utilized. Mothers (n = 19) received 36 text messages over 12 weeks. Feasibility and acceptability were assessed through staff logs and post-intervention surveys and an interview. Feasibility and acceptability criteria were met. Mothers reported positive reactions to the intervention; they liked the program, used the information, and all but one gave it an A or B grade. The majority made changes and shared the text messages with others. This research provides evidence that a theoretically grounded mHealth child obesity prevention intervention is feasible and acceptable to parents of African American girls.
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Moeijes J, van Busschbach JT, Bosscher RJ, Twisk JWR. Sports participation and psychosocial health: a longitudinal observational study in children. BMC Public Health 2018; 18:702. [PMID: 29879933 PMCID: PMC5992880 DOI: 10.1186/s12889-018-5624-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/29/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND It is well known that sports participation is positively associated with psychosocial health in children, but details about this association over time are lacking. This study aimed to explore longitudinal associations between several characteristics of sports participation and three aspects of psychosocial health (internalizing problems, externalizing problems and prosocial behaviour) in Dutch children aged 10-12 years. METHODS Data from 695 fourth-grade primary school children were included at baseline; 10-13 months later, 487 children (response rate 70.1%) were retained. At both time points, children reported on their sports participation (Move and Sports Monitor Questionnaire - Youth Aged 8-12 Years) and psychosocial health (Strength and Difficulties Questionnaire). Longitudinal associations between several characteristics of sports participation and the three aspects of psychosocial health were analysed using linear mixed models, both clustering the repeated measures within children and clustering the children within schools. In addition to crude analyses, analyses were performed adjusting for sex, age, BMI, household composition, SES and frequency of sports participation. RESULTS Membership in a sports club, moderate or high frequency of sports participation, performing team sports, performing outdoor sports, performing contact sports and involvement in competition were longitudinally associated with fewer internalizing problems. The longitudinal association of higher frequency of sports participation with fewer internalizing problems was stronger as a child's BMI increased. The association of performing team sports with fewer internalizing problems was only observed for boys. Membership in a sports club and moderate or high frequency of sports participation were also longitudinally associated with better prosocial behaviour. These associations with prosocial behaviour were stronger for girls. None of the characteristics of sports participation examined were longitudinally associated with externalizing problems. CONCLUSIONS This study shows that from a longitudinal perspective, fewer internalizing problems and better prosocial behaviour were seen in children who were active in sports. Fewer internalizing problems were also associated with the kind of sports participation; for example, with performing outdoor sports. No associations were found for externalizing problems. Future research should preferably take the form of an intervention to investigate whether the observed statistical associations are of a causal nature.
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Affiliation(s)
- Janet Moeijes
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017, CA, The Netherlands. .,Department of Epidemiology and Biostatistics, VU Medical Center Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
| | - Jooske T van Busschbach
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017, CA, The Netherlands.,University Medical Center Groningen, University Center for Psychiatry, PO Box 30001, 9700, RB, Groningen, The Netherlands
| | - Ruud J Bosscher
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017, CA, The Netherlands
| | - Jos W R Twisk
- Department of Public and Occupational Health, Amsterdam Public Health research institute (VUmc), Van der Boechorststraat 7, Amsterdam, 1081, BT, The Netherlands
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Quesada D, Ahmed NU, Fennie KP, Gollub EL, Ibrahimou B. A Review: Associations Between Attention-deficit/hyperactivity Disorder, Physical Activity, Medication Use, Eating Behaviors and Obesity in Children and Adolescents. Arch Psychiatr Nurs 2018; 32:495-504. [PMID: 29784236 DOI: 10.1016/j.apnu.2018.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 01/17/2018] [Accepted: 01/19/2018] [Indexed: 01/08/2023]
Abstract
UNLABELLED In the past few years we have become increasingly aware of strong associations between obesity and ADHD. Both conditions are major public health issues, affecting children, adolescents and adults alike. OBJECTIVE This review seeks to (1) examine prior research on the association between ADHD and obesity in children and adolescents; (2) discuss mechanisms and consequent behavioral attributes to gain understanding of the path association between ADHD and obesity, (3) review studies examining the role of physical activity, medication, eating behavior and gender on the relationship between ADHD and obesity in children and adolescents. METHOD PubMed, CINAHL and PsycINFO databases were used to search for studies whose subjects were children and adolescents, ages 0-17 years and whose publication years were from 2000 to 2016. After screening 31 studies were included in the review. RESULTS The literature suggests that there is a significant association between ADHD and obesity. Further, the inattentive and impulsive behaviors that characterize ADHD could contribute to dis-regulated eating behaviors and a lack of motivation to engage in physical activity. In addition, it is proposed that medication, gender and physical activity play a role in mediating and moderating the relationship between ADHD and obesity.
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Affiliation(s)
- Danielle Quesada
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, AHC5 (room 486), Miami, FL 33199, USA.
| | - Nasar U Ahmed
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, AHC5 (room 486), Miami, FL 33199, USA.
| | - Kristopher P Fennie
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, AHC5 (room 480), Miami, FL 33199, USA.
| | - Erica L Gollub
- Department of Health Studies, College of Health Professions, Pace University, 861 Bedford Road, Pleasantville, NY 10570, USA.
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, AHC5 (room 465), Miami, FL 33199, USA.
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Non-Nutritive Sweeteners and Metabolic Health Outcomes in Children: A Systematic Review and Meta-Analysis. J Pediatr 2018; 197:128-133.e2. [PMID: 29655865 DOI: 10.1016/j.jpeds.2018.01.081] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 12/21/2017] [Accepted: 01/31/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To systematically assess and quantitatively synthesize the literature regarding the association of consumption of non-nutritive sweeteners (NNS) during childhood with negative metabolic health outcomes. STUDY DESIGN Following the PRISMA guidelines, published literature was systematically reviewed. Eligible studies (N = 13) were identified through the screening of over 2500 publications. Random-effects meta-analyses were conducted on the association of NNS consumption with body mass index (BMI) increase. Sensitivity and subgroup analyses by sex were also undertaken. RESULTS Consumption of NNS during childhood and adolescence was associated with an increase in BMI (OR 1.15, 95% CI 1.06-1.25); the OR was similar in sensitivity analyses. The associations were positive but marginally significant in subanalyses by sex. The qualitative assessment of existing literature showed nonsignificant associations with other components of metabolic disease, such as waist circumference, fat mass accumulation, and type 2 diabetes. CONCLUSIONS Systematic assessment of observational studies showed no association of NNS intake during childhood with fat mass accumulation and waist circumference and a small, but statistically significant association with BMI increase. Inherent methodological weaknesses of to-date published investigations, including mainly underpowered size to explore the hypothesis, call for more research.
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Chidambaran V, Tewari A, Mahmoud M. Anesthetic and pharmacologic considerations in perioperative care of obese children. J Clin Anesth 2018; 45:39-50. [DOI: 10.1016/j.jclinane.2017.12.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 12/11/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
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Wright JA, Whiteley JA, Watson BL, Sheinfeld Gorin SN, Hayman LL. Tailored communications for obesity prevention in pediatric primary care: a feasibility study. HEALTH EDUCATION RESEARCH 2018; 33:14-25. [PMID: 29112721 PMCID: PMC6018684 DOI: 10.1093/her/cyx063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 10/06/2017] [Indexed: 06/07/2023]
Abstract
Recommendations for the prevention of childhood obesity encourage providers to counsel parents and their children on healthy diet and activity behaviors. This study evaluated the feasibility of a theory-based, tailored communication intervention for obesity prevention (Team Up for Health) delivered during a well-child visit. A two-armed randomized controlled trial was used. Parents of children aged 4-10 years were recruited from a list of patients due for a well-child visit at a pediatric primary care clinic. Parents were randomized to either the 'immediate' condition (parent and pediatrician received the tailored report at the well-child visit) or the 'delayed' condition (parent received the report at the end of the study). Self-report measures assessed physical activity, fruits, vegetables, television time, sugary drinks, and 100% fruit juice. Parents completed assessments at baseline, <48 h and 4-week follow-up. Providers were interviewed at the end of the study. Independent t-tests were used to examine between group differences. Seven areas of feasibility were evaluated: Recruitment, randomization, measurement, retention, acceptability, implementation and demand. Results showed high rates of measurement (85%) and acceptability (89%) and implementation (80%) of the intervention. In conclusion, Team Up for Health was feasible; however, a larger study is needed to evaluate its efficacy.
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Affiliation(s)
- Julie A Wright
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Jessica A Whiteley
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Bonnie L Watson
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
| | | | - Laura L Hayman
- Department of Nursing, University of Massachusetts Boston, Boston, MA 02125, USA
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Asif M, Aslam M, Altaf S. Mid-upper-arm circumference as a screening measure for identifying children with elevated body mass index: a study for Pakistan. KOREAN JOURNAL OF PEDIATRICS 2018; 61:6-11. [PMID: 29441106 PMCID: PMC5807990 DOI: 10.3345/kjp.2018.61.1.6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/26/2017] [Accepted: 10/12/2017] [Indexed: 11/27/2022]
Abstract
Purpose Mid-upper-arm circumference (MUAC) is considered an alternative screening method for obesity. The aims of this investigation were to examine the ability of MUAC to correctly identify children with elevated body mass index (BMI) and to determine the best MUAC cutoff point for identification of children with high BMI. Methods Anthropometric measurements (height, weight, and MUAC) from a cross-sectional sample of 7,921 Pakistani children aged 5–14 years were analyzed. Pearson correlation coefficients between MUAC and other anthropometric measurements were calculated. Receiver operating characteristic curve analysis was used to determine the optimal MUAC cutoff point for identifying children with high BMI. Results Among 7,921 children, the mean (±standard deviation) age, BMI, and MUAC were 10.00 (±2.86 years), 16.16 (±2.66 kg/m2), and 17.73 (±2.59 cm), respectively. The MUAC had a strong positive correlation with BMI. The optimal MUAC cutoff points indicating elevated BMI in boys ranged from 16.76 to 22.73, while the corresponding values in girls ranged from 16.38 to 20.57. Conclusion MUAC may be used as a simple indicator of overweight/obesity in children, with reasonable accuracy in clinical settings.
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Affiliation(s)
- Muhammad Asif
- Governmemnt Degree College, Qadir Pur Raan, Multan, Pakistan
| | - Muhammad Aslam
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | - Saima Altaf
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
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Yost G, Coyle L, Gallagher C, Graney N, Siemeck R, Tatooles A, Pappas P, Bhat G. The impact of extreme obesity on outcomes after left ventricular assist device implantation. J Thorac Dis 2017; 9:4441-4446. [PMID: 29268513 DOI: 10.21037/jtd.2017.10.52] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The association between extreme body mass index (BMI) and outcomes in left ventricular assist device (LVAD) patients has not been well established. With the commercial use of LVADs a larger number of patients with a BMI >40 have undergone device implantation. The purpose of this study was to evaluate the short and long-term outcomes of LVAD patients with extreme obesity. Methods A retrospective review of all patients (n=383) at our center who received a LVAD as primary implant between 2005-2015 was performed. Demographics, preoperative laboratory values, and postoperative outcomes were analyzed. Patients were divided into three groups based on BMI (kg/m2) classification (group 1: ≤25; group 2: 25 to 35; group 3: ≥35) and compared using one-way analysis of variance (ANOVA), Kruskal-Wallis and Chi-squared analysis as appropriate. Results Comparison of postoperative outcomes demonstrated an increased risk of respiratory failure and right ventricular (RV) failure in patients with a BMI ≥35 (range, 35-59). Length of stay, sternal infection, driveline/pocket infection, systemic infection, GI-bleeding, and neurological events within the first year of device therapy were not related to BMI. Survival at 30-day, 1- and 2-year was not significantly different among the three groups. The group with the smallest BMI demonstrated an increased risk for re-operative bleeding. Conclusions Despite an increased risk of early morbidity in patients with extreme obesity, long term survival was not significantly different between the BMI groups. Careful consideration is recommended when evaluating patients with an excessive BMI for LVAD therapy although it should not be a contraindication for device placement.
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Affiliation(s)
- Gardner Yost
- Advocate Christ Medical Center, Heart Institute, Heart and Vascular Institute Administration, Oak Lawn, IL 60453, USA
| | - Laura Coyle
- Advocate Christ Medical Center, Heart Institute, Heart and Vascular Institute Administration, Oak Lawn, IL 60453, USA
| | - Colleen Gallagher
- Advocate Christ Medical Center, Heart Institute, Heart and Vascular Institute Administration, Oak Lawn, IL 60453, USA
| | - Nicole Graney
- Advocate Christ Medical Center, Heart Institute, Heart and Vascular Institute Administration, Oak Lawn, IL 60453, USA
| | - Roxanne Siemeck
- Advocate Christ Medical Center, Heart Institute, Heart and Vascular Institute Administration, Oak Lawn, IL 60453, USA
| | - Antone Tatooles
- Advocate Christ Medical Center, Heart Institute, Heart and Vascular Institute Administration, Oak Lawn, IL 60453, USA
| | - Patroklos Pappas
- Advocate Christ Medical Center, Heart Institute, Heart and Vascular Institute Administration, Oak Lawn, IL 60453, USA
| | - Geetha Bhat
- Advocate Christ Medical Center, Heart Institute, Heart and Vascular Institute Administration, Oak Lawn, IL 60453, USA
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Wang YF, Ha S, Zauszniewski JA, Ross R. Psychometric properties of the Chinese version of the Dutch Eating Behavior Questionnaire in a sample of Taiwanese parents. Obes Res Clin Pract 2017; 12:129-132. [PMID: 29217141 DOI: 10.1016/j.orcp.2017.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 11/18/2017] [Accepted: 11/20/2017] [Indexed: 11/18/2022]
Abstract
The Dutch Eating Behavior Questionnaire (DEBQ) appraises overeating styles that may contribute to weight gain in adults. The purpose of this analysis was to assess the psychometric properties of a Chinese version of the DEBQ (C-DEBQ) in a sample of parents of school-age children in Taiwan. The C-DEBQ encompassing three subscales that including emotional eating, external eating, and restrained eating. Each subscale's reliability was assessed with Cronbach's alpha internal consistency. Confirmatory factor analysis (CFA) was conducted to validate the model fit. A total of 340 normal weight and overweight parents of school-age children from various geographical locations in Taiwan participated in the study. Each subscale, emotional, external, and restrained eating, displayed good-to-excellent internal consistency (Cronbach's alphas: .94, .81, and .89, respectively). CFA showed that the three-factor solution had close goodness-of-fit to the data for supporting the factorial validity (x2=1239.03, df=488, p<.001, x2/df=2.54, root mean square error of approximation=.067, comparative fit index=.879, Tucker-Lewis index=.869). Findings suggest that the C-DEBQ is a psychometrically reliable and valid instrument with the potential to assess overeating styles in Taiwanese parents of school-age children. Replication studies with more age- and gender-diverse populations are needed to provide further evidence of construct validity for the Chinese version of the DEBQ.
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Affiliation(s)
- Ya-Fen Wang
- College of Nursing, Kent State University, Kent, OH, USA; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA; School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA.
| | - Soonyoung Ha
- College of Nursing, Kent State University, Kent, OH, USA; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA; School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Jaclene A Zauszniewski
- College of Nursing, Kent State University, Kent, OH, USA; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA; School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Ratchneewan Ross
- College of Nursing, Kent State University, Kent, OH, USA; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA; School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
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Text Messaging Based Obesity Prevention Program for Parents of Pre-Adolescent African American Girls. CHILDREN-BASEL 2017; 4:children4120105. [PMID: 29207536 PMCID: PMC5742750 DOI: 10.3390/children4120105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 11/20/2017] [Accepted: 11/29/2017] [Indexed: 01/23/2023]
Abstract
African American girls are at a greater risk of obesity than their nonminority peers. Parents have the primary control over the home environment and play an important role in the child obesity prevention. Obesity prevention programs to help parents develop an obesity-preventive home environment are needed. The purpose of this study was to collect formative research from parents of 8-10-year old African American girls about perceptions, expectations, and content for a text messaging based program. Mothers (n = 30) participated in surveys and interviews to inform message development and content. A professional expert panel (n = 10) reviewed draft text messages via a survey. All the mothers reported owning a cellphone with an unlimited texting plan, and they used their cellphones for texting (90.0%) and accessing the Internet (100.0%). The majority were interested in receiving text messages about healthy eating and physical activity (86.7%). Interviews confirmed survey findings. One hundred and seven text messages promoting an obesity-preventive home environment were developed. The expert panel and parents reported positive reactions to draft text messages. This research provides evidence that mobile health (mHealth) interventions appeal to parents of African American girls and they have ready access to the technology with which to support this approach.
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Pazin DC, Rosaneli CF, Olandoski M, Oliveira ERND, Baena CP, Figueredo AS, Baraniuk AO, Kaestner TLDL, Guarita-Souza LC, Faria-Neto JR. Waist Circumference is Associated with Blood Pressure in Children with Normal Body Mass Index: A Cross-Sectional Analysis of 3,417 School Children. Arq Bras Cardiol 2017; 109:509-515. [PMID: 29185613 PMCID: PMC5783431 DOI: 10.5935/abc.20170162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/31/2017] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of childhood obesity and associated conditions, such as
hypertension, has become a major problem of public health. Although waist
circumference (WC) is a marker of cardiovascular risk in adults, it is
unclear whether this index is associated with cardiovascular risk factors in
children. Objective Our aim was to evaluate the association between increased WC and elevated
blood pressure (BP) in children with normal body mass index (BMI)
ranges. Methods Cross-sectional evaluation of students between 6 and 11 years with normal
BMI. WC was categorized by quartile for each age group. Normal BP was
defined as values < 90th percentile, and levels above this range were
considered elevated. Values of p < 0.05 were considered statistically
significant. Results Of the 5,037 children initially assessed, 404 (8%) were excluded for being
underweight and 1,216 (24.1%) were excluded for being overweight or obese. A
final sample of 3,417 children was evaluated. The prevalence of elevated BP
was 10.7%. In children with WC in the lowest quartile, the prevalence of
elevated BP was 8.1%. This prevalence increased in upper quartiles: 10.6% in
the second, 12.4% in third and 12.1% in the upper quartile. So, in this
group, being in the highest WC quartile was associated with a 57% higher
likelihood to present elevated BP when compared to those in the lowest
quartile (Q4 vs Q1; OR 1.57 - 95%CI 1.14 - 2.17). Conclusion In children aged 6 to 11 years, increased waist circumference is associated
with elevated BP even when BMI is normal.
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Affiliation(s)
| | | | - Márcia Olandoski
- Pontifícia Universidade Católica do Paraná, Curitiba, PR- Brazil
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Jacques-Tiura AJ, Carcone AI, Naar S, Brogan Hartlieb K, Albrecht TL, Barton E. Building Motivation in African American Caregivers of Adolescents With Obesity: Application of Sequential Analysis. J Pediatr Psychol 2017; 42:131-141. [PMID: 27246865 DOI: 10.1093/jpepsy/jsw044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 04/26/2016] [Indexed: 11/13/2022] Open
Abstract
Objective We sought to examine communication between counselors and caregivers of adolescents with obesity to determine what types of counselor behaviors increased caregivers' motivational statements regarding supporting their child's weight loss. Methods We coded 20-min Motivational Interviewing sessions with 37 caregivers of African American 12-16-year-olds using the Minority Youth Sequential Coding for Observing Process Exchanges. We used sequential analysis to determine which counselor communication codes predicted caregiver motivational statements. Results Counselors' questions to elicit motivational statements and emphasis on autonomy increased the likelihood of both caregiver change talk and commitment language statements. Counselors' reflections of change talk predicted further change talk, and reflections of commitment language predicted more commitment language. Conclusions When working to increase motivation among caregivers of adolescents with overweight or obesity, providers should strive to reflect motivational statements, ask questions to elicit motivational statements, and emphasize caregivers' autonomy.
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Affiliation(s)
- Angela J Jacques-Tiura
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, MI, USA
| | - April Idalski Carcone
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, MI, USA
| | - Sylvie Naar
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, MI, USA
| | - Kathryn Brogan Hartlieb
- Department of Dietetics and Nutrition, Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Terrance L Albrecht
- Karmanos Cancer Institute, School of Medicine, Wayne State University, MI, USA
| | - Ellen Barton
- Linguistics Program, Department of English, Wayne State University, MI, USA
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Akın O, Eker İ, Arslan M, Yavuz ST, Akman S, Taşçılar ME, Ünay B. Relation of insulin resistance to neurocognitive function and electroencephalography in obese children. J Pediatr Endocrinol Metab 2017; 30:1027-1032. [PMID: 28841575 DOI: 10.1515/jpem-2017-0186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 07/24/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Childhood obesity may lead to neuronal impairment in both the peripheral and the central nervous system. This study aimed to investigate the impact of obesity and insulin resistance (IR) on the central nervous system and neurocognitive functions in children. METHODS Seventy-three obese children (38 male and 35 female) and 42 healthy children (21 male and 21 female) were recruited. Standard biochemical indices and IR were evaluated. The Wechsler Intelligence Scale for Children-Revised (WISC-R) and electroencephalography (EEG) were administered to all participants. The obese participants were divided into two groups based on the presence or absence of IR, and the data were compared between the subgroups. RESULTS Only verbal scores on the WISC-R in the IR+ group were significantly lower than those of the control and IR- groups. There were no differences between the groups with respect to other parameters of the WISC-R or the EEG. Verbal scores of the WISC-R were negatively correlated with obesity duration and homeostatic model assessment-insulin resistance (HOMA-IR) values. EEGs showed significantly more frequent 'slowing during hyperventilation' (SDHs) in obese children than non-obese children. CONCLUSIONS Neurocognitive functions, particularly verbal abilities, were impaired in obese children with IR. An early examination of cognitive functions may help identify and correct such abnormalities in obese children.
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Kalantari N, Mohammadi NK, Rafieifar S, Eini-Zinab H, Aminifard A, Malmir H, Ashoori N, Abdi S, Gholamalizadeh M, Doaei S. Indicator for Success of Obesity Reduction Programs in Adolescents: Body Composition or Body Mass Index? Evaluating a School-based Health Promotion Project after 12 Weeks of Intervention. Int J Prev Med 2017; 8:73. [PMID: 29026505 PMCID: PMC5634063 DOI: 10.4103/ijpvm.ijpvm_306_16] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 04/03/2017] [Indexed: 12/13/2022] Open
Abstract
Background: Obesity in adolescence is the strongest risk factor for obesity in adulthood. This study aimed to evaluate the effects of a comprehensive lifestyle intervention on different anthropometric indices in 12–16-year-old boy adolescents after 12 Weeks of Intervention. Methods: A total of 96 male adolescents from two schools participated in this study. The schools were randomly assigned to intervention (53 students) and control school (43 students). Height and weight of students were measured and their body mass index (BMI) was calculated. Body fat percent (BF) and body muscle percent (BM) was assessed using a bioimpedance analyzer considering the age, gender, and height of students at baseline and after intervention. The obesity reduction intervention was implemented in the intervention school based on the Ottawa charter for health promotion. Results: Twelve weeks of intervention decreased BF percent in the intervention group in comparison with the control group (decreased by 1.81% in the intervention group and increased by 0.39% in the control group, P < 0.01). However, weight, BMI, and BM did not change significantly. Conclusions: The result of this study showed that a comprehensive lifestyle intervention decreased the body fat percent in obese adolescents, although these changes was not reflected in the BMI. It is possible that BMI is not a good indicator in assessment of the success of obesity management intervention.
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Affiliation(s)
- Naser Kalantari
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Shahram Rafieifar
- Department of Health Education and Promotion, Ministry of Health, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atefeh Aminifard
- Department of Food Industry, School of Food Sciences and Industry, Islamic Azad University, Khouzestan, Iran
| | - Hanieh Malmir
- Department of Community Nutrition, School of Nutrition and Biochemistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Narjes Ashoori
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sheyda Abdi
- Department of Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Gholamalizadeh
- Student Research Committee, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Doaei
- Student Research Committee, Department of community nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Callender C, Liu Y, Moore CE, Thompson D. The baseline characteristics of parents and African American girls in an online obesity prevention program: A feasibility study. Prev Med Rep 2017; 7:110-115. [PMID: 28652960 PMCID: PMC5477066 DOI: 10.1016/j.pmedr.2017.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/15/2017] [Accepted: 05/15/2017] [Indexed: 12/01/2022] Open
Abstract
The objective of this paper was to identify the relationships and associations between child and parent characteristics with child fruit and vegetable (FV) consumption in an online obesity prevention program for 8-10 year old African American girls. Girls and a parent (n = 342 child-parent pairs) in the southwestern US completed baseline data collection from 2012 to 2014. Girls and a parent completed self-report questionnaires online. Girls also completed two unannounced 24 hour telephone-based dietary recalls. The relationships of parent demographic characteristics, child FV intake, and psychosocial variables (child and parent) were examined by analysis of variance. Pearson correlation coefficients were calculated to determine the relationships between psychosocial variables and child FV intake. Child FV intake was significantly greater in the highest household education (p = 0.001) and income groups (p = 0.004). FV home availability was higher with older parents (p = 0.007) and two-parent households (p = 0.033). Child FV intake was positively related to child FV preferences (p < 0.001), FV home availability (p = 0.022), and FV home accessibility (p = 0.002) but was negatively related to family barriers to FV consumption (p = 0.000). The study highlighted significant findings between child FV consumption and parent psychosocial variables and demographic characteristics that may offer insights for the design of effective obesity prevention interventions for 8-10 year old African American girls. ClinicaTrials.gov (NCT01481948).
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Affiliation(s)
- Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
| | - Yan Liu
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
| | - Carolyn E. Moore
- Texas Woman's University, Department of Nutrition and Food Sciences, 6700 Fannin St, Houston, TX 77030, United States
| | - Deborah Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
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Landau Z, Abiri S, Lebenthal Y, Jakubowicz D, Mor N, Lerner-Geva L, Boaz M, Wainstein J, Bar-Dayan Y. Lifestyle intervention program benefits children with overweigh compared to children with obesity. Obes Res Clin Pract 2017; 12:85-92. [PMID: 28838814 DOI: 10.1016/j.orcp.2017.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 07/07/2017] [Accepted: 07/13/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lifestyle weight loss interventions represent the mainstay of treating children with obesity. Long-term follow-up studies of intervention programs are scarce. This study assessed the long-term effects and identified factors associated with significant weight loss. METHODS This prospective, observational study involved 165 children with body mass index (BMI) z-score ≥1.5 who participated in after-school intervention program. MAIN OUTCOME MEASURE change in BMI z-scores; decreased BMI z-score ≥0.5 units was defined as clinically significant. RESULTS At baseline, 55/165 (33.3%) had BMI z-score 1.5-2 and 98 (59.4%) had BMI z-score >2. At follow-up (mean 5.4±1.4 years), 80 (48.5%) had a clinically significant reduction in BMI z-score, while 56 (33.9%) reported a mildly decrease in BMI z-score of 0-0.5 and 29 (17.6%) reported increased BMI z-score. Lower BMI z-score at baseline and participation in sport activity at follow-up were associated with long-term decrease in BMI z-score. Participation in additional post-intervention weight control programs was correlated with weight gain. CONCLUSIONS Intervention program was associated with long-term improvement in weight control, especially in children with mild obesity. Physical activity was related to long-term success. Participation in an additional intervention program was associated with failure of weight control.
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Affiliation(s)
- Zohar Landau
- Pediatric Endocrinology Unit, Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shirli Abiri
- Pediatric Endocrinology Unit, Wolfson Medical Center, Holon, Israel
| | - Yael Lebenthal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniela Jakubowicz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Diabetes Unit, Wolfson Medical Center, Holon, Israel
| | - Naomi Mor
- Diabetes Unit, Wolfson Medical Center, Holon, Israel
| | - Liat Lerner-Geva
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Gertner Institute for Epidemiology and Health Policy Research, Women and Children's Health Research, Tel Hashomer, Israel
| | - Mona Boaz
- Epidemiology and Research Unit, E. Wolfson Medical Center, Holon, Israel
| | - Julio Wainstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Diabetes Unit, Wolfson Medical Center, Holon, Israel
| | - Yosefa Bar-Dayan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Diabetes Unit, Wolfson Medical Center, Holon, Israel.
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Cerniglia L, Muratori P, Milone A, Paciello M, Ruglioni L, Cimino S, Levantini V, Tambelli R. Paternal psychopathological risk and psychological functioning in children with eating disorders and Disruptive Behavior Disorder. Psychiatry Res 2017; 254:60-66. [PMID: 28456023 DOI: 10.1016/j.psychres.2017.04.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/12/2017] [Accepted: 04/22/2017] [Indexed: 10/19/2022]
Abstract
Several studies demonstrated that maternal psychopathological risk is related to child's maladjustment, but until recently research has relatively neglected fathers. Disruptive Behavior Disorder (DBD) and Eating disorders (ED) have a large prevalence during childhood but a few studies have focused on their association with paternal psychopathological risk. One-hundred and thirty-nine children and their fathers were recruited from pediatric hospitals and outpatient clinics and paired with a healthy control group (CG). Fathers were administered the SCL-90/R and the CBCL 6-18 to assess: 1) psychopathological risk of fathers of children with DBD, ED and CG; 2) significant differences between ED and DBD fathers' psychopathological profiles; and 3) associations between specific fathers' psychopathological symptoms and children's emotional-behavioral problems. Fathers of children with ED showed a higher psychopathological risk than fathers of DBD offspring. Children with DBD showed higher externalizing symptoms. Paternal hostility was associated with internalizing problems in children with DBD. Paternal hostility showed a non-significant but clinically interesting association with internalizing problems in DBD children; interpersonal sensitivity was associated with internalizing problems in ED children. This study can constitute a contribution to a better understanding of the clinical characteristics of fathers of children with DBD and ED.
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Affiliation(s)
- Luca Cerniglia
- International Telematic University Uninettuno, Psychology Faculty, Department of Psychology, Corso Vittorio Emanuele II, 39 - 00100, Rome, Italy.
| | - Pietro Muratori
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331, Calambrone, Pisa, Italy.
| | - Annarita Milone
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331, Calambrone, Pisa, Italy.
| | - Marinella Paciello
- International Telematic University Uninettuno, Psychology Faculty, Department of Psychology, Corso Vittorio Emanuele II, 39 - 00100, Rome, Italy.
| | - Laura Ruglioni
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331, Calambrone, Pisa, Italy.
| | - Silvia Cimino
- Sapienza, University of Rome, Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Via dei Marsi, 78 - 00186, Rome, Italy.
| | - Valentina Levantini
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331, Calambrone, Pisa, Italy.
| | - Renata Tambelli
- Sapienza, University of Rome, Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Via dei Marsi, 78 - 00186, Rome, Italy.
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Zamora-Kapoor A, Omidpanah A, Nelson LA, Kuo AA, Harris R, Buchwald DS. Breastfeeding in Infancy Is Associated with Body Mass Index in Adolescence: A Retrospective Cohort Study Comparing American Indians/Alaska Natives and Non-Hispanic Whites. J Acad Nutr Diet 2017; 117:1049-1056. [PMID: 28082060 PMCID: PMC5586593 DOI: 10.1016/j.jand.2016.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 11/17/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND American Indians and Alaska Natives have the highest obesity prevalence in the United States, but the influence of early childhood variables on body mass index (BMI; calculated as kg/m2) is not well understood. Previous studies have investigated the association between breastfeeding in infancy and offspring BMI, but rarely included American Indians and Alaska Natives. OBJECTIVE This study investigated the association between breastfeeding in infancy and BMI in American Indians and Alaska Native and non-Hispanic white adolescents and young adults. DESIGN Longitudinal analysis based on data from the National Longitudinal Study of Adolescent to Adult Health (1994 to 2008). PARTICIPANTS Adolescent respondents who self-identified as American Indians and Alaska Native or non-Hispanic white, and whose parents completed the parental questionnaire, reported their height and weight. The final sample included 655 American Indians and Alaska Native and 10,305 non-Hispanic white respondents. STATISTICAL ANALYSES PERFORMED Generalized estimating equations were used to measure the mean differences, 95% CIs, and P values of the association between breastfeeding in infancy and offspring BMI in adolescence, stratifying by race, and adjusting for demographic and socioeconomic variables. RESULTS The length of breastfeeding was inversely associated with BMI in both populations. American Indians and Alaska Natives that were breastfed for 6 to 12 months or for more than 12 months had a mean BMI of 2.69 (95% CI -3.46 to -1.92; P<0.01) and 1.54 (95% CI -2.75 to -0.33; P<0.05) units lower than those that were never breastfed. Non-Hispanic whites that were breastfed for 3 to 6 months, 6 to 12 months, or more than 12 months had a mean BMI of 0.71 (95% CI -0.93 to -0.50; P<0.01), 0.68 (95% CI -0.87 to -0.50; P<0.01), and 0.85 (95% CI -1.09 to -0.62; P<0.01) units lower than those that were never breastfed. The association between the length of breastfeeding and offspring BMI varied by race (P<0.01). CONCLUSIONS Breastfeeding in infancy is associated with lower mean BMI. Future research should investigate causal pathways and whether interventions promoting breastfeeding in American Indians and Alaska Natives can prevent increasing BMI.
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Affiliation(s)
- Anna Zamora-Kapoor
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
- Department of Pediatrics, University of Washington, Seattle, WA
| | - Adam Omidpanah
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Lonnie A. Nelson
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Alice A. Kuo
- Department of Pediatrics, University of California-Los Angeles, Los Angeles, CA
| | - Raymond Harris
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Dedra S. Buchwald
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
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Santomauro F, Lorini C, Pieralli F, Niccolai G, Picciolli P, Vezzosi S, Bonaccorsi G. Waist-to-height ratio and its associations with body mass index in a sample of Tuscan children in primary school. Ital J Pediatr 2017; 43:53. [PMID: 28592270 PMCID: PMC5463347 DOI: 10.1186/s13052-017-0372-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/31/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Visceral obesity in children increases the risk of developing cardiovascular diseases. To evaluate overweight children, in addition to Body Mass Index (BMI), waist-to-height ratio (WHtR) can be used to predict cardiometabolic risk. The goal of this study is to describe WHtR in a sample of Tuscan children. METHODS A sample of children living in the province of Pistoia, Tuscany, was measured for the following anthropometric parameters: weight, height, and waist circumference. BMI and WHtR were calculated. For the latter indicator, a threshold of 0.5 was considered as a cardiovascular risk predictor. The subjects were classified into underweight, normal weight, overweight, and obese using Cole's cut-offs. RESULTS The number of children enrolled were 1575 (821 males; 754 females), aged 6-11 years. Of them, 64.3% were normal weight, 4.9% underweight, 22.3% overweight, and 8.5% obese. Moreover, 12.8% had a WHtR ≥0.5 (85.7% males; 88.7% females). The average WHtR value was 0.45 ± 0.045, and was significantly different as per gender (F = 0.45 vs. M = 0.46). WHtR was significantly correlated with BMI (r = 0.766). CONCLUSION The average WHtR value was in line with previous studies conducted among children of similar age groups. Large-scale perspective studies are needed to validate the Italian WHtR cut-offs for children.
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Affiliation(s)
- Francesca Santomauro
- Department of Health Science, University of Florence, Viale G.B. Morgagni, 48, 50134, Florence, Italy.
| | - Chiara Lorini
- Department of Health Science, University of Florence, Viale G.B. Morgagni, 48, 50134, Florence, Italy
| | - Francesca Pieralli
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, Viale G.B. Morgagni, 48, 50134, Florence, Italy
| | - Giuditta Niccolai
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, Viale G.B. Morgagni, 48, 50134, Florence, Italy
| | - Paola Picciolli
- Local Health Unit Toscana Centro, Viale Matteotti, 19, 51100, Pistoia, Italy
| | - Stefania Vezzosi
- Local Health Unit Toscana Centro, Viale Matteotti, 19, 51100, Pistoia, Italy
| | - Guglielmo Bonaccorsi
- Department of Health Science, University of Florence, Viale G.B. Morgagni, 48, 50134, Florence, Italy
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Vanderwall C, Randall Clark R, Eickhoff J, Carrel AL. BMI is a poor predictor of adiposity in young overweight and obese children. BMC Pediatr 2017; 17:135. [PMID: 28577356 PMCID: PMC5457636 DOI: 10.1186/s12887-017-0891-z] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/28/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The body mass index (BMI) is a simple and widely utilized screening tool for obesity in children and adults. The purpose of this investigation was to evaluate if BMI could predict total fat mass (TFM) and percent body fat (%FAT) in a sample of overweight and obese children. METHODS In this observational study, body composition was measured by dual energy x-ray absorptiometry (DXA) in 663 male and female overweight and obese children at baseline within a multidisciplinary, pediatric fitness clinic at an academic medical center. Univariate and multivariate regression analyses were conducted to evaluate whether BMI z-score (BMIz) predicts TFM or %FAT. RESULTS The BMIz, sex and age of subjects were identified as significant predictors for both TFM and %FAT. In subjects younger than 9 years, the BMIz was a weak to moderate predictor for both TFM (R2 = 0.03 for males and 0.26 for females) and %FAT (R2 = 0.22 for males and 0.38 for females). For subjects between 9 and 18 years, the BMIz was a strong predictor for TFM (R2 between 0.57 and 0.73) while BMIz remained only moderately predictive for %FAT (R2 between 0.22 and 0.42). CONCLUSIONS These findings advance the understanding of the utility and limitations of BMI in children and adolescents. In youth (9-18y), BMIz is a strong predictor for TFM, but a weaker predictor of relative body fat (%FAT). In children younger than 9y, BMIz is only a weak to moderate predictor for both TFM and %FAT. This study cautions the use of BMIz as a predictor of %FAT in children younger than 9 years.
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Affiliation(s)
| | - R Randall Clark
- UW Health, University Hospital, 600 Highland Ave, Madison, WI, 53792, USA
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Abbs ES, Viñoles J, Alarcón JO, Johnson HM, Zunt JR. High prevalence of cardiovascular risk factors in Peruvian adolescents living in a peri-urban shantytown: a cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2017; 36:19. [PMID: 28532431 PMCID: PMC5440987 DOI: 10.1186/s41043-017-0093-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 05/10/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Adults of the peri-urban Peruvian shantytown of Lomas de Zapallal have a high prevalence of risk factors for developing cardiovascular disease (CVD)-likely due to behavioral choices established during childhood and adolescence. To guide the development of community-based risk reduction programs, we assessed the prevalence of risk factors for developing CVD among adolescents. METHODS We collected cross sectional data from adolescents of Peruvian peri-urban shantytown to evaluate four domains of CVD risk factors: (1) clinical (blood pressure, fasting blood glucose, and blood lipids), (2) anthropometric (height, weight, and waist circumference), (3) behavioral (physical activity, diet, and substance abuse), and (4) psychosocial (mental health and violence). RESULTS We enrolled 275 adolescents (56.4% female, mean age 14 years). Prevalence of overweight or obese status was 27.8%. High blood pressure was more common in males (37.4%) than females (20.5%) (p = 0.002). Total cholesterol was elevated (>170 mg/dL) in nearly half (45.5%) of the adolescents, and 71% had impaired fasting blood glucose (>100 mg/dL). Females were less likely to exercise daily (95.4%) than males (84.2%) (p = 0.002) but reported higher rates of depression (66.4%), anhedonia (67.6%), and self-harm behavior (37.9%) (all p < 0.01). CONCLUSIONS Adolescents living in the peri-urban population of Puente Piedra had high prevalence of risk factors for future development of CVD; preventative efforts focused on improving nutrition, increasing physical inactivity, and addressing mental health conditions could reduce such risk factors.
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Affiliation(s)
- Elizabeth S Abbs
- Department of Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143, USA.
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, H4/512 CSC, MC 3248, 600 Highland Avenue, Madison, 53792, WI, USA.
| | - José Viñoles
- Instituto de Medicina Tropical "D.A. Carrion" de la Universidad Nacional Mayor de San Marcos, Jiron Jose Santos Chocano 199, Lima, Peru
| | - Jorge O Alarcón
- Instituto de Medicina Tropical "D.A. Carrion" de la Universidad Nacional Mayor de San Marcos, Jiron Jose Santos Chocano 199, Lima, Peru
| | - Heather M Johnson
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, H4/512 CSC, MC 3248, 600 Highland Avenue, Madison, 53792, WI, USA
| | - Joseph R Zunt
- Departments of Neurology, Global Health and Medicine (Infectious Disease) of University of Washington, 325 Ninth Avenue, Seattle, WA, USA
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Akın O, Arslan M, Haymana C, Karabulut E, Hacihamdioglu B, Yavuz ST. Association of neck circumference and pulmonary function in children. Ann Allergy Asthma Immunol 2017; 119:27-30. [PMID: 28527867 DOI: 10.1016/j.anai.2017.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/06/2017] [Accepted: 04/24/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Childhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity. OBJECTIVE To investigate the correlation between anthropometric indices and pulmonary function test results in children without asthma. METHODS Children without any respiratory disorders were enrolled in this study. Anthropometric measurements, such as height, weight, neck circumference (NC), and waist circumference, were obtained from the enrollees and body mass index was calculated. Afterward, pulmonary function tests were performed using spirometry. RESULTS A total of 178 children (106 boys, 59.5%) with a mean age of 9.7 years were included the study. NC was above the 90th percentile in 65 children. Importantly, pulmonary parameters, such as forced expiratory volume during the first second (FEV1) and the ratio of FEV1 to forced vital capacity (FVC), were lower in subjects with a large NC. Similarly, waist circumference was above the 90th percentile in 67 children, and FEV1/FVC was significantly lower in children with a large waist circumference. Moreover, there was a statistically significant negative correlation among FEV1, FEV1/FVC, and body mass index SD score. Also, multivariable linear regression analysis showed that an NC above the 90th percentile was associated with lower FEV1 and FEV1/FVC values. CONCLUSION We identified NC as a novel anthropometric index that is strongly correlated with respiratory functions in children. Therefore, close monitoring of respiratory symptoms, particularly in children with obesity and a large NC, could help with early and prompt determination of respiratory complications of obesity.
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Affiliation(s)
- Onur Akın
- Department of Pediatric Endocrinology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Mutluay Arslan
- Department of Pediatrics, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Bulent Hacihamdioglu
- Department of Pediatric Endocrinology, GATA Military School of Medicine, Ankara, Turkey
| | - Suleyman Tolga Yavuz
- Department of Pediatric Allergy, GATA Military School of Medicine, Ankara, Turkey; Department of Pediatric Allergy, Children's Hospital, University of Bonn, Bonn, Germany.
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Fernandez-Luque L, Singh M, Ofli F, Mejova YA, Weber I, Aupetit M, Jreige SK, Elmagarmid A, Srivastava J, Ahmedna M. Implementing 360° Quantified Self for childhood obesity: feasibility study and experiences from a weight loss camp in Qatar. BMC Med Inform Decis Mak 2017; 17:37. [PMID: 28403865 PMCID: PMC5390457 DOI: 10.1186/s12911-017-0432-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 03/25/2017] [Indexed: 11/10/2022] Open
Abstract
Background The explosion of consumer electronics and social media are facilitating the rise of the Quantified Self (QS) movement where millions of users are tracking various aspects of their daily life using social media, mobile technology, and wearable devices. Data from mobile phones, wearables and social media can facilitate a better understanding of the health behaviors of individuals. At the same time, there is an unprecedented increase in childhood obesity rates worldwide. This is a cause for grave concern due to its potential long-term health consequences (e.g., diabetes or cardiovascular diseases). Childhood obesity is highly prevalent in Qatar and the Gulf Region. In this study we examine the feasibility of capturing quantified-self data from social media, wearables and mobiles within a weight lost camp for overweight children in Qatar. Methods Over 50 children (9–12 years old) and parents used a wide range of technologies, including wearable sensors (actigraphy), mobile and social media (WhatsApp and Instagram) to collect data related to physical activity and food, that was then integrated with physiological data to gain insights about their health habits. In this paper, we report about the acquired data and visualization techniques following the 360° Quantified Self (360QS) methodology (Haddadi et al., ICHI 587–92, 2015). Results 360QS allows for capturing insights on the behavioral patterns of children and serves as a mechanism to reinforce education of their mothers via social media. We also identified human factors, such as gender and cultural acceptability aspects that can affect the implementation of this technology beyond a feasibility study. Furthermore, technical challenges regarding the visualization and integration of heterogeneous and sparse data sets are described in the paper. Conclusions We proved the feasibility of using 360QS in childhood obesity through this pilot study. However, in order to fully implement the 360QS technology careful planning and integration in the health professionals’ workflow is needed. Trial Registration The trial where this study took place is registered at ClinicalTrials.gov on 14 November 2016 (NCT02972164).
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Affiliation(s)
- Luis Fernandez-Luque
- Qatar Computing Research Institute, Hamad bin Khalifa University, HBKU Research Complex, Qatar Foundation, Education City, Doha, Qatar.
| | - Meghna Singh
- Qatar Computing Research Institute, Hamad bin Khalifa University, HBKU Research Complex, Qatar Foundation, Education City, Doha, Qatar
| | - Ferda Ofli
- Qatar Computing Research Institute, Hamad bin Khalifa University, HBKU Research Complex, Qatar Foundation, Education City, Doha, Qatar
| | - Yelena A Mejova
- Qatar Computing Research Institute, Hamad bin Khalifa University, HBKU Research Complex, Qatar Foundation, Education City, Doha, Qatar
| | - Ingmar Weber
- Qatar Computing Research Institute, Hamad bin Khalifa University, HBKU Research Complex, Qatar Foundation, Education City, Doha, Qatar
| | - Michael Aupetit
- Qatar Computing Research Institute, Hamad bin Khalifa University, HBKU Research Complex, Qatar Foundation, Education City, Doha, Qatar
| | - Sahar Karim Jreige
- Department of Human Nutrition, College of Health Sciences, Qatar University, Doha, Qatar
| | - Ahmed Elmagarmid
- Qatar Computing Research Institute, Hamad bin Khalifa University, HBKU Research Complex, Qatar Foundation, Education City, Doha, Qatar
| | - Jaideep Srivastava
- Qatar Computing Research Institute, Hamad bin Khalifa University, HBKU Research Complex, Qatar Foundation, Education City, Doha, Qatar
| | - Mohamed Ahmedna
- Department of Human Nutrition, College of Health Sciences, Qatar University, Doha, Qatar
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Beamish AJ, Reinehr T. Should bariatric surgery be performed in adolescents? Eur J Endocrinol 2017; 176:D1-D15. [PMID: 28174231 DOI: 10.1530/eje-16-0906] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/08/2016] [Accepted: 01/10/2017] [Indexed: 12/26/2022]
Abstract
Adolescent obesity has markedly increased worldwide in both its extent and prevalence in recent decades and obesity prevention strategies are failing. As a result, effective treatment strategies are urgently needed. As behavioral and pharmacological treatment approaches have only moderate effects in severe obesity, bariatric surgery has begun to emerge as a treatment option. In this debate article, we offer arguments opposing and supporting bariatric surgery in the treatment of severe obesity in adolescents. Bariatric surgery has superior therapeutic outcomes with respect to weight loss and resolution of comorbid diseases over other existing treatments. However, long-term outcomes after bariatric surgery in adolescents are only just beginning to emerge. Furthermore, the procedures are generally considered irreversible, apart from gastric banding. Most importantly, not all adolescents seem to benefit greatly from bariatric surgery and we are not yet able to reliably identify those who stand to gain the greatest benefit. The authors agree that adolescent bariatric surgery should be offered exclusively within formal adolescent obesity programs, delivered by specialist multidisciplinary child/adolescent obesity teams, and within specialist centers, in order to optimize outcomes and minimize potential detrimental effects. Patients and their family/carers must be educated regarding the benefits and risks, potential side effects, expected changes in eating behavior and the lifelong requirement for regular medical follow-up after surgery. Before embarking upon a surgical treatment pathway in adolescents with severe obesity, it may also be beneficial to ensure compliance to treatment is demonstrated, in order to minimize the risk of nutritional deficiencies and associated potential complications.
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Affiliation(s)
- Andrew J Beamish
- Department of Gastrosurgical ResearchInstitute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden
- Research DepartmentThe Royal College of Surgeons of England, London, UK
| | - Thomas Reinehr
- Vestische Hospital for Children and Adolescents University of Witten/Herdecke Department of Pediatric EndocrinologyDiabetes, and Nutrition Medicine, Datteln, Germany
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Kumar S, Kelly AS. Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. Mayo Clin Proc 2017; 92:251-265. [PMID: 28065514 DOI: 10.1016/j.mayocp.2016.09.017] [Citation(s) in RCA: 794] [Impact Index Per Article: 113.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 09/12/2016] [Accepted: 09/21/2016] [Indexed: 12/11/2022]
Abstract
Childhood obesity has emerged as an important public health problem in the United States and other countries in the world. Currently 1 in 3 children in the United States is afflicted with overweight or obesity. The increasing prevalence of childhood obesity is associated with emergence of comorbidities previously considered to be "adult" diseases including type 2 diabetes mellitus, hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, and dyslipidemia. The most common cause of obesity in children is a positive energy balance due to caloric intake in excess of caloric expenditure combined with a genetic predisposition for weight gain. Most obese children do not have an underlying endocrine or single genetic cause for their weight gain. Evaluation of children with obesity is aimed at determining the cause of weight gain and assessing for comorbidities resulting from excess weight. Family-based lifestyle interventions, including dietary modifications and increased physical activity, are the cornerstone of weight management in children. A staged approach to pediatric weight management is recommended with consideration of the age of the child, severity of obesity, and presence of obesity-related comorbidities in determining the initial stage of treatment. Lifestyle interventions have shown only modest effect on weight loss, particularly in children with severe obesity. There is limited information on the efficacy and safety of medications for weight loss in children. Bariatric surgery has been found to be effective in decreasing excess weight and improving comorbidities in adolescents with severe obesity. However, there are limited data on the long-term efficacy and safety of bariatric surgery in adolescents. For this comprehensive review, the literature was scanned from 1994 to 2016 using PubMed using the following search terms: childhood obesity, pediatric obesity, childhood overweight, bariatric surgery, and adolescents.
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Affiliation(s)
- Seema Kumar
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, MN.
| | - Aaron S Kelly
- Department of Pediatrics and Department of Medicine, University of Minnesota, Minneapolis
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Quality of Life and Health Outcomes in Overweight and Non-Overweight Children With Asthma. J Pediatr Health Care 2017; 31:37-45. [PMID: 26874457 DOI: 10.1016/j.pedhc.2016.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/13/2016] [Accepted: 01/18/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND During the past two decades, the number of children and adolescents who are obese has more than doubled. Following this trend in childhood obesity, there has been an alarming increase in the number of children with asthma who are overweight. OBJECTIVE The aim of this study was to examine the differences in quality of life (QOL) and health outcomes of obese and overweight children with asthma compared with normal-weight children with asthma using a descriptive comparative survey design. METHODS This comparative study consisted of 90 overweight and normal-weight 9- to 14-year-olds with asthma. Health outcomes examined included asthma-related missed number of school days, emergency department (ED) visits, hospitalizations, number of days wheezing, and number of night awakenings. QOL was measured using the Pediatric Asthma Quality of Life Questionnaire. RESULTS The obese group reported the highest percentage of ED visits, hospitalizations, and number of days wheezing compared with the normal-weight group. A risk ratio analysis showed that the obese group had an overall 2.73 (95% confidence interval [CI] 2.15, 3.63) times higher likelihood of going to the ED and a 2.46 (95% CI 1.97, 3.19) times higher likelihood of hospitalization than the overweight and normal-weight groups. Asthma severity was a significant predictor of overall QOL (β = -23.737, p = .002). CONCLUSIONS The study results are consistent with other investigations that demonstrate that obese persons are at higher risk of experiencing severe asthma symptoms and support obesity as a potentially modifiable risk factor for asthma mitigation and prevention.
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Elvsaas IKØ, Giske L, Fure B, Juvet LK. Multicomponent Lifestyle Interventions for Treating Overweight and Obesity in Children and Adolescents: A Systematic Review and Meta-Analyses. J Obes 2017; 2017:5021902. [PMID: 29391949 PMCID: PMC5748119 DOI: 10.1155/2017/5021902] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/27/2017] [Accepted: 10/19/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Treatment of childhood obesity is important in preventing development of obesity-related diseases later in life. This systematic review evaluates the effect of multicomponent lifestyle interventions for children and adolescents from 2 to 18 years. METHODS AND RESULTS We performed systematic searches in nine databases. Thirty-nine studies met the criteria for meta-analyses. We found a significant difference in body mass index (BMI) after 6 months (MD -0.99 (95% CI -1.36 to -0.61)), 12 months (MD -0.67 (95% CI -1.01 to -0.32)), and 24 months (MD -0.96 (95% CI -1.63 to -0.29)) in favour of multicomponent lifestyle interventions compared to standard, minimal, and no treatment. We also found a significant difference in BMI Z scores after 6 months (MD -0.12 (95% CI -0.17 to -0.06)), 12 months (MD -0.16 (95% CI -0.21 to -0.11)), and 24 months (MD -0.16 (95% CI -0.21 to -0.10)) in favour of multicomponent lifestyle interventions. Subgroup analyses suggested an increased effect in specialist health care with a group treatment component included in the intervention. CONCLUSION Multicomponent lifestyle interventions have a moderate effect on change in BMI and BMI Z score after 6, 12, and 24 months compared with standard, minimal, and no treatment.
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Affiliation(s)
| | - L. Giske
- Norwegian Institute of Public Health, Oslo, Norway
| | - B. Fure
- Norwegian Institute of Public Health, Oslo, Norway
- The Arctic University of Norway, Tromsø, Norway
| | - L. K. Juvet
- Norwegian Institute of Public Health, Oslo, Norway
- University College of Southeast Norway, Notodden, Norway
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The Association of Serum Osteopontin Levels with Insulin Resistance in Obese, Dyslipidemic Children. IRANIAN JOURNAL OF PEDIATRICS 2016. [DOI: 10.5812/ijp.7483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vanderwall CM, Clark RR, Eickhoff JC, Carrel AL. Innovative Assessments Help Elucidate Sustained Improvements in Fitness and Metabolic Health in Obese Children. JOURNAL OF CHILDHOOD OBESITY 2016; 1:21. [PMID: 29721553 PMCID: PMC5927628 DOI: 10.21767/2572-5394.100020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Treatment of childhood obesity is a medical challenge and limited data are available describing successful long term interventions. This study presents a multi-disciplinary intervention that resulted in sustained physiological improvement over a one-year period. METHODS The criterion outcome variables include cardiovascular fitness (CVF) measured by a population-specific treadmill test to predict maximal oxygen uptake (predicted VO2 max) and the body composition (BC) variables of fat mass, non-bone lean mass and percent body fat from whole body dual energy x-ray absorptiometry (DXA) scans. Subjects were overweight and obese children (N=79) evaluated at baseline, 6 and 12 months at a University Hospital-based pediatric fitness clinic. RESULTS Statistically significant improvements in non-bone lean body mass (+4.24 kg ± 5.0, p<0.0001) and predicted VO2 max (+0.14L/min ± 0.10, p<0.0001) were seen at 6 months. These significant improvements were sustained over 12 months: body fat percentage (-2.28 ± 3.49, p<0.0001), lean mass (+6.0 kg ± 4.0, p<0.0001) and predicted VO2 max (+0.22 L/min ± 0.19, p<0.0001). These results were observed despite increases in weight and body mass index (BMI) at 6-months (weight: +6.6 kg ± 6.93, p<0.0001; BMI: +0.37 ± 1.21, p=0.47) and 12-months (weight: +6.3 kg ± 5.8, p<0.0001; BMI: +0.91 ± 2.06, p=0.0002). CONCLUSION These results reflect the sustained effect of a multidisciplinary approach, and the value of using valid and reliable assessment methods to measure sustained physiological changes in a sample of 79 overweight and obese children.
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Affiliation(s)
| | - R Randall Clark
- UW Health-University of Wisconsin Hospitals and Clinics Pediatric Fitness Clinic, USA
| | - Jens C Eickhoff
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, USA
| | - Aaron L Carrel
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, USA
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87
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Colip L, Burge MR, Sandy P, Ghahate D, Bobelu J, Faber T, Shah V. Exercise Intervention Improves the Metabolic Profile and Body Composition of Southwestern American Indian Adolescents. ACTA ACUST UNITED AC 2016; 3. [PMID: 28435884 PMCID: PMC5400367 DOI: 10.15436/2376-0494.16.1180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction/Purpose The Southwestern American Indian population carries a high prevalence of metabolic syndrome and obesity, placing this group at higher risk than the general population for developing early type 2 diabetes and cardiovascular disease, likely impacting overall lifespan. This study aims to evaluate the impact of early lifestyle interventions which promote healthy eating and regular exercise on risk factors contributing to the development of the metabolic syndrome among the adolescent Zuni Pueblo population. Materials and Methods We describe a prospective, single site, community-based cohort study performed among sixty-five adolescent Zuni Indians aged 13.9 ± 1.7 years who were recruited between March 2011 and January 2014. The study intervention consisted of a targeted, tri-weekly exercise regimen with nutritional counselling, and the primary study outcomes included changes from baseline in metabolic profile (fasting lipids, A1c), vital signs (blood pressure, resting heart rate) and anthropometric characteristics of the study group. Results 41 participants have anthropometric data measured at baseline and after completion, biochemical data are available from 30 participants, and body composition data from 26 patients. Using the paired Student’s t-test with Bonferroni correction, significant improvements were shown in pediatric BMI percentile, fasting lipid profile, A1C, total body fat, and fat free mass after six months of exercise and nutritional intervention. Conclusions A simple, standardized fitness program among Southwest American Indian adolescents was effective at reducing fasting lipids and adiposity, as well as improving glycemic indices over the course of six months.
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Affiliation(s)
- Leslie Colip
- School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Mark R Burge
- School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Phillip Sandy
- School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Donica Ghahate
- School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Jeanette Bobelu
- School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Thomas Faber
- Indian Health Services Comprehensive Centre in Zuni Pueblo, Zuni, New Mexico
| | - Vallabh Shah
- School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
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88
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Association of nerve conduction impairment and insulin resistance in children with obesity. Childs Nerv Syst 2016; 32:2219-2224. [PMID: 27503137 DOI: 10.1007/s00381-016-3210-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 07/29/2016] [Indexed: 10/21/2022]
Abstract
AIM The objective of our study was to investigate nerve conduction in normoglycemic obese children. METHODS A total of 60 children with obesity (30 female and 30 male) and 30 healthy children (15 female and 15 male) were enrolled in the study. Insulin resistance (IR) and other metabolic disturbances were investigated and nerve conduction was measured in all participants. Obese children were divided into groups according to the presence of IR. All results were compared between these subgroups. RESULTS The nerve conduction velocity (NCV) of motor median nerves in the IR+ group was significantly higher than that in the IR- group and lower than that in the control group. The NCV of the motor peroneal nerve in the IR+ group was significantly lower than that in the IR- group. The sensory nerve action potential (SNAP) of the sensory median nerve was significantly lower in the IR+ group compared to that in the IR- group. The sensory sural nerve's SNAP was significantly lower in the IR+ group than that in the control group. CONCLUSION Nerve conduction tests may help to detect early pathologies in peripheral nerves and to decrease morbidities in obese children.
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89
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Kelishadi R, Djalalinia S, Motlagh ME, Rahimi A, Bahreynian M, Arefirad T, Ardalan G, Safiri S, Hasani M, Asayesh H, Mansourian M, Qorbani M. Association of neck circumference with general and abdominal obesity in children and adolescents: the weight disorders survey of the CASPIAN-IV study. BMJ Open 2016; 6:e011794. [PMID: 27694487 PMCID: PMC5051415 DOI: 10.1136/bmjopen-2016-011794] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the association of neck circumference (NC) with obesity to determine the sex-specific and age-specific optimal cut-off points of this measure in association with obesity in a national sample of the Iranian paediatric population. METHODS This survey on weight disorders was conducted among a national sample of Iranian children and adolescents, aged 6-18 years. Using the area under the curve (AUC) of the receiver operator characteristic curves, we evaluated the association of NC with general and abdominal obesity. RESULTS This national survey was conducted among 23 043 school students (50.8% boys) with a mean age (SD) of 12.55 (3.31) years. A significant association was documented between NC and other anthropometric measures in both sexes and in the whole population. In all age groups and genders, NC performed relatively well in classifying participants to overweight (AUC: 0.67 to 0.75, p<0.001), general obesity (AUC: 0.81 to 0.85, p<0.001) and abdominal obesity (AUC: 0.73 to 0.78, p<0.001). CONCLUSIONS NC can be considered as a simple time-saving clinical tool for obesity detection in large population-based studies in children and adolescents. It is significantly correlated with indices of adiposity and can reliably identify children with general and abdominal obesity in the Iranian paediatric population.
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Affiliation(s)
- Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Djalalinia
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Ali Rahimi
- School of Humanities and Tourism Management, Bangkok University, Bangkok, Thailand
| | - Maryam Bahreynian
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Arefirad
- Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Gelayol Ardalan
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Motahare Hasani
- Department of Nutrition, School of School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Morteza Mansourian
- Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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90
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Nezami BT, Lytle LA, Tate DF. A randomized trial to reduce sugar-sweetened beverage and juice intake in preschool-aged children: description of the Smart Moms intervention trial. BMC Public Health 2016; 16:837. [PMID: 27542357 PMCID: PMC4992273 DOI: 10.1186/s12889-016-3533-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 08/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity in young children remains a public health concern, and maternal weight is one of the strongest predictors of obesity in early childhood. However, parental adherence in interventions for young children is often low and existing programs have had mixed success. An innovative approach to treatment is needed that increases adherence among mothers and improves weight-related behaviors simultaneously in mothers and children. The objective of the Smart Moms randomized controlled trial (RCT) is to test the efficacy of a 6-month primarily smartphone-delivered program to reduce sugar-sweetened beverage and juice consumption among children ages 3-5 whose mothers are overweight or obese. This paper describes the study design and intervention. METHODS/DESIGN Mother-child dyads were eligible if the mother was overweight or obese, owned a smartphone, and if the child was between the ages of 3-5 and consumed 12 oz or more per day of sugar-sweetened beverages (SSBs) and 100 % fruit juice. Participants were randomly assigned to the Smart Moms intervention or a waitlist control group. The intervention consisted of theoretically grounded and evidence-based behavioral strategies delivered through one group session, lessons on a mobile-optimized website, and text messages. Mothers submitted self-monitoring information via text message and received regular tailored feedback emails from interventionists. The primary outcome is change in child SSB and juice consumption and a secondary outcome is change in maternal weight. DISCUSSION This Smart Moms study was designed to determine if a low-burden intervention delivered using mobile methods and targeted towards mothers could be effective at changing child sugar-sweetened beverage intake. Results will indicate if mobile-based methods can be a feasible way to engage mothers in family-based studies and will inform successful strategies to prevent childhood obesity through parent-targeted approaches. TRIAL REGISTRATION Clinicaltrials.gov NCT02098902 (Registered March 25, 2014).
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Affiliation(s)
- Brooke T. Nezami
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Campus Box #7294, Chapel Hill, NC 27599-7294 USA
| | - Leslie A. Lytle
- Department of Health Behavior and Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Campus Box #7440, Chapel Hill, NC 27599 USA
| | - Deborah F. Tate
- Department of Health Behavior and Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Campus Box #7440, Chapel Hill, NC 27599 USA
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91
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Rosemond TN, Blake CE, Buff SM, Blake EW, Dunn BL, Browne T, Bell BA, Iachini AL. Sensitizing Future Health Professionals to Determinants of Childhood Obesity. Am J Prev Med 2016; 51:106-13. [PMID: 26876771 DOI: 10.1016/j.amepre.2016.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 12/08/2015] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
Abstract
Long-term solutions to the childhood obesity epidemic will require concerted interdisciplinary efforts that are sensitive to both individual and social determinants of health. The Junior Doctors of Health© (JDOH) program involves interprofessional education (IPE) with university students from health science fields (e.g., medicine, pharmacy, social work, public health) who deliver an interactive program in teams to at-risk school-aged youth. The purpose of this study was to assess the impact of participation in the JDOH IPE program on university students' beliefs about childhood obesity. Fifty-three of the 71 health sciences students enrolled in the JDOH IPE program between 2011 and 2013 participated in this study. Pre- and post-surveys assessed students' beliefs about the importance, causes of, and responsibility for reducing childhood obesity with both closed- and open-ended questions. In 2013, quantitative data were analyzed using Wilcoxon matched-pairs signed-rank tests and qualitative data were analyzed through open coding to identify emergent themes. Results indicate that after participation in the JDOH IPE program, students' identification of social and environmental causes of childhood obesity increased significantly. Further, students' ranking of the importance of obesity was initially higher than those of different issues typically portrayed as social or environmental (e.g., youth violence) but it was similarly ranked after participation in JDOH. This suggests a greater sensitivity to social and environmental challenges faced by youth. Findings suggest that IPE experiences that bring clinical and community-oriented health professions together to engage with disadvantaged youth foster sensitivity to the complexities of childhood obesity in low-income settings.
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Affiliation(s)
- Tiara N Rosemond
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
| | - Christine E Blake
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Scotty M Buff
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
| | - Elizabeth W Blake
- Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, South Carolina
| | - Brianne L Dunn
- Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, South Carolina
| | - Teri Browne
- College of Social Work, University of South Carolina, Columbia, South Carolina
| | - Bethany A Bell
- College of Social Work, University of South Carolina, Columbia, South Carolina
| | - Aidyn L Iachini
- College of Social Work, University of South Carolina, Columbia, South Carolina
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92
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Naar-King S, Ellis DA, Carcone AI, Templin T, Jacques-Tiura AJ, Brogan Hartlieb K, Cunningham P, Jen KLC. Sequential Multiple Assignment Randomized Trial (SMART) to Construct Weight Loss Interventions for African American Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2016; 45:428-41. [PMID: 25668386 PMCID: PMC4658314 DOI: 10.1080/15374416.2014.971459] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to develop an adaptive behavioral treatment for African American adolescents with obesity. In a sequential multiple assignment randomized trial, 181 youth ages 12-16 years with primary obesity and their caregiver were first randomized to 3 months of home-based versus office-based delivery of motivational interviewing plus skills building. After 3 months, nonresponders to first phase treatment were rerandomized to continued home-based skills or contingency management. Primary outcome was percent overweight and hypothesized moderators were adolescent executive functioning and depression. There were no significant differences in primary outcome between home-based or office-based delivery or between continued home-based skills or contingency management for nonresponders to first-phase treatment. However, families receiving home-based treatment initially attended significantly more sessions in both phases of the trial, and families receiving contingency management attended more sessions in the second phase. Overall, participants demonstrated decreases in percent overweight over the course of the trial (3%), and adolescent executive functioning moderated this effect such that those with higher functioning lost more weight. More potent behavioral treatments to address the obesity epidemic are necessary, targeting new areas such as executive functioning. Delivering treatment in the home with contingency management may increase session attendance for this population.
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93
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Wang KW, Valencia M, Banfield L, Chau R, Fleming A, Singh SK, Burrow S, de Souza RJ, Thabane L, Samaan MC. The effectiveness of interventions to treat obesity in survivors of childhood brain tumors: a systematic review protocol. Syst Rev 2016; 5:101. [PMID: 27301869 PMCID: PMC4908756 DOI: 10.1186/s13643-016-0274-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/27/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Pediatric brain tumors are the most common solid tumors in children. Advances in understanding the hallmarks of cancer biology and novel therapies have led to an increasing number of survivors of childhood brain tumors (SCBT). However, these survivors are at an increased risk of obesity and cardiometabolic disorders that affect their quality of life and lifespan. It is important to define effective strategies to treat and prevent obesity in this population. This systematic review aims to investigate the effectiveness of lifestyle interventions, pharmacotherapy, and bariatric surgery on treating obesity in SCBT. METHODS Searches will be conducted in PubMed, MEDLINE, EMBASE, PsycINFO, SPORTDiscus, CINAHL, Cochrane Database of Systematic Review, Cochrane Central Register of Controlled Trials (CENTRAL), and Database of Abstracts of Reviews of Effect (DARE). In addition, ClinicalTrials.gov and ProQuest Dissertations and Theses A&I will be searched to identify relevant gray literature. The reference lists of eligible articles will be searched for additional studies. All screening, quality assessment, and data abstraction will be done independently by two reviewers. We will perform meta-analysis if there are sufficient studies. DISCUSSION This review will summarize evidence for the effectiveness of interventions used to reduce obesity risk in SCBT. This has significant implications for SCBT, as it can identify gaps in knowledge and provide insights into the development of new interventions to manage obesity in survivors, which may improve their outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015025909.
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Affiliation(s)
- Kuan-Wen Wang
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada
| | - Marlie Valencia
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Ruth Chau
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada
| | - Adam Fleming
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Sheila K Singh
- Division of Neurosurgery, Department of Surgery, McMaster Children's Hospital, Hamilton, Ontario, Canada.,McMaster Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.,Centre for Evaluation of Medicines, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Biostatistics Unit, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada. .,Division of Pediatric Endocrinology, McMaster Children's Hospital, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada. .,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
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Bau AM, Ernert A, Krude H, Wiegand S. Hormonal regulatory mechanisms in obese children and adolescents after previous weight reduction with a lifestyle intervention: maintain - paediatric part - a RCT from 2009-15. BMC OBESITY 2016; 3:29. [PMID: 27298729 PMCID: PMC4901466 DOI: 10.1186/s40608-016-0110-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 05/28/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Weight loss improves cardiovascular risk factors and "quality of life". Most therapeutic approaches fail to induce a sustained weight loss and most individuals undergo weight regain. In this paper the comprehensive design of the "MAINTAIN" study, all assessments as well as the one year lifestyle intervention will be outlined in detail. METHODS/DESIGN One-center randomized controlled trial with seven assessment time points conducted 2009-2015. For the randomization eight groups were distinguished in a list to allocate intervention or control group: Females and males either pre-pubertal or pubertal and with a BMI-SDS under or over 2.5. SETTING Weight loss at a residential weight reduction programme Berlin/Brandenburg and intervention at a paediatric outpatient clinic; PARTICIPANTS 137 children and adolescents (10 to 17 years). INTERVENTION PARTICIPANTS were randomized after an initial weight loss at a residential weight reduction programme and allocated to intervention (n=65) and control (n=72) conditions. The intervention group received an one-year group multi-professional lifestyle intervention with monthly meetings at the paediatric outpatient obesity clinic. The control group had a free living phase for one year and both groups 48 months follow up. MAIN OUTCOME MEASURES PARTICIPANTS who are engaged in monthly intervention meetings will benefit in terms of a sustained weight maintenance. The primary aim is to describe the dynamic of hormonal and metabolic mechanisms counter-balancing sustained weight loss during puberty and adolescence. The secondary aim is to investigate the effect of an intensive family based lifestyle intervention during the weight maintenance period on the endogenous counter-regulation as well as on health related quality of life. The third aim is to establish predictors for successful weight maintenance and risk factors for weight regain in obese children and adolescents. DISCUSSION Weight maintenance after induced weight loss is one of the most important therapeutic challenges as long as most patients fail to maintain their weight loss. MAINTAIN is the first paediatric RCT addressing in parallel to a RCT in obese adults the course of weight regain after induced weight loss and is embedded in an experimental research consortium in order to also address several molecular mechanisms of weight regain. TRIAL REGISTRATION ClinicalTrials NCT00850629, first registration 17 February 2009, verified January 2012, Paediatric part of the interventional study. Ethic proposal approved at 08.04.2009.
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Affiliation(s)
- Anne-Madeleine Bau
- Institute for Experimental Paediatric Endocrinology, Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Andrea Ernert
- Institute for Experimental Paediatric Endocrinology, Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Heiko Krude
- Institute for Experimental Paediatric Endocrinology, Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Susanna Wiegand
- Institute for Experimental Paediatric Endocrinology, Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
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95
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Caicedo-Álvarez JC, Correa-Bautista JE, González-Jiménez E, Schmidt-RioValle J, Ramírez-Vélez R. Waist circumference distribution in Colombian schoolchildren and adolescents: The FUPRECOL Study. ACTA ACUST UNITED AC 2016; 63:265-73. [PMID: 27048873 DOI: 10.1016/j.endonu.2016.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/13/2016] [Accepted: 01/24/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study was intended to establish the percentile distribution of waist circumference in schoolchildren from Bogota, Colombia, participating in the FUPRECOL Study. METHODS A cross-sectional study conducted in 3,005 children and 2,916 adolescents aged 9 to 17.9 years. Height, weight, waist circumference, hip circumference, and self-assessed sexual maturity status were recorded. Percentiles (3(rd), 10(th), 25(th), 50(th), 75(th), 90(th), and 97(th)) and smoothed sex- and age-specific curves were calculated, and the waist circumference values found were compared to international references from other ethnic populations. RESULTS Fifty-seven percent of the overall population (n=5,921) were females (mean age, 12.7±2.3 years). In most age groups, waist circumference was greater in boys as compared to girls. The increase between the 50(th) and 97(th) percentiles by age was 15.7cm in boys aged 9 to 9.9 years and 16.0cm in girls aged 11-11.9 years. Comparison of our study results, by age group and sex, to international references showed that our 50(th) percentile was lower than reported in Peru and the UK except for studies in India, Venezuela (Merida), US, and Spain was higher. CONCLUSIONS Age- and sex-specific percentiles of waist circumference obtained from children and adolescents from Bogota, Colombia, are reported. They may be used as a reference both for nutritional assessment and for predicting cardiovascular risks at early ages.
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Affiliation(s)
- Juan Carlos Caicedo-Álvarez
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C, Colombia
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C, Colombia
| | - Emilio González-Jiménez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Granada, España; Grupo CTS-436, adscrito al Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC, Departamento de Enfermería, Facultad de Ciencias de la Salud, Granada, España
| | - Jacqueline Schmidt-RioValle
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Granada, España; Grupo CTS-436, adscrito al Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC, Departamento de Enfermería, Facultad de Ciencias de la Salud, Granada, España
| | - Robinson Ramírez-Vélez
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C, Colombia.
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96
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Gomez-Arbelaez D, Camacho PA, Cohen DD, Saavedra-Cortes S, Lopez-Lopez C, Lopez-Jaramillo P. Neck circumference as a predictor of metabolic syndrome, insulin resistance and low-grade systemic inflammation in children: the ACFIES study. BMC Pediatr 2016; 16:31. [PMID: 26956385 PMCID: PMC4782326 DOI: 10.1186/s12887-016-0566-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 02/29/2016] [Indexed: 12/14/2022] Open
Abstract
Background The current study aims to evaluate the association between neck circumference (NC) and several cardio-metabolic risk factors, to compare it with well-established anthropometric indices, and to determine the cut-off point value of NC for predicting children at increased risk of metabolic syndrome, insulin resistance and low-grade systemic inflammation. Methods A total of 669 school children, aged 8–14, were recruited. Demographic, clinical, anthropometric and biochemical data from all patients were collected. Correlations between cardio-metabolic risk factors and NC and other anthropometric variables were evaluated using the Spearman’s correlation coefficient. Multiple linear regression analysis was applied to further examine these associations. We then determined by receiver operating characteristic (ROC) analyses the optimal cut-off for NC for identifying children with elevated cardio-metabolic risk. Results NC was positively associated with fasting plasma glucose and triglycerides (p = 0.001 for all), and systolic and diastolic blood pressure, C-reactive protein, insulin and HOMA-IR (p < 0.001 for all), and negatively with HDL-C (p = 0.001). Whereas, other anthropometric indices were associated with fewer risk factors. Conclusions NC could be used as clinically relevant and easy to implement indicator of cardio-metabolic risk in children.
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Affiliation(s)
- Diego Gomez-Arbelaez
- Dirección de Investigaciones, Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Colombia. .,Instituto MASIRA, Facultad de la Ciencias de la Salud, Universidad de Santander - UDES, Bucaramanga, Colombia. .,Departamento de Endocrinología, Escuela de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, España.
| | - Paul Anthony Camacho
- Dirección de Investigaciones, Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Colombia.
| | - Daniel Dylan Cohen
- Dirección de Investigaciones, Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Colombia. .,Instituto MASIRA, Facultad de la Ciencias de la Salud, Universidad de Santander - UDES, Bucaramanga, Colombia.
| | - Sandra Saavedra-Cortes
- Instituto MASIRA, Facultad de la Ciencias de la Salud, Universidad de Santander - UDES, Bucaramanga, Colombia.
| | - Cristina Lopez-Lopez
- Escuela de Medicina, Universidad Autónoma de Bucaramanga - UNAB, Bucaramanga, Colombia.
| | - Patricio Lopez-Jaramillo
- Dirección de Investigaciones, Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Colombia. .,Instituto MASIRA, Facultad de la Ciencias de la Salud, Universidad de Santander - UDES, Bucaramanga, Colombia.
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97
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Zaki ME, Kamal S, Reyad H, Yousef W, Hassan N, Helwa I, Kholoussi S. The Validity of Body Adiposity Indices in Predicting Metabolic Syndrome and Its Components among Egyptian Women. Open Access Maced J Med Sci 2016; 4:25-30. [PMID: 27275324 PMCID: PMC4884246 DOI: 10.3889/oamjms.2016.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 02/24/2016] [Accepted: 02/26/2016] [Indexed: 11/05/2022] Open
Abstract
AIM To assess the associations between the body adiposity indices and risk of metabolic syndrome (MS) and its components in Egyptian women and to evaluate their predictive power. MATERIALS AND METHODS This was a cross-sectional analysis performed on 180 Egyptian women aged between 25-35 years. They were 90 women with MS diagnosed by International Diabetes Federation (IDF) and 90 healthy age matched controls. Body adiposity index (BAI), body mass index (BMI), waist to hip ratio (WHR) and waist to height ratio (WHtR) were calculated and serum samples were analyzed for metabolic parameters. Receiver operating characteristic curves (ROC) was used to determine the discriminatory capacity of BAI, WHR WHtR and BMI for MS. RESULTS Area under the curve (AUC) was highest for BIA, followed by WHR, WHtR and then BMI. All adiposity indices were significantly correlated with metabolic components and BAI had the highest correlation coefficients compared to other indices. CONCLUSION BAI is a practical predictor for MS and has satisfactory diagnostic accuracy for diagnosing MS among Egyptian women and can be used in addition to WHR, WHtR and BMI for identifying MS in the field studies.
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Affiliation(s)
- Moushira Erfan Zaki
- Biological Anthropology Department, Medical Division, National Research Centre, Giza, Egypt
| | - Sanaa Kamal
- Biological Anthropology Department, Medical Division, National Research Centre, Giza, Egypt
| | - Hanaa Reyad
- Biological Anthropology Department, Medical Division, National Research Centre, Giza, Egypt
| | - Walaa Yousef
- Biological Anthropology Department, Medical Division, National Research Centre, Giza, Egypt
| | - Naglaa Hassan
- Biological Anthropology Department, Medical Division, National Research Centre, Giza, Egypt
| | - Iman Helwa
- Immunogenetics Department, Human Genetics and Genome Research Division, National Research, Centre, Giza, Egypt
| | - Shams Kholoussi
- Immunogenetics Department, Human Genetics and Genome Research Division, National Research, Centre, Giza, Egypt
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98
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Reid AE, Chauhan BF, Rabbani R, Lys J, Copstein L, Mann A, Abou-Setta AM, Fiander M, MacKay DS, McGavock J, Wicklow B, Zarychanski R, Azad MB. Early Exposure to Nonnutritive Sweeteners and Long-term Metabolic Health: A Systematic Review. Pediatrics 2016; 137:e20153603. [PMID: 26917671 DOI: 10.1542/peds.2015-3603] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Nonnutritive sweetener (NNS) consumption is increasing among children, yet its long-term health impact is unclear, particularly when exposure occurs during early life. OBJECTIVE To synthesize evidence from prospective studies evaluating the association of early-life NNS exposure and long-term metabolic health. DATA SOURCES Medline, Embase, and Cochrane Library (inception to July 2015). STUDY SELECTION We aimed to include randomized controlled trials (RCTs) evaluating NNS-based interventions and prospective cohort studies reporting NNS exposure among pregnant women, infants, or children (<12 years of age), with a minimum study duration of 6 months. DATA EXTRACTION The primary outcome was BMI; secondary outcomes included growth velocity, overweight/obesity, adiposity, and adverse metabolic effects. Study quality and risk of bias were evaluated using validated assessment tools. RESULTS We identified 6 eligible cohort studies and 2 RCTs (n = 15,641 children). Half of the cohorts reported increasing weight gain or fat mass accumulation with increasing NNS intake, and pooled data from 2 cohorts showed a significant correlation with BMI gain (weighted mean correlation 0.023, 95% confidence interval 0.006 to 0.041). RCTs reported contradictory effects on weight change in children receiving NNSs. No eligible studies evaluated prenatal or infant NNS exposure. LIMITATIONS Meta-analysis was limited because of the small number of eligible studies and heterogeneity of populations and outcomes. CONCLUSIONS There is limited and inconsistent evidence of the long-term metabolic effects of NNS exposure during gestation, infancy, and childhood. Further research is needed to inform recommendations for the use of NNSs in this sensitive population.
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Affiliation(s)
| | - Bhupendrasinh F Chauhan
- George & Fay Yee Center for Healthcare Innovation, College of Pharmacy, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and
| | | | - Justin Lys
- George & Fay Yee Center for Healthcare Innovation
| | | | | | | | | | | | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and Pediatrics and Child Health, and Manitoba Developmental Origins of Chronic Diseases in Children Network
| | - Brandy Wicklow
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and Pediatrics and Child Health, and Manitoba Developmental Origins of Chronic Diseases in Children Network
| | - Ryan Zarychanski
- George & Fay Yee Center for Healthcare Innovation, Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Meghan B Azad
- George & Fay Yee Center for Healthcare Innovation, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and Pediatrics and Child Health, and Manitoba Developmental Origins of Chronic Diseases in Children Network
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99
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Akın O, Arslan M, Akgün H, Yavuz ST, Sarı E, Taşçılar ME, Ulaş ÜH, Yeşilkaya E, Ünay B. Visual and brainstem auditory evoked potentials in children with obesity. Brain Dev 2016; 38:310-6. [PMID: 26462657 DOI: 10.1016/j.braindev.2015.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 09/09/2015] [Accepted: 09/18/2015] [Indexed: 11/26/2022]
Abstract
AIMS The aim of our study is to investigate alterations in visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) in children with obesity. METHODS A total of 96 children, with a mean age of 12.1±2.0 years (range 9-17 years, 63 obese and 33 age and sex-matched control subjects) were included in the study. Laboratory tests were performed to detect insulin resistance (IR) and dyslipidemia. The latencies and amplitudes of VEP and BAEP were measured in healthy and obese subjects. RESULTS The VEP P100, BAEP interpeak latency (IPL) I-III and IPL I-V averages of obese children were significantly longer than the control subjects. When the obese group was divided into two subgroups, those with IR and without IR, BAEP wave I, wave III and P100 wave latencies were found to be longer in the group with IR. A statistically significant correlation was observed between BAEP wave I latency, IPL I-V, IPL I-III and the homeostatic model assessment insulin resistance (HOMA IR) index and fasting insulin level. CONCLUSIONS Our findings suggest that VEP and BAEP can be used to determine early subclinical on auditory and visual functions of obese children with insulin resistance.
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Affiliation(s)
- Onur Akın
- Gülhane Military Medical Academy, Department of Pediatric Endocrinology, Ankara, Turkey.
| | - Mutluay Arslan
- Gülhane Military Medical Academy, Department of Pediatric Neurology, Ankara, Turkey
| | - Hakan Akgün
- Gülhane Military Medical Academy, Department of Neurology, Ankara, Turkey
| | | | - Erkan Sarı
- Gülhane Military Medical Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Mehmet Emre Taşçılar
- Gülhane Military Medical Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Ümit Hıdır Ulaş
- Gülhane Military Medical Academy, Department of Neurology, Ankara, Turkey
| | - Ediz Yeşilkaya
- Gülhane Military Medical Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Bülent Ünay
- Gülhane Military Medical Academy, Department of Pediatric Neurology, Ankara, Turkey
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100
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Cochrane T, Davey RC, de Castella FR. Influence of school community and fitness on prevalence of overweight in Australian school children. Prev Med 2015; 81:433-7. [PMID: 26522093 DOI: 10.1016/j.ypmed.2015.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/12/2015] [Accepted: 10/25/2015] [Indexed: 11/24/2022]
Abstract
The study objectives were (1) to determine the variation in prevalence of overweight between school communities, (2) to evaluate the relationship between cardiorespiratory fitness and the probability of being overweight among different school communities, and (3) to test whether this relationship varies between school communities. Using a repeated cross-sectional design, data from 31,424 (15,298 girls, 16,126 boys) Australian school children who had objective assessments of body composition and physical performance were used. Ninety-one schools located across 5 states and territories were included. Independent samples were taken across 12 school years (2000-2011). Analysis used generalised linear mixed models in R with a two-level hierarchical structure-children, nested within school communities. Predictor variables considered were: level 1-gender, age, cardiorespiratory fitness and year of measurement; level 2-school community. A total of 24.6% of the children were overweight and 69% were of low fitness. Variation in the prevalence of overweight between school communities was significant, ranging from 19% to 34%. The probability of being overweight was negatively associated with increasing cardiorespiratory fitness. The relationship was steepest at low fitness and varied markedly between school communities. Children of low fitness had probabilities of being overweight ranging between 26% and 75% depending on school community, whereas those of high fitness had probabilities of <2%. Our findings suggest that most might be gained from a public health perspective by focusing intervention on the least fit children in the worst-performing communities.
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Affiliation(s)
- Thomas Cochrane
- Centre for Research and Action in Public Health, UC-Health Research Institute, University of Canberra, ACT 2601, Australia.
| | - Rachel C Davey
- Centre for Research and Action in Public Health, UC-Health Research Institute, University of Canberra, ACT 2601, Australia
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