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Johnson VR, Acholonu NO, Dolan AC, Krishnan A, Wang EHC, Stanford FC. Racial Disparities in Obesity Treatment Among Children and Adolescents. Curr Obes Rep 2021; 10:342-350. [PMID: 33988825 PMCID: PMC8120762 DOI: 10.1007/s13679-021-00442-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW With the growing obesity epidemic among children and adolescents, the evaluation of disease origin to slow disease progression is necessary. Racial disparities which are evident amid prevalence and treatment must be studied to counteract disease propagation. RECENT FINDINGS Disparities are pronounced among Black and Hispanic pediatric patients prior to conception and birth due to genetic composition and fetal environment. Postnatal environment and psychosocial influences can further increase a child/adolescent's propensity to increased weight. Current treatment options including nutrition, physical activity, behavior modification, pharmacotherapy, and surgery are underutilized in communities of color due to limited access to care and cost. Data is limited to demonstrate disparities among treatment of obesity in children and adolescents. The reviewed studies show the role of race on disease treatment. Increased research efforts, especially in pharmacotherapy and metabolic and bariatric surgery (MBS), will help combat obesity in pediatric communities of color.
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Affiliation(s)
- Veronica R Johnson
- Department of Internal Medicine, Northwestern Medicine, 259 E. Erie Street, Suite 2150, Chicago, IL, 60611, USA.
| | - Nonyerem O Acholonu
- Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA, USA
| | - Ana C Dolan
- University of Massachusetts Amherst, Amherst, MA, USA
| | | | | | - Fatima Cody Stanford
- Departments of Medicine, Neuroendocrine Unit and Pediatrics, Pediatric Endocrinology, Boston, MA, USA
- Nutrition Obesity Research Center at Harvard, MGH Weight Center, Massachusetts General Hospital, 50 Staniford Street, 4th Floor, Boston, MA, 02114, USA
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Kranjac AW, Kranjac D. Child obesity moderates the association between poverty and academic achievement. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Dinko Kranjac
- Department of Psychology University of La Verne La Verne California USA
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Fornari E, Brusati M, Maffeis C. Nutritional Strategies for Childhood Obesity Prevention. Life (Basel) 2021; 11:532. [PMID: 34201017 PMCID: PMC8227398 DOI: 10.3390/life11060532] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/31/2021] [Accepted: 05/31/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Reducing the spread of obesity represents a challenge for clinicians in which obesity prevention plays a key role in achieving this purpose. The aim of this review is to analyze the nutritional interventions that can be implemented to prevent childhood obesity. METHODS Searching PubMed and Cochrane Library between 2019 and 2021. Further searching with no date range for articles selected for their specific relevance in the pediatric area or for their scientific relevance. A total of 871 articles were identified and 90 were included. RESULTS We organized the results of the selected articles into age groups, and according to the subjects targeted for interventions or to the site of interventions, reserving an in-depth analysis on specific nutritional aspects. Promotion of breastfeeding, reduction of protein content of formulated milks, and diet of the first 12-24 months, involving family and schools in interventions that promote physical activity and healthy diet, are promising strategies for reduction of the risk of obesity. To increase the efficacy of interventions, a multidimensional approach is crucial. CONCLUSIONS A multidimensional approach, which takes into consideration different areas of intervention, is pivotal for childhood obesity prevention. Integrated programs involving several components (nutrition and physical activity at first) at different levels (individual, family, school, and institutional) are crucial.
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Affiliation(s)
- Elena Fornari
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
| | - Marco Brusati
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy;
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Keats EC, Das JK, Salam RA, Lassi ZS, Imdad A, Black RE, Bhutta ZA. Effective interventions to address maternal and child malnutrition: an update of the evidence. THE LANCET CHILD & ADOLESCENT HEALTH 2021; 5:367-384. [PMID: 33691083 DOI: 10.1016/s2352-4642(20)30274-1] [Citation(s) in RCA: 165] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 12/13/2022]
Abstract
Malnutrition-consisting of undernutrition, overweight and obesity, and micronutrient deficiencies-continues to afflict millions of women and children, particularly in low-income and middle-income countries (LMICs). Since the 2013 Lancet Series on maternal and child nutrition, evidence on the ten recommended interventions has increased, along with evidence of newer interventions. Evidence on the effectiveness of antenatal multiple micronutrient supplementation in reducing the risk of stillbirths, low birthweight, and babies born small-for-gestational age has strengthened. Evidence continues to support the provision of supplementary food in food-insecure settings and community-based approaches with the use of locally produced supplementary and therapeutic food to manage children with acute malnutrition. Some emerging interventions, such as preventive small-quantity lipid-based nutrient supplements for children aged 6-23 months, have shown positive effects on child growth. For the prevention and management of childhood obesity, integrated interventions (eg, diet, exercise, and behavioural therapy) are most effective, although there is little evidence from LMICs. Lastly, indirect nutrition strategies, such as malaria prevention, preconception care, water, sanitation, and hygiene promotion, delivered inside and outside the health-care sector also provide important nutritional benefits. Looking forward, greater effort is required to improve intervention coverage, especially for the most vulnerable, and there is a crucial need to address the growing double burden of malnutrition (undernutrition, and overweight and obesity) in LMICs.
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Affiliation(s)
- Emily C Keats
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jai K Das
- Division of Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Rehana A Salam
- Division of Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Zohra S Lassi
- Robinson Research Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Aamer Imdad
- Department of Pediatrics, Karjoo Family Center for Pediatric Gastroenterology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Robert E Black
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Centre of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan; Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan; Joannah and Brian Lawson Centre for Child Nutrition, Department of Nutrition, University of Toronto, Toronto, ON, Canada.
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Bhutta ZA, Hauerslev M, Farmer M, Lewis-Watts L. COVID-19, children and non-communicable diseases: translating evidence into action. Arch Dis Child 2021; 106:141-142. [PMID: 33051217 DOI: 10.1136/archdischild-2020-319923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/31/2020] [Accepted: 09/18/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada .,Institute for Global Health & Development, The Aga Khan University, Karachi, Pakistan
| | - Marie Hauerslev
- Department of Pediatrics, Herlev Hospital, Copenhagen, Denmark
| | | | - Laura Lewis-Watts
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
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[Determinants of health in adolescence: cardiorespiratory fitness and body composition]. NUTR HOSP 2021; 38:697-703. [PMID: 33720742 DOI: 10.20960/nh.03507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: cardiorespiratory fitness and body composition are determining indicators of health status during adolescence. The objective of the study was to analyze the relationship of both parameters with indicators of mental and psychosocial health, lifestyle habits, and sociodemographic variables, establishing their predictive factors. Method: a cross-sectional study was conducted with a representative sample of 761 students (14.51 ± 1.63 years old) from 25 educational centers in a northern region of Spain. Body mass index, maximum oxygen uptake, health-related quality of life, self-esteem, hours of nightly sleep, adherence to the Mediterranean diet, physical activity engagement, academic performance, and different sociodemographic factors were analyzed for all participants. Results: the results determined that being a boy, being younger, sleeping fewer hours at night, and presenting a lower academic performance were predictors of suffering from obesity, while being younger and being a migrant were predictors of being overweight. On the other hand, lower physical activity engagement, poorer academic performance, being a migrant, and not practicing extracurricular sports activities were predictive factors of cardiorespiratory fitness in the risk zone. In addition, the environment for performing physical activity and socioeconomic level also showed associations with cardiorespiratory fitness. Conclusions: given the influence of body composition and cardiorespiratory fitness on the physical and psychosocial health of adolescents, promotion strategies are required that take into account the identified predictors, with special attention to promoting healthy lifestyles.
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Lin X, Li H. Obesity: Epidemiology, Pathophysiology, and Therapeutics. Front Endocrinol (Lausanne) 2021; 12:706978. [PMID: 34552557 PMCID: PMC8450866 DOI: 10.3389/fendo.2021.706978] [Citation(s) in RCA: 360] [Impact Index Per Article: 120.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/10/2021] [Indexed: 12/20/2022] Open
Abstract
Obesity is a complex multifactorial disease that accumulated excess body fat leads to negative effects on health. Obesity continues to accelerate resulting in an unprecedented epidemic that shows no significant signs of slowing down any time soon. Raised body mass index (BMI) is a risk factor for noncommunicable diseases such as diabetes, cardiovascular diseases, and musculoskeletal disorders, resulting in dramatic decrease of life quality and expectancy. The main cause of obesity is long-term energy imbalance between consumed calories and expended calories. Here, we explore the biological mechanisms of obesity with the aim of providing actionable treatment strategies to achieve a healthy body weight from nature to nurture. This review summarizes the global trends in obesity with a special focus on the pathogenesis of obesity from genetic factors to epigenetic factors, from social environmental factors to microenvironment factors. Against this background, we discuss several possible intervention strategies to minimize BMI.
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