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Lopez RB, Brand J, Gilbert-Diamond D. Media Multitasking Is Associated With Higher Body Mass Index in Pre-adolescent Children. Front Psychol 2019; 10:2534. [PMID: 31798499 PMCID: PMC6863887 DOI: 10.3389/fpsyg.2019.02534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/25/2019] [Indexed: 11/16/2022] Open
Abstract
Obesity rates among children have climbed dramatically in the past two decades, a time period in which children also experienced greater exposure to portable media devices and smartphones. In the present study, we provide evidence of a potential link between media multitasking – using and switching between unrelated forms of digital media – and risk for obesity, as indexed by body mass index (BMI). Specifically, we recruited 179 pre-adolescent children (aged 9–11 years, 88 females) to participate in a study in which we assessed their media multitasking (MMT) tendencies, as well as BMI. Controlling for the influence of a known genetic risk factor for obesity and other covariates, including physical activity, we found a positive association between the frequency of children’s MMT behaviors and age- and sex-standardized BMI z-scores, b = 1.07, p = 0.011. These findings are consistent with other recent work showing similar patterns of covariation between MMT and risk for obesity in young adults. The present work can also inform future work in this realm, such as the design of longitudinal studies that prospectively measure children’s MMT behaviors and body composition to begin to identify directionality in the association.
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Affiliation(s)
- Richard B Lopez
- Department of Psychology, Bard College, Red Hook, NY, United States
| | - John Brand
- Department of Epidemiology, Dartmouth College, Hanover, NH, United States
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152
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Kelley GA, Kelley KS, Pate RR. Exercise and adiposity in overweight and obese children and adolescents: a systematic review with network meta-analysis of randomised trials. BMJ Open 2019; 9:e031220. [PMID: 31719081 PMCID: PMC6858189 DOI: 10.1136/bmjopen-2019-031220] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Determine both the effects and hierarchy of effectiveness for exercise interventions (aerobic, strength training or both) on selected measures of adiposity (body mass index (BMI) in kg/m2, fat mass and per cent body fat) in overweight and obese children and adolescents. DESIGN Network meta-analysis of randomised exercise intervention trials. SETTING Any setting where a randomised trial could be conducted. PARTICIPANTS Overweight and obese male and/or female children and adolescents 2-18 years of age. INTERVENTIONS Randomised exercise intervention trials>4 weeks, published between 1 January 1973 and 22 August 2018, and which included direct and/or indirect evidence for aerobic, strength training or combined aerobic and strength training. PRIMARY OUTCOMES Changes in BMI in kg/m2, fat mass and per cent body fat. RESULTS Fifty-seven studies representing 127 groups (73 exercise, 54 control) and 2792 participants (1667 exercise, 1125 control) met the criteria for inclusion. Length of training ([Formula: see text] ± SD) averaged 14.1±6.2 weeks, frequency, 3.3±1.1 days per week and duration 42.0±21.0 min per session. Significant and clinically important reductions in BMI, fat mass and per cent body fat were observed in aerobic versus control comparisons (BMI, mean, 95% CI -1.0, 1.4 to -0.6; fat mass -2.1, -3.3 to -1.0 kg; per cent fat -1.5, -2.2 to -0.9%) and combined aerobic and strength versus control comparisons (BMI -0.7, -1.4 to -0.1; fat mass -2.5, -4.1 to -1.0 kg; per cent fat, -2.2, -3.2 to -1.2%). A significant reduction in per cent fat was also found for strength vs control comparisons (-1.3,-2.5 to -0.1%). Combined aerobic and strength training was ranked first for improving both fat mass (kg) and per cent body fat while aerobic exercise was ranked first for improving BMI. CONCLUSIONS Aerobic and combined aerobic and strength training are associated with improvements in adiposity outcomes in overweight and obese children and adolescents. PROSPERO REGISTRATION NUMBER CRD42017073103.
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Affiliation(s)
- George A Kelley
- Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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153
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McDonnell T, Doyle O. Maternal employment and childcare during infancy and childhood overweight. Soc Sci Med 2019; 243:112639. [PMID: 31698206 DOI: 10.1016/j.socscimed.2019.112639] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 10/01/2019] [Accepted: 10/19/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This paper examines the joint impact of maternal employment and childcare during infancy on childhood weight at ages three and five in the context of weak social support for early childhood care and education. METHOD Using three waves of longitudinal data from the Growing-Up in Ireland survey (n = 8,393 age three, n = 8,039 age five), propensity score matching is used to address the endogeneity of employment and childcare decisions. Selection on observables is used to assess potential bias arising from selection on unobservables whereby unobserved characteristics of the mother or child may jointly influence child weight and maternal employment and childcare. RESULTS Full-time maternal employment at nine months combined with either formal or informal childcare increases the likelihood of being overweight at three years by 8.1% and 5.9% respectively, but only for children of highly educated mothers. Similar results are observed for part-time employment coupled with informal (7.5%) or parental (8.0%) care. The results for mothers with lower levels of education are either not significant or favourable. While the majority of the effects dissipate by age five, there is some evidence that full-time maternal employment coupled with informal care increases the risk of being overweight at both ages three and five for children of higher-educated mothers. An assessment of selection bias finds that the estimates of full-time employment combined with formal childcare by well-educated mothers are a lower bound, such that the true effect on child weight may be understated. CONCLUSIONS The findings for Ireland are consistent with studies from the United States and the United Kingdom, and are in contrast to findings from the rest of Europe, suggesting the role of institutional factors, such as the lack of subsidised, universal, high-quality childcare.
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Affiliation(s)
- Thérèse McDonnell
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | - Orla Doyle
- UCD School of Economics & UCD Geary Institute for Public Policy, University College Dublin, Ireland
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154
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Grammer AC, Byrne ME, Pearlman AT, Klein DA, Schvey NA. Overweight and obesity in sexual and gender minority adolescents: A systematic review. Obes Rev 2019; 20:1350-1366. [PMID: 31334601 DOI: 10.1111/obr.12906] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/21/2022]
Abstract
Population data indicate that sexual and gender minority adolescents may be at increased risk for excess weight gain compared with cisgender, heterosexual youth. However, no studies, to our knowledge, have systematically reviewed the literature on weight disparities in this population nor explored risk for overweight and obesity by sexual and gender minority subgroup across studies. The current systematic review, therefore, identified 21 studies that assessed the relationship between sexual and gender minority status and weight among adolescents. Results indicated an overall greater prevalence of overweight and obesity among sexual and gender minority adolescents compared with cisgender, heterosexual youth. However, cisgender sexual minority males demonstrated lower or no added risk for overweight and obesity, whereas cisgender sexual minority females demonstrated greater risk for overweight and obesity. Findings were mixed among gender minority adolescents. This study highlights weight disparities in sexual and gender minority youth, although important subgroup differences exist. Additional research is needed to elucidate the mechanisms that may contribute to differential weight trajectories in this population and to develop tailored approaches for prevention and treatment.
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Affiliation(s)
- Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, 63110
| | - Meghan E Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892
| | - Arielle T Pearlman
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814
| | - David A Klein
- Department of Family Medicine, Fort Belvoir Community Hospital (FBCH), Fort Belvoir, Virginia, 22032.,Department of Family Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814.,Department of Pediatrics, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892
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155
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Sokol RL, Gottfredson NC, Poti JM, Shanahan ME, Halpern CT, Fisher EB, Ennett ST. Sensitive Periods for the Association Between Childhood Maltreatment and BMI. Am J Prev Med 2019; 57:495-502. [PMID: 31542127 PMCID: PMC7142333 DOI: 10.1016/j.amepre.2019.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Although previous research has suggested a positive association between child maltreatment and BMI over the life course, it is unclear when this develops. METHODS The authors used time-varying effect models and data from a nationally representative, longitudinal, cohort study (Add Health), to test how childhood physical, sexual, and emotional abuse uniquely varied in associations with BMI from age 13 to 28 years, and whether different patterns existed for male and female participants. Add Health collected data from 1994 to 2008, and the present analyses took place in 2018. RESULTS Age 18 years was the earliest that a relationship between maltreatment and BMI emerged for either sex. Child sexual abuse was negatively associated with BMI among male participants from 18.5 to 20 years, but positively associated with BMI among female participants from 19 to 24.5 years, and childhood emotional abuse was positively associated with BMI among female participants from 18 to 28 years. CONCLUSIONS The relationship between child maltreatment and BMI varies as a function of type of maltreatment, sex, and time. Notably, associations between maltreatment and BMI did not emerge until young adulthood. Future research should investigate mechanisms by which the association between maltreatment and BMI changes over time to identify trauma-informed intervention targets for improving weight outcomes.
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Affiliation(s)
- Rebeccah L Sokol
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina.
| | - Nisha C Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer M Poti
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Meghan E Shanahan
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Carolyn T Halpern
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Edwin B Fisher
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Susan T Ennett
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
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156
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Adolescent obesity in the past decade: A systematic review of genetics and determinants of food choice. J Am Assoc Nurse Pract 2019; 31:344-351. [PMID: 31157651 PMCID: PMC6716557 DOI: 10.1097/jxx.0000000000000154] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background and purpose: As the incidence of global obesity increases, concerns about adverse health outcomes in adolescents continues to rise. The complexity and expense of this problem require early recognition and specific preventive treatments. Knowledge of genetics and determinants of food choices contributing to adolescent obesity warrants further examination. The primary goal was to appraise the literature from the past decade (2007–2017) on the current state of food choice and genetic determinants of adolescent overweight/obesity in the United States. The secondary goal was to determine trends in the literature and areas for future research. Methods: A systematic review of research studies in the United States from 2007 to 2017 was completed. Database searches were conducted using CINAHL, Embase, PsycINFO, PsycArticles, PubMed, Scopus, Academic Search Complete, Web of Science, BIOSIS, and the Cochrane Library. A total of 535 studies were selected. Of these, 283 studies focused on determinants of food choices and 165 studies focused on genetic factors. Conclusions: A total of 41 full-text articles included in this literature review contained studies limited exclusively to adolescents. Stress factors related to food choices demonstrated a new trend being explored. The need for precision health, the application of genetic information, could uncover ways food choices affect adolescent obesity. Implications for practice: The etiology of adolescent obesity requires that nurses gain knowledge of genetics and food choice determinants to inform personalized treatments for adolescents, which may establish effective interventions that promote healthy weight achievement.
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157
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Guseman EH, Beverly EA, Whipps J, Mort S. Foundational knowledge regarding childhood obesity: a cross-sectional study of medical students. BMC Public Health 2019; 19:1251. [PMID: 31510972 PMCID: PMC6737597 DOI: 10.1186/s12889-019-7499-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 08/14/2019] [Indexed: 11/16/2022] Open
Abstract
Background Documentation and diagnosis of childhood obesity in primary care is poor and providers are often unfamiliar with guidelines. This lack of knowledge may be attributed to insufficient training in medical school and residency; however, no studies have evaluated medical students’ knowledge of recommendations. Methods We distributed a modified version of the Physician Survey of Practice on Diet, Physical Activity, and Weight Control to medical students at a single university. Descriptive analyses assessed knowledge and attitudes of childhood obesity and diabetes. Results Of the 213 participating students, 74% indicated being unfamiliar with obesity screening recommendations. Few correctly identified BMI percentile cut-points for child overweight (21.2%), obesity (23.7%), and normal weight (29.4%). They reported screening glucose 4.5 years earlier in patients with risk factors compared to those without (p < 0.001). Conclusions Although students recognized the need for earlier diabetes screening in children with risk factors, we determined that overall, student knowledge of obesity-related preventative care was inadequate. Electronic supplementary material The online version of this article (10.1186/s12889-019-7499-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Emily Hill Guseman
- Diabetes Institute, Ohio University, Athens, OH, 45701, USA. .,Department of Family Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA.
| | - Elizabeth A Beverly
- Diabetes Institute, Ohio University, Athens, OH, 45701, USA.,Department of Family Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA
| | - Jonathon Whipps
- Translational Biomedical Sciences, Ohio University, Athens, OH, 45701, USA
| | - Sophia Mort
- Translational Biomedical Sciences, Ohio University, Athens, OH, 45701, USA.,Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA
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158
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Barbosa LMDA, Arruda IKGD, Canuto R, Lira PICD, Monteiro JS, Freitas DL, Paula WKASD, Batista Filho M. Prevalence and factors associated with excess weight in adolescents in a low-income neighborhood - Northeast, Brazil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2019. [DOI: 10.1590/1806-93042019000300010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to study the prevalence of excess weight and associated factors among adolescents from a low-income neighborhood located in the city of Recife, Pernambuco. Methods: cross-sectional study, in which behavioral, socioeconomic and demographic information was collected from June to December 2014. Excess weight was calculated based on body mass index for age and the cut-off points, by the World Health Organization (2007). To analyze associations between predictor variables and the outcome, multivariate data analysis was performed following the Poisson Regression (Prevalence Ratio - PR) with their respective 95% confidence intervals (95%CI). Results: twenty-five adolescents participated in the study, with a prevalence of 36.4% of excess weight: 20.4% overweight (95%CI=15.1-25.7) and 16.0% obesity (95%CI= 11.2-20.8), predominantly in female gender (42.5%; p=0.031). The outcome was associated with internet access (PR=1.20; 95%CI=1.01-1.43), the number of people in the family (PR= 1.12; 95%CI=1.01-1.28) and screen time (PR=1.13; 95%CI=1.01-1.27), but only in male gender. Conclusions: the prevalence found was higher than that of other national researches, especially for the female gender. In the male gender, not having internet access, a lesser number of family members and a longer screen time proved to be factors associated with being excess weight.
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159
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Post P, Palacios R. Aggie Play: A Gender-Relevant Physical Activity Program for Girls. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2019; 41:194-205. [PMID: 31330504 DOI: 10.1123/jsep.2018-0299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 06/10/2023]
Abstract
A majority of U.S. children age 6-17 years do not meet the recommended 60 min of moderate to vigorous physical activity per day. Girls are less likely to meet these daily physical activity guidelines than boys. Following a call for greater gender-relevant physical activity programming, Aggie Play, an after-school physical activity program, engaged female student athletes to serve as active role models who lead girls through high-energy activities twice a week over a school year. The purpose of this study was to explore how Aggie Play affected girls' self-efficacy and expected enjoyment for physical activity, time spent in various physical activity intensities during free play, and fitness, relative to a control group. Results revealed that the girls participating in Aggie Play increased ratings of physical activity self-efficacy and enjoyment compared with girls at a control site. Aggie Play girls also demonstrated greater improvements on the muscle-endurance test than girls at a control site. Results are consistent with prior gender-relevant physical activity and physical education research. This study extends prior results by documenting the benefits of gender-relevant physical activity programming when led by active female role models.
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160
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Abstract
PURPOSE OF REVIEW There is a growing evidence of the important role that fathers play in influencing their children's eating and other weight-related behaviors. Latino children are at high risk for obesity and associated medical conditions. Engaging Latino fathers is a potentially important and unique way to help promote healthy lifestyles for Latino children, but doing so requires a culturally sensitive understanding both of fathers' current role and the family perceptions of this role. RECENT FINDINGS Here, we review recent data and argue that there are subtle but important differences between the qualitative and quantitative research conducted regarding the role Latino fathers may play in promoting healthy eating and physical activity for their children. We suggest how to synthesize these findings and also present qualitative results for ways to best engage Latino fathers in research studies with a focus on physical activity. Results from the review support that Latino fathers are important potential targets for child obesity prevention, but our findings stress the importance of considering cultural values when trying to recruit, engage and retain Latino fathers for such research.
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161
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Huang CY, Chen DR. Association of weight change patterns in late adolescence with young adult wage differentials: A multilevel longitudinal study. PLoS One 2019; 14:e0219123. [PMID: 31276537 PMCID: PMC6611569 DOI: 10.1371/journal.pone.0219123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 06/17/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Numerous studies have demonstrated that different weight change patterns from adolescence to adulthood may exert different effects on opportunities from which individuals subsequently benefit. OBJECTIVES This study aimed to investigate the association of weight change patterns from late adolescence to young adulthood with monthly wage in young adulthood for both genders in Taiwan. METHODS A nationally representative retrospective panel of 3730 young people (1707 men and 2023 women) from the Taiwan Educational Panel Survey (2001-2014) was included. Individuals were divided into four weight-change-pattern categories based on changes in their body mass index at two time points that were 7 years apart, between late adolescence (aged 18-19 years) and young adulthood (aged 25-26 years). These categories were (1) no obesity, (2) obesity reversal, (3) developing obesity, and (4) persistent obesity. Cross-classified, hierarchical linear regression modeling analysis was performed to explore the association of weight change patterns with monthly wage in young adulthood, after adjustment for both individual- and contextual-level variables. RESULTS Of the weight-change-pattern categories for both genders, individuals with persistent obesity had the lowest monthly wage. For women, the mean monthly wage decreased progressively for the categories of no obesity, obesity reversal, developing obesity, and persistent obesity (test for difference, P = 0.016; test for trend, P = 0.026). Women with persistent obesity earned 20% less per month than did those who were never obese (P = 0.024), after controlling for individual and contextual factors. For men, no association was found between weight change patterns and monthly wage. CONCLUSION Persistent obesity from late adolescence to young adulthood is associated with low monthly wage in young adulthood in women but not in men. These findings highlight the urgency of addressing persistent obesity early in life, especially for women.
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Affiliation(s)
- Chiao-Yu Huang
- Department of Family Medicine, Renai Branch, Taipei City Hospital, Taipei City, Taiwan
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Duan-Rung Chen
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei City, Taiwan
- * E-mail:
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162
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The Contribution of Preschool Meals to the Diet of Finnish Preschoolers. Nutrients 2019; 11:nu11071531. [PMID: 31284433 PMCID: PMC6683016 DOI: 10.3390/nu11071531] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/17/2019] [Accepted: 06/26/2019] [Indexed: 01/13/2023] Open
Abstract
Preschool meals may influence the formation of children's dietary habits and health. We assessed the contribution of preschool meals to the diet of Finnish children. We used food record data from the cross-sectional DAGIS survey and selected recording days which included all three meals (breakfast, lunch, afternoon snack) at preschool. We analyzed the diet of three- to four-year-olds (n = 324) and five- to six-year-olds (n = 233). Preschool meals accounted for 54% of the weekday's energy intake in both age groups, and provided ≥60% of total fiber, polyunsaturated fatty acids, and vitamins D and E. More than 60% of fish dishes but only one third of total daily fresh fruit were consumed at preschool. The mean (SD) percentages of energy from protein and fat at preschool were 17% (3%) and 30% (7%) in the younger and 17% (3%) and 31% (6%) in the older age group, respectively. The mean proportions of energy from added sugar at preschool were below 5% in both age groups. On average, salt intake exceeded recommendations and 60% of salt came from preschool food. Tackling high salt intake should be a future goal of guidance for early childhood education and care food services.
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163
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Co-occurrence and clustering of the four major non-communicable disease risk factors in Brazilian adolescents: Analysis of a national school-based survey. PLoS One 2019; 14:e0219370. [PMID: 31269084 PMCID: PMC6609030 DOI: 10.1371/journal.pone.0219370] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 06/22/2019] [Indexed: 01/09/2023] Open
Abstract
Background The major non-communicable chronic diseases (NCD) are associated with a small group of modifiable lifestyle-related risk factors, including smoking, insufficient physical activity, unhealthy eating, and alcohol abuse. In this study, we evaluated the co-occurrence and clustering of the major NCD risk factors among Brazilian adolescents. Methods This cross-sectional study analyzed data of 101,607 adolescents from the Brazilian National Survey of School Health (PeNSE) 2015. The risk factors included were: regular consumption of ultra-processed foods, irregular consumption of fruits and vegetables, insufficient physical activity, smoking, and alcohol consumption. Clustering was defined through the ratio between observed and expected prevalences of combination of risk factors greater than 1. Expected prevalence of the co-occurrence of risk factors was calculated from the joint probability of the behaviors. Additionally, we examined the presence of at least four risk factors according to socioeconomic characteristics. Results Of the 32 combinations of risk factors, 13 corresponded to clustering. We observed a strong correlation between alcohol consumption and smoking, which were found together in 8 of the 13 clusters identified. The most frequent combinations of risk factors involved unhealthy eating and insufficient physical activity. Only 2.9% of the adolescents did not present any risk behaviors, while 38.0%, 32.9%, 9.4% and 1.8% accumulated two, three, four and five risk factors, respectively. The accumulation of risk factors was higher in girls, older adolescents, those who did not live with both parents, children of less-educated mothers, students attending public school, and residents of cities in more developed urban areas of the country. Conclusions The main risk factors for NCD are frequent and not randomly distributed among Brazilian adolescents. Our results provide information for policymakers to target specific groups and joint behavioral risk factors for health improvement in adolescents.
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164
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Tripicchio GL, Kachurak A, Davey A, Bailey RL, Dabritz LJ, Fisher JO. Associations between Snacking and Weight Status among Adolescents 12-19 Years in the United States. Nutrients 2019; 11:nu11071486. [PMID: 31261906 PMCID: PMC6682988 DOI: 10.3390/nu11071486] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/14/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022] Open
Abstract
Snacking is a significant contributor to energy intake among adolescents, but its association with weight status is unclear. To elucidate this association, data from 6545 adolescents (12-19 years) in the 2005-2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. The mean number of daily snack occasions, mean snack size, and mean snack energy density were examined by weight classification (body mass index (BMI)-for-age percentiles: normal weight (NW) <85th; overweight (OW) ≥85th to <95th; obese (OB) ≥95th). Models included all snacking parameters, mean meal size, demographic characteristics, survey cycle year, and dietary reporting accuracy. Adolescents with NW consumed fewer snacks daily (1.69 (0.02) snacks/day) and smaller snacks per occasion (262.32 (4.41) calories (kcal)/snack) compared to adolescents with OW (1.85 (0.05) snacks/day, p = 0.005; 305.41 (8.84) kcal/snack, p < 0.001), and OB (1.97 (0.05) snacks/day; 339.60 (10.12) kcal/snack, both p < 0.001). Adolescents with OW and OB also consumed more added sugar, saturated fat and sodium from snacks, but had lower mean energy density per snack compared to snacks consumed by NW adolescents. US adolescents with OW and OB consume more snacks daily and more calories at each snacking occasion compared to adolescents with NW. Future studies should examine the prospective associations between snacking and weight status and impact on overall diet quality.
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Affiliation(s)
- Gina L Tripicchio
- Center for Obesity Research and Education, Temple University, Philadelphia, PA 19140, USA.
| | - Alexandria Kachurak
- Center for Obesity Research and Education, Temple University, Philadelphia, PA 19140, USA
| | - Adam Davey
- Behavioral Health and Nutrition, University of Delaware, Newark, DE 19716, USA
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Lauren J Dabritz
- Center for Obesity Research and Education, Temple University, Philadelphia, PA 19140, USA
| | - Jennifer O Fisher
- Center for Obesity Research and Education, Temple University, Philadelphia, PA 19140, USA
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165
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Tompuri TT, Jääskeläinen J, Lindi V, Laaksonen DE, Eloranta AM, Viitasalo A, Laitinen T, Lakka TA. Adiposity Criteria in Assessing Increased Cardiometabolic Risk in Prepubertal Children. Front Endocrinol (Lausanne) 2019; 10:410. [PMID: 31293520 PMCID: PMC6606693 DOI: 10.3389/fendo.2019.00410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/07/2019] [Indexed: 01/08/2023] Open
Abstract
Objective: Adiposity induces the clustering of cardiometabolic risk factors, and pediatric adiposity is a better indicator for adulthood cardiometabolic diseases than pediatric metabolic syndrome. However, the observed prevalence of pediatric adiposity depends on the methods and cut-points used. Therefore, we aimed to define diagnostic criteria for adiposity which enable more valid identification of prepubertal children at increased cardiometabolic risk. Methods: The participants were 470 prepubertal children (249 boys) aged 6-8 years. The measures of adiposity included body mass index-standard deviation score (BMI-SDS), waist-to-height ratio (WHtR) and body fat percentage (BF%) assessed by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). Criteria for adiposity were determined by increased cardiometabolic risk. Cardiometabolic risk factors which correlated with BF% assessed by DXA in the upper but not lower half of BF% (serum insulin and plasma high-density lipoprotein cholesterol, triglycerides, gamma-glutamyl transferase, high-sensitivity C-reactive protein and uric acid) were included in the cardiometabolic risk score (CMS). We computed receiver operating characteristics curves for the measures of adiposity using the ≥90th percentile of CMS as a measure of increased cardiometabolic risk, and local regression curves were graphed to demonstrate the associations of the measures of adiposity with CMS. Results: In girls, WHtR of 0.445 (area under curve 0.778, its 95% confidence interval 0.65-0.91, sensitivity and specificity 0.73) and BF% of 19.5% assessed by BIA (0.801, 0.70-0.90, 0.73) were the best overall criteria for increased cardiometabolic risk. In boys, BMI-SDS of 0.48 (0.833, 0.75-0.92, 0.76) was the best overall criterion for increased cardiometabolic risk. While local regression curves in girls showed that WHtR of 0.445 corresponds well to a point where CMS began to increase, in boys local regression curves suggest that CMS began to increase even at a lower level of BMI-SDS than 0.48. Moreover, the diagnostic ability of the measures of adiposity to exclude increased cardiometabolic risk was poorer than the ability to detect it. Conclusions: In general, the measures of adiposity have sufficient diagnostic accuracy to be utilized as the screening tool for increased cardiometabolic risk. The observed cut-points for adiposity were lower than the traditional cut-points for adiposity.
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Affiliation(s)
- Tuomo Tapani Tompuri
- Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
- Institute of Biomedicine/Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Sense4Health Ltd., Kontio, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Virpi Lindi
- Institute of Biomedicine/Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | | | - Aino-Maija Eloranta
- Institute of Biomedicine/Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anna Viitasalo
- Institute of Biomedicine/Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Timo Antero Lakka
- Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
- Institute of Biomedicine/Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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166
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Mastroeni SSDBS, Mastroeni MF, Ekwaru JP, Setayeshgar S, Veugelers PJ, Gonçalves MDC, Rondó PHDC. Anthropometric measurements as a potential non-invasive alternative for the diagnosis of metabolic syndrome in adolescents. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:30-39. [PMID: 30864629 PMCID: PMC10118845 DOI: 10.20945/2359-3997000000100] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 11/14/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify which anthropometric measurement would be the best predictor of metabolic syndrome (MetS) in Brazilian adolescents. SUBJECTS AND METHODS Cross-sectional study conducted on 222 adolescents (15-17 years) from a city in southern Brazil. Anthropometric, physical activity, blood pressure and biochemical parameters were investigated. MetS criteria were transformed into a continuous variable (MetS score). Linear regression analyses were performed to assess the associations of BMI, hip circumference, neck circumference (NC), triceps skinfold, subscapular skinfold and body fat percentage with MetS score. ROC curves were constructed to determine the cutoff for each anthropometric measurement. RESULTS The prevalence of MetS was 7.2%. Each anthropometric measurement was significantly (p < 0.001) associated with MetS score. After adjusting for potential confounding variables (age, sex, physical activity, and maternal education), the standardized coefficients of NC and body fat percentage appeared to have the strongest association (beta = 0.69 standard deviation) with MetS score. The regression of BMI provided the best model fit (adjusted R2 = 0.31). BMI predicted MetS with high sensitivity (100.0%) and specificity (86.4%). CONCLUSIONS Our results suggest that BMI and NC are effective screening tools for MetS in adolescents. The early diagnosis of MetS combined with targeted lifestyle interventions in adolescence may help reduce the burden of cardiovascular diseases and diabetes in adulthood.
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Affiliation(s)
- Silmara Salete de Barros Silva Mastroeni
- Departamento de Educação Física, Universidade da Região de Joinville (Univille), Joinville, SC, Brasil.,Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Marco Fabio Mastroeni
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Programa de Pós-Graduação em Saúde e Meio Ambiente, Universidade da Região de Joinville (Univille), Joinville, SC, Brasil
| | - John Paul Ekwaru
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Solmaz Setayeshgar
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paul J Veugelers
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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167
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Türkoğlu S, Çetin FH. The relationship between chronotype and obesity in children and adolescent with attention deficit hyperactivity disorder. Chronobiol Int 2019; 36:1138-1147. [PMID: 31177853 DOI: 10.1080/07420528.2019.1622131] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) have a high prevalence of obesity, but the relationship between these two problems is not clear. Chronotype preferences may be one of the possible mechanisms underlying the link between ADHD and obesity. This is the first study to investigate whether chronotype preferences are a mechanism linking ADHD symptoms to obesity in children and adolescents. This cross-sectional study included 110 drug-naive children and adolescents aged 7-17 years with ADHD. The Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) was used to diagnose ADHD or to exclude psychiatric comorbidity. The Conners' Parents Rating Scale-Revised Short Version (CPRS-RS) and Children's Chronotype Questionnaire (CCQ) were used to assess the severity of ADHD symptoms and chronotype preferences. Body mass index (BMI) was calculated and classified according to national age- and gender-specific reference values. The participants were divided into three groups as normal weight (<85%, n = 38), overweight (85%-95%, n = 30) and obesity (>95%, n = 42) according to their BMI percentile. There were statistically significant differences between the three groups in terms of chronotype preference (p = .000). Morningness preference was 86.84% in the normal BMI group and 26.19% in the obese BMI group. Eveningness preference was 7.89% in the normal BMI group and 61.90% in the obese BMI group. There was a correlation between the BMI percentile scores and the morningness/eveningness scale (M/E) scores. Moreover, there was a correlation between the BMI percentile scores and the oppositional and ADHD index scores. According to logistic regression analysis, the odds ratio of having evening type for obesity was 5.66 and the odds ratio of having morning type for normal weight was 13.03. Independently from ADHD symptoms, eveningness was directly related to obesity and morningness was directly related to normal weight. Prospective studies should be performed to better understand the relationship between ADHD, overweight/obesity and chronotype.
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Affiliation(s)
- Serhat Türkoğlu
- a Department of Child and Adolescent Psychiatry , Selçuk University Faculty of Medicine , Konya , Turkey
| | - Fatih Hilmi Çetin
- a Department of Child and Adolescent Psychiatry , Selçuk University Faculty of Medicine , Konya , Turkey
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168
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Zhang A, Li S, Zhang Y, Jiang F, Jin X, Ma J. Nocturnal enuresis in obese children: a nation-wide epidemiological study from China. Sci Rep 2019; 9:8414. [PMID: 31182742 PMCID: PMC6557885 DOI: 10.1038/s41598-019-44532-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 05/17/2019] [Indexed: 01/20/2023] Open
Abstract
Childhood obesity increases the risk of obstructive sleep apnea syndrome, type 2 diabetes mellitus, cardiovascular abnormalities, and psychological and behavioral disorders. But it is unclear whether obesity is associated with childhood nocturnal enuresis (NE). This study aimed to assess the relationship between childhood obesity and NE in a nationally representative large sample in China. Subjects were enrolled from Urumqi, Chengdu, Xi'an, Hohhot, Wuhan, Canton, Shanghai, and Harbin cities in China in November and December 2005. The survey included 20,987 children aged 5-12 years and they and their caregivers completed questionnaires. Height and weight were measured by school teachers trained in healthcare. According to the WHO child growth standards, obesity was defined as a body mass index >95th percentile of peers with the same age and gender. NE was defined as bed wetting for more than twice a week for 3 consecutive months. Demographic variables were compared among different groups. The prevalence of obesity, asthma, attention-deficit/hyperactivity disorder (ADHD), depressive moods, and snoring were different between the NE and without-NE groups (P < 0.05). The raw odds ratio (OR) for NE and obesity was 1.36 (95%CI = 1.07-1.74; P = 0.013) and the adjusted OR was 1.42 (95%CI = 1.11-1.82; P = 0.005) in the multivariable analysis. When adjusting for co-occurring conditions, the results showed that asthma did not affect the risk of NE (OR = 1.42, 95%CI = 1.11-1.82; P = 0.005), but ADHD (OR = 1.41; 95%CI = 1.10-1.81; P = 0.006) and depressive moods (OR = 1.34; 95%CI = 1.07-1.76; P = 0.012) slightly weakens the association between NE in children and obesity, while snoring weakens the association between obesity and NE and the risk became non-significant (OR = 1.21; 95%CI = 0.94-1.56; P = 0.138). In conclusion, obese children were at a higher risk of incurring NE compared to non-obese children. This association was weaker in children who either snored, had ADHD, or had depressive mood.
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Affiliation(s)
- Anyi Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shenghui Li
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiwen Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingming Jin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Ma
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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169
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Colley P, Myer B, Seabrook J, Gilliland J. The Impact of Canadian School Food Programs on Children’s Nutrition and Health: A Systematic Review. CAN J DIET PRACT RES 2019; 80:79-86. [DOI: 10.3148/cjdpr-2018-037] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The quality of children’s diets has declined over the past few decades, giving rise to a variety of health-related consequences. In response to this trend, school food programs have become an increasingly effective method to support nutrition and lifelong healthy eating habits. This systematic review synthesizes current academic literature pertaining to school nutrition programs in Canada to identify existing interventions and their impacts on children’s nutritional knowledge, dietary behaviour, and food intake. The review was conducted through a search of the following databases: ERIC, Education Source, CINAHL, PubMed, SagePub, SCOPUS, EMBASE, and CBCA. Information extracted from the articles included the program objectives, intervention design and components, research evaluation, and primary outcomes. A total of 11 articles evaluating Canadian school nutrition programs were identified. The programs incorporated a variety of intervention components including policy, education, family and community involvement, and/or food provision. These multi-component interventions were positively associated with children’s development of nutrition knowledge, dietary behaviour changes, and intake of healthy foods; however, barriers associated with intervention duration, intensity, and availability of resources may have influenced the extent to which these programs impacted children’s diets and overall health.
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Affiliation(s)
- Paige Colley
- Health and Rehabilitation Sciences, Western University, London, ON
| | - Bronia Myer
- Medical Sciences and Psychology, Western University, London, ON
| | - Jamie Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
- Department of Paediatrics and Epidemiology & Biostatistics, Western University, London, ON
| | - Jason Gilliland
- Department of Geography, Health Studies, Paediatrics, and Epidemiology & Biostatistics, Western University, London, ON
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170
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Landry MJ, Markowitz AK, Asigbee FM, Gatto NM, Spruijt-Metz D, Davis JN. Cooking and Gardening Behaviors and Improvements in Dietary Intake in Hispanic/Latino Youth. Child Obes 2019; 15:262-270. [PMID: 30907624 PMCID: PMC6622558 DOI: 10.1089/chi.2018.0110] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: School gardening interventions typically include cooking and gardening (CG) components; however, few studies have examined associations between CG psychosocial behaviors (attitudes, self-efficacy, and motivation), dietary intake, and obesity parameters. This study assessed the association between changes in CG behaviors with changes in dietary intake and obesity in participants of the LA Sprouts study, an after-school, 12-week, randomized controlled CG intervention conducted in four inner-city elementary schools in Los Angeles. Methods: Process analysis using data from 290 low-income, primarily Hispanic/Latino third through fifth-grade students who were randomized to either the LA Sprouts intervention (n = 160) or control group (n = 130). Height, weight, waist circumference, dietary intake via questionnaire, and CG behaviors were collected at baseline and postintervention. Linear regressions determined whether changes in CG behaviors predicted changes in dietary intake and obesity outcomes. Results: There were no differences in changes in CG psychosocial behaviors between intervention and control groups, therefore groups were combined. Participants were 49% male, 87% Hispanic/Latino, and an average age of nine. Increases in cooking behaviors significantly predicted increases in dietary fiber intake (p = 0.004) and increases in vegetable intake (p = 0.03). Increases in gardening behaviors significantly predicted increased intake of dietary fiber (p = 0.02). Changes in CG behaviors were not associated with changes in BMI z-score or waist circumference. Conclusions: Results from this study suggest that school-based interventions should incorporate CG components, despite their potentially costly and time-intensive nature, as these behaviors may be responsible for improvements in dietary intake of high-risk minority youth.
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Affiliation(s)
- Matthew J. Landry
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX
| | - Annie K. Markowitz
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX
| | - Fiona M. Asigbee
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX
| | - Nicole M. Gatto
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Donna Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Jaimie N. Davis
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX.,Address correspondence to: Jaimie N. Davis, PhD, RD, Department of Nutritional Sciences, The University of Texas at Austin, 103 W. 24th Street, Building PAI 3.24, Austin, TX 78712
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171
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Cui Z, Truesdale KP, Robinson TN, Pemberton V, French SA, Escarfuller J, Casey TL, Hotop AM, Matheson D, Pratt CA, Lotas LJ, Po'e E, Andrisin S, Ward DS. Recruitment strategies for predominantly low-income, multi-racial/ethnic children and parents to 3-year community-based intervention trials: Childhood Obesity Prevention and Treatment Research (COPTR) Consortium. Trials 2019; 20:296. [PMID: 31138278 PMCID: PMC6540365 DOI: 10.1186/s13063-019-3418-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The recruitment of participants into community-based randomized controlled trials studying childhood obesity is often challenging, especially from low-income racial/ethnical minorities and when long-term participant commitments are required. This paper describes strategies used to recruit and enroll predominately low-income racial/ethnic minority parents and children into the Childhood Obesity Prevention and Treatment Research (COPTR) consortium. METHODS The COPTR consortium has run four independent 3-year, multi-level (individual, family, school, clinic, and community) community-based randomized controlled trials. Two were prevention trials in preschool children and the other two were treatment trials in pre-adolescents and adolescent youth. All trials reported monthly participant recruitment numbers using a standardized method over the projected 18-24 months of recruitment. After randomization of participants was completed, recruitment staff and investigators from each trial retrospectively completed a survey of recruitment strategies and their perceived top three recruitment strategies and barriers. RESULTS Recruitment was completed in 15-21 months across trials, enrolling a total of 1745 parent-child dyads- out of 6314 screened. The number of children screened per randomized child was 4.6 and 3.5 in the two prevention trials, and 3.1 and 2.5 in the two treatment trials. Recruitment strategies reported included: (1) careful planning, (2) working with trusting community partners, (3) hiring recruitment staff who were culturally sensitive, personality appropriate, and willing to work flexible hours, (4) contacting potential participants actively and repeatedly, (5) recruiting at times and locations convenient for participants, (6) providing incentives to participants to complete baseline measures, (7) using a tracking database, (8) evaluating whether participants understand the activities and expectations of the study, and (9) assessing participants' motivation for participating. Working with community partners, hiring culturally sensitive staff, and contacting potential participants repeatedly were cited by two trials among their top three strategies. The requirement of a 3-year commitment to the trial was cited by two trials to be among the top three recruitment barriers. CONCLUSIONS Comprehensive strategies that include community partnership support, culturally sensitive recruitment staff, and repeated contacts with potential participants can result in successful recruitment of low-income racial/ethnic minority families into obesity prevention and treatment trials. TRIAL REGISTRATION NET-Works trial: ClinicalTrials.gov, NCT01606891 . Registered on 28 May 2012. GROW trial: ClinicalTrials.gov, NCT01316653 . Registered on 16 March 2011. GOALS trial: ClinicalTrials.gov, NCT01642836 . Registered on 17 July 2012. IMPACT trial: ClinicalTrials.gov, NCT01514279 . Registered on 23 January 2012.
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Affiliation(s)
- Zhaohui Cui
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Kimberly P Truesdale
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas N Robinson
- Stanford Solutions Science Lab, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Victoria Pemberton
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Simone A French
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Juan Escarfuller
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Terri L Casey
- Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| | - Anne M Hotop
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Donna Matheson
- Stanford Solutions Science Lab, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Charlotte A Pratt
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Lynn J Lotas
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Eli Po'e
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sharon Andrisin
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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172
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Gebremariam MK, Arah OA, Bergh IH, Andersen LF, Ommundsen Y, Totland TH, Bjelland M, Grydeland M, Lien N. Gender-specific mediators of the association between parental education and adiposity among adolescents: the HEIA study. Sci Rep 2019; 9:7282. [PMID: 31086277 PMCID: PMC6514034 DOI: 10.1038/s41598-019-43604-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/27/2019] [Indexed: 01/22/2023] Open
Abstract
Identifying the mechanisms behind socioeconomic inequalities in adiposity among youth is vital for efforts aimed at combating these inequalities. The study explored whether a broad range of behavioral and familial factors mediated the associations between parental education and indicators of adiposity among adolescents. Baseline data from a school-based intervention study conducted in 2007 among 11-year-old adolescents were used. Anthropometric outcomes, physical activity and sedentary time among adolescents were objectively measured. Other behavioral variables and parental waist circumference were self-reported. Mediation analyses were conducted. Among boys, maternal waist circumference (WC), paternal WC and TV viewing mediated 16%, 11.5% and 13% of the association between parental education and adolescent WC. The respective proportions when body fat percentage was used as the outcome variable were 22.5%, 16% and 21%. Among girls, maternal and paternal WC mediated 20% and 14% of the association between parental education and WC. The respective proportions when body fat percentage was used as the outcome variable were 14% and 10%. Other included variables did not play any mediating role. Parental WC was found to be a mediator of socioeconomic differences in adiposity in both genders; underlying mechanisms were however not investigated. Among boys, reducing TV time could contribute to the reduction of social inequalities in adiposity.
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Affiliation(s)
- Mekdes K Gebremariam
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, United States. .,Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, United States.,UCLA Center for Health Policy Research, Los Angeles, California, United States.,California Center for Population Research, UCLA, Los Angeles, California, United States
| | - Ingunn H Bergh
- Department of Child Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Lene F Andersen
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Torunn H Totland
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Mona Bjelland
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - May Grydeland
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
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173
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Herbst RB, Khalsa AS, Schlottmann H, Kerrey MK, Glass K, Burkhardt MC. Effective Implementation of Culturally Appropriate Tools in Addressing Overweight and Obesity in an Urban Underserved Early Childhood Population in Pediatric Primary Care. Clin Pediatr (Phila) 2019; 58:511-520. [PMID: 30841719 DOI: 10.1177/0009922819832088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Overweight and obese children are at an increased risk of remaining obese. The American Academy of Pediatrics recommends addressing healthy habits at well-child checks, but this poses challenges, especially in low-income populations. A clinical innovation project was designed to adapt recommendations in a busy urban clinic and consisted of motivational interviewing, culturally tailored tools, and standardizing documentation. A quasi-experimental design examined innovation outcomes. Of 137 overweight and obese children aged 24 to 66 months, providers' documentation of weight during well-child check visits improved post-innovation ( P < .01), as did development of healthy habits goals ( P < .001). Families were more likely to return for visits post-innovation ( P = .01). A logistic regression analysis showed that adding body mass index to the problem list and establishing a specific follow-up timeframe most predicted follow-up visits to assess progress ( P < .001). Comprehensive innovations consisting of motivational interviewing, implementation of culturally tailored tools, and standardized documentation can enhance engagement in an urban clinic setting.
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Affiliation(s)
- Rachel Becker Herbst
- 1 Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA.,2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Amrik Singh Khalsa
- 3 Nationwide Children's Hospital, Columbus, OH, USA.,4 The Ohio State University, Columbus, OH, USA
| | - Haley Schlottmann
- 2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Katherine Glass
- 2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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174
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Park JH, Mun S, Choi DP, Lee JY, Kim HC. Association between Changes in Anthropometric Indices and in Fasting Insulin Levels among Healthy Korean Adolescents: The JS High School Study. Diabetes Metab J 2019; 43:183-191. [PMID: 30688051 PMCID: PMC6470103 DOI: 10.4093/dmj.2018.0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 11/08/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study investigated the association between changes in anthropometric indices and fasting insulin levels among healthy adolescents and whether the association differed by baseline obesity status. METHODS This analysis was based on data collected for the JS High School study; 884 healthy adolescents aged 15 to 16 years followed up for 24 to 30 months were included. Changes in anthropometric indices and fasting insulin levels were computed as the difference between baseline and follow-up values. Multivariate linear regression models were used to determine the association between changes in anthropometric indices and fasting insulin levels. Based on body mass index (BMI)-for-age and waist circumference (WC)-for-age percentiles, participants were classified as normal weight (<85th percentile), overweight (85th percentile to <95th percentile), or obese (≥95th percentile). RESULTS Changes in BMI, WC, waist-hip ratio, and waist-height ratio were significantly associated with changes in fasting insulin levels in both sexes (P<0.05). In analyses stratified by baseline obesity status, the association between change in BMI and change in fasting insulin was significantly stronger in overweight (males: standardized β=1.136; females: standardized β=1.262) and obese (males: standardized β=1.817; females: standardized β=2.290) participants than in those with normal weight (males: standardized β=0.957; females: standardized β=0.976) at baseline. Results were similar for changes in WC. CONCLUSION Changes in anthropometric indices were positively associated with fasting insulin level increases. Moreover, those who were overweight or obese at baseline had a higher absolute increase in fasting insulin levels per one standard deviation unit increase in anthropometric indices than adolescents with normal weight.
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Affiliation(s)
- Ji Hye Park
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Seyeon Mun
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Dong Phil Choi
- National Academy of Agricultural Science, Rural Development Administration, Wanju, Korea
| | - Joo Young Lee
- Department of Medical and Pharmaceutical Affairs, Mapo-gu Health Center, Seoul, Korea
| | - Hyeon Chang Kim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
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175
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Pesch MH, Viechnicki GB, Appugliese DP, Kaciroti N, Rosenblum KL, Miller AL, Lumeng JC. A mixed methods analysis of maternal response to children's consumption of a palatable food: differences by child weight status. Pediatr Obes 2019; 14:e12474. [PMID: 30350348 PMCID: PMC6495602 DOI: 10.1111/ijpo.12474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/11/2018] [Accepted: 08/21/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about how mothers respond to their child eating palatable foods. OBJECTIVES The objectives of the study are to examine maternal behaviours when children are presented with a large portion of energy-dense palatable food in an experimental setting and to examine differences by child weight status. METHODS Mother-child dyads (N = 37) (mean child age 70.8 months) participated in a videotaped eating protocol with cupcakes. Anthropometrics were measured. Videos were analysed using discourse analysis and were reliably coded for the presence or absence of the most salient theme. Analysis of variance examined theme presence by child and mother weight status. RESULTS Mothers disavowed responsibility for their child's eating. Mothers were observed to roll their eyes at the child, throw their hands up in exasperation and distance themselves both physically and emotionally when the child ate the cupcakes voraciously or with high enjoyment. Mothers of children with obesity (vs recommended weight) engaged in more counts of disavowal (p = 0.01). CONCLUSIONS Mothers of children with obesity distanced themselves from their child, seeming to disavow responsibility for the child's eating of 'junk food'. Mothers may respond to their child's seemingly gluttonous eating by disavowing responsibility due to the stigma of being a parent of a child with obesity.
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Affiliation(s)
- Megan H. Pesch
- Department of Pediatrics and Communicable Diseases, Division of Developmental and Behavioral Pediatrics, University of Michigan.,Center for Human Growth and Development, University of Michigan
| | | | | | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan
| | - Katherine L. Rosenblum
- Center for Human Growth and Development, University of Michigan.,Department of Psychiatry, University of Michigan
| | - Alison L. Miller
- Center for Human Growth and Development, University of Michigan.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan
| | - Julie C. Lumeng
- Department of Pediatrics and Communicable Diseases, Division of Developmental and Behavioral Pediatrics, University of Michigan.,Center for Human Growth and Development, University of Michigan.,Department of Nutrition Sciences, School of Public Health, University of Michigan
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176
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Evaluation of "Healthy Learning. Together", an Easily Applicable Mental Health Promotion Tool for Students Aged 9 to 18 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030487. [PMID: 30744053 PMCID: PMC6388215 DOI: 10.3390/ijerph16030487] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 12/13/2022]
Abstract
Schools play an important role in adolescents’ health promotion. Due to the limited resources of teachers, there is a need for short-time interventions that can be easily implemented in a regular class without extensive training. Therefore, the tool “Healthy learning. Together.” was developed within a joint venture research project in Jena, Germany. The tool consists of a box with 60 exercises and a poster exhibition for students in 5th grade and higher. One thousand one hundred and forty four (1144) students (56% female) from nine schools were assessed at an interval of 10 weeks in a parallelized pre-post-design with class-wise assignment to intervention group (IG) and control group (CG). In the IG, regular teachers implemented the health promotion tool. Before and after the intervention social integration, class climate, self-efficacy (as primary outcomes) and mental and physical wellbeing (as secondary outcomes) were measured using standardized questionnaires. ANCOVA analysis revealed that students of the IG showed more positive changes on primary outcomes with small effect sizes. Additional implementation outcomes showed high teacher and student enthusiasm but sometimes low exposure rates. Regarding the relatively small amount of time and preparation for teachers to get noticeable effects, the introduced tool is suitable as a first step into health promotion for schools.
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177
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Frayon S, Cherrier S, Cavaloc Y, Touitou A, Zongo P, Wattelez G, Yacef K, Caillaud C, Lerrant Y, Galy O. Nutrition behaviors and sociodemographic factors associated with overweight in the multi-ethnic adolescents of New Caledonia. ETHNICITY & HEALTH 2019; 24:194-210. [PMID: 28393546 DOI: 10.1080/13557858.2017.1315530] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 03/14/2017] [Indexed: 06/07/2023]
Abstract
Objectives: New Caledonia is a multi-ethnic French territory in the Pacific, characterized by communities with widely varying nutritional habits. Little is currently known about adolescent food behaviors and habits and their association with overweight. This study therefore determined the sociodemographic factors and food behaviors associated with overweight and underweight in this population, as well as the factors associated with skipping breakfast. Methods: A cross-sectional survey was conducted among New Caledonian adolescents using a self-administered questionnaire; anthropometric measurements were also taken. Weight status was determined using international cutoffs, and the factors associated with overweight and underweight were identified with multiple logistic regression analysis. The factors associated with breakfast skipping were also determined. Results: Skipping breakfast, being Melanesian, living in a rural area and having low economic status were positively associated with overweight in these adolescents. Skipping breakfast was relatively infrequent, reported by 18% and 13% of the males and females, respectively. Logistic regression models found that the main factors associated with breakfast consumption habits were gender, weight status and ethnicity. Conclusions: Several factors are associated with overweight status in New Caledonian adolescents. Breakfast education should be improved for adolescents living in rural areas and from low socioeconomic status.
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Affiliation(s)
- Stéphane Frayon
- a Interdisciplinary Laboratory for Research in Education, School for Teaching and Education , University of New Caledonia , Noumea , New Caledonia
| | - Sophie Cherrier
- a Interdisciplinary Laboratory for Research in Education, School for Teaching and Education , University of New Caledonia , Noumea , New Caledonia
| | - Yolande Cavaloc
- a Interdisciplinary Laboratory for Research in Education, School for Teaching and Education , University of New Caledonia , Noumea , New Caledonia
| | - Amandine Touitou
- a Interdisciplinary Laboratory for Research in Education, School for Teaching and Education , University of New Caledonia , Noumea , New Caledonia
| | - Paul Zongo
- b Laboratory ACTES, EA 3596 , UFR STAPS Antilles , Pointe à Pitre , French West Indies
| | - Guillaume Wattelez
- a Interdisciplinary Laboratory for Research in Education, School for Teaching and Education , University of New Caledonia , Noumea , New Caledonia
| | - Kalina Yacef
- c School of Information Technologies , University of Sydney , Sydney , Australia
| | - Corinne Caillaud
- d Faculty of Health Sciences and Charles Perkins Centre , University of Sydney , Sydney , Australia
| | - Yannick Lerrant
- a Interdisciplinary Laboratory for Research in Education, School for Teaching and Education , University of New Caledonia , Noumea , New Caledonia
| | - Olivier Galy
- a Interdisciplinary Laboratory for Research in Education, School for Teaching and Education , University of New Caledonia , Noumea , New Caledonia
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178
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Adise S, Geier CF, Roberts NJ, White CN, Keller KL. Food or money? Children's brains respond differently to rewards regardless of weight status. Pediatr Obes 2019; 14:e12469. [PMID: 30239165 DOI: 10.1111/ijpo.12469] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 07/12/2018] [Accepted: 07/17/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Brain responses to both food and monetary rewards have been linked to weight gain and obesity in adults, suggesting that general sensitivity to reward contributes to overeating. However, the relationship between brain reward response and body weight in children is unclear. OBJECTIVE The objective of this study was to assess the brain's response to multiple rewards and the relationship to body weight in children. METHODS We tested this by performing functional magnetic resonance imaging while children (7- to 11-years-old; healthy weight [n = 31], overweight/obese [n = 30]) played a modified card-guessing task to assess blood-oxygen-level-dependent (BOLD) response to anticipating and winning food and money rewards. Functional magnetic resonance imaging data were analysed using a region of interest and exploratory whole-brain approach. RESULTS Region of interest results demonstrated increased BOLD response in the striatum to anticipating food vs. neutral (control) and winning money vs. neutral. Whole-brain data showed that winning money vs. food was associated with increased activation in the striatum, as well as regions associated with cognitive control and emotion. Notably, for both approaches, these effects were independent of child weight status. Additionally, children's reported food responsiveness and emotional overeating were negatively correlated with the BOLD response in the left cingulate gyrus for winning food vs. money. CONCLUSION Overall, findings from this study show that regions associated with reward, cognitive control and emotion may play a role in the brain's response to food and money rewards, independently of how much the child weighs. These findings provide insight into reward sensitivity in children, which may have implications for understanding overeating and the development of obesity.
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Affiliation(s)
- S Adise
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - C F Geier
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - N J Roberts
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - C N White
- Department of Psychology, Missouri Western State University, St. Joseph, MO, USA
| | - K L Keller
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.,Department of Food Science, The Pennsylvania State University, University Park, PA, USA
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179
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Coles N, Patel BP, Li P, Cordeiro K, Steinberg A, Zdravkovic A, Hamilton JK. Breaking barriers: Adjunctive use of the Ontario Telemedicine Network (OTN) to reach adolescents with obesity living in remote locations. J Telemed Telecare 2018; 26:271-277. [PMID: 30526258 DOI: 10.1177/1357633x18816254] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Implementation of telemedicine has been shown to improve health outcomes, such as body mass index (BMI). However, it is unclear whether telemedicine is useful alongside traditional weight-management programmes for adolescents with complex obesity. The objective was to evaluate implementation of the Ontario Telemedicine Network (OTN), a videoconferencing programme, as an adjunctive tool to face-to-face counselling within the setting of an established interdisciplinary obesity treatment programme. METHODS Our observational cohort included two groups of adolescents enrolled in a clinical obesity-management programme over a two year period. Adolescents (n = 50) in group 1 attended both in-person and virtual visits (OTN group), and adolescents (n = 50) in group 2 received only in-person visits (comparison group). Within the OTN group, satisfaction survey responses were compared between patients and healthcare professionals. Change in BMI per month, paediatric quality of life scores, session attendance and demographic variables were compared between groups. RESULTS OTN subjects averaged 4.9 telehealth visits per adolescent over the two year programme. Both OTN and comparison groups had similar changes in BMI (p = 0.757), with increases over time (p = 0.042). Paediatric quality of life scores in both groups improved over time compared to baseline (p < 0.001), with higher scores for children compared to parental-reported child scores (p = 0.008). Both adolescents and healthcare professionals using the OTN were similarly satisfied with their experience. CONCLUSION Adjunctive use of the OTN within the setting of a weight-management programme is feasible, well accepted by families and healthcare providers, and led to similar outcomes compared to usual care.
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Affiliation(s)
- Nicole Coles
- Division of Endocrinology, The Hospital for Sick Children, Canada
| | - Barkha P Patel
- Division of Endocrinology, The Hospital for Sick Children, Canada
| | - Ping Li
- Division of Endocrinology, The Hospital for Sick Children, Canada
| | | | - Alissa Steinberg
- Division of Endocrinology, The Hospital for Sick Children, Canada
| | - Ana Zdravkovic
- Division of Endocrinology, The Hospital for Sick Children, Canada
| | - Jill K Hamilton
- Division of Endocrinology, The Hospital for Sick Children, Canada.,Department of Nutritional Sciences, University of Toronto, Canada
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180
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Soltero EG, Olson ML, Williams AN, Konopken YP, Castro FG, Arcoleo KJ, Keller CS, Patrick DL, Ayers SL, Barraza E, Shaibi GQ. Effects of a Community-Based Diabetes Prevention Program for Latino Youth with Obesity: A Randomized Controlled Trial. Obesity (Silver Spring) 2018; 26:1856-1865. [PMID: 30426694 PMCID: PMC6249045 DOI: 10.1002/oby.22300] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/26/2018] [Accepted: 07/18/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study examined the short- and long-term effects of a community-based lifestyle intervention among Latino youth with obesity. METHODS Latino adolescents (14-16 years old) were randomized to a 3-month lifestyle intervention (n = 67) or comparison control (n = 69) and followed for 12 months. The intervention included weekly nutrition and health classes delivered to groups of families and exercise sessions (3 days/week) delivered to groups of adolescents. Comparison youth received laboratory results and general health information. Primary outcomes included insulin sensitivity and weight-specific quality of life (QoL) with secondary outcomes of BMI percentile (BMI%), waist circumference, and percent body fat. RESULTS At 3 months, youth in the intervention group exhibited significant increases in insulin sensitivity (P < 0.05) and weight-specific QoL (P < 0.001), as well as reductions in BMI%, waist circumference, and percent body fat compared with controls. Increases in weight-specific QoL and reductions in BMI% and percent body fat remained significant at 12 months (P < 0.001), while changes in insulin sensitivity did not. In a subsample of youth with prediabetes at baseline, insulin sensitivity (P = 0.01), weight-specific QoL (P < 0.001), and BMI% (P < 0.001) significantly improved at 3 months. CONCLUSIONS Lifestyle intervention can improve cardiometabolic and psychosocial health in a vulnerable population of Latino adolescents at high risk for developing type 2 diabetes.
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Affiliation(s)
- Erica G Soltero
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Micah L Olson
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Allison N Williams
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
| | - Yolanda P Konopken
- Family Wellness Program, St. Vincent de Paul Medical and Dental Clinic, Phoenix, Arizona, USA
| | - Felipe G Castro
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | | | - Colleen S Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Donald L Patrick
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Stephanie L Ayers
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
| | - Estela Barraza
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, Arizona, USA
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
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181
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Yang C, Lee HK, Kong APS, Lim LL, Cai Z, Chung AC. Early-life exposure to endocrine disrupting chemicals associates with childhood obesity. Ann Pediatr Endocrinol Metab 2018; 23:182-195. [PMID: 30599479 PMCID: PMC6312913 DOI: 10.6065/apem.2018.23.4.182] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 01/09/2023] Open
Abstract
Increasing prevalence of childhood obesity poses threats to the global health burden. Because this rising prevalence cannot be fully explained by traditional risk factors such as unhealthy diet and physical inactivity, early-life exposure to endocrine disrupting chemicals (EDCs) is recognized as emerging novel risk factors for childhood obesity. EDCs can disrupt the hormone-mediated metabolic pathways, affect children's growth and mediate the development of childhood obesity. Many organic pollutants are recently classified to be EDCs. In this review, we summarized the epidemiological and laboratory evidence related to EDCs and childhood obesity, and discussed the possible mechanisms underpinning childhood obesity and early-life exposure to non-persistent organic pollutants (phthalates, bisphenol A, triclosan) and persistent organic pollutants (dichlorodiphenyltrichloroethane, polychlorinated biphenyls, polybrominated diphenyl ethers, per- and polyfluoroalkyl substances). Understanding the relationship between EDCs and childhood obesity helps to raise public awareness and formulate public health policy to protect the youth from exposure to the harmful effects of EDCs.
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Affiliation(s)
- Chunxue Yang
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong SAR, China
| | - Hin Kiu Lee
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong SAR, China
- HKBU Institute for Research and Continuing Education, Shenzhen, China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Lee Ling Lim
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Asia Diabetes Foundation, Hong Kong SAR, China
| | - Zongwei Cai
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong SAR, China
- HKBU Institute for Research and Continuing Education, Shenzhen, China
| | - Arthur C.K. Chung
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong SAR, China
- HKBU Institute for Research and Continuing Education, Shenzhen, China
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182
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Busch AM, Hubka A, Lynch BA. Primary Care Provider Knowledge and Practice Patterns Regarding Childhood Obesity. J Pediatr Health Care 2018; 32:557-563. [PMID: 30042051 DOI: 10.1016/j.pedhc.2018.04.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/25/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND We aimed to evaluate current childhood obesity management by providers and improve management of pediatric obesity through a provider-focused educational intervention. METHODS We surveyed family medicine and pediatric providers regarding documentation and intervention, knowledge gaps, and educational needs for childhood obesity. An educational program was implemented regarding detection, documentation, and follow-up/referral of pediatric obesity and comorbid conditions. We reviewed charts for 50 overweight or obese children before and after intervention. RESULTS The survey identified lack of time (73%) and perception of parents (77%) as the most frequent provider barriers to pediatric obesity care. Provider referrals increased from 6% to 16% after intervention, and laboratory testing increased from 14% to 26%. No changes were noted in discussion of weight status, diagnosis/documentation, or billing. CONCLUSION Provider education can improve appropriate ordering of laboratory studies and referrals for overweight children. Different intervention approaches may improve billing and documentation practices for pediatric obesity.
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183
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An R, Wang L, Xue H, Wang Y. Projecting the impact of a nationwide school plain water access intervention on childhood obesity: a cost-benefit analysis. Pediatr Obes 2018; 13:715-723. [PMID: 28941217 PMCID: PMC6062486 DOI: 10.1111/ijpo.12236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/19/2017] [Accepted: 06/01/2017] [Indexed: 01/30/2023]
Abstract
OBJECTIVE This study aimed to project the societal cost and benefit of an expansion of a water access intervention that promotes lunchtime plain water consumption by placing water dispensers in New York school cafeterias to all schools nationwide. METHODS A decision model was constructed to simulate two events under Markov chain processes - placing water dispensers at lunchtimes in school cafeterias nationwide vs. no action. The incremental cost pertained to water dispenser purchase and maintenance, whereas the incremental benefit was resulted from cases of childhood overweight/obesity prevented and corresponding lifetime direct (medical) and indirect costs saved. RESULTS Based on the decision model, the estimated incremental cost of the school-based water access intervention is $18 per student, and the corresponding incremental benefit is $192, resulting in a net benefit of $174 per student. Subgroup analysis estimates the net benefit per student to be $199 and $149 among boys and girls, respectively. Nationwide adoption of the intervention would prevent 0.57 million cases of childhood overweight, resulting in a lifetime cost saving totalling $13.1 billion. The estimated total cost saved per dollar spent was $14.5. CONCLUSION The New York school-based water access intervention, if adopted nationwide, may have a considerably favourable benefit-cost portfolio.
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Affiliation(s)
- Ruopeng An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA,Corresponding author contact information: Ruopeng An, 1206 South 4 Street, Champaign IL 61820, USA, Phone: 1-217-244-0966, Fax: 1-217-333-2766,
| | - Liang Wang
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, USA
| | - Hong Xue
- College of Health, Ball State University, Muncie, IN, USA
| | - Youfa Wang
- College of Health, Ball State University, Muncie, IN, USA
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184
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Household chaos and screen media use among preschool-aged children: a cross-sectional study. BMC Public Health 2018; 18:1210. [PMID: 30373557 PMCID: PMC6206857 DOI: 10.1186/s12889-018-6113-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/11/2018] [Indexed: 01/08/2023] Open
Abstract
Background Excess screen media use is a robust predictor of childhood obesity. Understanding how household factors may affect children’s screen use is needed to tailor effective intervention efforts. The preschool years are a critical time for obesity prevention, and while it is likely that greater household disorder influences preschool-aged children’s screen use, data on that relationship are absent. In this study, our goal was to quantify the relationships between household chaos and screen use in preschool-aged children. Methods A cross-sectional, online survey was administered to 385 parents of 2–5 year-olds recruited in 2017. Household chaos was measured with the Confusion, Hubbub and Order Scale (i.e., the chaos scale), a validated, parent-reported scale. The scale consists of 15 items, each scored on a 4-point Likert scale. Final scores were the sum across the 15 items and modeled as quartiles for analyses. Parents reported their children’s screen use for nine electronic media activities. Adjusted linear and Poisson regression were used to model associations between household chaos and children’s total weekly screen use, screen use within one hour of bedtime and screen use in the bedroom. Results Children averaged 31.0 (SD = 23.8) hours per week with screens, 49.6% used screens within one hour of bedtime and 41.0% used screens in their bedrooms. In adjusted regression models, greater household chaos was positively associated with weekly screen use (P = 0.03) and use of screens within one hour of bedtime (P < 0.01) in a dose-dependent manner. Children in the fourth versus the first quartile of household chaos were more likely to use screens in their bedroom (P = 0.03). Conclusions Greater household chaos was associated with increased total screen use as well as screen use behaviors that are related to disrupted nighttime sleep. Findings suggest that household chaos may be an obesity risk factor during the preschool years because of such effects on screen use, and highlight the need to consider household chaos when implementing home-based obesity prevention programs for young children. Electronic supplementary material The online version of this article (10.1186/s12889-018-6113-2) contains supplementary material, which is available to authorized users.
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185
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Murray M, Pearson JL, Dordevic AL, Bonham MP. The impact of multicomponent weight management interventions on quality of life in adolescents affected by overweight or obesity: a meta-analysis of randomized controlled trials. Obes Rev 2018; 20:278-289. [PMID: 30358046 DOI: 10.1111/obr.12774] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/23/2018] [Accepted: 08/28/2018] [Indexed: 11/28/2022]
Abstract
Adolescents affected by overweight or obesity report similar quality of life to adolescents with cancer. While weight management is important for physiological outcomes, it is unclear whether weight management improves quality of life in this age group. This meta-analysis assessed the impact of multicomponent weight management interventions on quality of life in adolescents affected by overweight or obesity. Ovid PsycINFO, Ovid Medline, Ovid Embase, Cochrane Library, Scopus and CINAHL Plus databases were searched up to July 2017. Eight eligible studies were randomized controlled trials of multicomponent weight management interventions for adolescents (10 to 19 years) affected by overweight or obesity, with quality of life and weight measurements. Meta-analyses determined a positive effect on quality of life (mean difference 0.20 [0.11, 0.29]; p < 0.01) and weight (mean difference 0.30 [0.12, 0.47]; p < 0.01) following intervention. There was no correlation between weight loss and improvements in quality of life (R2 = 0.103). Rather than weight loss, intervention factors such as parental involvement, group settings and a focus on psychosocial well-being appeared linked to improvements in quality of life. The reduced quality of life reported by this group may be due to social consequences of obesity, rather than actual weight.
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Affiliation(s)
- M Murray
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - J L Pearson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - A L Dordevic
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - M P Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
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186
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Abstract
Drawing upon data from the first two years of a statewide school-based buzz-centered health communication campaign that encouraged high school students to adopt healthy behavior, this article finds that the buzz marketing component increased campaign awareness among students in participating schools compared to those in the comparison schools, but there was no significant difference between their health attitudes. Furthermore, attitude toward the campaign mediated the effect of buzz exposure on health attitudes.
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Affiliation(s)
- Ming Wang
- a College of Journalism & Mass Communications , University of Nebraska-Lincoln , Lincoln , NE , USA
| | - Amy Struthers
- a College of Journalism & Mass Communications , University of Nebraska-Lincoln , Lincoln , NE , USA
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187
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de Souza Dantas M, Dos Santos MC, Lopes LAF, Guedes DP, Guedes MRA, Oesterreich SA. Clustering of Excess Body Weight-Related Behaviors in a Sample of Brazilian Adolescents. Nutrients 2018; 10:nu10101505. [PMID: 30326590 PMCID: PMC6213791 DOI: 10.3390/nu10101505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 09/24/2018] [Accepted: 10/11/2018] [Indexed: 11/16/2022] Open
Abstract
The aim of the study was to identify the existence of clusters in multiple lifestyle behaviors, including consumption of fruits/vegetables, sugary products/soft drinks, physical activity and sedentary behavior. The association between identified clusters and excess body weight in a sample of adolescents from Dourados, Brazil, was examined. This is a cross-sectional school-based study involving 578 participants aged 12⁻18 of both sexes. Anthropometric measurements were performed and a questionnaire was applied with structured questions to collect data. Excess body weight was identified through body mass index. Cluster analysis was performed to identify sex-specific clusters of multiple lifestyle behaviors. Analysis of covariance and logistic regression were used to analyze associations between clusters and excess body weight. Six clusters were identified in both sexes. Girls and boys in the cluster characterized by greater time spent in sedentary behavior were 53% (OR = 1.53 [1.06⁻2.26]) and 63% (OR = 1.63 [1.12⁻2.35]) more likely to present excess body weight compared to their peers in the reference cluster. In the case of adolescents in the cluster characterized by high consumption of sugary products/soft drinks, girls were 47% more likely to be overweight (OR = 1.47 [1.05⁻2.13]) and boys were 51% more likely (OR = 1.51 [1.05⁻2.16]). High consumption of fruits/vegetables, low consumption of sugary products/soft drinks and less sedentary behavior was considered the most effective combination for the maintenance of a healthy weight.
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Affiliation(s)
- Mônica de Souza Dantas
- University Hospital of the Federal University of Grande Dourados, Dourados, Mato Grosso do Sul 79823-501, Brazil.
| | - Michel Coutinho Dos Santos
- University Hospital of the Federal University of Grande Dourados, Dourados, Mato Grosso do Sul 79823-501, Brazil.
| | - Luiz Augusto Freire Lopes
- University Hospital of the Federal University of Grande Dourados, Dourados, Mato Grosso do Sul 79823-501, Brazil.
| | - Dartagnan Pinto Guedes
- Center for Research in Health Sciences, Northern University of Paraná, Londrina, Paraná 86041-120, Brazil.
| | | | - Silvia Aparecida Oesterreich
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul 79.804-970, Brazil.
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188
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Julian V, Thivel D, Miguet M, Pereira B, Costes F, Coudeyre E, Duclos M, Richard R. Eccentric cycling is more efficient in reducing fat mass than concentric cycling in adolescents with obesity. Scand J Med Sci Sports 2018; 29:4-15. [PMID: 30222208 PMCID: PMC7380043 DOI: 10.1111/sms.13301] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 08/30/2018] [Accepted: 09/10/2018] [Indexed: 12/25/2022]
Abstract
The benefits of eccentric (ECC) training on fat mass (FM) remain underexplored. We hypothesized that in obese adolescents, ECC cycling training is more efficient for decreasing whole-body FM percentage compared to concentric (CON) performed at the same oxygen consumption (VO2 ). Twenty-four adolescents aged 13.4 ± 1.3 years (BMI > 90th percentile) were randomized to ECC or CON. They performed three cyclo-ergometer sessions per week (30 min per session) for 12 weeks: two habituation, 5 at 50% VO2peak , and 5 at 70% VO2peak . Anthropometric measurements, body composition, maximal incremental CON tests, strength tests, and blood samples were assessed pre- and post-training. Whole-body FM percentage decreased significantly after compared to pretraining in both groups, though to a larger extent in the ECC group (ECC: -10% vs CON: -4.2%, P < 0.05). Whole-body lean mass (LM) percentage increased significantly in both groups after compared to pretraining, with a greater increase in the ECC group (ECC: 3.8% vs CON: 1.5%, P <0.05). The improvements in leg FM and LM percentages were greater in the ECC group (-6.5% and 3.0%, P = 0.01 and P < 0.01). Quadriceps isometric and isokinetic ECC strength increased significantly more in the ECC group (28.3% and 21.3%, P < 0.05). Both groups showed similar significant VO2peak improvement (ECC: 15.4% vs CON: 10.3%). The decrease in homeostasis model assessment of insulin resistance index was significant in the ECC group (-19.9%). In conclusion, although both ECC and CON cycling trainings are efficient to decrease FM, ECC induces greater FM reduction, strength gains, and insulin resistance improvements and represents an optimal modality to recommend for obese adolescents.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, Diet and Musculoskeletal Health Team, CRNH, INRA, University Teaching Hospital of Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Laboratory AME2P, University of Clermont Auvergne, Aubière, France
| | - Maud Miguet
- Laboratory AME2P, University of Clermont Auvergne, Aubière, France
| | - Bruno Pereira
- Department of Biostatistics, University Teaching Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Frédéric Costes
- Department of Sport Medicine and Functional Explorations, Diet and Musculoskeletal Health Team, CRNH, INRA, University Teaching Hospital of Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Emmanuel Coudeyre
- Department of Physical Medicine and Rehabilitation, Diet and Musculoskeletal Health Team, CRNH, INRA, University Teaching Hospital of Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, Diet and Musculoskeletal Health Team, CRNH, INRA, University Teaching Hospital of Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Ruddy Richard
- Department of Sport Medicine and Functional Explorations, Diet and Musculoskeletal Health Team, CRNH, INRA, University Teaching Hospital of Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand, France
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189
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Ruedl G, Ewald P, Niedermeier M, Kirschner W, Kopp M, Drenowatz C, Greier K. Long-term effect of migration background on the development of physical fitness among primary school children. Scand J Med Sci Sports 2018; 29:124-131. [PMID: 30276866 PMCID: PMC7379607 DOI: 10.1111/sms.13316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 09/25/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Children with a low socioeconomic status and migration background are more likely to exhibit unfavorable health behavior patterns and higher BMI scores as well as lower physical activity and physical fitness. AIM To evaluate the effect of migration background on the development of physical fitness among primary school children from first to third grade. METHODS In this longitudinal study, height, weight, and physical fitness of primary school children from Tyrol/Austria were measured five times over a period of 2.5 years using the German motor performance test DMT 6-18 consisting of eight items testing different subdomains of physical fitness. RESULTS A total of 266 children (45% girls) participated in all five tests, of which 69 (26%) children reported to have a migration background (MB). Mixed-model ANOVA did not reveal a significantly different development of physical fitness (according to the mean total Z-score of DMT 6-18) over time, P = 0.883, partial ƞ2 < 0.01. However, children with MB showed significantly lower physical fitness compared to children without MB, P < 0.001, partial ƞ2 = 0.06. Controlling for BMI and age did not alter the interpretation of the results. Analyses of the single test items revealed significant differences in motor tests involving strength and endurance. CONCLUSION Primary school children with and without MB significantly increased their physical fitness over time in a comparable manner. However, children with MB showed a significantly lower physical fitness at all test time points, which was only partly explained by a higher mean BMI in children with MB. Children with MB outreached the mean baseline fitness level of children without MB not until the fourth test time point, that is after two years. Therefore, a special focus on physical fitness particularly including strength and endurance capacities should be directed to children with MB already in young ages.
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Affiliation(s)
- Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Peter Ewald
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Physical Education, University of Education Upper Austria, Linz, Austria
| | - Klaus Greier
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria.,Physical Education and Sports, Division of Physical Education, University of Education Stams - KPH-ES, Stams, Austria
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190
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Toaima NN, El-Owaidy RH, Zaki DL, Eldin LB. Infections in children with simple obesity: The relation to phagocytic function and serum leptin. J Infect Public Health 2018; 12:57-61. [PMID: 30213469 DOI: 10.1016/j.jiph.2018.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/12/2018] [Accepted: 08/28/2018] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION There is a possible association between obesity and infections. We sought to investigate phagocytic functions in obese children and their relation to serum leptin levels. METHODS A cross sectional, controlled study was conducted, comprising 40 cases with simple visceral-type obesity. Subjects were evaluated for percentage of caloric intake, frequency and type of infections, body mass index (BMI) z score, in addition to complete blood counting, serum leptin assay (ELISA) and Dihydrorhodamine (DHR) flowcytometry. RESULTS Cases were 21 males (52.5%) and 19 females (47.5%) with mean age 7.14 years±2.73 SD with median duration of obesity 4.2 years (IQR: 2-6). Cases had higher frequency of infections compared with controls (p<0.001). Serum leptin was significantly higher among cases (t=-12.391, p<0.001), while DHR results were comparable in the studied groups (p=0.067). Among cases, absolute lymphocytic count (ALC) correlated negatively with percentage of total caloric intake (p=0.045). Leptin levels correlated positively with frequency of infections (p=0.019) but negatively with ALC (p=0.043). DHR results showed weak negative correlations with serum leptin (p=0.177) and with BMI Z score (p=0.109). CONCLUSION Obese children are posed at increased risk of infections and have higher serum leptin levels with possible negative effects of leptin on phagocytic functions.
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Affiliation(s)
- Nadin N Toaima
- Pediatric Endocrine Unit, Children's Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Rasha H El-Owaidy
- Pediatric Allergy and Immunology Unit, Children's Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Dina L Zaki
- Egyptian Ministry of Health Hospital, Cairo, Egypt.
| | - Lerine B Eldin
- Pediatric Endocrine Unit, Children's Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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191
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Abstract
OBJECTIVES Obesity in children can lead to morbidity and mortality due to metabolic and inflammatory comorbidities. AIMS The objective of the study was to investigate the alterations in acute inflammatory markers, serum amyloid P (SAP) and cortisol, and endocrine markers, leptin and insulin, in obese children. MATERIALS AND METHODS Serum leptin, insulin, cortisol, and amyloid P concentrations were measured in obese (BMI percentile >85, n = 17) and nonobese (BMI percentile < 75, n = 20) children using ELISA and Bio-Plex Bead-based assay. STATISTICAL ANALYSIS USED Serum concentrations of analytes were compared between normal and obese groups using 2-tailed student's t-test. RESULTS Mean leptin, insulin, and SAP serum concentrations were significantly higher in obese children as compared to the controls (97.19 vs. 4.06, P < 0.05; 21.31 vs 3.56, P < 0.05; 46.77 vs. 17.89, P < 0.05; respectively). No difference was found in mean serum cortisol levels of the two groups. However, cortisol values were higher in obese subjects compared to the control group (7.89 vs 6.30, P = 0.15). Leptin corelated with insulin (r = 0.42, P = 0.043) and cortisol (r = 0.48, P = 0.025) levels in the obese group. Furthermore, leptin, insulin, and SAP levels were corelated with BMI (r = 0.80, P < 0.000; r = 0.67, P = 0.015, respectively) and body weight (r = 0.52, P = 0.01; r = 0.52, P = 0.002; r = 0.54, P = 0.01, respectively) in the obese group but did not demonstrate a significant relationship in the nonobese group. CONCLUSION Elevated SAP levels and increase in leptin and insulin indicated a preeminent disposition of morbidly obese children to the development of low-grade inflammation and metabolic syndrome.
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Affiliation(s)
- Mehwish Anwer
- Centre for Research in Molecular Medicine, University of Lahore, Lahore, Pakistan
| | - Muhammad J. Iqbal
- Centre for Research in Molecular Medicine, University of Lahore, Lahore, Pakistan
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192
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Igwe SC, Brigo F. Does Melatonin and Melatonin Agonists Improve the Metabolic Side Effects of Atypical Antipsychotics?: A Systematic Review and Meta-analysis of Randomized Controlled Trials. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2018; 16:235-245. [PMID: 30121990 PMCID: PMC6124875 DOI: 10.9758/cpn.2018.16.3.235] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/18/2017] [Accepted: 10/19/2017] [Indexed: 01/21/2023]
Abstract
Atypical antipsychotics (AAPs) are increasingly used for the treatment of psychotic disorders but are known to be associated with metabolic abnormalities. This study is a systematic review and meta-analysis of randomized controlled trials (RCTs) studying the effectiveness of melatonin for the amelioration of AAP-induced metabolic syndrome. The MEDLINE (accessed via PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials, PsycINFO, LILACS, CINAHL, and OpenGrey databases were searched for RCTs without language restrictions. Inclusion criteria were randomized, double-blind clinical trials comparing melatonin or melatonin agonists with placebo for the amelioration of AAP-induced effects at any age with selected components of metabolic syndrome as outcome measures. Two reviewers independently selected articles and assessed quality using Cochrane risk of bias and concealment tools. Of 53 records, five RCTs were eligible for the systematic review and three for the meta-analysis. The meta-analyses showed no statistically significant difference in any anthropometric or metabolic variable considered. Analysis according to psychiatric diagnosis from one RCT showed significant decreases in diastolic blood pressure (5.5 vs. −5.7 mmHg for the placebo and melatonin groups, respectively; p=0.001), fat mass (2.7 vs. 0.2 kg, respectively; p=0.032), and triglycerides (D) (50.1 vs. −20 mg/dl, respectively; p=0.08) in the bipolar group but not the schizophrenia group. Although limited to five RCTs with small sample sizes, evidence from RCT indicates that melatonin improves AAP-induced metabolic syndrome. This beneficial effect seems more significant in patients with bipolar disorder than those with schizophrenia. Further RCTs are needed to definitively establish the potential ameliorative effect of melatonin and to justify its efficacy as an add-on therapy to curtail AAP-induced metabolic syndrome.
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Affiliation(s)
- Stanley C Igwe
- Department of Neuro-Psychiatry, Federal Teaching Hospital, Abakaliki, Nigeria
| | - Francesco Brigo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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193
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Ullmann G, Kedia SK, Homayouni R, Akkus C, Schmidt M, Klesges LM, Ward KD. Memphis FitKids: implementing a mobile-friendly web-based application to enhance parents' participation in improving child health. BMC Public Health 2018; 18:1068. [PMID: 30157819 PMCID: PMC6114180 DOI: 10.1186/s12889-018-5968-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/14/2018] [Indexed: 11/10/2022] Open
Abstract
Background Child obesity is a major public health challenge, increasing the risk of chronic medical conditions such as type 2 diabetes, metabolic syndrome, and hypertension. Among U.S. states, Tennessee has one of the highest rates of child obesity. Emerging communication technologies can help to deliver highly disseminable population-level interventions to improve health behavior. The aim of this paper is to report the implementation and the evaluation of the reach of Memphis FitKids, a web-based application, intended to promote healthy behaviors for families and children. Methods A community-level demonstration project, Memphis FitKids, was developed and implemented in Tennessee’s Greater Memphis Area. This application (www.memphisfitkids.org) was designed for parents to assess their children’s obesity risk through determinants such as weight, diet, physical activity, screen time, and sleep adequacy. A built-in “FitCheck” tool used this collected information to create a report with tailored recommendations on how to make healthy changes. A Geographic Information Systems component was implemented to suggest low-cost neighborhood resources that support a healthy lifestyle. A social marketing framework was used to develop and implement FitKids, and a Community Advisory Board with representatives from community partners (e.g., the YMCA of Memphis, the Pink Palace Family of Museums, and the Memphis Public Library) supported the implementation of the project. Five kiosks distributed in the community served as public access points to provide a broad reach across socioeconomic strata. Presentations at community events and the use of Facebook facilitated the promotion of FitKids. Website traffic and Facebook usage were evaluated with Google Analytics and Facebook Insights, respectively. Results In Tennessee, 33,505 users completed 38,429 FitCheck sessions between July 2014 and December 2016. Among these, 6763 sessions were completed at the five kiosks in the community. FitKids was presented at 112 community events and the social media posts reached 23,767 unique Facebook users. Conclusions The Memphis FitKids demonstration project showed that web-based health tools may be a viable strategy to increase access to information about healthy weight and lifestyle options for families. Mobile-friendly web-based applications like Memphis FitKids may also serve health professionals in their efforts to support their clients in adopting healthy behaviors. Electronic supplementary material The online version of this article (10.1186/s12889-018-5968-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gerhild Ullmann
- Social and Behavioral Sciences, School of Public Health, University of Memphis, 3825 Desoto Ave, Memphis, TN, 38152, USA.
| | - Satish K Kedia
- Social and Behavioral Sciences, School of Public Health, University of Memphis, 3825 Desoto Ave, Memphis, TN, 38152, USA
| | - Ramin Homayouni
- Bioinformatics, Biological Sciences, College of Arts and Sciences, University of Memphis, Memphis, TN, USA
| | - Cem Akkus
- Social and Behavioral Sciences, School of Public Health, University of Memphis, 3825 Desoto Ave, Memphis, TN, 38152, USA
| | - Michael Schmidt
- Art, College of Communication and Fine Arts, University of Memphis, Memphis, TN, USA
| | - Lisa M Klesges
- Epidemiology, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Kenneth D Ward
- Social and Behavioral Sciences, School of Public Health, University of Memphis, 3825 Desoto Ave, Memphis, TN, 38152, USA
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194
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Filardi M, Pizza F, Antelmi E, Pillastrini P, Natale V, Plazzi G. Physical Activity and Sleep/Wake Behavior, Anthropometric, and Metabolic Profile in Pediatric Narcolepsy Type 1. Front Neurol 2018; 9:707. [PMID: 30197622 PMCID: PMC6117389 DOI: 10.3389/fneur.2018.00707] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/03/2018] [Indexed: 12/26/2022] Open
Abstract
Objectives: Regular physical activity is routinely recommended in children and adolescents suffering from narcolepsy type 1 (NT1), but controlled studies analyzing its influence on sleep/wake behavior, metabolic, and anthropometric profile in pediatric NT1 are lacking. Methods: Fifty consecutive drug-naïve NT1 children and adolescents were assessed through actigraphic, clinical, and metabolic evaluations. Patients were compared with respect to their engagement in leisure-time physical activities (LTPA): patients engaged in LTPA (n = 30) and patients not engaged (No-LTPA, n = 20), respectively. Results: LTPA patients presented lower BMI, with different BMI categories distribution and higher HDL cholesterol, when compared with No-LTPA subjects. Increased night-sleep duration, higher sleep quality, and reduction of nap frequency were documented through actigraphy in LTPA subjects. Subjective sleepiness, as measured by ESS-CHAD, was also lower in LTPA subjects while cataplexy frequency proved similar between the two groups. Discussion: In pediatric NT1 patients, regular engagement in LTPA is associated with significant differences on sleepiness, anthropometric and metabolic profile and objectively assessed sleep/wake behavior. Engagement in LTPA is beneficial and should be strongly encouraged in pediatric NT1 patients.
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Affiliation(s)
- Marco Filardi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna (ISNB), Azienda Unità Sanitaria Locale (AUSL) di Bologna, Bologna, Italy
| | - Elena Antelmi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna (ISNB), Azienda Unità Sanitaria Locale (AUSL) di Bologna, Bologna, Italy
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Vincenzo Natale
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna (ISNB), Azienda Unità Sanitaria Locale (AUSL) di Bologna, Bologna, Italy
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195
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Julian V, Thivel D, Costes F, Touron J, Boirie Y, Pereira B, Perrault H, Duclos M, Richard R. Eccentric Training Improves Body Composition by Inducing Mechanical and Metabolic Adaptations: A Promising Approach for Overweight and Obese Individuals. Front Physiol 2018; 9:1013. [PMID: 30131705 PMCID: PMC6090036 DOI: 10.3389/fphys.2018.01013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 07/09/2018] [Indexed: 12/04/2022] Open
Abstract
Skeletal muscle generates force by either shortening (concentrically) or lengthening (eccentrically). Eccentric (ECC) exercise is characterized by a lower metabolic demand and requires less muscle activity than concentric (CON) exercise at the same level of exerted force. However, the specific effect of ECC training vs. CON training on lean and fat mass remains underexplored. The first aim of this paper was to review the available evidence regarding the effects of ECC training on whole body and segmental lean and fat mass and, when possible, compare these with the effects of CON training. The second aim was to provide some insights into the main mechanical, physiological, and metabolic adaptations of ECC training that contribute to its effects on body composition. The third aim was to determine the beneficial effects of ECC exercise on health-related parameters in overweight and obese patients. ECC training is an effective modality to improve lean mass, but when matched for load or work, the difference between ECC and CON trainings seems unclear. A few studies reported that ECC training is also efficient at reducing fat mass. By increasing post-exercise resting energy expenditure, modifying metabolic substrate, and improving both blood lipid profile and insulin resistance, ECC training is a potential exercise modality for individuals with chronic conditions such as those who are overweight and obese. Further investigations using standardized experimental conditions, examining not only segmental but also whole body composition, are required to compare ECC and CON trainings.
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Affiliation(s)
- Valérie Julian
- Service de Médecine du Sport et Explorations Fonctionnelles, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Laboratoire AME2P, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Frédéric Costes
- Service de Médecine du Sport et Explorations Fonctionnelles, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Julianne Touron
- INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Yves Boirie
- Service de Nutrition Clinique, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Bruno Pereira
- Service de Biostatistique, CHU Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Hélène Perrault
- Faculté des Sciences de la Santé, Université d'Ottawa, Ottawa, ON, Canada
| | - Martine Duclos
- Service de Médecine du Sport et Explorations Fonctionnelles, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Ruddy Richard
- Service de Médecine du Sport et Explorations Fonctionnelles, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
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196
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Wang H, Jeong H, Kim NH, Kang Y, Hwang K, Lee H, Hong JH, Oh KS. Association between beverage intake and obesity in children: The Korea National Health and Nutrition Examination Survey (KNHANES) 2013-2015. Nutr Res Pract 2018; 12:307-314. [PMID: 30090168 PMCID: PMC6078862 DOI: 10.4162/nrp.2018.12.4.307] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/08/2018] [Accepted: 06/12/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND/OBJECTIVES Numerous researches have studied the association between sugar intake and obesity of children in many countries. This study was undertaken to investigate the association between beverage intake and obesity of children by reviewing a database for total sugar contents established in all foods and presented in a nutrition survey by the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS Data of 1,520 children aged 6-11 years in the 6th KNHANES (2013-2015) were analyzed for this study. A database for total sugar intake comprises the total sugar contents of all foods included in the results of a nutrition survey using the 24-hour recall method of 6th KNHANES. Beverages were categorized into carbonated beverages, fruit & vegetable drinks, other drinks, tea, and coffee. RESULTS The average daily beverage intake of all children was 131.75 g/day, and the average daily total sugar intake in beverages was 13.76 g/day. Carbonated beverages had the highest intake rate (58.85 g/day) and also ranked highest for sugar intake (6.36 g/day). After adjusting for confounding variables, the odds ratio for obesity in children with beverage intake of ≥ 200 mL/day significantly increased by 1.83 times (95% CI, 1.11-3.00) as compared to children with beverage intake of < 200 mL/day. Also, a significant increase was observed in the odds ratio for obesity in total children (2.41 times; 95% CI, 1.35-4.33) and boys (3.15 times; 95% CI, 1.53-6.49) with carbonated beverage intake of ≥ 200 mL/day when compared with children who consumed < 200 mL/day. CONCLUSION A positive association is observed between beverage intake and obesity in Korean children. In particular, an intake of carbonated beverages has a positive correlation with childhood obesity in boys. This study can therefore be used as scientific evidence for reducing sugar, and for the continuous management and research on beverages.
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Affiliation(s)
- Hyewon Wang
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - HaYoung Jeong
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - Na-Hui Kim
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - YoonJung Kang
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - Kyungmi Hwang
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - HwaJung Lee
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - Jin-Hwan Hong
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - Keum-Soon Oh
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
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197
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Kumar S, Hossain MJ, Inge T, Balagopal PB. Roux-en-Y gastric bypass surgery in youth with severe obesity: 1-year longitudinal changes in spexin. Surg Obes Relat Dis 2018; 14:1537-1543. [PMID: 30131311 DOI: 10.1016/j.soard.2018.07.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/29/2018] [Accepted: 07/07/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Spexin is a novel peptide predominantly produced in human white adipose tissue and has recently been implicated as a potential signal in the regulation of body weight, energy homeostasis, and satiety. The effect of bariatric surgery on spexin is unknown. OBJECTIVES To study the effect of Roux-en-Y gastric bypass (RYGB) surgery on endogenous spexin concentration and various risk factors of type 2 diabetes and cardiovascular disease in youth with severe obesity. SETTING University hospital, United States METHODS: Spexin, body mass index (BMI), insulin, glucose, total and high molecular weight adiponectin, leptin, and high sensitivity C- reactive protein were measured longitudinally (baseline, 6 mo, and 12 mo) after RYGB surgery in girls with severe obesity (n = 12; age = 16.7 ± 1.5 years; BMI = 51.6 ± 2.9 kg/m2). RESULTS Serum spexin concentration increased (P = .01) at 6 months after surgery and stabilized afterward. Spexin level correlated negatively with homeostatic model assessment insulin resistance, HOMA-IR (Spearman correlation r = -.796, P < .001) and positively with high molecular weight adiponectin (Spearman correlation r = .691, P = .011). The change in spexin concentration, from baseline to 6 months after surgery, was inversely correlated with the corresponding change in BMI (Spearman correlation r = -.573, P = .051). Furthermore, the 6-month changes in spexin and HOMA-IR were inversely correlated (slope [standard error, SE] = -.0084 (.0019), P = .001)], even after adjusting for the change in BMI. CONCLUSIONS The enhancement of circulating spexin concentration in response to RYGB and correlations with beneficial postoperative changes in various adipokines in youth are novel findings that require further validation.
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Affiliation(s)
- Seema Kumar
- Division of Pediatric Endocrinology and Metabolism, Rochester, Minnesota; Department of Pediatrics, Mayo Clinic, Rochester, Minnesota
| | | | - Thomas Inge
- Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado
| | - P Babu Balagopal
- Department of Pediatrics, Mayo Clinic, Rochester, Minnesota; Nemours Children's Specialty Care, Jacksonville, Florida.
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198
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Conklin AI, Guo SX, Tam AC, Richardson CG. Gender, stressful life events and interactions with sleep: a systematic review of determinants of adiposity in young people. BMJ Open 2018; 8:e019982. [PMID: 30021752 PMCID: PMC6059347 DOI: 10.1136/bmjopen-2017-019982] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Overweight and obesity among young people are high and rising. Social stressors and sleep are independently associated with obesity, but are rarely studied together or examined for gender-specific effects. The literature regarding adolescent populations is especially lacking. This review assesses whether experiencing stressful life events results in greater adiposity in young women and young men compared with those who do not experience stressful life events, and whether the relationship is modified by sleep problems. DESIGN We systematically searched six bibliometric databases (Web of Science, Embase Ovid, PsycINFO, CINHAL, PubMed, ProQuest Dissertations) supplemented by hand searches. Longitudinal prospective studies or reviews were eligible for inclusion when they examined gender-specific changes in adiposity in young adults (age 13-18 years) as a function of stressful life event alone or in combination with sleep problems. RESULTS We found one study eligible for inclusion reporting mixed impact of stressful life events on body mass index (BMI) between genders. The study assessed specific life events and showed significantly lower BMI at follow-up among young men who experienced a residence change, but significantly higher BMI among young women who experienced setting up a family and who reported internal locus of control. CONCLUSIONS Despite ample research on social stressors or sleep problems and weight, we still know little about the role of stressful life events, or combined effects with sleep, on obesity risk in adolescents from a gender perspective. Existing evidence suggests specific life events affect weight differently between the genders. Robust, high-quality longitudinal studies to decipher this dual burden on obesity during adolescence should be prioritised, as firm conclusions remain elusive.
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Affiliation(s)
- Annalijn I Conklin
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Healthcare Research Institute, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Sherry Xr Guo
- Behavioural Neuroscience Program, Department of Psychology, Faculty of Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexander Ct Tam
- Department of Psychology, Faculty of Arts, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher G Richardson
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Healthcare Research Institute, St. Paul's Hospital, Vancouver, British Columbia, Canada
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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199
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Kulshrestha H, Gupta V, Mishra S, Mahdi AA, Awasthi S, Kumar S. Interleukin-10 as a novel biomarker of metabolic risk factors. Diabetes Metab Syndr 2018; 12:543-547. [PMID: 29615317 DOI: 10.1016/j.dsx.2018.03.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/26/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Interleukin-10 (IL-10) is an adipocytokine that is abundantly expressed in visceral fat tissue. We investigated the association of interleukin-10 with the number of metabolic risk factors. FINDING The study population comprised 220 children who underwent annual health checkups. Plasma Interleukin-10 levels were determined by enzyme-linked immunosorbent assay. We divided the subjects into 4 groups according to Interleukin-10 levels. A reduction of plasma interleukin-10 levels significantly correlated with an increase in the mean number of metabolic risk factors such as increased waist circumference, BMI, dyslipidaemia, high blood pressure and glucose intolerance. CONCLUSIONS Circulating Interleukin-10 levels negatively correlated with the multiplicity of metabolic risk factors, suggesting that IL-10 acts as a biomarker of metabolic disorders.
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Affiliation(s)
- Himani Kulshrestha
- Department of Physiology, King George's Medical University, Lucknow, India
| | - Vani Gupta
- Department of Physiology, King George's Medical University, Lucknow, India.
| | - Sameeksha Mishra
- Department of Physiology, King George's Medical University, Lucknow, India
| | - Abbas Ali Mahdi
- Department of Biochemistry, King George Medical University, Lucknow, India
| | - Shelly Awasthi
- Department of Paediatrics, King George Medical University, Lucknow, India
| | - Sandeep Kumar
- Department of Physiology, King George's Medical University, Lucknow, India
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200
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Gariépy G, Janssen I, Sentenac M, Elgar FJ. School Start Time and the Healthy Weight of Adolescents. J Adolesc Health 2018; 63:69-73. [PMID: 30060859 DOI: 10.1016/j.jadohealth.2018.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/02/2018] [Accepted: 01/11/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Studies have found that an early school start time is detrimental to the sleep, health, and well-being of youth, but its association with body weight remains unclear. We examined this association in Canadian adolescents. METHODS We collected information on start times from 362 schools that participated in the 2013/2014 Canadian Health Behaviour in School-aged Children Study (n = 29,635 students; ages 10-18). We estimated body mass indices (BMIs) and BMI z-scores, and identified overweight and obesity using international growth references. Multilevel regression models tested the associations between school start times and our outcomes, adjusted for grade, family affluence, school rurality, latitude, and province. RESULTS The average BMI was 21.2 (standard deviation 4.9) and BMI z-score was .48 (standard deviation 1.23). Every 10-minute delay in school start time corresponded with a .02 (95% confidence interval .00, .04) smaller BMI z-score. This association translated to BMIs in the 70th and 64th percentiles when comparing students from schools that started at 8:00 a.m. and 9:30 a.m., respectively. School start time was not significantly related to overweight or obesity. CONCLUSIONS Later school start time was linked to lower BMI in Canadian adolescents. Delaying school start time may be an additional strategy to support the healthy weight of adolescents. Future intervention and impact studies are recommended to confirm these findings.
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Affiliation(s)
- Geneviève Gariépy
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada.
| | - Ian Janssen
- School of Kinesiology and Health Studies, Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Mariane Sentenac
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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