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Harville EW, Apolzan JW, Bazzano LA. Maternal Pre-Pregnancy Cardiovascular Risk Factors and Offspring and Grandoffspring Health: Bogalusa Daughters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:E15. [PMID: 30577626 PMCID: PMC6338978 DOI: 10.3390/ijerph16010015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/10/2018] [Accepted: 12/19/2018] [Indexed: 12/16/2022]
Abstract
Both maternal pre-pregnancy body mass index (BMI) and gestational weight gain have been associated with cardiovascular health in the offspring beyond two generations. A total of 274 daughters (aged 12⁻54) of 208 mothers who participated in the Bogalusa Heart Study were interviewed about their reproductive history. Mothers' data was taken from the original study, and cardiovascular measures at the visit prior to pregnancy were correlated with daughter's measures. Maternal pre-pregnancy BMI, skinfold, and waist circumference were examined as a predictor of daughters' blood pressure, lipids, and glucose, as well as a predictor of birthweight and gestational age of grandchildren. Maternal pre-pregnancy BMI was associated with higher blood pressure and lower low-density lipoprotein (LDL) and cholesterol in the daughters. Most maternal cardiometabolic risk factors were not associated with grandchildren's birth outcomes, even though higher cholesterol and LDL was associated with lower gestational age, and higher BMI and skinfold thickness with an increased risk of preterm birth. In this pilot study, some associations were found between maternal adiposity and cardiovascular risk, daughters' cardiovascular risk, and grandchild birth outcomes. Lack of conclusive associations could be due to a true lack of effect, effects being primarily mediated through daughter's BMI, or the low power of the study.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
| | - John W Apolzan
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA.
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
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Abstract
Lifestyle changes such as exercise and dietary change are recommended first-line therapy for children with dyslipidemia, hypertension, and obesity. Although most clinicians recommend exercise, specific exercise prescriptions are not usually provided. The optimal type, duration, and intensity of activity to achieve a meaningful outcome is not definitively defined. As the pediatric population becomes more sedentary and morbidity accumulates from this lifestyle, understanding how targeted exercise prescriptions can benefit patients will be critical to effectively manage this group of patients. This review focuses on the role of exercise for the treatment of pediatric patients with dyslipidemia, hypertension, and obesity and describes additional factors that require future research to achieve desired outcomes in this at-risk population. [Pediatr Ann. 2018;47(12):e494-e498.].
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153
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Bostan Gayret Ö, Taşdemir M, Erol M, Tekin Nacaroğlu H, Zengi O, Yiğit Ö. Are there any new reliable markers to detect renal injury in obese children? Ren Fail 2018; 40:416-422. [PMID: 30035656 PMCID: PMC6060377 DOI: 10.1080/0886022x.2018.1489284] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
AIM The aim of this study was to examine the serum and urine levels of kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), matrix metalloproteinase-9 (MMP-9), and serum Cystatin-C to determine the renal effect of obesity in obese children. METHODS Seventy-two obese and 35 non-obese healthy children were included in this study. Blood pressure (BP) was evaluated with office measurement. Creatinine, cystatin C, lipids, fasting glucose, and insulin levels were measured, and homeostasis model assessment -insulin resistance (HOMA-IR) was calculated. The urine albumin/creatinine ratio was calculated. The serum and urine KIM-1, NGAL, OPN, and MMP-9 levels were measured. RESULTS Serum cystatin-C, triglyceride, and homeostasis model assessment-insulin resistance (HOMA-IR) index were found to be significantly higher in the obese group (p = .0001), and high-density lipoprotein (HDL) cholesterol was found to be significantly lower (p = .019) in the obese group. No significant differences were found in serum KIM-1, NGAL, OPN or MMP-9 levels between groups (p > .05). No significant differences were found in urine KIM-1 and MMP-9 levels (p > .05), Urine NGAL, and OPN levels were found significantly higher in obese groups (p < .05). CONCLUSIONS According to our results, although serum KIM-1, NGAL, OPN, MMP-9, and urine MMP-9, urine KIM-1 do not appear to be ideal markers to evaluate renal injury in the early period of obesity, the serum levels of cystatin C and urine NGAL, urine OPN can be used as a good marker for assessing the renal effect of obesity which can lead end stage renal disease in pediatric population.
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Affiliation(s)
- Özlem Bostan Gayret
- a Department of Pediatrics , Ministry of Health, Bağcılar Training and Research Hospital , Istanbul , Turkey
| | - Mehmet Taşdemir
- b Department of Pediatrics, Division of Pediatric Nephrology , Koc University Hospital , Istanbul , Turkey
| | - Meltem Erol
- a Department of Pediatrics , Ministry of Health, Bağcılar Training and Research Hospital , Istanbul , Turkey
| | | | - Oğuzhan Zengi
- d Department of Biochemistry , Ministry of Health, Bağcılar Training and Research Hospital , Istanbul , Turkey
| | - Özgül Yiğit
- a Department of Pediatrics , Ministry of Health, Bağcılar Training and Research Hospital , Istanbul , Turkey
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154
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Waist circumference, waist-to-height ratio and conicity index to evaluate android fat excess in Brazilian children. Public Health Nutr 2018; 22:140-146. [PMID: 30295220 DOI: 10.1017/s1368980018002483] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate the ability of anthropometric measurements to identify excess android fat and to propose cut-off points for excess central adiposity in children, according to age and sex. DESIGN A cross-sectional study with children from a municipality of Minas Gerais, Brazil. Receiver-operating characteristic curve analyses were performed to evaluate waist circumference (WC), waist-to-height ratio (WHtR) and conicity index (C-index) in estimating excess android fat by dual energy X-ray absorptiometry (DXA). SETTING Viçosa, Minas Gerais, Brazil. SUBJECTS Children aged 4-9 years (n 788). RESULTS Overweight prevalence was 29·1 % and android fat percentage was higher among girls. All central fat measurements were able to discriminate excess android fat in the age groups evaluated, especially WC and WHtR, with cut-off points showing good sensitivity and specificity overall. CONCLUSIONS Because these methods are easy to obtain and inexpensive, it is possible to use WC, WHtR and C-index in population surveys to evaluate central obesity. The proposed cut-off points showed satisfactory values of sensitivity and specificity and can be used in epidemiological studies.
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156
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Taylor JH, Jakubovski E, Gabriel D, Bloch MH. Predictors and Moderators of Antipsychotic-Related Weight Gain in the Treatment of Early-Onset Schizophrenia Spectrum Disorders Study. J Child Adolesc Psychopharmacol 2018; 28:474-484. [PMID: 29920116 PMCID: PMC6154761 DOI: 10.1089/cap.2017.0147] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Antipsychotic-related weight gain is a common clinically relevant side effect when treating psychotic disorders in pediatric populations, yet few predictors and no moderators of antipsychotic-related weight gain are known. METHODS The Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) study randomized 119 youths (age 8-19 years) with schizophrenia or schizoaffective disorder to 8 weeks of antipsychotic treatment with molindone, risperidone, or olanzapine and assessed treatment response and side effects. In this secondary analysis, we used multivariable linear regression and receiver operating characteristic analysis to investigate predictors and moderators of weight change and percent weight change from baseline to week 8. RESULTS Treatment assignment was the most discriminant predictor of weight change [F(2, 66) = 17.00, p < 0.001] and percent weight change [F(2, 66) = 16.85, p < 0.001]. Mean weight gain was 0.74 (standard deviation ±3.51) kg for molindone, 4.13 ± 3.79 kg for risperidone, and 7.29 ± 3.44 kg for olanzapine. After adjusting for treatment assignment, lower pretreatment hemoglobin A1C (HgbA1C) predicted more weight gain [F(1, 55) = 4.71, p = 0.03]. Diagnosis (schizoaffective vs. schizophrenia) moderated weight change [F(2, 63) = 6.02, p = 0.004] and percent weight change [F(2, 63) = 5.26, p = 0.008] such that schizoaffective diagnosis predicted larger weight gain for youths in the risperidone treatment arm. Age, sex, family income, baseline weight, and symptoms neither predicted nor moderated weight change or percent weight change. CONCLUSION We identified prognostic subgroups and novel risk factors for antipsychotic-related weight gain. We confirmed that antipsychotic choice is extremely important for predicting future weight gain. We also found that younger age did not predict greater weight gain, in contrast to prior studies. Our findings require replication in an independent sample because we did not adjust for multiple comparisons to minimize false negatives. ClinicalTrials.gov Identifier: NCT00053703.
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Affiliation(s)
- Jerome H. Taylor
- Child Study Center, Yale University, New Haven, Connecticut.,Department of Psychiatry, Yale University, New Haven, Connecticut.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Child and Adolescent Psychiatry and Behavioral Services, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Address correspondence to:Jerome H. Taylor, MDDepartment of PsychiatryUniversity of Pennsylvania3400 Spruce StreetGates Pavilion 10th FloorPhiladelphia, PA 19104
| | - Ewgeni Jakubovski
- Child Study Center, Yale University, New Haven, Connecticut.,Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Daniel Gabriel
- Child Study Center, Yale University, New Haven, Connecticut.,Sewanee: The University of the South, Sewanee, Tennessee
| | - Michael H. Bloch
- Child Study Center, Yale University, New Haven, Connecticut.,Department of Psychiatry, Yale University, New Haven, Connecticut
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Jiang Y, Dou YL, Xiong F, Zhang L, Zhu GH, Wu T, Zhang Y, Yan WL. Waist-to-height ratio remains an accurate and practical way of identifying cardiometabolic risks in children and adolescents. Acta Paediatr 2018; 107:1629-1634. [PMID: 29569350 DOI: 10.1111/apa.14323] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/24/2018] [Accepted: 03/14/2018] [Indexed: 11/30/2022]
Abstract
AIM We evaluated how effectively the waist-to-height ratio (WHtR) identified cardiometabolic risk (CMR) in children and adolescents, compared with the tri-ponderal mass index, percentage of body fat and other obesity indexes. METHODS Eligible subjects were recruited from three metropolitan regions of China from May 2013 to June 2014. Subjects with at least three of the following abnormalities - hypertension, dyslipidemia, elevated fasting blood glucose and central obesity - were defined as CMR1 and children with at least two were defined as CMR2. The area under the curve (AUC) of the receiver operating characteristic curve was used to compare how effectively obesity indexes predicted CMR. RESULTS We recruited 3556 subjects aged 7-18 years. All five obesity indexes showed good, comparable performances in identifying CMR and the AUCs ranged from 0.89 to 0.90 for CMR1 and 0.83 to 0.85 for CMR2. The cut-off of 0.467 for WHtR achieved a sensitivity of 0.91 and specificity of 0.80 for predicting CMR1, with the best cut-offs being 0.463 for boys and 0.469 for girls. CONCLUSION The WHtR was a superior and practical screening tool for detecting CMR in this paediatric population, as it provided comparable accuracy to other methods and just required a simple calculation.
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Affiliation(s)
- Yuan Jiang
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Ya-Lan Dou
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Feng Xiong
- Department of Endocrinology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Lan Zhang
- Department of Child Healthcare, Chengdu Women& Children's Central Hospital, Chengdu, China
| | - Gao-Hui Zhu
- Department of Endocrinology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Wu
- Department of Child Healthcare, Chengdu Women& Children's Central Hospital, Chengdu, China
| | - Yi Zhang
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Wei-Li Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
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158
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Correlation of Gut Microbiota Profile with Body Mass Index Among School Age Children. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.58049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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159
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Jung HC, Jeon S, Lee NH, Kim K, Kang M, Lee S. Effects of exercise intervention on visceral fat in obese children and adolescents. J Sports Med Phys Fitness 2018; 59:1045-1057. [PMID: 30035473 DOI: 10.23736/s0022-4707.18.08935-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION This meta-analysis study was aimed to assess the effects of exercise intervention on visceral fat in obese children and adolescents. EVIDENCE ACQUISITION Electronic database searches were performed in Academic Search Complete, CINAHL, Healthsource, MEDLINE, and SportDiscus, and from the earliest record to November 2017. Keywords included "exercise or training," "visceral fat," and "child or adolescent or youth." The inclusion criteria for eligible studies were as follows: 1) subjects were obese at baseline; 2) aged 6-19 years; 3) visceral fat was reported at baseline and after an intervention; and 4) studies were published in peer-reviewed journals written in English. EVIDENCE SYNTHESIS A total of 207 studies were observed at the initial search and 73 effect sizes (ESs) were derived from the 34 selected studies. The overall exercise intervention effect was large (Cohen's d [ES]=-1.003, 95% CI=-1.114, -0.892). Moderator analyses results showed that gender (Qb=8.23, df=2, P=0.016), exercise type (Qb=10.68, df=2, P=0.005), and intervention length (Qb=24.71, df=2, P<0.001) influenced the overall ES. CONCLUSIONS The group of both boys and girls (ES=-0.95) who participated combined exercise program (Aerobic + Resistance training; ES=-1.17) for 12 months (ES=-1.24) appeared to be the most effective exercise strategy for reducing visceral fat in obese youth.
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Affiliation(s)
- Hyun C Jung
- Department of Kinesiology, College of Health Sciences, University of Louisiana Monroe, Monroe, LA, USA
| | - Soeun Jeon
- Department of Counseling, Health, and Kinesiology, College of Education and Human Development, Texas A&M University-San Antonio, San Antonio, TX, USA
| | - Nan H Lee
- School of Biological Sciences, College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Kyungun Kim
- Department of Nutrition and Kinesiology, College of Health, Science & Technology, University of Central Missouri, Warrensburg, MO, USA
| | - Minsoo Kang
- Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, MS, USA
| | - Sukho Lee
- School of Biological Sciences, College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA -
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Gebrie A, Alebel A, Zegeye A, Tesfaye B, Ferede A. Prevalence and associated factors of overweight/ obesity among children and adolescents in Ethiopia: a systematic review and meta-analysis. BMC OBESITY 2018; 5:19. [PMID: 30002860 PMCID: PMC6036672 DOI: 10.1186/s40608-018-0198-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/22/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Overweight and obesity can be defined as excessive and abnormal fat depositions in our body. They have become one of the emerging and serious public health concerns of the twenty-first century in low income countries like Ethiopia. Hence, the aim of this study was to determine the pooled prevalence and review associated risk factors of overweight/obesity among children and adolescents in Ethiopia. METHOD The articles were identified through explicit and reproducible electronic search of reputable databases (PubMed, Google scholar, Science Direct, EMBASE, Cochrane library), and the hand search of reference lists of previous prevalence studies to retrieve more related articles. The 18 studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. Since the included studies exhibited considerable heterogeneity, a random effect model was used to estimate the pooled prevalence of overweight/obesity. Moreover, the risk factors of overweight/obesity were reviewed. RESULTS The combined pooled prevalence of overweight and obesity among children and adolescents in Ethiopia was 11.30% (95% CI: 8.71, 13.88%). Also, the separate pooled prevalence of overweight and obesity were 8.92 and 2.39%, respectively. Subgroup analysis revealed that the highest overweight/obesity prevalence among children and adolescents was observed in Addis Ababa, 11.94 (95% CI: 9.39, 14.50). Female gender of the children: 3.23 (95% CI 2.03,5.13), high family socioeconomic status: 3.16 (95% CI 1.87,5.34), learning in private school: 3.22 (95% CI 2.36,4.40), physical inactivity: 3.36 (95% CI 1.68,6.72), sweet nutriments preference: 2.78 (95% CI 1.97,3.93) and less use of fruits/vegetables: 1.39 (95% CI 1.10,1.75) have shown a positive association with the development of overweight/obesity among children and adolescents. CONCLUSION The pooled prevalence of overweight/obesity among children and adolescents in Ethiopia is substantially high, and has become an emerging nutrition linked problem. Female gender, high family socioeconomic status, learning in private school, physical inactivity, sweet nutriments preference and less use of fruits/vegetables were found to be significantly associated with overweight/obesity.
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Affiliation(s)
- Alemu Gebrie
- Department of Biomedical Science, School of Medicine, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Animut Alebel
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Abriham Zegeye
- Department of Biomedical Science, School of Medicine, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Bekele Tesfaye
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Aster Ferede
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Dhana K, Haines J, Liu G, Zhang C, Wang X, Field AE, Chavarro JE, Sun Q. Association between maternal adherence to healthy lifestyle practices and risk of obesity in offspring: results from two prospective cohort studies of mother-child pairs in the United States. BMJ 2018; 362:k2486. [PMID: 29973352 PMCID: PMC6031199 DOI: 10.1136/bmj.k2486] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To examine the association between an overall maternal healthy lifestyle (characterized by a healthy body mass index, high quality diet, regular exercise, no smoking, and light to moderate alcohol intake) and the risk of developing obesity in offspring. DESIGN Prospective cohort studies of mother-child pairs. SETTING Nurses' Health Study II (NHSII) and Growing Up Today Study (GUTS) in the United States. PARTICIPANTS 24 289 GUTS participants aged 9-14 years at baseline who were free of obesity and born to 16 945 NHSII women. MAIN OUTCOME MEASURE Obesity in childhood and adolescence, defined by age and sex specific cutoff points from the International Obesity Task Force. Risk of offspring obesity was evaluated by multivariable log-binomial regression models with generalized estimating equations and an exchangeable correlation structure. RESULTS 1282 (5.3%) offspring became obese during a median of five years of follow-up. Risk of incident obesity was lower among offspring whose mothers maintained a healthy body mass index of 18.5-24.9 (relative risk 0.44, 95% confidence interval 0.39 to 0.50), engaged in at least 150 min/week of moderate/vigorous physical activities (0.79, 0.69 to 0.91), did not smoke (0.69, 0.56 to 0.86), and consumed alcohol in moderation (1.0-14.9 g/day; 0.88, 0.79 to 0.99), compared with the rest. Maternal high quality diet (top 40% of the Alternate Healthy Eating Index 2010 diet score) was not significantly associated with the risk of obesity in offspring (0.97, 0.83 to 1.12). When all healthy lifestyle factors were considered simultaneously, offspring of women who adhered to all five low risk lifestyle factors had a 75% lower risk of obesity than offspring of mothers who did not adhere to any low risk factor (0.25, 0.14 to 0.47). This association was similar across sex and age groups and persisted in subgroups of children with various risk profiles defined by factors such as pregnancy complications, birth weight, gestational age, and gestational weight gain. Children's lifestyle did not significantly account for the association between maternal lifestyle and offspring obesity risk, but when both mothers and offspring adhered to a healthy lifestyle, the risk of developing obesity fell further (0.18, 0.09 to 0.37). CONCLUSION Our study indicates that adherence to a healthy lifestyle in mothers during their offspring's childhood and adolescence is associated with a substantially reduced risk of obesity in the children. These findings highlight the potential benefits of implementing family or parental based multifactorial interventions to curb the risk of childhood obesity.
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Affiliation(s)
- Klodian Dhana
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA 02115, USA
| | - Jess Haines
- Department of Family Relations and Applied Nutrition at the University of Guelph in Guelph, Canada
| | - Gang Liu
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA 02115, USA
| | - Cuilin Zhang
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alison E Field
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Qi Sun
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
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Gonzalez-Nahm S, Mendez MA, Benjamin-Neelon SE, Murphy SK, Hogan VK, Rowley DL, Hoyo C. DNA methylation of imprinted genes at birth is associated with child weight status at birth, 1 year, and 3 years. Clin Epigenetics 2018; 10:90. [PMID: 29988473 PMCID: PMC6025828 DOI: 10.1186/s13148-018-0521-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/19/2018] [Indexed: 12/19/2022] Open
Abstract
Background This study assessed the associations between nine differentially methylated regions (DMRs) of imprinted genes in DNA derived from umbilical cord blood leukocytes in males and females and (1) birth weight for gestational age z score, (2) weight-for-length (WFL) z score at 1 year, and (3) body mass index (BMI) z score at 3 years. Methods We conducted multiple linear regression in n = 567 infants at birth, n = 288 children at 1 year, and n = 294 children at 3 years from the Newborn Epigenetics Study (NEST). We stratified by sex and adjusted for race/ethnicity, maternal education, maternal pre-pregnancy BMI, prenatal smoking, maternal age, gestational age, and paternal race. We also conducted analysis restricting to infants not born small for gestational age. Results We found an association between higher methylation of the sequences regulating paternally expressed gene 10 (PEG10) and anthropometric z scores at 1 year (β = 0.84; 95% CI = 0.34, 1.33; p = 0.001) and 3 years (β = 1.03; 95% CI = 0.37, 1.69; p value = 0.003) in males only. Higher methylation of the DMR regulating mesoderm-specific transcript (MEST) was associated with lower anthropometric z scores in females at 1 year (β = - 1.03; 95% CI - 1.60, - 0.45; p value = 0.001) and 3 years (β = - 1.11; 95% CI - 1.98, - 0.24; p value = 0.01). These associations persisted when we restricted to infants not born small for gestational age. Conclusion Our data support a sex-specific association between altered methylation and weight status in early life. These methylation marks can contribute to the compendium of epigenetically regulated regions detectable at birth, influencing obesity in childhood. Larger studies are required to confirm these findings.
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Affiliation(s)
- Sarah Gonzalez-Nahm
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205 USA
| | - Michelle A. Mendez
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205 USA
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC USA
| | | | - Diane L. Rowley
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC USA
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Bryant M, Burton W, Collinson M, Hartley S, Tubeuf S, Roberts K, Sondaal AEC, Farrin AJ. Cluster randomised controlled feasibility study of HENRY: a community-based intervention aimed at reducing obesity rates in preschool children. Pilot Feasibility Stud 2018; 4:118. [PMID: 29977593 PMCID: PMC6013860 DOI: 10.1186/s40814-018-0309-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/13/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In the UK and beyond, public funding is used to commission interventions delivered in public health early years settings aimed at improving health and well-being and reducing inequalities in order to promote school readiness. This is a key setting for obesity prevention programmes, which are often commissioned despite the limited evidence base. The HENRY (Health, Exercise, Nutrition for the Really Young) programme is an 8-week programme delivered to parents of preschool children, designed to support families to optimise healthy weight behaviours. Early evidence suggests that it may be effective, but a robust evaluation using a randomised controlled design has not been conducted. This study begins this process by evaluating the feasibility of conducting a multi-centre definitive trial to evaluate the effectiveness and cost-effectiveness of HENRY to prevent obesity in the early years. METHODS This is a multi-centre, open labelled, two group, prospective, cluster randomised, controlled, feasibility study aiming to recruit 120 parents from 12 children's centres, based in two local authority areas. Within each of the two local authorities, three centres will be randomised to HENRY and three will be randomised to a control arm of standard care (usual provision of services within children's centres). We will explore HENRY commissioning, provision and delivery and assess the feasibility of local authority, centre and parent recruitment, the processes and time required to train and certify staff to deliver the intervention, the potential sources (and associated risk) of contamination and the feasibility of the trial procedures. Research includes a process evaluation, feasibility of cost-effectiveness evaluation, with progression to the definitive trial judged against pre-defined criteria. DISCUSSION This feasibility study will support the decision to proceed to, and the design of, a future definitive trial, providing an evidence base of an approach to prevent childhood obesity, which has been deemed attractive to all stakeholders, including parents. Given the widespread adoption of the intervention, this has the potential to impact on public health in the UK and beyond. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03333733 registered 6th November 2017Protocol date: 25th October 2017Protocol version: 4.0.
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Affiliation(s)
- Maria Bryant
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Wendy Burton
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Michelle Collinson
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Suzanne Hartley
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Sandy Tubeuf
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT UK
| | - Kim Roberts
- HENRY, 8 Elm Place, Old Witney Rd, Oxfordshire, OX29 4BD UK
| | | | - Amanda J. Farrin
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
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Feasibility of Ideal Cardiovascular Health Evaluation in a Pediatric Clinic Setting. Adv Prev Med 2018; 2018:5474838. [PMID: 30009058 PMCID: PMC6020661 DOI: 10.1155/2018/5474838] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/20/2018] [Indexed: 01/24/2023] Open
Abstract
The feasibility of “point-of-care” screening for ideal cardiovascular health was explored in a pediatric specialty clinic setting. Children and adolescents aged 9–18 years (n=91) with treated and stabilized diseases were recruited at a pediatric endocrinology clinic. A table-top device was used to assay fingerstick samples for non-HDL cholesterol (non-HDL-C), which was used to divide participants into two groups based on the non-HDL-C threshold for comparison of the remaining metrics between groups. A significant number of children had low scores, and score frequency distribution was similar to larger retrospective studies, with few participants achieving none or all of the health metrics. Healthy diet was the metric least often achieved. Those with a non-HDL-C above the ideal threshold of 3.1 mmol/L (120 mg/dl) had a higher BMI percentile (p<0.01) and diastolic blood pressure percentile (p<0.05). We conclude that pediatric risk factor screening and scoring can be performed in a specialty clinic with meaningful cardiovascular health scores for patients and providers. Association of abnormal “point-of care” non-HDL-C levels with elevated BMI and blood pressure supports evidence for risk factor clustering and use of the ideal health construct in pediatric clinic settings.
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Kakoma PK, Muyumba EK, Mukeng CK, Musung JM, Kakisingi CN, Mukuku O, Nkulu DN. [Blood pressure profile in adolescents at school in Lubumbashi, Democratic Republic of the Congo]. Pan Afr Med J 2018; 29:94. [PMID: 29875975 PMCID: PMC5987101 DOI: 10.11604/pamj.2018.29.94.14537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/06/2018] [Indexed: 02/05/2023] Open
Abstract
Introduction L'objectif de cette étude était de donner le profil de la pression artérielle (PA) des adolescents âgés de 15 à 19 ans en milieu scolaire à Lubumbashi, République Démocratique du Congo. Méthodes il s'agit d'une étude transversale, portant sur les adolescents âgés de 15 à 19 ans au moyen d'un échantillonnage aléatoire des écoles secondaires de Lubumbashi durant les années scolaires 2013-2014, 2014-2015 et 2015-2016. Trois mesures de PA étaient effectuées le même jour. Résultats 1766 adolescents âgés de 15-19 ans ont été inclus parmi eux 995 étaient de sexe féminin et 771 garçons. Les garçons avaient significativement une pression artérielle systolique élevée que les filles dans les tranches d'âges de 17, 18 et 19 ans. La pression artérielle diastolique n'était pas différente statistiquement dans toutes les tranches d'âges dans les deux sexes. Par contre, dans les deux sexes, la pression artérielle systolique été en corrélation significative avec le poids, la taille, l'indice de masse corporelle, le tour de taille et la fréquence cardiaque. Quant à la pression artérielle diastolique, des corrélations significatives étaient retrouvées avec le poids et l'indice de masse corporelle chez les filles alors que la fréquence cardiaque était en corrélation significative dans les deux sexes. Discussion Au cours de notre étude, il était question de déterminer les valeurs moyennes de PA et sa corrélation avec les paramètres anthropométriques, la FC et le poids de naissance chez les adolescents d'âge compris entre 15 et 19 ans. Notre étude a révélé des valeurs moyennes de PAS chez les garçons qui étaient plus élevées que les filles statistiquement significatives dans les tranches d'âges de 17, 18 et 19 ans alors que les valeurs moyennes de PAD n'avait pas de différence statistiquement significative dans toutes les tranches d'âges dans les deux sexes. Harrabi et al. [16], dans leur étude incluant 1569 sujets âgés de 13 à 19 ans, avaient trouvé que les garçons de 16, 17 et 18 ans avaient des PAS élevées sans différence statistiquement significatives mais les différences statistiquement significatives étaient remarquées chez les filles de 13 et 14 ans concernant la PAD. Dans son étude chez les enfants, Forrester et al. [17] avaient rapporté une corrélation positive entre la PAS et l'âge chez les garçons et négative chez les filles. Cette corrélation négative trouvée entre la PAS et l'âge chez les filles pourrait être expliquée par les modifications hormonales liées à la puberté qui commencent plus tôt chez les filles que chez les garçons. Se référant à la littérature, la PA augmente avec la croissance en âge plus chez les garçons suite à l'augmentation de la masse musculaire pendant la puberté [18-20]. Notre étude a montré que la PAS était en corrélation significative avec le poids, la taille, l'IMC, le tour de taille et la FC dans les deux sexes. Ce constat est similaire à celui faite par l'étude de Harrabi et al. [16] qui rapportait que la PAS était en corrélation positive avec la taille (garçons: r = 0,33; p < 0,0001; filles: r = 0,08; p = 0,02), le poids (garçons: r = 0,47, p < 0,0001; filles: r = 0,35; p < 0,0001) et l'âge (r = 0,12; p < 0,0001). Quant à la PAD dans notre étude, les corrélations significatives positives étaient retrouvées avec le poids (r = 0,093; p = 0,003) et l'IMC (r = 0,079; p = 0,012) seulement chez les filles, alors que la FC était en corrélation significative positive chez les garçons (r = 0,168; p < 0,0001) mais non chez les filles (r = 0,12, p < 0,0001) [16]. Dans une étude similaire chez les adolescents réalisée par Sinaiko et al. [21], une corrélation a été trouvée entre le poids et la PAS chez les garçons (r = 0,167, p < 0,0001) et les filles (r = 0,112, p < 0,0001). L'effet de la taille et du poids sur la PA a déjà été démontré dans plusieurs études transversales antérieures sur les enfants concluant en une forte corrélation positive [22,23]. L'insuffisance de déclaration des naissances à l'état civil dans plusieurs pays en développement, conséquente au recours aux poids de naissance déclarés auprès des parents ou tuteurs, serait un biais dans la réalisation des résultats statistiquement comparables. Conclusion Malgré les faiblesses potentielles de la présente étude dans sa conception transversale et les mesures de la PA le même jour, les données pourraient aider les responsables de la santé à adopter une stratégie nationale de prévention de l'hypertension artérielle dans notre population.
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Affiliation(s)
- Placide Kambola Kakoma
- Département de Médecine Interne, Université de Lubumbashi, République Démocratique du Congo
| | | | - Clarence Kaut Mukeng
- Département de Santé Publique, Université de Lubumbashi, République Démocratique du Congo
| | - Jaques Mbaz Musung
- Département de Médecine Interne, Université de Lubumbashi, République Démocratique du Congo
| | | | - Olivier Mukuku
- Institut Supérieur des Techniques Médicales de Lubumbashi, République Démocratique du Congo
| | - Dophra Ngoy Nkulu
- Département de Médecine Interne, Université de Lubumbashi, République Démocratique du Congo
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Furtado JM, Almeida SM, Mascarenhas P, Ferraz ME, Ferreira JC, Vilanova M, Monteiro MP, Ferraz FP. Anthropometric features as predictors of atherogenic dyslipidemia and cardiovascular risk in a large population of school-aged children. PLoS One 2018; 13:e0197922. [PMID: 29856786 PMCID: PMC5983423 DOI: 10.1371/journal.pone.0197922] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 05/10/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Autopsy studies reveal that atherosclerosis lesions can be found as early as two years of age. To slow the development of this early pathology, obesity and dyslipidemia prevention should start from childhood making it urgent to explore new ways to evaluate dyslipidemia risk in children that can be applied widely, such as the non-invasive anthropometric evaluation. OBJECTIVE Assess the metabolic profile of a pediatric population at a specific age to describe the association between anthropometric and biochemical cardiovascular disease risk factors; and evaluate selected anthropometric variables as potential predictors for dyslipidemic cardiovascular risk. DESIGN AND METHODS Anthropometric features, bioimpedance parameters and fasting clinical profile were assessed in Lisbon and the Tagus Valley region pre-pubertal nine-year-old children (n = 1.496) from 2009-2013 in a descriptive, cross-sectional study. Anthropometric variables predictive power was evaluated through regression analysis. RESULTS At least one abnormal lipid parameter was found in 65% of "normal weight", 73% of "overweight" and 81% of "obese" children according to the International Obesity Task Force (IOTF) standards. Dyslipidemia was present in 67.8% of children. Waist-hip ratio (WHR) explained 0.4% of total cholesterol (TC) variance. Waist circumference (WC) explained 2.8% of apolipoprotein (APO) A1 variance. Waist-circumference-to-height-ratio (WHtR) explained 2.7%, 2.8% and 1.9% of low-density lipoprotein cholesterol (LDL-c), APO B, and N_HDL-c variance, respectively. Children with abnormally high WHR levels had an increase in risk of 4.49, 3.40 and 5.30 times, respectively, for developing cardiovascular disease risk factors measured as high-risk levels of TC, LDL-c and non-HDL-c (N_HDL-c) (p<0.05). Only 29.9% of "normal weight" children had no anthropometric, bioimpedance or biochemical parameters associated with CV risk. CONCLUSION A large proportion of school age children have at least one lipid profile abnormality. BMI, zBMI, calf circumference (CC), hip circumference (HC), WC, and WHR are directly associated with dyslipidemia, whereas HC and calf circumference (CC) adjusted to WC, and mid-upper arm circumference (MUAC), are all inversely associated with dyslipidemia. Selected anthropometric variables are likely to help predict increased odds of having CV risk factors.
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Affiliation(s)
- José M. Furtado
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Instituto Universitário Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
| | - Sílvia M. Almeida
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Instituto Universitário Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
| | - Paulo Mascarenhas
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Instituto Universitário Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
| | - Maria E. Ferraz
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
| | - José C. Ferreira
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Department of Obstetrics and Gynecology of University of Medicine of Warsaw, Warsaw, Poland
| | - Manuel Vilanova
- Instituto de Investigação e Inovação em Saúde, and IBMC–Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Mariana P. Monteiro
- Clinical and Experimental Endocrinology Group, Unit for Multidisciplinary Research in Biomedicine UMIB, ICBAS, University of Porto, Porto, Portugal
| | - Fernando P. Ferraz
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Instituto Universitário Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
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Quesada D, Ahmed NU, Fennie KP, Gollub EL, Ibrahimou B. A Review: Associations Between Attention-deficit/hyperactivity Disorder, Physical Activity, Medication Use, Eating Behaviors and Obesity in Children and Adolescents. Arch Psychiatr Nurs 2018; 32:495-504. [PMID: 29784236 DOI: 10.1016/j.apnu.2018.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 01/17/2018] [Accepted: 01/19/2018] [Indexed: 01/08/2023]
Abstract
UNLABELLED In the past few years we have become increasingly aware of strong associations between obesity and ADHD. Both conditions are major public health issues, affecting children, adolescents and adults alike. OBJECTIVE This review seeks to (1) examine prior research on the association between ADHD and obesity in children and adolescents; (2) discuss mechanisms and consequent behavioral attributes to gain understanding of the path association between ADHD and obesity, (3) review studies examining the role of physical activity, medication, eating behavior and gender on the relationship between ADHD and obesity in children and adolescents. METHOD PubMed, CINAHL and PsycINFO databases were used to search for studies whose subjects were children and adolescents, ages 0-17 years and whose publication years were from 2000 to 2016. After screening 31 studies were included in the review. RESULTS The literature suggests that there is a significant association between ADHD and obesity. Further, the inattentive and impulsive behaviors that characterize ADHD could contribute to dis-regulated eating behaviors and a lack of motivation to engage in physical activity. In addition, it is proposed that medication, gender and physical activity play a role in mediating and moderating the relationship between ADHD and obesity.
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Affiliation(s)
- Danielle Quesada
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, AHC5 (room 486), Miami, FL 33199, USA.
| | - Nasar U Ahmed
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, AHC5 (room 486), Miami, FL 33199, USA.
| | - Kristopher P Fennie
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, AHC5 (room 480), Miami, FL 33199, USA.
| | - Erica L Gollub
- Department of Health Studies, College of Health Professions, Pace University, 861 Bedford Road, Pleasantville, NY 10570, USA.
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th St, AHC5 (room 465), Miami, FL 33199, USA.
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168
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Mahbuba S, Mohsin F, Rahat F, Nahar J, Begum T, Nahar N. Descriptive epidemiology of metabolic syndrome among obese adolescent population. Diabetes Metab Syndr 2018; 12:369-374. [PMID: 29358036 DOI: 10.1016/j.dsx.2017.12.026] [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: 11/30/2017] [Accepted: 12/21/2017] [Indexed: 01/19/2023]
Abstract
AIMS The study was done to assess the magnitude of problems of metabolic syndrome among obese adolescents. MATERIALS AND METHOD It was a cross-sectional study done from January 2013 to June 2014 in paediatric endocrine outpatient department in BIRDEM General Hospital, Dhaka, Bangladesh. Total 172 adolescents having exogenous obesity aged 10-18 years were included. Impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) were defined as per WHO criteria.The adolescents having Body Mass Index (BMI) ≥95th centile were classified as obese.Waist circumference was measured at the level midway between the lower rib margin & the iliac crest, at the level of umbilicus with the person breathing out gently in centimeter. Hip circumference was measured at the maximum width over the buttocks at the level of the greater trochanters in centimeter. RESULT Among 172 obese adolescents, metabolic syndrome was found in 66 patients (38.4%). The commonest metabolic abnormality among those having metabolic syndrome was low HDL level (77.3%) followed by high triglyceride level(71.2%). Glucose intolerance (IFG and/or IGT) was found in 16.7%, Type 2 DM in 10.6%, systolic hypertension in 10.7% and diastolic hypertension in 12.1%. Triglyceride (p = 0.042) and Cholesterol level (p = 0.016) were significantly higher and HDL-cholesterol level (p = 0.000) was significantly lower among obese adolescents having metabolic syndrome. Less physical activity (p = 0.04) was significantly related to the development of metabolic syndrome. On logistic regression analysis male sex, family history of obesity and low HDL-cholesterol correlated to metabolic syndrome. CONCLUSION The High rate of metabolic syndrome among obese adolescents is alarming.
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Affiliation(s)
| | | | - Farhana Rahat
- Shishu Shashthyo Foundation Hospital and Institute of Child Health, Dhaka, Bangladesh
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Quick V, Martin-Biggers J, Povis GA, Worobey J, Hongu N, Byrd-Bredbenner C. Long-term follow-up effects of the HomeStyles randomized controlled trial in families with preschool children on social cognitive theory constructs associated with physical activity cognitions and behaviors. Contemp Clin Trials 2018; 68:79-89. [DOI: 10.1016/j.cct.2018.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/01/2018] [Accepted: 03/12/2018] [Indexed: 12/19/2022]
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Sinaiko AR, Jacobs DR, Woo JG, Bazzano L, Burns T, Hu T, Juonala M, Prineas R, Raitakari O, Steinberger J, Urbina E, Venn A, Jaquish C, Dwyer T. The International Childhood Cardiovascular Cohort (i3C) consortium outcomes study of childhood cardiovascular risk factors and adult cardiovascular morbidity and mortality: Design and recruitment. Contemp Clin Trials 2018; 69:55-64. [PMID: 29684544 DOI: 10.1016/j.cct.2018.04.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/09/2018] [Accepted: 04/18/2018] [Indexed: 12/29/2022]
Abstract
Although it is widely thought that childhood levels of cardiovascular (CV) risk factors are related to adult CV disease, longitudinal data directly linking the two are lacking. This paper describes the design and organization of the International Childhood Cardiovascular Cohort Consortium Outcomes Study (i3C Outcomes), the first longitudinal cohort study designed to locate adults with detailed, repeated, childhood biological, physical, and socioeconomic measurements and a harmonized database. I3C Outcomes uses a Heart Health Survey (HHS) to obtain information on adult CV endpoints, using mail, email, telephone, and clinic visits in the United States (U.S.) and Australia and a national health database in Finland. Microsoft Access, REsearch Data Capture (REDCap) (U.S.), LimeSurvey (Australia), and Medidata™ Rave data systems are used to collect, transfer and organize data. Self-reported CV events are adjudicated via hospital and doctor-released medical records. After the first two study years, participants (N = 10,968) were more likely to be female (56% vs. 48%), non-Hispanic white (90% vs. 80%), and older (10.4 ± 3.8 years vs. 9.4 ± 3.3 years) at their initial childhood study visit than the currently non-recruited cohort members. Over 48% of cohort members seen during both adulthood and childhood have been found and recruited, to date, vs. 5% of those not seen since childhood. Self-reported prevalences were 0.7% Type 1 Diabetes, 7.5% Type 2 Diabetes, 33% hypertension, and 12.8% CV event. 32% of CV events were judged to be true. I3C Outcomes is uniquely able to establish evidence-based guidelines for child health care and to clarify relations to adult CV disease.
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Affiliation(s)
- Alan R Sinaiko
- University of Minnesota Medical School, Department of Pediatrics, 2450 Riverside Avenue, East Building, MB689, Minneapolis, MN 55454, United States.
| | - David R Jacobs
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, United States.
| | - Jessica G Woo
- University of Cincinnati Children's Hospital Medical Center, Department of Biostatistics and Epidemiology, Cincinnati, OH 45229, United States.
| | - Lydia Bazzano
- Tulane University, School of Public Health and Tropical Medicine, Department of Epidemiology, New Orleans, LA 70112, United States.
| | - Trudy Burns
- University of Iowa, College of Public Health, Department of Epidemiology, Iowa City, IA 52242, United States.
| | - Tian Hu
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, United States.
| | - Markus Juonala
- University of Turku, Department of Medicine, Turku, Finland.
| | - Ronald Prineas
- Wake Forest School of Medicine, Division of Public Health, Winston Salem, NC, United States.
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
| | - Julia Steinberger
- University of Minnesota Medical School, Department of Pediatrics, Minneapolis, MN, United States.
| | - Elaine Urbina
- University of Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States.
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - Cashell Jaquish
- National Heart, Lung, and Blood Institute, National Institutes of Health, Washington D.C., United States.
| | - Terry Dwyer
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom.
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Coughlin M, Goldie CL, Tranmer J, Khalid-Khan S, Tregunno D. Patient, Treatment, and Health Care Utilization Variables Associated with Adherence to Metabolic Monitoring Practices in Children and Adolescents Taking Second-Generation Antipsychotics. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63. [PMID: 29528720 PMCID: PMC5894916 DOI: 10.1177/0706743717751693] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Children and adolescents with a range of psychiatric disorders are increasingly being prescribed atypical or second-generation antipsychotics (SGAs). While SGAs are effective at treating conduct and behavioural symptoms, they infer significant cardiometabolic risk. This study aims to explore what patient, treatment, and health care utilization variables are associated with adherence to Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) metabolic monitoring guidelines. METHOD A retrospective chart review of 294 children and adolescents accessing a large outpatient psychiatry setting within a 2-year study period (2014-2016) was conducted. Baseline and follow-up metabolic monitoring, demographic, treatment, and health care utilization variables were then assessed over a 1-year period of interest. RESULTS Metabolic monitoring practices did not adhere to CAMESA guidelines and were very poor over the 1-year observation period. There were significant differences between children (ages 4-12 years, n = 99) and adolescents (ages 13-18 years, n = 195). In adolescents, factors associated with any baseline metabolic monitoring were a higher number of psychiatry visits (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.10 to 1.41), longer duration of contact (OR, 14; 95% CI, 2.31 to 82.4), and use of other non-SGA medications (OR, 3.2; 95% CI, 1.17 to 8.94). Among children, having an emergency room visit (OR, 3.4; 95% CI, 1.01 to 11.71) and taking aripiprazole (OR, 7.4; 95% CI, 2.02 to 27.45) increased the odds of receiving baseline metabolic monitoring. CONCLUSION Findings from this study highlight the need for better metabolic monitoring for children and adolescents taking SGAs. Enhanced focus on opportunities for multidisciplinary collaboration is needed to improve the quality of care offered to this population.
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Affiliation(s)
- Mary Coughlin
- 1 Department of Health Sciences, School of Nursing, Queen's University, Kingston, Ontario
| | | | - Joan Tranmer
- 1 Department of Health Sciences, School of Nursing, Queen's University, Kingston, Ontario
| | | | - Deborah Tregunno
- 1 Department of Health Sciences, School of Nursing, Queen's University, Kingston, Ontario
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Thompson DI, Cantu D, Callender C, Liu Y, Rajendran M, Rajendran M, Zhang Y, Deng Z. Photorealistic Avatar and Teen Physical Activity: Feasibility and Preliminary Efficacy. Games Health J 2018; 7:143-150. [PMID: 29406774 PMCID: PMC5905941 DOI: 10.1089/g4h.2017.0103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Exergames played with a photorealistic avatar may enhance motivation to play, in addition to frequency, duration, and intensity of game-play. This article reports the feasibility and preliminary efficacy of an exergame played with a photorealistic avatar on physical activity (PA) intensity in a laboratory-based study. MATERIALS AND METHODS Teens (12-14 years old) were recruited from a large, metropolitan area of the southwestern United States. Parents provided written informed consent. Teens completed online data collection, played an exergame with a photorealistic avatar in an observed laboratory setting, and then participated in postassessment data collection that included online questionnaires and a telephone interview. RESULTS The program was feasible: 42 out of 48 teens recruited (87.5%) completed all data collection activities; game enjoyment was 21.9 ± 8.4 out of possible score of 32; immersion, 49.7 ± 15.6 out of a possible score of 88; avatar identification, 43.9 ± 16.5 out of a possible score of 68; and program satisfaction, 15.6 ± 3.6 out of possible score of 20. Objectively assessed PA indicated that 15.88 minutes of the laboratory-based gameplay session (74.9% of total time) was in vigorous PA; small effect sizes were observed in autonomy (ES = 0.45; P = 0.01) and competence (ES = 0.36; P = 0.03). Little change was observed in relatedness (ES = 0.04; P = 0.82) Qualitative data confirmed participants enjoyed playing the game with a photorealistic avatar and provided suggestions to enhance the gameplay experience. CONCLUSION Playing an exergame with a photorealistic avatar holds promise as a method for increasing PA among youth. Additional research is needed to further explore its effects on gameplay frequency, intensity, and duration in nonlaboratory setting.
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Affiliation(s)
- Deborah I. Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Dora Cantu
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Yan Liu
- Department of Medicine–Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas
| | - Mayur Rajendran
- Department of Computer Science, University of Houston, Houston, Texas
| | - Madhur Rajendran
- Department of Computer Science, University of Houston, Houston, Texas
| | - Yuting Zhang
- Department of Computer Science, University of Houston, Houston, Texas
| | - Zhigang Deng
- Department of Computer Science, University of Houston, Houston, Texas
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Lifestyle of women before pregnancy and the risk of offspring obesity during childhood through early adulthood. Int J Obes (Lond) 2018; 42:1275-1284. [PMID: 29568108 DOI: 10.1038/s41366-018-0052-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 12/13/2017] [Accepted: 01/22/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND In women, adhering to an overall healthy lifestyle is associated with a dramatically reduced risk of cardio-metabolic disorders. Whether such a healthy lifestyle exerts an intergenerational effects on child health deserves examination. METHODS We included 5701 children (9-14 years old at baseline) of the Growing Up Today Study 2, and their mothers, who are participants in the Nurses' Health Study II. Pre-pregnancy healthy lifestyle was defined as a normal body mass index, no smoking, physical activity ≥150 min/week, and diet in the top 40% of the Alternative Healthy Eating Index-2010. Obesity during childhood and adolescence was defined using the International Obesity Task Force age- and sex-specific cutoffs. Multivariable log-binominal regression models with generalized estimating equations were used to evaluate the association of pre-pregnancy healthy lifestyle and offspring obesity. RESULTS We identified 520 (9.1%) offspring who became obese during follow-up. A healthy body weight of mothers and no smoking before pregnancy was significantly associated with a lower risk of obesity among offspring: the relative risks [RRs; 95% confidence intervals (CIs)] were 0.37 (0.31-0.43) and 0.64 (0.49-0.84), respectively. Eating a healthy diet and regular moderate-to-vigorous physical activities were inversely related to offspring obesity risk, but these relations were not statistically significant. Compared to children of mothers who did not meet any low-risk lifestyle factors, offspring of women who adhered to all four healthy lifestyle factors had 75% lower risk of obesity (RR: 0.25, 95% CI: 0.14-0.43). CONCLUSION Adherence to an overall healthy lifestyle before pregnancy is strongly associated with a low risk of offspring obesity in childhood, adolescence, and early adulthood. These findings highlight the importance of an overall healthy lifestyle before pregnancy as a potential strategy to prevent obesity in future generations.
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174
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Differential distribution and association of FTO rs9939609 gene polymorphism with obesity: A cross-sectional study among two tribal populations of India with East-Asian ancestry. Gene 2018; 647:198-204. [DOI: 10.1016/j.gene.2018.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/17/2017] [Accepted: 01/02/2018] [Indexed: 01/09/2023]
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175
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Nakagawa Y, Nakanishi T, Satake E, Matsushita R, Saegusa H, Kubota A, Natsume H, Shibata Y, Fujisawa Y. Postnatal BMI changes in children with different birthweights: A trial study for detecting early predictive factors for pediatric obesity. Clin Pediatr Endocrinol 2018; 27:19-29. [PMID: 29403153 PMCID: PMC5792818 DOI: 10.1297/cpe.27.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 10/04/2017] [Indexed: 01/16/2023] Open
Abstract
The purpose of this study was to clarify the degree of early postnatal growth by birthweight and detect early predictive factors for pediatric obesity. Body mass index (BMI) and degree of obesity were examined in children in the fourth year of elementary school and second year of junior high school. Their BMI at birth and three years of age were also examined. Based on birthweight, participants were divided into three groups: low (< 2500 g), middle (2500-3500 g), and high (> 3500 g). Furthermore, according to the degree of obesity, they were divided into two groups: obese (20% ≤) and non-obese (20% >). The change of BMI from birth to three years of age (ΔBMI) showed a strong inverse relationship with birthweight and was significantly different among the three birthweight groups (low > middle > high). The ΔBMI and BMI at three years of age were higher in obese than in non-obese children and showed significant positive correlations with the degree of obesity. Early postnatal growth might be determined by birthweight and was higher in obese than in non-obese children. The ΔBMI from birth to three years of age and BMI at age of three years could be predictive factors for pediatric obesity.
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Affiliation(s)
- Yuichi Nakagawa
- Department of Internal Medicine and Pediatrics, Shiraume Toyooka Hospital, Shizuoka, Japan.,Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Toshiki Nakanishi
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Eiichiro Satake
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Rie Matsushita
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan.,Department of Pediatrics, Kikugawa General Hospital, Shizuoka, Japan
| | - Hirokazu Saegusa
- Department of Pediatrics, Enshu General Hospital, Shizuoka, Japan
| | - Akira Kubota
- Department of Pediatrics, Chutoen General Medical Center, Shizuoka, Japan
| | - Hiromune Natsume
- Department of Pediatrics, Kosai General Hospital, Shizuoka, Japan
| | - Yukinobu Shibata
- Department of Pediatrics, Hamamatsu Red Cross Hospital, Shizuoka, Japan
| | - Yasuko Fujisawa
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
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176
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Vilchis-Gil J, Klünder-Klünder M, Flores-Huerta S. Effect on the Metabolic Biomarkers in Schoolchildren After a Comprehensive Intervention Using Electronic Media and In-Person Sessions to Change Lifestyles: Community Trial. J Med Internet Res 2018; 20:e44. [PMID: 29402762 PMCID: PMC5818679 DOI: 10.2196/jmir.9052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/07/2017] [Accepted: 12/01/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Obesity is a chronic low-intensity state of inflammation with metabolic alterations that, when acquired during childhood, lead to severe illness in adults. Encouraging healthy eating habits and physical activity is the basis for preventing and treating obesity and its complications. OBJECTIVE To evaluate how a comprehensive intervention promoting healthy eating habits and physical activities in schools affects children's metabolic biomarkers. METHODS Of four Mexico City primary schools in this study, two groups of children that were recruited at their schools were assigned to a 12-month intervention group (IG) and the other two were assigned to control groups (CGs). The intervention had two components: (1) parents/schoolchildren attended in-person educational sessions promoting healthy eating and physical activity habits, and were provided printed information; and (2) parents were able to seek information through a website, and also received brief weekly mobile phone text messages. Anthropometric measurements and fasting blood samples were taken from both groups of children at baseline and again after 12 months. RESULTS The study involved 187 children in the IG and 128 in the CG. Regardless of each child's nutritional status at the beginning of the study, the intervention improved metabolic parameters; the IG showed a negative effect on glucose concentrations (-1.83; CI 95% -3.06 to -0.60), low-density lipoprotein-cholesterol (-2.59; CI 95% -5.12 to -0.06), insulin (-0.84; CI 95% -1.31 to -0.37), and homeostasis model to assess the insulin resistance index (HOMA-IR; -0.21; CI 95% -0.32 to -0.09) in comparison to the CG. HOMA-IR improved in children who had higher than baseline body mass index z-scores. CONCLUSIONS Intervention through multiple components that promoted healthier eating and physical activity habits improved the metabolic parameters of the children in the study after one year, regardless of their nutritional status.
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Affiliation(s)
- Jenny Vilchis-Gil
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
| | - Miguel Klünder-Klünder
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
- Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Ciudad de México, Mexico
| | - Samuel Flores-Huerta
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
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177
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Akgul Gundogdu N, Sevig EU, Guler N. The effect of the solution-focused approach on nutrition-exercise attitudes and behaviours of overweight and obese adolescents: Randomised controlled trial. J Clin Nurs 2018; 27:e1660-e1672. [DOI: 10.1111/jocn.14246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Nurcan Akgul Gundogdu
- Department of Public Health Nursing; Faculty of Health Science; University of Cumhuriyet; Sivas Turkey
| | - Emine Umit Sevig
- Department of Nursing; Faculty of Health Science; University of Near East Turkish Republic of Northern Cyprus
| | - Nuran Guler
- Department of Public Health Nursing; Faculty of Health Science; University of Cumhuriyet; Sivas Turkey
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178
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Benmohammed K, Valensi P, Nguyen MT, Benmohammed F, Benlatreche M, Benembarek K, Lezzar A. Influence of waist circumference on blood pressure status in non-obese adolescents. Int J Adolesc Med Health 2018; 32:ijamh-2017-0127. [PMID: 29332014 DOI: 10.1515/ijamh-2017-0127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/09/2017] [Indexed: 11/15/2022]
Abstract
Objectives To check whether excess in abdominal adiposity and metabolic factors were associated with blood pressure abnormalities in non-obese adolescents. Methods We randomly selected 1100 adolescent students, aged 12-18 years, from schools and classrooms in the city of Constantine, Algeria. Among them 179 were overweight and 51 were obese (IOTF criteria). Waist circumference (WC) was considered high if >74 cm in boys and 75 cm in girls (mean of WC of all population studied). Hypertension (HBP) and prehypertension (preHBP) were defined by the NHBPEP's 2004 criteria. Results The prevalence of HBP/preHBP were 13.0%/12.4% with no difference between boys and girls. The percentages of HBP/preHBP patients were 15.6%/15.6% in overweight adolescents, 5.9%/31.4% in obese adolescents and 12.9%/10.6% in adolescents with normal body weight (p < 0.0001). In obese adolescents, the prevalence of HBP was higher among boys than girls (36% vs. 27%, p = 0.002). In normal and overweight adolescents, the prevalence of HBP and preHBP was similar in boys and girls (11.9% vs. 11.0% and 14.7% vs. 12.1%); the association of WC (high vs. not high) with HBP was found in boys (16.1% vs. 8.8%, p = 0.009) but not in girls (12.1% vs. 10.2%), and with preHBP in girls (15.5% vs. 8.0%, p = 0.029) but not in boys (16.2% vs. 13.6%). Waist circumference [OR: 1.04 (1.03-1.06); p < 0.0001] and HOMA index [OR: 1.65 (1.13-2.39); p = 0.009] were associated with an increased risk of HBP. Conclusion In non-obese adolescents, a high WC, defined by values over the mean WC observed in our population, is associated with a higher risk of HBP in boys.
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Affiliation(s)
- Karima Benmohammed
- Department of Endocrinology and Diabetology, Dr Benbadis University Hospital, Constantine University 3, Constantine, Algeria
| | - Paul Valensi
- Department of Endocrinology, Diabetology and Nutrition, Jean Verdier hospital, APHP, Paris Nord University, CRNH-IDF, CINFO, Bondy, France
| | - Minh Tuan Nguyen
- Department of Endocrinology, Diabetology and Nutrition, Jean Verdier hospital, APHP, Paris Nord University, CRNH-IDF, CINFO, Bondy, France
| | | | - Moufida Benlatreche
- Department of Animal Biology, Faculty of Life and Natural Sciences, University of Constantine 1, Biology and genetics research laboratory, Constantine, Algeria
| | - Karima Benembarek
- Department of Biochemistry, Research Laboratory on Biology and Genetic, Constantine University3, Constantine, Algeria
| | - Alkassem Lezzar
- Department of Endocrinology and Diabetology, Dr Benbadis University Hospital, Constantine University 3, Constantine, Algeria
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179
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Risk modeling of non-communicable diseases using socio-demographic characteristics, lifestyle and family disease history among university students in Bangladesh. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0895-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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180
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Dabelea D, Sauder KA. Intrauterine Exposure to Maternal Diabetes and Childhood Obesity. CONTEMPORARY ENDOCRINOLOGY 2018. [DOI: 10.1007/978-3-319-68192-4_13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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181
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Sultan S, Dowling M, Kirton A, DeVeber G, Linds A, Elkind MSV. Dyslipidemia in Children With Arterial Ischemic Stroke: Prevalence and Risk Factors. Pediatr Neurol 2018; 78:46-54. [PMID: 29229232 PMCID: PMC5776751 DOI: 10.1016/j.pediatrneurol.2017.09.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/27/2017] [Accepted: 09/29/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Risk factors for pediatric stroke are poorly understood and require study to improve prevention. Total cholesterol and triglyceride values peak to near-adult levels before puberty, a period of increased stroke incidence. The role of lipids in childhood arterial ischemic stroke has been minimally investigated. METHODS We performed a cross-sectional analysis of lipid and Lp(a) concentrations in children with arterial ischemic stroke in the International Pediatric Stroke Study to compare the prevalence of dyslipidemia and high- or low-ranking lipid values in our dataset with reported population values. We analyzed sex, body mass index, race, ethnicity, family history, and stroke risk factors for associations with dyslipidemia, high non-high-density lipoprotein cholesterol, and hypertriglyceridemia. RESULTS Compared with the National Health and Nutrition Examination Survey, a higher proportion of children ≥5 years with arterial ischemic stroke had dyslipidemia (38.4% versus 21%), high total cholesterol (10.6% versus 7.4%), high non-high-density lipoprotein cholesterol (23.1% versus 8.4%), and low high-density lipoprotein cholesterol (39.8% versus 13.4%). The lipid values that corresponded to one standard deviation above the mean (84th percentile) in multiple published national studies generally corresponded to a lower ranking percentile in children aged five years or older with arterial ischemic stroke. Dyslipidemia was more likely associated with an underweight, overweight, or obese body mass index compared with a healthy weight. Ethnic background and an acute systemic illness were also associated with abnormal lipids. CONCLUSIONS Dyslipidemia and hypertriglyceridemia may be more prevalent in children with arterial ischemic stroke compared with stroke-free children.
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Affiliation(s)
- Sally Sultan
- Department of Pediatrics, Columbia University Medical Center, New York, New York.
| | - Michael Dowling
- Department of Pediatrics and Neurology & Neurotherapeutics, Division of Pediatric Neurology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Adam Kirton
- Calgary Pediatric Stroke Program, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Gabrielle DeVeber
- Division of Neurology and Labatt Family Heart Centre, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alexandra Linds
- Division of Neurology, Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mitchell S V Elkind
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York
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182
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Xu F, Greaney ML, Cohen SA, Riebe D, Greene GW. The Association between Adolescent's Weight Perception and Health Behaviors: Analysis of National Health and Nutrition Examination Survey Data, 2011-2014. J Obes 2018; 2018:3547856. [PMID: 29850231 PMCID: PMC5937432 DOI: 10.1155/2018/3547856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/21/2018] [Accepted: 04/02/2018] [Indexed: 11/18/2022] Open
Abstract
The association between adolescents' weight perception and their physical activity (PA) and sedentary behaviors remains unclear. Therefore, these associations were explored using data from 2438 adolescents aged 12-19 years who participated in the National Health and Nutrition Examination 2011-2014 Survey. Respondents reported weight perception, and their weight perception accuracy was determined by examining whether the measured weight and perceived weight were concordant. Respondents also reported sedentary time (sitting time and screen time), PA, and intention to lose weight. Linear and logistic regression models were conducted to determine whether adolescents' PA, sedentary behaviors, and weight loss intention differed by weight perception and weight perception accuracy adjusted for demographic variables accounting for complex sampling. About one-quarter (21.4%) of the respondents had obesity. For respondents who perceived themselves as being overweight/fat, despite greater weight loss intention, males reported more sitting time (512.7 ± 16.3 versus 474.1 ± 10.2 minutes/day, p < 0.05) and females reported less PA (48.7 ± 5.0 versus 64.6 ± 3.3 minutes/day, p < 0.05) than respondents who perceived themselves as being normal weight. Similar patterns were observed for weight perception accuracy among individuals with obesity. Study results show that perceiving oneself as being overweight/fat regardless of accuracy was associated with more sedentary time for males or less PA for females despite higher weight loss intention.
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Affiliation(s)
- Furong Xu
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | - Mary L. Greaney
- Health Studies Program, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | - Steven A. Cohen
- Health Studies Program, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | - Deborah Riebe
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | - Geoffrey W. Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA
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183
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Lalji R, Tullus K. What's new in paediatric hypertension? Arch Dis Child 2018; 103:96-100. [PMID: 28818842 DOI: 10.1136/archdischild-2016-311662] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/31/2017] [Accepted: 06/12/2017] [Indexed: 11/04/2022]
Abstract
Paediatric hypertension predisposes to hypertension and cardiovascular disease in adult life. Despite clear guidelines, there remains a lack of screening. Diagnosis remains challenging given the high rate of false-positive high blood pressure (BP) readings at a single visit; thus, multiple visits are required to confirm the diagnosis. Depending on the normative data sets used, hypertension in overweight and obese children can be underestimated by up to 20%. Specific BP targets are required for subgroups such as adolescents, children with chronic kidney disease (CKD) and type 1 diabetes. High dietary salt intake is a risk factor for cardiovascular disease. Given the rise in processed food consumption, children in developed nations are likely to benefit from salt restriction at a population-based level.
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Affiliation(s)
- Rowena Lalji
- Departmentof Paediatric Nephrology, Great Ormond Street Hospital for Children, London, UK.,Departmentof Paediatric Nephrology, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia
| | - Kjell Tullus
- Departmentof Paediatric Nephrology, Great Ormond Street Hospital for Children, London, UK
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184
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Jayaraman R, Reinier K, Nair S, Aro AL, Uy-Evanado A, Rusinaru C, Stecker EC, Gunson K, Jui J, Chugh SS. Risk Factors of Sudden Cardiac Death in the Young: Multiple-Year Community-Wide Assessment. Circulation 2017; 137:1561-1570. [PMID: 29269388 DOI: 10.1161/circulationaha.117.031262] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 11/17/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Prevention of sudden cardiac arrest (SCA) in the young remains a largely unsolved public health problem, and sports activity is an established trigger. Although the presence of standard cardiovascular risk factors in the young can link to future morbidity and mortality in adulthood, the potential contribution of these risk factors to SCA in the young has not been evaluated. METHODS We prospectively ascertained subjects who experienced SCA between the ages of 5 and 34 years in the Portland, Oregon, metropolitan area (2002-2015, catchment population ≈1 million). We assessed the circumstances, resuscitation outcomes, and clinical profile of subjects who had SCA by a detailed evaluation of emergency response records, lifetime clinical records, and autopsy examinations. We specifically evaluated the association of standard cardiovascular risk factors and SCA, and sports as a trigger for SCA in the young. RESULTS Of 3775 SCAs in all age groups, 186 (5%) occurred in the young (mean age 25.9±6.8, 67% male). In SCA in the young, overall prevalence of warning signs before SCA was low (29%), and 26 (14%) were associated with sports as a trigger. The remainder (n=160) occurred in other settings categorized as nonsports. Sports-related SCAs accounted for 39% of SCAs in patients aged ≤18, 13% of SCAs in patients aged 19 to 25, and 7% of SCAs in patients aged 25 to 34. Sports-related SCA cases were more likely to present with shockable rhythms, and survival from cardiac arrest was 2.5-fold higher in sports-related versus nonsports SCA (28% versus 11%; P=0.05). Overall, the most common SCA-related conditions were sudden arrhythmic death syndrome (31%), coronary artery disease (22%), and hypertrophic cardiomyopathy (14%). There was an unexpectedly high overall prevalence of established cardiovascular risk factors (obesity, diabetes mellitus, hypertension, hyperlipidemia, smoking) with ≥1 risk factors in 58% of SCA cases. CONCLUSIONS Sports was a trigger of SCA in a minority of cases, and, in most patients, SCA occurred without warning symptoms. Standard cardiovascular risk factors were found in over half of patients, suggesting the potential role of public health approaches that screen for cardiovascular risk factors at earlier ages.
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Affiliation(s)
- Reshmy Jayaraman
- The Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.J., K.R., S.N., A.L.A., A.U.-E., C.R., S.S.C.)
| | - Kyndaron Reinier
- The Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.J., K.R., S.N., A.L.A., A.U.-E., C.R., S.S.C.)
| | - Sandeep Nair
- The Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.J., K.R., S.N., A.L.A., A.U.-E., C.R., S.S.C.)
| | - Aapo L Aro
- The Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.J., K.R., S.N., A.L.A., A.U.-E., C.R., S.S.C.)
| | - Audrey Uy-Evanado
- The Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.J., K.R., S.N., A.L.A., A.U.-E., C.R., S.S.C.)
| | - Carmen Rusinaru
- The Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.J., K.R., S.N., A.L.A., A.U.-E., C.R., S.S.C.)
| | | | | | - Jonathan Jui
- Department of Emergency Medicine (J.J.), Oregon Health and Science University, Portland
| | - Sumeet S Chugh
- The Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (R.J., K.R., S.N., A.L.A., A.U.-E., C.R., S.S.C.).
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185
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Distinct Lipoprotein Curves in Normal Weight, Overweight, and Obese Children and Adolescents. J Pediatr Gastroenterol Nutr 2017; 65:673-680. [PMID: 28691976 DOI: 10.1097/mpg.0000000000001674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Pediatric lipoprotein curves are based on population-based samples. As obesity, may alter lipoprotein levels, cutoffs not adjusted for body mass index (BMI) are potentially inappropriate. We aimed to develop distinct serum lipid curves based on sex- and BMI-percentiles for children and adolescents. METHODS Cross-sectional analysis included all healthy children and adolescents (age range 2-17 years) with available serum lipid concentrations (n = 152,820 of approximately 1.2 million children and adolescents per study year). These children and adolescents were categorized according to sex- and age-stratified BMI-percentiles: 100,375 normal weight (5th-85th percentile), 26,028 overweight (85th-95th percentile) and 26,417 obese (≥95th percentile) individuals. Excluded were individuals with hyperlipidemia, gastrointestinal disease, thyroid disease and lipid-lowering medications. Lambda-Mu-Sigma, smoothed percentile lipid curves were computed. RESULTS Obese children had a lipid profile pattern throughout childhood and adolescence similar to that of normal weight subjects but with a significant upward shift in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides (TGs) and a downward shift in high-density lipoprotein-cholesterol (HDL-C). Obese boys had 13 mg/dL higher TC levels (P < 0.001), 11 mg/dL higher LDL-C levels, 15 mg/dL higher non-HDL-C levels, and 5 mg/dL lower HDL-C levels (P < 0.001). Obese girls had 6 mg/dL higher TC levels, 7 mg/dL higher LDL-C levels, 11 mg/dl higher non-HDL-C levels, and 6 mg/dL lower HDL-C levels (P < 0.001). CONCLUSIONS Across a large, nationally representative cohort of children and adolescents, lipoprotein levels were found to vary in relation to weight status. On the basis of these findings, it is suggested that when evaluating the lipid profile in the pediatric population, in addition to sex-based curves, clinical decision making may require consideration of BMI-stratified curves.
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186
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Pazin DC, Rosaneli CF, Olandoski M, Oliveira ERND, Baena CP, Figueredo AS, Baraniuk AO, Kaestner TLDL, Guarita-Souza LC, Faria-Neto JR. Waist Circumference is Associated with Blood Pressure in Children with Normal Body Mass Index: A Cross-Sectional Analysis of 3,417 School Children. Arq Bras Cardiol 2017; 109:509-515. [PMID: 29185613 PMCID: PMC5783431 DOI: 10.5935/abc.20170162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/31/2017] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of childhood obesity and associated conditions, such as
hypertension, has become a major problem of public health. Although waist
circumference (WC) is a marker of cardiovascular risk in adults, it is
unclear whether this index is associated with cardiovascular risk factors in
children. Objective Our aim was to evaluate the association between increased WC and elevated
blood pressure (BP) in children with normal body mass index (BMI)
ranges. Methods Cross-sectional evaluation of students between 6 and 11 years with normal
BMI. WC was categorized by quartile for each age group. Normal BP was
defined as values < 90th percentile, and levels above this range were
considered elevated. Values of p < 0.05 were considered statistically
significant. Results Of the 5,037 children initially assessed, 404 (8%) were excluded for being
underweight and 1,216 (24.1%) were excluded for being overweight or obese. A
final sample of 3,417 children was evaluated. The prevalence of elevated BP
was 10.7%. In children with WC in the lowest quartile, the prevalence of
elevated BP was 8.1%. This prevalence increased in upper quartiles: 10.6% in
the second, 12.4% in third and 12.1% in the upper quartile. So, in this
group, being in the highest WC quartile was associated with a 57% higher
likelihood to present elevated BP when compared to those in the lowest
quartile (Q4 vs Q1; OR 1.57 - 95%CI 1.14 - 2.17). Conclusion In children aged 6 to 11 years, increased waist circumference is associated
with elevated BP even when BMI is normal.
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Affiliation(s)
| | | | - Márcia Olandoski
- Pontifícia Universidade Católica do Paraná, Curitiba, PR- Brazil
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187
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Promoting healthy home environments and lifestyles in families with preschool children: HomeStyles, a randomized controlled trial. Contemp Clin Trials 2017; 64:139-151. [PMID: 29079392 DOI: 10.1016/j.cct.2017.10.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/12/2017] [Accepted: 10/23/2017] [Indexed: 11/22/2022]
Abstract
The purpose of the HomeStyles randomized controlled trial was to determine the effect of participation in the HomeStyles intervention vs an attention control condition on the weight-related aspects of the home environment and lifestyle behavioral practices of families with preschool children. Parents of preschool children (n=489) were systematically randomized to experimental or attention control group after completing the baseline survey. Baseline and post surveys comprehensively assessed study outcomes using a socio-ecological approach incorporating valid, reliable intrapersonal (e.g., diet, activity), interpersonal (e.g., family meal frequency), and environmental measures (e.g., home media environment), and self-reported parent and child measured heights and weights. For all outcome measures, paired t-tests compared within group differences over time and ANCOVA, controlling for baseline scores and prognostic variables (e.g., parent sex), determined differences in post survey scores between groups. The final analytical sample (N=172; age 32.34±5.71SD; 58% White; 93% female) completed baseline and post surveys. The experimental group families had improved family meal and diet-related behaviors, and self-efficacy for food-related childhood obesity-protective practices. Household food supplies changed little, except for less availability of salty/fatty snacks. Within group effects indicated the control group also experienced some improvements, however these were few in number. ANCOVA revealed the experimental group parents had greater physical activity, reduced screentime, improved family mealtime behaviors, and increased self-efficacy for childhood obesity-protective behaviors and cognitions compared to the control group at post survey, though effect sizes were small. The HomeStyles program for families with preschool children promoted improvements in an array of obesity-preventive behaviors.
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188
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Effect of human milk formula with bovine colostrum supplementation on bone mineral density in infant cynomolgus macaques. J Dev Orig Health Dis 2017; 9:172-181. [PMID: 29039296 DOI: 10.1017/s2040174417000812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Insulin-like growth factor 1 (IGF1) is a regulator of human growth during infancy and childhood, known to promote bone and muscle growth as well as lipid accumulation. This study aimed to investigate the effects of formula milk with or without IGF1 supplementation (in the form of pure IGF1 or bovine colostrum) on growth and body composition in infant cynomolgus macaques during the first 6 months of life. Three groups of infants were nursery-reared and received formula milk with or without IGF1 or bovine colostrum supplementation for 4 months, and a fourth group consisting of breast-fed infants was included for comparison (n=6 for each group). Ranked-based analysis of covariance was used to detect differences between adjusted means for sex. No differences in weight, height, fat mass, and fat-free mass could be detected between groups. However, bone mineral density (BMD) was significantly different between groups at the end of formula feeding. Infants that received bovine colostrum supplementation displayed higher mean BMD than infants of all other groups, with no differences between the latter three groups. In conclusion, our results suggest that supplementation with bovine colostrum can enhance BMD in formula-fed infants, an effect that apparently does not depend on IGF1. Bovine colostrum supplementation could be beneficial for long-term bone health in infants with suboptimal bone growth.
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189
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Wang SR, Zhu YB, Cheng Y, Zhang YX. Profiles of blood pressure among children and adolescents with different body mass index categories in Shandong, China. Blood Press 2017; 27:56-61. [DOI: 10.1080/08037051.2017.1384308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Shu-Rong Wang
- Department of Blood Donation, Shandong Blood Center, Shandong, China
| | - Yong-Bao Zhu
- Department of Blood Donation, Shandong Blood Center, Shandong, China
| | - Yan Cheng
- Department of Blood Donation, Shandong Blood Center, Shandong, China
| | - Ying-Xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China
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190
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Nianogo RA, Wang MC, Wang A, Nobari TZ, Crespi CM, Whaley SE, Arah OA. Projecting the impact of hypothetical early life interventions on adiposity in children living in low-income households. Pediatr Obes 2017; 12:398-405. [PMID: 27283011 PMCID: PMC5290222 DOI: 10.1111/ijpo.12157] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 03/10/2016] [Accepted: 05/02/2016] [Indexed: 11/25/2022]
Abstract
It is difficult to evaluate the effectiveness of interventions aimed at reducing early childhood obesity using randomized trials. Objective To illustrate how observational data can be analysed using causal inference methods to estimate the potential impact of behavioural 'interventions' on early childhood adiposity. Methods We used longitudinal data from 1054 children 1-5 years old enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children and followed (WIC) from 2008 to 2010 for a mean duration of 23 months. The data came from a random sample of WIC families living in Los Angeles County in 2008. We used the parametric g-formula to estimate the impact of various hypothetical behavioural interventions. Results Adjusted mean weight-for-height Z score at the end of follow-up was 0.73 (95% CI 0.65, 0.81) under no intervention and 0.63 (95% CI 0.38, 0.87) for all interventions given jointly. Exclusive breastfeeding for 6 months or longer was the most effective intervention [population mean difference = -0.11 (95% CI -0.22, 0.01)]. Other interventions had little or no effect. Conclusions Compared with interventions promoting healthy eating and physical activity behaviours, breastfeeding was more effective in reducing obesity risk in children aged 1-5 years. When carefully applied, causal inference methods may offer viable alternatives to randomized trials in etiologic and evaluation research.
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Affiliation(s)
- Roch A Nianogo
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA 90095,California Center for Population Research, UCLA, Los Angeles, California, USA,Corresponding Author: Roch A. Nianogo, Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772 (; ). Office phone: 310 206 0050; Fax: 310 206 6039
| | - May C Wang
- California Center for Population Research, UCLA, Los Angeles, California, USA,Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, Los Angeles, CA
| | - Aolin Wang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA 90095,California Center for Population Research, UCLA, Los Angeles, California, USA
| | - Tabashir Z Nobari
- California Center for Population Research, UCLA, Los Angeles, California, USA,Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, Los Angeles, CA,Research and Evaluation Unit, Public Health Foundation Enterprises- Special Supplemental Nutrition Program for Women, Infants and Children (PHFE WIC), 12781 Schabarum Ave., Irwindale, CA 91706
| | - Catherine M Crespi
- Department of Biostatistics, UCLA School of Public Health, Box 951772, Los Angeles, CA 951772
| | - Shannon E Whaley
- Research and Evaluation Unit, Public Health Foundation Enterprises- Special Supplemental Nutrition Program for Women, Infants and Children (PHFE WIC), 12781 Schabarum Ave., Irwindale, CA 91706
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA 90095,California Center for Population Research, UCLA, Los Angeles, California, USA,UCLA Center for Health Policy Research, Los Angeles, California, USA
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191
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O'Hara V, Browne N, Fathima S, Sorondo B, Bayleran J, Johnston S, Hastey K. Obesity Cardiometabolic Comorbidity Prevalence in Children in a Rural Weight-Management Program. Glob Pediatr Health 2017; 4:2333794X17729303. [PMID: 28959708 PMCID: PMC5593208 DOI: 10.1177/2333794x17729303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 07/28/2017] [Indexed: 01/07/2023] Open
Abstract
This descriptive study examines the prevalence of obesity-related cardiometabolic (CM) risk factors using CM laboratory metrics, in 3 to 19 year olds presenting to a rural American Academy of Pediatrics stage 3 multidisciplinary weight management clinic based on gender, age ranges, and obesity classes. From 2009 to 2016, 382 children (body mass index ≥85th percentile) enrolled. Multiple logistic regression determined the effects of age, gender, or obesity class on CM risk factors. Odds of elevated insulin were more significant in 15 to 19 year olds than in 3 to 5 year olds, or in 6 to 11 year olds. Obesity class III had higher odds than class II, class I, and overweight in having elevated insulin; twice likely than class II for having low high-density lipoprotein; and twice as likely than class I for high triglycerides. Adolescents and obesity class III categories have significant CM risk but the burden in younger and less severe obesity cohorts cannot be underestimated.
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Affiliation(s)
- Valerie O'Hara
- Eastern Maine Medical Center, Cutler Health Center, Orono, ME, USA
| | - Nancy Browne
- Eastern Maine Medical Center, Cutler Health Center, Orono, ME, USA
| | - Samreen Fathima
- Eastern Maine Medical Center, Clinical Research Center, Bangor, ME, USA
| | - Barbara Sorondo
- Eastern Maine Medical Center, Clinical Research Center, Bangor, ME, USA
| | - Janet Bayleran
- Eastern Maine Medical Center, Clinical Research Center, Bangor, ME, USA
| | - Starr Johnston
- Eastern Maine Medical Center, Cutler Health Center, Orono, ME, USA
| | - Kathrin Hastey
- Eastern Maine Medical Center, Cutler Health Center, Orono, ME, USA
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192
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Alonso-Álvarez ML, Terán-Santos J, Gonzalez Martinez M, Cordero-Guevara JA, Jurado-Luque MJ, Corral-Peñafiel J, Duran-Cantolla J, Ordax Carbajo E, MasaJimenez F, Kheirandish-Gozal L, Gozal D. Metabolic biomarkers in community obese children: effect of obstructive sleep apnea and its treatment. Sleep Med 2017; 37:1-9. [DOI: 10.1016/j.sleep.2017.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 06/05/2017] [Accepted: 06/05/2017] [Indexed: 11/29/2022]
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193
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194
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Kresovich JK, Zheng Y, Cardenas A, Joyce BT, Rifas-Shiman SL, Oken E, Gillman MW, Hivert MF, Baccarelli AA, Hou L. Cord blood DNA methylation and adiposity measures in early and mid-childhood. Clin Epigenetics 2017; 9:86. [PMID: 28814982 PMCID: PMC5558655 DOI: 10.1186/s13148-017-0384-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 08/07/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Excess adiposity in childhood is associated with numerous adverse health outcomes. As this condition is difficult to treat once present, identification of risk early in life can help inform and implement strategies to prevent the onset of the condition. We performed an epigenome-wide association study to prospectively investigate the relationship between cord blood DNA methylation and adiposity measurements in childhood. METHODS We measured genome-wide DNA methylation from 478 children in cord blood and measured overall and central adiposity via skinfold caliper measurements in early (range 3.1-3.3 years) and mid-childhood (age range 7.3-8.3 years) and via dual X-ray absorptiometry (DXA) in mid-childhood. Final models were adjusted for maternal age at enrollment, pre-pregnancy body mass index, education, folate intake during pregnancy, smoking during pregnancy, and gestational weight gain, and child sex, race/ethnicity, current age, and cord blood cell composition. RESULTS We identified four promoter proximal CpG sites that were associated with adiposity as measured by subscapular (SS) and triceps (TR) ratio (SS:TR) in early childhood, in the genes KPRP, SCL9A10, MYLK2, and PRLHR. We additionally identified one gene body CpG site associated with early childhood SS + TR on PPAPDC1A; this site was nominally associated with SS + TR in mid-childhood. Higher methylation at one promoter proximal CpG site in MMP25 was also associated with SS:TR in mid-childhood. In regional analyses, methylation at an exonal region of GFPT2 was positively associated with SS:TR in early childhood. Finally, we identified regions of two long, non-coding RNAs which were associated with SS:TR (LOC100049716) and fat-free mass index (LOC102723493) in mid-childhood. CONCLUSION This analysis identified novel CpG loci associated with adiposity outcomes. However, our results suggest little consistency across the various adiposity outcomes tested, particularly among the more accurate DXA measurements of body composition. We recommend using caution when interpreting these associations.
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Affiliation(s)
- Jacob K. Kresovich
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL USA
- Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University, Chicago, IL USA
| | - Yinan Zheng
- Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University, Chicago, IL USA
| | - Andres Cardenas
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA USA
| | - Brian T. Joyce
- Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University, Chicago, IL USA
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA USA
| | - Matthew W. Gillman
- Environmental Influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, Bethesda, MD USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA USA
| | - Andrea A. Baccarelli
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Lifang Hou
- Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University, Chicago, IL USA
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195
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Wheelock KM, Fufaa GD, Nelson RG, Hanson RL, Knowler WC, Sinha M. Cardiometabolic risk profile based on body mass index in American Indian children and adolescents. Pediatr Obes 2017; 12:295-303. [PMID: 27170264 DOI: 10.1111/ijpo.12142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 03/23/2016] [Accepted: 03/25/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Childhood obesity is associated with increased cardiometabolic risk. OBJECTIVE To study the relationship between body mass index (BMI) and cardiometabolic risk factors in American Indian children and adolescents. METHODS Differences in metabolic variables by age and sex-specific BMI percentiles (2000 Centers for Disease Control and Prevention Growth Charts) were examined in a cross-sectional analysis of 2977 individuals across three age categories. Children with an exam in two consecutive age categories were included in a longitudinal analysis. Spearman's correlations were used to test the association of BMI percentile with anthropometric and biochemical variables. RESULTS Body mass index percentile correlated with systolic (r = 0.24 to 0.38) and diastolic (r = 0.13 to 0.22) blood pressure, fasting plasma glucose (r = 0.20 to 0.33), 2-h plasma glucose (r = 0.30 to 0.46), total cholesterol (r = 0.12 to 0.23), serum triglycerides (r = 0.40 to 0.51) and HDL cholesterol (r = -0.36 to -0.43) in each age group (5-9, 10-13 and 14-17 years). Among participants examined in multiple age categories, BMI percentile increased over time. Change in BMI percentile from one age category to the next was associated with an increase in fasting glucose, 2-h glucose and triglycerides and a decrease in HDL cholesterol. CONCLUSION Higher BMI was associated with blood pressure elevation, hyperglycaemia and dyslipidaemia in American Indian children and adolescents.
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Affiliation(s)
- K M Wheelock
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - G D Fufaa
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - R G Nelson
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - R L Hanson
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - W C Knowler
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - M Sinha
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
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196
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Larsen KT, Huang T, Møller NC, Andersen LB, Sørensen J. Cost-effectiveness of a day-camp weight-loss intervention programme for children: Results based on a randomised controlled trial with one-year follow-up. Scand J Public Health 2017; 45:666-674. [PMID: 28758542 DOI: 10.1177/1403494816688374] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aim was to analyse the cost-effectiveness of an intensive weight-loss intervention for children compared with a low-intensity intervention. METHODS One hundred and fifteen overweight children (mean age 12.0 ± 0.4) were randomised to either the camp group (CG) ( N=59) or the standard group (SG) ( N=56). Participants in the CG were offered a six-week day-camp weight-loss programme followed by a family-based supportive programme containing four meetings during the succeeding 46 weeks. Participants in the SG were offered a weekly two-hour exercise session for six weeks. Changes in body mass index (BMI) and BMI z-score 12 months after inclusion were used to compare the effects of the two interventions. Incremental cost-effectiveness ratios (ICER) were estimated from the perspective of a Danish municipality. To achieve the required number of participants, an additional intervention was initiated one year later. RESULTS In comparison with the SG, the CG changed their mean BMI by -1.2 (95% CI -1.8 to -0.5). Compared with the SG children, the CG children changed their BMI z-score by -0.20 (95% CI -0.35 to -0.05). The ICER per decreased BMI point in the CG compared with the SG was DDK 24,928. CONCLUSIONS Compared with the SG, the CG showed favourable effects after 12 months. However, the CG was more costly. The results observed in the present study may be helpful in guiding decision makers to take more informed decisions when choosing different types of intervention.
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Affiliation(s)
- Kristian Traberg Larsen
- 1 Centre of Research in Childhood Health (RICH), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Tao Huang
- 2 Department of Physical Education, Shanghai Jiao Tong University, China
| | - Niels Christian Møller
- 1 Centre of Research in Childhood Health (RICH), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Lars Bo Andersen
- 3 Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jan Sørensen
- 4 Center for Health Economic Research (COHERE), Department of Public Health, University of Southern Denmark, Denmark
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197
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Pastor-Villaescusa B, Cañete MD, Caballero-Villarraso J, Hoyos R, Latorre M, Vázquez-Cobela R, Plaza-Díaz J, Maldonado J, Bueno G, Leis R, Gil Á, Cañete R, Aguilera CM. Metformin for Obesity in Prepubertal and Pubertal Children: A Randomized Controlled Trial. Pediatrics 2017; 140:peds.2016-4285. [PMID: 28759403 DOI: 10.1542/peds.2016-4285] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Metformin has shown its effectiveness in treating obesity in adults. However, little research has been conducted in children, with a lack of attention on pubertal status. The objectives were to determine whether oral metformin treatment reduces BMI z score, cardiovascular risk, and inflammation biomarkers in children who are obese depending on pubertal stage and sex. METHODS This was a randomized, prospective, double-blind, placebo-controlled, multicenter trial, stratified according to pubertal stage and sex, conducted at 4 Spanish clinical hospitals. Eighty prepubertal and 80 pubertal nondiabetic children who were obese aged 7 to 14 years with a BMI >95th percentiles were recruited. The intervention included 1 g/d of metformin versus placebo for 6 months. The primary outcome was a reduction in BMI z score. Secondary outcomes comprised insulin resistance, cardiovascular risk, and inflammation biomarkers. RESULTS A total of 140 children completed the study (72 boys). Metformin decreased the BMI z score versus placebo in the prepubertal group (-0.8 and -0.6, respectively; difference, 0.2; P = .04). Significant increments were observed in prepubertal children treated with metformin versus placebo recipients in the quantitative insulin sensitivity check index (0.010 and -0.007; difference, 0.017; P = .01) and the adiponectin-leptin ratio (0.96 and 0.15; difference, 0.81; P = .01) and declines in interferon-γ (-5.6 and 0; difference, 5.6; P = .02) and total plasminogen activator inhibitor-1 (-1.7 and 2.4; difference, 4.1; P = .04). No serious adverse effects were reported. CONCLUSIONS “Metformin decreased the BMI z score and improved inflammatory and cardiovascular-related obesity parameters only in prepubertal children, but a differential effect of metformin was not observed in prepubertal compared to pubertal children. Nevertheless, the doses per kilogram of weight administrated may have had an impact on the metformin effect. Further investigations are necessary.”
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Affiliation(s)
- Belén Pastor-Villaescusa
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Center for Biomedical Research, University of Granada, Granada. Spain.,CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
| | - M Dolores Cañete
- PAIDI CTS-329, Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain
| | | | | | - Miriam Latorre
- Health Sciences Institute in Aragon, Zaragoza, Spain.,Pediatric Department, Lozano Blesa University Clinical Hospital, University of Zaragoza, Zaragoza, Spain
| | - Rocío Vázquez-Cobela
- Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Pediatric Department, Clinic University Hospital of Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Julio Plaza-Díaz
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Center for Biomedical Research, University of Granada, Granada. Spain.,CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
| | - José Maldonado
- Pediatric Gastroenterology and Nutrition Unit, Virgen de las Nieves University Hospital, Andalusian Health Service, Granada, Spain
| | - Gloria Bueno
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain.,Pediatric Department, Lozano Blesa University Clinical Hospital, University of Zaragoza, Zaragoza, Spain
| | - Rosaura Leis
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain.,Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Pediatric Department, Clinic University Hospital of Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Center for Biomedical Research, University of Granada, Granada. Spain.,CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; and
| | - Ramón Cañete
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain.,Unit of Pediatric Endocrinology, Reina Sofia University Hospital, Córdoba, Spain
| | - Concepción M Aguilera
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Center for Biomedical Research, University of Granada, Granada. Spain; .,CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; and
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198
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Teixeira FC, Pereira FEF, Pereira AF, Ribeiro BG. Metabolic syndrome's risk factors and its association with nutritional status in schoolchildren. Prev Med Rep 2017; 6:27-32. [PMID: 28239539 PMCID: PMC5318537 DOI: 10.1016/j.pmedr.2017.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/22/2017] [Accepted: 02/06/2017] [Indexed: 11/15/2022] Open
Abstract
The metabolic risk factors (RF) to the diagnosis of metabolic syndrome (MetS) have been evidenced at early ages, including children. The aim of the present study was to identify the prevalence of RF to the diagnosis of MetS and its association with nutritional status of schoolchildren from 6 to 10 years old. A cross-sectional study was carried out in 505 students of municipal schools in Macae, Brazil, conducted from 2013 to 2014. The RF evaluated were: blood pressure (mm Hg), triglycerides (mmol/L), HDL-cholesterol (mmol/L) fasting glucose (mmol/L) and waist circumference (cm). At least one RF was present in 61% (n = 308) of the sample. By nutritional status, there was higher prevalence of RF in overweight/obese schoolchildren compared to those with normal weight, except in the concentration of HDL-c. The prevalence of one, two and three RF (MetS) were 34.7% (n = 175), 21.0% (n = 106) and 5.3% (n = 27), respectively. Two RF were more present in overweight (28.2% 95%CI 19.0; 39.0) and obese (41.5% 95%CI 31.4; 52.1) compared to normal weight children (13.5% 95%CI 9.9; 17.8). Three or more RF were more frequent among obese (25.5% 95%CI 17.0; 35.5) in relation to overweight (2.4% 95%CI 0.2; 8.2) and normal weight children (0.3% 95%CI 0; 1.7). The data indicate high prevalence of RF and its relationship with the magnitude of body weight excess. Therefore, the identification and early treatment of these RF might minimize the risk of MetS and related diseases.
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Key Words
- 95%CI, 95% confidence interval
- Abdominal obesity
- BMI, body mass index
- BP, blood pressure
- CVD, cardiovascular disease
- Children
- DBP, diastolic blood pressure
- DM2, type 2 diabetes mellitus
- Dyslipidemia
- HAS, hypertension
- HDL-c, high density lipoprotein cholesterol concentration
- Hypertension
- IR, insulin resistance
- MetS, metabolic syndrome
- Metabolic syndrome
- RF, metabolic risk factors
- SBP, systolic blood pressure
- TG, triglycerides
- WC, waist circumference
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Affiliation(s)
- Fabiana Costa Teixeira
- Programa Pós Graduação em Nutrição, Instituto de Nutrição UFRJ, Laboratório Integrado de Pesquisa em Ciências do Esporte, UFRJ Campus Macaé, RJ,Brazil
| | - Flavia Erika Felix Pereira
- Programa Pós Graduação em Alimentação, Nutrição e Saúde, Universidade do Estado do Rio de Janeiro UERJ, RJ, Laboratório Integrado de Pesquisa em Ciências do Esporte, UFRJ Campus Macaé, RJ,Brazil
| | | | - Beatriz Gonçalves Ribeiro
- Prof. Curso de Nutrição, Laboratório Integrado de Pesquisa em Ciências do Esporte, UFRJ Campus Macaé, RJ, Brazil
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Amini Z, Kotagal S, Lohse C, Lloyd R, Sriram S, Kumar S. Effect of Obstructive Sleep Apnea Treatment on Lipids in Obese Children. CHILDREN (BASEL, SWITZERLAND) 2017; 4:E44. [PMID: 28587180 PMCID: PMC5483619 DOI: 10.3390/children4060044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 03/21/2017] [Accepted: 03/27/2017] [Indexed: 11/16/2022]
Abstract
Obesity in children is associated with several co-morbidities including dyslipidemia. Obstructive sleep apnea (OSA) is commonly seen in obese children. In adults, diagnosis of OSA independent of obesity is associated with cardiometabolic risk factors including dyslipidemia. There is limited data on the impact of treatment of OSA on lipids in children. The objective of the study was to examine the impact of treatment of OSA on lipids in 24 obese children. Methods: Seventeen children were treated with continuous positive airway pressure (CPAP) and five underwent adenotonsillectomy. Mean apnea hypopnea index prior to treatment was 13.0 + 12.1 and mean body mass index (BMI) was 38.0 + 10.6 kg/m². Results: Treatment of OSA was associated with improvement in total cholesterol (mean change = -11 mg/dL, p < 0.001), and low-density lipoprotein cholesterol (mean change = -8.8 mg/dL, p = 0.021). Conclusion: Obese children should be routinely screened for OSA, as treatment of OSA favorably influences lipids and therefore decreases their cardiovascular risk.
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Affiliation(s)
- Zarlasht Amini
- Department of Endocrinology, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada.
| | - Suresh Kotagal
- Division of Sleep Medicine; Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | - Christine Lohse
- Division of Biomedical Statistics and Informatics; Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | - Robin Lloyd
- Division of Sleep Medicine; Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | - Swetha Sriram
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | - Seema Kumar
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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Abood S, Eichelbaum S, Mustafi S, Veisaga ML, López LA, Barbieri M. Biomedical Properties and Origins of Sesquiterpene Lactones, with a Focus on Dehydroleucodine. Nat Prod Commun 2017. [DOI: 10.1177/1934578x1701200638] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dehydroleucodine, a sesquiterpene lactone, belongs to the terpenoid class of secondary metabolites. Dehydroleucodine and other Artemisia-derived phytochemicals evolved numerous biodefenses that were first co-opted for human pharmacological use by traditional cultures in the Middle East, Asia, Europe and the Americas. Later, these phytochemicals were modified through the use of medicinal chemical techniques to increase their potency. All sesquiterpene lactones contain an α-methylene-γ-lactone group, which confers thiol reactivity, which is responsible, in part, for their therapeutic effects. A wide range of therapeutic uses of sequiterpene lactones has been found, including anti-adipogenic, cytoprotective, anti-microbial, anti-viral, anti-fungal, anti-malarial and, anti-migraine effects. Dehydroleucodine significantly inhibits differentiation of murine preadipocytes and also significantly decreases the accumulation of lipid content by a dramatic down regulation of adipogenic-specific transcriptional factors PPARγ and C-EBPα. Dehydroleucodine also inhibits secretion of matrix metalloprotease-2 (MMP-2), which is a known protease involved in migration and invasion of B16 cells. In addition to these anti-adipogenic and anti-cancer effects, dehydroleucodine effectively neutralizes several bacterial species, including Bacillus cereus, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Helicobacter pylori, methicillin resistant Staphylococcus aueus (MRSA) and S. epidermis (MRSE). The compound also inhibits the growth and secretion of several toxins of Pseudomonas aeruginosa, possesses gastro-protective qualities and possesses anti-parasitic properties against Trypanosoma cruzi, responsible for Chagas disease. Other sesquiterpene lactones, such as parthenolide, costunolide, and helanin, also possess significant therapeutic utility.
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Affiliation(s)
- Steven Abood
- Department of Biological Sciences; Florida International University, Miami, FL 33199, USA
| | - Steven Eichelbaum
- Department of Biological Sciences; Florida International University, Miami, FL 33199, USA
| | - Sushmita Mustafi
- Department of Biological Sciences; Florida International University, Miami, FL 33199, USA
| | - Maria-Luisa Veisaga
- Biomolecular Sciences Institute; Florida International University, Miami, FL 33199, USA
| | - Luis A. López
- Laboratory of Cytoskeleton and Cell Cycle, Institute of Histology and Embryology, Faculty of Medicine, National University of Cuyo, 5500 Mendoza, Argentina
| | - Manuel Barbieri
- Department of Biological Sciences; Florida International University, Miami, FL 33199, USA
- Biomolecular Sciences Institute; Florida International University, Miami, FL 33199, USA
- Fairchild Tropical Botanic Garden, 10901 Old Cutler Road, Coral Gables, FL 33156, USA
- International Center of Tropical Botany, Florida International University, Miami, FL 33199, USA
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