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Freedman DS, Zemel BS, Dietz WH, Daymont C. Screening Accuracy of BMI for Adiposity Among 8- to 19-Year-Olds. Pediatrics 2024; 154:e2024065960. [PMID: 38828485 PMCID: PMC11211694 DOI: 10.1542/peds.2024-065960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Although the limitations of BMI have long been recognized, there are recent concerns that it is not a good screening tool for adiposity. We therefore examined the cross-sectional relation of BMI to adiposity among 6923 8- to 19-year-olds in the National Health and Nutrition Survey from 2011 through 2018. METHODS Participants were scanned with dual-energy x-ray absorptiometry. Adiposity was expressed as fat mass index (FMI, fat mass kg ÷ m2) and percentage of body fat (%fat). Lean mass was expressed as lean mass index (LMI, lean mass ÷ m2). Regression models and 2 × 2 tables were used to assess the relation of BMI to FMI, %fat, and LMI. RESULTS Age and BMI accounted (R2) for 90% to 94% of the variability of FMI and LMI in each sex. Associations with %fat were weaker (R2s ∼0.70). We also examined the screening abilities of a BMI ≥ Centers for Disease Control and Prevention 95th percentile for high levels of adiposity and LMI. Cut points were chosen so that prevalences of high values of these variables would be similar to that for high BMI. Of participants with a high BMI, 88% had a high FMI, and 76% had a high %fat. Participants with a high BMI were 29 times more likely to have a high FMI than those with lower BMIs; comparable relative risks were 12 for high %fat and 14 for high LMI. CONCLUSIONS Despite its limitations, a high BMI is a very good screening tool for identifying children and adolescents with elevated adiposity.
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Affiliation(s)
- David S. Freedman
- Retired from the Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Babette S. Zemel
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - William H. Dietz
- Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Carrie Daymont
- Departments of Pediatrics and Public Health Science, Penn State College of Medicine, Hershey, Pennsylvania
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El Kari K, Mankai A, El Kouki D, Mehdad S, Benjeddou K, El Hsaini H, El Mzibri M, Aguenaou H. Anthropometry-Based Prediction Equation of Body Composition in a Population Aged 12-88 Years. J Nutr 2023; 153:657-664. [PMID: 36931748 DOI: 10.1016/j.tjnut.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Direct anthropometric measurements to assess body composition have limited precision and/or specificity. OBJECTIVES The study aimed to develop a prediction equation based on anthropometric measurements for estimating total body water (TBW) in a healthy population. METHODS TBW was assessed using the deuterium dilution method in 398 Moroccan participants (235 women and 163 men) aged 11.6-88 y, then compared to the estimations made by previously published anthropometric equations. By sex, participants were randomly assigned into development (n = 199) and validation subgroups (n = 199). A new anthropometric equation was developed in the development subgroup from data obtained on body volume (BV), weight, and sex, where the BV was calculated from participants' height. Then the equation was validated in the validation subgroup using the Bland and Altman procedure, bias, and pure error. External validation was performed using a sample from Tunisia (n = 220, 51.8% female, 18-65 y). RESULTS Bias in predicting TBW showed unacceptable value for all previously published equations as it was significantly overestimated. The following new equation using anthropometric measurements [TBW (kg) = -5.249 + 107.502 BV (L) + 0.289 weight (kg) + 2.015 sex (male: 1, female: 0); (R2 = 0.91, RMSE = 1.885 kg)] was developed, and its internal validation was confirmed. The generated bias and pure error values were 0.047 kg (95% CI: -0.235, 0.330) and 2.02 kg (95% CI: 1.73, 2.31), respectively. The external validation of the new TBW prediction equation on a Tunisian sample showed a bias and pure error values of 0.07 kg (95% CI: -0.289, 0.429) and 2.36 kg, respectively. CONCLUSIONS The results indicate that the new anthropometric-based prediction equation provides a good estimation of TBW and other body composition compartments. It could be recommended as an alternative method to assess body composition for epidemiological and clinical studies.
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Affiliation(s)
- Khalid El Kari
- RDC-Nutrition, Ibn Tofaïl University, Centre National de l'Énergie, des Sciences et Techniques Nucléaires, Kenitra, Morocco.
| | - Amani Mankai
- Institut National de Nutrition et Technologie alimentaire de Tunis, Tunis, Tunisia
| | - Donia El Kouki
- Institut National de Nutrition et Technologie alimentaire de Tunis, Tunis, Tunisia
| | - Slimane Mehdad
- RDC-Nutrition, Ibn Tofaïl University, Centre National de l'Énergie, des Sciences et Techniques Nucléaires, Kenitra, Morocco; Institut National de Nutrition et Technologie alimentaire de Tunis, Tunis, Tunisia; Physiology and Physiopathology Research Team, Research Centre of Human Pathologies Genomics, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Kaoutar Benjeddou
- RDC-Nutrition, Ibn Tofaïl University, Centre National de l'Énergie, des Sciences et Techniques Nucléaires, Kenitra, Morocco
| | - Houda El Hsaini
- RDC-Nutrition, Ibn Tofaïl University, Centre National de l'Énergie, des Sciences et Techniques Nucléaires, Kenitra, Morocco; Institut National de Nutrition et Technologie alimentaire de Tunis, Tunis, Tunisia; Physiology and Physiopathology Research Team, Research Centre of Human Pathologies Genomics, Faculty of Sciences, Mohammed V University, Rabat, Morocco; College of Health Sciences, International University of Rabat, Salé, Morocco
| | - Mohammed El Mzibri
- RDC-Nutrition, Ibn Tofaïl University, Centre National de l'Énergie, des Sciences et Techniques Nucléaires, Kenitra, Morocco
| | - Hassan Aguenaou
- RDC-Nutrition, Ibn Tofaïl University, Centre National de l'Énergie, des Sciences et Techniques Nucléaires, Kenitra, Morocco
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Cross‐cultural Adaptation, validity, and Reliability of the Turkish Version of Health Promoting Activities Scale. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1109780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Purpose: The Health Promoting Activities Scale (HPAS) is a short scale designed to question activities that may be beneficial for the mental and physical health of the mother and to evaluate mothers in this sense. The aim of the study was to cross-culturally adapt the Turkish version of the Health Promoting Activities Scale (HPAS-T) and to assess its reliability and validity.
Methods: Eighty mothers of disabled children who received physiotherapy in a rehabilitation center were recruited in the study. HPAS-T was administered to mothers twice, one-week apart. Internal consistency of HPAS-T was assessed with Cronbach's alpha coefficient. Additionally, test–retest reliability was analyzed using intra-class correlation coefficient. Exploratory factor analysis was conducted to evaluate the construct validity. Besides, known-group validity in terms of body mass index was conducted to reveal the discriminant capacity of the HPAS-T.
Results: The mean age of the mothers and their children was 37.46.3 years and 8.14.1 years, respectively. The internal consistency and reproducibility of the HPAS-T total score was excellent (α>0.80, ICC>0.80). SEM95 and MDC95 of the HPAS-T values were 0.58 and 1.61, respectively. HPAS-T, all items were loaded into a single component (0.470-0.833). According to the results of known-group validity model, the HPAS-T score of the mothers in the group whose children's body mass index was ≥18 was significantly lower (p
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Martin CB, Stierman B, Yanovski JA, Hales CM, Sarafrazi N, Ogden CL. Body fat differences among US youth aged 8-19 by race and Hispanic origin, 2011-2018. Pediatr Obes 2022; 17:e12898. [PMID: 35135038 PMCID: PMC9177747 DOI: 10.1111/ijpo.12898] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/17/2021] [Accepted: 01/11/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The association between body mass index (BMI) and adiposity differs by race/ethnicity. OBJECTIVE To examine differences in adiposity by race/Hispanic origin among US youth and explore how those differences relate to differences in BMI using the most recent national data, including non-Hispanic Asian youth. METHODS Weight, height and DXA-derived fat mass index (FMI) and percentage body fat (%BF) from 6923 youth 8-19 years in the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were examined. Age-adjusted mean BMI, FMI and %BF were reported. Sex-specific linear regression models predicting %BF and FMI were adjusted for age, BMI category and BMI category*race/Hispanic origin interaction. RESULTS %BF was highest among Hispanic males (28.2%) and females (35.7%). %BF was lower among non-Hispanic Black (23.9%) compared with non-Hispanic White (26.0%) and non-Hispanic Asian (26.6%) males. There was no difference between non-Hispanic Black females (32.7%) and non-Hispanic White (33.2%) or non-Hispanic Asian (32.7%) females. FMI was higher among Hispanic youth compared with non-Hispanic White youth. Among youth with underweight/healthy weight, predicted %BF and FMI were lower among non-Hispanic Black males (-2.8%; -0.5) and females (-2.0%; -0.3), compared with non-Hispanic White youth, and higher among Hispanic males (0.9%; 0.2) and females (2.0%; 0.5), while %BF but not FMI was higher among non-Hispanic Asian males (1.3%) and females (1.4%). Among females with obesity, non-Hispanic Asian females had lower %BF (-2.3%) and FMI (-1.7) than non-Hispanic White females. CONCLUSIONS Differences in %BF and FMI by race/Hispanic origin were not consistent by BMI category among US youth in 2011-2018.
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Affiliation(s)
- Crescent B. Martin
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC
| | - Bryan Stierman
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC; Epidemic Intelligence Service, CDC
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH
| | - Craig M. Hales
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC; United States Public Health Service
| | - Neda Sarafrazi
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC
| | - Cynthia L. Ogden
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC
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Divala OH, Mwakhwawa Q, Phiri MM, Owino V, El Kari K, Maleta KM. Development of bioelectrical impedance-based equations for the prediction of body composition of Malawian adolescents aged 10-18 years: a cross-sectional study. BMJ Open 2022; 12:e058551. [PMID: 35379640 PMCID: PMC8981360 DOI: 10.1136/bmjopen-2021-058551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES The accuracy of bioelectrical impedance analysis (BIA) depends on population-specific prediction equations and there is no population-specific equation for predicting fat-free mass (FFM) in Malawian adolescents. This study aimed at determining the agreement between FFM measured by deuterium oxide dilution technique (the reference) and FFM by BIA; and propose BIA-based prediction equations to estimate FFM for Malawian adolescents. DESIGN This was a cross-sectional study. SETTING The study was conducted in Blantyre, Malawi PARTICIPANTS: 186 Malawian adolescents aged between 10 and 18 years were included in this study. Body composition was estimated by both the BodyStat BIA analyser and the deuterium oxide dilution method. RESULTS BIA inbuilt equation underestimated FFM compared with deuterium oxide dilution (p=0.039). The new prediction equation for FFM (kg)=-4.316+ 0.425* height2(cm)/resistance (Ω)+1.287* sex (male=1, female=0)+0.307*age(years)+0.344* weight(kg)+0.019*reactance(Ω) yielded an R2 of 0.926. The equation for total body water (TBW) (kg)=-2.152 + 0.328*height2(cm)/resistance (Ω) 0.910*sex (male=1, female=0)+0.307 *age (years)+0.249*weight(kg)+0.015*reactance(Ω) yielded an R2 of 0.922. The Bland-Altman plot illustrated a good level of concordance between the FFM and TBW predicted by the new equations and the values derived using deuterium dilution method. CONCLUSIONS The new BIA prediction equations for estimating FFM and TBW could be used to assess with very good accuracy and precision the body composition of Malawian and adolescents with similar characteristics.
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Affiliation(s)
- Oscar Henry Divala
- Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Queen Mwakhwawa
- Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Madalitso Makawa Phiri
- Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Victor Owino
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Khalid El Kari
- Nutrition and Food Unit, DSV, DERS, National Center for Energy Sciences and Nuclear Techniques, Rabat, Morocco
| | - Kenneth Mphatso Maleta
- Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
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Martinez-Martinez MU, Vázquez-Maldonado D, Ratering S, Godínez-Hernández C, Ortiz-Basurto RI, Soria-Guerra RE, Schneider B, Juárez-Flores BI, Portales-Pérez DP, Schnell S, Martinez-Gutierrez F. Fructans from Agave enhance probiotic yoghurt by modulating gut microbiota on children with overweight or obesity. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2021.101516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Jiménez-García E, Murillo-Escobar MÁ, Fontecha-Diezma J, López-Gutiérrez RM, Cardoza-Avendaño L. Telehealth Secure Solution to Provide Childhood Obesity Monitoring. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22031213. [PMID: 35161955 PMCID: PMC8840740 DOI: 10.3390/s22031213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/25/2022] [Accepted: 02/02/2022] [Indexed: 05/17/2023]
Abstract
Childhood obesity causes not only medical and psychosocial problems, it also reduces the life expectancy of the adults that they will become. On a large scale, obese adults adversely affect labor markets and the gross domestic product of countries. Monitoring the growth charts of children helps to maintain their body weight within healthy parameters according to the World Health Organization. Modern technologies allow the use of telehealth to carry out weight control programs and monitoring to verify children's compliance with the daily recommendations for risk factors that can be promoters of obesity, such as insufficient physical activity and insufficient sleep hours. In this work, we propose a secure remote monitoring and supervision scheme of physical activity and sleep hours for the children based on telehealth, multi-user networks, chaotic encryption, and spread spectrum, which, to our knowledge, is the first attempt to consider this service for safe pediatric telemedicine. In experimental results, we adapted a recent encryption algorithm in the literature for the proposed monitoring scheme using the assessment of childhood obesity as an application case in a multi-user network to securely send and receive fictitious parameters on childhood obesity of five users through the Internet by using just one communication channel. The results show that all the monitored parameters can be transmitted securely, achieving high sensitivity against secret key, enough secret key space, high resistance against noise interference, and 4.99 Mb/sec in computational simulations. The proposed scheme can be used to monitor childhood obesity in secure telehealth application.
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Affiliation(s)
- Elitania Jiménez-García
- Engineering, Architecture and Design Faculty, Autonomous University of Baja California (UABC), Ensenada 22860, Baja California, Mexico; (E.J.-G.); (M.Á.M.-E.); (L.C.-A.)
| | - Miguel Ángel Murillo-Escobar
- Engineering, Architecture and Design Faculty, Autonomous University of Baja California (UABC), Ensenada 22860, Baja California, Mexico; (E.J.-G.); (M.Á.M.-E.); (L.C.-A.)
| | - Jesús Fontecha-Diezma
- Department of Information Systems and Technologies, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Rosa Martha López-Gutiérrez
- Engineering, Architecture and Design Faculty, Autonomous University of Baja California (UABC), Ensenada 22860, Baja California, Mexico; (E.J.-G.); (M.Á.M.-E.); (L.C.-A.)
- Correspondence: ; Tel.: +52-(646)175-07-44
| | - Liliana Cardoza-Avendaño
- Engineering, Architecture and Design Faculty, Autonomous University of Baja California (UABC), Ensenada 22860, Baja California, Mexico; (E.J.-G.); (M.Á.M.-E.); (L.C.-A.)
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Children’s Changes in Perceptions and Body Composition Following a Family-Based Fitness Intervention. JOURNAL OF MOTOR LEARNING AND DEVELOPMENT 2021. [DOI: 10.1123/jmld.2020-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Physical fitness is associated with decreased weight in children, which helps improve youth obesity rates. Family programs can provide practical approaches to improving physical fitness for children. The purpose of this study was to assess the influence of a family-based fitness intervention on changes in body composition, fitness status, and perceptions of obese children. Families attended exercise and education sessions for 60–90 min once per week for 10 weeks. Participants consisted of 10 children who participated in semi-structured interviews, body composition, and fitness assessments at pre- and posttest. Following the intervention, results showed that children had a significant increase in sit-ups (p = .03, effect size = 0.79), lean mass (p < .001, Cohen’s d = 1.95), and bone mineral content (p < .001, Cohen’s d = 0.46). Using thematic analysis, four main themes emerged from the pre- and postintervention interviews: an increase in after-school and weekend intentional physical fitness, rules regarding sedentary behavior and screen time, more prevalent physical fitness reinforcements, and a shift in perception of exercise. Results from this study indicate a family-based intervention had an influence on children’s appreciation for and engagement in physical fitness, as well as healthy body composition and fitness outcomes.
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Reference values of fat mass index and fat-free mass index in healthy Spanish adolescents. NUTR HOSP 2021; 37:902-908. [PMID: 32960624 DOI: 10.20960/nh.03161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: body mass index (BMI) does not allow to discriminate the composition of the different body compartments. The aim of this study was to develop reference values for the fat mass index (FMI) and fat-free mass index (FFMI) in healthy adolescents using anthropometric techniques in order to provide reference standards for daily clinical practice. Methods: a cross-sectional study in 1,040 healthy Caucasian adolescents (470 boys and 570 girls) aged 10.1 to 14.9 years. Weight, height, and skinfold thickness were recorded, and BMI, percentage of total body fat, FMI and FFMI, and FMI and FFMI percentiles were calculated. Results: FFMI and FMI percentiles for healthy adolescents (both sexes) categorized by age are displayed. In boys a significant increase in FFMI is observed, and both the percentage of total body fat and FMI significantly decreased. In contrast, in girls the percentage of body fat mass, FMI, and FFMI significantly increased. Except at 10 years of age, FMI was higher (p < 0.05) in girls at all ages. FFMI was higher (p < 0.05) in boys at all ages. Conclusions: reference values of FMI and FFMI would be a very useful instrument in clinical practice for the diagnosis and, especially, the analysis of body composition changes during the treatment of childhood obesity.
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Uric acid reference values: report on 1750 healthy Brazilian children and adolescents. Pediatr Res 2021; 89:1855-1860. [PMID: 33036016 DOI: 10.1038/s41390-020-01185-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/04/2020] [Accepted: 09/22/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Our purpose was to determine reference values and determinants of serum uric acid (SUA) in children and adolescents. METHODS A fasting blood sample was collected from 1750 schoolchildren and adolescents (6-17 years). Puberty was defined according to the Tanner scale. Bodyweight, muscle mass, and body fat percentage were determined by bioimpedance. Data are given as cut-offs and mean ± standard deviation. RESULTS SUA level was higher in children that had already entered puberty (4.2 ± 1.1 mg/dL) than among prepubescent (3.6 ± 0.8 mg/dL; p < 0.01). Considering the 90 percentile (p90) as the upper reference value, the following values are proposed for boys and girls, respectively: <10 years or prepubescent: ≤4.5 mg/dL and ≤4.8 mg/dL; from 10 to 13 years: ≤5.7 mg/dL and ≤5.2 mg/dL; from 14 to 17 years: ≤6.4 mg/dL and ≤5.3 mg/dL. Muscle mass explained part of the variability in SUA after pubescence, acting as an independent variable for higher levels of SUA. CONCLUSIONS The sex, age, and phase of puberty influence SUA reference levels, and part of this influence could be explained by the higher muscle mass, mainly after the adolescence onset. IMPACT The key message of this study is that high levels of uric acid in the blood are associated with metabolic syndrome and cardiovascular risk factors. These diseases should be prevented since the infancy However, it is necessary to establish reference values of uric acid (SUA) for children and adolescents. The Brazilian population is highly admixed and these values were not determined so far. We studied a robust sample of Brazilian schoolchildren and adolescents (6-17 years) and defined the 90th percentile of uric acid as the upper limit of normality for sex, age, and pubertal stage. These values can be used as a reference for other populations with similar characteristics.
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Kelley GA, Kelley KS, Pate RR. How Many US Children and Adolescents with Overweight and Obesity Could Improve Their Percent Body Fat by Exercising?: Meta-Analytic Based Estimates. Child Obes 2021; 17:144-150. [PMID: 33544030 DOI: 10.1089/chi.2020.0245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Provide national estimates of the number of US children and adolescents with overweight and obesity who could improve their percent body fat by exercising. Methods: Data were derived from (1) a previous meta-analysis, (2) 2015-2016 prevalence data from the National Health and Nutrition Examination Survey (NHANES), and (3) 2017 US Census population data. Multiplicative calculations were based on (1) number-needed-to treat data from a previous meta-analysis of the number of children with overweight and obesity who could reduce their percent body fat by participating in either aerobic, strength, or combined aerobic and strength training, (2) 2015-2016 NHANES data on the prevalence of children and adolescents with overweight or obesity, and (3) 2017 US Census population data on children and adolescents 2-19 years of age. Results: For both children and adolescents with overweight or obesity, the number who could improve their percent body fat was estimated at 4,388,273 [95% confidence interval (CI) 3,831,523-4,845,023] for either aerobic or strength exercise and 6,507,410 (95% CI 5,744,285-7,267,534) for combined aerobic and strength exercise. Conclusions: A large number of US children and adolescents with overweight and obesity could improve their percent body fat by exercising.
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Russell R Pate
- Children's Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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Moulin-Mares SRA, Oliosa PR, Faria ER, Zago-Gomes MP, Mill JG. Association of uric acid with cardiovascular risk in Brazilian children and adolescents. Nutr Metab Cardiovasc Dis 2021; 31:314-321. [PMID: 33223404 DOI: 10.1016/j.numecd.2020.09.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 08/28/2020] [Accepted: 09/11/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM Hyperuricemia in adults is associated with cardiovascular risk factors. However, there is less data regarding this association in children and adolescents. Our purpose was to determine association between serum uric acid (SUA) and cardiovascular risk. METHODS AND RESULTS A fasting blood sample was collected from 1750 participants aged 6-17 years enrolled in a social project and public schools in Espírito Santo, Brazil. Internal cut-offs were generated to define high SUA (≥90th percentile of SUA concentration for sex and age group). Body mass index percentile (pBMI), body fat percentage (BFP) and muscle mass were determined by bioimpedance. Data are given as mean ± standard deviation. High SUA was associated with overweight/obesity (OR 3.7 CI 95% 2.7-5.0), high waist circumference (WC) (OR 3.9 CI 95% 2.9-5.4), low HDL (OR 2.0 CI 95% 1.5-2.8), high blood pressure (BP) (OR 1.8 CI 95% 1.1-3.2), high BFP (OR 4.1 CI 95% 2.7-6.4), metabolic syndrome (MetS) (OR 3.6 CI 95% 1.8-7.1) and insulin resistance (OR 1.7 CI 95% 1.1-2.7). Individuals in the fourth quartile of SUA, compared to those in the first quartile, showed higher age, pBMI, WC, BFP and muscle mass. Using a reference value of 5.5 mg/dL, the prevalence of hyperuricemia in the sample was 10.3% (CI 95% 8.9-11.7%). CONCLUSION Higher SUA values are associated with higher cardiovascular risk in childhood and adolescence. The main cardiovascular risk factors associated with hyperuricemia were overweight/obesity, high WC, dyslipidemia, high BFP, high BP, insulin resistance and MetS.
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Affiliation(s)
| | - Polyana R Oliosa
- Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Eliane R Faria
- Department of Nutrition, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Maria P Zago-Gomes
- Department of Medicine, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil
| | - José G Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil; Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, ES, Brazil
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Tran D, D'Ambrosio P, Verrall CE, Attard C, Briody J, D'Souza M, Fiatarone Singh M, Ayer J, d'Udekem Y, Twigg S, Davis GM, Celermajer DS, Cordina R. Body Composition in Young Adults Living With a Fontan Circulation: The Myopenic Profile. J Am Heart Assoc 2020; 9:e015639. [PMID: 32290749 PMCID: PMC7428525 DOI: 10.1161/jaha.119.015639] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background We sought to characterize body composition abnormalities in young patients living with a Fontan circulation and explore potential pathophysiologic associations. Methods and Results Twenty‐eight patients with a Fontan circulation were prospectively recruited in this cross‐sectional study. Participants underwent cardiopulmonary exercise testing, dual‐energy X‐ray absorptiometry, echocardiography, and biochemical assessment. Mean age was 26±7 years. Skeletal muscle mass, estimated by appendicular lean mass index Z score, was reduced compared with reference data (−1.49±1.10, P<0.001). Percentage body fat Z score overall was within normal range (0.23±1.26, P=0.35), although 46% had elevated adiposity. Those with reduced skeletal muscle mass (appendicular lean mass index Z score of −1 or lower) had lower percent predicted oxygen pulse (55±15 versus 76±16%, P=0.002). Overall agreement between body mass index and dual‐energy X‐ray absorptiometry to assess adiposity was fair only (weighted [linear] κ coefficient: 0.53; 95% CI, 0.34–0.73) and slight in the setting of muscle mass deficiency (weighted κ coefficient: 0.32; 95% CI, 0.13–0.50). Appendicular lean mass was independently associated with absolute peak VO2 (β=70.6 mL/min, P=0.001). Appendicular lean mass index Z score was inversely associated with hemoglobin (r=−0.4, P=0.04), and the degree of muscle deficit was associated with ventricular systolic impairment. Conclusions Young patients with a Fontan circulation have a body composition characterized by reduced skeletal muscle mass, which is associated with peak exercise capacity. Increased adiposity is common despite a normal body mass index. Low skeletal muscle mass is associated with systolic dysfunction and compensatory erythrocytosis.
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Affiliation(s)
- Derek Tran
- Sydney School of Health Sciences The University of Sydney Camperdown New South Wales Australia.,Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Paolo D'Ambrosio
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Charlotte E Verrall
- Heart Centre for Children The Children's Hospital at Westmead New South Wales Australia
| | - Chantal Attard
- Haematology Research Group Murdoch Children's Research Institute Parkville Victoria Australia
| | - Julie Briody
- Department of Nuclear Medicine The Children's Hospital at Westmead New South Wales Australia
| | - Mario D'Souza
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia
| | - Maria Fiatarone Singh
- Sydney School of Health Sciences The University of Sydney Camperdown New South Wales Australia.,Sydney Medical School The University of Sydney Camperdown New South Wales Australia
| | - Julian Ayer
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Heart Centre for Children The Children's Hospital at Westmead New South Wales Australia
| | - Yves d'Udekem
- Department of Paediatrics Faculty of Medicine The University of Melbourne Parkville Victoria Australia.,Department of Cardiac Surgery Royal Children's Hospital Melbourne Parkville Victoria Australia
| | - Stephen Twigg
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Endocrinology Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Glen M Davis
- Sydney School of Health Sciences The University of Sydney Camperdown New South Wales Australia
| | - David S Celermajer
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Rachael Cordina
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia
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14
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Khoshhali M, Heidari-Beni M, Qorbani M, Motlagh ME, Ziaodini H, Heshmat R, Kelishadi R. Tri-ponderal mass index and body mass index in prediction of pediatric metabolic syndrome: the CASPIAN-V study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:171-178. [PMID: 32236304 PMCID: PMC10118948 DOI: 10.20945/2359-3997000000206] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 03/29/2019] [Indexed: 11/23/2022]
Abstract
Objective Body mass index (BMI) and tri-ponderal mass index (TMI) are anthropometric measures to evaluate body adiposity in the various age groups. The present study aims to compare the predictive value of TMI and BMI for metabolic syndrome (Mets) in children and adolescents of both genders. Subjects and methods A cross-sectional study conducted on 3731 Iranian children and adolescents aged 7-18 years obtained from the fifth survey of 'Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease' (CASPIAN-V) study. The predictive value of BMI and TMI for MetS were determined using Receiver-operator curves. Logistic regression analysis was used to assess the relationship between these indices with MetS. Results 52.6% of participants were boys. The mean (standard deviations) age for boys and girls were 12.62 (3.02) and 12.25 (3.05) years, respectively. In boys, the area under the curve (AUC) of TMI was greater than BMI for all age groups. AUC of TMI was also greater than BMI for age group of 11-14 years (AUC = 0.74; 95% CI (0.67, 0.81)) in girls. Furthermore, our findings showed that odds ratio of Mets for TMI was greater than BMI in age groups of 11-14 years (OR = 1.33 vs 1.22) and 15-18 years (1.16 vs 1.15) in girls and boys, respectively. Conclusion TMI and BMI had moderate predictive value for identifying MetS. However, TMI was a better predictor of MetS than BMI in both genders, especially in age groups of 11-14 and 15-19 years for girls and boys.
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Affiliation(s)
- Mehri Khoshhali
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Hasan Ziaodini
- Health Psychology Research Center, Education Ministry, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Caprio S, Santoro N, Weiss R. Childhood obesity and the associated rise in cardiometabolic complications. Nat Metab 2020; 2:223-232. [PMID: 32694781 PMCID: PMC9425367 DOI: 10.1038/s42255-020-0183-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/17/2020] [Indexed: 02/06/2023]
Abstract
Childhood obesity is one of the most serious global public-health challenges of the twenty-first century. Over the past four decades, the number of children and adolescents with obesity has risen more than tenfold. Worldwide, an increasing number of youth are facing greater exposure to obesity throughout their lives, and this increase will contribute to the early development of type 2 diabetes, fatty liver and cardiovascular complications. Herein, we provide a brief overview of trends in the global shifts in, and environmental and genetic determinants of, childhood obesity. We then discuss recent progress in the elucidation of the central role of insulin resistance, the key element linking obesity and cardiovascular-risk-factor clustering, and the potential mechanisms through which ectopic lipid accumulation leads to insulin resistance and its associated cardiometabolic complications in obese adolescents. In the absence of effective prevention and intervention programs, childhood obesity will have severe public-health consequences for decades to come.
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Affiliation(s)
- Sonia Caprio
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
| | - Nicola Santoro
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
| | - Ram Weiss
- Department of Pediatrics, Ruth Rappaport Children's Hospital, Rambam Medical Center, Technion School of Medicine, Haifa, Israel.
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16
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Pitchford EA, Hasson RE, Hornyak JE, Lumeng JC, Peterson KE, Ulrich DA. Diurnal cortisol and obesity in adolescents with and without Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1401-1412. [PMID: 31441183 DOI: 10.1111/jir.12682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 06/19/2019] [Accepted: 08/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The prevalence of obesity in adolescents with Down syndrome (DS) far exceeds that in the general population. Cortisol, an adrenal hormone, can be obesogenic when dysregulated. However, the diurnal patterns of this hormone have not been examined among individuals with DS. Variations in adiposity may also mediate cortisol regulation. This study sought to examine diurnal cortisol patterns in adolescents with DS as well as associations between cortisol function and obesity. METHOD A total of 32 adolescents, including 16 with DS and 16 controls with typical development (TD) of similar sex, age and Tanner pubertal stage (P > 0.05), participated in this preliminary study. Participants completed a dual-energy X-ray absorptiometry scan to measure body composition and collected saliva samples for cortisol measurements in the morning, afternoon and night. Linear mixed models with random intercepts and repeated measures were used to examine the daily trajectory of log-transformed cortisol concentrations between adolescents with and without DS. A second model examined the interaction between DS and presence of elevated body fatness. RESULTS Adolescents with DS had higher morning cortisol concentrations (intercept = 0.37 μg/dL), but this was not significantly different than in TD (0.35 μg/dL, P = 0.16). Cortisol significantly declined across hours (b = -0.026 μg/dL/h, P < 0.001), but this decline also did not differ from that observed in TD (b = -0.024 μg/dL/h, P = 0.43). While cortisol levels were slightly higher among adolescents with elevated body fatness, this difference was not statistically significant (P > 0.05; d = 0.30). CONCLUSIONS This study is the first to examine diurnal cortisol in DS but is limited in sample size. These preliminary findings suggest that diurnal cortisol patterns are not significantly different between adolescents with DS and TD and that cortisol levels are not associated with adiposity in this population. Despite these non-significant differences, youth with DS continue to be an 'at-risk' population for paediatric obesity in need of clinical intervention.
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Affiliation(s)
- E A Pitchford
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - R E Hasson
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - J E Hornyak
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - J C Lumeng
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - K E Peterson
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - D A Ulrich
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
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17
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Kelley GA, Kelley KS, Pate RR. Exercise and adiposity in overweight and obese children and adolescents: a systematic review with network meta-analysis of randomised trials. BMJ Open 2019; 9:e031220. [PMID: 31719081 PMCID: PMC6858189 DOI: 10.1136/bmjopen-2019-031220] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Determine both the effects and hierarchy of effectiveness for exercise interventions (aerobic, strength training or both) on selected measures of adiposity (body mass index (BMI) in kg/m2, fat mass and per cent body fat) in overweight and obese children and adolescents. DESIGN Network meta-analysis of randomised exercise intervention trials. SETTING Any setting where a randomised trial could be conducted. PARTICIPANTS Overweight and obese male and/or female children and adolescents 2-18 years of age. INTERVENTIONS Randomised exercise intervention trials>4 weeks, published between 1 January 1973 and 22 August 2018, and which included direct and/or indirect evidence for aerobic, strength training or combined aerobic and strength training. PRIMARY OUTCOMES Changes in BMI in kg/m2, fat mass and per cent body fat. RESULTS Fifty-seven studies representing 127 groups (73 exercise, 54 control) and 2792 participants (1667 exercise, 1125 control) met the criteria for inclusion. Length of training ([Formula: see text] ± SD) averaged 14.1±6.2 weeks, frequency, 3.3±1.1 days per week and duration 42.0±21.0 min per session. Significant and clinically important reductions in BMI, fat mass and per cent body fat were observed in aerobic versus control comparisons (BMI, mean, 95% CI -1.0, 1.4 to -0.6; fat mass -2.1, -3.3 to -1.0 kg; per cent fat -1.5, -2.2 to -0.9%) and combined aerobic and strength versus control comparisons (BMI -0.7, -1.4 to -0.1; fat mass -2.5, -4.1 to -1.0 kg; per cent fat, -2.2, -3.2 to -1.2%). A significant reduction in per cent fat was also found for strength vs control comparisons (-1.3,-2.5 to -0.1%). Combined aerobic and strength training was ranked first for improving both fat mass (kg) and per cent body fat while aerobic exercise was ranked first for improving BMI. CONCLUSIONS Aerobic and combined aerobic and strength training are associated with improvements in adiposity outcomes in overweight and obese children and adolescents. PROSPERO REGISTRATION NUMBER CRD42017073103.
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Affiliation(s)
- George A Kelley
- Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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18
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Oliosa PR, Zaniqueli DDA, Barbosa MCR, Mill JG. Relação entre composição corporal e dislipidemias em crianças e adolescentes. CIENCIA & SAUDE COLETIVA 2019; 24:3743-3752. [DOI: 10.1590/1413-812320182410.17662017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/07/2018] [Indexed: 11/22/2022] Open
Abstract
Resumo Verificou-se a relação entre diferentes índices antropométricos e os lipídios plasmáticos. Os dados foram coletados de 2014 a 2016 em 854 escolares (6-18 anos). Foram aferidas a circunferência da cintura (CC), o percentual de gordura corporal (%G) por bioimpedância, o índice de massa corporal (IMC) e relação da cintura/estatura (RCE). Em sangue coletado em jejum mediu-se o colesterol total (CT), HDLc, e triglicerídeos e calculou-se o colesterol não HDL (Não HDLc). Os dados são apresentados por média ± desvio padrão, porcentagens. A comparação de médias foi feita pelo teste t ou ANOVA seguida de teste de Tukey. A associação entre variáveis foi testada por regressão linear. O estudo foi aprovado pelo Comitê de Ética da Universidade Federal do Espírito Santo. Meninos obesos tinham CT, Não HDLc e LDLc mais elevados do que os eutróficos. Em meninas este achado foi apenas para o Não HDLc. Crianças com o %G e RCE inadequados apresentaram LDLc e Não HDLc maiores (p < 0,001), os quais associaram-se positivamente (p < 0,001) com as frações lipídicas (CT e Não HDLc). O excesso de gordura corporal elevou em 21% a probabilidade de ocorrência de colesterol acima da referência (170 mg/dL). O excesso de gordura corporal associou-se com o perfil lipídico aterogênico (maior Não HDLc), principalmente em meninos.
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19
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Voskuil VR, Robbins LB, Pierce SJ. Predicting physical activity among urban adolescent girls: A test of the health promotion model. Res Nurs Health 2019; 42:392-409. [PMID: 31241204 DOI: 10.1002/nur.21968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 05/17/2019] [Indexed: 12/22/2022]
Abstract
The purpose of this study was to test hypothesized relationships of the health promotion model (HPM) as a means of predicting moderate-to-vigorous physical activity (MVPA) among urban, adolescent girls. A secondary analysis of baseline data from a group randomized controlled trial was conducted. The study involved eight urban schools in the Midwestern United States. The sample included girls (N = 517) in the 5th-8th grades. Data were collected on age, body mass index, pubertal status, enjoyment, self-efficacy, social support, options for physical activity (PA), and commitment to PA. MVPA was measured via accelerometers worn by the girls for 7 days. Structural equation modeling was used to analyze study aims. Mean age of the sample was 11.8 years (standard deviation [SD] = 1.0). Girls attained an average of 3.0 (SD = 1.2) minutes per hour of MVPA. Self-efficacy had a positive direct (β = .337; p < .001) and total effect (β = .310; p < .001) on MVPA. Social support and options for PA were not significant predictors of commitment to PA or MVPA. Commitment to PA had a negative but nonsignificant effect (β = -.056; p = .357) on MVPA. The model predicted 10.1% of the variance in MVPA with 9.6% of the variance predicted by self-efficacy. Limitations include lack of longitudinal analysis and inability to generalize the results to other populations such as boys. PA self-efficacy continues to emerge as a significant predictor of MVPA in the HPM. Continued theory testing is needed to better understand the correlates and determinants of PA among adolescent girls before designing theory-based interventions to promote PA.
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Affiliation(s)
| | | | - Steven J Pierce
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, Michigan
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20
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Linchey JK, King B, Thompson HR, Madsen KA. Parent Underestimation of Child Weight Status and Attitudes towards BMI Screening. HEALTH BEHAVIOR AND POLICY REVIEW 2019; 6:209-218. [PMID: 32874999 PMCID: PMC7457717 DOI: 10.14485/hbpr.6.3.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE In this study, we identify predictors of parental underestimation of child weight status and support for school-based BMI screening and reporting. METHODS Parents of 3rd through 7th grade students (N = 1002) participating in The Fit Study completed mailed surveys assessing parent race/ethnicity, weight status, perception of child weight status, and preference for BMI screening and reporting. RESULTS Only 33% and 6% of parents classified their overweight child as somewhat overweight and their obese child as very overweight, respectively. Support for BMI screening was stronger among Hispanic (OR = 2.3, p < .001), Asian (OR = 3.7, p < .001), and black (OR = 2.3, p = .04) parents than white parents and weaker among overweight versus normal-weight parents (OR = 0.6, p = .01). Compared to parents of 3rd grade students, parents of older children reported less support for BMI reporting (4th grade: OR = 0.4, p = .04; 6th grade: OR = 0.3, p = .02; 7th grade: OR = 0.3, p = .03). CONCLUSIONS Parent race/ethnicity, parent weight status, and child age are associated with support for BMI screening and reporting..
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Affiliation(s)
- Jennifer K Linchey
- University of California, Berkeley, School of Public Health, Berkeley, CA
| | - Benjamin King
- University of California, Berkeley, School of Public Health, Berkeley, CA
| | - Hannah R Thompson
- University of California, Berkeley, School of Public Health, Berkeley, CA
| | - Kristine A Madsen
- University of California, Berkeley, School of Public Health, Berkeley, CA
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21
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Ostrowski L, Speiser PW, Accacha S, Altshuler L, Fennoy I, Lowell B, Rapaport R, Rosenfeld W, Shelov SP, Ten S, Rosenbaum M. Demographics and anthropometrics impact benefits of health intervention: data from the Reduce Obesity and Diabetes Project. Obes Sci Pract 2019; 5:46-58. [PMID: 30847225 PMCID: PMC6381301 DOI: 10.1002/osp4.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 09/05/2018] [Accepted: 09/22/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine the efficacy of a 4-month school-based health, nutrition and exercise intervention on body fatness and examine possible effects of demographic and anthropometric covariates. METHODS Height, weight, waist circumference and body composition were measured in a diverse population of 644 NYC middle school students (mean ± SD age 12.7 ± 0.9 years; 46% male; 38% Hispanic, 17% East Asian, 15% South Asian, 13.5% African American, 8.5% Caucasian, 8% other) during the fall and spring semesters. Year 1 participants (n = 322) were controls. Experimental participants (year 2, n = 469) received a 12-session classroom-based health and nutrition educational programme with an optional exercise intervention. RESULTS Groups were demographically and anthropometrically similar. The intervention resulted in significant reductions in indices of adiposity (ΔBMI z-scores [-0.035 ± 0.014; p = 0.01], Δ% body fat [-0.5 ± 0.2; p < 0.0001] and Δwaist circumference [-0.73 ± 0.30 cm; p < 0.0001]). Intervention effects were greater (p = 0.01) in men (ΔBMI z-score = -0.052 ± 0.015) versus women (0.022 ± 0.018), participants who were obese (ΔBMI z-score -0.083 ± 0.022 kg m-2) versus lean (-0.0097 ± 0.020 kg m-2) and South Asians (Δ% body fat -1.03 ± 0.35) versus total (-0.49 ± 0.20%) participants (p = 0.005). CONCLUSION A 4-month school-based health intervention was effective in decreasing measures of adiposity in middle school students, particularly in men, participants who were obese and South Asians.
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Affiliation(s)
- L. Ostrowski
- Department of NeuroscienceBrown UniversityProvidenceRIUSA
| | - P. W. Speiser
- Pediatrics, Cohen Children's Medical Center of NYHofstra Northwell School of MedicineNew Hyde ParkNYUSA
| | - S. Accacha
- PediatricsWinthrop University HospitalMineolaNYUSA
| | | | - I. Fennoy
- Pediatrics and MedicineColumbia University College of Physicians and SurgeonsNew YorkNYUSA
| | - B. Lowell
- PediatricsMaimonides Medical CenterBrooklynNYUSA
| | - R. Rapaport
- PediatricsMt Sinai School of MedicineNew YorkNYUSA
| | - W. Rosenfeld
- PediatricsWinthrop University HospitalMineolaNYUSA
| | - S. P. Shelov
- PediatricsWinthrop University HospitalMineolaNYUSA
- PediatricsMaimonides Medical CenterBrooklynNYUSA
| | - S. Ten
- PediatricsMaimonides Medical CenterBrooklynNYUSA
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22
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Wilkes M, Thornton J, Horlick M, Sopher A, Wang J, Widen EM, Pierson R, Gallagher D. Relationship of BMI z score to fat percent and fat mass in multiethnic prepubertal children. Pediatr Obes 2019; 14:10.1111/ijpo.12463. [PMID: 30117308 PMCID: PMC6309265 DOI: 10.1111/ijpo.12463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 06/06/2018] [Accepted: 06/29/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The objective of the study is to examine the validity of body mass index z score (zBMI) as a measure of percent body fat in prepubertal children. METHODS One hundred eleven multiethnic, healthy, Tanner 1 children aged 6-12 years had fat percent and fat mass measured by the four-compartment method as part of the Paediatric Rosetta Body Composition Cohort. Multiple regression models were developed with fat percent as the dependent variable and zBMI, age, sex and ethnicity as independent variables. RESULTS Body mass index z score predicted fat percent, adjusted for age in both girls (P < 0.001, RMSE 5.67 and R2 0.54) and boys (P < 0.001, RMSE 4.71, R2 0.69). The average model percent error was 20.3% in girls and 21.6% in boys. zBMI2 predicted fat mass when adjusted for age and zBMI in both girls (P < 0.001, RMSE 2.27 and R2 0.82) and boys (P < 0.001, RMSE 2.08 and R2 0.81). The average percent error was 7.2% in girls and 8.7% in boys. Age was associated with percentage body fat (P < 0.01), while ethnicity was not (P > 0.05). CONCLUSIONS Given the relatively large error in the models, zBMI are not a useful indicator of fat mass in healthy, Tanner 1 children. zBMI2 scores are associated with significantly lower absolute percent errors in girls and boys.
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Affiliation(s)
- Meredith Wilkes
- New York Obesity Research Center, Dept. of Medicine,
College of Physicians and Surgeons, Columbia University,Department of Pediatrics, Icahn School of Medicine at Mount
Sinai,Department Pediatrics, College of Physicians and Surgeons,
Columbia University
| | - John Thornton
- Consultant,Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected
| | - Mary Horlick
- Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected
| | - Aviva Sopher
- Department Pediatrics, College of Physicians and Surgeons,
Columbia University
| | - Jack Wang
- Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected
| | - Elizabeth M. Widen
- New York Obesity Research Center, Dept. of Medicine,
College of Physicians and Surgeons, Columbia University,Department of Nutritional Sciences, University of Texas at
Austin
| | - Richard Pierson
- Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected
| | - Dympna Gallagher
- New York Obesity Research Center, Dept. of Medicine,
College of Physicians and Surgeons, Columbia University,Previous member of the Body Composition Unit, St.
Luke’s-Roosevelt Hospital where data were collected,Institute of Human Nutrition, College of Physicians and
Surgeons, Columbia University
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23
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Nakadate K, Hirakawa T, Tanaka-Nakadate S. Small intestine barrier function failure induces systemic inflammation in monosodium glutamate-induced chronically obese mice. Appl Physiol Nutr Metab 2018; 44:587-594. [PMID: 30345803 DOI: 10.1139/apnm-2018-0560] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Chronic obesity has increased worldwide, in conjunction with type 2 diabetes. Chronic obesity causes systemic inflammation that may result in functional deterioration of the gastrointestinal barrier. However, gastrointestinal conditions associated with chronic obesity have not been comprehensively investigated. The purpose of this study was to evaluate morphological changes in small intestine barrier structures during chronic obesity. A mouse model of chronic obesity induced by monosodium glutamate treatment was established. At postnatal week 15, pathological changes including in small intestinal epithelial cells were analyzed in chronically obese mice compared with controls. Numerous gaps were identified between small intestinal epithelial cells in chronically obese mice, and levels of both desmosomal and tight junction proteins were significantly lower in their small intestinal epithelial cells. Moreover, in chronically obese mice, a significant increase in the number of intestinal inflammatory cells, particularly macrophages, was observed; in addition, blood samples from the mouse model show an increase in markers of inflammation, tumor necrosis factor-alpha and interleukin-1-beta. These findings suggest that functional deterioration of adhesion structures between small intestinal epithelial cells causes gastrointestinal barrier function failure, leading to a rise in intestinal permeability to blood vessels and consequent systemic inflammation, characterized by macrophage infiltration.
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Affiliation(s)
- Kazuhiko Nakadate
- a Department of Basic Science, Educational and Research Center for Pharmacy, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588, Japan
| | - Tomoya Hirakawa
- a Department of Basic Science, Educational and Research Center for Pharmacy, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588, Japan
| | - Sawako Tanaka-Nakadate
- b Department of Pharmacology and Toxicology, Dokkyo Medical University School of Medicine, 880, Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
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Hawks EM, Sampilo ML, Weedn A, Gillaspy SR. Identifying Differences in the Prevalence of Psychological Symptoms between Underweight, Normal Weight, Overweight, and Obese Children in Primary Care. THE JOURNAL OF THE OKLAHOMA STATE MEDICAL ASSOCIATION 2018; 111:802-805. [PMID: 31289412 PMCID: PMC6615746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The prevalence of childhood obesity continues to be a major public health problem. Nearly one-third of children in the United States can be classified as overweight or obese, which is particularly concerning given that obesity is associated with a number of physical and mental health problems. Past studies have examined childhood obesity and psychological symptoms using samples of referred children who have already been identified as overweight or obese, leaving out children who are classified as underweight or healthy weight. This study aims to bridge this gap in the literature by evaluating differences in psychological symptoms among children who fall within all weight ranges within primary care. METHODS Data was obtained from a systematic chart review using EMR (Electronic Medical Record) for children ages 6 to 16 years from two primary care health clinics. Differences between weight groups regarding reported internalizing and externalizing symptoms were evaluated utilizing data from the Pediatric Behavioral Health Screen (PBHS). RESULTS Significant overall psychological symptoms (internalizing and externalizing) were endorsed for 13.2% of the sample (p > .01). Chi-Square analyses determined that the relationship between internalizing symptoms and weight category were significant. Specifically, children who were classified as overweight or obese were more likely to report significant internalizing symptoms than underweight or healthy weight children. CONCLUSIONS Children who fall into the overweight and obese weight categories may need to be screened for psychological symptoms and referred for mental health services following overweight/obese classification in primary care.
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Affiliation(s)
- Erin M. Hawks
- Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | | | - Ashley Weedn
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Stephen R. Gillaspy
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Seo YG, Kim JH, Kim Y, Lim H, Ju YS, Kang MJ, Lee K, Lee HJ, Jang HB, Park SI, Park KH. Validation of body composition using bioelectrical impedance analysis in children according to the degree of obesity. Scand J Med Sci Sports 2018; 28:2207-2215. [DOI: 10.1111/sms.13248] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/20/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Young-Gyun Seo
- Department of Family Medicine; Hallym University Sacred Heart Hospital; Anyang Korea
| | - Jae Hyun Kim
- Department of Pediatrics; Seoul National University Bundang Hospital; Seongnam Korea
| | - YoonMyung Kim
- University College; Yonsei University International Campus; Incheon Korea
| | - Hyunjung Lim
- Department of Medical Nutrition; Kyung Hee University; Yongin Korea
| | - Young-Su Ju
- Department of Occupational and Environmental Medicine; Hallym University Sacred Heart Hospital; Anyang Korea
| | - Min Jae Kang
- Department of Pediatrics; Hallym University Sacred Heart Hospital; Anyang Korea
| | - Kwanseop Lee
- Department of Radiology; Hallym University Sacred Heart Hospital; Anyang Korea
| | - Hye-Ja Lee
- Center for Biomedical Sciences; Korea National Institute of Health; Cheongju Korea
| | - Han Byul Jang
- Center for Biomedical Sciences; Korea National Institute of Health; Cheongju Korea
| | - Sang Ick Park
- Center for Biomedical Sciences; Korea National Institute of Health; Cheongju Korea
| | - Kyung Hee Park
- Department of Family Medicine; Hallym University Sacred Heart Hospital; Anyang Korea
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26
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Vanderwall C, Eickhoff J, Randall Clark R, Carrel AL. BMI z-score in obese children is a poor predictor of adiposity changes over time. BMC Pediatr 2018; 18:187. [PMID: 29880034 PMCID: PMC5992682 DOI: 10.1186/s12887-018-1160-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/29/2018] [Indexed: 11/17/2022] Open
Abstract
Background The age and sex standardized body mass index (BMIz) is a simple and widely utilized screening tool for obesity in children and adolescents. The purpose of this study was to evaluate the relationship between the BMIz trajectory versus the percent body fat (%FAT) trajectory, and if BMIz could predict significant changes in %FAT in a sample of obese children and adolescents. Methods In this longitudinal observational study, body composition was measured by dual energy x-ray absorptiometry (DXA) in obese children within a multidisciplinary pediatric fitness clinic at an academic medical center over a 3-year time period. Regression analyses were conducted to evaluate the association between changes in BMIz and changes in %FAT. Results Baseline assessment was obtained from 515 participants. The reduction observed in BMIz (2.20 to 2.08, p < 0.0001) correlated with the reduction in %FAT (38.5 to 35.8%, p < 0.05) in the first two years. The overall correlation between the slope in BMIz reduction versus %FAT reduction was moderate (r = 0.36, p < 0.0001) over the 3-year follow-up period. The sensitivity of BMIz changes for predicting a decrease in %FAT was acceptable (70, 95% CI: 61–78%), however the specificity was poor (42, 95% CI: 31–54%). Conclusions These findings advance the understanding of the utility and limitations of BMIz in children and adolescents. While BMIz may be sensitive to changes in adiposity, it is a weak predictor of these changes in total body fat (%FAT) due to the poor specificity. Therefore, clinicians must exercise caution when monitoring changes in a growing child’s body composition to avoid misclassifying or missing substantial change when utilizing BMIz alone.
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Affiliation(s)
- Cassandra Vanderwall
- University of Wisconsin, UW Health- University Hospital, 600 Highland Ave, Madison, WI, 53792, USA.
| | - Jens Eickhoff
- University of Wisconsin, UW Health- University Hospital, 600 Highland Ave, Madison, WI, 53792, USA
| | | | - Aaron L Carrel
- University of Wisconsin, UW Health- University Hospital, 600 Highland Ave, Madison, WI, 53792, USA
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27
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El Sayed S, Khairy E, Basheer AR, Zaki WS, Ahmad GF, Kassim SK. Evaluation of leptin and MMP2 genes methylation in childhood obesity. GENE REPORTS 2018. [DOI: 10.1016/j.genrep.2018.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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28
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Darke JD, Dandekar EM, Aguinaldo AL, Hazelwood SJ, Klisch SM. Effects of Game Pitch Count and Body Mass Index on Pitching Biomechanics in 9- to 10-Year-Old Baseball Athletes. Orthop J Sports Med 2018; 6:2325967118765655. [PMID: 29687013 PMCID: PMC5900828 DOI: 10.1177/2325967118765655] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Pitching while fatigued and body composition may increase the injury risk in youth and adult pitchers. However, the relationships between game pitch count, biomechanics, and body composition have not been reported for a study group restricted to 9- to 10-year-old athletes. Hypothesis: During a simulated game with 9- to 10-year-old athletes, (1) participants will experience biomechanical signs of fatigue, and (2) shoulder and elbow kinetics will correlate with body mass index (BMI). Study Design: Descriptive laboratory study. Methods: Thirteen 9- to 10-year-old youth baseball players pitched a simulated game (75 pitches). Range of motion and muscular output tests were conducted before and after the simulated game to quantify fatigue. Kinematic parameters at foot contact, maximum external rotation, and maximum internal rotation velocity (MIRV), as well as maximum shoulder and elbow kinetics between foot contact and MIRV were compared at pitches 1-5, 34-38, and 71-75. Multivariate analyses of variance were used to test the first hypothesis, and linear regressions were used to test the second hypothesis. Results: MIRV increased from pitches 1-5 to 71-75 (P = .007), and head flexion at MIRV decreased from pitches 1-5 to 34-38 (P = .022). Maximum shoulder horizontal adduction, external rotation, and internal rotation torques increased from pitches 34-38 to 71-75 (P = .031, .023, and .021, respectively). Shoulder compression force increased from pitches 1-5 to 71-75 (P = .011). Correlations of joint torque/force with BMI were found at every pitch period: for example, shoulder internal rotation (R2 = 0.93, P < .001) and elbow varus (R2 = 0.57, P = .003) torques at pitches 1-5. Conclusion: Several results differed from those of previous studies with adult pitchers: (1) pitch speed remained steady, (2) shoulder MIRV increased, and (3) shoulder kinetics increased during a simulated game. The strong correlations between joint kinetics and BMI reinforce previous findings that select body composition measures may be correlated with pitching arm joint kinetics for youth baseball pitchers. Clinical Relevance: The results improve our understanding of pitching biomechanics for 9- to 10-year-old baseball pitchers and may be used in future studies to improve evidence-based injury prevention guidelines.
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Affiliation(s)
- Jim D Darke
- Biomedical Engineering Department, California Polytechnic State University, San Luis Obispo, California, USA
| | - Eshan M Dandekar
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, California, USA
| | - Arnel L Aguinaldo
- Department of Kinesiology, Point Loma Nazarene University, San Diego, California, USA
| | - Scott J Hazelwood
- Biomedical Engineering Department, California Polytechnic State University, San Luis Obispo, California, USA
- Mechanical Engineering Department, California Polytechnic State University, San Luis Obispo, California, USA
| | - Stephen M Klisch
- Biomedical Engineering Department, California Polytechnic State University, San Luis Obispo, California, USA
- Mechanical Engineering Department, California Polytechnic State University, San Luis Obispo, California, USA
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Nielsen TRH, Fonvig CE, Dahl M, Mollerup PM, Lausten-Thomsen U, Pedersen O, Hansen T, Holm JC. Childhood obesity treatment; Effects on BMI SDS, body composition, and fasting plasma lipid concentrations. PLoS One 2018; 13:e0190576. [PMID: 29444114 PMCID: PMC5812566 DOI: 10.1371/journal.pone.0190576] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 12/18/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The body mass index (BMI) standard deviation score (SDS) may not adequately reflect changes in fat mass during childhood obesity treatment. This study aimed to investigate associations between BMI SDS, body composition, and fasting plasma lipid concentrations at baseline and during childhood obesity treatment. METHODS 876 children and adolescents (498 girls) with overweight/obesity, median age 11.2 years (range 1.6-21.7), and median BMI SDS 2.8 (range 1.3-5.7) were enrolled in a multidisciplinary outpatient treatment program and followed for a median of 1.8 years (range 0.4-7.4). Height and weight, body composition measured by dual-energy X-ray absorptiometry, and fasting plasma lipid concentrations were assessed at baseline and at follow-up. Lipid concentrations (total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), non-HDL, and triglycerides (TG)) were available in 469 individuals (264 girls). Linear regressions were performed to investigate the associations between BMI SDS, body composition indices, and lipid concentrations. RESULTS At baseline, BMI SDS was negatively associated with concentrations of HDL (p = 6.7*10-4) and positively with TG (p = 9.7*10-6). Reductions in BMI SDS were associated with reductions in total body fat percentage (p<2*10-16) and percent truncal body fat (p<2*10-16). Furthermore, reductions in BMI SDS were associated with improvements in concentrations of TC, LDL, HDL, non-HDL, LDL/HDL-ratio, and TG (all p <0.0001). Changes in body fat percentage seemed to mediate the changes in plasma concentrations of TC, LDL, and non-HDL, but could not alone explain the changes in HDL, LDL/HDL-ratio or TG. Among 81 individuals with available lipid concentrations, who increased their BMI SDS, 61% improved their body composition, and 80% improved their lipid concentrations. CONCLUSION Reductions in the degree of obesity during multidisciplinary childhood obesity treatment are accompanied by improvements in body composition and fasting plasma lipid concentrations. Even in individuals increasing their BMI SDS, body composition and lipid concentrations may improve.
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Affiliation(s)
- Tenna Ruest Haarmark Nielsen
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Cilius Esmann Fonvig
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Maria Dahl
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Pernille Maria Mollerup
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Ulrik Lausten-Thomsen
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens-Christian Holm
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Nobre GG, de Almeida MB, Nobre IG, Dos Santos FK, Brinco RA, Arruda-Lima TR, de-Vasconcelos KL, de-Lima JG, Borba-Neto ME, Damasceno-Rodrigues EM, Santos-Silva SM, Leandro CG, Moura-Dos-Santos MA. Twelve Weeks of Plyometric Training Improves Motor Performance of 7- to 9-Year-Old Boys Who Were Overweight/Obese: A Randomized Controlled Intervention. J Strength Cond Res 2018; 31:2091-2099. [PMID: 27787471 DOI: 10.1519/jsc.0000000000001684] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nobre, GG, de Almeida, MB, Nobre, IG, dos Santos, FK, Brinco, RA, Arruda-Lima, TR, de-Vasconcelos, KL, de-Lima, JG, Borba-Neto, ME, Damasceno-Rodrigues, EM, Santos-Silva, SM, Leandro, CG, and Moura-dos-Santos, MA. Twelve weeks of plyometric training improves motor performance of 7- to 9-year-old boys who were overweight/obese: a randomized controlled intervention. J Strength Cond Res 31(8): 2091-2099, 2017-The prevalence of childhood overweight/obesity has increased, and physical training at school may to be effective to combat this scenario. We analyzed the effects of a protocol of plyometric training on body composition and motor performance of boys who were overweight/obese aged 7-9 years. The sample was randomly assigned into 2 groups: plyometric training group (T, n = 40) and control group (C, n = 19). Training consisted of 20 min·d (twice a week, during 12 weeks) of lower extremity plyometric exercise. Health-related physical fitness was measured by handgrip strength, standing long jump (SLJ), curl-ups, sit and reach, square test, running speed, and mile run test. Gross motor coordination was evaluated by means of the Körperkoordinations-test für Kinder (KTK) tests. Baseline and postintervention differences were investigated, and effect size was estimated through Cohen's d coefficient. Both groups showed increased body weight, height, and sitting height after intervention with a negligible effect size. Only T group showed increased fat-free mass (p = 0.011) compared with baseline values with small effect size. Plyometric training improved handgrip strength (d = 0.23), sit and reach (d = 0.18), curl-ups (d = 0.39), SLJ (d = 0.80), agility (d = 0.48), and time in the mile run test (d = 0.38). For gross motor coordination results, T group showed better performance in all tests after plyometric training with moderate/large effect size. Thus, 12 weeks of PT improved health-related physical fitness components and motor coordination acquisition of 7- to 9-year-old boys who were overweight/obese.
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Affiliation(s)
- Gabriela G Nobre
- 1Department of Physical Education and Sports Science, CAV, Federal University of Pernambuco, Vitória de Santo Antão, PE, Brazil; 2Department of Physical Education, Federal University of Viçosa, Viçosa, MG, Brazil; 3Department of Nutrition, Federal University of Pernambuco, Recife, Brazil; and 4Superior School of Physical Education, University of Pernambuco, Recife, PE, Brazil
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31
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Buscemi S, Marventano S, Castellano S, Nolfo F, Rametta S, Giorgianni G, Matalone M, Marranzano M, Mistretta A. Role of anthropometric factors, self-perception, and diet on weight misperception among young adolescents: a cross-sectional study. Eat Weight Disord 2018; 23:107-115. [PMID: 27502108 DOI: 10.1007/s40519-016-0306-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/22/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Adolescence overweight and obesity have increased considerably, and the misperception of their weight status could reduce the efficiency of intervention programs. The aim of this study was to evaluate the prevalence rate of misperception and to assess the relationship between weight perception and anthropometric parameters, self-perception, physical activity, and adherence to the Mediterranean diet. METHODS A total of 1643 young adolescents (11-16 years old) were surveyed in a cross-sectional investigation during two scholastic years (period October-May of 2012-2013 and 2013-2014) in 15 secondary schools of Sicily, southern Italy. Data on demographic information, anthropometric characteristics (bioelectrical impedance), physical activity level, The Children and Youth Physical Self-Perception Profile, weight perception, and dietary habits (KIDMED) were collected. RESULTS Misperception was found in the 27.6 % of the young adolescents, and boys were more likely to underestimate their weight status, while girls had a high percentage of overestimation. The strong association with weight misperception was with socioeconomic status, waist circumference, physical activities, and physical self-worth. Moreover, a good adherence to the Mediterranean diet was inversely associated with both overestimation and underestimation in both boys and girls. CONCLUSION These findings highlight that almost one-third of the participants had a weight misperception that was associated with several anthropometric, social, and lifestyle factors. Future intervention to prevent overweight and obesity should consider not only gender-specific differences, but also parental SES, perception, and satisfaction of body weight status.
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Affiliation(s)
- Silvio Buscemi
- Laboratorio di Nutrizione Clinica, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), P. Giaccone Policlinico, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
| | - Stefano Marventano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - Sabrina Castellano
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
| | - Francesca Nolfo
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - Stefania Rametta
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - Gabriele Giorgianni
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - Margherita Matalone
- Department of School Policies, Municipality of Catania, 95131, Catania, CT, Italy
| | - Marina Marranzano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - Antonio Mistretta
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
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Kelley GA, Kelley KS, Pate RR. Exercise and adiposity in overweight and obese children and adolescents: protocol for a systematic review and network meta-analysis of randomised trials. BMJ Open 2017; 7:e019512. [PMID: 29288191 PMCID: PMC5770943 DOI: 10.1136/bmjopen-2017-019512] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Overweight and obesity is a worldwide public health problem among children and adolescents. However, the magnitude of effect, as well as hierarchy of exercise interventions (aerobic, strength training or both), on selected measures of adiposity is not well established despite numerous trials on this issue. The primary purposes of this study are to use the network meta-analytical approach to determine the effects and hierarchy of exercise interventions on selected measures of adiposity in overweight and obese children and adolescents. METHODS AND ANALYSIS Randomised exercise intervention trials >4 weeks, available in any language up to 31 August 2017 and which include direct and/or indirect evidence, will be included. Studies will be located by searching seven electronic databases, cross-referencing and expert review. Dual selection and abstraction of data will occur. The primary outcomes will be changes in body mass index (in kg/m2), fat mass and percent body fat. Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument while confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation instrument for network meta-analysis. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of exercise treatments (aerobic, strength or both). ETHICS AND DISSEMINATION This study does not require ethics approval. Findings will be presented at a professional conference and published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD 42017073103 .
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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Gállego Suárez C, Singer BH, Gebremariam A, Lee JM, Singer K. The relationship between adiposity and bone density in U.S. children and adolescents. PLoS One 2017; 12:e0181587. [PMID: 28723934 PMCID: PMC5517060 DOI: 10.1371/journal.pone.0181587] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/03/2017] [Indexed: 11/21/2022] Open
Abstract
Objective In adults, obesity has been associated with several health outcomes including increased bone density. Our objective was to evaluate the association between percent body fat and fat mass with bone mineral density (BMD) in a nationally representative population of children and adolescents. Study design A total of 8,348 participants 8–18 years of age from the National Health and Nutrition Examination Survey (NHANES) 1999–2006 had whole body DXA scans performed. We conducted linear regressions to examine the relationship between percent body fat and fat mass with outcome variables of total body, pelvic and lumbar spine areal BMD (aBMD), controlling for lean body mass and assessing for gender and race/ethnicity interactions. Results We found evidence of gender and race/ethnicity interactions with percent body fat and total fat mass for the different BMD areas. Generally, there were decreases in total body aBMD (p<0.001) and lumbar spine aBMD (p<0.001) with increasing percent body fat and total fat mass, with less consistent patterns for pelvic aBMD. Conclusion Our findings of regional differences in the relationship of adiposity to aBMD in children and adolescents with significant interactions by gender and race/ethnicity emphasizes the need for further investigations to understand the impact of adiposity on bone health outcomes.
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Affiliation(s)
- Cecilia Gállego Suárez
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Endocrinology and Metabolism, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Benjamin H. Singer
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Achamyeleh Gebremariam
- Child Health Evaluation and Research Unit (CHEAR), Department of Pediatrics and Communicable Diseases. University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Joyce M. Lee
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Endocrinology and Metabolism, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- Child Health Evaluation and Research Unit (CHEAR), Department of Pediatrics and Communicable Diseases. University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Kanakadurga Singer
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Endocrinology and Metabolism, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- * E-mail:
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Smith CL, Edwards LJ. A test of separate hypotheses for comparing linear mixed models with non nested fixed effects. COMMUN STAT-THEOR M 2017. [DOI: 10.1080/03610926.2015.1104352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ché L. Smith
- Department of Biostatistics, UNC Chapel Hill, Chapel Hill, NC, USA
| | - Lloyd J. Edwards
- Department of Biostatistics, UNC Chapel Hill, Chapel Hill, NC, USA
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Kelley GA, Kelley KS, Pate RR. Exercise and BMI z-score in Overweight and Obese Children and Adolescents: A Systematic Review and Network Meta-Analysis of Randomized Trials. J Evid Based Med 2017; 10:108-128. [PMID: 27792271 PMCID: PMC5553313 DOI: 10.1111/jebm.12228] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 07/10/2016] [Indexed: 01/29/2023]
Abstract
AIM Examine the effects of selected types of exercise (aerobic, strength training, both) on BMI z-score in overweight and obese children and adolescents. METHODS Randomized exercise intervention trials ≥ 4 weeks were included. Studies were retrieved by searching six electronic databases, cross-referencing and expert review. Dual selection and abstraction occurred. Risk of bias and confidence in cumulative evidence were assessed. Network meta-analysis was performed using multivariate random-effects meta-regression models while surface under the cumulative ranking curves were used to calculate a hierarchy of exercise treatments. The number needed to treat (NNT) and percentile improvement (U3 ) were also calculated. RESULTS Thirty-four studies representing 2,239 participants were included. Median exercise occurred 3 times per week, 50 minutes per session over a 12-week period. Statistically significant reductions in BMI z-score were found for aerobic exercise and combined aerobic and strength exercise, but not strength training alone (M±SD, 95% CI: aerobic, -0.10, -0.15 to -0.05; aerobic and strength, -0.11, -0.19 to -0.03; strength, 0.04, -0.07 to 0.15). Combined aerobic and strength training was ranked best, followed by aerobic exercise and strength training. The NNT was 2 for both aerobic exercise and combined aerobic exercise and strength training. Percentile improvements were 28.8% for aerobic exercise and 31.5% for combined aerobic exercise and strength training. Confidence in effect estimates was ranked as low for aerobic exercise and very low for combined aerobic and strength training as well as strength training. CONCLUSIONS Aerobic exercise and combined aerobic exercise and strength training are associated with reductions in BMI z-score.
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, West Virginia University, Morgantown, West Virginia, United States
| | - Kristi S Kelley
- Department of Biostatistics, West Virginia University, Morgantown, West Virginia, United States
| | - Russell R Pate
- Exercise Science, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States
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Patel A, Chan W, Aparasu RR, Ochoa-Perez M, Sherer JT, Medhekar R, Chen H. Effect of Psychopharmacotherapy on Body Mass Index Among Children and Adolescents with Bipolar Disorders. J Child Adolesc Psychopharmacol 2017; 27:349-358. [PMID: 28422528 DOI: 10.1089/cap.2016.0133] [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] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To assess the long-term effect of all treatment options for pediatric bipolar disorders on body mass index (BMI) and to explore individual characteristics associated with less BMI increase during psychotropic medication exposures. METHODS A retrospective cohort study was conducted by using the 1995 to 2010 General Electric Electronic Medical Record database. Individuals aged 18 years or younger who had a new bipolar disorder episode were identified. Treatment exposure was defined based on the medication regimens patients received, which include atypical antipsychotic (AT) monotherapy, mood stabilizer (MS) monotherapy, antidepressant (AD) monotherapy, AT+MS polytherapy, AT+AD polytherapy, MS+AD polytherapy, and no treatment. Both treatment exposure and BMI were coded as time varying, which could change from month to month. According to the duration of treatment and the availability of BMI measures, individuals were followed for up to 3, 6, 9, and 12 months since the treatment initiation. Repeated-measures mixed models were applied to compare the impact of different medication regimens and the length of drug exposure on BMI after adjusting for the baseline BMI, sociodemographic factors, comorbidities, and psychotherapy. RESULTS A total of 2299 treated and 4544 untreated children and adolescents who met the inclusion criteria were identified. Analysis using repeated-measures mixed models showed that those on AT monotherapy (the reference group) had a gradually diminished, but statistically significant, monthly increase in BMI during all durations of drug exposure (3 months: 0.36 kg/m2, 6 months: 0.20 kg/m2, 9 months: 0.17 kg/m2, and 12 months: 0.16 kg/m2). As compared with AT monotherapy, the magnitude of increase in BMI associated with MS, AD monotherapy, and no treatment was significantly less at all time points, indicating less steep slopes of BMI change over time compared with AT monotherapy, especially during the short-term exposure. The combinations of AT with other psychotropic medications (ATMS, ATAD) were associated with a similar BMI increase as AT monotherapy. Individual characteristics found to be associated with a less increase in BMI during psychotropic medication exposure were being younger and having a higher baseline BMI. CONCLUSION The long-term use of atypical antipsychotics, both as monotherapy or in combination with other psychotropic medications in children and adolescents with bipolar disorder, was associated with a steady and cumulative increase in BMI.
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Affiliation(s)
- Ayush Patel
- 1 Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy , Houston, Texas
| | - Wenyaw Chan
- 2 Department of Biostatistics, The University of Texas Health Science Center , School of Public Health, Houston, Texas
| | - Rajender R Aparasu
- 1 Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy , Houston, Texas
| | | | - Jeff T Sherer
- 4 Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy , Houston, Texas
| | - Rohan Medhekar
- 1 Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy , Houston, Texas
| | - Hua Chen
- 1 Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy , Houston, Texas
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Abstract
This study aims to describe patients' and families' perspectives regarding the ideal role and responsibilities of a health coach to facilitate pediatric weight management in the primary care setting. Systematic thematic analysis of semistructured interviews with overweight children and their parents was performed. The majority of participants self-identified as racial/ethnic minorities and were Medicaid eligible. Desired health coaching elements included ( a) customized support and encouragement, including goal setting and maintenance, cultural sensitivity, and consideration of budget and lifestyle; ( b) nutritional guidance, including meal planning, assistance obtaining healthy food, and education and counseling; and ( c) linkage to resources, including social services, physical activity support, and programs for children with special health care needs. We conclude that families' specific needs should be holistically considered in the design of health coaching programs targeting pediatric obesity. Such support may help overcome social and financial barriers to changing health behaviors related to weight management.
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Affiliation(s)
- Kerrilynn G Rice
- 1 Harvard T.H. Chan School of Public Health, Boston, MA, USA.,2 University of California San Francisco, San Francisco, CA, USA
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Wang G, Johnson S, Gong Y, Polk S, Divall S, Radovick S, Moon M, Paige D, Hong X, Caruso D, Chen Z, Mallow E, Walker SO, Mao G, Pearson C, Wang MC, Zuckerman B, Cheng TL, Wang X. Weight Gain in Infancy and Overweight or Obesity in Childhood across the Gestational Spectrum: a Prospective Birth Cohort Study. Sci Rep 2016; 6:29867. [PMID: 27417566 PMCID: PMC4945912 DOI: 10.1038/srep29867] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 06/27/2016] [Indexed: 12/15/2022] Open
Abstract
This study aimed to investigate the optimal degree of weight gain across the gestational spectrum in 1971 children enrolled at birth and followed up to age 7 years. Weight gain in infancy was categorized into four groups based on weight gain z-scores: slow (<-0.67), on track (-0.67 to 0.67), rapid (0.67 to 1.28), and extremely rapid (>1.28). Underweight and overweight or obesity (OWO) were defined as a body mass index ≤5(th) and ≥85(th) percentile, respectively, for age and gender. In our population, OWO was far more common than underweight (39.7% vs. 3.6%). Weight gain tracked strongly from age 4 to 24 months, and was positively associated with OWO and an unfavorable pattern of metabolic biomarkers, although the degree of weight gain for the risk was different across gestational categories. Extremely rapid weight gain led to a particularly high risk of OWO among children born early term and late preterm: odds ratio: 3.3 (95% confidence interval: 1.9 to 5.5) and 3.7 (1.8 to 7.5), respectively, as compared to those with on track weight gain. Our findings suggest that monitoring and ensuring optimal weight gain across the entire gestational spectrum beginning from birth represents a first step towards primary prevention of childhood obesity.
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Affiliation(s)
- Guoying Wang
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Sara Johnson
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
- Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Yiwei Gong
- University of Illinois at Urbana-Champaign, Champaign, USA.
| | - Sarah Polk
- Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Sara Divall
- Division of Endocrinology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Sally Radovick
- Division of Endocrinology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Margaret Moon
- Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA
| | - David Paige
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Xiumei Hong
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Deanna Caruso
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Zhu Chen
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Eric Mallow
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Sheila O. Walker
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Guangyun Mao
- School of Environmental Science & Public Health, Wenzhou Medical University Center on Clinical & Epidemiological Eye Research, the Affiliated Eye Hospital of Wenzhou Medical University Wenzhou, China
| | - Colleen Pearson
- Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, USA
| | - Mei-Cheng Wang
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Barry Zuckerman
- Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, USA
| | - Tina L. Cheng
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
- Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Center on Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
- Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA
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Furlong KR, Anderson LN, Kang H, Lebovic G, Parkin PC, Maguire JL, O'Connor DL, Birken CS. BMI-for-Age and Weight-for-Length in Children 0 to 2 Years. Pediatrics 2016; 138:peds.2015-3809. [PMID: 27343232 DOI: 10.1542/peds.2015-3809] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine the agreement between weight-for-length and BMI-for-age in children 0 to <2 years by using research-collected data, examine factors that may affect agreement, and determine if agreement differs between research- and routinely collected data. METHODS Cross-sectional data on healthy, term-born children (n = 1632) aged 0 to <2 years attending the TARGet Kids! practice-based research network in Toronto, Canada (December 2008-October 2014) were collected. Multiple visits for each child were included. Length (cm) and weight (kg) measurements were obtained by trained research assistants during research visits, and by nonresearch staff during all other visits. BMI-for-age z-scores were compared with weight-for-length z-scores (the criterion measure). RESULTS The correlation between weight-for-length and BMI-for-age was strong (r = 0.986, P < .0001) and Bland-Altman plots revealed good agreement (difference = -0.08, SD = 0.20, P = .91). A small proportion (6.3%) of observations were misclassified and most misclassifications occurred near the percentile cutoffs. There were no differences by age and sex. Agreement was similar between research- and routinely collected data (r = 0.99, P < .001; mean difference -0.84, SD = 0.20, P = .67). CONCLUSIONS Weight-for-length and BMI-for-age demonstrated high agreement with low misclassification. BMI-for-age may be an appropriate indicator of growth in the first 2 years of life and has the potential to be used from birth to adulthood. Additional investigation is needed to determine if BMI-for-age in children <2 years is associated with future health outcomes.
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Affiliation(s)
- Kayla R Furlong
- Child Health and Evaluative Sciences, Research Institute, and
| | - Laura N Anderson
- Child Health and Evaluative Sciences, Research Institute, and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Huiying Kang
- Dalla Lana School of Public Health, The Applied Research Centre of the Li Ka Shing Knowledge Institute, and
| | - Gerald Lebovic
- The Applied Research Centre of the Li Ka Shing Knowledge Institute, and Institute of Health Policy, Management, and Evaluation, and
| | - Patricia C Parkin
- Child Health and Evaluative Sciences, Research Institute, and Institute of Health Policy, Management, and Evaluation, and Paediatric Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; Departments of Paediatrics and
| | - Jonathon L Maguire
- The Applied Research Centre of the Li Ka Shing Knowledge Institute, and Institute of Health Policy, Management, and Evaluation, and Paediatric Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; Departments of Paediatrics and Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;and Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;and
| | - Catherine S Birken
- Child Health and Evaluative Sciences, Research Institute, and Institute of Health Policy, Management, and Evaluation, and Paediatric Outcomes Research Team, Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; Departments of Paediatrics and
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Progressive Depletion of Rough Endoplasmic Reticulum in Epithelial Cells of the Small Intestine in Monosodium Glutamate Mice Model of Obesity. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5251738. [PMID: 27437400 PMCID: PMC4942597 DOI: 10.1155/2016/5251738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 05/26/2016] [Accepted: 06/02/2016] [Indexed: 01/08/2023]
Abstract
Chronic obesity is a known risk factor for metabolic syndrome. However, little is known about pathological changes in the small intestine associated with chronic obesity. This study investigated cellular and subcellular level changes in the small intestine of obese mice. In this study, a mouse model of obesity was established by early postnatal administration of monosodium glutamate. Changes in body weight were monitored, and pathological changes in the small intestine were evaluated using hematoxylin-eosin and Nissl staining and light and electron microscopy. Consequently, obese mice were significantly heavier compared with controls from 9 weeks of age. Villi in the small intestine of obese mice were elongated and thinned. There was reduced hematoxylin staining in the epithelium of the small intestine of obese mice. Electron microscopy revealed a significant decrease in and shortening of rough endoplasmic reticulum in epithelial cells of the small intestine of obese mice compared with normal mice. The decrease in rough endoplasmic reticulum in the small intestine epithelial cells of obese mice indicates that obesity starting in childhood influences various functions of the small intestine, such as protein synthesis, and could impair both the defense mechanism against invasion of pathogenic microbes and nutritional absorption.
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Association between body mass index-for-age and slipped capital femoral epiphysis: the long-term risk for subsequent slip in patients followed until physeal closure. J Child Orthop 2016; 10:209-13. [PMID: 27095178 PMCID: PMC4909646 DOI: 10.1007/s11832-016-0731-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 03/28/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Children who present with idiopathic slipped capital femoral epiphysis (SCFE) have an increased risk of developing bilateral disease. Predicting which patients will develop problems with bilateral hips is important for determining treatment algorithms. This is a retrospective observational study that evaluates the relationship and risk between body mass index (BMI)-for-age and unilateral and bilateral SCFE in patients followed until physeal closure. METHODS This is a retrospective study of all patients with SCFE presenting to one institution from 1998-2005. Using the Center for Disease Control (CDC) references, BMI-for-age was calculated for each patient. The patients were followed up until complete closure of the bilateral proximal femoral physes, which was considered completion of the study. Statistical analysis for significant differences between groups was performed using the Kruskal-Wallis test for equality of populations. A logistic regression, controlling for age and gender, was used to identify BMI-for-age as a risk factor and to determine the significance of the odds ratios (ORs) for the relevant categorical variables-obese, overweight and healthy weight. RESULTS Eighty patients (56 male, 24 female) presented to a single institution between 1998 and 2005 with a diagnosis of SCFE. The mean age of patients was 12.2 years at initial presentation (range 8.5-16). Forty-eight patients (32 male, 16 female) presented with unilateral SCFE, with 22 of the 48 patients having a BMI for-age percentile ≥95 %. Thirty-two patients (24 male, 8 female) presented with bilateral SCFE, with 29 of the 32 patients having a BMI-for-age percentile ≥95 %. Patients with a BMI-for-age ≥95 % had a significantly increased risk of presentation with bilateral slips (OR 4.83; relative risk [RR] 3.01; p < 0.05]. All but one patient in this study with bilateral SCFE or unilateral SCFE with subsequent contralateral involvement had a BMI-for-age ≥85 % (44 out of 45 patients). Additionally, the overall risk of developing bilateral SCFE until physeal closure with a BMI-for-age ≥95 % was significantly increased (OR 3.84; RR 2.02; p < 0.05; number needed to treat [NNT] 3.01). CONCLUSIONS Previous work has established a relationship between BMI and SCFE. The CDC BMI-for-age growth charts more accurately measure obesity in the pediatric population compared to BMI and are therefore a more appropriate reference tool. This study demonstrates an association between obesity measured by BMI-for-age percentiles and SCFE. This study also demonstrates an association between BMI-for-age and risk for bilateral SCFE at presentation as well as overall incidence of developing bilateral SCFE in the obese pediatric population. By defining the at-risk population through BMI-for-age, physicians can screen the pediatric patient population and provide early strategies for therapeutic weight loss which may reduce the incidence of SCFE.
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Barnum JL, Petryk A, Zhang L, DeFor TE, Baker KS, Steinberger J, Nathan B, Wagner JE, MacMillan ML. Endocrinopathies, Bone Health, and Insulin Resistance in Patients with Fanconi Anemia after Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2016; 22:1487-1492. [PMID: 27180116 DOI: 10.1016/j.bbmt.2016.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/03/2016] [Indexed: 01/25/2023]
Abstract
A number of endocrinopathies have been described after hematopoietic cell transplantation (HCT), but data are limited in patients with Fanconi anemia (FA). We report several endocrine-based disorders in a cohort of 44 patients with FA after HCT compared with both 74 patients who received HCT for hematologic malignancies and with 275 healthy controls. Endocrinopathies assessed included hypothyroidism, hypogonadism, short stature, dyslipidemia, insulin resistance, abnormalities in body composition, and bone health. Most (86%) patients with FA had at least 1 endocrinopathy, with 11% having 3 or more. Hypothyroidism was seen in 57%, hypogonadism in 27%, short stature in 50%, and reduced total body and lumbar spine bone mineral density (BMD) (height adjusted Z-score < -1) in 57% and 21%, respectively. Vitamin D deficiency was seen in 71%. Short stature was associated with younger age at HCT and gonadal failure was associated with older age at HCT. Insulin resistance was associated with increased percent fat mass and increased android/gynoid ratio by dual energy X-ray absorptiometry. Hypothyroidism, short stature, and reduced total body BMD were more prevalent in patients with FA compared with patients with hematologic malignancies. We recommend an assessment before transplantation and close follow-up afterwards to ensure proper clinical management. Future studies should continue to explore the impact of HCT on endocrinopathies in FA patients.
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Affiliation(s)
- Jessie L Barnum
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Anna Petryk
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Division of Endocrinology, University of Minnesota, Minneapolis, Minnesota
| | - Lei Zhang
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota
| | - Todd E DeFor
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota; Biostatistics and Informatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - K Scott Baker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Division of Pediatric Cardiology, University of Minnesota, Minneapolis, Minnesota
| | - Brandon Nathan
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Division of Endocrinology, University of Minnesota, Minneapolis, Minnesota
| | - John E Wagner
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Margaret L MacMillan
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
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Kelley GA, Kelley KS. Exercise and BMI z-score in overweight and obese children and adolescents: protocol for a systematic review and network meta-analysis of randomised trials. BMJ Open 2016; 6:e011258. [PMID: 27084289 PMCID: PMC4838707 DOI: 10.1136/bmjopen-2016-011258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION While overweight and obesity in children and adolescents is a major global health problem, the effects of exercise on overweight and obesity in children and adolescents are not well established despite numerous studies on this topic. The purpose of this study is to use the network meta-analytic approach to determine the effects of exercise (aerobic, strength training or both) on body mass index (BMI) z-score in overweight and obese children and adolescents. METHODS AND ANALYSIS Randomised exercise intervention trials >4 weeks, published in any language between 1 January 1990 and 31 September 2015, and which include direct and/or indirect evidence, will be included. Studies will be retrieved by searching 6 electronic databases, cross-referencing and expert review. Dual abstraction of data will occur. The primary outcome will be changes in BMI z-score while the secondary outcome will be changes in body weight in kilograms (kg). Risk of bias will be assessed using the Cochrane risk of bias assessment instrument while confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument for network meta-analysis. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of exercise treatments (aerobic, strength training or both). DISSEMINATION The results of this study will be presented at a professional conference and published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER CRD42015026377.
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
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Simmonds M, Burch J, Llewellyn A, Griffiths C, Yang H, Owen C, Duffy S, Woolacott N. The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis. Health Technol Assess 2016; 19:1-336. [PMID: 26108433 DOI: 10.3310/hta19430] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND It is uncertain which simple measures of childhood obesity are best for predicting future obesity-related health problems and the persistence of obesity into adolescence and adulthood. OBJECTIVES To investigate the ability of simple measures, such as body mass index (BMI), to predict the persistence of obesity from childhood into adulthood and to predict obesity-related adult morbidities. To investigate how accurately simple measures diagnose obesity in children, and how acceptable these measures are to children, carers and health professionals. DATA SOURCES Multiple sources including MEDLINE, EMBASE and The Cochrane Library were searched from 2008 to 2013. METHODS Systematic reviews and a meta-analysis were carried out of large cohort studies on the association between childhood obesity and adult obesity; the association between childhood obesity and obesity-related morbidities in adulthood; and the diagnostic accuracy of simple childhood obesity measures. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and a modified version of the Quality in Prognosis Studies (QUIPS) tool. A systematic review and an elicitation exercise were conducted on the acceptability of the simple measures. RESULTS Thirty-seven studies (22 cohorts) were included in the review of prediction of adult morbidities. Twenty-three studies (16 cohorts) were included in the tracking review. All studies included BMI. There were very few studies of other measures. There was a strong positive association between high childhood BMI and adult obesity [odds ratio 5.21, 95% confidence interval (CI) 4.50 to 6.02]. A positive association was found between high childhood BMI and adult coronary heart disease, diabetes and a range of cancers, but not stroke or breast cancer. The predictive accuracy of childhood BMI to predict any adult morbidity was very low, with most morbidities occurring in adults who were of healthy weight in childhood. Predictive accuracy of childhood obesity was moderate for predicting adult obesity, with a sensitivity of 30% and a specificity of 98%. Persistence of obesity from adolescence to adulthood was high. Thirty-four studies were included in the diagnostic accuracy review. Most of the studies used the least reliable reference standard (dual-energy X-ray absorptiometry); only 24% of studies were of high quality. The sensitivity of BMI for diagnosing obesity and overweight varied considerably; specificity was less variable. Pooled sensitivity of BMI was 74% (95% CI 64.2% to 81.8%) and pooled specificity was 95% (95% CI 92.2% to 96.4%). The acceptability to children and their carers of BMI or other common simple measures was generally good. LIMITATIONS Little evidence was available regarding childhood measures other than BMI. No individual-level analysis could be performed. CONCLUSIONS Childhood BMI is not a good predictor of adult obesity or adult disease; the majority of obese adults were not obese as children and most obesity-related adult morbidity occurs in adults who had a healthy childhood weight. However, obesity (as measured using BMI) was found to persist from childhood to adulthood, with most obese adolescents also being obese in adulthood. BMI was found to be reasonably good for diagnosing obesity during childhood. There is no convincing evidence suggesting that any simple measure is better than BMI for diagnosing obesity in childhood or predicting adult obesity and morbidity. Further research on obesity measures other than BMI is needed to determine which is the best tool for diagnosing childhood obesity, and new cohort studies are needed to investigate the impact of contemporary childhood obesity on adult obesity and obesity-related morbidities. STUDY REGISTRATION This study is registered as PROSPERO CRD42013005711. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Mark Simmonds
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Jane Burch
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Alexis Llewellyn
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Huiqin Yang
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Christopher Owen
- Division of Population Health Sciences and Education, St George's, University of London, London, UK
| | - Steven Duffy
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Nerys Woolacott
- Centre for Reviews and Dissemination, University of York, York, UK
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The Relationships Among Sleep, Nutrition, and Obesity. CURRENT SLEEP MEDICINE REPORTS 2015. [DOI: 10.1007/s40675-015-0030-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sun Y, Krakow M, John KK, Liu M, Weaver J. Framing Obesity: How News Frames Shape Attributions and Behavioral Responses. JOURNAL OF HEALTH COMMUNICATION 2015; 21:139-147. [PMID: 26375052 DOI: 10.1080/10810730.2015.1039676] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Based on a public health model of obesity, this study set out to examine whether a news article reporting the obesity issue in a societal versus individual frame would increase perceptions of societal responsibilities for the obesity problem and motivate responsibility-taking behaviors. Responsibility-taking behaviors were examined at 3 levels: personal, interpersonal, and societal. Data from a Web-based experiment revealed significant framing effects on behaviors via causal and treatment responsibility attributions. The societal frame increased societal causal and treatment attribution, which led to greater likelihoods of interpersonal and social responsibility-taking behaviors as well as personal behaviors. Our findings suggest that news framing can be an effective venue for raising awareness of obesity as a societal issue and mobilizing collective efforts.
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Affiliation(s)
- Ye Sun
- a Department of Communication , University of Utah , Salt Lake City , Utah , USA
| | - Melinda Krakow
- a Department of Communication , University of Utah , Salt Lake City , Utah , USA
| | - Kevin K John
- b School of Communications , Brigham Young University , Provo , Utah , USA
| | - Miao Liu
- a Department of Communication , University of Utah , Salt Lake City , Utah , USA
| | - Jeremy Weaver
- a Department of Communication , University of Utah , Salt Lake City , Utah , USA
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Abstract
Childhood obesity prevalence has been increased and known to be related to various diseases and mortality in adult and body mass index (BMI) has been widely used as a screening tool in children with obesity. It is important to understand what BMI is and its limitations. BMI is a measure of weight adjusted for height. Weight scales to height with a power of about 2, is the basis of BMI (weight/height(2)) as the scaling of body weight to height across adults provides powers rounded to 2. BMI has the advantage of a simple and noninvasive surrogate measure of body fat, but it has limitation in differentiating body fat from lean (fat free) mass and low-moderate sensitivity is problematic for clinical applications. Among overweight children higher BMI levels can be a result of increased either fat or fat-free mass. BMI could be divided into fat-free mass index and fat mass index. Monitoring of the changes in body composition is important as distinguishing changes in each component occur with rapid growth in adolescents as it is occur in concert with changes in the hormonal environment. Reference values for each body composition indexes and chart created with selected percentiles of a normal adolescent population could be helpful in growth assessment and health risk evaluation.
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Affiliation(s)
- Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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Hirko KA, Kantor ED, Cohen SS, Blot WJ, Stampfer MJ, Signorello LB. Body mass index in young adulthood, obesity trajectory, and premature mortality. Am J Epidemiol 2015; 182:441-50. [PMID: 25977515 DOI: 10.1093/aje/kwv084] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/30/2015] [Indexed: 01/17/2023] Open
Abstract
Although much research has been conducted on the role adult body mass index (BMI) plays in mortality, there have been fewer studies that evaluated the associations of BMI in young adulthood and adult weight trajectory with mortality, and it remains uncertain whether associations differ by race or sex. We prospectively examined the relationships of BMI in young adulthood (21 years of age) and adult obesity trajectory with later-life mortality rates among 75,881 men and women in the Southern Community Cohort Study. Study participants were enrolled between 2002 and 2009 at ages 40-79 years and were followed through December, 2011. Multivariable Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. There were 7,301 deaths in the 474,970 person-years of follow-up. Participants who reported being overweight or obese as young adults had mortality rates that were 19% (95% confidence interval: 12, 27) and 64% (95% confidence interval: 52, 78) higher, respectively, than those of their normal weight counterparts. The results did not significantly differ by race or sex. Participants who reported being obese in young adulthood only or in both young and middle adulthood experienced mortality rates that were 40%-90% higher than those of participants who were nonobese at either time. These results suggest that obesity in young adulthood is associated with higher mortality risk regardless of race, sex, and obesity status in later life.
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Chorin E, Hassidim A, Hartal M, Havakuk O, Flint N, Ziv-Baran T, Arbel Y. Trends in Adolescents Obesity and the Association between BMI and Blood Pressure: A Cross-Sectional Study in 714,922 Healthy Teenagers. Am J Hypertens 2015; 28:1157-63. [PMID: 25736450 DOI: 10.1093/ajh/hpv007] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 01/09/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Seventeen percent of youth in the United States are obese. Obesity has been linked to higher prevalence of hypertension. Past studies were limited by their size and conflicting results. The aim of this study was to analyze trends in adolescents' obesity between 1998 and 2011 and to evaluate the relationship between blood pressure and body mass index (BMI) in healthy adolescents. METHODS All adolescents who underwent a medical exam in the years 1998-2011 and were found fit for combat duties in the Israeli Defense Force were included. RESULTS The cohort included 714,922 healthy adolescents with 59% of them being males. The mean age was 17.4±0.45 and mean BMI was 22±3.5 kg/m(2). The percentage of overweight adolescents (BMI > 25 kg/m(2)) has increased from 13.2% in 1998 to 21% in 2011, P < 0.001. The mean systolic and diastolic blood pressures increased with increasing BMI deciles (systolic blood pressure by 10mm Hg and diastolic blood pressure by 3-4mm Hg from the 1st decile to the 10th decile, P < 0.001 for both). In multivariate analysis, each increase of 1 unit of BMI was associated with an increased risk of systolic blood pressure above 130 mm Hg in both males (OR = 1.108, 95% CI 1.107-1.110, P < 0.001) and females (OR = 1.114, 95% CI 1.139-1.146, P < 0.001). CONCLUSIONS BMI in adolescents is significantly associated with systolic blood pressure and diastolic blood pressure in both genders and in both the normal weight and overweight groups. There has been consistent trend of increasing BMI values over recent years.
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Affiliation(s)
- Ehud Chorin
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | | | - Michael Hartal
- Israel Defense Forces Medical Corps, Israel; The Department of Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ofer Havakuk
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Nir Flint
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Ziv-Baran
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaron Arbel
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel;
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50
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Identifying Overweight and Obese Children. TOP CLIN NUTR 2015. [DOI: 10.1097/tin.0000000000000028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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