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Wood C, Khalsa AS. Overview of BMI and Other Ways of Measuring and Screening for Obesity in Pediatric Patients. Pediatr Clin North Am 2024; 71:781-796. [PMID: 39343492 DOI: 10.1016/j.pcl.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Despite a long history of advances in measuring body size and composition, body mass index (BMI) has remained the most commonly used clinical measure. We explore the advantages and disadvantages of using BMI and other measures to estimate adipose tissue, recognizing that no measure of body size or adiposity has fulfilled the goal of differentiating health from disease. BMI and waist circumference remain widely-used clinical screening measures for appropriate risk stratification as it relates to obesity.
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Affiliation(s)
- Charles Wood
- Department of Pediatrics, Division of General Pediatrics and Adolescent Health, Duke Center for Childhood Obesity Research, Duke University School of Medicine, 3116 N. Duke Street, Durham, NC 27704, USA.
| | - Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH 43205, USA
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2
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van Leeuwen GJ, Kemmeren LAM, Piscaer TM, Oei EHG, Bindels PJE, Bierma-Zeinstra SMA, van Middelkoop M. Knee Pain, Joint Loading, and Structural Abnormalities on MRI in 13-Year-Old Children in a Population-Based Birth Cohort. Am J Sports Med 2024:3635465241274792. [PMID: 39320429 DOI: 10.1177/03635465241274792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2024]
Abstract
BACKGROUND Knee pain is a common problem in children and adolescents, and it often has a chronic character. PURPOSE To examine the prevalence of knee pain in 13-year-old children and assess associations of knee pain with physical factors and the presence of structural abnormalities on magnetic resonance imaging (MRI). STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Data from the Generation R Study, a population-based birth cohort, were used. Prevalence and characteristics of knee pain were assessed, using a pain mannequin, in children 13 years of age (N = 1849). Patient characteristics and data on physical activity were extracted from questionnaires. The body mass index standard deviation score and waist-hip ratio were calculated from objectively measured weight and height. Structural abnormalities were assessed by MRI. The differences between children with and without knee pain were also analyzed. RESULTS A prevalence of 8.0% was found for knee pain in children, of which 92.3% persisted for >3 months (ie, chronic); 37.5% of the children experienced pain daily, and the pain was almost always located on the anterior side of the knee (98.6%). Higher body mass index standard deviation scores were seen in children with knee pain than in the children without knee pain. No differences in physical activity were seen between children with and without knee pain. Moreover, in children with knee pain compared with children without knee pain, characteristics of Osgood-Schlatter disease (6.8% vs 1.9%) and bipartite patella type 3 (4.7% vs 0.3%) were more often seen on MRI. CONCLUSION This study shows that knee pain is a relatively frequent problem in children. It is almost always located on the anterior aspect, has a chronic character, and is often experienced daily. However, the possible implication of structural abnormalities on MRI in children with knee pain and the possible relationship with the development of future knee complaints are still unclear.
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Affiliation(s)
- Guido J van Leeuwen
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Laura A M Kemmeren
- Department of Orthopedics and Sports Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tom M Piscaer
- Department of Orthopedics and Sports Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Orthopedics and Sports Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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3
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Mahmood S, Tanvir EM, Komarova T, Islam MN, Khatun M, Hossain MF, Ng JC, Whitfield KM, Hossain MS, Khalil MI, Shaw PN. Relationships between growth indicators, liver and kidney function markers, and blood concentrations of essential and potentially toxic elements in environmentally exposed young children. Int J Hyg Environ Health 2023; 253:114237. [PMID: 37544043 DOI: 10.1016/j.ijheh.2023.114237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/08/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
Environmental exposure to multiple metals and metalloids is widespread, leading to a global concern relating to the adverse health effects of mixed-metals exposure, especially in young children living around industrial areas. This study aimed to quantify the concentrations of essential and potentially toxic elements in blood and to examine the potential associations between multiple elements exposures, growth determinants, and liver and kidney function biomarkers in children living in several industrial areas in Dhaka, Bangladesh. The blood distribution of 20 trace elements As, Ag, Bi, Br, Cd, Co, Cr, Cu, I, Mn, Hg, Mo, Ni, Pb, Se, Sb, Tl, V, U, and Zn, growth determinants such as body mass index and body fats, blood pressure, liver and kidney injury biomarkers including serum alanine aminotransferase and alkaline phosphatase activities, serum calcium, and creatinine levels, blood urea nitrogen, and hemoglobin concentrations, and glomerular filtration rate were measured in 141 children, aged six to 16 years. Among these elements, blood concentrations of Ag, U, V, Cr, Cd, Sb, and Bi were measured below LOQs and excluded from subsequent statistical analysis. This comprehensive study revealed that blood concentrations of these elements in children, living in industrial areas, exceeded critical reference values to varying extents; elevated exposure to As, Pb, Br, Cu, and Se was found in children living in multiple industrial areas. A significant positive association between elevated blood Tl concentration and obesity (β = 0.300, p = 0.007) and an inverse relationship between lower As concentration and underweight (β = -0.351, p < 0.001) compared to healthy weight children indicate that chronic exposure to Tl and As may influence the metabolic burden and physical growth in children. Concentration-dependent positive associations were observed between the blood concentrations of Cu, Se, and Br and hepatic- and renal dysfunction biomarkers, an inverse association with blood Mo and I level, however, indicates an increased risk of Cu, Se, and Br-induced liver and kidney toxicity. Further in-depth studies are warranted to elucidate the underlying mechanisms of the observed associations. Regular biomonitoring of elemental exposures is also indispensable to regulate pollution in consideration of the long-term health effects of mixed-elements exposure in children.
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Affiliation(s)
- Shakil Mahmood
- Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh; Department of Biochemistry, Gonoshasthaya Samaj Vittik Medical College, Gono Bishwabidyalay (University), Dhaka, 1344, Bangladesh
| | - E M Tanvir
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, 4072, Australia; Institute of Food & Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Savar, Dhaka, 1349, Bangladesh
| | - Tatiana Komarova
- Inorganic Chemistry Laboratory, Queensland Public Health and Scientific Services, Coopers Plains, Queensland, 4108, Australia
| | - Md Nazrul Islam
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, Queensland, 4102, Australia; Department of Applied Chemistry and Chemical Engineering, University of Chittagong, Chittagong, 4331, Bangladesh
| | - Mahbuba Khatun
- Department of Biochemistry and Molecular Biology, Gono Bishwabidyalay (University), Dhaka, 1344, Bangladesh
| | - Md Fuad Hossain
- Department of Biochemistry and Molecular Biology, Gono Bishwabidyalay (University), Dhaka, 1344, Bangladesh
| | - Jack C Ng
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, Queensland, 4102, Australia
| | - Karen M Whitfield
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, 4072, Australia; Pharmacy Department, Royal Brisbane and Women's Hospital, Metro North Health Services District, Herston, Queensland, 4029, Australia
| | - Md Sabir Hossain
- Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Md Ibrahim Khalil
- Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
| | - P Nicholas Shaw
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, 4072, Australia.
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Hahnraths MTH, Winkens B, van Schayck OCP. Effects of School-Based Health-Promoting Activities on Children's Health: A Pragmatic Real-World Study. Nutrients 2023; 15:3349. [PMID: 37571286 PMCID: PMC10420810 DOI: 10.3390/nu15153349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
More insight into the health effects of scaled-up school-based interventions in real-world settings is vital to sustainably integrate health in all schools. This study investigated the effectiveness of the scaled-up Healthy Primary School of the Future (HPSF) initiative in real-world school contexts on children's health (behaviours). From 2019 to 2022, eleven Dutch primary schools implemented HPSF-related activities. In 315 children from study years four to six (aged 7-11 years) from these schools, anthropometric measurements were performed, and questionnaires assessing the children's dietary behaviours and physical activity were administered. COVID-19 greatly limited the implementation of HPSF-related activities. Therefore, the results were compared between schools categorised as medium implementers and schools categorised as low implementers. After correction for baseline, waist circumference in the medium implementer group was significantly higher at one-year follow-up (B = 1.089, p = 0.003) and two-year follow-up (B = 1.665, p < 0.001) compared with waist circumference in the low implementer group. No significant effects were observed for other outcomes. This study showed hardly any effects of the scaled-up HPSF initiative, mainly due to the limited implementation caused by COVID-19. More research investigating the real-world effectiveness of HPSF and comparable programmes is greatly encouraged to advance the field of school-based health promotion.
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Affiliation(s)
- Marla T. H. Hahnraths
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Onno C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
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van Beijsterveldt IALP, Dorrepaal DJ, de Fluiter KS, de Ridder MAJ, Hokken-Koelega ACS. Skinfold-based-equations to assess longitudinal body composition in children from birth to age 5 years. Clin Nutr 2023; 42:1213-1218. [PMID: 37225558 DOI: 10.1016/j.clnu.2023.04.024] [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: 01/06/2023] [Revised: 04/05/2023] [Accepted: 04/26/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND & AIMS In order to identify children at risk for excess adiposity, it is important to determine body composition longitudinally throughout childhood. However, most frequently used techniques in research are expensive and time-consuming and, therefore, not feasible for use in general clinical practice. Skinfold measurements can be used as proxy for adiposity, but current anthropometry-based-equations have random and systematic errors, especially when used longitudinally in pre-pubertal children. We developed and validated skinfold-based-equations to estimate total fat mass (FM) longitudinally in children aged 0-5 years. METHODS This study was embedded in the Sophia Pluto study, a prospective birth cohort. In 998 healthy term-born children, we longitudinally measured anthropometrics, including skinfolds and determined FM using Air Displacement Plethysmography (ADP) by PEA POD and Dual energy X-ray Absorptiometry (DXA) from birth to age 5 years. Of each child one random measurement was used in the determination cohort, others for validation. Linear regression was used to determine the best fitting FM-prediction model based on anthropometric measurements using ADP and DXA as reference methods. For validation, we used calibration plots to determine predictive value and agreement between measured and predicted FM. RESULTS Three skinfold-based-equations were developed for adjoined age ranges (0-6 months, 6-24 months and 2-5 years), based on FM-trajectories. Validation of these prediction equations showed significant correlations between measured and predicted FM (R: 0.921, 0.779 and 0.893, respectively) and good agreement with small mean prediction errors of 1, 24 and -96 g, respectively. CONCLUSIONS We developed and validated reliable skinfold-based-equations which may be used longitudinally from birth to age 5 years in general practice and large epidemiological studies.
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Affiliation(s)
- Inge A L P van Beijsterveldt
- Department of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands; Dutch Growth Research Foundation, Rotterdam, the Netherlands.
| | - Demi J Dorrepaal
- Department of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands
| | | | - Maria A J de Ridder
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Anita C S Hokken-Koelega
- Department of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands; Dutch Growth Research Foundation, Rotterdam, the Netherlands
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Kułaga Z, Świąder-Leśniak A, Kotowska A, Litwin M. Population-based references for waist and hip circumferences, waist-to-hip and waist-to-height ratios for children and adolescents, and evaluation of their predictive ability. Eur J Pediatr 2023:10.1007/s00431-023-05001-4. [PMID: 37140701 DOI: 10.1007/s00431-023-05001-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/11/2023] [Accepted: 04/22/2023] [Indexed: 05/05/2023]
Abstract
Childhood obesity is a public health problem globally as well as in Poland. This paper aimed to provide age- and sex-specific waist circumference, hip circumference, waist-to-height ratio and waist-to-hip ratio normative values for Polish children and adolescents aged 3 - 18 years for more precise monitoring of abdominal fat accumulation. The waist circumference, hip circumference, waist-to-height ratio and waist-to-hip ratio references were constructed with the lambda-mu-sigma (LMS) method using data from two nationally representative health surveys: the OLA study and the OLAF study, the largest available paediatric surveys in Poland which provided measured height, weight, waist, hip and blood pressure for 22,370 children and adolescents aged 3 - 18 years. The predictive ability of newly established references for overweight/obesity as defined by the International Obesity Task Force criteria and elevated blood pressure was tested with receiver operating characteristic. Abdominal obesity cut-offs linked to adult cardiometabolic cut-offs were established. Reference values for waist circumference, hip circumference, waist-to-height ratio and waist-to-hip ratio are presented, as well as waist circumference, waist-to-height ratio and waist-to-hip ratio cut-off values linked to adult's cut-offs of cardiometabolic risk. The predictive value for overweight and obesity of population-based waist, hip and waist-to-height ratio references was outstanding-area under the receiver operating characteristic curve > 0.95 in both sexes, whereas with regard to the elevated blood pressure predictive ability was low-area under the receiver operating characteristic curve < 0.65. Conclusion: This paper presents the first waist, hip, waist-to-height ratio and waist-to-hip ratio references for Polish children and adolescents aged 3-18 years. The 90th and 95th percentile and cut-offs linked to adult thresholds for cardiometabolic risk are proposed as cut-offs for abdominal obesity. What is Known: • Waist circumference, waist-to-height ratio and waist-to-hip ratio are used to assess abdominal obesity in children and adults. • In Poland, there is no abdominal obesity and hip circumference references for children and adolescents from 3 to 18 years of age. What is New: • Population-based references of central obesity indices and hip references for children and youth aged 3-18 years and cardiometabolic risk thresholds for children and adolescents linked to adult's cut-offs were established.
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Affiliation(s)
- Zbigniew Kułaga
- Public Health Department, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland.
| | - Anna Świąder-Leśniak
- Laboratory of Anthropology, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland
| | - Aneta Kotowska
- Public Health Department, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland
| | - Mieczysław Litwin
- Department of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland
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Toussaint N, Streppel MT, Mul S, Gündüz M, van Verseveld MDA, Janssen M, Weijs PJM, Fukkink RG. Effect and process evaluation of a preschool-based intervention to promote an early childhood education and care teacher-parent partnership about healthy behaviours in children: Study protocol for the cluster randomised controlled trial CO-HEALTHY. PLoS One 2023; 18:e0281999. [PMID: 36812263 PMCID: PMC9946211 DOI: 10.1371/journal.pone.0281999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/01/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Early Childhood Education and Care (ECEC) teachers at urban preschools are potential key figures to promote healthy behaviours in disadvantaged young children and to engage parents in lifestyle-related topics. An ECEC teacher-parent partnership regarding healthy behaviours may support parents and stimulate their children's development. However, it is not an easy task to establish such a collaboration and ECEC teachers need tools to communicate with parents about lifestyle-related topics. This paper describes the study protocol of a preschool-based intervention (CO-HEALTHY) to promote an ECEC teacher-parent partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children. METHODS A cluster randomised controlled trial will be performed at preschools in Amsterdam, the Netherlands. Preschools will be randomly allocated to an intervention or control group. The intervention consists of a toolkit with 10 parent-child activities and associated training for ECEC teachers. The activities were composed using the Intervention Mapping protocol. At intervention preschools, ECEC teachers will carry out the activities during standard contact moments. Parents will receive associated intervention materials and will be encouraged to perform similar parent-child activities at home. At control preschools, the toolkit and training will not be implemented. The primary outcome will be the teacher- and parent-reported partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children. The perceived partnership will be assessed by a questionnaire at baseline and at 6 months. In addition, short interviews with ECEC teachers will be held. Secondary outcomes include the knowledge, attitude, food- and activity-related practices of ECEC teachers and parents. Furthermore, children's eating, physical (in)activity and sleeping behaviours, and weight development will be assessed. A process evaluation of the intervention will be made. DISCUSSION The intervention aims to provide a practical tool for ECEC teachers at urban preschools to promote an ECEC teacher-parent partnership regarding a healthy lifestyle in young children. TRIAL REGISTRATION Netherlands Trial Register (NTR): NL8883. Date registered: September 8, 2020.
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Affiliation(s)
- Nicole Toussaint
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Martinette T. Streppel
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- * E-mail:
| | - Sandra Mul
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Meryem Gündüz
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Marloes D. A. van Verseveld
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mirka Janssen
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Peter J. M. Weijs
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Nutrition & Dietetics, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Ruben G. Fukkink
- Faculty of Child Development and Education, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
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Draijer L, Voorhoeve M, Troelstra M, Holleboom A, Beuers U, Kusters M, Nederveen A, Benninga M, Koot B. A natural history study of pediatric non-alcoholic fatty liver disease over 10 years. JHEP Rep 2023; 5:100685. [PMID: 37077274 PMCID: PMC10106916 DOI: 10.1016/j.jhepr.2023.100685] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 01/07/2023] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
Background & Aims The long-term outcome of paediatric non-alcoholic fatty liver disease (NAFLD) has not been well established. Between 2008 and 2012, an unselected cohort of 133 children with severe obesity was screened for NAFLD. The aim of this study was to determine the 10-year natural history of NAFLD in this cohort. Methods All 133 participants of the original study were approached. Proton magnetic resonance spectroscopy (1H-MRS) and the Enhanced Liver Fibrosis® (ELF) test were used to assess longitudinal changes in steatosis and fibrosis, respectively. Risk factors for disease progression were explored. Results Fifty-one of the 133 participants (38%) from the original cohort were included. The mean follow-up time was 10.3 years (range 7-13 years), 65% were female and 92% had persistent obesity. The proportion of participants with steatosis remained unchanged (47%). Nine individuals developed steatosis and in nine individuals steatosis resolved. Predefined relevant individual changes in 1H-MRS were seen in 38% of the participants. The mean ELF test did not change significantly (8.70 ± 0.58 vs. 8.51 ± 0.71, p = 0.22). However, 16% had a relevant increase in ELF test and 6% of those with NAFLD developed advanced fibrosis at follow-up. Changes in steatosis correlated with changes in established metabolic risk factors, alanine aminotransferase, and bariatric surgery. A change in the ELF test was associated with a change in triglycerides. Conclusions This 10-year follow-up study shows that one-third of the young adults who had childhood obesity develop steatosis and in one-third steatosis resolves. Six percent of those with NAFLD had developed advanced fibrosis at follow-up. These data underscore the importance of screening for NAFLD and monitoring for progression to advanced NAFLD in young people with obesity. Impact and implications Childhood obesity accompanied by fat accumulation in the liver persists into young adulthood in the vast majority, and 6% develop serious liver injury. Worsening of metabolic disturbances increases the risk of liver injury.
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Affiliation(s)
- Laura Draijer
- Department of Pediatric Gastroenterology and Nutrition, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children’s Hospital, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children’s Hospital, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, the Netherlands
- Corresponding author. Address: Meibergdreef 9, 1100 DD Amsterdam, the Netherlands. Tel.: +31-205662906
| | - Maaike Voorhoeve
- Department of Pediatric Gastroenterology and Nutrition, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children’s Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | - Marian Troelstra
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Adriaan Holleboom
- Department of Vascular Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Ulrich Beuers
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Meeike Kusters
- Department of Pediatrics, Amsterdam University Medical Centers, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Aart Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Marc Benninga
- Department of Pediatric Gastroenterology and Nutrition, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children’s Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | - Bart Koot
- Department of Pediatric Gastroenterology and Nutrition, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children’s Hospital, University of Amsterdam, Amsterdam, the Netherlands
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9
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Ben Othman R, Talbi E, Mizouri R, Ben Amor N, Gamoudi A, Lahmer I, Berriche O, Mahjoub F, Jamoussi H. Evaluation of anthropometric profile in obese children: risk factors & eating disorder. ALEXANDRIA JOURNAL OF MEDICINE 2022. [DOI: 10.1080/20905068.2022.2103884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Affiliation(s)
- rym Ben Othman
- University of Tunis El Manar, Tunisia
- University of Medicine of Tunis, Tunisia
- National Institute of Nutrition of Tunis, Tunisia
| | - emna Talbi
- University of Tunis El Manar, Tunisia
- University of Medicine of Tunis, Tunisia
- National Institute of Nutrition of Tunis, Tunisia
| | - ramla Mizouri
- University of Tunis El Manar, Tunisia
- University of Medicine of Tunis, Tunisia
- National Institute of Nutrition of Tunis, Tunisia
| | - nadia Ben Amor
- University of Tunis El Manar, Tunisia
- University of Medicine of Tunis, Tunisia
- National Institute of Nutrition of Tunis, Tunisia
| | - amel Gamoudi
- University of Tunis El Manar, Tunisia
- University of Medicine of Tunis, Tunisia
- National Institute of Nutrition of Tunis, Tunisia
| | - ines Lahmer
- University of Tunis El Manar, Tunisia
- University of Medicine of Tunis, Tunisia
- National Institute of Nutrition of Tunis, Tunisia
| | - olfa Berriche
- University of Tunis El Manar, Tunisia
- University of Medicine of Tunis, Tunisia
- National Institute of Nutrition of Tunis, Tunisia
| | - faten Mahjoub
- University of Tunis El Manar, Tunisia
- University of Medicine of Tunis, Tunisia
- National Institute of Nutrition of Tunis, Tunisia
| | - henda Jamoussi
- University of Tunis El Manar, Tunisia
- University of Medicine of Tunis, Tunisia
- National Institute of Nutrition of Tunis, Tunisia
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10
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van Dam MJCM, Pottel H, Vreugdenhil ACE. Relation between obesity-related comorbidities and kidney function estimation in children. Pediatr Nephrol 2022; 38:1867-1876. [PMID: 36416955 PMCID: PMC10154263 DOI: 10.1007/s00467-022-05810-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The current childhood obesity pandemic is likely to result in an increased risk of chronic kidney disease (CKD) later in life. Correlations between obesity-related comorbidities and kidney function can be found, but it is unclear to what extent this is caused by bias due to different mathematical forms of the estimated glomerular filtration rate (eGFR) equations. The present study aimed to analyze correlations between obesity-related comorbidities and different eGFR equations and to investigate whether rescaled serum creatinine (SCr/Q) for sex and age or height might be an alternative biomarker for kidney function estimation. METHODS This cross-sectional cohort study included 600 children with overweight and obesity. Mean age was 12.20 ± 3.28 years, 53.5% were female, and mean BMI z-score was 3.31 ± 0.75. All children underwent a comprehensive assessment that included anthropometrical and blood pressure measurements, laboratory examination, air displacement plethysmography, and polysomnography. Qage and Qheight polynomials were used to rescale SCr and multiple creatinine-based eGFR equations were compared. RESULTS SCr/Q and almost all GFR estimations significantly correlated with a waist-to-hip ratio, fat mass, homeostasis model assessment for insulin resistance, and triacylglyceride, HDL cholesterol, alanine transaminase, and serum uric acid concentrations. Multiple correlations, however, were not confirmed by all equations, which suggests dependency on the mathematical form of the different eGFR equations. CONCLUSIONS Correlations between obesity-related comorbidities and creatinine-based eGFR are present in children with overweight and obesity, but depend to a large extent on the eGFR equation of choice. SCr/Q might be an alternative biomarker for assessing correlations between obesity-related comorbidities and kidney function in children with overweight and obesity. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Mark J C M van Dam
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Pediatrics, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre +, Maastricht, The Netherlands.
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Anita C E Vreugdenhil
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Pediatrics, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre +, Maastricht, The Netherlands
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11
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Lassek WD, Gaulin SJC. Substantial but Misunderstood Human Sexual Dimorphism Results Mainly From Sexual Selection on Males and Natural Selection on Females. Front Psychol 2022; 13:859931. [PMID: 35664212 PMCID: PMC9156798 DOI: 10.3389/fpsyg.2022.859931] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/28/2022] [Indexed: 01/05/2023] Open
Abstract
Human sexual dimorphism has been widely misunderstood. A large literature has underestimated the effect of differences in body composition and the role of male contest competition for mates. It is often assumed that sexually dimorphic traits reflect a history of sexual selection, but natural selection frequently builds different phenotypes in males and females. The relatively small sex difference in stature (∼7%) and its decrease during human evolution have been widely presumed to indicate decreased male contest competition for mates. However, females likely increased in stature relative to males in order to successfully deliver large-brained neonates through a bipedally-adapted pelvis. Despite the relatively small differences in stature and body mass (∼16%), there are marked sex differences in body composition. Across multiple samples from groups with different nutrition, males typically have 36% more lean body mass, 65% more muscle mass, and 72% more arm muscle than women, yielding parallel sex differences in strength. These sex differences in muscle and strength are comparable to those seen in primates where sexual selection, arising from aggressive male mating competition, has produced high levels of dimorphism. Body fat percentage shows a reverse pattern, with females having ∼1.6 times more than males and depositing that fat in different body regions than males. We argue that these sex differences in adipose arise mainly from natural selection on women to accumulate neurodevelopmental resources.
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Affiliation(s)
| | - Steven J. C. Gaulin
- Department of Anthropology, University of California, Santa Barbara, Santa Barbara, CA, United States
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12
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Mellin J, Le Prevost M, Kenny J, Sturgeon K, Thompson LC, Foster C, Kessler HH, Goswami N, Klein N, Judd A, Castro H. Arterial Stiffness in a Cohort of Young People Living With Perinatal HIV and HIV Negative Young People in England. Front Cardiovasc Med 2022; 9:821568. [PMID: 35299977 PMCID: PMC8921599 DOI: 10.3389/fcvm.2022.821568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/07/2022] [Indexed: 12/19/2022] Open
Abstract
Background Antiretroviral therapy (ART) has increased life expectancy and consequently the risk of cardiovascular disease (CVD) in adults living with HIV. We investigated the levels and predictors of arterial stiffness in young people (YP) living with perinatal HIV (PHIV) and HIV negative YP in the Adolescents and Adults Living with Perinatal HIV (AALPHI) study. Methods AALPHI was a prospective study evaluating the impact of HIV infection and exposure to ART on YP living with PHIV (aged 13–21 years) who had known their HIV status for at least 6 months, and HIV negative YP (aged 13–23 years) who either had a sibling, friend or parent living with HIV. Participants were enrolled from HIV clinics and community services in England. Two hundred and thirteen PHIV and 65 HIV negative YP (42% siblings of PHIV) had pulse wave velocity (PWV) measurements taken (Vicorder software) from the supra-sternal notch to the middle of the thigh cuff, at their second interview in the study between 2015 and 2017. Average PWV was calculated from the three closest readings (≥3 and ≤ 12 m/s) within 0.6 m/s of each other. Linear regression examined predictors of higher (worse) PWV, including age, sex, HIV status and height as a priori, ethnicity, born outside UK/Ireland, alcohol/nicotine/drug use, weight, waist-to-hip-ratio, mean arterial pressure (MAP), caffeine 2 h before PWV and nicotine on day of PWV. A separate PHIV model included CD4, viral load, years taking ART and ART regimen. Findings One hundred and twenty eight (60%) PHIV and 45 (69%) HIV negative YP were female (p = 0.18), with median (IQR) age 18 (16, 20) and 18 (16, 21) years (p = 0.48) respectively. Most PHIV were taking a combination of three ART drugs from two classes. There was a trend toward higher (worse) mean PWV in the PHIV group than the HIV negative group [unvariable analysis 6.15 (SD 0.83) m/s vs. 5.93 (0.70) m/s, respectively, unadjusted p = 0.058], which was statistically significant in the multivariable analysis [adjusted p (ap) = 0.020]. In multivariable analysis being male (ap = 0.002), older age (ap < 0.001), higher MAP (ap < 0.001) and nicotine use on day of measurement (ap = 0.001) were also predictors of higher PWV. The predictors were the same in the PHIV model. Interpretation By late adolescence PHIV had worse PWV in comparison to HIV negative peers, and traditional risk factors for CVD (higher arterial pressure, being male and older age) were associated with higher PWV values. Regular detailed monitoring of cardiovascular risk factors should become standard of care for every young person with PHIV worldwide.
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Affiliation(s)
- J Mellin
- Gravitational Physiology and Medicine Research Unit, Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - M Le Prevost
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - J Kenny
- Guy's and St. Thomas' National Heath Service Foundation Trust, Evelina London Children's Hospital, St. Thomas' Hospital, London, United Kingdom
| | - K Sturgeon
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - L C Thompson
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - C Foster
- Imperial College Healthcare National Heath Service Trust, St. Mary's Hospital, London, United Kingdom
| | - H H Kessler
- Diagnostic and Research Institute of Hygiene, Microbiology, and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Nandu Goswami
- Gravitational Physiology and Medicine Research Unit, Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria.,Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - N Klein
- Department of Infection, Immunity and Inflammation, University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - A Judd
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - H Castro
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
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13
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Hajhashemy Z, Lotfi K, Heidari Z, Saneei P. Serum Vitamin D Levels in Relation to Abdominal Obesity in Children and Adolescents: A Systematic Review and Dose-Response Meta-Analysis. Front Nutr 2022; 9:806459. [PMID: 35252295 PMCID: PMC8888413 DOI: 10.3389/fnut.2022.806459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/12/2022] [Indexed: 11/28/2022] Open
Abstract
Background Findings of epidemiological studies that investigated the relationship between serum vitamin D levels and abdominal obesity were inconsistent. To evaluate the relationship between blood vitamin D levels and abdominal obesity in children and adolescents, we did a comprehensive review and dose-response meta-analysis. Methods A comprehensive search in electronic databases including Scopus, Web of Science (ISI), MEDLINE (Pubmed), EMBASE, and Google Scholar was conducted, up to May 2021, for epidemiological studies that investigated the linkage between serum vitamin D levels (as the exposure) and abdominal obesity (as the outcome) in children and adolescents. Results Combining 19 effect sizes from 14 cross-sectional studies that included 29,353 apparently healthy children illustrated that the highest vs. lowest level of serum vitamin D was related to a 35% reduced odds of abdominal obesity [odds ratio (OR): 0.65; 95% CI: 0.50, 0.84]. Linear dose-response analysis revealed that each 10 ng/ml increase in serum vitamin D levels was related to a 7% decrease in odds of abdominal obesity (OR: 0.93; 95% CI: 0.90, 0.95), only among investigations that used percentiles of waist circumference (>75th or 90th) to define the disorder (including 6,868 total subjects and 1,075 cases with abdominal obesity). Increasing serum vitamin D levels from 20 to 40 ng/ml was related to reduce odds of abdominal obesity in children. Conclusion A negative relationship between blood vitamin D levels and abdominal obesity in children and adolescents was discovered in this meta-analysis of epidemiologic studies. Among investigations that used waist circumference percentiles to define the disorder, the relationship was in a dose-response manner. To affirm this relationship, more research studies are needed, particularly using a prospective design. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021261319, PROSPERO 2021, identifier: CRD42021261319.
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Affiliation(s)
- Zahra Hajhashemy
- Students' Scientific Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- *Correspondence: Parvane Saneei ;
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14
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Arenas-Pinto A, Judd A, Melvin D, Le Prevost M, Foster C, Sturgeon K, Winston A, Thompson LC, Gibb DM, Castro H. Learning and memory function in young people with and without perinatal HIV in England. PLoS One 2022; 17:e0273645. [PMID: 36107958 PMCID: PMC9477265 DOI: 10.1371/journal.pone.0273645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/12/2022] [Indexed: 11/25/2022] Open
Abstract
Learning and memory are important for successful education and career progression. We assess these functions in young people (YP) with perinatal HIV (PHIV) (with or without a previous AIDS-defining illness) and a comparable group of HIV-negative YP. 234 PHIV and 68 HIV-negative YP completed 9 tests; 5 National Institutes of Health (NIH) Toolbox tests (2 executive function, 1 speed of information processing, 2 memory); 2 Hopkins Verbal Learning Test Revised (HVLT-R) (learning (L), delayed recall (R)), and 2 verbal application measures. Z-scores for each test were calculated using normative data and averaged by domain where appropriate. The effect of predictors on test scores in the three domains with the lowest z-scores were analysed using linear regression. 139(59%) and 48(71%) PHIV and HIV-negative YP were female, 202(86%) and 52(76%) Black, and median age was 19 [17, 21] and 18 [16, 21] years respectively. 55(24%) PHIV had a previous Center for Disease Control and Prevention (CDC) class C AIDS-defining diagnosis (PHIV/C). For HVLT-R, there was a trend towards PHIV/C YP having the lowest mean z-scores (L -1.5 (95% CI -1.8,-1.2), R -1.7 (-2.0,-1.4)) followed by PHIV without a CDC C diagnosis (L -1.3 (-1.4,-1.1), R -1.4 (-1.5,-1.2)) and then the HIV-negative group (L -1.0 (-1.3,-0.7), R -1.1 (-1.3,-0.8)); all were greater than 1 SD below the reference mean. The same trend was seen for verbal application measures; however, z-scores were within 1 SD below the reference mean. NIH Toolbox tests were similar for all groups. In multivariable analyses PHIV/C and Black ethnicity predicted lower HVLT-R scores. Black ethnicity also predicted lower executive function scores, however each year increase in age predicted higher scores. In conclusion, cognitive performance in verbal learning and recall fell below population normative scores, and was more pronounced in PHIV/C, supporting wider findings that earlier antiretroviral therapy initiation, before the occurrence of AIDS-defining conditions, may protect aspects of cognitive development.
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Affiliation(s)
- Alejandro Arenas-Pinto
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
- Centre for Clinical Research in Infection and Sexual Health, University College London Institute for Global Health, London, United Kingdom
- * E-mail:
| | - Ali Judd
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - Diane Melvin
- Imperial College Healthcare and Central North West London National Health Service Trust, London, United Kingdom
| | - Marthe Le Prevost
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - Caroline Foster
- Imperial College Healthcare and Central North West London National Health Service Trust, London, United Kingdom
| | - Kate Sturgeon
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | | | - Lindsay C. Thompson
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - Diana M. Gibb
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
| | - Hannah Castro
- Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom
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15
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Taxová Braunerová R, Kunešová M, Heinen MM, Rutter H, Hassapidou M, Duleva V, Pudule I, Petrauskienė A, Sjöberg A, Lissner L, Spiroski I, Gutiérrez-González E, Kelleher CC, Bergh IH, Metelcová T, Vignerová J, Brabec M, Buoncristiano M, Williams J, Simmonds P, Zamrazilová H, Hainer V, Yngve A, Rakovac I, Breda J. Waist circumference and waist-to-height ratio in 7-year-old children-WHO Childhood Obesity Surveillance Initiative. Obes Rev 2021; 22 Suppl 6:e13208. [PMID: 34402567 DOI: 10.1111/obr.13208] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/12/2022]
Abstract
Childhood obesity is a serious global health problem. Waist circumference (WC) and waist-to-height ratio (WHtR) reflect body fat distribution in children. The objectives of this study were to assess WC and WHtR in 7-year-old children and to determine body mass index (BMI), WC, and WHtR differences in children from 10 selected countries across Europe (Bulgaria, Czechia, Greece, Ireland, Latvia, Lithuania, North Macedonia, Norway, Spain, and Sweden) participating in the World Health Organization (WHO) Europe Childhood Obesity Surveillance Initiative (COSI). The 50th and 90th percentile of WC (according to COSI and "Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS" (IDEFICS) cutoff values) and WHtR above 0.5 were used as measures of abdominal obesity in a unique sample of 38,975 children aged 7.00-7.99 years. Southern European countries, including Greece and Spain, showed significantly higher BMI, WC, and WHtRin both genders (p < 0.0001) than Eastern and Northern Europe. The highest values for WC were observed in Greece (60.8 ± 7.36 cm boys; 60.3 ± 7.48 cm girls), North Macedonia (60.4 ± 7.91 cm boys; 59.0 ± 8.01 cm girls), and Spain (59.7 ± 6.96 cm boys; 58.9 ± 6.77 cm girls). WC and WHtRin may add an information about the occurrence of central obesity in children.
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Affiliation(s)
| | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Mirjam M Heinen
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Vesselka Duleva
- Department of Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Aušra Petrauskienė
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Agneta Sjöberg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Lauren Lissner
- School of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | | | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Tereza Metelcová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.,1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jana Vignerová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Marek Brabec
- Institute of Computer Science, Czech Academy of Sciences, Prague, Czech Republic
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Philippa Simmonds
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Vojtěch Hainer
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Agneta Yngve
- Department of Nutrition, Dietetics and Food Studies, Uppsala University, Sweden.,School of Health Sciences, Örebro University, Örebro, Sweden
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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16
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Vendula J, Miroslava P, Tereza K. Reference Curves of Selected Circumferential Parameters for Czech Children Aged 6 to 11 Years. CHILDREN-BASEL 2021; 8:children8100908. [PMID: 34682173 PMCID: PMC8534861 DOI: 10.3390/children8100908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/28/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022]
Abstract
(1) Background/objective: the globally discussed current issue is the increasing body weight of the population. This trend is observed in all age categories. Pediatricians and anthropologists use BMI percentile curves to determine the optimal body weight of children, based on which the child is categorized in the category of underweight, normal weight, overweight, or obese. Medical or anthropological examinations also use some methods to determine the amount of body fat. In addition to evaluating amounts of body fat, it is important to assess its distribution. The distribution of fat in the body, especially in terms of disproportionate distribution, is a risk factor for health complications, especially in terms of metabolic and health risk. Part of monitoring children’s growth is also measuring and evaluating circumferential parameters, such as abdominal circumference, gluteal circumference, and waist circumference. This study aimed to define age- and gender-specific reference curves for waist circumference (WC), abdominal circumference (AbC), and gluteal circumference (GC) in Czech children. (2) Methods: data on children’s circumferential parameters were collected via anthropometric measurements. The research sample consisted of 2093 children aged 6–11 years (boys, n = 1008; girls, n = 1085). Only children with parental informed consent were included. The statistical analysis was performed separately by age and gender using SPSS v. 22. Anthropometric data were summarized by mean and standard deviation. The percentile curves of WC, AbC, and GC were calculated (P3, P10, P25, P50, P75, P90, P97) in R 3.4.2 software (R Foundation for Statistical Computing, Vienna, Austria) using the gamlss package. (3) Results and conclusions: the study developed age- and gender-specific percentile curves of WC, AbC, and GC for Czech children aged 6–11 years. All parameters increased with age in both boys and girls. Generally, the boys had higher WC and AbC than did girls, but girls had higher GC than did boys. Female and male median WC percentiles (M) increased from the age of 6. Both girls’ and boys’ median percentiles showed a continuous increase. We found similar trends in the median GC and AbC percentile curves. All percentile curves showed similar trends in both sexes, but the 90th and 97th WC percentiles in boys were exceptions: from the age of 10, they exceeded the values of girls, reaching their peak at the age of 11 followed by a decrease in the case of the 97th percentile and a plateau in the case of the 90th percentile. This study serves as a reference to enrich the methods of evaluation of somatic and medical status in Czech children. Up–to–date percentile curves would be a practical addition to the BMI percentiles for the screening and evaluation of overweight and obese conditions and the related risks of abdominal obesity in the pediatric population.
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17
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Stagi S, Papacciuoli V, Ciofi D, Piccini B, Farello G, Toni S, Ferrari M, Chiarelli F. Retrospective Evaluation on the Use of a New Polysaccharide Complex in Managing Paediatric Type 1 Diabetes with Metabolic Syndrome (MetS). Nutrients 2021; 13:nu13103517. [PMID: 34684518 PMCID: PMC8540288 DOI: 10.3390/nu13103517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Children and adolescents affected by type 1 diabetes have an increased risk of being overweight or obese and of suffering from cardiometabolic symptoms. Aims: To retrospectively evaluate the effects of a new complex of polysaccharide macromolecules, Policaptil Gel Retard® (PGR), on auxological and metabolic parameters, glycaemic variability and control parameters in paediatric patients with type 1 diabetes and metabolic syndrome (MetS). Patients and Methods: Data for 27 paediatric patients with a diagnosis of type 1 diabetes in conjunction with obesity and MetS of at least 5 years’ standing were collected and retrospectively studied. Of these, 16 (median age 12.9, range 9.5–15.8 years) had been adjunctively treated with PGR and 11 (median age 12.6, range 9.4–15.6 years) had not been treated with PGR. Auxological, metabolic and glycaemic control and variability parameters and insulin dosing were compared after 6 months in the two groups. Results: PGR significantly reduced BMI standard deviation score (SDS) (p < 0.005), waist SDS (p < 0.005), HbA1c (p < 0.05) and daily mean insulin dose requirement (p < 0.005). A significant improvement was also observed in the metabolic and glycaemic variability parameters of mean daily blood glucose (BG) levels (p < 0.005), SD of daily BG levels (p < 0.0001), mean coefficient of variation (p < 0.05), LBGI (p < 0.0001), HBGI (p < 0.0001), J-index (p < 0.005), total cholesterol (p < 0.005), HDL-cholesterol (p < 0.005) and LDL-cholesterol (p < 0.005) and triglycerides (p < 0.05). Conclusions: PGR produces a good auxological and metabolic response in obese patients with MetS who are affected by type 1 diabetes. It led to a significant reduction in BMI SDS, waist SDS and an improvement in glucose control and variability as well as in other MetS parameters. The use of polysaccharide compounds, especially if associated with appropriate dietary changes, may help achieve treatment targets in type 1 diabetes and reduce the risk that patients develop metabolic syndrome.
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Affiliation(s)
- Stefano Stagi
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (D.C.); (M.F.)
- Correspondence: ; Tel.: +39-055-5662305
| | - Valeria Papacciuoli
- Pediatric Diabetology Unit, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (V.P.); (B.P.); (S.T.)
| | - Daniele Ciofi
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (D.C.); (M.F.)
| | - Barbara Piccini
- Pediatric Diabetology Unit, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (V.P.); (B.P.); (S.T.)
| | - Giovanni Farello
- Department of Paediatrics, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Sonia Toni
- Pediatric Diabetology Unit, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (V.P.); (B.P.); (S.T.)
| | - Marta Ferrari
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, 50139 Florence, Italy; (D.C.); (M.F.)
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18
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Vigorous physical activity is important in maintaining a favourable health trajectory in active children: the CHAMPS Study-DK. Sci Rep 2021; 11:19211. [PMID: 34584178 PMCID: PMC8478976 DOI: 10.1038/s41598-021-98731-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 09/03/2021] [Indexed: 12/17/2022] Open
Abstract
Physical activity (PA) is critical to improving health factors such as weight, adiposity, and aerobic fitness. However, children who meet PA guideline recommendations demonstrate developmental differences in health-related outcomes. To investigate prospective associations between PA behaviour (overall PA and PA intensity) and trajectories of health-related factors among physically active children. This prospective study (2.5 years) included 391 children (baseline age: 8.1 ± 1.4 years; girls 36.3%) from ten public schools. All children performed 60-min or more of moderate-to-vigorous physical activity (MVPA) per day objectively measured. Trajectories of BMI, waist circumference, and aerobic fitness were constructed with a group-based multi-trajectory model. Three trajectory subgroups were identified: ‘high fitness/normal weight’ (48.4% of children), ‘moderate fitness /normal weight’ (42.5% of children), and ‘low fitness/overweight-obese’ (9.1% of children). Children performing higher overall PA, were less likely of being classified as members of the ‘Low Fitness/Overweight-Obese’ [Relative Risk Ratio (RRR and 95% CI) = 0.56 (0.37 to 0.85) compared to ‘high fitness/normal weight’ subgroup. Each additional 5% in light PA time was associated with approximately twofold [RRR 2.12 (1.24–3.61)] increased risk of being in the ‘low fitness/overweight-obese’ trajectory relative to the ‘high fitness/normal weight’ trajectory. Each additional 2% in vigorous-PA time was associated with a 42% and 85% reduced risk (relative to ‘high fitness/normal weight’) of being in the ‘moderate fitness/normal weight’ [RRR 0.58 (0.38–0.96)] and ‘low fitness/overweight-obesity’ [RRR 0.15 (0.06–0.37)] trajectory, respectively. Overall PA and additional time in vigorous-PA was associated with improved health-related outcomes, while light PA was negatively associated with health-related outcomes among children who adhere to PA guideline recommendations. Vigorous PA was the strongest predictor of the health trajectories. All PA guidelines for children should place greater emphasis on the importance of vigorous PA.
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Anwar MY, Raffield LM, Lange LA, Correa A, Taylor KC. Genetic underpinnings of regional adiposity distribution in African Americans: Assessments from the Jackson Heart Study. PLoS One 2021; 16:e0255609. [PMID: 34347846 PMCID: PMC8336790 DOI: 10.1371/journal.pone.0255609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND African ancestry individuals with comparable overall anthropometric measures to Europeans have lower abdominal adiposity. To explore the genetic underpinning of different adiposity patterns, we investigated whether genetic risk scores for well-studied adiposity phenotypes like body mass index (BMI) and waist circumference (WC) also predict other, less commonly measured adiposity measures in 2420 African American individuals from the Jackson Heart Study. METHODS Polygenic risk scores (PRS) were calculated using GWAS-significant variants extracted from published studies mostly representing European ancestry populations for BMI, waist-hip ratio (WHR) adjusted for BMI (WHRBMIadj), waist circumference adjusted for BMI (WCBMIadj), and body fat percentage (BF%). Associations between each PRS and adiposity measures including BF%, subcutaneous adiposity tissue (SAT), visceral adiposity tissue (VAT) and VAT:SAT ratio (VSR) were examined using multivariable linear regression, with or without BMI adjustment. RESULTS In non-BMI adjusted models, all phenotype-PRS were found to be positive predictors of BF%, SAT and VAT. WHR-PRS was a positive predictor of VSR, but BF% and BMI-PRS were negative predictors of VSR. After adjusting for BMI, WHR-PRS remained a positive predictor of BF%, VAT and VSR but not SAT. WC-PRS was a positive predictor of SAT and VAT; BF%-PRS was a positive predictor of BF% and SAT only. CONCLUSION These analyses suggest that genetically driven increases in BF% strongly associate with subcutaneous rather than visceral adiposity and BF% is strongly associated with BMI but not central adiposity-associated genetic variants. How common genetic variants may contribute to observed differences in adiposity patterns between African and European ancestry individuals requires further study.
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Affiliation(s)
- Mohammad Y. Anwar
- School of Public Health & Information Sciences, The University of Louisville, Louisville, KY, United States of America
| | - Laura M. Raffield
- Department of Genetics, University of North Carolina, Chapel Hill, NC, United States of America
| | - Leslie A. Lange
- Division of Biomedical Informatics and Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Adolfo Correa
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Kira C. Taylor
- School of Public Health & Information Sciences, The University of Louisville, Louisville, KY, United States of America
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Yamanaka AB, Davis JD, Wilkens LR, Hurwitz EL, Fialkowski MK, Deenik J, Leon Guerrero RT, Novotny R. Determination of Child Waist Circumference Cut Points for Metabolic Risk Based on Acanthosis Nigricans, the Children's Healthy Living Program. Prev Chronic Dis 2021; 18:E64. [PMID: 34166179 PMCID: PMC8269744 DOI: 10.5888/pcd18.210021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Waist circumference is a common anthropometric measure for predicting abdominal obesity and insulin resistance. We developed optimal waist circumference cut points for children aged 2 to 8 years in the US-Affiliated Pacific (USAP) region based on the relationship of waist circumference and acanthosis nigricans in this population. METHODS We conducted a cross-sectional analysis from the Children's Healthy Living Program's 2012-2013 data on 4,023 children. We used receiver-operating characteristic analysis to determine the sensitivity and specificity for acanthosis nigricans across waist circumference, by sex and age. We determined optimal waist circumference cutoff points corresponding to Youden index (J), (equal to [sensitivity + specificity] - 1), with acanthosis nigricans. We compared these cut points with the 90th percentile. RESULTS The 90th-percentile cut points for boys aged 2 to 5 years (58.15 cm) and 6 to 8 years (71.63 cm) were slightly higher than for girls in both age groups (aged 2-5 y, 57.97 cm; 6-8 y: 70.37 cm). The optimal cut points (corresponding to the highest sensitivity and specificity) were as follows: for boys aged 2 to 5 years, 90th percentile (58.25 cm; sensitivity, 48.0%; specificity, 91.5%); for boys aged 6 to 8 years, 78th percentile (63.59 cm; sensitivity, 86.8%; specificity, 82.8%); for girls aged 2 to 5 years, 62nd percentile (53.27 cm; sensitivity, 71.4%; specificity, 63.1%), and for girls aged 6 to 8 years, 80th percentile (63.63 cm; sensitivity, 55.4%; specificity, 82.9%). CONCLUSION Among USAP children, waist circumference was a reasonable predictor for acanthosis nigricans. Further analysis is warranted to examine causes of acanthosis nigricans at lower-than-expected waist circumference percentiles. The cut points can be used for early detection of metabolic risk.
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Affiliation(s)
- Ashley B Yamanaka
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, Hawai'i
- College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, 1955 East West Rd, Agricultural Sciences 216, Honolulu, Hawai'i 96822.
| | - James D Davis
- Department of Biostatistics and Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - Lynne R Wilkens
- Biostatistics and Informatics Shared Resource, University of Hawai'i Cancer Center, Honolulu, Hawai'i
| | - Eric L Hurwitz
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - Marie K Fialkowski
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - Jonathan Deenik
- Department of Tropical Plant and Soil Sciences, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | | | - Rachel Novotny
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, Hawai'i
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Inokuchi M, Matsuo N, Takayama JI, Hasegawa T. Population-based waist circumference reference values in Japanese children (0-6 years): comparisons with Dutch, Swedish and Turkish preschool children. J Pediatr Endocrinol Metab 2021; 34:349-356. [PMID: 33675207 DOI: 10.1515/jpem-2020-0418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/12/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND During 1978-1981 the Japanese Standards Association conducted a national survey to collect 64 distinct body measurements for Japanese children and adults. During 1978-1981, the prevalence of childhood obesity was relatively low yet the population was well nourished in Japanese children. The aim of this study is to construct waist circumference and waist circumference to stature ratio reference centile curves for Japanese preschool children. METHODS We utilized 1978-1981 national survey data on body sizes. There are 4937 boys and 4758 girls age 0-6 years for waist circumference measurements. Waist circumference was measured at the level of the umbilicus. Using LMS method, centile curves were constructed for waist circumference and waist circumference to stature ratio. These reference values were compared with those of Dutch, Swedish and Turkish children. RESULTS Centile reference curves were made for clinical and epidemiological use. Japanese children had smaller waist circumference centile values as compared to waist circumference measured at the midpoint of the lowest rib cage and the iliac crest of Dutch, Swedish and Turkish children. However, Japanese children had comparable waist circumference to stature ratio centile values to those of Dutch and Turkish children. CONCLUSIONS This study presents the first age-, sex-, and ethnicity-specific reference values for waist circumference and waist circumference to stature ratio in Japanese preschool children.
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Affiliation(s)
- Mikako Inokuchi
- Health Center, Keio University, Tokyo, Japan
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Nobutake Matsuo
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
- The Institute for Healthcare Quality Improvement, Tokyo Healthcare Foundation, Tokyo, Japan
- National Center for Child Health and Development, Tokyo, Japan
| | - John I Takayama
- Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, USA
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Japan
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NASCIMENTO LM, MONTEIRO NVDN, VILAR TM, IBIAPINA CRLDS, FROTA KDMG. The influence of ultra-processed food consumption in anthropometric and atherogenic indices of adolescents. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To investigate the influence of ultra-processed food consumption on anthropometric and atherogenic indices. Methods A cross-sectional study was conducted with 327 adolescents aged 14 to 19 years. Sociodemographic, anthropometric, biochemical, and food consumption data were evaluated. The ratios of atherogenic indices were calculated using the Castelli I (Total Cholesterol/High Density Lipoprotein Cholesterol), Castelli II (Low Density Lipoprotein Cholesterol/High Density Lipoprotein Cholesterol), and estimated Low Density Lipoprotein Cholesterol particle size (Atherogenic Index of Plasma=Triglycerides/High-Density Lipoprotein Cholesterol) indices. Logistic regression was used for the unadjusted and adjusted analysis between ultra-processed foods consumption, anthropometric, and atherogenic indices. The level of significance was 5%. Results Most participants were female (59.3%). Girls had a higher consumption of ultra-processed foods (26.6% vs. 20.5%). Of the total number of adolescents, 16.5% were overweight and 65.7% were from public schools. Adolescents with altered values for the Castelli I and II Index, and for the Atherogenic Index of Plasma had significantly higher weights, Waist Circumference, Waist Circumference/ Height and Body Mass Index/ Age values. The adjusted analysis identified a significant association (Odds ratio=2.29; 95% Confidence interval: 1.23-4.28) between the high consumption of ultra-processed foods and the Castelli II index. Conclusion The associations between atherogenic indices and anthropometric indices and the consumption of ultra-processed foods highlight the negative influence of these foods on adolescents’ cardiovascular health.
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Martinis O, Čoklo M, Aladrović J, Belavić A, Missoni S. ANTHROPOMETRIC MEASUREMENTS, DIETARY HABITS, SERUM LIPID AND GLUCOSE LEVELS IN RELATION TO HIGH BLOOD PRESSURE AMONG ADOLESCENT BOYS AND GIRLS IN CROATIA. Acta Clin Croat 2020; 59:672-685. [PMID: 34285438 PMCID: PMC8253067 DOI: 10.20471/acc.2020.59.04.14] [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: 03/03/2019] [Accepted: 04/16/2019] [Indexed: 11/24/2022] Open
Abstract
The aim was to determine differences in anthropometric measurements, dietary habits, serum lipid and glucose levels in relation to high blood pressure (BP) among adolescent boys and girls in Croatia. The specific aim was to determine the effect of dietary habits and lifestyle on high BP in adolescents according to sex. The study included 260 (68.2%) adolescent girls and 121 (31.8%) boys with anthropometric data obtained (without missing values) from 246 girls and 111 boys. Participants answered questions from the questionnaire and anthropometric BP and blood test values were obtained. Non-parametric tests were used in analyses of reference intervals of systolic and diastolic BP in adolescent boys and girls according to age. High BP was defined as ≥90th percentile for adolescent girls and boys, with a value of ≥135/87.5 mm Hg. Mann-Whitney U test was used to analyze differences in anthropometric and laboratory values between the groups of girls and boys with high (≤90th percentile) and normal BP. Increase in systolic and diastolic BP was noted in the adolescents. In girls, BP values showed a decreasing systolic and increasing diastolic BP trend with age. Girls with high BP had a significantly higher body mass index (BMI) (p=0.020), waist circumference (WC) (p=0.002), waist-to-height ratio (WHtR) (p=0.016), waist-to-hip ratio (WHR) (p=0.043), hip circumference (HC) (p=0.015), triglyceride (TG) levels (p=0.021), higher prevalence of unhealthy diet at school breakfast (p=0.008) and lower prevalence of eating fish (p=0.02). Boys with high BP had a significantly higher BMI (p=0.045), WC (p=0.004), WHtR (p=0.017), WHR (p=0.022) and higher prevalence of eating meat products (p=0.015). Effective health interventions are needed to reduce the risk of developing cardiovascular diseases and preventing age-related illness.
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Affiliation(s)
| | - Miran Čoklo
- 1Croatian Education and Teacher Training Agency, Zagreb, Croatia; 2Centre for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia; 3University of Zagreb, Faculty of Veterinary Medicine, Zagreb, Croatia; 4Croatian Institute of Public Health, Zagreb, Croatia; 5Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 6Institute for Anthropological Research, Zagreb, Croatia
| | - Jasna Aladrović
- 1Croatian Education and Teacher Training Agency, Zagreb, Croatia; 2Centre for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia; 3University of Zagreb, Faculty of Veterinary Medicine, Zagreb, Croatia; 4Croatian Institute of Public Health, Zagreb, Croatia; 5Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 6Institute for Anthropological Research, Zagreb, Croatia
| | - Anja Belavić
- 1Croatian Education and Teacher Training Agency, Zagreb, Croatia; 2Centre for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia; 3University of Zagreb, Faculty of Veterinary Medicine, Zagreb, Croatia; 4Croatian Institute of Public Health, Zagreb, Croatia; 5Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 6Institute for Anthropological Research, Zagreb, Croatia
| | - Saša Missoni
- 1Croatian Education and Teacher Training Agency, Zagreb, Croatia; 2Centre for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia; 3University of Zagreb, Faculty of Veterinary Medicine, Zagreb, Croatia; 4Croatian Institute of Public Health, Zagreb, Croatia; 5Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 6Institute for Anthropological Research, Zagreb, Croatia
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Complementary feeding practices and their association with adiposity indicators at 12 months of age. J Dev Orig Health Dis 2020; 12:780-787. [PMID: 33222718 DOI: 10.1017/s2040174420001038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Nutrition during the first 1000 days of life represents a window of opportunity to reduce the risk of metabolic dysfunctions later in life. Exclusive breastfeeding (EBF) and adequate introduction of solid foods are essential to promote metabolic and nutritional benefits. We evaluated the association of infant feeding practices from birth to 6 months (M) with adiposity indicators at 12 M. We performed a secondary analysis of 106 healthy term infants born from a cohort of healthy pregnant women. Type of breastfeeding (exclusive or nonexclusive), the start of complementary feeding (CF) (before (<4 M) or after (≥4 M)), and adiposity (body mass index - BMI, body mass index-for-age - BMI/A, waist circumference - WC, and waist circumference-length ratio - WLR) were evaluated at 12 M using descriptive statistics, mean differences, X2, and linear regression models. During the first 6 M, 28.3% (n = 30) of the infants received EBF. Early CF (<4 M) was present in 26.4% (n = 28) of the infants. Children who started CF < 4 M were less breastfed, received added sugars as the most frequently introduced food category, and showed higher BMI, BMI/A, WC, and WLR; those who consumed added sugars early (<4 M) had a higher WC. Starting CF < 4 M was the main factor associated with a higher WC at 12 M. Unhealthy infant feeding practices, such as lack of EBF, early CF, and early introduction of sugars, may be associated with higher adiposity at 12 M.
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Neumeyer L, Merker A, Hagenäs L. Clinical charts for surveillance of growth and body proportion development in achondroplasia and examples of their use. Am J Med Genet A 2020; 185:401-412. [PMID: 33220165 PMCID: PMC7839678 DOI: 10.1002/ajmg.a.61974] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 11/11/2022]
Abstract
Clinical surveillance of infants and children with achondroplasia necessitates syndrome-specific charts due to extreme short stature with deviating body proportions. Height, arm span and leg length develop far below normal population ranges. We present growth and body proportion charts for ages 0-20 years, constructed from semi-longitudinal standardized measurements of about 450 children, along with some examples of achondroplasia typical and atypical growth pattern. We combine head circumference, height and weight for 0-4 years into one (infancy) page and height and weight for 4-20 years in another (childhood-adolescence) using nonlinear axes to account for the rapidly decreasing growth velocity. Similarly, weight and BMI are based on nonlinear axes to balance wide SD-channels at higher and narrow SD-channels at lower levels of weight/BMI. Charts for following sitting height, sitting height/height ratio, arm span, leg and foot length are also presented. Clinical examples illustrating the applicability of the charts include cases of extreme prematurity, extreme head circumference development before and after shunting, achondroplasia complicated by chromosomal or additional genetic abnormality and by growth hormone deficiency as well as of evaluating growth promoting therapy.
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Affiliation(s)
- Luitgard Neumeyer
- Pediatric Endocrinology Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Andrea Merker
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Lars Hagenäs
- Pediatric Endocrinology Unit, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Santos JLF, Valério VP, Fernandes RN, Duarte L, Assumpção AC, Guerreiro J, Sickler AL, Lemos ÁAR, Goulart Filho JG, Cesar LAM, Pinto IM, Magalhães C, Hussid MF, Camacho C, Avezum A, Sangaleti CT, Consolim-Colombo FM. Waist Circumference Percentiles and Cut-Off Values for Obesity in a Large Sample of Students from 6 To 10 Years Old Of The São Paulo State, Brazil. Arq Bras Cardiol 2020; 114:530-537. [PMID: 32267326 PMCID: PMC7792724 DOI: 10.36660/abc.20190043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023] Open
Abstract
Fundamento A prevalência da obesidade vem aumentando sistematicamente na população, inclusive nas crianças e adolescentes, ao redor do mundo. Objetivos Descrever curvas percentílicas de referência para a circunferência abdominal (CA) nas crianças brasileiras e fornecer pontos de corte da CA para identificar crianças com risco de obesidade. Métodos Um estudo multicêntrico, prospectivo, tranversal foi realizado em crianças com idades entre 6 e 10 anos, matriculadas no ensino fundamental de escolas públicas e particulares de 13 cidades do estado de São Paulo. A estatura, o peso e a CA foram medidos em duplicata em 22.000 crianças (11.199 meninos). Para estabelecer o melhor ponto de corte da CA para o diagnóstico da obesidade, foram calculadas curvas ROC com crianças classificadas como com peso normal e obesas, de acordo com as curvas do IMC, estratificadas por gênero e idade, e o índice Youden foi utilizado como a eficácia potencial máxima desse biomarcador. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados Os valores da CA aumentaram com a idade, tanto nos meninos quanto nas meninas. A prevalência de obesidade em cada grupo variou de 17% (6 anos de idade) a 21,6 % (9 anos de idade), dentre os meninos, e de 14,1% (7 anos de idade) a 17,3 % (9 anos de idade), dentre as meninas. As análises ROC mostraram o percentil 75 como ponto de corte para o risco de obesidade, e o diagnóstico de obesidade está classificado no percentil 85 ou acima. Conclusão Curvas de referência da CA específicas para idade e sexo em crianças brasileiras e pontos de corte para o risco de obesidade podem ser usados em triagem nacional e estudos intervencionais para reduzir a carga da obesidade no Brasil. (Arq Bras Cardiol. 2020; 114(3):530-537)
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Affiliation(s)
| | | | | | - Ligia Duarte
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | - Jayme Guerreiro
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Antonio L Sickler
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Álvaro A R Lemos
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | | | | | | | | | | | - Alvaro Avezum
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Carine T Sangaleti
- Universidade Estadual do Centro-Oeste - Enfermagem, Guarapuava, PR - Brasil
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Hébert JJ, Sénéchal M, Fairchild T, Møller NC, Klakk H, Wedderkopp N. Developmental Trajectories of Body Mass Index, Waist Circumference, and Aerobic Fitness in Youth: Implications for Physical Activity Guideline Recommendations (CHAMPS Study-DK). Sports Med 2020; 50:2253-2261. [PMID: 32880817 DOI: 10.1007/s40279-020-01335-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Describe the trajectories of body mass index (BMI), waist circumference, and aerobic fitness in children and identify different outcomes of guideline-recommended physical activity (PA) in a subset of active children. METHODS We recruited students from 10 public primary schools and obtained repeated measures of BMI, waist circumference, and aerobic fitness over 30 months. Aerobic fitness was measured with the Andersen test. We objectively measured physical activity behaviour with accelerometers and classified children as 'physically active' when they achieved ≥ 60 min of moderate-to-vigorous PA per day (guideline concordance). Univariate trajectories of BMI, waist circumference, and aerobic fitness were calculated for all children, and we constructed a multi-trajectory model comprising all outcomes in the subgroup of physically active children. The construct validity of all models was investigated by examining for between-group differences in cardiovascular disease risk factors obtained from fasting blood samples. RESULTS Data from 1208 children (53% female) with a mean (SD) age of 8.4 (1.4) years were included. The univariate trajectory models identified three distinct trajectories for BMI, waist circumference, and aerobic fitness. The multi-trajectory model classified 9.1% of physically active children as following an 'overweight/obese/low fitness' trajectory. There were moderate-to-large differences in cardiovascular risk factors between all trajectory groups (p < 0.001; d = 0.4-1.20). CONCLUSION We identified distinct developmental trajectories of BMI, waist circumference, and aerobic fitness in children. Nearly one in 10 children who met PA guideline recommendations followed an unfavourable health trajectory. Health-related PA recommendations may be insufficient for some children.
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Affiliation(s)
- Jeffrey J Hébert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada.
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia.
| | - Martin Sénéchal
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
- Cardiometabolic Exercise and Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
| | - Timothy Fairchild
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia
| | - Niels Christian Møller
- Department of Sports Science and Clinical Biomechanics, Exercise Epidemiology, Center for Research in Childhood Health, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Heidi Klakk
- Department of Sports Science and Clinical Biomechanics, Exercise Epidemiology, Center for Research in Childhood Health, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
- Center for Applied Health Science, University College Lillebælt, Odense, Denmark
| | - Niels Wedderkopp
- Department of Sports Science and Clinical Biomechanics, Exercise Epidemiology, Center for Research in Childhood Health, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
- The Orthopedic Department, Hospital of Southwestern Jutland, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Waist circumference, waist-to-hip ratio, and waist-to-height ratio reference percentiles for abdominal obesity among Macedonian adolescents. NUTR HOSP 2020; 37:786-793. [PMID: 32686451 DOI: 10.20960/nh.03006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: the goal of this study was to define waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHRt) smoothed reference percentiles for assessing abdominal obesity in Macedonian adolescents aged 11 to 18 years in order to investigate possible obesity cut-offs of WHR and WHtR, and to compare WC percentiles with those of other adolescents. Methods: the research was conducted on a sample of 2,490 adolescents of the Republic of Macedonia aged 11 to 18 years: 1,288 males and 1,202 females. Weight, height, body mass index (BMI), WC, hip circumference (HC), WHR and WHtR were measured and percentiles were calculated using Cole's Lambda, Mu and Sigma (LMS) method. The relation between WHR, WHtR and general obesity, as defined by the International Obesity Task Force, was investigated with a receiver operating characteristic (ROC) analysis. Results: the boys had statistically significant higher values in all anthropometric measures except in HC, where statistically significant gender differences were not found. BMI, WC, and HC showed an increasing trend with age. The WHtR variable is a better indicator for assessing general obesity in both boys and girls (AUC, 95 % CI: 0.905-0.928) than WHR, which showed lower AUC values (95 % CI: 0.697-0.734) in predicting IOTF obesity; the WHtR cut-off of 0.5 had a sensitivity of 74 % and a specificity of 92 % for both genders and all age groups. Conclusions: the obtained reference percentile curves can be used temporarily for early detection of abdominal obesity among Macedonian adolescents aged 11 to 18 years; a WHtR of 0.5 may also be used as an obesity threshold in these age groups.
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Karnebeek K, Rijks JM, Dorenbos E, Gerver WJM, Plat J, Vreugdenhil ACE. Changes in Free-Living Glycemic Profiles after 12 Months of Lifestyle Intervention in Children with Overweight and with Obesity. Nutrients 2020; 12:E1228. [PMID: 32357570 PMCID: PMC7282030 DOI: 10.3390/nu12051228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 02/06/2023] Open
Abstract
Previous studies demonstrated that hyperglycemic glucose concentrations are observed in children that are overweight or have obesity. The aim of this study was to evaluate the effect of a 12 month lifestyle intervention on free-living glycemic profiles in children that were overweight or had obesity, and the association of the alterations with changes in cardiovascular risk parameters. BMI z-score, free-living glycemic profiles, continuous overlapping net glycemic action (CONGA), and cardiovascular parameters were evaluated before and after a multidisciplinary lifestyle intervention, in 33 non-diabetic children that were overweight or had obesity. In children with a decrease in BMI z-score, the duration which glucose concentrations were above the high-normal threshold (6.7 mmol/L) and the glycemic variability decreased significantly. In these children, a decrease in median sensor glucose was associated with decreases in LDL-cholesterol, and systolic and diastolic blood pressure z-score. A decrease in BMI z-score was associated with a decrease in CONGA1, 2, and 4. In conclusion, the glycemic profiles in free-living conditions in children that were overweight improved in children with a decrease in BMI z-score after lifestyle intervention. In those children, changes in median sensor glucose concentrations were associated with changes in LDL-cholesterol and blood pressure z-scores. These results suggest that glucose homeostasis can improve after one year of lifestyle intervention and that these improvements are associated with improvements in cardiovascular health parameters.
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Affiliation(s)
- Kylie Karnebeek
- Centre for Overweight Adolescent and Children’s Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands; (K.K.); (J.M.R.); (E.D.)
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Jesse M. Rijks
- Centre for Overweight Adolescent and Children’s Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands; (K.K.); (J.M.R.); (E.D.)
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Elke Dorenbos
- Centre for Overweight Adolescent and Children’s Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands; (K.K.); (J.M.R.); (E.D.)
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Willem-Jan M. Gerver
- Department of Paediatrics, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands;
| | - Jogchum Plat
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229 ER Maastricht, The Netherlands;
| | - Anita C. E. Vreugdenhil
- Centre for Overweight Adolescent and Children’s Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands; (K.K.); (J.M.R.); (E.D.)
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229 ER Maastricht, The Netherlands
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Kühr P, Lima RA, Grøntved A, Wedderkopp N, Klakk H. Three times as much physical education reduced the risk of children being overweight or obese after 5 years. Acta Paediatr 2020; 109:595-601. [PMID: 31509297 PMCID: PMC7028115 DOI: 10.1111/apa.15005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 11/29/2022]
Abstract
AIM We evaluated the effect that increasing physical education lessons from 1.5 to 4.5 hours per week for 5 years had on the body mass index (BMI) and waist circumferences of children aged 5-11 years at inclusion. METHODS From 2008 to 2013, six intervention schools in Svendborg, Denmark, delivered 4.5 hours of physical education lessons per week to 750 children. Meanwhile, four matched control schools gave 549 children the standard 1.5 hours of physical education lessons per week. Measurements were taken at baseline and yearly for 5 years. Of the 1299 children, 81 joined the schools after 2008. RESULTS At baseline, the percentage of overweight children was 12% in the intervention schools and 13% in the control schools, whereas 15% and 19% were abdominal obese, respectively. After 5 years, the respective risks of remaining abdominal obese or overweight were 43% and 51% in the intervention schools and 78% and 84% in the control schools. Mean BMI increased 0.450 kg/m2 more in the control group over the five-year period. The intervention was not effective in decreasing the average waist circumference. CONCLUSION Three times as much physical education lessons per week, for 5 years, effectively decreased BMI and the likelihood of remaining overweight or obese.
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Affiliation(s)
- Petra Kühr
- Department of Sport Science and Clinical Biomechanics Research Unit for Exercise Epidemiology Centre of Research in Childhood Health Faculty of Health University of Southern Denmark Odense Denmark
- Faculty of Sport and Exercise Sciences University of Rome Rome Italy
| | - Rodrigo Antunes Lima
- Ministry of Education of Brazil CAPES Foundation Brasília – DF Brazil
- Institute of Sport Science University of Graz Graz Austria
| | - Anders Grøntved
- Department of Sport Science and Clinical Biomechanics Research Unit for Exercise Epidemiology Centre of Research in Childhood Health Faculty of Health University of Southern Denmark Odense Denmark
| | - Niels Wedderkopp
- Department of Sport Science and Clinical Biomechanics Research Unit for Exercise Epidemiology Centre of Research in Childhood Health Faculty of Health University of Southern Denmark Odense Denmark
- Institute of Regional Health Research University of Southern Denmark Odense M Denmark
- University of New Brunswick Fredericton NB Canada
- Orthopedic Department Hospital of Southwestern Jutland Esbjerg Denmark
| | - Heidi Klakk
- Department of Sport Science and Clinical Biomechanics Research Unit for Exercise Epidemiology Centre of Research in Childhood Health Faculty of Health University of Southern Denmark Odense Denmark
- Faculty of Applied Health Science University College Lillebaelt Odense Denmark
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Viitasalo A, Schnurr TM, Pitkänen N, Hollensted M, Nielsen TRH, Pahkala K, Atalay M, Lind MV, Heikkinen S, Frithioff-Bøjsøe C, Fonvig CE, Grarup N, Kähönen M, Carrasquilla GD, Larnkjaer A, Pedersen O, Michaelsen KF, Lakka TA, Holm JC, Lehtimäki T, Raitakari O, Hansen T, Kilpeläinen TO. Abdominal adiposity and cardiometabolic risk factors in children and adolescents: a Mendelian randomization analysis. Am J Clin Nutr 2019; 110:1079-1087. [PMID: 31504107 PMCID: PMC6904295 DOI: 10.1093/ajcn/nqz187] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 07/18/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Mendelian randomization studies in adults suggest that abdominal adiposity is causally associated with increased risk of type 2 diabetes and coronary artery disease in adults, but its causal effect on cardiometabolic risk in children remains unclear. OBJECTIVE We aimed to study the causal relation of abdominal adiposity with cardiometabolic risk factors in children by applying Mendelian randomization. METHODS We constructed a genetic risk score (GRS) using variants previously associated with waist-to-hip ratio adjusted for BMI (WHRadjBMI) and examined its associations with cardiometabolic factors by linear regression and Mendelian randomization in a meta-analysis of 6 cohorts, including 9895 European children and adolescents aged 3-17 y. RESULTS WHRadjBMI GRS was associated with higher WHRadjBMI (β = 0.021 SD/allele; 95% CI: 0.016, 0.026 SD/allele; P = 3 × 10-15) and with unfavorable concentrations of blood lipids (higher LDL cholesterol: β = 0.006 SD/allele; 95% CI: 0.001, 0.011 SD/allele; P = 0.025; lower HDL cholesterol: β = -0.007 SD/allele; 95% CI: -0.012, -0.002 SD/allele; P = 0.009; higher triglycerides: β = 0.007 SD/allele; 95% CI: 0.002, 0.012 SD/allele; P = 0.006). No differences were detected between prepubertal and pubertal/postpubertal children. The WHRadjBMI GRS had a stronger association with fasting insulin in children and adolescents with overweight/obesity (β = 0.016 SD/allele; 95% CI: 0.001, 0.032 SD/allele; P = 0.037) than in those with normal weight (β = -0.002 SD/allele; 95% CI: -0.010, 0.006 SD/allele; P = 0.605) (P for difference = 0.034). In a 2-stage least-squares regression analysis, each genetically instrumented 1-SD increase in WHRadjBMI increased circulating triglycerides by 0.17 mmol/L (0.35 SD, P = 0.040), suggesting that the relation between abdominal adiposity and circulating triglycerides may be causal. CONCLUSIONS Abdominal adiposity may have a causal, unfavorable effect on plasma triglycerides and potentially other cardiometabolic risk factors starting in childhood. The results highlight the importance of early weight management through healthy dietary habits and physically active lifestyle among children with a tendency for abdominal adiposity.
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Affiliation(s)
- Anna Viitasalo
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,Address correspondence to AV (e-mail: )
| | - Theresia M Schnurr
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Mette Hollensted
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tenna R H Nielsen
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark,Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland,Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Mustafa Atalay
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Mads V Lind
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Sami Heikkinen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Christine Frithioff-Bøjsøe
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Cilius E Fonvig
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark,The Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland,Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center, Tampere University, Tampere, Finland
| | - Germán D Carrasquilla
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anni Larnkjaer
- Department of Nutrition, Exercise, and Sports, Faculty of Science, 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
| | - Kim F Michaelsen
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Timo A Lakka
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Jens-Christian Holm
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Terho Lehtimäki
- Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center, Tampere University, Tampere, Finland,Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Klaver M, de Mutsert R, Wiepjes CM, Twisk JWR, den Heijer M, Rotteveel J, Klink DT. Early Hormonal Treatment Affects Body Composition and Body Shape in Young Transgender Adolescents. J Sex Med 2019; 15:251-260. [PMID: 29425666 DOI: 10.1016/j.jsxm.2017.12.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/08/2017] [Accepted: 12/14/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Transgender adolescents aspiring to have the body characteristics of the affirmed sex can receive hormonal treatment. However, it is unknown how body shape and composition develop during treatment and whether transgender persons obtain the desired body phenotype. AIM To examine the change in body shape and composition from the start of treatment with gonadotropin-releasing hormone agonists (GnRHa) until 22 years of age and to compare these measurements at 22 years with those of age-matched peers. METHODS 71 transwomen (birth-assigned boys) and 121 transmen (birth-assigned girls) who started treatment from 1998 through 2014 were included in this retrospective study. GnRHa treatment was started and cross-sex hormonal treatment was added at 16 years of age. Anthropometric and whole-body dual-energy x-ray absorptiometry data were retrieved from medical records. Linear mixed model regression was performed to examine changes over time. SD scores (SDS) were calculated to compare body shape and composition with those of age-matched peers. OUTCOMES Change in waist-hip ratio (WHR), total body fat (TBF), and total lean body mass (LBM) during hormonal treatment. SDS of measures of body shape and composition compared with age-matched peers at 22 years of age. RESULTS In transwomen, TBF increased (+10%, 95% CI = 7-11) while total LBM (-10%, 95% CI = -11 to -7) and WHR (-0.04, 95% CI = -0.05 to -0.02) decreased. Compared with ciswomen, SDS at 22 years of age were +0.3 (95% CI = 0.0-0.5) for WHR, and 0.0 (95% CI = -0.2 to 0.3) for TBF. Compared with cismen, SDS were -1.0 (95% CI = -1.3 to -0.7) for WHR, and +2.2 (95% CI = 2.2-2.4) for TBF. In transmen, TBF decreased (-3%, 95% CI = -4 to -1), while LBM (+3%, 95% CI = 1-4) and WHR (+0.03, 95% CI = 0.01-0.04) increased. Compared with ciswomen, SDS at 22 years of age were +0.6 (95% CI = 0.4-0.8) for WHR, and -1.1 (95% CI = -1.4 to -0.9) for TBF. Compared with cismen, SDS were -0.5 (95% CI = -0.8 to -0.3) for WHR, and +1.8 (95% CI = 1.6-1.9) for TBF. CLINICAL IMPLICATIONS Knowing body shape and composition outcomes at 22 years of age will help care providers in counseling transgender youth on expectations of attaining the desired body phenotype. STRENGTHS AND LIMITATIONS This study presents the largest group of transgender adults to date who started treatment in their teens. Despite missing data, selection bias was not found. CONCLUSIONS During treatment, WHR and body composition changed toward the affirmed sex. At 22 years of age, transwomen compared better to age-matched ciswomen than to cismen, whereas transmen were between reference values for ciswomen and cismen. Klaver M, de Mutsert R, Wiepjes CM, et al. Early Hormonal Treatment Affects Body Composition and Body Shape in Young Transgender Adolescents. J Sex Med 2018;15:251-260.
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Affiliation(s)
- Maartje Klaver
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University and Medical Center, Leiden, the Netherlands
| | - Chantal M Wiepjes
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Clinical Epidemiology, VU University, Amsterdam, The Netherlands
| | - Martin den Heijer
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Joost Rotteveel
- Department of Pediatrics, Division of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - Daniël T Klink
- Department of Pediatrics, Division of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands; Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Ghent, Belgium.
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Lassek WD, Gaulin SJ. Evidence supporting nubility and reproductive value as the key to human female physical attractiveness. EVOL HUM BEHAV 2019. [DOI: 10.1016/j.evolhumbehav.2019.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Khadilkar A, Ekbote V, Kajale N, Chiplonkar S, Prasad H, Agarwal S, Singh N, Patwardhan V, Lubree H, Ladkat D, Mandlik R, Vispute S, Palande S, Patel P, Lohiya N, Khadilkar V. Sitting height percentiles in 3-17-year-old Indian children: a multicentre study. Ann Hum Biol 2019; 46:267-271. [PMID: 31257924 DOI: 10.1080/03014460.2019.1637936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Sitting height (StH) percentiles are not described for the Indian paediatric population.Aim: To generate multicentre StH percentile values for Indian children.Subjects and methods: A total of 7961 apparently healthy children (3-17 years old, Boys: 4328) randomly selected from 10 schools from six states of India were measured for height (ht), StH and weight during July 2016-October 2017.Results: The StH:Ht ratio was 0.52 (0.02) and was similar between boys and girls (p > 0.1). The ratio decreased in boys until the age of 14 years and then slightly increased; the lowest ratio was observed during 13-15 years. In girls, however, the StH:Ht ratio decreased until the age of 9 years and then plateaued until 15 years of age with a slight increase at 16 years; the lowest ratio was observed at the age of 12-13 years. Sitting height percentiles (3rd, 10th, 25th, 50th, 75th, 90th and 97th) were computed using LMS chartmaker.Conclusions: The results indicate that, during the pubertal years, the lower limb growth is more predominant than trunk growth. Further, this study provides smoothened percentile curves for sitting height in Indian children for the first time.
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Affiliation(s)
- Anuradha Khadilkar
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Veena Ekbote
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Neha Kajale
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Shashi Chiplonkar
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Hemchand Prasad
- Department of Pediatric Endocrinology, Dr Mehta's Hospital Pvt Ltd, Chennai, India
| | - Sanwar Agarwal
- Department of Pediatric Endocrinology, Ekta Institute of Child Health, Raipur, India
| | - Narendra Singh
- Department of Anthropology, Assam University, Diphu, India
| | - Vivek Patwardhan
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Himangi Lubree
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Dipali Ladkat
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Rubina Mandlik
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Smruti Vispute
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Sonal Palande
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Prerna Patel
- Department of Biotechnology and Biochemistry, Khyati Institute of Science, Khyati Foundation, Ahmedabad, India
| | - Nikhil Lohiya
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
| | - Vaman Khadilkar
- Pediatric and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, India
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Barbie's new look: Exploring cognitive body representation among female children and adolescents. PLoS One 2019; 14:e0218315. [PMID: 31237885 PMCID: PMC6592527 DOI: 10.1371/journal.pone.0218315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/31/2019] [Indexed: 12/22/2022] Open
Abstract
The original Barbie doll’s unrealistic body shape can negatively affect young girls’ body image. Mattel produced new Barbie dolls with “tall”, “curvy”, and “petite” body types, yet how girls perceive and evaluate the three new Barbie body types remains unknown. This study investigated whether young girls engage in an automatic “self-other matching” process when viewing the different Barbie doll representations. Female children and adolescents (N = 38; Mage = 10; 6–14 years old; SD = 2.24 years) completed a body-part compatibility task to provide an index of how they implicitly relate cognitive representations of their own body to the different doll images. Significant (p < .05) body-part compatibility effects emerged for the original, curvy and petite dolls, but not for the tall Barbie. These findings indicate that girls engage in a self-other body matching process when viewing Barbie, but that the strength of this matching is influenced by the doll’s body type. Results provide new evidence on the underlying cognitive mechanisms that occur when girls are exposed to physique-salient toys, and may have implications for young girls’ body image development and use of appearance-based social comparisons.
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Bovet J. Evolutionary Theories and Men's Preferences for Women's Waist-to-Hip Ratio: Which Hypotheses Remain? A Systematic Review. Front Psychol 2019; 10:1221. [PMID: 31244708 PMCID: PMC6563790 DOI: 10.3389/fpsyg.2019.01221] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 05/08/2019] [Indexed: 01/20/2023] Open
Abstract
Over the last 25 years, a large amount of research has been dedicated to identifying men's preferences for women's physical features, and the evolutionary benefits associated with such preferences. Today, this area of research generates substantial controversy and criticism. I argue that part of the crisis is due to inaccuracies in the evolutionary hypotheses used in the field. For this review, I focus on the extensive literature regarding men's adaptive preferences for women's waist-to-hip ratio (WHR), which has become a classic example of the just-so storytelling contributing to the general mistrust toward evolutionary explanations of human behavior. The issues in this literature originate in the vagueness and incompleteness of the theorizing of the evolutionary mechanisms leading to mate preferences. Authors seem to have rushed into testing and debating the effects of WHR on women's attractiveness under various conditions and using different stimuli, without first establishing (a) clear definitions of the central evolution concepts (e.g., female mate value is often reduced to an imprecise concept of "health-and-fertility"), and (b) a complete overview of the distinct evolutionary paths potentially at work (e.g., focusing on fecundability while omitting descendants' quality). Unsound theoretical foundations will lead to imprecise predictions which cannot properly be tested, thus ultimately resulting in the premature rejection of an evolutionary explanation to human mate preferences. This paper provides the first comprehensive review of the existing hypotheses on why men's preferences for a certain WHR in women might be adaptive, as well as an analysis of the theoretical credibility of these hypotheses. By dissecting the evolutionary reasoning behind each hypothesis, I show which hypotheses are plausible and which are unfit to account for men's preferences for female WHR. Moreover, the most cited hypotheses (e.g., WHR as a cue of health or fecundity) are found to not necessarily be the ones with the strongest theoretical support, and some promising hypotheses (e.g., WHR as a cue of parity or current pregnancy) have seemingly been mostly overlooked. Finally, I suggest some directions for future studies on human mate choice, to move this evolutionary psychology literature toward a stronger theoretical foundation.
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Affiliation(s)
- Jeanne Bovet
- Stony Brook University, Stony Brook, NY, United States
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Nyati LH, Pettifor JM, Norris SA. The prevalence of malnutrition and growth percentiles for urban South African children. BMC Public Health 2019; 19:492. [PMID: 31046727 PMCID: PMC6498578 DOI: 10.1186/s12889-019-6794-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 04/09/2019] [Indexed: 11/12/2022] Open
Abstract
Background Low- and middle-income countries (LMIC) are experiencing a double-burden of malnutrition characterised by high prevalence of both under- and over-nutrition. We set out using data from the mixed-longitudinal Birth-to-Twenty Plus (Bt20+) birth cohort, to evaluate the patterns of malnutrition and growth in a large South African (SA) city by; (i) assessing the prevalence of undernutrition from birth to 5 years of age and overweight and obesity from ages 2 to 21 years in black and white, male and female children, and (ii) determining percentiles for height, weight, BMI, waist and hip circumferences and comparing the centiles to American and Dutch references. Methods Height, weight, waist and hip circumferences were measured on urban black and white SA children from the Bt20+. A total of 3273 children born between April and June 1990 in the Greater Johannesburg Metropolitan area were included in the cohort. Z-scores were derived using the WHO 2006 child growth standards (0–5 years), for defining stunting, underweight and wasting. The International Obesity Task Force (IOTF) references were used to define overweight and obesity. Percentiles were developed using the lambda mu sigma (LMS) method and compared to American and Dutch references. Results Black children were consistently shorter and black males lighter than white children and American references. The prevalence of stunting peaked at 2 years and was significantly higher in males than females and in black than white children. Black females had a greater prevalence of overweight and obesity than black males from 10 to 17 years. The percentiles for black females for weight and BMI were similar to those of South African white and American references but both black and white South African females had lower waist circumferences than American references. Conclusion The growth percentiles show that young South African urban black females are experiencing general but not central obesity due to a secular change which is faster in weight than height. High levels of undernutrition persist alongside high levels of over-nutrition with adolescence being a critical period for the upsurge in obesity in females. Early intervention is needed to combat the rise in obesity. Electronic supplementary material The online version of this article (10.1186/s12889-019-6794-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lukhanyo H Nyati
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa.
| | - John M Pettifor
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa
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Wouters M, Evenhuis HM, Hilgenkamp TIM. Physical fitness of children and adolescents with moderate to severe intellectual disabilities. Disabil Rehabil 2019; 42:2542-2552. [PMID: 30973765 DOI: 10.1080/09638288.2019.1573932] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Low levels of physical fitness are associated with low physical and mental health. The aims of this study were to assess the health-related physical fitness of children with intellectual disability (ID), and study the association of physical activity and motor development with physical fitness.Methods: One hundred and twenty-eight children with moderate to severe ID (83 boys; age 2-18 years) visiting specialised day programme centres engaged in field-based physical fitness tests (body composition, muscular strength, muscular endurance, and cardiorespiratory fitness). Scores were compared to reference values, and with linear regression analysis the association between the fitness outcomes and physical activity and motor development was studied.Results: High rates of overweight (23-25%) and obesity (10-15%) were found. A majority of the participants (71-91%) scored below reference values for muscular strength, endurance, and cardiorespiratory fitness tests. Physical activity and motor development were positively associated with scores on several fitness test (β = 0.27-0.44; p < 0.05).Conclusions: Children with moderate to severe ID visiting specialised day programme centres have strikingly low physical fitness levels. Policies and interventions to increase the physical fitness for this specific group of children are urgently needed, in which increasing physical activity and motor skills are expected to be effective components.Implications for rehabilitationStrikingly low levels of physical fitness were seen in children and adolescents with moderate to severe intellectual disabilities.This vulnerable group is in need of appropriate interventions to increase their physical fitness levels.Increasing the physical activity is a potential component in these interventions.Improving motor development will most likely lead to improved physical fitness as well.
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Affiliation(s)
- Marieke Wouters
- Reinaerde, Utrecht, the Netherlands.,Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Heleen M Evenhuis
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Thessa I M Hilgenkamp
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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Breastfeeding and cardiometabolic markers at age 12: a population-based birth cohort study. Int J Obes (Lond) 2019; 43:1568-1577. [PMID: 30886238 DOI: 10.1038/s41366-018-0317-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/15/2018] [Accepted: 08/29/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND There is growing evidence for a protective effect of breastfeeding against overweight and diabetes. It is less clear though, whether breastfed infants also have a more favorable cardiometabolic profile in childhood. OBJECTIVE We investigated whether children who were breastfed in infancy had more favorable cardiometabolic markers at 12 years of age than children who were never breastfed and received formula milk instead, and whether associations depended on the duration of breastfeeding. METHODS In 1509 participants of the population-based PIAMA birth cohort study, cardiometabolic markers were measured at 12 years of age. Duration of breastfeeding in weeks was assessed through parental questionnaires at 3 months and 1 year of age. Multivariable linear regression analysis was used to investigate associations of breastfeeding (any vs. never breastfeeding and duration of breastfeeding in categories <3 months, 3 to <6 months, and ≥6 months breastfeeding vs. never breastfeeding) with systolic and diastolic blood pressure (SBP and DBP, in Z-scores adjusted for age, sex, and height), total-to-high-density lipoprotein cholesterol (TC/HDLC), glycated hemoglobin (HbA1c, in mmol/mol), body mass index (BMI, in Z-scores adjusted for age and sex) and waist circumference (WC, in cm). Multivariable logistic regression was used to investigate the association of breastfeeding with odds of being overweight. RESULTS 1288 of 1509 children (85.3%) received any breastmilk in infancy. Breastfed children had a lower SBP Z-score (-0.21 SD (≈ -2.29 mmHg), 95% CI -0.37, -0.06), a lower DBP Z-score (-0.10 SD (≈ -1.19 mmHg), 95% CI -0.20, -0.00), a smaller WC (-1.12 cm, 95% CI -2.20; -0.04), and lower odds of being overweight (OR 0.61, 95% CI 0.38, 0.97) than never breastfed children. These associations were not different between children with shorter and longer duration of breastfeeding. No statistically significant differences in TC/HDLC, HbA1c, and BMI were observed between breastfed and never breastfed children. CONCLUSIONS We observed that breastfeeding was associated with a lower blood pressure, a smaller waist circumference and a lower risk of overweight in 12-year old children. These associations were independent of the duration of breastfeeding. No associations were observed between breastfeeding and other cardiometabolic markers.
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The effect of one year lifestyle intervention on eGFR in children and adolescents with overweight, obesity and morbid obesity. Sci Rep 2019; 9:4504. [PMID: 30872684 PMCID: PMC6418201 DOI: 10.1038/s41598-019-40767-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 02/11/2019] [Indexed: 01/07/2023] Open
Abstract
Obesity causes modifications in the kidneys reversed by weight loss in adults. There is little data on renal function and effects of weight loss in children with obesity. The aim of this prospective study was to examine renal function and effect of a lifestyle intervention in children with overweight, obesity and morbid obesity. Two hundred forty-five children (age 12.4 ± 3.3 years, 40% boys, BMI z-score 3.46 ± 0.70) participating in an out-patient lifestyle intervention were included. Children with at least 12 months follow-up (n = 144 (58.8%)) were included in the longitudinal study. Anthropometry, blood analysis and blood pressure measurements were performed at baseline and follow-up. Glomerular filtration rate (GFR) was estimated using the Schwartz and FAS equation. eGFR was de-indexed using body surface area. Different cut-off points for defining glomerular hyperfiltration were used for stratification. Depending on the definition and equation used, glomerular hyperfiltration was present in 2% to 18% of the participants. After intervention, de-indexed eGFR decreased significantly in children with baseline glomerular hyperfiltration, depending on the eGFR equation and definition for glomerular hyperfiltration used. No associations of changes in eGFR with changes in BMI z-score, blood pressure or parameters of glucose and lipid metabolism were found. In conclusion, after one year of lifestyle intervention, eGFR decreases in hyperfiltrating children and adolescents with overweight, obesity and morbid obesity. eGFR and changes over time in children with obesity depend on eGFR equation used and on de-indexing for body surface area.
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Karnebeek K, Thapar S, Willeboordse M, van Schayck OCP, Vreugdenhil ACE. Comorbidities in primary versus secondary school children with obesity and responsiveness to lifestyle intervention. J Clin Endocrinol Metab 2019; 104:3803-3811. [PMID: 30776292 DOI: 10.1210/jc.2018-02318] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 02/13/2019] [Indexed: 12/17/2022]
Abstract
CONTEXT Childhood obesity increases the risk of diseases as diabetes, cardiovascular disease and non-alcoholic fatty liver disease. OBJECTIVE To evaluate the prevalence of comorbidities in school-age children with obesity and to compare its prevalence and the effect of a lifestyle intervention between children in primary and secondary school and between boys and girls. DESIGN Cross-sectional analysis and lifestyle intervention. SETTING Centre for Overweight Adolescent and Children's Healthcare. PATIENTS Comorbidities were evaluated in 149 primary and 150 secondary school children with (morbid) obesity (162 girls). The effect of lifestyle intervention was studied in 82 primary and 75 secondary school children. INTERVENTION One-year interdisciplinary lifestyle intervention. RESULTS Insulin resistance (37%), impaired glucose tolerance (IGT) (3%), dyslipidemia (48%), hypertension (7%) and elevated liver transaminase levels (54%) were already common in primary school children. Glomerular hyperfiltration and insulin resistance were more prevalent in secondary school children. IGT was more prevalent in girls.The change in BMI z-score after intervention was greater in primary school children (primary vs. secondary: -0.25±0.32 vs. -0.11±0.47), even as the change in LDL cholesterol concentrations (primary vs. secondary: -0.30(-0.70;0.10) vs. -0.10(-0.40;0.30)) and systolic blood pressure z-score (primary vs. secondary: -0.32±1.27 vs. 0.24±1.3). The change in BMI z-score, but not in comorbidities, was greater in boys (boys vs. girls: -0.33±0.45 vs. -0.05±0.31). CONCLUSIONS The presence of comorbidities is already evident in primary school children with obesity. The effect of a lifestyle intervention on these comorbidities is greater in primary compared to secondary school children, stressing the need for early interventions.
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Affiliation(s)
- Kylie Karnebeek
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Supriya Thapar
- School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Maartje Willeboordse
- Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Onno C P van Schayck
- Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Anita C E Vreugdenhil
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
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42
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Zong X, Li H, Zhang Y, Wu H. Waist circumference and waist-to-height ratio in Chinese pre-school children: results from the 5th National Survey in 2015. Ann Hum Biol 2019; 45:440-446. [PMID: 30767616 DOI: 10.1080/03014460.2018.1513561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Waist circumference (WC) and waist-to-height ratio (WHtR) distributions have been described in Chinese pre-school children only in local areas. AIM To report reference data of WC and WHtR in a nationally representative sample of Chinese pre-school children. SUBJECTS AND METHODS A total of 53,172 children aged 3-7 years were surveyed as part of the 5th National Survey in 2015. WC and WHtR percentile values were calculated for each age- and sex-specific group. Urban-suburban rural differences of WC and WHtR were examined. Comparisons of WC and WHtR with other Chinese studies and foreign studies were assessed. RESULTS Eleven conventional percentile values of WC and WHtR were obtained for urban and suburban rural children. Urban-suburban rural differences of WC ranged from -0.2 cm to 0.6 cm for both boys and girls across all age groups and the differences of WHtR ranged from -0.01 to 0.01. Median WC and WHtR curves were generally in the middle of other Chinese studies. Median WC and WHtR curves in China were generally lower than other countries that were compared. CONCLUSION The presented percentile values of WC and WHtR may be useful to monitor growth and development and to assess abdominal fat distribution of younger children.
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Affiliation(s)
- Xinnan Zong
- a Department of Growth and Development , Capital Institute of Pediatrics , Beijing , PR China
| | - Hui Li
- a Department of Growth and Development , Capital Institute of Pediatrics , Beijing , PR China
| | - Yaqin Zhang
- a Department of Growth and Development , Capital Institute of Pediatrics , Beijing , PR China
| | - Huahong Wu
- a Department of Growth and Development , Capital Institute of Pediatrics , Beijing , PR China
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Rijks J, Vreugdenhil A, Dorenbos E, Karnebeek K, Joris P, Berendschot T, Mensink R, Plat J. Characteristics of the retinal microvasculature in association with cardiovascular risk markers in children with overweight, obesity and morbid obesity. Sci Rep 2018; 8:16952. [PMID: 30446681 PMCID: PMC6240121 DOI: 10.1038/s41598-018-35279-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/23/2018] [Indexed: 12/11/2022] Open
Abstract
To aim of this study was to evaluate characteristics of the retinal microvasculature, but particularly potential associations with classic and novel (endothelial function and low-grade inflammation)markers for cardiovascular risk, in a cohort of children with overweight and (morbid) obesity. Central retinal arteriolar equivalent(CRAE) and central retinal venular equivalent(CRVE) were assessed. CRAE was significantly lower and AVR significantly higher in children with morbid obesity than in children with overweight and normal weight(p < 0.01). CRVE did not differ significantly between the four weight categories. A multiple linear regression model with CRAE as dependent variable showed that only DBP z-score(β = −2.848,p = 0.029) and plasma glucose concentrations(β = 6.029,p = 0.019) contributed significantly to the variation in CRAE. Remarkably, despite a correlation between CRAE and circulating concentrations of the adhesion molecules VCAM-1 or ICAM-1, markers for inflammation and endothelial function did not contribute to the variation in CRAE. This is the first study showing in population of children with overweight and obesity that the retinal arteriolar microvasculature, but not venular diameter is aberrant, with increasing BMI z-score. CRAE was significantly associated with several cardiovascular risk markers, and multiple linear regression showed that a higher diastolic blood pressure z-score and lower fasting plasma glucose concentrations significantly contributed to the variance in CRAE.
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Affiliation(s)
- Jesse Rijks
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Anita Vreugdenhil
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands. .,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.
| | - Elke Dorenbos
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Kylie Karnebeek
- Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Paediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Peter Joris
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.,Department of Human Biology, Maastricht University, Maastricht, The Netherlands
| | - Tos Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ronald Mensink
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.,Department of Human Biology, Maastricht University, Maastricht, The Netherlands
| | - Jogchum Plat
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.,Department of Human Biology, Maastricht University, Maastricht, The Netherlands
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Lassek WD, Gaulin SJC. Do the Low WHRs and BMIs Judged Most Attractive Indicate Higher Fertility? EVOLUTIONARY PSYCHOLOGY 2018; 16:1474704918800063. [PMID: 30296846 PMCID: PMC10480809 DOI: 10.1177/1474704918800063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 08/20/2018] [Indexed: 12/30/2022] Open
Abstract
We examine the widely accepted view that very low waist-hip ratios and low body mass indices (BMIs) in women in well-nourished populations are judged attractive by men because these features reliably indicate superior fertility. In both subsistence and well-nourished populations, relevant studies of fertility do not support this view. Rather studies indicate lower fertility in women with anthropometric values associated with high attractiveness. Moreover, low maternal BMI predisposes to conditions that compromise infant survival. Consistent with these findings from the literature, new data from a large U.S. sample of women past reproductive age show that women with lower BMIs in the late teens had fewer live births, controlling for education, marital history, and race. They also had later menarche and earlier menopause compared with women with higher youth BMIs. In addition, data from the 2013 U.S. natality database show that mothers with lower prepregnancy BMIs have an increased risk of producing both low-birth-weight and preterm infants controlling for other relevant variables-conditions that would have adversely affected fitness over almost all of human evolution. Thus, a review of the relevant literature and three new tests fail to support the view that highly attractive women are more fertile.
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Affiliation(s)
- William D. Lassek
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Steven J. C. Gaulin
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
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Tack LJW, Craen M, Lapauw B, Goemaere S, Toye K, Kaufman JM, Vandewalle S, T'Sjoen G, Zmierczak HG, Cools M. Proandrogenic and Antiandrogenic Progestins in Transgender Youth: Differential Effects on Body Composition and Bone Metabolism. J Clin Endocrinol Metab 2018; 103:2147-2156. [PMID: 29672753 DOI: 10.1210/jc.2017-02316] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 04/11/2018] [Indexed: 02/13/2023]
Abstract
CONTEXT Progestins can be used to attenuate endogenous hormonal effects in late-pubertal transgender (trans) adolescents (Tanner stage B4/5 and G4/5). Currently, no data are available on the effects of progestins on the development of bone mass or body composition in trans youth. OBJECTIVE To study prospectively the evolution of body composition and bone mass in late-pubertal trans adolescents using the proandrogenic or antiandrogenic progestins lynestrenol (L) and cyproterone acetate (CA), respectively. DESIGN AND OUTCOME MEASUREMENTS Forty-four trans boys (Tanner B4/5) and 21 trans girls (Tanner G4/5) were treated with L or CA for 11.6 (4 to 40) and 10.6 (5 to 31) months, respectively. Anthropometry, grip strength, body composition, and bone mass, size, and density were determined by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography before the start of progestin and before addition of cross-sex hormones. RESULTS Using L, lean mass [+3.2 kg (8.6%)] and grip strength [+3 kg (10.6%)] significantly increased, which coincided with a more masculine body shape in trans boys. Trans girls showed loss of lean mass [-2.2 kg (4.7%)], gain of fat mass [+1.5 kg (9.4%)], and decreased grip strength Z scores. CA limited normal bone expansion and impeded pubertal bone mass accrual, mostly at the lumbar spine [Z score: -0.765 to -1.145 (P = 0.002)]. L did not affect physiological bone development. CONCLUSION Proandrogenic and antiandrogenic progestins induce body composition changes in line with the desired appearance within 1 year of treatment. Bone health, especially at the lumbar spine, is of concern in trans girls, as bone mass accrual is severely affected by androgen suppressive therapy.
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Affiliation(s)
- Lloyd J W Tack
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Margarita Craen
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Bruno Lapauw
- Department of Endocrinology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Stefan Goemaere
- Department of Endocrinology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Kaatje Toye
- Department of Endocrinology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Sara Vandewalle
- Department of Endocrinology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Guy T'Sjoen
- Department of Endocrinology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Hans-Georg Zmierczak
- Department of Endocrinology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Martine Cools
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital, Ghent University, Ghent, Belgium
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NASCIMENTO LM, GOMES KRO, MASCARENHAS MDM, MIRANDA CES, ARAÚJO TMED, FROTA KDMG. Association between the consumption of antioxidant nutrients with lipid alterations and cardiometabolic risk in adolescents. REV NUTR 2018. [DOI: 10.1590/1678-98652018000200005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective This study aimed at validating the associations between the consumption of antioxidant nutrients as well as lipid alterations and cardiometabolic risks in adolescents. Methods This cross-sectional study included 327 adolescents aged 14-19 years. Sociodemographic and dietary information, anthropometric and blood pressure measurements, and biochemical data were obtained. Cardiometabolic risk was calculated by aggregating the risk factors, which were expressed as the sum of Z-scores. Poisson regression was performed to estimate the prevalence ratios. Results In boys, low intake of zinc was associated with elevated total cholesterol and triglyceride levels, whereas it was associated with low high-density lipoprotein cholesterol levels and high low-density lipoprotein cholesterol and total cholesterol levels in girls, thus indicating a cardiometabolic risk. Furthermore, low intake of copper was associated with high triglyceride levels and cardiometabolic risk in girls. The high prevalence ratios of high low-density lipoprotein cholesterol and total cholesterol levels and cardiometabolic risk were higher in those with low intake of vitamin A. Among girls, associations were also observed between lower intake of vitamin A and high triglyceride levels. Low intake of vitamin C among boys was associated with elevated high low-density lipoprotein cholesterol and triglyceride levels. Among girls, the intake of this vitamin was associated with lower low high-density lipoprotein cholesterol levels. In girls, low intake of vitamin E was associated with low low high-density lipoprotein cholesterol levels and high total cholesterol levels. Conclusion The associations between antioxidant micronutrients as well as lipid alterations and cardiometabolic risk emphasize the importance of encouraging the consumption of foods that are rich in these nutrients to modulate lipid alterations and cardiometabolic risk.
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Andaki ACR, Mendes EL, Tinoco ALA, Santos A, Sousa B, Vale S, Mota J. Waist circumference percentile in children from municipalities of developed and developing countries. MOTRIZ: REVISTA DE EDUCACAO FISICA 2018. [DOI: 10.1590/s1980-6574201700si0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Edmar Lacerda Mendes
- Universidade Federal do Triângulo Mineiro, Brazil; Universidade do Porto, Portugal
| | | | | | - Bruno Sousa
- Universidade Lusófona de Humanidades e Tecnologias, Portugal
| | - Susana Vale
- Universidade do Porto, Portugal; Instituto Politénico do Porto, Portugal
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48
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Laimbacher J. [Not Available]. PRAXIS 2018; 107:77-85. [PMID: 29338628 DOI: 10.1024/1661-8157/a002872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Zusammenfassung. Adipositas im Kindes- und Jugendalter ist eine komplexe Herausforderung. Die Früherfassung durch den Grundversorger ist dabei wichtig. In der Schweiz können seit dem 01.01.2014 die umfassenden Betreuungsformen (individuell oder in der Gruppe) kostenpflichtig und leistungsberechtigt erbracht werden. Um der globalen Übergewichtsepidemie Einhalt zu gebieten, bedarf es weltweit aber bereits präkonzeptionell umfassender gesundheitsfördernder und primär präventiver Massnahmen.
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van Middelkoop M, Ligthart KAM, Paulis WD, van Teeffelen J, Kornelisse K, Koes BW. A multidisciplinary intervention programme for overweight and obese children in deprived areas. Fam Pract 2017; 34:702-707. [PMID: 28985299 DOI: 10.1093/fampra/cmx056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND GPs can refer obese children living in deprived areas to multidisciplinary programmes for a weight loss intervention, though the effectiveness of these local initiatives targeted to this specific group is unknown. OBJECTIVE To evaluate the effectiveness of the Kids4Fit intervention in deprived areas on child's weight status. METHODS Design and setting: cohort study, including a waiting list control period. Subjects: children (N = 154) aged 6-12 years, who signed up for the Kids4Fit intervention programme, led by a dietitian, physiotherapist and child psychologist were included. Measurements of standardized body mass index (BMI-z) and waist circumference were taken at start of the waiting list period, at start and at the end of the intervention and after 52 weeks. Mixed model analyses (random effects models) were used, expressed in effect per week [β with 95% confidence interval (CI)], compared to the waiting list expectancy over the 52-week study period. RESULTS Mixed model analyses showed a non-significant trend towards a lower BMI-z up to 52 weeks after start of Kids4Fit (β: -0.0024; 95% CI: -0.0053; 0.0004), compared to the waiting list expectancy. A significantly lower waist circumference was found over time compared to the waiting list expectancy (β: -0.0558; 95% CI: -0.0950; -0.0166). No differences were found in lifestyle and health-related quality of life. CONCLUSION A local multidisciplinary intervention programme in deprived areas is effective in reducing waist circumference of obese children, compared to a waiting list expectancy, but no significant changes in lifestyle and quality of life were shown.
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Affiliation(s)
- Marienke van Middelkoop
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Kelly A M Ligthart
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Winifred D Paulis
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jolande van Teeffelen
- Dietician Practice in Primary Care, dietistenpraktijk HRC, Rotterdam, The Netherlands
| | | | - Bart W Koes
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Surette V, Ward S, Morin P, Vatanparast H, Bélanger M. Food Reluctance of Preschool Children Attending Daycare Centers Is Associated with a Lower Body Mass Index. J Acad Nutr Diet 2017; 117:1749-1756. [PMID: 28917503 DOI: 10.1016/j.jand.2017.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 07/11/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Food reluctance can present as fussiness, picky eating, slowness in eating, and high satiety responsiveness. It can be associated with inadequate weight gain during early childhood. Although a majority of preschoolers attend daycare centers, associations between their eating behaviors at daycare and their body composition have not been studied. OBJECTIVE Our aim was to develop an estimate of food reluctance and to assess the relationship between food reluctance at daycare and body mass index (BMI) and waist circumference of preschoolers. DESIGN We conducted a cross-sectional secondary analyses. Food reluctance was estimated using weighted digital plate waste analysis. Intra-rater, inter-rater, and test-retest reliability and convergent validity of the food reluctance score were tested. The food reluctance score was then compared to preschool children's BMI and waist circumference. PARTICIPANTS/SETTING Participants included 309 children aged 3 to 5 years in 24 daycare centers across the Canadian province of New Brunswick. MAIN OUTCOME MEASURES Preschool children's waist circumference and age-adjusted BMI derived from objectively measured height and weight were analyzed. STATISTICAL ANALYSES PERFORMED Intraclass correlations were used to determine the reliability of the new estimate. Spearman correlation was used to compare the estimate with parental report of food reluctance. Multivariate linear regressions were used to examine the relationship between food reluctance and waist circumference and age-adjusted BMI. RESULTS The estimated food reluctance score demonstrated excellent inter- and intra-rater reliability (intraclass correlation>0.97; P<0.0001) and good test-retest reliability (intraclass correlation=0.72; P<0.0001). It also provided evidence of convergent validity through correlation with reluctance-related subscales of the Child Eating Behavior Questionnaire (ρ=.53, P<0.0001). Greater demonstration of food reluctance at the daycare center was associated with a lower age-adjusted BMI (adjusted β -1.41; 95% CI -.15 to -2.67), but was not associated with children's waist circumference (adjusted β -.60; 95% CI -2.06 to .86). CONCLUSIONS Signs of food reluctance can be observed in daycare and relate to lower BMI among preschoolers.
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