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Sigurðardóttir B, Gribsholt SB, Bjerregaard LG, Bruun JM. Review of impacts of using body mass index as a screening tool in school children: A scoping review. Clin Obes 2024; 14:e12639. [PMID: 38199975 DOI: 10.1111/cob.12639] [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] [Received: 08/21/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 01/12/2024]
Abstract
Body mass index (BMI) is used to screen for under- or overweight. However, it is unknown whether BMI-screening in school children reduces the incidence of overweight and obesity. We aimed to summarise the knowledge on positive and negative consequences on BMI and weight-related perceptions and behaviours of BMI-screening followed by an intervention to prevent and/or address obesity. We performed a systematic literature search, April 2023, using the PubMed, ScienceDirect and Google Scholar databases. We included randomised controlled trials and observational studies, including children aged 6 to 18 years and examining BMI-screening in a school setting. The primary outcome measures were BMI and weight status. Secondary outcome measures were weight-related perceptions and behaviours. Three studies met the inclusion criteria; two randomised controlled trials and one observational study. All studies used BMI-screening followed by sending report cards to the parents. None of the studies found a change in BMI z-scores in school children. Screening could cause transitory body-dissatisfaction and increase peer weight talk, yet potentially reduce problematic weight behaviours like skipping meals or excessive dieting. Reporting BMI to parents may influence their perception of their children's weight status, but does not change behaviour. The sparse evidence available suggested that BMI screening followed by sending report cards to parents does not change BMI z-scores among children in primary, middle and high school. Studies using appropriate evidence-based weight management interventions as a follow-up are lacking. Such studies may improve future prevention, detection and treatment of weight-related issues.
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Affiliation(s)
| | - Sigrid Bjerge Gribsholt
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Danish National Center for Obesity, Aarhus, Denmark
| | - Lise Geisler Bjerregaard
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jens Meldgaard Bruun
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Danish National Center for Obesity, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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2
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Jakubowska P, Balcerczyk-Lis M, Fortuna M, Janiak A, Kopaczyńska A, Skwira S, Młynarska E, Rysz J, Franczyk B. Influence of Metabolic Dysregulation in the Management of Depressive Disorder-Narrative Review. Nutrients 2024; 16:1665. [PMID: 38892598 PMCID: PMC11174513 DOI: 10.3390/nu16111665] [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: 04/25/2024] [Revised: 05/16/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Depressive disorders are heterogeneous in nature, and their global reach makes them the cause of suffering for a million individuals worldwide. Standard treatment does not work for one in three people, and side effects can significantly reduce the quality of life. A multidisciplinary approach allows for a broader insight into the nature of the disease, given its complex etiology. One of its elements is the hypothesis of inflammation, which also accompanies obesity-related disease. Obesity and depression interact, causing many researchers to develop new non-pharmacological treatment methods for both diseases. One suggestion is physical exercises that have great potential to be used in clinical practice. They can exert changes on the central nervous system and thus modulate mood. Another is diet, which concentrates on active molecules that also affect the central nervous system (CNS). There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice. There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice.
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Affiliation(s)
- Paulina Jakubowska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Marta Balcerczyk-Lis
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Milena Fortuna
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Aleksandra Janiak
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Adrianna Kopaczyńska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Sylwia Skwira
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
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Gutiérrez-González E, García-Solano M, Pastor-Barriuso R, Fernández de Larrea-Baz N, Rollán-Gordo A, Peñalver-Argüeso B, Peña-Rey I, Pollán M, Pérez-Gómez B. A nation-wide analysis of socioeconomic and geographical disparities in the prevalence of obesity and excess weight in children and adolescents in Spain: Results from the ENE-COVID study. Pediatr Obes 2024; 19:e13085. [PMID: 37963589 DOI: 10.1111/ijpo.13085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/22/2023] [Accepted: 10/22/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVE To estimate national and provincial prevalence of obesity and excess weight in the child and adolescent population in Spain by sex and sociodemographic characteristics, and to explore sources of inequalities in their distribution, and their geographical patterns. METHODS ENE-COVID is a nationwide representative seroepidemiological survey (68 287 participants) stratified by province and municipality size (April-June 2020). Participants answered a questionnaire which collected self-reported weight and height, that allowed estimating crude and model-based standardized prevalences of obesity and excess weight in the 10 543 child and adolescent participants aged 2-17 years. RESULTS Crude prevalences (WHO growth reference) were higher in boys than in girls (obesity: 13.4% vs. 7.9%; excess weight: 33.7% vs. 26.0%; severe obesity: 2.9% vs. 1.2%). These prevalences varied with age, increased with the presence of any adult with excess weight in the household, while they decreased with higher adult educational and census tract average income levels. Obesity by province ranged 1.8%-30.5% in boys and 0%-17.6% in girls; excess weight ranged 15.2%-49.9% in boys and 10.8%-40.8% in girls. The lowest prevalences of obesity and excess weight were found in provinces in the northern half of Spain. Sociodemographic characteristics only partially explained the observed geographical variability (33.6% obesity; 44.2% excess weight). CONCLUSIONS Childhood and adolescent obesity and excess weight are highly prevalent in Spain, with relevant sex, sociodemographic and geographical differences. The geographic variability explained by sociodemographic variables indicates that there are other potentially modifiable factors on which to focus interventions at different geographic levels to fight this problem.
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Affiliation(s)
| | | | - Roberto Pastor-Barriuso
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Belén Peñalver-Argüeso
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Marina Pollán
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Beatriz Pérez-Gómez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Bezerra TA, Souza Filho AND, Pessoa MLF, Ribeiro Bandeira PF, Cabral LGA, Moraes JFVND, Martins CMDL, Carvalho FO. Effects of a multicomponent intervention on cardiovascular risk factors in overweight children: a randomized clinical trial in light of complex systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1368-1378. [PMID: 35699999 DOI: 10.1080/09603123.2022.2088704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Analyzing the effects of interventions from a theoretical and statistical perspective that allows understanding these dynamic relationships of obesity etiology can be a more efficient and innovative way of understanding the phenomenon's complexity. Thus, we aimed to analyze the pattern of cardiovascular risk factors between-participants, and the effects within-participants of a multidisciplinary intervention on cardiovascular risk factors in overweight children. This is a randomized clinical trial, and 41 participated in this study. A multicomponent intervention (physical activities, nutritional and psychological counseling) was performed for 10 weeks. Anthropometric and hemodynamics measurements, lipid and glucose profile, cardiorespiratory fitness, and left ventricular mass were evaluated. A network analysis was done. Considering patterns in the network at baseline, WC, WHR, BMI, and Fat were the main variables for cardiovascular risks. Group was the most critical variable in the within-participant network. Participating in a multicomponent intervention and decreasing body fat promoted beneficial cardiovascular factors.
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Affiliation(s)
- Thaynã Alves Bezerra
- Department of Physical Education, Federal University of Paraiba, João Pessoa, Brazil
| | | | | | | | | | | | - Clarice Maria de Lucena Martins
- Department of Physical Education, Federal University of Paraiba, João Pessoa, Brazil
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, University of Porto, Portugal
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Gutiérrez-González E, Sánchez Arenas F, López-Sobaler AM, Andreu Ivorra B, Rollán Gordo A, García-Solano M. Socioeconomic and gender inequalities in childhood obesity in Spain. An Pediatr (Barc) 2023; 99:111-121. [PMID: 37517879 DOI: 10.1016/j.anpede.2023.05.008] [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: 02/16/2023] [Accepted: 05/22/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Childhood obesity is inversely associated with household socioeconomic status in high-income countries. Our aim was to explore the association between childhood weight status and household socioeconomic status in Spain in relation to family characteristics, perceptions and lifestyle habits and the school environment. METHODS We performed a descriptive analysis of child weight status according to family socioeconomic factors and mediating variables based on data from the ALADINO 2019 study in a sample of 16,665 schoolchildren representative of the population aged 6-9 years in Spain. RESULTS The prevalence of childhood obesity in households with low socioeconomic status (26.8% boys; 20.4% girls) was, in both sexes, twice as high as in those with higher socioeconomic status (12.1% boys; 8.7% girls). Unhealthy eating habits, sedentary lifestyles (mainly in girls) and the presence of screens in the bedroom (more prevalent in boys) were more frequent in school-aged children from low-income households. On the other hand, in the most disadvantaged households, a history of breastfeeding and physical activity (especially in girls) were less frequent. Similarly, schools attended by children from low-income households were less likely to have their own kitchens and indoor gymnasiums or offer sports activities. CONCLUSION A lower household socioeconomic status was associated with poorer dietary and physical activity habits and certain characteristics of the family and school environments that mediate the inverse association between household socioeconomic status and the prevalence of childhood obesity. Girls were less physically active and reported more sedentary lifestyles, while boys had greater access to screens. Interventions to combat childhood obesity should address the identified inequalities.
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Affiliation(s)
- Enrique Gutiérrez-González
- Subdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de Consumo, Madrid, Spain
| | | | - Ana María López-Sobaler
- Departamento de Nutrición y Ciencias de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain; Grupo de Investigación "Valoración Nutricional de Individuos y Colectivos: Metodología y Aplicaciones" (VALORNUT), Universidad Complutense de Madrid, Madrid, Spain
| | - Blanca Andreu Ivorra
- Servicio de Medicina Preventiva, Hospital Universitario de Alcorcón, Madrid, Spain
| | - Almudena Rollán Gordo
- Subdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de Consumo, Madrid, Spain
| | - Marta García-Solano
- Subdirección General de Nutrición, Agencia Española de Seguridad Alimentaria y Nutrición, Ministerio de Consumo, Madrid, Spain.
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Herouvi D, Paltoglou G, Soldatou A, Kalpia C, Karanasios S, Karavanaki K. Lifestyle and Pharmacological Interventions and Treatment Indications for the Management of Obesity in Children and Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1230. [PMID: 37508727 PMCID: PMC10378563 DOI: 10.3390/children10071230] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
Obesity is a multifactorial chronic impairment that further decreases quality of life and life expectancy. Worldwide, childhood obesity has become a pandemic health issue causing several comorbidities that frequently present already in childhood, including cardiovascular (hypertension, dyslipidemia), metabolic (Type 2 diabetes mellitus, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal and musculoskeletal disorders. In addition, obese children frequently experience stress and psychosocial symptoms, including mood disorders, anxiety, prejudice and low self-esteem. Given that cardiovascular risk factors and pediatric obesity have the tendency to pertain into adulthood, obesity management, including weight control and physical activity, should start before the late teens and certainly before the first signs of atherosclerosis can be detected. This review aims to concisely present options for childhood obesity management, including lifestyle modification strategies and pharmacological treatment, as well as the respective treatment indications for the general practitioner.
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Affiliation(s)
- Despina Herouvi
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - George Paltoglou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Alexandra Soldatou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Christina Kalpia
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Spyridon Karanasios
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
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Mihuta MS, Paul C, Borlea A, Roi CM, Velea-Barta OA, Mozos I, Stoian D. Unveiling the Silent Danger of Childhood Obesity: Non-Invasive Biomarkers Such as Carotid Intima-Media Thickness, Arterial Stiffness Surrogate Markers, and Blood Pressure Are Useful in Detecting Early Vascular Alterations in Obese Children. Biomedicines 2023; 11:1841. [PMID: 37509481 PMCID: PMC10376407 DOI: 10.3390/biomedicines11071841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
Obese children present a higher cardio-metabolic risk. Measuring vascular biomarkers that assess the evolution of arterial stiffness, subclinical atherosclerosis, and hypertension in such patients could be helpful in the long term. We studied 84 children, aged from 6 to 18 years: 50 obese subjects, versus 34 of normal weight. Clinical examination involved: BMI, waist circumference, waist-to-height ratio, and detection of the presence of acanthosis nigricans and irregular menstrual cycles (the latter in adolescent girls). The carotid intima-media thickness (CIMT) was measured with the Aixplorer MACH 30 echography device. The pulse wave velocity (PWV), augmentation index (AIx), and peripheral and central blood pressures (i.e., SBP, DBP, cSBP, cDBP, and cPP) were acquired through a Mobil-O-Graph device. Obese subjects underwent body composition analysis with a Tanita BC-418. Blood tests were: HOMA-IR, lipid panel, uric acid, and 25-OH vitamin D. All vascular biomarkers presented increased values in obese subjects versus controls. The following cut-off values were significant in detecting obesity: for PWV > 4.6 m/s, cSBP > 106 mmHg for the <12-year-olds, PWV > 4.5 m/s and cSBP > 115 mmHg for the 12-15-year-olds, and PWV > 5 m/s, cSBP > 123 mmHg for the >15-year-olds. AIx is higher in obese children, regardless of their insulin resistance status. Waist circumference and waist-to-height ratio correlate to all vascular parameters. HOMA-IR is an independent predictor for all vascular parameters except CIMT. Cut-off values for PWV of >4.8 m/s, SBP > 125 mmHg, and a cSBP > 117 mmHg predicted the presence of acanthosis nigricans. Obese girls with irregular menses displayed significantly higher PWV, SBP, and DPB. Elevated levels of uric acid, LDL-c, non-LDL-c, triglycerides, and transaminases, and low levels of HDL-c and 25-OH vitamin D correlated with higher arterial stiffness and CIMT values. We conclude that CIMT and the markers of arterial stiffness are useful in the early detection of vascular damage in obese children.
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Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Andreea Borlea
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Oana-Alexandra Velea-Barta
- 3rd Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Dana Stoian
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Drysdale RE, Tadesse AW, Worku A, Berhane HY, Shinde S, Madzorera I, Sharma D, Fawzi WW. Burden and contributing factors to overweight and obesity in young adolescents in Addis Ababa, Ethiopia. MATERNAL & CHILD NUTRITION 2023:e13479. [PMID: 37014175 DOI: 10.1111/mcn.13479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/14/2022] [Accepted: 01/05/2023] [Indexed: 04/08/2023]
Abstract
The prevalence of overweight/obesity in adolescents has increased globally, including in low- and middle-income countries. Early adolescence provides an opportunity to develop and encourage positive health and behavioural practices, yet it is an understudied age group with limited information to guide and inform appropriate interventions. This study aims to determine the prevalence of overweight/obesity in young adolescents, aged between 10 and 14 years attending public schools in Addis Ababa, Ethiopia, and to explore the contributing factors. A cross-sectional school-based study was conducted. Adolescents completed individual questionnaires. Weight (kg) and height (m) measurements were converted to BMI-for-age and gender z-scores. Multivariate regression analysis was conducted to determine the associated factors. The overall prevalence of overweight/obesity was 8% among adolescents aged 10-14 years and it was significantly higher in females (13%) than males (2%). The diet quality for the majority of the adolescents was inadequate, putting them at risk for poor health outcomes. The contributors to overweight/obesity were different between males and females. Age and no access to a flush toilet were negatively associated with overweight/obesity in males and access to a computer, laptop or tablet was positively associated. In females, menarche was positively associated with overweight/obesity. Living with only their mother or another female adult and an increase in physical activity were negatively associated with overweight/obesity. There is a need to improve the diet quality of young adolescents in Ethiopia and understand the reasons why females are less physically active to limit the risk of poor diet-related health outcomes.
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Affiliation(s)
- Roisin E Drysdale
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Amare W Tadesse
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alemayehu Worku
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hanna Y Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Sachin Shinde
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
- Center for Inquiry into Mental Health, Pune, India
| | - Isabel Madzorera
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
| | - Deepika Sharma
- Global Nutrition Cluster, UNICEF, New York City, New York, USA
| | - Wafaie W Fawzi
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
- Department of Epidemiology, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
- Department of Nutrition, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
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9
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Mihuta MS, Stoian D, Borlea A, Roi CM, Velea-Barta OA, Mozos I, Paul C. Evaluating the Arterial Stiffness as a Useful Tool in the Management of Obese Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020183. [PMID: 36832311 PMCID: PMC9955158 DOI: 10.3390/children10020183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/28/2022] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
Childhood obesity speeds up the development of arterial stiffness and progressively increases the values of arterial pressure. The purpose of this study is to investigate the value of using pulse wave analysis (PWA) to measure arterial stiffness as a sign of vascular wall impairment in obese children. The research was focused on 60 subjects: 33 obese and 27 normal-weight. Ages ranged from 6 to 18 years old. PWA includes parameters such as pulse wave velocity (PWV), augmentation index (AIx), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP), heart rate, and central pulse pressure (cPP). The device used was a Mobil-O-Graph. Blood parameters were taken from the subject's medical history, not older than 6 months. A high BMI and a large waist circumference are linked to a high PWV. The levels of LDL-c, triglycerides (TG), non-HDL-c, TG/HDL-c ratio, and total cholesterol-HDL-c ratio significantly correlate to PWV, SBP, and cSBP. Alanine aminotransferase is a reliable predictor of PWV, AIx, SBP, DBP, and cDBP, while aspartate aminotransferase is a significant predictor of AIx, mean arterial pressure (MAP), cSBP, and cPP. 25-OH-Vitamin D negatively correlates with PWV, SBP, and MAP and significantly predicts the MAP. Cortisol and TSH levels are not significant to arterial stiffness in obese children without specific comorbidities and neither is fasting glucose in obese children without impaired glucose tolerance. We conclude that PWA contributes valuable data regarding patients' vascular health and should be considered a reliable tool in the management of obese children.
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Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dana Stoian
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence:
| | - Andreea Borlea
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Oana-Alexandra Velea-Barta
- 3rd Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences—Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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10
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Deniz M, Doğan M, Gül Ö, Özhan B, Agladıoğlu SY, Enli Y, Şenol H. Evaluation of cardiovascular system and determination of cardiometabolic risk using novel biomarkers in childhood obesity. PROGRESS IN PEDIATRIC CARDIOLOGY 2022. [DOI: 10.1016/j.ppedcard.2022.101605] [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: 12/14/2022]
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11
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Anti-obesity weight loss medications: Short-term and long-term use. Life Sci 2022; 306:120825. [PMID: 35870619 DOI: 10.1016/j.lfs.2022.120825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/21/2022]
Abstract
As obesity prevalence increases, more and more drugs that assist with weight loss have been developed. Numerous weight loss drugs had been approved, but many have also been withdrawn based on their lack of efficacy as well as safety concerns. Initial approaches in developing weight loss drugs was by increasing physiological energy expenditure and suppressing the appetite. Subsequently, as more physiological mechanisms for weight gain has been unearthed, drugs targeting newly discovered receptors and/or enzymes have been introduced with improved safety profiles and fewer psychological adverse events. Additionally, drugs targeting hunger or satiety signaling have been actively studied, and have shown increased adoption by physicians. Studies have also evaluated drugs that target metabolic tissues-such as adipose tissue or muscle-to promote weight loss, however to-date nothing has carried on into clinical practice. Starting with a brief history of early obesity treatments, this review evaluates current weight loss pharmaceutical options based on their duration of therapy status.
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Gwag SH, Oh YR, Ha JW, Kang E, Nam HK, Lee Y, Rhie YJ, Lee KH. Weight changes of children in 1 year during COVID-19 pandemic. J Pediatr Endocrinol Metab 2022; 35:297-302. [PMID: 34881539 DOI: 10.1515/jpem-2021-0554] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/18/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has changed everyday life. The Korean government urged schools to close as a measure of social distancing, and children and adolescents seemed to gain weight due to home confinement. We aimed to investigate the trends in weight changes in children during the pandemic period. MATERIALS AND METHODS This retrospective study included 139 children aged between 6 and 12 years who visited the pediatric endocrine clinic for regular growth follow-up for 1 year during the COVID-19 pandemic. We analyzed changes in the body mass index (BMI), BMI z-score, and proportion of children who were overweight or obese over a period of 1 year. RESULTS The BMI and BMI z-scores of the 139 children increased significantly over the year. The increase was maximum during the first three months of the COVID-19 pandemic, with little change between the third and sixth month of the pandemic. The proportion of children who were overweight or obese increased over time, from 24.5% at the COVID-19 pandemic baseline to 38.1% 1 year later (p < 0.001). CONCLUSIONS The COVID-19-related lockdown resulted in significant weight gain in Korean children. Changes in BMI showed different trends depending on the degree of school closure. An overall shift from normal weight to overweight or obesity was observed during the pandemic period.
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Affiliation(s)
- Si-Hwa Gwag
- Department of Pediatrics, College of Medicine Korea University, Seoul, South Korea
| | - Ye Rim Oh
- Department of Pediatrics, College of Medicine Korea University, Seoul, South Korea
| | - Jae Wook Ha
- Department of Pediatrics, Veterans Health Service, Seoul, South Korea
| | - Eungu Kang
- Department of Pediatrics, College of Medicine Korea University, Seoul, South Korea
| | - Hyo-Kyoung Nam
- Department of Pediatrics, College of Medicine Korea University, Seoul, South Korea
| | - Yoon Lee
- Department of Pediatrics, College of Medicine Korea University, Seoul, South Korea
| | - Young-Jun Rhie
- Department of Pediatrics, College of Medicine Korea University, Seoul, South Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, College of Medicine Korea University, Seoul, South Korea
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The Mediation Role of Fatness in Associations between Cardiorespiratory Fitness and Blood Pressure after High-Intensity Interval Training in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031698. [PMID: 35162721 PMCID: PMC8834818 DOI: 10.3390/ijerph19031698] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Low cardiorespiratory fitness (CRF), elevated blood pressure (BP), and high fatness are cardiovascular disease risk factors. It remains unknown how fatness affects the influence of CRF on BP. Therefore, the aim was to examine whether the associations between baseline CRF and HIIT-postintervention resting BP were mediated through fatness in adolescents. MATERIAL AND METHODS The sample (n = 64) comprised 28 boys 36 girls aged 16 years. The analysed factors were fitness index- reflecting CRF, body fat mass (BFM), fat mass index (FMI), and body mass index (BMI). Bootstrapped mediation procedures were performed. The mediation analysis was conducted concerning the sex moderation effect. RESULTS The mediation effect of sex was confirmed; therefore, mediations models were designed separately for boys and girls. The results showed a statistically significant inverse relationship between baseline CRF and post-intervention systolic blood pressure (SBP) in both sexes (boys: B = -0.603, p = 0.010; girls: B = -0.394, p = 0.037). The relations between CRF and SBP revealed the mediation effect of the BFM and the FMI only in boys. CONCLUSIONS Fatness mediated associations between CRF and SBP in boys. Therefore, both CRF and fatness are necessary to maintain positive results of the BP revealed in normal SBP ranges after HIIT.
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Mustafa AEM, Assery AAA, Asiri FMA, Alfarhan NM, Alqarni AM, Alqahtani FMS. Childhood obesity and its relation with dietary habits among children in Aseer region, Southern Saudi Arabia. J Family Med Prim Care 2021; 10:3760-3764. [PMID: 34934677 PMCID: PMC8653482 DOI: 10.4103/jfmpc.jfmpc_558_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/04/2021] [Accepted: 07/09/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The rate of obesity in children is rising and it has become a growing epidemic worldwide; Childhood obesity is related to the high risk of obesity later in adult life. In the last 30 years the prevalence childhood obesity more than tripled. Overweight in paediatric population is suggested to be related to many cardio-metabolic risk factors such as metabolic syndrome, type 2 diabetes, hypertension, insulin resistance. Metabolic syndrome and dyslipidaemia and 70% obese children had first cardiovascular disease risk factor and 30% had second or more. AIM To estimate the prevalence and correlates of obesity among children in Aseer region. METHODOLOGY A descriptive cross-sectional survey was conducted in the schools of Abha and Khamis Mushayet Cities; Aseer region during the period from January to December 2019. The respondents were any of the parents of the child. After having permission from the school authority, self-administered questionnaires were distributed to a total of 300 children, with explanations about the questionnaire by the principal investigator and class teacher. RESULTS The study included 300 students with ages that ranged from 1 year up to 17 years and mean age was 8.6 years old. Exact of 55.3% of the students were males and 32% were at preschool age while 43.7% were at the primary level of education. Students' body mass index (BMI) distribution demonstrated that more than half of the children had overweight or obesity and 16.7% were with underweight. There was a significant relation between obesity among the children and some of their dietary habits including sweets, chocolate and fast food. CONCLUSIONS AND RECOMMENDATIONS In conclusion, the study revealed that nearly one-third of the children in the study group were overweight or obese with obesity more prevalent. Obesity was more recorded among old-aged children who frequently had unhealthy food. Improving the children lifestyle and dietary habits is mandatory to work against weight gain.
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Affiliation(s)
- Alam Eldin M. Mustafa
- Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Department of Pediatrics, Faculty of Medicine and Health Sciences; University of Kordofan, Sudan
| | - Abeer Ayed A. Assery
- Medical Student, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Nojoud M. Alfarhan
- Medical Student, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Afnan M. Alqarni
- Medical Student, College of Medicine, King Khalid University, Abha, Saudi Arabia
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La Valle A, Crocco M, Chiarenza DS, Maghnie M, d'Annunzio G. Endothelial impairment evaluation by peripheral arterial tonometry in pediatric endocrinopathies: A narrative review. World J Diabetes 2021; 12:810-826. [PMID: 34168730 PMCID: PMC8192248 DOI: 10.4239/wjd.v12.i6.810] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/30/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
Endothelial dysfunction (ED) is characterized by an imbalance between vasodilator and vasoconstriction agents. Several pathological conditions clinically diagnosed in childhood and adolescence are characterized by ED and increased risk for early development of microangiopathic and macroangiopathic impairment, in particular type 1 diabetes mellitus (T1DM), T2DM, obesity, metabolic syndromeand pituitary dysfunction associated to various endocrinopathies. More recently insulin resistance following chemotherapy or radiotherapy for tumors, bone marrow transplantation for hematological malignancies (i.e., cancer survivors), or immunosuppressive treatment for solid organ transplantation has been observed. Assessment of ED by means of non-invasive techniques is the gold standard for early ED detection before clinical manifestation. It is aimed to recognize patients at risk and to avoid the development and progression of more serious illnesses. Reactive hyperemia-peripheral artery tonometry is a noninvasive technique to assess peripheral endothelial function by measuring modifications in digital pulse volume during reactive hyperemia, and represents a non-invasive, reproducible and operator-independent tool able to detect precocious ED. This narrative review aimed to provide an overview of the most important papers regarding ED detection by EndoPat 2000 in children and adolescents with different endocrine diseases. A comprehensive search of English language articles was performed in the MEDLINE database without using other search filters except the publication interval between 2005 and 2020.
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Affiliation(s)
- Alberto La Valle
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
- Pediatric Clinic and Endocrinology, IRCCS Giannina Gaslini Institute, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, Genoa16147, Italy
| | - Marco Crocco
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
- Pediatric Clinic and Endocrinology, IRCCS Giannina Gaslini Institute, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, Genoa16147, Italy
| | - Decimo Silvio Chiarenza
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
- Pediatric Clinic and Endocrinology, IRCCS Giannina Gaslini Institute, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, Genoa16147, Italy
| | - Mohamad Maghnie
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
- Pediatric Clinic and Endocrinology, IRCCS Giannina Gaslini Institute, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, Genoa16147, Italy
| | - Giuseppe d'Annunzio
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
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Hill MA, Yang Y, Zhang L, Sun Z, Jia G, Parrish AR, Sowers JR. Insulin resistance, cardiovascular stiffening and cardiovascular disease. Metabolism 2021; 119:154766. [PMID: 33766485 DOI: 10.1016/j.metabol.2021.154766] [Citation(s) in RCA: 229] [Impact Index Per Article: 76.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 12/18/2022]
Abstract
The cardiometabolic syndrome (CMS) and obesity are typically characterized by a state of metabolic insulin resistance. As global and US rates of obesity increase there is an acceleration of the incidence and prevalence of insulin resistance along with associated cardiovascular disease (CVD). Under physiological conditions insulin regulates glucose homeostasis by enhancing glucose disposal in insulin sensitive tissues while also regulating delivery of nutrients through its vasodilation actions on small feed arteries. Specifically, insulin-mediated production of nitric oxide (NO) from the vascular endothelium leads to increased blood flow enhancing disposal of glucose. Typically, insulin resistance is considered as a decrease in sensitivity or responsiveness to the metabolic actions of insulin including insulin-mediated glucose disposal. However, a decreased sensitivity to the normal vascular actions of insulin, especially diminished nitric oxide production, plays an additional important role in the development of CVD in states of insulin resistance. One mechanism by which insulin resistance and attendant hyperinsulinemia promote CVD is via increases in vascular stiffness. Although obesity and insulin resistance are known to be associated with substantial increases in the prevalence of vascular fibrosis and stiffness the mechanisms and mediators that underlie vascular stiffening in insulin resistant states are complex and have only recently begun to be addressed. Current evidence supports the role of increased plasma levels of aldosterone and insulin and attendant reductions in bioavailable NO in the pathogenesis of impaired vascular relaxation and vascular stiffness in the CMS and obesity. Aldosterone and insulin both increase the activity of serum and glucocorticoid kinase 1 (SGK-1) which in turn is a major regulator of vascular and renal sodium (Na+) channel activity.The importance of SGK-1 in the pathogenesis of the CMS is highlighted by observations that gain of function mutations in SGK-1 in humans promotes hypertension, insulin resistance and obesity. In endothelial cells, an increase in Na+ flux contributes to remodeling of the cytoskeleton, reduced NO bioavailability and vascular stiffening. Thus, endothelial SGK-1 may represent a point of convergence for insulin and aldosterone signaling in arterial stiffness associated with obesity and the CMS. This review examines our contemporary understanding of the link between insulin resistance and increased vascular stiffness with emphasis placed on a role for enhanced SGK-1 signaling as a key node in this pathological process.
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Affiliation(s)
- Michael A Hill
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA; Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA.
| | - Yan Yang
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
| | - Liping Zhang
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA; Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Zhe Sun
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA; Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Guanghong Jia
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA; Diabetes and Cardiovascular Center, University of Missouri School of Medicine, Columbia, MO 65212, USA; Department of Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Alan R Parrish
- Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - James R Sowers
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA; Diabetes and Cardiovascular Center, University of Missouri School of Medicine, Columbia, MO 65212, USA; Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO 65212, USA; Department of Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA.
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Schneider BC, Menezes AMB, Wehrmeister FC, Gonçalves H. Gestational weight gain and childhood body mass index across three generations: Results from the 1993 Pelotas (Brazil) Birth Cohort. Pediatr Obes 2021; 16:e12760. [PMID: 33496054 DOI: 10.1111/ijpo.12760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gestational weight gain (GWG) has been associated with the accumulation of body fat in offspring, but little is known about the intergenerational relationship. OBJECTIVE To assess the effect of GWG in grandmothers and mothers on the child's body mass index (BMI). METHODS This is a sub-study nested in the 1993 Pelotas (Brazil) Birth Cohort at 22 years follow-up visit. We calculated the BMI-for-age z-score (BAZ) and evaluated overweight (>2 SD in ≤5 years of age and >1 SD for >5 years of age for BAZ). Grandmothers' and mothers' GWG were calculated as the difference between weight in the beginning of pregnancy and the last recorded weight before delivery. We standardized the GWG by adjusting for pre-gestational BMI. We also categorized GWG as adequate, excessive, or insufficient, in accordance with the Institute of Medicine (2009). Linear and logistic regressions stratified by child's age (≤2 years; 2.01-5 years; >5 years) were used. Structural equations were modelled to calculate the total, indirect, and direct effects of grandmothers' and mothers' GWG on children's BAZ. RESULTS Nine hundred and forty-six out of 1113 children evaluated were 5 years of age or under. There was an indirect effect (through maternal birthweight, maternal pre-gestational BMI, maternal GWG, and child birthweight) of grandmother GWG on grandchild BAZ, from 2.01 to 5 years of age [β = 0.12 95% CI: 0.04-0.20 (P < 0.01)]. Maternal GWG directly increased the child's BAZ at >5 years of age [β = 0.34 95% CI: 0.15-0.53 (P < 0.001)]. CONCLUSIONS GWG's effect on BMI does seem to be transmitted across three generations. Managing this will require health education during the gestational period for women and their families.
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Affiliation(s)
- Bruna C Schneider
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
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LiveWell in early childhood: results from a two-year pilot intervention to improve nutrition and physical activity policies, systems and environments among early childhood education programs in South Carolina. BMC Public Health 2021; 21:919. [PMID: 33985467 PMCID: PMC8120745 DOI: 10.1186/s12889-021-10975-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 05/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background Early childhood education (ECE) settings are critical intervention targets for obesity prevention. This study evaluated a pilot two-year community-based participatory research (CBPR) project designed to assist ECE center directors and caregivers in policy, systems and environmental (PSE) change for improving healthy eating (HE) and physical activity (PA). Methods A two-year CBPR study was conducted in 10 licensed ECE centers in Greenville, South Carolina. The intervention consisted of five steps: [1] baseline data collection and self-assessment using the Nutrition and Physical Activity Self-Assessment for Child Care (Go-NAP SACC), [2] tailored goal setting and action planning, [3] technical assistance and access to resources, [4] post intervention data collection and re-assessment, and [5] celebration of success. Main outcome measures (HE and PA environments, practices and policies) were assessed using the Environment and Policy Assessment and Observation (EPAO) tool at baseline and 24 months. One classroom of 3–5-year-olds was randomly selected for observation from each center (mean of 12 children per classroom). Means and standard deviations were calculated for total PA, total nutrition and each subscale of PA and nutrition. Paired sample t-tests were calculated to assess changes in EPAO scales from baseline to post intervention. Results Ten ECE centers enrolled in the pilot study and eight completed the two-year intervention. Center-based goals were accomplished across all 8 ECE centers over the two-year intervention: 16 child nutrition goals, 6 outdoor play goals, 11 physical activity goals and 8 screen time goals across the entire sample. Nutrition policy and PA policy significantly improved (p < 0.05), with greater improvements in PA (10.0 point increase, p = .048) as compared to nutrition (3.3 point increase, p = 0.02). Conclusions Utilizing a CBPR approach, this two-year nutrition and PA PSE intervention in ECE centers improved ECE center HE and PA policies.
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Beltran-Valls MR, Santos R, Mota J, Moreira C, Lopes L, Agostinis-Sobrinho C. The mediating role of adiposity in the longitudinal association between cardiorespiratory fitness and blood pressure in adolescents: LabMed cohort study. Eur J Clin Invest 2021; 51:e13430. [PMID: 33047322 DOI: 10.1111/eci.13430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The aim of this prospective cohort study was to examine whether the association between the cardiorespiratory fitness (CRF) at baseline and blood pressure (BP) at follow-up is mediated by adiposity in adolescents. MATERIALS AND METHODS The sample comprised 734 adolescents (349 girls) aged 12-18 years from the LabMed Physical Activity Cohort Study. The variables of interest were measured in 2011 (baseline) and in 2013 (2-year follow-up). CRF was assessed by the 20-m shuttle run test. Body mass index, waist circumference, body fat percentage, pubertal status and resting BP were assessed according to standard procedures. Boot-strapped mediation procedures were performed, and indirect effects (IE) with confidence intervals (CI) not including zero were considered statistically significant. RESULTS After adjusting for potential confounders, body mass index acted as a mediator of the relationship between CRF and systolic BP (IE = -0. 023; CI = -0.039; -0.009), pulse pressure (IE = -0.023; CI = -0.034; -0.012) and rate product pressure (IE = -2.839; CI = -5.329; -0.340). Similar results were obtained for waist circumference as mediator for systolic BP (IE = -0.019; CI = -0.033; -0.005), pulse pressure (IE = -0.017; CI = -0.028; -0.007) and rate product pressure (IE = -3.793; CI = -6.097; -1.689). Likewise, body fat percentage mediated the association for: systolic BP (IE = -0.029; CI = -0.048; -0.010), pulse pressure (IE = -0.027; CI = -0.041; -0.013) and rate product pressure (IE = -4.280; CI = -7.488; -1.264). CONCLUSIONS Adiposity mediated the association between CRF and BP in adolescents. Therefore, both optimal CRF and adiposity levels are important to maintain normal BP ranges throughout adolescence.
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Affiliation(s)
- Maria Reyes Beltran-Valls
- LIFE Research Group, University Jaume I, Castellon, Spain.,Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.,National Physical Activity Promotion Program, Directorate-General of Health, Porto, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Carla Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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Chen Y, Ye P, Liu X, Gong C, Li C, Yuan Y, Zheng H, Xu X, Dong H, Kong Q, Yan Y, Mi J. Characteristics of pediatric inpatients with primary and secondary hypertension. Pediatr Investig 2021; 5:28-32. [PMID: 33778424 PMCID: PMC7983996 DOI: 10.1002/ped4.12249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/14/2021] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Extensive population-based studies have explored the prevalence of primary hypertension (HTN) in children and adolescents. However, there is little published data on the characteristics of different types of pediatric HTN and the causes of secondary HTN. OBJECTIVE To investigate the characteristics of different types of pediatric HTN and the causes of secondary HTN in a hospital setting. METHODS The study cohort comprised pediatric inpatients (<18 years of age) discharged with a diagnosis of HTN from Beijing Children's Hospital during 2015-2020. Pediatric patients with HTN were allocated to secondary and primary HTN groups on the basis of comprehensive analyses of their diagnoses, family history of HTN, and findings on physical examination, as documented in their medical records. The Mann-Whitney U test, χ 2 and Fisher's exact test were used to assess differences in characteristics of patients with different HTN types and causes of secondary HTN. RESULTS Data of 1470 inpatients with HTN from 18 clinical departments were included in the analysis. Among them, 458 (31.2%) had primary HTN, and 1012 (68.8%) had secondary HTN. Compared with patients had primary HTN, children with secondary HTN were younger and had lower body mass indexes and longer lengths of stay. Moreover, children with primary HTN had mostly been managed by the Endocrinology and Cardiology Departments, 75.8% of them having obesity-related comorbidities. In contrast, most patients with secondary HTN had been managed by the Nephrology Department, renal diseases being the leading cause of their HTN (46.3%). INTERPRETATION Secondary HTN is more common than primary HTN in pediatric clinical settings, renal diseases being the leading cause of secondary HTN.
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Affiliation(s)
- Yijun Chen
- Department of Non‐communicable Disease ManagementBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Peiyu Ye
- Department of Non‐communicable Disease ManagementBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xiaorong Liu
- Department of NephrologyBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Chunxiu Gong
- Department of Endocrinology, Genetics and MetabolismBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Caifeng Li
- Department of RheumatologyBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Yue Yuan
- Department of CardiologyBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Huyong Zheng
- Hematology Oncology CenterBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xin Xu
- Information CenterBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Hongbo Dong
- Department of Non‐communicable Disease ManagementBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Qin Kong
- Information CenterBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Yinkun Yan
- Department of Non‐communicable Disease ManagementBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Jie Mi
- Department of Non‐communicable Disease ManagementBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
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Varagiannis P, Magriplis E, Risvas G, Vamvouka K, Nisianaki A, Papageorgiou A, Pervanidou P, Chrousos GP, Zampelas A. Effects of Three Different Family-Based Interventions in Overweight and Obese Children: The "4 Your Family" Randomized Controlled Trial. Nutrients 2021; 13:341. [PMID: 33498894 PMCID: PMC7911878 DOI: 10.3390/nu13020341] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 12/31/2022] Open
Abstract
Childhood overweight and obesity prevalence has risen dramatically in the past decades, and family-based interventions may be an effective method to improve children's eating behaviors. This study aimed to evaluate the effectiveness of three different family-based interventions: group-based, individual-based, or by website approach. Parents and school aged overweight or obese children, 8-12 years of age, were eligible for the study. A total of 115 children were randomly allocated in one of the three interventions, and 91 completed the study (79% compliance); Group 1 (n = 36) received group-based interventions by various experts; Group 2 (n = 30) had interpersonal family meetings with a dietitian; and Group 3 (n = 25) received training through a specifically developed website. Anthropometric, dietary, physical activity, and screen time outcomes were measured at baseline and at the end of the study. Within-group comparisons indicated significant improvement in body weight, body mass index (BMI)-z-score, physical activity, and screen time from baseline in all three study groups (p < 0.05). Furthermore, total body fat percentage (%TBF) was also decreased in Groups 2 and 3. Between-group differences varied with body weight and %TBF change, being larger in Group 3 compared to Groups 1 and 2, in contrast to BMI-z-score, screen time, and health behaviors, which were significantly larger in Group 2 than the other two groups. In conclusion, personalized family-based interventions are recommended to successfully improve children's lifestyle and body weight status.
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Affiliation(s)
- Panagiotis Varagiannis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Grigoris Risvas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Katerina Vamvouka
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Adamantia Nisianaki
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Anna Papageorgiou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Panagiota Pervanidou
- 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27 Athens, Greece; (P.P.); (G.P.C.)
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 115 27 Athens, Greece
| | - George P. Chrousos
- 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27 Athens, Greece; (P.P.); (G.P.C.)
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 115 27 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
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22
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Mummidi S, Farook VS, Reddivari L, Hernandez-Ruiz J, Diaz-Badillo A, Fowler SP, Resendez RG, Akhtar F, Lehman DM, Jenkinson CP, Arya R, Lynch JL, Canas JA, DeFronzo RA, Hale DE, Blangero J, Lopez-Alvarenga JC, Duggirala R, Vanamala JKP. Serum carotenoids and Pediatric Metabolic Index predict insulin sensitivity in Mexican American children. Sci Rep 2021; 11:871. [PMID: 33441626 PMCID: PMC7806924 DOI: 10.1038/s41598-020-79387-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 12/01/2020] [Indexed: 12/20/2022] Open
Abstract
High concentrations of carotenoids are protective against cardiometabolic risk traits (CMTs) in adults and children. We recently showed in non-diabetic Mexican American (MA) children that serum α-carotene and β-carotene are inversely correlated with obesity measures and triglycerides and positively with HDL cholesterol and that they were under strong genetic influences. Additionally, we previously described a Pediatric Metabolic Index (PMI) that helps in the identification of children who are at risk for cardiometabolic diseases. Here, we quantified serum lycopene and β-cryptoxanthin concentrations in approximately 580 children from MA families using an ultraperformance liquid chromatography-photodiode array and determined their heritabilities and correlations with CMTs. Using response surface methodology (RSM), we determined two-way interactions of carotenoids and PMI on Matsuda insulin sensitivity index (ISI). The concentrations of lycopene and β-cryptoxanthin were highly heritable [h2 = 0.98, P = 7 × 10-18 and h2 = 0.58, P = 1 × 10-7]. We found significant (P ≤ 0.05) negative phenotypic correlations between β-cryptoxanthin and five CMTs: body mass index (- 0.22), waist circumference (- 0.25), triglycerides (- 0.18), fat mass (- 0.23), fasting glucose (- 0.09), and positive correlations with HDL cholesterol (0.29). In contrast, lycopene only showed a significant negative correlation with fasting glucose (- 0.08) and a positive correlation with HDL cholesterol (0.18). Importantly, we found that common genetic influences significantly contributed to the observed phenotypic correlations. RSM showed that increased serum concentrations of α- and β-carotenoids rather than that of β-cryptoxanthin or lycopene had maximal effects on ISI. In summary, our findings suggest that the serum carotenoids are under strong additive genetic influences and may have differential effects on susceptibility to CMTs in children.
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Affiliation(s)
- Srinivas Mummidi
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA.
| | - Vidya S Farook
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Lavanya Reddivari
- Department of Food Science, Purdue University, West Lafayette, IN, USA
| | - Joselin Hernandez-Ruiz
- Clinical Pharmacology Unit, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Alvaro Diaz-Badillo
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Sharon P Fowler
- School of Public Health, University of Texas Health Houston, Houston, TX, USA
| | - Roy G Resendez
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Feroz Akhtar
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Donna M Lehman
- Department of Medicine, School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Christopher P Jenkinson
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Rector Arya
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Jane L Lynch
- Department of Pediatrics, School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Jose A Canas
- Johns Hopkins All Children's Hospital, St. Petersburg, FL, 33701, USA
| | - Ralph A DeFronzo
- Department of Medicine, School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Daniel E Hale
- Department of Pediatrics, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - John Blangero
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Juan Carlos Lopez-Alvarenga
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Ravindranath Duggirala
- South Texas Diabetes and Obesity Institute, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Jairam K P Vanamala
- Department of Food Science, Pennsylvania State University, University Park, PA, USA.
- Department of Plant Science, Pennsylvania State University, University Park, PA, USA.
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23
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Soltero EG, Solovey AN, Hebbel RP, Palzer EF, Ryder JR, Shaibi GQ, Olson M, Fox CK, Rudser KD, Dengel DR, Evanoff NG, Kelly AS. Relationship of Circulating Endothelial Cells With Obesity and Cardiometabolic Risk Factors in Children and Adolescents. J Am Heart Assoc 2020; 10:e018092. [PMID: 33372524 PMCID: PMC7955458 DOI: 10.1161/jaha.120.018092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Circulating endothelial cells (CECs) reflect early changes in endothelial health; however, the degree to which CEC number and activation is related to adiposity and cardiovascular risk factors in youth is not well described. Methods and Results Youth in this study (N=271; aged 8-20 years) were classified into normal weight (body mass index [BMI] percentage <85th; n=114), obesity (BMI percentage ≥95th to <120% of the 95th; n=63), and severe obesity (BMI percentage ≥120% of the 95th; n=94) catagories. CEC enumeration was determined using immunohistochemical examination of buffy coat smears and activated CEC (percentage of vascular cell adhesion molecule-1 expression) was assessed using immunofluorescent staining. Cardiovascular risk factors included measures of body composition, blood pressure, glucose, insulin, lipid profile, C-reactive protein, leptin, adiponectin, oxidized low-density lipoprotein cholesterol, carotid artery intima-media thickness, and pulse wave velocity. Linear regression models examined associations between CEC number and activation with BMI and cardiovascular risk factors. CEC number did not differ among BMI classes (P>0.05). Youth with severe obesity had a higher degree of CEC activation compared with normal weight youth (8.3%; 95% CI, 1.1-15.6 [P=0.024]). Higher CEC number was associated with greater body fat percentage (0.02 per percentage; 95% CI, 0.00-0.03 [P=0.020]) and systolic blood pressure percentile (0.01 per percentage; 95% CI, 0.00-0.01 [P=0.035]). Higher degree of CEC activation was associated with greater visceral adipose tissue (5.7% per kg; 95% CI, 0.4-10.9 [P=0.034]) and non-high-density lipoprotein cholesterol (0.11% per mg/dL; 95% CI, 0.01-0.21 [P=0.039]). Conclusions Methods of CEC quantification are associated with adiposity and cardiometabolic risk factors and may potentially reflect accelerated atherosclerosis as early as childhood.
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Affiliation(s)
- Erica G Soltero
- Department of Pediatrics Children's Nutrition Research CenterBaylor College of Medicine Houston TX
| | - Anna N Solovey
- Vascular Biology Center Division of Hematology Oncology & Transplantation University of Minnesota Medical School Minneapolis MN
| | - Robert P Hebbel
- Vascular Biology Center Division of Hematology Oncology & Transplantation University of Minnesota Medical School Minneapolis MN.,Department of Medicine University of Minnesota Medical School Minneapolis MN
| | - Elise F Palzer
- Division of Biostatistics School of Public Health University of Minnesota Minneapolis MN
| | - Justin R Ryder
- Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis MN.,Department of Pediatrics University of Minnesota Medical School Minneapolis MN
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention Arizona State University Phoenix AZ.,Department of Pediatric Endocrinology and Diabetes Phoenix Children's Hospital Phoenix AZ
| | - Micah Olson
- Center for Health Promotion and Disease Prevention Arizona State University Phoenix AZ.,Department of Pediatric Endocrinology and Diabetes Phoenix Children's Hospital Phoenix AZ
| | - Claudia K Fox
- Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis MN.,Department of Pediatrics University of Minnesota Medical School Minneapolis MN
| | - Kyle D Rudser
- Division of Biostatistics School of Public Health University of Minnesota Minneapolis MN.,Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis MN
| | - Donald R Dengel
- Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis MN.,Department of Pediatrics University of Minnesota Medical School Minneapolis MN.,School of Kinesiology University of Minnesota Minneapolis MN
| | - Nicholas G Evanoff
- Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis MN.,School of Kinesiology University of Minnesota Minneapolis MN
| | - Aaron S Kelly
- Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis MN.,Department of Pediatrics University of Minnesota Medical School Minneapolis MN
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24
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Angi A, Chiarelli F. Obesity and Diabetes: A Sword of Damocles for Future Generations. Biomedicines 2020; 8:E478. [PMID: 33171922 PMCID: PMC7694547 DOI: 10.3390/biomedicines8110478] [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: 10/14/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023] Open
Abstract
Childhood obesity is one of the most challenging problem of the 21st century. The prevalence has increased, reaching an alarming rate. Furthermore, the problem is global and is also affecting low- and middle-income countries. This global obesity epidemic explains how the roots of cardiovascular disease, the most common cause of mortality among adults, begin in childhood. Overweight and obese children are likely to stay obese into adulthood and to develop noncommunicable diseases such as diabetes and cardiovascular diseases at a younger age. Thus, prevention should be the major goal and should start early in life. The aim of this review is to present an updated framework of the current understanding of the cardiovascular and metabolic risks in obese children and adolescents and to discuss the available therapeutic options.
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Affiliation(s)
- Alessia Angi
- Department of Pediatrics, University of Chieti, 66100 Chieti, Italy;
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25
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Liao YY, Chu C, Wang Y, Zheng WL, Ma Q, Hu JW, Yan Y, Wang KK, Yuan Y, Chen C, Mu J. Sex differences in impact of long-term burden and trends of body mass index and blood pressure from childhood to adulthood on arterial stiffness in adults: A 30-year cohort study. Atherosclerosis 2020; 313:118-125. [DOI: 10.1016/j.atherosclerosis.2020.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/09/2020] [Accepted: 10/01/2020] [Indexed: 12/27/2022]
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26
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Biener AI, Cawley J, Meyerhoefer C. The medical care costs of obesity and severe obesity in youth: An instrumental variables approach. HEALTH ECONOMICS 2020; 29:624-639. [PMID: 32090412 DOI: 10.1002/hec.4007] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
This paper is the first to use the method of instrumental variables to estimate the impact of obesity and severe obesity in youth. on U.S. medical care costs. We examine data from the Medical Expenditure Panel Survey for 2001-2015 and instrument for child BMI using the BMI of the child's biological mother. Instrumental variables estimates indicate that obesity in youth raises annual medical care costs by $907 (in 2015 dollars) or 92%, which is considerably higher than previous estimates of the association of youth obesity with medical costs. We find that obesity in youth significantly raises costs in all major categories of medical care: outpatient doctor visits, inpatient hospital stays, and prescription drugs. The costs of youth obesity are borne almost entirely by third-party payers, which is consistent with substantial externalities of youth obesity, which in turn represents an economic rationale for government intervention.
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Affiliation(s)
- Adam I Biener
- Department of Economics, Lafayette College, Easton, Pennsylvania, USA
| | - John Cawley
- Department of Policy Analysis and Management and Department of Economics, Cornell University, New York, USA
| | - Chad Meyerhoefer
- College of Business and Economics, Lehigh University, Bethlehem, Pennsylvania, USA
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27
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Hamoen M, Welten M, Nieboer D, Bai G, Heymans MW, Twisk JWR, Raat H, Vergouwe Y, Wijga AH, de Kroon MLA. Development of a prediction model to target screening for high blood pressure in children. Prev Med 2020; 132:105997. [PMID: 31981642 DOI: 10.1016/j.ypmed.2020.105997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/07/2020] [Accepted: 01/21/2020] [Indexed: 02/07/2023]
Abstract
Targeted screening for childhood high blood pressure may be more feasible than routine blood pressure measurement in all children to avoid unnecessary harms, overdiagnosis or costs. Targeting maybe based e.g. on being overweight, but information on other predictors may also be useful. Therefore, we aimed to develop a multivariable diagnostic prediction model to select children aged 9-10 years for blood pressure measurement. Data from 5359 children in a population-based prospective cohort study were used. High blood pressure was defined as systolic or diastolic blood pressure ≥ 95th percentile for gender, age, and height. Logistic regression with backward selection was used to identify the strongest predictors related to pregnancy, child, and parent characteristics. Internal validation was performed using bootstrapping. 227 children (4.2%) had high blood pressure. The diagnostic model included maternal hypertensive disease during pregnancy, maternal BMI, maternal educational level, parental hypertension, parental smoking, child birth weight standard deviation score (SDS), child BMI SDS, and child ethnicity. The area under the ROC curve was 0.73, compared to 0.65 when using only child overweight. Using the model and a cut-off of 5% for predicted risk, sensitivity and specificity were 59% and 76%; using child overweight only, sensitivity and specificity were 47% and 84%. In conclusion, our diagnostic prediction model uses easily obtainable information to identify children at increased risk of high blood pressure, offering an opportunity for targeted screening. This model enables to detect a higher proportion of children with high blood pressure than a strategy based on child overweight only.
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Affiliation(s)
- Marleen Hamoen
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, Netherlands; Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, Netherlands
| | - Marieke Welten
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
| | - Daan Nieboer
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, Netherlands
| | - Guannan Bai
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
| | - Hein Raat
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, Netherlands
| | - Yvonne Vergouwe
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, Netherlands
| | - Alet H Wijga
- National Institute for Public Health and the Environment, Center for Nutrition, Prevention and Health Services, Bilthoven, Netherlands
| | - Marlou L A de Kroon
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, Netherlands; Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands.
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28
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Pettersson-Pablo P, Cao Y, Bäckström T, Nilsson TK, Hurtig-Wennlöf A. Body fat percentage and CRP correlates with a composite score of vascular risk markers in healthy, young adults - The Lifestyle, Biomarkers, and Atherosclerosis (LBA) study. BMC Cardiovasc Disord 2020; 20:77. [PMID: 32046640 PMCID: PMC7014751 DOI: 10.1186/s12872-020-01376-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 02/03/2020] [Indexed: 11/19/2022] Open
Abstract
Background Identification of early signs of atherosclerosis in young adults have the potential to guide early interventions to prevent later cardiovascular disease. We therefore analyzed measures of vascular structure and function and biomarkers of cardiovascular risk in a sample of young healthy adults. Methods Pulse-wave velocity (PWV), carotid-intima media thickness (cIMT) and augmentation index (AIX) were measured in 834 healthy non-smokers (ages 18.0–25.9). Emphasis was put on discriminating between individuals having a vascular structure and function associated with a higher or lower risk, and cluster analysis algorithms were employed to assign the subjects into groups based on these vascular measurements. In addition, a vascular status score (VSS) was calculated by summarizing the results according to quintiles of the vascular measurements. The associations between VSS and cardiovascular biomarkers were examined by regression analyses. Results The cluster analyses did not yield sufficiently distinct clustering (groups of individuals that could be categorized unequivocally as having either a vascular structure and function associated with a higher or lower CVD risk). VSS proved a better classificatory variable. The associations between VSS and biomarkers of cardiovascular risk were analyzed by univariable and multivariable regressions. Only body fat percentage and C-reactive protein (CRP) were independently associated with VSS. Conclusions A VSS calculation, which integrates PWV, cIMT, and AIX measurements is better suited for cardiovascular risk evaluation in young adults than cluster analyses. The independent associations of VSS with body fat percentage and CRP highlight the decisive role of adiposity and systemic inflammation in early atherosclerotic progression and suggests a subordinate role of insulin and lipid metabolism in this age span.
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Affiliation(s)
- Paul Pettersson-Pablo
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden. .,School of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. .,Department of Medical Biosciences/Clinical Chemistry, Umeå University, Umeå, Sweden.
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Torbjörn Bäckström
- Department of Clinical Science, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Torbjörn K Nilsson
- Department of Medical Biosciences/Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Anita Hurtig-Wennlöf
- School of Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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29
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Yin C, Hu W, Wang M, Lv W, Jia T, Xiao Y. Irisin as a mediator between obesity and vascular inflammation in Chinese children and adolescents. Nutr Metab Cardiovasc Dis 2020; 30:320-329. [PMID: 31740239 DOI: 10.1016/j.numecd.2019.09.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/14/2019] [Accepted: 09/23/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM This study aims to characterize the role of Irisin in obesity and early onset metabolic and vascular sequelae in Chinese children. Furthermore, we aim to examine whether Irisin mediate endothelial cells dysfunction and vascular inflammation which eventually leads to obesity. METHODS AND RESULTS We quantified plasma Irisin levels using enzyme-linked immunosorbent assay (ELISA) among 85 lean and 120 obese children, and assessed the association of Irisin levels with anthropometric, metabolic, cardiovascular and inflammatory parameters of obese children comparing with lean children. We further characterized the markers for endothelial cells and inflammation between obese and lean children to assess potential correlations. In addition, a potential direct effect of Irisin on the expression of endothelial adhesion molecules was assessed in human coronary artery endothelial cells. Irisin levels from obese children was significantly lower than lean children, and this reduced Irisin levels is correlated with certain physical parameters of studied children. Moreover, we identified significant inverse associations between inflammation markers of endothelial activation with Irisin levels in obese children. Multiple regression analyses confirm Irisin serves as a strong predictor of SDS-SBP, Ang-2, ICAM-1, E-selectin and hsCRP levels, independent of SDS-BMI. Lifestyle intervention results in a significant improvement of these cardiovascular and inflammatory parameters, and these were accompanied by a significant improvement of Irisin levels and weight loss. Finally, in the mediation effect model, our data showed that Irisin changes act as partial mediators of the relationship between SDS-BMI changes and changes in inflammatory and endothelial parameters for ICAM-1, E-selectin and hsCRP after controlling for covariates. Likewise, on the cellular level, Irisin inhibition hsCPR, ICAM-1 and E-selectin expression in endothelial cells, whereas Ang-2, VCAM-1 and eNOS expression were unaffected. CONCLUSIONS Our study showed that Irisin levels change may indicate the early stages of cardiovascular disease in obese children.
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Affiliation(s)
- Chunyan Yin
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi 710049, PR China.
| | - Wei Hu
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi 710049, PR China
| | - Ming Wang
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi 710049, PR China
| | - Weicheng Lv
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi 710049, PR China
| | - Tian Jia
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi 710049, PR China
| | - Yanfeng Xiao
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi 710049, PR China.
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30
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Scolaro B, de Andrade LF, Castro IA. Cardiovascular Disease Prevention: The Earlier the Better? A Review of Plant Sterol Metabolism and Implications of Childhood Supplementation. Int J Mol Sci 2019; 21:ijms21010128. [PMID: 31878116 PMCID: PMC6981772 DOI: 10.3390/ijms21010128] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 08/21/2019] [Accepted: 08/24/2019] [Indexed: 11/28/2022] Open
Abstract
Atherosclerosis is the underlying cause of major cardiovascular events. The development of atherosclerotic plaques begins early in life, indicating that dietary interventions in childhood might be more effective at preventing cardiovascular disease (CVD) than treating established CVD in adulthood. Although plant sterols are considered safe and consistently effective in lowering plasma cholesterol, the health effects of early-life supplementation are unclear. Studies suggest there is an age-dependent effect on plant sterol metabolism: at a younger age, plant sterol absorption might be increased, while esterification and elimination might be decreased. Worryingly, the introduction of low-cholesterol diets in childhood may unintentionally favor a higher intake of plant sterols. Although CVD prevention should start as early as possible, more studies are needed to better elucidate the long-term effects of plant sterol accumulation and its implication on child development.
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31
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Liu Y, Yan Y, Yang X, Li S, Bazzano L, He J, Chen W. Long-Term Burden of Higher Body Mass Index and Adult Arterial Stiffness Are Linked Predominantly Through Elevated Blood Pressure. Hypertension 2019; 73:229-234. [PMID: 30571556 DOI: 10.1161/hypertensionaha.118.12106] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obesity and hypertension are important risk factors of arterial stiffness. However, the complex relationship between increased body mass index (BMI), elevated blood pressure (BP), and arterial stiffness is largely unknown. We aim to examine the mediation effect of elevated BP on the association of early life BMI, long-term burden, and trend of BMI with arterial stiffness in midlife. The longitudinal study cohort consisted of 1190 participants (829 whites and 361 blacks, 518 males, mean age=40.0 years at follow-up) who had been examined for BMI and BP 4 to 15 times from childhood and aortic-femoral pulse wave velocity (afPWV) in adulthood, with a mean follow-up period of 30.3 years. Total area under the curve (AUCt) and incremental AUC (AUCi) were calculated in random-effects models and used as long-term measures of BMI and BP. Total effects of BMI measures on adult afPWV, adjusted for covariates were all significant without adult BMI and systolic BP (SBP) measures included in the models. The mediation effects of adult SBP (20.2%) and SBP AUCi (16.9%) were significant on the childhood BMI-afPWV association. Adult SBP showed significant mediation effects of 36.7% on the BMI AUCi-afPWV association and 36.4% on the BMI AUCt-afPWV association. The mediation effect of SBP AUCi was estimated at 63.3% ( P<0.01) on the BMI AUCi-afPWV association. Diastolic BP had similar total and mediation effects. These findings suggest that the association of increased childhood BMI and its cumulative burden with adult arterial stiffness measured as afPWV is predominantly mediated through the long-term and increasing trend of BP.
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Affiliation(s)
- Yang Liu
- From the Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (Y.L., X.Y.).,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.)
| | - Yinkun Yan
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.).,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China (Y.Y.)
| | - Xiangjun Yang
- From the Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (Y.L., X.Y.)
| | - Shengxu Li
- Children's Minnesota Research Institute, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN (S.L.)
| | - Lydia Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.)
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.)
| | - Wei Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.)
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Sönmez HE, Canpolat N, Ağbaş A, Taşdemir M, Ekmekçi ÖB, Alikaşifoğlu M, Sever L, Çalışkan S. The Relationship between the Waist Circumference and Increased Carotid Intima Thickness in Obese Children. Child Obes 2019; 15:468-475. [PMID: 31246513 DOI: 10.1089/chi.2019.0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: This study aimed to evaluate the cardiometabolic risk factors in normotensive obese and hypertensive obese (HT-obese) children by comparison of anthropomorphic measurements, fat distribution, carotid artery intima-media thickness (CIMT), and inflammatory markers. Methods: Fifty-three obese patients 10-18 years of age with a BMI-for-age/gender >95th percentile and 20 age- and gender-matched healthy volunteers enrolled in the study. Obese patients were divided into two groups according to the presence of hypertension (HT), as follows: HT-obese subgroup (n = 30) and nonhypertensive obese (non-HT-obese) subgroup (n = 23). Results: Weight standard deviation score (SDS), BMI-SDS, waist circumference (WC) SDS, and the fat tissue z-score were significantly higher (p < 0.001 for all) in the obese patients than the control groups. Obese patients had higher 24-hour systolic blood pressure (SBP) SDS and leptin, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-6 levels. Furthermore, CIMT and CIMT-SDS were significantly higher in them. HT-obese patients (n = 30) had significantly higher WC-SDS and lower serum leptin and adiponectin levels than those of non-HT-obese group (n = 23). Finally, an association between increased CIMT-SDS and WC-SDS (β = 0.399, p = 0.002) and 24-hour SBP-SDS (β = 0.272, p = 0.009) was shown. Conclusions: Association between increased WC and HT implies the importance of central obesity in atherosclerosis. We concluded that WC measurement could be used to define risk groups since it is related to cardiometabolic complications.
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Affiliation(s)
- Hafize Emine Sönmez
- Department of Pediatrics, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Nur Canpolat
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Ayşe Ağbaş
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Mehmet Taşdemir
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Özlem Balcı Ekmekçi
- Department of Biochemistry, and Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Müjgan Alikaşifoğlu
- Department of Adolescence, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Lale Sever
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Salim Çalışkan
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
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Validation of a Self-reported Food Frequency for Overweight and Obese Children, Using Parental 3-Day Food Records. ACTA ACUST UNITED AC 2019. [DOI: 10.1097/nt.0000000000000352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Fang Y, Ma Y, Mo D, Zhang S, Xiang M, Zhang Z. Methodology of an exercise intervention program using social incentives and gamification for obese children. BMC Public Health 2019; 19:686. [PMID: 31159776 PMCID: PMC6547593 DOI: 10.1186/s12889-019-6992-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/16/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Traditional exercise [supervised exercise (SE)] intervention has been proved to be one of the most effective ways to improve metabolic health. However, most exercise interventions were on a high-cost and small scale, moreover lacking of the long-term effect due to low engagement. On the other hand, it was noteworthy that gamification and social incentives were promising strategies to increase engagement and sustain exercise interventions effects; as well as mobile technologies such as WeChat also can provide an appropriate platform to deploy interventions on a broader, low-cost scale. Thus, we aim to develop a novel exercise intervention ('S&G exercise intervention') that combines SE intervention with gamification and social incentives design through WeChat, with the aim of improving metabolic health and poor behaviors among overweight and obesity children. METHODS We propose a randomized controlled trial of a 'S&G exercise intervention' among 420 overweight and obese children who have at least one marker of metabolic syndrome. Children will be randomized to control or intervention group in a 1:1 ratio. The exercise intervention package includes intervention designs based on integrated social incentives and gamification theory, involving targeted essential volume and intensity of activity (skipping rope) as well as monitoring daily information and providing health advice by WeChat. Participants will undertake assessments at baseline, at end of intervention period, in the follow-up time at months 3,6,12. The primary outcome is outcome of metabolic health. Secondary outcomes include behavioral (e.g., diary physical activity, diet) and anthropometric measures (e.g., body fat rate and muscle mass). DISCUSSIONS This will be the first study to design an exercise intervention model that combines traditional supervised exercise (SE) intervention with gamification and social incentives theory through WeChat. We believed that this study could explore a low-cost, easy-to-popularize, and effective exercise intervention model for improving metabolic health and promote healthy among obese children. Furthermore, it will also provide important evidence for guidelines to prevent and improve metabolic health and health behaviors. TRIAL REGISTRATION 10-04-2019;Registration number: ChiCTR1900022396 .
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Affiliation(s)
- Yue Fang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Dandan Mo
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | | | - Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China.
| | - Zhiruo Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China.
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Mohamedhussein N, Busuttil-Naudi A, Mohammed H, UlHaq A. Association of obesity with the eruption of first and second permanent molars in children: a systematic review. Eur Arch Paediatr Dent 2019; 21:13-23. [PMID: 31144286 DOI: 10.1007/s40368-019-00452-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/17/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Eruption timing of permanent teeth, particularly first and second molars, is of great importance due to its influence on occlusion, caries risk and timing of preventive and orthodontic intervention. AIM To evaluate the evidence assessing the correlation between obesity and eruption time of first and second permanent molars in children under 16 years of age as compared to normal-weight children. A secondary aim was to assess the total number of erupted teeth in both groups. METHODS A systematic search of databases including PubMed, MEDLINE, EMBASE, Scopus and Web of Science was conducted. Studies that assessed the effect of body mass index (BMI), adjusted BMI or z scores on dental eruption were included. National Institute of Health 'Quality Assessment Tool for Observational Cohort and Cross-sectional Studies' was used to assess the quality of included papers. A random-effects model with its 95% confidence intervals (CIs) was considered for meta-analysis. RESULTS A total of 381 papers were screened following duplicate removal. Twenty-six papers were read in full text, of which 19 were excluded. Seven studies were included in this review; one was longitudinal, and six were cross-sectional in design. A positive association of dental eruption with obesity was noted in six studies. Two studies were included in the explorative meta-analysis, the results of which indicated that obese, 12-year-olds are likely to have one more erupted tooth than their counterparts with a mean difference (MD) of (0.99, 95% CI 0.628-1.352). CONCLUSION There appears to be a positive correlation between obesity and dental eruption including the eruption timing of first and second permanent molars. Main risk of bias arises from the cross-sectional nature of included studies and lack of control of potential confounders. Further high-quality evidence is required to elucidate this association. Registration PROSPERO (CRD42017084368). REGISTRATION PROSPERO (CRD42017084368).
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Affiliation(s)
- N Mohamedhussein
- Paediatric Department, Edinburgh Dental Institute/The University of Edinburgh, Edinburgh, UK.
| | - A Busuttil-Naudi
- Paediatric Department, Edinburgh Dental Institute/The University of Edinburgh, Edinburgh, UK
| | - H Mohammed
- The University of Edinburgh, Edinburgh, UK
| | - A UlHaq
- Orthodontic Department, Edinburgh Dental Institute/The University of Edinburgh, Edinburgh, UK
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Ho HCH, Maddaloni E, Buzzetti R. Risk factors and predictive biomarkers of early cardiovascular disease in obese youth. Diabetes Metab Res Rev 2019; 35:e3134. [PMID: 30706683 DOI: 10.1002/dmrr.3134] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 01/26/2019] [Accepted: 01/29/2019] [Indexed: 12/20/2022]
Abstract
Obesity in childhood and adolescence continues to be a major health issue due to significant health implications and to the economic burden that arise from treating this disease and its complications. Current data show that childhood obesity is no longer just a concern for developed countries, but more significantly affecting developing countries. In adult population, cardiovascular disease is the main cause of mortality and morbidity among obese patients. It is therefore believed that risk factors found in adult patients could also be observed in obese youth. These risk factors will then persist and become progressively worse if obese youth remain obese as they reach adulthood. However, risk reduction is achievable through various prevention and management strategies of obesity and obese children who become nonobese in adulthood have a significant reduction in their risk of developing cardiovascular disease. New biomarkers to improve risk assessment in obese youth are an open research field, which will eventually lead to a more targeted approach in prevention and treatment. Nevertheless, there is still a need for continuous research in understanding the roles of these biomarkers and their potential in risk prediction. Cardiovascular risk modification of childhood obesity depends on a more concerted effort among the various parties involved and particularly a global collaboration to stop the rising prevalence of the epidemic in developing countries.
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Affiliation(s)
- Howard Chong Huat Ho
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ernesto Maddaloni
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Raffaella Buzzetti
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
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Tekola-Ayele F, Lee A, Workalemahu T, Sánchez-Pozos K. Shared genetic underpinnings of childhood obesity and adult cardiometabolic diseases. Hum Genomics 2019; 13:17. [PMID: 30947744 PMCID: PMC6449964 DOI: 10.1186/s40246-019-0202-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/20/2019] [Indexed: 12/12/2022] Open
Abstract
Background Obesity during childhood can lead to increased risk of adverse cardiometabolic diseases such as type 2 diabetes and coronary artery disease during adult life. Evidence for strong genetic correlations between child and adult body mass index (BMI) suggest the possibility of shared genetic effects. We performed a test for pleiotropy (shared genetics) and functional enrichment of single nucleotide polymorphisms (SNPs) associated with childhood BMI and 15 adult cardiometabolic traits using a unified statistical approach that integrates pleiotropy and functional annotation data. Results Pleiotropic genetic effects were significantly abundant in 13 out of 15 childhood BMI-adult cardiometabolic trait tests (P < 3.3 × 10−3). SNPs associated with both childhood BMI and adult traits were more likely to be functionally deleterious than SNPs associated with neither trait. Genetic variants associated with increased childhood obesity tend to increase risk of cardiometabolic diseases in adulthood. We replicated 39 genetic loci that are known to be associated with childhood BMI and adult traits (coronary artery disease, HDL cholesterol, myocardial infarction, triglycerides, total cholesterol, type 2 diabetes, BMI, waist circumference, and waist-to-hip ratio) in previous genome-wide association studies. We also found a novel association of rs12446632 near GPRC5B, which is highly expressed in adipose tissue and the central nervous system, with adult HDL cholesterol. Conclusions This study found significant pleiotropic genetic effects and enrichment of functional annotations in genetic variants that were jointly associated with childhood obesity and adult cardiometabolic diseases. The findings provide new avenues to disentangle the genetic basis of life course associations between childhood obesity and adult cardiometabolic diseases. Electronic supplementary material The online version of this article (10.1186/s40246-019-0202-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fasil Tekola-Ayele
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Room 3204, Bethesda, MD, 20892-7004, USA.
| | - Anthony Lee
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Room 3204, Bethesda, MD, 20892-7004, USA
| | - Tsegaselassie Workalemahu
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Room 3204, Bethesda, MD, 20892-7004, USA
| | - Katy Sánchez-Pozos
- Laboratorio de Endocrinologia Molecular, Hospital Juárez de México, Mexico City, Mexico
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Dunton GF, Ke W, Dzubur E, O’Connor SG, Lopez NV, Margolin G. Within-Subject Effects of Stress on Weight-Related Parenting Practices in Mothers: An Ecological Momentary Assessment Study. Ann Behav Med 2019; 53:415-425. [PMID: 31222228 PMCID: PMC6438347 DOI: 10.1093/abm/kay053] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Stress may compromise parenting practices related to children's dietary intake, physical activity, and sedentary behavior. PURPOSE The current study used Ecological Momentary Assessment (EMA) to examine microtemporal sequences underlying maternal stress and subsequent weight-related parenting practices. METHODS Mothers (n = 199) of children aged 8-12 years participated in two separate 7-day waves of EMA with up to eight randomly prompted surveys per day during children's nonschool time. EMA items assessed stress and weight-related parenting practices. RESULTS When mothers reported experiencing greater stress than usual, they subsequently engaged in less physical activity parenting (e.g., encouraging physical activity; p < .05) and more sedentary screen behavior parenting (e.g., limiting TV/video games; p < .05) over the next 2 hr. CONCLUSIONS Addressing within-day variations in maternal stress may be an important component of parent-focused child obesity prevention interventions.
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Affiliation(s)
- Genevieve F Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
- Department of Psychology, Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California
| | - Wangjing Ke
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
| | - Eldin Dzubur
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
| | - Sydney G O’Connor
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
| | - Nanette V Lopez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern Caifornia, Los Angeles, CA
| | - Gayla Margolin
- Department of Psychology, Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California
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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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Gamede M, Mabuza L, Ngubane P, Khathi A. Plant-Derived Oleanolic Acid (OA) Ameliorates Risk Factors of Cardiovascular Diseases in a Diet-Induced Pre-Diabetic Rat Model: Effects on Selected Cardiovascular Risk Factors. Molecules 2019; 24:molecules24020340. [PMID: 30669379 PMCID: PMC6359497 DOI: 10.3390/molecules24020340] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/04/2019] [Accepted: 01/09/2019] [Indexed: 02/08/2023] Open
Abstract
The pathogenesis of prediabetes is associated with risk factors such as chronic consumption of an unhealthy diet. Recent studies have reported that diet-induced pre-diabetes is also associated with risk factors of cardiovascular complications, hence this study was aimed at evaluating the effects of oleanolic acid (OA) on pre-diabetes rats. Pre-diabetes was induced by chronic exposure of Sprague Dawley rats (SD) to high-fat high-carbohydrate diet (20 weeks), whereas the non-pre-diabetes control (NC) was given standard rat chow. Pre-diabetes animals were grouped into five groups namely prediabetes control (PC), metformin treated (Met), metformin with diet intervention (Met + DI), oleanolic acid treated (OA), and oleanolic acid with diet intervention (OA + DI) then treated for 12 weeks. At the end of treatment, all animals were sacrificed where organs and tissues were harvested for biochemical analysis and histological studies. The results showed that PC had a significantly higher triglycerides (TGs), low density lipoprotein cholesterol (LDL-C, interleukin-6(IL-6), tumor necrosis factor alpha (TNFα), C-reactive protein (CRP), mean arterial pressure (MAP) and hearts weights in comparison to NC (p < 0.05). However, the administration of OA, in both the presence and absence of dietary intervention showed a significant decrease in TGs, LDL-C, IL-6, TNFα, CRP, MAP, hearts weights (p < 0.05). In conclusion, the administration of OA was able to lower the risks of developing CVDs in pre-diabetes rat model through ameliorating dyslipidaemia, oxidative stress, hypertension, and low-grade inflammation. Therefore OA has the potential to be used as an alternative treatment to prevent the onset of CVDs during pre-diabetes stage even in the absence of dietary and lifestyle intervention.
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Affiliation(s)
- Mlindeli Gamede
- Department of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban X54001, South Africa.
| | - Lindokuhle Mabuza
- Department of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban X54001, South Africa.
| | - Phikelelani Ngubane
- Department of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban X54001, South Africa.
| | - Andile Khathi
- Department of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban X54001, South Africa.
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Yıldırım Ö, Demircan T, Tüfekçi Ö, Kızılca Ö, Kuyum P, Kır M, Abacı A, Ünal N, Arslan N, Böber E, Yılmaz Ş, Ören H. Anemia and Its Effect on Cardiovascular Findings in Obese Adolescents. Turk J Haematol 2018; 35:192-196. [PMID: 29666035 PMCID: PMC6110443 DOI: 10.4274/tjh.2018.0103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 04/17/2018] [Indexed: 12/01/2022] Open
Abstract
Objective We assessed the effect of anemia on cardiovascular findings in obese adolescents. Materials and Methods We studied 29 anemic and 33 nonanemic obese adolescents, and 33 nonobese healthy adolescents. These three groups were investigated for clinical and laboratory features of anemia and obesity. Echocardiography was used to examine cardiac functions. Results The anemia was mild (mean hemoglobin: 11.67±0.79g/dL), ferritin level was significantly low, and C-reactive protein and fibrinogen levels were significantly high in anemic obese patients. Increased cardiac pulse and echocardiographic findings, which may be indicative of early left ventricular diastolic dysfunction, were present in these patients. Conclusion Anemia may develop due to iron deficiency and chronic inflammation in obese adolescents. Even mild anemia may cause increased heart rate and affect left ventricular diastolic functions. Diet programs for obese children should be carefully planned to avoid iron deficiency anemia, which may worsen the cardiac events in long-term follow-up.
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Affiliation(s)
- Öner Yıldırım
- Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, İzmir, Turkey
| | - Tülay Demircan
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Cardiology, İzmir, Turkey
| | - Özlem Tüfekçi
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Özgür Kızılca
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Cardiology, İzmir, Turkey
| | - Pınar Kuyum
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Gastroenterology and Metabolism, İzmir, Turkey
| | - Mustafa Kır
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Cardiology, İzmir, Turkey
| | - Ayhan Abacı
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Nurettin Ünal
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Cardiology, İzmir, Turkey
| | - Nur Arslan
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Gastroenterology and Metabolism, İzmir, Turkey
| | - Ece Böber
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Şebnem Yılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
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Gross AC, Kaizer AM, Ryder JR, Fox CK, Rudser KD, Dengel DR, Kelly AS. Relationships of Anxiety and Depression with Cardiovascular Health in Youth with Normal Weight to Severe Obesity. J Pediatr 2018; 199:85-91. [PMID: 29754863 PMCID: PMC6063783 DOI: 10.1016/j.jpeds.2018.03.059] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/27/2018] [Accepted: 03/22/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To evaluate the relationships of depression and anxiety symptoms with cardiovascular disease (CVD) risk factors and measures of vascular health in youth. STUDY DESIGN Participants (n = 202) were 8- to 18-year-olds from a cross-sectional study evaluating cardiovascular health across a wide range of body mass index values (normal weight to severe obesity). CVD risk measurement included blood pressure, fasting lipids, glucose, insulin, carotid artery intima-media thickness, compliance and distensibility, brachial artery flow-mediated dilation, carotid-radial artery pulse wave velocity, body fat percentage, and a metabolic syndrome cluster score. Anxiety and depression symptoms were self-reported on the Screen for Child Anxiety Related Disorders and Center for Epidemiological Studies Depression Scale for Children. Two sets of adjustment variables were used in evaluation of differences between those with and without anxiety or depression symptomatology for the CVD risk factor and vascular outcomes. The first set included adjustment for Tanner stage, sex, and race; the second was additionally adjusted for percent body fat. RESULTS Anxiety was not significantly associated with CVD risk factors or vascular health in either model. Depression was associated with high-density lipoprotein cholesterol, triglycerides, and metabolic syndrome cluster score; these relationships were attenuated when accounting for percent body fat. CONCLUSIONS When accounting for body fat, we found no clear relationship of self-reported depression or anxiety symptoms with CVD risk factors or vascular health in youth.
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Affiliation(s)
- Amy C. Gross
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN,Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN
| | - Alexander M. Kaizer
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN
| | - Justin R. Ryder
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN,Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN
| | - Claudia K. Fox
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN,Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN
| | - Kyle D. Rudser
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN,Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN
| | - Donald R. Dengel
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN,Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN,School of Kinesiology, University of Minnesota, Minneapolis, MN
| | - Aaron S. Kelly
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN,Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
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Santiprabhob J, Limprayoon K, Aanpreung P, Charoensakdi R, Kalpravidh RW, Phonrat B, Tungtrongchitr R. Impact of a group-based treatment program on adipocytokines, oxidative status, inflammatory cytokines and arterial stiffness in obese children and adolescents. J Pediatr Endocrinol Metab 2018; 31:733-742. [PMID: 29858907 DOI: 10.1515/jpem-2018-0012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/23/2018] [Indexed: 11/15/2022]
Abstract
Background Dysregulation of adipocytokines, inflammatory cytokines and oxidative stress are associated with the pathogenesis of obesity-related complications. This study aimed to evaluate the effect of a group-based lifestyle modification program on adipocytokines, inflammatory cytokines, oxidative status and arterial stiffness in obese youth. Methods A 1-year weight-reduction program was conducted. The program consisted of initial hospitalization and five outpatient group-based sessions held at 1, 2, 3, 6 and 9 months. Pre- and post-intervention measurements included anthropometric data, blood tests, body composition and brachial-ankle pulse wave velocity (ba-PWV). Results A total of 126 obese youths were recruited, and 115 of those completed the study. Twenty-four participants had increased percentage weight for height at the end of the study (group A), 30 had minimal reduction (group B) and 61 had substantial reduction (group C). Lean mass significantly increased in all three groups (all p<0.001). A significant decrease in leptin (group A, p=0.021; group B, p=0.005; group C, p<0.001), interleukin-6 (IL-6) (group A, p=0.019; group B, p=0.004; group C, p<0.001) and ba-PWV (group A, p=0.031; group B, p=0.015; group C, p<0.001) was also observed. No significant change in the oxidative status was found among the groups. Reduction in ba-PWV was correlated with decreases in plasma malondialdehyde (pMDA) (r=0.233, p=0.036) and homeostasis model assessment of insulin resistance (HOMA-IR) (r=0.253, p=0.025). Conclusions A group-based healthy lifestyle program for obese youths had beneficial effects on adipocytokines, inflammatory cytokines and arterial stiffness. Participants without change in weight status also benefited. These improvements may reduce the risk of obese youths developing atherosclerosis.
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Affiliation(s)
- Jeerunda Santiprabhob
- Associate Professor, Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand
| | - Kawewan Limprayoon
- Division of Respiratory and Critical Care, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prapun Aanpreung
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ratiya Charoensakdi
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ruchaneekorn W Kalpravidh
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Benjaluck Phonrat
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rungsunn Tungtrongchitr
- Department of Tropical Nutrition and Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Van De Maele K, Devlieger R, Gies I. In utero programming and early detection of cardiovascular disease in the offspring of mothers with obesity. Atherosclerosis 2018; 275:182-195. [PMID: 29929107 DOI: 10.1016/j.atherosclerosis.2018.06.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/14/2018] [Accepted: 06/08/2018] [Indexed: 12/11/2022]
Abstract
The offspring of women with obesity during their pregnancy are exposed to an altered intra-uterine environment. A subsequent influence on the cardiovascular development during fetal life is assumed. In the present thematic review, we report on the current knowledge about this early development of cardiovascular disease from fetal life until adolescence. Based on animal studies, different contributing mechanisms have been hypothesized that still need confirmation in human subjects. Insulin resistance, increased levels of leptin, chronic inflammatory state, perturbation of sympathetic tone and epigenetic modifications contribute to a suboptimal nutrient environment and changed hemodynamics. The ensuing aberrant cardiomyocyte development, impaired endothelial cell relaxation and atherogenic lipid profile put these children at risk for the development of endothelial cell dysfunction. Increasing possibilities for early detection of this preliminary stage of atherosclerotic disease offer new insights into future prevention and treatment strategies. Future research should focus on further unraveling the effect of moderate intense, aerobic exercise. Since it is used to treat the condition in children and adolescents with good results, it might be a contributor to tackling endothelial cell dysfunction at its cradle when applied in early pregnancy.
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Affiliation(s)
- Karolien Van De Maele
- Department of Pediatrics, Division of Pediatric Endocrinology, University Hospital of Brussels, Laarbeeklaan 101, 1090, Jette, Belgium; Research unit Organ Systems, Department of Development and Regeneration, Catholic University of Leuven, Herestraat 49, 3000 Leuven, Belgium; Research unit GRON, Free University of Brussels, Laarbeeklaan 103, 1090 Jette, Belgium.
| | - Roland Devlieger
- Department of Obstetrics and Gynecology, University Hospital of Leuven, Herestraat 49, 3000, Leuven, Belgium; Research unit Organ Systems, Department of Development and Regeneration, Catholic University of Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Inge Gies
- Department of Pediatrics, Division of Pediatric Endocrinology, University Hospital of Brussels, Laarbeeklaan 101, 1090, Jette, Belgium; Research unit GRON, Free University of Brussels, Laarbeeklaan 103, 1090 Jette, Belgium
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Orlando A, Cazzaniga E, Giussani M, Palestini P, Genovesi S. Hypertension in Children: Role of Obesity, Simple Carbohydrates, and Uric Acid. Front Public Health 2018; 6:129. [PMID: 29774210 PMCID: PMC5943632 DOI: 10.3389/fpubh.2018.00129] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 04/16/2018] [Indexed: 12/22/2022] Open
Abstract
Over the past 60 years there has been a dramatic increase in the prevalence of overweight in children and adolescents, ranging from 4% in 1975 to 18% in 2016. Recent estimates indicate that overweight or obese children and adolescents are more than 340 million. Obesity is often associated with hypertension, which is an important cardiovascular risk factor. Recent studies show that the presence of hypertension is a frequent finding in the pediatric age. Hypertensive children easily become hypertensive adults. This phenomenon contributes to increasing cardiovascular risk in adulthood. Primary hypertension is a growing problem especially in children and adolescents of western countries, largely because of its association with the ongoing obesity epidemic. Recently, it has been hypothesized that a dietary link between obesity and elevated blood pressure (BP) values could be simple carbohydrate consumption, particularly fructose, both in adults and in children. Excessive intake of fructose leads to increased serum uric acid (SUA) and high SUA values are independently associated with the presence of hypertension and weaken the efficacy of lifestyle modifications in children. The present review intends to provide an update of existing data regarding the relationship between BP, simple carbohydrates (particularly fructose), and uric acid in pediatric age. In addition, we analyze the national policies that have been carried out over the last few years, in order to identify the best practices to limit the socio-economic impact of the effects of excessive sugar consumption in children.
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Affiliation(s)
- Antonina Orlando
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Emanuela Cazzaniga
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Marco Giussani
- Family Pediatrician, Azienda Sanitaria Locale della Provincia di Milano, Milan, Italy
| | - Paola Palestini
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Simonetta Genovesi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.,Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy
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Zhao R, Xu L, Wu M, Huang S, Cao X. Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight. Women Birth 2018; 31:e20-e25. [DOI: 10.1016/j.wombi.2017.06.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 06/04/2017] [Accepted: 06/06/2017] [Indexed: 02/06/2023]
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47
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Lo MH, Lin IC, Lu PC, Huang CF, Chien SJ, Hsieh KS, Tain YL. Evaluation of endothelial dysfunction, endothelial plasma markers, and traditional metabolic parameters in children with adiposity. J Formos Med Assoc 2018; 118:83-91. [PMID: 29361384 DOI: 10.1016/j.jfma.2018.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 10/24/2017] [Accepted: 01/08/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND/PURPOSE To investigate the correlations among endothelial function assessment parameters, asymmetric dimethylarginine (ADMA)-related biomarkers, and traditional risk factors in adipose children. METHODS We enrolled adipose children aged 7-18 years between July 2014 and August 2016 as well as normal-weight controls from the outpatient clinic. Vascular measurements including echocardiography, carotid intima media thickness, pulse wave velocity (PWV), and flow-mediated dilation (FMD) were measured. Venous blood samples including traditional metabolic and endothelial dysfunction parameters were analyzed. Participants were grouped as adipose vs. normal-weight and as adipose with hypertension vs. adipose without hypertension. Clinical presentations, laboratory data, and cardiovascular measurement were compared. RESULTS Of the 105 enrolled children, 85 were adipose. Adipose children had higher systolic blood pressure, larger left ventricular (LV) mass, and adverse traditional metabolic biomarkers. FMD was significantly reduced (8.25 (5.32-12.06) % vs. 12.49 (7.18-16.58) %, p = 0.018) in the adipose group. PWV was markedly increased (4.65 (4.2-5.5) m/sec vs. 3.95 (3.38-4.35) m/sec, p < 0.001) in the hypertensive adipose children. Endothelial dysfunction parameters were not significantly changed in this study. CONCLUSION Adipose children were at higher risk of hypertension and LV hypertrophy. FMD, PWV and traditional cardiovascular biomarkers can detect subtle vascular changes. Hypertension is an important sign of arterial involvement in adipose children. Although ADMA-related biomarkers were not statistically significant, future studies are needed to confirm its correlation with adiposity and hypertension in children. The early detection and prevention of endothelial dysfunction may decrease the rate of progression to cardiovascular consequences in later life.
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Affiliation(s)
- Mao-Hung Lo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - I-Chun Lin
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Chen Lu
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Fu Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shao-Ju Chien
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kai-Sheng Hsieh
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - You-Lin Tain
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Zhang YX, Wang SR, Chen M, Cheng Y. Recent Trends in Body Mass Index and Waist Circumference among Children and Adolescents in Shandong China. J Trop Pediatr 2017; 63:461-467. [PMID: 28334944 DOI: 10.1093/tropej/fmx013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The present study examined the recent trends in body mass index (BMI) and waist circumference (WC), and the prevalence of general and abdominal obesity among children and adolescents in Shandong, China. METHODS Data for this study were obtained from two cross-sectional surveys of schoolchildren carried out in 2010 and 2014 in Shandong Province, China. A total of 72 755 students aged 7-18 years were included in this study. The BMI cutoff points recommended by the International Obesity Task Force were used to define overweight and general obesity. Abdominal obesity was defined as waist-to-height ratio (WHtR) ≥ 0.5. Both BMI and WHtR were used to define three types of obesity as follows: general obesity only, abdominal obesity only and combined obesity. RESULTS For both boys and girls, an increasing trend in BMI and WC was observed between 2010 and 2014 (p < 0.01), WC has increased faster than BMI. The sum of the prevalence of the three types of obesity increased from 16.63% (boys) and 8.13% (girls) in 2010 to 20.37% (boys) and 11.61% (girls) in 2014 (p < 0.01). CONCLUSION WC and abdominal obesity increased faster than BMI and general obesity among children and adolescents between 2010 and 2014. This study also suggested that distinguishing the types of obesity and examining the prevalence of various types of obesity are useful in practice.
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Affiliation(s)
- Ying-Xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong 250014, China
| | | | - Min Chen
- Shandong blood center, Shandong 250014, China
| | - Yan Cheng
- Shandong blood center, Shandong 250014, China
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49
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Yang J, Qiu J, Wang K, Zhu L, Fan J, Zheng D, Meng X, Yang J, Peng L, Fu Y, Zhang D, Peng S, Huang H, Zhang Y. Using molecular functional networks to manifest connections between obesity and obesity-related diseases. Oncotarget 2017; 8:85136-85149. [PMID: 29156709 PMCID: PMC5689599 DOI: 10.18632/oncotarget.19490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/05/2017] [Indexed: 01/04/2023] Open
Abstract
Obesity is a primary risk factor for many diseases such as certain cancers. In this study, we have developed three algorithms including a random-walk based method OBNet, a shortest-path based method OBsp and a direct-overlap method OBoverlap, to reveal obesity-disease connections at protein-interaction subnetworks corresponding to thousands of biological functions and pathways. Through literature mining, we also curated an obesity-associated disease list, by which we compared the methods. As a result, OBNet outperforms other two methods. OBNet can predict whether a disease is obesity-related based on its associated genes. Meanwhile, OBNet identifies extensive connections between obesity genes and genes associated with a few diseases at various functional modules and pathways. Using breast cancer and Type 2 diabetes as two examples, OBNet identifies meaningful genes that may play key roles in connecting obesity and the two diseases. For example, TGFB1 and VEGFA are inferred to be the top two key genes mediating obesity-breast cancer connection in modules associated with brain development. Finally, the top modules identified by OBNet in breast cancer significantly overlap with modules identified from TCGA breast cancer gene expression study, revealing the power of OBNet in identifying biological processes involved in the disease.
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Affiliation(s)
- Jialiang Yang
- College of Information Engineering, Changsha Medical University, Changsha 410219, P. R. China
| | - Jing Qiu
- Department of Mathematics/Network Engineering/Bioscience and Bioengineering/Library, Hebei University of Science and Technology, Shijiazhuang 050018, P. R. China
| | - Kejing Wang
- Department of Mathematics/Network Engineering/Bioscience and Bioengineering/Library, Hebei University of Science and Technology, Shijiazhuang 050018, P. R. China
| | - Lijuan Zhu
- Department of Mathematics/Network Engineering/Bioscience and Bioengineering/Library, Hebei University of Science and Technology, Shijiazhuang 050018, P. R. China
| | - Jingjing Fan
- Department of Mathematics/Network Engineering/Bioscience and Bioengineering/Library, Hebei University of Science and Technology, Shijiazhuang 050018, P. R. China
| | - Deyin Zheng
- Department of Mathematics, Hangzhou Normal University, Hangzhou 311121, P. R. China
| | - Xiaodi Meng
- Department of Food Science, Fujian Agriculture and Forestry University, Fuzhou 35002, P. R. China
| | - Jiasheng Yang
- Department of Civil and Environmental Engineering, National University of Singapore, Singapore 117576, Singapore
| | - Lihong Peng
- College of Information Engineering, Changsha Medical University, Changsha 410219, P. R. China
| | - Yu Fu
- Department of Mathematics/Network Engineering/Bioscience and Bioengineering/Library, Hebei University of Science and Technology, Shijiazhuang 050018, P. R. China
| | - Dahan Zhang
- Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, P. R. China
| | - Shouneng Peng
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Haiyun Huang
- Department of Mathematics/Network Engineering/Bioscience and Bioengineering/Library, Hebei University of Science and Technology, Shijiazhuang 050018, P. R. China
| | - Yi Zhang
- Department of Mathematics/Network Engineering/Bioscience and Bioengineering/Library, Hebei University of Science and Technology, Shijiazhuang 050018, P. R. China
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50
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Lucatelli P, Fagnani C, Tarnoki AD, Tarnoki DL, Sacconi B, Fejer B, Stazi MA, Salemi M, Cirelli C, d'Adamo A, Fanelli F, Catalano C, Maurovich-Horvat P, Jermendy AL, Jermendy G, Merkely B, Molnar AA, Pucci G, Schillaci G, Farina F, Meneghetti G, Baracchini C, Medda E. Genetic influence on femoral plaque and its relationship with carotid plaque: an international twin study. Int J Cardiovasc Imaging 2017; 34:531-541. [PMID: 29022127 DOI: 10.1007/s10554-017-1256-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 10/06/2017] [Indexed: 01/26/2023]
Abstract
To disentangle genetic and environmental influences on the development of femoral plaques using a population of adult twins. To evaluate the potential role of shared genetic and environmental factors in the co-occurrence of femoral and carotid plaques. The sample included 566 twins belonging to 164 monozygotic (MZ) and 119 dizygotic (DZ) twin pairs, who underwent peripheral arterial assessment by B-mode ultrasound in different centers. The variance in femoral plaques onset was due to genetic factors and the remaining 50% was explained by common (15%) and unique (35%) environmental factors. Findings on sidedness and number of femoral plaques indicated that also these traits were mainly under genetic control. No effect of common environment was found on plaques composition, and variability of this trait was explained by genetics (64%) and unique environment (36%). Covariation between the liabilities to carotid and femoral plaques was mainly attributed to shared genes (77%), with the remaining 23% explained by individual-specific environmental factors shared by the two districts. Inter-individual differences in plaque onset as well as in their number, sidedness and composition are mainly genetic in origin. The results on the cooccurrence of carotid and femoral plaque underline the genetic role in atherogenesis.
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Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
| | - Corrado Fagnani
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Adam Domonkos Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary.,Hungarian Twin Registry, Budapest, Hungary
| | - David Laszlo Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary.,Hungarian Twin Registry, Budapest, Hungary
| | - Beatrice Sacconi
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Bence Fejer
- Department of Radiology, Semmelweis University, Budapest, Hungary
| | - Maria Antonietta Stazi
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Miriam Salemi
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Carlo Cirelli
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Alessandro d'Adamo
- Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Fabrizio Fanelli
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional Radiology Unit, Department of Radiology, Oncology and Anatomic Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Adam L Jermendy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Gyorgy Jermendy
- 3rd Department of Internal Medicine, Bajcsy Zsilinszky Hospital, Budapest, Hungary
| | - Bela Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Andrea A Molnar
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Giacomo Pucci
- Unità di Medicina Interna, Ospedale 'S. Maria', Università di Perugia, Terni, Italy
| | - Giuseppe Schillaci
- Unità di Medicina Interna, Ospedale 'S. Maria', Università di Perugia, Terni, Italy
| | - Filippo Farina
- Department of Neurosciences, University of Padua School of Medicine, Padua, Italy
| | - Giorgio Meneghetti
- Department of Neurosciences, University of Padua School of Medicine, Padua, Italy
| | - Claudio Baracchini
- Department of Neurosciences, University of Padua School of Medicine, Padua, Italy
| | - Emanuela Medda
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
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