Quality of life improves in children and adolescents during a community-based overweight and obesity treatment

Long-term changes in eating-related problems and quality of life in children with overweight and obesity attending a 10-week lifestyle camp

BACKGROUND

Eating-related problems (e.g., binge eating (BE)) and impaired quality of life (QoL) is more prevalent in children with overweight and obesity. This study aimed to investigate changes in self-reported overeating (OE), BE, and QoL in children with overweight or obesity attending multicomponent 10-week lifestyle camps with a 52-weeks follow-up. Additionally, the study sought to investigate whether self-reported OE/BE before camp was associated with changes in QoL.

METHODS

Children aged 7 to 14-years could attend camp if they had overweight/obesity, were lonely, unhappy, or had social or family-related problems. In this study only children with overweight and obesity were included (n:185). OE, BE, and QoL were measured using self-reported questionnaires.

RESULTS

In total, 38 % of the children reported regular BE at baseline. Regular OE, occasional BE, and occasional OE was reported by 14 %, 13 %, and 11 %, respectively, while 24 % reported no eating-related problems. The relative risk of experiencing eating-related problems decreased at 10-weeks compared to baseline. Additionally, the probability of regular OE (RR 0.12 (95 % CI 0.04;0.38) (X2 = 8.44, p = 0.004)) and regular BE (RR 0.01 (95 % CI 0.00;0.11) (X2 = 9.91, p = 0.002)) remained lower at 52-weeks relative to baseline. All QoL dimensions improved after camp, and the presence of self-reported OE and regular BE at baseline was significantly associated with lower QoL at baseline, 10 and 52-weeks.

CONCLUSION

Children self-reporting OE and BE may be a particular vulnerable group that needs more support from camp staff and healthcare professionals to improve QoL.

CLINICAL TRIAL REGISTRATION

clinicaltrials.gov with ID: NCT04522921.

Clinical characteristics and outcomes of children, adolescents and young adults with overweight or obesity and mental health disorders

BACKGROUND

Mental disorders are important comorbidities in youth with obesity. Aim was to describe the clinical characteristics and outcome of youth with overweight or obesity having comorbid mental disorders.

METHODS

Data from children, adolescents, and young adults (age 6-30 years) with overweight or obesity and mental disorders (depression, anxiety disorder, eating disorder, attention deficit disorder (ADHD)) from 226 centers in Germany and Austria participating in the Adiposity Patient Registry (APV) were analyzed and compared with those without reported mental disorders using regression modeling.

RESULTS

Mental health comorbidity was reported in a total of 3969 out of 114,248 individuals with overweight or obesity: 42.5% had ADHD, 31.3% anxiety disorders, 24.3% depression, and 12.9% eating disorders. Being male (OR 1.39 (95%CI 1.27;1.52)), of older age (1.42 (1.25;1.62)), or with extreme obesity (1.45 (1.30;1.63)) were most strongly associated with mental health comorbidity. Regression analysis showed that mean BMI-SDS was significantly higher in the group of individuals with depression and eating disorders (BMI-SDS 2.13 (lower; upper mean:2.09;2.16) and 2.22 (2.17;2.26)) compared to those without reported mental health comorbidity (BMI-SDS 2.008 (2.005;2.011); p < 0.001). In youth with ADHD, BMI-SDS was lower compared to those without reported mental disorders (BMI-SDS 1.91 (1.89;1.93) vs 2.008 (2.005;2.011); p < 0.001). Proportion of severe obesity was higher in individuals with depression (23.7%), anxiety disorders (17.8%), and eating disorders (33.3%), but lower in ADHD (10.3%), compared to those without reported mental disorders (13.5%, p < 0.002). Proportions of dyslipidaemia and abnormal carbohydrate metabolism were not different in youth with and without reported mental health comorbidity. BMI-SDS change after one year of lifestyle intervention program ranged between -0.22 and -0.16 and was similar in youth without and with different mental disorders.

CONCLUSION

Health care professionals caring for youth with overweight or obesity should be aware of comorbid mental disorders and regular mental health screening should be considered.

Quality of life in congenital diaphragmatic hernia survivors treated at a non-ECMO centre from 1998 to 2015: a cross-sectional study

BACKGROUND

Survival of infants with congenital diaphragmatic hernia (CDH) has increased and more insight is warranted on the long-term issues of this condition.

METHODS

We conducted a cross-sectional study on consecutively born infants with CDH treated at a non-extracorporeal membrane oxygenation centre (ECMO) from 1998 to 2015. Quality of life was evaluated using the Pediatric Quality of Life Inventory Generic Core Scale 4.0 (PedsQL(4.0)) Questionnaire and an interview was conducted to assess for CDH-related morbidity.

RESULTS

71 eligible CDH survivors were identified and 51 consented to participate: aged 5-21 years, 28 (54.9%) male, 42 (82.4%) with left-sided hernias, 10 (19.6%) needed patch repair, median length of stay in hospital was 27.96 days (IQR 18.54-61.56). Forty-nine completed the questionnaire with a median PedsQL total score for participants of 82.6 vs 83.7 of the total proxy parent score (p=0.04). Total score was significantly lower for participants aged 5-12 years compared with participants aged 13-21 years (p=0.04); however, when reported by domains, only the physical score remained significantly lower (p=0.048). Two (4.1%) participants' and 8 (16.7%) proxy parents' scores were below 70 and considered at risk of impaired quality of life. We identified the presence of CDH-related morbidity in our population, and confirmed an association between respiratory morbidity and lower PedsQL scores (p=0.04).

CONCLUSION

We report an overall good quality of life in our population with CDH. However, a lower physical score was noted when compared with a national Danish cohort and individuals at risk of reduced quality of life were recognised. Structured follow-up programmes to identify and ensure early management of CDH-related issues may prevent a negative impact on quality of life.

Pediatric youth who have obesity have high rates of adult criminal behavior and low rates of homeownership

Objectives:

The social outcomes in adulthood for pediatric patients with obesity are not well-described. This study investigated lifetime criminal behavior and homeownership in youth with obesity.

Methods:

Retrospective data on all children enrolled in the weight management program from 1999 to 2009 and who completed exercise testing were collected. Demographic and public record collection included body habitus, death records, real estate transactions, and criminal conviction history with comparisons made to published normative data.

Results:

In the children with obesity studied (N = 716; 12.0 ± 3.1 years old), the now-adult patients (28.5 ± 3.7 years) had a 1.5% mortality rate (11/716). Overall, 9.6% of these adults were convicted of a felony compared to ~7% lifetime prevalence in Ohio (p = 0.03). Also, 14.7% of study patients purchased a home compared to 38.3% of Midwest adults <30 years old (p < 0.0001). Mortality, history of a criminal conviction, or homeownership was associated with any exercise or study parameter.

Conclusion:

Children with obesity appear to have greater social risk than their peers in adulthood with higher rates of criminal behavior and lower rates of homeownership. This appears to highlight the need for treatment in this vulnerable group of children and young adults.

Correlation of cephalometric variables with obstructive sleep apnea severity among children: a hierarchical regression analysis

OBJECTIVE

To evaluate the correlation between cephalometric parameters and apnea-hypopnea index (AHI) after controlling gender, body mass index (BMI), and adenoid size in children with obstructive sleep apnea (OSA).

METHODS

Sixty-four children with OSA (40 males, 24 females, 8.72 ± 0.899 years) were chosen by simple random sampling for a cross-sectional study from January 2018 to March 2022. They were diagnosed with OSA, assessed by Obstructive Sleep Apnea-18 questionnaire and home polysomnography and underwent lateral cephalograms.

RESULTS

Hierarchical regression analysis indicated that cephalometric parameters (except adenoid size) were associated with OSA severity, explaining 18.1% of the AHI variance. Among cephalometric measurements, AHI was positively associated with H-RGn and N-Go-Me angle (p < 0.05) and negatively associated with NP (p < 0.05).

CONCLUSION

The sagittal diameter of the oropharynx, lower gonial angle, and hyoid position are significant AHI predictors in children with OSA, independent of demographic characteristics and adenoid size.

Longitudinal evaluation of an mHealth overweight and obesity management tool

BACKGROUND

Efficient obesity treatment protocols are lacking. This study reports treatment results from a web-based application, originally developed for use in an in-person healthcare setting providing health, overweight, and obesity management.

METHODS

The web application DrHolmApp (WADHA) was evaluated in adult users two years after it was launched. The WADHA provides a personal and tailored treatment plan comprising a series of detailed action advices on everyday life, constructed from the user's input to a thorough online questionnaire. Throughout the subscription period, the WADHA users have full access to online healthcare professional support. We conducted a longitudinal cohort study using self-reported data.

RESULTS

This study included 940 adult WADHA users (861 female). The median body mass index (BMI) change across all WADHA users was -0.63 BMI points (95% CI: -0.7 to -0.57, P<0.001). 665 (71%) of all WADHA users reduced their BMI (median reduction: 0.94, 95% CI: 0.88 to 1.02). In the subset with obesity (n=675), BMI was reduced in 72%. The median number of days per week with physical activity for at least one hour per day increased with 1.5 days per week (from 2 days per week at baseline, P<0.001). Subsequently, the WADHA users improved their mood, quality of life, and body image satisfaction and reduced their appetite, bullying, and wish for weight loss (all P<0.001). A higher number of consultations associated with greater weight loss (P<0.001) independent of age and degree of obesity at treatment initiation.

CONCLUSIONS

Seventy-one percent of the WADHA users experienced weight loss, concomitant to an increased level of physical activity, improved mood, quality of life, and body image satisfaction, and reduced appetite, degree of bullying, and wish for weight loss.

KEYWORDS

Body mass index (BMI); mobile health (mHealth); obesity; treatment; weight loss.

Use of a Mobile Lifestyle Intervention App as an Early Intervention for Adolescents With Obesity: Single-Cohort Study

Background

Effective, resource-efficient treatment is urgently needed to address the high rates of pediatric and adolescent obesity. This need has been accelerated by the COVID-19 pandemic. The use of a mobile health tool as an early intervention before a clinic-based multidisciplinary weight management program could be an effective treatment strategy that is appropriate during a pandemic.

Objective

This study aims to assess the effectiveness of and adolescent engagement with a mobile app–based lifestyle intervention program as an early intervention before enrollment in a clinic-based multidisciplinary weight management program.

Methods

This prospective single-cohort study involved adolescents, aged 10-16 years, who were overweight and obese (defined as BMI percentile above the 85th percentile). Participants used the mobile Kurbo app as an early intervention before enrolling in a clinic-based multidisciplinary weight management program. Kurbo’s health coaches provided weekly individual coaching informed by a model of supportive accountability via video chat, and participants self-monitored their health behavior. The implementation of Kurbo as an early intervention was evaluated using the reach, effectiveness, adoption, implementation, and maintenance framework by reach (number who consented to participate out of all patients approached), implementation (Kurbo engagement and evaluation), and effectiveness as measured by the primary outcome of the BMI z-score at 3 months. Secondary outcome measures included changes in body fat percentage, nutrition and physical activity levels, and quality of life at 3 months. Maintenance was defined as the outcome measures at 6-month follow-up.

Results

Of the 73 adolescents who were approached for enrollment, 40 (55%) of adolescents were recruited. The mean age was 13.8 (SD 1.7) years, and the mean BMI z-score was 2.07 (SD 0.30). In the multiethnic Asian sample, 83% (33/40) of the participants had household incomes below the national median. Kurbo engagement was high, with 83% (33/40) of participants completing at least 7 coaching sessions. In total, 78% (18/23) of participants rated the app as good to excellent and 70% (16/23) stated that they would recommend it to others. There were no statistically significant changes in BMI z-scores at 3 months (P=.19) or 6 months (P=.27). Participants showed statistically significant improvements in measured body fat percentage, self-reported quality of life, and self-reported caloric intake from the 3-day food diaries at 3 and 6 months.

Conclusions

The use of Kurbo before enrollment in an outpatient multidisciplinary clinical care intervention is a feasible strategy to expand the reach of adolescent obesity management services to a low-income and racially diverse population. Although there was no significant change in BMI z-scores, the use of Kurbo as an early intervention could help to improve quality of life and reduce body fat percentage and total caloric intake.

The association of quality of life and personality characteristics with adolescent metabolic syndrome: a cohort study

BACKGROUND

An increased prevalence of adolescent metabolic syndrome (MS) is associated with adulthood cardiovascular diseases. This study aimed to explore the potential relationship of quality of life (QoL) and personality traits with adolescent MS.

METHODS

A total of 1961 participants from Chongqing with an average age of 11.68 years old from a cohort study established in 2014 and followed up through 2019 were included. QoL information, Eysenck's personality questionnaire and MS components were collected.

RESULTS

A higher QoL domain score of physical activity ability (PAA) was a protective factor for both MS and MS score (all P < 0.01), which was mainly negatively correlated with the MS components of central obesity, diastolic blood pressure (DBP) and triglyceride levels, as well as positively correlated with high density lipoprotein cholesterol (HDL-C) level. The total QoL score was negatively correlated with triglyceride levels and positively correlated with DBP (all P < 0.01). High extraversion personality score was a protective factor against adolescent MS (P = 0.04) and MS score (P < 0.05), which were mainly negatively correlated with the MS components of waist circumference, systolic blood pressure and TGs, and positively correlated with HDL-C (all P ≤ 0.01).

CONCLUSIONS

QoL score and extraversion personality score were independent protective factors against both MS prevalence and MS score, suggesting that community intervention to improve the QoL and psychological health of children are essential.

The association of quality of life and personality characteristics with adolescent metabolic syndrome: a cohort study

Background

An increased prevalence of adolescent metabolic syndrome (MS) is associated with adulthood cardiovascular diseases. This study aimed to explore the potential relationship of quality of life (QoL) and personality traits with adolescent MS.

Methods

A total of 1961 participants from Chongqing with an average age of 11.68 years old from a cohort study established in 2014 and followed up through 2019 were included. QoL information, Eysenck’s personality questionnaire and MS components were collected.

Results

A higher QoL domain score of physical activity ability (PAA) was a protective factor for both MS and MS score (all P < 0.01), which was mainly negatively correlated with the MS components of central obesity, diastolic blood pressure (DBP) and triglyceride levels, as well as positively correlated with high density lipoprotein cholesterol (HDL-C) level. The total QoL score was negatively correlated with triglyceride levels and positively correlated with DBP (all P < 0.01). High extraversion personality score was a protective factor against adolescent MS (P = 0.04) and MS score (P < 0.05), which were mainly negatively correlated with the MS components of waist circumference, systolic blood pressure and TGs, and positively correlated with HDL-C (all P ≤ 0.01).

Conclusions

QoL score and extraversion personality score were independent protective factors against both MS prevalence and MS score, suggesting that community intervention to improve the QoL and psychological health of children are essential.

Effects of physical activity on quality of life in overweight and obese children

Introduction

Background: in recent years the prevalence of obesity in infants, children, and adolescents has increased alarmingly, which may affect their health, educational level, and quality of life. Objectives: the aim of this study was to determine whether a program with physical activity and nutritional recommendations may improve health-related quality of life (HRQL) in overweight and obese children. Material and methods: the design of this study was that of a randomized clinical trial (RCT). The sample consisted of 54 children with a median age of 10.65 years, all of them overweight or obese. They were divided into a study (SG) and a control (CG) group, with 27 children each. The study group received physical activity and nutritional advice, while the control group only received theoretical-practical sessions on nutrition during 9 months. Families participated in the workshops on nutritional recommendations in both groups. Results: there was a significant difference in fat percentage before and after the intervention in the study group compared to the children who did not engage in sports activity. In the SF-10 quality-of-life perception questionnaire, statistically significant differences in both the physical and mental components may be seen at the end of the study between both groups (p < 0.001). Conclusions: an educational intervention with physical activity based on play and nutritional advice improved quality of life in overweight and obese children. Family involvement is vital for children to improve their life habits, and achieve favorable results in the reduction of overweight and obesity.

Quality of life in children and adolescents with overweight or obesity: Impact of obstructive sleep apnea

OBJECTIVES

To investigate the association between obstructive sleep apnea (OSA) and health related quality of life (HRQOL) in children and adolescents referred to an obesity treatment clinic. In addition, we examined the association between body mass index standard deviation score (BMI SDS) and HRQOL comparing children and adolescents with overweight or obesity without OSA with a control group of children and adolescents with normal weight without OSA.

METHODS

This cross-sectional study included 130 children and adolescents with overweight or obesity (BMI SDS > 1.28) aged 7-18 years recruited from an obesity treatment clinic. The control group consisted of 28 children and adolescents with normal weight (BMI SDS ≤ 1.28) aged 7-18 years recruited from schools. Sleep examinations were performed using a type 3 portable sleep monitor, Nox T3. OSA was defined as apnea-hypopnea index (AHI) ≥ 2. HRQOL was measured by the Pediatric Quality of Life Inventory (PedsQL) 4.0 generic core scale.

RESULTS

A total of 56 children and adolescents with overweight or obesity were diagnosed with OSA (43%). The children and adolescents with OSA were older (p = 0.01) and had higher BMI SDS (p = 0.04) than children and adolescents without OSA. In generalized linear regression analyses adjusted for age, sex, BMI SDS and pubertal development stage there was no association between OSA or AHI and HRQOL in children and adolescents with overweight or obesity. In the analysis, including children and adolescents without OSA and the normal-weight control group, the generalized linear regression adjusted for age, sex and AHI revealed an association between BMI SDS and HRQOL (p < 0.001).

CONCLUSION

We found no association between AHI or OSA and HRQOL in children and adolescents with overweight or obesity. However, we found an association between BMI SDS and HRQOL in children and adolescents without OSA.

The impacts of multiple obesity-related interventions on quality of life in children and adolescents: a randomized controlled trial

BACKGROUND AND PURPOSE

Obesity has become a serious public health problem and family- and school-based interventions including physical exercise and diet control have been widely applied to attempt to combat this issue. The purpose of our study was to verify the effectiveness of an obesity-related comprehensive intervention model aimed at improving quality of life (QoL) among adolescents.

METHODS

A cluster randomized controlled trial (RCT) was conducted involving 948 subjects who were divided into an intervention group (n = 518) and a control group (n = 430). The intervention group received 1 year of obesity-related health education, physical exercise, and diet control. Their baseline body mass index (BMI) was calculated, and their QoL and basic information were assessed both before and after the intervention period using a self-designed Adolescent Quality of Life Scale and a basic information questionnaire.

RESULTS

After the intervention, significant differences in the psychological, social, and pubertal dimensions, and in total QoL (P < 0.05) were observed in the intervention group relative to the control group. Improved psychological QoL in the intervention group was our most robust study finding, with increases in psychological (B = 1.883, SE = 0.646, P = 0.004), pubertal (B = 0.853, SE = 0.296, P = 0.004) and total (B = 3.024, SE = 1.214, P = 0.013) QoL all being higher in this group. This intervention effect was found to be more substantial in boys than in girls.

CONCLUSIONS

Family-individual-school-based interventions combining obesity-related health education, physical exercise, and diet control can improve psychological, pubertal, and total QoL in children, with these effects being most pronounced in boys.

TRIAL REGISTRATION

retrospectively registered NCT02343588 .

Socioeconomic inequalities in children's health-related quality of life according to weight status

OBJECTIVES

This study explores the association between socioeconomic position (SEP) and health-related quality of life (HRQoL) among Portuguese children according to their weight status.

METHODS

A total of 1215 primary school-aged children (mean age 8.78 years) from three Portuguese districts (Lisbon, Porto, Coimbra) were assessed during 2016/2017. Father and mother's education (low, medium, high) and work status (employed, unemployed/retired) were used as SEP indicators. Self-reported HRQoL was assessed with the KIDSCREEN-27. Height and weight were objectively measured and body mass index categorized in normal, overweight or obese. Age, sex, and district-adjusted linear regression models were fitted to estimate associations between SEP indicators and HRQoL dimensions, according to weight status.

RESULTS

We found that 24.9% of children were categorized as having overweight/obesity. The mean scores of the Physical Well-Being, and School Environment dimensions of HRQoL were lower among children classified with overweight/obesity compared to children with normal weight (57.21 vs 54.11, P < .001 and 57.85 vs 56.04, P = .010, respectively). Father's education was significantly associated with all HRQoL dimensions in children with a normal weight, but the same was not observed among children presenting overweight/obesity. An increase in the level of maternal education was also significantly associated with all HRQoL dimensions among children classified with a normal weight, and only for the School Environment dimension among children classified with overweight/obesity.

CONCLUSIONS

These results suggest the presence of socioeconomic inequalities in self-reported HRQoL from early age, particularly among children with normal weight.

The construct validity of the Child Health Utility 9D-DK instrument

Background

Relative to their application with adults there is currently little information about the application of preference-based health-related quality of life (HRQL) instruments among populations of young people. The Child Health Utility 9D (CHU9D) is a paediatric-specific generic preference-based HRQL instrument, recently translated and linguistically validated into Danish (CHU9D-DK). The purpose of this study was to investigate the construct validity of the CHU9D-DK in a sample of Danish high school students.

Methods

All students attending a Danish High School were invited to participate in a web-based survey in January 2018 (N = 272). The survey included the CHU9D-DK, the young adult version of the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL), self-reported health status, presence/absence of disability/chronic diseases, life satisfaction, and socio-economic questions. CHU9D-DK utility scores were generated by employing the two scoring algorithms developed from adults in the UK and adolescents in Australia, respectively. Internal consistency, reliability and construct validity of the CHU9D-DK instrument were investigated.

Results

Two hundred and twenty-eight (84%) students consented to participate and completed the survey. The mean ± (standard deviation) values of the CHU9D-DK utilities were 0.84 (0.11) when the UK adult algorithm was applied and 0.70 (0.22), when the Australian adolescent algorithm was applied. The mean PedsQL score was 82.32 (13.14). The CHU9D-DK showed good internal consistency reliability (Cronbach’s alpha = 0.803). Higher levels of health status and life satisfaction were significantly associated with higher CHU9D-DK utility scores regardless of which scoring algorithm was applied (p-values < 0.001). Students living with a disability/chronic disease exhibited significantly lower utility scores relative to their healthy peers (p-values < 0.05). Higher socio-economic status (approximated by financial situation and frequency of family vacations) was also associated with higher utility scores (p-values < 0.005).

Conclusion

The CHU9D-DK demonstrated good psychometric performance overall and shows potential as a valid and reliable instrument for assessing the HRQL of Danish young people.

Trial registration

ClinicalTrials.gov identifier: NCT03391999, Registered 15 October 2017.

Impact of weight-loss management on children and adolescents with obesity and obstructive sleep apnea

OBJECTIVES

To evaluate the impact of weight-loss management on obstructive sleep apnea (OSA) in children and adolescents with obesity. We hypothesized that a reduction in the degree of obesity was associated with a reduction in the apnea-hypopnea index (AHI).

METHODS

OSA (AHI ≥2) was investigated using a type 3 portable sleep device (Nox T3) in children and adolescents aged 7-18 years with overweight or obesity (body mass index standard deviation score (BMI SDS) > 1.28) at enrollment in a chronic care multidisciplinary overweight- and obesity treatment clinic. Individuals with OSA were included prospectively and longitudinally. A follow-up sleep examination was performed after 6 and 12 months from baseline accompanied by anthropometric measurements.

RESULTS

At baseline, 62 children with OSA were included (median age = 13.4 years, median BMI SDS = 3.16). A total of 55 out of 62 children (89%) attended the first follow-up, and 29 out of 34 children (85%) with residual OSA attended the second follow-up. By the end of the study, the AHI was normalized in 27 out of 62 children (44%). In a multiple linear regression analysis, the decrease in BMI SDS was associated with the decrease in AHI upon the first follow-up (p = 0.02) independently of sex; age; baseline puberty stage; baseline tonsillar hypertrophy; baseline AHI; baseline BMI SDS; and time to follow-up. There was no association between change in BMI SDS and change in AHI from the first to the second follow-up (p = 0.81).

CONCLUSIONS

OSA improved during obesity treatment, and the reduction in BMI SDS was significantly associated with the reduction in AHI after approximately six months of treatment. This indicates that obesity treatment should be considered among the first-line treatments of OSA in children and adolescents affected by overweight or obesity.

Multidisciplinary obesity treatment program improved health-related quality of life and positively correlated with anthropometric and body composition but not with cardiorespiratory fitness parameters in adolescents

PURPOSE

The aim of the present study was to verify the effects of a 16-week multidisciplinary obesity treatment program (MOTP) on health-related quality of life (HRQoL) in adolescents with weight excess. In addition, we verified a possible association between changes on HRQoL and anthropometric, body composition, and cardiorespiratory fitness (CRF) parameters.

METHODS

Two hundred four adolescents aged from 15 to 18 years were distributed in control group (CG) and intervention group (IG). They underwent a 16-week MOTP composed by nutritional, psychological, and health-related physical activity group sessions. Moreover, they performed physical exercise sessions three times per week during the whole 16-week program. Data on HRQoL, body composition, CRF and anthropometry were collected using standard protocols and validated questionnaires.

RESULTS

The MOTP promoted significant enhancements in all HRQoL domains, except for the school domain in IG. Furthermore, positive correlations between HRQoL and body weight (BW), body fat (BF), waist circumference (WC), and body mass index (BMI) z-score were verified. Higher scores of HRQoL might be achieved by improving these variables.

CONCLUSIONS

The 16-week MOTP was effective to improve HRQoL in adolescents with weight excess. This improvement has a positive correlation with enhancements in BW, BMI z-score, WC, and BF. Nevertheless, these findings have not reached a consensus on literature and still need to be further enlightened.

Genetic Susceptibility for Childhood BMI has no Impact on Weight Loss Following Lifestyle Intervention in Danish Children

OBJECTIVE

This study aimed to investigate the effect of a genetic risk score (GRS) comprising 15 single-nucleotide polymorphisms, previously shown to associate with childhood BMI, on the baseline cardiometabolic traits and the response to a lifestyle intervention in Danish children and adolescents.

METHODS

Children and adolescents with overweight or obesity (n = 920) and a population-based control sample (n = 698) were recruited. Anthropometric and biochemical measures were obtained at baseline and in a subgroup of children and adolescents with overweight or obesity again after 6 to 24 months of lifestyle intervention (n = 754). The effects of the GRS were examined by multiple linear regressions using additive genetic models.

RESULTS

At baseline, the GRS associated with BMI standard deviation score (SDS) both in children and adolescents with overweight or obesity (β = 0.033 [SE = 0.01]; P = 0.001) and in the population-based sample (β = 0.065 [SE = 0.02]; P = 0.001). No associations were observed for cardiometabolic traits. The GRS did not influence changes in BMI SDS or cardiometabolic traits following lifestyle intervention.

CONCLUSIONS

A GRS for childhood BMI was associated with BMI SDS but not with other cardiometabolic traits in Danish children and adolescents. The GRS did not influence treatment response following lifestyle intervention.

Utility values for childhood obesity interventions: a systematic review and meta-analysis of the evidence for use in economic evaluation

Rigorous estimates of preference-based utilities are important inputs into economic evaluations of childhood obesity interventions, yet no published review currently exists examining utility by weight status in paediatric populations. A comprehensive systematic literature review and meta-analysis was therefore undertaken, pooling data on preference-based health state utilities by weight status in children using a random-effects model. Tests for heterogeneity were performed, and publication bias was assessed. Of 3,434 potentially relevant studies identified, 11 met our eligibility criteria. Estimates of Cohen's d statistic suggested a small effect of weight status on preference-based utilities. Mean utility values were estimated as 0.85 (95% uncertainty interval [UI] 0.84-0.87), 0.83 (95% UI 0.81-0.85), 0.82 (95% UI 0.79-0.84) and 0.83 (95% UI 0.80-0.86) for healthy weight, overweight, obese and overweight/obese states, respectively. Meta-analysis of studies reporting utility values for both healthy weight and overweight/obese participants found a statistically significant weighted mean difference (0.015, 95% UI 0.003-0.026). A small but statistically significant difference was also estimated between healthy weight and overweight participants (0.011, 95% UI 0.004-0.018). Study findings suggest that paediatric-specific benefits of obesity interventions may not be well reflected by available utility measures, potentially underestimating cost-effectiveness if weight loss in childhood/adolescence improves health or well-being.