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Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 5] [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: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
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2
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Jiang Q, Risica PM, Tovar A, Cooksey Stowers K, Schwartz MB, Lombardi C, Gans KM. Mediation of the association between social environmental characteristics of family childcare home and weight status in children by diet quality. BMC Public Health 2023; 23:2301. [PMID: 37990180 PMCID: PMC10664465 DOI: 10.1186/s12889-023-17179-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND The food and beverages served in family childcare homes (FCCHs) may play an important role in the development of childhood overweight and obesity. This analysis examines whether children's diet quality mediates the relationship between foods and beverages served in FCCHs and preschool-aged children's weight status. METHODS Trained and certified staff conducted observations for two days in each FCCH, using the Environment and Policy Assessment and Observation (EPAO) measure to determine the foods and beverages served to children (N = 370) in FCCHs (N = 120). They also used the Dietary Observation in Child Care (DOCC) protocol to assess children's food and beverage intake during childcare, from which we calculated the Healthy Eating Index-2015 (HEI), a measure of diet quality. Height and weight were measured for each child with parent consent from which the child's body mass index (BMI) z-scores were calculated. A multilevel mediation analysis was conducted to indicate whether children's diet quality mediates the relations between food and beverage served in FCCHs and preschool-aged children's weight status. RESULTS Children's total HEI scores significantly mediated the relationship between the EPAO subscale Food Provided and children's BMI z-scores (B=-0.01, p < .05, 95% CI = [-0.03, - 0.002]). Further, the EPAO subscale Food Provided was positively associated with the total HEI score (B = 0.75, p < .01, 95% CI = [0.32, 1.18]). Total HEI scores were negatively associated with BMI z-score (B=-0.01, p < .05, 95% CI = [-0.02, - 0.001]). CONCLUSION Children's diet quality did significantly mediate the relationship between the food served in FCCHs and children's weight status. More longitudinal studies with longer follow-up periods need to be conducted to confirm these relationships. Further, future studies need to examine the relationships between a broader spectrum of FCCH environmental characteristics and home environment with children's weight status, as well as other mediators including physical activity.
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Affiliation(s)
- Qianxia Jiang
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA.
| | - Patricia Markham Risica
- Department of Behavioral and Social Health Sciences, School of Public Health, Brown University, Providence, RI, USA
- Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI, USA
| | - Alison Tovar
- Department of Behavioral and Social Health Sciences, School of Public Health, Brown University, Providence, RI, USA
- Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI, USA
| | | | - Marlene B Schwartz
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT, USA
| | - Caitlin Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Kim M Gans
- Department of Behavioral and Social Health Sciences, School of Public Health, Brown University, Providence, RI, USA
- Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI, USA
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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Jiang Q, Risica PM, Tovar A, Stowers KC, Schwartz MB, Lombardi C, Gans KM. Mediation of the Association between Social Environmental Characteristics of Family Childcare Home and Weight Status in Children by Diet Quality. RESEARCH SQUARE 2023:rs.3.rs-3147729. [PMID: 37645722 PMCID: PMC10462247 DOI: 10.21203/rs.3.rs-3147729/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Background The food and beverages served in family childcare homes (FCCHs) may play an important role in the development of childhood overweight and obesity. This analysis examines whether children's diet quality mediates the relationship between foods and beverages served in FCCHs and preschool-aged children's weight status. Methods Trained and certified staff conducted observations for two days in each FCCH, using the Environment and Policy Assessment and Observation (EPAO) measure to determine the foods and beverages served to children (N=370) in FCCHs (N=120). They also used the Dietary Observation in Child Care (DOCC) protocol to assess children's food and beverage intake during childcare, from which we calculated the Healthy Eating Index-2015 (HEI), a measure of diet quality. Height and weight were measured for each child with parent consent from which the child's body mass index (BMI) z-scores were calculated from. A multilevel mediation analysis was conducted to indicate whether children's diet quality mediates the relations between food and beverage served in FCCHs and preschool-aged children's weight status. Results Children's total HEI scores significantly mediated the relationship between the EPAO subscale "Food provided" and children's BMI z-scores (B=-.01, p<.05, 95% CI = [-.03, -.002]). Further, the EPAO subscale "Food provided" was positively associated with the total HEI score (B=.75, p<.01, 95% CI = [.32, 1.18]). Total HEI scores were negatively associated with BMI z-score (B=-.01, p<.05, 95% CI = [-.02, -.001]). Conclusion Children's diet quality did significantly mediate the relationship between the food served in FCCHs and children's weight status. More longitudinal studies with longer follow-up periods need to be conducted to confirm these relationships. Further, future studies need to examine the relationships between a broader spectrum of FCCH environmental characteristics and home environment with children's weight status, as well as other mediators including physical activity.
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4
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Soleimani M, Barone S, Luo H, Zahedi K. Pathogenesis of Hypertension in Metabolic Syndrome: The Role of Fructose and Salt. Int J Mol Sci 2023; 24:4294. [PMID: 36901725 PMCID: PMC10002086 DOI: 10.3390/ijms24054294] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Metabolic syndrome is manifested by visceral obesity, hypertension, glucose intolerance, hyperinsulinism, and dyslipidemia. According to the CDC, metabolic syndrome in the US has increased drastically since the 1960s leading to chronic diseases and rising healthcare costs. Hypertension is a key component of metabolic syndrome and is associated with an increase in morbidity and mortality due to stroke, cardiovascular ailments, and kidney disease. The pathogenesis of hypertension in metabolic syndrome, however, remains poorly understood. Metabolic syndrome results primarily from increased caloric intake and decreased physical activity. Epidemiologic studies show that an enhanced consumption of sugars, in the form of fructose and sucrose, correlates with the amplified prevalence of metabolic syndrome. Diets with a high fat content, in conjunction with elevated fructose and salt intake, accelerate the development of metabolic syndrome. This review article discusses the latest literature in the pathogenesis of hypertension in metabolic syndrome, with a specific emphasis on the role of fructose and its stimulatory effect on salt absorption in the small intestine and kidney tubules.
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Affiliation(s)
- Manoocher Soleimani
- Research Services, New Mexico Veterans Health Care Medical Center, Albuquerque, NM 87108, USA
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Sharon Barone
- Research Services, New Mexico Veterans Health Care Medical Center, Albuquerque, NM 87108, USA
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Henry Luo
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Kamyar Zahedi
- Research Services, New Mexico Veterans Health Care Medical Center, Albuquerque, NM 87108, USA
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
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Ozdemir O, Ucar A, Cakir AD, Misir E, Yigit O. The association of metabolic syndrome status with sensorineural hearing loss in pediatric obese patients. Int J Pediatr Otorhinolaryngol 2023; 165:111454. [PMID: 36696712 DOI: 10.1016/j.ijporl.2023.111454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/31/2022] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The prevalences of pediatric obesity and its associated comorbidities such as metabolic syndrome (metS) are rising. The aim of this study was to evaluate the association of metS status with sensorineural hearing loss in pediatric obese patients. METHODS A two-center observationalprospective study was designed. In this study, 252 consecutive treatment-naive pediatric obese patients aged 5.8-17.8 yr in a tertiary pediatric Endocrinology outpatient clinic were prospectively enrolled. Following standard clinical and biochemical evaluations, the obese patients were diagnosed as having metabolic syndrome (metS) or not according to Internetional Diabetes Federation Criteria. All the patients were evaluated with tympanometry and pure tone audiometry tests after otomicroscopic examination. Comparative analyses of audiometric evaluations were performed between metS+ and metS- subgroups of the obese patients. RESULTS The median age of the patients was 12.5 yr (range: 6.0-17.8 yr) and 56.3% of the patients were male. Metabolic syndrome was diagnosed in 82 (32.5%) patients. Age, gender distribution, history of the ventilation tube, and pubertal stage of the metS + patients and metS- counterparts were not statistically different (p > 0.05 for all). Pure tone hearing thresholds at all frequencies (125, 250, 500, 1k, 2k, 4k, 8k) were significantly higher in the metS + group then the metS- group (p˂0.05 for all). The tympanometry results were not statistically different between the two groups (p˃0.05). Abdominal obesity, hypertension, fasting hyperglycemia and dyslipidemia were not associated with increased hearing thresholds in metS + patients (p˃0.05 for all). CONCLUSION Metabolic syndrome was associated with increased rates of subclinical hearing loss in our cohort. None of the investigated metS components emerged as a positive association with hearing loss in our cohort. Longitudinal follow-up of our cohort may help probe the causality of the association we found.
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Affiliation(s)
- Ozan Ozdemir
- University of Health Sciences Istanbul Teaching and Research Hospital, Department of Otorhinolaryngology, Istanbul, Turkey.
| | - Ahmet Ucar
- University of Health Sciences Sisli Etfal Training and Research Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey.
| | - Aydilek Dagdeviren Cakir
- University of Health Sciences Sisli Etfal Training and Research Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey.
| | - Esra Misir
- University of Health Sciences Istanbul Teaching and Research Hospital, Department of Otorhinolaryngology, Istanbul, Turkey.
| | - Ozgur Yigit
- University of Health Sciences Istanbul Teaching and Research Hospital, Department of Otorhinolaryngology, Istanbul, Turkey.
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6
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Sun G, Li L, Zhang X. A visualized and scientometric analysis of research trends of weight loss in overweight/obese children and adolescents (1958-2021). Front Public Health 2022; 10:928720. [PMID: 36339176 PMCID: PMC9632180 DOI: 10.3389/fpubh.2022.928720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
Background Weight loss is an appropriate approach to reduce the health risks associated with overweight/obese children and adolescents, and the optimal method of weight loss requires further research. This study systematically explores scientific co-operation, disciplinary interaction, hotspots and trends in the field of weight loss in overweight/obese children and adolescents (WLOCA), and provides references for further research. Methods Citespace 5.8.R1 (64-bit) was adopted to conduct a comprehensive visualization analysis of the literature on WLOCA from Web of Science Core Collection, including publication, institution, country/region, author, journal, keywords and reference. Results 2,513 papers were found in the Web of Science Core Collection, and the annual number of papers published has increased significantly since 2003. Cincinnati Children's Hospital is the institution with the largest number of publications, while Washington University plays a pivotal role in the collaboration network. In terms of nations, USA has made greater contributions than the rest in terms of the number of publications and global co-operation research. The most influential authors in this field are Thomas H. Inge, Thomas Reinehr, Todd M. Jenkins, Epstein LH, Ogden CL, etc. The most active journals are "Obesity," "International Journal of Obesity," "Obesity Surgery," "Pediatrics," etc. which are characterized by interdisciplinary interactions. Research hot topics mainly include "assessment of obesity and pathophysiological mechanism," "comprehensive intervention," and "bariatric surgery," and there's a gradual shift from "lifestyle intervention" and "pathophysiological mechanism" to "clinical surgical application." In addition, disciplinary integration and comprehensive research, targeted intervention and treatment, and prospective research are the future research trends. Conclusion The overall trend in WLOCA study is positive. The main contribution of this study is to reveal the overall picture of the research in this field with visual maps and detailed data by combining quantitative with qualitative approaches, which can provide valuable references for relevant researchers to quickly understand the status of studies on WLOCA, to seek co-operation, and grasp research hotspots and frontier trends.
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Affiliation(s)
- Guotao Sun
- School of Physical Education, Chengdu Sport University, Chengdu, China,College of Education and Sports Science, Yangtze University, Jingzhou, China
| | - Long Li
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China,School of Physical Education, Xichang University, Xichang, China
| | - Xiaolin Zhang
- Sport Research Office, Chengdu Sport University, Chengdu, China,*Correspondence: Xiaolin Zhang
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7
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Kakko K, Keskinen P, Pihlakoski L, Salmelin R, Puura K. In search of measures to improve the detection of increased cardiometabolic risk in children using second-generation antipsychotic medications. Nord J Psychiatry 2022; 76:316-322. [PMID: 34431750 DOI: 10.1080/08039488.2021.1968489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Second-generation antipsychotic medications (SGAs) are widely used in child psychiatry. SGA-induced metabolic disturbances are common in children, but monitoring practices need systematisation. The study's aims were to test an SGA-monitoring protocol, examine the distributions of metabolic measurements compared to reference values in child psychiatry patients, and determine whether using a homeostasis model for the assessment of insulin resistance (HOMA-IR) and triglyceride/high-density lipoprotein (TG/HDL) ratio could improve the detection of increased cardiometabolic risk. MATERIALS AND METHODS A systematic monitoring protocol was implemented. Weight and height, blood pressure, fasting glucose, insulin, HDL, and TG were measured at baseline and four times during follow-up. HOMA-IR, TG/HDL ratio and zBMI were calculated. Age-, gender- and BMI-specific percentile curves for HOMA-IR were used to define elevated cardiometabolic risk. RESULTS The study patients (n = 55, mean age 9.9 years) were followed for a median of 9 months. A disadvantageous, statistically significant shift, often appearing within the reference range, was seen in zBMI, TG, HDL, glucose, insulin, HOMA-IR, and TG/HDL ratio. The increase in HOMA-IR appeared earlier than individual laboratory values and was more evident than the TG/HDL ratio increase. An HOMA-IR cut point of 1.98 resulted in a sensitivity and specificity of 83%. Compared to a previous study performed in the same location, the monitoring rates of metabolic parameters improved. CONCLUSION The monitoring protocol implementation improved the monitoring of metabolic parameters in child psychiatric patients using SGAs. Using HOMA-IR as part of systematic SGA monitoring could help detect metabolic adverse effects.
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Affiliation(s)
- Kirsi Kakko
- Department of Child Psychiatry, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Päivi Keskinen
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland.,Center for Child Health Research, Tampere University, Tampere, Finland
| | - Leena Pihlakoski
- Department of Child Psychiatry, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Raili Salmelin
- Department of Child Psychiatry, Tampere University Hospital, Tampere, Finland.,Faculty of Social Sciences/Health Sciences, Tampere University, Tampere, Finland
| | - Kaija Puura
- Department of Child Psychiatry, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Ying M, Hu X, Li Q, Dong H, Zhou Y, Chen Z. Long-term trajectories of BMI and cumulative incident metabolic syndrome: A cohort study. Front Endocrinol (Lausanne) 2022; 13:915394. [PMID: 36568079 PMCID: PMC9773063 DOI: 10.3389/fendo.2022.915394] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Body mass index (BMI) has been widely recognized as a risk factor for metabolic syndrome (MetS). However, the relationship between the trajectory of BMI and cumulative incident MetS is still unclear. We investigate the associations of long-term measurements of BMI with MetS among young adults in the China Health and Nutrition Survey. METHODS We enrolled individuals aged 10 to 20 at baseline with recorded BMI at each follow-up interview, and 554 participants were finally included in our study. The assessment and incidence of MetS were evaluated by blood tests and physical examinations in their adulthood. A latent class growth mixed model was used to identify three BMI trajectory patterns: a low baseline BMI with slow development (low-slow, n=438), a low baseline BMI with fast development (low-fast, n=66), and a high baseline BMI with fast development (high-fast, n=50). Logistic regression was used to explore the relationship between different BMI trajectories and the incidence of MetS. RESULT During a follow-up of 16 years, 61 (11.01%) participants developed MetS. The combination of elevated triglycerides and reduced high-density lipoprotein cholesterol was most frequent in diagnosed MetS. In multivariate adjusted models, the low-fast and high-fast BMI trajectories showed a significantly higher risk of MetS than those with the low-slow BMI trajectory (low-high: OR = 3.40, 95% CI: 1.14-10.13, P < 0.05; high-fast: OR = 5.81, 95% CI: 1.63-20.69, P < 0.05). CONCLUSION Our study identified three BMI trajectories in young adults and found that long-term measurements of BMI were also associated with cumulative incident MetS.
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Affiliation(s)
- Ming Ying
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China
| | - Xiangming Hu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qiang Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Haojian Dong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yingling Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Zhujun Chen, ; Yingling Zhou,
| | - Zhujun Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Zhujun Chen, ; Yingling Zhou,
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Mohammad A, Shahnaz T, Sorayya K. Effect of 8 weeks' supplementation grape seed extract on insulin resistance in iranian adolescents with metabolic syndrome: A randomized controlled trial. Diabetes Metab Syndr 2021; 15:197-203. [PMID: 33385766 DOI: 10.1016/j.dsx.2020.12.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS Insulin resistance in adolescents is a major health concern. The aim of this study was to evaluate the effect of grape seed extract on insulin resistance in adolescents with metabolic syndrome (MetS). METHODS Participants were divided into grape seed extract (GSE) and placebo groups (n = 24 each) and received 100 mg/day of GSE or placebo and were placed on a weight loss diet for 8 weeks. Anthropometric and biochemical indices, blood pressure, dietary intake, and physical activity were measured before and after the intervention. RESULTS Forty-two participants completed the trial. After the intervention, the age, sex, baseline values, energy intake and physical activity as a covariate adjusted using ANCOVA for determine differences between groups. The MD (mean difference ±SEM) of HOMA-IR between the GSE group (-1.46 ± 0.45) and the placebo group (-0.48 ± 0.47), (p = 0.020), and the MD of insulin between the GSE group (-7.05 ± 2.11) and the placebo group (-1.71 ± 2.12), (p = 0.024), were significant. Although changes were observed in other variables, they were not statistically significant. CONCLUSIONS GSE improves insulin concentration and insulin resistance in adolescents with MetS and provides a basis for possible application of the GSE in the clinical management of MetS in adolescents. This study registered under Randomized Clinical Trials.gov Identifier no. IRCT2013112611288N7.
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Affiliation(s)
- Alizadeh Mohammad
- Department of Biochemistry and Diet Therapy, Faculty of Nutrition Tabriz University of Medical Sciences, Attar Nishabouri St., Tabriz, Iran, Postal code: 5166614711, POBOX: 14711.
| | - Taghizadeh Shahnaz
- Student Research Committee, Department of Biochemistry and Diet Therapy, Faculty of Nutrition Tabriz University of Medical Sciences, Attar Nishabouri St., Tabriz, Iran, Postal code: 5166614711, POBOX: 14711.
| | - Kheirouri Sorayya
- Department of Biochemistry and Diet Therapy, Faculty of Nutrition Tabriz University of Medical Sciences, Attar Nishabouri St., Tabriz, Iran, Postal code: 5166614711, POBOX: 14711.
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The prevalence of pediatric metabolic syndrome-a critical look on the discrepancies between definitions and its clinical importance. Int J Obes (Lond) 2020; 45:12-24. [PMID: 33208861 PMCID: PMC7752760 DOI: 10.1038/s41366-020-00713-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 10/16/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023]
Abstract
Introduction The Metabolic Syndrome (MetS) describes the clustering of cardio-metabolic risk factors—including abdominal obesity, insulin resistance, elevated blood pressure, high levels of triglycerides, and low levels of high-density lipoproteins—that increase the risk for developing cardiovascular diseases and type 2 diabetes mellitus. However, a generally accepted definition of MetS in pediatric patients is still lacking. Objectives The aim was to summarize current prevalence data of childhood MetS as well as to discuss the continuing disagreement between different pediatric definitions and the clinical importance of such diagnosis. Methodology A systematic literature search on the prevalence of pediatric MetS was conducted. Articles that were published during the past 5 years (2014–2019), using at least one of four predetermined classifications (International Diabetes Federation, Cook et al., Ford et al., and de Ferranti et al.), were included. Results The search resulted in 1167 articles, of which 31 publications met all inclusion criteria. Discussion The prevalence of MetS ranged between 0.3 and 26.4%, whereby the rising number of children and adolescents with MetS partly depended on the definition used. The IDF definition generally provided the lowest prevalences (0.3–9.5%), whereas the classification of de Ferranti et al. yielded the highest (4.0–26.4%). In order to develop a more valid definition, further research on long-term consequences of childhood risk factors such as abdominal obesity, insulin resistance, hypertension, and dyslipidemia is needed. There is also a temptation to suggest one valid, globally accepted definition of metabolic syndrome for pediatric populations but we believe that it is more appropriate to suggest definitions of MetS that are specific to males vs. females, as well as being specific to race/ethnicity or geographic region. Finally, while this notion of definitions of MetS specific to certain subgroups is important, it still needs to be tested in future research.
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Lima RS, Assis Silva Gomes J, Moreira PR. An overview about DNA methylation in childhood obesity: Characteristics of the studies and main findings. J Cell Biochem 2020; 121:3042-3057. [DOI: 10.1002/jcb.29544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 10/10/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Rafael Silva Lima
- Laboratory of Cell‐Cell Interactions, Department of Morphology, Institute of Biological SciencesFederal University of Minas Gerais Minas Gerais Brazil
| | - Juliana Assis Silva Gomes
- Laboratory of Cell‐Cell Interactions, Department of Morphology, Institute of Biological SciencesFederal University of Minas Gerais Minas Gerais Brazil
| | - Paula Rocha Moreira
- Laboratory of Cell‐Cell Interactions, Department of Morphology, Institute of Biological SciencesFederal University of Minas Gerais Minas Gerais Brazil
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12
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Ayine P, Selvaraju V, Venkatapoorna CMK, Geetha T. Parental Feeding Practices in Relation to Maternal Education and Childhood Obesity. Nutrients 2020; 12:nu12041033. [PMID: 32283764 PMCID: PMC7231200 DOI: 10.3390/nu12041033] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/31/2020] [Accepted: 04/07/2020] [Indexed: 11/24/2022] Open
Abstract
Parental beliefs, attitudes, and feeding practices play a vital role in childhood obesity. This study aimed to assess parental perceptions, concerns about weight, feeding practices using the Child Feeding Questionnaire (CFQ), and its association with body mass index (BMI) and maternal education in elementary school children. Participants aged 6–10 years (n = 169) were recruited and anthropometric measurements were obtained. Pearson’s correlation and hierarchical linear regression analysis were used to examine the association between BMI z-score and the seven factors of the CFQ. The BMI z-score was significantly associated with parental perceived child weight and concern about child weight. The BMI z-score had a significant negative association with parents pressuring children to eat. Parents of obese children reported significantly higher (p < 0.001) levels of perceived child weight (β = 0.312) and concern (β = 0.320) about their child’s weight compared to the normal weight and overweight groups. Parents of overweight children showed considerably less (β = −0.224; p < 0.005) pressuring towards their children to eat as compared to parents of normal weight children. Additionally, we found that the parental feeding practice (pressure to eat) was only dependent upon maternal education. The path analysis indicates that maternal education has a mediating effect on BMI z-score and pressure to eat is related to BMI z-score through maternal education. The findings demonstrate the association between the parents’ perceptions, concerns, and pressure to eat with BMI z-score of elementary school-aged children. Only the parental feeding practice pressure to eat was dependent upon the maternal education.
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Affiliation(s)
- Priscilla Ayine
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (P.A.); (V.S.); (C.M.K.V.)
| | - Vaithinathan Selvaraju
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (P.A.); (V.S.); (C.M.K.V.)
| | - Chandra M. K. Venkatapoorna
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (P.A.); (V.S.); (C.M.K.V.)
| | - Thangiah Geetha
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (P.A.); (V.S.); (C.M.K.V.)
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
- Correspondence: ; Tel.: +1-334-844-7418
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13
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Kakko K, Pihlakoski L, Keskinen P, Salmelin R, Puura K. Current follow-up practices often fail to detect metabolic and neurological adverse reactions in children treated with second-generation antipsychotics. Acta Paediatr 2020; 109:342-348. [PMID: 31359492 DOI: 10.1111/apa.14951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 06/10/2019] [Accepted: 07/24/2019] [Indexed: 11/30/2022]
Abstract
AIM This study examined the use and adverse reactions of second-generation antipsychotics (SGAs), alone or combined with other psychotropic medication, to identify areas for standardising prescribing and monitoring practices. METHODS We conducted a retrospective study at Tampere University Hospital, Finland, involving 128 patients (81% boys) who were under 13 years old at SGA initiation and had SGA treatment between October 2013 and October 2014. RESULTS The median age at baseline was 9.4 years. Weight gain was reported as an adverse reaction in 33%, but an increase in standardised body mass index, adjusted for age and sex (BMI z-score), was detected in 75% of patients with sufficient data. The statistically significant median changes during the study were an increase of 0.46 in BMI z-score, a reduction of 0.25 mmol/L in fasting plasma high-density lipoprotein and an increase of 0.28 mmol/L in triglyceride values. The weight gain was most apparent in patients treated with just an SGA or SGA plus melatonin. Patients treated with an SGA plus medication for attention deficit hyperactivity disorder were less likely to gain weight. CONCLUSION SGA-induced metabolic disturbances remained partly unrecognised in children under 13 years of age and more systematic monitoring is needed.
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Affiliation(s)
- Kirsi Kakko
- Department of Child Psychiatry Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Leena Pihlakoski
- Department of Child Psychiatry Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Päivi Keskinen
- Department of Paediatrics Tampere University Hospital Tampere Finland
- Center for Child Health Research Tampere University Tampere Finland
| | - Raili Salmelin
- Department of Child Psychiatry Tampere University Hospital Tampere Finland
- Faculty of Social Sciences/Health Sciences Tampere University Tampere Finland
| | - Kaija Puura
- Department of Child Psychiatry Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
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14
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Rigamonti AE, Tringali G, De Micheli R, De Col A, Tamini S, Saezza A, Cella SG, Sartorio A. Impact of a Three-Week in-Hospital Multidisciplinary Body Weight Reduction Program on Body Composition, Muscle Performance and Fatigue in a Pediatric Obese Population with or without Metabolic Syndrome. Nutrients 2020; 12:E208. [PMID: 31941135 PMCID: PMC7019212 DOI: 10.3390/nu12010208] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/20/2022] Open
Abstract
Metabolic syndrome is a combination of cardiometabolic risk factors, frequently detected in obese children and adolescents. To date, few clinical studies have evaluated the effectiveness of multidisciplinary body weight reduction programs on body mass index, body composition, muscle performance and fatigue in pediatric obese subjects suffering from metabolic syndrome, which might represent a sub-population that is more difficult to be treated and worthy of more intensive interventions than a population less metabolically complicated. The aim of the present study was to compare the impact of a three-week in-hospital multidisciplinary integrated body weight reduction program (BWRP) on body mass index (BMI), body composition (particularly, fat mass (FM) and fat-free mass (FFM)), motor control (evaluated by one-leg standing balance (OLSB) test), muscle performance (evaluated by the stair climbing test (SCT)) and fatigue (evaluated by fatigue severity scale (FSS)) in a pediatric obese population with or without metabolic syndrome. A pediatric population of 548 obese subjects without metabolic syndrome (F/M = 312/236; age range: 8-18 years; BMI: 36.3 ± 6.7 kg/m2) and 96 obese subjects with metabolic syndrome (F/M = 53/43; age range: 9-18 years; BMI: 38.3 ± 6.9 kg/m2) was recruited. The BWRP significantly reduced BMI, FM (expressed as %), SCT time and FSS score, and increased OLSB time in all subgroups of obese subjects, independent of sex and metabolic syndrome, with preservation of FFM. No significant differences in |ΔBMI|, |ΔFM|, |ΔOLSB| or |ΔSCT| times and |ΔFSS| score were found when comparing subjects (males and females) with or without metabolic syndrome, apart from obese females without metabolic syndrome, who exhibited a lower weight loss and FM (expressed as %) reduction when compared to the corresponding male counterpart. In conclusion, the beneficial effects of a three-week BWRP on BMI, body composition, muscle performance and fatigue in a pediatric obese population were not found to be different in patients with or without metabolic syndrome, thus indicating that the more metabolically compromised patient is as responsive to a short-term BWRP as the patient without metabolic syndrome. More prolonged follow-up studies are, however, necessary in order to verify whether the adherence to the multidisciplinary recommendations at home and the long-term maintenance of the positive effects in the two subgroups of patients will remain similar or not.
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Affiliation(s)
| | - Gabriella Tringali
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo (VB), Italy; (G.T.); (R.D.M.); (A.D.C.); (S.T.); (A.S.)
| | - Roberta De Micheli
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo (VB), Italy; (G.T.); (R.D.M.); (A.D.C.); (S.T.); (A.S.)
| | - Alessandra De Col
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo (VB), Italy; (G.T.); (R.D.M.); (A.D.C.); (S.T.); (A.S.)
| | - Sofia Tamini
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo (VB), Italy; (G.T.); (R.D.M.); (A.D.C.); (S.T.); (A.S.)
| | - Antonella Saezza
- Division of Auxology and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo (VB), Italy;
| | - Silvano G. Cella
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy;
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo (VB), Italy; (G.T.); (R.D.M.); (A.D.C.); (S.T.); (A.S.)
- Division of Auxology and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo (VB), Italy;
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15
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Petrick JL, Jensen BW, Sørensen TI, Cook MB, Baker JL. Overweight Patterns Between Childhood and Early Adulthood and Esophageal and Gastric Cardia Adenocarcinoma Risk. Obesity (Silver Spring) 2019; 27:1520-1526. [PMID: 31380608 PMCID: PMC6707875 DOI: 10.1002/oby.22570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 05/23/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Esophageal adenocarcinoma (EA) and gastric cardia adenocarcinoma (GCA) are among the most rapidly increasing cancers in Western countries. Elevated BMI in adulthood is a known risk factor, but associations in early life are unclear. METHODS This study assessed weight change between childhood and early adulthood in relation to EA/GCA. Measured weights and heights during childhood (7-13 years) and early adulthood (17-26 years) were available for 64,695 young men from the Copenhagen School Health Records Register and the Danish Conscription Database. Individuals were categorized as having normal weight or overweight. Linkage with the Danish Cancer Registry identified 275 EA/GCA cases. Hazard ratios (HR) and 95% CI were estimated using Cox proportional hazards regression. RESULTS The risk of EA/GCA was 2.5 times higher in men who were first classified as having overweight at age 7 (HR = 2.49; 95% CI: 1.50-4.14) compared with men who were never classified as having overweight. Men who had persistent overweight at ages 7 and 13 and in early adulthood had an EA/GCA risk that was 3.2 times higher (HR = 3.18; 95% CI: 1.57-6.44). However, there was little evidence of increased EA/GCA risk for men with overweight during childhood and subsequent remittance by early adulthood. CONCLUSIONS Persistent overweight in early life is associated with increased EA/GCA risk, which declines if body weight is reduced.
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Affiliation(s)
- Jessica L. Petrick
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Britt Wang Jensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Thorkild I.A. Sørensen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael B. Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jennifer L. Baker
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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16
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Chetwynd EM, Stuebe AM, Rosenberg L, Troester MA, Palmer JR. Prepregnancy Diabetes and Breastfeeding Cessation Among Black Women in the United States. Breastfeed Med 2019; 14:249-255. [PMID: 30839228 PMCID: PMC6532327 DOI: 10.1089/bfm.2018.0074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: The incidence of diabetes is rising, and with it, the number of pregnancies affected by diabetes. U.S. black women have a disproportionately high prevalence of diabetes and lower rates of breastfeeding. Objective: The objective of this study was to quantify the relationship between diabetes before pregnancy and breastfeeding duration among black women in the United States. Materials and Methods: We analyzed women from the Black Women's Health Study (N = 59,000) to assess the relationship between prepregnancy diabetes and time to breastfeeding cessation occurring up to 24 months postdelivery using Kaplan-Meier survival curves, log rank tests, and Cox proportional hazards models. The study population included primiparous women with births between 1995 and 2009 (N = 3,404). Obesity, hypertension before pregnancy, and family history of diabetes were examined for effect modification. Results: Survival curves demonstrated a markedly reduced duration of breastfeeding in women who had been diagnosed with prepregnancy diabetes (p < 0.01). The hazard ratio for breastfeeding cessation for women with prepregnancy diabetes was 1.5 (95% confidence interval 1.1-2.0) compared with women without prepregnancy diabetes after control for age, body mass index (BMI) at age 18, prepregnancy BMI, other metabolic factors, demographics, and health behaviors. Conclusions: Our results suggest that prepregnancy diabetes is a strong predictor of curtailed breastfeeding duration, even after control for BMI. This underscores the need for targeted lactation support for diabetic women.
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Affiliation(s)
- Ellen M. Chetwynd
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina
| | - Alison M. Stuebe
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina
- Department of Maternal, Fetal Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Lynn Rosenberg
- Slone Epidemiology Center, Boston University, Boston, Massachusetts
| | - Melissa A. Troester
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Julie R. Palmer
- Slone Epidemiology Center, Boston University, Boston, Massachusetts
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17
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Wan N, Cai L, Tan W, Zhang T, Yang J, Chen Y. Associations of gestational weight gain with offspring thinness and obesity: by prepregnancy body mass index. Reprod Health 2018; 15:149. [PMID: 30180902 PMCID: PMC6123984 DOI: 10.1186/s12978-018-0585-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/14/2018] [Indexed: 12/11/2022] Open
Abstract
Background Previous studies indicated that excessive gestational weight gain (GWG) was positively associated with offspring obesity. Nevertheless, little is known about the effect of GWG on offspring thinness. This study aimed to assess the association of GWG with childhood weight status across the full range of weight status by prepregnancy body mass index (BMI). Methods We used data from a retrospective study of 33,828 Chinese children aged 6–18 years and their mothers. Children’s weight and height were objectively measured. Maternal GWG and other information were collected by using self-reported questionnaires. Multivariate linear regressions and logistic regressions were applied. Results Overall, the prevalence of thinness and overweight/obesity in children were 12.9 and 17.3% respectively (p < 0.05). Children’s BMI z-score was on average 0.021 higher for every 1-kg greater GWG. For mothers who were underweight or normal weight before pregnancy, excessive GWG was positively associated with offspring overweight/obesity [OR (95% CI): 1.51 (1.21, 1.90) and 1.30 (1.17, 1.45)], whereas inadequate GWG was associated with increased risk of offspring thinness [OR (95% CI): 1.24 (1.05, 1.46) and 1.17 (1.04, 1.32)]. Similar but non-significant associations were found in prepregnancy overweight mothers. Notably, there was a very high prevalence of child overweight/obesity (30.2%) in prepregnancy overweight subgroup regardless of GWG status. Conclusions Inadequate GWG was associated with an increased risk of offspring thinness, whereas excessive GWG was associated with an increased risk of offspring overweight and obesity among prepregnancy underweight and normal weight mothers only.
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Affiliation(s)
- Nianqing Wan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Weiqing Tan
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510000, China
| | - Ting Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Jiewen Yang
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510000, China.
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China.
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18
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Fallah Z, Feizi A, Hashemipour M, Kelishadi R. Effect of fermented camel milk on glucose metabolism, insulin resistance, and inflammatory biomarkers of adolescents with metabolic syndrome: A double-blind, randomized, crossover trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:32. [PMID: 29887900 PMCID: PMC5961288 DOI: 10.4103/jrms.jrms_1191_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 12/31/2017] [Accepted: 01/04/2018] [Indexed: 01/19/2023]
Abstract
Background: This study, for the first time, aimed to assess the effects of fermented camel milk (FCM) on glycemic and inflammatory parameters related to metabolic syndrome (MetS), an aggregation of cardiometabolic risk factors, in adolescents. Materials and Methods: In a double-blind, randomized crossover trial, overweight/obese adolescents (fulfilling MetS criteria, aged 11–18 years) were randomly assigned to receive FCM 250 cc per day for an 8-week period, a 4-week washout, and then diluted cow's yogurt (DCY) 250 cc/day for another 8-week period, or the reverse sequence. Fasting blood sugar (FBS), fasting insulin, insulin resistance by three equations, incretin hormone glucose-dependent insulinotropic peptide (GIP), and glucagon-like peptide-1 (GLP1) as well as inflammatory markers such as interleukin 6 (IL6) and tumor necrosis factor-alpha (TNF-α) were measured before and after each of the four periods. A 3-day food record and physical activity questionnaire were completed before each period. Statistical analyses were done using Minitab and SPSS software considering the significance level of 0.05. Results: Twenty-four participants with a mean (standard deviation) age of 13.77 (1.87) years (range: 10.45–16.25 years) (58% girls) completed the study. It resulted in nonsignificant mean reduction in IL6 (−18.28 pg/mL [95% confidence interval [CI]: −47.48; 10.90]; P = 0.20) and nonsignificant increase in glucose metabolizing hormones such as GIP (683.10 pg/mL [95% CI: −457.84; 1824.0]; P = 0.22) and GLP1 (6.98 pg/mL [95% CI: −66.61; 80.57]; P = 0.84) by FCM consumption in comparison to DCY. Nonsignificant decrease was observed in TNF-α in the first periods of the study. The changes of FBS, fasting insulin, and insulin resistance indices were not statistically significant as well. Conclusion: According to preliminary positive influences of FCM on inflammatory markers, and findings related to glucose metabolism, we suggest conducting further studies on its clinical impacts.
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Affiliation(s)
- Zahra Fallah
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahin Hashemipour
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Liu C, Chu C, Zhang J, Wu D, Xu D, Li P, Chen Y, Liu B, Pei L, Zhang L, Liu S, Qi T, Lou XY, Li L. IRX3 is a genetic modifier for birth weight, adolescent obesity and transaminase metabolism. Pediatr Obes 2018; 13:141-148. [PMID: 28316138 DOI: 10.1111/ijpo.12214] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/20/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVE IRX3 expression has been functionally associated in obesity-associated long-distance susceptibility loci, but the effect of the IRX3 genetic variants on human obesity and obesity-related metabolism remains uncertain. METHODS To determine the genetic role of IRX3, we conducted a molecular epidemiological analysis using three haplotype tagging single nucleotide polymorphisms (SNPs; rs8053360, rs3751723 and rs12445085) and one nonsynonymous SNP (rs1126960) at the IRX3 locus in 333 junior and senior high school students from a northeast Chinese population. RESULTS We identified significant associations between IRX3 SNPs and birth weight, body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST/ALT ratio. The rs8053360 CC and rs1126960 GG genotypes were associated with increased birth weight and BMI, especially in females. Individuals with the rs12445085 TT genotype had significantly higher levels of AST and ALT, whereas individuals with the rs1126960 GG genotype had a significantly lower AST/ALT ratio than did individuals with other genotypes. However, no significant relationships were found between any of the IRX3 SNPs and metabolic syndrome or diabetes. CONCLUSIONS IRX3 genetic variants associate with birth weight, BMI and AST/ALT-related transaminase metabolism, supporting the role of IRX3 as an obesity-associated susceptibility gene.
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Affiliation(s)
- C Liu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - C Chu
- Department of Applied Psychology, Humanities and Management Colleges, Guangdong Medical University, Guangdong, China
| | - J Zhang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - D Wu
- No. 2 Department of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - D Xu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - P Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Y Chen
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - B Liu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - L Pei
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - L Zhang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - S Liu
- Institute of Bioinformatics, Zhejiang University, Hangzhou, China
| | - T Qi
- Institute of Bioinformatics, Zhejiang University, Hangzhou, China
| | - X-Y Lou
- Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Arkansas Children's Research Institute, Little Rock, AR, USA
| | - L Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
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20
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Lim HH. Sleep duration independently influences metabolic body size phenotype in children and adolescents: a population-based study. Sleep Med 2018; 42:47-52. [DOI: 10.1016/j.sleep.2017.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/23/2017] [Accepted: 10/28/2017] [Indexed: 11/26/2022]
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21
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Associations between metabolic syndrome components and markers of inflammation in Welsh school children. Eur J Pediatr 2018; 177:409-417. [PMID: 29273941 PMCID: PMC5816764 DOI: 10.1007/s00431-017-3065-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 12/05/2017] [Indexed: 02/06/2023]
Abstract
UNLABELLED We investigated the multivariate dimensionality and strength of the relationship between metabolic syndrome (MetS) and inflammation in children. Caucasian school children (N = 229; 12-14 years) from Wales were tested on several health indicators including measures of body composition, inflammation, fasting glucose regulation, blood pressure, and lipids. The multivariate association between MetS and inflammation was investigated via canonical correlation analysis. Data were corrected for non-normality by log transformation, and sex-specific z-scores computed for variables where there was a significant sex difference. Structure r's were interpreted to determine the dimensions of MetS and inflammation responsible for significant canonical variates. The overall multivariate association between MetS and inflammation was significant (Wilks' Lambda = 0.54, p < 0.001). The relationship was explained primarily by the waist circumference dimension of MetS (CC = 0.87) and inflammatory markers of fibrinogen (CC = 0.52) and C-reactive protein (CC = 0.50). The pattern of results was similar regardless of whether variables were adjusted for sex differences. CONCLUSION Central adiposity is the strongest predictor of the inflammatory aspect of cardiovascular disease risk in Caucasian adolescents. Future research into MetS and cardiometabolic risk should consider multivariate statistical approaches, in order to identify the separate contributions of each dimension in interrelationships and to identify which dimensions are influenced by preventive interventions. What is Known: • Metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease (CVD) and type 2 diabetes. Markers of inflammation are also potential predictors of later development of CVD and type 2 diabetes. • The contribution of individual markers in interrelationships between MetS and inflammation is unknown. What is New: • We uniquely demonstrate that within a multivariate model, waist circumference is the primary link between MetS variables and markers of inflammation in children. • Waist circumference may therefore be a useful population-level screening tool to identify future risk of CVD.
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Sontichai W, Dejkhamron P, Pothacharoen P, Kongtaweelert P, Unachak K, Ukarapol N. Subtle inflammation: a possible mechanism of future cardiovascular risk in obese children. KOREAN JOURNAL OF PEDIATRICS 2017; 60:359-364. [PMID: 29234359 PMCID: PMC5725341 DOI: 10.3345/kjp.2017.60.11.359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/16/2017] [Accepted: 03/06/2017] [Indexed: 12/19/2022]
Abstract
Purpose The risk of cardiovascular disease (CVD) has been shown to be associated with systemic inflammation in obese adults with metabolic syndrome (MetS). The aims of this study were to evaluate the prevalence of MetS and its relation to inflammatory markers in obese Thai children. Methods A cross-sectional study was conducted. Children with history of endogenous obesity, chronic diseases, drug ingestion, and any acute illness within 2 weeks prior to enrollment were excluded. Their fasting blood glucose (FBG) levels, oral glucose tolerance tests, insulin, lipid profiles, and selected inflammatory markers, including interleukin-6, tumor necrosis factor-alpha, and high-sensitivity C-reactive protein (hs-CRP) levels, were tested. Results In this study, 58 obese Thai children (female, 20; male, 38) with a mean body mass index z score of 5.1±2.2 were enrolled. The prevalence of MetS and prediabetes was 31% and 17.2%, respectively. None of the children had diabetes. FBG levels, 2-hour glucose levels, and lipid profiles were not statistically different between those with and without MetS. However, obese children with MetS had higher insulin levels and homeostasis model assessment of insulin resistance values. Elevated hs-CRP levels were found in 69% of the cases, although it was not statistically different between the 2 groups. Conclusion We described a substantial prevalence of MetS in Thai obese children. Regardless of MetS status, two-thirds of the obese children had elevated hs-CRP level, indicating subtle ongoing inflammatory process. This chronic inflammation feasibly predisposes them to CVD in the future, even in children without MetS.
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Affiliation(s)
- Watchareewan Sontichai
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Prapai Dejkhamron
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Peraphan Pothacharoen
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Prachya Kongtaweelert
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kevalee Unachak
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nuthapong Ukarapol
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Jaruratanasirikul S, Thammaratchuchai S, Sriplung H. Trends of childhood diabetes in Southern Thailand: 20-year experience in a tertiary medical center. World J Pediatr 2017; 13:566-570. [PMID: 29058250 DOI: 10.1007/s12519-017-0049-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/18/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND The incidence and/or prevalence of both childhood diabetes and the percent of type 2 diabetes mellitus (T2DM) cases in children and young adolescents have been increasing worldwide. This study aimed to examine the 20-year trends of childhood diabetes in a single tertiary medical center in Southern Thailand. METHODS The medical records of pediatric diabetic patients, aged 0-15 years, diagnosed at Songklanagarind Hospital from 1995 to 2014 were retrospectively reviewed. RESULTS During the 20-year period, 156 children were diagnosed with DM: 99 (63.4%) with T1DM, 43 (27.6%) with T2DM, 2 (1.3%) with neonatal diabetes, and 12 (7.7%) with secondary diabetes. The estimated incidence of new patients with diabetes per 100 000 per year doubled from 0.12 in 1995-2000, to 0.24-0.28 in 2001-2004, and further increased to 0.39-0.48 in 2005-2012 and 0.59-0.64 in 2013-2014; and also the proportion of T2DM cases increased from 10%-15% during 1995-2003 to 25%-30% during 2004-2008, and 35%-40% during 2009-2014. At the time of diagnosis, the fasting plasma glucose and glycated hemoglobin levels were significantly greater in T1DM than T2DM patients while the lipid profiles were more abnormal in T2DM than T1DM patients. CONCLUSIONS The estimated incidences of both T1DM and T2DM in pediatric patients have increased markedly over the 20-year period, and also the percentage of T2DM cases, from 10%-15% in 1995 to 35%-40% in 2014.
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Affiliation(s)
- Somchit Jaruratanasirikul
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
| | - Sudarat Thammaratchuchai
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Hutcha Sriplung
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Pacheco LS, Blanco E, Burrows R, Reyes M, Lozoff B, Gahagan S. Early Onset Obesity and Risk of Metabolic Syndrome Among Chilean Adolescents. Prev Chronic Dis 2017; 14:E93. [PMID: 29023232 PMCID: PMC5645192 DOI: 10.5888/pcd14.170132] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Obesity and metabolic syndrome (MetS) indicators have increased globally among the pediatric population. MetS indicators in the young elevate their risk of cardiovascular disease and metabolic disorders later in life. This study examined early onset obesity as a risk factor for MetS risk in adolescence. METHODS A cohort of Chilean participants (N = 673) followed from infancy was assessed at age 5 years and in adolescence (mean age, 16.8 y). Adiposity was measured at both time points; blood pressure and fasting blood samples were assessed in adolescence only. Early onset obesity was defined as a World Health Organization z score of 2 standard deviations (SDs) or more for body mass index (BMI) at age 5 years. We used linear regression to examine the association between early onset obesity and adolescent MetS risk z score, adjusting for covariates. RESULTS Eighteen percent of participants had early onset obesity, and 50% of these remained obese in adolescence. Mean MetS risk z score in adolescence was significantly higher among those with early onset obesity than among those without (1.0; SD, 0.8 vs 0.2; SD, 0.8 [P < .001]). In the multivariable model, early onset obesity independently contributed to a higher MetS risk score in adolescence (β = 0.27, P < .001), controlling for obesity status at adolescence and sex, and explained 39% of the variance in MetS risk. CONCLUSION Early onset obesity as young as age 5 years relates to higher MetS risk.
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Affiliation(s)
- Lorena Sonia Pacheco
- University of California San Diego-San Diego State University Joint Doctoral Program in Public Health, La Jolla, California
| | - Estela Blanco
- Division of Child Development and Community Health, Department of Pediatrics, University of California, San Diego, California.,University of Chile Doctoral Program in Public Health, Santiago, Chile
| | - Raquel Burrows
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Marcela Reyes
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Betsy Lozoff
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan
| | - Sheila Gahagan
- Division of Child Development and Community Health, Department of Pediatrics, University of California, San Diego, California.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Pediatrics, University of California, San Diego, 9500 Gilman Dr, MC 0927, La Jolla, CA 92093-0927.
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Espitia-Bautista E, Velasco-Ramos M, Osnaya-Ramírez I, Ángeles-Castellanos M, Buijs RM, Escobar C. Social jet-lag potentiates obesity and metabolic syndrome when combined with cafeteria diet in rats. Metabolism 2017. [PMID: 28641787 DOI: 10.1016/j.metabol.2017.04.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND/OBJECTIVES Modern lifestyle promotes shifted sleep onset and shifted wake up time between weekdays and weekends, producing a condition termed "social-jet lag." Disrupted sleep promotes increased appetite for carbohydrate and fat-rich food, which in long term leads to overweight, obesity and metabolic syndrome. In order to mimic the human situation we produced an experimental model of social-jet lag (Sj-l). With this model, we explored the link between shifted sleep time with consumption of a cafeteria diet (CafD) and the development of obesity and metabolic syndrome. SUBJECTS/METHODS The first experiment was designed to create and confirm the model of Sj-l. Rats (n=8-10/group) were exposed to a shifted sleep time protocol achieved by placing the rats in slow rotating wheels from Monday to Friday during the first 4h of the light period, while on weekends they were left undisturbed. The second experiment (n=8-12/group) explored the combined effect of Sj-l with the opportunity to ingest CafD. All protocols lasted 12weeks. We evaluated the development of overweight and indicators of metabolic syndrome. The statistical significance for all variables was set at P<0.05. RESULTS Sj-l alone did not affect body weight gain but induced significant changes in cholesterol in metabolic variables representing a risk factor for metabolic syndrome. Daily restricted access to CafD in the day or night induced glucose intolerance and only CafD during the day led to overweight. Sj-l combined with CafD induced overconsumption of the diet, potentiated body weight gain (16%) and promoted 5 of the criteria for metabolic syndrome including high insulin and dislipidemia. CONCLUSION Present data provide an experimental model of social-jet lag that combined with overconsumption of CafD, and maximized the development of obesity and metabolic syndrome. Importantly, access to CafD during the night did not lead to overweight nor metabolic syndrome.
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Affiliation(s)
- Estefania Espitia-Bautista
- Facultad de Medicina, Departamento de Anatomía, Universidad Nacional Autónoma de México, México, DF 04510, Mexico
| | - Mario Velasco-Ramos
- Facultad de Medicina, Departamento de Anatomía, Universidad Nacional Autónoma de México, México, DF 04510, Mexico; Departamento de Biología Molecular, Instituto Nacional de Cardiología, 14080, México, DF, Mexico
| | - Iván Osnaya-Ramírez
- Facultad de Medicina, Departamento de Anatomía, Universidad Nacional Autónoma de México, México, DF 04510, Mexico
| | - Manuel Ángeles-Castellanos
- Facultad de Medicina, Departamento de Anatomía, Universidad Nacional Autónoma de México, México, DF 04510, Mexico
| | - Ruud M Buijs
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México, DF 04510, Mexico
| | - Carolina Escobar
- Facultad de Medicina, Departamento de Anatomía, Universidad Nacional Autónoma de México, México, DF 04510, Mexico.
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Teixeira FC, Pereira FEF, Pereira AF, Ribeiro BG. Metabolic syndrome's risk factors and its association with nutritional status in schoolchildren. Prev Med Rep 2017; 6:27-32. [PMID: 28239539 PMCID: PMC5318537 DOI: 10.1016/j.pmedr.2017.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/22/2017] [Accepted: 02/06/2017] [Indexed: 11/15/2022] Open
Abstract
The metabolic risk factors (RF) to the diagnosis of metabolic syndrome (MetS) have been evidenced at early ages, including children. The aim of the present study was to identify the prevalence of RF to the diagnosis of MetS and its association with nutritional status of schoolchildren from 6 to 10 years old. A cross-sectional study was carried out in 505 students of municipal schools in Macae, Brazil, conducted from 2013 to 2014. The RF evaluated were: blood pressure (mm Hg), triglycerides (mmol/L), HDL-cholesterol (mmol/L) fasting glucose (mmol/L) and waist circumference (cm). At least one RF was present in 61% (n = 308) of the sample. By nutritional status, there was higher prevalence of RF in overweight/obese schoolchildren compared to those with normal weight, except in the concentration of HDL-c. The prevalence of one, two and three RF (MetS) were 34.7% (n = 175), 21.0% (n = 106) and 5.3% (n = 27), respectively. Two RF were more present in overweight (28.2% 95%CI 19.0; 39.0) and obese (41.5% 95%CI 31.4; 52.1) compared to normal weight children (13.5% 95%CI 9.9; 17.8). Three or more RF were more frequent among obese (25.5% 95%CI 17.0; 35.5) in relation to overweight (2.4% 95%CI 0.2; 8.2) and normal weight children (0.3% 95%CI 0; 1.7). The data indicate high prevalence of RF and its relationship with the magnitude of body weight excess. Therefore, the identification and early treatment of these RF might minimize the risk of MetS and related diseases.
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Key Words
- 95%CI, 95% confidence interval
- Abdominal obesity
- BMI, body mass index
- BP, blood pressure
- CVD, cardiovascular disease
- Children
- DBP, diastolic blood pressure
- DM2, type 2 diabetes mellitus
- Dyslipidemia
- HAS, hypertension
- HDL-c, high density lipoprotein cholesterol concentration
- Hypertension
- IR, insulin resistance
- MetS, metabolic syndrome
- Metabolic syndrome
- RF, metabolic risk factors
- SBP, systolic blood pressure
- TG, triglycerides
- WC, waist circumference
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Affiliation(s)
- Fabiana Costa Teixeira
- Programa Pós Graduação em Nutrição, Instituto de Nutrição UFRJ, Laboratório Integrado de Pesquisa em Ciências do Esporte, UFRJ Campus Macaé, RJ,Brazil
| | - Flavia Erika Felix Pereira
- Programa Pós Graduação em Alimentação, Nutrição e Saúde, Universidade do Estado do Rio de Janeiro UERJ, RJ, Laboratório Integrado de Pesquisa em Ciências do Esporte, UFRJ Campus Macaé, RJ,Brazil
| | | | - Beatriz Gonçalves Ribeiro
- Prof. Curso de Nutrição, Laboratório Integrado de Pesquisa em Ciências do Esporte, UFRJ Campus Macaé, RJ, Brazil
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Drummond BK, Brosnan MG, Leichter JW. Management of periodontal health in children: pediatric dentistry and periodontology interface. Periodontol 2000 2017; 74:158-167. [DOI: 10.1111/prd.12195] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 12/11/2022]
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Perona JS. Membrane lipid alterations in the metabolic syndrome and the role of dietary oils. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2017; 1859:1690-1703. [PMID: 28428072 DOI: 10.1016/j.bbamem.2017.04.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/12/2017] [Accepted: 04/15/2017] [Indexed: 12/13/2022]
Abstract
The metabolic syndrome is a cluster of pathological conditions, including hypertension, hyperglycemia, hypertriglyceridemia, obesity and low HDL levels that is of great concern worldwide, as individuals with metabolic syndrome have an increased risk of type-2 diabetes and cardiovascular disease. Insulin resistance, the key feature of the metabolic syndrome, might be at the same time cause and consequence of impaired lipid composition in plasma membranes of insulin-sensitive tissues like liver, muscle and adipose tissue. Diet intervention has been proposed as a powerful tool to prevent the development of the metabolic syndrome, since healthy diets have been shown to have a protective role against the components of the metabolic syndrome. Particularly, dietary fatty acids are capable of modulating the deleterious effects of these conditions, among other mechanisms, by modifications of the lipid composition of the membranes in insulin-sensitive tissues. However, there is still scarce data based of high-level evidence on the effects of dietary oils on the effects of the metabolic syndrome and its components. This review summarizes the current knowledge on the effects of dietary oils on improving alterations of the components of the metabolic syndrome. It also examines their influence in the modulation of plasma membrane lipid composition and in the functionality of membrane proteins involved in insulin activity, like the insulin receptor, GLUT-4, CD36/FAT and ABCA-1, and their effect in the metabolism of glucose, fatty acids and cholesterol, and, in turn, the key features of the metabolic syndrome. This article is part of a Special Issue entitled: Membrane Lipid Therapy: Drugs Targeting Biomembranes edited by Pablo V. Escribá.
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Affiliation(s)
- Javier S Perona
- Bioactive Compunds, Nutrition and Health, Instituto de la Grasa-CSIC, Campus Universidad Pablo de Olavide, Ctra. Utrera km 1, Building 46, 41013 Seville, (Spain)
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29
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An update on the assessment and management of metabolic syndrome, a growing medical emergency in paediatric populations. Pharmacol Res 2017; 119:99-117. [PMID: 28111263 DOI: 10.1016/j.phrs.2017.01.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 01/19/2023]
Abstract
In the last decades the increasing rate of obesity in children and adolescents worldwide has led to the onset in paediatric age of metabolic syndrome, a disease commonly associated to adulthood. Central obesity, dyslipidaemia, hyperglycaemia, and hypertension are typical features of metabolic syndrome that seem to hesitate often in type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease, and many other clinical conditions. Thus preventing and curing metabolic syndrome in paediatric patients is becoming an urgent need for public health. While diagnostic criteria and therapy of metabolic syndrome in adults are very well defined, there is no consensus on the definition of metabolic syndrome in children and adolescents as well as on healing approaches. The aim of this review is to describe the recent advances on the pathogenesis and clinical outcomes of paediatric metabolic syndrome. We then detail the therapeutic strategies (i.e. dietary regimens, physical exercise, nutraceuticals, and medications) employed to manage the disease. Finally, we analyse the safety profile of the drugs used in children and adolescents by performing a retrospective review of paediatric adverse reactions reported in the FDA's Adverse Event Reporting System database.
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30
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Al-Daghri NM, Aljohani NJ, Al-Attas OS, Al-Saleh Y, Alnaami AM, Sabico S, Amer OE, Alharbi M, Kumar S, Alokail MS. Comparisons in childhood obesity and cardiometabolic risk factors among urban Saudi Arab adolescents in 2008 and 2013. Child Care Health Dev 2016; 42:652-7. [PMID: 27273258 DOI: 10.1111/cch.12361] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 05/05/2016] [Accepted: 05/07/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND We aimed to compare the prevalence of childhood obesity and other cardiometabolic risk factors from two independent cohorts (2008 and 2013) in Riyadh, Saudi Arabia. METHODS A total of 4549 adolescents aged 12-18 years [2454 boys, 2095 girls], taken from two independent cohorts, 5 years apart (2008 and 2013), were included. Anthropometrics were measured, and fasting blood samples were taken to ascertain glucose and lipid profile. RESULTS The overall prevalence of obesity was significantly higher in 2013 [15.3 (95% confidence interval 13.7-16.9)] than 2008 [12.6 (11.3-13.9)] (P = 0.012). Stratified by sex, the prevalence of obesity among boys was significantly higher in 2013 than 2008 [2008 = 12.0 (10.3-13.7) versus 2013 = 17.4 (15.1-19.7); P < 0.001]. The age groups 13 and 15 years had a significantly higher mean triglycerides in 2013 than 2008 (P-values 0.003 and <0.001, respectively) and lower mean HDL-cholesterol also in the 13 years old age group (P < 0.001). CONCLUSIONS The prevalence of childhood obesity in Saudi Arabia has increased in particular age groups (13-15 years) during a 5-year span. Special attention is warranted in these vulnerable age groups, particularly in boys, as cardiometabolic risk factors appear to worsen.
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Affiliation(s)
- N M Al-Daghri
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
| | - N J Aljohani
- Specialized Diabetes and Endocrine Center, College of Medicine, King Fahad Medical City and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - O S Al-Attas
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
| | - Y Al-Saleh
- Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia.,Faculty of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - A M Alnaami
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
| | - S Sabico
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
| | - O E Amer
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
| | - M Alharbi
- Diabetes Centers and Units Administration, Ministry of Health, Riyadh, Saudi Arabia
| | - S Kumar
- Division of Metabolic and Vascular Health, Clinical Sciences Research Institute, University Hospitals Coventry and Warwickshire Trust, Coventry, United Kingdom
| | - M S Alokail
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
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Barnes VA, Kristeller JL. Impact of Mindfulness-Based Eating Awareness on Diet and Exercise Habits in Adolescents. INTERNATIONAL JOURNAL OF COMPLEMENTARY & ALTERNATIVE MEDICINE 2016; 3:70. [PMID: 31633035 PMCID: PMC6800660 DOI: 10.15406/ijcam.2016.03.00070] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Childhood and adolescent overweight is one of the most important current public health concerns. There is an urgent need to initiate community-based prevention to support healthy eating and physical activity in children. Mindfulness-Based Eating Awareness Training (MB-EAT) is a 12-w eek manualized intervention developed by Kristeller et al. that uses focused meditation techniques to help obese individuals normalize eating behaviors, and improve exercise and dietary habits. OBJECTIVE To adapt the MB-EAT program to adolescents (MB-EAT-A) and assess the impact of the MB-EAT-A program implemented in a high school setting on self-reported assessment of eating and exercise habits and dietary intake of fat. METHODS 40 ninth grade adolescents (14 males; 35 African-Americans, 1 Caucasian, 4 Others; mean age 16.2±1.2 yrs; BMI=32.4±9.0, BMI range 19.1 to 58.4) from 6 high school health/physical education classes were randomly assigned to 12-weekly sessions of MB-EAT-A intervention (n=18) or health education control (CTL, n=22). Assessments of eating and exercise habits and dietary fat and caloric content were conducted at pre-test, post-test at 3 mo. immediately following intervention and follow-up, 3 months after intervention ended, with 85% retention at follow up. RESULTS At 6 mo. follow-up, the MB-EAT-A group increased days/week of moderate exercise >30 min/day (0.8 vs -0.7 days/week), and intense aerobic exercise >20 min/day (1.4 vs. -0.5 days/week, both ps<.05) compared to decreases in CTLs. At 6 mo. follow-up the MB-EAT-A group increased number of servings per week of low calorie foods (7.7 vs. -.05, p<.02), foods with no saturated fats (5.1 vs. -0.4, p<.10) and low in saturated fats (4.6 vs. -2.7, p<.02). At 6 mo. follow-up the MBEAT-A group increased number of foods with no fat (3.9 vs -0.3, p<.08) and low in fat (5.8 vs. -1.4, p<.02) compared to decreases in CTLs. Weight gains at follow-up (4.2 vs 6.2 lbs, MB-EAT-A vs CTL) did not differ significantly between the two conditions (p=.87). In a sub-sample of 29 African American adolescents, 58% reported, a binge eating problem with most being mild to moderate in severity. Excessively eating on a regular basis and thinking about trying to control eating urges were the most common features present. Binge eating severity did not significantly correlate with anxiety, depression, or self-esteem. CONCLUSION The MB-EAT-A program increased moderate and intense aerobic exercise and improved dietary habits in favor of low calorie and low fat foods in an overweight/obese adolescent sample. The MB-EAT-A program increased moderate and intense aerobic exercise and improved consumption of low calorie and low fat foods in overweight/obese adolescents. The study demonstrated feasibility of conducting the MB-EAT-A program in a high school setting, and good acceptability by the students. The successful implementation of MB-EAT-A points to the potential of school-based mindful eating programs as a means of addressing early onset of obesity in high-risk youth.
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Verduci E, Lassandro C, Giacchero R, Miniello VL, Banderali G, Radaelli G. Change in Metabolic Profile after 1-Year Nutritional-Behavioral Intervention in Obese Children. Nutrients 2015; 7:10089-99. [PMID: 26633492 PMCID: PMC4690072 DOI: 10.3390/nu7125520] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 11/20/2015] [Accepted: 11/25/2015] [Indexed: 02/06/2023] Open
Abstract
Research findings are inconsistent about improvement of specific cardio-metabolic variables after lifestyle intervention in obese children. The aim of this trial was to evaluate the effect of a 1-year intervention, based on normocaloric diet and physical activity, on body mass index (BMI), blood lipid profile, glucose metabolism and metabolic syndrome. Eighty-five obese children aged ≥6 years were analyzed. The BMI z-score was calculated. Fasting blood samples were analyzed for lipids, insulin and glucose. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated and insulin resistance was defined as HOMA-IR >3.16. HOMA-β%, quantitative insulin sensitivity check index and triglyceride glucose index were calculated. The metabolic syndrome was defined in accordance with the International Diabetes Federation criteria. At the end of intervention children showed a reduction (mean (95% CI)) in BMI z-score (-0.58 (-0.66; -0.50)), triglycerides (-0.35 (-0.45; -0.25) mmol/L) and triglyceride glucose index (-0.29 (-0.37; -0.21)), and an increase in HDL cholesterol (0.06 (0.01; 0.11) mmol/L). Prevalence of insulin resistance declined from 51.8% to 36.5% and prevalence of metabolic syndrome from 17.1% to 4.9%. Nutritional-behavioral interventions can improve the blood lipid profile and insulin sensitivity in obese children, and possibly provide benefits in terms of metabolic syndrome.
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Affiliation(s)
- Elvira Verduci
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, Milan 20142, Italy.
| | - Carlotta Lassandro
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, Milan 20142, Italy.
- Nutritional Sciences, University of Milano, Milan 20157, Italy.
| | - Roberta Giacchero
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, Milan 20142, Italy.
| | - Vito Leonardo Miniello
- Department of Pediatrics, Aldo Moro University of Bari, Giovanni XXIII Hospital, Bari 70126, Italy.
| | - Giuseppe Banderali
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, Milan 20142, Italy.
| | - Giovanni Radaelli
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, Milan 20142, Italy.
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Lassandro C, Banderali G, Radaelli G, Borghi E, Moretti F, Verduci E. Docosahexaenoic Acid Levels in Blood and Metabolic Syndrome in Obese Children: Is There a Link? Int J Mol Sci 2015; 16:19989-20000. [PMID: 26307979 PMCID: PMC4581336 DOI: 10.3390/ijms160819989] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 07/21/2015] [Accepted: 08/18/2015] [Indexed: 12/13/2022] Open
Abstract
Prevalence of metabolic syndrome is increasing in the pediatric population. Considering the different existing criteria to define metabolic syndrome, the use of the International Diabetes Federation (IDF) criteria has been suggested in children. Docosahexaenoic acid (DHA) has been associated with beneficial effects on health. The evidence about the relationship of DHA status in blood and components of the metabolic syndrome is unclear. This review discusses the possible association between DHA content in plasma and erythrocytes and components of the metabolic syndrome included in the IDF criteria (obesity, alteration of glucose metabolism, blood lipid profile, and blood pressure) and non-alcoholic fatty liver disease in obese children. The current evidence is inconsistent and no definitive conclusion can be drawn in the pediatric population. Well-designed longitudinal and powered trials need to clarify the possible association between blood DHA status and metabolic syndrome.
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Affiliation(s)
- Carlotta Lassandro
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
| | - Giuseppe Banderali
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
| | - Giovanni Radaelli
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
| | - Elisa Borghi
- Microbiology Unit, Department of Health Sciences, University of Milan, I-20142 Milan, Italy.
| | - Francesca Moretti
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
| | - Elvira Verduci
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, I-20142 Milan, Italy.
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