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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: 1] [Impact Index Per Article: 1.0] [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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Atwah A, Koshak E, Shalabi MS, Alsulami A, Alsaedi AS, Alharbi O, Almalki Z, Moamina A. Childhood Obesity May Be Linked to Feeding Habits and Screen Time. Cureus 2023; 15:e50933. [PMID: 38249252 PMCID: PMC10800011 DOI: 10.7759/cureus.50933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Background Childhood obesity is an alarming health problem. Early feeding habits and factors are among the etiological factors contributing to obesity. Objectives The objective of this study is to evaluate the correlation between breastfeeding, alongside other relevant factors, and their potential role as preventative measures against obesity. Methods A cross-sectional hospital-based study was conducted on children who attended a pediatric clinic. Demographic, clinical, and anthropometric measurements were taken from the hospital records. A questionnaire was completed by parents telephonically. Overweight was identified as a body mass index (BMI) of > 85-95% and obesity as a BMI of > 95%. Results A total of 101 children, with a mean age of 8.88 ± 4.01 (range one to 18) years, were involved, of whom 58.4% were boys. A high BMI (overweight or obese) was found in 30 (29.7%) children. The highest BMIs were among soft drink consumers [two children (66.7%) consumed daily and eight children (40%) consumed monthly], high birth weight in two children (40%), cow's milk formula feeding in eight children (38%), and weekly fast food consumption in 18 children (35%), none of these were statistically significant. Nevertheless, there was a significant association between mean electronic device usage and high (204.5 ± 164.76 hours) and normal BMI (147.61 ± 110.24 hours) (p-value < 0.05). Conclusion This small cross-sectional study shows that almost one-third of the included children were overweight or obese, which is comparable to what has been published in the literature. Moreover, there was a potential link between some factors and obesity, especially screen time, which may contribute to the controversial literature.
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Affiliation(s)
- Ali Atwah
- Pediatrics, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
| | - Emad Koshak
- Internal Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | | | | | - Ahmed S Alsaedi
- Medicine, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
| | - Osama Alharbi
- Pediatrics, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
| | - Ziyad Almalki
- Pediatrics, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
| | - Ahmed Moamina
- Pediatrics, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
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Lehnhard AR, Sehn AP, de Castro Silveira JF, Burns RD, Reuter CP, Franke SIR. Longitudinal relationship between screen time, cardiorespiratory fitness, and waist circumference of children and adolescents: a 3-year cohort study. BMC Pediatr 2023; 23:553. [PMID: 37925397 PMCID: PMC10625187 DOI: 10.1186/s12887-023-04378-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 10/20/2023] [Indexed: 11/06/2023] Open
Abstract
PURPOSE The aim of this study was to examine the interaction between screen time and cardiorespiratory fitness (CRF) in their longitudinal association with waist circumference (WC) during a follow-up of 3 years from childhood to adolescence. METHODS Observational 3-year longitudinal study with 401 students (224 females), seven to 15 years of age at baseline. The CRF was evaluated by estimating peak oxygen uptake (VO2peak) from an indirect field-based test and body mass index. Screen time was assessed using self-reported questionnaires. Moderation analyses were tested using a multiple linear regression model with adjustments for sex, age, puberty stage, and ethnicity. RESULTS A statistically significant interaction term was observed (B = -0.0003; 95% CI: -0.007; -0.0001). Since screen time was contextualized as the independent variable, the results show that relationship between screen time and WC varies across different CRF levels. CONCLUSION The findings suggest that higher CRF can attenuate the harmful association that increased sedentary behavior might have on abdominal adiposity.
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Affiliation(s)
- Aline Rosso Lehnhard
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Ana Paula Sehn
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | | | - Ryan Donald Burns
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, USA
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Silvia Isabel Rech Franke
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil.
- Health Promotion, University of Santa Cruz do Sul, Independência Av, 2293 - Universitário, Santa Cruz do Sul, RS, 96815-900, Brazil.
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Zhao D, Zhou J, Su D, Li Y, Sun W, Tan B, Li S, Zhang R, Song P. Combined associations of general obesity and central obesity with hypertension stages and phenotypes among children and adolescents in Zhejiang, China. J Clin Hypertens (Greenwich) 2023; 25:983-992. [PMID: 37787088 PMCID: PMC10631097 DOI: 10.1111/jch.14733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 10/04/2023]
Abstract
General and central obesity are suggested to be associated with elevated blood pressure (BP), whereas few studies have investigated their combined associations with hypertension in children. This study aimed to assess the associations of combinations of general obesity and central obesity with hypertension in Chinese children, including its stages and phenotypes. A total of 5430 children aged 7-17 years in Zhejiang Province were enrolled. General obesity was evaluated by body mass index (BMI), while central obesity was by waist circumference (WC). Then all children were sorted into three mutually exclusive groups: normal weight with or with no central obesity (NW), abnormal weight with no central obesity (AWNCO), and abnormal weight with central obesity (AWCO). Hypertension was defined as either a systolic or diastolic BP ≥ 95th percentile, and further classified into stage 1 hypertension, stage 2 hypertension, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic diastolic hypertension (SDH). Logistic regression was used. AWNCO and AWCO were associated with stage 1 hypertension (AWNCO, odds ratio [OR] = 1.94, 95% confidence interval [CI]: 1.59-2.37; AWCO, 2.67, 2.20-3.25), stage 2 hypertension (AWNCO, 2.35, 1.33-4.13; AWCO, 4.53, 2.79-7.37), ISH (AWNCO, 2.50, 1.96-3.18; AWCO, 3.95, 3.15-4.95), and SDH (AWNCO, 2.48, 1.75-3.52; AWCO, 2.78, 1.94-3.99). Children with AWCO were more likely to have stage 1 and stage 2 hypertension, as well as ISH and SDH. The combined measurement of general and central obesity is suggested as an appropriate screening tool for hypertension among children and adolescents.
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Affiliation(s)
- Dong Zhao
- Department of Nutrition and Food SafetyZhejiang Provincial Center for Disease Control and PreventionHangzhouZhejiangChina
| | - Jiali Zhou
- Department of Nutrition and Food SafetyZhejiang Provincial Center for Disease Control and PreventionHangzhouZhejiangChina
- School of Public HealthZhejiang University School of MedicineZhejiang UniversityHangzhouZhejiangChina
| | - Danting Su
- Department of Nutrition and Food SafetyZhejiang Provincial Center for Disease Control and PreventionHangzhouZhejiangChina
| | - Yun Li
- Division of Chronic Non‐communicable Disease and Health EducationPinghu Municipal Center for Disease Control and PreventionPinghuZhejiangChina
| | - Weidi Sun
- School of Public HealthZhejiang University School of MedicineZhejiang UniversityHangzhouZhejiangChina
| | - Boren Tan
- School of Public HealthZhejiang University School of MedicineZhejiang UniversityHangzhouZhejiangChina
| | - Shuting Li
- School of Public HealthZhejiang University School of MedicineZhejiang UniversityHangzhouZhejiangChina
| | - Ronghua Zhang
- Department of Nutrition and Food SafetyZhejiang Provincial Center for Disease Control and PreventionHangzhouZhejiangChina
| | - Peige Song
- School of Public HealthZhejiang University School of MedicineZhejiang UniversityHangzhouZhejiangChina
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Borka Balas R, Meliț LE, Lupu A, Lupu VV, Mărginean CO. Prebiotics, Probiotics, and Synbiotics-A Research Hotspot for Pediatric Obesity. Microorganisms 2023; 11:2651. [PMID: 38004665 PMCID: PMC10672778 DOI: 10.3390/microorganisms11112651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
Childhood obesity is a major public health problem worldwide with an increasing prevalence, associated not only with metabolic syndrome, insulin resistance, hypertension, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD), but also with psychosocial problems. Gut microbiota is a new factor in childhood obesity, which can modulate the blood lipopolysaccharide levels, the satiety, and fat distribution, and can ensure additional calories to the host. The aim of this review was to assess the differences and the impact of the gut microbial composition on several obesity-related complications such as metabolic syndrome, NAFLD, or insulin resistance. Early dysbiosis was proven to be associated with an increased predisposition to obesity. Depending on the predominant species, the gut microbiota might have either a positive or negative impact on the development of obesity. Prebiotics, probiotics, and synbiotics were suggested to have a positive effect on improving the gut microbiota and reducing cardio-metabolic risk factors. The results of clinical trials regarding probiotic, prebiotic, and synbiotic administration in children with metabolic syndrome, NAFLD, and insulin resistance are controversial. Some of them (Lactobacillus rhamnosus bv-77, Lactobacillus salivarius, and Bifidobacterium animalis) were proven to reduce the body mass index in obese children, and also improve the blood lipid content; others (Bifidobacterium bifidum, Bifidobacterium longum, Lactobacillus acidophilus, Lacticaseibacillus rhamnosus, Enterococcus faecium, and fructo-oligosaccharides) failed in proving any effect on lipid parameters and glucose metabolism. Further studies are necessary for understanding the mechanism of the gut microbiota in childhood obesity and for developing low-cost effective strategies for its management.
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Affiliation(s)
- Reka Borka Balas
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, Gheorghe Marinescu Street, No. 38, 540136 Târgu Mureș, Romania; (R.B.B.); (C.O.M.)
| | - Lorena Elena Meliț
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, Gheorghe Marinescu Street, No. 38, 540136 Târgu Mureș, Romania; (R.B.B.); (C.O.M.)
| | - Ancuța Lupu
- Department of Pediatrics, University of Medicine and Pharmacy Gr. T. Popa Iași, Universității Street No 16, 700115 Iași, Romania; (A.L.); (V.V.L.)
| | - Vasile Valeriu Lupu
- Department of Pediatrics, University of Medicine and Pharmacy Gr. T. Popa Iași, Universității Street No 16, 700115 Iași, Romania; (A.L.); (V.V.L.)
| | - Cristina Oana Mărginean
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, Gheorghe Marinescu Street, No. 38, 540136 Târgu Mureș, Romania; (R.B.B.); (C.O.M.)
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Soltero EG, Lopez C, Musaad SM, O'Connor TM, Thompson D. Fit24, a digital health intervention to reduce type 2 diabetes risk among Hispanic youth: Protocol for a feasibility pilot study. Contemp Clin Trials 2023; 127:107117. [PMID: 36775009 PMCID: PMC10065958 DOI: 10.1016/j.cct.2023.107117] [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: 11/02/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Poor physical activity (PA) and sleep behaviors in Hispanic adolescents contributes to increased risk for type 2 diabetes. Commonly owned digital devices and services like smartphones and text-messaging are highly used among adolescents and are promising intervention tools for reaching this age group. Personal activity trackers assess activity and sleep, making them ideal tools for addressing these behaviors. We propose to examine the feasibility of a 12-week intervention that uses theoretically grounded text messages and a Fitbit device to improve PA and sleep among Hispanic adolescents with obesity, as compared to a wait-list control group with a Fitbit device only. METHODS Participants (N = 48; 14-16 years) will be randomized (1:1) to the intervention or wait-list control group. Youth in the intervention will receive a Fitbit Charge 5 and daily text messages. Youth in the wait-list control group will receive a Fitbit Charge 5 and information on PA and sleep guidelines. RESULTS Feasibility will be examined by collecting process evaluation data on the following criteria: (1) recruit 48 Hispanic adolescents 14-16 years; (2) retain 85% of participants for post-assessments; (3) Fitbit wear ≥4 days/week and respond to 80% of text messages when prompted; (4) ≤10% technical issues; and (5) obtain 80% satisfaction from participants. DISCUSSION This study will advance our knowledge on the feasibility of digital prevention strategies to promote PA and sleep behaviors to reduce T2D risk among Hispanic youth. If feasible, this approach has the potential to be a scalable, cost-effective diabetes prevention strategy among high-risk youth. TRIAL REGISTRATION NCT04953442, registered on July 8, 2021.
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Affiliation(s)
- Erica G Soltero
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
| | - Callie Lopez
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Salma M Musaad
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
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Childhood Obesity and the Cryptic Language of the Microbiota: Metabolomics’ Upgrading. Metabolites 2023; 13:metabo13030414. [PMID: 36984854 PMCID: PMC10052538 DOI: 10.3390/metabo13030414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023] Open
Abstract
The growing obesity epidemic in childhood is increasingly concerning for the related physical and psychological consequences, with a significant impact on health care costs in both the short and the long term. Nonetheless, the scientific community has not yet completely clarified the complex metabolic mechanisms underlying body weight alterations. In only a small percentage of cases, obesity is the result of endocrine, monogenic, or syndromic causes, while in much more cases, lifestyle plays a crucial role in obesity development. In this context, the pediatric age appears to be of considerable importance as prevention strategies together with early intervention can represent important therapeutic tools not only to counteract the comorbidities that increasingly affect children but also to hinder the persistence of obesity in adulthood. Although evidence in the literature supporting the alteration of the microbiota as a critical factor in the etiology of obesity is abundant, it is not yet fully defined and understood. However, increasingly clear evidence is emerging regarding the existence of differentiated metabolic profiles in obese children, with characteristic metabolites. The identification of specific pathology-related biomarkers and the elucidation of the altered metabolic pathways would therefore be desirable in order to clarify aspects that are still poorly understood, such as the consequences of the interaction between the host, the diet, and the microbiota. In fact, metabolomics can characterize the biological behavior of a specific individual in response to external stimuli, offering not only an eventual effective screening and prevention strategy but also the possibility of evaluating adherence and response to dietary intervention.
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Miller J. Genetic Obesity-Causes and Treatments. Pediatr Ann 2023; 52:e57-e61. [PMID: 36779883 DOI: 10.3928/19382359-20230102-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Genetic abnormalities are responsible for up to 70% of severe, early onset obesity. With recent advances in genetic testing, more individuals with genetic etiology of excessive weight are being identified. However, treatment will need to be individualized based on the cause and underlying pathophysiology. Several treatment options are being investigated, and there are several treatment options now commercially available for some of these genetic conditions. [Pediatr Ann. 2023;52(2):e57-e61.].
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Sanz-Martín D, Zurita-Ortega F, Ruiz-Tendero G, Ubago-Jiménez JL. Moderate-Vigorous Physical Activity, Screen Time and Sleep Time Profiles: A Cluster Analysis in Spanish Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2004. [PMID: 36767372 PMCID: PMC9915036 DOI: 10.3390/ijerph20032004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
The study had two aims: (1) To classify the adolescents according to their levels of moderate-vigorous physical activity, screen time and sleep time, and (2) to analyze, in a descriptive and correlational manner, the profiles of moderate-vigorous physical activity, screen time and sleep time of each cluster according to the sex and grade of the adolescents. The study design was cross-sectional, with descriptive and correlational analysis. The sample consisted of 663 adolescents in Compulsory Secondary Education from Soria (Spain). The Four by One-Day Physical Activity Questionnaire was used to measure levels of physical activity, screen time and sleep time. The results showed that the young people had an average of 67.99 ± min/day of moderate-vigorous physical activity, 112.56 min/day of screen time and 548.63 min/day of sleep time. Adolescents were classified into three clusters according to their levels of physical activity, screen time and sleep time (FMANOVA (6,1318) = 314.439; p ≤ 0.001; β = 1; f = 1.177). In conclusion, only 28.21% of the young people accomplished the recommendations for physical activity practice, screen time and sleep time. Moreover, these results vary according to the sex and grade of the adolescents.
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Affiliation(s)
- Daniel Sanz-Martín
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Humanities and Educational Sciences, University of Jaén, 23071 Jaén, Spain
| | - Félix Zurita-Ortega
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain
| | - Germán Ruiz-Tendero
- Department of Languages, Arts and Physical Education Teaching, Faculty of Education, Complutense University of Madrid, 28040 Madrid, Spain
| | - José Luis Ubago-Jiménez
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain
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Wang Y, Zhang L, Wu L, Cao R, Peng X, Fu L. An Association Between FNDC5, PGC-1α Genetic Variants and Obesity in Chinese Children: A Case-Control Study. Diabetes Metab Syndr Obes 2023; 16:47-59. [PMID: 36760581 PMCID: PMC9843619 DOI: 10.2147/dmso.s391219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/15/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Fibronectin type III domain containing protein 5 (FNDC5) gene encodes irisin that regulates adipose tissue metabolism. Peroxide-proliferator-activated receptor γ coactivator 1α (PGC-1α) is a powerful promoter of mitochondrial biosynthesis and oxidative metabolism, which plays an important role in inducing heat production and energy consumption of brown fat. PGC1-α expression stimulated an increase in expression of FNDC5. PURPOSE The aims of this study were to analyze the association between FNDC5, PGC-1α genetic variants and overweight or obesity in Chinese children and adolescents. METHODS A total of 198 children and adolescents with overweight or obesity and 198 children and adolescents with normal weight were screened according to gender and age 1:1. The healthy eating behaviors, moderate-to-vigorous physical activity time were surveyed using food frequency questionnaire and CLASS questionnaire, respectively. Genotypes of FNDC5 and PGC-1α gene were detected using SNaPshot method. RESULTS GT genotype of FNDC5 (rs16835198) increased the risk of overweight or obesity in boys (OR (95% CI): 1.68 (1.00, 2.93)) based on overdominant model; GG genotype of FNDC5 (rs16835198) decreased the risk of overweight or obesity in girls and boys (OR (95% CI): 0.45 (0.21,0.97), 0.45 (0.24, 0.83), respectively) based on dominant model; TT genotype of FNDC5 (rs16835198) increased the risk of overweight or obesity in girls based on recessive model (OR (95% CI): 2.46 (1.19, 5.05)), and based on the additive model (OR (95% CI): 3.82 (1.49, 9.80)). There was significant interaction between FNDC5 (rs16835198) and PGC-1α (rs3755863, rs8192678), healthy eating behaviors, moderate-to-vigorous physical activity time, interaction between PGC-1α (rs8192678) and moderate-to-vigorous physical activity time in the occurrence of overweight or obesity in Chinese children and adolescents. CONCLUSION FNDC5 (rs16835198) played an independent or interactive role with PGC-1α (rs3755863, rs8192678), healthy eating behaviors, moderate-to-vigorous physical activity time in the occurrence of overweight or obesity in Chinese children and adolescents.
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Affiliation(s)
- Yuanyuan Wang
- Department of Children and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, People’s Republic of China
| | - Li Zhang
- Department of Children and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, People’s Republic of China
| | - Lu Wu
- Graduate School of Wannan Medical College, Wuhu, People’s Republic of China
| | - Ruiyao Cao
- Department of Children and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, People’s Republic of China
| | - Xingwang Peng
- Department of Children and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, People’s Republic of China
| | - Lianguo Fu
- Department of Children and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, People’s Republic of China
- Correspondence: Lianguo Fu, Department of Children and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, 233000, People’s Republic of China, Tel +8613195529639, Fax +86-5523175215, Email
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Methodological aspects and characteristics of participants in the study on the prevalence of obesity in children and adolescents in Florianópolis, Southern Brazil, 2018-2019: EPOCA study. Ann Epidemiol 2023; 77:13-23. [PMID: 36343894 DOI: 10.1016/j.annepidem.2022.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To describe the methodological aspects and characteristics of the participants of the EPOCA survey. METHODS The study was conducted with schoolchildren aged between seven to 14 years old from 30 schools in Florianópolis, Southern Brazil. Body mass, height, girths, and skinfold thicknesses were measured. Food consumption and physical activity from the previous day were self-reported using the validated Web-CAAFE questionnaire. Adolescents completed a specific questionnaire about physical activity, meal consumption, and weight control behaviors. Parents/guardians responded to a sociodemographic and habits questionnaire. RESULTS A total of 1671 schoolchildren participated in the study (response rate: 27.2%). About 63% of schoolchildren were enrolled in public schools. Most studied in the morning shift (54.2%), were female (53.1%) and aged between seven and 10 years (58.1%). The prevalence of overweight was 33.7% and obesity was 11.3%. CONCLUSIONS The data obtained will allow us to assess the trend in the prevalence of overweight and obesity and associated factors when compared to other surveys performed. Descriptions of the logistics and protocols can help in the development and improvement of similar studies. It is hoped that the results of EPOCA 2018/2019 may help in the design of obesity prevention policies and programs for this population.
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Changes in Nutritional State and Cardiovascular Parameters in Alimentary Obese Children after a Month-Long Stay in Children's Treatment Center. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111610. [PMID: 36360338 PMCID: PMC9688163 DOI: 10.3390/children9111610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Childhood and adolescent obesity has become an important public health issue, as it leads to higher risk of cardio−metabolic, orthopedic, and psychological comorbidities. The aim of this study was to evaluate the changes in nutritional state and cardiovascular system parameters in obese children. Sixty respondents aged 9−17 years with alimentary obesity participated in this research. Anthropometric parameters (body weight (BWT), body mass index (BMI), percentage of body fat (%), waist and hip circumference (WC and HC), waist−hip ratio (WHR)) and cardiovascular parameters (systolic and diastolic blood pressure (SP and DP), cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), pulse wave velocity and its variability (PWV and PWVV), and parameters of pulse wave analysis) were measured. Every respondent went through two sets of measurements, the first (I.) after their admission to the children’s hospital and the second (II.) at the end of their one-month-long therapeutic stay. Statistically significant differences between measurements I. and II. were observed in the following parameters: BWT (p < 0.01), BMI (p < 0.01), WC (p < 0.01), HC (p < 0.01), DP (p < 0.01), PWV (p < 0.05), and ABI (p < 0.01). The results of this study show that obesity has a mostly negative impact on the cardiovascular health of affected children, with likely negative results in their adulthood.
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Turkay E, Kabaran S. Neck circumference cut-off points for detecting overweight and obesity among school children in Northern Cyprus. BMC Pediatr 2022; 22:594. [PMID: 36229791 PMCID: PMC9563478 DOI: 10.1186/s12887-022-03644-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 09/16/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Neck circumference is one of the anthropometric parameters that is widely used in practical applications, clinical and epidemiological studies in children. It is aimed to determine the neck circumference cut-off points and to use them in the detection of overweight and obesity in children living in Northern Cyprus. SUBJECTS This cross-sectional study was conducted between October 2019 and January 2020, and covered a sample of 692 children (367 girls and 325 boys) aged 6-10 years attending primary schools in the Northern Cyprus. METHODS Body weight, height, neck circumference, waist circumference, subscapular and triceps skinfold tickness were measured. BF% was calculated with Slaughter equations. World Health Organization BMI cut-off points for age and gender percentiles were used to categorize obesity. BMI, WHtR, NC, body fat were calculated. The Pearson Correlation co-efficient between NC and the other anhtropometric measurements were calculated. Receiver operating characteristics analysis, sensitivity, specificity, PV + ve PV- was used to determine the optimal NC cut-off points for identifying children with overweight and obesity. RESULTS NC was a statistically significant positive and strong relationship with body weight, BMI, waist circumference and hip circumference (p < 0,005). NC cut-off values to define overweight and obesity were calculated as 26,9 cm in girls (AUC: 0,851, 95% CI: 0,811-0,891, sensitivity 70,50%, specificity 84,65%) and 27,9 cm in boys (AUC: 0,847, 95% CI: 0,805-0,888, sensitivity 76,4%, specificity 79,3%). The ROC curves accurately define overweight and obesity of the whole cohort regardless of age for both sexes of children. CONCLUSIONS The cut-off points for neck circumference were found to be 27,9 cm for boys and 26,9 cm for girls in determining overweight and obesity in children aged 6-10 years. The NC cut-off points obtained in this study can be used to define overweight and obesity in children in epidemiological studies. It is considered to shed light on studies that will examine the relationship between neck circumference and diseases with more people in future studies.
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Affiliation(s)
- Ezgi Turkay
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Eastern Mediterranean University, T.R. North Cyprus via Mersin 10, Famagusta, Turkey.
| | - Seray Kabaran
- grid.461270.60000 0004 0595 6570Department of Nutrition and Dietetics, Faculty of Health Sciences, Eastern Mediterranean University, T.R. North Cyprus via Mersin 10, Famagusta, Turkey
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Moddemann MK, Kieslich M, Koenig R. Intrafamilial variability in six family members with ERF-related craniosynostosis syndrome type 4. Am J Med Genet A 2022; 188:2969-2975. [PMID: 35852485 DOI: 10.1002/ajmg.a.62900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 01/31/2023]
Abstract
ERF-related craniosynostosis syndrome type 4 (CRS4, OMIM #600775) is a rare autosomal dominant malformation syndrome, caused by pathogenic variants in the ERF gene and characterized by craniosynostosis, developmental delay, and dysmorphic features such as hypertelorism, exophthalmos, depressed nasal bridge, and retrognathia. So far, there are mostly individual reports and only a few descriptions of families with more than two affected patients, allowing statements about the penetrance of a certain variant and its variability only to a limited extent. In this study, we report an in-depth analysis of the clinical course of six family members from three generations with the novel heterozygous nonsense variant c.286A>T (p.Lys96*) in the ERF gene. At the time of examination, all of the six patients showed mild dysmorphic features and brachydactyly, five were overweight/obese and had delayed speech development, and four were short in stature. Hyperactivity, a short concentration span and a history of learning difficulties were found in half of the affected family members. To this day, none of the patients developed increased intracranial hypertension that would require surgical intervention. This work provides further information on the expressive variability of an ERF variant in six members of one family and focuses on the need for close neuropediatric surveillance.
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Affiliation(s)
- Marina K Moddemann
- Department of Human Genetics, Bioscientia Institute for Medical Diagnostics, Ingelheim, Germany
| | - Matthias Kieslich
- Division of Neurology, Neurometabolics and Prevention, Department of Pediatrics, Faculty of Medicine, University of Frankfurt, Frankfurt am Main, Germany
| | - Rainer Koenig
- Department of Human Genetics, Bioscientia Institute for Medical Diagnostics, Ingelheim, Germany
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Sanz-Martín D, Melguizo-Ibáñez E, Ruiz-Tendero G, Zurita-Ortega F, Ubago-Jiménez JL. Physical Activity, Energy Expenditure, Screen Time and Social Support in Spanish Adolescents-Towards an Explanatory Model about Health Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10222. [PMID: 36011855 PMCID: PMC9408611 DOI: 10.3390/ijerph191610222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Youth obesity has been a pandemic for decades. One of its causes is a low level of physical activity. It is necessary to know the specific situation of adolescents and the factors that influence it in order to be able to act accordingly. The first aim of the current study is to create an explanatory model to establish the relationships between light physical activity time, light physical activity energy expenditure, screen time and social support. The second aim is to propose a theoretical model specifying the relationships between moderate-vigorous physical activity time, moderate-vigorous physical activity energy expenditure, screen time and social support. The study design was non-experimental (ex post facto), descriptive-correlational and cross-sectional. A total of 694 adolescents from the region of Soria (12-17 years) participated in the study. The instruments administered were the Four by One-Day Physical Activity Questionnaire, Parent Support Scale and Peer Support Scale. Two structural equation models were developed to analyse the relationships between the variables that comprised the explanatory models. The results show that social support had a negative influence on screen time in the proposed model in relation to light physical activity (r = -0.210; p ≤ 0.001) and in the proposed one regarding moderate-vigorous physical activity (r = -0.173; p ≤ 0.05). Social support was negatively related to light physical activity time (r = -0.167; p ≤ 0.05). Family support had a greater influence than did peer support. In conclusion, the models for light and moderate-vigorous physical activity are useful to describe the relationships between time, energy expenditure, screen time and social support.
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Affiliation(s)
- Daniel Sanz-Martín
- Faculty of Humanities and Social Sciences, Isabel I University, 09003 Burgos, Spain
| | - Eduardo Melguizo-Ibáñez
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain
| | - Germán Ruiz-Tendero
- Department of Languages, Arts and Physical Education Teaching, Faculty of Education, Complutense University of Madrid, 28040 Madrid, Spain
| | - Félix Zurita-Ortega
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain
| | - José Luis Ubago-Jiménez
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain
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Shi M, Chen W, Sun X, Bazzano LA, He J, Razavi AC, Li C, Qi L, Khera AV, Kelly TN. Association of Genome-Wide Polygenic Risk Score for Body Mass Index With Cardiometabolic Health From Childhood Through Midlife. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2022; 15:e003375. [PMID: 35675159 DOI: 10.1161/circgen.121.003375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Genetic information may help to identify individuals in childhood who are at increased risk for cardiometabolic disease. METHODS We included 1201 BHS (Bogalusa Heart Study) participants (832 White participants and 369 Black participants) who were followed up to 42.3 years, starting at a mean age of 9.8 years. A validated genome-wide polygenic risk score (PRS) was tested for association with midlife body mass index (BMI), fasting plasma glucose, and systolic blood pressure using multiple linear regression models. Cox proportional hazards models tested associations of the PRS with incident obesity, diabetes, and hypertension. All analyses were conducted according to race and adjusted for baseline age, sex, ancestry, and BMI. RESULTS The constructed PRS was significantly and modestly correlated with midlife BMI in both White and Black participants, with correlation coefficients of 0.27 (P=1.94×10-8) and 0.16 (P=5.50×10-3), respectively. In White participants, per SD increase of PRS was associated with an average 1.29 kg/m2 higher BMI (P=4.44×10-9), 2.82 mg/dL higher fasting plasma glucose (P=1.17×10-3), and 1.09 mm Hg higher systolic blood pressure (P=3.57×10-2) at midlife. The PRS also conferred a 26% higher increased risk of obesity (P=3.50×10-6) in White participants. In addition, the variance in midlife BMI explained increased from 0.1973 to 0.2293 when PRS was added to the model including age, sex, principal components, and baseline BMI (P<0.0001). No associations were observed in Black participants. CONCLUSIONS Adiposity-related genetic information independently predicted cardiometabolic health in White BHS participants. Null associations observed in Black BHS participants highlight the urgent need for PRS development in multi-ancestry populations.
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Affiliation(s)
- Mengyao Shi
- Department of Epidemiology, School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University, Suzhou, China (M.S.)
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (M.S., W.C., X.S., L.A.B., J.H., A.C.R., C.L., L.Q., T.N.K.)
| | - Wei Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (M.S., W.C., X.S., L.A.B., J.H., A.C.R., C.L., L.Q., T.N.K.)
| | - Xiao Sun
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (M.S., W.C., X.S., L.A.B., J.H., A.C.R., C.L., L.Q., T.N.K.)
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (M.S., W.C., X.S., L.A.B., J.H., A.C.R., C.L., L.Q., T.N.K.)
| | - Jiang He
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.H., A.C.R.)
| | - Alexander C Razavi
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (M.S., W.C., X.S., L.A.B., J.H., A.C.R., C.L., L.Q., T.N.K.)
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.H., A.C.R.)
| | - Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (M.S., W.C., X.S., L.A.B., J.H., A.C.R., C.L., L.Q., T.N.K.)
| | - Lu Qi
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (M.S., W.C., X.S., L.A.B., J.H., A.C.R., C.L., L.Q., T.N.K.)
| | - Amit V Khera
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA (A.V.K.)
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA (A.V.K.)
| | - Tanika N Kelly
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (M.S., W.C., X.S., L.A.B., J.H., A.C.R., C.L., L.Q., T.N.K.)
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Kilic Yildirim G, Dinleyici M, Vandenplas Y, Dinleyici EC. Effects of Multispecies Synbiotic Supplementation on Anthropometric Measurements, Glucose and Lipid Parameters in Children With Exogenous Obesity: A Randomized, Double Blind, Placebo-Controlled Clinical Trial (Probesity-2 Trial). Front Nutr 2022; 9:898037. [PMID: 35845797 PMCID: PMC9286749 DOI: 10.3389/fnut.2022.898037] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022] Open
Abstract
Studies on the effects of synbiotics on obesity in children are limited. The objective of this randomized double-blind placebo-controlled trial was to test the effects of a multispecies synbiotic during 12 weeks on anthropometric measurements, glucose metabolism and lipid parameters in 61 children with exogenous obesity. All children were treated with a standard diet and increased physical activity and received once daily a synbiotic supplement (probiotic mixture including Lactobacillus acidophilus, Lacticaseibacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium longum, Enterococcus faecium and fructo-oligosaccharides) or daily placebo for 12 weeks. At baseline, no statistically significant differences existed in anthropometric measurements, glucose and lipid parameters between both groups. We observed changes for anthropometric measures (% reduction comparing to baseline) in both synbiotic and placebo groups. After 12 weeks; changes (% reduction comparing to baseline) in weight (p < 0.01), BMI (p < 0.05), waist circumference (p < 0.05) and waist circumference to height ratio (p < 0.05) were significantly higher in the children receiving the synbiotic supplement. There is no difference in glucose metabolism, lipid parameters, presence of non-alcoholic fatty liver disease between both groups after 12 weeks. The daily intake of a multispecies synbiotic in addition to diet and increased physical activity did improve anthropometric measurements: body weight, BMI, waist circumference and waist/height ratio. The supplementation of this synbiotic is an efficient weight-loss strategy above diet and exercise in pediatric obesity (Trial identifier: NCT05162209).
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Affiliation(s)
- Gonca Kilic Yildirim
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
- Pediatrics Nutrition and Metabolism Unit, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Meltem Dinleyici
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
- Department of Social Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Yvan Vandenplas
- UZ Brussel, KidZ Health Castle, Vrije Unversiteit Brussel, Brussels, Belgium
| | - Ener Cagri Dinleyici
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
- *Correspondence: Ener Cagri Dinleyici
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PRATES CB, PASSOS MAZ, MASQUIO DCL. Parental feeding practices and ultra-processed food consumption in preschool children. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e210269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
ABSTRACT: Objective: To investigate the association between parental feeding practices and the consumption of ultra-processed foods in preschool children. Methods: Cross-sectional study with 140 parents (father and mother) and their children (2-6 year-old). Parental feeding practices were assessed using the Comprehensive Feeding Practices Questionnaire. Children’s body weight and height were measured, and body mass index z-score per age was calculated. Parental anthropometric measurements (body weight and height) were obtained by self-report, and body mass index was calculated. The consumption of ultra-processed foods was assessed through the Child Food Frequency Questionnaire and the daily intake score was calculated. Multivariable linear regression analyses were performed to investigate the association between parental feeding practices and the consumption of ultra-processed foods. Results: Children’s ultra-processed food consumption was negatively associated with the “Monitoring” parental feeding practices. On the other hand, “Emotion Regulation” and “Health restriction” parental feeding practices were positively associated with the ultra-processed food consumption score. Conclusion: Ultra-processed food consumption was associated to the “Monitoring”, “Emotion regulation” and “Health restriction” parental feeding practices in preschool children. These results support the importance of using successful parental feeding practices to promote healthy eating in preschoolers.
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Shehzad MA, Khurram H, Iqbal Z, Parveen M, Shabbir MN. Nutritional status and growth centiles using anthropometric measures of school-aged children and adolescents from Multan district. Arch Pediatr 2021; 29:133-139. [PMID: 34955308 DOI: 10.1016/j.arcped.2021.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/21/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Nutritional status among children and adolescents is assessed using growth rates. The aim of this study was to assess age- and gender-specific height, weight, and body mass index (BMI) centiles among children and adolescents relative to World Health Organization (WHO) references. METHODS A sample of 1040 school-aged children and adolescents aged 3-18 years from Multan District in Pakistan were selected for the study between January and March 2020. Multistage stratified random sampling was used for sample selection. Centile curves of height, weight, and BMI for age and gender were obtained using the lambda-mu-sigma (LMS) method, and results were compared with WHO 2007 references. RESULTS For boys and girls, the average height was 137.37 ± 8.24 and 135.62 ± 9.64 cm, average weight was 36.32 ± 6.84 and 35.21 ± 7.27 kg, and average BMI was 18.44 ± 2.67 and 18.36 ± 2.91, respectively. The height centiles of boys were higher than the WHO reference, and during the prepubertal period (age 8 years or older) the centiles were lower than the WHO reference. The height centiles of girls were higher than the WHO reference, and during the pubertal period (age 10 years or older) the centiles were lower than the WHO reference. The gender-wise BMI centiles were higher compared to the WHO reference. CONCLUSION The prevalence of thinness, overweight, and obesity in boys and girls was significantly higher than the WHO reference. The results of this study on centiles are up-to-date and will be used as a standard for comparison.
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Affiliation(s)
| | - Haris Khurram
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan; Department of Sciences and Humanities, National University of Computer and Emerging Sciences, Chiniot-Faisalabad Campus, Chiniot, Pakistan.
| | - Zafer Iqbal
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | - Maqsooda Parveen
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
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Koch VH. Obesity Facts and Their Influence on Renal Function Across the Life Span. Front Med (Lausanne) 2021; 8:704409. [PMID: 34869407 PMCID: PMC8632716 DOI: 10.3389/fmed.2021.704409] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity is a chronic disease, with a rapidly increasing prevalence worldwide. Body mass index (BMI) provides the most useful population-level measure of overweight and obesity. For adults, overweight is defined as a BMI (Kg/m2) ≥ 25, and obesity as a BMI ≥ 30, for non-Asians and ≥ 27.5 for Asians. Abdominal obesity can be defined as a waist circumference equal to or higher than 102 cm for men and ≥88 cm for women. The definition of children and adolescents BMI changes with age and sex. Obesity may be exogenous or endogenous obesity, the latter is multifactorial and predominantly manifested during childhood. Presently, overweight and obesity are linked to more deaths worldwide than underweight. The total kidney glomerular filtration rate (GFR) is determined by the sum of nephrons and the GFR within each nephron or single nephron GFR. In clinical practice, GFR is more frequently calculated by GFR estimating equations based upon the plasma levels of creatinine, cystatin C, or both. The measured value of plasma creatinine is strongly influenced by non-GFR factors, by its tubular and gastrointestinal secretion, and by the problems associated with the lack of standardization of creatinine's laboratory assay discrediting it as an ideal GFR biomarker. Unlike creatinine, cystatin C plasma levels are mainly determined by GFR. Obesity may affect the kidney, via development of systemic arterial hypertension and/or diabetes mellitus, or directly, by ectopic accumulation of adipose tissue in the kidney. As obesity is a clinical condition associated with altered body composition, creatinine may not be the ideal biomarker for GFR measurement in obese individuals.
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Affiliation(s)
- Vera H Koch
- Pediatric Nephrology Unit, Department of Pediatrics, Instituto da Criança e do Adolescente do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Lek D, Haveman-Nies A, Bezem J, Zainalabedin S, Schetters-Mouwen S, Saat J, Gort G, Roovers L, van Setten P. Two-year effects of the community-based overweight and obesity intervention program Gezond Onderweg! (GO!) in children and adolescents living in a low socioeconomic status and multi-ethnic district on Body Mass Index-Standard Deviation Score and quality of life. EClinicalMedicine 2021; 42:101217. [PMID: 34901795 PMCID: PMC8640234 DOI: 10.1016/j.eclinm.2021.101217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/30/2021] [Accepted: 11/12/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In most childhood obesity interventions, disadvantaged groups are underrepresented, and results are modest and not maintained. A long-term collaborative community-based approach is necessary to reach out to children from multi-ethnic backgrounds and achieve sustainable behavior change, resulting in sustained Body Mass Index-Standard Deviation Score (BMI-SDS) reductions. The objective is to determine the effects of GO! on BMI-SDS and Health-Related Quality of Life (HRQoL) for children and adolescents having overweight or obesity. METHODS A prospective, longitudinal cohort study was used to collect two-year follow-up data from November 2014 to July 2019. Children and adolescents (4-19 years old) from the low socioeconomic status and multi-ethnic district of Malburgen in the Dutch city of Arnhem were included. 178 children having overweight or obesity were recruited, with 155 children measured at baseline and after two years as a minimum, while 23 were lost to follow up. Participants attending the program for over six months were defined as completers (n=107) and participants attending the program for less than six months were defined as non-completers (n=48). The child health coach (CHC) acts as a central care provider in the collaborative community with healthcare providers from both medical and social fields. This coach coordinates, monitors and coaches healthy lifestyles, while increasing self-management for both children and parents. This is done in a customized and neighborhood-oriented manner and provided by all the stakeholders involved in GO!. The main outcomes are the change in BMI-SDS scores and HRQoL scores reported by participants. FINDINGS After 24 months, completers showed a decrease in BMI-SDS of -0·32 [95% CI: -0·42, -0·21], compared with -0·14 [95% CI: -0·29, 0·01] for non-completers (adjusted for gender and ethnicity; P=0.036). While 25% suffered from overweight and 75% from obesity at the start, following the intervention 5% showed normal weight, with 33% overweight and 62% with obesity. HRQoL reported by participants improved over time, showing no differences between completers and non-completers, gender and ethnicity after two years. INTERPRETATION Our results suggest that the GO! program might be effective in reaching out and reducing BMI-SDS for participants in a low socioeconomic status and multi-ethnic district over a two-year period. We noticed also trends to beneficial shifts in obesity grades. HRQoL improved regardless of the participation rate, gender and ethnic background. In light of the study limitations, further studies are needed to corroborate our observations. FUNDING Dullerts-foundation, Nicolai Broederschap foundation, Burger en Nieuwe weeshuis foundation, Rijnkind foundation, Arnhems Achterstandswijken foundation, Menzis-foundation, the municipalities of Arnhem, Rheden, Overbetuwe and Lingewaard, the Association of Dutch municipalities, and Province of Gelderland.
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Affiliation(s)
- Dagna Lek
- Wageningen University & Research, Consumption and Healthy Lifestyles, Wageningen, The Netherlands
- Corresponding author: Dagna Lek: C/O Petra van Setten. Department of Pediatric Endocrinology, Amalia Children's Hospital, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, P.O. Box 9101, 6500HB Nijmegen, The Netherlands
| | - Annemien Haveman-Nies
- Wageningen University & Research, Consumption and Healthy Lifestyles, Wageningen, The Netherlands
| | - Janine Bezem
- Public Health Services Gelderland-Midden, Department of Youth Health, Arnhem, The Netherlands
| | - Sonay Zainalabedin
- Malburgen Medical Center, General Practice Malburgen Arnhem, The Netherlands
| | - Safina Schetters-Mouwen
- Public Health Services Gelderland-Midden, Department of Youth Health, Arnhem, The Netherlands
| | - Jenneke Saat
- Academic Collaborative Center AMPHI, Integrated Health Policy, Department of Primary and Community Care, ELG 117, Radboud University Medical Center, Nijmegen, The Netherlands
- HAN University of Applied Sciences, Academy of Paramedical Studies, Department of Nutrition and Dietetics, Nijmegen, The Netherlands
| | - Gerrit Gort
- Wageningen University, Biometris, Wageningen, The Netherlands
| | - Lian Roovers
- Rijnstate Hospital, Clinical Research Department, Arnhem, The Netherlands
| | - Petra van Setten
- Rijnstate Hospital, Department of Pediatrics, Arnhem, The Netherlands
- Department of Pediatric Endocrinology, Amalia Children's Hospital, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Pacheco M, de Maio Godoi Filho JR, Nunes da Silva Filho J, Pontes Dos Santos J, Dos Santos Farias E. The relation between body mass index and body fat percentage in Brazilian adolescents: assessment of variability, linearity, and categorisation. Ann Hum Biol 2021; 48:437-442. [PMID: 34530666 DOI: 10.1080/03014460.2021.1982002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Reliable but accessible measures to capture body composition are highly important as the world is in an era of obesity-increase. The most used measure, the body mass index (BMI), nevertheless, has been judged as non-reliable to estimate body fat percentage (BF%). The present manuscript assessed the criticisms of BMI as a predictor of BF% and the BMI-based categories of nutritional status. 4164 children/adolescents from 9 to 18 years of age from Porto Velho, Brazil, had their anthropometric and skinfold measures taken. Controlling for socioeconomic status, school (private, public), sex and age, we compared proposed models/variables in the literature relating BMI and BF%. We evaluated the functions and the residual data to understand the variability of BF% estimate per BMI and evaluated three possible categorisations from BMI to predict BF% nutritional status. The function utilising (linear) BMI was the best to predict BF% (R2 = 0.70) with a variability of only 6.49% around the function. Nevertheless, no categorisation of nutritional status was reliable to predict the nutritional status of individuals. BMI is reliable to estimate BF%. Nevertheless, new normative values must be proposed; the original categorisation fails to capture the nutritional status of children/adolescents from this region.
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Affiliation(s)
- Matheus Pacheco
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
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Vendula J, Miroslava P, Tereza K. Reference Curves of Selected Circumferential Parameters for Czech Children Aged 6 to 11 Years. CHILDREN-BASEL 2021; 8:children8100908. [PMID: 34682173 PMCID: PMC8534861 DOI: 10.3390/children8100908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/28/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022]
Abstract
(1) Background/objective: the globally discussed current issue is the increasing body weight of the population. This trend is observed in all age categories. Pediatricians and anthropologists use BMI percentile curves to determine the optimal body weight of children, based on which the child is categorized in the category of underweight, normal weight, overweight, or obese. Medical or anthropological examinations also use some methods to determine the amount of body fat. In addition to evaluating amounts of body fat, it is important to assess its distribution. The distribution of fat in the body, especially in terms of disproportionate distribution, is a risk factor for health complications, especially in terms of metabolic and health risk. Part of monitoring children’s growth is also measuring and evaluating circumferential parameters, such as abdominal circumference, gluteal circumference, and waist circumference. This study aimed to define age- and gender-specific reference curves for waist circumference (WC), abdominal circumference (AbC), and gluteal circumference (GC) in Czech children. (2) Methods: data on children’s circumferential parameters were collected via anthropometric measurements. The research sample consisted of 2093 children aged 6–11 years (boys, n = 1008; girls, n = 1085). Only children with parental informed consent were included. The statistical analysis was performed separately by age and gender using SPSS v. 22. Anthropometric data were summarized by mean and standard deviation. The percentile curves of WC, AbC, and GC were calculated (P3, P10, P25, P50, P75, P90, P97) in R 3.4.2 software (R Foundation for Statistical Computing, Vienna, Austria) using the gamlss package. (3) Results and conclusions: the study developed age- and gender-specific percentile curves of WC, AbC, and GC for Czech children aged 6–11 years. All parameters increased with age in both boys and girls. Generally, the boys had higher WC and AbC than did girls, but girls had higher GC than did boys. Female and male median WC percentiles (M) increased from the age of 6. Both girls’ and boys’ median percentiles showed a continuous increase. We found similar trends in the median GC and AbC percentile curves. All percentile curves showed similar trends in both sexes, but the 90th and 97th WC percentiles in boys were exceptions: from the age of 10, they exceeded the values of girls, reaching their peak at the age of 11 followed by a decrease in the case of the 97th percentile and a plateau in the case of the 90th percentile. This study serves as a reference to enrich the methods of evaluation of somatic and medical status in Czech children. Up–to–date percentile curves would be a practical addition to the BMI percentiles for the screening and evaluation of overweight and obese conditions and the related risks of abdominal obesity in the pediatric population.
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Soltero EG, O'Connor TM, Thompson D, Shaibi GQ. Opportunities to Address Obesity Disparities Among High-Risk Latino Children and Adolescents. Curr Obes Rep 2021; 10:332-341. [PMID: 34263434 PMCID: PMC9116051 DOI: 10.1007/s13679-021-00445-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW This review highlights obesity-related disparities among Latino children and adolescents, discusses the social determinants of health (SDoH) that drive disparities, and presents case studies of strategies for reducing disparities and promoting health equity. RECENT FINDINGS Recommended strategies for reducing obesity-related disparities include the use of culturally grounded programming, multi-sector collaborations, and technology. We present two exemplar studies that demonstrate that integrating cultural values and enhancing the overall cultural fit of prevention programs can increase engagement among high-risk Latino families. We also examine the use of multi-sector collaborations to build community capacity and address key SDoH that impact health behaviors and outcomes. Our last example study demonstrates the utility of technology for engaging youth and extending the reach of prevention strategies in vulnerable communities. To address growing obesity-related disparities, there is an urgent need to develop and test these strategies among high-risk, vulnerable populations like Latino children and adolescents.
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Affiliation(s)
- Erica G Soltero
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA.
| | - Teresia M O'Connor
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA
| | - Deborah Thompson
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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Angi A, Chiarelli F. Obesity and Diabetes: A Sword of Damocles for Future Generations. Biomedicines 2020; 8:E478. [PMID: 33171922 PMCID: PMC7694547 DOI: 10.3390/biomedicines8110478] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023] Open
Abstract
Childhood obesity is one of the most challenging problem of the 21st century. The prevalence has increased, reaching an alarming rate. Furthermore, the problem is global and is also affecting low- and middle-income countries. This global obesity epidemic explains how the roots of cardiovascular disease, the most common cause of mortality among adults, begin in childhood. Overweight and obese children are likely to stay obese into adulthood and to develop noncommunicable diseases such as diabetes and cardiovascular diseases at a younger age. Thus, prevention should be the major goal and should start early in life. The aim of this review is to present an updated framework of the current understanding of the cardiovascular and metabolic risks in obese children and adolescents and to discuss the available therapeutic options.
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Affiliation(s)
- Alessia Angi
- Department of Pediatrics, University of Chieti, 66100 Chieti, Italy;
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Said MA, Silva LSTE, de Oliveira Rocha AM, Alves GGB, Piotto DGP, Len CA, Terreri MT. Adverse drug reactions associated with treatment in patients with chronic rheumatic diseases in childhood: a retrospective real life review of a single center cohort. Adv Rheumatol 2020; 60:53. [PMID: 33153496 DOI: 10.1186/s42358-020-00154-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/11/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adverse drug reactions (ADRs) are the sixth leading causes of death worldwide; monitoring them is fundamental, especially in patients with disorders like chronic rheumatic diseases (CRDs). The study aimed to describe the ADRs investigating their severity and associated factors and resulting interventions in pediatric patients with CRDs. METHODS A retrospective, descriptive and analytical study was conducted on a cohort of children and adolescents with juvenile idiopathic arthritis (JIA), juvenile systemic lupus erythematosus (JSLE) and juvenile dermatomyositis (JDM). The study evaluated medical records of the patients to determine the causality and the management of ADRs. In order to investigate the risk factors that would increase the risk of ADRs, a logistic regression model was carried out on a group of patients treated with the main used drug. RESULTS We observed 949 ADRs in 547 patients studied. Methotrexate (MTX) was the most frequently used medication and also the cause of the most ADRs, which occurred in 63.3% of patients, followed by glucocorticoids (GCs). Comparing synthetic disease-modifying anti-rheumatic drugs (sDMARDs) vs biologic disease-modifying anti-rheumatic drugs (bDMARDs), the ADRs attributed to the former were by far higher than the latter. In general, the severity of ADRs was moderate and manageable. Drug withdrawal occurred in almost a quarter of the cases. In terms of risk factors, most patients who experienced ADRs due to MTX, were 16 years old or younger and received MTX in doses equal or higher than 0.6 mg/kg/week. Patients with JIA and JDM had a lower risk of ADRs than patients with JSLE. In the multiple regression model, the use of GCs for over 6 months led to an increase of 0.5% in the number of ADRs. CONCLUSIONS Although the ADRs highly likely affect a wide range of children and adolescents with CRDs they were considered moderate and manageable cases mostly. However, triggers of ADRs need further investigations.
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Affiliation(s)
- Manar Amanouil Said
- Division of Pediatric Rheumatology, Department of Pediatrics, Federal University Sao Paulo (Unifesp), Rua Borges Lagoa, 802, Sao Paulo, ZIP CODE: 04038-001, Brazil.
| | - Liana Soido Teixeira E Silva
- Division of Pediatric Rheumatology, Department of Pediatrics, Federal University Sao Paulo (Unifesp), Rua Borges Lagoa, 802, Sao Paulo, ZIP CODE: 04038-001, Brazil
| | - Aline Maria de Oliveira Rocha
- Division of Pediatric Rheumatology, Department of Pediatrics, Federal University Sao Paulo (Unifesp), Rua Borges Lagoa, 802, Sao Paulo, ZIP CODE: 04038-001, Brazil
| | - Gustavo Guimarães Barreto Alves
- Division of Pediatric Rheumatology, Department of Pediatrics, Federal University Sao Paulo (Unifesp), Rua Borges Lagoa, 802, Sao Paulo, ZIP CODE: 04038-001, Brazil
| | - Daniela Gerent Petry Piotto
- Division of Pediatric Rheumatology, Department of Pediatrics, Federal University Sao Paulo (Unifesp), Rua Borges Lagoa, 802, Sao Paulo, ZIP CODE: 04038-001, Brazil
| | - Claudio Arnaldo Len
- Division of Pediatric Rheumatology, Department of Pediatrics, Federal University Sao Paulo (Unifesp), Rua Borges Lagoa, 802, Sao Paulo, ZIP CODE: 04038-001, Brazil
| | - Maria Teresa Terreri
- Division of Pediatric Rheumatology, Department of Pediatrics, Federal University Sao Paulo (Unifesp), Rua Borges Lagoa, 802, Sao Paulo, ZIP CODE: 04038-001, Brazil
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Borges LPSL, de Santana NL, da Costa THM. Adherence to National Food Guide Recommendations: Can It Slow the Obesity Epidemic? A Systematic Review. Curr Nutr Rep 2020; 9:316-328. [PMID: 33145722 DOI: 10.1007/s13668-020-00339-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Dietary guidelines (DG) have the objective to promote healthy diet and prevent chronic diseases. In order to evaluate if this purpose is being achieved, we systematically reviewed studies that associated adherence to DG with obesity. RECENT FINDINGS We identified 2012 articles published in the last 5 years, and 38 remained in the final sample. The majority of studies demonstrated a negative association between adherence to DG and obesity. Studies with positive or no association presented mutual characteristics, such as populations composed only by children or adolescents, and dietary intake or dietary adherence assessed through non-validated or weak methods. Adherence to DG seems to be a protective factor for obesity in adults, but this relationship is not so clear for children and adolescents. To improve the quality of dietary intake results, studies must utilize appropriate methods to answer their questions with less biased estimate of dietary intake.
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Affiliation(s)
| | | | - Teresa Helena Macedo da Costa
- Department of Nutrition, School of Health Science, University of Brasilia, Brasilia, 70919-970, Brazil.
- University of Oxford, Oxford, England.
- Human Nutrition Research, Medical Research Council, Cambridge, England.
- Sabbatical at Iowa State University, Ames, IA, USA.
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Dushnicky MJ, Nazarali S, Mir A, Portwine C, Samaan MC. Is There A Causal Relationship between Childhood Obesity and Acute Lymphoblastic Leukemia? A Review. Cancers (Basel) 2020; 12:cancers12113082. [PMID: 33105727 PMCID: PMC7690432 DOI: 10.3390/cancers12113082] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/20/2022] Open
Abstract
Simple Summary The childhood obesity epidemic is impacting tens of millions of children globally. While obesity causes several cancers in adults, its potential role in causing pediatric cancers remains unclear. In this review, we assess the potential contribution of obesity to the development of acute lymphoblastic leukemia (ALL), the most common pediatric cancer. We review the possible mechanisms by which the adipose tissue attracts and protects leukemia cells and how it interferes with the actions of chemotherapies used in ALL treatment. We also examine adipose tissue-secreted molecules and fuels that may support leukemia development. While there are no current definite causal links between obesity and ALL, there are plausible mechanisms that need further investigation to explore the impact of obesity on causing ALL and on impacting treatment outcomes. Abstract Childhood obesity is a growing epidemic with numerous global health implications. Over the past few years, novel insights have emerged about the contribution of adult obesity to cancer risk, but the evidence base is far more limited in children. While pediatric patients with acute lymphoblastic leukemia (ALL) are at risk of obesity, it is unclear if there are potential causal mechanisms by which obesity leads to ALL development. This review explores the endocrine, metabolic and immune dysregulation triggered by obesity and its potential role in pediatric ALL’s genesis. We describe possible mechanisms, including adipose tissue attraction and protection of lymphoblasts, and their impact on ALL chemotherapies’ pharmacokinetics. We also explore the potential contribution of cytokines, growth factors, natural killer cells and adipose stem cells to ALL initiation and propagation. While there are no current definite causal links between obesity and ALL, critical questions persist as to whether the adipose tissue microenvironment and endocrine actions can play a causal role in childhood ALL, and there is a need for more research to address these questions.
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Affiliation(s)
- Molly J. Dushnicky
- Department of Pediatrics, McMaster University, Hamilton, ON L8N 3Z5, Canada; (M.J.D.); (S.N.); (A.M.); (C.P.)
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
| | - Samina Nazarali
- Department of Pediatrics, McMaster University, Hamilton, ON L8N 3Z5, Canada; (M.J.D.); (S.N.); (A.M.); (C.P.)
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, ON L8S4L8, Canada
| | - Adhora Mir
- Department of Pediatrics, McMaster University, Hamilton, ON L8N 3Z5, Canada; (M.J.D.); (S.N.); (A.M.); (C.P.)
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, ON L8S4L8, Canada
| | - Carol Portwine
- Department of Pediatrics, McMaster University, Hamilton, ON L8N 3Z5, Canada; (M.J.D.); (S.N.); (A.M.); (C.P.)
- Division of Pediatric Hematology/Oncology, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
| | - Muder Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, ON L8N 3Z5, Canada; (M.J.D.); (S.N.); (A.M.); (C.P.)
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, ON L8N 3Z5, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, ON L8S4L8, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada
- Correspondence:
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Litsfeldt S, Ward TM, Hagell P, Garmy P. Association Between Sleep Duration, Obesity, and School Failure Among Adolescents. J Sch Nurs 2020; 36:458-463. [PMID: 31973678 PMCID: PMC7675773 DOI: 10.1177/1059840520901335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to investigate the association between sleep duration, overweight/obesity, and school failure using data obtained from self-reported questionnaires completed by 13- to 15-year-olds in Sweden (n = 1,363; 50.7% female). The height and weight of the participants were measured by school nurses. A multiple logistic regression analysis was used to analyze the association between sleep duration and overweight/obesity, school failure, and perceived economic situation. A short sleep duration (<7 hr) was associated with overweight/obesity (p = .001), school failure (p = .007), and poorer perceived economic situation (p = .004). Modifying the sleep habits of adolescents is a potential target for obesity intervention as well as for improving school success. This information is particularly well suited for school nurses to disseminate to students and their parents.
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Affiliation(s)
- Sofie Litsfeldt
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Teresa M Ward
- Department of Psychosocial and Community Health, School of Nursing, 7284University of Washington, Seattle, WA, USA
| | - Peter Hagell
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Pernilla Garmy
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.,Department of Health Sciences, Clinical Health Promotion Centre, Lund University, Lund, Sweden
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Delvecchio M, Pastore C, Valente F, Giordano P. Cardiovascular Implications in Idiopathic and Syndromic Obesity in Childhood: An Update. Front Endocrinol (Lausanne) 2020; 11:330. [PMID: 32582026 PMCID: PMC7296059 DOI: 10.3389/fendo.2020.00330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/28/2020] [Indexed: 01/02/2023] Open
Abstract
Childhood obesity is a modern worldwide epidemic with significant burden for health. It is a chronic metabolic disorder associated with multiple cardiovascular risk factors such as dyslipidemia, hypertension, stroke, and insulin resistance. Many obese adolescents remain obese into adulthood, with increased morbidity and mortality. As childhood obesity is a risk factor for adult obesity, the childhood obesity-related disorders account for an increased risk of cardiovascular consequences in adults, in addition to the effects already exerted by the fat mass in adulthood. Several papers have already described the cardiovascular implications of idiopathic obesity, while few data are available about syndromic obesity, due to the small sample size, not homogeneous phenotypes, and younger age at death. The aim of this mini-review is to give a comprehensive overview on knowledge about cardiovascular implications of idiopathic and syndromic obesity to allow the reader a quick comparison between them. The similarities and differences will be highlighted.
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Affiliation(s)
- Maurizio Delvecchio
- Metabolic Disorders and Diabetes Unit, “Giovanni XXIII” Children Hospital, AOU Policlinico di Bari, Bari, Italy
- *Correspondence: Maurizio Delvecchio
| | - Carmela Pastore
- “B. Trambusti” Pediatric Unit, “Giovanni XXIII” Children Hospital, AOU Policlinico di Bari, Bari, Italy
| | - Federica Valente
- Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Paola Giordano
- “B. Trambusti” Pediatric Unit, “Giovanni XXIII” Children Hospital, AOU Policlinico di Bari, Bari, Italy
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Champilomati G, Notara V, Prapas C, Konstantinou E, Kordoni M, Velentza A, Mesimeri M, Antonogeorgos G, Rojas-Gil AP, Kornilaki EN, Lagiou A, Panagiotakos DB. Breakfast consumption and obesity among preadolescents: An epidemiological study. Pediatr Int 2020; 62:81-88. [PMID: 31713282 DOI: 10.1111/ped.14050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/18/2019] [Accepted: 11/07/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aimed to examine the association between breakfast consumption and childhood weight status, in relation to various socioeconomic and lifestyle factors. METHODS A cross-sectional survey was conducted including 1,728 children aged 10-12 years and their parents, during the school years 2014-2016. Primary schools from five Greek counties (including the Athens metropolitan area) were randomly selected. Parental and child data were collected through self-administered, anonymous questionnaires. Children's weight status was based on gender- and age-specific tables derived from the International Obesity Task Force body mass index cutoffs. Logistic regression was used to determine the association between frequency and type of breakfast consumption and children's weight status. RESULTS The frequency of breakfast consumption was not associated with childhood overweight or obesity, even when other factors were included in the analysis like sex, age, physical activity, meals / day, family annual income, parental weight status, parental physical activity level, parental educational level and parental employment status. From the nine foods that were included only the consumption of bread or rusks and chocolate milk were found to have a negative association with childhood overweight or obesity (odds ratio: 0.51; 95% CI: 0.34, 0.79 and OR: 0.50; 95% CI: 0.28, 0.87, respectively). CONCLUSIONS The result that frequency of breakfast consumption was not associated with children's overweight / obesity may lead to a deeper investigation of the foods consumed during breakfast. Bread or rusks and chocolate milk seemed to have a protective effect; further nutritional analysis is needed to explore the potential mechanisms of this observation.
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Affiliation(s)
- Georgia Champilomati
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Venetia Notara
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Christos Prapas
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Eleni Konstantinou
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Marialena Kordoni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Anna Velentza
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Magdalini Mesimeri
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - George Antonogeorgos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Andrea Paola Rojas-Gil
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, Efstathiou & Stamatikis Valioti and Plateon, University of Peloponnese, Sparta, Greece
| | - Ekaterina N Kornilaki
- Department of Preschool Education, School of Education, University of Crete, Crete, Greece
| | - Areti Lagiou
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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Sönmez HE, Canpolat N, Ağbaş A, Taşdemir M, Ekmekçi ÖB, Alikaşifoğlu M, Sever L, Çalışkan S. The Relationship between the Waist Circumference and Increased Carotid Intima Thickness in Obese Children. Child Obes 2019; 15:468-475. [PMID: 31246513 DOI: 10.1089/chi.2019.0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: This study aimed to evaluate the cardiometabolic risk factors in normotensive obese and hypertensive obese (HT-obese) children by comparison of anthropomorphic measurements, fat distribution, carotid artery intima-media thickness (CIMT), and inflammatory markers. Methods: Fifty-three obese patients 10-18 years of age with a BMI-for-age/gender >95th percentile and 20 age- and gender-matched healthy volunteers enrolled in the study. Obese patients were divided into two groups according to the presence of hypertension (HT), as follows: HT-obese subgroup (n = 30) and nonhypertensive obese (non-HT-obese) subgroup (n = 23). Results: Weight standard deviation score (SDS), BMI-SDS, waist circumference (WC) SDS, and the fat tissue z-score were significantly higher (p < 0.001 for all) in the obese patients than the control groups. Obese patients had higher 24-hour systolic blood pressure (SBP) SDS and leptin, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-6 levels. Furthermore, CIMT and CIMT-SDS were significantly higher in them. HT-obese patients (n = 30) had significantly higher WC-SDS and lower serum leptin and adiponectin levels than those of non-HT-obese group (n = 23). Finally, an association between increased CIMT-SDS and WC-SDS (β = 0.399, p = 0.002) and 24-hour SBP-SDS (β = 0.272, p = 0.009) was shown. Conclusions: Association between increased WC and HT implies the importance of central obesity in atherosclerosis. We concluded that WC measurement could be used to define risk groups since it is related to cardiometabolic complications.
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Affiliation(s)
- Hafize Emine Sönmez
- Department of Pediatrics, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Nur Canpolat
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Ayşe Ağbaş
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Mehmet Taşdemir
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Özlem Balcı Ekmekçi
- Department of Biochemistry, and Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Müjgan Alikaşifoğlu
- Department of Adolescence, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Lale Sever
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
| | - Salim Çalışkan
- Department of Pediatric Nephrology, Faculty of Cerrahpasa Medical, Istanbul University, Istanbul, Turkey
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Samara A, Li X, Pivik RT, Badger TM, Ou X. Brain activation to high-calorie food images in healthy normal weight and obese children: a fMRI study. BMC OBESITY 2018; 5:31. [PMID: 30524736 PMCID: PMC6276149 DOI: 10.1186/s40608-018-0209-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/21/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Understanding how normal weight and obese young children process high-calorie food stimuli may provide information relevant to the neurobiology of eating behavior contributing to childhood obesity. In this study, we used fMRI to evaluate whether brain activation to high-calorie food images differs between normal weight and obese young children. METHODS Brain activation maps in response to high-calorie food images and non-food images for 22 healthy, 8-10-years-old children (N = 11/11 for normal weight/obese respectively) were generated and compared between groups. RESULTS When comparing brain activation differences in response to viewing high-calorie food versus non-food images between normal weight and obese children, group differences were observed in areas related to memory and cognitive control. Specifically, normal weight children showed higher activation of posterior parahippocampal gyri (PPHG) and dorsomedial prefrontal cortex (DMPFC). Further ROI analyses indicated higher activation strength (Z scores) in the right PPHG (p = 0.01) and higher activation strength (p < 0.001) as well as a larger activation area (p = 0.02) in the DMPFC in normal weight than obese children. CONCLUSIONS Normal weight and obese children process high-calorie food stimuli differently even from a young age. Normal weight children exhibit increased brain activation in regions associated with memory and cognitive control when viewing high-calorie food images.
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Affiliation(s)
- Amjad Samara
- Arkansas Children’s Nutrition Center, Little Rock, AR USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Xuehua Li
- Arkansas Children’s Nutrition Center, Little Rock, AR USA
| | - R. T. Pivik
- Arkansas Children’s Nutrition Center, Little Rock, AR USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Thomas M. Badger
- Arkansas Children’s Nutrition Center, Little Rock, AR USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Xiawei Ou
- Arkansas Children’s Nutrition Center, Little Rock, AR USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR USA
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR USA
- Arkansas Children’s Research Institute, Little Rock, AR USA
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Roth CL, Jain V. Rising Obesity in Children: A Serious Public Health Concern. Indian J Pediatr 2018; 85:461-462. [PMID: 29455329 DOI: 10.1007/s12098-018-2639-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Christian L Roth
- Division of Endocrinology and Diabetes, Department of Pediatrics, Seattle Children's Hospital, University of Washington, 4800 Sand Point Way NE, Seattle, WA, 98105, USA.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Vandana Jain
- Division of Pediatric Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
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