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Hussein MH, Elshazli RM, Attia AS, Nguyen TP, Aboueisha M, Munshi R, Toraih EA, Fawzy MS, Kandil E. Asthma and COVID-19; different entities, same outcome: a meta-analysis of 107,983 patients. J Asthma 2021; 59:851-858. [PMID: 33504226 DOI: 10.1080/02770903.2021.1881970] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE There are varying reports of the prevalence and effect of comorbid asthma in coronavirus disease-2019 (COVID-19) patients. We sought to conduct a meta-analysis comparing asthmatic and non-asthmatic patients to determine the clinical significance of preexisting asthma in COVID-19 patients. DATA SOURCES Online databases PubMed, ScienceDirect, Web of Science, and Scopus, were searched up to July 15, 2020, for papers comparing asthma versus non-asthma COVID-19 patients. STUDY SELECTION According to prespecified inclusion criteria, this analysis included eleven retrospective studies with 107,983 COVID-19 patients. Subgroup analysis was performed based on age groups. RESULTS The mean age of the patients was 59.9 years (95%CI = 51.9-67.9). Across studies, the prevalence of asthma was 11.2% (95%CI: 9.1%-13.3%) among COVID-19 patients who attended the hospitals. Asthma patients were more likely to be younger (SMD = -0.36, 95%CI = -0.61 to -0.10, p = 0.005), and obese (OR = 1.98, 95%CI = 1.54-2.55, p < 0.001), there was no differential risk of hospitalization rate, ICU admission, or development of acute respiratory distress syndrome (ARDS) between asthmatic and non-asthmatic cohorts. However, asthmatic patients had increased risk of endotracheal intubation (RR = 1.27, 95%CI = 1.02-1.58, p = 0.030) especially patients aged <50 years (RR = 6.68, 95%CI = 1.76-11.13, p = 0.009). Despite this result, asthmatic patients had better recovery with a higher liability of being discharged and were less likely to die (RR = 0.80, 95%CI = 0.65-0.97, p = 0.026). CONCLUSION To our knowledge, our meta-analysis is the largest to shed light on preexisting asthma as a predictor of intubation in COVID-19, especially in young and obese patients. Identifying high-risk groups is crucial for designing more effective intervention plans and optimization of efficient resource allocation.
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Affiliation(s)
- Mohammad H Hussein
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA
| | - Rami M Elshazli
- Department of Biochemistry and Molecular Genetics, Faculty of Physical Therapy, Horus University - Egypt, New Damietta, Egypt
| | - Abdallah S Attia
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA
| | | | - Mohamed Aboueisha
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA
| | - Ruhul Munshi
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA
| | - Eman A Toraih
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA.,Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Manal S Fawzy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.,Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
| | - Emad Kandil
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA
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Toori KU, Chaudhry A. Characteristics of Chronic Cough in adults in Pakistani population: A cross sectional study. Pak J Med Sci 2020; 36:360-364. [PMID: 32292434 PMCID: PMC7150408 DOI: 10.12669/pjms.36.3.1868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Objective: Data about causes of chronic cough are lacking in our part of world. The aim of our study was to look for spectrum of causes in our setup and to determine a correlation between causes of cough and baseline factors of age, gender, and BMI and compare it to other populations. Methods: Total 236 chronic cough patients who attended chest clinic at KRL Hospital Islamabad from January 2018 to June 2019 were included in this cross-sectional study. Chronic cough was defined as cough greater than eight weeks. Main causes of chronic cough taken were cough variant asthma, allergic rhinitis, interstitial lung disease, Gastro-esophageal reflux disease, bronchial hyper-reactivity, ACE-I induced cough and others’. Other demographic and clinical data were also recorded. Results: The mean age was 45.16± 16.50 years and BMI was 26.23 ± 4.68kg/m2. Major cause of chronic cough was cough variant asthma in 111(47%). Age had significant positive correlations with ILD, ACE-I induced cough and CCF, while significant negative correlations with CVA and AR. On gender correlation, ILD and ACE-I cough were significantly found more in females. BMI had significant correlation with ACE-I cough only. Conclusion: Variability of epidemiology of cough variant asthma, allergic rhinitis and ACE-I induced cough is comparable to worldwide data while differences exist with epidemiology of interstitial lung disease. Further research is needed in the field to delineate the local trends in this regard and compare to other population groups.
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Affiliation(s)
- Kaleem Ullah Toori
- Dr. Kaleem Ullah Toori, FRCP (Glasgow). Department of Medicine, KRL Hospital, Islamabad, Pakistan
| | - Asma Chaudhry
- Dr. Asma Chaudhry, MRCP (UK). Department of Medicine, KRL Hospital, Islamabad, Pakistan
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3
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Associations between obesity, asthma and physical activity in children and adolescents. APUNTS SPORTS MEDICINE 2020. [DOI: 10.1016/j.apunsm.2020.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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4
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Kemper KA, Pate SP, Powers AR, Fair M. Promoting Healthy Environments In Afterschool Settings: The LiveWell Greenville Afterschool Initiative. Prev Chronic Dis 2018; 15:E144. [PMID: 30468420 PMCID: PMC6266516 DOI: 10.5888/pcd15.180164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION LiveWell Greenville, a multi-organization community coalition, launched an initiative in 2011 to help afterschool programs promote environments that decrease the risk of obesity among children and adolescents. The objective of this study was to describe changes in nutrition and physical activity environments, policies, and practices among 37 afterschool programs after their participation in the LiveWell Greenville Afterschool Initiative. METHODS The study used a nonexperimental, pre- and postsurvey design. The survey was based on the Nutrition and Physical Activity Self-Assessment for Child Care questionnaire and modified for afterschool settings. Items addressed sedentary time, physical activity time, availability of sugar-sweetened beverages, sweet and salty snack consumption, fruit consumption, staff behaviors, and policies that support nutrition and physical activity practices. The self-assessment survey was completed by an afterschool program supervisor at each site. The 9-month intervention consisted of program staff members' completing the pre-assessment and goal-setting worksheet, receiving technical support and training from LiveWell Greenville staff, attending networking meetings about nutrition and physical activity promotion strategies, and completing a postassessment. RESULTS We found significant positive changes in afterschool environments in the type and frequency of snacks offered, duration of children's sedentary time, staff behaviors that supported healthy nutrition and physical activity practices, and education provided to staff, children, and parents. CONCLUSION We found the LiveWell Greenville Afterschool Initiative, which involved self-assessment, goal setting and technical support, to be a successful strategy to change nutrition and physical activity environments in afterschool settings.
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Affiliation(s)
- Karen A Kemper
- Department of Public Health Sciences, Clemson University, 533 Edwards Hall, Clemson, SC 29634. .,LiveWell Greenville, Greenville, South Carolina
| | | | - Alicia R Powers
- LiveWell Greenville, Greenville, South Carolina.,Supplemental Nutrition Assistance Program-Education, Alabama Cooperative Extension, Auburn University, Alabama
| | - Melissa Fair
- Institute for the Advancement of Community Health, Furman University, Greenville, South Carolina
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5
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Esteban-Gorgojo I, Antolín-Amérigo D, Domínguez-Ortega J, Quirce S. Non-eosinophilic asthma: current perspectives. J Asthma Allergy 2018; 11:267-281. [PMID: 30464537 PMCID: PMC6211579 DOI: 10.2147/jaa.s153097] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Although non-eosinophilic asthma (NEA) is not the best known and most prevalent asthma phenotype, its importance cannot be underestimated. NEA is characterized by airway inflammation with the absence of eosinophils, subsequent to activation of non-predominant type 2 immunologic pathways. This phenotype, which possibly includes several not well-defined subphenotypes, is defined by an eosinophil count <2% in sputum. NEA has been associated with environmental and/or host factors, such as smoking cigarettes, pollution, work-related agents, infections, and obesity. These risk factors, alone or in conjunction, can activate specific cellular and molecular pathways leading to non-type 2 inflammation. The most relevant clinical trait of NEA is its poor response to standard asthma treatments, especially to inhaled corticosteroids, leading to a higher severity of disease and to difficult-to-control asthma. Indeed, NEA constitutes about 50% of severe asthma cases. Since most current and forthcoming biologic therapies specifically target type 2 asthma phenotypes, such as uncontrolled severe eosinophilic or allergic asthma, there is a dramatic lack of effective treatments for uncontrolled non-type 2 asthma. Research efforts are now focusing on elucidating the phenotypes underlying the non-type 2 asthma, and several studies are being conducted with new drugs and biologics aiming to develop effective strategies for this type of asthma, and various immunologic pathways are being scrutinized to optimize efficacy and to abolish possible adverse effects.
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Affiliation(s)
| | | | - Javier Domínguez-Ortega
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ).,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ).,CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain
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6
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Giombi K, Wiecha J, Vine J, Rogers VW. Policies and Practices of High-Performing Let’s Go! Schools. AMERICAN JOURNAL OF HEALTH EDUCATION 2018. [DOI: 10.1080/19325037.2018.1489742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | - Jackie Vine
- The Barbara Bush Children’s Hospital at Maine Medical Center
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7
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Azizpour Y, Delpisheh A, Montazeri Z, Sayehmiri K, Darabi B. Effect of childhood BMI on asthma: a systematic review and meta-analysis of case-control studies. BMC Pediatr 2018; 18:143. [PMID: 29699517 PMCID: PMC5922016 DOI: 10.1186/s12887-018-1093-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 03/15/2018] [Indexed: 01/07/2023] Open
Abstract
Background Asthma is a multifactorial syndrome that threatens the health of children. Body mass index (BMI) might be one of the potential factors but the evidence is controversial. The aim of this study is to perform a comprehensive meta-analysis to investigate the association between asthma and BMI. Methods Electronic databases including, Web of Science, Pubmed, Scopus, Science Direct, ProQuest, up to April 2017, were searched by two researchers independently. The keywords “asthma, body mass index, obesity, overweight, childhood and adolescence” were used. Random and fixed effects models were applied to obtain the overall odds ratios (ORs) and standardized mean difference (SMD). Heterogeneity between the studies was examined using I2 and Cochrane Q statistics. Results After reviewing 2511 articles, 16 studies were eligible for meta-analysis according to inclusion/exclusion criteria. A meta-analysis from 11 case-control studies revealed OR of asthma and overweight as OR = 1.64; (95% Confidence Interval (CI): 1.13–2.38) and from 14 case-control studies, OR for asthma and obesity was OR = 1.92 (95% CI: 1.39–2.65), which indicated that risk of asthma in overweight and obese children and adolescence was significantly higher (1.64 and 1.92 times) than that of individuals with (p-value < 0.01 for underweight/normal weight in both cases). Furthermore, there was a significant relationship between asthma and BMI > 85 percentile according to SMD SMD = 0.21; (95%CI: 0.03–0.38; p-value = 0.021). Conclusions The results showed a significant relationship between BMI (obesity/overweight) and asthma among children and adolescents. It is important to study the confounding factors that affect the relationship between asthma and BMI in future epidemiological researches. Electronic supplementary material The online version of this article (10.1186/s12887-018-1093-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yosra Azizpour
- Department of Clinical Epidemiology, Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Delpisheh
- Department of Clinical Epidemiology, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Zahra Montazeri
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Kourosh Sayehmiri
- Department of Biostatistics, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.
| | - Behzad Darabi
- Department of Pediatrics, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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8
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Bronchitis and Its Associated Risk Factors in First Nations Children. CHILDREN-BASEL 2017; 4:children4120103. [PMID: 29186802 PMCID: PMC5742748 DOI: 10.3390/children4120103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 11/20/2017] [Accepted: 11/22/2017] [Indexed: 11/17/2022]
Abstract
Respiratory diseases, such as bronchitis and pneumonia, are common in First Nations children in Canada. The objectives are to determine prevalence and associated risk factors of bronchitis in children 6–17 years old residing in two reserve communities. The cross-sectional study was conducted in 2013 and children from two First Nations reserve communities participated. The outcome was ever presence/absence of bronchitis. Logistic regression analysis was conducted to examine the relationship between bronchitis and the individual and environmental factors. A total of 351 First Nations children participated in the study. The prevalence of bronchitis was 17.9%. While 86.6% had at least one parent who smoked, smoking inside home was 43.9%. Signs of mold and mildew in homes were high. Prevalence of houses with any damage caused by dampness was 42.2%, with 44.2% of homes showing signs of mold or mildew. Significant predictors of increased risk of bronchitis were: being obese; having respiratory allergies; exposed to parental cigarette smoking; and signs of mold and mildew in the home. There are several modifiable risk factors that should be considered when examining preventive interventions for bronchitis including obesity, smoking exposure, and home mold or dampness.
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9
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Pujalte GGA, Ahanogbe I, Thurston MJ, White RO, Roche-Green A. Addressing Pediatric Obesity in Clinic. Glob Pediatr Health 2017; 4:2333794X17736971. [PMID: 29119130 PMCID: PMC5665102 DOI: 10.1177/2333794x17736971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 09/13/2017] [Indexed: 11/15/2022] Open
Abstract
There is an epidemic of pediatric obesity in the United States. In most cases, there is an excess in the amount of calories consumed, compared with the amount of calories expended. Numerous body systems are affected by pediatric obesity, with complications varying between boys and girls. Behavioral, genetic, and environmental factors affect the ability of children to avoid becoming obese. Primary care physicians should screen for obesity in children as much as possible. Associated risk factors for obesity should be uncovered. Methods of preventing obesity should be discussed routinely with children and their families. Healthy dietary habits are key, and so are family-oriented interventions, such as eating together at dinnertime. One hour of moderate to vigorous activity daily is recommended for children and adolescents. While pediatric bariatric surgery is an option, there are also numerous nonpharmacological and pharmacological measures available as management for pediatric obesity. Family-based approaches, such as reducing screen time, have been very successful. Non-weight-bearing exercises also help children and adolescents expend calories without causing injury to themselves. Family availability, activity preference, and developmental levels should all be considerations when managing pediatric obesity. Motivational interviewing may also be helpful, especially when customized for each specific patient and family. Clinicians will play an increasing role in terms of identifying, treating, and preventing pediatric obesity; measures that can be done in the clinic should be considered more and more.
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10
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Shore SA, Cho Y. Obesity and Asthma: Microbiome-Metabolome Interactions. Am J Respir Cell Mol Biol 2017; 54:609-17. [PMID: 26949916 DOI: 10.1165/rcmb.2016-0052ps] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Obesity is a risk factor for asthma, but obese subjects with asthma respond poorly to standard asthma drugs. Obesity also alters gut bacterial community structure. Obesity-related changes in gut bacteria contribute to weight gain and other obesity-related conditions, including insulin resistance and systemic inflammation. Here, we review the rationale for the hypothesis that obesity-related changes in gut bacteria may also play a role in obesity-related asthma. The metabolomes of the liver, serum, urine, and adipose tissue are altered in obesity. Gut bacteria produce a large number of metabolites, which can reach the blood and circulate to other organs, and gut bacteria-derived metabolites have been shown to contribute to disease processes outside the gastrointestinal tract, including cardiovascular disease. Here, we describe the potential roles for two such classes of metabolites in obesity-related asthma: short-chain fatty acids and bile acids. Greater understanding of the role of microbiota in obesity-related asthma could lead to novel microbiota-based treatments for these hard-to-treat patients.
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Affiliation(s)
- Stephanie A Shore
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Youngji Cho
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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11
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Kral TVE, Chittams J, Moore RH. Relationship between food insecurity, child weight status, and parent-reported child eating and snacking behaviors. J SPEC PEDIATR NURS 2017; 22:10.1111/jspn.12177. [PMID: 28321980 PMCID: PMC5398923 DOI: 10.1111/jspn.12177] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/27/2016] [Accepted: 02/07/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE Prior studies showed that food insecurity may increase the odds of obesity in children and adults. We still know very little about the familial aggregation of obesity in food-insecure households or the mechanisms by which food insecurity confers an increased risk of obesity to children. The purpose of this study was to compare children and mothers from food-insecure and food-secure households in their weight status, child eating patterns/behaviors, and maternal feeding practices. DESIGN AND METHODS Fifty mothers of 8-10-year-old children were asked to complete questionnaires, including the U.S. Household Food Security survey, and had their own and their children's heights and weights measured. RESULTS The odds of a child being obese were five times higher for children from food-insecure households compared with children from food-secure households (95% confidence interval 1.15-20.8). In univariate analyses, children from food-insecure households showed significantly greater external eating, both past satiation and in the absence of hunger (p < .03), and mothers from food-insecure households expressed significantly greater concern about their children's weight and used restrictive feeding practices to a greater extent (p < .03) when compared with families from food-secure households. A greater proportion of children from food-secure households consumed three to four snacks per day (45.9 vs. 15.4%), while a higher proportion of children from food-insecure households consumed five or more snacks per day (15.4 vs. 0%; p = .02). PRACTICE IMPLICATIONS These findings provide further support for an association between food insecurity and childhood obesity and suggest that differences in external eating, child snacking patterns, and select maternal feeding practices may be implicated in food-insecure children's overconsumption of calories. When caring for food-insecure children, healthcare providers should screen for problematic eating patterns and feeding practices.
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Affiliation(s)
- Tanja V E Kral
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jesse Chittams
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Reneé H Moore
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Relationship Between Current Substance Use and Unhealthy Weight Loss Practices Among Adolescents. Matern Child Health J 2017; 20:870-7. [PMID: 26649881 DOI: 10.1007/s10995-015-1875-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To determine the relationship between current substance use and unhealthy weight loss practices (UWLP) among 12-to-18 year olds. METHODS Participants were 12-to-18 year olds who completed the 2013 Youth Risk Behavior Survey in Florida (N = 5620). Current alcohol, tobacco, and marijuana use was self-reported based on last 30-day use. UWLP was defined based on self-report of at least one of three methods to lose weight in last 30-days: (1) ≥24 h of fasting, (2) diet pill use, and (3) laxative use/purging. The reference group included those with no reported UWLP. Logistic regression models adjusted for age, gender, race/ethnicity, academic performance, age-sex-specific body mass index percentiles, and perceived weight status were fitted to assess relationships between UWLP and current substance use. RESULTS About 15 and 41 % of adolescents reported ≥1 UWLP and use of ≥1 substance in the last 30-days, respectively. Over half (60.1 %) of adolescents who reported substance use engaged in UWLP (p < 0.0001). The prevalence of current alcohol use (50.6 %) was the highest among those who reported UWLP, followed by marijuana (31.9 %), tobacco (19.7 %), and cocaine (10.5 %) use. Adolescents who reported current tobacco [adjusted odds ratio (AOR) 2.7, 95 % confidence interval (CI) 2.1-3.6], alcohol (AOR 2.2, 95 % CI 1.9-2.6), or marijuana (AOR 2.1, 95 % CI 1.7-2.5) use had significantly higher odds of UWLP compared to their non-user counterparts. CONCLUSIONS This cross-sectional study shows that substance use and UWLP behaviors are likely to co-exist in adolescents. Further studies are necessary to determine the temporal relationship between substance use and UWLP. It is recommended that intervention programs for youth consider targeting these multiple health risk behaviors.
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13
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Loman DG, Kwong CG, Henry LD, Mahl C, Meadows L, Ellis AG. Asthma control and obesity in urban African American children. J Asthma 2016; 54:578-583. [PMID: 27753512 DOI: 10.1080/02770903.2016.1244827] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To examine the relationship between body mass index (BMI), gender, age, controller medication use, household smoke exposure, season, and allergic rhinitis status with asthma control in a group of lower income, African American children. We hypothesized that non-obese children would have better asthma control. METHODS Baseline data from a longitudinal study of children in a school-based asthma program in a Midwest urban area were analyzed. 360 children, ages 4-15 years, who were enrolled in either the 2012-2013 or 2013-2014 program were included. Asthma control was classified using criteria from the 2007 National Asthma Education and Prevention Program. Multiple ordinal regression was performed. RESULTS The median age was 9 years, 61% had well-controlled asthma, and 29% were obese. The model included all main effects plus two interaction terms and was significant (χ2(7) = 22.17, p =.002). Females who were normal weight (OR, 2.78; 95% CI, 1.38-5.60, p =.004) or overweight (OR, 3.12; 95% CI, 1.26-7.72, p =.014) had better asthma control than obese females. For males, there were no differences by BMI category but males without allergic rhinitis had significantly better asthma control (OR, 2.23; 95% CI, 1.25-3.97, p =.006) than those with allergic rhinitis. CONCLUSIONS Non-obese girls and non-allergic males had better asthma control. Promotion of healthy activity and nutrition as well as management of allergic rhinitis should be part of the asthma plan in school-based programs in low income urban areas. Innovative approaches to address asthma care in low income populations are essential.
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Affiliation(s)
- Deborah G Loman
- a Saint Louis University School of Nursing , St. Louis , Missouri , USA
| | - Christina G Kwong
- b Department of Pediatrics , Washington University School of Medicine , St. Louis , Missouri , USA
| | - Lisa D Henry
- c St. Louis Children's Hospital , St. Louis , Missouri , USA
| | - Christina Mahl
- c St. Louis Children's Hospital , St. Louis , Missouri , USA
| | - Lisa Meadows
- c St. Louis Children's Hospital , St. Louis , Missouri , USA
| | - Alysa G Ellis
- b Department of Pediatrics , Washington University School of Medicine , St. Louis , Missouri , USA
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Tabbakh T, Freeland-Graves J. Development and validation of the Multidimensional Home Environment Scale (MHES) for adolescents and their mothers. Eat Behav 2016; 22:76-82. [PMID: 27089386 DOI: 10.1016/j.eatbeh.2016.03.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/07/2016] [Accepted: 03/30/2016] [Indexed: 10/22/2022]
Abstract
The home environment is an important setting for the development of weight status in adolescence. At present a limited number of valid and reliable tools are available to evaluate the weight-related comprehensive home environment of this population. The goal of this research was to develop the Multidimensional Home Environment Scale which measures multiple components of the home. It includes psychological, social, and environmental domains from the perspective of an adolescent and the mother. Items were generated based on a literature review and then assessed for content validity by an expert panel and focus group in the target population. Internal consistency reliability was determined using Cronbach's α. Principal components analysis with varimax rotation was employed for assessment of construct validity. Temporal stability was evaluated using paired sample t-tests and bivariate correlations between responses at two different times, 1-2weeks apart. Associations between adolescent and mother responses were utilized for convergent validity. The final versions contained 32-items for adolescents and 36-items for mothers; these were administered to 218 adolescents and mothers. The subscales on the questionnaires exhibited high construct validity, internal consistency reliability (adolescent: α=0.82, mother: α=0.83) and test-retest reliability (adolescent: r=0.90, p<0.01; mother: r=0.91, p<0.01). Total home environment scores were computed, with greater scores reflecting a better health environment. These results verify the utility of the MHES as a valid and reliable instrument. This promising tool can be utilized to capture the comprehensive home environment of young adolescents (11-14years old).
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Affiliation(s)
- Tamara Tabbakh
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX 78701, United States.
| | - Jeanne Freeland-Graves
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX 78701, United States.
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Falbe J, Cotterman C, Linchey J, Madsen KA. Ethnic Disparities in Trends in High BMI Among California Adolescents, 2003-2012. Am J Prev Med 2016; 51:e45-e55. [PMID: 27067033 PMCID: PMC4958536 DOI: 10.1016/j.amepre.2016.02.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 01/19/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Because California is home to one in eight U.S. children and accounts for the highest Medicaid and Children's Health Insurance Program spending, childhood obesity trends in California have important implications for the entire nation. California's racial/ethnic diversity and large school-based data set provide a unique opportunity to examine trends by race/ethnicity, including understudied Asian and American Indian youth, which has not been possible using national data sets. This study examined racial/ethnic disparities in prevalence of high BMI from 2003 to 2012. METHODS This observational study included 11,624,865 BMI records from repeated cross-sections of fifth-, seventh-, and ninth-graders who underwent California's school-based fitness testing. Analyses conducted in 2015 used logistic regression to identify trends in prevalence of high BMI (BMI ≥85th, 95th, and 97th percentiles) and differences in trends by race/ethnicity from 2003 to 2012. RESULTS African American and Hispanic girls and American Indian boys increased in prevalence of high BMI, whereas non-Hispanic white and Asian youth and Hispanic boys decreased in prevalence of high BMI (p-values<0.05) from 2003 to 2012. Over this period, African American, Hispanic, and American Indian youth had higher slopes for trends in high BMI than non-Hispanic white youth (p-values<0.05). CONCLUSIONS Based on California's statewide data, there is evidence that racial/ethnic disparities in prevalence of high BMI have widened over time. Minority youth have either decreased more slowly or increased in prevalence compared with non-Hispanic white youth. There continues to be an urgent need for policies and interventions that effectively reduce racial/ethnic obesity prevalence disparities.
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Affiliation(s)
- Jennifer Falbe
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California.
| | - Carolyn Cotterman
- Interdepartmental Group in Biostatistics, University of California, Berkeley, California
| | - Jennifer Linchey
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California
| | - Kristine A Madsen
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California
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16
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Geier DA, Kern JK, Homme KG, Sykes LK, Geier MR. Thimerosal-containing Hepatitis B Vaccine Exposure is Highly Associated with Childhood Obesity: A Case-control Study Using the Vaccine Safety Datalink. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2016; 8:297-306. [PMID: 27583238 PMCID: PMC4982359 DOI: 10.4103/1947-2714.187148] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Obesity among children and adolescents in the United States has tripled since 1980, and has become a major public health concern. AIMS The purpose of this study was to evaluate the potential relationship between exposure to organic mercury from Thimerosal-containing hepatitis B vaccines and the children's subsequent risk of an obesity diagnosis. MATERIALS AND METHODS A hypothesis-testing, case-control study was undertaken to evaluate exposure to organic mercury from Thimerosal-containing hepatitis B vaccines, which were administered at specific intervals in the first 6 months of life, among cases diagnosed with childhood obesity and controls by examining automated medical records for children born from 1991 to 2000 who were continuously enrolled in the Vaccine Safety Datalink database. RESULTS This study found highly significant associations as follows. Cases diagnosed with obesity were significantly (P < 0.00001) more likely to have received greater exposure to organic mercury from Thimerosal-containing hepatitis B vaccines administered within the first month of life (odds ratio (OR) =1.511), first 2 months of life (OR = 1.486), and first 6 months of life (OR = 3.795) than the controls. Similar outcomes were observed when the overall data were separated by gender. In a dose-response manner, cases diagnosed with obesity were significantly more likely than controls to have received greater exposure to organic mercury from Thimerosal-containing hepatitis B vaccines, which were administered within the first 6 months of life (OR = 1.0375 per μg of mercury, P < 0.00001). CONCLUSIONS In a dose-response manner, the present study associates an increased organic mercury exposure from Thimerosal-containing hepatitis B vaccines with an increased risk of obesity diagnosis, and suggests that Thimerosal is an obesogen. The results are biologically plausible and future studies are needed to examine this phenomenon.
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Affiliation(s)
- David A. Geier
- Department of Research, Institute of Chronic Illnesses Inc., MD, USA
- Department of Research, CoMeD, Inc., Silver Spring, MD, USA
| | - Janet K. Kern
- Department of Research, Institute of Chronic Illnesses Inc., MD, USA
- Department of Research, CoMeD, Inc., Silver Spring, MD, USA
- CONEM US Autism Research Group, Allen, TX, USA
| | - Kristin G. Homme
- International Academy of Oral Medicine and Toxicology, Champions Gate, FL, USA
| | - Lisa K. Sykes
- Department of Research, CoMeD, Inc., Silver Spring, MD, USA
| | - Mark R. Geier
- Department of Research, Institute of Chronic Illnesses Inc., MD, USA
- Department of Research, CoMeD, Inc., Silver Spring, MD, USA
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17
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Yasuda E, Suzuki Y, Shimada T, Sawamoto K, Mackenzie WG, Theroux MC, Pizarro C, Xie L, Miller F, Rahman T, Kecskemethy HH, Nagao K, Morlet T, Shaffer TH, Chinen Y, Yabe H, Tanaka A, Shintaku H, Orii KE, Orii KO, Mason RW, Montaño AM, Fukao T, Orii T, Tomatsu S. Activity of daily living for Morquio A syndrome. Mol Genet Metab 2016; 118:111-22. [PMID: 27161890 PMCID: PMC5016714 DOI: 10.1016/j.ymgme.2016.04.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 04/07/2016] [Indexed: 01/26/2023]
Abstract
The aim of this study was to evaluate the activity of daily living (ADL) and surgical interventions in patients with mucopolysaccharidosis IVA (MPS IVA). The factor(s) that affect ADL are age, clinical phenotypes, surgical interventions, therapeutic effect, and body mass index. The ADL questionnaire comprises three domains: "Movement," "Movement with cognition," and "Cognition." Each domain has four subcategories rated on a 5-point scale based on the level of assistance. The questionnaire was collected from 145 healthy controls and 82 patients with MPS IVA. The patient cohort consisted of 63 severe and 17 attenuated phenotypes (2 were undefined); 4 patients treated with hematopoietic stem cell transplantation (HSCT), 33 patients treated with enzyme replacement therapy (ERT) for more than a year, and 45 untreated patients. MPS IVA patients show a decline in ADL scores after 10years of age. Patients with a severe phenotype have a lower ADL score than healthy control subjects, and lower scores than patients with an attenuated phenotype in domains of "Movement" and "Movement with cognition." Patients, who underwent HSCT and were followed up for over 10years, had higher ADL scores and fewer surgical interventions than untreated patients. ADL scores for ERT patients (2.5years follow-up on average) were similar with the-age-matched controls below 10years of age, but declined in older patients. Surgical frequency was higher for severe phenotypic patients than attenuated ones. Surgical frequency for patients treated with ERT was not decreased compared to untreated patients. In conclusion, we have shown the utility of the proposed ADL questionnaire and frequency of surgical interventions in patients with MPS IVA to evaluate the clinical severity and therapeutic efficacy compared with age-matched controls.
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Affiliation(s)
- Eriko Yasuda
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA; Department of Medical Informatics, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Yasuyuki Suzuki
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, Kanazawa, Japan
| | - Tsutomu Shimada
- Medical Education Development Center, Gifu University, Gifu, Japan
| | - Kazuki Sawamoto
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | | | - Mary C Theroux
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | | | - Li Xie
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Freeman Miller
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Tariq Rahman
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | | | - Kyoko Nagao
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Thierry Morlet
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Thomas H Shaffer
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Yasutsugu Chinen
- Department of Pediatrics, Faculty of Medicine, University of the Ryukyus, Ryukyu, Japan
| | - Hiromasa Yabe
- Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Akemi Tanaka
- Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Haruo Shintaku
- Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kenji E Orii
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Koji O Orii
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Robert W Mason
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Adriana M Montaño
- Department of Pediatrics, Saint Louis University, St. Louis, MO, USA; Department of Biochemistry and Molecular Biology, Saint Louis University, St. Louis, MO, USA
| | - Toshiyuki Fukao
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Tadao Orii
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
| | - Shunji Tomatsu
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA; Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
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Tarver T, Woodson D, Fechter N, Vanchiere J, Olmstadt W, Tudor C. A Novel tool for Health Literacy: Using Comic Books to Combat Childhood Obesity. ACTA ACUST UNITED AC 2016; 16:152-159. [PMID: 27840597 DOI: 10.1080/15323269.2016.1154768] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Childhood obesity remains a serious problem that requires health literacy projects to engage both parents and children in making healthy choices. This paper describes an award-funded project designed by LSU Health Shreveport (LSUHS) faculty from the Health Sciences Library and the Department of Pediatrics who created a comic book to help children and their parents learn practical ways children can make healthier lifestyle choices. LSUHS also collaborated with LSU-Shreveport to recruit a student artist, who illustrated the comic and designed promotional items used to promote the print and online versions of the book throughout the community.
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Affiliation(s)
- Talicia Tarver
- research and education librarian at the Tompkins-McCaw Library for the Health Sciences, Virginia Commonwealth University, Richmond, VA
| | - Deidra Woodson
- Metadata & Digitization Librarian, Health Sciences Library, LSU Health Shreveport, Shreveport, LA
| | - Nick Fechter
- owner of Nick Fechter Illustration and Design, Shreveport, LA
| | - John Vanchiere
- Associate Professor and Chief of Pediatric Infectious Disease in the Department of Pediatrics, Section of Pediatric Infectious Diseases at LSU Health Shreveport, Shreveport, LA
| | - Willam Olmstadt
- Associate Director, Health Sciences Library, LSU Health Shreveport, Shreveport, LA
| | - Charlie Tudor
- Systems Librarian at the Health Sciences Library, LSU Health Shreveport, Shreveport, LA
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Phillips KL, Schieve LA, Visser S, Boulet S, Sharma AJ, Kogan MD, Boyle CA, Yeargin-Allsopp M. Prevalence and impact of unhealthy weight in a national sample of US adolescents with autism and other learning and behavioral disabilities. Matern Child Health J 2015; 18:1964-75. [PMID: 24553796 DOI: 10.1007/s10995-014-1442-y] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We estimated the prevalence of obesity, overweight, and underweight among US adolescents with and without autism and other learning and behavioral developmental disabilities (DDs) and assessed the health consequences of obesity among adolescents with DDs. From the 2008 to 2010 National Health Interview Survey, we selected 9,619 adolescents ages 12-17 years. Parent respondents reported weight, height, presence of DDs and health conditions. We calculated body mass index (BMI) and defined obesity, overweight, and underweight as ≥95th, ≥85th to <95th, and <5th percentiles, respectively, using established criteria. We created mutually-exclusive DD subgroups using the following order of precedence: autism; intellectual disability; attention-deficit-hyperactivity-disorder; learning disorder/other developmental delay. We compared BMI outcomes among adolescents in each DD group versus adolescents without DDs using multivariable logistic regression. Socio-demographic factors and birthweight were included as confounders. Estimates were weighted to reflect the US population. Both obesity and underweight prevalences were higher among adolescents with than without DDs [adjusted prevalence ratios (aPR) 1.5 (1.25-1.75) and 1.5 (1.01-2.20), respectively]. Obesity was elevated among adolescents with all DD types, and was highest among the autism subgroup [aPR 2.1 (1.44-3.16)]. Adolescents with either a DD or obesity had higher prevalences of common respiratory, gastrointestinal, dermatological and neurological conditions/symptoms than nonobese adolescents without DDs. Adolescents with both DDs and obesity had the highest estimates for most conditions. Obesity is high among adolescents with autism and other DDs and poses added chronic health risks. Obesity prevention and management approaches for this vulnerable population subgroup need further consideration.
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Affiliation(s)
- Keydra L Phillips
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop E-86, Atlanta, GA, 30333, USA
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20
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Abstract
BACKGROUND Obesity is associated with reduced pulmonary function. We evaluated pulmonary function and status of asthma and obstructive sleep apnoea syndrome (OSAS) before and 5 years after bariatric surgery. METHODS Spirometry was performed at baseline and 5 years postoperatively. Information of asthma and OSAS were recorded. Of 113 patients included, 101 had undergone gastric bypass, 10 duodenal switch and 2 sleeve gastrectomy. RESULTS Eighty (71%) patients were women, mean preoperative age was 40 years and preoperative weight was 133 kg in women and 158 kg in men. Five years postoperatively, weight reduction was 31% (42 kg; p < 0.001) in women and 24% (38 kg; p < 0.001) in men. Forced expiratory volume in 1 s (FEV1) increased 4.1% (116 ml; p < 0.001) in women and 6.7% (238 ml; p = 0.003) in men. Forced vital capacity (FVC) increased 5.8% (209 ml; p < 0.001) in women and 7.6% (349 ml; p < 0.001) in men. Gender and weight loss were independently associated with the improvements in FEV1 and FVC. At follow-up, FEV1 had increased 36% of the difference towards the estimated normal FEV1, and there was a corresponding 70% recovery of FVC. These improvements occurred despite an expected decline in pulmonary function by age during the study period. Of the asthmatics and OSAS patients, 48 and 80%, respectively, were without symptoms 5 years postoperatively. CONCLUSIONS Pulmonary function measured with spirometry was significantly improved 5 years after bariatric surgery, despite an expected age-related decline during this period. Symptoms of asthma and OSAS also improved.
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Azhdam DB, Reyhan I, Grant-Guimaraes J, Feinstein R. Prevalence and documentation of overweight and obesity in hospitalized children and adolescents. Hosp Pediatr 2014; 4:377-381. [PMID: 25362080 DOI: 10.1542/hpeds.2014-0040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Overweight and obesity (OAO) are major problems among children and adolescents. Hospitalization of pediatric patients provides an opportunity for physicians to initiate point-of-care services related to weight status. Our goal was to determine the prevalence of OAO among hospitalized pediatric patients and to assess the extent of documentation of OAO in their medical records. METHODS We conducted a retrospective chart review of 8- to 18-year-olds admitted to an inpatient pediatric unit during 6 months in 2012. Age, gender, height, weight, BMI, discharge diagnosis, and admitting specialty were extracted from electronic medical records. BMI percentile was calculated from Centers for Disease Control and Prevention growth charts. Prevalence of OAO was determined for medical and surgical subspecialties, and charts were queried for documentation of weight status. RESULTS The study included 603 patients. Approximately one-third (36.5%) of patients were either overweight or obese, and nearly one-fifth (19.7%) were obese. The prevalence of overweight was similar between medical and surgical specialties. Obesity prevalence differed slightly, at 20.8% and 17.3% (P > .05), respectively. Only 0.9% of overweight and obese patients had documented discharge diagnoses of overweight or obesity, and only 13.2% had documentation of weight status noted anywhere in their medical record. CONCLUSIONS We identified a significant number of hospitalized OAO patients, an overwhelming percentage of whom never had weight status documented during their admission. Hospitalization offers health providers a window of opportunity to identify obesity, communicate risks, and initiate weight management interventions.
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Affiliation(s)
| | | | - Jamilah Grant-Guimaraes
- Departments of Pediatrics, and Department of Pediatrics, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY
| | - Ronald Feinstein
- Adolescent Medicine, Cohen Children's Medical Center, New Hyde Park, New York; and
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22
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Mo F, Morrison H, Neutel IC. Population attributable risk from obesity to arthritis in the Canadian Population Health Longitudinal Survey 1994-2006. Int J Rheum Dis 2014; 17:628-34. [DOI: 10.1111/1756-185x.12372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Frank Mo
- Social Determinants and Science Integration Directorate; Public Health Agency of Canada; Ottawa Ontario Canada
| | - Howard Morrison
- Social Determinants and Science Integration Directorate; Public Health Agency of Canada; Ottawa Ontario Canada
| | - Ineke C. Neutel
- The R. Samuel McLaughlin Centre; Institute of Population Health; University of Ottawa; Ottawa Ontario Canada
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23
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Basch CH, Hammond R, Ethan D, Samuel L. Food advertisements in two popular U.S. parenting magazines: results of a five-year analysis. Glob J Health Sci 2013; 6:175-82. [PMID: 24576378 PMCID: PMC4825216 DOI: 10.5539/gjhs.v6n2p175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 11/14/2013] [Accepted: 11/29/2013] [Indexed: 11/12/2022] Open
Abstract
Obesity rates among American youth have prompted an examination of food advertisements geared towards children. Research indicates children’s high exposure to these advertisements and their influence on food preferences. Less is known about the presence of these advertisements in parenting magazines. This study’s objective was to examine prevalence of food advertisements in popular parenting magazines and identify products by USDA food category. We analyzed 116 issues of two popular U.S. parenting magazines across five years. All food and beverage advertisements for USDA Food Category were coded. Breakfast cereals were coded for nutritional quality. The coding took place at varied libraries in New Jersey, in the United States. A total of 19,879 food and beverage products were analyzed. One-third of advertisements (32.5%) were for baked goods, snacks, and sweets -- products generally low in nutrient density. Two-thirds of the breakfast cereals were low in nutritional quality (64.6%). Beverages comprised 11% of the advertisements, fruit juices the highest proportion. Less than 3% of advertisements were for fruits and vegetables combined. No significant food product trends were evident across the five-year period. Food advertisements identified in parenting magazines were generally low in nutritional value. Additional research is necessary to determine the influence of food advertisements on parents’ purchasing habits.
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Pacheco Y, Freymond N, Devouassoux G. Impact of montelukast on asthma associated with rhinitis, and other triggers and co-morbidities. J Asthma 2013; 51:1-17. [PMID: 23834429 DOI: 10.3109/02770903.2013.822081] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Rhinitis and other specific triggers or co-morbidities (tobacco exposure, excess weight, aspirin sensitivity or heredity factors) are frequently associated with uncontrolled asthma. Asthma associated with these exacerbating factors appears to be related to an increase in leukotriene-mediated inflammation. METHODS We reviewed the role of montelukast, a leukotriene receptor antagonist, in the treatment of asthma associated with these factors by using the PubMed database to search the English and French biomedical literature for articles describing randomized-controlled trials, large observational studies and reviews (published up to May 2012, inclusive). RESULTS Montelukast, either alone or in combination with other drugs, is an effective treatment against rhinitis-associated asthma. Montelukast also offers therapeutic benefits against exercise-induced asthma or in cases of asthma linked to tobacco exposure, excess weight or aspirin hypersensitivity. Thus, for some patients, montelukast may constitute an alternative to the gold-standard treatment of inhaled corticosteroids. Polymorphisms in several genes encoding proteins of the leukotriene signaling pathway may contribute to the variability in response to montelukast. CONCLUSIONS In conclusion, we have shown that montelukast treatment could be of particular benefit to subgroups of patients with asthma associated with rhinitis, exercise, tobacco exposure, being overweight or aspirin hypersensitivity.
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Affiliation(s)
- Yves Pacheco
- Department of Respiratory Diseases, Centre Hospitalier Lyon Sud , and
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25
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Pobutsky A, Bradbury E, Reyes-Salvail F, Kishaba G. Overweight and obesity among Hawai'i children aged 4 to 5 years enrolled in public schools in 2007-2008 and comparison with a similar 2002-2003 cohort. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2013; 72:225-236. [PMID: 23900736 PMCID: PMC3727572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This assessment provides the most recent estimates of overweight and obesity among children 4 to 5 years old who were enrolled in public schools in the 2007-2008 school year, using data obtained from Student Health Records for 12,823 children, which represents 91% of the 14,070 children who were enrolled in kindergarten in 2007-2008. This assessment is a census of 4 to 5 year olds that entered public schools in Hawai'i in 2007-2008 and represents approximately 38% of the total Hawai'i population for those aged 4 to 5 years, since kindergarten is not a requirement. A limited data set with data on age, sex, height, and weight was used to calculate BMI (body mass index) percentiles. We compare this data with age and sex-specific BMI obtained from Student Health Records from 10,199 children aged 4 to 5 years entering public schools during 2002-2003. The results illustrate that like the 2002-2003 data (28.5%), over one in four (28.6%) of the children aged 4 to 5 years entering Hawai'i public schools in 2007-2008 were either overweight or obese. Total proportions overweight and obese were persistently higher (32.5% or more in both 2002-2003 and 2007-2008) in some specific school complexes on O'ahu as well as in some rural and Neighbor Island school complexes. Physicians, public health and school health professionals, advocates, schools, and communities should be vigilant about this persistent problem and seek to implement practices to combat overweight and obesity. In addition, the use of Student Health Records for on-going pediatric obesity surveillance should be explored more fully.
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Affiliation(s)
- Ann Pobutsky
- Hawai'i State Department of Health, Honolulu, HI, USA
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26
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Pakhale S, Luks V, Burkett A, Turner L. Effect of physical training on airway inflammation in bronchial asthma: a systematic review. BMC Pulm Med 2013; 13:38. [PMID: 23758826 PMCID: PMC3751945 DOI: 10.1186/1471-2466-13-38] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 06/04/2013] [Indexed: 12/16/2022] Open
Abstract
Background The majority of the global population cannot afford existing asthma pharmacotherapy. Physical training as an airway anti-inflammatory therapy for asthma could potentially be a non-invasive, easily available, affordable, and healthy treatment modality. However, effects of physical training on airway inflammation in asthma are currently inconclusive. The main objective of this review is to summarize the effects of physical training on airway inflammation in asthmatics. Methods A peer reviewed search was applied to Medline, Embase, Web of Science, Cochrane, and DARE databases. We included all observational epidemiological research studies and RCTs. Studies evaluating at least one marker of airway inflammation in asthmatics after a period of physical training were selected. Data extraction was performed in a blinded fashion. We decided a priori to avoid pooling of the data in anticipation of heterogeneity of the studies, specifically heterogeneity of airway inflammatory markers studied as outcome measures. Results From the initial 2635 studies; 23 studies (16 RCTs and 7 prospective cohort studies) were included. Study sizes were generally small (median sample size = 30). There was a reduction in C-reactive protein, malondialdehyde, nitric oxide, sputum cell counts and IgE in asthmatics with physical training. Mixed results were observed after training for fractional excretion of nitric oxide and bronchial hyperresponsiveness. The data was not pooled owing to significant heterogeneity between studies, and a funnel plot tests for publication bias were not performed because there were less than 10 studies for almost all outcome measures. Physical training intervention type, duration, intensity, frequency, primary outcome measures, methods of assessing outcome measures, and study designs were heterogeneous. Conclusion Due to reporting issues, lack of information and heterogeneity there was no definite conclusion; however, some findings suggest physical training may reduce airway inflammation in asthmatics.
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Affiliation(s)
- Smita Pakhale
- The Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada.
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Cazzola M, Calzetta L, Lauro D, Bettoncelli G, Cricelli C, Di Daniele N, Rogliani P. Asthma and COPD in an Italian adult population: role of BMI considering the smoking habit. Respir Med 2013; 107:1417-22. [PMID: 23702090 DOI: 10.1016/j.rmed.2013.04.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/14/2013] [Accepted: 04/23/2013] [Indexed: 12/28/2022]
Abstract
Smoking and body mass index (BMI) are well-documented risk factors that contribute substantially to chronic obstructive pulmonary disease (COPD) and asthma. However, the relations among smoking, obesity, and COPD or asthma remain to be clarified. We conducted a population-based cross-sectional epidemiologic study to explore the association between BMI and COPD or asthma among non-smokers, smokers and ex-smokers using information obtained from the Health Search database (HSD) owned by the Italian College of General Practitioners (SIMG), which stores information on about 1.5% of the total Italian population served by general practitioners (GPs). Our study confirms the importance of smoking status in patients with COPD, but not in those with asthma. Moreover, it demonstrates that the increase in BMI is frequently associated with the diagnosis of COPD or asthma, suggesting that the probability of suffering from COPD or asthma increases with the increase in body weight regardless of the smoking status. The association between an increase in BMI appears to be greater in women than in men. Our data also show that underweight is significantly associated with COPD, but only in men, while being underweight apparently protects from the possibility of suffering from asthma.
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Affiliation(s)
- Mario Cazzola
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy.
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Lee YL, Chen YC, Chen YA. Obesity and the occurrence of bronchitis in adolescents. Obesity (Silver Spring) 2013; 21:E149-53. [PMID: 23505197 DOI: 10.1002/oby.20262] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 05/29/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Previous studies have shown that an elevated BMI was associated with higher risks of bronchitis among children. The magnitude of how increase in BMI influencing the risk of incident bronchitis remained unexplored. The objective of this study is to assess the association between BMI and the incidence of bronchitis in the Taiwan Children Health Study. DESIGN A school-based prospective cohort study. METHODS We conducted a population-based prospective cohort study among seventh-grade school children in 14 Taiwanese communities. A total of 3,634 adolescents completed follow-up questionnaire in 2009. Associations between BMI and incident bronchitis were analyzed by multiple Poisson regression models, taking overdispersion into account. RESULTS Among eligible cohort participants without bronchitis at study entry, the proportion of overweight and obesity were 32.1% and 17.9%. Overweight was 40.7% and obesity was 27.7% among those with incident bronchitis. The BMI percentile categories showed significant increasing trends for bronchitis in total eligible children and in girls (P for trend <0.001). Overweight and obesity were both associated with increased risks of incident bronchitis. This association was significant in girls only while stratified by gender. CONCLUSIONS Our data showed that the BMI percentile and weight status were associated with higher risks of incident bronchitis in adolescents, especially in girls.
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Affiliation(s)
- Yungling L Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Abstract
This article assesses the role played by media in contributing to the current epidemic of childhood obesity. Electronic media use, often referred to as screen time, is significantly correlated with child adiposity. Although the causal mechanism that accounts for this relationship is unclear, it is well established that reducing screen time improves weight status. Media advertising for unhealthy foods contributes to obesity by influencing children's food preferences, requests, and diet. Industry efforts have failed to improve the nutritional quality of foods marketed on television to children, leading public health advocates to recommend government restrictions on child-targeted advertisements for unhealthy foods.
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Feehan K, O'Neil ME, Abdalla D, Fragala-Pinkham M, Kondrad M, Berhane Z, Turchi R. Factors influencing physical activity in children and youth with special health care needs: a pilot study. Int J Pediatr 2012; 2012:583249. [PMID: 22611411 PMCID: PMC3352328 DOI: 10.1155/2012/583249] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 02/03/2012] [Accepted: 02/13/2012] [Indexed: 12/18/2022] Open
Abstract
Background. Evidence suggests that children and youth with special health care needs (CYSHCN) have decreased physical activity compared to peers. This study describes weight status and physical activity in CYSHCN and identifies factors associated with physical activity and community resources to promote physical activity. Methods. Parents (n = 21) and CYSHCN (n = 23) were recruited from a pediatric clinic. The most prevalent diagnoses were autism (n = 7, 30%) and cerebral palsy (n = 3, 13%). Interviews were conducted with parents for information on physical activity and community resources. Children's height and weight were measured to calculate body mass index (BMI). Results. The majority of CYSHCN (n = 13, 59%) were obese. CYSHCN did not meet recommended levels of 60 minutes of daily physical activity and engaged in more screen time than recommended. More children with cognitive/behavioral/emotional diagnoses were obese compared to children with physical/medical diagnoses. A majority of parents (n = 16, 73%) indicated their CYSHCN need more supervision to participate in physical activity in community programs. Conclusion. The majority of CYSHCN in this study were obese and sedentary. Resources to promote physical activity are needed for this population.
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Affiliation(s)
- Katie Feehan
- Drexel School of Public Health, Drexel University, 245 N. 15th Street, Mail Stop 660, Philadelphia, PA 19102, USA
| | - Margaret E. O'Neil
- Drexel College of Nursing and Health Professions, Drexel University, 245 N. 15th Street, Mail Stop 1030, Philadelphia, PA 19102, USA
| | - Diana Abdalla
- Drexel College of Nursing and Health Professions, Drexel University, 245 N. 15th Street, Mail Stop 1030, Philadelphia, PA 19102, USA
| | - Maria Fragala-Pinkham
- The Research Center, Franciscan Hospital for Children, 30 Warren Street, Brighton, MA 02135, USA
| | - Monica Kondrad
- Department of Pediatrics, St. Christopher's Hospital for Children, 3601 A Street, Philadelphia, PA 19134, USA
| | - Zekarias Berhane
- Drexel School of Public Health, Drexel University, 245 N. 15th Street, Mail Stop 660, Philadelphia, PA 19102, USA
| | - Renee Turchi
- Drexel School of Public Health, Drexel University, 245 N. 15th Street, Mail Stop 660, Philadelphia, PA 19102, USA
- Department of Pediatrics, St. Christopher's Hospital for Children, 3601 A Street, Philadelphia, PA 19134, USA
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Gene-gene and gene-environmental interactions of childhood asthma: a multifactor dimension reduction approach. PLoS One 2012; 7:e30694. [PMID: 22355322 PMCID: PMC3280263 DOI: 10.1371/journal.pone.0030694] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 12/22/2011] [Indexed: 01/24/2023] Open
Abstract
Background The importance of gene-gene and gene-environment interactions on asthma is well documented in literature, but a systematic analysis on the interaction between various genetic and environmental factors is still lacking. Methodology/Principal Findings We conducted a population-based, case-control study comprised of seventh-grade children from 14 Taiwanese communities. A total of 235 asthmatic cases and 1,310 non-asthmatic controls were selected for DNA collection and genotyping. We examined the gene-gene and gene-environment interactions between 17 single-nucleotide polymorphisms in antioxidative, inflammatory and obesity-related genes, and childhood asthma. Environmental exposures and disease status were obtained from parental questionnaires. The model-free and non-parametrical multifactor dimensionality reduction (MDR) method was used for the analysis. A three-way gene-gene interaction was elucidated between the gene coding glutathione S-transferase P (GSTP1), the gene coding interleukin-4 receptor alpha chain (IL4Ra) and the gene coding insulin induced gene 2 (INSIG2) on the risk of lifetime asthma. The testing-balanced accuracy on asthma was 57.83% with a cross-validation consistency of 10 out of 10. The interaction of preterm birth and indoor dampness had the highest training-balanced accuracy at 59.09%. Indoor dampness also interacted with many genes, including IL13, beta-2 adrenergic receptor (ADRB2), signal transducer and activator of transcription 6 (STAT6). We also used likelihood ratio tests for interaction and chi-square tests to validate our results and all tests showed statistical significance. Conclusions/Significance The results of this study suggest that GSTP1, INSIG2 and IL4Ra may influence the lifetime asthma susceptibility through gene-gene interactions in schoolchildren. Home dampness combined with each one of the genes STAT6, IL13 and ADRB2 could raise the asthma risk.
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Lombardi C, Gargioni S, Gardinazzi A, Canonica GW, Passalacqua G. Impact of bariatric surgery on pulmonary function and nitric oxide in asthmatic and non-asthmatic obese patients. J Asthma 2011; 48:553-7. [PMID: 21707447 DOI: 10.3109/02770903.2011.587581] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Asthma is an important co-morbidity of obesity. This study evaluated the impact of bariatric surgery on respiratory function in obese patients and compared the outcomes in asthmatic and non-asthmatic subjects. METHODS The study was observational and prospective and included subjects on waiting list for bariatric surgery. Pulmonary function, symptoms, and exhaled nitric oxide were assessed before surgery and 1 year after. RESULTS Twenty-nine severe obese subjects (age range: 25-66 years) with a mean body mass index of 44.8 ± 4.7 kg/m(2) were included. Fourteen of them had also intermittent to moderate asthma. In the whole population, the body mass index decreased from 44.8 ± 4.7 to 41.1 ± 3.9 kg/m(2) (p = .0001) and the forced vital capacity increased from 3.05 ± 0.83 to 3.50 ± 0.81 L (p = .043). No change was seen in forced expiratory volume and oxygen saturation. These results remained valid also analyzing asthmatics and non-asthmatics separately. Concerning nitric oxide, the decrease at 1 year was significantly different between the two populations, since in asthma patients exhaled nitric oxide decreased by 4.86 ppb after bariatric surgery and increased by 0.27 ppb in non-asthmatics (p = .04). CONCLUSIONS Bariatric surgery significantly reduces the intake of inhaled corticosteroids and the levels of exhaled nitric oxide, thus bronchial inflammation, in asthmatics.
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Affiliation(s)
- Carlo Lombardi
- Allergy Unit, Department of Internal Medicine, Sant'Orsola-Poliambulanza Hospital, Brescia, Italy
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Chen Y, Mai XM. Smoking and asthma in men and women with normal weight, overweight, and obesity. J Asthma 2011; 48:490-4. [PMID: 21486195 DOI: 10.3109/02770903.2011.570404] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a complex interrelationship among smoking, body weight, and asthma. It needs to be clarified whether smoking is related to an increased risk of asthma after taking into account for relative body weight. OBJECTIVE To examine the association between cigarette smoking and the prevalence of asthma in Canadian men and women with normal weight, overweight, and obesity. METHODS The analysis was based on data from 112,830 Canadians aged 18 years or more who participated in a national survey in 2007-2008. A questionnaire covered the information on prevalent asthma, smoking status, height, weight, and other factors. Logistic regression analysis was used to determine the association between smoking and the prevalence of asthma stratified by sex and body mass index (BMI). RESULTS The crude prevalence of asthma was 6.6% for men and 9.3% for women. After adjustment for covariates, the odds ratios (ORs) for current smoking associated with asthma was 1.20 [95% confidence interval (CI): 1.01-1.43] for men with normal weight, 0.98 (95% CI: 0.81, 1.18) for overweight men, and 1.02 (95% CI: 0.80-1.30) for obese men. For women, the corresponding adjusted ORs were 1.41 (95% CI: 1.23-1.62), 1.27 (95% CI: 1.05-1.54), and 1.28 (95% CI: 1.03-1.59), respectively. CONCLUSION Current smoking was significantly associated with prevalent asthma in all women regardless of their relative body weight. In men, however, the association was only observed in those with under- or normal weight.
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Affiliation(s)
- Yue Chen
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
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Bronchial hyperreactivity and airway wall thickening in obstructive sleep apnea patients. Sleep Breath 2010; 15:341-50. [DOI: 10.1007/s11325-010-0387-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 06/22/2010] [Accepted: 06/22/2010] [Indexed: 10/19/2022]
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Abstract
Worldwide prevalence of childhood obesity has increased greatly during the past three decades. The increasing occurrence in children of disorders such as type 2 diabetes is believed to be a consequence of this obesity epidemic. Much progress has been made in understanding of the genetics and physiology of appetite control and from these advances, elucidation of the causes of some rare obesity syndromes. However, these rare disorders have so far taught us few lessons about prevention or reversal of obesity in most children. Calorie intake and activity recommendations need reassessment and improved quantification at a population level because of sedentary lifestyles of children nowadays. For individual treatment, currently recommended calorie prescriptions might be too conservative in view of evolving insight into the so-called energy gap. Although quality of research into both prevention and treatment has improved, high-quality multicentre trials with long-term follow-up are needed. Meanwhile, prevention and treatment approaches to increase energy expenditure and decrease intake should continue. Recent data suggest that the spiralling increase in childhood obesity prevalence might be abating; increased efforts should be made on all fronts to continue this potentially exciting trend.
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Affiliation(s)
- Joan C. Han
- Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS
| | - Debbie A. Lawlor
- MRC Centre for Causal Analyses in Translational Epidemiology Department of Social Medicine, University of Bristol
| | - Sue Y.S. Kimm
- Department of Internal Medicine/Epidemiology, University of New Mexico School of Medicine
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Ertel KA, Koenen KC, Rich-Edwards JW, Gillman MW. Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity. Paediatr Perinat Epidemiol 2010; 24:179-89. [PMID: 20415775 PMCID: PMC4106300 DOI: 10.1111/j.1365-3016.2010.01098.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Antenatal depression is associated with small-for-gestational age, but few studies have examined associations with weight during childhood. Similarly, few studies address whether antenatal and postpartum depression differentially affect child weight. Among 838 mother-child dyads in Project Viva, a prospective cohort study, we examined relationships of antenatal and postpartum depression with child weight and adiposity. We assessed maternal depression at mid-pregnancy and 6 months postpartum with the Edinburgh Postnatal Depression Scale (score > or =13 indicating probable depression). We assessed child outcomes at age 3 years: body mass index (BMI) z-score, weight-for-height z-score, sum of subscapular (SS) and triceps (TR) skinfold thickness (SS + TR) for overall adiposity, and SS : TR ratio for central adiposity. Sixty-nine (8.2%) women experienced antenatal depression and 59 (7.0%) postpartum depression. Mean (SD) outcomes at age 3 were: BMI z-score, 0.45 (1.01); SS + TR, 16.72 (4.03) mm; SS : TR, 0.64 (0.15). In multivariable models, antenatal depression was associated with lower child BMI z-score (-0.24 [95% confidence interval: -0.49, 0.00]), but higher SS : TR (0.05 [0.01, 0.09]). There was no evidence of a dose-response relationship between antenatal depression and these outcomes. Postpartum depression was associated with higher SS + TR (1.14 [0.11, 2.18]). In conclusion, whereas antenatal depression was associated with smaller size and central adiposity at age 3 years, postpartum depression was associated with higher overall adiposity.
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Affiliation(s)
- Karen A Ertel
- Departments of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
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Camargo CA, Boulet LP, Sutherland ER, Busse WW, Yancey SW, Emmett AH, Ortega HG, Ferro TJ. Body mass index and response to asthma therapy: fluticasone propionate/salmeterol versus montelukast. J Asthma 2010; 47:76-82. [PMID: 20100025 DOI: 10.3109/02770900903338494] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We studied the relationship between body mass index (BMI) on responses to asthma therapy using a retrospective analysis of four previously reported clinical trials. Fluticasone propionate (FP)/salmeterol via Diskus 100/50 microg twice daily and montelukast (MON) 10 mg daily were compared. BMI was classified as underweight (less than 20 kg/m(2)), normal (20-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), obese-1 (30-34.9 kg/m(2)), obese-2 (35-39.9 kg/m(2)), or obese-3 (at least 40 kg/m(2)). Outcomes assessed included forced expiratory volume in one second (FEV(1)), asthma symptom score, and albuterol use. FP/salmeterol produced greater improvements compared to MON in each of the asthma outcomes studied over the entire BMI range at the week-12 endpoint, with statistically significant differences noted among normal, overweight, obese-1, and obese-3 subjects. The within-treatment responses to FP/salmeterol across BMI ranges at the week-12 endpoint was statistically significantly greater in normal compared to obese-3 for FEV(1) and albuterol use, and in overweight compared to the obese-3 for each outcome studied. The within-treatment comparisons of MON across BMI ranges were significant for albuterol use in normal and underweight compared to obese-3 at the week-12 endpoint. Compared to subjects with normal BMI, the onset to peak FEV(1) may require longer treatment exposure in the very obese. Treatment responses to FP/salmeterol were consistently greater compared to MON and persisted at higher BMI.
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Affiliation(s)
- Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Barranco P, Delgado J, Sastre J, Vega JM, Pascual MJ, Barranco R, García-Río F, Parra A, Quirce S. Obesity is not associated with mild asthma diagnosis in a population of Spanish adults. J Asthma 2009; 46:867-71. [PMID: 19905910 DOI: 10.3109/02770900903225386] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Several studies have suggested a relationship between asthma and obesity. Moreover, atopy is an important risk factor for asthma, but the relationship between obesity and atopy is uncertain. METHODS A cross-sectional multicenter study was conducted in a population of Spanish adults between November 2007 and July 2008. The subjects included had experienced asthma symptoms in the last year but had a forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) > 70%. Mild asthma diagnosis was confirmed by measuring airway hyperresponsiveness to methacholine. Body mass index in kg/m(2) was used as measure of obesity. Subjects were considered atopic when they had at least one positive skin prick test to common aeroallergens. Adjusted odd ratios (OR) were obtained by logistic regression. RESULTS A total of 662 subjects were included and 234 subjects (35.3%) were diagnosed with asthma (consistent symptoms and positive methacholine test). After adjusting the model for age, gender, atopy, baseline FEV(1), and FEV(1)/FVC ratio, there was no association between overweight or obesity with asthma diagnosis, with OR of 0.889 (95% CI, 0.60-1.38) and 0.925 (95% CI, 0.577-1.48), respectively. A multivariable logistic regression analysis confirmed that atopy increases the risk of asthma (p = 0.008). The non-atopic obese group had an increased risk of asthma compared to the non-atopic group with normal weight or overweight (p = 0.0032). CONCLUSIONS In this study obesity was not associated with a diagnosis of asthma. The presence of atopy was a risk factor for asthma, independent of obesity. Obesity, however, may be a risk factor for the development of asthma among non-atopic subjects.
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Affiliation(s)
- Pilar Barranco
- Hospital Universitario La Paz, Allergy Department, P degree Castellana, 261, 28046 Madrid, Spain.
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The impact of morbid obesity and bariatric surgery on comorbid conditions: a comprehensive examination of comorbidities in an employed population. J Occup Environ Med 2009; 51:170-9. [PMID: 19209038 DOI: 10.1097/jom.0b013e31818def04] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Find conditions with significantly different prevalence among employees diagnosed with morbid obesity (DMO). Examine the effect of bariatric surgery on the prevalence of all categories of comorbid conditions after surgery. METHODS This large employer retrospective database analysis used matching to create two cohorts: Those with a DMO and those without. RESULTS The DMO cohort had higher diagnosis rates in every Agency for Healthcare Research and Quality major diagnostic category except pregnancy, and it had significantly higher prevalence in 147 of 261 Agency for Health care Research and Quality specific categories. Those electing to undergo bariatric surgery experienced significant prevalence decreases in 26 of 261 specific categories. CONCLUSION Employees DMO are at higher risk for many serious diseases. Bariatric surgery has been effective in promoting weight loss and decreasing the rates of many serious comorbidities.
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de Vries A, Howie SEM. Diet and asthma--can you change what you or your children are by changing what you eat? Pharmacol Ther 2009; 122:78-82. [PMID: 19248808 DOI: 10.1016/j.pharmthera.2009.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Accepted: 02/04/2009] [Indexed: 01/03/2023]
Abstract
In this review we focus on dietary fat content and subsequent effects on asthma. According to the World Health Organisation over 300 million people currently have asthma. The majority of asthma cases are 'extrinsic' and result from inappropriate 'allergic' immune responses to inhaled environmental substances. Whilst some individuals are allergic to particular food components it is becoming clear that the content of the diet can more generally affect the health of the immune system. Components of maternal and early life diets have been reported to influence offspring immune function and asthma. There has been speculation that different types of dietary fat have pro- and anti-inflammatory effects but the results of various studies are contradictory. Asthma and obesity are two conditions that have almost simultaneously reached epidemic levels in some societies. There is evidence that diet-induced obesity alters immune function and there is little doubt that consumption of a high caloric diet with high fat content leads to obesity. However, there is conflicting information over whether and how obesity is linked to asthma in children and adults. Whilst obesity is to be avoided there is accumulating evidence that dietary fat per se does not necessarily predispose towards allergic symptoms.
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Affiliation(s)
- Annick de Vries
- Translational Medicine Research Collaboration, University of Dundee, James Arrott Drive, Ninewells Campus, Dundee DD19SY, UK.
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