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Bongers-Karmaoui MN, Hirsch A, Budde RPJ, Roest AAW, Jaddoe VWV, Gaillard R. The cardiovascular exercise response in children with overweight or obesity measured by cardiovascular magnetic resonance imaging. Int J Obes (Lond) 2024:10.1038/s41366-024-01589-1. [PMID: 39107494 DOI: 10.1038/s41366-024-01589-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 06/14/2024] [Accepted: 07/10/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Overweight and obesity are among the main causes of cardiovascular diseases. Exercise testing can aid in the early detection of subtle cardiac dysfunction not present in rest. We hypothesized that the cardiovascular response to exercise is impaired among children with overweight or obesity, characterized by the inability of the cardiovascular system to adapt to exercise by increasing cardiac volumes and blood pressure. We performed a cardiovascular stress test to investigate whether the cardiovascular exercise response is altered in children with overweight and obesity, as compared to children with a normal weight. SUBJECTS A subgroup of the Generation R population-based prospective cohort study, consisting of 41 children with overweight or obesity and 166 children with a normal weight with a mean age of 16 years, performed an isometric exercise. METHODS Continuous heart rate and blood pressure were measured during rest, exercise and recovery. Cardiovascular magnetic resonance (CMR) measurements were performed during rest and exercise. RESULTS Higher BMI was associated with a higher resting systolic and diastolic blood pressure (difference: 0.24 SDS (95% CI 0.10, 0.37) and 0.20 SDS (95% CI 0.06, 0.33)) and lower systolic and diastolic blood pressure increases from rest to peak exercise (-0.11 SDS (95% CI -0.20, -0.03) and -0.07 SDS (95% CI -0.07, -0.01)). BMI was also associated with a slower decrease in systolic and diastolic blood pressure during recovery (p values < 0.05). Higher childhood BMI was associated with lower BSA corrected left ventricular mass, end-diastolic volume and stroke volume (p values < 0.05). There were no associations of childhood BMI with the cardiac response to exercise measured by heart rate and CMR measurements. CONCLUSION Childhood BMI is, across the full range, associated with a blunted blood pressure response to static exercise but there were no differences in cardiac response to exercise. Our findings suggest that adiposity may especially affect the vascular exercise reaction without affecting cardiac response.
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Affiliation(s)
- Meddy N Bongers-Karmaoui
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alexander Hirsch
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ricardo P J Budde
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Arno A W Roest
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands.
- Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands.
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Talbot JS, Perkins DR, Dawkins TG, Lord RN, Oliver JL, Lloyd RS, McManus AM, Stembridge M, Pugh CJA. Flow-mediated dilation is modified by exercise training status during childhood and adolescence: preliminary evidence of the youth athlete's artery. Am J Physiol Heart Circ Physiol 2024; 327:H331-H339. [PMID: 38847760 DOI: 10.1152/ajpheart.00287.2024] [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] [Received: 05/06/2024] [Revised: 06/04/2024] [Accepted: 06/04/2024] [Indexed: 07/17/2024]
Abstract
Chronic exercise training is associated with an "athlete's artery" phenotype in young adults and an attenuated age-related decline in endothelium-dependent arterial function. Adolescence is associated with an influx of sex-specific hormones that may exert divergent effects on endothelial function, but whether training adaptations interact with biological maturation to produce a "youth athlete's artery" has not been explored. We investigated the influence of exercise-training status on endothelium-dependent arterial function during childhood and adolescence. Brachial artery flow-mediated dilation (FMD) was assessed in n = 102 exercise-trained (males, n = 25; females, n = 29) and untrained (males, n = 23; females, n = 25) youths, characterized as pre (males, n = 25; females, n = 26)- or post (males, n = 23; females, n = 28)-predicted age at peak height velocity (PHV). Baseline brachial artery diameter was larger in post- compared with pre-PHV youths (P ≤ 0.001), males compared with females (P ≤ 0.001), and trained compared with untrained youths (3.26 ± 0.51 vs. 3.11 ± 0.42 mm; P = 0.041). Brachial FMD was similar in pre- and post-PHV youths (P = 0.298), and males and females (P = 0.946). However, exercise-trained youths demonstrated higher FMD when compared with untrained counterparts (5.3 ± 3.3 vs. 3.0 ± 2.6%; P ≤ 0.001). Furthermore, brachial artery diameter (r2 = 0.142; P = 0.007 vs. r2 = 0.004; P = 0.652) and FMD (r2 = 0.138; P = 0.008 vs. r2 = 0.003; P = 0.706) were positively associated with cardiorespiratory fitness in post-, but not pre-PHV youths, respectively. Collectively, our data indicate that exercise training is associated with brachial artery remodeling and enhanced endothelial function during youth. However, arterial remodeling and endothelium-dependent function are only associated with elevated cardiorespiratory fitness during later stages of adolescence.NEW & NOTEWORTHY We report preliminary evidence of the "youth athlete's artery," characterized by training-related arterial remodeling and elevated endothelium-dependent arterial function in children and adolescents. However, training-related adaptations in brachial artery diameter and flow-mediated dilation (FMD) were associated with cardiorespiratory fitness in adolescents, but not in children. Our findings indicate that endothelium-dependent arterial function is modifiable with chronic exercise training during childhood, but the association between FMD and elevated cardiorespiratory fitness is only apparent during later stages of adolescence.
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Affiliation(s)
- Jack S Talbot
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
- Cardiometabolic Health and Exercise Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Dean R Perkins
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Tony G Dawkins
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Rachel N Lord
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Jon L Oliver
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Rhodri S Lloyd
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, Waikato, New Zealand
| | - Ali M McManus
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Mike Stembridge
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Christopher J A Pugh
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
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Khvostenko K, Muñoz-Pina S, García-Hernández J, Heredia A, Andrés A. Impact of Fava Bean ( Vicia faba) Processing on Quality Characteristics and Digestibility of a Protein-Rich Snack. Foods 2024; 13:2372. [PMID: 39123563 PMCID: PMC11311399 DOI: 10.3390/foods13152372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
The impact of fava bean processing methods (soaking, autoclaving, fermentation) on a legume-based bars' quality, protein characteristics, and digestibility was shown. The antioxidant and the angiotensin-converting enzyme-inhibitory capacity before and after in vitro digestion were investigated to reveal the potential advantages of fava bean usage for snacks. All bars have demonstrated high protein content, varying from 22.1 to 25.1 g/100 g DB. Based on the fermented fava beans of Pleurotus ostreatus, the samples were characterized by a higher concentration of essential amino acids by 8.6% and a reduction of tannins by 18.5% compared with bars based on soaked fava beans. Sensory evaluation improved the color, texture, and overall acceptability of the bars with fermented legumes. Various types of bean processing did not significantly affect the protein digestibility of the bars. The fermentation method positively affected the angiotensin-converting enzyme-inhibitory properties of bars and increased by 16.5% (before digestion) and 15% (after digestion) compared with other samples. After digestion, samples were characterized by a high level of Fe bioaccessibility (100, 83, and 79% for the bars based on soaked, autoclaved, and fermented fava beans, respectively) and increased total phenolic content. These findings highlight the potential health benefits of fava bean usage for snack products.
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Affiliation(s)
- Kateryna Khvostenko
- Instituto Universitario de Ingeniería de Alimentos para el Desarrollo (FoodUPV), Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain (A.A.)
| | - Sara Muñoz-Pina
- Instituto Universitario de Ingeniería de Alimentos para el Desarrollo (FoodUPV), Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain (A.A.)
| | - Jorge García-Hernández
- Centro Avanzado de Microbiología de Alimentos (CAMA), Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Ana Heredia
- Instituto Universitario de Ingeniería de Alimentos para el Desarrollo (FoodUPV), Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain (A.A.)
| | - Ana Andrés
- Instituto Universitario de Ingeniería de Alimentos para el Desarrollo (FoodUPV), Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain (A.A.)
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Van De Maele K, Bruyndonckx L. Quantifying cardiovascular risk: will measuring endothelial function suffice? Eur J Prev Cardiol 2024; 31:1150-1151. [PMID: 38407826 DOI: 10.1093/eurjpc/zwae084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 02/23/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Karolien Van De Maele
- Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
- Department of Paediatrics, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Luc Bruyndonckx
- Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
- Department of Paediatrics, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
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5
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Song Y, Li X, Hu B, Chen Y, Cui P, Liang Y, He X, Yang G, Li J. A study on the configuration of factors influencing overweight and obesity in adolescents based on fuzzy set qualitative comparative analysis. J Adolesc 2024. [PMID: 38946211 DOI: 10.1002/jad.12369] [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: 09/13/2023] [Revised: 06/14/2024] [Accepted: 06/20/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE Overweight and obesity among adolescents are grave public health issues around the world. Although the conditions that contribute to obesity have been extensively researched, little is known about how multiple conditions interact to cause overweight and obesity. The current study intends to investigate the histomorphic configuration pathways of several conditions of adolescent overweight and obesity by gender. METHOD The data came from a social survey conducted in June 2021 in Changchun, Jilin Province, China. The sample collected was 14-year-old adolescents, including 167 boys and 137 girls. The school physicians examined the participants' weight and height, and questionnaires were used to collect risk indicators from adolescents, such as sleep duration, electronic screens times, consumption of sugary drinks and fried foods, and physical activity. Simultaneously, a Fuzzy Qualitative Comparative Analysis will be performed to investigate the combinations of diverse conditions. RESULT We found that there is no determining necessary condition that, once present, directly determines that an individual is in a state of overweight and obesity. Simultaneously, this study revealed nine alternative configurational paths of overweight and obesity in teenagers of different genders, with a concordance of 0.805 for six male groupings and 0.916 for three female groupings. The outcomes of overweight obesity in adolescents under different genders are similar but not identical. CONCLUSION This study examined the interactions of a number of conditions from the individual, behavioral, learning and living environment that led to the same overweight obese outcome among adolescents of different genders. Our research will be useful to policymakers in that interventions should take into account the combined effects of a number of different aspects rather than focusing on a single factor that causes overweight and obesity.
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Affiliation(s)
- Yiwen Song
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xinru Li
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Bingqin Hu
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yitong Chen
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Peiyao Cui
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yifang Liang
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xin He
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Guofeng Yang
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jinghua Li
- School of Public Health, Jilin University, Changchun, Jilin Province, China
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Ong J, Roem J, Ducharme-Smith K, Vizthum D, Lu M, Agrawal P, Urbina EM, Brady TM. Association of Sodium and Sugar-Sweetened Beverage Intake With Cardiovascular Disease Risk Factors in Adolescents and Young Adults With Obesity. Clin Pediatr (Phila) 2024; 63:669-679. [PMID: 37477185 DOI: 10.1177/00099228231186666] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Cardiovascular disease (CVD) risk factors in children have increased in prevalence. Dietary intake may modify risk. Data collected during a randomized trial testing the effect of a behavioral intervention on adiposity, blood pressure (BP), and left ventricular mass index (LVMI) were analyzed using multivariable regression to determine independent associations of sodium, sugar-sweetened beverage (SSB), and artificially sweetened beverage (ASB) intake with outcomes. High sodium intake (≥3.5 g) was associated with hypertensive BP (odds ratio 12.8; P = .027) in minimally adjusted models. High SSB intake (≥4 oz) was independently associated with body mass index z-score (β = .34; P = .035) and waist circumference z-score (β = .49; P = .022) in fully adjusted models. Any ASB intake was associated with LVMI in fully adjusted model (% change 38.22; P = .004). There was no effect modification between sodium and SSB on outcomes. Dietary factors explored in this study independently impacted CVD risk. Further effect measure modification should be explored in larger cohorts.
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Affiliation(s)
- Jason Ong
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer Roem
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Mengyang Lu
- Johns Hopkins Institute for Clinical & Translational Research, Baltimore, MD, USA
| | - Pranjal Agrawal
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elaine M Urbina
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tammy M Brady
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Liu L, Tang W, Wu S, Ma J, Wei K. Pulmonary succinate receptor 1 elevation in high-fat diet mice exacerbates lipopolysaccharides-induced acute lung injury via sensing succinate. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167119. [PMID: 38479484 DOI: 10.1016/j.bbadis.2024.167119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/23/2024] [Accepted: 03/06/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Individuals with obesity have higher level of circulating succinate, which acts as a signaling factor that initiates inflammation. It is obscure whether succinate and succinate receptor 1 (SUCNR1) are involved in the process of obesity aggravating acute lung injury (ALI). METHODS The lung tissue and blood samples from patients with obesity who underwent lung wedgectomy or segmental resection were collected. Six-week-old male C57BL/6J mice were fed a high-fat diet for 12 weeks to induce obesity and lipopolysaccharides (LPS) were injected intratracheally (100 μg, 1 mg/ml) for 24 h to establish an ALI model. The pulmonary SUCNR1 expression and succinate level were measured. Exogenous succinate was supplemented to assess whether succinate exacerbated the LPS-induced lung injury. We next examined the cellular localization of pulmonary SUCNR1. Furthermore, the role of the succinate-SUCNR1 pathway in LPS-induced inflammatory responses in MH-s macrophages and obese mice was investigated. RESULT The pulmonary SUCNR1 expression and serum succinate level were significantly increased in patients with obesity and in HFD mice. Exogenous succinate supplementation significantly increased the severity of ALI and inflammatory response. SUCNR1 was mainly expressed on lung macrophages. In LPS-stimulated MH-s cells, knockdown of SUCNR1 expression significantly inhibited pro-inflammatory cytokines' expression, the increase of hypoxia-inducible factor-1α (HIF-1α) expression, inhibitory κB-α (IκB-α) phosphorylation, p65 phosphorylation and p65 translocation to nucleus. In obese mice, SUCNR1 inhibition significantly alleviated LPS-induced lung injury and decreased the HIF-1α expression and IκB-α phosphorylation. CONCLUSION The high expression of pulmonary SUCNR1 and serum succinate accumulation at least partly participate in the process of obesity aggravating LPS-induced lung injury.
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Affiliation(s)
- Ling Liu
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Wenjing Tang
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Siqi Wu
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jingyue Ma
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ke Wei
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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de Brito JN, Pereira MA, Kelly AS, Erickson DJ, Sherwood NE, Mason SM, Loth KA, French SA, Evanoff NG, Dengel DR, Kunin-Batson AS. Body Mass Index Trajectories and Biomarkers of Cardiometabolic Risk in Children from Low-Income and Racially and Ethnically Diverse Households. Child Obes 2024; 20:243-253. [PMID: 37327058 PMCID: PMC11250839 DOI: 10.1089/chi.2022.0216] [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] [Indexed: 06/17/2023]
Abstract
Background: This study examined the associations between BMI trajectories and emerging cardiometabolic risk (CMR) in children living in low-income and racially and ethnically diverse households in the United States. Methods: Data were drawn from NET-Works randomized intervention trial and NET-Works 2 prospective follow-up study (N = 338). BMI was measured across 6 follow-up visits and biomarkers of cardiometabolic risk (CMR) at the sixth visit. Group-based trajectory modeling identified child BMI trajectories. Adjusted multivariable linear regressions evaluated the associations between BMI trajectories and CMR. Results: We identified two BMI trajectories: 25% followed a trajectory of steep BMI increase, and 75% followed a moderate decreasing BMI trajectory over time. Relative to children in the moderate decreasing trajectory, children in the increasing trajectory had higher adjusted mean levels of C-reactive protein [CRP; 3.3; 95% confidence interval (CI): 1.6 to 5.0], leptin (63.1; 95% CI: 44.3 to 81.8), triglycerides (35.4; 95% CI: 22.1 to 48.6), triglyceride/high-density lipoprotein (HDL) ratio (1.2; 95% CI: 0.8 to 1.6), hemoglobin A1c (HbA1C; 0.1; 95% CI: 0.03 to 0.2), fasting glucose (1.8; 0.1 to 3.5) and insulin (8.8; 95% CI: 6.5 to 11.0), overall CMR score (0.7; 95% CI: 0.5 to 0.9), and lower adiponectin (-1.3; 95% CI: -2.5 to -0.1) and HDL (-10.8; 95% CI: -14.3 to -7.4). Conclusions: Children with high BMIs early in childhood were more likely to maintain an accelerated BMI trajectory throughout childhood, which was associated with adverse CMR in pre-adolescence. To advance health equity and support children's healthy weight and cardiovascular health trajectories, public health efforts are needed to address persistent disparities in childhood obesity and CMR.
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Affiliation(s)
- Junia N. de Brito
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mark A. Pereira
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Aaron S. Kelly
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Darin J. Erickson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Nancy E. Sherwood
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Susan M. Mason
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Katie A. Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Simone A. French
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Nicholas G. Evanoff
- Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Donald R. Dengel
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Alicia S. Kunin-Batson
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
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Vizzuso S, Torto AD, Fiore G, Carugo S, Zuccotti G, Verduci E. Tri-ponderal mass index and left ventricular hypertrophy in a cohort of caucasian children and adolescents with obesity. Ital J Pediatr 2024; 50:75. [PMID: 38637874 PMCID: PMC11027303 DOI: 10.1186/s13052-024-01634-9] [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: 05/11/2023] [Accepted: 03/23/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Pediatric obesity is a global emerging burden for society; among its health-related consequences there are hypertension (HTN) and left ventricular hypertrophy (LVH). Several anthropometric indices have been investigated for the early identification of cardiovascular risk in children. The aim of the present study was to assess whether tri-ponderal mass index (TMI) was associated with LVH in a cohort of Caucasian children and adolescents with obesity. METHODS In this observational study, 63 children and adolescents with obesity aged 7-to-16 years were enrolled. During outpatient visits, adiposity, and cardio-metabolic indices (BMI z-score, WHR, TMI, ABSI) were collected. All subjects underwent a 24-hour ambulatory blood pressure monitoring (ABPM) and transthoracic echocardiography. RESULTS Children and adolescents with obesity with LVH had significantly higher BMI z-score (p = 0.009), WHR (p = 0.006) and TMI (p = 0.026) compared to children without LVH. WC and WHR were the only indices significantly associated with left ventricular mass index (LVMI). CONCLUSION Left ventricular remodeling is associated with the cardio-metabolic risk markers WC and WHR, but not with the adiposity index TMI among children with obesity.
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Affiliation(s)
- Sara Vizzuso
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, Milan, Italy.
| | | | - Giulia Fiore
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Stefano Carugo
- Department of Internal Medicine, Cardiology Unity, University of Milan, Fondazione Ospedale Maggiore IRCCS Policlinico Milano, Milano, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Elvira Verduci
- Department of Pediatrics, Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
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Wang K, Li Y, Liu S, Liu H, Zhang T, Luo J. Can an intervention integrating sports and medicine improve children's health more effectively? Monitoring based on sleep, body mass index, and heart rate variability. J Glob Health 2024; 14:04040. [PMID: 38635801 PMCID: PMC11026036 DOI: 10.7189/jogh.14.04040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
Background Theoretical studies have suggested that the integration of sports and medicine with one another could positively affect children's health. By monitoring the variation characteristics of children's sleep, body mass index (BMI), and heart rate variability (HRV), we explored and compared the influences of and differences between two interventions - physical exercise and an intervention integrating sports and medicine - on improving children's health. Methods We conducted a randomised controlled study, where we randomly divided 136 children into the physical exercise group (PEG), the integration of sports and medicine group (ISMG), and the control group. We measured sleep, BMI, and HRV at baseline and week eight. Results After the eight-week intervention, the sleep scores in the PEG and the ISMG were significantly lower than in the control group, while the scores in the ISMG were significantly lower than in the PEG. After the eight-week intervention, the BMI of both the PEG and the ISMG was significantly lower than that of the control group, without a significand difference between the two intervention groups. After the eight-week intervention, the standard deviation of normal-to-normal intervals (SDNN), root mean square differences of the standard deviation (RMSSD), low-frequency of normal (LFn), and high-frequency of normal (HFn) in the PEG and the ISMG were significantly higher than those in the control group, again without a significant difference between the two intervention groups. After intervention, sleep, BMI, and HRV of the three groups were correlated with one another to different degrees, but the correlation coefficient of the two exercise groups was higher. Conclusions Based on the interventions, we observed a significant correlation between sleep, BMI, and HRV in children. Regular physical exercise or an intervention integrating sports and medicine could synergistically improve sleep, BMI, and HRV in this population, with the latter having a better effect on improving sleep quality.
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Affiliation(s)
- Kun Wang
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
| | - Yan Li
- College of Liberal Studies, Chongqing Industry Polytechnic College (Sports Work Department), Yubei, Chongqing, China
| | - Shiqi Liu
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
| | - Hengxu Liu
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
| | - Tingran Zhang
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
| | - Jiong Luo
- College of Physical Education, Southwest University, Research Centre for Exercise Detoxification, Chongqing, China
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11
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Leyden GM, Urquijo H, Hughes AD, Davey Smith G, Richardson TG. Characterizing the Causal Pathway From Childhood Adiposity to Right Heart Physiology and Pulmonary Circulation Using Lifecourse Mendelian Randomization. J Am Heart Assoc 2024; 13:e030453. [PMID: 38456449 PMCID: PMC11010002 DOI: 10.1161/jaha.123.030453] [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] [Received: 04/06/2023] [Accepted: 10/19/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Observational epidemiological studies have reported an association between childhood adiposity and altered cardiac morphology and function in later life. However, whether this is due to a direct consequence of being overweight during childhood has been difficult to establish, particularly as accounting for other measures of body composition throughout the lifecourse can be exceptionally challenging. METHODS AND RESULTS In this study, we used human genetics to investigate this using a causal inference technique known as lifecourse Mendelian randomization. This approach allowed us to evaluate the effect of childhood body size on 11 measures of right heart and pulmonary circulation independent of other anthropometric traits at various stages in the lifecourse. We found strong evidence that childhood body size has a direct effect on an enlarged right heart structure in later life (eg, right ventricular end-diastolic volume: β=0.24 [95% CI, 0.15-0.33]; P=3×10-7) independent of adulthood body size. In contrast, childhood body size effects on maximum ascending aorta diameter attenuated upon accounting for body size in adulthood, suggesting that this effect is likely attributed to individuals remaining overweight into later life. Effects of childhood body size on pulmonary artery traits and measures of right atrial function became weaker upon accounting for adulthood fat-free mass and childhood height, respectively. CONCLUSIONS Our findings suggest that, although childhood body size has a long-term influence on an enlarged heart structure in adulthood, associations with the other structural components of the cardiovascular system and their function may be largely attributed to body composition at other stages in the lifecourse.
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Affiliation(s)
- Genevieve M. Leyden
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of BristolBristolUK
- Bristol Medical School: Translational Health Sciences, Dorothy Hodgkin BuildingUniversity of BristolBristolUK
| | - Helena Urquijo
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of BristolBristolUK
| | - Alun D. Hughes
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science and Experimental MedicineInstitute of Cardiovascular Science, University College LondonLondonUK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of BristolBristolUK
| | - Tom G. Richardson
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of BristolBristolUK
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12
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Dusenbery SM, de Ferranti SD, Kerstein J, Mendelson M, Colan S, Gauvreau K, Arya P. Relationship of Left Ventricular Mass to Lean Body Mass in the Obese Pediatric Population. Pediatr Cardiol 2024; 45:640-647. [PMID: 36988707 DOI: 10.1007/s00246-023-03133-w] [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: 11/15/2022] [Accepted: 02/20/2023] [Indexed: 03/30/2023]
Abstract
Our primary aim was to investigate the relationship between LVM and anthropometric measures including lean body mass (LBM) in obese pediatric subjects compared to normal weight controls. A retrospective chart review identified subjects 2-18 years old who were normotensive and had normal echocardiograms between 1995 and 2020 at Boston Children's Hospital. LVM was calculated with the 5/6 area length rule from 2D echocardiograms. LBM was calculated with equations derived from dual-energy X-ray absorptiometry. Of the 2217 subjects who met inclusion criteria, 203 were obese and 2014 had normal weight. The median age was 11.9 (2.0-18.9); 46% were female. The median LVM was 94.5 g (59.3-134.3) in obese subjects vs. 78.0 g (51.5-107.7) in controls. The median LBM was 37.2 kg (18.9-50.6) in obese subjects vs. 30.5 kg (17.6-40.8) in controls. In control and obese subjects, LBM had the strongest correlation to LVM (R2 0.86, P < 0.001) and (R2 0.87, P < 0.001), respectively. There was at most a modest correlation between tissue Doppler velocity z-scores and LV mass, and the largest was Septal E' z-score in obese subjects (r = - 0.31, P = 0.006). In this cohort, LBM was found to have the strongest relationship to LVM in obese subjects. The largest correlation between tissue Doppler velocity z-scores and LV mass was Septal E' z-score. Future studies will evaluate which measurements are more closely aligned with clinical outcomes in obese children.
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Affiliation(s)
- Susan M Dusenbery
- Departments of Cardiology, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, USA
- Department of Cardiology, Atrius Health, Boston, USA
| | - Sarah D de Ferranti
- Departments of Cardiology, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Jason Kerstein
- Departments of Cardiology, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Michael Mendelson
- Departments of Cardiology, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Steven Colan
- Departments of Cardiology, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Kimberlee Gauvreau
- Departments of Cardiology, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Puneeta Arya
- Department of Cardiology, Massachusetts General Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, USA.
- Mass General Hospital for Children: Pediatric and Congenital Cardiology, Yawkey Center for Outpatient Care, 55 Fruit St., Suite 6C, Boston, MA, 02114, USA.
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13
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Wang F, Zhang P, Ren Y, Huang D, Xu F, Ma J, Luo S, Liang X. The estimated effect of increasing fruit interventions on controlling body weight in children and adolescents: A meta-analysis. Prev Med 2024; 179:107785. [PMID: 37992975 DOI: 10.1016/j.ypmed.2023.107785] [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: 05/14/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND The impact of increased fruit consumption on weight change remains a matter of debate. OBJECTIVE This study aimed to evaluate the effects of interventions targeted at promoting fruit consumption and managing body weight in children and adolescents. METHODS Four electronic databases, including PubMed, Web of science, Embase, and the Cochrane Library, were searched from January 1, 2000, to October 10th, 2023, to identify Randomized controlled trials (RCTs) that assessed changes in fruit consumption and obesity indicators. RESULTS A total of 22 trials including 12,678 participants who met our inclusion criteria were selected for this review. The meta-analysis demonstrated that the interventions increased fruit intake (MD = 78.58 g/day (95% CI 53.09 to 104.07), P < 0.001) in children and adolescents. The mean reduction of body mass index was 0.27 kg/m2 (95% CI -0.59 to 0.05 kg/m2, P = 0.101). And no significant decreases were observed in body mass index-z scores, but there was a significant decrease in waist circumference (MD = -0.65 cm (95% CI -1.15 to -0.05 cm), P < 0.05). Increased fruit intake was shown to be associated with a lower prevalence of obesity when compared to the control group (odds ratio [OR]: 0.74, 95% CI 0.60 to 0.90), P < 0.05). CONCLUSIONS This meta-analysis provided evidence that interventions aimed at increasing fruit consumption were effective at reducing obesity prevalence.
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Affiliation(s)
- Fengming Wang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Ping Zhang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Yanling Ren
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Daochao Huang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Fenglin Xu
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Jun Ma
- Shimian People's Hospital, Ya'an, China
| | - Shunqing Luo
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China.
| | - Xiaohua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China.
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14
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Vandoni M, Marin L, Cavallo C, Gatti A, Grazi R, Albanese I, Taranto S, Silvestri D, Di Carlo E, Patanè P, Carnevale Pellino V, Zuccotti G, Calcaterra V. Poor Motor Competence Affects Functional Capacities and Healthcare in Children and Adolescents with Obesity. Sports (Basel) 2024; 12:44. [PMID: 38393264 PMCID: PMC10891969 DOI: 10.3390/sports12020044] [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: 12/18/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND From a young age, children learn different motor skills known as fundamental motor skills. The acquisition of these skills is crucial for the future development of context-tailored actions that could improve adherence to physical activity (PA) practice. Motor competence and function deficits have been associated with pediatric obesity. We reviewed the literature data regarding motor competence in pediatrics and impaired motor performance in children and adolescents with obesity. METHODS We assessed the abstracts of the available literature (n = 110) and reviewed the full texts of potentially relevant articles (n = 65) that were analyzed to provide a critical discussion. RESULTS Children and adolescents with obesity show impaired motor performance, executive functions, postural control, and motor coordination. Children's age represents a crucial point in the development of motor skills. Early interventions are crucial to preventing declines in motor proficiency and impacting children's PA and overall fitness levels. CONCLUSIONS To involve children, the PA protocol must be fun and tailored in consideration of several aspects, such as clinical picture, level of physical fitness, and motor skills. A supervised adapted exercise program is useful to personalized PA programs from an early pediatric age.
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Affiliation(s)
- Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Luca Marin
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Caterina Cavallo
- Department of Sport and Exercise Science, LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg;
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Roberta Grazi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Ilaria Albanese
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Industrial Engineering Department, University of Tor Vergata, 00133 Rome, Italy
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Dario Silvestri
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Eleonora Di Carlo
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Pamela Patanè
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Industrial Engineering Department, University of Tor Vergata, 00133 Rome, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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15
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Giontella A, Tagetti A, Bonafini S, Marcon D, Cattazzo F, Bresadola I, Antoniazzi F, Gaudino R, Cavarzere P, Montagnana M, Pietrobelli A, Maffeis C, Minuz P, Fava C. Comparison of Performance in the Six-Minute Walk Test (6MWT) between Overweight/Obese and Normal-Weight Children and Association with Haemodynamic Parameters: A Cross-Sectional Study in Four Primary Schools. Nutrients 2024; 16:356. [PMID: 38337641 PMCID: PMC10857357 DOI: 10.3390/nu16030356] [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: 01/01/2024] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Physical activity plays a pivotal role in preventing obesity and cardiovascular risks. The six-minute walk test (6MWT) is a tool to assess functional capacity and predict cardiovascular events. The aim of this cross-sectional study was to compare the performance and haemodynamic parameters before and after a 6MWT between obese/overweight vs. normal-weight children (average age 8.7 ± 0.7 years) participating in a project involving four primary schools in South Verona (Italy). Validated questionnaires for physical activity and diet, as well as blood drops, were collected. Overweight or obese children (OW&OB; n = 100) covered a shorter 6MWT distance compared to normal-weight children (NW, n = 194). At the test's conclusion, the OW&OB group exhibited a higher Rate Pulse Product (RPP = Systolic Blood Pressure × Heart Rate) as compared to the NW. Body Mass Index, waist-to-height ratio, fat mass by electrical impedance, and trans fatty acids showed direct correlations with pre and post-test haemodynamic parameters, such as RPP, and inverse correlations with oxygen saturation. OW&OB children demonstrated lower performance in this low-intensity exercise test, along with an elevated haemodynamic response. Excess fat in childhood can be considered a risk factor for haemodynamic stress, with potential deleterious consequences later in life. Efforts should be initiated early to break this cycle.
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Affiliation(s)
- Alice Giontella
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Angela Tagetti
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Sara Bonafini
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Denise Marcon
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Filippo Cattazzo
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Irene Bresadola
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Franco Antoniazzi
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
| | - Rossella Gaudino
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
| | - Paolo Cavarzere
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
| | - Martina Montagnana
- Department of Engineering for Innovative Medicine, University of Verona, 37100 Verona, Italy;
| | - Angelo Pietrobelli
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Claudio Maffeis
- Department of Surgical, Odontostomatological and Maternal-Infantile Sciences, University of Verona, 37129 Verona, Italy; (F.A.); (R.G.); (P.C.); (A.P.); (C.M.)
| | - Pietro Minuz
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
| | - Cristiano Fava
- Department of Medicine, University of Verona, 37100 Verona, Italy; (A.G.); (A.T.); (D.M.); (F.C.); (I.B.); (P.M.); (C.F.)
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16
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Poulos A, Wilson K, Schulke M, Nam K, Ohri-Vachaspati P, Bai Y, Kulinna PH. A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools. BMC Public Health 2024; 24:225. [PMID: 38238751 PMCID: PMC10797942 DOI: 10.1186/s12889-023-17605-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/28/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not. METHODS PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. RESULTS Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. CONCLUSIONS Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.
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Affiliation(s)
- Allison Poulos
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA.
| | - Kylie Wilson
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA
| | - Marissa Schulke
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA
| | - Kahyun Nam
- Mary Lou Fulton Teachers College, Arizona State University, Tempe, AZ, 85281, USA
| | - Punam Ohri-Vachaspati
- College of Health Solutions, Arizona State University, ABC 222 425 North 5th Street, Phoenix, AZ, 85004, USA
| | - Yang Bai
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, 84112, USA
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Rao J, Yan Y, Cheng H, Hou D, Zhao X, Shan X, Mi J. Uric acid mediated the relationship between obesity and hypertension in children and adolescents: A population‑based cohort study. Nutr Metab Cardiovasc Dis 2024; 34:214-222. [PMID: 37993286 DOI: 10.1016/j.numecd.2023.10.007] [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: 04/22/2023] [Revised: 08/21/2023] [Accepted: 10/05/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND AND AIM Obesity and hyperuricemia (HUA) often coexist and have been widely accepted as risk factors for hypertension, but the role of uric acid (UA) in the relationship between obesity and hypertension remains unknown in children and adolescents. METHODS AND RESULTS A total of 7525 subjects aged 6-16 years were from the School-based Cardiovascular and Bone Health Promotion Program (SCVBH) at baseline (2017) and followed up in 2019. Multivariable logistic regression with interaction terms, cross-lagged panel analysis, and causal mediation model were applied to delineate the joint impact of obesity and HUA on hypertension, including the interaction effect, the temporal association, and the mediating effect of UA in the relationship between obesity and hypertension. There were 10.8 % of the participants with normotension at baseline developed hypertension after two years of follow-up. Cross-lagged panel analysis showed that the two-time point association was significant only from baseline BMI to follow-up UA (β1 = 0.302, P < 0.001), but not from baseline UA to follow-up BMI (β2 = 0.002, P = 0.745). Multivariable logistic regression showed that both obesity and HUA increased the risk of hypertension, but no interaction effect between HUA and obesity. The causal mediation analysis found that UA partially mediated the association between BMI and SBP (mediate proportion: 20.3 %, 95 % CI: 17.4-22.9 %) or DBP (mediate proportion: 11.9 %, 95 % CI: 3.9-18.2 %). The results were consistent in the analysis of systolic hypertension rather than diastolic hypertension. CONCLUSIONS It is mediating effect that UA played in the progress from obesity to hypertension, particularly systolic hypertension in children and adolescents.
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Affiliation(s)
- Jiahuan Rao
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yinkun Yan
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoyuan Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Xinying Shan
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Jie Mi
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
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18
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Chamoso-Sanchez D, Rabadán Pérez F, Argente J, Barbas C, Martos-Moreno GA, Rupérez FJ. Identifying subgroups of childhood obesity by using multiplatform metabotyping. Front Mol Biosci 2023; 10:1301996. [PMID: 38174068 PMCID: PMC10761426 DOI: 10.3389/fmolb.2023.1301996] [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] [Received: 09/25/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction: Obesity results from an interplay between genetic predisposition and environmental factors such as diet, physical activity, culture, and socioeconomic status. Personalized treatments for obesity would be optimal, thus necessitating the identification of individual characteristics to improve the effectiveness of therapies. For example, genetic impairment of the leptin-melanocortin pathway can result in rare cases of severe early-onset obesity. Metabolomics has the potential to distinguish between a healthy and obese status; however, differentiating subsets of individuals within the obesity spectrum remains challenging. Factor analysis can integrate patient features from diverse sources, allowing an accurate subclassification of individuals. Methods: This study presents a workflow to identify metabotypes, particularly when routine clinical studies fail in patient categorization. 110 children with obesity (BMI > +2 SDS) genotyped for nine genes involved in the leptin-melanocortin pathway (CPE, MC3R, MC4R, MRAP2, NCOA1, PCSK1, POMC, SH2B1, and SIM1) and two glutamate receptor genes (GRM7 and GRIK1) were studied; 55 harboring heterozygous rare sequence variants and 55 with no variants. Anthropometric and routine clinical laboratory data were collected, and serum samples processed for untargeted metabolomic analysis using GC-q-MS and CE-TOF-MS and reversed-phase U(H)PLC-QTOF-MS/MS in positive and negative ionization modes. Following signal processing and multialignment, multivariate and univariate statistical analyses were applied to evaluate the genetic trait association with metabolomics data and clinical and routine laboratory features. Results and Discussion: Neither the presence of a heterozygous rare sequence variant nor clinical/routine laboratory features determined subgroups in the metabolomics data. To identify metabolomic subtypes, we applied Factor Analysis, by constructing a composite matrix from the five analytical platforms. Six factors were discovered and three different metabotypes. Subtle but neat differences in the circulating lipids, as well as in insulin sensitivity could be established, which opens the possibility to personalize the treatment according to the patients categorization into such obesity subtypes. Metabotyping in clinical contexts poses challenges due to the influence of various uncontrolled variables on metabolic phenotypes. However, this strategy reveals the potential to identify subsets of patients with similar clinical diagnoses but different metabolic conditions. This approach underscores the broader applicability of Factor Analysis in metabotyping across diverse clinical scenarios.
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Affiliation(s)
- David Chamoso-Sanchez
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Boadilla del Monte, Spain
| | | | - Jesús Argente
- Department of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación Sanitaria La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- IMDEA Food Institute, Madrid, Spain
| | - Coral Barbas
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Boadilla del Monte, Spain
| | - Gabriel A. Martos-Moreno
- Department of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación Sanitaria La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco J. Rupérez
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Boadilla del Monte, Spain
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19
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Tuvel AL, Winiger EA, Ross JM. A Review of the Effects of Adolescent Cannabis Use on Physical Health. Psychiatr Clin North Am 2023; 46:719-739. [PMID: 37879834 DOI: 10.1016/j.psc.2023.03.005] [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] [Indexed: 10/27/2023]
Abstract
The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascular, gastrointestinal, and endocrine function as well as body mass index and sleep. At this time, more research is needed to understand the influence of cannabis use on physical health, particularly among adolescent samples.
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Affiliation(s)
- Abigail L Tuvel
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1777 Exposition Drive, Boulder, CO 80301
| | - Evan A Winiger
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045
| | - J Megan Ross
- Department of Psychiatry, Division of Addiction Sciences, Treatment and Prevention, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045.
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20
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Su Q, Li M, Yang L, Fan L, Liu P, Ying X, Zhao Y, Tian X, Tian F, Zhao Q, Li B, Gao Y, Qiu Y, Song G, Yan X. ASC/Caspase-1-activated endothelial cells pyroptosis is involved in vascular injury induced by arsenic combined with high-fat diet. Toxicology 2023; 500:153691. [PMID: 38042275 DOI: 10.1016/j.tox.2023.153691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 12/04/2023]
Abstract
Environmental arsenic (As) or high-fat diet (HFD) exposure alone are risk factors for the development of cardiovascular disease (CVDs). However, the effects and mechanisms of co-exposure to As and HFD on the cardiovascular system remain unclear. The current study aimed to investigate the combined effects of As and HFD on vascular injury and shed some light on the underlying mechanisms. The results showed that co-exposure to As and HFD resulted in a significant increase in serum lipid levels and significant lipid accumulation in the aorta of rats compared with exposure to As or HFD alone. Meanwhile, the combined exposure altered blood pressure and disrupted the morphological structure of the abdominal aorta in rats. Furthermore, As combined with HFD exposure upregulated the expression of vascular endothelial cells pyroptosis-related proteins (ASC, Pro-caspase-1, Caspase-1, IL-18, IL-1β), as well as the expression of vascular endothelial adhesion factors (VCAM-1 and ICAM-1). More importantly, we found that with increasing exposure time, vascular injury-related indicators were significantly higher in the combined exposure group compared with exposure to As or HFD alone, and the vascular injury was more severe in female rats compared with male rats. Taken together, these results suggested that the combination of As and HFD induced vascular endothelial cells pyroptosis through activation of the ASC/Caspase-1 pathway. Therefore, vascular endothelial cells pyroptosis may be a potential molecular mechanism for vascular injury induced by As combined with HFD exposure.
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Affiliation(s)
- Qiang Su
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Meng Li
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China; Changzhi Maternal and Child Health Hospital, Changzhi, Shanxi 046000, China
| | - Lingling Yang
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Linhua Fan
- Laboratory Animal Center, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Penghui Liu
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China; Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, China
| | - Xiaodong Ying
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China; School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China
| | - Yannan Zhao
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Xiaolin Tian
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Fengjie Tian
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Qian Zhao
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Ben Li
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Yi Gao
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Yulan Qiu
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Guohua Song
- Laboratory Animal Center, Shanxi Key Laboratory of Experimental Animal Science and Animal Model of Human Disease, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Xiaoyan Yan
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China.
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21
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Nimpum D, Jittham W. Echocardiographic assessment of cardiac function abnormalities and related risk factors in Thai overweight and obese children. Ann Pediatr Cardiol 2023; 16:413-421. [PMID: 38817261 PMCID: PMC11135886 DOI: 10.4103/apc.apc_134_23] [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: 09/07/2023] [Revised: 11/21/2023] [Accepted: 01/29/2024] [Indexed: 06/01/2024] Open
Abstract
Background Childhood obesity has become a global concern, with its prevalence steadily increasing over the past decade. This condition negatively impacts the cardiovascular system, increasing the risk of morbidity and mortality in adulthood. This study aimed to identify cardiac function abnormalities and related risk factors among overweight and obese Thai children. Materials and Methods A cross-sectional observational study of 70 children with body mass index (BMI) >1 standard deviation above the mean for Thai children was conducted at Naresuan University Hospital. Body fat percentage (%Fat) was measured, and standard transthoracic echocardiography was performed. Metabolic profiles were collected from medical records. Results The thickness and diameter of the Left ventricle (LV) wall, including the LV posterior wall, LV internal diameter, and interventricular septum (IVS), were significantly increased in both systolic and diastolic phases in obese children. LV concentric hypertrophy and an abnormal E/E' ratio were found in 27% and 34.3% of participants, respectively. Right ventricular systolic dysfunction indicated by abnormal tricuspid annular plane systolic excursion values was found in 55.7% of all participants. In addition, 27.1% of all obese children had pulmonary hypertension. Significant differences in BMI and %Fat were detected between children with abnormal and normal IVS diastolic (IVSd) (P = 0.016). Our univariate and multivariate correlation analyses revealed a significant positive association between abnormal IVSd and %Fat, with an odd ratio (OR) of 1.13 (95% confidence interval [CI]: 1.01-1.27; P = 0.047) and an adjusted OR of 1.17 (95% CI: 1.01-1.36; P = 0.04). Conclusions Cardiac function abnormalities in childhood obesity exhibit a significant positive correlation with BMI and various cardiac dimensions, including ventricular wall thickness. One important related risk factor for increased IVS thickness is %Fat. Therefore, multidisciplinary management of obesity should be initiated as early as possible to prevent future cardiovascular morbidity and mortality.
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Affiliation(s)
- Darunwan Nimpum
- Department of Cardio-Thoracic Technology, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Worawan Jittham
- Department of Pediatric, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
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Hanssen H, Moholdt T, Bahls M, Biffi A, Siegrist M, Lewandowski AJ, Biondi-Zoccai G, Cavarretta E, Kokkvoll A, Løchen ML, Maestrini V, Pinto RS, Palermi S, Thivel D, Wojcik M, Hansen D, Van Craenenbroeck EM, Weghuber D, Kraenkel N, Tiberi M. Lifestyle interventions to change trajectories of obesity-related cardiovascular risk from childhood onset to manifestation in adulthood: a joint scientific statement of the task force for childhood health of the European Association of Preventive Cardiology and the European Childhood Obesity Group. Eur J Prev Cardiol 2023; 30:1462-1472. [PMID: 37491406 DOI: 10.1093/eurjpc/zwad152] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/20/2023] [Accepted: 05/06/2023] [Indexed: 07/27/2023]
Abstract
There is an immediate need to optimize cardiovascular (CV) risk management and primary prevention of childhood obesity to timely and more effectively combat the health hazard and socioeconomic burden of CV disease from childhood development to adulthood manifestation. Optimizing screening programs and risk management strategies for obesity-related CV risk in childhood has high potential to change disease trajectories into adulthood. Building on a holistic view on the aetiology of childhood obesity, this document reviews current concepts in primary prevention and risk management strategies by lifestyle interventions. As an additional objective, this scientific statement addresses the high potential for reversibility of CV risk in childhood and comments on the use of modern surrogate markers beyond monitoring weight and body composition. This scientific statement also highlights the clinical importance of quantifying CV risk trajectories and discusses the remaining research gaps and challenges to better promote childhood health in a population-based approach. Finally, this document provides an overview on the lessons to be learned from the presented evidence and identifies key barriers to be targeted by researchers, clinicians, and policymakers to put into practice more effective primary prevention strategies for childhood obesity early in life to combat the burden of CV disease later in life.
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Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Women's Clinic, St. Olavs Hospital, Trondheim, Norway
| | - Martin Bahls
- Department of Internal Medicine B University Medicine Greifswald, University of Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Alessandro Biffi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Monika Siegrist
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Ane Kokkvoll
- Department of Paediatrics, Finnmark Hospital Trust, Hammerfest, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, 'Sapienza' University of Rome, Policlinico Umberto I, Rome, Italy
| | | | - Stefano Palermi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Malgorzata Wojcik
- Department of Pediatric and Adolescent Endocrinology, Jagiellonian University Medical College, Krakow, Poland
| | - Dominique Hansen
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Daniel Weghuber
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Nicolle Kraenkel
- Deutsches Herzzentrum der Charité (DHZC), Department of Cardiology, Angiology and Intensive Care, Campus Benjamin-Franklin (CBF), Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner site Berlin, Germany
- Friede Springer- Cardiovascular Prevention Center @ Charité, Charite- Universitätsmedizin Berlin, Berlin, Germany
| | - Monica Tiberi
- Department of Public Health, Azienda Sanitaria Unica Regionale Marche AV 1, Pesaro, Italy
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23
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Bibi S, Naeem M, Bahls M, Dörr M, Friedrich N, Nauck M, Bülow R, Völzke H, Paulista Markus MR, Ittermann T. Body composition markers from classic anthropometry, bioelectrical impedance analysis, and magnetic resonance imaging are associated with inflammatory markers in the general population. Nutr Metab Cardiovasc Dis 2023; 33:1899-1906. [PMID: 37500343 DOI: 10.1016/j.numecd.2023.05.026] [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: 01/31/2023] [Revised: 04/28/2023] [Accepted: 05/24/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND AND AIM The associations of body composition markers derived from different modalities with inflammatory markers are unclear. The aim of this study was to determine associations of the body composition markers from different modalities with inflammatory markers in a population-based study. METHODS AND RESULTS We analyzed data from 4048 participants (2081 women, 51.4%) aged 20-84 years. Linear regression models adjusted for confounding were used to analyze the association of classic anthropometry markers, absolute and relative fat mass, absolute fat-free mass (FFM), and body cell mass (BCM) assessed by bioelectrical impedance analysis, subcutaneous, visceral, and liver fat from magnetic resonance imaging (MRI), with markers of inflammation. We found positive associations of classic anthropometry markers, total body fat, subcutaneous, visceral, and liver fat, with all inflammatory markers. Waist circumference (WC) showed the strongest association with high-sensitivity C-reactive protein (hsCRP) (β: 1.39; 95% confidence interval [CI]: 1.22 to 1.56) and white blood cell (WBC) (0.39; 0.29 to 0.48), whereas visceral fat showed the strongest association with ferritin (41.9; 34.7 to 49.0). Relative body fat was strongly associated with hsCRP (1.39; 1.20 to 1.58), fibrinogen (0.29; 0.27 to 0.32), and WBC (0.35; 0.25 to 0.46). Conversely, we found inverse associations of body height, FFM, and BCM with hsCRP, fibrinogen, and WBC. CONCLUSIONS Our study indicates the importance of WC as an easily measured marker for early inflammation. MRI-assessed markers of central obesity seem to be most strongly related to ferritin.
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Affiliation(s)
- Saima Bibi
- Institute for Community Medicine - Department Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany.
| | - Muhammad Naeem
- Institute for Community Medicine - Department Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany; Department of Zoology, University of Malakand, 18800, Pakistan
| | - Martin Bahls
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; DZHK (German Center for Cardiovascular Research), partner site Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; DZHK (German Center for Cardiovascular Research), partner site Greifswald, Germany
| | - Nele Friedrich
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Germany; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Matthias Nauck
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Germany; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Robin Bülow
- Institute for Radiology and Neuroradiology, University Medicine Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine - Department Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany; DZHK (German Center for Cardiovascular Research), partner site Greifswald, Germany
| | - Marcello Ricardo Paulista Markus
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; DZHK (German Center for Cardiovascular Research), partner site Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine - Department Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany; DZHK (German Center for Cardiovascular Research), partner site Greifswald, Germany
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24
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Di Salvo G, Cattapan I, Fumanelli J, Pozza A, Moscatelli S, Sabatino J, Avesani M, Reffo E, Sirico D, Castaldi B, Cerutti A, Biffanti R, Pergola V. Childhood Obesity and Congenital Heart Disease: A Lifelong Struggle. J Clin Med 2023; 12:6249. [PMID: 37834891 PMCID: PMC10573337 DOI: 10.3390/jcm12196249] [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: 07/31/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Congenital heart disease (CHD) affects approximately one in every one hundred infants worldwide, making it one of the most prevalent birth abnormalities globally. Despite advances in medical technology and treatment choices, CHD remains a significant health issue and necessitates specialized care throughout an individual's life. Childhood obesity has emerged as a novel global epidemic, becoming a major public health issue, particularly in individuals with lifelong conditions such as CHD. Obesity has profound effects on cardiac hemodynamics and morphology, emphasizing the importance of addressing obesity as a significant risk factor for cardiovascular health. Obesity-induced alterations in cardiac function can have significant implications for cardiovascular health and may contribute to the increased risk of heart-related complications in obese individuals. Moreover, while diastolic dysfunction may be less apparent in obese children compared to adults, certain parameters do indicate changes in early left ventricular relaxation, suggesting that obesity can cause cardiac dysfunction even in pediatric populations. As most children with CHD now survive into adulthood, there is also concern about environmental and behavioral health risk factors in this particular patient group. Addressing obesity in individuals with CHD is essential to optimize their cardiovascular health and overall quality of life. This review aims to succinctly present the data on the impact of obesity on CHD and to enhance awareness of this perilous association among patients, families, and healthcare providers.
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Affiliation(s)
- Giovanni Di Salvo
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
- Working Group on Congenital Heart Disease and Cardiovascular Prevention in Children, Italian Society of Cardiology (SIC), 00198 Rome, Italy;
| | - Irene Cattapan
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Jennifer Fumanelli
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Alice Pozza
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Sara Moscatelli
- Working Group on Congenital Heart Disease and Cardiovascular Prevention in Children, Italian Society of Cardiology (SIC), 00198 Rome, Italy;
- Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Jolanda Sabatino
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
- Working Group on Congenital Heart Disease and Cardiovascular Prevention in Children, Italian Society of Cardiology (SIC), 00198 Rome, Italy;
| | - Martina Avesani
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
- Working Group on Congenital Heart Disease and Cardiovascular Prevention in Children, Italian Society of Cardiology (SIC), 00198 Rome, Italy;
| | - Elena Reffo
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Domenico Sirico
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Biagio Castaldi
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Alessia Cerutti
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Roberta Biffanti
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Valeria Pergola
- Cardiology Unit, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy;
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25
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Spring KE, Carroll AV, Wadsworth DD. The relationship in early childhood body composition and physical activity levels regarding fundamental motor skill development. BMC Pediatr 2023; 23:461. [PMID: 37704949 PMCID: PMC10500867 DOI: 10.1186/s12887-023-04298-2] [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: 11/10/2022] [Accepted: 09/08/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Fundamental motor skills (FMS) are considered essential for sport participation and might be deficit in obese children. While evidence indicates that physical activity (PA) levels impact motor skill development, the relationship between body composition, PA, and motor competence, particularly in early childhood, is not thoroughly understood. We aimed to determine if PA, fat mass (FM), and fat-free mass (FFM) are predictors of FMS. METHODS Preschoolers (n = 47) from two preschools were assessed for FMS, PA, and body composition. Peabody Developmental Motor Scales (PDMS-2) subscale scores were used to assess FMS. PA was assessed with a wrist-worn accelerometer for five days during school. FM and FFM were measured with foot-to-foot bioelectrical impedance. RESULTS Linear regressions indicate significant models for stationary skills (SS) (F = 4.57, p = .004) and object manipulation skills (OMS) (F = 4.66, p = .003). FFM was the only significant predictor of SS (t = 3.98, p < .001) and OMS (t = 3.50, p = .001). FM and all intensities of PA were nonsignificant predictors in all models. CONCLUSIONS These results indicate that interventions that target improving or maintaining FFM may improve FMS.
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Affiliation(s)
- Katherine E Spring
- School of Kinesiology, Auburn University, Auburn, AL, USA.
- Division of Population and Public Health Science, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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Lin D, Chen D, Huang J, Li Y, Wen X, Ou P, Shi H. Breastfeeding is associated with reduced risks of central obesity and hypertension in young school-aged children: a large, population-based study. Int Breastfeed J 2023; 18:52. [PMID: 37697319 PMCID: PMC10496387 DOI: 10.1186/s13006-023-00581-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 08/04/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Previous studies examined the effects of breastfeeding on measured values of body circumferences or blood pressure during childhood. However, limited data are available for the association between child feeding and a specific disease diagnosed as central obesity or hypertension. Hence, we aimed to examine whether the type and duration of breastfeeding are associated with obesity/central obesity or hypertension in young school-aged children. METHODS We matched the data obtained from a cross-sectional survey in 2019 with retrospective breastfeeding information recorded in the database. Heights, weights, waist circumferences, and blood pressures of 8480 children in first grade of primary schools in Shanghai, China were measured to diagnose obesity, central obesity, and hypertension. Data on child feeding was collected retrospectively from clinical records. Associations between the type/duration of breastfeeding and children's measured values of body mass index, waist circumference, and blood pressure were analysed by linear regression. Associations between the type/duration of breastfeeding and risks of obesity, central obesity, and hypertension were analysed by generalised linear models. RESULTS Breastfeeding duration was inversely associated with blood pressure values in children in the first grade. Each month's increase in the duration of any breastfeeding was associated with a 0.07 mmHg decrease in systolic blood pressure (P < 0.01) and a 0.05 mmHg decrease in diastolic blood pressure (P < 0.01). Any breastfeeding > one month was associated with a reduced risk of hypertension (adjusted risk ratio 0.84; 95% CI 0.73, 0.96, P = 0.01). Exclusive breastfeeding > one month was associated with a reduced risk of central obesity (adjusted risk ratio 0.76; 95% CI: 0.60, 0.96, P = 0.02). Any breastfeeding > 12 months was linked with a lower risk of hypertension (adjusted risk ratio 0.83; 95% CI 0.70, 0.98, P = 0.03). CONCLUSIONS Lack of breastfeeding is associated with higher risks of central obesity and hypertension during middle childhood. As a potential component of the public health strategy to reduce population levels of metabolic and cardiovascular diseases, breastfeeding could be a vital prevention strategy.
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Affiliation(s)
- Dan Lin
- Fujian Maternity and Child Health Hospital, Fuzhou, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Didi Chen
- Minhang Center of Disease Control and Prevention, Shanghai, China
- Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Jun Huang
- Minhang Maternal and Child Health Centre, Shanghai, China
| | - Yun Li
- Minhang Maternal and Child Health Centre, Shanghai, China
| | - Xiaosa Wen
- Minhang Center of Disease Control and Prevention, Shanghai, China
- Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Ping Ou
- Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Huijing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
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Harrison MR. Effects of public-private partnership on diet-related obesity risk factors among school-aged children: A systematic literature review. Nutr Health 2023; 29:453-463. [PMID: 36330724 PMCID: PMC10503256 DOI: 10.1177/02601060221136184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background: Childhood obesity is a major public health challenge. Public-private partnerships (PPPs) have been proposed as a solution; however, valid concerns exist as to whether commercial interest can be balanced with public health goals. Aims: This study describes the effects of interventions carried out through PPPs on diet-related obesity risk factors, namely fruit and vegetable (F&V), sugar-sweetened beverage (SSB), and energy-dense food consumption, among school-aged children. Methods: A systematic literature review was conducted from January 1990 to December 2021 across three databases. Out of the 276 articles initially identified, 8 were included. Data were extracted from each article on study characteristics, partners involved, partnership descriptions, and partnership outcomes. A descriptive analysis included frequency counts for specific study attributes. Results: All studies took place in the United States and were published between 2010 and 2017. Most were cohort studies (75%) and involved structured, healthy lifestyle interventions (75%). Nearly all interventions included components targeting F&V consumption (88%), followed by energy-dense food consumption (50%), and SSB consumption (38%). Business sector partners were largely food producers, food retailers, and private healthcare providers; however, few studies provided details on their partnering arrangements. No studies reported harmful changes in diet-related obesity risk factors. Conclusion: Collaboration across sectors is needed to address drivers of obesity where children live, learn, and play. The small sample size and heterogeneity in this review prohibits definitive conclusions pertaining to the effect of PPPs on childhood obesity. Future research efforts are needed to develop a taxonomy for better classifying and examining PPPs.
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Tinney EM, Loui P, Raine LB, Hiscox LV, Delgorio PL, Kramer MK, Schwarb H, Martens CR, Kramer AF, Hillman CH, Johnson CL. Influence of mild cognitive impairment and body mass index on white matter integrity assessed by diffusion tensor imaging. Psychophysiology 2023; 60:e14306. [PMID: 37038273 PMCID: PMC10524314 DOI: 10.1111/psyp.14306] [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: 12/20/2022] [Revised: 03/16/2023] [Accepted: 03/27/2023] [Indexed: 04/12/2023]
Abstract
Mild cognitive impairment (MCI), a prodromal stage of Alzheimer's disease, is characterized by decreased memory and cognition, which are linked to degenerative changes in the brain. To assess whether white matter (WM) integrity is compromised in MCI, we collected diffusion-weighted images from 60 healthy older adults (OA) (69.16 ± 0.7) and 20 older adults with amnestic MCI (72.45 ± 1.9). WM integrity differences were examined using Tract-Based Spatial Statistics (TBSS). We hypothesized that those with MCI would have diminished WM integrity relative to OA. In a whole-brain comparison, those with MCI showed higher axial diffusivity in the splenium (SCC) and body of the corpus callosum (BCC), superior corona radiata (SCR), and the retrolenticular part of the internal capsule (RLIC) (p's < .05 TFCE-corrected). Additionally, significant between-group connectivity differences were observed using probabilistic tractography between the SCC, chosen from the TBSS results, and forceps major and minor (p-value's < .05). To further relate a physical health indicator to WM alterations, linear regression showed significant interactions between cognitive status and body mass index (BMI) on diffusivity outcome measures from probabilistic tractography (p-value-'s < .05). Additionally, we examined the association between relational memory, BMI, and WM integrity. WM integrity was positively associated with relational memory performance. These findings suggest that these regions may be more sensitive to early markers of neurodegenerative disease and health behaviors, suggesting that modifiable lifestyle factors may affect white matter integrity.
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Affiliation(s)
- Emma M. Tinney
- Northeastern University, Department of Psychology
- Northeastern University, Center for Cognitive and Brain Health
| | - Psyche Loui
- Northeastern University, Department of Psychology
- Northeastern University, Center for Cognitive and Brain Health
| | - Lauren B. Raine
- Northeastern University, Center for Cognitive and Brain Health
- Northeastern University, Department of Physical Therapy Movement Rehabilitation Sciences
- Northeastern University, Department of Medicinal Sciences
| | - Lucy V. Hiscox
- University of Delaware, Department of Biomedical Engineering
| | | | - Mary K. Kramer
- University of Delaware, Department of Biomedical Engineering
| | - Hillary Schwarb
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology
| | | | - Arthur F. Kramer
- Northeastern University, Department of Psychology
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology
| | - Charles H. Hillman
- Northeastern University, Department of Psychology
- Northeastern University, Center for Cognitive and Brain Health
- Northeastern University, Department of Physical Therapy Movement Rehabilitation Sciences
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Brero M, Meyer CL, Jackson-Morris A, Spencer G, Ludwig-Borycz E, Wu D, Espinosa De Candido AF, Ferre Eguiluz MI, Bonvecchio Arenas A, Jewell J, Nugent R. Investment case for the prevention and reduction of childhood and adolescent overweight and obesity in Mexico. Obes Rev 2023; 24:e13595. [PMID: 37464960 DOI: 10.1111/obr.13595] [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: 09/20/2022] [Revised: 04/11/2023] [Accepted: 05/21/2023] [Indexed: 07/20/2023]
Abstract
Despite efforts to curb the rise in Mexico's child and adolescent overweight and obesity rates, prevalence in Mexico has grown by 120% since 1990 to 43.3% in 2022. This investment case identifies policies that will produce the largest returns for Mexico. The investment case model builds beyond a cost-of-illness analysis by predicting the health and societal economic impact of implementing child and adolescent overweight and obesity interventions in a cohort aged 0-19 from 2025 to 2090. The Markov model's impacts include healthcare expenditures, years of life lost, and reduced wages and productivity. We projected and compared costs in a status quo scenario to an intervention scenario to estimate cost savings and calculate return-on-investment (ROI). Total lifetime health and economic costs amount to USD 1.8 trillion-USD 30 billion on average per year. Implementing five interventions can reduce lifetime costs by approximately 7%. Each intervention has a low cost per disability-adjusted life year averted over 30-year, 50-year, and lifetime horizons. The findings demonstrate that a package of interventions mitigating child and adolescent overweight and obesity offers a strong ROI. The novel investment case methods should be applied to other countries, particularly low- and middle-income countries.
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Affiliation(s)
| | - Christina L Meyer
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | - Angela Jackson-Morris
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | - Garrison Spencer
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | | | - Daphne Wu
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | | | | | - Anabelle Bonvecchio Arenas
- Directora de Investigación en Políticas y Programas de Nutrición, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
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Hauser JA, Burden SJ, Karunakaran A, Muthurangu V, Taylor AM, Jones A. Whole-Body Magnetic Resonance Imaging Assessment of the Contributions of Adipose and Nonadipose Tissues to Cardiovascular Remodeling in Adolescents. J Am Heart Assoc 2023; 12:e030221. [PMID: 37489750 PMCID: PMC10492986 DOI: 10.1161/jaha.123.030221] [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] [Received: 03/16/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023]
Abstract
Background Greater body mass index is associated with cardiovascular remodeling in adolescents. However, body mass index cannot differentiate between adipose and nonadipose tissues. We examined how visceral and subcutaneous adipose tissue are linked with markers of early cardiovascular remodeling, independently from nonadipose tissue. Methods and Results Whole-body magnetic resonance imaging was done in 82 adolescents (39 overweight/obese; 36 female; median age, 16.3 [interquartile range, 14.4-18.1] years) to measure body composition and cardiovascular remodeling markers. Left ventricular diastolic function was assessed by echocardiography. Waist, waist:height ratio, and body mass index z scores were calculated. Residualized nonadipose tissue, subcutaneous adipose tissue, and visceral adipose tissue variables, uncorrelated with each other, were constructed using partial regression modeling to allow comparison of their individual contributions in a 3-compartment body composition model. Cardiovascular variables mostly related to nonadipose rather than adipose tissue. Nonadipose tissue was correlated positively with left ventricular mass (r=0.81), end-diastolic volume (r=0.70), stroke volume (r=0.64), left ventricular mass:end-diastolic volume (r=0.37), and systolic blood pressure (r=0.35), and negatively with heart rate (r=-0.33) (all P<0.01). Subcutaneous adipose tissue was associated with worse left ventricular diastolic function (r=-0.42 to -0.48, P=0.0007-0.02) and higher heart rates (r=0.34, P=0.007) but linked with better systemic vascular resistance (r=-0.35, P=0.006). There were no significant relationships with visceral adipose tissue and no associations of any compartment with pulse wave velocity. Conclusions Simple anthropometry does not reflect independent effects of nonadipose tissue and subcutaneous adipose tissue on the adolescent cardiovascular system. This could result in normal cardiovascular adaptations to growth being misinterpreted as pathological sequelae of excess adiposity in studies reliant on such measures.
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Affiliation(s)
- Jakob A. Hauser
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
| | - Samuel J. Burden
- Department of PaediatricsUniversity of Oxford, John Radcliffe HospitalOxfordUnited Kingdom
- Department of Women and Children’s HealthKing’s College London, St Thomas’ HospitalLondonUnited Kingdom
| | - Ajanthiha Karunakaran
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
| | - Vivek Muthurangu
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
| | - Andrew M. Taylor
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
- Great Ormond Street Hospital for Children NHS Foundation TrustLondonUnited Kingdom
| | - Alexander Jones
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
- Department of PaediatricsUniversity of Oxford, John Radcliffe HospitalOxfordUnited Kingdom
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Broadwin M, Harris DD, Sabe SA, Sengun E, Sylvestre AJ, Alexandrov BS, Selke FW, Usheva A. Impaired cardiac glycolysis and glycogen depletion are linked to poor myocardial outcomes in juvenile male swine with metabolic syndrome and ischemia. Physiol Rep 2023; 11:e15742. [PMID: 37537137 PMCID: PMC10400405 DOI: 10.14814/phy2.15742] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 08/05/2023] Open
Abstract
Obesity continues to rise in the juveniles and obese children are more likely to develop metabolic syndrome (MetS) and related cardiovascular disease. Unfortunately, effective prevention and long-term treatment options remain limited. We determined the juvenile cardiac response to MetS in a swine model. Juvenile male swine were fed either an obesogenic diet, to induce MetS, or a lean diet, as a control (LD). Myocardial ischemia was induced with surgically placed ameroid constrictor on the left circumflex artery. Physiological data were recorded and at 22 weeks of age the animals underwent a terminal harvest procedure and myocardial tissue was extracted for total metabolic and proteomic LC/MS-MS, RNA-seq analysis, and data underwent nonnegative matrix factorization for metabolic signatures. Significantly altered in MetS versus. LD were the glycolysis-related metabolites and enzymes. In MetS compared with LD Glycogen synthase 1 (GYS1)-glycogen phosphorylases (PYGM/PYGL) expression disbalance resulted in a loss of myocardial glycogen. Our findings are consistent with the concept that transcriptionally driven myocardial changes in glycogen and glucose metabolism-related enzymes lead to a deficiency of their metabolite products in MetS. This abnormal energy metabolism provides insight into the pathogenesis of the juvenile heart in MetS. This study reveals that MetS and ischemia diminishes ATP availability in the myocardium via altering the glucose-G6P-pyruvate axis at the level of metabolites and gene expression of related enzymes. The observed severe glycogen depletion in MetS coincides with disbalance in expression of GYS1 and both PYGM and PYGL. This altered energy substrate metabolism is a potential target of pharmacological agents for improving juvenile myocardial function in MetS and ischemia.
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Affiliation(s)
- Mark Broadwin
- Division of Cardiothoracic Surgery, Department of SurgeryWarren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Dwight D. Harris
- Division of Cardiothoracic Surgery, Department of SurgeryWarren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Sharif A. Sabe
- Division of Cardiothoracic Surgery, Department of SurgeryWarren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Elif Sengun
- Division of Cardiology, Department of MedicineWarren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Amber J. Sylvestre
- Division of Cardiothoracic Surgery, Department of SurgeryWarren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | | | - Frank W. Selke
- Division of Cardiothoracic Surgery, Department of SurgeryWarren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Anny Usheva
- Division of Cardiothoracic Surgery, Department of SurgeryWarren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
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Herouvi D, Paltoglou G, Soldatou A, Kalpia C, Karanasios S, Karavanaki K. Lifestyle and Pharmacological Interventions and Treatment Indications for the Management of Obesity in Children and Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1230. [PMID: 37508727 PMCID: PMC10378563 DOI: 10.3390/children10071230] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
Obesity is a multifactorial chronic impairment that further decreases quality of life and life expectancy. Worldwide, childhood obesity has become a pandemic health issue causing several comorbidities that frequently present already in childhood, including cardiovascular (hypertension, dyslipidemia), metabolic (Type 2 diabetes mellitus, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal and musculoskeletal disorders. In addition, obese children frequently experience stress and psychosocial symptoms, including mood disorders, anxiety, prejudice and low self-esteem. Given that cardiovascular risk factors and pediatric obesity have the tendency to pertain into adulthood, obesity management, including weight control and physical activity, should start before the late teens and certainly before the first signs of atherosclerosis can be detected. This review aims to concisely present options for childhood obesity management, including lifestyle modification strategies and pharmacological treatment, as well as the respective treatment indications for the general practitioner.
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Affiliation(s)
- Despina Herouvi
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - George Paltoglou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Alexandra Soldatou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Christina Kalpia
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Spyridon Karanasios
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
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O'Kane N, Watson S, Kehoe L, O'Sullivan E, Muldoon A, Woodside J, Walton J, Nugent A. The patterns and position of snacking in children in aged 2-12 years: A scoping review. Appetite 2023:106974. [PMID: 37421978 DOI: 10.1016/j.appet.2023.106974] [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: 04/10/2023] [Revised: 06/12/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Childhood obesity is associated with serious comorbidities during childhood and into adulthood. One potential risk factor for childhood obesity is consumption of unhealthy, energy-dense foods. This scoping review examines evidence on snacking in children aged 2-12years of age and presents the patterns and position of snacking in children's diets. METHODS A search of electronic databases (MEDLINE, Web of Science, PubMed, Embase) for articles published from March 2011 to November 2022 was conducted. Articles providing insight into the position of snacking (e.g., energy contribution), or patterns (e.g., location, timing), in children aged 2-12years were included. A quality assessment was conducted and data was synthesised according to data source (nationally representative or other). RESULTS Twenty-one articles were included, most (n = 13) reporting nationally representative data. The average number of daily snacks was 3, with 92.9-100.0% of children consuming snacks. Most were consumed in the afternoon (75.2-84.0%) and at home (46.5-67.3%). Snacks frequently consumed were 'fruits and vegetables', 'baked desserts', 'sweets, candy and confectionery', and 'dairy products'. Snacks contributed 231-565 kcal daily, up to a third of daily carbohydrate intake, a quarter of fat intake, and a fifth of protein intake. Snacks provided up to one third of vitamin C intake, one quarter of vitamin E, potassium and magnesium intake, and a fifth of calcium, folic acid, vitamins D and B12, iron and sodium intake. DISCUSSION This scoping review provides insight into patterns and position of snacking within children's diets. Snacking plays a significant role in children's diets with multiple snacking occasions occurring throughout a child's day, the overconsumption of which has the potential to increase risk of childhood obesity. Further research is required into the role of snacking, particularly specific foods playing a role in micronutrient intake, and clear guidance for snacking intake in children.
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Affiliation(s)
- Niamh O'Kane
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Ireland; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland.
| | - Sinead Watson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland
| | - Laura Kehoe
- Department of Biological Sciences, Munster Technological University, Cork, Ireland; School of Food & Nutritional Sciences, University College Cork, Cork, Ireland
| | - Emma O'Sullivan
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Aine Muldoon
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Jayne Woodside
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Ireland; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland
| | - Janette Walton
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - Anne Nugent
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Ireland; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Ireland
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Chen R, Ji L, Ma L, Chen Y, Duan J, Ma M, Sun Y, Tai J, Meng L. Accuracy and capability of tri-ponderal mass index in assessing cardio-metabolic risk factors in Chinese children and adolescents aged 3 to 17 years, compared with body mass index. Chin Med J (Engl) 2023; 136:1339-1348. [PMID: 36848203 PMCID: PMC10309518 DOI: 10.1097/cm9.0000000000002349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Tri-ponderal mass index (TMI) has been reported to be a more accurate estimate of body fat than body mass index (BMI). This study aims to compare the effectiveness of TMI and BMI in identifying hypertension, dyslipidemia, impaired fasting glucose (IFG), abdominal obesity, and clustered cardio-metabolic risk factors (CMRFs) in 3- to 17-year-old children. METHODS A total of 1587 children aged 3 to 17 years were included. Logistic regression was used to evaluate correlations between BMI and TMI. Area under the curves (AUCs) were used to compare discriminative capability among indicators. BMI was converted to BMI- z scores, and accuracy was compared by false-positive rate, false-negative rate, and total misclassification rate. RESULTS Among children aged 3 to 17 years, the mean TMI was 13.57 ± 2.50 kg/m 3 for boys and 13.3 ± 2.33 kg/m 3 for girls. Odds ratios (ORs) of TMI for hypertension, dyslipidemia, abdominal obesity, and clustered CMRFs ranged from 1.13 to 3.15, higher than BMI, whose ORs ranged from 1.08 to 2.98. AUCs showed similar ability of TMI (AUC: 0.83) and BMI (AUC: 0.85) in identifying clustered CMRFs. For abdominal obesity and hypertension, the AUC of TMI was 0.92 and 0.64, respectively, which was significantly better than that of BMI, 0.85 and 0.61. AUCs of TMI for dyslipidemia and IFG were 0.58 and 0.49. When 85th and 95th of TMI were set as thresholds, total misclassification rates of TMI for clustered CMRFs ranged from 6.5% to 16.4%, which was not significantly different from that of BMI- z scores standardized according to World Health Organization criteria. CONCLUSIONS TMI was found to have equal or even better effectiveness in comparison with BMI in identifying hypertension, abdominal obesity, and clustered CMRFs TMI was more stable than BMI in 3- to 17-year-old children, while it failed to identify dyslipidemia and IFG. It is worth considering the use of TMI for screening CMRFs in children and adolescents.
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Affiliation(s)
- Rui Chen
- Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing 100020, China
| | - Lang Ji
- Central Laboratory, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
| | - Lijuan Ma
- Department of Clinical Laboratory, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
| | - Yitong Chen
- Infectious Diseases Control and Prevention Division, Daxing Center for Disease Prevention and Control, Beijing 102699, China
| | - Jiali Duan
- Health Promotion Office, Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Mingjing Ma
- Department of Health Care, Tuanjiehu Community Health Service Center, Chaoyang District, Beijing 100026, China
| | - Ying Sun
- Health Promotion Office, Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Jun Tai
- Department of Otorhinolaryngology, Head and Neck Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
| | - Linghui Meng
- Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing 100020, China
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
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Han YJ, Baek JH, Jung SK, Yang JS, Shin NR, Park MY. Association between the Dietary Phytochemical Index and Lower Prevalence of Obesity in Korean Preschoolers. Nutrients 2023; 15:2439. [PMID: 37299402 PMCID: PMC10255342 DOI: 10.3390/nu15112439] [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: 04/11/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Little is known regarding Korean preschooler dietary phytochemical index (DPIs). We used the 24 h recall data of 1196 participants aged 3-5 years from the Korea National Health and Nutrition Examination Survey to study the association between dietary food intake and obesity prevalence. The amount of dietary intake by food group was compared according to sex and DPI quartile. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. The average total DPI and energy from phytochemical food groups were not significantly different according to sex, although boys had a higher total daily food intake. Different inclinations between DPI quartiles and amount of intake were observed in the food groups; specifically, beans showed a higher intake difference between Q1 and Q4 for boys than in the other food groups. The highest DPI quartile had a significantly lower obesity prevalence than the lowest DPI quartile in all models for boys only when obesity prevalence by weight percentile was analyzed (Model 3, OR: 0.287, 95% CI: 0.095-0.868, p for trend < 0.05). Our results suggest a high DPI could help prevent obesity in preschoolers.
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Affiliation(s)
- Ye-Ji Han
- Department of Food and Nutrition, Sungshin Women’s University, Seoul 01133, Republic of Korea;
| | - Jung-Hyun Baek
- Department of Pediatrics, Woori Children’s Hospital, Seoul 08291, Republic of Korea; (J.-H.B.); (S.-K.J.)
| | - Seong-Kwan Jung
- Department of Pediatrics, Woori Children’s Hospital, Seoul 08291, Republic of Korea; (J.-H.B.); (S.-K.J.)
| | - Joshua SungWoo Yang
- Healthcare Development Head, R&D Center, NGeneBio Inc., Seoul 08390, Republic of Korea; (J.S.Y.); (N.-R.S.)
| | - Na-Rae Shin
- Healthcare Development Head, R&D Center, NGeneBio Inc., Seoul 08390, Republic of Korea; (J.S.Y.); (N.-R.S.)
| | - Mi-Young Park
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
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Elish P, Boedeker P, Lash TL, Gazmararian J. Longitudinal weight status and academic achievement in elementary schoolchildren in the United States. Int J Obes (Lond) 2023:10.1038/s41366-023-01309-1. [PMID: 37085587 PMCID: PMC10119509 DOI: 10.1038/s41366-023-01309-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND/OBJECTIVES Childhood overweight and obesity have a well-established negative impact on children's health. Overweight and obesity might also negatively impact children's academic performance, but existing literature on this association is inconclusive. This study uses a longitudinal design in a large, diverse elementary school sample to rigorously test the association between longitudinal weight status and academic achievement. Analyses also investigate modification by sex, race/ethnicity, and cardiorespiratory fitness (CRF). SUBJECTS/METHODS In a large suburban school district in the United States, 4936 Grade 4 students were recruited. Demographic, course grade, and standardized test data were collected from school records for Grades 3-5, and body mass index and CRF were assessed each year. Students wore accelerometers during the school day for up to 15 days across three semesters (Grade 4 Fall and Spring, Grade 5 Fall) to objectively measure physical activity. Multiple imputation addressed missing data and multilevel analyses controlled for student demographics and clustering within schools. RESULTS Unadjusted multilevel models found small negative associations between persistent obesity and course grades and standardized test scores, but these associations largely disappeared when controlling for demographic characteristics. Residual associations for math and writing course grades were attenuated when controlling for CRF, though some marginal negative associations for math and writing remained for students who developed obesity during follow-up. There was also evidence of marginal negative associations with course grades for students who developed overweight/obesity. There was no evidence of modification by sex or race/ethnicity. CONCLUSIONS Results suggest very small associations between weight status and academic achievement that were largely explained by sociodemographic factors and CRF. Evidence of an association between weight status and achievement was stronger among students who developed overweight/obesity. Interventions promoting healthy weight and high CRF remain critical for schools given the link between student health and achievement.
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Affiliation(s)
- Paul Elish
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Peter Boedeker
- Department of Education, Innovation and Technology, Baylor College of Medicine, Houston, TX, USA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Julie Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Wasniewska M, Pepe G, Aversa T, Bellone S, de Sanctis L, Di Bonito P, Faienza MF, Improda N, Licenziati MR, Maffeis C, Maguolo A, Patti G, Predieri B, Salerno M, Stagi S, Street ME, Valerio G, Corica D, Calcaterra V. Skeptical Look at the Clinical Implication of Metabolic Syndrome in Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040735. [PMID: 37189984 DOI: 10.3390/children10040735] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/25/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
Metabolic syndrome (MetS) is defined by a cluster of several cardio-metabolic risk factors, specifically visceral obesity, hypertension, dyslipidemia, and impaired glucose metabolism, which together increase risks of developing future cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). This article is a narrative review of the literature and a summary of the main observations, conclusions, and perspectives raised in the literature and the study projects of the Working Group of Childhood Obesity (WGChO) of the Italian Society of Paediatric Endocrinology and Diabetology (ISPED) on MetS in childhood obesity. Although there is an agreement on the distinctive features of MetS, no international diagnostic criteria in a pediatric population exist. Moreover, to date, the prevalence of MetS in childhood is not certain and thus the true value of diagnosis of MetS in youth as well as its clinical implications, is unclear. The aim of this narrative review is to summarize the pathogenesis and current role of MetS in children and adolescents with particular reference to applicability in clinical practice in childhood obesity.
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Affiliation(s)
- Malgorzata Wasniewska
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Giorgia Pepe
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Tommaso Aversa
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Simonetta Bellone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
| | - Luisa de Sanctis
- Department of Public Health and Pediatric Sciences, University of Torino, 10126 Turin, Italy
| | - Procolo Di Bonito
- Department of Internal Medicine, "Santa Maria delle Grazie" Hospital, 80078 Pozzuoli, Italy
| | - Maria Felicia Faienza
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Nicola Improda
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, 80122 Napoli, Italy
| | - Maria Rosaria Licenziati
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, 80122 Napoli, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
| | - Alice Maguolo
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy
| | - Giuseppina Patti
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genova, 16128 Genova, Italy
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Largo del Pozzo, 71, 41124 Modena, Italy
| | - Mariacarolina Salerno
- Pediatric Endocrinology Unit, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Stefano Stagi
- Health Sciences Department, University of Florence and Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Maria Elisabeth Street
- Unit of Paediatrics, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, 43126 Parma, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Napoli "Parthenope", 80133 Napoli, Italy
| | - Domenico Corica
- Division of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, 98121 Messina, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, "Vittore Buzzi" Children's Hospital, 20157 Milano, Italy
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Naylor Metoyer B, Chuang RJ, Lee M, Markham C, Brown EL, Almohamad M, Dave JM, Sharma SV. Fruit and Vegetable Intake and Home Nutrition Environment among Low-Income Minority Households with Elementary-Aged Children. Nutrients 2023; 15:nu15081819. [PMID: 37111037 PMCID: PMC10145522 DOI: 10.3390/nu15081819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023] Open
Abstract
Racial/ethnic and socioeconomic differences were shown to have an influence on child fruit and vegetable intake. This study examined the associations between parent and child fruit and vegetable intake and the home nutrition environment among Hispanic/Latino and African American families. Through a cross-sectional study design, self-reported surveys (n = 6074) were obtained from adult-child dyad participants enrolled in Brighter Bites, an evidence-based health promotion program, in the fall of 2018. For every once/day increase in frequency of parent FV intake, there was an increase in child FV intake by 0.701 times/day (CI: 0.650, 0.751, p < 0.001) and 0.916 times/day (CI: 0.762, 1.07; p < 0.001) among Hispanic/Latinos and African Americans, respectively. In Hispanic/Latino participants, significant positive associations were found between fruits as well as vegetables served at mealtimes ≥3 times/week (p < 0.001), family mealtimes 7 times/week (p = 0.018), parent-child communication about healthy eating and nutrition at least sometimes during the past 6 months (p < 0.05), and frequency of child FV intake, after adjusting for covariates. In African American participants, a significant positive association was found in fruits served at mealtimes ≥1 times/week (p < 0.05), and vegetables served at mealtimes ≥5 times/week (p < 0.05). Meals cooked from scratch a few times a day/all the time were significantly positively associated with frequency of child FV intake for both Hispanic/Latino (p = 0.017) and African American (p = 0.007) groups. The relationship between home nutrition environment and child FV intake varied by race and ethnicity. Future programs should consider designing culturally tailored interventions to address racial/ethnic-specific influences that match the child's race, culture, and ethnicity.
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Affiliation(s)
- Brittni Naylor Metoyer
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Ru-Jye Chuang
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - MinJae Lee
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center (UTSW), 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 7000 Fannin Street, Houston, TX 77030, USA
| | - Eric L Brown
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Maha Almohamad
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Ave, Houston, TX 77030, USA
| | - Shreela V Sharma
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
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Tran AH, Urbina EM. Is There a Role for Imaging Youth at Risk of Atherosclerosis? Curr Atheroscler Rep 2023; 25:119-126. [PMID: 36848015 DOI: 10.1007/s11883-023-01089-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE OF REVIEW Cardiovascular (CV) risk factors such as dyslipidemia, hypertension, diabetes, and obesity are associated with an increased risk for CV events in adults. Noninvasive measures of vascular health are associated with these CV events and can potentially help risk stratify children with CV risk factors. The purpose of this review is to summarize recent literature regarding vascular health in children with cardiovascular risk factors. RECENT FINDINGS Adverse changes in pulse wave velocity, pulse wave analysis, arterial distensibility, and carotid intima-media thickness are seen in children with CV risk factors supporting potential utility in risk stratification. Assessing vascular health in children can be challenging due to growth-related changes in vasculature, multiple assessment modalities, and differences in normative data. Vascular health assessment in children with cardiovascular risk factors can be a valuable tool for risk stratification and help identify opportunities for early intervention. Future areas of research include increasing normative data, improving conversion of data between different modalities, and increasing longitudinal studies in children linking childhood risk factors to adult CV outcomes.
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Affiliation(s)
- Andrew H Tran
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Elaine M Urbina
- Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7002, Cincinnati, OH, 45229, USA.
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA.
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Bittencourt JC, Scheinbein GHA, de Oliveira Junior WC, Bassi RL, Moura LB, Correa ALD, de Lima Bernardes RG, Freitas LS, Lemos JC, Gonçalves GKN, Rodrigues-Machado MDG. Arterial stiffness indices, pulse wave velocity and central systolic blood pressure, are able to discriminate between obese and non-obese children. Eur J Pediatr 2023; 182:1403-1415. [PMID: 36680578 PMCID: PMC9862226 DOI: 10.1007/s00431-023-04807-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/09/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023]
Abstract
The objectives of this study were to verify, first, if arterial stiffness indices can discriminate between obese and healthy children. Second, to evaluate arterial stiffness index predictors and hemodynamic parameters in obese children. Arterial stiffness indices evaluated were pulse wave velocity (PWV), central systolic blood pressure (SBPc), and central pulse pressure (PPc). A cross-sectional, descriptive, comparative study design was used. The sample consisted of 78 normal-weight children (8.1 ± 1.96 years) and 58 obese children (9.0 ± 1.87 years). PWV, PPc, and SBPc were significantly higher in the group of obese children than in the control group. The ROC curve analysis showed that maximum PWV and SBPc sensitivity and specificity in differentiating obese from non-obese children occurred at 4.09 m/s and 86.17 mmHg, respectively. PPc did not exhibit a discriminatory capacity between the two groups. Peripheral systolic blood pressure (SBPp), peripheral pulse pressure (PPp), and PPc (R2 = 0.98) were predictors of increased PWV. Augmentation pressure, PPp, and reflection coefficient (R2 = 0.873) were predictors of PPc. Age, augmentation index, total vascular resistance, cardiac index, and mean fat percentage (R2 = 0.801) were predictors of SBPc. CONCLUSION This study shows for the first time that PWV > 4.09 m/s and SBPc > 86.17 mmHg are cut-off points associated with a higher risk of obesity. These results indicate that the simple, rapid, and noninvasive measurement of arterial stiffness adds prognostic information regarding cardiovascular risk, in addition to increased body mass index. WHAT IS KNOWN • Overweight and obesity are strongly associated with comorbidities que contribute to the development of cardiovascular diseases. WHAT IS NEW • This is the first study to show that PWV and SBPc can discriminate obese from non-obese children. These results show that, in addition to an increased BMI, a simple, rapid, and noninvasive measurement of arterial stiffness adds prognostic information on cardiovascular risk.
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Affiliation(s)
- Juliana Cabral Bittencourt
- Faculty of Medical Sciences of Minas Gerais (FCM-MG), Post-Graduate Program in Health Sciences, Belo Horizonte, MG Brazil
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Cashion JM, Young KM, Sutherland BA. How does neurovascular unit dysfunction contribute to multiple sclerosis? Neurobiol Dis 2023; 178:106028. [PMID: 36736923 DOI: 10.1016/j.nbd.2023.106028] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/17/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system (CNS) and the most common non-traumatic cause of neurological disability in young adults. Multiple sclerosis clinical care has improved considerably due to the development of disease-modifying therapies that effectively modulate the peripheral immune response and reduce relapse frequency. However, current treatments do not prevent neurodegeneration and disease progression, and efforts to prevent multiple sclerosis will be hampered so long as the cause of this disease remains unknown. Risk factors for multiple sclerosis development or severity include vitamin D deficiency, cigarette smoking and youth obesity, which also impact vascular health. People with multiple sclerosis frequently experience blood-brain barrier breakdown, microbleeds, reduced cerebral blood flow and diminished neurovascular reactivity, and it is possible that these vascular pathologies are tied to multiple sclerosis development. The neurovascular unit is a cellular network that controls neuroinflammation, maintains blood-brain barrier integrity, and tightly regulates cerebral blood flow, matching energy supply to neuronal demand. The neurovascular unit is composed of vessel-associated cells such as endothelial cells, pericytes and astrocytes, however neuronal and other glial cell types also comprise the neurovascular niche. Recent single-cell transcriptomics data, indicate that neurovascular cells, particular cells of the microvasculature, are compromised within multiple sclerosis lesions. Large-scale genetic and small-scale cell biology studies also suggest that neurovascular dysfunction could be a primary pathology contributing to multiple sclerosis development. Herein we revisit multiple sclerosis risk factors and multiple sclerosis pathophysiology and highlight the known and potential roles of neurovascular unit dysfunction in multiple sclerosis development and disease progression. We also evaluate the suitability of the neurovascular unit as a potential target for future disease modifying therapies for multiple sclerosis.
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Affiliation(s)
- Jake M Cashion
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Kaylene M Young
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Brad A Sutherland
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
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Rosal MC, Lemon SC, Borg A, Lopez-Cepero A, Sreedhara M, Silfee V, Pbert L, Kane K, Li W. The Healthy Kids & Families study: Outcomes of a 24-month childhood obesity prevention intervention. Prev Med Rep 2023; 31:102086. [PMID: 36820371 PMCID: PMC9938323 DOI: 10.1016/j.pmedr.2022.102086] [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] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Socioeconomically disadvantaged children experience a high burden of obesity but few interventions address obesity prevention in this population subgroup. The Healthy Kids & Families study tested the effect of a parent-focused community health worker (CHW)-delivered lifestyle intervention to prevent childhood obesity. Participants were child-parent/guardian (Kindergarten to 6th grade at baseline) dyads (n = 247) recruited through schools located in socioeconomically disadvantaged neighborhoods in Worcester, MA, USA. Using a quasi-experimental design, the study tested the impact of Healthy Kids & Families, a theory-based, low-intensity, parent-focused, CHW-delivered intervention to improve children's weight, healthy eating and physical activity. The attention-control comparison condition was a positive parenting intervention. The primary outcome was change in child body mass index (BMI) z-score at 24 months. Secondary outcomes included number of positive child and parent changes in selected diet and physical activity behaviors targeted by the intervention and change in parent BMI. Outcomes were assessed following the intent-to-treat principle and using multivariable generalized linear mixed models. Compared to the attention-control comparison condition, the Healthy Kids & Families intervention led to a greater reduction in children's BMI z-score (β = -0.17, 95 %CI: -1.92 to -0.36; p = 0.057) and a greater number of positive behavior changes among children (β = 0.57, 95 %CI: 0.08-1.06; p = 0.02) at 24 months. There was no significant change in parent outcomes. The Healthy Kids & Families intervention shows promise for obesity prevention among children in socioeconomically disadvantaged communities.
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Affiliation(s)
- Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Stephenie C. Lemon
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Amy Borg
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Andrea Lopez-Cepero
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Meera Sreedhara
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Valerie Silfee
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Weight Watchers International, NY, USA
| | - Lori Pbert
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Kevin Kane
- Health Statistics and Geography Lab, Center for Health Statistics and Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, MA, USA
| | - Wenjun Li
- Health Statistics and Geography Lab, Center for Health Statistics and Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, MA, USA
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Kim N, Park J. Total energy expenditure measured by doubly labeled water method in children and adolescents: a systematic review. Clin Exp Pediatr 2023; 66:54-65. [PMID: 36265521 PMCID: PMC9899554 DOI: 10.3345/cep.2022.00472] [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: 03/18/2022] [Accepted: 09/22/2022] [Indexed: 02/04/2023] Open
Abstract
Total energy expenditure (TEE) is essential for understanding the growth, development, and physical activity of children and adolescents. This study aimed to summarize the existing evidence on TEE measured using the doubly labeled water (DLW) technique in children and adolescents aged 1-18 years. Furthermore, this review compared TEE between obese and normal-weight participants. This systematic review used the PubMed, ScienceDirect, Web of Science, and EBSCO databases. These studies were limited to those published in English between January 2000 and December 2021. Articles presenting objectively measured data on the TEE of children and adolescents aged 1-18 years measured using the DLW method were included. Physical activity level (PAL; TEE/basal metabolic rate [BMR]) and BMR data were also obtained. The search strategy identified 2,351 articles, of which 63 (n=4,283 children and adolescents; 45.4% male) met the selection criteria. The participants in the 10 studies were overweight or obese (n=413). In our study, TEE increased in male and female participants aged 1-18 years. PAL increased with age in males (y=0.0272x+1.3887, r2=0.511) and females (y=0.0199x+1.401, r2=0.335), and the slope of PAL with age did not differ between males and females. The TEE of obese and overweight participants was higher than that of normal-weight participants, but the slope of TEE did not differ between normal-weight (y=132.99x+702.24, r2=0.877) and obese individuals (y=136.18x+1,037.9, r2=0.842). In conclusion, this review provides convincing evidence that daily TEE progressively increases with growth in males and females aged 1-18 years.
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Affiliation(s)
- Nahyun Kim
- Department of Physical Education, Korea University, Seoul, Korea
| | - Jonghoon Park
- Department of Physical Education, Korea University, Seoul, Korea
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Kahan D, Poulos A. Models of school recess for combatting overweight in the United States. Prev Med Rep 2023; 31:102081. [PMID: 36820369 PMCID: PMC9938318 DOI: 10.1016/j.pmedr.2022.102081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/03/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives The aim of the study was to quantify and compare potential energy expenditure associated with school recess in the U.S. based on four scenarios: professional recommendations and state policies for the conduct of recess, previous studies that measured physical activity intensity during recess (i.e., reality), and no daily recess. Methods Estimated energy expenditure (kcal) was modeled using secondary data over six years of elementary school for boys and girls using a standard formula: Intensity × duration × frequency × mass . Results Boys and girls would expend similar energy under the professional recommendation (boys, 69,146 kcal; girls, 63,993 kcal) and state policy (boys, 69,532 kcal; girls, 64,351 kcal) scenarios. These values are significantly greater than a no recess scenario (boys, 26,974 kcal; girls, 24,821 kcal). The greatest energy expenditure was found for the reality scenario, based on actual studies that measured physical activity intensity (boys, 82,208 kcal; girls, 75,628 kcal). Conclusions Professional recommendations and state policies for recess duration may be overly conservative and recommendations for percentage of MVPA may be overly liberal compared to the reality of energy expended during recess. Both potential and real estimates dwarf a scenario of withholding recess (i.e., no recess), which is discouraged in only six state policies. Mandated reporting with "groundtruthing" is needed to determine true recess frequency/duration and state policy compliance.
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Affiliation(s)
- David Kahan
- Spadoni College of Education and Social Sciences, Coastal Carolina University, Conway, SC, USA
| | - Allison Poulos
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Dormanesh B, Arasteh P, Daryanavard R, Mardani M, Ahmadi M, Nikoupour H. Epidemiology of obesity and high blood pressure among school-age children from military families: the largest report from our region. BMC Pediatr 2023; 23:37. [PMID: 36683049 PMCID: PMC9868491 DOI: 10.1186/s12887-023-03839-z] [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: 09/13/2022] [Accepted: 01/06/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND For the first time, we aimed to determine the epidemiology and associated factors of obesity and hypertension among children of military families in our region. METHODS In this multi-centered study, children between the ages of 5 to 12 years old, entered the study. Data on baseline and clinical characteristics, history of disease and anthropometric measurements, were collected. RESULTS Among 504 children, 44.2% were males. Mean (SD) age of participants was 7.9 ± 1.9 years. Overall, 5% were obese and 9.9% were overweight. In total, 16.3% had elevated BP, 12.5% had stage one and 0.2% had stage two hypertension. Age (beta = 0.306, OR = 1.35, 95% CI:1.14-1.61), obesity/overweight (OR = 5.58, 95% CI:2.59-12.0), history of hypertension in mother (OR = 43.24, 95% CI:5.99-312.11), low birth weight (OR = 7.96, 95% CI:2.59-12.0), physical activity (OR = 0.27, 95% CI:0.10-0.72), and consumption of fast food more than once a week (OR = 3.36, 95% CI:1.82-6.19), were associated with risk of hypertension. Furthermore, age (beta = 0.346, OR = 1.41, 95% CI:1.21-1.64), history of childhood obesity in the father (OR = 3.78, 95% CI: 1.77-8.06) and mother (OR = 2.44, 95% CI:1.07-5.56), and physical activity (OR = 0.27, 95% CI:0.11-0.66), were associated with obesity. CONCLUSION Age, obesity/overweight, history of hypertension in the mother, birth weight, physical activity, and consumption of fast food, were associated with risk of hypertension. Moreover, age, history of childhood obesity in parents, and physical activity, were associated with obesity. Furthermore, we found that school-age children in military families have higher rates of hypertension and overweight compared to other reports from our region.
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Affiliation(s)
- Banafshe Dormanesh
- Department of Pediatric, AJA University of medical sciences, Tehran, Iran
| | - Peyman Arasteh
- AJA University of Medical Sciences, Tehran, Iran
- Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roya Daryanavard
- Department of Pediatric, AJA University of medical sciences, Tehran, Iran
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Mannarino S, Santacesaria S, Raso I, Garbin M, Pipolo A, Ghiglia S, Tarallo G, De Silvestri A, Vandoni M, Lucini D, Carnevale Pellino V, Bernardelli G, Gatti A, Rossi V, Calcaterra V, Zuccotti G. Benefits in Cardiac Function from a Remote Exercise Program in Children with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1544. [PMID: 36674299 PMCID: PMC9861570 DOI: 10.3390/ijerph20021544] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Physical activity (PA) is a crucial factor in preventing and treating obesity and related complications. In this one-arm pre−post longitudinal prospective study, we evaluated the effects of a 12-week online supervised training program on cardiac morphology, function and blood pressure (BP) in children with obesity. The training program consisted of three sessions per week, each lasting 60 min. Advanced echocardiographic imaging (tissue Doppler and longitudinal strain analysis) was used to detect subclinical changes in heart function. Categorical variables were described as counts and percentages; quantitative variables as the mean and standard deviation (SD) as they were normally distributed (Shapiro−Wilks test). Pre−post comparisons were made with a paired t-test. A total of 27/38 (71%) enrolled patients (18M/9F, 11 ± 2 years) completed the training protocol and were considered in the analysis. At baseline, no hypertensive patient was noted; all echocardiographic variables were within the normal range. After training, we observed a significant reduction in BP parameters, including systolic BP values and Z-score, diastolic BP values, centiles and Z-score, and mean arterial pressure (all p < 0.05). Significant variations in echocardiographic interventricular septum (IVSd) thickness (p = 0.011), IVSd Z-score (p = 0.001), left ventricular (LV) end-diastolic diameter (p = 0.045), LV posterior wall thickness Z-score (p = 0.017), and LV global longitudinal strain (p = 0.016) were detected. No differences in LV diastolic function and right ventricular strain were noted. PA plays a decisive role in improving BP control and has benefits on left ventricle systolic function, representing a strategic approach to limit CV risk. Online exercise could be an excellent method of training in children with obesity.
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Affiliation(s)
- Savina Mannarino
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Sara Santacesaria
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Irene Raso
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Massimo Garbin
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Andreana Pipolo
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Silvia Ghiglia
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Gabriele Tarallo
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Annalisa De Silvestri
- Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Daniela Lucini
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
- Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giuseppina Bernardelli
- Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy
- DISCCO Department, University of Milan, 20122 Milan, Italy
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Virginia Rossi
- Pediatric Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milan, Italy
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Cai Q, Zhao X, Dong L, Zhang X, Wang C, Wang S, Zhou Y, Zhou X, Li Y, Wang S, Liu L, Hu A. Keeping obesity status is a risk factor of hypertension onset: evidence from a community-based longitudinal cohort study in North China. Front Public Health 2023; 11:1170334. [PMID: 37181695 PMCID: PMC10173577 DOI: 10.3389/fpubh.2023.1170334] [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] [Received: 02/20/2023] [Accepted: 03/28/2023] [Indexed: 05/16/2023] Open
Abstract
Objective The purpose of our study was to investigate the association of obesity status change with hypertension onset based on a community-based longitudinal cohort study in North China. Methods This longitudinal study included 3,581 individuals free of hypertension at baseline in the first survey (2011-2012). All participants were followed up (2018-2019). According to the criteria, a total of 2,618 individuals were collected for analysis. We used adjusted Cox regression models and Kaplan-Meier survival analysis to estimate the association between obesity status change and hypertension onset. Additionally, we applied the forest plot to visualize the subgroup analysis including age, gender, and the differences in some variables between baseline and follow-up. Finally, we conducted a sensitivity analysis to examine the stability of our results. Results Over nearly 7 years of follow-up, a total of 811 (31%) developed hypertension. The new hypertension incidence was mostly observed in those who were obese all the time (P for trend < 0.01). In the fully adjusted Cox regression model, being obese all the time increased the risk of hypertension by 30.10% [HR 4.01 (95% CI 2.20-7.32)]. The Kaplan-Meier survival analysis revealed the change in obesity status as an important feature to predict the occurrence of hypertension. Sensitivity analysis shows a consistent trend between the change in obesity status and hypertension onset in all populations. Subgroup analysis showed that age above 60 years was an important risk factor for hypertension onset, that men were more likely than women to develop hypertension, and that weight control was beneficial in avoiding future hypertension in women. There were statistically significant differences in ΔBMI, ΔSBP, ΔDBP, and ΔbaPWV between the four groups, and all variables, except baPWV changes, increased the risk of future hypertension. Conclusion Our study shows that obese status was notably associated with a significant risk of hypertension onset among the Chinese community-based cohort.
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Affiliation(s)
- Qiujing Cai
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaolei Zhao
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Liguang Dong
- Center for Health Care Management, Peking University Shougang Hospital, Beijing, China
- Beijing Hypertension League, Beijing, China
| | - Xinmin Zhang
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Chenglong Wang
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shu Wang
- Beijing Hypertension League, Beijing, China
| | - Yi Zhou
- Department of Cardiology, Fuwai Hospital, Beijing, China
| | - Xianliang Zhou
- Department of Cardiology, Fuwai Hospital, Beijing, China
| | - Yanqi Li
- Beijing Hypertension League, Beijing, China
| | - Shuyu Wang
- Beijing Hypertension League, Beijing, China
| | | | - Aihua Hu
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- *Correspondence: Aihua Hu
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Abstract
The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascular, gastrointestinal, and endocrine function as well as body mass index and sleep. At this time, more research is needed to understand the influence of cannabis use on physical health, particularly among adolescent samples.
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Affiliation(s)
- Abigail L Tuvel
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1777 Exposition Drive, Boulder, CO 80301
| | - Evan A Winiger
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045
| | - J Megan Ross
- Department of Psychiatry, Division of Addiction Sciences, Treatment and Prevention, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045.
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Metoyer BN, Chuang RJ, Lee M, Markham C, Brown E, Almohamad M, Dave JM, Sharma SV. Fruit and Vegetable Shopping Behavior and Intake among Low-Income Minority Households with Elementary-Aged Children. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010082. [PMID: 36670633 PMCID: PMC9857335 DOI: 10.3390/children10010082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023]
Abstract
Low-income children and families do not meet the recommendations for fruit and vegetable (FV) intake. This study aimed to assess the association between FV shopping behavior and child FV intake through a cross-sectional study design analyzing self-reported surveys (n = 6074) from adult-child dyads of Hispanic/Latino and African American participants enrolled in the Brighter Bites co-op program. Through quantitative mixed effects linear regression models, accounting for school-level clustering and adjusting for covariates, child FV intake was positively associated with shopping for FV at large chain grocery stores (p < 0.001), natural/organic supermarkets (p < 0.001), warehouse club stores (p = 0.002), discount superstores (p < 0.001), small local stores/corner stores (p = 0.038), convenience stores (p = 0.022), ethnic markets (p = 0.002), farmers’ markets/co-op/school farm stands (p < 0.001), and gardens (p = 0.009) among Hispanic/Latinos participants. Among African American participants, there was significant positive association between child FV intake and shopping for FV at natural/organic supermarkets (p < 0.001), discount superstores (p = 0.005), and convenience stores (p = 0.031). The relationship between location and frequency of shopping for FV and child FV intake varied between races. Further research is needed to better understand the influence of cultural and physical environmental factors. Nutrition education programs are vital to encouraging families to make healthier food choices and purchases to improve child FV consumption.
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Affiliation(s)
- Brittni N. Metoyer
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Ru-Jye Chuang
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - MinJae Lee
- Department of Population and Data Sciences, Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center (UTSW), 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 7000 Fannin Street, Houston, TX 77030, USA
| | - Eric Brown
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Maha Almohamad
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Ave, Houston, TX 77030, USA
| | - Shreela V. Sharma
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
- Correspondence: ; Tel.: +713-500-9344; Fax: +713-500-9264
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Ferreira MS, Marson FAL, Wolf VLW, Zambon MP, Antonio MÂRDGM, Ribeiro JD, Mendes RT. Association between Pulmonary Function and Body Composition in Children and Adolescents with and without Obesity. J Clin Med 2022; 11:7410. [PMID: 36556026 PMCID: PMC9782625 DOI: 10.3390/jcm11247410] [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] [Received: 11/07/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
Lung function in children and adolescents with obesity must consider the coexistence of two complex and related phenomena: obesity and growth. The assessment of body composition can identify changes in respiratory dynamics arising, exclusively or jointly, from adiposity and lean body mass. This study aimed to compare pulmonary function and the dysanapsis indices of children and adolescents without asthma, with and without obesity, considering body composition, pubertal development, and physical activity practice. We performed a cross-sectional study with 69 participants, 41 (59.42%) of whom have obesity. All participants carried out spirometry and the assessment of, respectively, body composition by dual-energy X-ray absorptiometry, vital signs, pubertal development, and physical activity practice. In our data, the group with obesity had higher values of forced vital capacity (FVC) and lower values of the ratio between forced expiratory volume in one second and FVC (FEV1/FVC). Analyzing the entire sample, we found a positive correlation between FVC and a negative correlation between FEV1/FVC with fat mass markers. At the same time, inspiratory capacity, expiratory reserve volume, and peak expiratory flow were correlated with lean body mass markers. In addition, participants with obesity presented a lower dysanapsis index. In conclusion, children and adolescents with obesity showed increased FVC and reduced FEV1/FVC. Our findings are possibly related to the increase in fat mass, not to lean body mass. We hypothesize that these findings are associated with the dysanaptic growth pattern, which is higher in obesity, evidenced by the reduction of the dysanapsis index.
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Affiliation(s)
- Mariana Simões Ferreira
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
- Laboratory of Lung Function, Center of Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
- Teaching and Research Center of Rede Mário Gatti, Campinas 13036-902, Brazil
| | - Fernando Augusto Lima Marson
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
- Laboratory of Lung Function, Center of Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
- Laboratory of Human and Medical Genetics, Post-Graduation Program in Health Sciences, São Francisco University, Bragança Paulista 12916-900, Brazil
| | - Vaneza Lira Waldow Wolf
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
- Laboratory of Lung Function, Center of Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
| | - Mariana Porto Zambon
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
| | | | - José Dirceu Ribeiro
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
- Laboratory of Lung Function, Center of Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
| | - Roberto Teixeira Mendes
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil
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