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Guariguata L, Burlar A, Greaves N, Harewood H, Khan R, Rosario-Rosado RV, Jones W, Roy B, Hassan S. A systems thinking framework for understanding rising childhood obesity in the Caribbean. Health Res Policy Syst 2024; 22:115. [PMID: 39169406 PMCID: PMC11337753 DOI: 10.1186/s12961-024-01201-y] [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: 05/03/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024] Open
Abstract
OBJECTIVE The aim of this study is to develop a systems thinking framework to describe the common complexities of childhood obesity in the Caribbean region and identify potential areas of intervention. METHODS Group model building (GMB) is a form of systems science. Trained GMB facilitators in Puerto Rico, the US Virgin Islands, Barbados, and Trinidad and Tobago convened a group of multi-disciplinary stakeholders in a series of virtual meetings in 2021 to elaborate a hypothesis of the system driving childhood obesity represented by causal loop diagrams (CLD). Commonalities and differences between the CLDs from each island were identified and reconciled to create a synthesized CLD. RESULTS A single explanatory CLD across the islands was developed and includes nine reinforcing loops. These loops addressed the interconnected role of schools, policy, commercial determinants, community and the personal experience of the child in rising childhood obesity rates. CONCLUSIONS Despite differences across settings, there is a core system driving childhood obesity in the Caribbean, as described by stakeholders in GMB workshops. Policy solutions to the problem must be multi-faceted and multi-level to address the interlinked reinforcing loops of the complex system and reduce rates of childhood obesity.
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Affiliation(s)
- Leonor Guariguata
- Faculty of Economics and Business, Access to Medicine Research Center, Katholieke Universiteit Leuven, Leuven, Belgium
- Department of Pre-Clinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Bridgetown, Barbados
| | - Amy Burlar
- School of Nursing, Virginia Commonwealth University, Richmond, USA
| | - Natalie Greaves
- Department of Pre-Clinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Bridgetown, Barbados
| | - Heather Harewood
- Department of Pre-Clinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Bridgetown, Barbados
| | - Raveed Khan
- Department of Para Clinical Sciences, The University of the West Indies, St. Augustine, Trinidad
| | - Rosa V Rosario-Rosado
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico at Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Waneisha Jones
- Department of Pre-Clinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Bridgetown, Barbados
| | - Brita Roy
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Saria Hassan
- Department of Medicine, Emory School of Medicine, Atlanta, GA, USA.
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Li J, Lei L, Wang W, Ding W, Yu Y, Pu B, Peng Y, Li Y, Zhang L, Guo Y. Social Risk Profile and Cardiovascular-Kidney-Metabolic Syndrome in US Adults. J Am Heart Assoc 2024; 13:e034996. [PMID: 39136302 DOI: 10.1161/jaha.124.034996] [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: 03/06/2024] [Accepted: 05/07/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND Poor cardiovascular-kidney-metabolic (CKM) health is associated with premature mortality and excess morbidity in the United States. Adverse social conditions have a prominent impact on cardiometabolic diseases during the life course. We aim to examine the association between social risk profile (SRP) and CKM multimorbidity among US adults. METHODS AND RESULTS We used data from the National Health and Nutrition Examination Survey from 1999 to 2018. The definition of CKM syndrome is the coexistence of subclinical or clinical cardiovascular disease, chronic kidney disease, and metabolic disorders. We classified participants by 4 CKM stages according to the different clinical severity of different forms of CKM syndrome. We calculated the summed number of positive SRP measures, including employed, high-income level, food secure, high education attainment, private insurance, owning a house, and married, as SRP scores and classified them into 4 levels by quartiles: low (0-2), lower-middle (3-4), upper-middle (5-6), and high (7-8). A total of 18 373 US adults, aged 20 to 79 years, were included in our analyses. There were 2567 (9.4%) participants with low SRP score level. Most individual SRP measures and a combined SRP score were associated with CKM stages. Compared with high SRP score level, low SRP level was associated with higher odds of having CKM stage 1 (odds ratio [OR], 1.34 [95% CI, 1.06-1.70]), CKM stage 2 (OR, 2.03 [95% CI, 1.59-2.58]), CKM stage 3 (OR, 5.28 [95% CI, 3.29-8.47]), and CKM stage 4 (OR, 5.97 [95% CI, 4.20-8.49]). CONCLUSIONS Cumulative social disadvantage, denoted by higher SRP burden, was associated with higher odds of CKM multimorbidity, independent of demographic and lifestyle factors.
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Affiliation(s)
- Jingkuo Li
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Lubi Lei
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Wei Wang
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
- Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology Beijing China
| | - Wenbo Ding
- Cardio-Metabolic Medicine Center, National Center for Cardiovascular Diseases, Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Yanwu Yu
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Boxuan Pu
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Yue Peng
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Yinchu Li
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Lihua Zhang
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Yuanlin Guo
- Cardio-Metabolic Medicine Center, National Center for Cardiovascular Diseases, Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
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Kawahara T, Doi SK, Isumi A, Matsuyama Y, Tani Y, Fujiwara T. Impact of COVID-19 pandemic on children overweight in Japan in 2020. Pediatr Obes 2024; 19:e13128. [PMID: 38812373 DOI: 10.1111/ijpo.13128] [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: 09/29/2023] [Revised: 02/28/2024] [Accepted: 04/29/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVES This study aimed to explore the association between the coronavirus disease (COVID-19) pandemic and overweight incidence among preadolescent elementary school children in Japan. METHODS A population-based longitudinal study was conducted in Adachi City, Tokyo, Japan, using data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study. The control group (2016-2018) comprised 434 children, and the COVID-19 exposure group (2018-2020) included 3500 children. Overweight was defined as a body mass index (BMI) z-score of 1 SD or more according to the World Health Organization standards. The study design involved comparing BMI z-scores before and after exposure to the pandemic, considering the associated lifestyle changes and potential consequences on physical activity, parental employment status and income. RESULTS By 6th grade, the prevalence of overweight increased from 17.7% to 19.2% in the control group and 22.5% to 29.5% in the COVID-19 exposure group. Difference-in-differences analysis revealed that children's exposure to COVID-19 significantly increased BMI z-scores (coefficient 0.22, 95% confidence interval (CI) 0.14-0.29) and a higher odds ratio of overweight (odds ratio 2.51, 95% CI 1.12-5.62), even after adjusting for time-varying covariates. CONCLUSION The COVID-19 pandemic has been associated with an increased prevalence of overweight among elementary school children in Japan.
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Affiliation(s)
- Tomoki Kawahara
- Department of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satomi Kato Doi
- Department of Health Policy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Aya Isumi
- Department of Health Policy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Matsuyama
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukako Tani
- Department of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Cepni AB, Vilson R, Helbing RR, Walsh DW, Johnston CA, Yoon CY, Hughes SO, Ledoux TA. The most optimal school recruitment strategies for school-based obesity prevention and health promotion research in the United States: A systematic review with Delphi study. Obes Rev 2024:e13808. [PMID: 39032149 DOI: 10.1111/obr.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 06/03/2024] [Accepted: 07/08/2024] [Indexed: 07/22/2024]
Abstract
This systematic review with the Delphi study aimed to identify effective and resource-efficient (optimal) strategies for recruiting schools into health promotion interventions in the United States. A literature search was conducted in PubMed, Cochrane Library, and CINAHL (EBSCO). A total of 116 interventions reported in 160 articles were included. Most school-based interventions did not report data regarding school recruitment duration (81%), target school size (63%), and school recruitment strategies (78%). Further, no details were provided regarding the reasons for declining to participate despite being eligible. For the Delphi, responses from 23 researchers in school-based clinical trials were collected. A qualitative descriptive approach was used for coding responses and collapsed into higher-order categories based on school recruitment strategies. Delphi participants reported that (1) creating new or leveraging pre-existing partnerships, (2) intervention champion, (3) minimal school disruptions, (4) working with open mind/flexibility, and (5) transparent communication are the most optimal school recruitment strategies. Staff time and travel were the most frequently reported costs for implementing those strategies. The overall trend in school-based obesity prevention intervention studies illustrates the importance of a better understanding school recruitment. Improved reporting can allow researchers to budget their time and resources better and provide greater confidence in reaching their target school size.
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Affiliation(s)
- Aliye B Cepni
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Reshma Vilson
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Rachel R Helbing
- University Libraries, University of Houston, Houston, Texas, USA
| | - David W Walsh
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Craig A Johnston
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Cynthia Y Yoon
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Tracey A Ledoux
- Health and Human Performance Department, University of Houston, Houston, Texas, USA
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Cobal S, Bender DV, Kljusurić JG, Rumora Samarin I, Krznarić Ž. Effect of School-Based Educational Intervention on Childhood Obesity in Croatian Urban and Rural Settings. CHILDREN (BASEL, SWITZERLAND) 2024; 11:867. [PMID: 39062316 PMCID: PMC11276343 DOI: 10.3390/children11070867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based "PETICA-Play for Health" obesity prevention program in urban and rural areas in Croatia. METHODS This before-and-after study included 28 elementary schools in Croatia focused on pupils (n = 753, 2nd grade) and their guardians (n = 753) during the school year 2022/2023. "PETICA" multicomponent lessons and workshops (10) were implemented in the school curriculum and home settings (parents) as part of the intervention. Knowledge and lifestyle habit changes were evaluated via the questionnaire on knowledge and habits regarding nutrition and physical activity pre-/post-education. The Wilcoxon test for paired samples, Student's t-test (dependent and independent samples), multiple Mann Whitney U tests (p < 0.05), Spearman's correlation, and heatmaps were used. RESULTS The analysis showed a significant increase in acquired knowledge among pupils (both settings) and habits in the rural setting (increase in sports activities participation, breakfast, and vegetables consumption (p < 0.001, p = 0.003, p = 0.004)), decrease of sweets and salty snacks intake (p = 0.027, p = 0.011), and also, the link between parents' and children's physical activity levels (p = 0.028 vs. p = 0.022), emphasizing the importance of parents as healthy lifestyle role-models. CONCLUSION The study shows that "PETICA" is an efficient school-based educational model that contributes to positive changes in children's knowledge and lifestyle habits that are a prerequisite for childhood obesity prevention.
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Affiliation(s)
- Sara Cobal
- Croatian Medical Association, Šubićeva 9, 10 000 Zagreb, Croatia;
| | - Darija Vranešić Bender
- Unit of Clinical Nutrition, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia;
| | - Jasenka Gajdoš Kljusurić
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.G.K.); (I.R.S.)
| | - Ivana Rumora Samarin
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.G.K.); (I.R.S.)
| | - Željko Krznarić
- Croatian Medical Association, Šubićeva 9, 10 000 Zagreb, Croatia;
- Unit of Clinical Nutrition, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia;
- School of Medicine, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia
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Treister-Goltzman Y. An Ecological Association Between Air Pollution and Adolescent Obesity Study. J Occup Environ Med 2024; 66:542-547. [PMID: 38595273 DOI: 10.1097/jom.0000000000003111] [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: 04/11/2024]
Abstract
OBJECTIVES The purposes of this study were to assess the association between exposure to particulate matter (PM 2.5 ) and adolescent obesity and to identify and visualize the world areas where the problems of adolescent obesity and air pollution by fine PM are more severe. METHODS This is an ecological study, based on publicly available data from a World Health Organization site. RESULTS For each increase in air pollution there was an increase in the probability of being in the higher prevalence obesity group (OR = 1.18 (95% CI, 1.06-1.31). High prevalence rates for both adolescent obesity and air pollution by PM 2.5 were identified in several countries, including Venezuela, Algeria, Libya, Saudi Arabia, Iraq, and Oceania islands. CONCLUSIONS Efforts by local authorities and world organizations should be focused on the countries with the highest prevalence rates for both conditions.
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Affiliation(s)
- Yulia Treister-Goltzman
- From the Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Y.T.-G.); and Clalit Health Services, Southern District, Beer-Sheva, Israel (Y.T.-G.)
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Liu H, Wu YC, Chau PH, Chung TWH, Fong DYT. Prediction of adolescent weight status by machine learning: a population-based study. BMC Public Health 2024; 24:1351. [PMID: 38769481 PMCID: PMC11103824 DOI: 10.1186/s12889-024-18830-1] [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: 05/15/2023] [Accepted: 05/13/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Adolescent weight problems have become a growing public health concern, making early prediction of non-normal weight status crucial for effective prevention. However, few temporal prediction tools for adolescent four weight status have been developed. This study aimed to predict the short- and long-term weight status of Hong Kong adolescents and assess the importance of predictors. METHODS A population-based retrospective cohort study of adolescents was conducted using data from a territory-wide voluntary annual health assessment service provided by the Department of Health in Hong Kong. Using diet habits, physical activity, psychological well-being, and demographics, we generated six prediction models for successive weight status (normal, overweight, obese and underweight) using multiclass Decision Tree, Random Forest, k-Nearest Neighbor, eXtreme gradient boosting, support vector machine, logistic regression. Model performance was evaluated by multiple standard classifier metrics and the overall accuracy. Predictors' importance was assessed using Shapley values. RESULTS 442,898 Primary 4 (P4, Grade 4 in the US) and 344,186 in Primary 6 (P6, Grade 6 in the US) students, with followed up until their Secondary 6 (Grade 12 in the US) during the academic years 1995/96 to 2014/15 were included. The XG Boosts model consistently outperformed all other model in predicting the long-term weight status at S6 from P4 or P6. It achieved an overall accuracy of 0.72 or 0.74, a micro-averaging AUC of 0.92 or 0.93, and a macro-averaging AUC of 0.83 or 0.86, respectively. XG Boost also demonstrated accurate predictions for each predicted weight status, surpassing the AUC values obtained by other models. Weight, height, sex, age, frequency and hours of aerobic exercise were consistently the most important predictors for both cohorts. CONCLUSIONS The machine learning approaches accurately predict adolescent weight status in both short- and long-term. The developed multiclass model that utilizing easy-assessed variables enables accurate long-term prediction on weight status, which can be used by adolescents and parents for self-prediction when applied in health care system. The interpretable models may help to provide the early and individualized interventions suggestions for adolescents with weight problems particularly.
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Affiliation(s)
- Hengyan Liu
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, PR China
| | - Yik-Chung Wu
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, PR China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, PR China
| | | | - Daniel Yee Tak Fong
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, PR China.
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Guleken Z, Ceylan Z, Çeçen S, Elgörmüş Y, Cebulski J, Depciuch J. Quantitative or qualitative biomolecular changes in blood serum composition induced by childhood obesity: A Fourier transform infrared examination. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 313:124153. [PMID: 38492465 DOI: 10.1016/j.saa.2024.124153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
Childhood obesity (CO) negatively affects one in three children and stands as the fourth most common risk factor of health and well-being. Clarifying the molecular and structural modifications that transpire during the development of obesity is crucial for understanding its progression and devising effective therapies. The study was indeed conducted as part of an ongoing CO treatment trial, where data were collected from children diagnosed with CO before the initiation of non-drug treatment interventions. Our primary aim was to analyze the biochemical changes associated with childhood obesity, specifically focusing on concentrations of lipids, lipoproteins, insulin, and glucose. By comparing these parameters between the CO group (n = 60) and a control group of healthy children (n = 43), we sought to elucidate the metabolic differences present in individuals with CO. Our biochemical analyses unveiled lower LDL (low-density lipoproteins) levels and higher HDL (high-density lipoproteins), cholesterol, triglycerides, insulin, and glucose levels in CO individuals compared to controls. To scrutinize these changes in more detail, we employed Fourier transform infrared (FTIR) spectroscopy on the serum samples. Our results indicated elevated levels of lipids and proteins in the serum of CO, compared to controls. Additionally, we noted structural changes in the vibrations of glucose, β-sheet, and lipids in CO group. The FTIR technique, coupled with principal component analysis (PCA), demonstrated a marked differentiation between CO and controls, particularly in the FTIR region corresponding to amide and lipids. The Pearson test revealed a stronger correlation between biochemical data and FTIR spectra than between 2nd derivative FTIR spectra. Overall, our study provides valuable insights into the molecular and structural changes occurring in CO.
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Affiliation(s)
- Zozan Guleken
- Gaziantep University of Science and Technology, Faculty of Medicine, Department of Physiology Gaziantep, Turkey
| | - Zeynep Ceylan
- Samsun University, Faculty of Engineering, Department of Industrial Engineering, Samsun, Turkey
| | - Serpil Çeçen
- Health Science University, Hamidiye Faculty of Medicine, Department of Physiology, İstanbul, Turkey
| | - Yusuf Elgörmüş
- Faculty of Medicine, Department of Pediatrics, İstanbul Atlas University Medicine Hospital, İstanbul 34408, Turkey
| | - Jozef Cebulski
- Institute of Physics, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Joanna Depciuch
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, Lublin 20-093, Poland; Institute of Nuclear Physics, PAS, 31342 Krakow, Poland.
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Aagaard KM, Barkin SL, Burant CF, Carnell S, Demerath E, Donovan SM, Eneli I, Francis LA, Gilbert-Diamond D, Hivert MF, LeBourgeois MK, Loos RJF, Lumeng JC, Miller AL, Okely AD, Osganian SK, Ramirez AG, Trasande L, Van Horn LV, Wake M, Wright RJ, Yanovski SZ. Understanding risk and causal mechanisms for developing obesity in infants and young children: A National Institutes of Health workshop. Obes Rev 2024; 25:e13690. [PMID: 38204366 DOI: 10.1111/obr.13690] [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: 11/10/2022] [Revised: 10/02/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024]
Abstract
Obesity in children remains a major public health problem, with the current prevalence in youth ages 2-19 years estimated to be 19.7%. Despite progress in identifying risk factors, current models do not accurately predict development of obesity in early childhood. There is also substantial individual variability in response to a given intervention that is not well understood. On April 29-30, 2021, the National Institutes of Health convened a virtual workshop on "Understanding Risk and Causal Mechanisms for Developing Obesity in Infants and Young Children." The workshop brought together scientists from diverse disciplines to discuss (1) what is known regarding epidemiology and underlying biological and behavioral mechanisms for rapid weight gain and development of obesity and (2) what new approaches can improve risk prediction and gain novel insights into causes of obesity in early life. Participants identified gaps and opportunities for future research to advance understanding of risk and underlying mechanisms for development of obesity in early life. It was emphasized that future studies will require multi-disciplinary efforts across basic, behavioral, and clinical sciences. An exposome framework is needed to elucidate how behavioral, biological, and environmental risk factors interact. Use of novel statistical methods may provide greater insights into causal mechanisms.
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Affiliation(s)
- Kjersti M Aagaard
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Shari L Barkin
- Department of Pediatrics, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Charles F Burant
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ellen Demerath
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Illinois, USA
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Illinois, USA
| | - Ihuoma Eneli
- Center for Healthy Weight and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
- Center of Nutrition, Department of Pediatrics, University of Colorado, Aurora, Colorado, USA
| | - Lori A Francis
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Monique K LeBourgeois
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Ruth J F Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Anthony D Okely
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
- llawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
- Department of Sport, Food, and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Stavroula K Osganian
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Amelie G Ramirez
- Department of Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University (NYU) School of Medicine, New York, New York, USA
- Department of Environmental Medicine, New York University (NYU) School of Medicine, New York, New York, USA
- Department of Population Health, New York University (NYU) School of Medicine, New York, New York, USA
| | - Linda V Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | - Melissa Wake
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, New York, USA
| | - Susan Z Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
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10
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Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
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11
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Thibault V, Gallant F, Paiement K, Chiasson SW, Lemieux S, Nader PA, Bélanger M. A Canadian longitudinal study of the associations between weight control status and lifestyle behaviors during adolescence. Prev Med Rep 2023; 36:102498. [PMID: 38107420 PMCID: PMC10724827 DOI: 10.1016/j.pmedr.2023.102498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/30/2023] [Accepted: 11/05/2023] [Indexed: 12/19/2023] Open
Abstract
This study aimed to estimate associations between weight control status (trying to lose, gain or maintain weight) and lifestyle behaviors (moderate-to-vigorous physical activity (MVPA), screen time, and the consumption of breakfast, fast food, fruits and vegetables, and sugar-sweetened beverages (SSB)) in adolescents. Data from 919 adolescents in the MATCH study, in New Brunswick, Canada, who self-reported their weight control status at least once within 24 data collection cycles over 8 years (from 2011 to 2019) and from 812 who provided data at least once over the 7 cycles on eating behaviors were used. Generalized estimating equations were used. At the first cycle, mean age was 11.3 (SD = 1.2) years old and 56% were girls. Trying to gain (β = 0.47, CI = [0.15, 0.79]) and maintain weight (β = 0.35, CI = [0.12, 0.57]) were positively associated with MVPA. Trying to lose weight was negatively associated with breakfast (IRR = 0.90, CI = [0.85, 0.94]) and positively associated with screen time (β = 0.62, CI = [0.15, 1.10]), fruit and vegetable (IRR = 1.12, CI = [1.01, 1.25]) and SSB (IRR = 1.42, CI = [1.10, 1.84]). Changes from one weight control status to trying to lose weight were associated with increases in fast food consumption (β = 0.49, CI = [0.15, 0.84]). Weight control status was associated with healthy and unhealthy behaviors in adolescents. Trying to gain or maintain weight was generally associated with more favorable health-related behaviors. Education on healthy weight management behaviors is needed to improve adolescents' health.
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Affiliation(s)
- Véronique Thibault
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec J1K 2R1, Canada
- Centre de formation médicale du Nouveau-Brunswick, Moncton, New Brunswick E1A 7R1, Canada
| | - François Gallant
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec J1K 2R1, Canada
- Centre de formation médicale du Nouveau-Brunswick, Moncton, New Brunswick E1A 7R1, Canada
| | - Karine Paiement
- Faculté de médecine, Université de Montréal, Montréal, Québec H3T 1J4, Canada
| | - Stephanie Ward Chiasson
- Faculté des sciences de la santé et des services communautaires, Université de Moncton, Moncton, New Brunswick E1A 3E9, Canada
| | - Simone Lemieux
- École de nutrition, Université Laval, Québec, Québec G1V 0A6, Canada
| | - Patrick Abi Nader
- Faculté des sciences de l’activité physique, Université de Sherbrooke, Sherbrooke, Québec J1K 2R1, Canada
| | - Mathieu Bélanger
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec J1K 2R1, Canada
- Centre de formation médicale du Nouveau-Brunswick, Moncton, New Brunswick E1A 7R1, Canada
- Vitalité Health Network, Moncton, New Brunswick E1C 2Z3, Canada
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12
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Bertrand-Protat S, Chen J, Jonquoy A, Frayon S, Thu Win Tin S, Ravuvu A, Caillaud C, Galy O. Prevalence, causes and contexts of childhood overweight and obesity in the Pacific region: a scoping review. OPEN RESEARCH EUROPE 2023; 3:52. [PMID: 38031554 PMCID: PMC10685071 DOI: 10.12688/openreseurope.15361.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
Background Non-communicable diseases (NCDs) are a major threat to health and development and account for 75% of deaths in the Pacific Islands Countries and Territories (PICTs). Childhood obesity has been identified as a main risk factor for NCDs later in life. This review compiled overweight and obesity (OWOB) prevalence (anthropometric data) for children aged six to 12 years old living in the Pacific region and identified possible related causes. Methods We conducted a systematic search using PubMed, Google Scholar and ScienceDirect for articles published between January 1980 and August 2022. We also searched for technical reports from Ministries of Health. Guided by the eligibility criteria, two authors independently read the selected articles and reports to extract and summarise relevant information related to overweight and obesity. Results We selected 25 articles, two worldwide analyses of population-based studies and four national reports. Information revealed that childhood OWOB prevalence reached 55% in some PICTs. This review also indicated that age, gender and ethnicity were linked to children's weight status, while dietary practices, sleep time and level of physical activity played a role in OWOB development, as well as the living environment (socio-economic status and food availability), parenting practices and education level. Conclusion This review highlighted that anthropometric data are limited and that comparisons are difficult due to the paucity of surveys and non-standardized methodology. Main causes of overweight and obesity are attributed to individual characteristics of children and behavioural patterns, children's socio-economic environment, parenting practices and educational level. Reinforcement of surveillance with standardised tools and metrics adapted to the Pacific region is crucial and further research is warranted to better understand root causes of childhood OWOB in the Pacific islands. More robust and standardized anthropometric data would enable improvements in national strategies, multisectoral responses and innovative interventions to prevent and control NCDs.
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Affiliation(s)
- Solene Bertrand-Protat
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Juliana Chen
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Aurélie Jonquoy
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Stéphane Frayon
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Si Thu Win Tin
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Amerita Ravuvu
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Corinne Caillaud
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Olivier Galy
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Ndumele CE, Rangaswami J, Chow SL, Neeland IJ, Tuttle KR, Khan SS, Coresh J, Mathew RO, Baker-Smith CM, Carnethon MR, Despres JP, Ho JE, Joseph JJ, Kernan WN, Khera A, Kosiborod MN, Lekavich CL, Lewis EF, Lo KB, Ozkan B, Palaniappan LP, Patel SS, Pencina MJ, Powell-Wiley TM, Sperling LS, Virani SS, Wright JT, Rajgopal Singh R, Elkind MSV. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation 2023; 148:1606-1635. [PMID: 37807924 DOI: 10.1161/cir.0000000000001184] [Citation(s) in RCA: 87] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and the cardiovascular system and has profound impacts on morbidity and mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with the most significant clinical impact being the high associated incidence of cardiovascular disease events and cardiovascular mortality. There is a high prevalence of poor cardiovascular-kidney-metabolic health in the population, with a disproportionate burden seen among those with adverse social determinants of health. However, there is also a growing number of therapeutic options that favorably affect metabolic risk factors, kidney function, or both that also have cardioprotective effects. To improve cardiovascular-kidney-metabolic health and related outcomes in the population, there is a critical need for (1) more clarity on the definition of cardiovascular-kidney-metabolic syndrome; (2) an approach to cardiovascular-kidney-metabolic staging that promotes prevention across the life course; (3) prediction algorithms that include the exposures and outcomes most relevant to cardiovascular-kidney-metabolic health; and (4) strategies for the prevention and management of cardiovascular disease in relation to cardiovascular-kidney-metabolic health that reflect harmonization across major subspecialty guidelines and emerging scientific evidence. It is also critical to incorporate considerations of social determinants of health into care models for cardiovascular-kidney-metabolic syndrome and to reduce care fragmentation by facilitating approaches for patient-centered interdisciplinary care. This presidential advisory provides guidance on the definition, staging, prediction paradigms, and holistic approaches to care for patients with cardiovascular-kidney-metabolic syndrome and details a multicomponent vision for effectively and equitably enhancing cardiovascular-kidney-metabolic health in the population.
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Zhao W, Wang J, Chen J, Xie H, Yang J, Liu K, He X, Xu X. The rate of orthokeratology lens use and associated factors in 33,280 children and adolescents with myopia: a cross-sectional study from Shanghai. Eye (Lond) 2023; 37:3263-3270. [PMID: 37046055 PMCID: PMC10564736 DOI: 10.1038/s41433-023-02503-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/21/2023] [Accepted: 03/08/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES To investigate the rate of orthokeratology lens (ortho-k lens) use and its associated factors in children and adolescents with myopia. METHODS Cross-sectional study. Children from 104 primary and middle schools in Shanghai were enrolled by cluster sampling. Ophthalmic examinations were conducted and information was obtained using questionnaires for associated factors analysis. RESULTS A total of 72,920 children and adolescents were included, among which 32,259 were the potential population for ortho-k lens use. A total of 1021 participants used ortho-k lenses, equating to a use rate of 1.4% in the total population and 3.1% in the potential population. Age (OR 0.91, 95% CI: 0.88-0.95, p < 0.001), BMI (≥95th percentile: OR 0.48, 95% CI: 0.35-0.66, p < 0.001), age at initiation of refractive correction (≤12 years: OR 1.75, 95% CI: 1.31-2.33, p < 0.001), and parental myopia (either: OR 2.09, 95% CI: 1.58-2.75, p < 0.001; both: OR 3.94, 95% CI: 3.04-5.11, p < 0.001) were independently associated with ortho-k lens use. Of the ortho-k lenses users, 12.4% had a logMAR CVA of ≥0.3. A correction target (SE) of ≤-3.0 D (OR 2.05, 95% CI: 1.38-3.05, p < 0.001) and a sleeping duration of ≤6 h (OR 4.19, 95% CI: 2.03-8.64, p < 0.001) were factors independently associated with CVA ≥ 0.3. CONCLUSIONS A certain proportion of children and adolescents in Shanghai chose to wear ortho-k lenses, related to the situation of parents and children themselves. Health education and follow-ups should be strengthened to ensure orthokeratology application quality.
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Affiliation(s)
- Wenchen Zhao
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Hui Xie
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Jinliuxing Yang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Kun Liu
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China.
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China.
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
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Cipolla C, Lazzareschi I, Curatola A, Lasorella C, Pane LC, Sessa L, Rotunno G, Rigante D, Sodero G. Characteristics of Children and Adolescents with Hyperinsulinemia Undergoing Oral Glucose Tolerance Test: A Single-Center Retrospective Observational Study. Diseases 2023; 11:110. [PMID: 37754306 PMCID: PMC10530243 DOI: 10.3390/diseases11030110] [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: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
The aim of this study was to evaluate a potential correlation between results of the oral glucose tolerance test (OGTT) and the auxological/metabolic parameters in a cohort of overweight patients assessed for suspicion of hyperinsulinism. We analyzed 206 patients, comparing those with insulin peak below (nonhyperinsulinemic) and over 100 uIU/mL (hyperinsulinemic) at the OGTT. We found a significant difference in weight (p = 0.037), body mass index (BMI, p < 0.001) and BMI standard deviations (SD, p < 0.001), waist circumference (p = 0.001), hip circumference (p = 0.001), and waist-to-height ratio (WHtR, p = 0.016) between the two groups. Analyzing the median insulin value during OGTT in the whole population, a weakly positive correlation emerged with weight SD (p < 0.001; rho = 0.292) and a moderate positive correlation with BMI SD (p < 0.001; rho = 0.323). We also found a weakly positive correlation with waist circumference (p = 0.001; rho = 0.214), hip circumference (p = 0.001; rho = 0.217), and WHTR (p = 0.016; rho = 0.209) and a moderate positive correlation with the HOMA index (p < 0.001; rho = 0.683). The median insulin value correlates with high triglyceride (p < 0.001; rho = 0.266) and triiodothyronine values (p = 0.003; rho = 0.193) and with low HDL values (p < 0.001; rho = -0.272). In clinical practice the interpretation of laboratory and anthropometric parameters could predict the level of insulin, highlighting also a possible underlying diagnosis of insulin resistance and/or hyperinsulinemia without performing an OGTT.
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Affiliation(s)
- Clelia Cipolla
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito n. 1, 00168 Rome, Italy; (C.C.); (I.L.); (A.C.); (C.L.); (L.C.P.); (L.S.); (G.R.); (D.R.)
| | - Ilaria Lazzareschi
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito n. 1, 00168 Rome, Italy; (C.C.); (I.L.); (A.C.); (C.L.); (L.C.P.); (L.S.); (G.R.); (D.R.)
- Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Antonietta Curatola
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito n. 1, 00168 Rome, Italy; (C.C.); (I.L.); (A.C.); (C.L.); (L.C.P.); (L.S.); (G.R.); (D.R.)
| | - Claudia Lasorella
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito n. 1, 00168 Rome, Italy; (C.C.); (I.L.); (A.C.); (C.L.); (L.C.P.); (L.S.); (G.R.); (D.R.)
| | - Lucia Celeste Pane
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito n. 1, 00168 Rome, Italy; (C.C.); (I.L.); (A.C.); (C.L.); (L.C.P.); (L.S.); (G.R.); (D.R.)
| | - Linda Sessa
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito n. 1, 00168 Rome, Italy; (C.C.); (I.L.); (A.C.); (C.L.); (L.C.P.); (L.S.); (G.R.); (D.R.)
| | - Giulia Rotunno
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito n. 1, 00168 Rome, Italy; (C.C.); (I.L.); (A.C.); (C.L.); (L.C.P.); (L.S.); (G.R.); (D.R.)
| | - Donato Rigante
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito n. 1, 00168 Rome, Italy; (C.C.); (I.L.); (A.C.); (C.L.); (L.C.P.); (L.S.); (G.R.); (D.R.)
- Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Giorgio Sodero
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito n. 1, 00168 Rome, Italy; (C.C.); (I.L.); (A.C.); (C.L.); (L.C.P.); (L.S.); (G.R.); (D.R.)
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Konuthula D, Tan MM, Burnet DL. Challenges and Opportunities in Diagnosis and Management of Cardiometabolic Risk in Adolescents. Curr Diab Rep 2023; 23:185-193. [PMID: 37273161 PMCID: PMC10240116 DOI: 10.1007/s11892-023-01513-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE OF REVIEW This review aims to elucidate the limitations of diagnosing metabolic syndrome in adolescents as well as challenges and opportunities in the identification and reduction of cardiometabolic risk in this population. RECENT FINDINGS There are multiple criticisms of how we define and approach obesity in clinical practice and scientific research, and weight stigma further complicates the process of making and communicating weight-related diagnoses. While the goal of diagnosing and managing metabolic syndrome in adolescents would be to identify individuals at elevated future cardiometabolic risk and intervene to reduce the modifiable component of this risk, there is evidence that identifying cardiometabolic risk factor clustering may be more useful in adolescents than establishing a cutoff-based diagnosis of metabolic syndrome. It has also become clear that many heritable factors and social and structural determinants of health contribute more to weight and body mass index than do individual behavioral choices about nutrition and physical activity. Promoting cardiometabolic health equity requires that we intervene on the obesogenic environment and mitigate the compounding effects of weight stigma and systemic racism. The existing options to diagnose and manage future cardiometabolic risk in children and adolescents are flawed and limited. While striving to improve population health through policy and societal interventions, there are opportunities to intervene at all levels of the socioecological model in order to decrease future morbidity and mortality from the chronic cardiometabolic diseases associated with central adiposity in both children and adults. More research is needed to identify the most effective interventions.
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Affiliation(s)
| | - Marcia M Tan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Deborah L Burnet
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Pediatrics, University of Chicago, Chicago, IL, USA
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17
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Kao TSA, Ling J, Vu C, Hawn R, Christodoulos H. Motivational Interviewing in Pediatric Obesity: A Meta-analysis of the Effects on Behavioral Outcomes. Ann Behav Med 2023:7169372. [PMID: 37195909 PMCID: PMC10354860 DOI: 10.1093/abm/kaad006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Currently, the effects of motivational interviewing (MI) on children's behavioral changes remain obscure. PURPOSE This systematic review and meta-analysis examined the effects of MI on children's lifestyle behavioral changes (fruits and vegetables [F/V], dairy, sugary beverages, calories, snacks, fat intake, moderate vigorous physical activity [MVPA], and screen time). METHODS Six databases (CINAHL, Cochrane, Embase, PsycINFO, PubMed, and Web of Sciences) from 2005 to 2022 were searched. Thirty-one intervention studies with a comparison group met the criteria. Random-effects models were performed to estimate the pooled effects; exploratory moderation analyses with mixed-effects models were used to explore potential intervention moderators. RESULTS The pooled effect size was 0.10 (p = .334) on ↑F/V, 0.02 (p = .724) on ↑dairy, -0.29 (p < .001) on ↓calories, -0.16 (p = .054) on ↓sugary beverages, -0.22 (p = .002) on ↓snacks, -0.20 (p = .044) on ↓fat, 0.22 (p = .001) on ↑MVPA, and -0.06 (p = .176) on ↓screen time. The effects of MIs were moderated by ↑MI sessions regarding ↓snacks (B = -0.04, p = .010). Multicomponent and clinical programs had greater effects on dairy intake than their counterparts (0.09 vs. -0.21, p = .034; 0.12 vs. -0.14, p = .027, respectively). Similarly, interventions with a fidelity check resulted in greater dairy intake than those without a check (0.29 vs. -0.15, p = .014). A few long-term follow-up assessments revealed effects on ↓F/V (-0.18; p = .143, k = 2), ↓dairy (-0.13, p = .399, k = 4), ↓MVPA (-0.04; p = .611, k = 6), and ↑screen time (0.12; p = .242, k = 4). CONCLUSIONS Our findings support the short-term effects of MI on improving children's lifestyle behaviors. Additional investigations are needed to better sustain children's long-term behavioral changes.
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Affiliation(s)
| | - Jiying Ling
- College of Nursing, Michigan State University, USA
| | - Christina Vu
- College of Nursing, Michigan State University, USA
| | - Rachel Hawn
- College of Nursing, Michigan State University, USA
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Calcaterra V, Cena H, Rossi V, Santero S, Bianchi A, Zuccotti G. Ultra-Processed Food, Reward System and Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050804. [PMID: 37238352 DOI: 10.3390/children10050804] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
Obesity and overweight are a major public health problem globally. Diet quality is critical for proper child development, and an unhealthy diet is a preventable risk factor for noncommunicable diseases (NCDs), such as obesity. Consumption of sugar-sweetened beverages and ultra-processed foods (UPFs) in childhood may increase the BMI/BMI z-score, body fat percentage, or likelihood of overweight. A strict feeding regulation system allows for sufficient food to be consumed to meet ongoing metabolic demands while avoiding overconsumption. This narrative review explores the issues of obesity and the regulation of food intake related to reward systems and UPF consumption. Nutrient composition alone cannot explain the influence of UPFs on the risk of obesity. Furthermore, the non-nutritional properties of UPFs may explain the mechanisms underlying the relationship with obesity and NCDs. UPFs are designed to be highly palatable, appealing, and energy dense with a unique combination of the main taste enhancer ingredients to generate a strong rewarding stimulus and influence the circuits related to feeding facilitation. How individual UPF ingredients influence eating behavior and reward processes remains not fully elucidated. To increase the knowledge on the relationship between UPFs and pediatric obesity, it may be useful to limit the rapid growth in the prevalence of obesity and subsequent related complications, and to develop new strategies for appropriate food and nutrition policies.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Clinical Nutrition Unit, General Medicine, Istituti Clinici Salvatore Maugeri Istituto di Ricovero e Cura a Carattere Sscientifico, 27100 Pavia, Italy
| | - Virginia Rossi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Sara Santero
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Alice Bianchi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
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Sun H, Qian Y, Wan N, Liu L. Differential diagnosis of precocious puberty in girls during the COVID-19 pandemic: a pilot study. BMC Pediatr 2023; 23:185. [PMID: 37081435 PMCID: PMC10116441 DOI: 10.1186/s12887-023-04009-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/12/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND To investigate the differential diagnosis of girls aged 6 to 8 years with idiopathic premature thelarche (IPT) and central precocious puberty (CPP) during the COVID-19 pandemic. We explored predicted adult height (PAH) discrepancy to guide appropriate diagnosis and treatment. METHODS From January 2020 to December 2021, Chinese girls aged 6 to 8 years with precocious puberty were recruited. They were divided into IPT and CPP groups. Clinical characteristics, including height, weight, body mass index (BMI), basal luteinizing hormone (LH), oestradiol, uterine length and volume, follicle numbers (d > 4 mm) and bone age (BA) were recorded. We analysed differential diagnosis and PAH discrepancy in both groups. Binary logistic regression analysis was used to explore risk factors for CPP, and receiver operating characteristic (ROC) curves were generated to evaluate the diagnostic value of related indexes. RESULTS Sixty patients, including 40 girls with IPT and 20 girls with CPP, were recruited. The prevalence of overweight and obesity in the entire cohort was 25% (15/60) and was significantly higher in IPT than CPP, 32.5% (13/40) vs. 10% (2/20), respectively (P=0.045). There were significant differences in LH, uterine volume, follicle numbers and BA (P<0.05). The impaired PAH of IPT and CPP was 0.01 ± 1.19 SD and 0.62 ± 0.94 SD with significant differences (P=0.047). Logistic regression analysis showed that LH and follicle numbers were independent risk factors for CPP. The ROC curve showed that the area under the curve (AUC) of LH and follicle numbers were 0.823 and 0.697. The sensitivity and specificity of LH with a cut off of 0.285 IU/L were 78.9% and 77.8%. The sensitivity and specificity of follicle numbers with a cut off of 3.5 were 89.5% and 52.8%. CONCLUSION The prevalence of overweight and obesity in 6- to 8-year-old girls with precocious puberty was high. Auxological data should not be used in the differential diagnosis of IPT and CPP. Basal LH above 0.285 IU/L and follicle numbers greater than 4 were important features suggestive of CPP. PAH was impaired in individuals with CPP, but it was not impaired in individuals with IPT.
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Affiliation(s)
- Huihui Sun
- Pediatrics Department, Beijing Jishuitan Hospital, Beijing, China
| | - Yi Qian
- Pediatrics Department, Beijing Jishuitan Hospital, Beijing, China
| | - Naijun Wan
- Pediatrics Department, Beijing Jishuitan Hospital, Beijing, China
| | - Lili Liu
- Acupuncture Department, Beijing Jishuitan Hospital, Beijing, China.
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Zembura M, Lula P, Matusik P. Ten-Year Differences in Nutritional Status and Obesity-Related Risk Factors in Polish Preschool Children. CHILDREN 2023; 10:children10040636. [PMID: 37189885 DOI: 10.3390/children10040636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
The aim of this study was to assess ten-year differences in nutritional statuses and obesity prevalences between populations of preschool children from Katowice, Poland, examined in 2007 and 2017, and to determine factors associated with overweight and obesity in preschool children. A cross-sectional questionnaire was conducted among parents and legal guardians of 276 preschool children in 2007 and 259 preschool children in 2017. Basic anthropometric measurements were performed. Overall, the prevalence of overweight and obesity among our sample of Polish preschool children (median age 5.25 year) was 16.82%, whereas 4.49% of children were obese. No significant differences in the number of overweight and obese children were observed when comparing the years 2017 to 2007. Overall body mass index (BMI) z-score was significantly lower in this group of children from 2017. However, median values of the BMI z-score were higher in two of the weight categories (overweight and obesity) in 2017. The child’s BMI z-score was positively correlated with birth weight (r = 0.1, p < 0.05). The BMI z-score was positively correlated with maternal BMI, paternal BMI, and maternal pregnancy weight gain, r = 0.24 p < 0.01; r = 0.16 p < 0.01; r = 0.12 p < 0.05, respectively. A decrease in overweight and obesity prevalence over the past decade and higher median values of BMI z-scores in the group of children with excessive weight in 2017 were observed. Birth weight, maternal BMI, paternal BMI, and maternal pregnancy weight gain all correlate positively with a child’s BMI z-score.
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Belando-Pedreño N, Blanco-García ME, Chamorro JL, García-Martí C. Pilot Study on Satisfaction in Children and Adolescents after a Comprehensive Educational Program on Healthy Habits. Nutrients 2023; 15:nu15051161. [PMID: 36904158 PMCID: PMC10005745 DOI: 10.3390/nu15051161] [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: 02/07/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
Prospective research in the area of Education Sciences and Physical-Sports Education agree on the need to design and implement educational programs that promote emotional competencies (ECs), interpersonal competencies (ICs), an adequate level of healthy physical activity (NAFS) and a good adherence to the Mediterranean diet (ADM). The main objective of the study is to design an intervention program in intra- and interpersonal competencies together with nutritional education and corporality called "MotivACTION". The sample consisted of 80 primary schoolchildren aged 8 to 14 years (M = 12.70; SD = 2.76) (37 girls and 43 boys) from two schools in the Community of Madrid. An ad-hoc questionnaire was created to assess the participant's perception of the usefulness of the "MotivACTION" educational experience. The program "MotivACTION: Feed your SuperACTION" is designed and implemented based on the development of a workshop organized through the Universidad Europea de Madrid. As the main preliminary results of the pilot study, the schoolchildren who experienced the "MotivACTION" workshop showed high satisfaction with the educational program. They were able to create a healthy menu with the frog chef. They also felt better and happier at the end of it, and they enjoyed practicing physical activity moving to the rhythm of the music while doing mathematical calculations.
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Affiliation(s)
- Noelia Belando-Pedreño
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Correspondence:
| | | | - José L. Chamorro
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almeria, Spain
| | - Carlos García-Martí
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
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Psychiatric Disorders and Obesity in Childhood and Adolescence-A Systematic Review of Cross-Sectional Studies. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020285. [PMID: 36832413 PMCID: PMC9955505 DOI: 10.3390/children10020285] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
Obesity and psychiatric disorders have high prevalence and are both considered major health problems. Within the last decades, the rates of obesity have risen over 6%, while the prevalence of psychiatric disorders is over 12% for children and adolescents. The aim of this study was to systematically review the evidence regarding the relation of obesity and psychiatric disorders in childhood and adolescence. This review, based on the PRISMA guidelines, included cross-sectional studies published within the last decade, pertaining to the relation between psychiatric disorders and obesity in children and adolescents up to the age of 19 years. Studies on eating disorders were excluded. A total of 14 studies of 23,442 children and adolescents that investigated the relation of obesity with anxiety, mood disorders, and psychosis were included in this systematic review. Nine of the included studies reported a significant relationship between the psychiatric disorder under investigation and obesity. Understanding the nexus between obesity and psychiatric disorders in children and adolescents is of great importance, given the alarming increase in both conditions in youth. Such findings could facilitate the development and implementation of targeted interventions.
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Johnson S, Gupta S, Mackey E, McCarron K, Fischer L, Panton D, Essel K. "We Feel Like We Are in It Alone": A Mixed-Methods Study of Pediatric Primary Care Barriers for Weight Management. Child Obes 2023; 19:3-12. [PMID: 35275705 DOI: 10.1089/chi.2021.0274] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: Obesity is a chronic multifactorial disease affecting approximately one in five youth. Many pediatric clinical strategies focus on behavioral change/lifestyle modification efforts, but are limited by their intensity and muted by their inability to address the sociocultural contexts of obesity. The primary objective of the study was to explore primary care pediatric clinicians' current barriers/management practices of patients with obesity. Methods: A mixed-methods study was conducted by distributing an electronic survey to pediatric providers in Washington, DC, and its surrounding metropolitan area. Three focus groups were conducted with a subgroup of these primary care clinicians to further explore their responses. Results: Pediatric clinicians (n = 81) completed the survey out of 380 invitations sent, and 20 took part in 3 focus groups, ranging in size between 4 and 8 clinicians. Over 90% of clinicians felt comfortable advising patients. However, 52% lacked confidence in addressing obesity and over 80% indicated that time constraint is a barrier to care and emphasized the need for more training in obesity management. Six themes emerged regarding clinician barriers to addressing obesity, including (1) limited time, (2) clinician perceived familial resistance, (3) challenges with racial and ethnic concordance, (4) perceived environmental barriers, (5) limited knowledge of community resources, and (6) inadequate collaborative support. Conclusions: Clinicians have difficulty implementing obesity management strategies into their everyday practice due to a variety of barriers. This study emphasized the need for better implementation strategies, tools, and collaboration with community stakeholders for clinicians to engage weight management more effectively.
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Affiliation(s)
- Sheryl Johnson
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Simran Gupta
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Eleanor Mackey
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Children's National Hospital, Washington, DC, USA
| | - Kristy McCarron
- Young Men's Christian Association of Metropolitan DC, Washington, DC, USA
| | | | | | - Kofi Essel
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Children's National Hospital, Washington, DC, USA
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Lee B, Kwon CY. Comparative Effectiveness of East Asian Traditional Medicine for Childhood Simple Obesity: A Systematic Review and Network Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192012994. [PMID: 36293575 PMCID: PMC9602315 DOI: 10.3390/ijerph192012994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 05/28/2023]
Abstract
Childhood obesity leads to various comorbidities and usually persists into adulthood, increasing socioeconomic burden. In the absence of a clearly effective treatment, East Asian traditional medicine (EATM) therapies have been widely used. We aimed to analyze the comparative effectiveness and safety of EATM techniques for children with simple obesity through network meta-analysis (NMA). Twelve databases were searched for randomized controlled trials (RCTs) evaluating the effect of EATMs on childhood simple obesity. Individual EATMs were ranked based on the surface under the cumulative ranking curve. The risk of bias in the individual studies and publication bias in the NMA were evaluated. Thirty-three RCTs were included. Acupuncture, chuna, chuna plus acupressure, cupping plus acupressure, herbal medicine (HM), and HM plus acupuncture significantly reduced BMI compared with lifestyle management. Based on the treatment ranking, cupping plus acupressure was optimal for BMI reduction compared with a non-medical management, followed by chuna and HM. The quality of evidence for individual findings was usually moderate to low, and no serious adverse events of EATM were reported. Cupping plus acupressure might have a large beneficial effect, and chuna or HM probably have a moderate beneficial effect on reducing BMI in children with simple obesity.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan 47227, Korea
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Xu E, Yin C, Yi X, Liu Y. Lifestyle Improvements and Vitamin D Supplementation Play an Important Role in the Prevention of Childhood Diabetes. DISEASE MARKERS 2022; 2022:6133908. [PMID: 36246569 PMCID: PMC9553552 DOI: 10.1155/2022/6133908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022]
Abstract
Objective This study was to investigate the characteristics of insulin secretion and the 25-hydroxyvitamin D3 (25(OH)D3) levels in children with obesity. Methods A retrospective analysis was conducted among children who underwent health checkups in the pediatric healthcare department of our hospital from January 2018 to January 2021, and they were divided into a normal group and an obese group according to their BMI. The insulin secretion and the 25(OH)D3 levels of the two groups of children were compared. A total of 721 children were included in the study, including 591 in the normal group and 130 in the obese group, with an obesity rate of 18.03%. Results The blood glucose of the normal group was 4.55 ± 1.75 mmol/L, and the 2 h PG was 7.51 ± 2.11 mmol/L; in the obesity group, they were 6.03 ± 2.16 mmol/L and 8.92 ± 3.24 mmol/L, respectively. The FPG and 2 h PG in the obese group were significantly higher than those in the normal group (all P < 0.05). The incidence of IFG/IGT in the normal group was 5.24% (31/591), and the incidence of DM was 3.71% (22/591); the incidence of IFG/IGT in the obese group was 14.62% (19/130), and the incidence of DM was 13.08% (17/130). The incidences of IFG/IGT and DM in the obese group were significantly higher than those in the normal group (P < 0.05). The FINS of the children in the normal group was 18.46 ± 3.15 μU/mL, and the HOMA-IR was 2.64 ± 0.62; the above indicators in the obese group were 19.11 ± 4.72 μU/mL and 3.01 ± 0.83, respectively. The FINS and HOMA-IR in the obese group were significantly higher than those in the normal group (P < 0.05). The serum 25(OH)D3 level in the normal group was 28.15 ± 5.27 ng/mL, of which 556 cases were normal in 25(OH)D3 and 35 cases were deficient in 25(OH)D3. The serum 25(OH)D3 level in the obese group was 24.35 ± 4.51 ng/mL, of which 112 cases were normal in 25(OH)D3 and 18 cases were deficient in 25(OH)D3. The level of serum 25(OH)D3 in the normal group was significantly higher than that in the normal group, and the ratio of 25(OH)D3 deficiency was significantly lower than that in the normal group (P < 0.05). Conclusions The blood glucose level of childhood obesity was significantly increased, the incidence of abnormal glucose metabolism and diabetes was significantly increased, and the level of 25(OH) vitamin D3 was significantly decreased. Lifestyle improvements and vitamin D supplementation play an important role in the prevention of childhood diabetes. Because the major causes of childhood obesity are excessive caloric intake and lack of exercise, the most effective and direct measures to prevent obesity are a reasonable lifestyle, reasonable eating habits, and moderate exercise. Although genetics are critical, there is no reliable way to eliminate obesity genes in the human body. Therefore, the role of obesity genes is required to be ultimately eliminated by reduced caloric intake and increased physical activity.
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Affiliation(s)
- Erdi Xu
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chunyan Yin
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoqing Yi
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuesheng Liu
- Department of Pediatric, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Tsolakis C, Cherouveim ED, Skouras AZ, Antonakis-Karamintzas D, Czvekus C, Halvatsiotis P, Savvidou O, Koulouvaris P. The Impact of Obesity on the Fitness Performance of School-Aged Children Living in Rural Areas-The West Attica Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811476. [PMID: 36141749 PMCID: PMC9517351 DOI: 10.3390/ijerph191811476] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 05/17/2023]
Abstract
This study aimed to investigate the relationship of body mass index (BMI) with muscle and cardiorespiratory fitness in children living within rural areas (regional unit of West Attica) in Greece. Participants included 399 students (187 boys, 212 girls), ages 8-12 years old, and were evaluated in physical performance tests. The point prevalence of overweight and obesity was 21.39% and 26.20% in boys, and 19.90% and 23.79% in girls. Significant differences were observed in all physical performance tests (handgrip, long jump, shuttle run, trunk flexors, and extensors endurance) between normal weight and obese participants. BMI was positively correlated with handgrip (r = 0.442-0.462, p < 0.001). There was a negative association with long jump (r = -0.206, p < 0.001), 20 m shuttle run (r = -0.394, p < 0.001), trunk flexors (r = -0.403, p < 0.001) and trunk extensors endurance (r = -0.280, p < 0.001). The regression analysis showed that 20-30% of the overall variation for physical performance assessments could be accounted for by BMI, age, and sex. With the exception of the long jump and the endurance of the trunk extensors, BMI alone may explain more than 10% of the outcome of most tests. This study highlights the determinant of BMI on muscle and cardiorespiratory fitness. The management of obesity should begin early in childhood to prevent adult chronic cardiovascular and metabolic diseases.
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Affiliation(s)
- Charilaos Tsolakis
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Sports Performance Laboratory, School of Physical Education & Sports Science, National and Kapodistrian University of Athens, 17237 Athens, Greece
- Correspondence: ; Tel.: +30-693-275-5173
| | - Evgenia D. Cherouveim
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
- School of Physical Education & Sports Science, National and Kapodistrian University of Athens, 17237 Athens, Greece
| | - Apostolos Zacharias Skouras
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | | | - Cara Czvekus
- Health Science, James Madison University, Harrisonburg, VA 22807, USA
| | - Panagiotis Halvatsiotis
- 2nd Department of Internal Medicine Propaedeutic “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Olga Savvidou
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Panagiotis Koulouvaris
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
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LIMIT: LIfestyle and Microbiome InTeraction Early Adiposity Rebound in Children, a Study Protocol. Metabolites 2022; 12:metabo12090809. [PMID: 36144214 PMCID: PMC9504829 DOI: 10.3390/metabo12090809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/07/2022] [Accepted: 08/24/2022] [Indexed: 11/24/2022] Open
Abstract
Childhood obesity is a strong predictor of adult obesity with health and economic consequences for individuals and society. Adiposity rebound (AR) is a rise in the Body Mass Index occurring between 3 and 7 years. Early adiposity rebound (EAR) occurs at a median age of 2 years and predisposes to a later onset of obesity. Since obesity has been associated with intestinal dysbiosis, we hypothesize that EAR could be related to early microbiome changes due to maternal/lifestyle changes and environmental exposures, which can increase the unhealthy consequences of childhood obesity. LIMIT is a prospective cohort study that aims at identifying the longitudinal interplay between infant gut microbiome, infant/maternal lifestyle, and environmental variables, in children with EAR vs. AR. Methods. The study evaluated 272 mother-infant pairs, enrolled at an Italian neonatal unit, at different time points (T0, at delivery; T1, 1 month; T2, 6 months; T3, 12 months; T4, 24 months; T5, 36 months after birth). The variables that were collected include maternal/infant anthropometric measurements, lifestyle habits, maternal environmental endocrine disruptor exposure, as well as infant AR. The LIMIT results will provide the basis for early identification of those maternal and infant modifiable factors on which to act for an effective and personalized prevention of childhood obesity.
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Janpeang J, Suwannapoom C, Anukunwathaka N. Nutritional status and related factors among ethnic preschool children in Northern Thailand: a cross-sectional study. CHILD HEALTH NURSING RESEARCH 2022; 28:176-186. [PMID: 35953067 PMCID: PMC9371800 DOI: 10.4094/chnr.2022.28.3.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/30/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose: This study investigated the nutritional status of ethnic (belonging to minority groups) preschool children in Northern Thailand.Methods: In this cross-sectional descriptive study, the sample group included 147 parents and 147 preschool children (2-6 years old). Participants volunteered to complete a questionnaire on the personal information of children and parents, as well as family- and school-related factors. Data were analyzed using descriptive statistics, a nutritional status calculator, and logistic regression analysis.Results: A birth weight of less than 2,500 g was related to weight-for-age and weight-for-height. Not having been breastfed and having been breastfed for less than 6 months were related to weight-for-height. An elementary school education level among parents was related to children's height-for-age. Familial unhealthy food consumption for 1-2 days per week was related to weight-for-age and height-for-age.Conclusion: This study reflects the importance of nutritional care for children at the beginning of pregnancy and continuing to the preschool age, as well as the importance of breastfeeding. Families were found to be a key factor in supporting good nutrition among children.
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Affiliation(s)
| | - Chatmongkon Suwannapoom
- Associate Professor, School of Agriculture and Natural Resources, University of Phayao, Phayao, Thailand
| | - Natnaree Anukunwathaka
- Nursing Instructor, School of Nursing, University of Phayao, Phayao, Thailand
- Corresponding author Natnaree Anukunwathaka School of Nursing, University of Phayao, 19, Moo 2, Mae Kha, Muang, Phayao 56000, Thailand TEL: +66-91-851-4832 FAX: +66-54-466-666 E-MAIL:
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Zozaya N, Oliva-Moreno J, Vallejo-Torres L. Association between maternal and paternal employment and their children's weight status and unhealthy behaviours: does it matter who the working parent is? BMC Public Health 2022; 22:1331. [PMID: 35821024 PMCID: PMC9277834 DOI: 10.1186/s12889-022-13735-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background The growing number of employed women has been associated with an increase in the prevalence of overweight and obesity in children. We sought to determine whether childhood overweight/obesity in Spain is associated with labour participation of mothers and fathers, and whether the identity of the main caregiver has an influence on child’s weight and unhealthy behaviour. Methods We used microdata from the 2010 and 2014 Health Behaviour in School-Aged Children surveys performed in Spain (n = 32,694). Logistic and linear multi-level regression models were applied to assess the association between parental employment and children’s self-reported weight status, accounting for school effects and controlling for socioeconomic factors. Separated binary models were also fitted for consumption of fruit, sweets, screen viewing and sedentarism. Results In most cases, the significant associations between children’s weight and their parents’ work status disappeared once the models were adjusted for family wealth and education. However, we found persistent associations for some groups. Girls under 13 years-old living in households where the mother was the only employed parent were more likely to be affected by obesity and to report a higher body mass index value. Children in this type of household were more likely to show unhealthy lifestyles related to diet and leisure time activities. Conclusions Parents’ socioeconomic characteristics had a protective effect on their children’s risk of obesity. Unhealthy behaviours were observed in households with a non-working father and a working mother, although the link with obesity was limited to girls. Our results suggest the need for a more equally shared burden of caregiving. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13735-3.
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Affiliation(s)
- Néboa Zozaya
- Department of Quantitative Methods in Economics and Management, Universidad de Las Palmas de Gran Canaria, Calle Saulo Torón, 4 Las Palmas de Gran Canaria, 35017, Las Palmas, Spain. .,Weber Economía Y Salud, Calle Moreto 17, 28014, Madrid, Spain.
| | - Juan Oliva-Moreno
- Department of Economic Analysis and Finance, Universidad de Castilla La Mancha, Cobertizo de San Pedro Mártir, s/n, 45002, Toledo, Spain
| | - Laura Vallejo-Torres
- Department of Quantitative Methods in Economics and Management, Universidad de Las Palmas de Gran Canaria, Calle Saulo Torón, 4 Las Palmas de Gran Canaria, 35017, Las Palmas, Spain
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Koivusilta L, Alanne S, Kamila M, Ståhl T. A qualitative study on multisector activities to prevent childhood obesity in the municipality of Seinäjoki, Finland. BMC Public Health 2022; 22:1298. [PMID: 35794541 PMCID: PMC9258052 DOI: 10.1186/s12889-022-13658-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/16/2022] [Indexed: 11/26/2022] Open
Abstract
Background Multisector activities are needed to prevent childhood obesity due to its multifactorial background. The first aim was to identify the activities that had been undertaken for obesity prevention and deduce their main targets. Second, we analyzed the public health policy approaches (upstream, midstream, and downstream) which were followed. Finally, we studied the perception of interviewees regarding their sectors’ roles in implementing the local obesity program. Methods Deductive content analysis was used to analyze semi-structured interviews with 34 key professionals (from seven administrative sectors) who had participated in multisector health promotion during 2009–2016 and five representatives of other core parties. Results Several midstream and upstream activities were targeted at making physical activity (PA) and healthy eating (HE) integral parts of children’s lifestyle. One long-term strategy was to create environments for PA accessible to every inhabitant and build and renovate the interiors and yards of schools and day-care centers. The healthiness of meals was increased progressively. In addition to midstream and upstream activities, as a downstream activity, an intervention targeting children at risk of obesity was implemented. The impact of management on the activities was considerable; childhood obesity prevention was included in the city strategy and systematically coordinated at the highest managerial level. Altogether, various sectors operated efficiently to promote obesity-preventing lifestyles; however, not all (important) sectors recognized their role in the multisector process. Conclusion Most of the activities to guide children towards obesity-preventing lifestyles were either at the midstream or upstream level. Among the latter, considerable work is aimed at creating opportunities to practice PA and making it a natural part of the daily life. The aim of familiarizing children with lifestyles that include PA and HE was shared across sectors, including sectors that had not yet acknowledged their role in obesity prevention. Strong support from city management and systematic coordination of the activity are important factors that contribute to the engagement of several administrative sectors in working towards a shared aim, such as the prevention of childhood obesity.
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Rummo P, Sze J, Elbel B. Association Between a Policy to Subsidize Supermarkets in Underserved Areas and Childhood Obesity Risk. JAMA Pediatr 2022; 176:646-653. [PMID: 35532919 PMCID: PMC9086932 DOI: 10.1001/jamapediatrics.2022.1153] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
IMPORTANCE The establishment and renovation of supermarkets may promote healthy diet practices among youth by increasing retail infrastructure for fresh foods. OBJECTIVE To estimate the association between the Food Retail Expansion to Support Health (FRESH) program and the weight status of children and adolescents. DESIGN, SETTING, AND PARTICIPANTS Using a difference-in-differences (DiD) design and including 12 months before and after a FRESH supermarket opened, data were analyzed for residentially stable public school students in kindergarten through 12th grade with objectively measured height and weight data from the academic years 2009 through 2016. Of the 8 FRESH-subsidized supermarkets in residential neighborhoods in New York City, New York, 5 were new and 3 were renovation projects between December 2011 and June 2014. Data were analyzed from June 2021 to January 2022. INTERVENTIONS The treatment group included students who resided within 0.50 miles of a FRESH-subsidized supermarket and had at least 1 body mass index (BMI) measurement within 12 months before and 3 to 12 months after the month a FRESH supermarket opened (n = 22 712 student-year observations). A 2-stage matching-weighting approach was used to construct a control group of students who resided more than 0.50 miles from a FRESH supermarket in a FRESH-eligible area (n = 86 744 student-year observations). MAIN OUTCOMES AND MEASURES BMI z score was calculated using objectively measured height and weight data from FITNESSGRAM, an annual, school-based, standardized fitness assessment of every New York City public school student. Obesity was defined as 95th percentile or greater of the BMI z score using Centers for Disease Control and Prevention growth charts. RESULTS The treatment group in the analytic sample had 11 356 students (22 712 student-year observations), and the control group had 43 372 students (86 744 student-year observations). The students were predominately Black (18.8%) and Hispanic and Latino (68.5%) and eligible for free or reduced-priced lunch (84.6%). There was a significant decrease in BMI z score among students who resided within 0.50 miles of a FRESH supermarket (vs control group students) in the 3- to 12-month follow-up period (DiD, -0.04; 95% CI, -0.06 to -0.02). This was true for those exposed to supermarkets that were either new (DiD, -0.07; 95% CI, -0.11 to -0.03) or renovated (DiD, -0.03; 95% CI, -0.06 to -0.01). A statistically significant decrease was also observed in the likelihood of obesity (DiD, -0.01; 95% CI, -0.02 to -0.002). CONCLUSIONS AND RELEVANCE Government-subsidized supermarkets may contribute to a small decrease in obesity risk among children residing near those supermarkets, if part of a comprehensive policy approach.
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Affiliation(s)
- Pasquale Rummo
- New York University Grossman School of Medicine, Department of Population Health, New York
| | - Jeremy Sze
- New York University Grossman School of Medicine, Department of Population Health, New York
| | - Brian Elbel
- New York University Grossman School of Medicine, Department of Population Health, New York,Wagner Graduate School of Public Service, New York University, New York
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Thomas LN, Donadio A, Carnevale T, Neal P. Improved management of pediatric obesity in the primary care setting through implementation of the healthy care for healthy kids obesity toolkit. J Pediatr Nurs 2022; 65:e115-e125. [PMID: 35484005 DOI: 10.1016/j.pedn.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/14/2022] [Accepted: 04/07/2022] [Indexed: 12/11/2022]
Abstract
Pediatric obesity has become a major health care concern over the last several decades. This condition can lead to detrimental life-long physical and mental comorbidities. Pediatric primary care providers have a unique opportunity to both prevent and treat pediatric obesity in their clinics. However, discussing this topic with families can be uncomfortable and time consuming. Time efficient resources to educate and increase confidence are needed to improve the management of pediatric obesity. This quality improvement project integrated the Healthy Care for Healthy Kids by the National Institute for Children's Healthcare Quality (2014) into the electronic medical record at a pediatric primary care office in rural East Tennessee. This toolkit included handouts, management algorithms, and provider education for pediatric obesity. After an 8-week implementation period, improvements in lab draws and evaluation of a family''s readiness to change were noted. Overall, providers reported the toolkit was helpful and improved patient interaction. Currently, the clinic is still utilizing the integrated resources and handouts.
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Affiliation(s)
- Logan N Thomas
- College of Nursing, East Tennessee State University, United States.
| | - Andrew Donadio
- College of Nursing, Tennessee Technological University, United States
| | - Teresa Carnevale
- College of Nursing, Tennessee Technological University, United States
| | - Penelope Neal
- College of Nursing, Tennessee Technological University, United States
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Reschke F, Galuschka L, Landsberg S, Weiner C, Guntermann C, Sadeghian E, Lange K, Danne T. Successful telehealth transformation of a pediatric outpatient obesity teaching program due to the COVID-19 pandemic - the "Video KiCK" program. J Pediatr Endocrinol Metab 2022; 35:803-812. [PMID: 35575788 DOI: 10.1515/jpem-2022-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/22/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To investigate if digital approaches can ameliorate the known consequences of social-distancing restrictions in the context of the global COVID-19 pandemic for adolescent participants originally registered for a face-to-face outpatient weight regulation program and whether video-based multiprofessional outpatient obesity therapy is successful for a group of adolescents with preexisting obesity. METHODS The certified KiCK outpatient training program for children and adolescents with overweight and obesity was remodeled as a consequence of the lockdown traditional face-to-face program to a completely digital and video-based format on short notice. The virtual approach was compared with the results of the conventional program regarding metabolic parameters, body mass index standard deviation score (BMI SDS), well-being, and physical fitness. RESULTS Sixty-nine of 77 enrolled participants for KiCK (age 8 to 17 years, BMI z score >2.0) were able and willing to participate virtually. After the first lockdown significant improvements of BMI SDS (mean 0.18; p=0.02), homeostasis model assessment (HOMA) index (mean 1.4; p=0.016), triglycerides (mean 0.18 mmol/dL; p=0.021), 6 minute-walk-test (mean 97.0 m; p=0.030, and well-being according to the World Health Organization 5 (WHO-5) questionnaire (mean 2.5; p=0.002) were found after the virtual intervention, which was comparable to the results observed previously in matched pairs data from the program during the pre-COVID period. After the end of the second lockdown weight SDS, BMI SDS, HOMA INDEX, and cholesterol were also measured reduced compared to baseline parameters measured before program initiation. Walking distance in the 6 MWT and improvement in general well-being in the WHO-5 questionnaire also persisted. CONCLUSIONS These results indicate good acceptance and efficacy of the video-intervention for youth with overweight and obesity during the lockdown, supporting the use of virtual modules in future programs after the pandemic.
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Affiliation(s)
- Felix Reschke
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Laura Galuschka
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Sarah Landsberg
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Chantal Weiner
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Cathrin Guntermann
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Evelin Sadeghian
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Karin Lange
- Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Thomas Danne
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
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Mardali F, Naziri M, Sohouli MH, Fatahi S, Sadat Hosseini-Baharanchi F, Găman MA, Shidfar F. Predictors of central and general obesity in Iranian preschool children: which anthropometric indices can be used as screening tools? BMC Pediatr 2022; 22:320. [PMID: 35641965 DOI: 10.1186/s12887-022-03365-4.pmid:] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/16/2022] [Indexed: 07/31/2024] Open
Abstract
AIM To compare the ability of anthropometric indices [waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), neck-to-height ratio (NHR), conicity index (CI), body adiposity index (BAI), tri-ponderal mass index (TMI) and body mass index (BMI)] and,measuerments like neck(NC), hip(HC) and waist circumferences to predict overweight and obesity in Iranian preschool children. MATERIALS AND METHODS A total of 498 Iranian preschool children were included in this case-control study conducted in Tehran, Iran. The participants were selected using the stratified random sampling procedure based on gender and school. Using sex-based receiver operating curve (ROC) analysis, we compared the area under the curve and defined the cut-off points for detecting central and general obesity for each index in order to identify the most suitable tools in predicting obesity. RESULTS Boys had significantly higher values for NC, WC, WHR, NHR, CI, TMI and BMI as compared to girls, whereas BAI and HC were higher in girls. The area under the curve was calculated for all the possible predictors of central obesity, i.e., NC (0.841-0.860), WC (0.70-0.679), HC (0.785-0.697), WHR (0.446-0.639) and CI (0.773-0.653) in boys and girls, respectively. And according to the ROC curve analysis, BMI (0.959-0.948), TMI (0.988-0.981), WHtR (0.667-0.553) and NHR (0.785-0.769) were predictors of general obesity and NC (0.841-0.860) as predictor of central obesity in boys and girls, respectively. The optimal cut-off points for TMI (13.80-15.83), NC (28.68-27.5) and for other anthropometric indices were estimated in both boys and girls. CONCLUSION TMI and NC seem to predict general and central obesity in Iranian preschool children.
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Affiliation(s)
- Farzaneh Mardali
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdyieh Naziri
- Student of Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
- Department of Biostatics, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somaye Fatahi
- Student of Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadat Hosseini-Baharanchi
- Minimally Invasive Surgery Research Center & Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, Department of Hematology, Center of Hematology and Bone Marrow Transplantation, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania, Fundeni Clinical Institute, Bucharest, Romania
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Garrido-Fernández A, García-Padilla FM, Ramos-Pichardo JD, Romero-Martín M, Sosa-Cordobés E, Sánchez-Alcón M. Attitude towards the Promotion of Healthy Eating among Secondary School Teachers—Construction and Validation of a Questionnaire. Nutrients 2022; 14:nu14112271. [PMID: 35684071 PMCID: PMC9183166 DOI: 10.3390/nu14112271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 02/01/2023] Open
Abstract
Health promotion activities in secondary schools are scarce and have little involvement of the teaching staff. Most often, activities are developed from the curriculum that appears in school materials, with little capacity for adaptation and innovation. The aim of this study was to construct and validate a tool to find out teachers’ attitudes towards activities to promote healthy eating in secondary schools. For this purpose, a descriptive study was conducted. The total sample of the study consisted of 200 teachers from secondary schools. Internal consistency was determined by Cronbach’s alpha coefficient globally and by dimension, and with the corrected item–test correlation. The construct validity of the questionnaire was assessed by means of an exploratory factor analysis, for which the principal components method with Varimax rotation was used. A Likert-type scale with nine items and four response options about attitude was designed. The exploratory factor analysis showed a nine-factor solution, of which two had eigenvalues greater than 1. These two factors explained 63.4% of the variance. The Cronbach’s alpha internal consistency index obtained for the global scale was 0.81, and 0.75 and 0.85 for each component. The results obtained with this structure confirmed an adequate reliability and validity of the questionnaire.
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Risk Behavioral Contexts in Adolescence of Obese Adults. J Adolesc Health 2022; 70:817-824. [PMID: 35165031 DOI: 10.1016/j.jadohealth.2021.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 11/14/2021] [Accepted: 11/23/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Previous research suggests that poor nutrition, physical activity, sleep, and social/emotional climate are associated with weight gain. However, few empirical studies have examined how these factors relate to each other in adolescents who are later obese. Are these factors uniformly present, or do some co-occur or occur independently? This study seeks to identify subgroups of obese individuals at ages 24-32 years who exhibited unique, co-occurring behavioral and emotional contexts for obesity at ages 14-17 years. METHODS To identify subgroups of behavioral and contextual profiles in adolescence, the study applies latent class analysis to a sample of individuals who were obese in the fourth wave of the National Longitudinal Study of Adolescent to Adult Health (Add Health, N = 1,889). The study then explored covariates (e.g., gender, race) of class membership. RESULTS Considerable heterogeneity exists in risk profiles of adolescents obese as adults. For example, 21.1 percent of the sample is in a class with no differentiating risk factors, whereas two classes containing 22.1 percent of the sample exhibit high levels of depression, and nearly all the emotional factors are considered. Although some covariates are predictive of class membership, clear patterns are difficult to discern. However, poor physical health is clearly predictive of membership in the classes exhibiting a high risk of depression. DISCUSSION Clinicians should be aware that at younger ages, people who are ultimately obese display a range of factors linked to obesity. Although some exhibit behaviors such as high screen time and processed food consumption, others exhibit mainly poor social/emotional climate.
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Kwansa AL, Akparibo R, Cecil JE, Infield Solar G, Caton SJ. Risk Factors for Overweight and Obesity within the Home Environment of Preschool Children in Sub-Saharan Africa: A Systematic Review. Nutrients 2022; 14:nu14091706. [PMID: 35565675 PMCID: PMC9100775 DOI: 10.3390/nu14091706] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.
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Affiliation(s)
- Albert L. Kwansa
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Robert Akparibo
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Joanne E. Cecil
- School of Medicine, Population and Behavioural Sciences, University of St Andrews, St Andrews KY16 9TF, UK;
| | | | - Samantha J. Caton
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
- Correspondence:
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Choi YY, Jensen ML, Fleming-Milici F, Harris JL. Caregivers' provision of sweetened fruit-flavoured drinks to young children: importance of perceived product attributes and differences by socio-demographic and behavioural characteristics. Public Health Nutr 2022; 25:1-9. [PMID: 35440350 PMCID: PMC9991680 DOI: 10.1017/s1368980022000751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/24/2022] [Accepted: 03/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Drinks containing added sugar and/or non-nutritive sweeteners are not recommended for children under 6 years. Yet, most young children consume these products. The current study examined factors associated with caregivers' provision of sweetened drinks to their young child. DESIGN Caregivers reported frequency of providing sweetened fruit-flavoured drinks (fruit drinks and flavoured water) and unsweetened juices (100 % juice and juice/water blends) to their 1- to 5-year-old child in the past month and perceived importance of product attributes (healthfulness, product claims and other characteristics), other drinks provided, reading the nutrition facts panel and socio-demographic characteristics. A partial proportional odds model measured the relationship between these factors and frequency of providing sweetened fruit-flavoured drinks. SETTING Online cross-sectional survey. PARTICIPANTS U.S. caregivers (n 1763) with a young child (ages 1-5). RESULTS The majority (74 %) of caregivers provided sweetened fruit-flavoured drinks to their child in the past month; 26 % provided them daily. Provision frequency was positively associated with some drink attributes, including perceived healthfulness, vitamin C claims and box/pouch packaging; child requests and serving other sweetened drinks and juice/water blends. Provision frequency was negatively associated with perceived importance of 'no/less sugar' and 'all natural' claims. Reading nutrition facts panels, serving water to their child and child's age were not significant. CONCLUSION Misunderstanding of product healthfulness and other marketing attributes contribute to frequent provision of sweetened drinks to young children. Public health efforts to address common misperceptions, including counter marketing, may raise awareness among caregivers about the harms of providing sweetened drinks to young children.
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Affiliation(s)
- Yoon Y Choi
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT06103, USA
- Korea Rural Economic Institute, Naju-Si, Jeollanam-do58321, Republic of Korea
| | - Melissa L Jensen
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT06103, USA
| | - Frances Fleming-Milici
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT06103, USA
| | - Jennifer L Harris
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT06103, USA
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Ramirez A, Tovar A, Garcia G, Nieri T, Hernandez S, Sastre M, Cheney AM. Involvement of Non-Parental Caregivers in Obesity Prevention Interventions among 0-3-Year-Old Children: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084910. [PMID: 35457780 PMCID: PMC9031125 DOI: 10.3390/ijerph19084910] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION We examined the scope of literature including non-parental caregiver involvement in child obesity prevention interventions. METHODS We conducted a scoping review following the Arksey and O'Malley framework, including only studies reporting the effect of an intervention on growth, weight, or early childhood obesity risk among children ages 0 to three years, published between 2000 and 2021. Interventions that did not include non-parental caregivers (adults regularly involved in childcare other than parents) were excluded. RESULTS Of the 14 studies that met the inclusion criteria, all were published between 2013 and 2020, and most interventions (n = 9) were implemented in the United States. Eight of the 14 interventions purposefully included other non-parental caregivers: five included both parents and non-parental caregivers, and the remaining three included only non-parental caregivers. Most interventions (n = 9) showed no significant impact on anthropometric outcomes. All interventions found improvements in at least one behavioral outcome (e.g., food groups intake (n = 5), parental feeding practices (n = 3), and screen time (n = 2)). This review can inform future interventions that plan to involve non-parental caregivers, which may be beneficial in shaping early health behaviors and preventing obesity early in life.
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Affiliation(s)
- Andrea Ramirez
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA;
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02903, USA;
| | - Gretel Garcia
- Graduate School of Education, University of California Riverside, Riverside, CA 92521, USA;
| | - Tanya Nieri
- Department of Sociology, University of California Riverside, Riverside, CA 92521, USA; (T.N.); (M.S.)
| | - Stephanie Hernandez
- School of Public Policy, University of California Riverside, Riverside, CA 92507, USA;
| | - Myrna Sastre
- Department of Sociology, University of California Riverside, Riverside, CA 92521, USA; (T.N.); (M.S.)
| | - Ann M. Cheney
- Department of Social Medicine, Population and Public Health, School of Medicine, University of California Riverside, Riverside, CA 92521, USA
- Correspondence:
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KANAT YARIM A, RASULOVA K, ÇATLI G, KÜME T, ABACI A, KIZILDAĞ S. Leptin and leptin receptor gene polymorphisms in obese and healthy children. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.977534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Integrative Analysis of Exosomal miR-452 and miR-4713 Downregulating NPY1R for the Prevention of Childhood Obesity. DISEASE MARKERS 2022; 2022:2843353. [PMID: 35401881 PMCID: PMC8986441 DOI: 10.1155/2022/2843353] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/17/2022] [Accepted: 02/28/2022] [Indexed: 12/25/2022]
Abstract
Neuropeptides are associated with childhood obesity and exploring their regulatory mechanisms may reveal new insights for novel treatments. Childhood obesity data were downloaded from the GEO database and were used to screen for differentially expressed neuropeptides in patients with obesity. NPY1R expression was significantly upregulated in children with obesity compared to children without obesity (p < 0.05). The GEO database was used to filter differentially expressed miRNAs in patients with obesity. And hsa-mir-4713 and hsa-mir-452 were found significantly downregulated in adipose tissue. The GEO, TRRUST, and TFacts databases were used to screen all transcription factors for differentially expressed genes (DEGs). The potential regulatory networks between the differentially expressed miRNAs, TFs, and neuropeptides were mapped. In the constructed NPY1R regulatory network, the transcription factors TCF4, HEY1, and GATA3 are significantly associated with NPY1R. TCF4 and HEY1 were positively correlated with NPY1R, while GATA3 was negatively correlated with NPY1R. In the clinical peripheral blood samples, NPY1R, TCF4, and HEY1 were significantly more expressed in the obesity and the obesity with fracture group compared to the control group, while there was no statistically significant difference between the obesity group and the obesity with fracture group in terms of expression. The expression of GATA3, miR-452, and miR-4713 was also significantly lower in the obesity and the obesity with fracture groups when compared to the NC group. Therefore, NPY1R, TCF4, HEY1, GATA3, miR-452, and miR-4713 may be risk factors for fracture in obese children. The potential NPY1R regulatory function was exerted by two pathways: positive regulation caused by TCF4 and HEY1 acting on miR-4713 and negative regulation via GATA3 acting on miR-452. Potential NPY1R-related targets for the treatment of childhood obesity were provided in this study.
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Khaytin I, Stewart TM, Zelko FA, Kee MA, Osipoff JN, Slattery SM, Weese-Mayer DE. Evolution of physiologic and autonomic phenotype in rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation over a decade from age at diagnosis. J Clin Sleep Med 2022; 18:937-944. [PMID: 34694990 PMCID: PMC8883099 DOI: 10.5664/jcsm.9740] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022]
Abstract
Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) is a rare cause of syndromic obesity with risk of cardiorespiratory arrest and neural crest tumor. No ROHHAD-specific genetic test exists at present. Rapid weight gain of 20-30 pounds, typically between ages 2-7 years in an otherwise healthy child, followed by multiple endocrine abnormalities herald the ROHHAD phenotype. Vigilant monitoring for asleep hypoventilation (and later awake) is mandatory as hypoventilation and altered control of breathing can emerge rapidly, necessitating artificial ventilation as life support. Recurrent hypoxemia may lead to cor pulmonale and/or right ventricular hypertrophy. Autonomic dysregulation is variably manifest. Here we describe the disease onset with "unfolding" of the phenotype in a child with ROHHAD, demonstrating the presentation complexity, need for a well-synchronized team approach, and optimized management that led to notable improvement ("refolding") in many aspects of the child's ROHHAD phenotype over 10 years of care. CITATION Khaytin I, Stewart TM, Zelko FA, et al. Evolution of physiologic and autonomic phenotype in rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation over a decade from age at diagnosis. J Clin Sleep Med. 2022;18(3):937-944.
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Affiliation(s)
- Ilya Khaytin
- Division of Autonomic Medicine, Center for Autonomic Medicine in Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
- Stanley Manne Children’s Research Institute, Chicago, Illinois
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Tracey M. Stewart
- Division of Autonomic Medicine, Center for Autonomic Medicine in Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Frank A. Zelko
- Stanley Manne Children’s Research Institute, Chicago, Illinois
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | | | - Jennifer N. Osipoff
- Division of Pediatric Endocrinology, Stony Brook University, East Setauket, New York
| | - Susan M. Slattery
- Division of Autonomic Medicine, Center for Autonomic Medicine in Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
- Stanley Manne Children’s Research Institute, Chicago, Illinois
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Debra E. Weese-Mayer
- Division of Autonomic Medicine, Center for Autonomic Medicine in Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
- Stanley Manne Children’s Research Institute, Chicago, Illinois
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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43
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Mackey ER, Burton ET, Cadieux A, Getzoff E, Santos M, Ward W, Beck AR. Addressing Structural Racism Is Critical for Ameliorating the Childhood Obesity Epidemic in Black Youth. Child Obes 2022; 18:75-83. [PMID: 34491828 DOI: 10.1089/chi.2021.0153] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Racism and childhood obesity are both pervasive factors adversely affecting the health and wellbeing of children and adolescents in the United States. The association between racism and obesity has been touched upon in the literature; yet most work has focused on a few dimensions of intersectionality of these two domains at one time. The renewed focus on structural racism as the primary contributor to distress of Black individuals in the United States has highlighted the urgency of identifying the contributions of racism to the childhood obesity epidemic. The current article is not a complete review of the literature, rather, it is meant to take a broad narrative review of the myriad ways in which racism contributes to the obesity epidemic in Black youth to serve as a call to action for more research, prevention, and intervention. The current article illustrates how a number of mechanisms for the etiology and maintenance of obesity are heavily influenced by racism and how addressing racism is critical for ameliorating the childhood obesity epidemic.
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Affiliation(s)
- Eleanor R Mackey
- Children's National Hospital, Center for Translational Research, Washington, DC, USA
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - E Thomaseo Burton
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Adelle Cadieux
- Department of Behavioral Health, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, Michigan State University, Lansing MI, USA
| | - Elizabeth Getzoff
- Department of Psychology and Neuropsychology, Mt. Washington Pediatric Hospital, Baltimore, MD, USA
| | - Melissa Santos
- Division of Pediatric Psychology, Connecticut Children's, Hartford, CT, USA
| | - Wendy Ward
- Department of Pediatrics, College of Medicine, University of Arkansas Medical Center, Little Rock, AR, USA
| | - Amy R Beck
- Center for Children's Healthy Lifestyles and Nutrition and Division of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA
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Apperley LJ, Blackburn J, Erlandson-Parry K, Gait L, Laing P, Senniappan S. Childhood obesity: A review of current and future management options. Clin Endocrinol (Oxf) 2022; 96:288-301. [PMID: 34750858 DOI: 10.1111/cen.14625] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 02/02/2023]
Abstract
Obesity is becoming increasingly prevalent in paediatric populations worldwide. In addition to increasing prevalence, the severity of obesity is also continuing to rise. Taken together, these findings demonstrate a worrying trend and highlight one of the most significant challenges to public health. Childhood obesity affects multiple organs in the body and is associated with both significant morbidity and ultimately premature mortality. The prevalence of complications associated with obesity, including dyslipidaemia, hypertension, fatty liver disease and psychosocial complications are becoming increasingly prevalent within the paediatric populations. Treatment guidelines currently focus on intervention with lifestyle and behavioural modifications, with pharmacotherapy and surgery reserved for patients who are refractory to such treatment. Research into adult obesity has established pharmacological novel therapies, which have been approved and established in clinical practice; however, the research and implementation of such therapies in paediatric populations have been lagging behind. Despite the relative lack of widespread research in comparison to the adult population, newer therapies are being trialled, which should allow a greater availability of treatment options for childhood obesity in the future. This review summarizes the current evidence for the management of obesity in terms of medical and surgical options. Both future therapeutic agents and those which cause weight loss but have an alternative indication are also included and discussed as part of the review. The review summarizes the most recent research for each intervention and demonstrates the potential efficacy and limitations of each treatment option.
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Affiliation(s)
- Louise J Apperley
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
| | - James Blackburn
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | | | - Lucy Gait
- Department of Paediatric Clinical Psychology, Alder Hey Children's Hospital, Liverpool, UK
| | - Peter Laing
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
| | - Senthil Senniappan
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
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Demir D, Bektas M. The Effect of an Obesity Prevention Program on Children's Eating Behaviors, Food Addiction, Physical Activity, and Obesity Status. J Pediatr Nurs 2021; 61:355-363. [PMID: 34563806 DOI: 10.1016/j.pedn.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study was carried out to determine the effect of an obesity prevention program on children's eating behaviors, food addiction, physical activity, and obesity prevalence. DESIGN AND METHODS A pretest-posttest quasi-experimental design was used in the study. The study was conducted with a total of 128 students, including 55 in the intervention and 73 in the control groups. The obesity prevention program was implemented in the intervention group, and a routine curriculum training program was followed in the control group. The study data were collected before the intervention and in the third, sixth, and fifteenth months after the completion of the intervention. The data were evaluated using the chi-square test, McNeamer test, Cochrane Q test, multivariate analysis of variance in repeated measures, the Bonferroni adjusted paired t-test, power analysis, effect size, and regression analysis. RESULTS At the end of the study, it was determined that the body mass index values and food addiction rates of the students in the intervention group were lower than those of the students in the control group (p < .05). There was a significant difference between the mean scores of the students in the intervention and control groups obtained from the eating behavior questionnaire and the physical activity questionnaire in terms of time, group, and group * time interaction (p < .05). Also, the intervention program was found to have a large effect size (0.39) and a strong effect (0.85) on body mass index. CONCLUSION The obesity prevention intervention program was found to be effective in increasing children's positive eating behaviors and mean physical activity score and decreasing food addiction rates and body mass index values. PRACTICE IMPLICATIONS We recommend that the intervention program implemented in this study should be used widely in the curriculum of the Ministry of Education. This program shows that the school nurse is effective in preventing obesity in children. For this reason, there should be a school nurse in schools for implementing health-promoting education programs.
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Affiliation(s)
- Dilek Demir
- Dokuz Eylul University Health Science Institute, Departmant of Pediatric Nursing, Turkey; Dokuz Eylul University Health Science Institute, Departmant of Pediatric Nursing, Inciraltı, Turkey.
| | - Murat Bektas
- Dokuz Eylul University Faculty of Nursing, Inciraltı, Turkey
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Cord Blood Metabolome and BMI Trajectory from Birth to Adolescence: A Prospective Birth Cohort Study on Early Life Biomarkers of Persistent Obesity. Metabolites 2021; 11:metabo11110739. [PMID: 34822398 PMCID: PMC8625562 DOI: 10.3390/metabo11110739] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022] Open
Abstract
There is increasing recognition on the role of early life metabolic programming in childhood obesity. This study sought to investigate whether newborn cord blood metabolome can predict future BMI. It included 946 children in the Boston Birth Cohort, a sample of high-risk yet understudied US urban, low-income, predominantly Black and Hispanic children, who were enrolled at birth and followed prospectively up to age 18 years. A total of 376 metabolites were measured in cord blood plasma. Longitudinal BMI trajectories were defined and categorized into three distinct patterns: early onset overweight and obesity (early-OWO), late onset OWO (late-OWO), and normal weight trajectory (NW). Multinomial logistic regression models were used to identify metabolites individually or as network modules associated with BMI trajectories. Of the 946 children, 388, 254, and 304 were classified as early-OWO, late-OWO, and NW, respectively. Of the seven co-metabolomic network modules defined, two were inversely correlated with early-OWO. Among the 68 metabolites within the two modules, 22 triacylglycerols and diacylglycerols were negatively associated with early-OWO; 5 cholesterol esters were positively associated with early-OWO. In this prospective birth cohort, we demonstrated distinctive longitudinal BMI trajectories and identified multiple cord plasma metabolites in relevant biological pathways that were associated with early-OWO.
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Flattum C, Friend S, Horning M, Lindberg R, Beaudette J, Fulkerson JA. Family-focused obesity prevention program implementation in urban versus rural communities: a case study. BMC Public Health 2021; 21:1915. [PMID: 34674674 PMCID: PMC8532281 DOI: 10.1186/s12889-021-11967-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 09/15/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose Despite public health efforts to reduce childhood obesity, there remains an unequal distribution of obesity among rural and urban children, with higher rates in rural areas. However, few studies have compared differences in program delivery. This paper aims to describe differences between an urban and rural program delivery of a family-focused, community-based intervention program to prevent and reduce obesity among children. Methods This paper uses a case study format to provide a descriptive analysis of similar obesity prevention programs, designed by the same research team, implemented in Minnesota in different settings (i.e., an urban and rural setting) with significant community engagement in the adaptation process. The rural NU-HOME program is compared to HOME-Plus, an urban family-based obesity prevention program for school-aged children. Results Community engagement in the adaptation process of an urban program to a rural program confirmed some anticipated program content and delivery similarities while identifying key differences that were necessary for adaptation related to engagement with the community, recruitment and data collection, and intervention delivery. Discussion When adapting research-tested programs from urban to rural areas, it is important to identify the modifiable behavioral, social, and environmental factors associated with obesity to ensure the content of effective childhood obesity prevention programs is relevant. Customizing a program to meet the needs of the community may increase reach, engagement, and sustainability. In addition, long-term dissemination of a tailored program may significantly reduce childhood obesity in rural communities and be implemented in other rural settings nationally.
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Affiliation(s)
- Colleen Flattum
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., Suite 300, Minneapolis, MN, 55454, USA.
| | - Sarah Friend
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Melissa Horning
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
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Vorkoper S, Arteaga SS, Berrigan D, Bialy K, Bremer AA, Cotton P, Czajkowski S, Neilson E, Osganian SK, Pratt CA, Price LSN, Tabor DC, Walker JR, Williams MJ, Anand N. [Prevención transfronteriza de la obesidad infantil: comentario de los National Institutes of Health]. Obes Rev 2021; 22 Suppl 5:e13348. [PMID: 34708535 DOI: 10.1111/obr.13348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Susan Vorkoper
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - S Sonia Arteaga
- Office of the Director, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - David Berrigan
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Kevin Bialy
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Andrew A Bremer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Paul Cotton
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Susan Czajkowski
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Elizabeth Neilson
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Stavroula K Osganian
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Charlotte A Pratt
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Le Shawndra N Price
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Derrick C Tabor
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Jenelle R Walker
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Makeda J Williams
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, EE. UU
| | - Nalini Anand
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, EE. UU
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Johnson VR, Acholonu NO, Dolan AC, Krishnan A, Wang EHC, Stanford FC. Racial Disparities in Obesity Treatment Among Children and Adolescents. Curr Obes Rep 2021; 10:342-350. [PMID: 33988825 PMCID: PMC8120762 DOI: 10.1007/s13679-021-00442-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW With the growing obesity epidemic among children and adolescents, the evaluation of disease origin to slow disease progression is necessary. Racial disparities which are evident amid prevalence and treatment must be studied to counteract disease propagation. RECENT FINDINGS Disparities are pronounced among Black and Hispanic pediatric patients prior to conception and birth due to genetic composition and fetal environment. Postnatal environment and psychosocial influences can further increase a child/adolescent's propensity to increased weight. Current treatment options including nutrition, physical activity, behavior modification, pharmacotherapy, and surgery are underutilized in communities of color due to limited access to care and cost. Data is limited to demonstrate disparities among treatment of obesity in children and adolescents. The reviewed studies show the role of race on disease treatment. Increased research efforts, especially in pharmacotherapy and metabolic and bariatric surgery (MBS), will help combat obesity in pediatric communities of color.
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Affiliation(s)
- Veronica R Johnson
- Department of Internal Medicine, Northwestern Medicine, 259 E. Erie Street, Suite 2150, Chicago, IL, 60611, USA.
| | - Nonyerem O Acholonu
- Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA, USA
| | - Ana C Dolan
- University of Massachusetts Amherst, Amherst, MA, USA
| | | | | | - Fatima Cody Stanford
- Departments of Medicine, Neuroendocrine Unit and Pediatrics, Pediatric Endocrinology, Boston, MA, USA
- Nutrition Obesity Research Center at Harvard, MGH Weight Center, Massachusetts General Hospital, 50 Staniford Street, 4th Floor, Boston, MA, 02114, USA
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50
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Barefield KL, Rollins B. Review of telehealth interventions for childhood obesity in minority, low‐income or underserved populations: Opportunity for pharmacists. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Kimberly L. Barefield
- Philadelphia College of Osteopathic Medicine, School of Pharmacy Pharmacy Practice Suwanee Georgia USA
| | - Brent Rollins
- Philadelphia College of Osteopathic Medicine, School of Pharmacy Pharmacy Practice Suwanee Georgia USA
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