[Calcium intake, serum vitamin D and obesity in children: is there an association?]

The joint effect of vitamin-D status and tobacco exposure on overweight and obesity in children

This study aimed to explore the combined effects of serum vitamin-D level and tobacco exposure on the risk of overweight and obesity in children. This cross-sectional study analysed the data of 11 636 children aged 2-17 years from the National Health and Nutrition Examination Surveys database between 2007 and 2018. Univariable and multivariate weighted logistic regression models were used to analyse the associations of serum vitamin-D or cotinine levels with overweight and obesity in children as well as the combined effects of serum vitamin-D and cotinine on the risk of overweight and obesity in children. Subgroup analysis was performed in terms of gender, age, race and household smokers. OR with corresponding 95 % CI was presented. The elevated risk of overweight and obesity in children was found in those with serum vitamin-D < 20 ng/ml (OR = 1·44, 95 % CI: 1·29, 1·61). Also, the odds of overweight and obesity in children was 1·14 (OR = 1·14, 95 % CI: 1·01, 1·29) in children with cotinine ≥ 0·05 ng/ml. Relative to participants with serum vitamin-D ≥ 20 ng/ml and cotinine < 0·05 ng/ml, increased risk of overweight and obesity was identified in those with serum vitamin-D < 20 ng/ml and cotinine < 0·05 ng/ml (OR = 1·45, 95 % CI: 1·26, 1·68) and serum vitamin-D < 20 ng/ml and cotinine ≥ 0·05 ng/ml (OR = 1·62, 95 % CI: 1·38, 1·91). Serum vitamin-D and cotinine exposure had combined effects on the risk of overweight and obesity in children.

Activation of estrogen-related receptor γ by calcium and cadmium

Objective

Estrogen-related receptor γ (ERRγ) is a metabolic regulator with no identified physiological ligands. This study investigates whether calcium is an ERRγ ligand that mediates the effects of glucagon and whether cadmium, which mimics the effects of calcium, disrupts metabolism through ERRγ.

Method

HepG2, MCF-7, and HEK293T transfected with ERRγ were treated with glucagon, calcium, cadmium, ERRγ agonist, or ERRγ inhibitor. Cells were then collected for in vitro assays including real-time qPCR, Western blot, ChIP, immunofluorescence, mutational analysis, or gene set enrichment analysis. Molecular dynamics simulations were performed to study mutation sites.

Results

In HepG2 cells, treatment with glucagon, calcium, or cadmium re-localized ERRγ to the cell nucleus, recruited ERRγ to estrogen-related response elements, induced the expression of ERRγ-regulated genes, and increased extracellular glucose that was blocked by an ERRγ antagonist. In MCF-7 cells and HEK293T cells transfected with ERRγ, similar treatments induced the expression of metabolic genes. Mutational analysis identified S303, T429, and E452 in the ligand-binding domain as potential interaction sites. Molecular dynamics simulations showed that calcium induced changes in ERRγ similar to ERRγ agonist.

Conclusion

The results suggest that calcium is a potential ligand of ERRγ that mediates the effects of glucagon and cadmium disrupts metabolism through ERRγ.

Use of Dietary Supplements among Polish Children with Inflammatory Bowel Disease: A Two-Center Pilot Study

Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). These diseases are characterized by inflammation, which may be a consequence of changes in the intestinal microbiota and lead to mineral and vitamin deficiencies. The aims of this study were to determine the level of dietary supplement intake in children with IBD and to determine the influence of factors such as sex, nutritional status, diet, and other comorbidities on supplement intake. The study was conducted from May 2022 to September 2023 and was a prospective study. The group of children with IBD that ultimately qualified for the study numbered 96, and the control group numbered 30. The children who participated in the study were aged 4-18 years. Most parents of children with IBD (81.4%) declared that they use supplementation for their children, while 75% of parents of children without IBD declared giving their children nutritional supplements. Vitamins in both groups were most often given to children as dietary supplements (p = 0.018), including vitamin D. Depending on the diet used, the intake of vitamin B6 (p = 0.018), vitamin E (p = 0.040) and iron (p = 0.006) was significantly different among children with IBD. Statistical significance (p = 0.021) was observed for supplementation use and disease stage among children with IBD. For 80.2% of parents of children with IBD, the main reason for using supplements was a doctor's recommendation. In the control group, 43.3% of parents indicated that the main reason for using supplements was to correct nutritional deficiencies. Supplementation was common in both groups, but attention should be paid to other current diseases in children with IBD and to nutritional status. In our opinion, educating parents about supplementation is important, especially among parents of children with IBD.

EFFECTS OF OMEGA-3 FATTY ACIDS ASSOCIATED WITH ANTIOXIDANT VITAMINS IN OVERWEIGHT AND OBESE CHILDREN

Introduction

Antioxidants and unsaturated fatty acids have protective effects in obesity.

Aim

We investigated the benefits of Omega-3 fatty acids associated with antioxidant vitamins in obese children. Magnesemia and calcemia were observed in relation with other metabolic parameters, before and after the treatment.

Materials and methods

60 obese children were compared with 35 normal weight children. Each obese child received daily, one pill, containing: 130mg docosahexaenoic acid, 25mg of eicosapentaenoic acid, vitamin A 200µg, vitamin D 1,25µg, vitamin E 2,5mg and vitamin C 30mg for three months. All the participants were instructed not to change their lifestyle.

Results

The serum values for these minerals and for 25(OH) vitamin D were lower in obese children. The obese children had insulin resistance (HOMA-IR) and an imbalance of serum adipocytokines. In obese children, the body mass index was negatively correlated with calcemia (r=-0.34) and serum 25(OH) vitamin D (r=-0.33). The HOMA-IR was negatively correlated with magnesemia (r=-0.34) and serum adiponectin (r=-0.29). The treatment improved the mineral serum level, the insulin sensitivity and the adipocytokines levels.

Conclusion

In obese children, the intake of Omega-3 fatty acids associated with antioxidant vitamins, for three months improved calcemia and magnesemia and increased insulin sensitivity.

Machine learning framework for gut microbiome biomarkers discovery and modulation analysis in large-scale obese population

BACKGROUND

The gut microbiome has proven to be an important factor affecting obesity; however, it remains a challenge to identify consistent biomarkers across geographic locations and perform precisely targeted modulation for obese individuals.

RESULTS

This study proposed a systematic machine learning framework and applied it to 870 human stool metagenomes across five countries to obtain comprehensive regional shared biomarkers and conduct a personalized modulation analysis. In our pipeline, a heterogeneous ensemble feature selection diagram is first developed to determine an optimal subset of biomarkers through the aggregation of multiple techniques. Subsequently, a deep reinforcement learning method was established to alter the targeted composition to the desired healthy target. In this manner, we can realize personalized modulation by counterfactual inference. Consequently, a total of 42 species were identified as regional shared biomarkers, and they showed good performance in distinguishing obese people from the healthy group (area under curve (AUC) =0.85) when demonstrated on validation datasets. In addition, by pooling all counterfactual explanations, we found that Akkermansia muciniphila, Faecalibacterium prausnitzii, Prevotella copri, Bacteroides dorei, Bacteroides eggerthii, Alistipes finegoldii, Alistipes shahii, Eubacterium sp. _CAG_180, and Roseburia hominis may be potential broad-spectrum targets with consistent modulation in the multi-regional obese population.

CONCLUSIONS

This article shows that based on our proposed machine-learning framework, we can obtain more comprehensive and accurate biomarkers and provide modulation analysis for the obese population. Moreover, our machine-learning framework will also be very useful for other researchers to further obtain biomarkers and perform counterfactual modulation analysis in different diseases.

High Prevalence of Hypovitaminosis D in Adolescents Attending a Reference Centre for the Treatment of Obesity in Switzerland

Background: Hypovitaminosis D is common in populations with obesity. This study aimed at assessing (1) the prevalence of hypovitaminosis D and (2) the associations between vitamin D levels and cardiovascular risk factors in adolescents attending a reference centre for the treatment of obesity. Design: Cross-sectional pilot study conducted in the paediatric obesity unit of the Lausanne university hospital, Switzerland. Methods: Participants were considered eligible if they (1) were aged between 10 to 16.9 years and (2) consulted between 2017 and 2021. Participants were excluded if (1) they lacked vitamin D measurements or (2) the vitamin D measurement was performed one month after the base anthropometric assessment. Hypovitaminosis D was considered if the vitamin D level was <30 ng/mL (<75 nmol/L). Severe obesity was defined as a BMI z-score > 3 SD. Results: We included 52 adolescents (31% girls, mean age 13 ± 2 years, 33% with severe obesity). The prevalence of hypovitaminosis D was 87.5% in girls and 88.9% in boys. The vitamin D levels were inversely associated with BMI, Spearman r and 95% CI: −0.286 (−0.555; −0.017), p = 0.037; they were not associated with the BMI z-score: −0.052 (−0.327; 0.224), p = 0.713. The vitamin D levels were negatively associated with the parathormone levels (−0.353 (−0.667; −0.039), p = 0.028) and positively associated with the calcium levels (0.385 (0.061; 0.708), p = 0.020), while no association was found between vitamin D levels and blood pressure and lipid or glucose levels. Conclusion: almost 9 out of 10 adolescents with obesity in our cohort presented with hypovitaminosis D. Hypovitaminosis D does not seem to be associated with a higher cardiovascular risk profile in this group.

Association between anthropometric markers of adiposity, adipokines and vitamin D levels

Inverse association between serum levels of vitamin D and obesity has been pointed out in several studies. Our aim was to identify to the associations between vitamin D levels and a large panel of anthropometric markers and adipokines. Cross-sectional study including 6485 participants. Anthropometric markers included body mass index (BMI), % body fat, waist, waist-to-hip (WHR), waist-to-height (WHtR), conicity index, body roundness index (BRI) and a body shape index (ABSI). 55.7% of women and 60.1% of men presented with vitamin D deficiency. Vitamin D levels were negatively associated with most anthropometric markers, with correlation coefficients ranging between -0.017 (ABSI) and -0.192 (BMI) in women and between -0.026 (weight) and -0.130 (% body fat) in men. Vitamin D levels were inversely associated with leptin levels in both sexes and positively associated with adiponectin levels in women only. The likelihood of vitamin D deficiency increased with increasing adiposity levels, except for ABSI (women) and BMI (men). Total body fat, rather than localized or unevenly distributed body fat, is the adiposity marker most associated with decreased vitamin D levels. Monitoring vitamin D levels in people with overweight/obesity is essential.

Biochemical markers and anthropometric profile of children enrolled in public daycare centers

OBJECTIVE

The nutritional status resultant from dietary habits along with socioeconomic conditions and the school environment are directly related to the individual's health condition not only in their childhood but also throughout adulthood. The aim of this study was to evaluate the effects of socioeconomic factors on the anthropometric profile and to analyze a probable association between this profile and biochemical markers in children attending public daycare centers.

METHODS

It is a transversal study developed in a probability sample of clusters of children from 6 months to 5 years old. Anthropometric and socioeconomic data were gathered at the CMEIs, questionnaires on the nutritional status were applied and blood was collected at the Family Health Units (USFs).

RESULTS

Female children are three times more likely to be underweight; in families with five members, it is 1/3 more likely that children of higher-educated parents are overweight. Among the results of the biochemical tests, hypervitaminosis A was a relevant aspect, positively correlating with copper (p=0.005) and zinc (p=0.008).

CONCLUSION

Therefore, since the influence of the family is an important predictor of overweight and its future outcomes related to nutritional deficiencies and inadequate dietary intake, educational interventions are vital as a way to pave the path to prevention.

Tenth year reenrollment randomized trial investigating the effects of childhood probiotics and calcium supplementation on height and weight at adolescence

Microbiota and its modification with specific probiotics in early life could provide long term health benefits. Probiotics and calcium strengthen intestinal integrity and may support linear growth. This study investigated the long-term effects of childhood probiotics and calcium supplementation on growth in adolescence. We re-enrolled 238 adolescents aged 11-18 years from 494 children 10-years after 6-months of supplementation with either low-lactose milk fortified with low levels of calcium (LC, ∼50 mg/day, n = 53/124), with regular levels of calcium (RC, ∼440 mg/day, n = 70/126), or with regular calcium + 5 x 108 CFU/day Lactobacillus reuteri DSM 17938 (Reuteri, n = 55/124), or regular calcium + 5 x 108 CFU/day L. casei CRL 431 (Casei, n = 60/120). Changes in height-for-age z-score (HAZ) and body mass index-for-age z-score (BMIZ) were determined from the end of intervention to re-enrollment. General linear models were used to assess the effects on HAZ and BMIZ of group, gender, living area, maternal education, family income, physical activity, diet quality, nutritional status, and gut integrity as determined by urinary lactulose/mannitol ratio (L:M). Adolescent mean age was 15.3 years, mean HAZ was - 1.11, mean BMIZ was - 0.2 and median L:M (n = 155) was 0.23. Changes in HAZ and BMIZ were not significantly different between Casei, Reuteri, LC compared to RC. However, a significant decrease in BMIZ was observed among female adolescents in the Casei compared to RC group (- 0.5 SD, 95% CI - 0.8 to - 0.003, p = 0.048). Childhood probiotic and calcium supplementation may therefore selectively affect female adolescents.Clinical trial registration: This follow-up study has been registered at www.clinicaltrials.gov , Registry name: Rina Agustina, Registration number: NCT04046289, First Registration Date 06/08/19. web link: https://www.clinicaltrials.gov/ct2/show/NCT04046289 .

Patterns of Calcium- and Chloride-Ion Disorders and Predictors among Obese Outpatient Adults in Southern Ethiopia

BACKGROUND

Obesity is a condition characterized by abnormal or excess accumulation of fat in body tissue, which may impair health and result in electrolyte derangement. Hypercalcemia and hypochloremia are significant problems in obese patients, and can cause substantial morbidity and mortality. Determination of patterns of calcium and chloride may play a major role in the management of obese patients. Therefore, this study aimed to determine calcium and chloride disorders and their predictors among obese adults in the outpatient department at Wolkite University Specialized Hospital, southern Ethiopia from May to August 2020.

METHODS

This institution-based cross-sectional study was conducted on 250 obese adults attending the outpatient department from May to August 2020. Structured questionnaires through face-to-face interviews and participants' medical records were used to collect information on determinants related to calcium- and chloride-ion disturbances. Levels of serum calcium and chloride were measured using an ion-selective electrode analyzer. Bivariate and multivariate logistic regression analyses were done to identify determinants associated with calcium and chloride disorders. Using ORs and 95% CIs,P<0.05 was considered significant.

RESULTS

Among the 250 patients, 18% (95% CI 53.02-111) and 17.6% (95% CI 0.78-12) of study participants were hypochloremic and hypercalcemic, respectively. Age ≥50 years (AOR 3.58, 95% CI 2.57-11.10), diuretic use (AOR 2.35, 95% CI 1.31-4.23), and obesity (AOR, 6.82, 95% CI 2.26-14.62) were independent predictors of hypochloremia on multivariate logistic regression, and obesity (AOR 9.21, 95% CI 2.50-14.81), overweight (AOR 8.32, 95% CI 1.61-10.20) and physical inactivity (AOR 4.28, 95% CI 1.71-10.44) were predictors of hypercalcemia.

CONCLUSION

High burdens of hypochloremia (18%) and hypercalcemia (17.6%) were observed in these patients. Increased age, diuretic use, being overweight, and physical inactivity were predictors of electrolyte disorders. The findings of this study should be taken into consideration to implement preventive interventions on these predictors in obese patients. Promoting sufficient fruit and vegetable consumption and physical exercise and determination of serum-chloride and -calcium levels in adult overweight/obese patients are recommended to minimize the emergence of electrolyte disorders.

The functional nutritional and regulatory activities of calcium supplementation from eggshell for obesity disorders management

The present study was to investigate the effective role of renewable sources of Ca⁺² from eggshell (ES) with different doses to restrict obesity disorders. Rats were classified as follows, G₁ : normal diet for 26 weeks; G₂ : high-fat diet (HFD) for 26 weeks; G₃ , G₄ , and G₅ were supplemented with HFD for 16 weeks and treated with 7.2 g Ca⁺² ES/Kg rat chow, 18 g Ca⁺² ES/Kg rat chow, and 2% diet containing fat (DCF), respectively, for the remaining 10 weeks. Results revealed a significant effect of the low dose of Ca⁺² supplement in form of ES than high dose and 2% DCF; on basis of anthropometric parameters, lipid, leptin, adiponectin, thyroid hormones, Ca⁺² , 25-hydroxyl vitamin-D, and oxidative and inflammatory parameters were regulated. Results were confirmed with the histopathological study. Therefore, it was concluded that Ca⁺² supplementation can be used as a beneficial source for obesity management with anticholesterol actions. PRACTICAL APPLICATIONS: Obesity represented public health hazards. The eggshell is one of the waste products that contain a high percentage of Ca⁺² . The current data exposed using a low dose of ES as a new source of Ca⁺² supplement for treatment of HFD rats leads to significant enhancement of lipid profiles, liver enzymes, kidney functions, leptin, adiponectin, Ca⁺² , 25(OH)-D, TSH, fT_4, and PTH levels. Also, there was a reduction in weight gain, Bwt, BMI, BG, insulin, and HOMA-IR. Moreover, the oxidant-pro-oxidant system was improved in both hepatic and adipose tissues where NO and TBARS concentrations were diminished, and SOD specific activity was elevated. Additionally, TNF-α and ADAM17 expression were downregulated. Hence, it was concluded that there was good evidence that diets supplemented with ES were associated with the reduction of obesity complications especially regulating fat processing and storage in the body.

Association between Dietary Calcium Intake and Adiposity in Male Adolescents

The aim was to investigate the possible association of dietary calcium intake with adiposity, insulin resistance, and adipocytokine values in adolescent boys. In this cross-sectional study, participants were 123 adolescent boys aged 13–15 years, who were divided into tertiles according to their dietary calcium intake. Dietary calcium intake was assessed using three 24 h dietary recalls. In addition, energy intake, body composition, physical activity (PA), and blood biochemical values were also measured. Mean body fat%, fat mass (FM), trunk FM, trunk fat%, and leptin differed between high and low tertiles of calcium intake after adjustment for age, pubertal stage, and PA. For the entire cohort, mean calcium intake was 786 ± 380 mg/day and was related to body mass index (BMI), FM, and trunk fat% but not to insulin resistance or adipocytokine values after adjusting for possible confounders. In addition, only 15.4% of the participants obtained or exceeded their mean dietary calcium intake requirements. These subjects who met their dietary calcium intake had significantly lower body fat% in comparison with subjects not meeting their dietary calcium intake. Odds ratio of being in the highest tertile of FM, trunk FM, and trunk fat% was 3.2–4.4 (95% confidence interval 1.19–12.47; p < 0.05) times higher for boys in low calcium intake tertile, compared to those boys in high calcium intake tertile. In conclusion, dietary calcium intake is inversely associated with total body and abdominal adiposity values in a specific group of healthy male adolescents with different body mass values.

Association of vitamin D status with metabolic syndrome and its components: A cross-sectional study in a population of high educated Iranian adults

AIM

We aimed to assess the association of vitamin D status with metabolic syndrome and its components among high educated Iranian adults.

METHOD

In this cross-sectional study, 352 faculty members with age of 35 years or more, belong to Tarbiat Modares University, Tehran, Islamic Republic of Iran, were recruited during 2016 and 2017. Fasting blood samples were obtained to quantify serum 25(OH)D concentrations, glycemic indicators and lipid profile. Metabolic syndrome was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Multivariate logistic regression adjusted for potential confounders was used to evaluate the association between vitamin D status and metabolic syndrome.

RESULT

Metabolic syndrome and vitamin D insufficiency were prevalent among 26% and 60.2% of subjects, respectively. There was no statistically significant difference in the prevalence of metabolic syndrome across quartiles of 25(OH)D levels either before or after adjusting for potential confounders (OR: 0.94, 95% CI: 0.43-1.95). In terms of metabolic syndrome components, subjects in the highest quartile of vitamin D levels had 59% decreased risk of abdominal obesity compared with those in the lowest quartile (OR: 0.41, 95% CI: 0.17-0.99), after adjusting for potential confounders. Such inverse relationship was also seen for elevated blood pressure (OR: 0.37, 95% CI: 0.14-0.99), and abnormal glucose homeostasis (OR: 0.40, 95% CI: 0.19-0.85).

CONCLUSION

Serum levels of 25(OH)D was inversely associated with the risk of abdominal obesity, hypertension, and abnormal glucose homeostasis. However, no significant relationship was seen for metabolic syndrome.

Inverse association of calcium intake with abdominal adiposity and C-reactive protein in Brazilian children

OBJECTIVE

To evaluate Ca intake and its association with cardiometabolic risk factors during childhood.

DESIGN

A cross-sectional study with a representative sample. Food consumption was assessed through three 24 h dietary recalls. Anthropometry, body composition and biochemical measurements were also conducted.

SETTING

Viçosa, Minas Gerais, Brazil.

SUBJECTS

Children between 8 and 9 years old (n 350) enrolled in public and private schools in the urban area of the municipality of Viçosa.

RESULTS

Almost all children had inadequate intake of Ca (97·4 %), especially those with low income, non-white and who studied in public schools. Foods that contributed most to Ca intake were 'milk' and 'cheeses and yoghurts' (R 2=0·66 and 0·13, respectively), and intake of 'milk' was correlated with 'chocolate milk powder' intake (r=0·538, P<0·01). Children with lower Ca intake had a higher prevalence of increased C-reactive protein (prevalence ratio=2·93; 95 % CI 1·21, 7·07), increased waist circumference (prevalence ratio=2·86; 95 % CI 1·01, 8·13) and a lower prevalence of high LDL cholesterol (prevalence ratio=0·64; 95 % CI 0·41, 0·99).

CONCLUSIONS

Lower Ca intake was associated with excess abdominal adiposity and subclinical inflammation in Brazilian children. Monitoring of adequate Ca intake is important, especially in poorer communities.

Lower vitamin D intake is associated with low HDL cholesterol and vitamin D insufficiency/deficiency in Brazilian children

OBJECTIVE

To evaluate the association of vitamin D intake with dyslipidaemia and vitamin D insufficiency/deficiency in Brazilian children and identify the main food group sources of this nutrient in the sample.

DESIGN

A cross-sectional study carried out with a representative sample. Blood was collected after 12 h of fasting. Laboratory tests were performed to determine total cholesterol, HDL cholesterol (HDL-C), LDL cholesterol, TAG, apoB, apoA1, 25-hydroxyvitamin D and parathyroid hormone. Dietary intake was evaluated by a 24 h recall.

SETTING

Viçosa, Minas Gerais, Brazil.

SUBJECTS

Children between 8 and 9 years old enrolled in urban schools (n 378).

RESULTS

We found an elevated prevalence of inadequate vitamin D intake (91·3 %), dyslipidaemia (72·8 %) and vitamin D insufficiency/deficiency (56·2 %). The food groups that contributed the most to vitamin D intake were dairy products and fish. Lower vitamin D intake was associated with increased prevalence of both low HDL-C (prevalence ratio=2·51; 95 % CI 1·02, 6·18; P<0·05) and vitamin D insufficiency/deficiency (prevalence ratio=1·61; 95 % CI 1·01, 2·58; P<0·05).

CONCLUSIONS

Given the elevated prevalence of inadequate vitamin D intake and its association with low HDL-C and vitamin D insufficiency/deficiency, it is important to develop specific actions in food and nutritional education as well as programmes that stimulate and facilitate access to vitamin D food sources, such as dairy products and fish.

Lifestyle and resulting body composition in young athletes

BACKGROUND

Key aspects in a lifestyle analysis are physical activity level and eating habits. An unhealthy lifestyle results in fat mass increase and in a predisposition to non-communicable chronic diseases even in young age. The purpose of this study was to investigate the lifestyle and body composition in young athletes.

METHODS

The subjects underwent to an assessment of body composition and they completed two questionnaires, one concerning the level of physical activity and the other regarding eating habits.

RESULTS

One hundred fifty-two young athletes (63 females and 89 males) aged 8 to 18 years (13.4±2.5 years, height 159±14 cm) were enrolled in this study. 80.3% of subjects were normal weight (13.4±2.6 years) and 19.7% subjects (13.5±2.5 years) were overweight or obese. Greater sedentary behaviors were found in the overweight or obese participants compared to normal weight (618±125 vs. 523±89 min; P<0.001) and a lower consumption of milk and yoghurt (5.0±3.2 vs. 6.9±4.1 times/week; P=0.031).

CONCLUSIONS

Although competitive sports often increase physical activity levels in young people, this activity does not seem to reach the daily recommended amount of physical activity during youth. Therefore, it is necessary to have a comprehensive approach to create a primary prevention strategy from even a young age.