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Saade MB, Holden S, Kakinami L, McGrath JJ, Mathieu MÈ, Poirier P, Barnett TA, Beaucage P, Henderson M. Adiposity and cardiac autonomic function in children with a family history of obesity. Clin Auton Res 2024:10.1007/s10286-024-01063-y. [PMID: 39304555 DOI: 10.1007/s10286-024-01063-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 09/02/2024] [Indexed: 09/22/2024]
Abstract
PURPOSE Data on associations between adiposity and heart rate variability (HRV) in prepubertal children are limited. We examined the associations between adiposity indices and HRV, independent of lifestyle behaviors, comparing multiple indicators of adiposity, and explored differences between boys and girls. METHODS Data stem from 469 participants of the QUALITY cohort (630 children aged 8-10 years with a parental history of obesity). Adiposity indices included waist-to-height ratio, body mass index (BMI) percentiles and categories (overweight, obesity), dual-energy x-ray absorptiometry (DEXA) defined fat mass percentage and android/gynoid ratio. HRV indices in the frequency and the spectral domain were derived from a daytime 3-h Holter recording. Multivariable linear regression models were adjusted for age, sex, Tanner stage, physical activity, screen time, and fitness. Interactions between sex and adiposity were tested. RESULTS Greater adiposity was associated with decreased parasympathetic modulation and increased sympathetic dominance. Waist-to-height ratio was associated with lower parasympathetic activity: root mean square of the successive differences (RMSSD) [B = -23.32, 95% confidence interval (CI) -42.42, -4.22], pNN50 (B = -16.93, 95% CI - 28.58, - 5.27), LF/HF ratio (B = 1.83, 95% CI 0.97-2.70). Patterns of association were similar for android/gynoid ratio. Overweight was not associated with altered HRV. Obesity was negatively associated with RMSSD and pNN50 and positively with LF/HF ratio. Greater fat mass percentage was associated with lower RMSSD, pNN50, and HF, and increased LF/HF ratio. There were no differences between boys and girls. CONCLUSIONS Specific markers of adiposity relate to altered HRV in childhood, with waist-to-height ratio being potentially a more relevant marker of HRV than BMI and more pragmatic than percent body fat. TRIAL REGISTRATION NCT03356262, 11 November 2017.
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Affiliation(s)
- Marie-Béatrice Saade
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- Department of Pediatrics, CHU de Rennes, Rennes, France
| | - Samuel Holden
- Department of Mathematics and Statistics, Concordia University, Montréal, QC, Canada
| | - Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, Montréal, QC, Canada
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | | | - Marie-Ève Mathieu
- Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, Canada
| | - Paul Poirier
- Faculté de Pharmacie, Université Laval, Quebec, QC, Canada
- Institut Universitaire de Cardiologie et de Pneumologie, Quebec, QC, Canada
| | - Tracie A Barnett
- Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- Family Medicine Department, McGill University, Montreal, QC, Canada
| | - Pierre Beaucage
- Department of biochemistry & chemistry, Faculty of Sciences, University of Moncton, Moncton, Canada
| | - Mélanie Henderson
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada.
- Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montreal, Canada.
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2
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Saidj S, Ruchat SM, Henderson M, Tremblay A, Mathieu ME. Physiological response during exercise is preserved in children exposed to a suboptimal gestational environment. Obesity (Silver Spring) 2024; 32:1551-1557. [PMID: 39045675 DOI: 10.1002/oby.24049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/05/2024] [Accepted: 04/06/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE This study investigated whether exposure to suboptimal gestational factors (SGFs) alters mechanical efficiency (ME) and substrate oxidation during rest and exercise in children as a mechanism contributing to obesity. METHODS Data from the Quebec Adiposity and Lifestyle Investigation in Youth cohort were used. Children aged 8 to 10 years performed an incremental maximal cycling test with indirect calorimetry. Their ME was measured during submaximal and maximal effort. The substrate oxidation during rest and submaximal effort was also computed. ME and substrate oxidation results between children exposed to each SGF during pregnancy (gestational diabetes mellitus: n = 68; hypertensive disorders: n = 49; maternal smoking: n = 77) and nonexposed children (n = 370) were compared. RESULTS No difference was observed for ME during submaximal (F[3,540] = 0.46, p = 0.713) and maximal effort (F[3,545] = 0.86, p = 0.463) between exposed and nonexposed children. The percentage contributions of lipids and carbohydrates did not differ during rest (F[3,545] =1.68, p = 0.169) or submaximal exercise (F[3,544] = 0.31, p = 0.534) between exposed and nonexposed children. CONCLUSIONS Children exposed to investigated SGFs display a similar physiological response regarding ME and substrate oxidation during rest and exercise compared to nonexposed children. Future studies should confirm these novel results and continue investigating other research avenues to explain the higher risk of obesity in this population.
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Affiliation(s)
- Soraya Saidj
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Mélanie Henderson
- Azrieli Research Center, Sainte-Justine University Hospital Center, Montréal, Québec, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
- School of Public Health, Université de Montréal, Montreal, Québec, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Université de Laval, Québec City, Québec, Canada
| | - Marie-Eve Mathieu
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
- Azrieli Research Center, Sainte-Justine University Hospital Center, Montréal, Québec, Canada
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3
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Park H, Choi JE, Jun S, Lee H, Kim HS, Lee HA, Park H. Metabolic complications of obesity in children and adolescents. Clin Exp Pediatr 2024; 67:347-355. [PMID: 37986568 PMCID: PMC11222907 DOI: 10.3345/cep.2023.00892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 11/22/2023] Open
Abstract
The global prevalence of childhood and adolescent obesity, exacerbated by the coronavirus disease 2019 pandemic, affects school-aged children and preschoolers. Early-onset obesity, which carries a high risk of metabolic complications, may contribute to a lower age at the onset of cardiovascular disease. As metabolic diseases such as diabetes, dyslipidemia, and nonalcoholic fatty liver disease observed in adulthood are increasingly recognized in the pediatric population, there is an emphasis on moving disease susceptibility assessments from adulthood to childhood to enable early detection. However, consensus is lacking regarding the definition of metabolic diseases in children. In response, various indicators such as the pediatric simple metabolic syndrome score, continuous metabolic syndrome score, single-point insulin sensitivity estimator, and fatty liver index have been proposed in several studies. These indicators may aid the early detection of metabolic complications associated with pediatric obesity, although further validation studies are needed. Obesity assessments are shifting in perspective from visual obesity to metabolic health and body composition considerations to fill the gap in health impact assessments. Sarcopenic obesity, defined as the muscle- to-fat ratio, has been proposed in pediatric populations and is associated with metabolic health in children and adolescents. The National Health Screening Program for Children in Korea has expanded but still faces limitations in laboratory testing. These tests facilitate timely intervention by identifying groups at a high risk of metabolic complications. Early detection and intervention through comprehensive health screening are critical for mitigating long-term complications of childhood obesity.
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Affiliation(s)
- Hyunjin Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Jung Eun Choi
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Seunghee Jun
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hyelim Lee
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
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4
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Kraus EM, Pierce SL, Porter R, Kompaniyets L, Vos MB, Blanck HM, King RJ, Goodman AB. Using Real-World Electronic Health Record Data to Assess Chronic Disease Screening in Children: A Case Study of Non-Alcoholic Fatty Liver Disease. Child Obes 2024; 20:41-47. [PMID: 36862137 PMCID: PMC10790548 DOI: 10.1089/chi.2022.0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Background: Data sources for assessing pediatric chronic diseases and associated screening practices are rare. One example is non-alcoholic fatty liver disease (NAFLD), a common chronic liver disease prevalent among children with overweight and obesity. If undetected, NAFLD can cause liver damage. Guidelines recommend screening for NAFLD using alanine aminotransferase (ALT) tests in children ≥9 years with obesity or those with overweight and cardiometabolic risk factors. This study explores how real-world data from electronic health records (EHRs) can be used to study NAFLD screening and ALT elevation. Research Design: Using IQVIA's Ambulatory Electronic Medical Record database, we studied patients 2-19 years of age with body mass index ≥85th percentile. Using a 3-year observation period (January 1, 2019 to December 31, 2021), ALT results were extracted and assessed for elevation (≥1 ALT result ≥22.1 U/L for females and ≥25.8 U/L for males). Patients with liver disease (including NAFLD) or receiving hepatotoxic medications during 2017-2018 were excluded. Results: Among 919,203 patients 9-19 years of age, only 13% had ≥1 ALT result, including 14% of patients with obesity and 17% of patients with severe obesity. ALT results were identified for 5% of patients 2-8 years of age. Of patients with ALT results, 34% of patients 2-8 years of age and 38% of patients 9-19 years of age had ALT elevation. Males 9-19 years of age had a higher prevalence of ALT elevation than females (49% vs. 29%). Conclusions: EHR data offered novel insights into NAFLD screening: despite screening recommendations, ALT results among children with excess weight were infrequent. Among those with ALT results, ALT elevation was common, underscoring the importance of screening for early disease detection.
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Affiliation(s)
- Emily M. Kraus
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Public Health Informatics Institute, Taskforce for Global Health, Atlanta, GA, USA
| | - Samantha Lange Pierce
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Renee Porter
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- McKing Consulting Corporation, Atlanta, GA, USA
| | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Miriam B. Vos
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- United States Public Health Service, Washington, DC, USA
| | - Raymond J. King
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alyson B. Goodman
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- United States Public Health Service, Washington, DC, USA
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5
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El-Setouhy M, Safhi AM, Dallak MY, Ayoub AY, Suwaid OAH, Moafa AK, Al-Ahmed AM, Zaino M, Al Sayed A. Prevalence and associated factors of pediatric hypertension in Jazan region, south of the Kingdom of Saudi Arabia. A pilot cross-sectional study. PLoS One 2023; 18:e0287698. [PMID: 37428728 DOI: 10.1371/journal.pone.0287698] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 06/09/2023] [Indexed: 07/12/2023] Open
Abstract
Hypertension (HTN) is a primary global health concern. Moreover, according to the 2010 Global Burden of Disease, hypertension accounted for roughly a quarter of cardiovascular disease fatalities and 1.9 percent of all deaths in Saudi Arabia in 2010. Also, hypertension is a significant risk factor for cardiovascular disease, morbidity, and mortality. However, assessing blood pressure (BP) and preventing hypertension among children and adolescents has become a global priority. This study aims to determine the prevalence of hypertension among children in the Jazan region of Saudi Arabia. Also, to determine the common risk factors associated with pediatric hypertension. We conducted this cross-sectional study among boys and girls aged 6-14 years visiting Al-Rashid Mall, one of the two main malls in Jazan city, the capital of Jazan region, Saudi Arabia, between November 2021 and January 2022. We included children willing to participate in the study after obtaining their parents' consent and children's assent. We used a standardized questionnaire to interview the parents to collect the children's data. We also measured the children's resting BP. Then we classified the measurements according to the updated International Pediatric Hypertension Association (IPHA) chart. We also measured the height and weight of the children and calculated their BMI. We used SPSS version 25 for the data entry and analysis. Our results showed that the prevalence of hypertension and prehypertension was insignificantly higher in females (11.84% and 12.65%) compared to males (11.52% and 11.52%), respectively. Our participants' main associated factors with prehypertension and hypertension were overweight, obesity, and family income. Pediatric hypertension and prehypertension were highly prevalent in Jazan region. Therefore, being overweight and obese should be considered risk factors for pediatric hypertension. Our study emphasizes the need for early intervention to prevent pediatric HTN, particularly among overweight and obese children.
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Affiliation(s)
- Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
- Department of Community Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Emergency Medicine, Faculty of Medicine, Maryland University, Baltimore, MD, United States of America
| | - Abdulrahman M Safhi
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Musab Y Dallak
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ahmed Y Ayoub
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Osama A H Suwaid
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ahmed K Moafa
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Alhassan M Al-Ahmed
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Mohammad Zaino
- Medical Laboratory Technology Department, Faculty of Applied Medical Science, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ahmed Al Sayed
- Department of Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
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6
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Lee J, Cha SG, Lee JS, Kim ST, Song YH. Association between Obesity and Cardiovascular Disease Risk Factors in Different Age Groups of Adolescents: An Analysis of Data from the Korean National Health and Nutritional Examination Survey. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050827. [PMID: 37238375 DOI: 10.3390/children10050827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023]
Abstract
We investigated the association between obesity and cardiovascular disease risk factors (CVDRFs) in adolescents. We performed a cross-sectional study using the data from 8149 adolescents, aged 10-18 years, included in the Korean National Health and Nutrition Examination Survey (2011-2020). Using the body mass index, we defined "overweight" (≥85th to <95th percentile) and "obese" (≥95th percentile). We analyzed the associations between obesity and CVDRFs (high blood pressure, abnormal lipid profiles, and high fasting glucose levels) by sex and age groups (early [10-12 years], middle [13-15 years], and late [16-18 years] adolescence). When analyzing all the subjects, being overweight was correlated with high blood pressure and abnormal all-lipid profiles in boys and high triglyceride and low high-density lipoprotein cholesterol levels in girls, while obesity was associated with all CVDRFs in both boys and girls. Analyzing separately in the age subgroups, the correlation between obesity and CVDRFs tended to be shown earlier in boys than in girls, and obesity tended to be associated with CVDRFs earlier than being overweight. The association between obesity and CVDRFs may begin to be shown at different periods of youth, depending on the degree of obesity, CVDRF variables, and sex.
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Affiliation(s)
- Joowon Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Seul Gi Cha
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jue Seong Lee
- Department of Pediatrics, Korea University Anam Hospital, Seoul 08308, Republic of Korea
| | - Susan Taejung Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul 03080, Republic of Korea
| | - Young Hwan Song
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
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7
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Skinner AC, Staiano AE, Armstrong SC, Barkin SL, Hassink SG, Moore JE, Savage JS, Vilme H, Weedn AE, Liebhart J, Lindros J, Reilly EM. Appraisal of Clinical Care Practices for Child Obesity Treatment. Part II: Comorbidities. Pediatrics 2023; 151:190446. [PMID: 36622098 DOI: 10.1542/peds.2022-060643] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The objective of this technical report is to provide clinicians with actionable evidence-based information upon which to make treatment decisions. In addition, this report will provide an evidence base on which to inform clinical practice guidelines for the management and treatment of overweight and obesity in children and adolescents. To this end, the goal of this report was to identify all relevant studies to answer 2 overarching key questions: (KQ1) "What are effective clinically based treatments for obesity?" and (KQ2) "What is the risk of comorbidities among children with obesity?" See Appendix 1 for the conceptual framework and a priori Key Questions.
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Affiliation(s)
- Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Amanda E Staiano
- Louisiana State University Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Sarah C Armstrong
- Departments of Pediatrics and Population Health Sciences, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Shari L Barkin
- Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia
| | - Sandra G Hassink
- Medical Director, American Academy of Pediatrics, Institute for Healthy Childhood Weight, Wilmington, Delaware
| | - Jennifer E Moore
- Institute for Medicaid Innovation, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Pennsylvania State University, Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania
| | - Helene Vilme
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Ashley E Weedn
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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8
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Nakhleh A, Sakhnini R, Furman E, Shehadeh N. Cardiometabolic risk factors among children and adolescents with overweight and Class 1 obesity: A cross-sectional study. Insights from stratification of Class 1 obesity. Front Endocrinol (Lausanne) 2023; 14:1108618. [PMID: 36798669 PMCID: PMC9927000 DOI: 10.3389/fendo.2023.1108618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
CONTEXT Severe childhood obesity is associated with increased prevalence of cardiometabolic risk factors (CMRFs). Among children with Class 1 obesity, higher BMI may indicate greater cardiometabolic risk. Class 1 obesity reflects a wide spectrum of BMI values. Each 10% increase in BMI above the 95th percentile is equivalent to an average increase of 2.15 kg/m2 and 2.75 kg/m2 in BMI among children and adolescents, respectively. Such increments may be of clinical importance. OBJECTIVES The study aimed to determine the prevalence and clustering of CMRFs in children and adolescents with BMI 110%-119% of the 95th BMI percentile. METHODS A cross-sectional analysis of data, from an Israeli health maintenance organization, of children and adolescents (5-17 years) with overweight or Class 1 obesity, and at least one measurement of lipid profile during Jan/2020-May/2021. CMRFs were defined as abnormal lipid profile, elevated alanine aminotransferase, hypertension, and prediabetes or diabetes. Study groups included overweight and Class 1 Obesity-A (BMI < 110%) and Obesity-B (BMI ≥ 110%) of the 95th BMI percentile. RESULTS Of 7211 subjects included, 40.2% were overweight, 50.3% obesity-A, and 9.5% obesity-B. Multivariable analyses showed that children and adolescents from the Obesity-B group had increased odds for higher triglycerides, LDL cholesterol, and ALT levels; and lower HDL cholesterol levels, as compared to Obesity-A. The odds of prediabetes (insignificant) tended to be higher in the Obesity-B group, which was associated with increased CMRFs clustering. CONCLUSIONS Among children and adolescents with Class 1 obesity, BMI ≥ 110% of the 95th percentile was associated with higher prevalence and clustering of CMRFs.
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Affiliation(s)
- Afif Nakhleh
- Maccabi Healthcare Services, Haifa, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- *Correspondence: Afif Nakhleh,
| | - Rizan Sakhnini
- Maccabi Healthcare Services, Haifa, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | | | - Naim Shehadeh
- Maccabi Healthcare Services, Haifa, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
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9
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Pozuelo-Carrascosa DP, Martínez-Vizcaíno V, Torres-Costoso A, Martinez MS, Rodríguez-Gutiérrez E, Garrido-Miguel M. "Fat but Fit" Paradox and Cardiometabolic Risk in Children: The Role of Physical Activity. Child Obes 2022. [PMID: 35881859 DOI: 10.1089/chi.2022.0073] [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] [Indexed: 11/13/2022]
Abstract
Background: The "fat but fit" paradigm suggests that high fitness levels counteract the negative consequences of obesity on cardiometabolic risk, nevertheless, this paradigm has been less studied in children. Objectives: To analyze the relationship between "fat but fit" categories and cardiometabolic risk factors in school children, and to examine whether the intensity of physical activity (PA) is related with the fat but fit (FF) category in which the child is classified. Methods: We analyzed the baseline measurements of 312 school children aged 9-11 years involved in the clinical trial MOVI-daFit!, including adiposity parameters (BMI, waist circumference, and body fat mass percentage), cardiorespiratory fitness (CRF), blood pressure parameters, PA, and biochemical parameters (blood lipid profile, insulin, C-reactive protein, and glycosylated hemoglobin). Results: The cluster analysis of body fat mass percentage and VO2 max estimate z-scores agreed with the four categories of the "fat but fit" paradigm: fat unfit (FU), unfat unfit (UU), FF, and unfat fit (UF). Analysis of variance (ANOVA) models indicated that children in the FF and UF clusters had better levels of biochemical parameters [high-density lipoprotein cholesterol (HDL-c), triglycerides (TG), TG/HDL-c, insulin], vigorous PA amount and metabolic syndrome (MetS) index than their peers in the FU and UU cluster categories (p < 0.05). Conclusions: Our results reinforce the "fat but fit" paradigm proving that CRF levels can counteract the effect of obesity on some cardiometabolic risk factors (HDL-c, TG, TG/HDL-c, insulin, PA, and MetS) in school children. ClinicalTrials.gov Identifier: NCT03236337.
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Affiliation(s)
- Diana P Pozuelo-Carrascosa
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain.,Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
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10
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Parra KL, Alaofe HS, Ehiri JE, Nuño VL, Mazariegos M, Garcia B, Martinez E, Junkins A, Jolly P. Prevalence and Determinants of Underweight, Overweight, and Obesity: A Cross-Sectional Study of Sociodemographic, Dietary, and Lifestyle Factors Among Adolescent Girls in Jutiapa, Guatemala. Food Nutr Bull 2021; 42:502-519. [PMID: 34809474 PMCID: PMC8622352 DOI: 10.1177/03795721211019638] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND As the incidence of overweight continues to increase among children and adolescents in Guatemala, underweight remains a prominent health problem. However, the prevalence of overweight or underweight and associated risk factors has not been investigated among adolescent girls. OBJECTIVE To determine the prevalence of underweight and overweight/obesity and associated sociodemographic, dietary, and lifestyle factors among adolescent girls in Jutiapa, Guatemala. METHODS A cross-sectional study of a subsample of 392 girls aged 12 to 17 years from an agriculture-nutrition trial was conducted. Anthropometric data were obtained using standard methods. Sociodemographic, dietary, and lifestyle data were collected using a structured questionnaire. Multivariable logistic regression was conducted using underweight (body mass index [BMI] for age < 5th percentile) and overweight/obesity (BMI for age ≥ 85th percentile) as outcome variables. RESULTS The prevalence of underweight and overweight/obesity was 9.9% and 15.6%, respectively. Age (15-17 years), high waist circumference, high blood pressure, father being a farmer, large family (> 5 persons), hours spent watching TV, and high red meat consumption were significantly associated with underweight. Whereas being in school, high waist circumference, high blood pressure, overweight/obese mother, unemployed father, watching TV for more than 2 hours, having soft drinks at home, and meeting fruit recommendations were significantly associated with overweight/obesity. CONCLUSIONS Our findings highlight the importance of concurrently addressing underweight and overweight/obesity among adolescent girls in rural Guatemala. Studies in various parts of the country are needed to confirm the results of the present study and for appropriate strategies to be implemented to reduce both underweight and overweight.
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Affiliation(s)
- Kimberly L. Parra
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Halimatou S. Alaofe
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - John E. Ehiri
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Velia Leybas Nuño
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | | | - Brenda Garcia
- Institute of Nutrition of Central America and Panama, Guatemala
| | - Estefania Martinez
- University of Alabama at Birmingham, School of Public Health Birmingham, AL, USA
| | - Anna Junkins
- University of Alabama at Birmingham, School of Public Health Birmingham, AL, USA
| | - Pauline Jolly
- University of Alabama at Birmingham, School of Public Health Birmingham, AL, USA
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Bhagavathula AS, Al-Hamad S, Yasin J, Aburawi EH. Distribution of Cardiometabolic Risk Factors in School-Aged Children with Excess Body Weight in the Al Ain City, United Arab Emirates: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:884. [PMID: 34682149 PMCID: PMC8534827 DOI: 10.3390/children8100884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/14/2021] [Accepted: 10/01/2021] [Indexed: 11/17/2022]
Abstract
(1) Background: This study aimed to examine the distribution of cardiometabolic risk factors (CMRF) in school-aged children with excess body weight (overweight and obese) in Al Ain City, United Arab Emirates and identify the factors associated with increased cardiovascular risk factors between boys and girls. (2) Methods: A cross-sectional survey of children aged 6-17 years was conducted in Al Ain from 1 August 2019 to 31 December 2020. Binary logistic regression analysis was performed to investigate the relationship between excess body weight and CMRF between the groups and reported odds ratios (OR) with 95% confidence intervals (CI). (3) Results: A total of 966 school-aged children (490 boys and 476 girls) participated in the study, and the mean age of the children was 11.8 ± 2.9 years. The proportions of overweight and obesity were 13.5% and 10.2% in boys and 11.1% and 10.3% in girls. Higher glucose of ≥100 mg/dL (26.4%), triglycerides of ≥150 mg/dL and low-density lipoprotein cholesterol: ≥130 mg/dL (23.2%) were more prevalent in children with excess body weight. These children were at least two times more likely to have higher triglycerides levels, high total cholesterol (≥200 mg/dL) in girls (OR:2.06, 95% CI: 1.01-4.21) and low high-density lipoprotein (<35 mg/dL) in boys (OR: 2.20; 95% CI: 1.12-4.31). (4) Conclusions: Excess body weight in school-aged children was associated with increased CMRF, particularly triglycerides.
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Affiliation(s)
- Akshaya Srikanth Bhagavathula
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al Ain 17666, United Arab Emirates;
| | - Sania Al-Hamad
- Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al Ain 17666, United Arab Emirates;
| | - Javed Yasin
- Department of Medicine, College of Medicine and Health Sciences, UAE University, Al Ain 17666, United Arab Emirates;
| | - Elhadi H. Aburawi
- Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al Ain 17666, United Arab Emirates;
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Henderson M, Friedrich M, Van Hulst A, Pelletier C, Barnett TA, Benedetti A, Bigras JL, Drapeau V, Lavoie JC, Levy E, Mathieu ME, Nuyt AM. CARDEA study protocol: investigating early markers of cardiovascular disease and their association with lifestyle habits, inflammation and oxidative stress in adolescence using a cross-sectional comparison of adolescents with type 1 diabetes and healthy controls. BMJ Open 2021; 11:e046585. [PMID: 34497076 PMCID: PMC8438758 DOI: 10.1136/bmjopen-2020-046585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Little is known regarding associations between potentially modifiable lifestyle habits and early markers of cardiovascular disease (CVD) in pediatric type 1 diabetes (T1D), hindering early prevention efforts. Specific objectives are: (1) compare established risk factors (dyslipidemia, hypertension) with novel early markers for CVD (cardiac phenotype, aortic distensibility, endothelial function) in adolescents with T1D and healthy age-matched and sex-matched controls; (2) examine associations between these novel early markers with: (i) lifestyle habits; (ii) adipokines and measures of inflammation; and (iii) markers of oxidative stress among adolescents with T1D and controls, and determine group differences in these associations; (3) explore, across both groups, associations between CVD markers and residential neighbourhood features. METHODS AND ANALYSES Using a cross-sectional design, we will compare 100 participants aged 14-18 years with T1D to 100 healthy controls. Measures include: anthropometrics; stage of sexual maturity (Tanner stages); physical activity (7-day accelerometry); sleep and sedentary behaviour (self-report and accelerometry); fitness (peak oxygen consumption); and dietary intake (three non-consecutive 24- hour dietary recalls). Repeated measures of blood pressure will be obtained. Lipid profiles will be determined after a 12- hour fast. Cardiac structure/function: non-contrast cardiac magnetic resonance imaging (CMR) images will evaluate volume, mass, systolic and diastolic function and myocardial fibrosis. Aortic distensibility will be determined by pulse wave velocity with elasticity and resistance studies at the central aorta. Endothelial function will be determined by flow-mediated dilation. Inflammatory markers include plasma leptin, adiponectin, tumour necrosis factor alpha (TNF-α), type I and type II TNF-α soluble receptors and interleukin-6 concentrations. Measures of endogenous antioxidants include manganese superoxide dismutase, glutathione peroxidase and glutathione in blood. Neighbourhood features include built and social environment indicators and air quality. ETHICS AND DISSEMINATION This study was approved by the Sainte-Justine Hospital Research Ethics Board. Written informed assent and consent will be obtained from participants and their parents. TRIAL REGISTRATION NUMBER NCT04304729.
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Affiliation(s)
- Mélanie Henderson
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Matthias Friedrich
- Department of Cardiology, McGill University Health Centre, Montréal, Québec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Catherine Pelletier
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Tracie A Barnett
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
- Research Institute, McGill University Health Centre, Montréal, Québec, Canada
| | - Jean-Luc Bigras
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Vicky Drapeau
- Department of Physical Education, Université Laval, Québec, Québec, Canada
| | - Jean-Claude Lavoie
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Nutrition, Université de Montréal, Montréal, Québec, Canada
| | - Emile Levy
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Nutrition, Université de Montréal, Montréal, Québec, Canada
| | - Marie-Eve Mathieu
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, Québec, Canada
| | - Anne-Monique Nuyt
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
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Harnois-Leblanc S, Van Hulst A, Sabiston CM, Maximova K, Béland M, Doré I, Sylvestre MP, Henderson M. Self-reported weight loss attempts and weight-related stress in childhood: Heightening the risk of obesity in early adolescence. Int J Eat Disord 2021; 54:764-772. [PMID: 33496346 DOI: 10.1002/eat.23474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/06/2021] [Accepted: 01/09/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Weight loss attempts occur as early as childhood. The impacts of weight loss attempts and weight-related stress on the occurrence of obesity during childhood remain unknown. We aimed to: (a) assess the prevalence of self-reported weight loss attempts and weight-related stress in 8-10 year-old children and (b) determine associations with adiposity 2 years later. METHOD Data were collected from a cohort study of 564 Canadian children aged 8-10 years, having one or both biological parents with obesity (Quebec Adipose and Lifestyle Investigation in Youth cohort). Self-reported weight loss attempts and weight-related stress were assessed at baseline in the child's questionnaire. Adiposity was measured at baseline and 2 years later using body mass index z-scores (zBMI), waist-to-height ratio (WHtR), and percentage of body fat (%BF) obtained from dual-energy x-ray absorptiometry. Linear and logistic regression analyses were used while adjusting for potential confounders. RESULTS Forty-eight percent of children reported previous weight loss attempts and 20% reported weight-related stress. Self-reported weight loss attempts and weight-related stress were associated with higher zBMI, WHtR, and %BF 2 years later in adjusted models, although estimates were attenuated when including baseline adiposity measures. Self-reported weight loss attempts, but not weight-related stress, increased the risk of becoming overweight among children who were normal weight at baseline. DISCUSSION Weight loss attempts are prevalent in children with parental obesity. Children reporting weight loss attempts and weight-related stress tend to have higher adiposity 2 years later and are more likely to become overweight.
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Affiliation(s)
- Soren Harnois-Leblanc
- Department of Metabolic and Cardiovascular Health, Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada.,Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada.,Department of Population Health, Research Center of Centre Hospitalier Universitaire de Montréal, Montreal, Quebec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mélanie Béland
- Department of Metabolic and Cardiovascular Health, Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Isabelle Doré
- Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada.,Department of Population Health, Research Center of Centre Hospitalier Universitaire de Montréal, Montreal, Quebec, Canada.,School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Marie-Pierre Sylvestre
- Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada.,Department of Population Health, Research Center of Centre Hospitalier Universitaire de Montréal, Montreal, Quebec, Canada
| | - Mélanie Henderson
- Department of Metabolic and Cardiovascular Health, Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada.,Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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Saidj S, Ruchat SM, Henderson M, Drapeau V, Mathieu ME. Which healthy lifestyle habits mitigate the risk of obesity and cardiometabolic risk factors in Caucasian children exposed to in utero adverse gestational factors? Nutr Metab Cardiovasc Dis 2021; 31:286-296. [PMID: 33121841 DOI: 10.1016/j.numecd.2020.08.008] [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: 01/24/2020] [Revised: 06/23/2020] [Accepted: 08/10/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS This study explored if lifestyle habits [physical activity (PA), sleep duration, intake of fruits and vegetables, grains, and dairy products] can moderate the positive associations between prenatal exposure to suboptimal gestational factors (SGF: i.e. gestational diabetes mellitus, hypertensive disorders during pregnancy, maternal smoking during pregnancy) and obesity and cardiometabolic risk factors in children. METHODS AND RESULTS Data from the "Quebec Adiposity and Lifestyle Investigation in Youth" (QUALITY) study collected between 2005 - 2008 in Montreal and Quebec City, were used. Analyses included a sample of 619 children aged 8-10 years. Children's PA and sleep duration were obtained using an accelerometer and daily servings of food were assessed using three 24 h diet recalls. Moderation analyses were performed to investigate if each lifestyle habit, in all children, and in boys and girls, could reduce the positive associations between SGF, and obesity and cardiometabolic risk factors. High LPA duration was protective against low levels of HDL cholesterol in boys who were exposed to more than one SGF (p = 0.005). Sleep duration did not have a protective effect respectively against high waist circumference and obesity in children and girls who were prenatally exposed to maternal smoking during pregnancy. Diet and MVPA did not moderate the positive associations between SGF, obesity and cardiometabolic risk factors in children. CONCLUSION Among the three lifestyle habits, only LPA had a protective effect against low levels of HDL-cholesterol in boys. More studies are needed to confirm these results to inform future lifestyle intervention in this population.
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Affiliation(s)
- Soraya Saidj
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, QC, Canada
| | - Stephanie-M Ruchat
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Melanie Henderson
- Research Center, Sainte-Justine University Hospital Center, Montréal, QC, Canada; Department of Pediatrics, Université de Montréal, QC, Canada
| | - Vicky Drapeau
- Department of Physical Education, Faculty of Educational Sciences, Université de Laval, Québec, QC, Canada
| | - Marie-E Mathieu
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, QC, Canada; Research Center, Sainte-Justine University Hospital Center, Montréal, QC, Canada.
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Choi YS, Beltran TA, Klaric JS. Prevalence of Optimal Metabolic Health in U.S. Adolescents, NHANES 2007-2016. Metab Syndr Relat Disord 2020; 19:56-63. [PMID: 33170075 DOI: 10.1089/met.2020.0099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: While the overweight and obesity epidemic in the adolescent population is well described, a comprehensive evaluation of cardiometabolic health markers has not been reported. Our purpose was therefore to determine the prevalence of cardiometabolic risk factors among non-diabetic individuals 12 to19 years of age in the United States. Methods: We analyzed data from nationally representative samples of U.S. adolescents (NHANES, 2007-2016). Optimal cardiometabolic health was defined as an absence of risk factors, that is, at least normal values on each of the following 11 measures: body mass index (BMI) percentile, waist circumference percentile, blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, non-HDL cholesterol, triglycerides, fasting plasma glucose, alanine aminotransferase, and insulin resistance. Domain analyses were conducted with Rao-Scott chi-square tests of independence. Multivariable linear/logistic regressions examined sociodemographic associations with cardiometabolic health. Results: Less than a quarter of the population (22.0%; 95% CI; 19.4%-24.8%) was found to have no cardiometabolic risk factors. Among individuals with a normal BMI, 35.7% (95% CI; 31.6%-40.1%) had no cardiometabolic risk factors. Family poverty-to-income ratio was identified as an independent predictor of cardiometabolic health (P = 0.01). A consistent trend was present between increasing BMI percentile and number of cardiometabolic risk markers. Conclusions: The overall prevalence of U.S. adolescents with no cardiometabolic risk factors is less than 25%. Even among those without increased BMI, less than half meet all metabolic health criteria. In addition, socioeconomic disparities are predictors of metabolic health.
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Sbaraini M, Cureau FV, Sparrenberger K, Teló GH, Kuschnir MCC, Oliveira JS, Leal VS, Bloch KV, Schaan BD. Severity of obesity is associated with worse cardiometabolic risk profile in adolescents: Findings from a Brazilian national study (ERICA). Nutrition 2020; 75-76:110758. [PMID: 32302931 DOI: 10.1016/j.nut.2020.110758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/11/2020] [Accepted: 01/19/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The prevalence of obesity and severe obesity among adolescents has increased dramatically in developing countries. However, the distribution of cardiometabolic risk factors through the severity of obesity continuum is relatively unknown among youth. The aim of this study was to evaluate the association of weight categories with cardiometabolic risk factors among Brazilian adolescents. METHODS ERICA (The Study of Cardiovascular Risk in Adolescents) was a multicenter, school-based, cross-sectional study composed of Brazilian adolescents (12-17 y of age). Severity of obesity was classified according to the International Obesity Task Force reference values for body mass index (BMI) and several cardiometabolic risk factors were measured after clinical and biochemical exams and categorized using standard definitions of abnormal values. RESULTS Among the 37 892 adolescents enrolled, 8708 had excess weight, being classified with overweight (17.2%), obesity (5.6%), and severe obesity (1.3%). Increasing severity of obesity was associated with a worse cardiometabolic profile in the overall sample. Multivariable models that controlled for age, sex, skin color, socioeconomic status, physical activity, and total energy intake, showed that individuals in higher categories of severity of obesity tended to have higher prevalence ratios of most cardiometabolic risk factors compared with the other weight groups, except for high fasting blood glucose among boys. CONCLUSIONS Progressive degrees of excess weight are positively associated with cardiometabolic risk factors in youth from a middle-income country, indicating the importance in classifying the severity of weight excess among adolescents and considering this to plan prevention programs against early development of obesity-related diseases.
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Affiliation(s)
- Mariana Sbaraini
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil.
| | - Felipe Vogt Cureau
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil
| | - Karen Sparrenberger
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Gabriela Heiden Teló
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Maria Cristina Caetano Kuschnir
- Universidade do Estado do Rio de Janeiro (UERJ), Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brazil
| | - Juliana Souza Oliveira
- Universidade Federal de Pernambuco (UFPE), Centro Acadêmico de Vitória, Vitória de Santo Antão, PE, Brazil
| | - Vanessa Sá Leal
- Universidade Federal de Pernambuco (UFPE), Centro Acadêmico de Vitória, Vitória de Santo Antão, PE, Brazil
| | - Katia Vergetti Bloch
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva (IESC), Rio de Janeiro, RJ, Brazil
| | - Beatriz D Schaan
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Jiménez-Aguilar A, Rodríguez-Oliveros MG, Uribe-Carvajal R, González-Unzaga MA, Escalante-Izeta EI, Reyes-Morales H. Design of an educational strategy based on Intervention Mapping for nutritional health promotion in Child Care Centers. EVALUATION AND PROGRAM PLANNING 2019; 76:101672. [PMID: 31233988 DOI: 10.1016/j.evalprogplan.2019.101672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/01/2019] [Accepted: 06/11/2019] [Indexed: 06/09/2023]
Abstract
Early childhood is a critical period for instilling healthy habits to prevent overweight and obesity. This paper describes the development of an educational intervention for the promotion of healthy eating and physical activity among two-to-four-year-old children in public child care centers (CCCs) in Mexico City. Following the Intervention Mapping (IM) protocol, we developed the Bright Futures multidisciplinary intervention. First, a formative research process to identify the personal and environmental determinants of childhood overweight and obesity, behavioral outcomes and performance objectives was conducted. Then, a matrix of change objectives by intersecting the performance objectives with the determinants was integrated. Bright Futures lasted six months and included 24 weekly sessions, each composed of five phases: warm-up, theory, active movements, relaxation, and hydration. Ad hoc interactive teaching materials focused on recreational activities, and formulated plans for the adoption, implementation and process/impact evaluation of the intervention was developed. IM successfully guided the design of a theory-driven and evidence-based intervention for children in CCCs within a socio-ecological and participatory planning framework. This is one of the first studies in Mexico to use IM in the context of CCCs.
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Affiliation(s)
- Alejandra Jiménez-Aguilar
- Center for Evaluation and Surveys Research, National Institute of Public Health, Av. Universidad No 655, Col. Sta. Ma. Ahuacatitlan, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - María Guadalupe Rodríguez-Oliveros
- Center for Population Health Research, National Institute of Public Health, Av. Universidad No 655, Col. Sta. Ma. Ahuacatitlán, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Rebeca Uribe-Carvajal
- Center for Evaluation and Surveys Research, National Institute of Public Health, Av. Universidad No 655, Col. Sta. Ma. Ahuacatitlan, C.P. 62100, Cuernavaca, Morelos, Mexico
| | | | - Ericka Ileana Escalante-Izeta
- Ibero-American University Puebla, Blvrd del Niño Poblano 2901, Reserva Territorial Atlixcayotl, Centro Comercial Puebla, 72810 San Andres Cholula, Puebla, Mexico
| | - Hortensia Reyes-Morales
- Center for Health Systems Research, National Institute of Public Health, Av. Universidad No 655, Col. Sta. Ma. Ahuacatitlan, C.P. 62100, Cuernavaca, Morelos, Mexico.
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Khadilkar AV, Lohiya N, Mistry S, Chiplonkar S, Khadilkar V, Kajale N, Ekbote V, Vispute S, Mandlik R, Prasad H, Singh N, Agarwal S, Palande S, Ladkat D. Random Blood Glucose Concentrations and their Association with Body Mass Index in Indian School Children. Indian J Endocrinol Metab 2019; 23:529-535. [PMID: 31803592 PMCID: PMC6873251 DOI: 10.4103/ijem.ijem_536_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE AND AIMS Overweight/obese children are at risk of developing type 2 diabetes mellitus. Random glucose elevations provide early warning signs of glycemic dysregulation. To assess random blood glucose (RBG) concentrations and risk factors associated with prediabetes in children aged 3-18 years from six Indian regions. METHOD Multicenter, cross sectional, observational school-based study; multi-stage stratified random sampling was carried out. Height and weight measured; body mass index (BMI) was computed. RBG measured using a glucometer. National sample survey was used for dietary patterns. Data were analyzed using SPSS 25.0 for Windows. SETTING Study centers were from Maharashtra, Gujarat, Chhattisgarh, Assam, Tamil Nadu and Punjab from 40 selected schools. PARTICIPANT Children aged 3-18 years were measured. RESULTS Data on 14339 subjects (7413 boys) were analyzed. Prevalence of obesity was 5.8% and overweight-10.6%. Overall, 1% had low (<3 mmol/L), 93.7% in reference range (3.9-7.2 mmol/L) and 5.3% had elevated RBG (>7.2 mmol/L). With increasing mean BMI, there was increase in RBG concentrations. Children from Tamil Nadu were more likely to have RBG outside reference range compared to other regions (P < 0.05). Assam and Punjab had highest prevalence of RBG and BMI within reference range. Energy intake partly explained regional variations. Multivariate analysis showed male gender, urban residency, age >10 yrs (girls) and 13 yrs (boys), and overweight or obesity were predictive of prediabetes. CONCLUSION Increased prevalence of overweight, obesity and prediabetes in Indian children are a matter of concern. Regional differences suggest that strategies to prevent obesity and combat perturbations in blood sugar may have to be customized.
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Affiliation(s)
- Anuradha V. Khadilkar
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Nikhil Lohiya
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Sejal Mistry
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Shashi Chiplonkar
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Neha Kajale
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Veena Ekbote
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Smruti Vispute
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Rubina Mandlik
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Hemchand Prasad
- Department of Paediatric Endocrinology, Dr Mehta's Hospital Pvt Ltd, Chennai, Tamil Nadu, India
| | - Narendra Singh
- Department of Anthropology, Assam University, Diphu, Assam, India
| | - Sanwar Agarwal
- Department of Paediatric Endocrinology, Ekta Institute of Child Health, Raipur, India
| | - Sonal Palande
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Dipali Ladkat
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
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19
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Delvin E, Alos N, Rauch F, Marcil V, Morel S, Boisvert M, Lecours MA, Laverdière C, Sinnett D, Krajinovic M, Dubois J, Drouin S, Lefebvre G, Samoilenko M, Nyalendo C, Cavalier E, Levy E. Vitamin D nutritional status and bone turnover markers in childhood acute lymphoblastic leukemia survivors: A PETALE study. Clin Nutr 2019; 38:912-919. [DOI: 10.1016/j.clnu.2018.02.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/29/2017] [Accepted: 02/03/2018] [Indexed: 11/26/2022]
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20
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Reid RER, Thivel D, Mathieu ME. Understanding the potential contribution of a third "T" to FITT exercise prescription: the case of timing in exercise for obesity and cardiometabolic management in children. Appl Physiol Nutr Metab 2019; 44:911-914. [PMID: 30875478 DOI: 10.1139/apnm-2018-0462] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Currently, exercise prescription relies heavily on parameters included in the FITT principle: frequency, intensity, time (duration), and type of exercise. In this paper, the benefits of including timing (FITT+T), referring to when exercise is performed in relation to meal-time, is discussed. Current research indicates that timing is outcome-specific. Total energy and lipid intakes, and postprandial hypertriglyceridemia can be reduced when exercise is performed pre-meal, while glycemic control is improved with post-meal exercise. Although findings indicate that timing can aid in obesity management and cardiometabolic-risk reduction, most research involves adult subjects and acute investigations. Some research with children, concerning the effect of timing on appetite, indicates that pre-meal exercise helps regulate energy balance, but also identifies key differences in response compared with adults. Overall, current findings support the benefits of timing, but research is required to establish guidelines that are specific to the pediatric population and their health-related goals, while incorporating other FITT components.
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Affiliation(s)
- Ryan E R Reid
- a Department of Kinesiology, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - David Thivel
- b Metabolic Adaptation to Exercise Under PhyioPathological condition Laboratory (AME2P), Center for Human Nutrition Research (CRNH Auvergne), Clermont Auvergne University, Clermont-Ferrand, France
| | - Marie-Eve Mathieu
- a Department of Kinesiology, Université de Montréal, Montréal, QC H3C 3J7, Canada.,c Research Center, Sainte-Justine University Hospital Research Center, Montréal, QC H3T 1C5, Canada
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21
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Henderson M, Van Hulst A, von Oettingen JE, Benedetti A, Paradis G. Normal weight metabolically unhealthy phenotype in youth: Do definitions matter? Pediatr Diabetes 2019; 20:143-151. [PMID: 30294842 DOI: 10.1111/pedi.12785] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/14/2018] [Accepted: 09/19/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Normal weight metabolically unhealthy (NWMU) adults are at increased risk of cardiometabolic disease, however, little is known regarding NWMU children. OBJECTIVES We examined the associations between existing definitions of NWMU in children aged 8 to 10 years and insulin sensitivity (IS) and secretion 2 years later. METHODS Data stem from the Quebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort of 630 Caucasian youth, 8 to 10 years old at baseline, with at least one obese biological parent. Of these, 322 normal weight children were classified as NWMU using four definitions. At 10 to 12 years, IS was measured with the Matsuda-insulin sensitivity index; insulin secretion was measured with the ratio of the area under the curve (AUC) of insulin to the AUC of glucose over a 2-hour oral glucose tolerance test. Multiple linear regression models were used. RESULTS Because few children met the existing definitions of metabolic syndrome, associations were examined for less stringent definitions (eg, having two vs no risk factors). At baseline, IS was lower in NWMU children compared to children with no risk factors (virtually all definitions). Moreover, after 2 years, IS was 14.4-19.3% lower in NWMU children with one or more risk factors, and up to 29.7% lower in those with two or more risk factors compared to those with none. Insulin secretion was not predicted by components of the metabolic syndrome. CONCLUSION Existing definitions of NWMU youth performed relatively similarly in predicting IS as youth entered puberty. Children with one or more components of metabolic syndrome-even when of normal weight-have significantly lower IS over time.
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Affiliation(s)
- Mélanie Henderson
- Division of Endocrinology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine and Université de Montréal, Montreal, Quebec, Canada.,Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Andraea Van Hulst
- Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Julia E von Oettingen
- Department of Pediatrics, McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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22
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Vukovic R, Dos Santos TJ, Ybarra M, Atar M. Children With Metabolically Healthy Obesity: A Review. Front Endocrinol (Lausanne) 2019; 10:865. [PMID: 31920976 PMCID: PMC6914809 DOI: 10.3389/fendo.2019.00865] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
Abstract
Children with "metabolically healthy obesity" (MHO) are a distinct subgroup of youth with obesity, who are less prone to the clustering of cardiometabolic risk factors. Although this phenotype, frequently defined by the absence of metabolic syndrome components or insulin resistance, was first described during the early 1980s, a consensus-based definition of pediatric MHO was introduced only recently, in 2018. The purpose of this review was to concisely summarize current knowledge regarding the MHO phenomenon in youth. The prevalence of MHO in children varies from 3 to 87%, depending on the definition used and the parameters evaluated, as well as the ethnicity and the pubertal status of the sample. The most consistent predictors of MHO in youth include younger age, lower body mass index, lower waist circumference, and lower body fat measurements. Various hypotheses have been proposed to elucidate the underlying factors maintaining the favorable MHO phenotype. While preserved insulin sensitivity and lack of inflammation were previously considered to be the main etiological factors, the most recent findings have implicated adipokine levels, the number of inflammatory immune cells in the adipose tissue, and the reduction of visceral adiposity due to adipose tissue expandability. Physical activity and genetic factors also contribute to the MHO phenotype. Obesity constitutes a continuum-increased risk for cardiometabolic complications, which is less evident in children with MHO. However, some findings have highlighted the emergence of hepatic steatosis, increased carotid intima-media thickness and inflammatory biomarkers in the MHO group compared to peers without obesity. Screening should be directed at those more likely to develop clustering of cardiometabolic risk factors. Lifestyle modifications should include behavioral changes focusing on sleep duration, screen time, diet, physical activity, and tobacco smoke exposure. Weight loss has also been associated with the improvement of insulin sensitivity and inflammation. Further investigative efforts are needed in order to elucidate the mechanisms which protect against the clustering of cardiometabolic risk factors in pediatric obesity, to provide more efficient, targeted treatment approaches for children with obesity, and to identify the protective factors preserving the MHO profile, avoiding the crossover of MHO to the phenotype with metabolically unhealthy obesity.
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Affiliation(s)
- Rade Vukovic
- Department of Pediatric Endocrinology, Mother and Child Healthcare Institute of Serbia “Dr Vukan Cupic”, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
- *Correspondence: Rade Vukovic
| | | | - Marina Ybarra
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, QC, Canada
- Centre Armand-Frappier, Institut National de la Recherche Scientifique, Université du Québec, Laval, QC, Canada
| | - Muge Atar
- Department of Pediatric Endocrinology, School of Medicine, Demirel University, Isparta, Turkey
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23
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Van Hulst A, Paradis G, Harnois-Leblanc S, Benedetti A, Drapeau V, Henderson M. Lowering Saturated Fat and Increasing Vegetable and Fruit Intake May Increase Insulin Sensitivity 2 Years Later in Children with a Family History of Obesity. J Nutr 2018; 148:1838-1844. [PMID: 30383280 PMCID: PMC6533243 DOI: 10.1093/jn/nxy189] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/17/2018] [Indexed: 01/01/2023] Open
Abstract
Background Identifying dietary factors that determine insulin sensitivity and secretion in children entering puberty may provide valuable information for the early prevention of type 2 diabetes. Objectives We assessed whether macronutrients and food groups are longitudinally associated with insulin sensitivity and secretion over a 2-y period in children with a family history of obesity, and whether associations differ by level of adiposity. Methods Data were derived from the Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) Study, an ongoing prospective cohort including 630 children recruited at ages 8-10 y, with ≥1 obese parent, and followed 2 y later (n = 564). The intake of macronutrients and foods was assessed at baseline using three 24-h dietary recalls. At age 10-12 y, insulin sensitivity was assessed by the Matsuda Insulin Sensitivity Index (ISI) and the homeostatic model assessment of insulin resistance. Insulin secretion was assessed by the ratio of the area under the curve of insulin to the area under the curve of glucose at 30 min and at 120 min of an oral-glucose-tolerance test. Multivariable linear regression models were fitted for each dietary factor while adjusting for age, sex, puberty, physical activity, screen time, total energy intake, and percentage of body fat; and interaction terms between dietary factors and percentage of body fat were tested. Results Saturated fat intake was associated with a 1.95% lower (95% CI: -3.74%, -0.16%) Matsuda ISI, whereas vegetable and fruit intake was associated with a 2.35% higher (95% CI: 0.18%, 4.52%) Matsuda ISI 2 y later. The association of saturated fat intake with insulin sensitivity was most deleterious among children with a higher percentage of body fat (P-interaction = 0.023). Other than fiber intake, no longitudinal associations between dietary intake and insulin secretion were found. Conclusions Lowering saturated fat and increasing vegetable and fruit intakes during childhood may improve insulin sensitivity as children enter puberty. This study was registered at www.clinicaltrials.gov as NCT03356262.
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Affiliation(s)
| | - Gilles Paradis
- Departments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Soren Harnois-Leblanc
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Canada,School of Public Health, University of Montreal, Montreal, Canada
| | - Andrea Benedetti
- Departments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada,Medicine, McGill University, Montreal, Canada
| | - Vicky Drapeau
- Faculty of Educational Sciences, Department of Physical Education,Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada,Quebec Heart and Lung Institute/Research Center, Quebec City, Canada
| | - Mélanie Henderson
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, Canada,Division of Endocrinology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine and University of Montreal, Montreal, Canada,Address correspondence to MH (e-mail: )
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24
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Amin MM, Ebrahimpour K, Parastar S, Shoshtari-Yeganeh B, Hashemi M, Mansourian M, Poursafa P, Fallah Z, Rafiei N, Kelishadi R. Association of urinary concentrations of phthalate metabolites with cardiometabolic risk factors and obesity in children and adolescents. CHEMOSPHERE 2018; 211:547-556. [PMID: 30092535 DOI: 10.1016/j.chemosphere.2018.07.172] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/28/2018] [Accepted: 07/28/2018] [Indexed: 05/10/2023]
Abstract
This study aimed to investigate the association of urinary concentration of phthalate metabolites with obesity and cardiometabolic risk factors in a pediatric population. This study was conducted in 2016 on 242 children and adolescents, aged 6-18 years, living in Isfahan, Iran. Urinary concentration of mono-butyl phthalate (MBP), mono-benzyl phthalate (MBzP), Mono-2-ethylhexyl phthalate (MEHP), Mono-methyl phthalate (MMP), Mono (2-ethyl-5-exohexyl) phthalate (MEOHP), and mono (2-ethyl-5hydroxyhexyl) phthalate (MEHHP) metabolites were determined. The association of these metabolites with obesity and cardiometabolic risk factors was examined using student t-test, linear and logistics regression tests. Of the 242 participants studied, 140 (57.9%) were girls and 102 (42.1%) were boys. The mean (SD) age of the population was 11.34 (2.55) years and no significant difference existed in terms of age (p-value = 0.374). MBzP, MBP, MMP were observed in urine samples of all subjects, and MEHP, MEOHP, and MEHHP were observed in 99.6, 95.87, and 96.28% of the subjects, respectively. Of the total participants, 15.2% (n = 37) were obese and 37.7% (n = 92) were overweight. According to the logistic regression analysis, except MEOHP, all other pollutants were significantly associated with obesity (OR adjusted >1, p-value ≤ 0.002). A significant association existed between MBP and elevated blood pressure [OR crude in tertile3 = 4.87 (CI: 1.02-23.32), p-value = 0.024]. MBzP and MEHP were significantly associated with obesity, elevated levels of triglyceride and blood pressure. Increase in MBzP metabolite in the 3rd tertile resulted to about 2.5-fold increase in triglyceride levels than the first tertile [OR multivariate adjusted = 2.7 (CI: 1.23-6.22)]. The findings of this study clearly showed the association between phthalate metabolites with obesity, cardiometabolic risk factors in children and adolescents, however further longitudinal studies are necessary to evaluate the clinical effects of this finding.
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Affiliation(s)
- Mohammad Mehdi Amin
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Karim Ebrahimpour
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Parastar
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahareh Shoshtari-Yeganeh
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Hashemi
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Environmental Health Engineering, School of Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Marjan Mansourian
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parinaz Poursafa
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Fallah
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran; Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasim Rafiei
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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25
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Spahis S, Alvarez F, Ahmed N, Dubois J, Jalbout R, Paganelli M, Grzywacz K, Delvin E, Peretti N, Levy E. Non-alcoholic fatty liver disease severity and metabolic complications in obese children: impact of omega-3 fatty acids. J Nutr Biochem 2018; 58:28-36. [DOI: 10.1016/j.jnutbio.2018.03.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 03/24/2018] [Accepted: 03/26/2018] [Indexed: 02/06/2023]
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26
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Mumena WA, Francis-Granderson I, Phillip LE, Gray-Donald K. Rapid increase of overweight and obesity among primary school-aged children in the Caribbean; high initial BMI is the most significant predictor. BMC OBESITY 2018; 5:4. [PMID: 29423240 PMCID: PMC5789680 DOI: 10.1186/s40608-018-0182-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 01/19/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND To examine predictors of increasing overweight among children in two developing countries. METHODS Primary school children (6-10 y at baseline, n = 336) and their caregivers.Longitudinal data were collected in 2012, with follow-up 18 months later. Data on children's height, weight and dietary intake were collected within 8 primary public schools in Trinidad and 7 schools in St. Kitts. Caregivers' demographic and anthropometric data were also collected. RESULTS At baseline, children's age and sex and caregivers' BMI, age, and marital status and reported dietary intake were similar across all weight groups. The incidence of overweight and obesity among children was 8.8% and 8.1%, respectively. Dietary intake at baseline was not related to becoming overweight or obese. Similarly there were no differences in reported intake among children who became overweight or obese except that they consumed fewer fruits (0.54±0.92 vs. 0.98±1.66, p = 0.017). Misreporting of energy intake was higher among overweight/obese children as compared to those who were not overweight/obese (27% vs. 17%, p = 0.047). The baseline predictors of increasing BMI (adjusted) of the children were older age, higher baseline BMI z-score and higher height-for-age (HFA) z-score; caregiver BMI, children's energy intake (with adjustment for misreporting) did not predict changes in children's BMI. CONCLUSIONS The increasing prevalence of overweight/obesity among children is a serious problem in the Caribbean. Heavier children are at elevated risk of continued rapid increase in their weight status, pointing to the need for early intervention.
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Affiliation(s)
- Walaa A. Mumena
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, Al-Madinah, Saudi Arabia
| | | | - Leroy E. Phillip
- Department of Animal Science, McGill University 21, 111 Lakeshore Road, Sainte-Anne-de-Bellevue, Québec H9X 3V9 Canada
| | - Katherine Gray-Donald
- School of Dietetics and Human Nutrition, McGill University 21, 111 Lakeshore Road, Sainte-Anne-de-Bellevue, Québec H9X 3V9 Canada
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Kâ K, Rousseau MC, Tran SD, Henderson M, Nicolau B. Association between metabolic syndrome and gingival inflammation in obese children. Int J Dent Hyg 2017; 16:397-403. [PMID: 29124887 DOI: 10.1111/idh.12322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Our previous work showed a positive association between metabolic syndrome (MetS) and gingival crevicular fluid (GCF) tumour necrosis factor-alpha (TNF-α) in a sample of obese and non-obese children. However, whether this association persists among obese children is unknown. We aim to investigate the extent to which MetS is associated with GCF TNF-α level among obese children. METHODOLOGY We performed a cross-sectional analysis using data from visit 1 of the QUebec Adipose and Lifestyle InvesTigation in Youth cohort. A total of 219 obese children aged 8-10 years, for whom data were available for both MetS and TNF-α, were included in our analysis. The independent variable, MetS, was defined according to the International Diabetes Federation recommendations. GCF samples were collected from the gingival sulcus using a paper strip, and the concentration of TNF-α was determined by enzyme-linked immunosorbent assay. Analyses included descriptive statistics and sex-specific linear regression analyses adjusting for potential confounders. RESULTS In this sample comprising only obese children, 24 (10.9%) had MetS. Among obese boys, those with MetS had 44.9% higher GCF TNF-α (95% confidence interval: 16.5%-73.3%) compared to those without MetS. No such association was detected in obese girls. CONCLUSION MetS was positively associated with GCF TNF-α concentration in obese boys. These results suggest that obese boys with MetS may have a worse gingival health profile compared to their obese counterpart without MetS.
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Affiliation(s)
- K Kâ
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - M-C Rousseau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - S D Tran
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - M Henderson
- Centre de Recherche du Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montreal, QC, Canada
| | - B Nicolau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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28
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Nyström CD, Henriksson P, Martínez-Vizcaíno V, Medrano M, Cadenas-Sanchez C, Arias-Palencia NM, Löf M, Ruiz JR, Labayen I, Sánchez-López M, Ortega FB. Does Cardiorespiratory Fitness Attenuate the Adverse Effects of Severe/Morbid Obesity on Cardiometabolic Risk and Insulin Resistance in Children? A Pooled Analysis. Diabetes Care 2017; 40:1580-1587. [PMID: 28939688 DOI: 10.2337/dc17-1334] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 08/22/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate 1) differences in cardiometabolic risk and HOMA of insulin resistance (HOMA-IR) across BMI categories (underweight to morbid obesity), 2) whether fit children have lower cardiometabolic risk/HOMA-IR than unfit children in each BMI category, and 3) differences in cardiometabolic risk/HOMA-IR in normal-weight unfit children and obese fit children. RESEARCH DESIGN AND METHODS A pooled study including cross-sectional data from three projects (n = 1,247 children aged 8-11 years). Cardiometabolic risk was assessed using the sum of the sex- and age-specific z scores for triglycerides, HDL cholesterol, glucose, and the average of systolic and diastolic blood pressure and HOMA-IR. RESULTS A significant linear association was observed between the risk score and BMI categories (P trend ≤0.001), with every incremental rise in BMI category being associated with a 0.5 SD higher risk score (standardized β = 0.474, P < 0.001). A trend was found showing that as BMI categories rose, cardiorespiratory fitness (CRF) attenuated the risk score, with the biggest differences observed in the most obese children (-0.8 SD); however, this attenuation was significant only in mild obesity (-0.2 SD, P = 0.048). Normal-weight unfit children had a significantly lower risk score than obese fit children (P < 0.001); however, a significant reduction in the risk score was found in obese fit compared with unfit children (-0.4 SD, P = 0.027). Similar results were obtained for HOMA-IR. CONCLUSIONS As BMI categories rose so did cardiometabolic risk and HOMA-IR, which highlights the need for obesity prevention/treatment programs in childhood. Furthermore, CRF may play an important role in lowering the risk of cardiometabolic diseases in obese children.
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Affiliation(s)
| | - Pontus Henriksson
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Promoting Fitness and Health Through Physical Activity (PROFITH) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - María Medrano
- Department of Nutrition and Food Science, University of the Basque Country, UPV/EHU, Vitoria-Gasteiz, Spain
| | - Cristina Cadenas-Sanchez
- Promoting Fitness and Health Through Physical Activity (PROFITH) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Natalia María Arias-Palencia
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,School of Education, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Jonatan R Ruiz
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Promoting Fitness and Health Through Physical Activity (PROFITH) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Idoia Labayen
- Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Mairena Sánchez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,School of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Francisco B Ortega
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Promoting Fitness and Health Through Physical Activity (PROFITH) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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29
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Chamberland K, Sanchez M, Panahi S, Provencher V, Gagnon J, Drapeau V. The impact of an innovative web-based school nutrition intervention to increase fruits and vegetables and milk and alternatives in adolescents: a clustered randomized trial. Int J Behav Nutr Phys Act 2017; 14:140. [PMID: 29037203 PMCID: PMC5644089 DOI: 10.1186/s12966-017-0595-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 10/09/2017] [Indexed: 01/13/2023] Open
Abstract
Background The increase in overweight and obesity in adolescents and its health-related consequences highlight the need to develop strategies, which could help them adopt healthy eating habits. The objective of this study was to evaluate the impact of an innovative web-based school nutrition intervention (Team Nutriathlon) aimed at promoting the consumption of vegetables and fruit (V/F) and milk and alternatives (M/A) in high school students and to identify facilitators and/or barriers influencing its success. Methods Ten classes of first and second year secondary students (grades 7 and 8) from the Québec City region were randomized into two groups (control n = 89 and intervention n = 193). Participants in the intervention (Team Nutriathlon) were to increase their consumption of V/F and M/A using an innovative web-based platform, developed for this study, over 6 weeks. The control group followed the regular school curriculum. The number of servings of V/F and M/A consumed by students per day was compared between the two groups before, during, immediately after and 10 weeks after the intervention using a web-based platform. Main outcome measures included V/F and M/A servings and facilitators and/or barriers of program success. Repeated measures linear fixed effects models were used to assess the impact of Team Nutriathlon on V/F and M/A consumption. A P-value of <0.05 was considered significant. Results Students in the intervention reported a significant increase of 3 servings and 1.8 servings per day of V/F and M/A, respectively, compared to the control group (P < 0.05); however, this was only observed in the short-term. Some factors contributing to the success of Team Nutriathlon included the team aspect of the program, use of the technology and recording results outside of classroom hours. Conclusion Team Nutriathlon represents an innovative web-based nutrition program which positively impacts V/F and M/A consumption among high school students. Using web-based or technological platforms may help youth adopt healthy eating habits that will have implications later in adulthood; however, further studies are needed to determine their long-term effects. Trial registration NCT03117374 (retrospectively registered).
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Affiliation(s)
- Karine Chamberland
- Département de l'éducation Physique, Faculté des Sciences de l'éducation, Université Laval, Québec City, QC, G1V 0A6, Canada
| | - Marina Sanchez
- Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, QC, Canada
| | - Shirin Panahi
- Département de l'éducation Physique, Faculté des Sciences de l'éducation, Université Laval, Québec City, QC, G1V 0A6, Canada.,Département de Kinésiologie, Université Laval, Québec City, QC, G1V 0A6, Canada
| | - Véronique Provencher
- Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec City, QC, Canada
| | - Jocelyn Gagnon
- Département de l'éducation Physique, Faculté des Sciences de l'éducation, Université Laval, Québec City, QC, G1V 0A6, Canada.,Centre de Recherche Interuniversitaire sur la Formation et la Profession Enseignante (CRIFPE-Laval), Université Laval, Québec City, QC, Canada
| | - Vicky Drapeau
- Département de l'éducation Physique, Faculté des Sciences de l'éducation, Université Laval, Québec City, QC, G1V 0A6, Canada. .,Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, QC, Canada. .,Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec City, QC, Canada. .,Centre de Recherche Interuniversitaire sur la Formation et la Profession Enseignante (CRIFPE-Laval), Université Laval, Québec City, QC, Canada.
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O'Hara V, Browne N, Fathima S, Sorondo B, Bayleran J, Johnston S, Hastey K. Obesity Cardiometabolic Comorbidity Prevalence in Children in a Rural Weight-Management Program. Glob Pediatr Health 2017; 4:2333794X17729303. [PMID: 28959708 PMCID: PMC5593208 DOI: 10.1177/2333794x17729303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 07/28/2017] [Indexed: 01/07/2023] Open
Abstract
This descriptive study examines the prevalence of obesity-related cardiometabolic (CM) risk factors using CM laboratory metrics, in 3 to 19 year olds presenting to a rural American Academy of Pediatrics stage 3 multidisciplinary weight management clinic based on gender, age ranges, and obesity classes. From 2009 to 2016, 382 children (body mass index ≥85th percentile) enrolled. Multiple logistic regression determined the effects of age, gender, or obesity class on CM risk factors. Odds of elevated insulin were more significant in 15 to 19 year olds than in 3 to 5 year olds, or in 6 to 11 year olds. Obesity class III had higher odds than class II, class I, and overweight in having elevated insulin; twice likely than class II for having low high-density lipoprotein; and twice as likely than class I for high triglycerides. Adolescents and obesity class III categories have significant CM risk but the burden in younger and less severe obesity cohorts cannot be underestimated.
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Affiliation(s)
- Valerie O'Hara
- Eastern Maine Medical Center, Cutler Health Center, Orono, ME, USA
| | - Nancy Browne
- Eastern Maine Medical Center, Cutler Health Center, Orono, ME, USA
| | - Samreen Fathima
- Eastern Maine Medical Center, Clinical Research Center, Bangor, ME, USA
| | - Barbara Sorondo
- Eastern Maine Medical Center, Clinical Research Center, Bangor, ME, USA
| | - Janet Bayleran
- Eastern Maine Medical Center, Clinical Research Center, Bangor, ME, USA
| | - Starr Johnston
- Eastern Maine Medical Center, Cutler Health Center, Orono, ME, USA
| | - Kathrin Hastey
- Eastern Maine Medical Center, Cutler Health Center, Orono, ME, USA
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A coconut oil-rich meal does not enhance thermogenesis compared to corn oil in a randomized trial in obese adolescents. INSIGHTS IN NUTRITION AND METABOLISM 2017; 1:30-36. [PMID: 28758166 PMCID: PMC5531289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Consumption of medium chain triglycerides (MCT) in overweight adults increases thermogenesis and improves weight management. Coconut oil is a rich natural source of MCT, but its thermogenic effect is unknown. Our study evaluated the effects of a test oil enriched in coconut oil, on energy expenditure, satiety, and metabolic markers in a randomized, double blind, cross-over study. METHODS AND FINDINGS Fifteen children, age 13-18 years, body mass index >85th percentile for age and sex, were enrolled. Two test meals, containing 20 g of fat from either corn oil or a coconut oil-enriched baking fat (1.1 g of fatty acids with chain lengths ≤ 10C), were administered. A fasting blood sample was taken before breakfast and at 30, 45, 60, 120, and 180 min post-meal for measurement of metabolites. Thermic effect of food (TEF) was assessed over 6 h using indirect calorimetry. Satiety was measured using visual analog scales (VAS). There was no significant effect of fat type, time, or fat type × time interaction on TEF, appetite/satiety, glucose, and insulin area under the curve. There was a significant effect of fat type on leptin (P=0.027), triglycerides (P=0.020) and peptide YY (P=0.0085); leptin and triglyceride concentrations were lower and peptide YY concentrations were higher with corn oil consumption. CONCLUSION A coconut oil-enriched baking fat does not enhance thermogenesis and satiety in children. Given that this is the only current study of its kind, more research is needed into the use of coconut oil as a tool in weight management in overweight and obese children.
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PREVALENCIA DE SÍNDROME METABÓLICO EN NIÑOS Y ADOLESCENTES DE AMÉRICA. TIP REVISTA ESPECIALIZADA EN CIENCIAS QUÍMICO-BIOLÓGICAS 2017. [DOI: 10.1016/j.recqb.2016.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Diet quality as measured by the Diet Quality Index-International is associated with prospective changes in body fat among Canadian children. Public Health Nutr 2016; 20:456-463. [PMID: 27660199 DOI: 10.1017/s1368980016002500] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To quantify the association of dietary quality with prospective changes in adiposity. DESIGN Children participating in the QUALITY (QUebec Adipose and Lifestyle InvesTigation in Youth) study underwent examination at baseline and at 2-year follow-up. Dietary quality was assessed by the Diet Quality Index-International (DQII) using three non-consecutive 24 h diet recalls at baseline. The DQII has four main categories: dietary adequacy, variety, moderation and overall balance. Fat mass index (FMI; [fat mass (kg)]/[height (m)]2), central FMI (CFMI; [trunk fat mass (kg)]/[height (m)]2), percentage body fat (%BF; [total fat mass (kg)]/[total mass (kg)]) and percentage central BF (%CBF; [trunk fat mass (kg)]/[total mass (kg)]) were assessed through dual-energy X-ray absorptiometry. SETTING Children were selected from schools in the greater Montreal, Sherbrooke and Quebec City metropolitan areas between 2005 and 2008, Quebec, Canada. SUBJECTS A total of 546 children aged 8-10 years, including 244 girls and 302 boys. RESULTS Regression analysis adjusting for age, sex, energy intake, physical activity and Tanner stage revealed that every 10-unit improvement in overall DQII score was associated with lower gain in CFMI (β=-0·08; 95 % CI -0·17, -0·003) and %BF (β=-0·55; 95 % CI -1·08, -0·02). Each unit improvement in dietary adequacy score was associated with lower gain in FMI (β=-0·05; 95 % CI -0·08, -0·008), CFMI (β=-0·03; 95 % CI -0·05, -0·007), %BF (β=-0·15; 95 % CI -0·28, -0·03) and %CBF (β=-0·09; 95 % CI -0·15, -0·02). CONCLUSIONS Promotion of dietary quality and adequacy may reduce weight gain in childhood and prevent chronic diseases later in life.
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The Prevalence of Left Ventricular Hypertrophy in Obese Children Varies Depending on the Method Utilized to Determine Left Ventricular Mass. Pediatr Cardiol 2016; 37:993-1002. [PMID: 27033247 DOI: 10.1007/s00246-016-1380-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/21/2016] [Indexed: 01/19/2023]
Abstract
Obesity and left ventricular hypertrophy (LVH) have been identified as independent risk factors for cardiovascular events. The definition of LVH depends on the geometric algorithm used to calculate LV mass (LVM) by echocardiography and the method used to normalize LVM for body size. This study evaluates the effect of these methods on the prevalence of LVH in obese children. LVM for 109 obese and 109 age-matched non-obese children was calculated using M-mode or two-dimensional echocardiography (2DE). LVM was then normalized to height 2.7 as indexed LVM (LVMI), to body surface area (BSA), height, and lean body mass (LBM) as LVM Z-scores. LVH was defined as LVMI >95th ‰ using age-specific normal reference values or LVM Z-scores ≥2. The prevalence of LVH by LVMI and LVM Z-scores was compared. There was a correlation between LVM determined by M-mode and by 2DE (R (2) = 0.91), although M-mode LVM was greater than 2DE LVM. However, the difference between these values was greater in obese children than in non-obese children. Based on the method of normalization, the prevalence of LVH among obese children was 64 % using LVMI, 15 % using LVM Z-scores for height, 8 % using LVM Z-scores for BSA and 1 % using LVM Z-scores for LBM. Height-based normalization correlates with obesity and hypertension. The methods used to measure and normalize LVM have a profound influence on the diagnosis of LVH in obese children. Further study is needed to determine which method identifies children at risk for cardiovascular morbidity and mortality.
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Obesity prevention and obesogenic behavior interventions in child care: A systematic review. Prev Med 2016; 87:57-69. [PMID: 26876631 DOI: 10.1016/j.ypmed.2016.02.016] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/26/2016] [Accepted: 02/06/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Review peer-reviewed interventions designed to reduce obesity and improve obesogenic behaviors, including physical activity, diet, and screen time, at child care centers. Interventions components and outcomes, study design, duration, use of behavioral theory, and level of social ecological influence are detailed. METHODS Article searches were conducted from March 2014, October 2014, March 2015, January 2016 across three databases. Eligible interventions were conducted in child care settings, included 3-to-5-year-old children, included an outcome measure of obesity or obesogenic behavior, and published in English. Study design quality was assessed using Stetler's Level of Quantitative Evidence. RESULTS All unique records were screened (n=4589): 237 articles were assessed for eligibility. Of these, 97 articles describing 71 interventions met inclusion criteria. Forty-four articles included multi-level interventions. Twenty-nine interventions included an outcome measure of obesity. Forty-one interventions included physical activity. Forty-five included diet. Eight included screen time. Fifty-five percent of interventions were Level II (randomized controlled trials), while 37% were Level III (quasi-experimental or pre-post only study design), and 8% were Level IV (non-experimental or natural experiments). Most interventions had the intended effect on the target: obesity 48% (n=14), physical activity 73% (n=30), diet 87% (n=39), and screen time 63% (n=5). CONCLUSION Summarizing intervention strategies and assessing their effectiveness contributes to the existing literature and may provide direction for practitioners and researchers working with young children in child care. Most interventions produced the targeted changes in obesity and obesity-associated behaviors, supporting current and future efforts to collaborate with early-care centers and professionals for obesity prevention.
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Erşan I, Battal F, Aylanç H, Kara S, Arikan S, Tekin M, Gencer B, Tufan HA. Noninvasive assessment of the retina and the choroid using enhanced-depth imaging optical coherence tomography shows microvascular impairments in childhood obesity. J AAPOS 2016; 20:58-62. [PMID: 26917074 DOI: 10.1016/j.jaapos.2015.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 10/10/2015] [Accepted: 10/18/2015] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the retinal vascular diameters and macular and subfoveal choroidal thicknesses of obese and nonobese children using enhanced-depth imaging spectral domain optical coherence tomography (EDI SD-OCT). METHODS The retinal vascular diameters of the 4 largest retinal arterioles and venules and macular and subfoveal choroidal thickness measurements of 40 obese children (body mass index [BMI] z score above +2.0 standard deviations) were obtained by EDI SD-OCT and compared with those of 40 age- and sex-matched nonobese children. Anthropometric measures, including weight and height, were also obtained. BMI z score was defined using standardized protocols. RESULTS The mean BMI z scores of obese children were 2.59 ± 0.62; of nonobese children, -0.20 ± 0.92. The mean diameter of retinal arterioles was significantly smaller (P = 0.002) in obese children compared to nonobese children, whereas the mean diameter of retinal venules was larger (P = 0.008). The macular and subfoveal choroidal thicknesses were significantly thinner (P = 0.031 and 0.014, resp.) in obese children compared to nonobese children. CONCLUSIONS The narrower retinal arterioles, wider retinal venules, and thinner macular and subfoveal choroidal thicknesses in obese children seem to be associated with microvascular impairments in childhood obesity.
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Affiliation(s)
- Ismail Erşan
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey.
| | - Fatih Battal
- Department of Pediatrics, Canakkale Onsekiz Mart University School of Medicine, Canakkale
| | - Hakan Aylanç
- Department of Pediatrics, Canakkale Onsekiz Mart University School of Medicine, Canakkale
| | - Selcuk Kara
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Sedat Arikan
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Mustafa Tekin
- Department of Pediatrics, Canakkale Onsekiz Mart University School of Medicine, Canakkale
| | - Baran Gencer
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Hasan Ali Tufan
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
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Skinner AC, Perrin EM, Moss LA, Skelton JA. Cardiometabolic Risks and Severity of Obesity in Children and Young Adults. N Engl J Med 2015; 373:1307-17. [PMID: 26422721 DOI: 10.1056/nejmoa1502821] [Citation(s) in RCA: 620] [Impact Index Per Article: 68.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The prevalence of severe obesity among children and young adults has increased over the past decade. Although the prevalence of cardiometabolic risk factors is relatively low among children and young adults who are overweight or obese, those with more severe forms of obesity may be at greater risk. METHODS We performed a cross-sectional analysis of data from overweight or obese children and young adults 3 to 19 years of age who were included in the National Health and Nutrition Examination Survey from 1999 through 2012 to assess the prevalence of multiple cardiometabolic risk factors according to the severity of obesity. Weight status was classified on the basis of measured height and weight. We used standard definitions of abnormal values for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, glycated hemoglobin, and fasting glucose and report the prevalence of abnormal values in children and young adults according to weight status. RESULTS Among 8579 children and young adults with a body-mass index at the 85th percentile or higher (according to the Centers for Disease Control and Prevention growth charts), 46.9% were overweight, 36.4% had class I obesity, 11.9% had class II obesity, and 4.8% had class III obesity. Mean values for some, but not all, cardiometabolic variables were higher with greater severity of obesity in both male and female participants, and the values were higher in male participants than in female participants; for HDL cholesterol, the mean values were lower with greater severity of obesity. Multivariable models that controlled for age, race or ethnic group, and sex showed that the greater the severity of obesity, the higher the risks of a low HDL cholesterol level, high systolic and diastolic blood pressures, and high triglyceride and glycated hemoglobin levels. CONCLUSIONS Severe obesity in children and young adults was associated with an increased prevalence of cardiometabolic risk factors, particularly among boys and young men.
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Affiliation(s)
- Asheley C Skinner
- From the Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, School of Medicine (A.C.S., E.M.P.), Department of Health Policy and Management, Gillings School of Global Public Health (A.C.S.), and Injury Prevention Research Center (L.A.M.), University of North Carolina at Chapel Hill, Chapel Hill, and the Department of Pediatrics, Wake Forest School of Medicine, and Brenner FIT (Families in Training), Brenner Children's Hospital, Winston-Salem (J.A.S.) - all in North Carolina
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Propst M, Colvin C, Griffin RL, Sunil B, Harmon CM, Yannam G, Johnson JE, Smith CB, Lucas AP, Diaz BT, Ashraf AP. DIABETES AND PREDIABETES ARE SIGNIFICANTLY HIGHER IN MORBIDLY OBESE CHILDREN COMPARED WITH OBESE CHILDREN. Endocr Pract 2015; 21:1046-53. [PMID: 26121438 DOI: 10.4158/ep14414.or] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The objective of this study was to examine the prevalence and characteristics of comorbidities in obese and morbidly obese children with a comparison between the 2 sets of children. METHODS This was a retrospective electronic chart review of obese and morbidly obese children and adolescents as defined by body mass index. We evaluated medical history of comorbid conditions, medication use, and cardiovascular risk markers, including blood pressure, lipid profile, and glycosylated hemoglobin. RESULTS There were 1,111 subjects (African American = 635; non-Hispanic white = 364; Hispanic = 36; others = 86), of which 274 were obese and 837 were morbidly obese children with a mean age of 12.7 ± 3.37 years. Morbidly obese children had a higher prevalence of prediabetes (19.5% of obese versus 27.3% of morbidly obese; P<.0001) and type 2 diabetes (39.8% of obese versus 52.4% of morbidly obese; P<.0001). Use of medications for treatment of asthma was significantly higher in the morbidly obese group compared with the obese group (21% versus 14%; P = .01). CONCLUSION Morbidly obese children have a higher prevalence of diabetes, prediabetes, and use of asthma medications compared with obese children.
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Kakinami L, Henderson M, Chiolero A, Cole TJ, Paradis G. Identifying the best body mass index metric to assess adiposity change in children. Arch Dis Child 2014; 99:1020-4. [PMID: 24842797 PMCID: PMC4215345 DOI: 10.1136/archdischild-2013-305163] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Although dual-energy X-ray absorptiometry (DEXA) is the preferred method to estimate adiposity, body mass index (BMI) is often used as a proxy. However, the ability of BMI to measure adiposity change among youth is poorly evidenced. This study explored which metrics of BMI change have the highest correlations with different metrics of DEXA change. METHODS Data were from the Quebec Adipose and Lifestyle Investigation in Youth cohort, a prospective cohort of children (8-10 years at recruitment) from Québec, Canada (n=557). Height and weight were measured by trained nurses at baseline (2008) and follow-up (2010). Metrics of BMI change were raw (ΔBMIkg/m(2) ), adjusted for median BMI (ΔBMIpercentage) and age-sex-adjusted with the Centers for Disease Control and Prevention growth curves expressed as centiles (ΔBMIcentile) or z-scores (ΔBMIz-score). Metrics of DEXA change were raw (total fat mass; ΔFMkg), per cent (ΔFMpercentage), height-adjusted (fat mass index; ΔFMI) and age-sex-adjusted z-scores (ΔFMz-score). Spearman's rank correlations were derived. RESULTS Correlations ranged from modest (0.60) to strong (0.86). ΔFMkg correlated most highly with ΔBMIkg/m(2) (r = 0.86), ΔFMI with ΔBMIkg/m(2) and ΔBMIpercentage (r = 0.83-0.84), ΔFMz-score with ΔBMIz-score (r = 0.78), and ΔFMpercentage with ΔBMIpercentage (r = 0.68). Correlations with ΔBMIcentile were consistently among the lowest. CONCLUSIONS In 8-10-year-old children, absolute or per cent change in BMI is a good proxy for change in fat mass or FMI, and BMI z-score change is a good proxy for FM z-score change. However change in BMI centile and change in per cent fat mass perform less well and are not recommended.
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Affiliation(s)
- Lisa Kakinami
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Mélanie Henderson
- Division of Endocrinology, Department of Pediatrics, CHU Sainte-Justine and Université de Montréal, Montreal, QC, Canada
| | - Arnaud Chiolero
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Tim J Cole
- Population, Policy and Practice Programme, University College London Institute of Child Health, London, UK
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
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Hjorth MF, Chaput JP, Damsgaard CT, Dalskov SM, Andersen R, Astrup A, Michaelsen KF, Tetens I, Ritz C, Sjödin A. Low physical activity level and short sleep duration are associated with an increased cardio-metabolic risk profile: a longitudinal study in 8-11 year old Danish children. PLoS One 2014; 9:e104677. [PMID: 25102157 PMCID: PMC4125285 DOI: 10.1371/journal.pone.0104677] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 07/16/2014] [Indexed: 01/02/2023] Open
Abstract
Background As cardio-metabolic risk tracks from childhood to adulthood, a better understanding of the relationship between movement behaviors (physical activity, sedentary behavior and sleep) and cardio-metabolic risk in childhood may aid in preventing metabolic syndrome (MetS) in adulthood. Objective To examine independent and combined cross-sectional and longitudinal associations between movement behaviors and the MetS score in 8-11 year old Danish children. Design Physical activity, sedentary time and sleep duration (seven days and eight nights) were assessed by accelerometer and fat mass index (fat mass/height2) was assessed using Dual-energy X-ray absorptiometry. The MetS-score was based on z-scores of waist circumference, mean arterial blood pressure, homeostatic model assessment of insulin resistance, triglycerides and high density lipoprotein cholesterol. All measurements were taken at three time points separated by 100 days. Average of the three measurements was used as habitual behavior in the cross-sectional analysis and changes from first to third measurement was used in the longitudinal analysis. Results 723 children were included. In the cross-sectional analysis, physical activity was negatively associated with the MetS-score (P<0.03). In the longitudinal analysis, low physical activity and high sedentary time were associated with an increased MetS-score (all P<0.005); however, after mutual adjustments for movement behaviors, physical activity and sleep duration, but not sedentary time, were associated with the MetS-score (all P<0.03). Further adjusting for fat mass index while removing waist circumference from the MetS-score rendered the associations no longer statistically significant (all P>0.17). Children in the most favorable tertiles of changes in moderate-to-vigorous physical activity, sleep duration and sedentary time during the 200-day follow-up period had an improved MetS-score relative to children in the opposite tertiles (P = 0.005). Conclusion The present findings indicate that physical activity, sedentary time and sleep duration should all be targeted to improve cardio-metabolic risk markers in childhood; this is possibly mediated by adiposity.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Stine-Mathilde Dalskov
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Andersen
- National Food Institute, Division of Nutrition, Technical University of Denmark, Søborg, Denmark
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Inge Tetens
- National Food Institute, Division of Nutrition, Technical University of Denmark, Søborg, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Anders Sjödin
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Jabbour G, O'Loughlin J, Sabiston C, Tremblay A, Mathieu ME. Increased lipid oxidation during exercise in obese pubertal girls: a QUALITY study. Obesity (Silver Spring) 2014; 22:E85-90. [PMID: 23983110 DOI: 10.1002/oby.20611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 08/10/2013] [Accepted: 08/19/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study explores differences in LO rates between pre-pubertal and pubertal girls of three body weight status groups. METHODS The sample included 39 pre-pubertal girls [12 normal-weight (NW), 12 overweight (OW), and 15 obese (OB)] and 37 pubertal girls [16 NW, 10 OW, and 11 OB]. Following a rest period, the girls performed a graded maximal cycling test. The %LO contribution was computed at each stage. RESULTS The %LO contribution did not differ between NW, OW, or OB pre-pubertal girls at each exercise stage. In contrast, pubertal OB girls showed a statistically significantly higher %LO contribution at 25, 50, and 75 W stages compared with OW and NW as well as with OB pre-pubertal girls. CONCLUSIONS Our results demonstrate that entering puberty is a period associated with differentiation in substrate selection in obese girls. A higher %LO contribution may help girls to solicit more fat while performing submaximal exercise.
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Affiliation(s)
- Georges Jabbour
- School of Kinesiology and Recreation, Faculty of Health and Community Services, University of Moncton, NB, E1A 3E9, Canada
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A Single Institution's Overweight Pediatric Population and Their Associated Comorbid Conditions. ISRN OBESITY 2014; 2014:517694. [PMID: 24693463 PMCID: PMC3945184 DOI: 10.1155/2014/517694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 12/30/2013] [Indexed: 11/28/2022]
Abstract
Background. Obesity studies are often performed on population data. We sought to examine the incidence of obesity and its associated comorbidities in a single freestanding children's hospital. Methods. We performed a retrospective analysis of all visits to Boston Children's Hospital from 2000 to 2012. This was conducted to determine the incidence of obesity, morbid obesity, and associated comorbidities. Each comorbidity was modeled independently. Incidence rate ratios were calculated, as well as odds ratios. Results. A retrospective review of 3,185,658 person-years in nonobese, 26,404 person-years in obese, and 25,819 person-years in the morbidly obese was conducted. Annual rates of all major comorbidities were increased in all patients, as well as in our obese and morbidly obese counterparts. Incidence rate ratios (IRR) and odds ratios (OR) were also significantly increased across all conditions for both our obese and morbidly obese patients. Conclusions. These data illustrate the substantial increases in obesity and associated comorbid conditions. Study limitations include (1) single institution data, (2) retrospective design, and (3) administrative undercoding. Future treatment options need to address these threats to longevity and quality of life.
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Laurson KR, Welk GJ, Eisenmann JC. Diagnostic performance of BMI percentiles to identify adolescents with metabolic syndrome. Pediatrics 2014; 133:e330-8. [PMID: 24470650 DOI: 10.1542/peds.2013-1308] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To compare the diagnostic performance of the Centers for Disease Control and Prevention (CDC) and FITNESSGRAM (FGram) BMI standards for quantifying metabolic risk in youth. METHODS Adolescents in the NHANES (n = 3385) were measured for anthropometric variables and metabolic risk factors. BMI percentiles were calculated, and youth were categorized by weight status (using CDC and FGram thresholds). Participants were also categorized by presence or absence of metabolic syndrome. The CDC and FGram standards were compared by prevalence of metabolic abnormalities, various diagnostic criteria, and odds of metabolic syndrome. Receiver operating characteristic curves were also created to identify optimal BMI percentiles to detect metabolic syndrome. RESULTS The prevalence of metabolic syndrome in obese youth was 19% to 35%, compared with <2% in the normal-weight groups. The odds of metabolic syndrome for obese boys and girls were 46 to 67 and 19 to 22 times greater, respectively, than for normal-weight youth. The receiver operating characteristic analyses identified optimal thresholds similar to the CDC standards for boys and the FGram standards for girls. Overall, BMI thresholds were more strongly associated with metabolic syndrome in boys than in girls. CONCLUSIONS Both the CDC and FGram standards are predictive of metabolic syndrome. The diagnostic utility of the CDC thresholds outperformed the FGram values for boys, whereas FGram standards were slightly better thresholds for girls. The use of a common set of thresholds for school and clinical applications would provide advantages for public health and clinical research and practice.
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Affiliation(s)
- Kelly R Laurson
- School of Kinesiology and Recreation, Illinois State University, Normal, Illinois
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Dietary composition and its associations with insulin sensitivity and insulin secretion in youth. Br J Nutr 2013; 111:527-34. [DOI: 10.1017/s0007114513002572] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objectives of the present study were to examine the associations between macronutrient intake and insulin sensitivity (IS) and insulin secretion (ISct), taking into consideration moderate-to-vigorous physical activity (MVPA), fitness and sedentary behaviour. Caucasian youth (n630) aged 8–10 years at recruitment, with at least one obese biological parent, were studied (QUebec Adipose and Lifestyle InvesTigation in Youth cohort). IS was measured using the homeostasis model assessment (HOMA) of insulin resistance and Matsuda IS index. ISct was measured using HOMA2 %-β, the ratio of the AUC of insulin:glucose over the first 30 min (AUC I/Gt= 30min) of the oral glucose tolerance test and AUC I/Gt= 120minover 2 h. Fitness was measured using VO2peak, percentage of fat mass by dual-energy X-ray absorptiometry, and 7 d MVPA using accelerometry; screen time (ST) by average daily hours of self-reported television, video game or computer use. Dietary composition was measured using three non-consecutive dietary recalls. Non-parametric smoothing splines were used to model non-linear associations; all models were adjusted for age, sex, season, pubertal stage, MVPA, fitness, ST and adiposity. The percentage of total daily energy from dietary protein, fat, saturated fat and carbohydrate and the consumption of dietary vitamin D, sugar-sweetened beverages, fibre and portions of fruits and vegetables were taken into consideration. No dietary component was associated with any measure of IS after adjusting for MVPA, fitness, ST and adiposity. For every 1 % increase in daily protein intake (%), AUC I/Gt= 30mindecreased by 1·1 % (P= 0·033). Otherwise, dietary composition was not associated with ISct. While long-term excess of energy intake has been shown to lead to overweight and obesity, dietary macronutrient composition is not independently correlated with IS or ISct in youth.
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Kâ K, Rousseau MC, Lambert M, Tremblay A, Tran SD, Henderson M, Nicolau B. Metabolic syndrome and gingival inflammation in Caucasian children with a family history of obesity. J Clin Periodontol 2013; 40:986-93. [PMID: 23980866 DOI: 10.1111/jcpe.12146] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2013] [Indexed: 11/29/2022]
Abstract
AIM To investigate whether metabolic syndrome (MetS) and its components are associated with gingival inflammation in children. MATERIALS AND METHODS This is a cross-sectional analysis from the baseline visit of the QUebec Adipose and Lifestyle InvesTigation in Youth cohort, an ongoing longitudinal study investigating the natural history of obesity in children of Quebec, Canada. The analytic sample includes 448 children aged 8-10 years, 39% of whom were overweight or obese. MetS was defined according to the International Diabetes Federation recommendations. Gingival inflammation was defined by the level of gingival crevicular fluid (GCF) tumour necrosis factor alpha (TNF-α) and the extent of gingival bleeding. Sex-specific linear regression analyses estimated the associations between MetS and gingival inflammation, adjusting for potential confounders. RESULTS Twenty-five children had MetS. Boys with MetS compared to those without, had a 49.5% (p-value = 0.001) higher GCF TNF-α level and 13.7% (p-value = 0.033) more sites with gingival bleeding. Moreover, for three of the five components of MetS - waist circumference, fasting plasma triglycerides, systolic blood pressure - an increase was associated with increased GCF TNF-α level in boys. No such findings were seen in girls. CONCLUSION An association between MetS and gingival inflammation was observed as early as in childhood, and may differ by sex.
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Affiliation(s)
- Khady Kâ
- Oral Health and Society Unit, Faculty of Dentistry, McGill University, Montreal, QC, Canada; Epidemiology Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
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Cardiovascular Risk-Factor Profiles of Normal and Overweight Children and Adolescents: Insights From the Canadian Health Measures Survey. Can J Cardiol 2013; 29:976-82. [DOI: 10.1016/j.cjca.2012.08.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 08/16/2012] [Accepted: 08/17/2012] [Indexed: 11/23/2022] Open
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Role of the Waist/Height Ratio in the Cardiometabolic Risk Assessment of Children Classified by Body Mass Index. J Am Coll Cardiol 2013; 62:742-51. [DOI: 10.1016/j.jacc.2013.01.026] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 12/24/2012] [Accepted: 01/08/2013] [Indexed: 11/21/2022]
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Neighborhood built and social environment characteristics: a multilevel analysis of associations with obesity among children and their parents. Int J Obes (Lond) 2013; 37:1328-35. [PMID: 23736374 DOI: 10.1038/ijo.2013.81] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 04/12/2013] [Accepted: 05/01/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine associations between characteristics of neighborhood built and social environments and likelihood of obesity among family triads living at the same residential address and to explore whether these associations differ between family members. METHODS Data were from the baseline wave of QUALITY (Quebec Adipose and Lifestyle Investigation in Youth), an ongoing study on the natural history of obesity in 630 Quebec youth aged 8-10 years with a parental history of obesity. Weight and height were measured in children and both biological parents and body mass index was computed. Residential neighborhood environments were characterized using a Geographic Information System and in-person neighborhood audits. Principal components analysis allowed for identification of overarching neighborhood indicators including poverty, prestige, level of urbanicity, traffic, physical disorder and deterioration, and pedestrian friendliness. Multilevel logistic regressions were used to examine associations between neighborhood indicators and obesity within multiple family members residing at the same address while controlling for household-level sociodemographic variables. RESULTS A total of 417 families were included in the analysis. Families residing in lower and average prestige neighborhoods were more likely to be obese (odds ratio (OR)=1.69, 95% confidence interval (CI): 1.16, 2.44, and OR=1.51, 95% CI: 1.09, 2.11, respectively) than those residing in higher prestige neighborhoods. Residing in lower traffic neighborhoods was associated with less obesity (OR=0.69, 95% CI: 0.50, 0.95). Other neighborhood indicators may have differential effects across family members. For example, as neighborhood poverty increased, obesity was more likely among children but less likely among fathers and no different for mothers. CONCLUSION Findings indicate that some shared neighborhood exposures are associated with greater risk of obesity for entire families whereas other exposures may heighten obesity risk in some but not all family members. Patterns may reflect differences in the way in which family members use residential neighborhood environments.
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Chaput JP, Saunders TJ, Mathieu MÈ, Henderson M, Tremblay MS, O'Loughlin J, Tremblay A. Combined associations between moderate to vigorous physical activity and sedentary behaviour with cardiometabolic risk factors in children. Appl Physiol Nutr Metab 2013; 38:477-83. [DOI: 10.1139/apnm-2012-0382] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The objective of this study was to examine the combined associations between time spent in moderate- to vigorous-intensity physical activity (MVPA) and time spent sedentary in relation to cardiometabolic risk factors in a cohort of Canadian children. A cross-sectional study was conducted on 536 white children aged 8–10 years with at least 1 obese biological parent. Time spent in MVPA and sedentary behaviour over 7 days was measured using accelerometry and participants were stratified by tertiles. Daily screen time over 7 days was also self-reported by the child. Outcomes included waist circumference, systolic and diastolic blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and glucose concentrations. Analyses of covariance comparing tertiles of sedentary time/MVPA showed that higher levels of MVPA were associated with lower waist circumference, fasting triglycerides and diastolic blood pressure, and higher high-density lipoprotein (HDL) cholesterol, irrespective of sedentary time. In linear regression, MVPA was inversely associated with waist circumference and diastolic blood pressure and positively associated with HDL cholesterol, independent of covariates including sedentary time. In contrast, sedentary time was positively associated with diastolic blood pressure but after adjustment for MVPA the association was no longer statistically significant. Self-reported screen time was positively associated with waist circumference and negatively associated with HDL cholesterol independent of covariates including MVPA. Overall, a high level of MVPA was associated with reduced cardiometabolic risk in this sample of children, regardless of their amount of sedentary behaviour. The type of sedentary behaviour (i.e., screen time) might be more important than overall sedentary time in relation to cardiometabolic risk.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Travis John Saunders
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Marie-Ève Mathieu
- Department of Kinesiology, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Mélanie Henderson
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 0G4, Canada
| | - Mark Stephen Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Jennifer O'Loughlin
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
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Choi J, Joseph L, Pilote L. Obesity and C-reactive protein in various populations: a systematic review and meta-analysis. Obes Rev 2013; 14:232-44. [PMID: 23171381 DOI: 10.1111/obr.12003] [Citation(s) in RCA: 463] [Impact Index Per Article: 42.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 10/09/2012] [Accepted: 10/16/2012] [Indexed: 12/13/2022]
Abstract
Obesity has been associated with elevated levels of C-reactive protein (CRP), a marker of inflammation and predictor of cardiovascular risk. The objective of this systematic review and meta-analysis was to estimate the associations between obesity and CRP according to sex, ethnicity and age. MEDLINE and EMBASE databases were searched through October 2011. Data from 51 cross-sectional studies that used body mass index (BMI), waist circumference (WC) or waist-to-hip ratio (WHR) as measure of obesity were independently extracted by two reviewers and aggregated using random-effects models. The Pearson correlation (r) for BMI and ln(CRP) was 0.36 (95% confidence interval [CI], 0.30-0.42) in adults and 0.37 (CI, 0.31-0.43) in children. In adults, r for BMI and ln(CRP) was greater in women than men by 0.24 (CI, 0.09-0.37), and greater in North Americans/Europeans than Asians by 0.15 (CI, 0-0.28), on average. In North American/European children, the sex difference in r for BMI and ln(CRP) was 0.01 (CI, -0.08 to 0.06). Although limited to anthropometric measures, we found similar results when WC and WHR were used in the analyses. Obesity is associated with elevated levels of CRP and the association is stronger in women and North Americans/Europeans. The sex difference only emerges in adulthood.
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Affiliation(s)
- J Choi
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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