The prevalence of underweight, overweight and obesity in children and adolescents from Ukraine

Prevalence of overweight and obesity, dietary behaviors, and physical activities among sixth graders: a cross-sectional study in Ho Chi Minh City, Vietnam

The prevalence of overweight and obesity among adolescents has been increasing worldwide and is a significant public health challenge. Obesity is linked to several non-communicable diseases. This study aimed to determine the prevalence of overweight and obesity based on three growth references and described physical activities and dietary patterns among sixth graders in Ho Chi Minh City (HCMC). From 2018 to 2020, a cross-sectional study was conducted on 1375 students from 16 junior high schools in HCMC. We applied Probability Proportional to Size sampling to select schools. Anthropometric measurements, pubertal status assessment, and diet and physical activity data were collected through Food Frequency and Physical Activity Questionnaires. The study revealed a high prevalence of overweight and obesity among grade 6 students, with ∼45%-56% of students classified as overweight or obese using various growth references. Moreover, most students did not meet the World Health Organization's physical activity and sedentary behavior recommendations. Most students spent <60 min/day on moderate to vigorous physical activity, and over 70% spent at least 120 min/day on sedentary activities during weekdays and weekends. The diet of the students was also imbalanced, with high intakes of protein, lipids, and carbohydrates and low consumption of fruits and vegetables. Nutritionists and policymakers should inform and encourage opportunities for healthier food and more daily activity for children, starting before the sixth-grade, so they can learn how to make healthier choices and change their behavior before they reach adolescence.

Trends in Undernutrition among Macao Children and Adolescents Aged 7~18 Years: An Analysis from Four Successive Macau Government Surveys from 2005 to 2020

Background

We aimed to explore the epidemiological trends and characteristics of undernutrition among children and adolescents aged 7~18 years in Macao from 2005 to 2020 to provide insights into the improvement of nutritional status among the youth in Macao, China.

Methods

Based on the data collected from the Citizen Physical Fitness surveillance sessions in Macao in 2005, 2010, 2015, and 2020, the prevalence of undernutrition among children and adolescents aged 7~18 years in Macao was calculated.

Result

In 2020, the prevalence of undernutrition among children and adolescents aged 7~18 years in Macao was 12.11%. Among them, the rates of stunting, moderate or severe wasting, and mild wasting were 0.63%, 5.25%, and 6.23%, respectively. The prevalence of undernutrition among boys (13.81%) was higher than that among girls (10.06%). Mild wasting was the main form of undernutrition among students. From 2005 to 2020, the prevalence of malnutrition showed a decreasing trend (P<0.05), but there was a rebound in 2020 from 2015, mainly because it may be caused by the COVID-19 pandemic in 2020. The prevalence of undernutrition among children and adolescents in Macao was lower than that in Mainland China (P<0.01).

Conclusion

The detection rates of undernutrition showed a decreasing trend from 2005 to 2020. In the post-pandemic era, Macao should undertake more effective measures in areas such as promoting balanced nutritional intake, increasing physical activity levels, enhancing school physical education, and incorporating mental health education. These efforts are essential for further reducing the prevalence of undernutrition among children and adolescents.

Health-promoting effect for students from physical loads of speed and strength orientation

OBJECTIVE

Aim: To investigate the impact of speed and strength physical loads on promoting health and reducing the biological age of student youth.

PATIENTS AND METHODS

Materials and Methods: The research involved 180 students aged 18-19. The first stage provided for the study of the indicators of the biological age of 120 students, and the second stage covered substantiation of the methodology for martial arts training sessions, based on physical loads of speed and strength orientation. To test its effectiveness, 60 students were involved (30 were in the experimental group (EG), 30 - in the control group (CG)).

RESULTS

Results: The methodology for martial arts training sessions was developed and tested. In the dynamics of the experiment, there is a tendency to a decrease in the difference between the biological and the passport age, but these changes were unreliable in the CG, while a statistically significant decrease in this difference was recorded in the EG. In addition, there were significant changes in the EG in the following indicators: inspiratory breath holding (11.6 %), subjective health assessment (38.5 %), and static balancing (20.0 %).

CONCLUSION

Conclusions: The use of physical loads of speed and strength orientation in the course of martial arts training has established a health-promoting effect and positive dynamics of the biological age indicators of student youth. The results of the research can be implemented in physical education and the process of sports improvement of students in higher educational institutions.

The Use of Nautical Activities in Formal Education: A Systematic Review

INTRODUCTION

The implementation of nautical sports, particularly in coastal areas, during the school stage is a growing phenomenon. It offers unique opportunities for students to develop the necessary competencies outlined in their physical education curriculum in an immersive manner, within a natural and inherently motivating environment.

MATERIAL AND METHODS

This study aims to delve deeper into this subject by conducting a systematic review of the utilization of water sports in formal education. To carry out this bibliographic search, the following keywords were employed: "Nautical Activities", "Nautical Sports", "Nautical Camps", "Formal Education", "Children Education", "Primary School", and "Secondary School". The Boolean operator "and" was used to combine these keywords during the search conducted in databases such as Scopus, PubMed, Web of Science, and SPORTDiscus. The PRISMA Protocol was utilized for the search process, resulting in the selection and categorization of eight papers into the following thematic areas: Wellbeing, Physical and Mental Health, Education, and Management.

RESULTS

The primary findings of this review indicate that the inclusion of these programs within physical education classes enhances overall physical health, mental well-being, and personal development.

CONCLUSIONS

The results demonstrate a positive impact on peer interaction and short-term improvement in self-confidence.

Risks of obesity and diabetes development in the population of the Ivano-Frankivsk region in Ukraine

The epidemic of obesity that parallels diabetes mellitus and its complications are diseases of major concern to modern societies. Community-based screening is an effective strategy to identify people at high risk of developing overweight, obesity, prediabetes, diabetes, and related health problems. Here, we present the results of screening the population of four locations in the Ivano-Frankivsk region (Western Ukraine). The study group consisted of 400 adults and 252 children. The measured parameters were: (1) main vital signs - body temperature, resting heart rate, blood pressure; (2) anthropometric indicators - body mass and height, body mass index, waist circumference; and (3) metabolic parameters - fasting capillary blood glucose, total body fat, visceral fat, physical activity level and 10-year risk of developing type 2 diabetes. The study found that 23 % of the adults were overweight and 14.8 % obese. Among children, 9.9 % were overweight and 8.7 % obese. Adult body mass index correlated with visceral fat percentage, systolic/diastolic blood pressure and levels of fasting capillary blood glucose. Adults over 18 years of age had fasting capillary blood glucose ≥5.6 mmol/L (14.3 %), including those with undiagnosed pre-diabetes (13.3 %) and suspected diabetes mellitus (1.0 %). The percentage of visceral body fat in adults was positively associated with the 10-year risk of developing type 2 diabetes.

Gender differences and climate zones in overweight and obesity prevalence in European elementary school children from 2000 to 2020: a systematic review and meta-analysis

Introduction

After 2000, there are more obese than underweight people in the world. We face a rapid increase in average global warming of 1.5°C, reported as a syndemic problem of three interconnected epidemics: obesity, global warming, and undernutrition. We aimed to analyze the impact and association between global warming and obesity in children and differences by gender across Europe after 2000.

Methods

We searched PubMed, MEDLINE, Google Scholar, ScienceDirect, and Embase databases. The considered population were children aged 6-14. Only cross-sectional studies that defined obesity by the IOTF cutoffs and the subjects' place of residence, used to determine precise climate zones, were included. We assessed the prevalence of obesity and overweight using a random-effects and the Mantel-Haenszel fixed-effect method when heterogeneity was greater/lower than 50%. We did a subgroup analysis for prevalence across gender, obesity, and overweight, two decades, regions, countries, and the Köppen-Geiger climate zones. Random effects of the meta-regression were used to study the global warming impact and differences in trends across European countries by gender for both conditions separately.

Results

We identified 114 studies that included 985,971 children from 39 European countries. A significant difference between genders was in favor of obese girls 4.78 (95% CI: 3.85-5.93) versus boys 5.76% (95% CI: 5.11-6.48, p = 0.03), respectively, but not for overweight children. Most of the obese girls were in South Europe 7.51% (95% CI: 6.61-8.51) versus East Europe 2.86% (95% CI: 23-3.12), versus boys in South Europe 8.66% (95% CI: 7.68-9.74) and North Europe 3.49% (95% CI: 2.90-4.19), respectively. The "cold" Köppen-Geiger climate zone, with lowest temperatures, has the largest trend rise between two decades of 2.8% and 1.53% for obese girls and boys, and 5.31% and 1.81% for overweight girls and boys, respectively, followed by the smallest number of obese girls 3.28% (95% CI: 2.17-4.92) and boys 3.58% (95% CI: 2.39-5.33), versus the zone with the highest temperatures "hot" for girls 7.02% (95% CI: 6.30-7.82) and for boys 8.23% (95% CI: 7.55-8.96), respectively. The meta-regression proved global warming has a significant impact on the distribution of obesity and overweight across climate zones, R2 = 0.52 and R2 = 0.22. No significant gender differences, or significant interaction, was noted.

Conclusion

Our meta-analysis provides a comprehensive overview of the association between and impact of global warming on obesity. This impact increases obesity among children in Europe throughout all climate zones, and emphasizes an urgent call for further preventive methods in schools, since obesity differences continue their trend of disappearing into the future.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021282127, identifier: CRD42021282127.

Triglyceride glucose index, pediatric NAFLD fibrosis index, and triglyceride-to-high-density lipoprotein cholesterol ratio are the most predictive markers of the metabolically unhealthy phenotype in overweight/obese adolescent boys

Introduction

The prevalence of obesity constantly increases worldwide and definitely increases the risk of premature death in early adulthood. While there is no treatment yet with proven efficacy for the metabolic clamp such as arterial hypertension, dyslipidemia, insulin resistance, diabetes type 2, and fatty liver disease, it is imperative to find a way to decrease cardiometabolic complications. Early prevention strategies beginning in childhood are the most logical step to reduce future cardiovascular morbidity and mortality. Therefore, the aim of the current study is to determine the most sensitive and specific predictive markers of the metabolically unhealthy phenotype with high cardiometabolic risk in overweight/obese adolescent boys.

Methods

This study was carried out at the Ternopil Regional Children's hospital (Western Ukraine) and involved 254 randomly chosen adolescent overweight or obese boys [median age was 16.0 (15.0,16.1) years]. A control group of 30 healthy children with proportional body weight comparable in gender and age to the main group was presented. A list of anthropometrical markers with biochemical values of carbohydrate and lipid metabolism with hepatic enzymes was determined. All overweight/obese boys were divided into three groups: 51.2% of the boys with metabolic syndrome (MetS) based on the IDF criteria; 19.7% of the boys were metabolically healthy obese (MHO) without hypertension, dyslipidemia, and hyperglycemia; and the rest of the boys (29.1%) were classified as metabolically unhealthy obese (MUO) with only one criterion (hypertension, dyslipidemia, or hyperglycemia).

Results

Based on multiple logistic regression analysis that included all anthropometric and biochemical values and calculated indexes in boys from the MHO group and MetS, it was revealed that the maximum likelihood in the prediction of MetS makes the combination of triglyceride glucose index, pediatric nonalcoholic fatty liver disease fibrosis index (PNFI), and triglyceride-to-high-density lipoprotein cholesterol ratio (R² =0.713, p<0.000). By tracing the receiver operating characteristic curve, the model is confirmed as a good predictor of MetS (AUC=0.898, odds ratio=27.111 percentage correct=86.03%) in overweight and obese boys.

Conclusion

Triglyceride glucose index, pediatric NAFLD fibrosis index, and triglyceride-to-high-density lipoprotein cholesterol ratio are a valuable combination of predictive markers of the metabolically unhealthy phenotype in Ukrainian overweight/obese boys.

Differences in Classification Standards For the Prevalence of Overweight and Obesity in Children. A Systematic Review and Meta-Analysis

The prevalence of childhood obesity has increased dramatically all over the world in recent years. While obesity in adults can be easily measured using the BMI calculation, determining overweight and obesity in children is more controversial. The aim was to compare the three most used international classification systems (WHO 2007, CDC 2000 and Cole-IOTF) to determine overweight and obesity in infant and adolescent populations. We performed a systematic review in accordance with the PRISMA 2020 guidelines of articles comparing any of the three classification systems. The main findings were that the WHO 2007 criteria show the highest prevalence of overweight and obesity in the child and youth population. The prevalence of childhood overweight and obesity was determined to be higher in boys than in girls in most studies, when analysing the classifications of the WHO 2007, CDC 2000 and Cole-IOTF together. However, there was a higher prevalence of overweight and obesity in girls than in boys when only the CDC 2000 and Cole-IOTF criteria were considered. Both the results of the review and the great heterogeneity found in the meta-analysis show that it is necessary to unify the criteria for the classification of childhood overweight and obesity. International standards are insufficient for working with the current population. A working group should be created to address this issue and agree on the unification of a gold standard, taking into account the geographical region, the ethnic groups and the age groups of the child and youth population and above all, the secular growth.

Fat–fat-free index in body mass assessment in young people

The study aimed to personalize the classification of body weight using the fat–fat-free (FFF) index with the percentage of body fat and to develop classification standards for the FFF index for men aged 18–25 years. Moreover, 1,642 adolescents (1,200 ♀) were examined. Using body composition analyzers, weight was determined, as well as overall and segmental body composition. Based on the obtained values for fat mass and fat-free tissue mass, an overall FFF index was calculated. According to the BMI classification, 9% of ♀ and 6% of ♂ are underweight, 29% of ♀ and 13% of ♂ are overweight, and 5% of the subjects are obese. Women and men classified in the same group according to BMI differed statistically significantly in terms of body weight, FM%, and FFM. In contrast to BMI and FM%, the FFF used takes into account the ratio of fat mass to fat-free tissue and muscle tissue mass. The proposed classification of FFF was made taking into account the differences that arise with sexual development and physiological changes occurring in ontogeny. Assessment of body mass using the FFF index should be used as part of preventive screening for the early diagnosis and prevention of overweight and thus many chronic diseases for which overweight or obesity is a risk factor.

Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees

Aim

Millions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians.

Methods

A systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review.

Results

In 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication.

Conclusion

Ukrainian children often have poor health and host countries need to be aware of their needs.

Prevalence and associated factors of overweight and obesity among primary school children: a cross-sectional study in Thanhhoa City, Vietnam

OBJECTIVE

To determine the prevalence and associated factors of overweight and obesity among primary school children (6-11 years old) in Thanhhoa city in 2021.

DESIGN

Cross-sectional study.

SETTING

Seven primary schools in Thanhhoa city, Vietnam.

PARTICIPANTS

782 children (and their parents).

PRIMARY AND SECONDARY OUTCOME MEASURES

Two-stage cluster random sampling was used for selecting children and data were collected from January to February 2021. A self-administrated questionnaire was designed for children and their parents. Children's height and weight were measured and body mass index (BMI)-for-age z-scores were computed using the WHO Anthro software V.1.0.4. Data were analysed using R software V.4.1.2. The associations between potential factors and childhood overweight/obesity were analysed through univariate and multivariate logistic regression analyses. Variables were selected using the Bayesian Model Averaging method.

RESULTS

The prevalence of overweight/obesity among primary school children in Thanhhoa city was 35.93% (overweight 21.61% and obesity 14.32%). The proportion of overweight girls was nearly equal to that of boys (20.78% and 22.52%, respectively, p=0.6152) while the proportion of boys with obesity was four times as many as that of girls (23.86% and 5.62%, respectively, p<0.0001). Child's sex was the factor significantly associated with childhood overweight/obesity. Boys had double the risk of being overweight/obese than girls (adjusted OR: aOR=2.48, p<0.0001). Other potential factors which may be associated with childhood overweight/obesity included mode of transport to school, the people living with the child, mother's occupation, father's education, eating confectionery, the total time of doing sports, and sedentary activities.

CONCLUSION

One in every three primary school children in Thanhhoa city were either overweight or obese. Parents, teachers and policy-makers can implement interventions in the aforementioned factors to reduce the rate of childhood obesity. In forthcoming years, longitudinal studies should be conducted to determine the causal relationships between potential factors and childhood overweight/obesity.

Obesity and Mitochondrial Function in Children: A case–control study

OBJECTIVES: Childhood obesity has increased over the past years worldwide. Therefore, changes in mitochondrial function as the risk factors of obesity in children need to consider. AIM: The study aimed to evaluate the connection between obesity and mitochondrial function in obese children. PATIENTS AND METHODS: This study was a case–control study conducted in the primary school children in Mosul city. The study included 100 children, with an age ranged from 6 to 12 years. Fifty child with obesity (BMI ≥ 95th percentile) for children enrolled in this work and compared to 50 control with BMI <95th percentile. Mitochondrial function assessed by measurement of serum lactic acid, lactate/pyruvate ratio, and L-carnitine and mt-DNA copy number. RESULTS: Serum lactate and the lactate/pyruvate ratio were significantly higher in obese children than in the control group, while serum pyruvate levels in children with obesity are not significantly different from those in the control group. Serum levels of L-carnitine and mt-DNA copy number significantly reduced in obese children comparison to the control group. CONCLUSION: Changes of mitochondrial function may be involved in obesity of children.

Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study

Background and Aims: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. Methods: Cross-sectional analysis of 8–16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. Results: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% ‘increased risk’, 9.7% ‘high risk’, 14.3% ‘very high risk’). Participants in the ‘very high risk’ group were less likely to be females (odds ratio 0.63; 95% CI: 0.52–0.76) and adolescents (0.60; 95% CI: 0.49–0.72), to practice ≥60 min/day of moderate-vigorous physical activity (MVPA) (0.73; 95% CI: 0.57–0.93), and to watch <120 min/day of total screen time on weekdays (0.61; 95% CI: 0.49–0.76). Mothers of participants in the ‘very high risk’ group were less likely to have a high educational level, be in the overweight or normal range, have never smoked or were former smokers, and watch <120 min/day of total screen time on weekends. Participants in the ‘increased’ and ‘high risk’ categories had mothers with normal weight and ≥60 min/day of MVPA. Participants in the ’high risk’ group did not achieve ≥60 min/day of MVPA and showed lower adherence to the Mediterranean diet. Conclusions: Adherence to a healthy lifestyle in children and adolescents, but also in their mothers/female caregivers during offspring’s childhood and adolescence, is associated with low BMI-WHtR disease risk.

Prevalence of arterial hypertension among Ukrainian students: the comparison of European and American guidelines

INTRODUCTION

Arterial hypertension (HTN) among children is progressively increasing. These concerns have led to an update of the guidelines about childhood hypertension by the European Society of Hypertension (ESH) in 2016 and the American Academy of Pediatrics (AAP) in 2017, and their thresholds for HTN differ. The current research aims to compare the prevalence of hypertension in Ukrainian teenagers using 2 different guidelines and to check the impact of gender, age, and excess weight on hypertension.

MATERIAL AND METHODS

The sample includes 540 Ukrainian students of 2 secondary urban schools, aged 10-17 years. Blood pressure and anthropometrical measurements were taken and compared with percentile tables.

RESULTS

The prevalence of abnormal BP (11.3% and 15.2%) and HTN (1.9% and 4.1%) was determined with ESH and AAP guidelines, respectively, and they strongly depended on which definitions and criteria were used. Boys were much more predisposed to abnormal BP. Comparing both guidelines, there was no significant difference in HTN prevalence in children aged 10-12 years; nevertheless, AAP recognized HTN almost twice as often in teenagers aged ≥ 13 years. Excess body weight was identified in 17.2% of the school-age children, twice as frequently as in males.

CONCLUSIONS

The results have shown a higher prevalence of HTN in teenagers and children with excessive weight more significant in boys and between children with positive markers of abdominal obesity due to both guidelines, without a significant difference in prevalence after re-classification; however, AAP recommendations might be preferable.

A review on association and correlation of genetic variants with eating disorders and obesity

Background

Now, eating disorders and obesity and their correlations are danger signal in worldwide which is caused by multifactor and associated with significant mortality and morbidity.

Main body

Every aspect of a patient’s life is influenced by eating disorders and obesity and their correlations. Due to frequent seeing of obese patients, eating disorders have been included in the review as they can sometimes be associated with obesity. However, it should be noted that most patients having eating disorder are at risk to be obese or overweight. This research explores the risk factors for the two disorders, as well as the assessment of medical complications and treatment recommendations for the disorders. In these two disorders, there is also a correlation. The essential consideration is that eating disorders are impulse-control disorders which are similar to addictive behaviors in some aspects. So it is a crying need to treat a patient with obesity and eating disorders simultaneously to ensure success. Genome-wide association studies (GWASs) have increased our knowledge of the pathophysiology of eating disorders (EDs) and obesity and their correlation.

Conclusion

This review enlightens on the summary of eating disorder, obesity, genotypic traits, molecular relations, interaction, correlation, and effect of eating disorder and obesity which outline potential future directions and clinical implications for patients with EDs and obesity.

Chamomile as a potential remedy for obesity and metabolic syndrome

Obesity is an increasing health concern related to many metabolic disorders, including metabolic syndrome, diabetes type 2 and cardiovascular diseases. Many studies suggest that herbal products can be useful dietary supplements for weight management due to the presence of numerous biologically active compounds, including antioxidant polyphenols that can counteract obesity-related oxidative stress. In this review we focus on Matricaria chamomilla, commonly known as chamomile, and one of the most popular medicinal plants in the world. Thanks to a high content of phenolic compounds and essential oils, preparations from chamomile flowers demonstrate a number of pharmacological effects, including antioxidant, anti-inflammatory, antimicrobial and sedative actions as well as improving gastrointestinal function. Several recent studies have shown certain positive effects of chamomile preparations in the prevention of obesity and complications of diabetes. These effects were associated with modulation of signaling pathways involving the AMP-activated protein kinase, NF-κB, Nrf2 and PPARγ transcription factors. However, the potential of chamomile in the management of obesity seems to be underestimated. This review summarizes current data on the use of chamomile and its individual components (apigenin, luteolin, essential oils) to treat obesity and related metabolic disorders in cell and animal models and in human studies. Special attention is paid to molecular mechanisms that can be involved in the anti-obesity effects of chamomile preparations. Limitation of chamomile usage is also analyzed.

Longitudinal Analysis (1994-2020) of Prevalence and Trends of Underweight in Polish Children

Nutritional status disorders are a worldwide problem. Approximately 5.9 million children under the age of five die each year, and 45% of these deaths are related to malnutrition. The aim of the study was to analyse the prevalence of underweight children aged between 6 and 7 years old, living in the Gdańsk, Poland, in the years 1994–2020. The anthropometric parameters of 67,842 children were analysed. BMI (Body Mass Index) value <5 percentile (pc) was defined as underweight. The BMI value was compared to the WHO (World Health Organization) centile charts and the OLAF (research project PL0080) national reference charts. The prevalence of underweight children in relation to the WHO charts was 1.9%; underweight status was found to be more significant in the group of boys (2.1%) than the group of girls (1.7%) (p < 0.001). According to the OLAF centile charts, the underweight figure among all of the study population was 2.1% and no statistical significance between boys (2.1%) and girls (2.0%) was found (p = 0.670). The occurrence of underweight indviduals in the studied group slightly increased in the years 1994–2020. We found a statistically significant increasing linear trend in the analysis of underweight children in our group (p < 0.001), in group of boys (p < 0.001), but not girls (WHO p = 0.603; OLAF p = 0.787). This points to the need to conduct regular screening systems for children and adolescents.

Prevalence of Underweight, Overweight and Obesity in School-Aged Children in the Urban Area of the Northwestern Part of Romania

INTRODUCTION

During the last three decades, there has been an excess weight epidemic due to changes in nutrition and lifestyle. Few data on the prevalence of overweight and obesity in children in Romania were published, without a single study representative at the national level. There are reports on the higher level of overweight and obesity in urban areas compared to rural ones. This study aimed to estimate the prevalence of underweight, overweight, obesity and severe obesity in children enrolled in schools from the urban area.

MATERIAL AND METHODS

For this cross-sectional study, children from 177 schools from the urban area of five counties from the northwestern part of Romania were included after the parents signed written informed consent. Anthropometric data were recorded (weight, height) based on World Health Organization (WHO) recommendations and Body-Mass-Index (BMI), and the z-score for BMI were calculated. The nutritional status was estimated using three reference criteria: WHO, International Obesity Task Force (IOTC) and the Center for Disease Control and Prevention (CDC).

RESULTS

We analyzed data of 21,650 children (48.19% boys) age between 7 and 18 years. The prevalence of overweight was 13.8%, 16.2% and 20.3%, of obesity was 10.7%, 10.0% and 5.7% and of severe obesity was 5.1%, 1.2% and 1.6% (using WHO, CDC and IOTF cut-offs). Underweight was present in 5.2% (WHO), 6% (CDC) and 2.6% (IOTF). The highest prevalence of overweight (including obesity) was found in children aged 10 years, and the lowest in adolescents at 18 years. Boys have a higher prevalence of excess weight than girls. Using IOTF cut-offs, the prevalence of obesity and severe obesity was lower than using WHO criteria.

CONCLUSIONS

The prevalence of overweight (including obesity) in children from the urban area of Western Romania was recorded at alarming levels, higher in boys and at the pre-puberty ages. There are significant differences based on the reference system used. It is important to correctly choose the reference for the definition of overweight and obesity to have the correct estimation of the target for public health measures.

Prevalence and trends of underweight in European children and adolescents: a systematic review and meta-analysis

PURPOSE

This study aimed at providing prevalence trend estimates of underweight among children and adolescents in Europe from 2000 to 2017.

METHODS

MEDLINE, Web of Science, Scopus and CINAHL were searched from their inception up to March 2020. Moreover, searches were conducted on health institutions' websites to identify studies not published in scientific journals. Underweight was defined according to the body mass index (BMI) cut-offs proposed by the International Obesity Task Force (IOTF) and the World Health Organization (WHO) definition criteria. The Mantel-Haenszel method was used to compute the pooled prevalence estimates whenever there was no evidence of heterogeneity; otherwise, the DerSimonian and Laird random-effects method was used. Subgroup analyses by sex, age range (2-13 and 14-18 years old), study year (2000-2006 and 2007-2017), country and European region were conducted.

RESULTS

A total of 49 studies with data from 323,420 children and adolescents aged 2 to 18 years, from 26 countries were included. From 2000 to 2017, according to the IOTF criteria, the prevalence of underweight showed an increasing trend in Eastern, Northern and Southern Europe, where the underweight prevalence ranged from 9.1 to 12.0%, from 4.1 to 6.8%, and from 5.8 to 6.7%, respectively. In Western Europe, the prevalence of underweight tended to decrease, from 14.0 to 11.8%. No significant differences were found by sex or age range.

CONCLUSION

The prevalence of underweight is considerable (overall, around 8-9%), particularly in Eastern Europe, and follows a slight upward trend during the past decade.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017056924.

Secular Trends of Underweight, Overweight, and Obesity in Children and Adolescents from Ukraine

Overweight and obesity, as well as underweight in children and adolescents, pose a significant public health issue. This study aimed to investigate the secular trend of the incidence of underweight, overweight, and obesity in children from Ukraine in 2013/2014 and 2018/2019. The studies were conducted in randomly selected primary and secondary schools in Ukraine. In total, 13,447 children (6468 boys and 6979 girls) participated in the study in 2013/2014 and 18,144 children (8717 boys and 9427 girls) participated in 2018/2019. Measurements of body weight and height were performed in triplicate. Underweight, overweight, and obesity were diagnosed according to the standards of the World Health Organization (WHO). In the group of girls, a significant difference between 2013/2014 and 2018/2019 measurements was found only among 7-year-olds. The percentage of girls at this age exceeding the body mass index (BMI) norm was lower in the 2018/2019 study. In boys, a significant difference was also found in 7-year-olds, and, as in girls, a lower share of overweight and obesity was found in 2018/2019. But for the ages of 12, 13, and 15, the significant differences had a different character-more overweight or obese boys were found in the 2018/2019 study. The proportion of underweight children was similar for the majority of age groups in both genders and did not differ in a statistically significant way.

Assessment of body mass index in a pediatric population aged 7-17 from Ukraine according to various international criteria-A cross-sectional study

Childhood obesity is one of the most serious public health problems. The prevalence of obesity among children is increasing and may negatively affect their immediate health, but it can also lead to obesity in adulthood. The aim of the study was to compare BMI cut-off points by examining three main international references: the World Health Organization (WHO), the International Task Force Obesity (IOTF) and the US Center for Disease Control and Prevention (CDC). Ultimately, the study group consisted of 18,144 children and adolescents aged 6.5–17.5 years. Body mass was measured on medical scales with an accuracy of ± 100 g and height measurement was taken using a height meter with an accuracy of ± 0.1 cm three times. Underweight, overweight and obesity were calculated according to WHO, IOTF and CDC BMI international references. There were differences in the incidence of underweight between the classifications: 16.8% according to IATF, 5.3% according to WHO and 9.9% according to CDC. There were also differences in the incidence of overweight and obesity between the classifications: 13% according to IOTF, 19.7% according to WHO and 14.1% according to CDC. In the CDC and WHO studies, a significantly higher prevalence of childhood obesity (4.0% and 4.7%, respectively) was observed compared with IOTF (2.1%). The prevalence of overweight and obesity in this study was higher among boys compared to girls. However, estimates of prevalence of overweight and obesity differ in methods and reference cut-off points. Higher prevalence was obtained in IOTF classification, followed by the WHO and CDC classification.

Assessment of the Impact of Parental BMI on the Incidence of Overweight and Obesity in Children from Ukraine

The aim of this study was to assess the impact of parental body mass index (BMI) on the risk of having an overweight or obese child in Ukraine. This study included 22,576 parents (11,288 mothers and fathers) and the same number of children (boys 48%, girls 52%) aged 6.0-18.9 years who live in Ukraine. The study was conducted in randomly selected primary, secondary and high schools of Ukraine. Body weight and height was measured in triplicate. Based on the results obtained, BMI was calculated. The analysis was carried out based on z-score values of children and BMI classification of children. Odds ratios (OR) were calculated using logistic regression analysis. For fathers, 38.1% had normal BMI, 15.9% were obese, and 45.6% were overweight. For mothers, 52.1% of those surveyed had normal BMI, 31.8% were overweight and 13.5% were classified as obese. The vast majority (72.7%) of children had normal weight, 10.2% were overweight, and 15.0% were underweight. Children of overweight fathers had a higher risk of becoming overweight (OR = 1.41). Children of obese fathers had both a greater risk of being overweight (OR = 2.04) and obese (OR = 2.56). The odds ratios indicate that children of overweight mothers had a greater risk of being overweight (OR = 1.45) and obese (OR = 1.76). Children of obese mothers had both a greater risk of becoming overweight (OR = 2.05) and obese (OR = 2.70). More often, overweight and obese parents had children who also had higher BMI.

Child Nutrition Trends Over the Past Two Decades and Challenges for Achieving Nutrition SDGs and National Targets in China

Background: The objectives of the current study were to identify the trends in child nutrition, the gaps in achieving child nutrition-related goals, and implications for program and policy options for the Chinese government. Methods: Eight child nutrition-related indicators from the Sustainable Development Goals (SDGs) and China’s national nutrition plans, and two datasets, Global Burden of Disease 2016 and Chinese National Nutrition and Health Surveillance, were used in our analysis. Results: Over the past 26 years, the prevalence of stunting, wasting, and underweight for children under 5 years was reduced by 58.7%, 53.4%, and 69.2%, respectively. Overweight for children aged 1–4 years increased 88.9% and obesity increased 2.14 times. Exclusive breastfeeding of newborns (7–28 days) was stable, at about 30%. We estimated child wasting would be 3.0% lower than the target of 5.0% based on predictive values for meeting the SDGs in 2025. The number of stunted children under five years would be reduced by 39.7%, while overweight would increase 2.2% throughout China. Conclusion: These results highlight the urgent need for targeted policies and interventions to reduce child stunting and overweight and increase exclusive breastfeeding to improve child health and meet the SDG targets and China’s national goals.

Role of body mass category in the development of faulty postures in school-age children from a rural area in south-eastern Poland: a cross-sectional study

OBJECTIVE

The aim of the study was to assess the relationship between body mass index (BMI) and the incidence of abnormalities in selected parameters measured in the trunk area.

DESIGN

Cross-sectional studies.

SETTING

The research was conducted in a primary school in the Trzebownisko Municipality, a rural area in south-eastern Poland.

PARTICIPANTS

A group of 464 children, ranging in age from 6 to 16 years (234 boys and 230 girls), was recruited to participate in the study.

OUTCOME MEASURES

The examination of their body postures was conducted with the use of the Zebris system. Body mass was determined using a body mass analyser Tanita MC-780 MA. BMI was calculated based on the acquired data.

RESULTS

It was noticed that the children with overweight and obesity tended to have an incorrect position of the shoulders and pelvis in comparison to children with normal body weight. It was found that greater body mass (higher BMI) coincided with a larger distance of the scapulae from the frontal plane (p=0.009).

CONCLUSIONS

Increase in children's BMI produces adverse effects in the position of the shoulder blades, reflected by their greater distance from the frontal plane. Increase in BMI is not significantly related to the position of the shoulder joints or pelvis; however, the subjects with overweight or obesity presented a greater difference in the position of the shoulder joints and pelvis.

Analysis of Fruit and Vegetable Consumption by Children in School Canteens Depending on Selected Sociodemographic Factors

Background and Objectives: Eating habits acquired or changed during childhood are likely to track into adulthood. Due to the fact that nutritional behaviours are not so strongly formed among children, it is easier to change and develop them in children than in adults. The aim of this study was to assess the impact of selected sociodemographic factors affecting fruit and vegetable consumption (i.e., age, parents' body mass index, parents' level education, duration of breastfeeding, child's time spent in front of computer/television) among children in school canteens. Materials and Methods: The sample consisted of 106 participants (52 girls, 54 boys) aged 6-12. The frequency of consuming fruits and vegetables at a school canteen was assessed using bar code cards for two weeks. Body composition estimates were obtained using a foot-to-foot bioelectrical impedance analysis, body height was measured using a stadiometer Seca 213. The questionnaire contained questions about selected factors which can have an influence on fruit and vegetable consumption. In the study group, 13.2% of participants were overweight and 17.9% were obese. Results: Our results showed a statistically significant relationship between age and fruit and vegetable consumption, and it increased with age in both sexes. Conclusions: Bearing in mind the various conditions discussed when shaping the eating habits of pre-school- and early-school-aged children, the importance of proper nutritional education should be stressed both among children and parents.

The association between total antioxidant capacity and resting metabolic rate (RMR) / respiratory quotient (RQ) in overweight and obese woman

OBJECTIVE

The effect of total antioxidant capacity on resting metabolic rate (RMR) and respiratory quotient (RQ) of overweight and obese woman has been debated globally. Total Antioxidant Capacity may have an independent effect on resting metabolic rate and respiratory quotient.

METHODS AND MATERIALS

A study population of 263 aged 18-50 years participated in this cross-sectional study from the communities of Tehran based on cluster sampling. Dietary intake assessed by using a semi quantitative food frequency questionnaire (FFQ) Demographic questions. Anthropometrics measurements for each participant were done. Dietary total antioxidant capacity (DTAC) was calculated by the 147-item food frequency questionnaire (FFQ) and FRAP assay. Resting metabolic rate and respiratory quotient was measured by Indirect calorimetry.

RESULTS

The mean DTAC of the study participants was 1251.8 (SD 893.60). There was a statistically significant relationship between dietary total antioxidant capacity (DTAC) and respiratory quotient (P > 0.013). People with high dietary total antioxidant capacity have tended to show a lower RQ than those with a lower one. There was a significant correlation between DTAC and RQ for both the adjusted model for age, total energy intake, BMI, physical activity, higher DTAC diet and the crude model which were (β = 0.011; SE = 0.005; CI = -0.021_0) and (β = -3.143E-6; SE = 0; CI = 0), respectively. However, we found no correlation between the DTAC and RMR/FFM-RES (P < 0.49). Also, a significantly higher relationship was demonstrated between dietary total antioxidant capacity and intake vegetables (P ≤ 0.006), fruits (P ≤ 0.009), white meet (P ≤ 0.03) and dairy products (P ≤ 0.005).

CONCLUSION

RQ is correlated with total antioxidant capacity. Increased intake of high DTAC foods may result in weight loss maintenance. This result may suggest a beneficial role of higher-DTAC diets in the prevention of obesity.

Prevalence of underweight in children and adolescents (aged 3-18 years) from Kraków (Poland) in 1983 and 2010

OBJECTIVE

To estimate the changes in the prevalence of underweight among girls and boys living in Kraków that occurred between 1983 and 2010.

DESIGN

The study was based on two cross-sectional surveys conducted in 1983 and 2010. The prevalence of underweight was estimated based on the International Obesity Task Force (IOTF) and Centers for Disease Control and Prevention (CDC) cut-off points.

SETTING

The study was conducted in Kraków, Poland.

PARTICIPANTS

Children aged 3-18 years (n 5245).

RESULTS

Between 1983 and 2010 the prevalence of underweight decreased in both sexes. Using the IOTF criteria, the prevalence of underweight decreased from 10·5 to 10·3 % in girls and from 8·9 to 7·5 % in boys, but it was still higher in girls than in boys. According to the CDC criteria, this prevalence decreased from 5·1 to 4·4 % and from 5·9 to 4·6 %, respectively, and was slightly lower in girls. According to the IOTF criteria, underweight prevalence increased slightly during childhood in both sexes while according to the CDC criteria it decreased in boys and did not change in girls. Among juveniles and adolescents, it decreased regardless of the method used.

CONCLUSIONS

The frequency of underweight in the population of children and adolescents from Kraków changed slightly in 1983 and 2010 despite economic and social changes. Depending on the cut-off points used, not only the magnitude but also the direction of changes between series could be different. In order to aid global monitoring, the prevalence of underweight as well as overweight should always be evaluated by several methods.

Prevalence of overweight and obesity among adolescents in Bangladesh: do eating habits and physical activity have a gender differential effect?

The aim of this study was to examine the gender differential effects of eating habits and physical activity on overweight and obesity among school-aged adolescents in Bangladesh. Nationally representative data extracted from the 2014 Global School-based Student Health Survey (GSHS) were utilized. The survey collected information related to physical and mental health from 2989 school-aged adolescents in Bangladesh. An exploratory data analysis and multivariate logistic regression model were employed in this study. Female adolescents were at a lower risk of being overweight or obese (AOR=0.573) than males, with a prevalence of 7.4% (males: 9.9%). The results showed that high consumption of vegetables (both: AOR=0.454; males: AOR=0.504; females: AOR=0.432), high soft drink consumption (both: AOR=2.357; males: AOR=2.929; females: AOR=1.677), high fast food consumption (both: AOR=2.777; males: AOR=6.064; females: AOR=1.695), sleep disturbance (both: AOR=0.675; males: AOR=0.590; females: AOR=0.555) and regular walking or cycling to school (both: AOR=0.472; males: AOR=0.430; females: AOR=0.557) were vital influencing factors for being overweight or obese among adolescents for both sexes. Sedentary activities during leisure time were also identified as significant predictors of being overweight or obese for males. Regular fruit and vegetable consumption, the avoidance of soft drinks and fast food, an increase in vigorous physical activity, regular attendance at physical education classes and fewer sedentary leisure time activities could all help reduce the risk of being overweight or obese for both sexes.

Genetic aspects of metabolic disorders in pregnant women with pathological weight gain

Polymorphism of the leptin receptor gene (LEPR) has been shown to be linked to obesity-related metabolic markers and phenotype. Therefore, we hypothesized that the Gln233Arg LEPR polymorphism is related to metabolic changes in pregnancy and the risk of excessive gestational weight gain (GWG). A total of 97 pregnant women with a singleton gestation were enrolled from April 2016 until December 2018. Genetic variants of LEPR were analyzed by real-time polymerase chain reaction, leptin by enzyme-linked immunosorbent assay, lipid profile, and carbohydrate status were assessed in the first, and third trimesters of pregnancy. The recommended GWG was diagnosed in 34.0%, insufficient in 19.6%, and excessive in 46.4% patients. Statistical analysis revealed that 20.6% patients were with AA genotype, 50.5% – AG genotype, and 28.9% – GG genotype. The frequency of GG-alleles carriers of the LEPR Gln233Arg gene in the group of excessive GWG patients was 3 times higher compared to recommended GWG patients. Thus, the inheritance of pathological G-homozygotes increases the risk of excessive weight gain by 7 times, compared to carriers of the AA genotype. LEPR GG polymorphism was significantly associated with high levels of triglycerides, total cholesterol, lipoprotein low and very low density, and leptin compared to homozygous А-carriers in the third trimester of pregnancy. In pregnant women with GG polymorphism, the glucose level, insulin level, and HOMO-IR index were significantly increased compared to women with AA genotype in late pregnancy. In the group with excessive GWG, the presence of GG-alleles of the LEPR gene was accompanied by a higher level of hyperleptinemia, compared to carriers of AA-genotype. Inheritance of pathological G-homozygotes was associated with hyperlipidemia, leptin resistance with high leptin serum levels, and increased insulin resistance, which was especially manifested in excessive GWG. In our opinion, excessive GWG can be seen as a marker of the mother's genotype and genetic predisposition to the development of metabolic diseases after delivery.

Analysis of the diet quality and dietary habits of children and adolescents with type 1 diabetes

INTRODUCTION

The dietary habits of patients with type 1 diabetes are key elements of treatment as they facilitate the normalization of glycemia and maintenance of normal body weight (BW), lipid concentration, and the level of blood pressure. Therefore, the aim of this study was to analyze dietary habits and to verify the influence of the quality of diet on insulin dosage and selected clinical variables.

MATERIALS AND METHODS

The study included 194 subjects (8-18 years old) suffering from type 1 diabetes and treated with the use of insulin pump. A modified KomPAN questionnaire was used to assess dietary habits and the frequency of the consumption of selected products. Two groups of patients were distinguished: G1 (poorer quality of diet) and G2 (better quality of diet). Clinical data were also collected.

RESULTS

Very low scores were noted in the whole study group as regards the index of healthy diet (27.6±11.1, 3.8-61.0). After dividing the participants into groups, it was observed that G1 included more boys (63.8%), and more girls were found in G2 (66.9%). G2 patients chose sweet and salty snacks and fried meals less frequently, and they consumed boiled dishes and avoided sweetening with sugar or honey more frequently. The following characteristics were observed in G1 patients: longer duration of the disease (6.5 vs 5.2 years), higher doses of insulin (0.86 vs 0.76 U/kg of BW/day), and being overweight (31.0% vs 17.6%) and underweight (19.0% vs 8.8%) noted twice more frequently. We did not observe differences concerning the concentration of glycated hemoglobin and lipids in the serum and the values of blood pressure.

CONCLUSION

The findings revealed unsatisfactory dietary habits in children and adolescents with type 1 diabetes and indicated the necessity to analyze additional factors that might influence the quality of diet of the patients.

Interplay between diet-induced obesity and oxidative stress: Comparison between Drosophila and mammals

Obesity caused by excessive fat accumulation in adipocytes is a growing global problem and is a major contributing risk factor for many chronic metabolic diseases. There is increasing evidence that oxidative stress plays a crucial role in both obesity progression and obesity-related complications. In recent years, Drosophila models of diet-induced obesity and associated pathologies have been successfully developed through manipulation of carbohydrate or fat concentrations in the food. Obese flies accumulate triacylglycerols in the fat body, an organ homologous to mammalian adipose tissue and exhibit metabolic and physiological complications including hyperglycemia, redox imbalance and shortened longevity; these are all similar to those observed in obese humans. In this review, we summarize current data on the mechanisms of oxidative stress induction in obesity, with emphasis on metabolic switches and the involvement of redox-responsive signaling pathways such as NF-κB and Nfr2. The recent achievements with D. melanogaster model suggest a complicated relationship between obesity, oxidative stress, and longevity but the Drosophila model offers probably the best opportunities to delve further into unraveling these interactions, particularly the roles of antioxidants and of Nrf2-regulated responses, in order to increase our understanding of the obese metabolic phenotype and test and develop anti-obesity pharmaceuticals.