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Al Zein M, Akomolafe AF, Mahmood FR, Khrayzat A, Sahebkar A, Pintus G, Kobeissy F, Eid AH. Leptin is a potential biomarker of childhood obesity and an indicator of the effectiveness of weight-loss interventions. Obes Rev 2024; 25:e13807. [PMID: 39044542 DOI: 10.1111/obr.13807] [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: 10/08/2023] [Revised: 05/12/2024] [Accepted: 07/02/2024] [Indexed: 07/25/2024]
Abstract
Childhood obesity represents a significant public health concern, imposing a substantial burden on the healthcare system. Furthermore, weight-loss programs often exhibit reduced effectiveness in adults who have a history of childhood obesity. Therefore, early intervention against childhood obesity is imperative. Presently, the primary method for diagnosing childhood obesity relies on body mass index (BMI), yet this approach has inherent limitations. Leptin, a satiety hormone produced by adipocytes, holds promise as a superior tool for predicting both childhood and subsequent adulthood obesity. In this review, we elucidate the tools employed for assessing obesity in children, delve into the biological functions of leptin, and examine the factors governing its expression. Additionally, we discuss maternal and infantile leptin levels as predictors of childhood obesity. By exploring the relationship between leptin levels and weight loss, we present leptin as a potential indicator of the effectiveness of obesity interventions.
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Affiliation(s)
- Mohammad Al Zein
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | | | - Fathima R Mahmood
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ali Khrayzat
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gianfranco Pintus
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Ali H Eid
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
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Legrand K, Manneville F, Langlois J, Böhme P, Dosda A, Beguinet M, Briançon S, Spitz E, Lecomte E, Omorou AY. Ten-year postintervention follow-up of adolescents participating in the management of overweight and social inequalities (PRALIMAP-INÈS intervention): the PRALIMAP-CINeCO survey protocol. BMJ Open 2024; 14:e083090. [PMID: 39266314 PMCID: PMC11404294 DOI: 10.1136/bmjopen-2023-083090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2024] Open
Abstract
INTRODUCTION The short-term effectiveness of the PRomotion de l'ALIMentation et de l'Activité Physique-INÈgalités de Santé' (PRALIMAP-INÈS) intervention to reduce social inequalities in overweight and obesity management among adolescents between 2012 and 2015 was demonstrated. This longitudinal mixed-methods study is a 10-year postintervention follow-up of the PRALIMAP-INÈS intervention with the aim of investigating social, economic, educational and health (especially weight) trajectories from adolescence to young adulthood. METHODS AND ANALYSIS Among adolescents enrolled in PRALIMAP-INÈS (n=1419), we estimate the number of participants to be 852. Adolescents who were included in the PRALIMAP-INÈS intervention will be contacted 10 years later and invited to participate in a follow-up visit. Participants will self-report their sociodemographic characteristics, body image perceptions, overweight/obesity care pathway, lifestyle and dietary behaviours and attitudes, psychological health and experience of the PRALIMAP-INÈS intervention. A check-up visit will be scheduled by a clinical research nurse to record waist circumference and weight and height for body mass index calculation and to construct the healthcare pathway from adolescence to young adulthood. 40 participants will be invited to participate in a semistructured interview conducted by a sociologist to deepen the understanding of trajectories regarding social aspects that are likely to influence health behaviours in participants. ETHICS AND DISSEMINATION The PRALIMAP-CINeCO trial was approved by French Persons Protection Committee (no. 2021-A00949-32) and a conformity declaration was made with French National Commission for Data Protection and Liberties. Results will be presented at conferences and published in international peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05386017; Pre-results.
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Affiliation(s)
- Karine Legrand
- UMR 1319 INSPIIRE, Université de Lorraine, Inserm, F-54000 Nancy, France
| | - Florian Manneville
- UMR 1319 INSPIIRE, Université de Lorraine, Inserm, F-54000 Nancy, France
- CIC-EC 1433, CHRU, Inserm, Université de lorraine, F-54000 Nancy, France
| | | | - Philip Böhme
- Department of Diabetology, Metabolic Diseases and Nutrition, CHRU de Nancy, Nancy, France
| | - Arnaud Dosda
- UMR 1319 INSPIIRE, Université de Lorraine, Inserm, F-54000 Nancy, France
| | - Mélanie Beguinet
- CIC-EC 1433, CHRU, Inserm, Université de lorraine, F-54000 Nancy, France
| | - Serge Briançon
- UMR 1319 INSPIIRE, Université de Lorraine, Inserm, F-54000 Nancy, France
| | - Elisabeth Spitz
- UMR 1319 INSPIIRE, Université de Lorraine, Inserm, F-54000 Nancy, France
| | - Edith Lecomte
- Conservatoire National des Arts et Metiers, Nancy, France
| | - Abdou Y Omorou
- UMR 1319 INSPIIRE, Université de Lorraine, Inserm, F-54000 Nancy, France
- CIC-EC 1433, CHRU, Inserm, Université de lorraine, F-54000 Nancy, France
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Dakin M, Manneville F, Langlois J, Briançon S, Lecomte E, Spitz E, Legrand K, Böhme P, Guillemin F, Omorou A. Role of dietary intake and physical activity in reducing weight social inequalities among adolescents: an application of G-formula to PRALIMAP-INÈS trial. Br J Nutr 2024; 132:182-191. [PMID: 38800976 DOI: 10.1017/s0007114524001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Interventions aiming to reduce social inequalities of weight status in adolescents usually focus on lifestyle behaviours, but their effectiveness is limited. This study analysed the effect of achieving levels of dietary intake (DI) and/or physical activity (PA) guidelines on reducing social inequalities in weight status among adolescents. We included adolescents from the PRomotion de l'ALIMentation et de l'Activité Physique - INÉgalité de Santé (PRALIMAP-INÈS) trial with weight status data available at baseline and 1-year follow-up (n 1130). PA and DI were measured using the International Physical Activity Questionnaire and a validated FFQ, respectively. We estimated the likelihood of a 1-year reduction in BMI z-score (BMIz) and population risk difference (PRD) under hypothetical DI and PA levels and socio-economic status using the parametric G-formula. When advantaged and less advantaged adolescents maintained their baseline DI and PA, we found social inequalities in weight status, with a PRD of a 1-year reduction in BMIz of -1·6 % (-3·0 %, -0·5 %). These inequalities were not observed when less advantaged adolescents increased their proportion of achieving DI guidelines by 30 % (PRD = 2·2 % (-0·5 %, 5·0 %)) unlike the same increase in PA (PRD = -3·9 % (-6·8 %, -1·3 %)). Finally, social inequalities of weight status were not observed when levels of achievement of both PA and DI guidelines increased by 30 % (PRD = 2·2 % (-0·5 %, 4·0 %)). Enhancing DI rather than PA could be effective in reducing social inequalities in weight status among adolescents. Future interventions aiming to reduce these inequalities should mostly target DI to be effective.
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Affiliation(s)
- Mohamed Dakin
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
| | - Florian Manneville
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy F-54000, France
| | - Johanne Langlois
- Conservatoire National des Arts et Métiers - Institut scientifique et technique de la nutrition et de l'alimentation (Cnam-ISTNA), Nancy, France
| | - Serge Briançon
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
| | - Edith Lecomte
- Conservatoire National des Arts et Métiers - Institut scientifique et technique de la nutrition et de l'alimentation (Cnam-ISTNA), Nancy, France
| | - Elisabeth Spitz
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
| | - Karine Legrand
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy F-54000, France
| | - Philip Böhme
- Service d'endocrinologie, diabétologie et nutrition, CHRU Nancy, Nancy, F-54000, France
| | - Francis Guillemin
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy F-54000, France
| | - Abdou Omorou
- Inserm, UMR 1319 INSPIIRE, Université de Lorraine, Nancy, Metz, France
- Inserm, CHRU Nancy, Université de Lorraine, CIC-Clinical Epidemiology, Nancy F-54000, France
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Gray LA. Evidence for central obesity risk-related thresholds for adolescents aged 11 to 18 years in England using the LMS method. Obes Res Clin Pract 2024; 18:249-254. [PMID: 39019689 DOI: 10.1016/j.orcp.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/20/2024] [Accepted: 07/06/2024] [Indexed: 07/19/2024]
Abstract
INTRODUCTION Central obesity has been shown to better indicate health risks compared to general obesity. Measures of central obesity include waist-to-height ratio (WHtR), waist-to-hip ratio (WHR) and waist circumference (WC). The National Institute of Health and Care Excellence (NICE) recently recommended the use of WHtR alongside body mass index (BMI) to identify risks in adults and children, whilst recognising the need for more evidence relating to WHtR in children. This study explores risk thresholds for central obesity measures throughout adolescence. It compares these with those currently recommended in England and discusses whether these thresholds are age- and sex-specific. METHODS Data on adolescents aged 11 to 18 years from the Health Survey for England (HSE) during 2005 to 2014 was used to calculate WHtR, WHR and WC percentiles. Next, smoothed lambda-mu-sigma (LMS) curves were created and the percentiles which align with the adult thresholds at age 18 years identified. This allows the most appropriate risk related thresholds for each measure during adolescence to be determined. RESULTS WHtR LMS curves are stable and flat throughout adolescence. WHR decreases in girls and WC increases in both boys and girls, during adolescence. Across all measures, there is slightly more fluctuation in higher percentiles, and in girls' WHR. DISCUSSION In practice, WHtR thresholds are simple to use to identify central obesity related risks. In particular, they are recommended because the same thresholds can be used for males and females and for adolescents and adults. The results support NICE guidance to use WHtR thresholds alongside BMI thresholds to identify individual risk. IMPLICATIONS AND CONTRIBUTION This study uses central obesity measures, including waist-to-height and waist-to-hip ratios, to investigate risk-related thresholds for adolescents. It is the first to do so using English data. It provides support for current NICE recommendations to use adult waist-to-height thresholds in adults and children, alongside BMI measures in clinical and non-clinical settings.
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Affiliation(s)
- Laura A Gray
- Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield S10 2TN, UK; Healthy Lifespan Institution, University of Sheffield, S10 2TN, UK.
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Strugnell C, Orellana L, Crooks N, Malakellis M, Morrissey B, Rennie C, Hayward J, Bliss J, Swinburn B, Gaskin CJ, Allender S. Healthy together Victoria and childhood obesity study: effects of a large scale, community-based cluster randomised trial of a systems thinking approach for the prevention of childhood obesity among secondary school students 2014-2016. BMC Public Health 2024; 24:355. [PMID: 38308292 PMCID: PMC10835842 DOI: 10.1186/s12889-024-17906-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/27/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Healthy Together Victoria (HTV) was a Victorian Government initiative that sought to reduce the prevalence of overweight and obesity through targeting chronic disease risk factors including physical activity, poor diet quality, smoking, and harmful alcohol use. The intervention involved a boosted workforce of > 170 local-level staff in 12 communities; employed to deliver system activation around health and wellbeing for individuals, families and communities. A cluster randomised trial (CRT) of a systems thinking approach to obesity prevention was embedded within HTV. We present the two-year changes in overweight and obesity and associated behaviours among secondary school students across Victoria, Australia. METHODS Twenty-three geographically bounded areas were randomised to intervention (12 communities) or comparison (11 communities). Randomly selected secondary schools within each community were invited to participate in the trial in 2014 and 2016. Students in Grade 8 (aged approximately 13-15 years) and Grade 10 (aged approximately 15-16 years) at participating schools were recruited using an opt-out approach across July-September 2014 and 2016. Primary outcomes were body mass index (BMI) and waist circumference. Secondary outcomes were physical activity, sedentary behaviour, diet quality, health-related quality of life, and depressive symptoms. Linear mixed models were fit to estimate the intervention effect adjusting for child/school characteristics. RESULTS There were 4242 intervention children and 2999 control children in the final analysis. For boys, the two-year change showed improvement in intervention versus control for waist circumference (difference in change: - 2.5 cm; 95% confidence interval [CI]: - 4.6, - 0.5) and consumption of sugar-sweetened beverages per day (< 1 serve: 8.5 percentage points; 95% CI: 0.6, 16.5). For girls, there were no statistically significant differences between conditions. CONCLUSIONS HTV seemed to produce favourable changes in waist circumference and sugar-sweetened beverage consumption for boys, however, no effect on BMI was observed. Although the HTV intervention was cut short, and the period between data collection points was relatively short, the changes observed in HTV contribute to the growing evidence of whole-of-community interventions targeting childhood obesity. TRIAL REGISTRATION This trial is unregistered. The intervention itself was a policy setting delivered by government and our role was the collection of data to evaluate the effect of this natural experiment. That is, this study was not a trial from the classical point of view and we were not responsible for the intervention.
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Affiliation(s)
- Claudia Strugnell
- Faculty of Health, Global Centre for Prevention Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia.
- Institute for Physical Activity and Nutrition, Deakin University Waterfront Campus, Geelong, Victoria, 3220, Australia.
| | - Liliana Orellana
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Australia
| | - Nicholas Crooks
- Faculty of Health, Global Centre for Prevention Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Mary Malakellis
- Faculty of Health, Global Centre for Prevention Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Bridget Morrissey
- Faculty of Health, Global Centre for Prevention Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Claire Rennie
- Faculty of Health, Global Centre for Prevention Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Joshua Hayward
- Faculty of Health, Global Centre for Prevention Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Jo Bliss
- Faculty of Health, Global Centre for Prevention Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Cadeyrn J Gaskin
- Faculty of Health, Global Centre for Prevention Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Steven Allender
- Faculty of Health, Global Centre for Prevention Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
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Luengo-Pérez LM, Fernández-Bueso M, Ambrojo A, Guijarro M, Ferreira AC, Pereira-da-Silva L, Moreira-Rosário A, Faria A, Calhau C, Daly A, MacDonald A, Rocha JC. Body Composition Evaluation and Clinical Markers of Cardiometabolic Risk in Patients with Phenylketonuria. Nutrients 2023; 15:5133. [PMID: 38140392 PMCID: PMC10745907 DOI: 10.3390/nu15245133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Cardiovascular diseases are the main cause of mortality worldwide. Patients with phenylketonuria (PKU) may be at increased cardiovascular risk. This review provides an overview of clinical and metabolic cardiovascular risk factors, explores the connections between body composition (including fat mass and ectopic fat) and cardiovascular risk, and examines various methods for evaluating body composition. It particularly focuses on nutritional ultrasound, given its emerging availability and practical utility in clinical settings. Possible causes of increased cardiometabolic risk in PKU are also explored, including an increased intake of carbohydrates, chronic exposure to amino acids, and characteristics of microbiota. It is important to evaluate cardiovascular risk factors and body composition in patients with PKU. We suggest systematic monitoring of body composition to develop nutritional management and hydration strategies to optimize performance within the limits of nutritional therapy.
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Affiliation(s)
- Luis M. Luengo-Pérez
- Biomedical Sciences Department, University of Extremadura, 06008 Badajoz, Spain
- Clinical Nutrition and Dietetics Unit, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (A.A.); (M.G.)
| | - Mercedes Fernández-Bueso
- Clinical Nutrition and Dietetics Unit, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (A.A.); (M.G.)
| | - Ana Ambrojo
- Clinical Nutrition and Dietetics Unit, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (A.A.); (M.G.)
| | - Marta Guijarro
- Clinical Nutrition and Dietetics Unit, Badajoz University Hospital, 06008 Badajoz, Spain; (M.F.-B.); (A.A.); (M.G.)
| | - Ana Cristina Ferreira
- Reference Centre of Inherited Metabolic Diseases, Centro Hospitalar Universitário de Lisboa Central, Rua Jacinta Marto, 1169-045 Lisboa, Portugal; (A.C.F.); or (J.C.R.)
| | - Luís Pereira-da-Silva
- CHRC—Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Universidade Nova de Lisboa, 1349-008 Lisboa, Portugal; (L.P.-d.-S.); (A.F.)
- NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.M.-R.); (C.C.)
| | - André Moreira-Rosário
- NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.M.-R.); (C.C.)
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School (NMS), Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
| | - Ana Faria
- CHRC—Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Universidade Nova de Lisboa, 1349-008 Lisboa, Portugal; (L.P.-d.-S.); (A.F.)
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School (NMS), Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
| | - Conceição Calhau
- NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.M.-R.); (C.C.)
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School (NMS), Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
| | - Anne Daly
- Birmingham Children’s Hospital, Birmingham B4 6NH, UK; (A.D.); (A.M.)
| | - Anita MacDonald
- Birmingham Children’s Hospital, Birmingham B4 6NH, UK; (A.D.); (A.M.)
| | - Júlio César Rocha
- Reference Centre of Inherited Metabolic Diseases, Centro Hospitalar Universitário de Lisboa Central, Rua Jacinta Marto, 1169-045 Lisboa, Portugal; (A.C.F.); or (J.C.R.)
- NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.M.-R.); (C.C.)
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School (NMS), Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal
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Vieira M, Carvalho GS. The "Planning Health in School" Programme (PHS-pro) to Improve Healthy Eating and Physical Activity: Design, Methodology, and Process Evaluation. Nutrients 2023; 15:4543. [PMID: 37960196 PMCID: PMC10649764 DOI: 10.3390/nu15214543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Few interventions have successfully promoted healthy eating and active living among children with effective changes in anthropometric health outcomes. Well-designed interventions involving multiple strategies to convert the knowledge already available into action are needed for preventing childhood obesity. In this study, an educational programme called "Planning Health in School" (PHS-pro) was designed, implemented and evaluated to contribute to the prevention of obesity in childhood. The PHS-pro aimed at improving the eating behaviours and lifestyles of Portuguese grade-6 children towards healthier nutritional status. This paper describes and evaluates the PHS-pro concerning: (i) the research design within the theoretical framework grounded on "The Transtheoretical Model" and the stages of change; (ii) the educational components and the application of the participatory methodology to engage children to meet their needs, as active participants in their change process; and (iii) the process evaluation of the intervention. The implementation of the PHS-pro took into account the views and inputs of the participants for evaluating the educational components that should be considered in the designing of interventions aiming to be effective strategies. From the health promotion perspective, this study is important because it examines new approaches and pathways to effectively prevent overweight and obesity in children.
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Affiliation(s)
- Margarida Vieira
- Research Centre on Child Studies, University of Minho, 4710-057 Braga, Portugal;
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Moroni I, De Amicis R, Ardissone A, Ravella S, Bertoli S. Nutritional status of children affected by X-linked adrenoleukodystrophy. J Hum Nutr Diet 2023; 36:1316-1326. [PMID: 36991579 DOI: 10.1111/jhn.13173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Adrenoleukodystrophy (ALD) is a rare X-linked metabolic disorder that causes the accumulation of very-long-chain fatty acids (VLCFAs) (C26:0) and the subsequent variety of clinical and neurological symptoms. Little is known about nutritional status and dietary habits of children affected by ALD, and so the present study aimed to assess nutritional status and food intake in children with ALD, also exploring the relationship between food intake and the consumption of disease-specific dietary supplements to reduce blood C26:0 concentrations and increase monounsaturated fatty acids (C26:1). METHODS All patients underwent a clinical and neurological evaluation and a comprehensive nutritional assessment. The association of VLCFA concentrations with dietary lipids was assessed. RESULTS Nine boys (11.49 ± 3.61 years) were enrolled in a cross-sectional study. All patients were normal weight, with normal resting energy expenditure. Only six of nine patients followed the low-fat diet and dietary supplements. An inverse association was found between the food intake of polyunsaturated lipids and C26:0; conversely, the C26:0 was positively associated with the dietary saturated lipids. When consumed, dietary supplement consumption correlated positively with C26:1 (ρ = 0.917, p = 0.029) and no correlation was found with C26:0 (ρ = 0.410, p = 0,493). CONCLUSIONS No children were found to be malnourished or overweight or obese; however, half of the children reported excessive body fat, probably as a result of the pharmacotherapies. A low-fat diet could be adjuvant in the management of the accumulation of VLCFAs, but poor dietary compliance to disease-specific nutritional guidelines appears to be a major problem of this condition and underlines the need for a structured and personalised nutritional management in ALD disease.
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Affiliation(s)
- Isabella Moroni
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Besta, Milan, Italy
| | - Ramona De Amicis
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
- Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Anna Ardissone
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Besta, Milan, Italy
| | - Simone Ravella
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
| | - Simona Bertoli
- Department of Food Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy
- Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Omorou AY, Langlois J, Böhme P, Legrand K, Muller L, Saez L, Pourcher-Lambolez C, Spitz E, Briançon S, Lecomte E. Proportionate universalism intervention is effective for tackling nutritional social gradient in adolescents: the PRALIMAP-INÈS mixed randomised trial. Public Health 2023; 221:79-86. [PMID: 37423032 DOI: 10.1016/j.puhe.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/15/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE This study aimed to investigate the effectiveness of proportionate universalism intervention to reduce the slope of the nutritional social gradient in adolescents. STUDY DESIGN A mixed (experimental and quasi-experimental) multicentre trial. METHODS Data from 985 adolescents of the PRALIMAP-INÈS trial (North-eastern France, 2012-2015) were analysed. For this, adolescents were split into five social classes according to the Family Affluence Scale: Highly Less Advantaged (H.L.Ad; n = 33), Less Advantaged (L.Ad; n = 155), Intermediate (Int; n = 404), Advantaged (Ad; n = 324) and Highly Advantaged (H.Ad; n = 69). The overweight care management was a standard care for all and a strengthened one adapted to the social class of adolescents. The main outcome was the 1-year change of the body mass index z-score (BMIz) slope. Other nutritional outcomes were BMI, ΔBMIp95 (BMI minus 95th percentile of the WHO reference), %BMIp95 (percent of 95th percentile of the WHO reference), leisure-time sport, consumption of fruits and vegetables and consumption of sugary foods and drinks. RESULTS The inclusion data confirmed a weight social gradient expressed by a significant BMIz linear regression coefficient (β = -0.09 [-0.14 to -0.04], P < 0.0001). The higher the social class, the lower the BMIz. The 1-year BMIz linear regression coefficient was -0.07 [-0.12 to -0.02], corresponding to a significant weight social gradient reduction of 23.3% (β = 0.021 [0.001 to 0.041]; P = 0.04). Consistent results were found for other nutritional outcomes. CONCLUSIONS PRALIMAP-INÈS shows that proportionate universalism intervention is effective to reduce the adolescents' nutritional social gradient and suggests that equitable health programmes and policies are a realistic goal.
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Affiliation(s)
- A Y Omorou
- University of Lorraine, APEMAC, Nancy, Metz, France; CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France.
| | - J Langlois
- National Conservatory of Arts and Crafts, Nancy, France
| | - P Böhme
- CHRU-Nancy, Department of Diabetology, Metabolic Diseases and Nutrition, Nancy, France
| | - K Legrand
- University of Lorraine, APEMAC, Nancy, Metz, France; CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France
| | - L Muller
- University of Lorraine, APEMAC, Nancy, Metz, France
| | - L Saez
- University of Lorraine, APEMAC, Nancy, Metz, France
| | | | - E Spitz
- University of Lorraine, APEMAC, Nancy, Metz, France
| | - S Briançon
- University of Lorraine, APEMAC, Nancy, Metz, France
| | - E Lecomte
- National Conservatory of Arts and Crafts, Nancy, France
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10
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De Amicis R, Leone A, Pellizzari M, Foppiani A, Battezzati A, Lessa C, Tagliabue A, Ferraris C, De Giorgis V, Olivotto S, Previtali R, Veggiotti P, Bertoli S. Long-term follow-up of nutritional status in children with GLUT1 Deficiency Syndrome treated with classic ketogenic diet: a 5-year prospective study. Front Nutr 2023; 10:1148960. [PMID: 37293674 PMCID: PMC10244766 DOI: 10.3389/fnut.2023.1148960] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/09/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction The classic ketogenic diet (cKD) is an isocaloric, high fat, low-carbohydrate diet that induces the production of ketone bodies. High consumption of dietary fatty acids, particularly long-chain saturated fatty acids, could impair nutritional status and increase cardiovascular risk. The purpose of this study was to evaluate the long-term effects of a 5-year cKD on body composition, resting energy expenditure, and biochemical parameters in children affected by Glucose Transporter 1 Deficiency Syndrome (GLUT1DS). Methods This was a prospective, multicenter, 5-year longitudinal study of children with GLUT1DS treated with a cKD. The primary outcome was to assess the change in nutritional status compared with pre-intervention, considering anthropometric measurements, body composition, resting energy expenditure, and biochemical parameters such as glucose and lipid profiles, liver enzymes, uric acid, creatinine, and ketonemia. Assessments were conducted at pre-intervention and every 12 months of cKD interventions. Results Ketone bodies increased significantly in children and adolescents, and remained stable at 5 years, depending on the diet. No significant differences were reported in anthropometric and body composition standards, as well as in resting energy expenditure and biochemical parameters. Bone mineral density increased significantly over time according to increasing age. Body fat percentage significantly and gradually decreased in line with the increase in body weight and the consequent growth in lean mass. As expected, we observed a negative trend in respiratory quotient, while fasting insulin and insulin resistance were found to decrease significantly after cKD initiation. Conclusion Long-term adherence to cKD showed a good safety profile on anthropometric measurements, body composition, resting energy expenditure, and biochemical parameters, and we found no evidence of potential adverse effects on the nutritional status of children and adolescents.
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Affiliation(s)
- Ramona De Amicis
- ICANS-DIS, Department of Food Environmental and Nutritional Sciences, University of Milan, Milan, Italy
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Alessandro Leone
- ICANS-DIS, Department of Food Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Marta Pellizzari
- ICANS-DIS, Department of Food Environmental and Nutritional Sciences, University of Milan, Milan, Italy
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Andrea Foppiani
- ICANS-DIS, Department of Food Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Alberto Battezzati
- ICANS-DIS, Department of Food Environmental and Nutritional Sciences, University of Milan, Milan, Italy
- Clinical Nutrition Unit, Department of Endocrine and Metabolic Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara Lessa
- ICANS-DIS, Department of Food Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Anna Tagliabue
- Human Nutrition and Eating Disorder Centre, University of Pavia, Pavia, Italy
- Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensic Medicine University of Pavia, Pavia, Italy
| | - Cinzia Ferraris
- Human Nutrition and Eating Disorder Centre, University of Pavia, Pavia, Italy
- Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensic Medicine University of Pavia, Pavia, Italy
| | - Valentina De Giorgis
- Department of Child Neurology and Psychiatry, IRCCS “C. Mondino” National Neurological Institute, Pavia, Italy
| | - Sara Olivotto
- Pediatric Neurology Unit, “V. Buzzi” Hospital, Milan, Italy
| | - Roberto Previtali
- Pediatric Neurology Unit, “V. Buzzi” Hospital, Milan, Italy
- Biomedical and Clinical Sciences Department, University of Milan, Milan, Italy
| | - Pierangelo Veggiotti
- Pediatric Neurology Unit, “V. Buzzi” Hospital, Milan, Italy
- Biomedical and Clinical Sciences Department, University of Milan, Milan, Italy
| | - Simona Bertoli
- ICANS-DIS, Department of Food Environmental and Nutritional Sciences, University of Milan, Milan, Italy
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
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11
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Makary S, Abd El Moez K, Elsayed M, Hassan H. Second-generation antipsychotic medications and metabolic disturbance in children and adolescents. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2023; 59:14. [DOI: 10.1186/s41983-023-00612-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 01/16/2023] [Indexed: 09/02/2023] Open
Abstract
Abstract
Background
The second-generation antipsychotics (SGAs) are a group of antipsychotic drugs, used to treat psychiatric conditions. SGAs have been shown to precipitate rapid weight gain and dyslipidemia, as well as to promote insulin resistance, leading to the emergence of type 2 diabetes and metabolic syndrome. Prescriptions of SGAs in children have increased 6- to 10-fold during the last decade. This research work designed to find correlation between duration of second-generation antipsychotics (SGA) use, in children and adolescent, and the increase in metabolic syndrome disturbance components including weight gain, hypertension, hyperlipidemia and diabetes mellitus. This is cross-sectional analytic study was carried out in Suez Canal University Hospital, Psychiatry Outpatient Clinic on Children and adolescent aged 4–17 years. It included 151 children and adolescents diagnosed by Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). They were divided into two groups, 72 patients who regular on (SGA) as treated group and 79 patients who did not receive pharmacological medication as control group.
Results
The overall prevalence of metabolic syndrome in the current study was high 27.81% in SGA-treated children compared to 0.60% in control group. In the SGA-treated group, 22.22% had type 2 diabetes, compared with 2.53% in the control group. SGA-treated patients showed a highly significant increase in their weight, body mass index and waist circumference compared to their control group patients. The correlation of different metabolic syndrome indices and SGAs duration showed positive correlation with body mass index, fasting blood sugar, and blood lipids (low density lipoproteins and cholesterol) but negative correlation with high density lipoproteins. Blood pressure did not correlate with SGA-duration in the studied patients. Indices which showed correlation could be predictors of the metabolic syndrome developments. Although the correlation and regression model showed moderate degree of association, this is considered important issue for the young patients.
Conclusion
SGA treatment in children and adolescence confers a significantly increased risk for metabolic syndrome and SGA-treatment duration is important for MtS development.
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Reference growth curves to identify weight status (underweight, overweight or obesity) in children and adolescents: systematic review. Br J Nutr 2023:1-13. [PMID: 36695353 DOI: 10.1017/s0007114522003786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The identification of somatic growth, through reference curves, can be used to create strategies and public policies to reduce public health problems such as malnutrition and obesity and to identify underweight, overweight and obesity. The purpose of this systematic review was to identify studies providing reference growth curves for weight status in children and adolescents. A systematic search was conducted in eight databases and in gray literature (Google scholar). To assess the risk of bias/methodological quality of studies, the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-sectional Studies (NHLBI) was used. Overall, 86 studies that met the inclusion criteria were included. Through the values of reference growth curves for the identification of underweight, overweight and obesity, it was possible to verify that there is great variability among percentiles for the identification of underweight, overweight and obesity. The most prevalent percentiles for underweight were P3 and P5; for overweight, the most prevalent was P85 and the most prevalent percentiles for obesity were P95 and P97. The most prevalent anthropometric indicators were Body Mass Index (BMI), Waist Circumference (WC), Body Mass (BM) for age and height for age. Conclusion: Such data can demonstrate that the optimal growth must be reached, through the standard growth curves, but that the reference curves demonstrate a cut of the population growth, raising possible variables that can influence the optimal growth, such as an increase in the practice of physical activities and an awareness of proper nutrition.
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13
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Rigamonti AE, Frigerio G, Caroli D, De Col A, Cella SG, Sartorio A, Fustinoni S. A Metabolomics-Based Investigation of the Effects of a Short-Term Body Weight Reduction Program in a Cohort of Adolescents with Obesity: A Prospective Interventional Clinical Study. Nutrients 2023; 15:529. [PMID: 36771236 PMCID: PMC9921209 DOI: 10.3390/nu15030529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Metabolomics applied to assess the response to a body weight reduction program (BWRP) may generate valuable information concerning the biochemical mechanisms/pathways underlying the BWRP-induced cardiometabolic benefits. The aim of the present study was to establish the BWRP-induced changes in the metabolomic profile that characterizes the obese condition. In particular, a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) targeted metabolomic approach was used to determine a total of 188 endogenous metabolites in the plasma samples of a cohort of 42 adolescents with obesity (female/male = 32/10; age = 15.94 ± 1.33 year; body mass index standard deviation score (BMI SDS) = 2.96 ± 0.46) who underwent a 3-week BWRP, including hypocaloric diet, physical exercise, nutritional education, and psychological support. The BWRP was capable of significantly improving body composition (e.g., BMI SDS, p < 0.0001), glucometabolic homeostasis (e.g., glucose, p < 0.0001), and cardiovascular function (e.g., diastolic blood pressure, p = 0.016). A total of 64 metabolites were significantly reduced after the intervention (at least p < 0.05), including 53 glycerophospholipids (23 PCs ae, 21 PCs aa, and 9 lysoPCs), 7 amino acids (tyrosine, phenylalanine, arginine, citrulline, tryptophan, glutamic acid, and leucine), the biogenic amine kynurenine, 2 sphingomyelins, and (free) carnitine (C0). On the contrary, three metabolites were significantly increased after the intervention (at least p < 0.05)-in particular, glutamine, trans-4-hydroxyproline, and the octadecenoyl-carnitine (C18:1). In conclusion, when administered to adolescents with obesity, a short-term BWRP is capable of changing the metabolomic profile in the plasma.
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Affiliation(s)
- Antonello E. Rigamonti
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy
| | - Gianfranco Frigerio
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, 6 Avenue Du Swing, L-4367 Belvaux, Luxembourg
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Diana Caroli
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
| | - Alessandra De Col
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
| | - Silvano G. Cella
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo-Verbania, Italy
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, 20145 Milan, Italy
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Julia C, Omorou A, Lecomte E, Langlois J, Touvier M, Hercberg S, Briançon S, Kesse-Guyot E, Guillemin F. Behavioural risk patterns in adolescents with excess weight participating in the PRALIMAP-INÈS trial. Public Health Nutr 2023; 26:96-105. [PMID: 35272723 PMCID: PMC11077442 DOI: 10.1017/s136898002200057x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/01/2022] [Accepted: 03/09/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate clustering of risk behaviours in adolescents with excess weight. DESIGN Cross-sectional analysis of baseline data from the PRALIMAP-INÈS trial. Information on food frequency consumption (fruit, vegetables, sugary products and beverages), physical activity, sedentary behaviour (week and weekend days), smoking and alcohol consumption (current frequency and intoxication episodes) and socio-demographic data was collected using self-reported questionnaires. Behavioural risk factors were entered as categorical variables in a two-step clustering procedure: multiple correspondence analysis followed by hierarchical clustering. Associations between cluster membership and socio-demographic variables were investigated using multivariable multinomial logistic regression. SETTING French PRALIMAP-INÈS trial. PARTICIPANTS Adolescents with excess weight. RESULTS A total of 1391 participants (13-18 years old, 58·2 % female) were included in the analysis, which resulted in the identification of four groups of participants, including, respectively, 543 (39·0 %), 373 (26·8 %), 246 (17·7 %) and 229 (16·5 %) participants. Clusters 1 and 4 showed associations of rather healthy behaviours (high physical activity and low consumption of sugary products; high consumption of fruit and vegetables, respectively), while clusters 2 and 3 showed associations of rather unhealthy behaviours (high sedentary behaviour and low consumption of fruit and vegetables; smoking and alcohol consumption, respectively). Both social status and family structure were associated with cluster membership. CONCLUSIONS Risk behaviour patterns in adolescents with excess weight were clustered in both healthier and less healthy ways, with a complex interplay with socio-demographic factors.
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Affiliation(s)
- Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny, France
- University of Lorraine, EA 4360 APEMAC, Nancy, France
| | - Abdou Omorou
- University of Lorraine, EA 4360 APEMAC, Nancy, France
- CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France
| | - Edith Lecomte
- National Conservatory of Arts and Crafts, Nancy, France
| | | | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny, France
| | | | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University of Paris (CRESS), Bobigny, France
| | - Francis Guillemin
- University of Lorraine, EA 4360 APEMAC, Nancy, France
- CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France
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15
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Lee S, Kim Y, Han M. Influence of Waist Circumference Measurement Site on Visceral Fat and Metabolic Risk in Youth. J Obes Metab Syndr 2022; 31:296-302. [PMID: 36274244 PMCID: PMC9828705 DOI: 10.7570/jomes22046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/07/2022] [Accepted: 10/05/2022] [Indexed: 01/21/2023] Open
Abstract
Although the rate of childhood obesity seems to have plateaued in recent years, the prevalence of obesity among children and adolescents remains high. Childhood obesity is a major public health concern as overweight and obese youth suffer from many co-morbid conditions once considered exclusive to adults. It is now well demonstrated that abdominal obesity as measured by waist circumference (WC) is an independent risk factor for cardiovascular disease and metabolic dysfunction in youth. Despite the strong associations between WC and cardiometabolic risk factors, there is no consensus regarding the optimal WC measurement sites to assess abdominal obesity and obesity-related health risk in children and adolescents. Currently, the WC measurement site that provides the best reflections of visceral fat and the best correlations with cardiometabolic risk factors is unclear. The purpose of this review is to explore whether WC measurement sites influence the relationships between WC, visceral fat, and cardiometabolic risk factors in children and adolescents.
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Affiliation(s)
- SoJung Lee
- Division of Sports Medicine, Graduate School of Physical Education, Kyung Hee University, Yongin, Korea,Corresponding author SoJung Lee https://orcid.org/0000-0002-6634-6800 Graduate School of Physical Education, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin 17104, Korea Tel: +82-31-201-2751 Fax: +82-31-204-8117 E-mail:
| | - Yejin Kim
- Graduate School, Kyung Hee University, Yongin, Korea
| | - Minsub Han
- Division of Sports Medicine, Graduate School of Physical Education, Kyung Hee University, Yongin, Korea
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16
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The Impact of the 'Planning Health in School' Programme on a Pair of Twins with Obesity. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121866. [PMID: 36553309 PMCID: PMC9777452 DOI: 10.3390/children9121866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
This case study describes the impact of the 'Planning Health in School' programme (PHS-pro) on the nutritional status and lifestyle behaviours of two twins with obesity. As part of a larger research project involving 449 adolescents in grade-6, PHS-pro aims at preventing obesity and guiding children towards healthy behaviours. Twins were evaluated for anthropometric measurements-height, weight, body mass index (BMI), waist circumference (WC), and lifestyle behaviours before (baseline) and after (8 months) PHS-pro and at a follow-up (one-year later). At the baseline, both twins were obese according to the international cut-off points of Cole. After PHS-pro, improvements in anthropometric parameters were found: the boy decreased his BMI by 10% and lost 9.0 cm in WC, while remaining obese; the girl decreased her BMI by 8% and lost 8.7 cm in WC, changing to the overweight category. At the follow-up, a slight increase in the anthropometric parameters was found in both twins; however, they did not return to the baseline values. The programme successfully promoted positive changes in behaviours and improved nutritional status, showing the long-term effects of the PHS-pro. Although it is a school-based intervention to prevent obesity, the PHS-pro is helpful in weight reduction even in children already with obesity.
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Marsigliante S, Ciardo V, Di Maglie A, My G, Muscella A. Efficacy of school-based intervention programs in reducing overweight: A randomized trial. Front Nutr 2022; 9:1001934. [PMID: 36245531 PMCID: PMC9557174 DOI: 10.3389/fnut.2022.1001934] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Childhood obesity represents a serious public health problem and this study evaluates the effectiveness of a 6-month educational intervention on lifestyle, nutrient adequacy, and diet quality in the school setting in improving the knowledge and behavior of primary school children regarding correct eating habits. The strategy was implemented over a 6-month period and participants were randomly assigned to either the intervention group (n = 200) or the non-intervention group (control group, n = 197). Participants had a mean body mass index of 18.3 ± 2.7 kg/m2 and its variation in the intervention group (−2.7 ± 0.5 kg/m2) was significantly different from that in the control group (3.41 ± 0.8 kg/m2). In the experimental group, there were significant differences between the proportion of children who were overweight, underweight, normal weight, or obese before and after intervention (p < 0.05). The best results were seen in the female sex, and after the intervention, there were no more girls with obesity. Furthermore, there were significant waist circumference decrement effects in the intervention group compared to the control group (p < 0.05). Finally, many of the participating children acquired healthy eating habits. Therefore, the quantitative results obtained suggest that a school intervention program represents an effective strategy to prevent and improve the problem of childhood overweight and obesity.
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Affiliation(s)
- Santo Marsigliante
- Department of Biological and Environmental Science and Technologies (DiSTeBA), University of Salento, Lecce, Italy
| | - Vito Ciardo
- Department of Biological and Environmental Science and Technologies (DiSTeBA), University of Salento, Lecce, Italy
| | - Antonio Di Maglie
- Department of History, Society and Human Studies, University of Salento, Lecce, Italy
| | - Giulia My
- Department of Biological and Environmental Science and Technologies (DiSTeBA), University of Salento, Lecce, Italy
| | - Antonella Muscella
- Department of Biological and Environmental Science and Technologies (DiSTeBA), University of Salento, Lecce, Italy
- *Correspondence: Antonella Muscella
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Radetti G, Grugni G, Lupi F, Fanolla A, Caroli D, Bondesan A, Sartorio A. High Tg/HDL-Cholesterol Ratio Highlights a Higher Risk of Metabolic Syndrome in Children and Adolescents with Severe Obesity. J Clin Med 2022; 11:jcm11154488. [PMID: 35956105 PMCID: PMC9369869 DOI: 10.3390/jcm11154488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/11/2022] [Accepted: 07/27/2022] [Indexed: 12/11/2022] Open
Abstract
Few data are currently available on the reliability of the different anthropometric, instrumental and biochemical indexes in recognizing the presence of metabolic syndrome (MetS) in children and adolescents with severe obesity. Therefore, the objective of our study was to find out the simplest and most accurate predictive index of MetS in this population at-risk. In 1065 children and adolescents (563 f, 502 m), aged 14.6 ± 2.1 years (range 10–17), with severe obesity [BMI-SDS 3.50 ± 0.36 (range 3.00–5.17)], the following indexes were evaluated: BMI, BMI-SDS, Tri-Ponderal Mass Index, Waist-to-Height ratio, TG/HDL-Cholesterol ratio, Cardiometabolic Index (CMI), and Visceral Adiposity Index (VAI). For each subject, all the components of MetS, defined according to the IDF criteria, were determined. Overall, the presence of MetS was found in 324 patients (30.4%), 167 males (33.3%) and 157 females (27.9%). According to the ROC analysis, three indexes (VAI, CMI and TG/HDL-Cholesterol ratio), performed significantly better than the other ones in identifying MetS, with no difference among them. In conclusion, the TG/HDL ratio, which just needs the evaluation of two simple biochemical parameters, offers the same accuracy as other more sophisticated indexes in recognizing MetS in children and adolescents with severe obesity, thus making it the best predictor to be easily used.
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Affiliation(s)
| | - Graziano Grugni
- Experimental Laboratory for Auxo-Endocrinological Research, Division of Auxology, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo-Verbania, Italy; (G.G.); (D.C.); (A.B.); (A.S.)
| | - Fiorenzo Lupi
- Newborn Intensive Care Unit, Regional Hospital of Bolzano, 39100 Bolzano, Italy;
| | - Antonio Fanolla
- Observatory for Health Provincial Government South Tyrol, 39100 Bolzano, Italy;
| | - Diana Caroli
- Experimental Laboratory for Auxo-Endocrinological Research, Division of Auxology, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo-Verbania, Italy; (G.G.); (D.C.); (A.B.); (A.S.)
| | - Adele Bondesan
- Experimental Laboratory for Auxo-Endocrinological Research, Division of Auxology, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo-Verbania, Italy; (G.G.); (D.C.); (A.B.); (A.S.)
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Division of Auxology, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo-Verbania, Italy; (G.G.); (D.C.); (A.B.); (A.S.)
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Changing trends of obesity and lipid profiles among Bangkok school children after comprehensive management of the bright and healthy Thai kid project. BMC Public Health 2022; 22:1323. [PMID: 35810278 PMCID: PMC9271254 DOI: 10.1186/s12889-022-13712-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 06/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background Cardiovascular diseases are the world’s leading cause of death. Children in Thailand are currently facing obesity, hyperlipidemia, and high atherogenic indices. This study aimed to assess the success of the Bright and Healthy Thai Kid project in reducing obesity and high lipid profiles among Bangkok school children. Methods A community-based, intervention (participatory action) with pre-post comparison of anthropometric and lipid profile data was conducted in five randomly selected Bangkok primary schools. The participatory action involved teachers, students, and parents. Data collection on anthropometric measurements, dietary intake, physical activity, and fasting blood samples of three generations of students was carried out during July–August (midterm months in Thailand) in the years 2004, 2017, and 2019. SPSS for Windows, version 16 was used for data analysis. Results Comparing the data from 2004, 2017, and 2019, obesity rates of 19.3 in 2004 gradually declined to 16.9 and 15.6 in 2017 and 2019 (P < 0.001). High serum total cholesterol, triglyceride, LDL-C, and atherogenic indices decreased significantly (p < 0.001). Conclusions We believe that the great time and effort expended for a campaign to reduce rates of obesity and hyperlipidemia in school children does work to prevent future cardiovascular diseases. Long-term investment in national programs is required to achieve whole societal involvement in improving knowledge and skills related to health, nutrition, and healthy food choices. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13712-w.
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Family socioeconomic status and childhood adiposity in Europe - A scoping review. Prev Med 2022; 160:107095. [PMID: 35594926 DOI: 10.1016/j.ypmed.2022.107095] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/28/2022] [Accepted: 05/13/2022] [Indexed: 11/23/2022]
Abstract
Childhood obesity is a considerable public health problem worldwide. In Europe, lower parental socioeconomic status (SES) relates to higher childhood adiposity. This scoping review strives to discover, which SES indicators are the most commonly used and meaningful determinants of childhood adiposity (greater level of continuous adiposity indicator, e.g. body mass index z-score, or overweight or obesity categorized by established definitions). The review focused on studies about European general populations from the 21st century (January 2000-April 2021) considering children and adolescents aged 0-17 years. PubMed and reference lists of articles were searched in February-April 2021. Total of 53 studies with 121 association analyses between different SES indicators and adiposity indicators, were identified and reviewed. Different SES indicators were grouped to 25 indicators and further to six indicator groups. The most used indicator was mother's education (n of association analyses = 24) and the most used indicator group was parental education (n of association analyses = 51). Of all association analyses, 55% were inverse, 36% were non-significant, and 8% were positive. Composite SES (80%), parental education (69%) and parental occupation (64%) indicators showed most frequently inverse associations with obesity measures (i.e. lower parental SES associating with higher adiposity), while parental income (50% inverse; 50% non-significant) and property and affluence (42% inverse; 50% nonsignificant) indicators showed approximately even number of inverse and non-significant associations. Instead, majority of parental employment (60%) indicators, showed non-significant associations and 33% showed positive associations (i.e. higher parental SES associating with higher adiposity). Despite some variation in percentages, majority of the associations were inverse in each age group and with different outcome categorizations. In girls and in boys, non-significant associations predominated. It seems that children with parents of higher SES have lower likelihood of adiposity in Europe. Parents' employment appears to differ from other SES indicators, so that having an employed parent(s) does not associate with lower likelihood of adiposity. Positive associations seem to occur more frequently in poorer countries. Criteria for uniform childhood SES and adiposity measures should be established and used in studies in order to be able to produce comparable results across countries.
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Kjetså I, Halvorsen PA, Kokkvoll AS. Age, income and sleep duration were associated with outcomes in children participating in weight management. Acta Paediatr 2022; 111:1412-1419. [PMID: 35322469 PMCID: PMC9324948 DOI: 10.1111/apa.16339] [Citation(s) in RCA: 2] [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] [Received: 10/21/2021] [Revised: 03/08/2022] [Accepted: 03/21/2022] [Indexed: 12/12/2022]
Abstract
Aim To explore associations between baseline factors and weight‐related outcomes among participants enrolled in a paediatric obesity trial. Methods We included children aged 6–12 years participating in a 2‐year multidisciplinary family programme who attended a postintervention follow‐up 36 months from baseline (n = 62). Outcome measures were change in body mass index standard deviation score (BMI SDS), reduction in BMI SDS ≥0.25 and change in waist circumference (WC). Independent variables included in linear and logistic regression models were age, sex, household income, parents' education, sleep duration, screen time and physical activity. Results Altogether, 26 children (42%) attained a reduction of BMI SDS ≥0.25. Higher family income and longer sleep duration were associated with greater change in BMI SDS (−0.05 per 100.000 NOK, p = 0.02, and −0.24 per hour, p = 0.02, respectively). Higher age was associated with greater change in WC (−2.1 cm per year, p = 0.01) but lower odds of attaining a reduction in BMI SDS ≥0.25 (OR per year 0.70, p = 0.04). There was a borderline statistically significant trend towards greater increase in WC with longer daily screen time (p = 0.05). Conclusion Age, family income and sleep duration at baseline were associated with weight‐related outcomes 1‐year postintervention.
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Affiliation(s)
- Ingrid Kjetså
- Department of Radiology Helse Møre og Romsdal Molde Sjukehus Molde Norway
| | - Peder Andreas Halvorsen
- Research Unit for General Practice Department of Community Medicine UiT The Arctic University of Norway Tromsø Norway
| | - Ane Sofie Kokkvoll
- Department of Paediatrics Finnmark Hospital Trust Hammerfest Norway
- Paediatric Research Group Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
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Rodrigo T, Dulani S, Nimali Seneviratne S, De Silva AP, Fernando J, De Silva HJ, Jayasekera, Wickramasinghe VP. Effects of probiotics combined with dietary and lifestyle modification on clinical, biochemical, and radiological parameters in obese children with nonalcoholic fatty liver disease/nonalcoholic steatohepatitis: a randomized clinical trial. Clin Exp Pediatr 2022; 65:304-311. [PMID: 34773939 PMCID: PMC9171460 DOI: 10.3345/cep.2021.00787] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/23/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Childhood obesity is a global problem associated with metabolic abnormalities. The gut-liver axis is thought to play a major role in its pathogenesis. Probiotics are known to alter the gut microbiota and, therefore, could be a therapeutic option in the management of childhood obesity-related complications. PURPOSE This double-blind randomized placebo-controlled trial evaluated the effects of probiotics on metabolic derangement in obese children with nonalcoholic fatty liver disease/ nonalcoholic steatohepatitis (NAFLD/NASH). METHODS Obese children with NAFLD/NASH treated at the nutrition clinic of the University Paediatric Unit at Lady Ridgeway Hospital, Colombo, were recruited. Anthropometry, body fat, metabolic derangement, and liver ultrasound scan (USS) results were evaluated at baseline and after 6 months. Transient elastography (FibroScan) was performed on a subsample of these patients. Eighty-four patients were recruited and randomized into the probiotics (n=43) and placebo (n= 41) groups. The mean age was 11.3±1.9 versus 12.1±1.5 years in the probiotic and placebo groups, respectively. Baseline parameters including liver disease stage on USS, body fat percentage, fasting blood sugar, lipid profile, liver function, and C-reactive protein showed no significant intergroup differences. RESULTS In the probiotic group, a statistically significant reduction in body mass index was noted from the baseline value. However, the reduction was not significant compared with the placebo group. There was a significant reduction in triglycerides, aspartate transaminase (AST), alanine aminotransferase (ALT), AST/ALT ratio, and alkaline phosphatase in the placebo group over the treatment period. Although the liver disease stage on USS improved from stage II-III to stage I in a small number of patients in the probiotic-treated group, transient elastography performed in a subsample did not demonstrate significant improvement in either group. CONCLUSION Our results indicate that probiotics have no advantage over lifestyle modification for improving obesityassociated metabolic derangement in children.
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Affiliation(s)
- Thushara Rodrigo
- Post Graduate Institute of Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Samaranayake Dulani
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Arjuna P De Silva
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - Jerad Fernando
- Department of Radiology, Lady ridgeway Hospital for Children, Colombo, Sri Lanka
| | - H Janaka De Silva
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - Jayasekera
- Department of Pediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Mardali F, Naziri M, Sohouli MH, Fatahi S, Sadat Hosseini-Baharanchi F, Găman MA, Shidfar F. Predictors of central and general obesity in Iranian preschool children: which anthropometric indices can be used as screening tools? BMC Pediatr 2022; 22:320. [PMID: 35641965 PMCID: PMC9153200 DOI: 10.1186/s12887-022-03365-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
AIM To compare the ability of anthropometric indices [waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), neck-to-height ratio (NHR), conicity index (CI), body adiposity index (BAI), tri-ponderal mass index (TMI) and body mass index (BMI)] and,measuerments like neck(NC), hip(HC) and waist circumferences to predict overweight and obesity in Iranian preschool children. MATERIALS AND METHODS A total of 498 Iranian preschool children were included in this case-control study conducted in Tehran, Iran. The participants were selected using the stratified random sampling procedure based on gender and school. Using sex-based receiver operating curve (ROC) analysis, we compared the area under the curve and defined the cut-off points for detecting central and general obesity for each index in order to identify the most suitable tools in predicting obesity. RESULTS Boys had significantly higher values for NC, WC, WHR, NHR, CI, TMI and BMI as compared to girls, whereas BAI and HC were higher in girls. The area under the curve was calculated for all the possible predictors of central obesity, i.e., NC (0.841-0.860), WC (0.70-0.679), HC (0.785-0.697), WHR (0.446-0.639) and CI (0.773-0.653) in boys and girls, respectively. And according to the ROC curve analysis, BMI (0.959-0.948), TMI (0.988-0.981), WHtR (0.667-0.553) and NHR (0.785-0.769) were predictors of general obesity and NC (0.841-0.860) as predictor of central obesity in boys and girls, respectively. The optimal cut-off points for TMI (13.80-15.83), NC (28.68-27.5) and for other anthropometric indices were estimated in both boys and girls. CONCLUSION TMI and NC seem to predict general and central obesity in Iranian preschool children.
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Affiliation(s)
- Farzaneh Mardali
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdyieh Naziri
- Student of Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
- Department of Biostatics, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somaye Fatahi
- Student of Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadat Hosseini-Baharanchi
- Minimally Invasive Surgery Research Center & Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, Department of Hematology, Center of Hematology and Bone Marrow Transplantation, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania, Fundeni Clinical Institute, Bucharest, Romania
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Mardali F, Naziri M, Sohouli MH, Fatahi S, Sadat Hosseini-Baharanchi F, Găman MA, Shidfar F. Predictors of central and general obesity in Iranian preschool children: which anthropometric indices can be used as screening tools? BMC Pediatr 2022; 22:320. [PMID: 35641965 DOI: 10.1186/s12887-022-03365-4.pmid:] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/16/2022] [Indexed: 07/31/2024] Open
Abstract
AIM To compare the ability of anthropometric indices [waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), neck-to-height ratio (NHR), conicity index (CI), body adiposity index (BAI), tri-ponderal mass index (TMI) and body mass index (BMI)] and,measuerments like neck(NC), hip(HC) and waist circumferences to predict overweight and obesity in Iranian preschool children. MATERIALS AND METHODS A total of 498 Iranian preschool children were included in this case-control study conducted in Tehran, Iran. The participants were selected using the stratified random sampling procedure based on gender and school. Using sex-based receiver operating curve (ROC) analysis, we compared the area under the curve and defined the cut-off points for detecting central and general obesity for each index in order to identify the most suitable tools in predicting obesity. RESULTS Boys had significantly higher values for NC, WC, WHR, NHR, CI, TMI and BMI as compared to girls, whereas BAI and HC were higher in girls. The area under the curve was calculated for all the possible predictors of central obesity, i.e., NC (0.841-0.860), WC (0.70-0.679), HC (0.785-0.697), WHR (0.446-0.639) and CI (0.773-0.653) in boys and girls, respectively. And according to the ROC curve analysis, BMI (0.959-0.948), TMI (0.988-0.981), WHtR (0.667-0.553) and NHR (0.785-0.769) were predictors of general obesity and NC (0.841-0.860) as predictor of central obesity in boys and girls, respectively. The optimal cut-off points for TMI (13.80-15.83), NC (28.68-27.5) and for other anthropometric indices were estimated in both boys and girls. CONCLUSION TMI and NC seem to predict general and central obesity in Iranian preschool children.
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Affiliation(s)
- Farzaneh Mardali
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdyieh Naziri
- Student of Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
- Department of Biostatics, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somaye Fatahi
- Student of Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadat Hosseini-Baharanchi
- Minimally Invasive Surgery Research Center & Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, Department of Hematology, Center of Hematology and Bone Marrow Transplantation, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania, Fundeni Clinical Institute, Bucharest, Romania
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Rigamonti AE, Bondesan A, Rondinelli E, Cella SG, Sartorio A. The Role of Aspartate Transaminase to Platelet Ratio Index (APRI) for the Prediction of Non-Alcoholic Fatty Liver Disease (NAFLD) in Severely Obese Children and Adolescents. Metabolites 2022; 12:metabo12020155. [PMID: 35208229 PMCID: PMC8879448 DOI: 10.3390/metabo12020155] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/26/2022] [Accepted: 02/05/2022] [Indexed: 02/06/2023] Open
Abstract
The aspartate transaminase to platelet ratio index (APRI) has been proposed as an easy-to-use biochemical marker in obese adults with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatotic hepatitis (NASH). The objective of the present study was to evaluate the clinical and predictive value of APRI in a paediatric obese population. Seven hundred fifty-seven obese children and adolescents (BMI standard deviation score, SDS: >2.0; age range: 10–18.5 years), not consuming alcohol and without hepatitis B or C, were recruited after having been screened for NAFLD by ultrasonography. A series of demographic, biochemical and clinical parameters was compared between the two subgroups (with or without NAFLD); the same parameters were correlated with APRI; and finally, univariable and multivariable logistic regression was used to evaluate the predictors of NAFLD. NAFLD was diagnosed in about 39% of the entire paediatric population, predominantly in males and in subjects suffering from metabolic syndrome. APRI was correlated with the waist circumference (WC), high-density lipoprotein cholesterol (HDL-C), uric acid, total bilirubin, C reactive protein (CRP) and systolic blood pressure (SBP). Furthermore, APRI was higher in males than females, but independent from steatosis severity and metabolic syndrome. With the univariable analysis, the BMI SDS, triglycerides (TG), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), APRI, uric acid and metabolic syndrome were positive predictors of NAFLD, with female sex being negative predictor. At multivariable analysis; however, only BMI SDS, TG, HOMA-IR and APRI were positive predictors of NAFLD, with female sex being a negative predictor. The accuracy of APRI as a biochemical marker of NAFLD was about 60%.In conclusion, in a large (Italian) paediatric obese population, parameters, such as BMI SDS, TG, HOMA-IR and APRI, were positive predictors of NAFLD, with female sex being a negative predictor and most of the prediction explained by APRI. Nevertheless, APRI appears to be a simple biochemical marker of liver injury rather than of NAFLD/NASH and, moreover, is endowed with a limited accuracy for the prediction/diagnosis of NAFLD.
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Affiliation(s)
- Antonello E. Rigamonti
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy;
- Correspondence: ; Tel.: +39-02-503-17013; Fax: +39-02-503-17011
| | - Adele Bondesan
- Experimental Laboratory for Auxo-Endocrinological Research, IRCCS, Istituto Auxologico Italiano, 28824 Verbania, Italy; (A.B.); (A.S.)
| | - Eugenia Rondinelli
- Research Laboratory Unit, IRCCS, Istituto Auxologico Italiano, 28824 Verbania, Italy;
| | - Silvano G. Cella
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy;
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, IRCCS, Istituto Auxologico Italiano, 28824 Verbania, Italy; (A.B.); (A.S.)
- Division of Auxology and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, 28824 Verbania, Italy
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Di Maglie A, Marsigliante S, My G, Colazzo S, Muscella A. Effects of a physical activity intervention on schoolchildren fitness. Physiol Rep 2022; 10:e15115. [PMID: 35075816 PMCID: PMC8787616 DOI: 10.14814/phy2.15115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023] Open
Abstract
The global prevalence of childhood obesity is high. Obesity main causes are linked to sedentary lifestyles. Increasing physical activity (PA) and reducing sedentary activities are recommended to prevent and treat obesity. This study aimed to evaluate the effectiveness of a 6-month school PA intervention on obesity prevention and healthy behaviors in school-aged children. Participating students (10-11 years of age) were randomly divided into an intervention group and a control group. Children in the intervention group (n = 80) participated in a multicomponent PA that included improvement in extracurricular physical activities (with an additional 40 min per day for 5/6 days per week). Children (n = 80) in the control group participated in usual practice. Participants had mean body mass index of 19.7 ± 2.9 kg/m2 , and 33.7% of them were overweight or with obesity at T0. The change in body mass index in intervention group (-2.4 ± 0.6 kg/m2 ) was significantly different from that in control group (3.01 ± 1.8 kg/m2 ). The effects on waist circumference, waist-to-height ratio, and physic fitness were also significant in intervention group compared with control group (all p < 0.05). Furthermore, there is a significant decrease in overweight or children with obesity in the experimental group (to 17.5%, p < 0.05). These findings suggest that a school-based intervention program represents an effective strategy for decreasing the number of overweight and children with obesity.
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Affiliation(s)
- Antonio Di Maglie
- Department of History, Society and Human StudiesUniversity of SalentoLecceItaly
| | - Santo Marsigliante
- Department of Biological and Environmental Science and Technologies (DiSTeBA)University of SalentoLecceItaly
| | - Giulia My
- Department of Biological and Environmental Science and Technologies (DiSTeBA)University of SalentoLecceItaly
| | - Salvatore Colazzo
- Department of History, Society and Human StudiesUniversity of SalentoLecceItaly
| | - Antonella Muscella
- Department of Biological and Environmental Science and Technologies (DiSTeBA)University of SalentoLecceItaly
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Vergani E, Bruno C, Cipolla C, Currò D, Mancini A. Plasma Levels of Neudesin and Glucose Metabolism in Obese and Overweight Children. Front Endocrinol (Lausanne) 2022; 13:881524. [PMID: 35909572 PMCID: PMC9331476 DOI: 10.3389/fendo.2022.881524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022] Open
Abstract
Childhood overweight and obesity are among the major health problems of modern times, especially in Western countries, due to their association with increased cardiovascular and cancer risk in adulthood. Neudesin, a recently discovered peptide secreted mainly in the brain and adipose tissue, is being investigated for its possible activity as a negative regulator of energy expenditure. We conducted a cross-sectional observational preliminary study with the aim of testing the hypothesis that plasma levels of neudesin can be modified in obese and overweight children and to evaluate any possible relationship between plasma neudesin levels and metabolic and anthropometric parameters. 34 Children (Tanner's stage 1) were included and divided in two groups according to Cole's criteria. Group A included obese and overweight children (23 patients, 17 females and 6 males, aged 4-10 years); Group B included healthy normal-weight children (11 subjects, 7 females and 4 males, aged 3-10 years). Metabolic (glucose and insulin, total, LDL- and HDL-cholesterol, triglycerides, uric acid) and hormonal (fT3, fT4, TSH, IGF-1, leptin) parameters were evaluated. HOMA-IR and QUICKI index and the area under the curve (AUC) of glucose and insulin after oral glucose load were calculated in obese and overweight children. Neudesin was measured by ELISA. Neudesin levels were significantly higher in obese/overweight children than in controls. In obese and overweight children, plasma neudesin levels were significantly directly correlated with blood glucose and glucose AUC. Taken together, these results, although preliminary, may suggest a possible age-related role of neudesin in glucose homeostasis in obese/overweight children.
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Affiliation(s)
- Edoardo Vergani
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Carmine Bruno
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Clelia Cipolla
- Dipartimento di Scienza e Salute della donna e del bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Diego Currò
- Dipartimento di Sicurezza e Bioetica, Sezione di Farmacologia, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- *Correspondence: Antonio Mancini, ; Diego Currò,
| | - Antonio Mancini
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
- *Correspondence: Antonio Mancini, ; Diego Currò,
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Vieira M, Teixeira A, Carvalho GS. Effectiveness of the "Planning Health in School" Programme on Children's Nutritional Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312846. [PMID: 34886571 PMCID: PMC8657562 DOI: 10.3390/ijerph182312846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022]
Abstract
Effective interventions for guiding children to change behaviours are needed to tackle obesity. We evaluated the effectiveness of the 'Planning Health in School' programme (PHS-pro) on children's nutritional status. A non-randomised control group pretest-posttest trial was conducted at elementary schools of a sub-urban municipality in Porto's metropolitan area (Portugal). A total of 504 children of grade-6, aged 10-14, were assigned in two groups: children of one school as the intervention group (IG), and three schools as the control group (CG). Anthropometric measures included height, weight, waist circumference (WC), BMI and waist-to-height ratio (WHtR), and lifestyle behaviours (self-reported questionnaire) were assessed at baseline and after PHS-pro. IG children grew significantly taller more than CG ones (p < 0.001). WC had reduced significantly in IG (-0.4 cm) whereas in the CG had increased (+0.3 cm; p = 0.015), and WHtR of IG showed a significant reduction (p = 0.002) compared with CG. After PHS-pro, IG children consumed significantly fewer soft drinks (p = 0.043) and ate more fruit and vegetables daily than CG. Physical activity time increased significantly in IG (p = 0.022), while CG maintained the same activity level. The PHS-pro did improve anthropometric outcomes effectively leading to better nutritional status and appears to be promising in reducing overweight and obesity.
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Affiliation(s)
- Margarida Vieira
- Research Centre on Child Studies, University of Minho, 4710-057 Braga, Portugal;
- Correspondence: ; Tel.: +351-253-601-212
| | - Andreia Teixeira
- Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- ADiT-LAB, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial Nun’Álvares, 4900-347 Viana do Castelo, Portugal
| | - Graça S. Carvalho
- Research Centre on Child Studies, University of Minho, 4710-057 Braga, Portugal;
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Katsa ME, Kostopoulou E, Magana M, Ioannidis A, Chatzipanagiotou S, Sachlas A, Dimopoulos I, Spiliotis BE, Rojas Gil AP. Association of the apoptotic marker APO1/Fas with children's predisposing factors for metabolic syndrome and with mean platelet volume. J Pediatr Endocrinol Metab 2021; 34:1393-1400. [PMID: 34332515 DOI: 10.1515/jpem-2021-0352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/12/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Apoptosis antigen 1/FAS receptor (APO1/Fas) signaling in endothelial cells plays a significant role in angiogenesis while increased mean platelet volume (MPV) is an important marker for platelet activation. We investigated the possible correlation between APO1/Fas and both metabolic parameters and platelet activity (indicated by the MPV) in a healthy pediatric population. METHODS One hundred and eighty-five children, aged 5-17 years old, were enrolled in the study. The participants were divided into subgroups according to their age and body mass index percentile (BMI%). APO1/Fas was measured by enzyme-linked immunosorbent assay (ELISA) and MPV by the MEK-6410K. RESULTS Eighty-one children (43.8%) had excess weight, which was more prevalent in children ≤9 years of age. Sixty-five children (35.1%) exhibited a predisposition for metabolic syndrome. A negative correlation was found between APO1/Fas and predisposing factors for metabolic syndrome: Glucose, cholesterol, uric acid, low-density lipoprotein (LDL), and triglycerides. In contrast, a positive correlation was found between APO1/Fas and C-reactive protein (CRP). Receiver operating characteristic (ROC) analysis showed a predisposition to metabolic syndrome when APO1/Fas was <78.46 pg/mL. A negative correlation was also observed between APO1/Fas and MPV. MPV was also positively correlated with predisposing factors for metabolic syndrome: BMI%, glucose, cholesterol, uric acid, LDL, and negatively with high-density lipoprotein. CONCLUSIONS APO1/Fas expression is associated with a lower predisposition to metabolic syndrome may be through endothelial homeostasis, the induction of apoptosis of cells involved in atherosclerosis, and platelet activity. It may also enhance CRP-mediated noninflammatory clearance of apoptotic cells. Early monitoring of all the components of metabolic syndrome in overweight children is important in order to prevent metabolic and cardiovascular complications.
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Affiliation(s)
- Maria Efthymia Katsa
- Laboratory of Biology and Biochemistry, Faculty of Health Sciences, Department of Nursing, University of Peloponnese, Tripoli, Greece
| | - Eirini Kostopoulou
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University of Patras School of Medicine, Patras, Greece
| | - Maria Magana
- Laboratory of Biology and Biochemistry, Faculty of Health Sciences, Department of Nursing, University of Peloponnese, Tripoli, Greece
| | - Anastasios Ioannidis
- Laboratory of Biology and Biochemistry, Faculty of Health Sciences, Department of Nursing, University of Peloponnese, Tripoli, Greece
| | | | - Athanasios Sachlas
- Department of Statistics and Insurance Science, Faculty of Finance and Statistics, University of Piraeus, Athens, Greece
| | | | - Bessie E Spiliotis
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University of Patras School of Medicine, Patras, Greece
| | - Andrea Paola Rojas Gil
- Laboratory of Biology and Biochemistry, Faculty of Health Sciences, Department of Nursing, University of Peloponnese, Tripoli, Greece
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Taxová Braunerová R, Kunešová M, Heinen MM, Rutter H, Hassapidou M, Duleva V, Pudule I, Petrauskienė A, Sjöberg A, Lissner L, Spiroski I, Gutiérrez-González E, Kelleher CC, Bergh IH, Metelcová T, Vignerová J, Brabec M, Buoncristiano M, Williams J, Simmonds P, Zamrazilová H, Hainer V, Yngve A, Rakovac I, Breda J. Waist circumference and waist-to-height ratio in 7-year-old children-WHO Childhood Obesity Surveillance Initiative. Obes Rev 2021; 22 Suppl 6:e13208. [PMID: 34402567 DOI: 10.1111/obr.13208] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/12/2022]
Abstract
Childhood obesity is a serious global health problem. Waist circumference (WC) and waist-to-height ratio (WHtR) reflect body fat distribution in children. The objectives of this study were to assess WC and WHtR in 7-year-old children and to determine body mass index (BMI), WC, and WHtR differences in children from 10 selected countries across Europe (Bulgaria, Czechia, Greece, Ireland, Latvia, Lithuania, North Macedonia, Norway, Spain, and Sweden) participating in the World Health Organization (WHO) Europe Childhood Obesity Surveillance Initiative (COSI). The 50th and 90th percentile of WC (according to COSI and "Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS" (IDEFICS) cutoff values) and WHtR above 0.5 were used as measures of abdominal obesity in a unique sample of 38,975 children aged 7.00-7.99 years. Southern European countries, including Greece and Spain, showed significantly higher BMI, WC, and WHtRin both genders (p < 0.0001) than Eastern and Northern Europe. The highest values for WC were observed in Greece (60.8 ± 7.36 cm boys; 60.3 ± 7.48 cm girls), North Macedonia (60.4 ± 7.91 cm boys; 59.0 ± 8.01 cm girls), and Spain (59.7 ± 6.96 cm boys; 58.9 ± 6.77 cm girls). WC and WHtRin may add an information about the occurrence of central obesity in children.
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Affiliation(s)
| | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Mirjam M Heinen
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Vesselka Duleva
- Department of Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Aušra Petrauskienė
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Agneta Sjöberg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Lauren Lissner
- School of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | | | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Tereza Metelcová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.,1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jana Vignerová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Marek Brabec
- Institute of Computer Science, Czech Academy of Sciences, Prague, Czech Republic
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Philippa Simmonds
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Vojtěch Hainer
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Agneta Yngve
- Department of Nutrition, Dietetics and Food Studies, Uppsala University, Sweden.,School of Health Sciences, Örebro University, Örebro, Sweden
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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Vendula J, Miroslava P, Tereza K. Reference Curves of Selected Circumferential Parameters for Czech Children Aged 6 to 11 Years. CHILDREN-BASEL 2021; 8:children8100908. [PMID: 34682173 PMCID: PMC8534861 DOI: 10.3390/children8100908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/28/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022]
Abstract
(1) Background/objective: the globally discussed current issue is the increasing body weight of the population. This trend is observed in all age categories. Pediatricians and anthropologists use BMI percentile curves to determine the optimal body weight of children, based on which the child is categorized in the category of underweight, normal weight, overweight, or obese. Medical or anthropological examinations also use some methods to determine the amount of body fat. In addition to evaluating amounts of body fat, it is important to assess its distribution. The distribution of fat in the body, especially in terms of disproportionate distribution, is a risk factor for health complications, especially in terms of metabolic and health risk. Part of monitoring children’s growth is also measuring and evaluating circumferential parameters, such as abdominal circumference, gluteal circumference, and waist circumference. This study aimed to define age- and gender-specific reference curves for waist circumference (WC), abdominal circumference (AbC), and gluteal circumference (GC) in Czech children. (2) Methods: data on children’s circumferential parameters were collected via anthropometric measurements. The research sample consisted of 2093 children aged 6–11 years (boys, n = 1008; girls, n = 1085). Only children with parental informed consent were included. The statistical analysis was performed separately by age and gender using SPSS v. 22. Anthropometric data were summarized by mean and standard deviation. The percentile curves of WC, AbC, and GC were calculated (P3, P10, P25, P50, P75, P90, P97) in R 3.4.2 software (R Foundation for Statistical Computing, Vienna, Austria) using the gamlss package. (3) Results and conclusions: the study developed age- and gender-specific percentile curves of WC, AbC, and GC for Czech children aged 6–11 years. All parameters increased with age in both boys and girls. Generally, the boys had higher WC and AbC than did girls, but girls had higher GC than did boys. Female and male median WC percentiles (M) increased from the age of 6. Both girls’ and boys’ median percentiles showed a continuous increase. We found similar trends in the median GC and AbC percentile curves. All percentile curves showed similar trends in both sexes, but the 90th and 97th WC percentiles in boys were exceptions: from the age of 10, they exceeded the values of girls, reaching their peak at the age of 11 followed by a decrease in the case of the 97th percentile and a plateau in the case of the 90th percentile. This study serves as a reference to enrich the methods of evaluation of somatic and medical status in Czech children. Up–to–date percentile curves would be a practical addition to the BMI percentiles for the screening and evaluation of overweight and obese conditions and the related risks of abdominal obesity in the pediatric population.
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Moya M, Pérez-Fernandez V. Estimating trunk fat in children according to sex using basic somatic readings: an opportunity for improving evaluation among girls. BMC Pediatr 2021; 21:446. [PMID: 34629070 PMCID: PMC8504037 DOI: 10.1186/s12887-021-02918-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The fat mass estimators waist-to-height ratio (WHtR) and relative fat mass-pediatric (RFMp) complement the widely accepted body mass index (BMI) in obesity evaluation. AIMS OF THE STUDY Conduct an easy appraisal of trunk fat and the cardiometabolic risk associated with pediatric obesity. METHODS A total of 472 children (39% boys in the total sample) were classified as underweight, normal weight, overweight or obese (nutritional groups, NGs) according to BMI Z-score after initial anthropometric data were obtained and ad hoc exclusion criteria were applied. WHtR and RFMp (% of total fat) were calculated for each group, associations were assessed through multiple linear regression (MLR), and differences between sexes were evaluated (medians, IQR). RESULTS The mean age (mean (95% CI)) was 10.8 y (10.1-11.1). The values in the total sample were as follows: WHtR, 0.5 (0.49-0.51) and RFMp%, 32.3 (31.7-33.0). In the overweight group, the values were as follows: WHtR, 0.51 (0.50-0.52) and RFMp(%), 34.2 (33.3-35.1). In the obese group, the values were as follows: WHtR, 0.56 (0.55-0.57) and RFMp(%), 37.8 (36.9-38.6). The associations were as follows (NG; independent variables): In the NG, adjusted R2 values were between 0.74 and 0.78. In the total sample, the beta coefficient was 3.36 (P < 0.001) for RFMp for girls; for waist circumference (WC), the beta coefficient was 2.97 (P < 0.001), and for WHtR the beta coefficients were - 0.01 (p < 0.001) and 0.03 (p < 0.001),for girls and for WC respectively. The sex differences were as follows: BMI exhibited no differences in the NG (Mann-Whitney U). WHtR (median (IQR)) differed (M vs. F) in the total sample (0.49 (0.45-0.54) vs. 0.52 (0.45-0.56), p < 0.004); in the overweight group (0.51 (0.48-0.53) vs. 0.54 (0.51-0.55), p < 0.001); and in the obese group (0.55 (0.52-0.57) vs. 0.57 (0.54-0.60), p < 0.004). RFMp (%) differed in the total group (29.21 (24.27-32.92) vs. 36.63 (30.2-39.51), p < 0.001); in the overweight group (31.24 (28.35-32.35) vs. 37.95 (35.75-38.82), p < 0.001) and in the obese group (35.89 (32.05-36.15) vs. 40.63 (38.27-42.42), p < 0.001). CONCLUSIONS WHtR and RFMp are simple and reliable indices that do not require centile charts. Their values, including waist circumference, can be used to estimate the different trunk fat components in boys and girls better than BMI, especially if individuals are overweight or obese. RFMp proved to be more reliable as it considers sex. Both should be included in routine anthropometric readings.
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Affiliation(s)
- Manuel Moya
- Universidad Miguel Hernández, Health Sciences Campus of S. Juan, UMH Campus de S. Juan, Edificio Balmis, room S01 P002; Av Ramón y Cajal s/n. 03550 San Juan, Alicante, Spain
| | - Virginia Pérez-Fernandez
- Department of Surgery, Pediatrics and Obs & Gynecology, Facultad de Medicina, Universidad de Murcia, LAIB Building, Av. Buenavista s/n 30120 El Palmar, Murcia, Spain
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Lessons GR, Bhakta D, McCarthy D. Development of muscle mass and body fat reference curves for white male UK firefighters. Int Arch Occup Environ Health 2021; 95:779-790. [PMID: 34599408 DOI: 10.1007/s00420-021-01761-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/14/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study describes the development of the world's first suite of firefighter body composition centile reference curves which can be used as both academic research tools and clinical references, to plot and track individual firefighter skeletal muscle mass (SMM) and fat mass (FM) measurements against the representative reference sample. METHODS The body composition of 497 white male London (England) firefighters was measured by anthropometry and bioelectrical impedance analysis. Smoothed centile curves were then generated for skeletal muscle mass index (SMMI), fat mass index (FMI), body fat percentage (BF%) and waist-to-height ratio (WHtR). RESULTS Between 48 and 62 years, firefighter SMMI is greater than the UK white male age-matched general population by a mean of 0.35 units, although SMMI declines 0.006 units/years faster in firefighters between these ages. This is estimated to translate to a mean decline of approximately 0.6% of absolute SMM per year. Between 40 and 49 years, firefighter FMI is 0.1 units greater than the UK white male age-matched general population, which becomes identical (7 units) between 50 and 54 years. At the 50th centile, WHtR exceeds 0.5 by 39 years reaching 0.55 at 62 years. This contrasts with FMI which remains stable from 47 years. CONCLUSION Firefighters in this study possess greater FM and SMM compared with the UK general population. SMM appears to decline rapidly within older age ranges. These references offer a novel improvement upon the limitations of BMI and BF% for the benefit of an occupational group at elevated risk of cardiovascular disease.
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Affiliation(s)
- Greg Richard Lessons
- Public Health Nutrition Research Group, London Metropolitan University, London, N7 8DB, UK.
| | - Dee Bhakta
- Public Health Nutrition Research Group, London Metropolitan University, London, N7 8DB, UK
| | - David McCarthy
- Public Health Nutrition Research Group, London Metropolitan University, London, N7 8DB, UK
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Rigamonti AE, Caroli D, Grugni G, Cella SG, Sartorio A. Frequent Medical Supervision Increases the Effectiveness of a Longitudinal Multidisciplinary Body Weight Reduction Program: A Real-World Experience in a Population of Children and Adolescents with Obesity. Nutrients 2021; 13:nu13103362. [PMID: 34684362 PMCID: PMC8539124 DOI: 10.3390/nu13103362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 12/11/2022] Open
Abstract
Regular medical supervision represents a fundamental component of the clinical management of obesity. In fact, when frequently supplied it reduces the risk of failure associated with any body weight reduction program (BWRP), resulting in body weight gain. The aim of the present study was to establish the potential beneficial effects of increasing medical supervision on weight loss and other auxometric and cardiometabolic parameters in a population of children and adolescents with obesity (n = 158; F/M = 94/64; age range 9.7-17.3 years; body mass index, BMI = 37.8 ± 6.9 kg/m2), followed up for one year in a real-world setting, after and before a 3-week in-hospital BWRP. Weight loss was significantly associated with medical supervision and changes in several auxometric and cardiometabolic parameters such as fat mass, fat-free mass, waist and hip circumferences, total and LDL cholesterols, triglycerides, glucose, insulin, HOMA-IR, systolic blood pressure and IDF criteria for the diagnosis of metabolic syndrome. As expected, weight loss and, congruently, medical supervision, were significantly higher in responsive and stable subjects than in those belonging to the non-responsive group and in responsive subjects than those belonging to the stable group. While weight loss was significantly higher in subjects having class 2 and 3 obesity than those belonging to class 1 obesity group, medical supervision was significantly higher in subjects having class 3 than those having class 1 obesity. Weight loss was significantly higher in subjects suffering from metabolic syndrome than those without; nevertheless, no significant difference was found in medical supervision between these groups. Finally, sex was associated with no differences in weight loss and medical supervision. In conclusion, based on the results of a real-world experience, frequent medical supervision increases the weight loss associated with a longitudinal multidisciplinary BWRP, with a parallel improvement of a set of auxometric and cardiometabolic parameters. Prospectively, incentivising regular medical supervision should reduce the risk of BWRP failure and body weight gain, thus contributing to counteract the detrimental transition from simple obesity to metabolic syndrome in pediatric patients.
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Affiliation(s)
- Antonello E. Rigamonti
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy;
- Correspondence: ; Tel.: +39-02-503-17013; Fax: +39-02-503-17011
| | - Diana Caroli
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy; (D.C.); (G.G.); (A.S.)
| | - Graziano Grugni
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy; (D.C.); (G.G.); (A.S.)
- Division of Auxology and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy
| | - Silvano G. Cella
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy;
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy; (D.C.); (G.G.); (A.S.)
- Division of Auxology and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy
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Roscoe CMP, Duncan MJ, Clark CCT. The 24-h Movement Compositions in Weekday, Weekend Day or Four-Day Periods Differentially Associate with Fundamental Movement Skills. CHILDREN (BASEL, SWITZERLAND) 2021; 8:828. [PMID: 34682096 PMCID: PMC8534336 DOI: 10.3390/children8100828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/14/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022]
Abstract
The aim of this study was to investigate the relationship between weekday, weekend day and four-day physical activity (PA) behaviours and fundamental movement skills (FMS) in British preschool children from a low socio-economic status background using compositional data analysis (CoDA). One hundred and eighty-five preschool children aged 3-4 years provided objectively assessed PA and sedentary behaviour (SB) data (GENEActiv accelerometer) and FMS (TGMD-2). The association of 24-h movement behaviours with FMS was explored using CoDA and isotemporal substitution (R Core Team, 3.6.1). When data were considered compositionally (SB, light PA (LPA), moderate and vigorous PA (MVPA)) and adjusted for age, BMI and sex, the weekday-derived composition predicted total motor competence (r2 = 0.07), locomotor (r2 = 0.08) and object control skills (r2 = 0.09); the weekend day-derived composition predicted total motor competence (r2 = 0.03) and object control skills (r2 = 0.03), the 4-day-derived composition predicted total motor competence (r2 = 0.07), locomotor (r2 = 0.07) and object control skills (r2 = 0.06) (all p < 0.05). Reallocation of 5 min of LPA at the expense of any behaviour was associated with significant improvements in total motor competence, locomotor and object control skills; for weekend-derived behaviours, MVPA was preferential. Considering movement behaviours over different time periods is required to better understand the effect of the 24-h movement composition on FMS in preschool children.
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Affiliation(s)
| | - Michael J. Duncan
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5RW, UK;
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5RW, UK;
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Percentage of energy contribution according to the degree of industrial food processing and associated factors in adolescents (EVA-JF study, Brazil). Public Health Nutr 2021; 24:4220-4229. [PMID: 33436138 DOI: 10.1017/s1368980021000100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate energetic contribution according to the degree of industrial food processing and its association with sociodemographic, anthropometric, biochemical, clinical and behavioural characteristics in adolescents. DESIGN Cross-sectional study (Adolescent Lifestyle Study). Food consumption was assessed using 24-h dietary recalls, with foods classified by degree of industrial progressing. The usual diet was estimated using the Multiple Source Method. In a linear regression model, the energy percentage (E %) was associated with sociodemographic, anthropometric, biochemical, clinical and behavioural characteristics, after adjustment for sex and age. SETTING Juiz de Fora, Brazil. PARTICIPANTS Eight hundred and four adolescents, of both sexes, 14-19 years of age, enrolled in public schools. RESULTS The E % of unprocessed or minimally processed foods corresponded to 43·1 %, processed foods to 11·0 % and the ultraprocessed foods to 45·9 %. E % of unprocessed foods was associated with socio-economic stratum (adjusted β = -0·093; P = 0·032), neck circumference (adjusted β = 0·017; P = 0·049), screen time (adjusted β = -0·247; P = 0·036) and HDL-cholesterol (adjusted β = -0·156; P = 0·003). E % of ultraprocessed foods was associated with socio-economic stratum (adjusted β = 0·118; P = 0·011), screen time (adjusted β = 0·375; P = 0·003), BMI (adjusted β = -0·029; P = 0·025), neck circumference (adjusted β = -0·017; P = 0·028) and HDL-cholesterol (adjusted β = 0·150; P = 0·002). CONCLUSIONS There was a high E % of ultraprocessed foods in the diet of the adolescents. Actions are needed to raise the awareness of adopting healthy eating habits.
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Warnakulasuriya LS, Samaranayake DL, Adikaram AVN, Fernando MMA, Rytter E, Ciba I, Bergsten P, Forslund AH, Renuka Ruchira Silva KD, Wickramasinghe VP. Metabolic Abnormalities in a Cohort of Overweight and Obese Children in an Urban Setting of Sri Lanka. Int J Endocrinol 2021; 2021:9936889. [PMID: 34285694 PMCID: PMC8275386 DOI: 10.1155/2021/9936889] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/24/2021] [Accepted: 06/21/2021] [Indexed: 12/18/2022] Open
Abstract
Childhood obesity-related metabolic derangements are increasing among South Asian populations. Most of these changes persist to adulthood. This study aims to describe the distribution of metabolic abnormalities among 7- to 17-year-old overweight and obese children in the Gampaha District of Sri Lanka. Overweight children (age- and gender-adapted BMI>+1SD, WHO standards) were selected from a community survey carried out in the Negombo Education Zone of Gampaha District. After a 12-hour overnight fast, blood was drawn, and blood glucose (FBG), lipid profile, insulin, and liver transaminases were measured. Two hours after a glucose load, blood was drawn for random blood glucose (RBG) and insulin. Metabolic syndrome (MetS) was diagnosed using modified IDF criteria for children. Anthropometry, fat mass (FM), and blood pressure were measured. Hepatic fat pattern was assessed ultrasonically. The data of 403 children (210 boys) were analysed. Of the study population, 16.4% were overweight (BMI for age +1 to +2SD), 72% were obese (BMI for age >+2 to +3SD), and 11.6% were severely obese (BMI for age >+3SD). Insulin resistance was seen in 46.8%, and prevalence increased with age. Mean postprandial insulin ranged from 368 to 625 pmol/L and was elevated in 35%. Dysglycaemia was seen among 20.8%. MetS was present in 19.8%, and 84% had at least one metabolic abnormality. Different degrees of hepatic steatosis were observed in 32.5%, and elevated ALT/AST ratio was seen in 58% of the population. Overweight and obesity during childhood were associated with multiple metabolic abnormalities including MetS, and they occur from a young age. It is important to screen children for overweight/obesity early in life and intervene to prevent them from developing metabolic complications.
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Affiliation(s)
| | | | | | | | - Elisabet Rytter
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Science, Faculty of Medicine, Uppsala University, Uppsala, Sweden
| | - Iris Ciba
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Uppsala University Children's Hospital, Uppsala, Sweden
| | - Peter Bergsten
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Uppsala University Children's Hospital, Uppsala, Sweden
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Anders H. Forslund
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Uppsala University Children's Hospital, Uppsala, Sweden
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Hüls A, Wright MN, Bogl LH, Kaprio J, Lissner L, Molnár D, Moreno LA, De Henauw S, Siani A, Veidebaum T, Ahrens W, Pigeot I, Foraita R. Polygenic risk for obesity and its interaction with lifestyle and sociodemographic factors in European children and adolescents. Int J Obes (Lond) 2021; 45:1321-1330. [PMID: 33753884 PMCID: PMC8159747 DOI: 10.1038/s41366-021-00795-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 02/03/2021] [Accepted: 02/23/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Childhood obesity is a complex multifaceted condition, which is influenced by genetics, environmental factors, and their interaction. However, these interactions have mainly been studied in twin studies and evidence from population-based cohorts is limited. Here, we analyze the interaction of an obesity-related genome-wide polygenic risk score (PRS) with sociodemographic and lifestyle factors for BMI and waist circumference (WC) in European children and adolescents. METHODS The analyses are based on 8609 repeated observations from 3098 participants aged 2-16 years from the IDEFICS/I.Family cohort. A genome-wide polygenic risk score (PRS) was calculated using summary statistics from independent genome-wide association studies of BMI. Associations were estimated using generalized linear mixed models adjusted for sex, age, region of residence, parental education, dietary intake, relatedness, and population stratification. RESULTS The PRS was associated with BMI (beta estimate [95% confidence interval (95%-CI)] = 0.33 [0.30, 0.37], r2 = 0.11, p value = 7.9 × 10-81) and WC (beta [95%-CI] = 0.36 [0.32, 0.40], r2 = 0.09, p value = 1.8 × 10-71). We observed significant interactions with demographic and lifestyle factors for BMI as well as WC. Children from Southern Europe showed increased genetic liability to obesity (BMI: beta [95%-CI] = 0.40 [0.34, 0.45]) in comparison to children from central Europe (beta [95%-CI] = 0.29 [0.23, 0.34]), p-interaction = 0.0066). Children of parents with a low level of education showed an increased genetic liability to obesity (BMI: beta [95%-CI] = 0.48 [0.38, 0.59]) in comparison to children of parents with a high level of education (beta [95%-CI] = 0.30 [0.26, 0.34]), p-interaction = 0.0012). Furthermore, the genetic liability to obesity was attenuated by a higher intake of fiber (BMI: beta [95%-CI] interaction = -0.02 [-0.04,-0.01]) and shorter screen times (beta [95%-CI] interaction = 0.02 [0.00, 0.03]). CONCLUSIONS Our results highlight that a healthy childhood environment might partly offset a genetic predisposition to obesity during childhood and adolescence.
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Affiliation(s)
- Anke Hüls
- Department of Epidemiology and Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Marvin N Wright
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
- Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Leonie H Bogl
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Institute of Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Institute of Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Lauren Lissner
- Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Dénes Molnár
- Department of Paediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Stefaan De Henauw
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
- Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
- Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Ronja Foraita
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
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Ng E, Wake M, Olds T, Lycett K, Edwards B, Le H, Dumuid D. Equivalence Curves for Healthy Lifestyle Choices. Pediatrics 2021; 147:peds.2020-025395. [PMID: 33771915 DOI: 10.1542/peds.2020-025395] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Understanding equivalence of time-use trade-offs may inform tailored lifestyle choices. We explored which time reallocations were associated with equivalent changes in children's health outcomes. METHODS Participants were from the cross-sectional Child Health CheckPoint Study (N = 1179; 11-12 years; 50% boys) nested within the population-based Longitudinal Study of Australian Children. Outcomes were adiposity (bioelectrical impedance analysis, BMI and waist girth), self-reported health-related quality of life (HRQoL; Pediatric Quality of Life Inventory), and academic achievement (standardized national tests). Participants' 24-hour time use (sleep, sedentary behavior, light physical activity, and moderate-to-vigorous physical activity [MVPA]) from 8-day 24-hour accelerometry was regressed against outcomes by using compositional log-ratio linear regression models. RESULTS Children with lower adiposity and higher HRQoL had more MVPA (both P ≤ .001) and sleep (P = .001; P < .02), and less sedentary time (both P < .001) and light physical activity (adiposity only; P = .03), each relative to remaining activities. Children with better academic achievement had less light physical activity, relative to remaining activities (P = .003). A 0.1 standardized decrease in adiposity was associated with either 52 minutes more sleep, 56 minutes less sedentary time, 65 minutes less light physical activity, or 17 minutes more MVPA. A 0.1 standardized increase in HRQoL was associated with either 68 minutes more sleep, 54 minutes less sedentary time, or 35 minutes more MVPA. CONCLUSIONS Equivalent differences in outcomes were associated with several time reallocations. On a minute-for-minute basis, MVPA was 2 to 6 times as potent as sleep or sedentary time.
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Affiliation(s)
- Emily Ng
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Liggins Institute, University of Auckland, Grafton, New Zealand
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kate Lycett
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Ben Edwards
- Centre for Social Research and Methods, College of Arts and Social Sciences, The Australian National University, Canberra, Australia; and
| | - Ha Le
- Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia;
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Peng L, Wu S, Zhou N, Zhu S, Liu Q, Li X. Clinical characteristics and risk factors of nonalcoholic fatty liver disease in children with obesity. BMC Pediatr 2021; 21:122. [PMID: 33711964 PMCID: PMC7953770 DOI: 10.1186/s12887-021-02595-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 03/04/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND With the increasing number of children with obesity worldwide, nonalcoholic fatty liver disease (NAFLD) has become the most common liver disease among children. It is necessary to recognize the risk factors of NAFLD for prevention in childhood since NAFLD is asymptomatic in the early stage. OBJECTIVES The objective of this study was to investigate possible risk factors of NAFLD in children with obesity, providing evidence for monitoring and prevention strategies at an early stage for obese children with NAFLD. METHODS Data were collected from 428 children and adolescents aged 6-16 years recruited from the Children's Hospital at Nanjing Medical University from September 2015 to April 2018 and analyzed. Based on a combination of ultrasound results and alanine transaminase levels, subjects were divided into three groups: simple obesity (SOB), simple steatosis (SS), and nonalcoholic fatty hepatitis (NASH). Blood biochemical examination included glucose, insulin, uric acid, lipid profile and liver enzymes. RESULTS Among 428 children with obesity, 235 (54.9%) had SS and 45 (10.5%) had NASH. Body mass index, body mass index standard deviation score (BMI-SDS), waist circumference, body fat, liver enzymes, uric acid and HOMA-IR level were significantly higher in the NASH group than in the SS and SOB groups (p < 0.001). 53.3% of the SS group and 49.8% of the NASH group had metabolic syndrome, significantly more than in the SOB group (19.6%, p < 0.001). After adjustment for confounding factors, logistic regression models revealed that NASH was associated with BMI-SDS ≥ 3, gender, hyperuricemia and insulin resistance. CONCLUSIONS The prevalence of NASH in children with obesity is closely related to high BMI-SDS, gender, insulin resistance and hyperuricemia. These findings provide evidence that monitoring risk factors of childhood obesity can assist in developing prevention strategies for liver disease at an early stage.
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Affiliation(s)
- Luting Peng
- Department of Children Health Care, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, People's Republic of China
| | - Su Wu
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, People's Republic of China
| | - Nan Zhou
- Department of Children Health Care, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, People's Republic of China
| | - Shanliang Zhu
- Department of Ultrasonography, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Qianqi Liu
- Department of Children Health Care, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, People's Republic of China
| | - Xiaonan Li
- Department of Children Health Care, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, People's Republic of China. .,Institute of Pediatric Research, Nanjing Medical University, Nanjing, 210008, China.
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Varagiannis P, Magriplis E, Risvas G, Vamvouka K, Nisianaki A, Papageorgiou A, Pervanidou P, Chrousos GP, Zampelas A. Effects of Three Different Family-Based Interventions in Overweight and Obese Children: The "4 Your Family" Randomized Controlled Trial. Nutrients 2021; 13:341. [PMID: 33498894 PMCID: PMC7911878 DOI: 10.3390/nu13020341] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 12/31/2022] Open
Abstract
Childhood overweight and obesity prevalence has risen dramatically in the past decades, and family-based interventions may be an effective method to improve children's eating behaviors. This study aimed to evaluate the effectiveness of three different family-based interventions: group-based, individual-based, or by website approach. Parents and school aged overweight or obese children, 8-12 years of age, were eligible for the study. A total of 115 children were randomly allocated in one of the three interventions, and 91 completed the study (79% compliance); Group 1 (n = 36) received group-based interventions by various experts; Group 2 (n = 30) had interpersonal family meetings with a dietitian; and Group 3 (n = 25) received training through a specifically developed website. Anthropometric, dietary, physical activity, and screen time outcomes were measured at baseline and at the end of the study. Within-group comparisons indicated significant improvement in body weight, body mass index (BMI)-z-score, physical activity, and screen time from baseline in all three study groups (p < 0.05). Furthermore, total body fat percentage (%TBF) was also decreased in Groups 2 and 3. Between-group differences varied with body weight and %TBF change, being larger in Group 3 compared to Groups 1 and 2, in contrast to BMI-z-score, screen time, and health behaviors, which were significantly larger in Group 2 than the other two groups. In conclusion, personalized family-based interventions are recommended to successfully improve children's lifestyle and body weight status.
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Affiliation(s)
- Panagiotis Varagiannis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Grigoris Risvas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Katerina Vamvouka
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Adamantia Nisianaki
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Anna Papageorgiou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
| | - Panagiota Pervanidou
- 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27 Athens, Greece; (P.P.); (G.P.C.)
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 115 27 Athens, Greece
| | - George P. Chrousos
- 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27 Athens, Greece; (P.P.); (G.P.C.)
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 115 27 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55 Athens, Greece; (P.V.); (E.M.); (G.R.); (K.V.); (A.N.); (A.P.)
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Waist-to-height ratio and body mass index as indicators of obesity in children from Montenegro. NUTR HOSP 2021; 38:884-885. [PMID: 34132565 DOI: 10.20960/nh.03687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction
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Navti LK, Foudjo BUS. 10-Year Changes in Adiposity in Cameroon School-Age Children: Evidence for Increasing Central Adiposity and Higher Adiposity Levels in Tallest-for-Age Children. J Obes 2021; 2021:6866911. [PMID: 34691777 PMCID: PMC8536440 DOI: 10.1155/2021/6866911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/04/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To examine changes in measures of adiposity and determine the prevalence of excess adiposity in relation to height in school children between 2010 and 2020. METHODS 5-12-year-old urban school-age children participated in two cross-sectional surveys in 2010 (n = 1274) and 2020 (n = 1550). Standard procedures were used for anthropometric measurements. Changes in BMI, waist circumference (WC), and waist-to-height ratio (WHtR) and the corresponding proportions of children with excess adiposity were analyzed and adjusted for design variables (class and school type) and age. Children were classified according to quartiles of height z-score and prevalence of excess adiposity estimated across each quartile. RESULTS There was a 2.4% and 3.3% increase in adjusted mean BMI and WC, respectively, between 2010 and 2020. The prevalence of central overweight/obesity (WC) and WHtR ≥ 0.5 increased by 7.3% (X 2 = 27.151, p < 0.001) and 5.3% (X 2 = 26.117, p < 0.001), respectively, between the two surveys except BMI overweight/obesity. The odds of excess adiposity significantly increased in 2020 for central overweight/obesity (WC) (OR 2.8, 95% CI 2.0-3.6) and WHtR ≥ 0.5 (OR 1.8, 95% CI 1.3-2.4) and not for BMI overweight/obesity (OR 1.3, 95% CI 0.8-1.7). The prevalence of BMI overweight/obesity significantly increased from 33% in 2010 to 51.5% in 2020 in the fourth quartile of height z-score (X 2 = 19.198, p < 0.001). Similarly, the prevalence of central overweight/obesity (WC) significantly increased from 23.5% in 2010 to 42.4% in 2020 in the fourth quartile of height z-score (X 2 = 18.733, p < 0.001). CONCLUSION Central overweight/obesity has increased more than BMI overweight/obesity over the last decade. Children with a higher height-for-age tend to accumulate more adiposity. Objective monitoring of adiposity levels and height of children is needed in future to identify groups for targeted intervention and prevention of chronic diseases.
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Affiliation(s)
- Lifoter K. Navti
- Department of Biochemistry, The University of Bamenda, P.O. Box 39,Bambili, Bamenda, Cameroon
- Department of Biochemistry, Catholic University of Cameroon (CATUC), Bamenda P.O. Box 782, Bamenda, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
| | - Brice U. S. Foudjo
- Department of Biochemistry, The University of Bamenda, P.O. Box 39,Bambili, Bamenda, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
- Association Sahelienne de Recherche Appliquee Pour le Developpement Durable (ASRADO), P.O. Box 2449, Djamena, Chad
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Use of Anthropometry Versus Ultrasound for the Assessment of Body Fat and Comorbidities in Children With Obesity. J Pediatr Gastroenterol Nutr 2020; 71:782-788. [PMID: 32740519 DOI: 10.1097/mpg.0000000000002884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES We aimed to examine the association between abdominal fat measured by ultrasound and anthropometric indices in children with obesity, and those with normal weight. We also examined the association between anthropometry and fat measures in the prediction of comorbidities in children with obesity. METHODS Forty children with body mass index of >95th percentile were included as cases, and a comparable group of 32 healthy average-weight peers were included as controls in this study. All children underwent clinical assessment, anthropometric measures, and evaluation of abdominal subcutaneous fat (SCF) and visceral fat by ultrasound. Fasting blood sugar, serum transaminases, and lipid profile of all the included children were also evaluated. RESULTS Children with obesity had a mean age of 8.7 ± 2.9 years (range 3-13). The SCF and intraperitoneal fat (IPF) values correlated well with each other and with anthropometric measurements in children with obesity. Among all the included cases, 90% were metabolically unhealthy, 70% had hypertension, 52.5% had dyslipidemia, and 22.5% had echogenic liver. Anthropometric measures, abdominal SCF and IPF were higher in children with complications. SCF was observed as a good predictor for hepatic echogenicity among the measured ultrasound parameters (P: 0.03, odds ratio 4.6). The best cutoff value for SCF in cases with hepatic echogenicity was 23.2 mm with an overall accuracy of 80%. CONCLUSIONS In children with obesity, abdominal SCF and IPF correlated well with anthropometric measures and were higher in children with comorbidities. This finding, however, did not predict comorbidities apart from those with echogenic liver.
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Di Credico A, Gaggi G, Ghinassi B, Mascherini G, Petri C, Giminiani RD, Di Baldassarre A, Izzicupo P. The Influence of Maturity Status on Anthropometric Profile and Body Composition of Youth Goalkeepers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8247. [PMID: 33171648 PMCID: PMC7664635 DOI: 10.3390/ijerph17218247] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022]
Abstract
The anthropometric profile assessment is an important aspect to consider during the growth stages of youth sport practitioners due to its usefulness in controlling maturity status and overall health. We performed an anthropometric profile evaluation in a sample of youth goalkeepers (n = 42) during a training camp, dividing them into three categories based on their years from peak height velocity (YPHV). We also checked if the selection of goalkeepers was associated with the birth quartile. The results showed that most of the participants' anthropometric parameters followed the normal trend according to the maturation stages. However, several subjects showed an overweight/obese condition and/or high waist circumference. Non-optimal values were found, mostly in the group of goalkeepers around the PHV. In addition, no selection based on birth quartile was seen. Therefore, the anthropometric profile and body composition of youth goalkeepers are physiologically affected by maturity status. However, several subjects were found to be overweight/obese and at cardiometabolic risk, suggesting that children and adolescents, although practicing sport, should pay attention to potentially contributing factors such as the attainment of the recommended levels of physical activity, lowering sedentary time, and adopt a healthy lifestyle.
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Affiliation(s)
- Andrea Di Credico
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
| | - Giulia Gaggi
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
| | - Barbara Ghinassi
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
| | - Gabriele Mascherini
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy; (G.M.); (C.P.)
| | - Cristian Petri
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy; (G.M.); (C.P.)
| | - Riccardo Di Giminiani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
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O’Donnell A, Buffini M, Kehoe L, Nugent A, Kearney J, Walton J, Flynn A, McNulty B. The prevalence of overweight and obesity in Irish children between 1990 and 2019. Public Health Nutr 2020; 23:2512-2520. [PMID: 32613932 PMCID: PMC10200483 DOI: 10.1017/s1368980020000920] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/27/2020] [Accepted: 03/10/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study aimed to examine the temporal prevalence of overweight and obesity in Irish children through different methodologies and evaluate the change in rates between 1990 and 2019. DESIGN Anthropometric data from three Irish national food consumption surveys were used to examine the change in the prevalence of BMI and waist circumference-derived overweight and obesity levels. SETTING Three cross-sectional food consumption surveys from the Republic of Ireland: the Irish National Nutrition Survey (1990), the National Children's Food Survey (2005) and The Second National Children's Food Survey (2019). PARTICIPANTS A demographically representative sample of Irish children aged 5-12 years: 1990 (n 148), 2005 (n 594) and 2019 (n 596). RESULTS Twelve percentage of children had overweight/obesity in 1990, which was significantly higher in 2005 at 25 % and significantly lower in 2019 at 16 % (P = 0·003). In 2019, more girls had overweight/obesity in comparison with boys (19 v. 14 %), whilst children from the lowest social class group had the highest levels of overweight/obesity (P = 0·019). Overall, the proportion of children with abdominal overweight/obesity was significantly lower in 2019 in comparison with 2005 (P ≤ 0·001). CONCLUSIONS Evidence from the most recent national survey suggests that overweight and obesity levels are plateauing and in some cases reducing in children in Ireland. Despite this, rates remain high, with the highest prevalence in 2019 observed in girls and in those from the lowest social class group. Thus, overweight/obesity prevention and intervention policies are necessary and should be continued.
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Affiliation(s)
- Aisling O’Donnell
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin4, Ireland
| | - Maria Buffini
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin4, Ireland
| | - Laura Kehoe
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Anne Nugent
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin4, Ireland
| | - John Kearney
- School of Biological & Health Sciences, Technological University Dublin, Dublin, Ireland
| | - Janette Walton
- Department of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Breige McNulty
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin4, Ireland
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Pallan M, Griffin T, Hurley KL, Lancashire E, Blissett J, Frew E, Griffith L, Hemming K, Jolly K, McGee E, Thompson JL, Jackson L, Gill P, Parry J, Adab P. Cultural adaptation of an existing children's weight management programme: the CHANGE intervention and feasibility RCT. Health Technol Assess 2020; 23:1-166. [PMID: 31293236 DOI: 10.3310/hta23330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Excess weight in children is a continuing health issue. Community-based children's weight management programmes have had some effect in promoting weight loss. Families from minority ethnic communities are less likely to complete these programmes but, to date, no programmes have been culturally adapted to address this. OBJECTIVES We aimed to (1) culturally adapt an existing weight management programme for children aged 4-11 years and their families to make it more suited to Pakistani and Bangladeshi communities but inclusive of all families and (2) evaluate the adapted programme to assess its feasibility and acceptability, as well as the feasibility of methods, for a future full-scale trial. DESIGN In phase I, a cultural adaptation of a programme that was informed by formative research and guided by two theoretical frameworks was undertaken and in phase II this adapted programme was delivered in a cluster-randomised feasibility study (for which the clusters were the standard and adapted children's weight management programmes). SETTING Birmingham: a large, ethnically diverse UK city. PARTICIPANTS In phase I, Pakistani and Bangladeshi parents of children with excess weight, and, in phase II, children aged 4-11 years who have excess weight and their families. INTERVENTIONS A culturally adapted children's weight management programme, comprising six sessions, which was delivered to children and parents, targeting diet and physical activity and incorporating behaviour change techniques, was developed in phase I and delivered in the intervention arm to 16 groups in phase II. The eight groups in the comparator arm received the standard (unadapted) children's weight management programme. MAIN OUTCOME MEASURES The primary outcome was the proportion of Pakistani and Bangladeshi families completing (attending ≥ 60% of) the adapted programme. Secondary outcomes included the proportion of all families completing the adapted programme, the feasibility of delivery of the programme, the programme's acceptability to participants, the feasibility of trial processes and the feasibility of collection of outcome and cost data. RESULTS The proportion of Pakistani and Bangladeshi families and all families completing the adapted programme was 78.8% [95% confidence interval (CI) 64.8% to 88.2%] and 76.3% (95% CI 67.0% to 83.6%), respectively. The programme was feasible to deliver with some refinements and was well received. Ninety-two families participated in outcome data collection. Data collection was mostly feasible, but participant burden was high. Data collection on the cost of programme delivery was feasible, but costs to families were more challenging to capture. There was high attrition over the 6-month follow-up period (35%) and differential attrition in the two study arms (29% and 52% in the intervention and comparator arms, respectively). LIMITATIONS The study was not designed to address the issue of low participant uptake of children's weight management programmes. The design of a future trial may include individual randomisation and a 'minimal intervention' arm, the acceptability of which has not been evaluated in this study. CONCLUSIONS The theoretically informed, culturally adapted children's weight management programme was highly acceptable to children and families of all ethnicities. Consideration should be given to a future trial to evaluate clinical effectiveness and cost-effectiveness of the adapted programme, but the design of a future trial would need to address the logistics of data collection, participant burden and study attrition. TRIAL REGISTRATION Current Controlled Trials ISRCTN81798055. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 33. See the NIHR Journals Library website for further project information. Kate Jolly is part-funded by the Collaboration for Leadership in Applied Health Research and Care West Midlands.
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Affiliation(s)
- Miranda Pallan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tania Griffin
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kiya L Hurley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Emma Lancashire
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jacqueline Blissett
- School of Psychology, University of Birmingham, Birmingham, UK.,Faculty Research Centre for Technology Enabled Health Research, Coventry University, Coventry, UK
| | - Emma Frew
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Laura Griffith
- School of Social Policy, University of Birmingham, Birmingham, UK
| | - Karla Hemming
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Eleanor McGee
- Birmingham Community Nutrition, Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Janice L Thompson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Louise Jackson
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Paramjit Gill
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Jayne Parry
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Hardy LL, Mihrshahi S. Elements of Effective Population Surveillance Systems for Monitoring Obesity in School Aged Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186812. [PMID: 32962004 PMCID: PMC7558984 DOI: 10.3390/ijerph17186812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022]
Abstract
The continuing high prevalence of child overweight and obesity globally means that it remains the most common chronic health condition in children. Population-based child obesity surveillance systems are critical for monitoring trends in obesity and related behaviours, and determining the overall effect of child obesity prevention strategies. Effective surveillance systems may vary in methods, scope, purpose, objectives, and attributes, and our aim was to provide an overview of child obesity surveillance systems globally, and to highlight main components and other types of survey data that can enhance our understanding of child obesity. Measures of adiposity, including body mass index and waist circumference are essential, but effective surveillance must also include measures of weight-related behaviours, including diet, physical activity, sedentary time, and sleep. While objective measures are desirable, the variability in psychometrics and rapid evolution of wearable devices is potentially problematic for examining long-term trends over time and how behaviours may change. Questionnaires on self-reported behaviours are often used but also have limitations. Because the determinants of obesity are not only functioning at the individual level, some measures of the broader environmental and commercial determinants, including the built and food environments, are useful to guide upstream policy decisions.
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Affiliation(s)
- Louise L. Hardy
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Correspondence: ; Tel.: +61-2-86271846
| | - Seema Mihrshahi
- Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2190, Australia;
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Cardiovascular Risk in Children: Focus on Pathophysiological Aspects. Int J Mol Sci 2020; 21:ijms21186612. [PMID: 32927656 PMCID: PMC7555342 DOI: 10.3390/ijms21186612] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 12/15/2022] Open
Abstract
Cardiovascular diseases are the leading cause of death, disability, and health care costs in industrialized countries. In general, cardiovascular diseases occur in adulthood, but cardiovascular damage, including stiffening of the arteries, begins very early. Already in the first decade of life, alterations that will favor the formation of atherosclerotic plaques may be present. Cardiovascular risk factors, associated with genetic predisposition, may trigger a sequence of pathophysiological changes which are associated with the progression of the atherosclerosis process. In this frame, the role of obesity has been increasingly emphasized. Different mechanisms linking obesity to cardiovascular disease have been postulated. Endothelial dysfunction and subclinical inflammation seem to be related to the worsening of cardiovascular risk factors in obese subjects and might have an essential role in the development of insulin resistance and the initiation and progression of atherosclerotic lesions. Excess weight, and in particular visceral adiposity, are associated with hypertrophy and hyperplasia of the adipocytes, increased secretion of adipokines and inflammatory cytokines and increase in serum uric acid levels. The list of obesity-related biomarkers associated with cardiovascular damage is rapidly expanding and their importance has already been described in children as well. Pathophysiological changes involved in determining early cardiovascular damage starting from childhood are discussed in this Special Issue.
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50
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Santos JLF, Valério VP, Fernandes RN, Duarte L, Assumpção AC, Guerreiro J, Sickler AL, Lemos ÁAR, Goulart Filho JG, Cesar LAM, Pinto IM, Magalhães C, Hussid MF, Camacho C, Avezum A, Sangaleti CT, Consolim-Colombo FM. Waist Circumference Percentiles and Cut-Off Values for Obesity in a Large Sample of Students from 6 To 10 Years Old Of The São Paulo State, Brazil. Arq Bras Cardiol 2020; 114:530-537. [PMID: 32267326 PMCID: PMC7792724 DOI: 10.36660/abc.20190043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023] Open
Abstract
Fundamento A prevalência da obesidade vem aumentando sistematicamente na população, inclusive nas crianças e adolescentes, ao redor do mundo. Objetivos Descrever curvas percentílicas de referência para a circunferência abdominal (CA) nas crianças brasileiras e fornecer pontos de corte da CA para identificar crianças com risco de obesidade. Métodos Um estudo multicêntrico, prospectivo, tranversal foi realizado em crianças com idades entre 6 e 10 anos, matriculadas no ensino fundamental de escolas públicas e particulares de 13 cidades do estado de São Paulo. A estatura, o peso e a CA foram medidos em duplicata em 22.000 crianças (11.199 meninos). Para estabelecer o melhor ponto de corte da CA para o diagnóstico da obesidade, foram calculadas curvas ROC com crianças classificadas como com peso normal e obesas, de acordo com as curvas do IMC, estratificadas por gênero e idade, e o índice Youden foi utilizado como a eficácia potencial máxima desse biomarcador. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados Os valores da CA aumentaram com a idade, tanto nos meninos quanto nas meninas. A prevalência de obesidade em cada grupo variou de 17% (6 anos de idade) a 21,6 % (9 anos de idade), dentre os meninos, e de 14,1% (7 anos de idade) a 17,3 % (9 anos de idade), dentre as meninas. As análises ROC mostraram o percentil 75 como ponto de corte para o risco de obesidade, e o diagnóstico de obesidade está classificado no percentil 85 ou acima. Conclusão Curvas de referência da CA específicas para idade e sexo em crianças brasileiras e pontos de corte para o risco de obesidade podem ser usados em triagem nacional e estudos intervencionais para reduzir a carga da obesidade no Brasil. (Arq Bras Cardiol. 2020; 114(3):530-537)
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Affiliation(s)
| | | | | | - Ligia Duarte
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | - Jayme Guerreiro
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Antonio L Sickler
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Álvaro A R Lemos
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | | | | | | | | | | | - Alvaro Avezum
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Carine T Sangaleti
- Universidade Estadual do Centro-Oeste - Enfermagem, Guarapuava, PR - Brasil
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