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Goel A, Reddy S, Goel P. Causes, Consequences, and Preventive Strategies for Childhood Obesity: A Narrative Review. Cureus 2024; 16:e64985. [PMID: 39161504 PMCID: PMC11332093 DOI: 10.7759/cureus.64985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2024] [Indexed: 08/21/2024] Open
Abstract
Childhood obesity is a complex public health challenge with profound implications for both physical and psychological well-being. A significant portion of the global population struggles with obesity. Sedentary lifestyles, increased consumption of ultra-processed foods, and socioeconomic disparities are major contributors. The COVID-19 pandemic has further exacerbated these issues, leading to a surge in obesity rates among children. The consequences of childhood obesity extend beyond immediate health issues like type 2 diabetes and cardiovascular diseases; obese children are at higher risk for psychological problems such as depression, anxiety, and low self-esteem, which can persist into adulthood. These health challenges also impose substantial economic burdens due to increased healthcare costs and reduced productivity. This paper synthesizes findings from various articles to provide an overview of the causes, consequences, and preventive strategies related to childhood obesity. It highlights the varied nature of obesity, including genetic, environmental, and lifestyle factors, and discusses the profound impact on physical health, socioemotional skills, and mental health. Additionally, it examines the global challenge of childhood obesity, particularly in developing nations, and emphasizes the importance of preventive measures, family and parental behaviors, and effective policy interventions.
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Affiliation(s)
- Ashish Goel
- Department of Cardiology, Fayth Clinic, Mumbai, IND
| | - Spoorti Reddy
- Department of General Medicine, Jan Sewa Hospital, Tantia University, Sri Ganganagar, IND
| | - Paula Goel
- Department of Pediatrics, Fayth Clinic, Mumbai, IND
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2
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Lee S. Impact of the child's birth weight on maternal misperceptions of young children's weight: A retrospective study with nationally representative data. Jpn J Nurs Sci 2024:e12610. [PMID: 38894593 DOI: 10.1111/jjns.12610] [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: 03/17/2024] [Revised: 04/29/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024]
Abstract
AIM A young child's abnormal birth weight (BW) can affect a mother's misperceptions of her child's weight, potentially hindering the child's health management. Therefore, this study investigated the impact of children's BW on maternal misperceptions of children's weight during early childhood. METHODS A retrospective study was conducted for 485,095 children who were 54-60 months of age, born between 2011 and 2013, and participated in South Korea's Sixth National Health Screening Program for Infants and Children (NHSPIC). Data on BW, weight, sex, birth year, preterm birth, breastfeeding history, maternal age, mothers' perceptions of the child's weight, and socioeconomic status were collected and incorporated in the final analysis via data linkage between the NHSPIC and Korean healthcare claims information. Multiple logistic regression analysis was applied to identity the impact of BW on mothers' misperceptions of children's weight, after adjustment for all variables. RESULTS Low BW (LBW) children had the lowest proportion (57.1%) of mothers who accurately identified their child's weight compared to normal or high BW. LBW was an independent factor affected maternal misperception of the child's weight (underestimation: adjusted odds ratio [aOR]: 1.46, 95% confidence interval [CI]: 1.41-1.52; overestimation: aOR: 0.84, 95% CI: 0.73-0.97). Overweight or underweight status, male gender, preterm birth, a younger mother, and low socioeconomic status were also associated with both underestimation and overestimation. CONCLUSION LBW emerged as an important risk factor for maternal misperception of a child's weight. Therefore, pediatric nurses need to apply interventions to improve perceptions of children's weight among mothers of young LBW children.
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Affiliation(s)
- Sangmi Lee
- College of Nursing, Dongyang University, Yeongju, South Korea
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3
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Kranjac AW, Kranjac D, Kain ZN, Ehwerhemuepha L, Jenkins BN. Obesity Heterogeneity by Neighborhood Context in a Largely Latinx Sample. J Racial Ethn Health Disparities 2024; 11:980-991. [PMID: 36997832 PMCID: PMC10933170 DOI: 10.1007/s40615-023-01578-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/27/2023] [Accepted: 03/19/2023] [Indexed: 04/01/2023]
Abstract
Neighborhood socioeconomic context where Latinx children live may influence body weight status. Los Angeles County and Orange County of Southern California both are on the list of the top ten counties with the largest Latinx population in the USA. This heterogeneity allowed us to estimate differential impacts of neighborhood environment on children's body mass index z-scores by race/ethnicity using novel methods and a rich data source. We geocoded pediatric electronic medical record data from a predominantly Latinx sample and characterized neighborhoods into unique residential contexts using latent profile modeling techniques. We estimated multilevel linear regression models that adjust for comorbid conditions and found that a child's place of residence independently associates with higher body mass index z-scores. Interactions further reveal that Latinx children living in Middle-Class neighborhoods have higher BMI z-scores than Asian and Other Race children residing in the most disadvantaged communities. Our findings underscore the complex relationship between community racial/ethnic composition and neighborhood socioeconomic context on body weight status during childhood.
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Affiliation(s)
- Ashley W Kranjac
- Department of Sociology, Chapman University, Orange, CA, USA
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
| | - Dinko Kranjac
- Department of Psychology, Institute for Mental Health and Psychological Well-Being, University of La Verne, La Verne, CA, USA
| | - Zeev N Kain
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | | | - Brooke N Jenkins
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA.
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA.
- Department of Psychology, Chapman University, One University Drive, Orange, CA, 92866, USA.
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4
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Wang J, Zhuang P, Lin B, Li H, Zheng J, Tang W, Ye W, Chen X, Zheng M. Gut microbiota profiling in obese children from Southeastern China. BMC Pediatr 2024; 24:193. [PMID: 38500150 PMCID: PMC10946167 DOI: 10.1186/s12887-024-04668-4] [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: 08/11/2023] [Accepted: 02/23/2024] [Indexed: 03/20/2024] Open
Abstract
Childhood obesity not only has a negative impact on a child's health but is also a significant risk factor for adult obesity and related metabolic disorders, making it a major global public health concern. Recent studies have revealed the crucial role of gut microbiota in the occurrence and development of obesity, in addition to genetic and lifestyle factors. In this study, we recruited 19 normal-weight children and 47 children with varying degrees of obesity. A questionnaire survey was conducted to inquire about the family background, lifestyle habits and dietary composition of the 66 children. Findings indicate that fathers of obese children tend to be obese themselves, while children with highly educated mothers are more likely to maintain a normal weight. Furthermore, overweight children tend to spend more time on electronic devices and less time on physical activities compared to their normal-weight counterparts. Obese children exhibit significant differences in breakfast and dinner dietary composition when compared to children with normal weight. Additionally, the gut microbiota of these 66 children was analyzed using 16S rRNA sequencing. Analysis of gut microbiota composition showed similar compositions among children with varying degrees of obesity, but significant differences were observed in comparison to normal-weight children. Obese children exhibited a reduced proportion of Bacteroidota and an increased proportion of Firmicutes, resulting in an elevated Firmicutes/Bacteroidota ratio. Moreover, Actinobacteriota were found to be increased in the gut microbiota of children with varying degrees of obesity. PICRUSt analysis indicated significant metabolic differences in the microbiota functions between obese and normal-weight children, suggesting the composition of gut microbiota could be a crucial factor contributing to obesity. These findings provide valuable insights for the treatment of childhood obesity.
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Affiliation(s)
- Jingjing Wang
- Department of Pediatrics, Ningde Municipal Hospital of Ningde Normal University, Ningde, China.
- Clinical Medicine Depeatmant of Fujian Medical University, Fuzhou, China.
| | - Peifeng Zhuang
- Department of Joint Surgery and Sports Medicine, Ningde Municipal Hospital of Ningde Normal University, Ningde, China
| | - Bin Lin
- Department of Pediatrics, Ningde Municipal Hospital of Ningde Normal University, Ningde, China
| | - Haiqing Li
- Department of Pediatrics, Ningde Municipal Hospital of Ningde Normal University, Ningde, China
| | - Jinlu Zheng
- Department of Pediatrics, Ningde Municipal Hospital of Ningde Normal University, Ningde, China
| | - Wenlin Tang
- Department of Pediatrics, Ningde Municipal Hospital of Ningde Normal University, Ningde, China
| | - Wenbin Ye
- Department of Pediatrics, Ningde Municipal Hospital of Ningde Normal University, Ningde, China
| | - Xiangjian Chen
- Department of Pediatrics, Ningde Municipal Hospital of Ningde Normal University, Ningde, China
| | - Mingping Zheng
- Department of Pediatrics, Ningde Municipal Hospital of Ningde Normal University, Ningde, China
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5
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Vandoni M, Marin L, Cavallo C, Gatti A, Grazi R, Albanese I, Taranto S, Silvestri D, Di Carlo E, Patanè P, Carnevale Pellino V, Zuccotti G, Calcaterra V. Poor Motor Competence Affects Functional Capacities and Healthcare in Children and Adolescents with Obesity. Sports (Basel) 2024; 12:44. [PMID: 38393264 PMCID: PMC10891969 DOI: 10.3390/sports12020044] [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: 12/18/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND From a young age, children learn different motor skills known as fundamental motor skills. The acquisition of these skills is crucial for the future development of context-tailored actions that could improve adherence to physical activity (PA) practice. Motor competence and function deficits have been associated with pediatric obesity. We reviewed the literature data regarding motor competence in pediatrics and impaired motor performance in children and adolescents with obesity. METHODS We assessed the abstracts of the available literature (n = 110) and reviewed the full texts of potentially relevant articles (n = 65) that were analyzed to provide a critical discussion. RESULTS Children and adolescents with obesity show impaired motor performance, executive functions, postural control, and motor coordination. Children's age represents a crucial point in the development of motor skills. Early interventions are crucial to preventing declines in motor proficiency and impacting children's PA and overall fitness levels. CONCLUSIONS To involve children, the PA protocol must be fun and tailored in consideration of several aspects, such as clinical picture, level of physical fitness, and motor skills. A supervised adapted exercise program is useful to personalized PA programs from an early pediatric age.
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Affiliation(s)
- Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Luca Marin
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Caterina Cavallo
- Department of Sport and Exercise Science, LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg;
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Roberta Grazi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Ilaria Albanese
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Industrial Engineering Department, University of Tor Vergata, 00133 Rome, Italy
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Dario Silvestri
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta;
| | - Eleonora Di Carlo
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
| | - Pamela Patanè
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
- Industrial Engineering Department, University of Tor Vergata, 00133 Rome, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA)—Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (L.M.); (A.G.); (I.A.); (P.P.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy; (R.G.); (S.T.); (E.D.C.); (G.Z.); (V.C.)
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
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7
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Kshatriya M, Wang KW, Hildebrand J, Crawford R, Nadarajah A, Youssef M, Rivas A, Kaushal A, Banfield LE, Thabane L, Samaan MC. The Effectiveness of Indigenous Knowledge-Based Lifestyle Interventions in Preventing Obesity and Type 2 Diabetes Mellitus in Indigenous Children in Canada: A Systematic Review. Adolesc Health Med Ther 2023; 14:175-193. [PMID: 37790916 PMCID: PMC10544169 DOI: 10.2147/ahmt.s405814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023] Open
Abstract
Background Indigenous children in Canada have high rates of obesity and type 2 diabetes mellitus (T2DM). Culturally appropriate interventions, guided by an Indigenous knowledge-based view of health, are crucial to target these conditions. The objective of this systematic review was to assess the impact of indigenous Knowledge-based lifestyle interventions on the prevention of obesity and T2DM in Indigenous children in Canada. Methods Database searches were conducted from inception until February 22, 2022. The main outcomes were changes in Body Mass Index (BMI) z-score and the development of T2DM. The other outcomes included adiposity, metabolic, and lifestyle determinants of health. The GRADE approach was used to assess confidence in the evidence. Results Four non-randomized controlled trials (non-RCTs) and six uncontrolled studies were identified. Peer-led interventions led to a reduction in BMI z-score and waist circumference. GRADE assessment revealed very low quality of evidence due to a lack of randomization and small sample sizes. There were no diabetes-specific reported programs. Conclusion Limited evidence from non-randomized studies suggest that peer-led indigenous Knowledge-based lifestyle interventions improve BMI z-score and central adiposity. There is a need for community-owned and adequately powered randomized studies for interventions that aim to treat and prevent obesity and T2DM in Indigenous children in Canada. Systematic Review Registration PROSPERO CRD42017072781.
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Affiliation(s)
- Maya Kshatriya
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Julia Hildebrand
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Rebecca Crawford
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Indigenous Undergraduate Summer Research Program, McMaster University, Hamilton, Ontario, Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Michael Youssef
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ashleen Kaushal
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Laura E Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, St. Joseph’s Healthcare-Hamilton, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph’s Health Care, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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8
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Qu HQ, Connolly JJ, Kraft P, Long J, Pereira A, Flatley C, Turman C, Prins B, Mentch F, Lotufo PA, Magnus P, Stampfer MJ, Tamimi R, Eliassen AH, Zheng W, Knudsen GPS, Helgeland O, Butterworth AS, Hakonarson H, Sleiman PM. Trans-ethnic polygenic risk scores for body mass index: An international hundred K+ cohorts consortium study. Clin Transl Med 2023; 13:e1291. [PMID: 37337639 DOI: 10.1002/ctm2.1291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/16/2023] [Accepted: 05/27/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND While polygenic risk scores hold significant promise in estimating an individual's risk of developing a complex trait such as obesity, their application in the clinic has, to date, been limited by a lack of data from non-European populations. As a collaboration model of the International Hundred K+ Cohorts Consortium (IHCC), we endeavored to develop a globally applicable trans-ethnic PRS for body mass index (BMI) through this relatively new international effort. METHODS The polygenic risk score (PRS) model was developed, trained and tested at the Center for Applied Genomics (CAG) of The Children's Hospital of Philadelphia (CHOP) based on a BMI meta-analysis from the GIANT consortium. The validated PRS models were subsequently disseminated to the participating sites. Scores were generated by each site locally on their cohorts and summary statistics returned to CAG for final analysis. RESULTS We show that in the absence of a well powered trans-ethnic GWAS from which to derive marker SNPs and effect estimates for PRS, trans-ethnic scores can be generated from European ancestry GWAS using Bayesian approaches such as LDpred, by adjusting the summary statistics using trans-ethnic linkage disequilibrium reference panels. The ported trans-ethnic scores outperform population specific-PRS across all non-European ancestry populations investigated including East Asians and three-way admixed Brazilian cohort. CONCLUSIONS Here we show that for a truly polygenic trait such as BMI adjusting the summary statistics of a well powered European ancestry study using trans-ethnic LD reference results in a score that is predictive across a range of ancestries including East Asians and three-way admixed Brazilians.
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Affiliation(s)
- Hui-Qi Qu
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - John J Connolly
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alexandre Pereira
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Christopher Flatley
- Division of Health Data and Digitalization, Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
| | - Constance Turman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Bram Prins
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Frank Mentch
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Paulo A Lotufo
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - Per Magnus
- University of Oslo, Oslo, Norway
- Center for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Meir J Stampfer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H., Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Rulla Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Gun Peggy Stromstad Knudsen
- Division of Health Data and Digitalization, Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
| | - Oyvind Helgeland
- Division of Health Data and Digitalization, Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
| | - Adam S Butterworth
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- The National Institute for Health Research Blood and Transplant Research Unit (NIHR BTRU) in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Hakon Hakonarson
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Patrick M Sleiman
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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9
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Ho RST, Chui KY, Huang WY, Wong SHS. Methodological Quality of Systematic Reviews on Bodyweight Management Strategies for Children and Adolescents. Med Sci Sports Exerc 2023; 55:892-899. [PMID: 36728305 DOI: 10.1249/mss.0000000000003116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Systematic reviews (SRs) synthesize empirical evidence from randomized controlled trials, to answer a research question. Methodological flaws in SRs can, however, reduce the trustworthiness of conclusions, subsequently hindering decision making. We aimed to appraise the methodological quality of existing SRs on bodyweight management strategies for children and adolescents. METHODS We searched Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, and SPORTDiscus. A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) was used to evaluate the methodological quality of SRs including 16 individual AMSTAR 2 domains and the total AMSTAR score. Association between bibliographical characteristics and total AMSTAR score of SRs was explored using multiple linear regression analysis. RESULTS Three critical domain-specific items of AMSTAR 2 among the included SRs showed unsatisfactory results including (i) justifying deviation from their SR protocols, (ii) using comprehensive literature search strategies, and (iii) giving details of both included and excluded studies. "More recent publication year journal," "higher impact factor of the journal," and "greater number of review authors" were associated with better methodological quality of the included SRs. CONCLUSIONS Future SRs' authors in the field of bodyweight management strategies for children and adolescents should improve the following criteria: (i) justify deviations from SR protocol, (ii) explain selection of the included study designs, (iii) use comprehensive literature search strategy, (iv) give details for both included and excluded studies, (v) report funding sources among included studies, and (vi) assess the potential impact of risk of bias among the included studies on meta-analysis results.
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Affiliation(s)
- Robin Sze-Tak Ho
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, CHINA
| | - King Yin Chui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, CHINA
| | - Wendy Yajun Huang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, CHINA
| | - Stephen Heung-Sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, CHINA
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10
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Spadaccini D, Guazzotti S, Goncalves Correia FP, Daffara T, Tini S, Antonioli A, Aimaretti G, Marzullo P, Caputo M, Antoniotti V, Prodam F. Beyond bariatric surgery and weight loss medicaments. A systematic review of the current practice in obesity rehabilitative inpatient programs in adults and pediatrics. Front Nutr 2022; 9:963709. [PMID: 36245519 PMCID: PMC9556721 DOI: 10.3389/fnut.2022.963709] [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: 06/07/2022] [Accepted: 09/14/2022] [Indexed: 11/14/2022] Open
Abstract
Background Obesity treatment strategies mainly include outpatient lifestyle modification, drugs and bariatric surgery. Voluntary rehabilitative inpatient programs are gaining relevance as potential alternative settings of care that focus on weight loss and prevention of weight regain through a multidisciplinary approach, but their prevalence is still limited due to the high costs. Aim Considering the lack of evidence in this area, the objective of this study is to systematically review the currently available literature on non-pharmacological and non-surgical inpatient programs aimed at weight loss, to clarify the efficacy and the characteristics of these interventions. Methods Proper English language articles from 2000 to 2022 were searched on relevant databases. Quality assessment was performed by two different authors using ROB2 and robvis tools. Adult and pediatric studies were reviewed separately and their characteristics were systematically displayed. Results 36 articles were included (20 on adults, 16 on children, and adolescents) for a total of 5,510 individuals. The multidisciplinary approach was mainly comprehensive of a low-calorie diet, scheduled physical activity, and psychological support based on behavioral treatment. Educational and cooking sessions were present at a lower rate. Globally, inpatient weight loss programs showed a consistent efficacy in reducing body weight and inducing beneficial effects on quality of life, psychological well-being, eating behavior, physical performance, and fatigue. Follow-up data were scarce, but with a high percentage of patients regaining weight after a short period. Conclusion Weight loss inpatient rehabilitation is a promising area that has evidence of all-rounded success in the amelioration of several aspects related to obesity. Nevertheless, it appears to be quite inconsistent in preserving these benefits after the intervention. This might slow the innovation process in this area and preclude further investments from national healthcare. Personalized and enriched programs could show greater impact when focusing on the behavioral and educational aspects, which are crucial points, in particular in pediatrics, for setting up a long-lasting lifestyle modification. More studies are therefore necessary to evaluate long-term efficacy based on the different work-up models.
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Affiliation(s)
- Daniele Spadaccini
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Silvia Guazzotti
- Biological Mass Spectrometry Lab, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | | | - Tommaso Daffara
- Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Sabrina Tini
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | | | - Gianluca Aimaretti
- Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Paolo Marzullo
- Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Division of General Medicine, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Verbania, Italy
| | - Marina Caputo
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Valentina Antoniotti
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Flavia Prodam
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
- Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- *Correspondence: Flavia Prodam,
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11
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The Cardiovascular Disease (CVD) Risk Continuum from Prenatal Life to Adulthood: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148282. [PMID: 35886134 PMCID: PMC9317926 DOI: 10.3390/ijerph19148282] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 02/06/2023]
Abstract
The risk of developing cardiovascular diseases (CVDs) arises from the interaction of prenatal factors; epigenetic regulation; neonatal factors; and factors that affect childhood and adolescence, such as early adiposity rebound (AR) and social and environmental influences. Thus, CVD risk varies between the group of low-risk metabolically healthy normal-weight subjects (MHNW); the intermediate-risk group, which includes metabolically healthy obese (MHO) and metabolically unhealthy normal-weight subjects (MUHNW); and the high-risk group of metabolically unhealthy obese (MUHO) subjects. In this continuum, several risk factors come into play and contribute to endothelial damage, vascular and myocardial remodeling, and atherosclerotic processes. These pathologies can occur both in prenatal life and in early childhood and contribute to significantly increasing CVD risk in young adults over time. Early intervention in the pediatric MUHO population to reduce the CVD risk during adulthood remains a challenge. In this review, we focus on CVD risk factors arising at different stages of life by performing a search of the recent literature. It is urgent to focus on preventive or early therapeutic strategies to stop this disturbing negative metabolic trend, which manifests as a continuum from prenatal life to adulthood.
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12
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Use of Physical Activity and Exercise to Reduce Inflammation in Children and Adolescents with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116908. [PMID: 35682490 PMCID: PMC9180584 DOI: 10.3390/ijerph19116908] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 12/13/2022]
Abstract
Childhood obesity is a leading public health problem worldwide, as it is increasingly prevalent and therefore responsible for serious obesity-related comorbidities, not only in childhood but also in adulthood. In addition to cardio-metabolic obesity-related disorders, recent evidence suggests that excess adipose tissue in turn is associated with immune cell infiltration, increased adipokine release, and the development of low-grade systemic inflammation obesity. Exercise is considered a non-pharmacological intervention that can delay obesity-related comorbidities, improving cardiovascular fitness and modulating the inflammatory processes. It has been reported that the anti-inflammatory effect of regular exercise may be mediated by a reduction in visceral fat mass, with a subsequent decrease in the release of adipokines from adipose tissue (AT) and/or by the induction of an anti-inflammatory environment. In this narrative review, we discuss the role of AT as an endocrine organ associated with chronic inflammation and its role in obesity-related complications, focusing on the effect of exercise in reducing inflammation in children and adolescents with obesity. Regular physical exercise must be considered as a natural part of a healthy lifestyle, and promoting physical activity starting from childhood is useful to limit the negative effects of obesity on health. The crucial role of the immune system in the development of obesity-induced inflammatory processes and the efficacy of exercise as an anti-inflammatory, non-pharmacological intervention may provide possible targets for the development of new treatments and early preventive strategies.
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13
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Marjanovic V, Budic I, Golubovic M, Breschan C. Perioperative respiratory adverse events during ambulatory anesthesia in obese children. Ir J Med Sci 2022; 191:1305-1313. [PMID: 34089150 PMCID: PMC9135828 DOI: 10.1007/s11845-021-02659-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/21/2021] [Indexed: 11/05/2022]
Abstract
Obesity is one of the most common clinical conditions in the pediatric population with an increasing prevalence ranging from 20 to 30% worldwide. It is well known that during ambulatory anesthesia, obese children are more prone to develop perioperative respiratory adverse events (PRAEs) associated with obesity. To avoid or at least minimize these adverse effects, a thorough preoperative assessment should be undertaken as well as consideration of specific anesthetic approaches such as preoxygenation before induction of anesthesia and optimizing drug dosing. The use of short-acting opioid and nonopioid analgesics and the frequent implementation of regional anesthesia should also be included. Noninvasive airway management, protective mechanical ventilation, and complete reversion of neuromuscular blockade and awake extubation also proved to be beneficial in preventing PRAEs. During the postoperative period, continuous monitoring of oxygenation and ventilation is mandatory in obese children. In the current review, we sought to provide recommendations that might help to reduce the severity of perioperative respiratory adverse events in obese children, which could be of particular importance for reducing the rate of unplanned hospitalizations and ultimately improving the overall postoperative recovery.
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Affiliation(s)
- Vesna Marjanovic
- Faculty of Medicine, University of Nis, Blvd. dr Zorana Djindjica 81, 18000 Nis, Serbia
- Clinic for Anesthesia and Intensive Therapy, Clinical Centre Nis, Blvd. dr Zorana Djindjica 48, 18000 Nis, Serbia
| | - Ivana Budic
- Faculty of Medicine, University of Nis, Blvd. dr Zorana Djindjica 81, 18000 Nis, Serbia
- Clinic for Anesthesia and Intensive Therapy, Clinical Centre Nis, Blvd. dr Zorana Djindjica 48, 18000 Nis, Serbia
| | - Mladjan Golubovic
- Faculty of Medicine, University of Nis, Blvd. dr Zorana Djindjica 81, 18000 Nis, Serbia
- Clinic for Anesthesia and Intensive Therapy, Clinical Centre Nis, Blvd. dr Zorana Djindjica 48, 18000 Nis, Serbia
| | - Christian Breschan
- Department of Anesthesia, Klinikum Klagenfurt, Feschigstrasse 11, 9020 Klagenfurt, Austria
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14
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Bennett J, Wong MC, McCarthy C, Fearnbach N, Queen K, Shepherd J, Heymsfield SB. Emergence of the adolescent obesity epidemic in the United States: five-decade visualization with humanoid avatars. Int J Obes (Lond) 2022; 46:1587-1590. [PMID: 35610336 DOI: 10.1038/s41366-022-01153-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Body size and shape have increased over the past several decades with one in five adolescents now having obesity according to objective anthropometric measures such as weight, height, and body mass index (BMI). The gradual physical changes and their consequences may not be fully appreciated upon visual inspection by those managing the long-term health of adolescents. This study aimed to develop humanoid avatars representing the gradual changes in adolescent body size and shape over the past five decades and to align avatars with key BMI percentile cut points for underweight, normal weight, overweight, and obesity. PARTICIPANTS/METHODS Participants included 223 children and adolescents between the ages of 5 and 18 years approximately representative of the race/ethnicity and BMI of the noninstitutionalized US population. Each participant completed a three-dimensional whole-body scan, and the collected data was used to develop manifold regression models for generating humanoid male and female avatars from specified ages, weights, and heights. Secular changes in the mean weights and heights of adolescents were acquired from six U.S. National Health and Nutrition Surveys beginning in 1971-1974 and ending in 2015-2018. Male and female avatars at two representative ages, 10 and 15 years, were developed for each survey and at the key BMI percentile cut points based on data from the 2015-2018 survey. RESULTS The subtle changes in adolescent Americans' body size and shape over the past five decades are represented by 24 male and female 10- and 15-year-old avatars and 8 corresponding BMI percentile cut points. CONCLUSIONS The current study, the first of its kind, aligns objective physical examination weights and heights with the visual appearance of adolescents. Aligning the biometric and visual information may help improve awareness and appropriate clinical management of adolescents with excess adiposity passing through health care systems. TRIAL REGISTRATION ClinicalTrials.Gov NCT03706612.
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Affiliation(s)
- Jonathan Bennett
- University of Hawaii Cancer Center, Honolulu, HI, USA.,Graduate Program in Nutritional Sciences, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Michael C Wong
- University of Hawaii Cancer Center, Honolulu, HI, USA.,Graduate Program in Nutritional Sciences, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Nicole Fearnbach
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Katie Queen
- Our Lady of the Lake Children's Health, Baton Rouge, LA, USA
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA.
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15
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Vescio A, Testa G, Sapienza M, Caldaci A, Montemagno M, Andreacchio A, Canavese F, Pavone V. Is Obesity a Risk Factor for Loss of Reduction in Children with Distal Radius Fractures Treated Conservatively? CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030425. [PMID: 35327797 PMCID: PMC8947058 DOI: 10.3390/children9030425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/08/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022]
Abstract
Background: Obesity in children is a clinical and social burden. The distal radius (DR) is the most common site of fractures in childhood and conservative treatment is widely used. Loss of reduction (LOR) is the major casting complication. The aim of this study is to evaluate obesity as a risk factor for LOR in children with displaced DR fractures (DRF) treated conservatively. Methods: 189 children under 16 years of age were treated conservatively for DRF. Patients were divided into three groups: normal weight (NW), overweight (OW) and obese (OB). The following radiographic criteria were evaluated in all patients: amount of initial translation (IT); quality of initial reduction; Cast (CI), Padding (PI), Canterbury (CaI), Gap (GI) and Three-Points (3PI) indices and the presence of LOR. Results: Statistically significant differences were found between the NW and the OB group for number of LOR (p = 0.002), severity (grade) of initial translation (p = 0.008), quality of initial reduction (p = 0.01) as well as CsI and CaI (p < 0.001). Conclusions: Obese children have a significantly higher rate of LOR compared to NW and OW children. A close follow-up is necessary in this population of patients. Preventive percutaneous pinning could be considered in older obese patients in order to reduce the need for further treatment.
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Affiliation(s)
- Andrea Vescio
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy; (A.V.); (G.T.); (M.S.); (A.C.); (M.M.)
| | - Gianluca Testa
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy; (A.V.); (G.T.); (M.S.); (A.C.); (M.M.)
| | - Marco Sapienza
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy; (A.V.); (G.T.); (M.S.); (A.C.); (M.M.)
| | - Alessia Caldaci
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy; (A.V.); (G.T.); (M.S.); (A.C.); (M.M.)
| | - Marco Montemagno
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy; (A.V.); (G.T.); (M.S.); (A.C.); (M.M.)
| | - Antonio Andreacchio
- Department of Pediatric Orthopedic Surgery, “V. Buzzi” Children Hospital, 20154 Milan, Italy;
| | - Federico Canavese
- Pediatric Orthopedic Surgery Service, Hôpital Jeanne de Flandre, University of Lille, 59037 Lille, France;
| | - Vito Pavone
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, Italy; (A.V.); (G.T.); (M.S.); (A.C.); (M.M.)
- Correspondence:
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16
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The Role of Urotensin-II in Obesity and Metabolic Syndrome in Pediatric Population. CHILDREN 2022; 9:children9020204. [PMID: 35204924 PMCID: PMC8870523 DOI: 10.3390/children9020204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 12/04/2022]
Abstract
Background: Urotensin-II (U-II) is a short cyclic peptide that is widely recognized as one of the most potent vasoconstrictors. U-II plays a role in the pathophysiology of MS, participating in the development of essential hypertension, insulin resistance, hyperglycemia, and a proinflammatory state. Methods: This study comprised 52 obese children and adolescents with a body mass index (BMI) z score > 2, aged 10 to 18 years. Serum levels of U-II were assessed using an enzyme-linked immunosorbent assay along with other standard biochemical parameters. Results: Elevated serum levels of U-II were recorded in the group of obese subjects with MS when compared with the group of obese subjects without MS (4.99 (8.97–3.16) vs. 4.17 (5.17–2.03) ng/mL, median and IQR, p = 0.026). Furthermore, a subgroup of study subjects with high blood pressure had significantly higher U-II levels in comparison with the normotensive subgroup (4.98 (7.19–3.22) vs. 3.32 (5.06–1.97) ng/mL, p = 0.027), while the subgroup with a positive family history of high blood pressure had significantly higher U-II levels when compared with subjects who had a negative family history of elevated blood pressure (5.06 (6.83–4.45) vs. 3.32 (6.13–2.21) ng/mL, p = 0.039). Conclusions: To the best of the author’s knowledge, this is the first study on the levels of U-II in obese children and adolescents, including a possible link to MS.
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17
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Neck circumference - A simple and valid screening tool for obesity in school children. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.899255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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18
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Cason-Wilkerson R, Thompson D, Mitchell N. Weight Change for Pediatric Completers in a National Weight Loss Program. Glob Pediatr Health 2021; 8:2333794X211057716. [PMID: 34869795 PMCID: PMC8641111 DOI: 10.1177/2333794x211057716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022] Open
Abstract
Overweight and obese children in low-income households have limited access to weight loss programs. Low-cost programs should be evaluated in this population. The objective of the current study is to determine weight change among 7 to 17-year-old participants in Take Off Pounds Sensibly (TOPS), a national, low-cost weight loss program. This nonconcurrent prospective study analyzes the cumulative change in weight z-score for overweight and obese children and adolescents who joined TOPS from 2008 to 2011 and consecutively renewed their annual membership. The study includes 586 individuals. At 1-year, cumulative mean (SD) weight z-score change was -0.13 (31). In general, mean change in weight z-scores was no different in subsequent years. Mean weight z-score of children and adolescent TOPS participants who renew their program membership decreased significantly in the first year. Randomized controlled trials should prospectively evaluate this program in children and adolescents.
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19
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Musić Milanović S, Buoncristiano M, Križan H, Rathmes G, Williams J, Hyska J, Duleva V, Zamrazilová H, Hejgaard T, Jørgensen MB, Salanave B, Shengelia L, Kelleher CC, Spinelli A, Nardone P, Abdrakhmanova S, Usupova Z, Pudule I, Petrauskiene A, Farrugia Sant'Angelo V, Kujundžić E, Fijałkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Boymatova K, Yardim MS, Tanrygulyyeva M, Melkumova M, Weghuber D, Nurk E, Mäki P, Bergh IH, Ostojic SM, Russell Jonsson K, Spiroski I, Rutter H, Ahrens W, Rakovac I, Whiting S, Breda J. Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region. Obes Rev 2021; 22 Suppl 6:e13209. [PMID: 34235843 DOI: 10.1111/obr.13209] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 12/22/2022]
Abstract
Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.
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Affiliation(s)
- Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - 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
| | - Helena Križan
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Giulia Rathmes
- 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
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | | | - Benoît Salanave
- Department of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint-Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Alexandra Cucu
- Faculty of Midwifery and Nursing, Discipline of Public Health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.,National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania
| | - Lacramioara Aurelia Brinduse
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, WHO Country Office for Tajikistan, Dushanbe, Tajikistan
| | | | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Marina Melkumova
- Institute of Child and Adolescent Health, Arabkir Medical Centre-Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - 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
| | - Stephen Whiting
- 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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20
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Robinson TN, Matheson D, Haydel KF, Flora J, Desai M. Packaging and Scaling the Stanford Pediatric Weight Control Program: A Family-Based, Group, Behavioral Weight Management Program for Children with Obesity and Their Families: Background, Rationale, and Design of the Stanford CORD 3.0 Project. Child Obes 2021; 17:S86-S92. [PMID: 34569840 PMCID: PMC8574198 DOI: 10.1089/chi.2021.0166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Efficacious treatments for children with obesity have not been broadly disseminated. The Stanford Pediatric Weight Control Program (SPWCP) is grounded in behavioral theory and prior observations, follows a proven treatment model, and is consistent with the US Preventive Services Task Force (USPSTF) recommendations. It has shown high levels of participation and retention and reductions in BMI and percent of median BMI for age and sex comparable to many studied programs, as well as improvements in physiological risk factors, psychological measures, and diet, activity, and screen time behaviors in children with obesity when delivered as a real-world clinical program with sociodemographically diverse families in multiple clinic and community settings. The Stanford CORD 3.0 Project proposes to use technology, design, behavioral theory, and biomedical business innovation strategies to package and scale the SPWCP to reach low-income children throughout the United States. Efficacy and success of implementation of the new packaged program will be tested in a one-arm pilot implementation study when delivered by community partners.
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Affiliation(s)
- Thomas N. Robinson
- Stanford Solutions Science Lab and Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA, USA.,Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA.,Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.,Address correspondence to: Thomas N. Robinson, MD, MPH, Stanford Solutions Science Lab, Division of General Pediatrics, Department of Pediatrics, Stanford University, 3145 Porter Drive, Palo Alto, CA 94304, USA.
| | - Donna Matheson
- Stanford Solutions Science Lab and Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - K. Farish Haydel
- Stanford Solutions Science Lab and Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - June Flora
- Stanford Solutions Science Lab and Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA, USA.,Department of Civil and Environmental Engineering, Stanford University, Stanford, CA, USA
| | - Manisha Desai
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.,Quantitative Sciences Unit, Department of Medicine, Stanford University, Stanford, CA, USA.,Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
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21
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Developing neck circumference growth reference charts for Pakistani children and adolescents using the lambda-mu-sigma and quantile regression method. Public Health Nutr 2021; 24:5641-5649. [PMID: 34431474 DOI: 10.1017/s1368980021003669] [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: 12/15/2022]
Abstract
OBJECTIVE Neck circumference (NC) is currently used as an embryonic marker of obesity and its associated risks. But its use in clinical evaluations and other epidemiological purposes requires sex and age-specific standardised cut-offs which are still scarce for the Pakistani paediatric population. We therefore developed sex and age-specific growth reference charts for NC for Pakistani children and adolescents aged 2-18 years. DESIGN Cross-sectional multi-ethnic anthropometric survey (MEAS) study. SETTING Multan, Lahore, Rawalpindi and Islamabad. PARTICIPANTS The dataset of 10 668 healthy Pakistani children and adolescents aged 2-18 years collected in MEAS were used. Information related to age, sex and NC were taken as study variables. The lambda-mu-sigma (LMS) and quantile regression (QR) methods were applied to develop growth reference charts for NC. RESULTS The 5th, 10th, 25th, 50th, 75th, 90th and 95th smoothed percentile values of NC were presented. The centile values showed that neck size increased with age in both boys and girls. During 8 and 14 years of age, girls were found to have larger NC than boys. A comparison of NC median (50th) percentile values with references from Iranian and Turkish populations reveals substantially lower NC percentiles in Pakistani children and adolescents compared to their peers in the reference population. CONCLUSION The comparative results suggest that the uses of NC references of developed countries are inadequate for Pakistani children. A small variability between empirical centiles and centiles obtained by QR procedure recommends that growth charts should be constructed by QR as an alternative method.
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22
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Niknam M, Omidvar N, Amiri P, Eini-Zinab H, Kalantari N. Community readiness for childhood obesity prevention programs: findings from an urban population in Iran. Health Promot Int 2021; 36:824-835. [PMID: 33111938 DOI: 10.1093/heapro/daaa101] [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: 11/15/2022] Open
Abstract
This study aimed to examine the Iranian local communities' readiness stage to engage with childhood obesity prevention programs for late primary school children in districts 2 and 16 of Tehran as the representatives of high and low socio-economic districts, respectively. First, a Delphi approach was conducted to assess the socio-cultural necessity/appropriateness and adequacy of the community readiness model and its dimensions as a planning basis for childhood obesity prevention program(s) in Iran. Then, the community readiness interview guide's translation, modification, content and face validity were performed. Finally, 66 interviews with key informants were conducted and scored to assess community readiness. The socio-cultural necessity/appropriateness and adequacy of community readiness model and its dimensions were confirmed by Delphi participants and two questions were added to the interview guide. Content and face validity of the interview guide were at acceptable levels. Assessment of the community readiness based on the key informants' perspective showed that the overall mean readiness score of targeted local communities was 4.61 ± 0.54 and 4.22 ± 0.26 in high and low socio-economic districts, respectively, corresponded to 'preplanning stage'. The highest score was 5.00 ± 0.48 correspond to the 'preparation stage', which belonged to girls' schools in district 2. Small differences were found in the readiness stage of local communities by sex and socio-economic status of schools. The results highlight the need to increase community awareness, gain their support to recognize childhood obesity as a priority, address cultural misconceptions and improve the obesity prevention programs to achieve a higher level of readiness.
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Affiliation(s)
- Mahdieh Niknam
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran 1985717413
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
| | - Naser Kalantari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
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23
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Köse S, Yılmaz Kafalı H, Erkan İdris ZG, Şentürk Pilan B, Özbaran B, Erermiş S. The prevalence and risk factors for overweight/obesity among Turkish children with neurodevelopmental disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 114:103992. [PMID: 34049231 DOI: 10.1016/j.ridd.2021.103992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/24/2021] [Accepted: 05/11/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To compare the prevalence and correlates of overweight (OW) and obesity (OB) between autism spectrum disorder (ASD), intellectual disability (ID), and attention deficit-hyperactivity disorder (ADHD) and to investigate which variables significantly contribute to OW/OB in each group. METHODS Of 267 cases (96 with ASD, 80 with ID, and 91 with ADHD) aged 2-18 years, body mass index (BMI) percentiles, birth weight, food reward usage, weekly screen and physical activity time, and psychotropics used were recorded. RESULTS OB (OB + OW) prevalence was 22.9 % (36.4 %) in ASD; 22.5 % (40 %) in ID; and 17.6 % (27.5 %) in ADHD. Although the ADHD group had the highest rate of stimulant usage (χ2 = 69.605, p < 0.001), physical activity attendance (χ2 = 49.751, p < 0.001), and the lowest anti-psychotic (χ2 = 69.142, p < 0.001), and anti-depressant usage (χ2 = 7.219, p < 0.001) than ID/DD or ASD, BMI percentile of the participants did not differ between the groups (H(2) = 1.652, p = 0.43). In hierarchical logistic regression analysis, in ASD, food reward (OR = 4.65, 95 %Cl = 1.25-17.19) and the number of psychotropics used (OR = 2.168, 95 %Cl = 1.07-4.36) were significantly related to the risk of OW/OB. In ADHD, each drugs administered and a 1-kilogram elevation in birth weight was associated with a 4.09 and 2.82 increased risk for OW/OB. CONCLUSION OW/OB is prevalent in children with neurodevelopmental disorders regardless of their diagnosis. Our findings showed that food rewards put a higher risk for OW/OB in ASD than administering a psychotropic. It could be better to use other positive reinforcements other than edible ones to prevent OW/OB in these children.
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Affiliation(s)
- Sezen Köse
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Turkey.
| | - Helin Yılmaz Kafalı
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Turkey.
| | | | - Birsen Şentürk Pilan
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Turkey.
| | - Burcu Özbaran
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Turkey.
| | - Serpil Erermiş
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Turkey.
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24
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Lee H, Koh DH. [Obesity and Pancreatobiliary Disease]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021; 75:240-245. [PMID: 32448855 DOI: 10.4166/kjg.2020.75.5.240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 01/04/2023]
Abstract
Obesity has become a major medical and public health problem worldwide. Recent studies have shown that obesity is a chronic disease that is associated with many diseases, such as gallstone disease, acute pancreatitis, fatty liver, and digestive cancer. Obesity is also a risk factor for the formation of cholesterol gallstones. Clinical and epidemiological studies have suggested that obesity is positively associated with the risk of gallbladder cancer. Obesity may modulate the lipid and endogenous hormones metabolism, affect gallbladder motility, increase the risk of gallstones, and increased the risk of gallbladder cancer. In addition, obesity has been considered a risk factor for pancreatic diseases, including pancreatitis and pancreatic cancer. Obese patients develop systemic and local complications of acute pancreatitis more frequently. Several epidemiologic studies have suggested an association of pancreatic cancer with high body mass and lack of physical activity. This study reviewed the literature on obesity and pancreatobiliary disease in terms of epidemiology and mechanism.
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Affiliation(s)
- Hoongoo Lee
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Dong Hee Koh
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
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25
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Córdoba-Rodríguez DP, Iglesia I, Gomez-Bruton A, Miguel-Berges ML, Flores-Barrantes P, Casajús JA, Moreno LA, Rodríguez G. Quantitative peripheral computed tomography to measure muscle area and assess lean soft tissue mass in children. Ann Hum Biol 2021; 48:93-100. [PMID: 33470135 DOI: 10.1080/03014460.2021.1877352] [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: 10/22/2022]
Abstract
BACKGROUND Skeletal muscle is one of the main components of lean soft tissue mass (LSTM). Low levels in children affect locomotion, posture, and increase the risk of metabolic syndrome. AIM (1) To evaluate the association between muscle cross-sectional area (MCSA) of the lower left leg measured by peripheral quantitative computed tomography (pQCT) and total LSTM; namely, total left leg and left lower leg LSTM assessed by dual-energy X-ray absorptiometry (DXA) in a group of children, (2) to examine if MCSA is a predictor of LSTM, (3) to determine the ability of pQCT to identify children with low LSTM. SUBJECTS AND METHODS Lower left leg MCSA and LSTM were measured using pQCT and DXA, respectively, in 396 children. RESULTS Statistically significant positive correlations were found between the lower leg MCSA - total LSTM (r² = 0.789), total leg LSTM (r² = 0.79), and lower leg LSTM (r² = 0.791) (p < .01). MCSA explained 64-68% of the variance in LSTM. Receiver operator characteristic (ROC) curves determined the capacity of the lower left leg MCSA to identify low LSTM in girls (AUC 0.95) and boys (AUC 0.87). CONCLUSIONS Our results showed that lower left leg MCSA, measured using pQCT, could be a tool to predict low LSTM in children.
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Affiliation(s)
- Diana Paola Córdoba-Rodríguez
- Food, Nutrition, and Health Research Group, Faculty of Science, Pontificia Universidad Javeriana, Bogota, DC, Colombia
| | - Iris Iglesia
- Growth, Exercise, Nutrition, and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain
| | - Alejandro Gomez-Bruton
- Growth, Exercise, Nutrition, and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Sciences (FCSD), Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - María L Miguel-Berges
- Growth, Exercise, Nutrition, and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition, and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - José Antonio Casajús
- Growth, Exercise, Nutrition, and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Sciences (FCSD), Universidad de Zaragoza, Zaragoza, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition, and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Department of Physiatry and Nursing, Faculty of Health and Sport Sciences (FCSD), Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Gerardo Rodríguez
- Growth, Exercise, Nutrition, and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain.,Departamento de Pediatría, Universidad de Zaragoza, Zaragoza, Spain
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26
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Robinson TN, Matheson D, Wilson DM, Weintraub DL, Banda JA, McClain A, Sanders LM, Haskell WL, Haydel KF, Kapphahn KI, Pratt C, Truesdale KP, Stevens J, Desai M. A community-based, multi-level, multi-setting, multi-component intervention to reduce weight gain among low socioeconomic status Latinx children with overweight or obesity: The Stanford GOALS randomised controlled trial. Lancet Diabetes Endocrinol 2021; 9:336-349. [PMID: 33933181 PMCID: PMC8241238 DOI: 10.1016/s2213-8587(21)00084-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 02/28/2021] [Accepted: 03/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND There are few long-term studies of interventions to reduce in low socioeconomic status children with overweight or obesity. The Stanford GOALS trial evaluated a 3-year, community-based, multi-level, multi-setting, multi-component (MMM) systems intervention, to reduce weight gain among low socioeconomic status, Latinx children with overweight or obesity. METHODS We did a two-arm, parallel group, randomised, open-label, active placebo-controlled trial with masked assessment over 3 years. Families from low-income, primarily Latinx communities in Northern California, CA, USA, with 7-11-year-old children with overweight or obesity were randomly assigned to a MMM intervention or a Health Education (HE) comparison intervention. The MMM intervention included home environment changes and behavioural counselling, community after school team sports, and reports to primary health-care providers. The primary outcome was child BMI trajectory over three years. Secondary outcomes included one- and two-year changes in BMI. This trial is registered with ClinicalTrials.govNCT01642836. FINDINGS Between July 13, 2012, and Oct 3, 2013, 241 families were recruited and randomly assigned to MMM (n=120) or HE (n=121). Children's mean age was 9·5 (SD 1·4) years, 134 (56%) were female and 107 (44%) were male, and 236 (98%) were Latinx. 238 (99%) children participated in year 1, 233 (97%) in year 2, and 227 (94%) in year 3 of follow-up assessments. In intention-to-treat analysis, over 3 years, the difference between intervention groups in BMI trajectory was not significant (mean adjusted difference -0·25 [95% CI -0·90 to 0·40] kg/m2; Cohen's d=0.10; p=0·45). Children in the MMM intervention group gained less BMI over 1 year than did children in the HE intervention group (-0·73 [-1·07 to -0·39] kg/m2, d=0.55); the same was true over 2 years (-0·63 [-1·13 to -0·14] kg/m2; d =0.33). No differential adverse events were observed. INTERPRETATION The MMM intervention did not reduce BMI gain versus HE over 3 years but the effects over 1 and 2 years in this rigorous trial show the promise of this systems intervention approach for reducing weight gain and cardiometabolic risk factors in low socioeconomic status communities. FUNDING US National Institutes of Health.
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Affiliation(s)
- Thomas N Robinson
- Stanford Solutions Science Lab, Department of Pediatrics, Stanford University, Stanford, CA, USA; Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA, USA; Prevention Research Center, Stanford University, Stanford, CA, USA; Department of Medicine, Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
| | - Donna Matheson
- Stanford Solutions Science Lab, Department of Pediatrics, Stanford University, Stanford, CA, USA; Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Darrell M Wilson
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Dana L Weintraub
- Stanford Solutions Science Lab, Department of Pediatrics, Stanford University, Stanford, CA, USA; Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Jorge A Banda
- Department of Public Health, Purdue University, West Lafayette, Indiana, USA
| | | | - Lee M Sanders
- Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | | | - K Farish Haydel
- Stanford Solutions Science Lab, Department of Pediatrics, Stanford University, Stanford, CA, USA; Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | | | - Charlotte Pratt
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MA, USA
| | | | - June Stevens
- Department of Nutrition, University of Carolina, Chapel Hill, NC, USA; Department of Epidemiology, University of Carolina, Chapel Hill, NC, USA
| | - Manisha Desai
- Quantitative Sciences Unit, Stanford University, Stanford, CA, USA; Department of Medicine, Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA; Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
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27
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Quitadamo P, Zenzeri L, Mozzillo E, Giorgio V, Rocco A, Franzese A, Nardone G, Staiano A. Plasma dosage of ghrelin, IGF-1, GLP- 1 and leptin related to gastric emptying and esophageal pH-impedance in children with obesity. J Endocrinol Invest 2021; 44:1275-1281. [PMID: 32960416 DOI: 10.1007/s40618-020-01425-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/14/2020] [Indexed: 01/11/2023]
Abstract
PURPOSE The main aim of the study was to assess the relationship between leptin, ghrelin, insulin-like growth factor 1 (IGF-1), and glucagon-like peptide 1 (GLP-1) blood levels and gastric motility in children with obesity compared to healthy children. Secondary aims were to assess the possible association between these hormones and obesity, reflux impedance parameters, reflux symptoms, other GI disorders, and quality-of-life scores within the same groups. METHODS Children with obesity plus GERD symptoms and 2 control groups of children with obesity without GERD and healthy lean children aged 4-17 years underwent an auxological evaluation, an assessment of gastro-intestinal symptoms and quality of life, hormonal dosages, and an evaluation of gastric emptying time (GET) through 13C-octanoic acid breath test. RESULTS No significant association was found between hormones and gastric motility. Leptin and ghrelin levels were significantly associated with obesity parameters. No significant differences were found between GET and hormones of the patients with obesity, either with or without GERD. CONCLUSION Although we found an association between auxological parameters and both leptin and ghrelin levels, this association did not imply an effect on the upper GI motility. Therefore, our hypothesis that alterations of these hormones in children with obesity could affect gastric emptying, triggering GERD, was not supported by our data.
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Affiliation(s)
- P Quitadamo
- Department of Translational Medical Science, Section of Pediatrics, "Federico II" University of Naples, Naples, Italy.
- Department of Pediatrics, A.O.R.N. Santobono-Pausilipon, Via Mario Fiore 6, 80129, Naples, Italy.
| | - L Zenzeri
- Department of Pediatrics, University of Perugia, Perugia, Italy
| | - E Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, "Federico II" University of Naples, Naples, Italy
| | - V Giorgio
- UOC Pediatria, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - A Rocco
- Department of Gastroenterology, "Federico II" University of Naples, Naples, Italy
| | - A Franzese
- Department of Translational Medical Science, Section of Pediatrics, "Federico II" University of Naples, Naples, Italy
| | - G Nardone
- Department of Gastroenterology, "Federico II" University of Naples, Naples, Italy
| | - A Staiano
- Department of Translational Medical Science, Section of Pediatrics, "Federico II" University of Naples, Naples, Italy
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28
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Nalbantoğlu A, Kızılca Ö, Güzel S, Emeksiz HC, Nalbantoğlu B. Increased Carotid Intima-Media Thickness and Endothelial Cell-Specific Molecule-1 (Endocan) Levels in Obese Children. Angiology 2021; 72:633-639. [PMID: 33715456 DOI: 10.1177/0003319721995664] [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: 11/17/2022]
Abstract
Obesity in children appears to be associated with increased risk of cardiovascular and metabolic diseases later in life. Early development of insulin resistance (IR) may lead to endothelial dysfunction and increased carotid intima-media thickness (cIMT) even in childhood. We compared endothelial cell-specific molecule-1 (endocan) levels in pediatric obese patients with those in healthy controls to determine whether endocan could be used as a biological marker of complications caused by endothelial damage. In 80 obese pubertal children (44 males [M] and 36 females [F], mean age: 12.8 ± 2.5 years), anthropometric measurements, cIMT, endocan levels, and IR indices (homeostasis model assessment of insulin resistance [HOMA-IR]) were evaluated and compared with 80 healthy pubertal patients (42M/38F, mean age: 12.3 ± 3.2 years). High-resolution ultrasound was used to measure the cIMT. Obese children had higher levels of endocan compared with the controls (P < .001). Fasting insulin levels and HOMA-IR were also higher in obese children (P < .001 for both). In addition, obese children had an increased cIMT (P < .001). In obese children, there was a significant correlation between cIMT and HOMA-IR (β = -1.314, P = .002) and between cIMT and endocan (β = .483, P = .004). Measuring cIMT and endocan levels (noninvasive investigations) in obese children, together with early preventive measures, could significantly decrease morbidity and mortality in adulthood.
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Affiliation(s)
- Ayşin Nalbantoğlu
- Faculty of Medicine, Department of Pediatrics, 472605Namık Kemal University, Tekirdağ, Turkey
| | - Özgür Kızılca
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, 472605Namık Kemal University, Tekirdağ, Turkey
| | - Savaş Güzel
- Faculty of Medicine, Department of Biochemistry, 472605Namık Kemal University, Tekirdağ, Turkey
| | - Hamdi Cihan Emeksiz
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, 485544Istanbul Medeniyet University, Istanbul, Turkey
| | - Burçin Nalbantoğlu
- Faculty of Medicine, Department of Pediatrics, 472605Namık Kemal University, Tekirdağ, Turkey
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The fetal origins of disease: a prospective cohort study on the association of preeclampsia and childhood obesity. J Dev Orig Health Dis 2021; 13:68-74. [PMID: 33650483 DOI: 10.1017/s2040174421000027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Cardiovascular diseases are the main cause of mortality worldwide, and childhood excess weight/obesity are strong correlators of accumulated risk in later life. A relationship between maternal preeclampsia and offspring's childhood obesity is recognized, but most studies fail to control for strong confounders. Our goal is to analyze the association between preeclampsia and childhood excess weight/obesity, after accounting for important confounders. We recruited 5133 women with singleton pregnancies during admission for delivery. Sixty-seven pregnancies were complicated by preeclampsia. Maternal and children outcomes were assessed at 10 years of age. We analyzed the association between preeclampsia and childhood excess weight/obesity by fitting a linear regression model (using offspring body mass index (BMI) z-score at 10 years of age) and a logistic regression model (using excess weight/obesity status). We then controlled both models for known confounders, namely maternal prepregnancy BMI, parity, and smoking during pregnancy. At 10 years of age, offspring of preeclamptic mothers had a higher BMI z-score and were more likely classified as overweight/obese, but these differences were not statistically significant. After controlling for maternal prepregnancy BMI, parity, and smoking during pregnancy, there was a high magnitude change in the beta coefficient of preeclampsia in the linear (0.175; -0.014) and the logistic regression models (1.48; 1.23) suggesting that the association between preeclampsia and childhood excess weigh/obesity is significantly confounded by these variables. These confounders also showed a significant association with childhood obesity. This finding suggests that in utero exposure to preeclampsia seems to have less impact in childhood obesity than the previously described confounders.
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30
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Onan D, Ulger O. Investigating the Relationship between Body Mass Index and Pain in the Spine in Children or Adolescents: A Systematic Review. Child Obes 2021; 17:86-99. [PMID: 33570458 DOI: 10.1089/chi.2020.0266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: Neck pain (NP), back pain (BP), and low back pain (LBP) are generally defined as "pain in the spine." With the increasing prevalence of childhood obesity, secondary problems such as pain in the spine have arisen. The purpose of this review was to investigate the relationship between body mass index (BMI) and pain in the spine in children or adolescents. Methods: Publications were searched in PubMed, Web of Science, Scopus, and Google Scholar databases up to December 12, 2020. The search strategy in the database consisted of free text words and MeSH terms. Results: Twelve studies were reviewed. It was determined that different methods were used in all 12 studies to evaluate pain. In the evaluation of overweight/obesity, these studies performed BMI assessment by dividing body weight in kilograms by height squared. Five studies showed a relationship between LBP and BMI, two studies showed a relationship between BP and BMI, and two studies showed a relationship between NP and BMI. Conclusions: The review shows that there is a relationship between BMI and pain in the spine, especially LBP. There may be factors affecting this condition such as mechanical loading and hormonal metabolic activity in childhood and adolescence. Different methods are used in the studies in literature for the assessment pain in the spine and BMI, overweight, and obesity.
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Affiliation(s)
- Dilara Onan
- Back and Neck Health Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ozlem Ulger
- Back and Neck Health Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Concordance between Body Composition Indices Measured with Dual-Energy X-Ray Absorptiometry and Bioelectrical Impedance Analysis in Obese Children in Sri Lanka. Int J Pediatr 2021; 2021:6638057. [PMID: 33628278 PMCID: PMC7896873 DOI: 10.1155/2021/6638057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 11/17/2022] Open
Abstract
Dual-energy X-ray absorptiometry (DXA) is the reference standard in the measurement of body composition indices. But, its utility is limited due to the high cost, expertise required, lack of portability, and restricted availability. Therefore, bioelectrical impedance analysis (BIA) has gained recognition in resource-limited settings for the measurement of body composition indices in the screening of children for childhood obesity. To determine whether BIA represents a viable alternative to DXA in the assessment of body composition in obese children in the community setting in Sri Lanka, the concordance between BIA and DXA was determined. Fat mass (FM), percentage fat mass (%FM), and fat-free mass (FFM) were measured in 97 obese children using DXA and BIA, and the concordance between the methods was analyzed using independent sample t-test, regression analysis, and Bland-Altman plots. Significant mean differences were observed between DXA and BIA in measuring FM and FFM. However, high correlations were seen in DXA- and BMI-derived FM and FFM measurements (FM r = 0.92 and FFM 0.83, P < 0.001 for both). Compared to DXA, BIA overestimated FM and %FM and underestimated FFM. When compared with DXA-derived measurements, the accuracy errors (SEE) of BIA for FM, FFM, and %FM were relatively higher in boys (3.56 kg, 4.49 kg, and 5.46%, respectively) than in girls (2.44 kg, 3.72 kg, and 3.5%), respectively. BA plots showed a systematic error in the measurements of FM, FFM, and %FM in both sexes. Despite the limitations inherited, BIA is a viable alternative to DXA for the measurement of body composition in obese children of 5-15 yrs. The accuracy errors observed, however, need to be taken into consideration when interpreting results at the individual level.
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Hajihashemi P, Azadbakht L, Hashemipour M, Kelishadi R, Saneei P, Esmaillzadeh A. Whole grain intake favorably affects blood glucose and serum triacylglycerols in overweight and obese children: A randomized controlled crossover clinical trial. Nutrition 2021; 87-88:111200. [PMID: 33744640 DOI: 10.1016/j.nut.2021.111200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/23/2021] [Accepted: 02/01/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The aim of this study was to determine the effects of whole grain consumption on the metabolic profiles of overweight or obese children. METHODS This was a randomized crossover clinical trial with 44 overweight or obese girls. After a 2-wk run-in period, girls were randomly assigned to either intervention or control groups. Participants in the intervention group were asked to obtain 50% of their grain servings from whole grain foods each day for 6 wk. Those in the control group were asked not to consume any of these foods. A 4-wk washout period was applied following which participants were crossed over to the alternate arm. Fasting blood samples were taken before and after each phase of study. RESULTS Mean (± SD) age and body mass index was 11.2 ± 1.49 y and 23.5 ± 2.5 kg/m2, respectively. Mean whole grain intake in intervention and control groups throughout the study was 26.5 and 3.7 g/d, respectively (P = 0.01). Whole grain consumption resulted in lower concentrations of plasma glucose (changes from baseline in intervention group: -0.10 versus 0.21 mmol/L in control group, P = 0.01), serum triacylglycerols (changes from baseline in intervention group: -0.18 versus 0.08 mmol/L in control group, P = 0.01) and higher concentrations of serum high-density lipoprotein cholesterol (changes from baseline in intervention group: 0.16 versus -0.14 mmol/L in control group, P = 0.05) after 6 wk of intervention. No effects of whole grain intake on serum concentrations of total- and low-density lipoprotein cholesterol or on blood pressure were found. CONCLUSION This study provided evidence supporting the beneficial effects of whole grain foods on serum concentrations of glucose, triacylglycerols and high-density lipoprotein cholesterol in overweight children.
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Affiliation(s)
- Parisa Hajihashemi
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahin Hashemipour
- Pediatrics Department, Faculty of Medicine and Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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The effects of whole grain intake on anthropometric measures in overweight and obese children: a crossover randomised clinical trial. Br J Nutr 2021; 126:1459-1465. [DOI: 10.1017/s000711452100026x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Abstract
Whole-grain foods have been reported to affect body weight and satiety. However, we are aware of no study in this regard among children. The present study aimed to determine the effects of whole grain consumption on anthropometric measures in overweight or obese children. In this randomised crossover clinical trial, forty-four overweight or obese girls participated. After a 2-week run-in period, subjects were randomly assigned to either intervention (n 44) or non-intervention (n 44) groups. Subjects in the intervention group were given a list of whole-grain foods and were asked to obtain half of their grain servings from these foods each day for 6 weeks. Individuals in the non-intervention group were asked not to consume any of these foods. A 4-week washout period was applied. Then, participants were crossed over to the alternate arm. The measurements were done before and after each phase. Mean age, weight and BMI of participants were 11·2 (sd 1·49) years, 51·2 (sd 10·2) kg and 23·5 (sd 2·5) kg/m2, respectively. Despite the slight reduction in weight and BMI, there were no significant differences in changes in these anthropometric measures. We found a significant effect of whole grain intake on waist circumference (−2·7 v. 0·3 cm, P = 0·04). No significant changes in hip circumference were observed. Changes in the prevalence of overweight, obesity and abdominal obesity were not significantly different. This study indicated a beneficial effect of whole-grain foods on waist circumference in overweight children; however, these foods did not influence weight and BMI.
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Whiting S, Buoncristiano M, Gelius P, Abu-Omar K, Pattison M, Hyska J, Duleva V, Musić Milanović S, Zamrazilová H, Hejgaard T, Rasmussen M, Nurk E, Shengelia L, Kelleher CC, Heinen MM, Spinelli A, Nardone P, Abildina A, Abdrakhmanova S, Aitmurzaeva G, Usuopva Z, Pudule I, Petrauskiene A, Sant'Angelo VF, Kujundzic E, Popovic S, Fismen AS, Bergh IH, Fijalkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Abdurrahmonova Z, Boymatova K, Yardim N, Tanrygulyyeva M, Weghuber D, Schindler K, Stojisavljević D, Filipović Hadžiomeragić A, Markidou Ionnaidu E, Ahrens W, Hassapidou M, Kovacs VA, Ostojic SM, Ticha L, Starc G, Russell Jonsson K, Spiroski I, Rutter H, Mendes R, Williams J, Rakovac I, Breda J. Physical Activity, Screen Time, and Sleep Duration of Children Aged 6-9 Years in 25 Countries: An Analysis within the WHO European Childhood Obesity Surveillance Initiative (COSI) 2015-2017. Obes Facts 2021; 14:32-44. [PMID: 33352575 PMCID: PMC7983588 DOI: 10.1159/000511263] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/24/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. OBJECTIVES This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6-9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). METHOD The fourth COSI data collection round was conducted in 2015-2017, using a standardized protocol that included a family form completed by parents with specific questions about their children's PA, screen time, and sleep duration. RESULTS Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for <2 h/day, and 84.9% slept for 9-11 h/night. Country-specific analyses of these behaviours showed pronounced differences, with national prevalences in the range of 61.7-98.3% actively playing for >1 h/day, 8.2-85.6% were not members of a sport or dancing club, 17.7-94.0% walked or cycled to school each day, 32.3-80.0% engaged in screen time for <2 h/day, and 50.0-95.8% slept for 9-11 h/night. CONCLUSIONS The prevalence of engagement in PA and the achievement of healthy screen time and sleep duration are heterogenous across the region. Policymakers and other stakeholders, including school administrators and parents, should increase opportunities for young people to participate in daily PA as well as explore solutions to address excessive screen time and short sleep duration to improve the overall physical and mental health and well-being of children.
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Affiliation(s)
- Stephen Whiting
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation,
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal,
| | - Marta Buoncristiano
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Peter Gelius
- Department of Sport Science and Sport, FAU, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU, Erlangen, Germany
| | - Mary Pattison
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Vesselka Duleva
- National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Sanja Musić Milanović
- School of Medicine, University of Zagreb, Croatian Institute of Public Health, Zagreb, Croatia
| | - Hana Zamrazilová
- Institute of Endocrinology, Obesity Management Centre, Prague, Czechia
| | | | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Eha Nurk
- National Institute for Health Development, Tallinn, Estonia
| | - Lela Shengelia
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Cecily C Kelleher
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland
| | - Mirjam M Heinen
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland
| | | | | | - Akbota Abildina
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Shynar Abdrakhmanova
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | | | | | - Iveta Pudule
- Ministry of Health, Centre for Disease Prevention and Control, Riga, Latvia
| | - Aušra Petrauskiene
- Lithuanian University of Health Sciences, Health Research Institute and Department of Preventive Medicine, Kaunas, Lithuania
| | | | - Enisa Kujundzic
- Institute of Public Health of Montenegro, Podgorica, Montenegro
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Anne-Siri Fismen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Anna Fijalkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Ana Isabel Rito
- National Institute of Health Dr Ricardo Jorge I.P., Lisbon, Portugal
| | | | | | | | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Health, Madrid, Spain
| | | | - Zulfinissio Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Duschanbe, Tajikistan
| | | | - Nazan Yardim
- Diabetes and Metabolic Disorders Department, Ministry of Health, Public Health Institution, Ankara, Turkey
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | | | - Dragana Stojisavljević
- Public Health Institute of Republic of Srpska, the University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and Herzegovina
| | | | | | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Institute of Statistics, University of Bremen, Bremen, Germany
| | | | | | - Sergej M Ostojic
- Faculty of Sport and PE, University of Novi Sad, Novi Sad, Serbia
| | - Lubica Ticha
- National Institute of Children Diseases, Medical Faculty of Comenius University, Bratislava, Slovakia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Igor Spiroski
- Department of Physiology and Monitoring of Nutrition, Institute of Public Health, Skopje, North Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Romeu Mendes
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Julianne Williams
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Ivo Rakovac
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - João Breda
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
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Liu M, Cao B, Liu M, Liang X, Wu D, Li W, Su C, Chen J, Gong C. High Prevalence of Obesity but Low Physical Activity in Children Aged 9-11 Years in Beijing. Diabetes Metab Syndr Obes 2021; 14:3323-3335. [PMID: 34321899 PMCID: PMC8312620 DOI: 10.2147/dmso.s319583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/06/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To investigate the prevalence and associated factors of childhood overweight/obesity in the Shunyi district of Beijing, China. METHODS This study adopted a cross-sectional survey and included 10,855 children aged 6-18 years in the Shunyi district of Beijing, China. Analyses were stratified by age group (6-8, 9-11, 12-14, and 15-18 years). RESULTS The prevalence of overweight and obesity among children aged 6-18 years was high with 17.62% and 29.05% in boys, 17.57% and 18.04% in girls, respectively. Both boys and girls aged 9-11 years had the highest rate of obesity in comparison with the other age groups, though the differences in children aged 9-11 years and 12-14 years were not statistically significant. Compared with age 6-8 years, age 9-11 years (OR=1.59, 95% CI 1.41-1.79, P<0.01) and 12-14 years (OR=1.26, 95% CI 1.48-1.73, P<0.01) were independently positively associated with obesity. Importantly, in all subjects, the percentages of being physically active (exercise time ≥120 minutes/week) were lower in children aged 9-11 years in comparison to children in other age groups. This phenomenon remained when this comparison was performed respectively in the normal-weight, overweight, and obesity groups. Even after adjustment for other potential confounders, the probability of being physically active (exercise time ≥120 minutes/week) was lower in children aged 9-11 years (OR=0.86, 95% CI 0.78-0.94, P<0.01), but higher in children aged 12-14 years (OR=1.91, 95% CI 1.69-2.17, P<0.01) and aged 15-18 years (OR=2.22, 95% CI 1.85-2.66, P<0.01), when compared with children aged 6-8 years. CONCLUSION Children aged 9-11 years had a higher prevalence of obesity, but a lower percentage of being physically active. Targeted intervention programs in this key group are needed to address this problem in China.
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Affiliation(s)
- Meijuan Liu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Bingyan Cao
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Min Liu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Xuejun Liang
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Di Wu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Wenjing Li
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Chang Su
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Jiajia Chen
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Chunxiu Gong
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
- Correspondence: Chunxiu Gong Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of ChinaTel +86-10-59616161 Email
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ALTIN Z, BAYRAK B. The relationship between sleep and metabolic factors in diabetes mellitus. FAMILY PRACTICE AND PALLIATIVE CARE 2020. [DOI: 10.22391/fppc.747615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Asif M, Aslam M, Wyszyńska J, Altaf S, Ahmad S. Diagnostic Performance of Neck Circumference and Cut-off Values for Identifying Overweight and Obese Pakistani Children: A Receiver Operating Characteristic Analysis. J Clin Res Pediatr Endocrinol 2020; 12:366-376. [PMID: 32295325 PMCID: PMC7711643 DOI: 10.4274/jcrpe.galenos.2020.2019.0212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Neck circumference (NC) is considered to be an alternative screening method for obesity. The aims were: (1) to examine the correlation between body mass index (BMI) and NC; and (2) to determine diagnostic performance including the best cut-off values of NC for identification of overweight and obese Pakistani children. METHODS The study sample was 7,921 children, aged 5-14 years, by cross-sectional survey carried-out in four major cities of Pakistan. Receiver operating characteristic analysis was used to investigate the diagnostics performance of NC and to determine the optimal cut-off points for identifying children with overweight and obesity. RESULTS The mean of each anthropometric variable (i.e., height, weight, BMI and NC) increased with age in both sexes. In the whole sample, NC had a strong positive correlation (r=0.61, p<0.01) with BMI. NC optimal cut-off points for identifying overweight and obesity in Pakistani boys ranged between 25.00 to 30.35 cm and the corresponding values for the girls were 24.00 to 31.62 cm. In the prepubertal period, NC cut-off points indicative overweight, in both boys and girls were 26.36 cm and 25.27 cm, respectively; the corresponding values for obesity were 26.78 cm and 25.02 cm. During puberty, the cut-off values for overweight and obesity respectively were 28.32 cm and 28.57 cm in boys and 28.70 cm and 28.82 cm in girls. CONCLUSION NC may be used as a simple and widely applicable measure for identification of overweight and obesity with reasonable accuracy in Pakistani children.
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Affiliation(s)
- Muhammad Asif
- Govt. Degree College, Qadir Pur Raan, Department of Statistics, Multan, Pakistan,* Address for Correspondence: Govt. Degree College, Qadir Pur Raan, Department of Statistics, Multan, Pakistan Phone: +923326038247 E-mail:
| | - Muhammad Aslam
- Bahauddin Zakariya University, Department of Statistics, Multan, Pakistan
| | | | - Saima Altaf
- Bahauddin Zakariya University, Department of Statistics, Multan, Pakistan
| | - Shakeel Ahmad
- Bahauddin Zakariya University, Department of Statistics, Multan, Pakistan
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Angi A, Chiarelli F. Obesity and Diabetes: A Sword of Damocles for Future Generations. Biomedicines 2020; 8:E478. [PMID: 33171922 PMCID: PMC7694547 DOI: 10.3390/biomedicines8110478] [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: 10/14/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023] Open
Abstract
Childhood obesity is one of the most challenging problem of the 21st century. The prevalence has increased, reaching an alarming rate. Furthermore, the problem is global and is also affecting low- and middle-income countries. This global obesity epidemic explains how the roots of cardiovascular disease, the most common cause of mortality among adults, begin in childhood. Overweight and obese children are likely to stay obese into adulthood and to develop noncommunicable diseases such as diabetes and cardiovascular diseases at a younger age. Thus, prevention should be the major goal and should start early in life. The aim of this review is to present an updated framework of the current understanding of the cardiovascular and metabolic risks in obese children and adolescents and to discuss the available therapeutic options.
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Affiliation(s)
- Alessia Angi
- Department of Pediatrics, University of Chieti, 66100 Chieti, Italy;
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A neurobehavioral study on the efficacy of price interventions in promoting healthy food choices among low socioeconomic families. Sci Rep 2020; 10:15435. [PMID: 32963284 PMCID: PMC7508865 DOI: 10.1038/s41598-020-71082-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/16/2020] [Indexed: 11/08/2022] Open
Abstract
Given the healthcare costs associated with obesity (especially in childhood), governments have tried several fiscal and policy interventions such as lowering tax and giving rebates to encourage parents to choose healthier food for their family. The efficacy of such fiscal policies is currently being debated. Here we address this issue by investigating how behavioral and brain-based responses in parents with low socioeconomic status change when rebates and lower taxes are offered on healthy food items. We performed behavioral and brain-based experiments, with the latter employing electroencephalography (EEG) acquired from parents while they shop in a simulated shopping market as well as follow up functional magnetic resonance imaging (fMRI) in the more restricted scanner environment. Behavioral data show that lower tax and rebate on healthy foods increase their purchase significantly compared to baseline. Rebate has a higher effect than lower tax treatment. From the EEG and fMRI experiments, we first show that healthy/unhealthy foods elicit least/maximal reward response in the brain, respectively. Further, by offering lower tax or rebate on healthy food items, the reward signal for such items in the brain is significantly enhanced. Second, we demonstrate that rebate is more effective than lower tax in encouraging consumers to purchase healthy food items, driven in part, by higher reward-related response in the brain for rebate. Third, fiscal interventions decreased the amount of frontal cognitive control required to buy healthy foods despite their lower calorific value as compared to unhealthy foods. Finally, we propose that it is possible to titrate the amount of tax reductions and rebates on healthy food items so that they consistently become more preferable than unhealthy foods.
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Abstract
OBJECTIVE This paper evaluates the association between caffeine consumption during pregnancy and overweight or obesity in the offspring. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted using MedLine, PubMed, CINAHL-Plus and Google Scholar databases. Inclusion criteria were cohort studies on participants with live singleton births at ≥28 weeks gestation who had consumed caffeine during pregnancy. Included were studies reporting both measurement of maternal caffeine intake and offspring anthropometric measurements. Studies reporting serum paraxanthine, a measurement of caffeine intake, were also included. RESULTS After final elimination, there were eight studies meeting our inclusion criteria. From these studies, we deduced that caffeine intake during pregnancy between 50 mg and <150 mg/day was associated with increased risk of overweight and obesity by excess fat deposition or increased weight, and elevated BMI per International Obesity Task Force (IOTF) criteria using a reference population. The majority of studies reported the strongest association with maternal caffeine intake during pregnancy and overweight and obesity risk beginning at ≥300 mg/day. CONCLUSIONS AND GLOBAL HEALTH IMPLICATION The risk of childhood overweight or obesity was associated with caffeine consumption at 50 mg/day during pregnancy with a stronger association at intakes ≥300 mg/day and higher. The current recommendation of <200 mg/day of caffeine during pregnancy is likely associated with lower risk of overweight or obesity in offspring but avoidance of the substance is recommended.
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Affiliation(s)
- Natalie C Frayer
- Nutrition and Dietetics Program, Central Michigan University, 1200 S. Franklin St. Mount Pleasant, MI 48859, USA
| | - Yeonsoo Kim
- Nutrition and Dietetics Program, Central Michigan University, 207 Wightman Hall 1202 S. Washington St. Mount Pleasant, MI 48859, USA
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Asif M, Aslam M, Altaf S, Mustafa S. Developing waist circumference, waist-to-height ratio percentile curves for Pakistani children and adolescents aged 2-18 years using Lambda-Mu-Sigma (LMS) method. J Pediatr Endocrinol Metab 2020; 33:/j/jpem.ahead-of-print/jpem-2019-0527/jpem-2019-0527.xml. [PMID: 32623376 DOI: 10.1515/jpem-2019-0527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 04/11/2020] [Indexed: 01/29/2023]
Abstract
Objectives Children from different countries and with different ethnic backgrounds have a distinct pattern of central fat deposition. Therefore, it is essential to develop population-specific percentiles of waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-height ratio exponent (WHtR (exp)) for the evaluation of central obesity. The objective of this study was to develop age-and-gender-specific smoothed WC and WHtR percentile curves for the Pakistani children and adolescents aged 2-18 years. Methods A cross-sectional data-set from a multi-ethnic anthropometric survey was considered. A sample of 10,668 healthy subjects (boys = 51.92%; and girls = 48.08%), aged 2-18 years was studied. Height (cm) and WC (cm) of each subject was measured under standard procedure and WHtR & WHtR (exp) were calculated. Age-and-gender-specific smoothed curves were obtained using the lambda-mu-sigma (LMS) method and compared with percentile curves obtained from different countries. Results Except few early ages, the WC values increased with age in both sexes. Both boys and girls had approximately similar WC during 6-11 years of age and after age of 11, the boys had larger WC than the girls had. For WHtR, the centile curves showed a continuous decrease by 16 years of age and then increased gradually. WHtR of the girls in various ages were having similar or higher than those of the boys. In comparison of WC 50th and 90th percentiles with other countries, it was found that except few ages, the Pakistani children had larger WC than the other reference populations and the results of WHtR were also comparable to the other nations. Conclusions We present new reference data of WC, WHtR and WHtR (exp) using a representative sample of the Pakistani children aged 2-18 years. These reference values can be used provisionally for early detection of central obesity and its associated risks in the Pakistani children.
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Affiliation(s)
| | - Muhammad Aslam
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | - Saima Altaf
- Department of Statistics, Bahauddin Zakariya University, Multan, Pakistan
| | - Sajid Mustafa
- Civil Hospital Sahiwal Medical College, Sahiwal, Pakistan
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Park HK, Kim J, Shim YS. Association between Sleep Duration and Body Composition in Girls Ten to Eighteen Years of Age: A Population-Based Study. Child Obes 2020; 16:281-290. [PMID: 32181679 DOI: 10.1089/chi.2019.0191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: This study aimed to evaluate the relationship between sleep duration and body composition as measured by dual-energy X-ray absorptiometry (DXA). Methods: Based on data obtained from the Korea National Health and Nutrition Examination Survey (2010), 303 girls were divided into three groups by sleep duration: very short, short, and recommended. Results: By analysis of covariance, compared with the "very short" group, the "recommended" group had reduced adjusted mean DXA-assessed total mass (TM, 46.46 kg vs. 51.36 kg, p = 0.012), fat mass (FM, 14.38 kg vs. 17.55 kg, p = 0.002), and fat mass percentage (FMP, 30.66% vs. 33.15%, p = 0.017) in the whole body; TM (20.85 kg vs. 23.63 kg, p = 0.007), FM (5.82 kg vs. 7.64 kg, p = 0.001), and FMP (27.48% vs. 30.70%, p = 0.009) in the trunk; TM (4.59 kg vs. 5.15 kg, p = 0.006), FM (1.62 kg vs. 2.05 kg, p = 0.001), and FMP (27.48% vs. 30.70%, p = 0.019) in the arms; and TM (16.75 kg vs. 18.23 kg, p = 0.042) and FM (6.09 kg vs. 6.97 kg, p = 0.018) in the legs. By multiple linear regression analysis, sleep duration in hours had a significant negative association with DXA-assessed TM (β = -1.221, p = 0.016) and FM (β = -0.760, p = 0.006) in the whole body; FM (β = -0.014, p = 0.026) in the head; TM (β = -0.699, p = 0.010), FM (β = -0.454, p = 0.003), and FMP (β = -0.714, p = 0.030) in the trunk; TM (β = -0.152, p = 0.005) and FM (β = -0.101, p = 0.004) in the arms; and FM (β = -0.191, p = 0.045) in the legs. Conclusions: Our results suggest that shorter sleep duration is related to higher FM, but not lean mass, especially in the trunk.
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Affiliation(s)
- Hong Kyu Park
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jin Kim
- Department of Computer Engineering, Hallym University School of Software, Chuncheon, Korea
| | - Young Suk Shim
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
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43
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Wang HH, Lee DK, Liu M, Portincasa P, Wang DQH. Novel Insights into the Pathogenesis and Management of the Metabolic Syndrome. Pediatr Gastroenterol Hepatol Nutr 2020; 23:189-230. [PMID: 32483543 PMCID: PMC7231748 DOI: 10.5223/pghn.2020.23.3.189] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome, by definition, is not a disease but is a clustering of individual metabolic risk factors including abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension, and low high-density lipoprotein cholesterol levels. These risk factors could dramatically increase the prevalence of type 2 diabetes and cardiovascular disease. The reported prevalence of the metabolic syndrome varies, greatly depending on the definition used, gender, age, socioeconomic status, and the ethnic background of study cohorts. Clinical and epidemiological studies have clearly demonstrated that the metabolic syndrome starts with central obesity. Because the prevalence of obesity has doubly increased worldwide over the past 30 years, the prevalence of the metabolic syndrome has markedly boosted in parallel. Therefore, obesity has been recognized as the leading cause for the metabolic syndrome since it is strongly associated with all metabolic risk factors. High prevalence of the metabolic syndrome is not unique to the USA and Europe and it is also increasing in most Asian countries. Insulin resistance has elucidated most, if not all, of the pathophysiology of the metabolic syndrome because it contributes to hyperglycemia. Furthermore, a major contributor to the development of insulin resistance is an overabundance of circulating fatty acids. Plasma fatty acids are derived mainly from the triglycerides stored in adipose tissues, which are released through the action of the cyclic AMP-dependent enzyme, hormone sensitive lipase. This review summarizes the latest concepts in the definition, pathogenesis, pathophysiology, and diagnosis of the metabolic syndrome, as well as its preventive measures and therapeutic strategies in children and adolescents.
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Affiliation(s)
- Helen H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dong Ki Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Liu
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari Medical School, Bari, Italy
| | - David Q.-H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Biener AI, Cawley J, Meyerhoefer C. The medical care costs of obesity and severe obesity in youth: An instrumental variables approach. HEALTH ECONOMICS 2020; 29:624-639. [PMID: 32090412 DOI: 10.1002/hec.4007] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
This paper is the first to use the method of instrumental variables to estimate the impact of obesity and severe obesity in youth. on U.S. medical care costs. We examine data from the Medical Expenditure Panel Survey for 2001-2015 and instrument for child BMI using the BMI of the child's biological mother. Instrumental variables estimates indicate that obesity in youth raises annual medical care costs by $907 (in 2015 dollars) or 92%, which is considerably higher than previous estimates of the association of youth obesity with medical costs. We find that obesity in youth significantly raises costs in all major categories of medical care: outpatient doctor visits, inpatient hospital stays, and prescription drugs. The costs of youth obesity are borne almost entirely by third-party payers, which is consistent with substantial externalities of youth obesity, which in turn represents an economic rationale for government intervention.
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Affiliation(s)
- Adam I Biener
- Department of Economics, Lafayette College, Easton, Pennsylvania, USA
| | - John Cawley
- Department of Policy Analysis and Management and Department of Economics, Cornell University, New York, USA
| | - Chad Meyerhoefer
- College of Business and Economics, Lehigh University, Bethlehem, Pennsylvania, USA
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Sezen Erhamza T, Kilicaslan Y, Nazik Unver F. Effect of body mass index percentile on skeletal maturation of cervical vertebrae and hand-wrist and dental maturation. Acta Odontol Scand 2020; 78:236-240. [PMID: 31909677 DOI: 10.1080/00016357.2019.1709891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The aim of this study was to evaluate the relationship between age- and gender-specific body mass index (BMI) percentile and skeletal and dental maturation in Turkish adolescents.Materials and methods: A sample of 429 patients (171 males, 258 females aged between 7 and 17 years) was selected. Skeletal maturation was identified in the hand-wrist radiography by Björk, Grave and Brown (BGB), and the cervical vertebrae maturation (CVM) method defined by Hassel and Farman in lateral cephalometric radiography. Dental maturation was determined by the Demirjian method. BMI was calculated by reference curves used for Turkish children. A regression model was used for the relationship between BMI percentile and skeletal and dental maturation.Results: There was no significant correlation between BMI and skeletal maturation of cervical vertebrae and dental maturation. A one-percentile increase in BMI percentile accelerates the increase of period (likelihood of being post-pubertal period) to 1.016 times (p < .05). Skeletal maturation of hand-wrist and cervical vertebrae and dental maturation were more prominent in females compared to males (p < .05). Males and females were not statistically significantly different in BMI percentile (p = .52).Conclusions: BMI may be considered before deciding to estimate the skeletal and dental maturation in an individual by the relevant methods.
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Affiliation(s)
- Turkan Sezen Erhamza
- Faculty of Dentistry, Department of Orthodontics, Kirikkale University, Kirikkale, Turkey
| | - Yagmur Kilicaslan
- Faculty of Dentistry, Department of Orthodontics, Kirikkale University, Kirikkale, Turkey
| | - Fatma Nazik Unver
- Faculty of Dentistry, Department of Orthodontics, Kirikkale University, Kirikkale, Turkey
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Berdahl T, Biener A, McCormick MC, Guevara JP, Simpson L. Annual Report on Children's Healthcare: Healthcare Access and Utilization by Obesity Status in the United States. Acad Pediatr 2020; 20:175-187. [PMID: 31843708 DOI: 10.1016/j.acap.2019.11.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 11/04/2019] [Accepted: 11/16/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To examine access to care and utilization patterns across a set of healthcare measures by obesity status and socio-demographic characteristics among children. METHODS Nationally representative data from the Medical Expenditure Panel Survey (2010-2015) provides data on obesity status, well-child visits, access to a usual source of care provider, preventive dental visits, and prescription medication fills in the past year. RESULTS Uninsured adolescents with obesity were less likely to have a usual source of care provider relative to children without obesity (73% vs 65%). Among younger children, children with obesity were less likely to report a well-child visit (difference of 8 percentage points). Younger children with obesity who lived in the Northeast were more than twice as likely as those living in the West to have a well-child visit. Children with obesity were less likely to report preventive dental use relative to their nonobese counterparts. Obesity status was associated with more prescription medication fills for adolescents, but not for younger children. CONCLUSIONS Our findings provide a baseline assessment for examining obesity and utilization trends among children in the future, especially as coverage patterns change with potential changes in childhood insurance coverage access through the Child Health Insurance Programs and Medicaid programs. Our findings highlight new directions for future research, particularly regarding the lower rates of preventive dental care among children with obesity.
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Affiliation(s)
- Terceira Berdahl
- Agency for Healthcare Research and Quality, Department of Health and Human Services, Rockville, Md (T Berdahl).
| | - Adam Biener
- Department of Economics, Lafayette College, Easton, Pa (A Biener)
| | - Marie C McCormick
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Mass (MC McCormick)
| | - James P Guevara
- Division of General Pediatrics, Children's Hospital of Philadelphia (JP Guevara)
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O'Neil ME. Examining the Relationship Between Weight Gain Trajectories and Pain Interference During Transitions from Adolescence to Adulthood: Informing Prevention and Intervention Strategies. PAIN MEDICINE 2020; 21:435-436. [PMID: 31880773 DOI: 10.1093/pm/pnz305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Margaret E O'Neil
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, Physical Therapy, New York, New York, USA
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48
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Dilley MA, Rettiganti M, Christie L, O'Brien E, Patterson M, Weeks C, Aronson J, Scurlock AM, Perry TT, Pesek RD, Bell MC, Kennedy JL, Chandler P, Magee J, Simmons L, Chervinskiy SK, Casey P, Jones SM. Impact of food allergy on food insecurity and health literacy in a tertiary care pediatric allergy population. Pediatr Allergy Immunol 2019; 30:363-369. [PMID: 30672621 DOI: 10.1111/pai.13019] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/19/2018] [Accepted: 01/10/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Food insecurity (FI), limited availability of or access to nutritional foods, is linked to poor child/caregiver health. We examined FI in food-allergic and non-food-allergic children to determine whether dietary limitations associated with food allergy increases risk of FI. METHODS Food-allergic and non-food-allergic children (1-17 years) were recruited from Arkansas Children's Hospital allergy/asthma clinics. The USDA Food Security Survey, the Newest Vital Sign Health Literacy (HL) questionnaire, and the Food Allergy Impact Scale QOL survey were administered. Logistic regression and analysis of covariance models were utilized for data analysis. RESULTS Subjects (n = 650) included 325 food-allergic and 325 non-food-allergic children. Overall rate of FI was 21.5% (food allergic 22.2% and non-food allergic 20.9%) with no significant difference in the prevalence of FI between groups (OR = 1.30; 95% CI 0.86-1.96; P = 0.21). FI was increased in households of children with both milk and egg allergy when compared to those without food allergy and those with single food allergy (OR = 2.5; 95% CI 1.4-4.6; P = 0.003). Mean HL rates were higher in the food-secure vs food-insecure groups (mean diff = 0.31; 95% CI 0.03-0.59; P = 0.03). Among food-allergic children, QOL was better in the food-secure vs food-insecure group (mean diff = 0.61; 95% CI 0.002-1.23; P = 0.049). CONCLUSION Food allergy to milk and egg was associated with increased risk of household FI. Food-insecure participants had lower HL than their food-secure counterparts. Further work is needed to define risks associated with FI among food-allergic children to improve screening and management strategies.
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Affiliation(s)
- Meredith A Dilley
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Mallikarjuna Rettiganti
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | | | - Erin O'Brien
- Arkansas Children's Hospital, Little Rock, Arkansas
| | | | | | | | - Amy M Scurlock
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Tamara T Perry
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Robbie D Pesek
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Matthew C Bell
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Joshua L Kennedy
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Peggy Chandler
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - James Magee
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Larry Simmons
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Sheva K Chervinskiy
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Patrick Casey
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
| | - Stacie M Jones
- University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Children's Hospital, Little Rock, Arkansas
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Interventions for obesity among schoolchildren: A systematic review and meta-analyses. PLoS One 2019; 14:e0209746. [PMID: 30625165 PMCID: PMC6326548 DOI: 10.1371/journal.pone.0209746] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 12/11/2018] [Indexed: 11/19/2022] Open
Abstract
Background Childhood overweight and obesity has emerged as a major public health threat worldwide with challenges in its management. This review assessed the effectiveness of interventions for childhood overweight and obesity. Methods A systematic literature search was conducted using CINAHL, EMBASE, Ovid MEDLINE, PsycINFO and SPORTDiscus databases to retrieve articles published from 1st January 2000 to 31st December 2017. Randomised controlled trials (RCTs) and quasi-experimental studies comparing different strategies in managing overweight and obesity among schoolchildren (6 to 12 years of age) were included. The main outcomes of interest were reductions in weight related variables included anthropometry and body composition measurements. All variables were analysed using random effects meta-analyses. Results Fourteen studies were reviewed, 13 were RCTs and one was a quasi-experimental study. The risk of bias for randomisation was low risk for all of RCTs except for one, which was unclear. The risk of bias for randomisation was high for the quasi-experimental study. Most interventions incorporated lifestyle changes and behavioural strategies such as coping and problem solving skills with family involvement. The meta-analyses did not show significant effects of the intervention in reducing weight related outcomes when compared with controls. Conclusion Meta-analyses of the selected studies did not show significant effects of the interventions on weight related outcomes among overweight and obese schoolchildren when compared with controls. The role of interdisciplinary team approaches with family involvement using behaviour and lifestyle strategies to curb obesity among schoolchildren is important.
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Nakamura D, Ogawa M, Nakamura T, Izawa KP. Impact of Parents' Comprehensive Health Literacy on BMI in Children: A Multicenter Cross-Sectional Study in Japan. THE JOURNAL OF SCHOOL HEALTH 2018; 88:910-916. [PMID: 30392184 DOI: 10.1111/josh.12700] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 01/08/2018] [Accepted: 01/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Low-functional health literacy (HL) of parents influences poor child health outcomes. This study aimed to assess the relationship between comprehensive HL of parents and body mass index (BMI) of their children. METHODS We enrolled 3- to 6-year-old preschool-aged children and their parents in this multicenter cross-sectional cohort study. We evaluated parents' comprehensive HL with the 14-item HL scale. Children's BMI categories were defined using International Obesity Task Force cutoffs according to age and sex. We analyzed differences in data between the high-HL group and the low-HL group and investigated the association between HL of parents and their children's BMI by multivariate logistic regression analysis. RESULTS The high-HL group comprised 208 (75.1%) children and the low-HL group comprised 69 (24.9%) children of whom 23 (8.3%) were overweight and 35 (12.6%) were thin. The low-HL group had more children with poor BMI than the high-HL group. Multivariate analysis showed an association between the low HL of parents and the poor BMI of their children after adjustment for all other confounding factors. CONCLUSIONS Comprehensive HL of parents appears to affect the BMI of their children independently, suggesting that interventions to improve HL in parents are necessary.
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Affiliation(s)
- Daisuke Nakamura
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
- Cardiovascular stroke Renal Project (CRP), Kobe, Japan
| | - Masato Ogawa
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
- Cardiovascular stroke Renal Project (CRP), Kobe, Japan
| | - Teruhiko Nakamura
- Educational Corporation Tukushi Gakuen, 2-3-11 Takadai, Chitose, Hokkaido 066-0035, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
- Cardiovascular stroke Renal Project (CRP), Kobe, Japan
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