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Cuda S. Special considerations for the child with obesity: An Obesity Medicine Association (OMA) clinical practice statement (CPS) 2024. OBESITY PILLARS 2024; 11:100113. [PMID: 38953014 PMCID: PMC11216014 DOI: 10.1016/j.obpill.2024.100113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 07/03/2024]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details assessment and management of the child with overweight or obesity. The term "child" is defined as the child between 2 and 12 years of age. Because children are in a continual state of development during this age range, we will specify when our discussion applies to subsets within this age range. For the purposes of this CPS, we will use the following definitions: overweight in the child is a body mass index (BMI) ≥ 85th and <95th percentile, obesity in the child is a BMI ≥95th percentile, and severe obesity is a BMI ≥120% of the 95th percentile. Methods The information and clinical guidance in this OMA Clinical Practice Statement are based on scientific evidence, supported by medical literature, and derived from the clinical perspectives of the authors. Results This OMA Clinical Practice Statement provides an overview of prevalence of disease in this population, reviews precocious puberty in the child with obesity, discusses the current and evolving landscape of the use of anti-obesity medications in children in this age range, discusses the child with obesity and special health care needs, and reviews hypothalamic obesity in the child. Conclusions This OMA Clinical Practice Statement on the child with obesity is an evidence based review of the literature and an overview of current recommendations. This CPS is intended to provide a roadmap to the improvement of the health of children with obesity, especially those with metabolic, physiological, psychological complications and/or special healthcare needs. This CPS addresses treatment recommendations and is designed to help the clinician with clinical decision making.
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Affiliation(s)
- Suzanne Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway, Ste 145, San Antonio, TX, 78218, USA
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Armstrong SC, Skinner AC. Severe Obesity in Toddlers: A Canary in the Coal Mine for the Health of Future Generations. Pediatrics 2024; 153:e2023063799. [PMID: 38105671 DOI: 10.1542/peds.2023-063799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 12/19/2023] Open
Affiliation(s)
- Sarah C Armstrong
- Departments of Pediatrics and Population Health Sciences, Duke Center for Childhood Obesity Research, Duke Clinical Research Institute, Duke Global Health Institute, Duke University School of Medicine, Durham, North Carolina
| | - Asheley C Skinner
- Departments of Pediatrics and Population Health Sciences, Duke Center for Childhood Obesity Research, Duke Clinical Research Institute, Duke Global Health Institute, Duke University School of Medicine, Durham, North Carolina
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Yang B, Lai Q, Chen A, Ye L, Wang X, Lai Y, Liu D, Man MQ. Body Mass Index z Scores Correlate with Epidermal Function in Chinese Children. Diabetes Metab Syndr Obes 2023; 16:3393-3401. [PMID: 37929059 PMCID: PMC10624195 DOI: 10.2147/dmso.s435512] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/15/2023] [Indexed: 11/07/2023] Open
Abstract
Background/Objective Epidermal function is altered in a number of cutaneous and extracutaneous disorders. To determine whether epidermal function is also altered in children with obesity, we assessed the correlation between the body mass index (BMI) z score and epidermal function in children. Participants and Methods Participants were enrolled from outpatient clinic, schools and kindergartens. Epidermal biophysical properties, including transepidermal water loss rate, stratum corneum hydration and skin surface pH, were measured on the flexor forearm and shin. Correlations between epidermal biophysical properties and BMI were analyzed. In addition, the association of epidermal biophysical properties with BMI z score was also determined. Results Overall, BMI did not differ significantly between boys and girls among the age groups. BMI z scores correlated negatively with stratum corneum hydration levels and positively with skin surface pH in boys, but not in girls. The negative correlation between TEWL and BMI z score was not significant. Moreover, stratum corneum hydration levels were lower in boys with a BMI z score of ≥2 than in those with a BMI z score of -2 to 0.99. Conclusion Both stratum corneum hydration levels and skin surface pH are significantly correlated with BMI z scores in boys, but not in girls. Whether epidermal function influences BMI or vice versa remains to be determined.
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Affiliation(s)
- Bin Yang
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou City, Guangdong, 510091, People’s Republic of China
| | - Qingsong Lai
- Department of Dermatology, Medical Center for Public Health of Puning, Puning City, Guangdong, 515300, People’s Republic of China
| | - Aiqi Chen
- Department of Dermatology, Medical Center for Public Health of Puning, Puning City, Guangdong, 515300, People’s Republic of China
| | - Li Ye
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou City, Guangdong, 510091, People’s Republic of China
| | - Xiaohua Wang
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou City, Guangdong, 510091, People’s Republic of China
| | - Yulin Lai
- Department of Dermatology, Medical Center for Public Health of Puning, Puning City, Guangdong, 515300, People’s Republic of China
| | - Dan Liu
- Department of Product Development, Dermatology Hospital, Southern Medical University, Guangzhou City, Guangdong, 510091, People’s Republic of China
| | - Mao-Qiang Man
- Department of Product Development, Dermatology Hospital, Southern Medical University, Guangzhou City, Guangdong, 510091, People’s Republic of China
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Russell A, Jansen E, Burnett AJ, Lee J, Russell CG. Children's eating behaviours and related constructs: conceptual and theoretical foundations and their implications. Int J Behav Nutr Phys Act 2023; 20:19. [PMID: 36793039 PMCID: PMC9933409 DOI: 10.1186/s12966-023-01407-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 01/06/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND There is a substantial body of research on children's eating behaviours (e.g., food responsiveness and fussiness) and related constructs (e.g., eating in the absence of hunger, appetite self-regulation). This research provides a foundation for understanding children's dietary intakes and healthy eating behaviours, as well as efforts at intervention, whether in relation to food avoidance, overeating and/or trajectories to excess weight gain. The success of these efforts and their associated outcomes is dependent on the theoretical foundation and conceptual clarity of the behaviours and constructs. This, in turn contributes to the coherence and precision of the definitions and measurement of these behaviours and constructs. Limited clarity in these areas ultimately creates uncertainty around the interpretation of findings from research studies and intervention programs. At present there does not appear to be an overarching theoretical framework of children's eating behaviours and associated constructs, or for separate domains of children's eating behaviours/constructs. The main purpose of the present review was to examine the possible theoretical foundations of some of the main current questionnaire and behavioural measures of children's eating behaviours and related constructs. METHODS We reviewed the literature on the most prominent measures of children's eating behaviours for use with children aged ~ 0-12 years. We focused on the explanations and justifications for the original design of the measures and whether these included theoretical perspectives, as well as current theoretical interpretations (and difficulties) of the behaviours and constructs. RESULTS We found that the most commonly used measures had their foundations in relatively applied or practical concerns rather than theoretical perspectives. CONCLUSIONS We concluded, consistent with Lumeng & Fisher (1), that although existing measures have served the field well, to advance the field as a science, and better contribute to knowledge development, increased attention should be directed to the conceptual and theoretical foundations of children's eating behaviours and related constructs. Suggestions for future directions are outlined.
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Affiliation(s)
- Alan Russell
- grid.1014.40000 0004 0367 2697College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia Australia
| | - Elena Jansen
- grid.21107.350000 0001 2171 9311Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Alissa J. Burnett
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jookyeong Lee
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia ,grid.1021.20000 0001 0526 7079CASS Food Research Centre, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Catherine G. Russell
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Han SH, Yee JY, Pyo JS. Impact of Short Sleep Duration on the Incidence of Obesity and Overweight among Children and Adolescents. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081037. [PMID: 36013503 PMCID: PMC9415582 DOI: 10.3390/medicina58081037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The prevalence of obesity among children is increasing and is highlighting many problems. Lack of sleep is common among children and adolescents. Although several studies have investigated sleep duration and overweight and obesity from a sex perspective, data regarding age and sex effects remain limited and inconclusive. This study aimed to evaluate the risk(s) for overweight or obesity according to sleep duration among children and adolescents; to evaluate the effect of short sleep duration on the incidence of overweight/obesity among children and adolescents; and to evaluate sex differences in the risk of overweight or obesity with shorter sleep durations. Materials and Methods: The PubMed database was searched for relevant studies published up to June 30, 2021. Odds ratios for obesity/overweight were estimated for short compared with long sleep duration. Subgroup analysis based on sleep duration, sex, and study location was also performed. Results: The estimated odds ratio for combined obesity and overweight was 1.171 (95% confidence interval (CI) 1.092−1.256) according to short sleep duration. Obesity/overweight with short sleep duration was significantly prevalent in the <6 and 6−10 years’ subgroups (odds ratio 1.226 (95% CI 1.083−1.387) and 1.341 (95% CI 1.175−1.530), respectively). Among boys, short sleep duration was significantly correlated with a high occurrence of obesity/overweight (odds ratio 1.294 (95% CI 1.153−1.452)); no such correlation was found among girls. Conclusions: Short sleep duration may increase risk of obesity among children and adolescents, especially those <6 and 6−10 years of age. In the subgroup analysis, the incidence of obesity/overweight for short sleep time revealed significant results among Asians and boys.
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Affiliation(s)
- Seung-Ho Han
- Department of Physiology and Biophysics, Eulji University School of Medicine, Daejeon 34824, Korea; (S.-H.H.); (J.-Y.Y.)
| | - Jae-Yong Yee
- Department of Physiology and Biophysics, Eulji University School of Medicine, Daejeon 34824, Korea; (S.-H.H.); (J.-Y.Y.)
| | - Jung-Soo Pyo
- Department of Pathology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu 11759, Korea
- Correspondence: ; Tel.: +82-31-951-2493
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Carpena Lucas PJ, Sánchez-Cubo F, Vargas Vargas M, Mondéjar Jiménez J. Influence of Lifestyle Habits in the Development of Obesity during Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4124. [PMID: 35409807 PMCID: PMC8998286 DOI: 10.3390/ijerph19074124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 12/18/2022]
Abstract
Background: The alarming increase in childhood obesity is a global public health problem since it has significant health consequences. This cross-sectional study aimed to identify the potentially modifiable risk factors for developing excess weight and determine the importance of developing certain habits to prevent childhood overweight and obesity. Methods: The sample included 416 students between the ages of 12 and 14 (12.8 ± 0.62) first-year high school students from Murcia in Spain. Data were collected on their lifestyle habits through the ENHASA questionnaire, and the somatometry of the participants was measured. Such data were studied through structural equation modeling and importance-performance map analyses. Results: The modifiable risk factors that presented the greatest potency directly regarding when developing excess weight in adolescents were ‘use of electronic devices’ and ‘not performing physical activity’ (p < 0.001). ‘Social and school environment’ and ‘diet’ showed relationships but no significant differences with overweight or obesity. Globally, the lifestyle habit of the greatest importance for not being overweight was ‘engagement in extracurricular physical activities’. On the other hand, the habits related to using new technologies in a sedentary way showed the best capacity for improvement. Therefore, it would be very efficient to focus on them to control excess weight. Conclusion: Responsible and limited use of screens and engaging in extracurricular physical activities may be the most remarkable and cost-effective strategies for obesity prevention programs.
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Affiliation(s)
| | - Francisco Sánchez-Cubo
- Department of Political Economy and Public Finance, Economic and Business Statistics and Economic Policy, Faculty of Social Sciences, University of Castilla-La Mancha, 16007 Cuenca, Spain;
| | - Manuel Vargas Vargas
- Faculty of Economic and Business Sciences, University of Castilla-La Mancha, 02006 Albacete, Spain;
| | - José Mondéjar Jiménez
- Department of Statistics, Faculty of Social Sciences in Cuenca, University of Castilla-La Mancha, 16007 Cuenca, Spain;
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Carpena Lucas PJ, Jiménez Candel MI, Sánchez-Cubo F, Ceballos-Santamaría G, Vargas Vargas M, Mondéjar Jiménez J. Gender differences in the development of childhood obesity in young teenagers in Murcia, Spain. Pediatr Int 2022; 64:e15065. [PMID: 34807492 DOI: 10.1111/ped.15065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/09/2021] [Accepted: 11/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The number of overweight children is increasing at an alarming rate. This issue requires effective action plans, as childhood obesity has become a problem in which addressing environmental factors is decisive. Significant differences have also been shown in lifestyle habits that determine overweight based on sex. This study therefore aimed to examine these risk factors according to sex. METHODS The sample included first-year high school students from Murcia, Spain. Information was collected through the "Questionnaire on Healthy Habits in Adolescents," validated for this age range, and the weight, height, and waist circumference of the participants were obtained. Data were analyzed through partial least squares structural equation modeling to determine which modifiable risk factors promoted the appearance of excess weight and in what magnitude. RESULTS A total of 421 students participated in the study, and 40.6% of overweight patients were detected according to their body mass index. No differences were found between the sexes and weights. The environment and the use of new technologies that do not involve sitting were significant only in girls (P < 0.05). Conversely, physical activity was significantly higher in boys (P < 0.05). Dietary factors and sedentary activities did not differ according to sex. CONCLUSIONS The social and school environment, the use of new technologies (for girls), and physical activity (for boys) condition nutritional status. Identifying gender disparities in behaviors that involve health should be a priority for new prevention programs. Targeting young people's health from a gender perspective has considerable potential to reduce overweight problems in adulthood.
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Affiliation(s)
| | | | - Francisco Sánchez-Cubo
- Department of Political Economy and Public Finance, Economic and Business Statistics and Economic Policy, Faculty of Social Sciences, University of Castilla-La Mancha, Cuenca, Spain
| | | | - Manuel Vargas Vargas
- Department of Statistics, Faculty of Social Sciences, Castilla-La Mancha University, Cuenca, Spain
| | - José Mondéjar Jiménez
- Department of Statistics, Faculty of Social Sciences, Castilla-La Mancha University, Cuenca, Spain
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Gu F, Zhou S, Lou K, Deng R, Li X, Hu J, Dong B. Lifestyle Risk Factors and the Population Attributable Fractions for Overweight and Obesity in Chinese Students of Zhejiang Province. Front Pediatr 2021; 9:734013. [PMID: 34631629 PMCID: PMC8493597 DOI: 10.3389/fped.2021.734013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Objectives: To assess the relationship between modifiable lifestyle factors and risk of overweight/obesity in Chinese students, and to evaluate the predicting prevalence of overweight if the lifestyle risk factors were removed. Methods: A cross-sectional survey was conducted among 40,141 students in grade three and above (8-24yrs) in 2019 in Zhejiang Province, China. Physical examination was performed, and a self-administered questionnaire was used to collect lifestyle information, including dietary behavior, physical activity, TV watching, sleeping, smoking, drinking, and tooth-brushing habits. Logistic regression models were performed to assess the relationship between overweight/obesity and a series of lifestyle factors. Population attributable fractions (PAFs) were used to calculate the predicting prevalence of overweight/obesity if lifestyle risk factors were removed. Results: The prevalence of overweight/obesity of participants was 25.5% (male 32.3%, female 18.1%). Overweight/obesity were associated with adverse lifestyle factors, such as watch TV ≥1 h/day (OR = 1.14, 95% CI: 1.11-1.22), insufficient sleep (OR = 1.14, 95% CI: 1.11-1.22), and irregular toothbrushing habits (OR = 1.19, 95% CI: 1.01-1.39). Based on the calculated PAFs, the predicted prevalence of overweight/obesity would decline moderately if lifestyle factors were modified, with the magnitudes of decrease vary by sex, age and residence. Generally, a larger reduction was estimated if the sleeping time was increased and TV time was reduced, with the prevalence of overweight/obesity decreased by 1.1% (95% CI: 0.7, 1.5%) and 0.9% (95% CI: 0.6, 1.2%), respectively. Conclusions: Predicted prevalence of overweight/ obesity in Chinese students may decrease if modifiable lifestyle risk factors were removed. The attributable risk for obesity of lifestyle behaviors varied in age, sex and residence groups. The findings of this study may provide insights for planning and optimizing future obesity intervention endeavors.
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Affiliation(s)
- Fang Gu
- Institute for Nutrition and Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Siliang Zhou
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ke Lou
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Rui Deng
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xingxiu Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
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