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Allali B, Pereira B, Fillon A, Pouele L, Masurier J, Cardenoux C, Isacco L, Boirie Y, Duclos M, Thivel D, Julian V. The effectiveness of multidisciplinary weight loss interventions is associated with initial cardiorespiratory fitness in adolescents with obesity. Pediatr Obes 2024:e13147. [PMID: 38922794 DOI: 10.1111/ijpo.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 05/01/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND The identification of predictive parameters of the success of multidisciplinary weight loss interventions (MWLI) appears essential to optimize obesity management. The association between baseline cardiorespiratory fitness (CRF) and changes in anthropometric parameters and body composition during MWLI remains underexplored in adolescents with obesity. OBJECTIVES To assess whether baseline CRF was associated with the effectiveness of a 16-week MWLI measured through improved body mass, body mass index (BMI) and body composition (percentage of total fat mass (FM) as the main criterion). METHODS Cardiorespiratory fitness and body composition were respectively measured by peak oxygen consumption (VO2peak) during maximal exercise tests and dual-photon x-ray absorptiometry (DXA), before (T0) and after (T1) a 16-week MWLI in 165 adolescents (aged 13.3 ± 1.38 years, 61.2% female, BMI 35.11 ± 5.16 kg/m2). RESULTS Reductions in BMI and total FM percentage between T0 and T1 were greater in subjects with a baseline VO2peak ≥ 3rd quartile compared to the first quartile (p < 0.001) and the interquartile range (p < 0.05 and p < 0.001, respectively). Baseline VO2peak and VO2 at the first ventilator threshold were positively correlated with the reductions in body mass, BMI and total and visceral FM percentages and with the increase in lean mass (LM) percentage between T0 and T1 after adjustment for age and gender (p < 0.001). CONCLUSION Initial CRF is associated with the success of MWLI in adolescents with obesity. Improving their aerobic fitness before starting a MWLI might be a promising strategy to optimize its benefits.
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Affiliation(s)
- Brahim Allali
- Department of Pediatrics, University Teaching Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Department of Biostatistics, University Teaching Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Alicia Fillon
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), University of Clermont Auvergne, Aubière, France
| | - Lili Pouele
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), University of Clermont Auvergne, Aubière, France
| | - Julie Masurier
- Pediatric Obesity Center of La Bourboule, Clermont-Ferrand, France
| | | | - Laurie Isacco
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), University of Clermont Auvergne, Aubière, France
| | - Yves Boirie
- Department of Clinical Nutrition, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, Human Nutrition Research Center, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, Human Nutrition Research Center, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), University of Clermont Auvergne, Aubière, France
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, Human Nutrition Research Center, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
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Manique L, Paulo R, Ramalho A, Duarte-Mendes P, Petrica J, Serrano J. Physical fitness in children in Cabo Verde: differences between gender, eutrophic vs. overweight subjects, and practitioners vs. non-practitioners of sports. Minerva Pediatr (Torino) 2024; 76:217-226. [PMID: 33820413 DOI: 10.23736/s2724-5276.21.06020-5] [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: 11/08/2022]
Abstract
BACKGROUND There are few or even rare studies conducted in Cabo Verde (Republic of Cabo Verde) that address the issue of physical fitness and body composition in the juvenile population. This investigation aims to study the physical fitness in children in Cabo Verde: differences between gender, eutrophic, and overweight subjects, between practitioners and non-practitioners of sports. METHODS The sample consisted of 93 individuals aged between 10 and 15 years, from the 2nd and 3rd cycles and secondary school of the Portuguese College based in Cabo Verde. The instruments used for data collection were the FITescola® test battery (Lisboa, Portugal), and the questionnaire Quantification de l'activite physique en altitude chez les enfants (QAPACE) for assessment of physical activity level. Regarding the statistical analysis using the SPSS 23.0 software (SPSS Inc., Chicago, IL, USA), the first analysis was performed to verify the distribution of the sample (Kolmogorov-Smirnov Test and Shapiro-Wilk Test). Then, for variables with normal distribution we used the t-test and for the remaining variables with non-normal distribution we used the Mann-Whitney Test, with a significance level of 5%. RESULTS Gender differences were found, in which the male gender obtained more favorable mean values in the "sit-ups," "push-ups," "horizontal impulsion," "shuttle" and "agility" variables, while the females showed superiority in the variables "sit and reach;" differences between the eutrophic and overweight group where, as expected, more favorable mean values for eutrophics than the overweight group in all PF tests. Finally, differences between practitioners and non-practitioners of sports, with the best results being attributed to practitioners of sports. CONCLUSIONS We concluded that male subjects have greater proficiency in strength and aerobic fitness tests while female subjects have greater flexibility. High BMI values in overweight children have been found to be associated with increased abdominal fat as well as a reduction in overall PF. As expected, sports practitioners show better results in motor performance on PF tests.
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Affiliation(s)
- Liliana Manique
- Department of Sport and Wellbeing, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| | - Rui Paulo
- Department of Sport and Wellbeing, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal -
- Sport, Health and Exercise Research Unit (SHERU), Castelo Branco, Portugal
- Research in Education and Community Intervention (RECI), Almada, Portugal
| | - André Ramalho
- Department of Sport and Wellbeing, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- Sport, Health and Exercise Research Unit (SHERU), Castelo Branco, Portugal
| | - Pedro Duarte-Mendes
- Department of Sport and Wellbeing, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- Sport, Health and Exercise Research Unit (SHERU), Castelo Branco, Portugal
- Research in Education and Community Intervention (RECI), Almada, Portugal
| | - João Petrica
- Department of Sport and Wellbeing, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- Sport, Health and Exercise Research Unit (SHERU), Castelo Branco, Portugal
| | - João Serrano
- Department of Sport and Wellbeing, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
- Sport, Health and Exercise Research Unit (SHERU), Castelo Branco, Portugal
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Ross MG, Kavasery MP, Cervantes MK, Han G, Horta B, Coca KP, Costa SO, Desai M. High-Fat, High-Calorie Breast Milk in Women with Overweight or Obesity and Its Association with Maternal Serum Insulin Concentration and Triglycerides Levels. CHILDREN (BASEL, SWITZERLAND) 2024; 11:141. [PMID: 38397253 PMCID: PMC10887191 DOI: 10.3390/children11020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
The childhood obesity epidemic continues to be a challenge. Maternal obesity and excessive infant weight gain are strong predictors of childhood obesity, which itself is a major risk factor for adult obesity. The primary source of nutrition during early life is breast milk, and its composition is impacted by maternal habitus and diet. We thus studied the relationship between maternal BMI, serum lipids and insulin, and breast milk fat and calorie content from foremilk to hindmilk. Women who were exclusively breastfeeding at 7-8 weeks postpartum were BMI classified as Normal (18.5-24.9, n = 9) and women with Overweight/Obese (OW/OB ≥ 25, n = 13). Maternal blood and continuous breast milk samples obtained from foremilk to hindmilk were analyzed, and infant milk intake was assessed. Women with OW/OB had significantly higher milk fat and calorie content in the first foremilk and last hindmilk sample as compared to Normal BMI women. Amongst all women, maternal serum triglycerides, insulin, and HOMA were significantly correlated with foremilk triglyceride concentration, suggesting that maternal serum triglyceride and insulin action contribute to human milk fat content. As the milk fat content of OW/OB women has caloric implications for infant growth and childhood obesity, these results suggest the potential for modulating milk fat content by a reduction in maternal serum lipids or insulin.
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Affiliation(s)
- Michael G. Ross
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
- Department of Obstetrics and Gynecology, Charles R. Drew University, Los Angeles, CA 90059, USA
| | - Manasa P. Kavasery
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - MacKenzie K. Cervantes
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Guang Han
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Bernardo Horta
- School of Medicine, Universidade Federal de Pelotas, Pelotas 96010-610, Brazil;
| | - Kelly P. Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo 04023-900, Brazil;
| | - Suleyma O. Costa
- Laboratory of Metabolic Disorders, School of Applied Sciences, University of Campinas, Campinas 13083-970, Brazil;
| | - Mina Desai
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
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Avelar A, Araujo MYC, da Silva CB, de Lima MCS, Codogno JS, Turi-Lynch BC, Fernandes RA, Mantovani AM. The impact of early sports participation on body fatness in adulthood is not mediated by current physical activity. Am J Hum Biol 2024; 36:e23981. [PMID: 37610138 DOI: 10.1002/ajhb.23981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/27/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVE The aim was to analyze the relationship between early sports participation (ESP) and body fatness (BF) in adults, as well as to identify whether this possible relationship is directly influenced by the current physical activity (PA) level. METHODS This cross-sectional study combined baseline data of two cohort. The BF estimated by DXA. The ESP, the subjects reported the engagement in sports during childhood (7-10 years) and adolescence (11-17 years) through two yes/no questions and current PA (described as steps) was device-measured using pedometers. Were identified as potential covariates and therefore adjusted the multivariate models: age, ethnicity, alcohol consumption, smoking, and sleep quality. Statistical analysis consisted of the chi-square test, analysis of variance/covariance, and structural equation modeling (software BioEstat version 5.0; p-value < .05). RESULTS Adults engaged in ESP had lower BF; among women, the variance in BF explained by ESP was 25.5%; among men, it was 9.2%. Sports participation in early life (r = -.436 [95% CI: -0.527 to -0.346]) and current PA (r = -.431 [95% CI: -0.522 to -0.340]) were inversely related to BF, as well as positively related to each other (r = .328 [95% CI: 0.226 to 0.430]). In the mediation model, current PA partially mediated (18.5%) the impact of ESP on BF, while current PA and ESP remained relevant determinants of BF. CONCLUSION Early sports participation and current PA have a significant impact on BF in adulthood, which is of similar magnitude and independent of each other.
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Affiliation(s)
- Ademar Avelar
- Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
- Department of Physical Education, State University of Maringá, Maringá, Brazil
| | - Monique Yndawe Castanho Araujo
- Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Camila Buonani da Silva
- Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Manoel Carlos Spiguel de Lima
- Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Jamile Sanches Codogno
- Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Bruna Camilo Turi-Lynch
- Department of Physical Education & Exercise Science, Lander University, Greenwood, South Carolina, USA
| | - Rômulo Araújo Fernandes
- Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Alessandra Madia Mantovani
- Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
- Toledo Prudente University Center, Presidente Prudente, Sao Paulo, Brazil
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Oktaviani S, Mizutani M, Nishide R, Tanimura S. Factors associated with overweight/obesity of children aged 6-12 years in Indonesia. BMC Pediatr 2023; 23:484. [PMID: 37749512 PMCID: PMC10518961 DOI: 10.1186/s12887-023-04321-6] [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: 12/30/2022] [Accepted: 09/19/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Globally, the prevalence of childhood obesity has increased considerably, including in Indonesia. Obesity results from multifactorial interactions at the personal, familial, and environmental levels. However, little is known about the factors associated with overweight/obesity among children in Indonesia. This study is intended to identify personal, familial, and environmental factors associated with overweight/obesity in children aged 6-12 years in Indonesia. METHODS Study design was a secondary data analysis using the Indonesia Family Life Survey in 2014/2015, focusing on 6,090 children aged 6-12 years. The questions covered the child's body mass index and potential personal, familial, and environmental factors. Logistic regression analysis was performed to identify the personal, familial, and environmental factors. RESULTS The mean age of participants was 8.9 years (SD = 2.0); 51.0% were boys; 9.4% were overweight; and 8.1% were obese. Overweight and obesity were associated with age [AOR 1.09 (95% CI 1.04-1.14)], having an overweight [AOR 1.93 (95% CI 1.58-2.36)] or obese [AOR 3.36 (95% CI 2.43-4.61)] father compared with a normal father, being of Chinese [AOR 9.51 (95% CI 1.43-79.43)] or Javanese [AOR 1.60 (95% CI 1.16-2.24)] ethnicity compared with Sundanese ethnicity, and residing in an urban area [AOR 1.36 (95% CI 1.10-1.70)]. A lower risk of child overweight/obesity was associated with the father's perception [AOR 0.56 (95% CI 0.38-0.80)] and mother's perception [AOR 0.66 (95% CI 0.43-0.98)] of the child's food consumption as being less than adequate compared with adequate. CONCLUSIONS Risk factors in children for overweight/obesity were older age, having an overweight/obese father, membership of certain ethnic groups, and urban residence. The main protective factor was parents' perception that a child's food consumption was less than adequate. Health promotion programs focused on these factors could help control or prevent childhood obesity in Indonesia.
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Affiliation(s)
- Sofi Oktaviani
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
- Indramayu College of Health Science, Indramayu, Indonesia
| | - Mayumi Mizutani
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Ritsuko Nishide
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Susumu Tanimura
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
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Pimenta IT, Griep RH, de Matos SMA, de Fatima Haueisen Sander Diniz M, Moreno AB, de Jesus Mendes da Fonseca M. Body shape trajectories are associated with birth weight, body mass index and sociodemographic conditions in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a multiple correspondence analysis. BMC Public Health 2023; 23:1857. [PMID: 37749586 PMCID: PMC10518926 DOI: 10.1186/s12889-023-16779-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Evaluating lifelong weight trajectories is challenging due to the high costs of studies that follow individuals from childhood to adulthood. The use of silhouette scales has been a new approach to assess the body shape trajectory across life as a proxy for body weight trajectory. Depending on body shape trajectories, individuals may be more prone to develop diseases in adulthood. Therefore, identifying factors related to them is essential for public health. This study aimed to evaluate body shape trajectories across the lifespan and to verify associations between them, birth weight, body mass index, and sociodemographic conditions in a Brazilian cohort. METHODS This is a cross-sectional analysis conducted with 14,014 participants of first follow-up data collection of Longitudinal Study of Adult Health (ELSA-Brasil). ELSA-Brasil is a multicentric prospective cohort study initiated in 2008 with civil servants of six public institutions in the Northeast, South and Southeast regions of Brazil. We applied a clustering method to longitudinal data to identify body shape trajectories from 5 to 40 years of age and assessed the associations between these trajectories and birth weight, body mass index and sociodemographic conditions (race, education, maternal education and monthly per capita family income) using multiple correspondence analysis. RESULTS We found five body shape trajectories for women and three for men. Low birth weight was associated with a slight to moderate increase in shape. High birth weight was associated with maintaining large body size in both sexes and markedly increased body shape in women. Higher sociodemographic status and white race were associated with marked increases in body shape in men and maintenance of medium body shape in women. CONCLUSIONS The study shows that variables related to worse lifetime weight status (evaluated by anthropometry), such as presence of obesity, are also associated with worse body shape trajectories, as assessed with silhouette scales. Our results suggest that body shape trajectories are a good indicator of body weight trajectories and may be used when cohort studies are not possible.
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Affiliation(s)
| | - Rosane Harter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Arlinda B Moreno
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Lister NB, Baur LA, Felix JF, Hill AJ, Marcus C, Reinehr T, Summerbell C, Wabitsch M. Child and adolescent obesity. Nat Rev Dis Primers 2023; 9:24. [PMID: 37202378 DOI: 10.1038/s41572-023-00435-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/20/2023]
Abstract
The prevalence of child and adolescent obesity has plateaued at high levels in most high-income countries and is increasing in many low-income and middle-income countries. Obesity arises when a mix of genetic and epigenetic factors, behavioural risk patterns and broader environmental and sociocultural influences affect the two body weight regulation systems: energy homeostasis, including leptin and gastrointestinal tract signals, operating predominantly at an unconscious level, and cognitive-emotional control that is regulated by higher brain centres, operating at a conscious level. Health-related quality of life is reduced in those with obesity. Comorbidities of obesity, including type 2 diabetes mellitus, fatty liver disease and depression, are more likely in adolescents and in those with severe obesity. Treatment incorporates a respectful, stigma-free and family-based approach involving multiple components, and addresses dietary, physical activity, sedentary and sleep behaviours. In adolescents in particular, adjunctive therapies can be valuable, such as more intensive dietary therapies, pharmacotherapy and bariatric surgery. Prevention of obesity requires a whole-system approach and joined-up policy initiatives across government departments. Development and implementation of interventions to prevent paediatric obesity in children should focus on interventions that are feasible, effective and likely to reduce gaps in health inequalities.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
- Weight Management Services, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Andrew J Hill
- Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Claude Marcus
- Division of Paediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Reinehr
- Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Martin Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Centre, Ulm, Germany
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Malovic P, Vrevic E, Bacovic D, Bojanic D, Ljubojevic M. The Relationship between Certain Parental/Household Socio-Economic Characteristics and Female Adolescent Obesity in Montenegro. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050820. [PMID: 37238368 DOI: 10.3390/children10050820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Considering that obesity is characterized today as a public health challenge and an epidemic in many countries in the world and that one of the main predictors for obesity is socio-economic status (SES), the aim of this paper was to assess the relationship between the SES of parents/guardians and female adolescent obesity in Montenegro. METHODS A stratified random probability sample method was used, and the number of participants in this study was 596, aged 15.8 ± 0.58, from all three regions in Montenegro. As SES was a factor in this research, specific SES parameters such as household wealth and parental educational level were collected for parent/guardian of each child. The following anthropometric indices were utilized to evaluate nutritional status: body mass index (BMI) and waist to height ratio (WHtR). RESULTS Regarding nutritional status, it can be said that no statistically significant difference between female adolescents according to the regions of Montenegro was found. Of all the adolescents in the study, 15.4% of them were above the normal nutrition level as measured by BMI, while 12.2% were classified as obese by the WHtR. Furthermore, the study found a significant negative relationship between a mother's level of education and obesity in female adolescents, with odds ratios of 0.31 (p = 0.035) and 0.19 (p = 0.009) for secondary and high level education, respectively. This suggests that daughters of mothers with higher levels of education are less likely to be obese. CONCLUSIONS In regard to the nutritional status of the respondents in this study, their values fell within the normal range compared to the European average. However, the results regarding the relationship between certain SES characteristics and obesity suggest a similarity to developed countries.
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Affiliation(s)
- Pavle Malovic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
| | - Erol Vrevic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
| | - Dragan Bacovic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
| | - Danilo Bojanic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
| | - Milovan Ljubojevic
- Faculty for Sport and Physical Education, University of Montenegro, 81400 Niksic, Montenegro
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Taghizadeh S, Alesaeidi S, Jafari-Koshki T, Valizadeh-Otaghsara SM, Poursheikhali A, Tousi AZ, Abbasalizad–Farhangi M. Trend Impact Analysis (TIA) of community-based futures study for pediatric obesity in Iran. BMC Pediatr 2023; 23:66. [PMID: 36750801 PMCID: PMC9905010 DOI: 10.1186/s12887-023-03880-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Childhood obesity has been regarded as one of the main healthcare challenges in the last century, leading to critical health problems and reduced life expectancy. Many factors can play a role in its development or prevention. Using the Trend Impact Analysis (TIA), this study aimed to conduct a community-based futures study for pediatric obesity in Iran. METHODS We obtained the prevalence of overweight and obesity from the database of the Ministry of Health and Medical Education. Moreover, we reviewed 21 documents, texts, and comments from three key stakeholders in Iran and prepared a list of key experts, who were stakeholders in the field of obesity prevention of childhood in different organizations. Then, we collected the expert opinions by Delphi method. Data analysis was performed using the Excel and R software. RESULTS Fourteen experts participated in the first stage and nine experts in the second stage. We identified two positive drivers, including the prevalence of coronavirus disease 2019 (COVID-19) and the widespread expansion of online educational programs. Meanwhile, we identified five negative drivers as follows: (1) controlling and limiting obesogenic environments in the community, school, and family; (2) running annual compulsory anthropometry programs for students of all educational levels in health centers; (3) integrating nutrition education interventions in the curricula of all educational levels; (4) taxation of unhealthy and fast foods; and (5) preparing safe and appropriate sports environments for children and adolescents (on the streets, schools, parks, and sports clubs). Without considering the drivers, the prevalence of overweight and obesity is predicted to reach 29.10% in 2031. However, it is expected that the negative drivers can increase the prevalence trend from 23.40% in 2018 to 19.57% in 2031, the positive drivers to 32.61%, and the combination of all drivers to 23.07%. CONCLUSION It seems that measures such as the effective communication of policy makers, basic evaluation of the programs and policies related to the prevention of childhood obesity, and localization of the programs of international organizations for the prevention of obesity can greatly control the prevalence of childhood obesity.
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Affiliation(s)
- Shahnaz Taghizadeh
- grid.412888.f0000 0001 2174 8913Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sogol Alesaeidi
- grid.411036.10000 0001 1498 685XDepartment of Pediatric Medicine, Imam Hossein Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tohid Jafari-Koshki
- grid.412888.f0000 0001 2174 8913Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Atousa Poursheikhali
- grid.412105.30000 0001 2092 9755Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ayda Zahiri Tousi
- grid.444802.e0000 0004 0547 7393Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
| | - Mahdieh Abbasalizad–Farhangi
- grid.412888.f0000 0001 2174 8913Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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10
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Polfuss M, Liu T, Smith K, Murphy PS, Ward E, Thibadeau J, Dosa NP, Wang Y, Sawin KJ. Weight Status of Children Participating in the National Spina Bifida Patient Registry. Pediatrics 2022; 150:e2022057007. [PMID: 36416007 PMCID: PMC11037268 DOI: 10.1542/peds.2022-057007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Describe the distribution of weight status categories and determine factors associated with overweight and obesity (OW/OB) in children and adolescents with spina bifida (SB) using the National Spina Bifida Patient Registry. METHODS Demographic, anthropometric, and clinical data collected from 2009 through 2018 was used to describe the prevalence of OW/OB. The generalized estimating equation model (GEE) identified factors associated with OW/OB among individuals with SB. RESULTS Participants (n = 7215) were aged 2 to 19 years (mean = 11.1; standard error, 0.06) and 51.4% female. The majority were non-Hispanic white (57.2%) followed by Hispanic or Latino (25.1%) and non-Hispanic Black (7.5%). The myelomeningocele (MMC) subgroup accounted for 76.3%. Most (60.2%) were community ambulators. The overall percentage of OW/OB was 45.2%, with 49.2% of MMC and 32.0% of nonmyelomeningocele OW/OB. Following the Centers for Disease Control Obesity Severity Classification System, 19.7% of MMC were in class 1, 6.6% in class 2, and 3.5% in class 3. Univariate analysis of MMC participants demonstrated demographic (age, sex, race/ethnicity, and clinic region) and clinical variables (functional level of lesion, ambulation, and number of shunt surgeries) were associated with OW/OB. The GEE model showed that OW/OB was independently, and significantly, associated with age, sex, race/ethnicity, lesion levels, and geographic location of the clinics. CONCLUSIONS The demographic and clinical factors associated with OW/OB in children and adolescents with SB further our understanding of factors contributing to the higher prevalence of OW/OB in this population and may inform OW/OB prevention and treatment strategies.
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Affiliation(s)
- Michele Polfuss
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
- Children’s Wisconsin, Milwaukee, Wisconsin, USA
| | - Tiebin Liu
- Rare Disorders and Health Outcomes Team, Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathryn Smith
- Department of Pediatrics, Children’s Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California, USA
| | - Pamela S. Murphy
- District Medical Group Children’s Rehabilitative Services, Phoenix, Arizona, USA
| | - Elisabeth Ward
- Carter Consulting, Inc, Consultant to Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Nienke P. Dosa
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Yinding Wang
- McKing Consulting Corporation, Consultant to Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathleen J. Sawin
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
- Children’s Wisconsin, Milwaukee, Wisconsin, USA
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11
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Ross MG, Kobayashi K, Han G, Desai M. Modulation of Milk and Lipid Synthesis and Secretion in a3-Dimensional Mouse Mammary Epithelial Cell Culture Model: Effects of Palmitate and Orlistat. Nutrients 2022; 14:4948. [PMID: 36500977 PMCID: PMC9739267 DOI: 10.3390/nu14234948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Human milk synthesis is impacted by maternal diet, serum composition, and substrate uptake and synthesis by mammary epithelial cells (MECs). The milk of obese/high-fat-diet women has an increased fat content, which promote excess infant weight gain and the risk of childhood/adult obesity. Yet, the knowledge of milk synthesis regulation is limited, and there are no established approaches to modulate human milk composition. We established a 3-dimensional mouse MEC primary culture that recreates the milk production pathway and tested the effects of the major saturated fatty acid in human milk (palmitate) and a lipoprotein lipase inhibitor (orlistat) on triglyceride production. Positive immunostaining confirmed the presence of milk protein and intracellular lipid including milk globules in the cytoplasm and extracellular space. The treatment with palmitate activated "milk" production by MECs (β-casein) and the lipid pathway (as evident by increased protein and mRNA expression). Consistent with these cellular changes, there was increased secretion of milk protein and triglyceride in MEC "milk". The treatment with orlistat suppressed milk triglyceride production. Palmitate increased milk and lipid synthesis, partly via lipoprotein lipase activation. These findings demonstrate the ability to examine MEC pathways of milk production via both protein and mRNA and to modulate select pathways regulating milk composition in MEC culture.
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Affiliation(s)
- Michael G. Ross
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA 90502, USA
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA
- Department of Obstetrics and Gynecology, Charles R. Drew University, Los Angeles, CA 90059, USA
| | - Ken Kobayashi
- Laboratory of Cell and Tissue Biology, Research Faculty of Agriculture, Hokkaido University, Sapporo 060-8589, Japan
| | - Guang Han
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA 90502, USA
| | - Mina Desai
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA 90502, USA
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA
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12
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Kim T, Kwon EH. Investigating socioecological obesogenic factors in children with Autism Spectrum Disorder. Front Public Health 2022; 10:867456. [PMID: 36276345 PMCID: PMC9582449 DOI: 10.3389/fpubh.2022.867456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/21/2022] [Indexed: 01/21/2023] Open
Abstract
Obesity-related information in children with Autism Spectrum Disorder (ASD) is limited, and research findings are contradictory. Thus, this study aimed to use a nationwide non-clinical sample to examine the association of sociological factors with overweight status in children with ASD and reveal the degree of differences in the risk factors for overweight in children with and without ASD. The data for this cross-sectional study, based on the modified ecological system theory model, were obtained from the 2019 National Survey of Children's Health. The weighted logistic regressions were performed to determine the factors associated with overweight status in children with ASD, controlling for demographics, physical activity-related behaviors, and family and environmental conditions. A total of 529 children were identified (mean age 13.78 years, 83.21% boys). Two-parent households, less healthy parents and households, households with smokers, poor sleep quality, and greater participation in organized activities were associated with a higher likelihood of overweight in children with ASD (all P < 0.05). The determinants of obesity among children with ASD go beyond the individual level; family and community support are important. Therefore, greater attention should be directed toward the families of children with ASD and community-level administrative policies to improve quality of life by preventing or reducing obesity in children with ASD.
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Affiliation(s)
- TaeEung Kim
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Eun Hye Kwon
- Department of Counseling, Health & Kinesiology, Texas A&M University-San Antonio, San Antonio, TX, United States
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13
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Hecht AA, Dunn CG, Kinsey EW, Read MA, Levi R, Richardson AS, Hager ER, Seligman HK. Estimates of the Nutritional Impact of Non-Participation in the National School Lunch Program during COVID-19 School Closures. Nutrients 2022; 14:1387. [PMID: 35406001 PMCID: PMC9003403 DOI: 10.3390/nu14071387] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic resulted in widespread school closures, reducing access to school meals for millions of students previously participating in the US Department of Agriculture (USDA) National School Lunch Program (NSLP). School-prepared meals are, on average, more nutritious than home-prepared meals. In the absence of recent data measuring changes in children's diets during the pandemic, this article aims to provide conservative, back-of-the-envelope estimates of the nutritional impacts of the pandemic for school-aged children in the United States. We used administrative data from the USDA on the number of NSLP lunches served in 2019 and 2020 and nationally representative data from the USDA School Nutrition and Meal Cost Study on the quality of school-prepared and home-prepared lunches. We estimate changes in lunchtime calories and nutrients consumed by NSLP participants from March to November 2020, compared to the same months in 2019. We estimate that an NSLP participant receiving no school meals would increase their caloric consumption by 640 calories per week and reduce their consumption of nutrients such as calcium and vitamin D. Because 27 to 78 million fewer lunches were served per week in March-November 2020 compared to the previous year, nationally, students may have consumed 3 to 10 billion additional calories per week. As students return to school, it is vital to increase school meal participation and update nutrition policies to address potentially widening nutrition disparities.
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Affiliation(s)
- Amelie A. Hecht
- Institute for Research on Poverty, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Caroline Glagola Dunn
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Eliza W. Kinsey
- Department of Family Medicine & Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | | | - Ronli Levi
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA 94143, USA; (R.L.); (H.K.S.)
| | | | - Erin R. Hager
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Hilary K. Seligman
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA 94143, USA; (R.L.); (H.K.S.)
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14
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Chen B, Kattelmann K, Comstock C, McCormack L, Wey H, Meendering J. Parenting Styles, Food Parenting Practices and Dietary Intakes of Preschoolers. Nutrients 2021; 13:nu13103630. [PMID: 34684630 PMCID: PMC8537258 DOI: 10.3390/nu13103630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
Previous evidence suggests that children’s eating behaviors were largely influenced by the parent and home eating structure. This study examined the relationship between parenting styles (including authoritative, authoritarian, indulgent, and uninvolved), food parenting practices (within Structure, Coercive Control, and Autonomy Support constructs) and dietary intakes of preschoolers. Children aged 3–5 years and their parents were recruited from preschools/daycare centers and parents completed the surveys (n = 166). Dietary intakes were collected using the Harvard Service Food Frequency Questionnaire (HSFFQ), parenting style was assessed using the Parenting Dimensions Inventory-Short Version (PDI-S), and food parenting practices were measured using Comprehensive Home Environment Survey (CHES). The results showed that food parenting practices had a higher number of specific significant findings on children’s nutrient and food group intakes than parenting styles. Correlation analyses showed positive parenting practices within Structure were significantly related to healthier children’s intakes (e.g., vegetables, iron, and folate) and less unhealthy dietary intakes (e.g., sweets and total fats). Regression models show that children with authoritative parents consumed more fruits compared to children with authoritarian parents and indulgent parents. The results addressed the importance of parental influences for preschoolers’ healthy dietary intakes, which suggested that future interventions and educational programs could enhance parenting practices to impact child diet.
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Affiliation(s)
- Biyi Chen
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
| | - Kendra Kattelmann
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
- Correspondence: ; Tel.: +1-605-688-4045
| | - Christopher Comstock
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
| | - Lacey McCormack
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
| | - Howard Wey
- Ethel Austin Martin Program, South Dakota State University, Brookings, SD 57006, USA;
| | - Jessica Meendering
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
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15
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Mohanty N, Padilla R, Leo MC, Tilmon S, Akhabue E, Rittner SS, Crawford P, Okihiro M, Persell SD. Disparities in Elevated Body Mass Index in Youth Receiving Care at Community Health Centers. FAMILY & COMMUNITY HEALTH 2021; 44:238-244. [PMID: 34292227 PMCID: PMC9172270 DOI: 10.1097/fch.0000000000000307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Childhood obesity has increased significantly in the United States. Racial subgroups are often grouped into categories in research, limiting our understanding of disparities. This study describes the prevalence of obesity among youth of diverse racial and ethnic backgrounds receiving care at community health centers (CHCs). This cross-sectional study describes the prevalence of elevated body mass index (BMI) (≥85th percentile) and obesity (≥95th percentile) in youth aged 9 to 19 years receiving care in CHCs in 2014. Multilevel logistic regression estimated the prevalence of elevated BMI and obesity by age, race/ethnicity, and sex. Among 64 925 youth, 40% had elevated BMI and 22% were obese. By race, obesity was lowest in the combined Asian/Pacific Islander category (13%); however, when subgroups were separated, the highest prevalence was among Native Hawaiians (33%) and Other Pacific Islanders (42%) and the lowest in Asians. By sex, Black females and Hispanic and Asian males were more likely to be obese. By age, the highest prevalence of obesity was among those aged 9 to 10 years (25%). Youth served by CHCs have a high prevalence of obesity, with significant differences observed by race, sex, and age. Combining race categories obscures disparities. The heterogeneity of communities warrants research that describes different populations to address obesity.
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Affiliation(s)
- Nivedita Mohanty
- AllianceChicago, Chicago, Illinois (Dr Mohanty and Ms Padilla); SASU Project Management (Ms Rittner) and General Internal Medicine and Geriatrics, Department of Medicine (Dr Persell), Northwestern University Feinberg School of Medicine (Dr Mohanty), Chicago, Illinois; Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Dr Leo and Mr Crawford); University of Chicago, Chicago, Illinois (Ms Tilmon); Division of Cardiology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (Dr Akhabue); and University of Hawaii at Manoa, Honolulu (Dr Okihiro)
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16
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Rachmah Q, Kriengsinyos W, Rojroongwasinkul N, Pongcharoen T. Development and validity of semi-quantitative food frequency questionnaire as a new research tool for sugar intake assessment among Indonesian adolescents. Heliyon 2021; 7:e07288. [PMID: 34222687 PMCID: PMC8242999 DOI: 10.1016/j.heliyon.2021.e07288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/05/2020] [Accepted: 06/08/2021] [Indexed: 12/04/2022] Open
Abstract
Robust evidence has shown that sugar is a major contributor to obesity and Non-Communicable Diseases (NCDs). However, there have not been sufficient tools to estimate sugar intakes. Therefore, developing a new and valid tool to assess sugar intake, based on cultural eating habits, is crucial. The study was done in two phases; the first focused on the development of Semi-quantitative Food Frequency Questionnaire (SFFQ), and the second focused on researching the validity of the questionnaire. Food items in the SFFQ were selected from the latest national survey review, exploratory survey, and food market observation. Forty-nine food items were included in the final SFFQ with five open-ended questions for fruit groups. One hundred and six adolescents aged 15-17 years participated in the study. The total sugar intake among the adolescents was 58.80 g/day (52.7 g sucrose; 1.47 g fructose; 1.49 glucose) which contributed to 11.6% of the total energy intake per day. The reliability analysis showed a good agreement between the two administered SFFQs in a one-month interval. The relative validity results, using 6-days food diaries as a reference method, demonstrated a superior ability to rank individuals into the same and adjacent classification and only <10% gross misclassification in all sugar intakes. The developed SFFQ in turn has been proven to have moderate to good validity and be applicable for a larger epidemiological study.
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Affiliation(s)
- Qonita Rachmah
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Indonesia
| | - Wantanee Kriengsinyos
- Nutrition and Dietetics Program, Institute of Nutrition, Mahidol University, Thailand
| | - Nipa Rojroongwasinkul
- Nutrition and Dietetics Program, Institute of Nutrition, Mahidol University, Thailand
| | - Tippawan Pongcharoen
- Nutrition and Dietetics Program, Institute of Nutrition, Mahidol University, Thailand
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17
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Appannah G, Emi NA, Magendiran M, Mohd Shariff Z, Anuar Zaini A, Shamsuddin NH, Suppiah S, Mohamad Saini S, Thambiah SC, Ching SM. PUTRA-Adol study: protocol for an observational follow-up study to assess the tracking of dietary patterns linked to cardiometabolic risk factors and its prospective relationship with non-alcoholic fatty liver disease, carotid intima-medial thickness and mental well-being during adolescence in Malaysia. BMJ Open 2021; 11:e044747. [PMID: 34035098 PMCID: PMC8154930 DOI: 10.1136/bmjopen-2020-044747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Growing evidence suggesting that dietary intakes of adolescents are generally of poor quality but not adequately assessed in relation to the early manifestation of non-communicable diseases. This study aimed; (1) to examine tracking of an empirical dietary pattern (DP) linked to cardiometabolic risk factors and, (2) to assess prospective relationships between a DP characterised by high intakes of dietary energy density (DED) and added sugar, and cardiometabolic risk factors, non-alcoholic fatty liver disease (NAFLD), carotid intima-medial thickness (CIMT) and mental well-being during adolescence. METHODS AND ANALYSIS The PUTRA-Adol is a prospective follow-up study that builds up from 933 Malaysian adolescents who were initially recruited from three southern states in Peninsular Malaysia in 2016 (aged 13 years then). Two sessions are planned; the first session will involve the collection of socio-economy, physical activity, dietary intakes, mental well-being, body image, risk taking behaviour, sun exposure, family functioning and menstrual (in women) information. The second session of data collection will be focused on direct assessments such as venesection for blood biochemistry, anthropometry and ultrasonography imaging of liver and bilateral carotid arteries. Z-scores for an empirical DP will be identified at 16 years using reduced rank regression. Multilevel modelling will be conducted to assess the tracking of DP and prospective analysis between the DP, cardiometabolic health, NAFLD, CIMT and mental well-being. ETHICS AND DISSEMINATION Ethical approval for the conduct of this follow-up study was obtained from the Universiti Putra Malaysia's Ethics Committee for Research Involving Human Subjects (JKEUPM) (Reference number: JKEUPM-2019-267). The findings from this study will be disseminated in conferences and peer-reviewed journals. DISCUSSION The findings gathered from this study will provide evidence on prospective relationships between DPs, cardiometabolic risk factors, NAFLD, early atherosclerosis and mental well-being and that it may be mediated particularly DED and added sugar during adolescence.
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Affiliation(s)
- Geeta Appannah
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nor Aishah Emi
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mugambikai Magendiran
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Azriyanti Anuar Zaini
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nurainul Hana Shamsuddin
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Subapriya Suppiah
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Suraini Mohamad Saini
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Subashini C Thambiah
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang, Malaysia
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Kelley GA, Kelley KS, Pate RR. How Many US Children and Adolescents with Overweight and Obesity Could Improve Their Percent Body Fat by Exercising?: Meta-Analytic Based Estimates. Child Obes 2021; 17:144-150. [PMID: 33544030 DOI: 10.1089/chi.2020.0245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Provide national estimates of the number of US children and adolescents with overweight and obesity who could improve their percent body fat by exercising. Methods: Data were derived from (1) a previous meta-analysis, (2) 2015-2016 prevalence data from the National Health and Nutrition Examination Survey (NHANES), and (3) 2017 US Census population data. Multiplicative calculations were based on (1) number-needed-to treat data from a previous meta-analysis of the number of children with overweight and obesity who could reduce their percent body fat by participating in either aerobic, strength, or combined aerobic and strength training, (2) 2015-2016 NHANES data on the prevalence of children and adolescents with overweight or obesity, and (3) 2017 US Census population data on children and adolescents 2-19 years of age. Results: For both children and adolescents with overweight or obesity, the number who could improve their percent body fat was estimated at 4,388,273 [95% confidence interval (CI) 3,831,523-4,845,023] for either aerobic or strength exercise and 6,507,410 (95% CI 5,744,285-7,267,534) for combined aerobic and strength exercise. Conclusions: A large number of US children and adolescents with overweight and obesity could improve their percent body fat by exercising.
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Russell R Pate
- Children's Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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19
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Sharma T, Morassut RE, Langlois C, Meyre D. Effect of sex/gender on obesity traits in Canadian first year university students: The GENEiUS study. PLoS One 2021; 16:e0247113. [PMID: 33592058 PMCID: PMC7886219 DOI: 10.1371/journal.pone.0247113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 02/01/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND While weight gain during first year of university has been well documented in North America, literature on sex-specific effects is scarce and inconsistent. The objective of this investigation was to explore sex-specific changes in obesity traits during first year of university at McMaster University (Ontario, Canada). METHODS 245 first-year students (80.4% females) were followed longitudinally with data collected early in the academic year and towards the end of the year. Obesity parameters including weight, waist and hip circumferences, BMI, and waist to hip ratio were investigated. The Mann-Whitney U test and the Wilcoxon signed-rank test were used for pairwise comparison of traits in the absence of adjustments. Additionally, the repeated-measures ANOVA test was used with covariate adjustments to investigate the interaction between sex and time. RESULTS Overall sample trends indicated a significant increase in mean weight by 1.55 kg (95% CI: 1.24-1.86) over the school year (p<0.001). This was accompanied by significant gains in BMI, and waist and hip circumferences (p<0.001) in the overall sample. At baseline, males presented with higher body weight, BMI, waist and hip circumferences, and WHR, as compared to their females counterparts (p<0.01). Additionally, sex-stratified analysis indicated significant gains in weight, BMI, and waist and hip circumferences in both males and females (p<0.01). However, a comparison of the magnitude of change over time between the two sex groups revealed no significant difference for any of the investigated traits (p>0.05). CONCLUSION While our study confirms significant weight gain in both male and female first year university students in Ontario, Canada, it does not show sex specific differences within this context. Our investigation highlights the importance of accounting for sex and gender in health research and supports the need of further studies in this area.
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Affiliation(s)
- Tanmay Sharma
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Rita E. Morassut
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Christine Langlois
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - David Meyre
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
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20
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Prospective association between dietary patterns and BMI Z-score in Brazilian adolescents. Public Health Nutr 2021; 24:4230-4237. [PMID: 33472719 DOI: 10.1017/s1368980021000252] [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: 11/07/2022]
Abstract
OBJECTIVE To identify dietary patterns and prospectively evaluate their influence on the BMI Z-score of adolescents. DESIGN A longitudinal study, using data from the Longitudinal Study on Sedentary Behavior, Physical Activity, Eating Habits and Adolescent Health - LONCAAFS. SETTING To obtain data on food consumption, a 24-h recall survey was conducted; a second 24-h recall was applied to 30 % of the sample in all waves. Dietary patterns were identified by exploratory factor analysis using principal components. BMI Z-score was determined according to the recommendation of the WHO, based on the BMI for age and sex. Socio-economic data, sedentary behaviour and physical activity level were obtained. Associations between BMI Z-score and dietary patterns and between BMI Z-score and variables of interest were determined using generalised estimating equations. PARTICIPANTS Totally, 1431 adolescents were assessed in 2014, 1178 in 2015, 959 in 2016 and 773 in 2017, belonging to the public schools of João Pessoa, Northeast Brazil. RESULTS Three dietary patterns were identified throughout the study: 'traditional', 'snacks' and 'Western'. The 'Western' dietary pattern was positively associated with BMI Z-score (β = 0·025; 95 % CI 0·002, 0·048), regardless of sex and physical activity level, prospectively. CONCLUSION A dietary pattern composed of foods with high energy density, high fat and sugars, and low fibre influences the BMI Z-score of adolescents over time.
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Lier LM, Breuer C, Ferrari N, Friesen D, Maisonave F, Schmidt N, Graf C. Individual Physical Activity Behaviour and Group Composition as Determinants of the Effectiveness of a Childhood Obesity Intervention Program. Obes Facts 2021; 14:100-107. [PMID: 33352573 PMCID: PMC7983679 DOI: 10.1159/000512293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 10/12/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Up to now, there is limited clarity on factors that determine the effectiveness of childhood obesity interventions. OBJECTIVE This study intends to uncover individual- and program-level predictors of BMI-SDS and fitness to achieve significant, sustainable health improvements. METHODS Data of 249 children with obesity or overweight who participated in an outpatient multidisciplinary program were analysed and compared to 54 waitlist controls. Linear regression models were used to examine associations between individual- and group-level variables and BMI-SDS and fitness. RESULTS Among intervention children, BMI-SDS decreased by 0.19 units and physical fitness increased by 11.5%, versus a BMI-SDS decrease of 0.07 and a 1.8% decrease in fitness in the control group. Participants who reported being physically active before the program start achieved greater improvements in BMI-SDS (β = -0.177, p < 0.05) and physical fitness (β = 0.174, p < 0.05) than inactive peers. BMI-SDS decreased significantly more for members of gender-heterogeneous groups (β = 0.194, p < 0.05) with a narrow age range (β = 0.152, p < 0.05). CONCLUSIONS The program under review is effective in counteracting juvenile obesity. The results give reason to believe that forming mixed-gender groups with a small age range and providing increased support for reportedly inactive children may improve program effectiveness.
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Affiliation(s)
- Liesa Marie Lier
- Department of Sports Economics and Sport Management, German Sport University Cologne, Cologne, Germany,
| | - Christoph Breuer
- Department of Sports Economics and Sport Management, German Sport University Cologne, Cologne, Germany
| | - Nina Ferrari
- Cologne Center for Prevention and Youth/Heart Center Cologne, University Hospital Cologne, Cologne, Germany
| | - David Friesen
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Fernanda Maisonave
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Nikola Schmidt
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Christine Graf
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
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Julian V, Isacco L, Khammassi M, Fillon A, Miguet M, Dutheil F, Courteix D, Zak M, Bicki J, Głuszek S, Duclos M, Boirie Y, Pereira B, Thivel D. Appetite Control Might not Be Improved after Weight Loss in Adolescents with Obesity, Despite Non-Persistent Metabolic Syndrome. Nutrients 2020; 12:E3885. [PMID: 33353174 PMCID: PMC7766326 DOI: 10.3390/nu12123885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the effect of a multidisciplinary weight loss intervention on energy intake and appetite sensations in adolescents with obesity, depending on the initial diagnosis or persistence of the metabolic syndrome. Ninety-two adolescents with obesity (12-15 years) followed a 16-week multidisciplinary weight loss intervention. Anthropometric and body composition characteristics, metabolic profile, ad libitum daily energy intake, and appetite sensations were assessed before and after the intervention. The presence of metabolic syndrome (MS) was determined at baseline (MS vs. non-MS) and after the program (persistent vs. non-persistent). While the intervention was effective in inducing weight loss (body weight T0: 87.1 ± 14.9 vs. T1: 81.2 ± 13.0 kg; p < 0.001) and body composition improvements in both adolescents with and without MS, energy intake (p = 0.07), hunger (p = 0.008), and prospective food consumption (p = 0.03) increased, while fullness decreased (p = 0.04) in both groups. Energy intake and appetite were not improved in non-persistent MS after the program and remained significantly higher among non-persistent adolescents compared with initially non-MS adolescents. To conclude, appetite control seems impaired in obese adolescents, irrespective of being affected by MS or not, whereas the treatment of MS in this population might fail to effectively preclude the adolescents from potential post-intervention compensatory food intake and subsequent weight regain.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, 63000 Clermont-Ferrand, France; (V.J.); (M.D.)
- UFR Medicine, Clermont Auvergne University, 63000 Clermont-Ferrand, France;
| | - Laurie Isacco
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Marwa Khammassi
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Alicia Fillon
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Maud Miguet
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Frederic Dutheil
- Departement de Médecine du travail, Clermont-Ferrand University Hospital, G. Montpied Hospital, 63000 Clermont-Ferrand, France;
- CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont Auvergne University, 63000 Clermont-Ferrand, France
| | - Daniel Courteix
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Marek Zak
- Collegium Medicum, Jan Kochanowski University, Zeromskiego 5, 25-369 Kielce, Poland; (M.Z.); (J.B.); (S.G.)
| | - Jacek Bicki
- Collegium Medicum, Jan Kochanowski University, Zeromskiego 5, 25-369 Kielce, Poland; (M.Z.); (J.B.); (S.G.)
| | - Stanisław Głuszek
- Collegium Medicum, Jan Kochanowski University, Zeromskiego 5, 25-369 Kielce, Poland; (M.Z.); (J.B.); (S.G.)
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, 63000 Clermont-Ferrand, France; (V.J.); (M.D.)
- UFR Medicine, Clermont Auvergne University, 63000 Clermont-Ferrand, France;
- INRA, UMR 1019, 63000 Clermont-Ferrand, France
- CRNH-Auvergne, 63000 Clermont-Ferrand, France
| | - Yves Boirie
- UFR Medicine, Clermont Auvergne University, 63000 Clermont-Ferrand, France;
- INRA, UMR 1019, 63000 Clermont-Ferrand, France
- CRNH-Auvergne, 63000 Clermont-Ferrand, France
- Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied Hospital, 63000 Clermont-Ferrand, France
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics unit (DRCI), 63000 Clermont-Ferrand, France;
| | - David Thivel
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
- CRNH-Auvergne, 63000 Clermont-Ferrand, France
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Effect of living arrangement on anthropometric traits in first-year university students from Canada: The GENEiUS study. PLoS One 2020; 15:e0241744. [PMID: 33156864 PMCID: PMC7647062 DOI: 10.1371/journal.pone.0241744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/19/2020] [Indexed: 12/25/2022] Open
Abstract
Background The transition to university often involves a change in living arrangement for many first-year students. While weight gain during first year of university has been well documented, Canadian literature on the impact of living arrangement within this context is limited. The objective of this investigation was to explore the effect of living arrangement on anthropometric traits in first-year university students from Ontario, Canada. Methods 244 first-year undergraduate students were followed longitudinally with data collected early in the academic year and towards the end of the year. Anthropometric parameters including weight, waist and hip circumference, body mass index (BMI), and waist-to-hip ratio (WHR) were examined. The Wilcoxon signed-rank test was used for pairwise comparison of traits from the beginning to end the year in the absence of adjustments. Additionally, linear regression models with covariate adjustments were used to investigate effect of the type of living arrangement (i.e. on-campus, off-campus, or family home) on the aforementioned traits. Results In the overall sample, a significant weight increase of 1.55kg (95% CI: 1.24–1.86) was observed over the school year (p<0.001), which was also accompanied by significant gains in BMI, and waist and hip circumferences (p<0.001). At baseline, no significant differences were found between people living on-campus, off-campus, and at home with family. Stratified analysis of change by type of living arrangement indicated significant gains across all traits among students living on-campus (p<0.05), and significant gains in weight and BMI among students living at home with family. Additionally, a comparison between living arrangements revealed that students living on campus experienced significantly larger gains in weight and BMI compared to students living off-campus (p<0.05). Conclusion Our findings indicate that living arrangement is associated with different weight gain trajectories in first-year university students.
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Gagné-Ouellet V, Breton E, Thibeault K, Fortin CA, Desgagné V, Girard Tremblay É, Cardenas A, Guérin R, Perron P, Hivert MF, Bouchard L. Placental Epigenome-Wide Association Study Identified Loci Associated with Childhood Adiposity at 3 Years of Age. Int J Mol Sci 2020; 21:ijms21197201. [PMID: 33003475 PMCID: PMC7582906 DOI: 10.3390/ijms21197201] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/22/2020] [Accepted: 09/21/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to identify placental DNA methylation (DNAm) variations associated with adiposity at 3 years of age. We quantified placental DNAm using the Infinium MethylationEPIC BeadChips. We assessed associations between DNAm at single-CpGs and skinfold thickness using robust linear regression models adjusted for gestational age, child's sex, age at follow-up and cellular heterogeneity. We sought replication of DNAm association with child adiposity in an independent cohort. We quantified placental mRNA levels for annotated gene using qRT-PCR and tested for correlation with DNAm. Lower DNAm at cg22593959 and cg22436429 was associated with higher adiposity (β = -1.18, q = 0.002 and β = -0.82, q = 0.04). The cg22593959 is located in an intergenic region (chr7q31.3), whereas cg22436429 is within the TFAP2E gene (1p34.3). DNAm at cg22593959 and cg22436429 was correlated with mRNA levels at FAM3C (rs = -0.279, p = 0.005) and TFAP2E (rs = 0.216, p = 0.03). In an independent cohort, the association between placental DNAm at cg22593959 and childhood adiposity was of similar strength and direction (β = -3.8 ± 4.1, p = 0.36), yet non-significant. Four genomic regions were also associated with skinfold thickness within FMN1, MAGI2, SKAP2 and BMPR1B genes. We identified placental epigenetic variations associated with adiposity at 3 years of age suggesting that childhood fat accretion patterns might be established during fetal life.
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Affiliation(s)
- Valérie Gagné-Ouellet
- Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.G.-O.); (E.B.); (K.T.); (C.-A.F.); (V.D.); (É.G.T.); (R.G.)
| | - Edith Breton
- Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.G.-O.); (E.B.); (K.T.); (C.-A.F.); (V.D.); (É.G.T.); (R.G.)
| | - Kathrine Thibeault
- Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.G.-O.); (E.B.); (K.T.); (C.-A.F.); (V.D.); (É.G.T.); (R.G.)
| | - Carol-Ann Fortin
- Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.G.-O.); (E.B.); (K.T.); (C.-A.F.); (V.D.); (É.G.T.); (R.G.)
| | - Véronique Desgagné
- Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.G.-O.); (E.B.); (K.T.); (C.-A.F.); (V.D.); (É.G.T.); (R.G.)
- Department of Medical Biology, CIUSSS Saguenay-Lac-Saint-Jean—Hôpital Universitaire de Chicoutimi, Saguenay, QC G7H 5H6, Canada
| | - Élise Girard Tremblay
- Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.G.-O.); (E.B.); (K.T.); (C.-A.F.); (V.D.); (É.G.T.); (R.G.)
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720-7360, USA;
| | - Renée Guérin
- Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.G.-O.); (E.B.); (K.T.); (C.-A.F.); (V.D.); (É.G.T.); (R.G.)
- Department of Medical Biology, CIUSSS Saguenay-Lac-Saint-Jean—Hôpital Universitaire de Chicoutimi, Saguenay, QC G7H 5H6, Canada
| | - Patrice Perron
- Department of Medicine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (P.P.); (M.-F.H.)
- Centre de Recherche du CHUS, Sherbrooke, QC J1H 5N4, Canada
| | - Marie-France Hivert
- Department of Medicine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (P.P.); (M.-F.H.)
- Diabetes Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Luigi Bouchard
- Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.G.-O.); (E.B.); (K.T.); (C.-A.F.); (V.D.); (É.G.T.); (R.G.)
- Department of Medical Biology, CIUSSS Saguenay-Lac-Saint-Jean—Hôpital Universitaire de Chicoutimi, Saguenay, QC G7H 5H6, Canada
- Centre de Recherche du CHUS, Sherbrooke, QC J1H 5N4, Canada
- Correspondence:
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Investigating the Role of Childhood Adiposity in the Development of Adult Type 2 Diabetes in a 64-year Follow-up Cohort: An Application of the Parametric G-formula Within an Agent-based Simulation Study. Epidemiology 2020; 30 Suppl 2:S101-S109. [PMID: 31569159 DOI: 10.1097/ede.0000000000001062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The contribution of childhood obesity to adult type 2 diabetes (T2DM), not through adult adiposity, as well as the causal pathways through which childhood obesity increases adult T2DM risk are not well understood. This study investigated the contribution of childhood obesity to incident T2DM including pathways not through adult adiposity, and explored whether race modified this contribution. METHODS We used data from the Virtual Los Angeles Cohort, an agent-based longitudinal birth cohort composed of 98,230 simulated individuals born in 2009 and followed until age 65 years. We applied the parametric mediational g-formula to the causal mediation analysis investigating the impact of childhood obesity on the development of adult T2DM. RESULTS The marginal adjusted odds ratio (aOR) for the total effect of childhood obesity on adult T2DM was 1.37 (95% CI = 1.32, 1.46). Nearly all the effect of childhood obesity on adult T2DM was mostly attributable to pathways other than through adult obesity; the aOR for the pure direct effect was 1.36 (95% CI = 1.31, 1.41). In all racial subpopulations, a similar 3% of the total effect of childhood obesity on adult T2DM was attributable to its effect on adult obesity. CONCLUSIONS Childhood obesity remains a risk factor for adult T2DM separate from its effects on adult obesity. This study emphasizes the potential benefits of early interventions and illustrates that agent-based simulation models could serve as virtual laboratories for exploring mechanisms in obesity research.
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Ochieng BMN. Healthy weight maintenance strategy in early childhood: The views of black African migrant parents and health visitors. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1551-1559. [PMID: 32173948 DOI: 10.1111/hsc.12979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
In Europe and the US, childhood obesity is found to be higher in migrant children from black African communities and other visible minority ethnic groups. However, very little is known about the factors that contribute to the significant rates of obesity in these groups. The material for this study is drawn from a community-based qualitative study that examined the sociocultural, familial and environmental factors that either facilitate or hinder healthy weight in black African children during early childhood. The participants for the study were black African parents (n = 30) and health visitors (n = 32), residing and working in the East Midlands, UK. The participants were purposively selected according to an inclusion/exclusion criterion and invited to participate in seven focus groups (FG-7) conducted for parents (FG-4) and health visitors (FG-3) at a time and place convenient to the participants, between March and June 2018. The focus groups examined a number of issues, including the participants' views on the barriers and facilitators to achieving and maintaining a healthy weight. Thematic analysis was used to identify themes within the data. Although participants were knowledgeable about the need for a healthy weight in early childhood, the parents discussed how immigration status and experiences of discrimination had an impact on their children's diet and well-being, also discussing how structural factors influenced the decisions they made regarding healthy weight in early childhood. While the health visitors in general felt they did not have the skills to advise black African parents about the cultural influences on diet during early childhood, findings highlighted a need for a system-based approach in meeting the nutritional needs of black African children. This study concludes by suggesting the need for broad social-environment and economic changes that address factors such as migration status, deprivation and discrimination, coupled with culturally specific healthy diet messages.
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Affiliation(s)
- Bertha M N Ochieng
- Integrated Health and Social Care, Faculty of Health & Life Sciences, De Montfort University, Leicester, UK
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Lier LM, Breuer C, Ferrari N, Friesen D, Maisonave F, Schmidt N, Graf C. Cost-effectiveness of a family-based multicomponent outpatient intervention program for children with obesity in Germany. Public Health 2020; 186:185-192. [PMID: 32858303 DOI: 10.1016/j.puhe.2020.06.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/15/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Facing an epidemic of childhood obesity and budget constraints, public health administrations are showing an urgent interest in interventions that are both health effective and cost-effective. Thus, this study intends to analyze the return on investment of these existing programs. STUDY DESIGN All analyses are based on a comprehensive data set from 249 children with obesity and overweight children who participated in the Children's Health InterventionaL Trial (CHILT), an 11-month outpatient multidisciplinary family-based program. METHODS Cost-effectiveness was assessed by comparing estimated savings associated with a reduction in weight and improvement of obesity-related health parameters with intervention costs. Projected future savings in health care expenditures were modeled on existing research, using estimates of health care costs associated with juvenile obesity and remission thresholds of obesity-related disease. RESULTS On average, participants achieved a 0.19-unit reduction in the body mass index standard deviation score, showed reduction in their blood pressure values (systolic = -1.76 mmHg, diastolic = -2.82 mmHg), and showed improvement in their high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol values (HDL = +1.31 mg/dL, LDL = -4.82 mg/dL). The intervention costs were 1799€ per participant, and the benefits of avoided future health care costs varied by individual. On an aggregated level, future savings amounted to between 1859€ and 1926€ per person, translating into a return on investment of 3.3-7.0%. CONCLUSIONS This study shows that a multicomponent obesity intervention, such as the CHILT, not only results in weight loss and improves important health parameters but also is cost-effective.
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Affiliation(s)
- L M Lier
- MA. Strategy & International Management, BSc Business Administration & Economics Department of Sports Economics and Sport Management, German Sport University Cologne, Cologne, Germany, Eisenstraße 5, 50925, Cologne, Germany.
| | - C Breuer
- Habilitation Sport Science Department of Sports Economics and Sport Management, German Sport University Cologne, Cologne, Germany
| | - N Ferrari
- PhD Sport Science Cologne Center for Prevention and Youth/Heart Center Cologne, University Hospital Cologne, Germany
| | - D Friesen
- MA Sports Science Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - F Maisonave
- Diploma in Sport Science Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - N Schmidt
- BA Sport Science, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - C Graf
- Habilitation Sport Science, PhD Sports Medicine Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
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Family-based treatment program contributors to child weight loss. Int J Obes (Lond) 2020; 45:77-83. [PMID: 32546860 PMCID: PMC7738379 DOI: 10.1038/s41366-020-0604-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/08/2020] [Accepted: 05/14/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Multicomponent family-based behavioral treatment (FBT) program for pediatric obesity includes nutrition and physical activity education, as well as behavior therapy techniques. Studies suggest that parent weight loss is the best predictor of child weight loss in FBT. However, given the important role that parents play in the implementation of FBT for their child, isolating the effects of specific FBT treatment component requires consideration of parent influences over time. METHODS The following treatment components were assessed: stimulus control (high/low-fat food items in home), nutrition knowledge, energy intake, physical activity, and parental monitoring, as well as weekly anthropometric measures. Adjusted models of interest using inverse probability weights were used to evaluate the effect of specific FBT components on time-varying child weight loss rate, adjusting for time-varying influence of parent weight loss. RESULTS One hundred thirty-seven parent-child dyads (CHILD: mean BMI = 26.4 (3.7) and BMIz = 2.0 (0.3); mean age = 10.4 (1.3); 64.1% female; ADULT: mean BMI = 31.9 (6.3); mean age = 42.9 (6.5); 30.1% Hispanic parents; 87.1% female) participated in an FBT program. In traditional model, adult BMI change (b = 0.08; p < 0.01) was the most significant predictor of child weight loss rates and no other treatment components were significant (p's > 0.1). In models that accounted for potential influences from parental weight loss and differential attendance during treatment period, lower availability of high-fat items (b = 1.10, p < 0.02), higher availability of low-fat items (b = 3.73; p < 0.01), and higher scores on parental monitoring practices (b = 1.10, p < 0.01) were associated with greater rates of weight loss, respectively. CONCLUSION Results suggest that outside of parent weight change, changes in stimulus control strategies at home and improved parental-monitoring practices are important FBT components for child weight loss.
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Reifsnider E, Jeong M, Chatterjee P. An Ecological Approach to Obesity in Mexican American Children. J Pediatr Health Care 2020; 34:212-221. [PMID: 31813667 DOI: 10.1016/j.pedhc.2019.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/19/2019] [Accepted: 09/25/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The objective of this study was to explore the risk factors that contribute to obesity in Mexican American children compared with Mexican American normal weight children. No hypotheses were tested in the study. When risk factors are known, nurses can use evidence to reduce risky behavior. METHOD A cross-sectional descriptive design was used, comparing two groups of children to discern the risk factors for obesity. The setting is a county in South Texas along the border with Mexico. The sample consisted of 55 Mexican American dyads (mother-child). The following measures, based on the Ecological Model of Growth, were used to collect data: anthropometrics, dietary data of children, home environment, perceived stress of mother, and maternal acculturation. Independent sample t tests, chi-square tests, Fisher exact tests, and a hierarchical logistic regression analysis were used to analyze the data. RESULTS The findings show children's age and maternal body mass index (BMI) are positively correlated with childhood obesity, as measured by BMI percentile by age/sex. There were significant differences in the host and agent factors of prolonged bottle feeding, amount of outdoor play, and fruit drinks between normal weight and obese children. DISCUSSION Engagement and involvement of other family members in outdoor activities, nutrition/feeding, and child care may mitigate the negative effects of host and agent factors on child body size.
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Zulkefli SHB, Barr A, Singh A, Carver A, Mavoa S, Scheurer J, Badland H, Bentley R. Associations between Public Transport Accessibility around Homes and Schools and Walking and Cycling among Adolescents. CHILDREN-BASEL 2020; 7:children7040030. [PMID: 32268507 PMCID: PMC7230441 DOI: 10.3390/children7040030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/26/2020] [Accepted: 03/27/2020] [Indexed: 11/17/2022]
Abstract
Good public transport accessibility is associated with active travel, but this is under-researched among adolescents. We tested associations between public transport accessibility and active travel among school-going adolescents (12–18 years; n = 1329) from Melbourne, Australia analysing Victorian Integrated Survey of Travel and Activity data. Outcomes included main mode of transport to school and accumulating ≥20 min of active travel over the day. Low and high compared to no public transport accessibility around homes were associated with higher odds of public transport use (low (odds ratio (OR): 1.94 95% confidence interval (CI): 1.28, 2.94) high (OR: 2.86 95% CI: 1.80, 4.53)). Low and high public transport accessibility around homes were also associated with higher prevalence of achieving ≥20 min of active travel (low (prevalence ratio (PR): 1.14 95% CI: 0.97, 1.34) high (PR: 1.31 95% CI: 1.11, 1.54)) compared to none. Public transport accessibility around schools was associated with public transport use (low (OR: 2.13 95% CI: 1.40, 3.24) high (OR: 5.07 95% CI: 3.35, 7.67)) and achieving ≥20 min of active travel (low (PR: 1.18 95% CI: 1.00, 1.38) high (PR: 1.64 95% CI: 1.41, 1.90)). Positive associations were confirmed between public transport accessibility and both outcomes of active travel.
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Affiliation(s)
- Syafiqah Hannah Binte Zulkefli
- Centre for Health Equity, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia; (S.H.B.Z.); (A.B.); (S.M.); (R.B.)
| | - Alison Barr
- Centre for Health Equity, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia; (S.H.B.Z.); (A.B.); (S.M.); (R.B.)
| | - Ankur Singh
- Centre for Health Equity, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia; (S.H.B.Z.); (A.B.); (S.M.); (R.B.)
- Correspondence: ; Tel.: +61-3-8344-9256
| | - Alison Carver
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia;
| | - Suzanne Mavoa
- Centre for Health Equity, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia; (S.H.B.Z.); (A.B.); (S.M.); (R.B.)
| | - Jan Scheurer
- Centre for Urban Research, Royal Melbourne Institute of Technology (RMIT), Melbourne, VIC 3000, Australia; (J.S.); (H.B.)
| | - Hannah Badland
- Centre for Urban Research, Royal Melbourne Institute of Technology (RMIT), Melbourne, VIC 3000, Australia; (J.S.); (H.B.)
| | - Rebecca Bentley
- Centre for Health Equity, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia; (S.H.B.Z.); (A.B.); (S.M.); (R.B.)
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia
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Annan RA, Sowah SA, Apprey C, Agyapong NAF, Okonogi S, Yamauchi T, Sakurai T. Relationship between breakfast consumption, BMI status and physical fitness of Ghanaian school-aged children. BMC Nutr 2020; 6:19. [PMID: 32266078 PMCID: PMC7114787 DOI: 10.1186/s40795-020-00344-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background Good nutrition and physical activity of school-aged children are important for ensuring optimum growth and reducing obesity. This present study assessed associations between breakfast consumption, BMI-for-Age (BMI) and physical fitness in a cross-section of school-aged children attending government-owned primary schools in Kumasi, Ghana. Method The sample consisted of 438 pupils (boys = 213; girls = 225; mean age 11.1 ± 1.1), attending 10 randomly selected schools. Weight (kg), height (cm) and Mid Upper Arm Circumference (MUAC) were measured for each participant, and BMI-for-age z-scores determined using the World Health Organisation (WHO) anthroplus software. Participants were stratified into thinness, normal weight, overweight/obese using WHO cut offs. Physical fitness was assessed using forward jump, left and right handgrips, flexibility, sit-ups and 50 metre run following standard procedures and converted to scores of 1 to 10 following Japanese standards, based on which percentiles were derived. Total fitness score for each pupil was computed by adding all scores. A questionnaire was used to assess meal intake patterns. Results The mean BMI-for-age z-score for participants was − 0.24 ± 0.99. Thinness, normal weight and overweight/obesity were 2.7, 86.5, and 10.5% respectively among the pupils. Overweight was higher in girls (14.2%) compared to boys (4.2%), p = 0.003. Similarly, mean MUAC was significantly (p = 0.021) higher in the girls (22.0 ± 3.2 cm) than the boys (20.7 ± 7.3 cm). For physical fitness, the girls scored higher in forward jump (p < 0.0001), 50-m run (p = 0.002) and overall fitness score than the boys (21.0 ± 6.2 versus 19.2 ± 8.3, p = 0.012). However, a larger proportion of boys performed excellently and poorly than girls (p = 0.019). A positive correlation was observed between BMI z-score and hand grip (r = 0.21, p < 0.001), while sit up (r = − 0.11, p = 0.018) showed a negative correlation with BMI z-score. No other fitness test varied by BMI. Overweight children performed best in handgrip. Majority of children said they engaged in exercise (89.9%) and consumed breakfast (78.9%). Breakfast consumption was not associated with BMI z-score (x2 0.0359, p = 0.549) but non-breakfast consumers performed better in 50 m run compared to consumers (7.0 seconds ± 2.3 vrs 6.3 seconds ± 2.5, p = 0.022). Children who reported to exercise were physically fitter than those who did not. Conclusion Underweight levels were low while overweight was over 10% in these children. Girls were more than 3 times affected by overweight than boys, and were also physically fitter than boys. Breakfast consumption was not related to weight or fitness.
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Affiliation(s)
- Reginald Adjetey Annan
- 1Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Solomon Adjetey Sowah
- 1Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Apprey
- 1Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nana Ama Frimpomaa Agyapong
- 1Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Satoru Okonogi
- 2Faculty of Agriculture, The University of Tokyo, Tokyo, Japan
| | - Taro Yamauchi
- 3Faculty of Health Sciences, School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takeshi Sakurai
- 2Faculty of Agriculture, The University of Tokyo, Tokyo, Japan
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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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Gibson-Smith D, Halldorsson TI, Bot M, Brouwer IA, Visser M, Thorsdottir I, Birgisdottir BE, Gudnason V, Eiriksdottir G, Launer LJ, Harris TB, Gunnarsdottir I. Childhood overweight and obesity and the risk of depression across the lifespan. BMC Pediatr 2020; 20:25. [PMID: 31964368 PMCID: PMC6971945 DOI: 10.1186/s12887-020-1930-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 01/15/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Obesity has been longitudinally associated with depression but only few studies take a life course approach. This longitudinal study investigates whether being overweight or obese at age 8 and 13 years is associated with depressive symptoms more than 60 years later and whether this association is independent of late-life body mass index (BMI). We also investigated the association of being overweight/obese at age 8 or 13 years with ever having major depressive disorder (lifetime MDD). METHOD This analysis is based on a sub-sample of 889 AGES-Reykjavik participants with measured BMI data from early life. Late-life depressive symptoms were measured with the Geriatric Depression Scale (GDS) and lifetime MDD was assessed at late-life using the Mini International Neuropsychiatric Interview. Logistic regression analysis was used to estimate the relationships between BMI (continuous and categorical) at age 8 or 13 years, and late-life depressive symptoms (measured as GDS ≥ 5) or lifetime MDD, adjusted for sex, education, physical activity, smoking status and alcohol use. In a separate model, additional adjustments were made for late-life BMI. RESULTS One hundred and one subjects (11%) had depressive symptoms at late-life (GDS ≥ 5), and 39 subjects (4.4%) had lifetime MDD. Being overweight or obese at age 8 or 13 years was not associated with higher depressive symptoms during late-life, irrespective of late-life BMI. Being overweight or obese at age 8 years, but not age 13 years was associated with an increased risk of lifetime MDD (Odds Ratio (OR) (95% confidence interval [CI]) for age 8 = 4.03[1.16-13.96]P = 0.03 and age 13 = 2.65[0.69-10.26] P = 0.16, respectively). CONCLUSION Being overweight in childhood was associated with increased odds of lifetime MDD, although the magnitude of the risk is uncertain given the small numbers of participants with lifetime MDD. No clear association was observed between childhood and adolescent overweight/obesity and late-life depressive symptoms irrespective of late life BMI.
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Affiliation(s)
| | - Thorhallur I. Halldorsson
- Unit for Nutrition Research, Landspitali, The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Eiriksgata 29, 101, Reykjavik, Iceland
- Department of Epidemiology Research, Centre for Fetal Programming, Statens Serum Institut, 5, Artillerivej, 2300 Copenhagen S, Denmark
| | - Mariska Bot
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ingeborg A. Brouwer
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Department of Internal Medicine, Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Inga Thorsdottir
- Unit for Nutrition Research, Landspitali, The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Eiriksgata 29, 101, Reykjavik, Iceland
| | - Bryndis E. Birgisdottir
- Unit for Nutrition Research, Landspitali, The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Eiriksgata 29, 101, Reykjavik, Iceland
| | | | | | - Lenore J. Launer
- National Institute on Aging, Laboratory of Epidemiology, and Population Sciences, 7201 Wisconsin Avenue, Bethesda, MD 20892-9205 USA
| | - Tamara B. Harris
- National Institute on Aging, Laboratory of Epidemiology, and Population Sciences, 7201 Wisconsin Avenue, Bethesda, MD 20892-9205 USA
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Landspitali, The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Eiriksgata 29, 101, Reykjavik, Iceland
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Mireku MO, Rodriguez A. Family Income Gradients in Adolescent Obesity, Overweight and Adiposity Persist in Extremely Deprived and Extremely Affluent Neighbourhoods but Not in Middle-Class Neighbourhoods: Evidence from the UK Millennium Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E418. [PMID: 31936305 PMCID: PMC7013671 DOI: 10.3390/ijerph17020418] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/03/2020] [Accepted: 01/04/2020] [Indexed: 01/22/2023]
Abstract
We investigated whether family income gradients in obesity, overweight, and adiposity persist at geographic-level deprivation quintiles using a nationally representative cohort of UK adolescents. Data from 11,714 eligible adolescents from the sixth sweep of the Millennium Cohort Study (14 years old) were analysed in this study. The International Obesity Task Force age- and sex-specific thresholds were used to define obesity and overweight. Self-reported family income was standardized using the Organisation for Economic Co-operation and Development (OECD)'s equivalised income scale. Geographic-level deprivation was defined by the index of multiple deprivation 2004. Results showed that the prevalence of obesity and overweight was 8.0% and 27.2%, respectively. Mean percentage body fat was 16.9% (standard error, SE = 0.2%) in male and 27.3% (SE = 0.1%) in female adolescents. Risk of obesity, overweight, and adiposity increased with decreasing family income quintiles (p for trend <0.001). After stratifying by geographic-level deprivation quintiles, a U-shaped association emerged, whereby family income gradients in the risk of adolescent obesity and adiposity persisted in extremely affluent and extremely deprived neighbourhoods but attenuated to non-significance in middle-class neighbourhoods. These results focus on the findings from England. Recognition of the persistence of inequalities in the risk of obesity in the most deprived and affluent neighbourhoods may be necessary in planning public health resources and interventions.
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Affiliation(s)
- Michael Osei Mireku
- School of Psychology, University of Lincoln, Lincoln LN6 7TS, UK
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK;
| | - Alina Rodriguez
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK;
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Kelley GA, Kelley KS, Pate RR. Exercise and adiposity in overweight and obese children and adolescents: a systematic review with network meta-analysis of randomised trials. BMJ Open 2019; 9:e031220. [PMID: 31719081 PMCID: PMC6858189 DOI: 10.1136/bmjopen-2019-031220] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Determine both the effects and hierarchy of effectiveness for exercise interventions (aerobic, strength training or both) on selected measures of adiposity (body mass index (BMI) in kg/m2, fat mass and per cent body fat) in overweight and obese children and adolescents. DESIGN Network meta-analysis of randomised exercise intervention trials. SETTING Any setting where a randomised trial could be conducted. PARTICIPANTS Overweight and obese male and/or female children and adolescents 2-18 years of age. INTERVENTIONS Randomised exercise intervention trials>4 weeks, published between 1 January 1973 and 22 August 2018, and which included direct and/or indirect evidence for aerobic, strength training or combined aerobic and strength training. PRIMARY OUTCOMES Changes in BMI in kg/m2, fat mass and per cent body fat. RESULTS Fifty-seven studies representing 127 groups (73 exercise, 54 control) and 2792 participants (1667 exercise, 1125 control) met the criteria for inclusion. Length of training ([Formula: see text] ± SD) averaged 14.1±6.2 weeks, frequency, 3.3±1.1 days per week and duration 42.0±21.0 min per session. Significant and clinically important reductions in BMI, fat mass and per cent body fat were observed in aerobic versus control comparisons (BMI, mean, 95% CI -1.0, 1.4 to -0.6; fat mass -2.1, -3.3 to -1.0 kg; per cent fat -1.5, -2.2 to -0.9%) and combined aerobic and strength versus control comparisons (BMI -0.7, -1.4 to -0.1; fat mass -2.5, -4.1 to -1.0 kg; per cent fat, -2.2, -3.2 to -1.2%). A significant reduction in per cent fat was also found for strength vs control comparisons (-1.3,-2.5 to -0.1%). Combined aerobic and strength training was ranked first for improving both fat mass (kg) and per cent body fat while aerobic exercise was ranked first for improving BMI. CONCLUSIONS Aerobic and combined aerobic and strength training are associated with improvements in adiposity outcomes in overweight and obese children and adolescents. PROSPERO REGISTRATION NUMBER CRD42017073103.
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Affiliation(s)
- George A Kelley
- Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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Li F, Mao L, Chen P. Physical activity and prevention of chronic disease in Chinese youth: A public health approach. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:512-515. [PMID: 31720059 PMCID: PMC6835010 DOI: 10.1016/j.jshs.2019.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 05/09/2023]
Abstract
•The proportion of school-aged children and adolescents in China who engage in recommended levels of physical activity (PA), in or outside of school time, has been declining for decades.•Current PA promotion policies for Chinese schools are primarily "stand-alone" approaches and their efficacy appears limited.•Re-evaluating the problem from a comprehensive social-ecological perspective within a public health model offers greater potential for developing effective and culturally appropriate interventions to increase PA among Chinese youth.•If the goals of Healthy China 2030, including the prevention of the early onset of chronic diseases among Chinese children and adolescents, are to be met by reversing the trend of declining PA, careful consideration of this new paradigm is imperative.
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Affiliation(s)
- Fuzhong Li
- Oregon Research Institute, Eugene, OR 97403, USA
| | - Lijuan Mao
- Shanghai University of Sport, Shanghai 200438, China
| | - Peijie Chen
- Shanghai University of Sport, Shanghai 200438, China
- Corresponding author.
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Exploring Energy Expenditure and Body Movement of Exergaming in Children of Different Weight Status. Pediatr Exerc Sci 2019; 31:438-447. [PMID: 31394495 PMCID: PMC7030900 DOI: 10.1123/pes.2019-0006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/21/2019] [Accepted: 05/28/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE This study examined differences in energy expenditure and bodily movement among children of different weight status during exergames that varied in mode and intensity. METHODS Fifty-seven 8- to 12-year-old children including overweight/obesity (n = 28) and normal weight (n = 29) played three 10-minute interval Xbox One exergames (Fruit Ninja, Kung-Fu, and Shape Up) categorized based on predominantly upper-, whole-, or lower-limb movement, respectively. The authors measured bodily movement through accelerometry and obtained energy expenditure and metabolic equivalent (MET) via indirect calorimetry. RESULTS Energy expended during gameplay was the highest in Shape Up (P < .01) and higher in Kung-Fu than Fruit Ninja (P < .01). Absolute energy expenditure was significantly higher in overweight/obese children (P < .01), but not when controlling for body mass across 3 exergames (P > .05). Based on the MET cut-points, overweight/obese children spent more time at light intensity (<3 METs) for Fruit Ninja (P < .05) and Shape Up (P < .01), but less time at vigorous intensity (≥6 METs) for Kung-Fu (P < .01) and Shape Up (P < .01). Lower-limb movements during Shape Up were less in overweight/obese children (P = .03). CONCLUSION Although children in both groups expended similar energy relative to their body mass during gameplay, overweight/obese children spent more time at light intensity but less time at vigorous intensity with fewer movements especially while playing a lower limb-controlled exergame.
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Hammons AJ, Hannon BA, Teran-Garcia M, Barragan M, Villegas E, Wiley A, Fiese B. Effects of Culturally Tailored Nutrition Education on Dietary Quality of Hispanic Mothers: A Randomized Control Trial. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:1168-1176. [PMID: 31375361 DOI: 10.1016/j.jneb.2019.06.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess whether participation in a culturally tailored nutrition education program increases diet quality of Hispanic mothers. DESIGN A randomized controlled trial. SETTING Community centers and universities. PARTICIPANTS Sixty-five mothers (35 in experimental group, 30 in control group) completed pre- and postworkshop surveys. Eligibility criteria included being of Mexican or Puerto Rican descent and having a child between the ages of 6 and 18 years who could participate in the workshops with the parent. INTERVENTION Families in the experimental group participated in a 6-week workshop series that included weekly nutrition education classes. MAIN OUTCOME MEASURE Diet quality was assessed by the Rate Your Plate questionnaire. ANALYSIS Repeated measures ANOVA was used to compare differences between the experimental and control groups. A Wilcoxon signed rank test was conducted to test for significant shifts in categorization pre- and postprogram. RESULTS There was a significant change in diet quality categorization after participating in the workshops (P < .001, effect size 0.39). No changes were found in the control group. CONCLUSIONS AND IMPLICATIONS Abriendo Caminos was effective at increasing the diet quality of Hispanic mothers who participated the most in the program. More research is needed in this at-risk population to determine the relationships among nutrition knowledge, diet quality, and achievement of healthy weight.
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Affiliation(s)
- Amber J Hammons
- Department of Child and Family Science, California State University, Fresno, CA.
| | - Bridget A Hannon
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, IL
| | - Margarita Teran-Garcia
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, IL; Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign, IL; University of Illinois Extension, University of Illinois, Urbana-Champaign, IL; Family Resiliency Center, University of Illinois, Urbana-Champaign, IL
| | - Maribel Barragan
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, IL
| | - Elizabeth Villegas
- Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign, IL
| | - Angela Wiley
- Department of Human Development and Family Studies, Auburn University, Auburn, AL
| | - Barbara Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign, IL; Family Resiliency Center, University of Illinois, Urbana-Champaign, IL
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Roscoe CMP, James RS, Duncan MJ. Accelerometer-Based Physical Activity Levels Differ between Week and Weekend Days in British Preschool Children. J Funct Morphol Kinesiol 2019; 4:jfmk4030065. [PMID: 33467380 PMCID: PMC7739425 DOI: 10.3390/jfmk4030065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 09/07/2019] [Indexed: 11/16/2022] Open
Abstract
Participation in physical activity (PA) is fundamental to children's future health. Studies examining the temporal pattern of PA between weekdays and weekends in British preschool children are lacking. Therefore, the aim of this study was to compare PA levels between week and weekend days for UK preschool children, using objective measurements. One hundred and eighty-five preschool children (99 boys, 86 girls, aged 4-5 years), from central England wore a triaxial accelerometer (GENEActiv) for 4 days to determine PA. The time (min) and percentage (%) of time spent in light, moderate and vigorous PA (MVPA) was determined using specific cut-points for counts per minute related to 3-5 year olds. Of the sample, none of the children met the UK recommended 180 min or more of PA per day. A significant difference (P < 0.05) was observed between the amount of time that preschool children spent in sedentary behaviours on weekdays (91.9%) compared to weekend days (96.9%). During weekdays and weekend days, 6.3% and 2.0% of time was spent in MVPA, respectively. Therefore, a substantial proportion of British preschool children's day is spent in sedentary behaviours, with less MVPA accrued during the weekend. Regular engagement during the weekdays provides opportunities to accrue PA, which may not be present on weekend days.
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Affiliation(s)
- Clare M. P. Roscoe
- Human Sciences Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK
- Correspondence: ; Tel.: +44-1332-591284
| | - Rob S. James
- Centre for Applied Biological and Exercise Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK; (R.S.J.); (M.J.D.)
| | - Michael J. Duncan
- Centre for Applied Biological and Exercise Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK; (R.S.J.); (M.J.D.)
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Fonseca MJ, Santos AC, Barros H. Different levels of cardiometabolic indicators in multiple vs. singleton children. BMC Pediatr 2019; 19:331. [PMID: 31510947 PMCID: PMC6737661 DOI: 10.1186/s12887-019-1707-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 09/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to compare cardiometabolic indicators in singletons and multiples at age 7 and explore the birthweight mediation effect. METHODS We studied 5431 singletons and 103 sets of multiples from Generation XXI birth cohort. Anthropometric measurements, body composition, and fasting blood samples were obtained. Age- and sex-specific z-scores were calculated (additionally height-specific for blood pressure). Adjusted regression coefficients and respective 95% confidence intervals [β (95%CI)] were computed using path analysis. RESULTS Multiples had lower weight [- 0.419 (- 0.616;-0.223)], height [- 0.404 (- 0.594;-0.213)], BMI [- 0.470 (- 0.705;-0.234)], fat mass index [- 0.359 (- 0.565;-0.152)], waist circumference [- 0.342 (- 0.537;-0.147)], and waist-to-height ratio [- 0.165 (- 0.326;-0.003)] z-scores. These results were explained by the indirect effect via birthweight, which was also negative and significant for all the aforementioned cardiometabolic indicators, while no direct effect was present. There were also significant indirect effects regarding fat-free mass index, glucose, insulin, and blood pressure, though the total effects were not significant, due to the balance between direct and indirect effects. The only significant direct effect was regarding diastolic blood pressure [- 0.165 (- 0.302;-0.028)]. CONCLUSIONS At age 7, multiples presented better cardiometabolic indicators explained by lower weight at birth, except for the lower blood pressure which was independent of an effect via birthweight.
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Affiliation(s)
- Maria João Fonseca
- ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas n° 135, 4050-600, Porto, Portugal.
| | - Ana Cristina Santos
- ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas n° 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Henrique Barros
- ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas n° 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
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Miguet M, Fearnbach NS, Metz L, Khammassi M, Julian V, Cardenoux C, Pereira B, Boirie Y, Duclos M, Thivel D. Effect of HIIT versus MICT on body composition and energy intake in dietary restrained and unrestrained adolescents with obesity. Appl Physiol Nutr Metab 2019; 45:437-445. [PMID: 31505120 DOI: 10.1139/apnm-2019-0160] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
High-intensity interval training (HIIT) has been suggested as an effective alternative to traditional moderate-intensity continuous training (MICT) that can yield improvements in a variety of health outcomes. Yet, despite the urgent need to find effective strategies for the treatment of pediatric obesity, only a few studies have addressed the impact of HIIT on eating behaviors and body composition in this population. This study aimed to compare the effect of HIIT versus MICT on eating behaviors in adolescents with obesity and to assess if the participants' baseline dietary status is associated with the success of the intervention. Forty-three adolescents with obesity were randomly assigned to a 16-week MICT or HIIT intervention. Body composition and 24-h ad libitum energy intake were assessed at baseline and at the end of the program. Restrained eating, emotional eating, and external eating were assessed using the Dutch Eating Behavior Questionnaire at baseline. Both interventions led to significant weight, body mass index (BMI), and fat mass percentage (FM%) reductions, with better improvements in FM% in the HIIT group; whereas 24-h ad libitum energy intake increased to a similar extent in both groups. HIIT provides better body composition improvements over MICT, despite a similar increase in energy intake. Restrained eaters experienced less weight loss and smaller BMI reduction compared with unrestrained eaters; higher baseline cognitively restrained adolescents showed a greater increase of their ad libitum energy intake. Novelty HIIT favors better body composition improvements compared with MICT. Both MICT and HIIT increased ad libitum energy intake in adolescents with obesity. Weight loss achievement is better among unrestrained eaters.
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Affiliation(s)
- Maud Miguet
- Laboratory of Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, 63171 Aubière, France
| | - Nicole S Fearnbach
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA
| | - Lore Metz
- Laboratory of Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, 63171 Aubière, France
| | - Marwa Khammassi
- Laboratory of Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, 63171 Aubière, France
| | - Valérie Julian
- Department of Sport Medicine and Functionnal Explorations, University Hospital of Clermont-Ferrand, 63000, France
| | - Charlotte Cardenoux
- Childhood Obesity Department, Romagnat Pediatric Medical Center, 63540 Romagnat, France
| | - Bruno Pereira
- Délégation à la Recherche Clinique et à l'Innovation (DRCI), Clermont-Ferrand, 63000, France
| | - Yves Boirie
- Centre hospitalier universitaire (CHU), Clermont-Ferrand, 63000, France
| | - Martine Duclos
- Centre hospitalier universitaire (CHU), Clermont-Ferrand, 63000, France
| | - David Thivel
- Laboratory of Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, 63171 Aubière, France
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42
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Zhang T, Whelton PK, Xi B, Krousel-Wood M, Bazzano L, He J, Chen W, Li S. Rate of change in body mass index at different ages during childhood and adult obesity risk. Pediatr Obes 2019; 14:e12513. [PMID: 30702812 PMCID: PMC6684349 DOI: 10.1111/ijpo.12513] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/05/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Childhood body mass index (BMI) predicts adult obesity. How growth trajectories during childhood relate to adult obesity risk is not well defined. OBJECTIVE We aimed to characterize BMI growth trajectories from childhood to midlife and to examine the associations between BMI growth rates at childhood age points and adult obesity risk. METHODS The longitudinal study included 2732 participants with repeated BMI measurements from childhood (4-19 y) to adulthood (20-51 y). A random-effects model was used to construct BMI growth curves by race and sex. Model-estimated levels and linear growth rates of BMI were linked to adult obesity in separate multivariable logistic regression models at individual childhood age points. RESULTS BMI followed cubic growth curves. Childhood BMI linear slope estimates were higher in adults with obesity than in adults without obesity (P < 0.001). The association between childhood BMI growth rate and adult obesity was significantly higher in puberty and postpuberty (12-19 y) than in early childhood (4-11 y) with a peak at age 14 (odds ratio = 3.1 and 95% confidence interval, 2.7-3.5). CONCLUSIONS Rates of change in BMI at different childhood ages are differentially associated with adult obesity. Puberty and postpuberty are crucial periods for the development of obesity in later life.
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Affiliation(s)
- Tao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Paul K. Whelton
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Bo Xi
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Marie Krousel-Wood
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA,Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA,Ochsner Health System, New Orleans, LA, USA
| | - Lydia Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Wei Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Shengxu Li
- Children’s Minnesota Research Institute, Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN
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Robson SM, Ziegler ML, McCullough MB, Stough CO, Zion C, Simon SL, Ittenbach RF, Stark LJ. Changes in diet quality and home food environment in preschool children following weight management. Int J Behav Nutr Phys Act 2019; 16:16. [PMID: 30717746 PMCID: PMC6360745 DOI: 10.1186/s12966-019-0777-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 01/30/2019] [Indexed: 01/21/2023] Open
Abstract
Background Family-based obesity treatment interventions can successfully reduce energy intake in preschoolers. An implicit goal of obesity treatment interventions is to improve diet quality, but diet quality has been less examined as a treatment outcome in studies of preschoolers. The purpose of this study was to conduct a secondary analysis comparing the change in diet quality and home food environment in preschoolers assigned to a behavioral family-based obesity intervention (LAUNCH), motivational interviewing (MI) condition, or standard care (STC) condition. Methods Three 24-h dietary recalls were completed at baseline and 6-months and were analyzed using NDS-R software; diet quality was assessed using the Healthy Eating Index-2010 (HEI-2010). Availability of foods and beverages in the home was assessed through direct observation using the Home Health Environment tool that classifies foods and beverages as ‘red’ or ‘green’ based upon fat and sugar content. Repeated measures linear mixed effects models were used to examine changes in diet quality and home food environment between conditions (LAUNCH, MI, STC). Results At 6-months, preschoolers in the LAUNCH condition had a higher HEI-2010 total score (62.8 ± 13.7) compared to preschoolers in the MI (54.7 ± 13.4, P = 0.022) and STC (55.8 ± 11.6, P = 0.046) conditions. Regarding the home food environment, families in LAUNCH had significantly less ‘red’ foods in their home at 6-months (12.5 ± 3.4 ‘red’ foods) compared to families in MI (14.0 ± 3.7 ‘red’ foods, P = 0.030), and STC (14.3 ± 3.4 ‘red’ foods, P = 0.006). There were no statistically significant differences across home food environments for number of ‘green’ foods. Conclusion Family-based obesity treatment interventions for preschoolers can improve overall diet quality and alter the home food environment through reductions in ‘red’ foods. Trial registration Clinicaltrials.gov, NCT01546727. Registered March 7, 2012.
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Affiliation(s)
- Shannon M Robson
- Department of Behavioral Health and Nutrition, University of Delaware, 26 N College Avenue, Newark, DE, 19716, USA.
| | - Melissa L Ziegler
- Biostatistics Core, College of Health Sciences, University of Delaware, 540 S. College Avenue, Newark, DE, 19713, USA
| | - Mary Beth McCullough
- Psychology Department, Suffolk University, 73 Tremont Street, Boston, MA, 02108, USA
| | - Cathleen Odar Stough
- Department of Psychology, University of Cincinnati, 47 W Corry Blvd Edwards 1 Bldg Suite 4130, P.O. Box 210376, Cincinnati, OH, 45219, USA
| | - Cynthia Zion
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 3015, Cincinnati, OH, 45229, USA
| | - Stacey L Simon
- Department of Pediatrics, Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13123 E 16th Ave B395 Aurora, Aurora, CO, 80045, USA
| | - Richard F Ittenbach
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 5041, Cincinnati, OH, 45229, USA
| | - Lori J Stark
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 3015, Cincinnati, OH, 45229, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA
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Hazrati S, Khan F, Huddleston K, De La Cruz F, Deeken JF, Fuller A, Wong WSW, Niederhuber JE, Hourigan SK. Clinical and social factors associated with excess weight in Hispanic and non-Hispanic White children. Pediatr Res 2019; 85:256-261. [PMID: 30643189 DOI: 10.1038/s41390-018-0264-9] [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: 08/14/2018] [Revised: 11/01/2018] [Accepted: 11/05/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Hispanic children are disproportionately affected by obesity, with this disparity starting at a young age, and there is a paucity of data comparing factors associated with excess weight in the first year of life in Hispanic vs. non-Hispanic populations. METHODS Excess weight was defined as weight-for-length ≥95th percentile. The associations of potential risk factors were compared by ethnicity stratification. RESULTS Of the 1009 children, 302 (30.0%) were Hispanic and 707 (70.0%) were non-Hispanic White. The rate of excess weight was 30.1% and 13.6% among Hispanic and non-Hispanic White children, respectively. Factors associated with excess weight for non-Hispanic White children were higher than recommended weight gain during pregnancy (odds ratio (OR) 1.8 (1.2-3.1)), higher paternal body mass index (BMI) (OR 1.1 (1.02-1.15)), higher birth weight (OR 1.001 (1.001-1.002)), and lower breast milk feedings at 6 months (OR 0.98 (0.96-0.98)). Factors associated with excess weight for Hispanic children were lower maternal education (OR 2.37 (1.1-4.5)) and lower breast milk feedings at 6 months (OR 0.98 (0.96-0.99)). CONCLUSION There are differential risk factors associated with excess weight at 12 months between Hispanic and non-Hispanic White children. Identification of differential factors in different ethnicities may allow for more targeted anticipatory guidance reduce obesity in at-risk populations.
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Affiliation(s)
- Sahel Hazrati
- Inova Translational Medicine Institute, Falls Church, VA, USA.
| | - Farah Khan
- Inova Children's Hospital, Falls Church, VA, USA
| | | | | | - John F Deeken
- Inova Translational Medicine Institute, Falls Church, VA, USA
| | - Alma Fuller
- Inova Translational Medicine Institute, Falls Church, VA, USA
| | - Wendy S W Wong
- Inova Translational Medicine Institute, Falls Church, VA, USA
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45
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Kelly B, West J, Yang TC, Mason D, Hasan T, Wright J. The association between body mass index, primary healthcare use and morbidity in early childhood: findings from the Born In Bradford cohort study. Public Health 2019; 167:21-27. [PMID: 30610958 DOI: 10.1016/j.puhe.2018.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/01/2018] [Accepted: 10/25/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The objective of the article was to examine the association between body mass index (BMI), health and general practice (GP) healthcare use in early childhood. STUDY DESIGN This study is a prospective cohort study. METHODS Multivariate Poisson and logistic regression models were used to explore the association between BMI and health outcomes using data from the Born In Bradford cohort study, linked to routine data capturing objective measures of BMI at age 5 years, alongside GP appointment rates, GP prescriptions and specific morbidities in the subsequent 3-year period. RESULTS Compared with healthy weight, children who were obese at the age of 5 years had significantly higher rates of GP appointments (incident rate ratio 1.14, 95% confidence interval [CI]: 1.06-1.23), GP prescriptions (incident rate ratio 1.15, 95% CI: 1.04-1.27), asthma (odds ratio 1.46, 95% CI: 1.21-1.77), sleep apnoea (odds ratio 2.50, 95% CI: 1.36-4.58), infections (incident rate ratio 1.19, 95% CI: 1.08-1.30), antibiotic prescriptions (incident rate ratio 1.25, 95% CI: 1.10-1.42) and accidents (incident rate ratio 1.20, 95% CI: 1.01-1.42) in the subsequent 3 years. Underweight children were found to have higher rates of GP appointments (incident rate ratio 1.25, 95% CI: 1.04-1.52), but there were no differences between overweight and healthy weight children. CONCLUSIONS Childhood obesity was found to be associated with increased primary healthcare use and a range of poorer health outcomes at the age of 8 years, underlining the importance of reducing childhood obesity in early childhood.
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Affiliation(s)
- B Kelly
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
| | - J West
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - T C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - D Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - T Hasan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK; Department of Health Sciences, University of York, York, UK
| | - J Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Reesor L, Moreno JP, Johnston CA, Hernandez DC. School-Based Weight Management Program Curbs Summer Weight Gain Among Low-Income Hispanic Middle School Students. THE JOURNAL OF SCHOOL HEALTH 2019; 89:59-67. [PMID: 30506696 PMCID: PMC9912972 DOI: 10.1111/josh.12713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Research shows that elementary students gain weight over the summer. It is unknown if these findings apply to Hispanic adolescents. We evaluated school and summer standardized body mass index (zBMI) changes in Hispanic middle school students. METHODS Hispanic middle school students were randomly assigned to a weight management program (N = 230) or control condition (N = 195). Paired sample t-tests compared zBMI change scores during the school year versus summer when not enrolled in a weight management program (eg, control group). We used 2 × 2 repeated measures analysis of variances to determine program group differences in zBMI scores across school versus summer periods separately for normal and overweight/obese students. RESULTS In the control group, students' zBMI change scores decreased during the school year, but increased during summer for both normal weight and overweight/obese students. Program effects on zBMI indicated school year decreases and summer increases for both normal and overweight/obese students. However, zBMI scores did not differ by program status for normal weight students. Overweight/obese students in the program compared to the control group increased zBMI to a lesser extent over the summer. CONCLUSION For all students, zBMI increased during the summer. A school-based weight management program protected overweight/obese students against potentially greater summer weight gain.
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Affiliation(s)
- Layton Reesor
- Department of Health and Human Performance, University of Houston, 3875 Holman St., Rm 104 Garrison, Houston, TX 77204-6015
| | - Jennette P Moreno
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, 3875 Holman St., Rm 104 Garrison, Houston, TX 77204-6015
| | - Daphne C Hernandez
- Department of Health and Human Performance, HEALTH Research Institute, University of Houston, 3875 Holman St., Rm 104 Garrison, Houston, TX 77204-6015
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Patro Golab B, Voerman E, van der Lugt A, Santos S, Jaddoe VWV. Subcutaneous fat mass in infancy and abdominal, pericardial and liver fat assessed by Magnetic Resonance Imaging at the age of 10 years. Int J Obes (Lond) 2018; 43:392-401. [PMID: 30568271 DOI: 10.1038/s41366-018-0287-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 10/19/2018] [Accepted: 11/29/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND/OBJECTIVES Fat mass development in infancy contributes to later adiposity, but its relation to ectopic fat depots is unknown. We examined the associations of infant subcutaneous fat with childhood general and organ-specific fat. SUBJECTS/METHODS Among 593 children from a population-based prospective cohort study, we obtained total subcutaneous fat mass (as sum of biceps, triceps, suprailiacal, and subscapular skinfolds thickness), central-to-total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thickness/total subcutaneous fat) at 1.5, 6 and 24 months of age. At 10 years, we assessed BMI, fat mass index (FMI) based on total body fat by dual-energy X-ray absorptiometry, and abdominal subcutaneous, visceral and pericardial fat mass indices, and liver fat fraction by Magnetic Resonance Imaging. RESULTS A higher central-to-total subcutaneous fat ratio at 1.5 months only and higher total subcutaneous fat at 6 and 24 months were associated with higher BMI, FMI and subcutaneous fat mass index at 10 years. The observed associations were the strongest between total subcutaneous fat at 24 months and these childhood outcomes (difference per 1-SDS increase in total subcutaneous fat: 0.15 SDS (95% Confidence Interval (CI) 0.08, 0.23), 0.17 SDS (95% CI 0.10, 0.24), 0.16 SDS (95% CI 0.08, 0.23) for BMI, FMI and childhood subcutaneous fat mass index, respectively). Infant subcutaneous fat measures at any time point were not associated with visceral and pericardial fat mass indices, and liver fat fraction at 10 years. CONCLUSIONS Our results suggest that infant subcutaneous fat is associated with later childhood abdominal subcutaneous fat and general adiposity, but not with other organ-specific fat depots.
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Affiliation(s)
- Bernadeta Patro Golab
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Ellis Voerman
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Aad van der Lugt
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands. .,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands. .,Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
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48
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Miguet M, Masurier J, Chaput JP, Pereira B, Lambert C, Dâmaso AR, Courteix D, Duclos M, Boirie Y, Thivel D. Cognitive restriction accentuates the increased energy intake response to a 10-month multidisciplinary weight loss program in adolescents with obesity. Appetite 2018; 134:125-134. [PMID: 30576727 DOI: 10.1016/j.appet.2018.12.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/19/2018] [Accepted: 12/13/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Multidisciplinary interventions have shown some merits in weight reduction strategies in youth, however, their impact on subsequent daily energy intake remains largely unknown. The aim of the present study was to evaluate the nutritional responses to a 10-month multidisciplinary intervention among adolescents with obesity, in relation to their eating behavior characteristics. METHODS Thirty-five adolescents (mean age: 13.4 ± 1.2 years) with obesity took part in a 10-month residential multidisciplinary weight loss program. Anthropometric measurements, body composition (dual-energy X-ray absorptiometry), 24-h ad libitum energy intake (weighted), eating behaviors (Dutch Eating Behavior Questionnaire) and appetite sensations (Visual Analogue Scales) were assessed on three occasions: at their arrival in the institution (T0), after 5 months (T1), and at the end of the 10-month program (T2). RESULTS The mean weight loss reached 11% of the adolescents' initial body weight, with an important inter-individual variability (-25% to +3% of their initial body weight). Results revealed sex differences change, with boys showing a higher decrease in fat mass percent and increase in fat-free mass compared with girls. Weight loss was accompanied by a significant decrease in emotional (-8.3%, p < 0.05) and external (-14.8%, p < 0.001) eating scores and a significant increase in 24-h ad libitum energy intake (+246 kcal, p < 0.001). The observed subsequent increased 24-h ad libitum energy intake at T2 compared to T0 was significantly higher in cognitively restrained eaters (+492 kcal) compared to unrestrained eaters (+115 kcal, p = 0,015). Dietary restraint score at baseline was inversely correlated with the percentage of weight loss (r = -0.44, p = 0.010). CONCLUSION A 10-month multidisciplinary weight loss intervention induced an increase in 24-h ad libitum energy intake compared to baseline, especially in cognitively restrained eaters. Moreover, initially cognitively restrained eaters tended to lose less body weight compared to unrestrained ones. These findings suggest that cognitive restriction may be a useful eating behavior characteristic to consider as a screening tool for identifying adverse responders to weight loss interventions in youth.
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Affiliation(s)
- M Miguet
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France.
| | - J Masurier
- UGECAM Nutrition Obesity Ambulatory Hospital, Clermont-Ferrand, France
| | - J P Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - B Pereira
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - C Lambert
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - A R Dâmaso
- Post Graduate Program of Nutrition, Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862-Vila Clementino, São Paulo, SP 04020-050, Brazil
| | - D Courteix
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France
| | - M Duclos
- CRNH-Auvergne, Clermont-Ferrand, France; Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France; INRA, UMR 1019, Clermont-Ferrand, France; University Clermont 1, UFR Medicine, Clermont-Ferrand, France
| | - Y Boirie
- CRNH-Auvergne, Clermont-Ferrand, France; INRA, UMR 1019, Clermont-Ferrand, France; University Clermont 1, UFR Medicine, Clermont-Ferrand, France; Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France
| | - D Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France
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Akhabue E, Perak AM, Chan C, Greenland P, Allen NB. Racial Differences in Rates of Change of Childhood Body Mass Index and Blood Pressure Percentiles. J Pediatr 2018; 202:98-105.e6. [PMID: 30177351 PMCID: PMC6203603 DOI: 10.1016/j.jpeds.2018.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/18/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess whether racial differences in rates of change in body mass index (BMI) and blood pressure (BP) percentiles emerge during distinct periods of childhood. STUDY DESIGN In this retrospective cohort study, we included children aged 5-20 years who received regular outpatient care at a large academic medical center between January 1996 and April 2016. BMI was expressed as age- and sex-specific percentiles and BP as age-, sex-, and height-specific percentiles. Linear mixed models incorporating linear spline functions with 2 breakpoints at 9 and 12 years of age were used to estimate the changes in BMI and BP percentiles over time during age periods: <9, 9-<12, and >12 years of age. RESULTS Among 5703 children (24.8% black, 10.1% Hispanic), Hispanic females had an increased rate of change in BMI percentile per year relative to white females during ages 5-9 years (+2.94%; 95% CI, 0.24-5.64; P = .033). Black and Hispanic males also had an increased rate of change in BMI percentile per year relative to white males that occurred from ages 5-9 (+2.35% [95% CI, 0.76-3.94; P = .004]; +2.63% [95% CI, 0.31-4.95; P = .026], respectively). There were no significant racial differences in the rate of change of BP percentiles, although black females had higher hypertension rates compared with white females (10.0% vs 5.7%; P < .001). CONCLUSIONS Childhood patterns in BMI percentiles differ by race. Racial differences in rates of change in BMI percentile emerge early in childhood. Further study of early patterns could help to identify critical periods during childhood where disparities begin to emerge.
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Affiliation(s)
- Ehimare Akhabue
- Division of Cardiovascular Diseases and Hypertension, Rutgers University Robert Wood Johnson Medical School, New Brunswick, NJ.
| | - Amanda M Perak
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Cheeling Chan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
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An R, Wang L, Xue H, Wang Y. Projecting the impact of a nationwide school plain water access intervention on childhood obesity: a cost-benefit analysis. Pediatr Obes 2018; 13:715-723. [PMID: 28941217 PMCID: PMC6062486 DOI: 10.1111/ijpo.12236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/19/2017] [Accepted: 06/01/2017] [Indexed: 01/30/2023]
Abstract
OBJECTIVE This study aimed to project the societal cost and benefit of an expansion of a water access intervention that promotes lunchtime plain water consumption by placing water dispensers in New York school cafeterias to all schools nationwide. METHODS A decision model was constructed to simulate two events under Markov chain processes - placing water dispensers at lunchtimes in school cafeterias nationwide vs. no action. The incremental cost pertained to water dispenser purchase and maintenance, whereas the incremental benefit was resulted from cases of childhood overweight/obesity prevented and corresponding lifetime direct (medical) and indirect costs saved. RESULTS Based on the decision model, the estimated incremental cost of the school-based water access intervention is $18 per student, and the corresponding incremental benefit is $192, resulting in a net benefit of $174 per student. Subgroup analysis estimates the net benefit per student to be $199 and $149 among boys and girls, respectively. Nationwide adoption of the intervention would prevent 0.57 million cases of childhood overweight, resulting in a lifetime cost saving totalling $13.1 billion. The estimated total cost saved per dollar spent was $14.5. CONCLUSION The New York school-based water access intervention, if adopted nationwide, may have a considerably favourable benefit-cost portfolio.
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Affiliation(s)
- Ruopeng An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA,Corresponding author contact information: Ruopeng An, 1206 South 4 Street, Champaign IL 61820, USA, Phone: 1-217-244-0966, Fax: 1-217-333-2766,
| | - Liang Wang
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, USA
| | - Hong Xue
- College of Health, Ball State University, Muncie, IN, USA
| | - Youfa Wang
- College of Health, Ball State University, Muncie, IN, USA
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