1
|
Santibáñez Cárcamo C, Silva Gómez R. [Factors associated with the development of malnutrition due to excess in children]. NUTR HOSP 2024; 41:554-559. [PMID: 37929834 DOI: 10.20960/nh.04861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Introduction Introduction: malnutrition due to excess is a serious public health problem currently affecting 53 % of children and adolescents in Chile. The early identification of associated factors is key in prevention and necessary to guide interventions from early stages of life. Objective: to identify factors associated with the development of malnutrition due to excess in three-year-old children under control at Ancora Family Health. Methods: a case-control study was carried out in three Ancora Family Health Centers located in the communes of La Pintana and Puente Alto; it included 133 children and their mothers. Factors dependent on the child and the mother were analyzed and their importance in the development of malnutrition due to excess was determined. Results: logistic regression showed maternal smoking during pregnancy as a risk factor (OR = 4.065, 95 % CI: 1.119-14.770, p = 0.033) and as protective factors birth weight < 4,000 g (OR = 0.112, 95 % CI: 0.026-0.483, p = 0.003) and weight gain during the first year of life < 6.4 kg in women and < 6.9 kg in men (OR = 0.060, 95 % CI: 0.017-0.210, p = 0.000). Conclusions: the most important risk factor was maternal smoking and the protective factors were birth weight and weight gain in the first year. Health programs and public policies should focus on modifiable factors such as smoking during pregnancy and adequate weight gain in the first year of life.
Collapse
|
2
|
Aronsen-Kongerud H, Bastien S, Klepp KI. The centrality of food in Norwegian adolescents' life; a photo elicitation study among Norwegian youth. Health Promot Int 2024; 39:daae043. [PMID: 38809235 PMCID: PMC11135210 DOI: 10.1093/heapro/daae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
The purpose of the study was to explore how adolescents from a high school in Viken county define and interact with food systems in their immediate environments to understand if and how health and sustainability affect their food choices. A qualitative case study design and a participatory approach were employed. Data were collected through photo elicitation combined with group interviews. Pictures were analyzed in collaboration with participants, and the group interview through systematic text condensation. Results indicate that adolescents perceive food systems as being a substantial part of their everyday life, that they care about their health and that of the planet, and they wish to take sustainability and health into consideration when making food choices. Their food choices are affected by aspects such as family, friends, marketing, price, time, availability and accessibility. They perceive that their agency to influence their own diet and food systems is limited. Adolescents hold unique and important knowledge of their food-related behaviors and value their autonomy to make food choices. Future research and policies aiming to help adolescents make healthy and sustainable food choices should therefore actively include adolescents.
Collapse
Affiliation(s)
- Helene Aronsen-Kongerud
- Department of Public Health Sciences, Norwegian University of Life Sciences, Post Box 5003, 1432 Ås, Norway
| | - Sheri Bastien
- Department of Public Health Sciences, Norwegian University of Life Sciences, Post Box 5003, 1432 Ås, Norway
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW Calgary, Alberta, T2N 4Z6 Canada
| | - Knut-Inge Klepp
- Department of Nutrition, Faculty of Medicine, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
| |
Collapse
|
3
|
França C, Ashraf S, Santos F, Dionísio M, Ihle A, Marques A, de Maio Nascimento M, Gouveia ÉR. Estimated Energy Expenditure in Youth While Playing Active Video Games: A Systematic Review. Sports (Basel) 2024; 12:39. [PMID: 38393259 PMCID: PMC10892794 DOI: 10.3390/sports12020039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/25/2024] Open
Abstract
Sedentary behavior and inadequate energy expenditure are serious global public health concerns among youngsters. The exponential growth in technology emerges as a valuable opportunity to foster physical activity, particularly through active video games. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in PubMed, Web of Science, Cochrane, and Scopus to provide a comprehensive view of the literature on energy expenditure levels among adolescents while playing active video games. Among the 574 manuscripts identified at the first screening stage, 23 were retained for analysis. Ten studies were characterized by longitudinal and thirteen by cross-sectional designs. The results showed that short-term active video games elicited energy expenditure values comparable to moderate-intensity physical activity (3-6 METs). However, in intervention programs (with at least six weeks) the results indicate no significant effects of active video games on youngsters' energy expenditure levels and physical activity profiles between baseline and follow-up assessments. Overall, active video games based on sports and dance were the most used, and boys tended to achieve higher energy expenditure than girls. The diversity of methods implemented limits comparing results and drawing generalized conclusions. However, considering its attractiveness to youth, active video games might emerge as a complementary tool to traditional physical activities promoted in schools and local communities. Details regarding gender differences and contradictory results of longitudinal approaches should be considered in future research based on standardized methods.
Collapse
Affiliation(s)
- Cíntia França
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (C.F.); (S.A.); (F.S.)
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-801 Vila Real, Portugal
| | - Sadaf Ashraf
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (C.F.); (S.A.); (F.S.)
| | - Francisco Santos
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (C.F.); (S.A.); (F.S.)
- Faculty of Sport Sciences and Physical Education, CIDAF, University of Coimbra, 3040-248 Coimbra, Portugal
| | - Mara Dionísio
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Faculty of Exact Sciences and Engineering, University of Madeira, 9020-105 Funchal, Portugal
| | - Andreas Ihle
- Department of Psychology, University of Geneva, 1227 Carouge, Switzerland;
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1227 Carouge, Switzerland
- Swiss Center of Expertise in Life Course Research LIVES, 1227 Carouge, Switzerland; (A.M.); (M.d.M.N.)
| | - Adilson Marques
- Swiss Center of Expertise in Life Course Research LIVES, 1227 Carouge, Switzerland; (A.M.); (M.d.M.N.)
- CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, 1499-002 Lisboa, Portugal
- Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, 1649-020 Lisbon, Portugal
| | - Marcelo de Maio Nascimento
- Swiss Center of Expertise in Life Course Research LIVES, 1227 Carouge, Switzerland; (A.M.); (M.d.M.N.)
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina 56304-917, Brazil
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (C.F.); (S.A.); (F.S.)
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Swiss Center of Expertise in Life Course Research LIVES, 1227 Carouge, Switzerland; (A.M.); (M.d.M.N.)
| |
Collapse
|
4
|
Newson L, Abayomi J. Reframing interventions for optimal child nutrition and childhood obesity: the importance of considering psychological factors. Proc Nutr Soc 2024:1-12. [PMID: 38205619 DOI: 10.1017/s0029665124000028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
This review aims to emphasise the impact of poor nutrition on children's health and psychological well-being, urging those involved in childhood obesity or nutrition services to broaden their intervention approach. Poor nutrition and childhood obesity affect physical and psychological health. The stress of living with obesity further impacts quality of life, well-being and self-esteem. Children living with obesity may experience adverse childhood events and stress, and young people are able to recall the impact of psychosocial issues such as experiencing stigma and discrimination. Food is often a coping mechanism for managing negative emotions, perpetuating cycles of emotional coping and unhealthy eating behaviours. UK guidelines recommend family-based, multi-component weight management interventions for children living with obesity. Interventions mainly target health behaviours and utilise behaviour change techniques attempting to directly improve diet and physical activity as behavioural outcomes. Whilst these interventions may show some improvements in psychological well-being, there is limited consideration or understanding of the underlying mechanisms of action which indirectly influence engagement and the sustainability of the behaviour change. Lack of attention and inclusion of psychosocial variables in intervention implementation may help explain the variable effectiveness reported across childhood obesity interventions. In conclusion, enhancing the effectiveness of childhood obesity interventions requires a broader approach that fully incorporates psychosocial factors. Those responsible for commissioning, designing and implementing these interventions should adopt a holistic approach that addresses psychological and emotional needs while incorporating underlying mechanisms of action. This shift in focus could result in more sustainable and comprehensive treatment for childhood obesity.
Collapse
Affiliation(s)
- Lisa Newson
- School of Psychology, Research Centre for Brain and Behaviour, Faculty of Health, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Julie Abayomi
- Faculty of Health, Social Care and Medicine, Edgehill University, Liverpool, UK
| |
Collapse
|
5
|
Fiore G, Scapaticci S, Neri CR, Azaryah H, Escudero-Marín M, Pascuzzi MC, La Mendola A, Mameli C, Chiarelli F, Campoy C, Zuccotti G, Verduci E. Chrononutrition and metabolic health in children and adolescents: a systematic review and meta-analysis. Nutr Rev 2023:nuad122. [PMID: 37944081 DOI: 10.1093/nutrit/nuad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
CONTEXT Obesity has emerged as a global health issue for the pediatric population, increasing the need to investigate physiopathological aspects to prevent the appearance of its cardiometabolic complications. Chrononutrition is a field of research in nutritional sciences that investigates the health impact of 3 different dimensions of feeding behavior: regularity of meals, frequency, and timing of food intake. OBJECTIVE We carried out a systematic review and meta-analysis to investigate the association between chrononutrition in children and adolescents and the risk of overweight/obesity or a cluster of metabolic abnormalities related to glucose and lipid metabolism, blood pressure, and cardiovascular disease risk. DATA EXTRACTION A literature search was performed using PubMed, EMBASE, and The Cochrane Library for relevant articles published before August 2022. DATA ANALYSIS A total of 64 articles were included in the narrative synthesis (47 cross-sectional and 17 cohort studies), while 16 studies were included in the meta-analysis. Meta-analysis showed that non-daily breakfast consumers (≤6 d/wk) had a higher risk of overweight/obesity (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.08-1.82] compared with daily breakfast eaters (7 d/wk). Similarly, irregular breakfast consumption (only 0-to-3 times/wk) increased the risk of abdominal obesity (waist-to-height ratio ≥ 0.5) compared with regular consumption (5-to-7 times/wk) (OR, 1.38; 95% CI, 1.26-1.49). There was evidence to suggest that a regular frequency of meal consumption (≥4 times/d) is preventive against overweight/obesity development compared with fewer meals (≤3 times/d) (OR, 0.83; 95% CI, 0.70-0.97). In the narrative synthesis, snacking habits showed controversial results, while food timing was the most understudied dimension. CONCLUSION Overall, our data indicate a potential implication of chrononutrition in affecting pediatric metabolic health; however, the evidence of this association is limited and heterogeneous. Further prospective and intervention studies with a consistent approach to categorize the exposure are needed to elucidate the importance of chrononutrition for pediatric metabolic health.
Collapse
Affiliation(s)
- Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Serena Scapaticci
- Department of Pediatrics, University of Chieti "G. D'Annunzio", Chieti, Italy
| | - Costanza R Neri
- Department of Pediatrics, University of Chieti "G. D'Annunzio", Chieti, Italy
| | - Hatim Azaryah
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Pediatric Research, Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Mireia Escudero-Marín
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Pediatric Research, Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs-GRANADA), San Cecilio University Hospital, Granada, Spain
- Neurosciences Institute Dr. Federico Oloriz, University of Granada, Granada, Spain
| | - Martina C Pascuzzi
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Alice La Mendola
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Chiara Mameli
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti "G. D'Annunzio", Chieti, Italy
| | - Cristina Campoy
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Pediatric Research, Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs-GRANADA), San Cecilio University Hospital, Granada, Spain
- Neurosciences Institute Dr. Federico Oloriz, University of Granada, Granada, Spain
- Spanish Network of Biomedical Research in Epidemiology and Public Health (CIBERESP), Granada's Node, Institute of Health Carlos III, Madrid, Spain
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Elvira Verduci
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| |
Collapse
|
6
|
Jakobovich R, Berry EM, Levita A, Levin-Zamir D. Developing Healthy Lifestyle Behaviors in Early Age-An Intervention Study in Kindergartens. Nutrients 2023; 15:nu15112615. [PMID: 37299578 DOI: 10.3390/nu15112615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/21/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Childhood obesity prevention is a leading public health challenge requiring the adoption of healthy lifestyles at an early age. We examined how the kindergarten environment can promote eating sensibly, drinking water and becoming physically active. The effects of an intervention program among 42 Israeli kindergartens (1048 children, aged 4-6) whose teachers participated in a health education training program were compared to 32 kindergartens (842 children) whose teachers did not undergo this training program. An eight-month intervention program focused on knowledge/mathematical/logical/critical thinking, self-regulation/control acquisition, and sensible decision-making abilities. We hypothesized that nutrition and physical-exercise-oriented intervention programs, combining knowledge/mathematical logical thinking, would positively impact the quality of children's mid-morning snack and water consumption, their ability to express feelings following physical exercise, and the adoption of healthy lifestyles at home. The quality of mid-morning snacks and water consumption were observed in both groups pre- and post-intervention. Qualitative interviews documented children's subjective feelings following physical exercise. A significant improvement (p < 0.001) was observed in the mid-morning snacks composition and in water drinking habits in the intervention group; 80% of children offered a physiological explanation regarding energy expenditure processes following intense physical exercise. In conclusion, kindergarten interventions implemented by trained teachers can promote adoption of health behaviors necessary for obesity prevention.
Collapse
Affiliation(s)
- Ronit Jakobovich
- Department of Health Promotion, School of Public Health, Tel Aviv University, Tel Aviv 6209804, Israel
| | - Elliot M Berry
- Department of Human Nutrition and Metabolism, Braun School of Public Health, Hebrew University Hadassah Medical School, Jerusalem 9103102, Israel
| | - Asia Levita
- Faculty of Science and Technology Education, Technion, Haifa 3498838, Israel
| | - Diane Levin-Zamir
- School of Public Health, University of Haifa, Haifa 3498838, Israel
- Department of Health Education and Promotion, Clalit Health Services, School of Public Health, University of Haifa, Tel Aviv 6209804, Israel
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Lattanzi G, Di Rosa C, Spiezia C, Sacco R, Cattafi S, Romano L, Benvenuto D, Fabris S, De Gara L, Khazrai YM. "Nutripiatto": A tool for nutritional education. A survey to assess dietary habits in preschool children. PLoS One 2023; 18:e0282748. [PMID: 36881589 PMCID: PMC9990952 DOI: 10.1371/journal.pone.0282748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
Childhood obesity is a global public health concern linked to metabolic and psychological comorbidities. There is growing evidence that children's lifestyle habits are shifting towards obesity, with dire consequences for their future well-being and healthcare costs. In this interventional study, we enrolled 115 children aged between 4-5 years (53% females and 47% males) and carried out nutrition education interventions to improve their dietary habits. We introduced "Nutripiatto", a visual plate icon and easy guide, which was used by the children during the study. We investigated the children's dietary habits using a Food Frequency Questionnaire at the beginning and end of the study, after one month of using "Nutripiatto". The results showed that the children significantly increased the portion sizes and frequency of vegetable consumption (P<0.001) and reduced the consumption of several junk foods such as French fries and crisps (P<0.001), reaching the recommended dietary allowances and frequency of consumption. Daily consumption of water also significantly increased, reaching the suggested amount of six glasses per day. Based on these results, "Nutripiatto" can be considered an effective visual guide and helpful tool to achieve small changes and empower families to make healthier food choices. It can also be considered an effective educational tool for nutritionists and healthcare professionals to improve children's dietary behavior.
Collapse
Affiliation(s)
- Greta Lattanzi
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, Rome, Italy
| | - Claudia Di Rosa
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, Rome, Italy
| | - Chiara Spiezia
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, Rome, Italy
| | - Roberto Sacco
- Unit of Child & Adolescent Neuropsychiatry, Campus Bio-Medico University of Rome, Rome, Italy
| | - Samanta Cattafi
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, Rome, Italy
| | - Leonardo Romano
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, Rome, Italy
| | - Domenico Benvenuto
- Unit of Medical Statistic and Molecular Epidemiology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Silvia Fabris
- Unit of Medical Statistic and Molecular Epidemiology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Laura De Gara
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, Rome, Italy
| | - Yeganeh Manon Khazrai
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, Rome, Italy
| |
Collapse
|
9
|
Saat JJEH, Naumann E, Fransen GAJ, Voss L, van der Velden K, Assendelft WJJ. Implementation of Combined Lifestyle Interventions for Children with Overweight or Obesity: Experiences of Healthcare Professionals in Multiple Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2156. [PMID: 36767530 PMCID: PMC9915371 DOI: 10.3390/ijerph20032156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND To counteract children with obesity, different protocols for combined lifestyle interventions (CLIs) are implemented by healthcare providers (HCPs). To understand the effects of CLI, we studied the implementation process, facilitators and barriers experienced by HCPs. METHODS A multiple case study design in which community-based CLIs (n = 4), implemented in a total of ten different communities, are conceptualized as a "case". Qualitative data were collected via group interviews among HCPs (n = 48) regarding their implementation protocol, their network involvement and the adoption of the CLI in a community. Transcripts were coded and analysed using ATLAS.ti. RESULTS Barriers were the absence of a proper protocol, the low emphasis on the construction of the network and difficulty in embedding the CLI into the community. Funding for these activities was lacking. Facilitating factors were the involvement of a coordinator and to have everyone's role regarding signalling, diagnosis, guidance and treatment clearly defined and protocolled. HCPs suggested adding certain professions to their team because they lacked expertise in parenting advice and providing mental support to children. CONCLUSIONS Carrying out and adapting the content of the CLI to the community was experienced as easier compared to the management of the organizational aspects of the CLI. For these aspects, separate funding is essential. In the future, mapping the characteristics of a community will help to clarify this influence on the implementation even better.
Collapse
Affiliation(s)
- Jenneke J. E. H. Saat
- Academic Collaborative Center AMPHI, Department of Primary and Community Care, ELG 117, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Research Group Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6503 GL Nijmegen, The Netherlands
- Department of Primary and Community Care, ELG 117, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Elke Naumann
- Research Group Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6503 GL Nijmegen, The Netherlands
| | - Gerdine A. J. Fransen
- Academic Collaborative Center AMPHI, Department of Primary and Community Care, ELG 117, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Department of Primary and Community Care, ELG 117, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Lieneke Voss
- Agrotechnology & Food Sciences Group, Chair Group Nutrition and Disease, Division of Human Nutrition and Health, Wageningen University, 6708 PB Wageningen, The Netherlands
| | - Koos van der Velden
- Academic Collaborative Center AMPHI, Department of Primary and Community Care, ELG 117, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Agrotechnology & Food Sciences Group, Chair Group Nutrition and Disease, Division of Human Nutrition and Health, Wageningen University, 6708 PB Wageningen, The Netherlands
| | - Willem J. J. Assendelft
- Department of Primary and Community Care, ELG 117, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| |
Collapse
|
10
|
Huang X, Huang Y, Hu B. Melatonin Treatment of Circadian Rhythm Sleep-Wake Disorder in Obese Children Affects the Brain-Derived Neurotrophic Factor Level. Neuropediatrics 2023. [PMID: 36634691 DOI: 10.1055/s-0042-1760368] [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] [Indexed: 01/14/2023]
Abstract
BACKGROUND Previous studies proved that the brain-derived neurotrophic factor (BDNF) is correlated with sleep regulation, yet how BDNF functions and reacts in the melatonin treatment of circadian rhythm sleep-wake disorder (CRSWD) among obese children remain enigmatic. Focusing on CRSWD in obese children, this study monitored their sleep efficiency and serum BDNF level changes during the treatment of melatonin. METHODS In total, 35 obese children diagnosed with CRSWD were included in this study and administrated melatonin (3 mg/night) for 3 months. Blood samples were collected 24 hours before and after the treatment (08:00, 12:00, 16:00, 20:00, 24:00, and 04:00). Subsequently, the plasma melatonin level and serum BDNF level were measured by enzyme-linked immunosorbent assay. Sleep parameters, including sleep quality, Pittsburgh Sleep Quality Index as well as melatonin and BDNF levels before and after treatment, were recorded to profile the effectiveness and safety of melatonin treatment. RESULTS Melatonin treatment increased plasma melatonin concentration and restored circadian rhythm. Besides, the serum BDNF level showed a significant increase, representing a strong positive correlation with melatonin concentration (p = 0.026). Patients experienced much-improved sleep efficiency (P < 0.001), with longer actual sleep time (P < 0.001), shorter sleep onset latency, and fewer awakenings after treatment (P < 0.001). Besides, melatonin was well tolerated by patients without producing severe side effects. CONCLUSION Melatonin treatment effectively improved CRSWD among obese children with their serum BDNF levels increased, indicating that BDNF is a key regulator in CRSWD in obese children. This study may offer theoretical support for melatonin treatment of CRSWD in obese children.
Collapse
Affiliation(s)
- Xuesong Huang
- Department of Pediatrics, Yichun People's Hospital, Yichun, Jiangxi, China
| | - Ying Huang
- Department of Pediatrics, Yichun People's Hospital, Yichun, Jiangxi, China
| | - Bing Hu
- Department of Pediatrics, Yichun People's Hospital, Yichun, Jiangxi, China
| |
Collapse
|
11
|
Domingos DS, Troster EJ, Vieira TCA. Content validation of a questionnaire to assess the knowledge of pediatricians, family, and community physicians on obesity. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022063. [PMID: 36921177 PMCID: PMC10013993 DOI: 10.1590/1984-0462/2023/41/2022063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/16/2022] [Indexed: 03/17/2023]
Abstract
OBJECTIVE The aim of this study was to validate the content of a questionnaire in order to assess the attitudes and practices in childcare consultations, knowledge on overweight and obesity, their risk factors, and barriers in addressing the issue by pediatricians and family physicians. METHODS The Delphi technique was used, with the objective of reaching a consensus on a certain subject, through experts' opinions. The content validity index (CVI) of each item, axis, and questionnaire was calculated. The inter-rater reliability was calculated using an agreement coefficient suitable for the answer distribution such as Gwet's AC2 with ordinal weight. RESULTS A total of 63 experts were invited to assess and give their opinion on the questionnaire. In all, 52 accepted the invitation and analyzed the instrument. After two rounds, the questionnaire reached the proper CVI for the study and was considered complete, with its final version having 40 questions, a final index of 95%, and an inter-rate reliability of 0.905. CONCLUSIONS This instrument, developed to assess attitudes and practices, knowledge, and barriers found in addressing the obesity by primary care physicians, obtained a CVI greater than 0.8 and an excellent agreement coefficient of the 52 judges. Therefore, its content can be considered validated.
Collapse
Affiliation(s)
| | - Eduardo Juan Troster
- Universidade de São Paulo, São Paulo, SP, Brazil.,Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil
| | | |
Collapse
|
12
|
Soares MM, Juvanhol LL, Ribeiro SAV, Franceschini SDCC, Shivappa N, Hebert JR, Araújo RMA. Proinflammatory maternal diet and early weaning are associated with the inflammatory diet index of Brazilian children (6-12 mo): A pathway analysis. Nutrition 2023; 105:111845. [PMID: 36323148 DOI: 10.1016/j.nut.2022.111845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of this study was to assess the dietary inflammatory index (DII) and its association with maternal factors and excess body weight in Brazilian children aged <2 y during complementary feeding. METHODS This was a cross-sectional study (2016-2019), conducted with 231 mothers and children ages 6 to 24 mo. The food consumption of the mother-child dyad was obtained through the mean of three 24-h recalls, as well as information on the consumption of breast milk. The DII was used to verify the quality of the diet. Children's weight and length were measured, and the weight/height index was calculated. Path analysis was used to assess the interrelationships between variables. Multiple linear regression was conducted to identify the components of the child's DII (C-DII) that contributed the most to explaining its variation. RESULTS The children had an anti-inflammatory diet (C-DII -0.37 ± 0.91) whereas the mothers had a proinflammatory diet (M-DII +0.24 ± 0.86). Fiber was the nutrient that contributed most to the variations in the C-DII. Approximately 28% of children were overweight. In the pathway analysis, we verified a direct negative effect of education on excess body weight (standardized coefficients [SC], -0.180; P = 0.034) and C-DII (SC, -0.167; P = 0.002); negative direct effect of breastfeeding on the C-DII (SC, -0.294; P < 0.001); and positive direct effect of M-DII on C-DII (SC, 0.119; P = 0.021). CONCLUSION Children's proinflammatory diet during the period of complementary feeding was associated with maternal proinflammatory diets, lower education, and absence of breastfeeding practice.
Collapse
Affiliation(s)
- Marcela Martins Soares
- Department of Nutrition and Health of the Federal University of Viçosa, Minas Gerais, Brazil.
| | | | | | | | - Nitin Shivappa
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, Columbia, South Carolina, USA
| | - James R Hebert
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, Columbia, South Carolina, USA
| | | |
Collapse
|
13
|
Moliterno P, Matjazic J, Widhalm K. Improvement of body composition in 8- to 11-year-old schoolboys: effects of a 6-months lifestyle intervention A retrospective evaluation of the “EDDY-Kids” prevention study. CHILD AND ADOLESCENT OBESITY 2022. [DOI: 10.1080/2574254x.2022.2140576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Julia Matjazic
- Austrian Academic Institute for Clinical Nutrition. Austria
| | - Kurt Widhalm
- Austrian Academic Institute for Clinical Nutrition. Austria
- Medical University of Vienna. Vienna Austria
| |
Collapse
|
14
|
Implementation and Evaluation of a School-Based Educational Program Targeting Healthy Diet and Exercise (DIEX) for Greek High School Students. Sports (Basel) 2022; 10:sports10120196. [PMID: 36548493 PMCID: PMC9781068 DOI: 10.3390/sports10120196] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
The present study examined the effectiveness of a school-based health education program promoting healthy diet and exercise, named DIEX, implemented on adolescents. The program is based on the Theory of Planned Behavior (TPB) and is supported by life skills training. The recipients of the program were high school students (n = 367; 168 boys and 199 girls) from 14 schools in Greece who attended 10 1 h sessions implemented by their schoolteachers. Data were collected before and after the program implementation through online questionnaires for: a. attitude, intention, subjective norms, and PBC toward healthy eating; b. knowledge about healthy eating; c. exercise behavior and attitude toward the DIEX program; and d. satisfaction with the DIEX program (only post-program). The results showed that there were significant differences among the pre- and post-measures of students' knowledge and behavior about healthy diet, as well as attitudes and satisfaction toward the program's application. The results show that the DIEX program may have improved nutrition behavior variables. Conclusively, a theory-based behavioral intervention with skills training may result in positive behavioral changes for young students during health education in school settings with the assistance of new technologies.
Collapse
|
15
|
Totzauer M, Escribano J, Closa-Monasterolo R, Luque V, Verduci E, ReDionigi A, Langhendries JP, Martin F, Xhonneux A, Gruszfeld D, Socha P, Grote V, Koletzko B, Carlier C, Hoyos J, Poncelet P, Dain E, Martin F, Xhonneux A, Langhendries J, Van Hees J, Closa‐Monasterolo R, Escribano J, Luque V, Mendez G, Ferre N, Zaragoza‐Jordana M, Giovannini M, Riva E, Agostoni C, Scaglioni S, Verduci E, Vecchi F, Re Dionigi A, Socha J, Socha P, Dobrzańska A, Gruszfeld D, Stolarczyk A, Kowalik A, Janas R, Pietraszek E, Perrin E, von Kries R, Groebe H, Reith A, Hofmann R, Koletzko B, Grote V, Totzauer M, Rzehak P, Schiess S, Beyer J, Fritsch M, Handel U, Pawellek I, Verwied‐Jorky S, Hannibal I, Demmelmair H, Haile G, Theurich M. Different protein intake in the first year and its effects on adiposity rebound and obesity throughout childhood: 11 years follow-up of a randomized controlled trial. Pediatr Obes 2022; 17:e12961. [PMID: 36355369 DOI: 10.1111/ijpo.12961] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 06/06/2022] [Accepted: 06/30/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Infant feeding affects child growth and later obesity risk. We examined whether protein supply in infancy affects the adiposity rebound, body mass index (BMI) and overweight and obesity up to 11 years of age. METHODS We enrolled healthy term infants from five European countries in a double blind randomized trial, with anticipated 16 examinations within 11 years follow-up. Formula-fed infants (n = 1090) were randomized to isoenergetic formula with higher or lower protein content within the range stipulated by EU legislation in 2001. A breastfed reference group (n = 588) was included. Adiposity rebound and BMI trajectories were estimated by generalized additive mixed models in 917 children, with 712 participating in the 11 year follow-up. RESULTS BMI trajectories were elevated in the higher compared to the lower protein group, with significantly different BMI at adiposity rebound (0.24 kg/m2, 0.01-0.47, p = 0.040), and an increased risk for overweight at 11 years (adjusted Odds Ratio 1.70; 1.06-2.73; p = 0.027) but no significant difference for obesity (adjusted Odds Ratio 1.47; 0.66-3.27). The two formula groups did not differ in the timing of adiposity rebound, but all children with obesity at 11 years had an early adiposity rebound before four years. CONCLUSIONS Compared to conventional high protein formula, feeding lower protein formula in infancy lowers BMI trajectories up to 11 years and achieves similar BMI values at adiposity rebound as observed in breastfed infants.
Collapse
Affiliation(s)
- Martina Totzauer
- LMU - Ludwig-Maximilians-Universität Munich, Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospitals, Munich, Germany
| | - Joaquin Escribano
- Department of Pediatrics, Hospital Sant Joan, Reus, Universitat Rovira i Virgili, IISPV, Reus, Spain
| | - Ricardo Closa-Monasterolo
- Neonatal Unit, Hospital Joan XXIII, Tarragona, Universitat Rovira i Virgili, IISPV, Tarragona, Spain
| | - Veronica Luque
- Department of Pediatrics, Hospital Sant Joan, Reus, Universitat Rovira i Virgili, IISPV, Reus, Spain
| | - Elvira Verduci
- Department of Paediatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | - Alice ReDionigi
- Department of Paediatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | | | | | | | - Dariusz Gruszfeld
- Children's Memorial Health Institute, Neonatal Intensive Care Unit, Warsaw, Poland
| | - Piotr Socha
- Children's Memorial Health Institute, Department of Gastroenterology, Hepatology and Eating Disorders, Warsaw, Poland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Rezaei Niyasar A, Moradi A, Radman N, Sadeghi M, Mahmoudi M. Is online self-regulatory training effective in weight control? A pilot experiment on adolescence obesity during coronavirus-19 lockdown. Brain Behav 2022; 12:e2772. [PMID: 36209468 PMCID: PMC9660493 DOI: 10.1002/brb3.2772] [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: 04/06/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Studies have shown that obesity is associated with decreased executive function. Impaired executive functions lead to poor self-regulation, which in turn may result in persistence of unhealthy behaviors, including eating behaviors, throughout life. Increasing self-regulation in childhood and adolescence has positive effects on creating healthy behaviors such as reducing unnecessary eating and changing unhealthy eating habits. The main purpose of this study is to evaluate an intervention package based on cognitive self-regulation training in changing eating behaviors and reducing obesity in children and adolescents. METHODS Fifty-six students with obesity aged 12-16 years participated in the study in three groups (cognitive self-regulation training [CSRT], diet, and control). The CSRT group received twenty 30-min online training sessions with a diet over 10 weeks. The diet group received only a diet with no other intervention, and the control group did not receive any intervention. RESULTS The results of our 2 × 3 repeated-measures ANOVA showed that the CSRT group had a mean BMI decrease of 2.21 (kg/m2 ) after ten weeks, and 3.24 (kg/m2 ) at the follow-up time. The diet group had a BMI decrease of 0.49 (kg/m2 ) at the ten weeks. In addition, the results showed that the CSRT had a significant reduction in eating behaviors such as external eating and emotional eating. However, the other two groups showed no changes in eating behaviors. CONCLUSIONS Our results show that online cognitive self-regulation training has been effective in weight loss and eating behaviors. This study shows promising evidence for the efficacy of the online CSRT-training as a weight stabilization intervention in children with obesity.
Collapse
Affiliation(s)
- Asiyeh Rezaei Niyasar
- Cognitive Psychology Department, Institute for Cognitive Science Studies, Tehran, Iran
| | - Alireza Moradi
- Cognitive Psychology Department, Institute for Cognitive Science Studies, Tehran, Iran.,Department of Clinical Psychology, Kharazmi University, Tehran, Iran
| | - Narges Radman
- School of Nutrition and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,School of Cognitive Sciences, Institute for Research in fundamental Sciences, Tehran, Iran
| | - Meysam Sadeghi
- Cognitive Psychology Department, Institute for Cognitive Science Studies, Tehran, Iran
| | - Maryam Mahmoudi
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
17
|
Dor C, Stark AH, Dichtiar R, Keinan-Boker L, Sinai T. Non-Dairy Animal Protein Consumption Is Positively Associated with Overweight and Obesity in Israeli Adolescents. Foods 2022; 11:foods11142072. [PMID: 35885315 PMCID: PMC9317251 DOI: 10.3390/foods11142072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
Protein consumption apparently plays a role in weight control. This cross-sectional study examined the association of protein consumption in Israeli adolescents with overweight/obesity. 7th−12th grade students participating in a national school-based survey (2015−2016) completed self-administered questionnaires, including a food frequency questionnaire, and height and weight measurements (n = 3443, 48% males, 15.2 ± 1.6 years). WHO growth standards served to define weight status. Intakes of total protein and protein source were calculated. Multivariable logistic regression analyses evaluated associations with overweight/obesity (BMI z-score ≥ 1), adjusting for possible covariates. Total protein intake (median (IQR)) was 62.5 (45.5, 85.7) g/d, accounting for 12.0 (10.5, 13.6) percent of daily energy. Of participants, 31.4% were overweight/obese. In multivariable models, overweight/obesity was positively associated with incremental increases of 10 g/d in total protein intake (OR = 1.07, 95% CI: 1.02−1.12, p < 0.01), total animal protein intake (OR = 1.05, 95% CI: 1.01−1.10, p = 0.026), and non-dairy animal protein intake (OR = 1.06, 95% CI: 1.01−1.11, p = 0.029). No associations were found with plant or dairy protein intake. These associations remained when protein intake was reported as a percentage of daily energy and when overweight and obesity were analyzed individually. High daily protein intakes, principally from non-dairy animal sources, were positively associated with overweight/obesity in adolescents. Additional studies are needed to establish causality of these findings.
Collapse
Affiliation(s)
- Chen Dor
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan 5262100, Israel; (C.D.); (R.D.); (L.K.-B.)
| | - Aliza Hannah Stark
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel;
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan 5262100, Israel; (C.D.); (R.D.); (L.K.-B.)
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan 5262100, Israel; (C.D.); (R.D.); (L.K.-B.)
- School of Public Health, University of Haifa, Haifa 3498838, Israel
| | - Tali Sinai
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan 5262100, Israel; (C.D.); (R.D.); (L.K.-B.)
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel;
- Correspondence: ; Tel.: +972-3-7371568; Fax: +972-2-5655994
| |
Collapse
|
18
|
Benefits of Exercise in Multidisciplinary Treatment of Binge Eating Disorder in Adolescents with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148300. [PMID: 35886152 PMCID: PMC9315465 DOI: 10.3390/ijerph19148300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
Obesity in childhood and adolescence represents a serious health problem worldwide. Similarly, eating disorders (EDs) are complex diseases that affect adolescents with an increasing prevalence and are an alarming health concern to both physical and mental health. Traditionally, obesity and EDs, particularly binge eating disorder (BED), have been considered separate conditions, but there is emerging evidence such as etiology, comorbidities, risk factors, psychosocial impairment, and prevention approaches, highlighting important overlaps among these conditions. In youth, the two conditions share risk factors and consequences at both the physical and psychological levels, requiring special care. Exercise, useful as strategy to prevent and treat overweight conditions, may have beneficial effects on BED symptoms, suggesting that it may be considered as one of the key factors in the treatment of individuals affected by obesity with BED. The purpose of this narrative review is to examine the bidirectional impact of obesity and BED in adolescents, in terms of risk factors, etiology and comorbid conditions. Specifically, we focused on the benefits of physical activity (PA) in the multidisciplinary treatment of subjects affected by obesity with BED. Even though additional research is needed to reach conclusions about the role of exercise in the treatment of obesity and comorbid BED, especially in adolescents, promising results have already suggested that closely monitored exercise is safe and, paired with cognitive behavioral therapy, may provide multiple benefits on both the physical and psychological levels. Tailored and integrated treatments for weight management and eating disorders are important to promptly and effectively treat obese subjects that have BED.
Collapse
|
19
|
Gomahr J, Julian V, Thivel D, Maruszczak K, Schneider AM, Weghuber D. Childhood obesity prevention: what can be achieved? Curr Opin Clin Nutr Metab Care 2022; 25:223-231. [PMID: 35256565 DOI: 10.1097/mco.0000000000000831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Childhood obesity is a pandemic generating an enormous individual and socioeconomic burden worldwide. This narrative review summarizes recent evidence on successful and recommended prevention strategies according to age groups and different levels of interventions. RECENT FINDINGS Effective prevention of childhood obesity is feasible and most successful early in life up to preschool age, and it should include a multicomponent approach, integrating individuals, family and society. Trials that improve nutrition and/or enhance physical activity are the cornerstones of childhood obesity prevention on an individual level. However, their efficacy is determined by the combination of interventions for the target age group. Further, improving family support and sleep, as well as reducing screen time, lead to favourable results. Many research gaps remain, including a lack of effective interventions for high-risk groups. SUMMARY As a multifactorial condition, childhood obesity requires a multicomponent approach. Interventions should be developmental stage-specific and adjusted to the setting. Current research gaps need to be targeted by future trials, with a special focus on the benefit of the most vulnerable groups. From a systems response perspective, a paradigm shift from interventions focusing on the individual to approaches that target society as a whole is warranted.
Collapse
Affiliation(s)
- Julian Gomahr
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand
| | - David Thivel
- Laboratory AME2P, University of Clermont Auvergne, Aubiere, Franoe
| | - Katharina Maruszczak
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Anna-Maria Schneider
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Weghuber
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
20
|
Dalrymple KV, Vogel C, Godfrey KM, Baird J, Harvey NC, Hanson MA, Cooper C, Inskip HM, Crozier SR. Longitudinal dietary trajectories from preconception to mid-childhood in women and children in the Southampton Women's Survey and their relation to offspring adiposity: a group-based trajectory modelling approach. Int J Obes (Lond) 2022; 46:758-766. [PMID: 34916617 PMCID: PMC8960403 DOI: 10.1038/s41366-021-01047-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/23/2021] [Accepted: 11/26/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Rates of childhood obesity are increasing globally, with poor dietary quality an important contributory factor. Evaluation of longitudinal diet quality across early life could identify timepoints and subgroups for nutritional interventions as part of effective public health strategies. OBJECTIVE This research aimed to: (1) define latent classes of mother-offspring diet quality trajectories from pre-pregnancy to child age 8-9 years, (2) identify early life factors associated with these trajectories, and (3) describe the association between the trajectories and childhood adiposity outcomes. DESIGN Dietary data from 2963 UK Southampton Women's Survey mother-offspring dyads were analysed using group-based trajectory modelling of a diet quality index (DQI). Maternal diet was assessed pre-pregnancy and at 11- and 34-weeks' gestation, and offspring diet at ages 6 and 12 months, 3, 6-7- and 8-9-years using interviewer-administered food frequency questionnaires. At each timepoint, a standardised DQI was derived using principal component analysis. Adiposity age 8-9 years was assessed using dual-energy X-ray absorptiometry (DXA) and BMI z-scores. RESULTS A five-trajectory group model was identified as optimal. The diet quality trajectories were characterised as stable, horizontal lines and were categorised as poor (n = 142), poor-medium (n = 667), medium (n = 1146), medium-better (n = 818) and best (n = 163). A poorer dietary trajectory was associated with higher maternal pre-pregnancy BMI, smoking, multiparity, lower maternal age and lower educational attainment. Using linear regression adjusted for confounders, a 1-category decrease in the dietary trajectory was associated with higher DXA percentage body fat (0.08 SD (95% confidence interval 0.01, 0.15) and BMI z-score (0.08 SD (0.00, 0.16) in the 1216 children followed up at age 8-9 years. CONCLUSION Mother-offspring dietary trajectories are stable across early life, with poorer diet quality associated with maternal socio-demographic and other factors and childhood adiposity. The preconception period may be an important window to promote positive maternal dietary changes in order to improve childhood outcomes.
Collapse
Affiliation(s)
- Kathryn V Dalrymple
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Christina Vogel
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Janis Baird
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark A Hanson
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK.
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK.
| |
Collapse
|
21
|
Bhattacharya S, Saleem SM, Bera OP. Prevention of childhood obesity through appropriate food labeling. Clin Nutr ESPEN 2022; 47:418-421. [DOI: 10.1016/j.clnesp.2021.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/02/2021] [Accepted: 12/13/2021] [Indexed: 10/19/2022]
|
22
|
Billeaud C, Adamon L, Piloquet H, Hays NP, Dupuis L, Metreau I, Léké A. A new partially hydrolyzed whey-based follow-on formula with age-adapted protein content supports healthy growth during the first year of life. Front Pediatr 2022; 10:937882. [PMID: 36245743 PMCID: PMC9554543 DOI: 10.3389/fped.2022.937882] [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: 05/06/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Standard infant formulae often have higher protein content than breastmilk in order to compensate for potentially lower digestibility; excess protein intake may promote adverse effects later in life. A new partially hydrolyzed whey-based (pHF-W) follow-on formula (FoF) with age-adapted protein content was evaluated for growth and gastrointestinal (GI) tolerance in healthy infants. METHODS Formula-fed (FF) infants (n = 108) received standard pHF-W formula (1.9 g protein/100 kcal) from enrollment (age ≤ 30 days) until age 120 days followed by new pHF-W FoF (1.6 g protein/100 kcal) until 360 days. Weight gain velocity (WGV) (mean daily WG from enrollment to age 180 days) was compared to WHO growth standards and a breastfed (BF) reference group (n = 86) (non-inferiority margin -3 g/day). GI tolerance was assessed using a validated questionnaire (scale range 13-65). RESULTS WGV in FF infants (mean ± SD 24.0 ± 4.4 g/day) was non-inferior to BF (23.7 ± 3.9 g/day) and WHO standards (all p ≤ 0.013). Weight-for-age, length-for-age, weight-for-length, and head circumference-for-age z-scores of FF infants were not significantly different from BF at any timepoint. Symptoms of GI intolerance were low (≤23) at all timepoints and similar between groups. CONCLUSION A new pHF-W FoF with age-adapted protein content fed sequentially after standard pHF-W infant formula is safe, well-tolerated, and promotes a healthy growth pattern consistent with BF infants and WHO standards during the first year of life. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/], identifier [NCT03276663].
Collapse
Affiliation(s)
- Claude Billeaud
- CIC Pédiatrique 1401 INSERM, Centre d'Investigation Clinique Bordeaux, Bordeaux, France
| | - Latif Adamon
- Department of Neonatology, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Hugues Piloquet
- Child Chronic Disease Service, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Nicholas P Hays
- Nestlé Product Technology Center - Nutrition, Vevey, Switzerland
| | | | | | - André Léké
- Neonatal Medicine and Intensive Care, Centre Hospitalier Universitaire Amiens Picardie, Amiens, France
| |
Collapse
|
23
|
BALESTRIN M, KIRSTEN VR, WAGNER MB. Healthy and Safe School Cafeteria Program: a randomized controlled study. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e210265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACT Objective To assess the effect of an educational intervention program focused on health risk conditions, based on an assessment of the hygiene and quality of food sold in school cafeterias. Methods This is a controlled, parallel, randomized, two-arm, community study. Public and private schools with cafeterias were invited to participate. This study was conducted in 27 school cafeterias in northern and northwestern Rio Grande do Sul, a state in southern Brazil. Representatives of the school communities in the intervention group received an educational program consisting of 160-hour distance training. The most relevant outcomes were the assessment of the hygienic conditions and composition of the menus sold in school cafeterias. All outcomes were analyzed as intention-to-treat and per-protocol. For the analysis of continuous data with normal distribution, an analysis of covariance and the Generalized Linear Model were used. The level of statistical significance considered was p<0.05 for a 95% CI. Results No statistically significant difference was observed between the intervention group and the control group in the studied outcomes. There was a reduction of 76.2 points in the score for hygienic handling conditions (95% CI: -205 to 357; p=0.581). Regarding menu composition, the difference between groups was 0.48% (95% CI: -2.69 to 3.64; p=0.760) for ultra-processed foods, 0.23% (95% CI: -1.13 to 1.60; p=0.740) for processed foods, and 1.02% (95% CI: -2.59 to 4.64; p=0.581) for fresh foods. Conclusion There is not enough evidence to conclude that the intervention had a positive impact on any of the outcomes studied.
Collapse
|
24
|
Zhang Y, Wang Q, Xue M, Pang B, Yang M, Zhang Z, Niu W. Identifying factors associated with central obesity in school students using artificial intelligence techniques. Front Pediatr 2022; 10:1060270. [PMID: 36533227 PMCID: PMC9748186 DOI: 10.3389/fped.2022.1060270] [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: 10/03/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES We, in a large survey of school students from Beijing, aimed to identify the minimal number of promising factors associated with central obesity and the optimal machine-learning algorithm. METHODS Using a cluster sampling strategy, this cross-sectional survey was conducted in Beijing in early 2022 among students 6-14 years of age. Information was gleaned via online questionnaires and analyzed by the PyCharm and Python. RESULTS Data from 11,308 children were abstracted for analysis, and 3,970 of children had central obesity. Light gradient boosting machine (LGBM) outperformed the other 10 models. The accuracy, precision, recall, F1 score, area under the receiver operating characteristic of LGBM were 0.769982, 0.688312, 0.612323, 0.648098, and 0.825352, respectively. After a comprehensive evaluation, the minimal set involving top 6 important variables that can predict central obesity with descent performance was ascertained, including father's body mass index (BMI), mother's BMI, picky for foods, outdoor activity, screen, and sex. Validation using the deep-learning model indicated that prediction performance between variables in the minimal set and in the whole set was comparable. CONCLUSIONS We have identified and validated a minimal set of six important factors that can decently predict the risk of central obesity when using the optimal LGBM model relative to the whole set.
Collapse
Affiliation(s)
- Yicheng Zhang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qiong Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Mei Xue
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Bo Pang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Min Yang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Zhixin Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.,International Medical Services, China-Japan Friendship Hospital, Beijing, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| |
Collapse
|
25
|
Kawai M. Disruption of the circadian rhythms and its relationship with pediatric obesity. Pediatr Int 2022; 64:e14992. [PMID: 34525248 DOI: 10.1111/ped.14992] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/23/2021] [Accepted: 09/13/2021] [Indexed: 11/26/2022]
Abstract
The circadian clock system is an evolutionarily conserved system by which organisms adapt their metabolic activities to environmental inputs, including nutrient availability. The disruption of this system has been pathogenically linked to the disintegration of metabolic homeostasis, leading to the development of metabolic complications, including obesity. Lifestyle factors that disrupt this system have been found to be associated with the development of metabolic disorder, which is most evidenced by the finding that shift workers are at an increased risk of developing various disorders, such as obesity and obesity-related complications. Lifestyle factors that contribute to a misalignment between the internal clock system and environmental rhythms have also been identified in children. A short sleep duration and skipping breakfast are prevalent in children and there is mounting evidence that these factors are associated with an increased risk of pediatric obesity; however, the underlying mechanisms have not yet been elucidated in detail. Our current understanding of the impact of lifestyle factors that cause a misalignment between the internal clock system and environmental rhythms on the development of pediatric obesity is summarized herein, with a discussion of potential mechanistic factors.
Collapse
Affiliation(s)
- Masanobu Kawai
- Department of Bone and Mineral Research, Research Institute, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.,Department of Gastroenterology, Nutrition, and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| |
Collapse
|
26
|
Alshahrani A, Shuweihdi F, Swift J, Avery A. Underestimation of overweight weight status in children and adolescents aged 0-19 years: A systematic review and meta-analysis. Obes Sci Pract 2021; 7:760-796. [PMID: 34877014 PMCID: PMC8633945 DOI: 10.1002/osp4.531] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Perceptions of children's weight status may be important in obesity prevention and treatment. AIMS This review identifies the prevalence of the underestimation of overweight status in children by parents/main carers, children, and healthcare professionals (HCP). The review critically synthesized both quantitative and qualitative evidence to explore the factors associated with this underestimation. The diverse methods used to assess this phenomenon are reported. METHODS Pooled effect sizes were calculated using random-effects model. Published studies, up to 2020, were accessed using the following search engines: CINAHL, EMBASE, PUBMED, and Psych-Info and including the "Cited by" and "Related Articles" functions. Hand-searching was used to retrieve further articles. Publication language and location had no bearing on the nature of the included studies. RESULTS A total of 91 articles were included. In the quantitative studies, 55% (95% CI 49%-61%) of caregivers underestimated their child's level of overweight and obesity using a verbal scale and 47% (95% CI 36%-55%) using visual scales. Of the children studied, 34% (95% CI 25%-43%) underestimated their own level of overweight and obesity using both scales. In (n = 3) articles, HCPs reflected this misperception, but limited studies prevented meta-analysis. Underestimation was associated with the child's age, gender, BMI and parental weight status, ethnicity and education. In the qualitative studies, parents/main carers of children with overweight and obesity described their child's weight in terms other than overweight, for example, "big boned," "thick," and "solid." CONCLUSION The results confirm the prevalence of underestimation of child overweight status across international studies. Understanding the factors which lead to this inaccuracy may help to improve communication within the therapeutic triad and facilitate the recognition and management of children's overweight status.
Collapse
Affiliation(s)
- Abrar Alshahrani
- Division of Nutritional SciencesUniversity of NottinghamNottinghamUK
| | - Farag Shuweihdi
- Leeds Institute of Health SciencesFaculty of MedicineLeeds UniversityLeedsUK
| | - Judy Swift
- Division of Nutritional SciencesUniversity of NottinghamNottinghamUK
| | - Amanda Avery
- Division of Food, Nutrition and DieteticsUniversity of NottinghamNottinghamUK
| |
Collapse
|
27
|
Analysis of gene expression from human breastmilk cells: A comparison between low and high producers, and the influence of anxiety and depression on milk production, gene expression and bacterial production. Heliyon 2021; 7:e08335. [PMID: 34825075 PMCID: PMC8605299 DOI: 10.1016/j.heliyon.2021.e08335] [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: 07/11/2021] [Revised: 10/05/2021] [Accepted: 11/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background Breastmilk is considered the gold standard of infant nutrition. Many mothers have difficulty with breastfeeding and over 50% of women stop due to perceived low production. Aims and methods Our study compared gene expression in 8 samples of low and high producers of milk. All subjects were administered GAD-7 and PHQ-9 questionnaires. Low-producers were all found to have more depression and anxiety compared to high-producers. Results We did not find significant differences between gene expression between low and high milk producers. Only 5 of 8 samples contained a significant number of human cells. We did find differences in the amount of various bacterial populations. Conclusion Our results indicate that gene expression in breastmilk is complicated by collection methods. We recommend that even though some women produced less than 600 ml of milk over a 24-hour period of time, due to the nature of the bacteria found in milk they try to breastfeed as much as they can for the health benefits of their infants. the rich bacterial diversity in all patients including the low producers strongly suggests that even women producing lesser quantities of milk confer their children numerous benefits by breastfeeding them.
Collapse
|
28
|
Rosell M, Carlander A, Cassel S, Henriksson P, J‐son Höök M, Löf M. Generation Pep Study: A population-based survey on diet and physical activity in 12,000 Swedish children and adolescents. Acta Paediatr 2021; 110:2597-2606. [PMID: 33752250 DOI: 10.1111/apa.15850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/11/2021] [Accepted: 03/19/2021] [Indexed: 12/17/2022]
Abstract
AIM This study presents dietary intake and physical activity in a large nationally representative sample of children and adolescents in Sweden. It also reports the study protocol for the Generation Pep Study that will be used for yearly repeated measurements. METHODS A random sample of children and adolescents aged 4-17 years living in Sweden was invited to fill in a Web-based questionnaire on dietary intake and physical activity. For participants aged <12 years, the parents were asked to fill in the questionnaire together with their child. Information on socio-economic background was collected from the parents. RESULTS A total number of 12,441 children and adolescents participated in the study (participation rate 43%). The results indicate that 13- to 17-year-olds have notably less healthy dietary intake and lower physical activity compared with younger age groups. In general, the dietary intake was most healthy among 4- to 6-year-olds. A socio-economic gradient was seen for many of the studied variables. CONCLUSION Participants of a high socio-economic status and younger age generally had healthier dietary intake and higher physical activity. The study provides novel national data as it includes a wide age of children and adolescents (4-17 years).
Collapse
Affiliation(s)
- Magdalena Rosell
- Department of Biosciences and Nutrition Karolinska Institutet Stockholm Sweden
| | - Anders Carlander
- SOM Institute University of Gothenburg Gothenburg Sweden
- Wallenberg Centre for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
| | - Sophie Cassel
- SOM Institute University of Gothenburg Gothenburg Sweden
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
| | | | - Marie Löf
- Department of Biosciences and Nutrition Karolinska Institutet Stockholm Sweden
- Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
| |
Collapse
|
29
|
Usheva N, Lateva M, Galcheva S, Koletzko BV, Cardon G, De Craemer M, Androutsos O, Kotowska A, Socha P, Moreno LA, Manios Y, Iotova V. Breastfeeding and Overweight in European Preschoolers: The ToyBox Study. Nutrients 2021; 13:nu13082880. [PMID: 34445041 PMCID: PMC8401161 DOI: 10.3390/nu13082880] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/04/2022] Open
Abstract
The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates.
Collapse
Affiliation(s)
- Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, 9002 Varna, Bulgaria
- Correspondence: ; Tel.: +359-52677164
| | - Mina Lateva
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | - Sonya Galcheva
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | - Berthold V. Koletzko
- Division of Metabolic and Nutritional Medicine, Department Paediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospitals, 80337 Munich, Germany;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium;
- Research Foundation Flanders, 1000 Brussels, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 382 21 Volos, Greece;
| | - Aneta Kotowska
- Public Health Department, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (A.K.); (P.S.)
| | - Piotr Socha
- Public Health Department, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (A.K.); (P.S.)
| | - Luis A. Moreno
- GENUD (Growth, Exercise, Drinking Behaviour and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 176 76 Athens, Greece;
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | | |
Collapse
|
30
|
Taveras EM, Perkins ME, Boudreau AA, Blake-Lamb T, Matathia S, Kotelchuck M, Luo M, Price SN, Roche B, Cheng ER. Twelve-Month Outcomes of the First 1000 Days Program on Infant Weight Status. Pediatrics 2021; 148:peds.2020-046706. [PMID: 34326179 PMCID: PMC8579422 DOI: 10.1542/peds.2020-046706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine the effects of the First 1000 Days intervention on the prevalence of infant overweight and maternal postpartum weight retention and care. METHODS Using a quasi-experimental design, we evaluated the effects of the First 1000 Days program among 995 term, low-income infants and their mothers receiving care in 2 intervention community health centers and 650 dyads in 2 comparison health centers. The program includes staff training, growth tracking, health and behavioral screening, patient navigation, text messaging, educational materials, and health coaching. Comparison centers implemented usual care. Infant outcomes were assessed at 6 and 12 months, including weight-for-length z score and overweight (weight for length ≥97.7th percentile). We also examined maternal weight retention and receipt of care 6 weeks' post partum. RESULTS The mean birth weight was 3.34 kg (SD 0.45); 57% of infants were Hispanic; 66% were publicly insured. At 6 months, infants had lower weight-for-length z scores (β: -.27; 95% confidence interval [CI]: -.39 to -.15) and lower odds of overweight (adjusted odds ratio [OR]: 0.46; 95% CI: 0.28 to 0.76) than infants in comparison sites; differences persisted at 12 months (z score β: -.18; 95% CI: -.30 to -.07; adjusted OR for overweight: 0.60; 95% CI: 0.39 to 0.92). Mothers in the intervention sites had modestly lower, but nonsignificant, weight retention at 6 weeks' post partum (β: -.51 kg; 95% CI: -1.15 to .13) and had higher odds (adjusted OR: 1.50; 95% CI: 1.16 to 1.94) of completing their postpartum visit compared with mothers in the comparison sites. CONCLUSIONS An early-life systems-change intervention combined with coaching was associated with improved infant weight status and maternal postpartum care.
Collapse
Affiliation(s)
- Elsie M. Taveras
- The Kraft Center for Community Health,Division of General Academic Pediatrics, Department of
Pediatrics, Massachusetts General Hospital for Children,Department of Nutrition, Harvard T.H. Chan School of Public
Health, Harvard University, Boston, Massachusetts
| | - Meghan E. Perkins
- Division of General Academic Pediatrics, Department of
Pediatrics, Massachusetts General Hospital for Children
| | - Alexy Arauz Boudreau
- Division of General Academic Pediatrics, Department of
Pediatrics, Massachusetts General Hospital for Children
| | - Tiffany Blake-Lamb
- The Kraft Center for Community Health,Department of Obstetrics and Gynecology, Massachusetts General
Hospital, Boston, Massachusetts
| | - Sarah Matathia
- The Kraft Center for Community Health,Massachusetts General Hospital Everett Family Care Community
Health Center, Everett, Massachusetts
| | - Milton Kotelchuck
- Division of General Academic Pediatrics, Department of
Pediatrics, Massachusetts General Hospital for Children
| | - Mandy Luo
- Division of General Academic Pediatrics, Department of
Pediatrics, Massachusetts General Hospital for Children
| | - Sarah N. Price
- Division of General Academic Pediatrics, Department of
Pediatrics, Massachusetts General Hospital for Children
| | - Brianna Roche
- Division of General Academic Pediatrics, Department of
Pediatrics, Massachusetts General Hospital for Children
| | - Erika R. Cheng
- Division of Children’s Health Services Research,
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| |
Collapse
|
31
|
Fornari E, Barbetti F, Iafusco D, Lombardo F, Miraglia Del Giudice E, Rabbone I, Mozzillo E. Type 2 diabetes in pediatrics. Minerva Pediatr (Torino) 2021; 73:549-562. [PMID: 34286947 DOI: 10.23736/s2724-5276.21.06530-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Type 2 diabetes (T2D) in adolescents has become an increasing health concern throughout the world and its prevention and screening should be implemented in pediatric care. As clinical features at presentation, in some cases can be similar to type 1 diabetes and family history can be in favour of a monogenic form of diabetes, it is pivotal for physicians to be aware of youth-onset T2D specificities to ensure an accurate diagnosis. The global increase of overweight and obesity can complicate the diagnostic process and makes it essential to apply a systematic approach to each new diagnosis. Microvascular complications may be present at the time of diagnosis and chronic complications are frequent and need to be screened regularly. Regular screening of comorbidities should also be performed. Childhood T2D should be followed up by pediatric diabetes units to avoid diagnostic errors and delay in care. A multidisciplinary approach, by an experienced team, is pivotal to provide treatment options targeting the unique needs of pediatric patients. Treatment programs must include the whole family and address all the aspects of the care (lifestyle, pharmacological therapy, psychological aspects, complications and comorbidities). An organized process of transition to adult care is essential.
Collapse
Affiliation(s)
- Elena Fornari
- Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics and Gynecology, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Fabrizio Barbetti
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Dario Iafusco
- Department of Pediatrics, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Fortunato Lombardo
- Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy
| | - Emanuele Miraglia Del Giudice
- Department of the Woman, of the Child, of General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ivana Rabbone
- Division of Paediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Enza Mozzillo
- Regional Center of Pediatric Diabetes, Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy -
| |
Collapse
|
32
|
De Rosso S, Schwartz C, Ducrot P, Nicklaus S. The Perceptions and Needs of French Parents and Pediatricians Concerning Information on Complementary Feeding. Nutrients 2021; 13:nu13072142. [PMID: 34206652 PMCID: PMC8308433 DOI: 10.3390/nu13072142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 12/13/2022] Open
Abstract
Appropriate complementary feeding (CoF) is the key to preventing childhood obesity and promoting long-term health. Parents must be properly informed through the CoF process. Pediatricians have opportunities to interact with parents during the CoF transition and influence parental feeding decisions. They can convey public health nutrition messages to parents. With the release of new CoF recommendations in France in 2019, and from the perspective of their conversion into official public health communication material, the aim of this study was to explore parents’ and pediatricians’ perceptions and needs regarding information on CoF. Two online surveys were disseminated to gather information on CoF communication and guidance: one for parents (n = 1001, January 2020); one for pediatricians (n = 301, October 2019). The results showed that the importance of CoF for children’s healthy growth was well recognized by both parents and pediatricians. Parents acknowledged pediatricians as the most influential source of advice; and pediatricians were aware of their responsibility in counselling parents on CoF. However, pediatricians neglected the fact that parents gave high trust to their personal network when looking for advice. The Internet was a well-recognized source of information according to all. Diverging from what pediatricians considered useful, parents were interested in practical advice for implementing CoF. This study highlights common expectations and points of divergence between parents’ needs and pediatricians’ perceptions of those needs with regard to CoF information.
Collapse
Affiliation(s)
- Sofia De Rosso
- Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France; (S.D.R.); (C.S.)
| | - Camille Schwartz
- Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France; (S.D.R.); (C.S.)
| | - Pauline Ducrot
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France;
| | - Sophie Nicklaus
- Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France; (S.D.R.); (C.S.)
- Correspondence: ; Tel.: +33-3-80-69-35-18
| |
Collapse
|
33
|
Nutritional Strategies for Childhood Obesity Prevention. Life (Basel) 2021; 11:life11060532. [PMID: 34201017 PMCID: PMC8227398 DOI: 10.3390/life11060532] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/31/2021] [Accepted: 05/31/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Reducing the spread of obesity represents a challenge for clinicians in which obesity prevention plays a key role in achieving this purpose. The aim of this review is to analyze the nutritional interventions that can be implemented to prevent childhood obesity. METHODS Searching PubMed and Cochrane Library between 2019 and 2021. Further searching with no date range for articles selected for their specific relevance in the pediatric area or for their scientific relevance. A total of 871 articles were identified and 90 were included. RESULTS We organized the results of the selected articles into age groups, and according to the subjects targeted for interventions or to the site of interventions, reserving an in-depth analysis on specific nutritional aspects. Promotion of breastfeeding, reduction of protein content of formulated milks, and diet of the first 12-24 months, involving family and schools in interventions that promote physical activity and healthy diet, are promising strategies for reduction of the risk of obesity. To increase the efficacy of interventions, a multidimensional approach is crucial. CONCLUSIONS A multidimensional approach, which takes into consideration different areas of intervention, is pivotal for childhood obesity prevention. Integrated programs involving several components (nutrition and physical activity at first) at different levels (individual, family, school, and institutional) are crucial.
Collapse
|
34
|
Kharofa RY, Khalsa AS, Zeller MH, Modi AC, Ollberding NJ, Copeland KA. Giving "prescriptions" for paediatric weight management follow-up in primary care. Clin Obes 2021; 11:e12448. [PMID: 33733574 DOI: 10.1111/cob.12448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 12/01/2022]
Abstract
The American Academy of Paediatrics recommends that primary care paediatricians "prescribe" follow-up for weight management between well child checks. We sought to describe rates and predictors of prescribed and actual clinic attendance for weight management in primary care in a predominantly low-income population. A chart review was performed at a large, hospital-based, primary care clinic, where a treatment algorithm for obesity exists. Eligible children were 6 to 12 years of age with a body mass index (BMI) ≥85th percentile and seen for a well child check in 2014. Primary outcomes were the physician prescribing follow-up in primary care and the patient returning for weight management. Multivariable logistic regression was used to identify predictors of prescribing follow-up and predictors of return. Participants included 1339 patients: mean age 9 years (SD: 1.8 years); 53% female; 79% Black; 89% Medicaid-insured; 56% with an obese BMI (vs overweight). Twenty-seven percent of patients were prescribed follow-up in primary care, of which 13% returned (only 4% of the original sample). The odds of the physician prescribing follow-up were greater if the child had obesity (vs overweight), was older, female or non-Medicaid insured. Older and non-Black patients had greater odds of returning. Patients prescribed follow-up within 2 months or less (vs 3-6 months) were also more likely to return (aOR 2.66; CI: 1.34, 5.26). Rates of prescription for weight management in primary care are low and few patients return, even when follow-up is prescribed. Prescribing follow-up at shorter intervals from the index visit (≤ 2 months) may improve patient return.
Collapse
Affiliation(s)
- Roohi Y Kharofa
- Centre for Better Health and Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Meg H Zeller
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Centre for Child Behavior and Nutrition Research and Training, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
| | - Avani C Modi
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Centre for Adherence and Self-Management, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
| | - Nicholas J Ollberding
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
| | - Kristen A Copeland
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
| |
Collapse
|
35
|
Sanders GJ, Marwa WL, Wade B, Gately P. Efficacy of a county-wide schools weight management intervention. Perspect Public Health 2021; 142:319-327. [PMID: 33998330 DOI: 10.1177/17579139211006738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS This study aimed to evaluate the effectiveness of the Local Authority commissioned large-scale public health service that provided a 6-week school-based weight management intervention for children aged 4-19 years. METHODS A quantitative retrospective cohort study identified participants from 130 schools consisting of 8550 potential children aged 4-19 years across a mixture of Lower Super Output Area (LSOA) deprivation groups. Participants were invited to take part in a 5- to 12-week Healthy Lifestyles intervention with a focus on weight management delivered by OneLife Suffolk between 1 January 2017 and 1 January 2020. This resulted in a final sample of 5163 participants. The following information for each child was collected anonymously: (1) age, (2) gender, (3) preprogramme body mass index (BMI), (4) postprogramme BMI, (5) weight category and (6) LSOA category. RESULTS Following the 6-week school-based intervention, there was a significant decrease in mean ΔBMI SDS (standardised body mass index) of -0.07 (-14.89%) among participants. Wilcoxon signed-rank test showed a significant change in weight status post 6-week weight management programme (WMP): BMI (Z = -15.87, p < .001), BMI SDS (Z = -21.54, p < .001), centile (Z = -20.12, p < .01) and weight category (Z = -7.89, p < .001), whereas Mann-Whitney U test showed no statistically significant difference in mean BMI SDS change between gender groups (p = .24) and Kruskal-Wallis test revealed no statistically significant differences in mean BMI SDS change between child LSOA groups (c2(4) = 1.67, p = .796), school LSOA groups (c2(4) = 4.72, p = .317), ethnic groups (c2(4) = 2.53, p = .640) and weight category at the start of the intervention (c2(3) = 6.20, p = .102). CONCLUSIONS This study contributes to the growing body of evidence demonstrating the efficacy of multicomponent school-based weight management interventions and demonstrates that such interventions can be successfully implemented as part of a wider healthy lifestyles service, without widening health inequalities.
Collapse
Affiliation(s)
- G J Sanders
- Carnegie School of Sport, Leeds Beckett University, Fairfax Hall Rm 230, Headingley Campus, Leeds LS6 3QS, UK
| | - W L Marwa
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - B Wade
- OneLife Suffolk, Inspire Suffolk, Ipswich, UK
| | - P Gately
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| |
Collapse
|
36
|
Androutsos O, Perperidi M, Georgiou C, Chouliaras G. Lifestyle Changes and Determinants of Children's and Adolescents' Body Weight Increase during the First COVID-19 Lockdown in Greece: The COV-EAT Study. Nutrients 2021; 13:nu13030930. [PMID: 33805678 PMCID: PMC7998995 DOI: 10.3390/nu13030930] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/05/2021] [Accepted: 03/10/2021] [Indexed: 01/31/2023] Open
Abstract
Previous studies showed that the coronavirus disease 2019 (COVID-19) lockdown imposed changes in adults’ lifestyle behaviors; however, there is limited information regarding the effects on youth. The COV-EAT study aimed to report changes in children’s and adolescents’ lifestyle habits during the first COVID-19 lockdown and explore potential associations between changes of participants’ lifestyle behaviors and body weight. An online survey among 397 children/adolescents and their parents across 63 municipalities in Greece was conducted in April–May 2020. Parents self-reported changes of their children’s lifestyle habits and body weight, as well as sociodemographic data of their family. The present study shows that during the lockdown, children’s/adolescents’ sleep duration and screen time increased, while their physical activity decreased. Their consumption of fruits and fresh fruit juices, vegetables, dairy products, pasta, sweets, total snacks, and breakfast increased, while fast-food consumption decreased. Body weight increased in 35% of children/adolescents. A multiple regression analysis showed that the body weight increase was associated with increased consumption of breakfast, salty snacks, and total snacks and with decreased physical activity. The COV-EAT study revealed changes in children’s and adolescents’ lifestyle behaviors during the first COVID-19 lockdown in Greece. Effective strategies are needed to prevent excessive body weight gain in future COVID-19 lockdowns.
Collapse
Affiliation(s)
- Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.P.); (C.G.)
- Correspondence: ; Tel.: +30-24310-47108
| | - Maria Perperidi
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.P.); (C.G.)
| | - Christos Georgiou
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.P.); (C.G.)
| | - Giorgos Chouliaras
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| |
Collapse
|
37
|
Bricarello LP, de Almeida Alves M, Retondario A, de Moura Souza A, de Vasconcelos FDAG. DASH diet (Dietary Approaches to Stop Hypertension) and overweight/obesity in adolescents: The ERICA study. Clin Nutr ESPEN 2021; 42:173-179. [PMID: 33745574 DOI: 10.1016/j.clnesp.2021.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/12/2021] [Accepted: 02/01/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND & AIMS Childhood and adolescent obesity is one of the most important issues in the global health of the population and has been increasing dramatically in recent decades. The aim of this study was to evaluate the association between overweight/obesity and the Dietary Approaches to Stop Hypertension (DASH) diet score in a representative sample of Brazilian adolescents. METHODS Data from the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based survey, were used. A total of 71,553 adolescents (12-17 years old), of both sexes, participated in the study; they had their anthropometric measurements taken and responded to a 24-h dietary recall. Eight food components of the DASH score were evaluated. 1) fruits (except fruit juices), 2) vegetables (except potatoes and beans), 3) pulses/nuts, 4) whole grains, 5) low-fat and diet/light dairy products, 6) sodium, 7) red and processed meats, and 8) sugary drinks and fruit juices. A higher score was indicative of greater accordance with the DASH diet, with a final score ranging from eight to 40 points. The association between overweight/obesity and the DASH score was assessed using Poisson regression models. RESULTS The highest prevalence of overweight/obesity was observed among boys aged 12-14 years (28.2%), white (27.7%), enrolled in private schools (32.4%) and among those who practiced ≥300 min physical activity/week (26.1%). The food groups most frequently consumed were sugary drinks, pulses and nuts, and red and processed meats. No association was found between overweight/obesity and the DASH diet score in Brazilian adolescents, in the adjusted analysis models. CONCLUSIONS Low consumption of foods considered protective and high consumption of health-risk foods, even among adolescents with greater accordance with the DASH diet, may have contributed to these findings. Public health measures are needed to prevent/reduce the prevalence of overweight/obesity in adolescence, as it is a risk for overweight/obesity in adulthood as well as other complications, leading to loss of quality of life for the individual and increased health spending.
Collapse
Affiliation(s)
| | | | | | - Amanda de Moura Souza
- Institute of Study in Public Health, Federal University of Rio de Janeiro, Ilha Do Fundão, Cidade Universitária, Rio de Janeiro, 21941-598, Brazil
| | | |
Collapse
|
38
|
Balestrin M, Brasil CCB, Bellei EA, Kirsten VR, Wagner MB. Program for Healthier School Cafeterias in Rio Grande do Sul, Brazil: Protocol for a Community-Based Randomized Trial. JMIR Res Protoc 2021; 10:e22680. [PMID: 33464219 PMCID: PMC7854040 DOI: 10.2196/22680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/12/2020] [Accepted: 10/20/2020] [Indexed: 02/01/2023] Open
Abstract
Background School cafeterias can promote poor eating habits, as these retail outlets have a variety of foods considered to be nonnutritive and unhealthy. However, despite the need for effective preventive strategies, there is still disagreement on the best approach due to the lack of evidence on interventions to prevent and treat obesity in the school settings. Objective We aim to verify the efficacy of an educational intervention program to improve the hygienic conditions and the composition of the menu offered in school cafeterias in the state of Rio Grande do Sul, Brazil. Methods We will conduct a randomized, parallel, two-arm, community-based controlled study. Elementary and high schools, both public and private, in the State of Rio Grande do Sul, Brazil, that have a cafeteria will be eligible. Schools will be recruited and randomly assigned to the intervention (n=27) or control (n=27) group. The intervention group will receive an educational intervention program based on the guidelines issued by the Ministry of Health of Brazil, consisting of a 160-hour distance-learning qualification course, for 10 weeks, and using the Moodle platform and WhatsApp app. The intervention targets the owners and people in charge of the cafeterias, food handlers, principals, vice principals, teachers, pedagogical coordinators, dietitians, representatives of students' parents, and students over 16 years old. Meanwhile, the control group will receive only a printed copy of the book containing the guidelines used. The efficacy of the intervention will be determined by the hygienic conditions of the cafeteria and the composition of the menu offered, also considering the levels of processing of food sold. All outcomes will be analyzed as intention-to-treat and per-protocol. We will use covariance analysis or a generalized linear model for continuous data and ordinal logistic regression for ordinal categorical data. The level of statistical significance considered will be P<.05 for a 95% CI. Results This project was funded in early 2018. We administered the intervention program in 2019. All data have already been collected, and we are analyzing the data. The results are expected in 2021. Conclusions To our knowledge, this may be the first randomized controlled study in school cafeterias held in Brazil. The results will provide evidence for the formulation of public food and nutritional security policies and for the development of effective strategies to provide safe and healthy school meals. Trial Registration Brazilian Clinical Trials Registry RBR-9rrqhk; https://ensaiosclinicos.gov.br/rg/RBR-9rrqhk International Registered Report Identifier (IRRID) DERR1-10.2196/22680
Collapse
Affiliation(s)
- Mariana Balestrin
- Faculty of Medical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Ericles Andrei Bellei
- Institute of Exact Sciences and Geosciences, University of Passo Fundo (UPF), Passo Fundo, Brazil
| | - Vanessa Ramos Kirsten
- Department of Foods and Nutrition, Federal University of Santa Maria (UFSM), Palmeira das Missões, Brazil
| | - Mario Bernardes Wagner
- Faculty of Medical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| |
Collapse
|
39
|
Herrera-Cuenca M, Previdelli AN, Koletzko B, Hernandez P, Landaeta-Jimenez M, Sifontes Y, Gómez G, Kovalskys I, García MCY, Pareja R, Cortés LY, Rigotti A, Fisberg M. Childbearing Age Women Characteristics in Latin America. Building Evidence Bases for Early Prevention. Results from the ELANS Study. Nutrients 2020; 13:E45. [PMID: 33375712 PMCID: PMC7824015 DOI: 10.3390/nu13010045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 12/16/2022] Open
Abstract
Latin American (LA) women have been exposed to demographic and epidemiologic changes that have transformed their lifestyle, with increasing sedentary and unhealthy eating behaviors. We aimed to identify characteristics of LA women to inform public policies that would benefit these women and their future children. The Latin American Study of Nutrition and Health (ELANS) is a multicenter cross-sectional study of representative samples in eight Latin American countries (n = 9218) with a standardized protocol to investigate dietary intake, anthropometric variables, physical activity, and socioeconomic characteristics. Here we included the subsample of all 3254 women of childbearing age (15 to <45 years). The majority of ELANS women had a low socioeconomic status (53.5%), had a basic education level (56.4%), had a mostly sedentary lifestyle (61.1%), and were overweight or obese (58.7%). According to the logistic multiple regression model, living in Peru and Ecuador predicts twice the risk of being obese, and an increased neck circumference is associated with a 12-fold increased obesity risk. An increased obesity risk was also predicted by age <19 years (Relative Risk (RR) 19.8) and adequate consumption of vitamin D (RR 2.12) and iron (RR 1.3). In conclusion, the identification of these risk predictors of obesity among Latin American women may facilitate targeted prevention strategies focusing on high-risk groups to promote the long-term health of women and their children.
Collapse
Affiliation(s)
- Marianella Herrera-Cuenca
- Center for Development Studies, Central University of Venezuela (CENDES-UCV), Caracas 1050, Venezuela
- Bengoa Foundation for Food and Nutrition, Caracas 1071, Venezuela; (M.L.-J.); (Y.S.)
| | | | - Berthold Koletzko
- Departamento Paediatrics, Division Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, LMU University of Munich, D-80377 Munich, Germany;
| | - Pablo Hernandez
- School of Nutrition and Dietetics, Faculty of Medicine, Central University of Venezuela, Caracas 1041-A, Venezuela;
| | | | - Yaritza Sifontes
- Bengoa Foundation for Food and Nutrition, Caracas 1071, Venezuela; (M.L.-J.); (Y.S.)
- School of Nutrition and Dietetics, Faculty of Medicine, Central University of Venezuela, Caracas 1041-A, Venezuela;
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, University of Costa Rica, San José 11501-2060, Costa Rica;
| | - Irina Kovalskys
- Faculty of Medicine, The Pontifical Catholic University of Argentina, Buenos Aires C1107AAZ, Argentina;
| | | | - Rossina Pareja
- Nutrition Research Institute, La Molina, Lima 15026, Peru;
| | - Lilia Yadira Cortés
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, Bogotá 110111, Colombia;
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, Santiago 833-0024, Chile;
| | - Mauro Fisberg
- Instituto Pensi, José Egydio Setubal Foundation, Sabará Children’s Hospital, São Paulo 01239-040, Brazil
- Department of Pediatrics, Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-062, Brazil
| | | |
Collapse
|
40
|
Bognar Z, De Luca D, Domellöf M, Hadjipanayis A, Haffner D, Johnson M, Kolacek S, Koletzko B, Saenz de Pipaon M, Shingadia D, Tissieres P, Titomanlio L, Topaloglu R, Trück J. Promoting Breastfeeding and Interaction of Pediatric Associations With Providers of Nutritional Products. Front Pediatr 2020; 8:562870. [PMID: 33324589 PMCID: PMC7723897 DOI: 10.3389/fped.2020.562870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/25/2020] [Indexed: 12/14/2022] Open
Abstract
Pediatric associations have been urged not to interact with and not to accept support from commercial providers of breast milk substitutes (BMSs), based on the assumption that such interaction would lead to diminished promotion and support of breastfeeding. The leadership of seven European pediatric learned societies reviewed the issue and share their position and policy conclusions here. We consider breastfeeding as the best way of infant feeding and strongly encourage its active promotion, protection, and support. We support the World Health Organization (WHO) Code of Marketing of BMSs. Infant formula and follow-on formula for older infants should not be advertised to families or the public, to avoid undermining breastfeeding. With consistently restricted marketing of BMSs, families need counseling on infant feeding choices by well-informed pediatricians. Current and trustworthy information is shared through congresses and other medical education directed and supervised by independent pediatric organizations or public bodies. Financial support from commercial organizations for congresses, educational, and scientific activities of pediatric organizations is an acceptable option if scientific, ethical, societal, and legal standards are followed; any influence of commercial organizations on the program is excluded, and transparency is ensured. Public-private research collaborations for improving and evaluating pharmaceuticals, vaccines, medical devices, dietetic products, and other products and services for children are actively encouraged, provided they are guided by the goal of enhancing child health and are performed following established high standards. We support increasing investment of public funding for research aiming at promoting child health, as well as for medical education.
Collapse
Affiliation(s)
- Zsolt Bognar
- Pediatric Section of the European Society of Emergency Medicine (EUSEM), Paediatric Emergency Department, Heim Pal National Paediatric Institute, Budapest, Hungary
| | - Daniele De Luca
- European Society of Paediatric and Neonatal Intensive Care, Paris Saclay University Hospitals-APHP, Medical Center A. Beclere, Clamart, France
| | - Magnus Domellöf
- Chair Nutrition Committee, European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Adamos Hadjipanayis
- European Academy of Paediatrics (EAP), European University Cyprus, Paediatric Department, Larnaca General Hospital, Larnaca, Cyprus
| | - Dieter Haffner
- European Society for Paediatric Nephrology (ESPN), Department of Paediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Hanover, Germany
| | - Mark Johnson
- European Society for Paediatric Research (ESPR), National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Sanja Kolacek
- European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), University Department of Paediatrics, Children's Hospital Zagreb, Zagreb, Croatia
| | - Berthold Koletzko
- European Academy of Paediatrics (EAP), Department of Paediatrics, University Hospital LMU Munich, Dr. von Hauner Children's Hospital, LMU-Ludwig-MaximiliansUniversität München, Munich, Germany
| | - Miguel Saenz de Pipaon
- European Society for Paediatric Research (ESPR), Department of Pediatrics, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Delane Shingadia
- European Society for Paediatric Infectious Diseases (ESPID), Institute of Child Health, University College London, Great Ormond Street Hospital, London, United Kingdom
| | - Pierre Tissieres
- European Society of Paediatric and Neonatal Intensive Care, Paediatric and Neonatal Intensive Care Unit, Paris Saclay University Hospitals-APHP, Le Kremlin-Bicêtre, France
| | - Luigi Titomanlio
- Pediatric Section of the European Society of Emergency Medicine (EUSEM), Pediatric Emergency Department and Migraine and Neurovascular Diseases Clinic, INSERM U1141—Paris University, Robert Debré Hospital, Paris, France
| | - Rezan Topaloglu
- European Society for Paediatric Nephrology (ESPN), Department Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Johannes Trück
- European Society for Paediatric Infectious Diseases (ESPID), University Children's Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
41
|
Laurens MLL, Kraus-Friedberg C, Kar W, Sanfilippo D, Rajasekaran S, Comstock SS. Dietary Intake Influences Metabolites in Healthy Infants: A Scoping Review. Nutrients 2020; 12:nu12072073. [PMID: 32668684 PMCID: PMC7400847 DOI: 10.3390/nu12072073] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/11/2022] Open
Abstract
Metabolites are generated from exogenous sources such as diet. This scoping review will summarize nascent metabolite literature and discriminating metabolites for formula vs. human- milk-fed infants. Using the PICOS framework (P—Patient, Problem or Population; I—Intervention; C—Comparison; O—Outcome; S—Study Design) and PRISMA item-reporting protocols, infants less than 12 months old, full-term, and previously healthy were included. Protocol was registered with Open Science Framework (OSF). Publications from 1 January 2009–2019 were selected, for various biofluids, study designs, and techniques (such as high-performance liquid chromatography (HPLC)). From 711 articles, blinded screening of 214 articles using Abstrackr® software, resulted in 24 for final review. Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines were adopted, which included a 24-point checklist. Articles were stratified according to biofluid. Of articles reporting discriminating metabolites between formula- and human milk-fed infants, 62.5% (5/8) of plasma/serum/dried blood spot, 88% (7/8) of urine and 100% (6/6) of feces related articles reported such discriminating metabolites. Overall, no differences were found between analytical approach used (targeted (n = 9) vs. un-targeted (n = 10)). Current articles are limited by small sample sizes and differing methodological approaches. Of the metabolites reviewed herein, fecal metabolites provided the greatest distinction between diets, which may be indicative of usefulness for future diet metabolite-focused work.
Collapse
Affiliation(s)
- Mara L. Leimanis Laurens
- Pediatric Critical Care Unit, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USA; (D.S.); (S.R.)
- Department of Pediatrics and Human Development, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA
- Correspondence: ; Tel.: +1-616-267-0106
| | | | - Wreeti Kar
- Department of Food Science and Human Nutrition, Michigan State University, Room 139C Trout 469 Wilson Rd, East Lansing, MI 48824, USA; (W.K.); (S.S.C.)
| | - Dominic Sanfilippo
- Pediatric Critical Care Unit, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USA; (D.S.); (S.R.)
- Department of Pediatrics and Human Development, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA
| | - Surender Rajasekaran
- Pediatric Critical Care Unit, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USA; (D.S.); (S.R.)
- Department of Pediatrics and Human Development, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA
| | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, Room 139C Trout 469 Wilson Rd, East Lansing, MI 48824, USA; (W.K.); (S.S.C.)
| |
Collapse
|
42
|
Zorena K, Jachimowicz-Duda O, Ślęzak D, Robakowska M, Mrugacz M. Adipokines and Obesity. Potential Link to Metabolic Disorders and Chronic Complications. Int J Mol Sci 2020; 21:E3570. [PMID: 32443588 PMCID: PMC7278967 DOI: 10.3390/ijms21103570] [Citation(s) in RCA: 178] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/19/2022] Open
Abstract
The World Health Organization (WHO) has recognized obesity as one of the top ten threats to human health. It is estimated that the number of obese and overweight people worldwide exceeds the number of those who are undernourished. Obesity is not only a state of abnormally increased adipose tissue in the body, but also of increased release of biologically active adipokines. Adipokines released into the circulating blood, due to their specific receptors on the surface of target cells, act as classic hormones affecting the metabolism of tissues and organs. What is more, adipokines and cytokines may decrease the insulin sensitivity of tissues and induce inflammation and development of chronic complications. Certainly, it can be stated that in an era of a global obesity pandemic, adipokines may gain more and more importance as regards their use in the diagnostic evaluation and treatment of diseases. An extensive search for materials on the role of white, brown and perivascular fatty tissue and obesity-related metabolic and chronic complications was conducted online using PubMed, the Cochrane database and Embase.
Collapse
Affiliation(s)
- Katarzyna Zorena
- Department of Immunobiology and Environment Microbiology, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Olga Jachimowicz-Duda
- Independent Public Specialized Health Care Center in Lębork, Department of Internal Diseases, Węgrzynowicza 13, 84-300 Lębork, Poland;
| | - Daniel Ślęzak
- Department of Emergency Medicine, Faculty of Health Sciences, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland;
| | - Marlena Robakowska
- Department of Public Health & Social Medicine, Faculty of Health Sciences, Medical University of Gdańsk, Al. Zwycięctwa 42a, 80-210 Gdańsk, Poland;
| | - Małgorzata Mrugacz
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, Kilinskiego 1, 15-089 Białystok, Poland;
| |
Collapse
|
43
|
Kansra AR, Lakkunarajah S, Jay MS. Childhood and Adolescent Obesity: A Review. Front Pediatr 2020; 8:581461. [PMID: 33511092 PMCID: PMC7835259 DOI: 10.3389/fped.2020.581461] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is a complex condition that interweaves biological, developmental, environmental, behavioral, and genetic factors; it is a significant public health problem. The most common cause of obesity throughout childhood and adolescence is an inequity in energy balance; that is, excess caloric intake without appropriate caloric expenditure. Adiposity rebound (AR) in early childhood is a risk factor for obesity in adolescence and adulthood. The increasing prevalence of childhood and adolescent obesity is associated with a rise in comorbidities previously identified in the adult population, such as Type 2 Diabetes Mellitus, Hypertension, Non-alcoholic Fatty Liver disease (NAFLD), Obstructive Sleep Apnea (OSA), and Dyslipidemia. Due to the lack of a single treatment option to address obesity, clinicians have generally relied on counseling dietary changes and exercise. Due to psychosocial issues that may accompany adolescence regarding body habitus, this approach can have negative results. Teens can develop unhealthy eating habits that result in Bulimia Nervosa (BN), Binge- Eating Disorder (BED), or Night eating syndrome (NES). Others can develop Anorexia Nervosa (AN) as they attempt to restrict their diet and overshoot their goal of "being healthy." To date, lifestyle interventions have shown only modest effects on weight loss. Emerging findings from basic science as well as interventional drug trials utilizing GLP-1 agonists have demonstrated success in effective weight loss in obese adults, adolescents, and pediatric patients. However, there is limited data on the efficacy and safety of other weight-loss medications in children and adolescents. Nearly 6% of adolescents in the United States are severely obese and bariatric surgery as a treatment consideration will be discussed. In summary, this paper will overview the pathophysiology, clinical, and psychological implications, and treatment options available for obese pediatric and adolescent patients.
Collapse
Affiliation(s)
- Alvina R Kansra
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sinduja Lakkunarajah
- Division of Adolescent Medicine, Department of Pediatrics, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, United States
| | - M Susan Jay
- Division of Adolescent Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| |
Collapse
|