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Lister NB, Baur LA, Felix JF, Hill AJ, Marcus C, Reinehr T, Summerbell C, Wabitsch M. Child and adolescent obesity. Nat Rev Dis Primers 2023; 9:24. [PMID: 37202378 DOI: 10.1038/s41572-023-00435-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/20/2023]
Abstract
The prevalence of child and adolescent obesity has plateaued at high levels in most high-income countries and is increasing in many low-income and middle-income countries. Obesity arises when a mix of genetic and epigenetic factors, behavioural risk patterns and broader environmental and sociocultural influences affect the two body weight regulation systems: energy homeostasis, including leptin and gastrointestinal tract signals, operating predominantly at an unconscious level, and cognitive-emotional control that is regulated by higher brain centres, operating at a conscious level. Health-related quality of life is reduced in those with obesity. Comorbidities of obesity, including type 2 diabetes mellitus, fatty liver disease and depression, are more likely in adolescents and in those with severe obesity. Treatment incorporates a respectful, stigma-free and family-based approach involving multiple components, and addresses dietary, physical activity, sedentary and sleep behaviours. In adolescents in particular, adjunctive therapies can be valuable, such as more intensive dietary therapies, pharmacotherapy and bariatric surgery. Prevention of obesity requires a whole-system approach and joined-up policy initiatives across government departments. Development and implementation of interventions to prevent paediatric obesity in children should focus on interventions that are feasible, effective and likely to reduce gaps in health inequalities.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
- Weight Management Services, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Andrew J Hill
- Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Claude Marcus
- Division of Paediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Reinehr
- Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Martin Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Centre, Ulm, Germany
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Wilkinson K, Ata A, Neaton S, Woll C. Evaluation of Safety Measures at a Medical Summer Camp During the SARS-CoV-2 Pandemic. Wilderness Environ Med 2023; 34:77-81. [PMID: 36517390 PMCID: PMC9688782 DOI: 10.1016/j.wem.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/28/2022] [Accepted: 10/14/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION SARS-CoV-2 poses challenges for the safe delivery of a camp experience with a medically complex camper population. Multiple studies have investigated the effect of nonpharmaceutical interventions for preventing SARS-CoV-2 transmission in traditional summer camp settings, but none in the medical summer camp settings. Our objective was to describe and evaluate the nonpharmaceutical interventions on SARS-CoV-2 transmission rate in a medical summer camp setting. METHODS This was a single-institution cross-sectional study conducted between June 2021 and August 2021 in a rural summer camp setting in upstate New York. Nonpharmaceutical interventions consisted of prearrival guidance on low-risk activities, obtaining negative SARS-CoV-2 polymerase chain reaction results within 72 h prior to arrival, adult SARS-CoV-2 vaccine mandate, universal masking mandate, small cohorts, daily symptom screening, and rapid testing on site. Primary cases were defined as an individual with a positive SARS-CoV-2 test result of any type while at camp or 2 wk after departure from camp without any known exposure at camp; secondary cases were defined as cases from potential exposures within camp. RESULTS Two hundred and ninety-three campers were included. Nine individuals were tested owing to potentially infectious symptoms while at camp. Thirty-four campers were tested because they arrived from a county with an a priori intermediate level of SARS-CoV-2 community spread. Zero on-site rapid tests were positive for SARS-CoV-2. CONCLUSIONS We describe the implementation of multilayered nonpharmaceutical interventions at a medical summer camp during the SARS-CoV-2 pandemic.
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Affiliation(s)
| | - Ashar Ata
- Departments of Surgery and Emergency Medicine, Albany Medical Center, Albany, NY
| | | | - Christopher Woll
- Double H Hole-in-the-Woods Ranch, Lake Luzerne, NY; Departments of Pediatrics and Emergency Medicine, Albany Medical Center, Albany, NY.
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Vlaev I, Taylor MJ, Taylor D, Gately P, Gunn LH, Abeles A, Kerkadi A, Lothian J, Jreige SK, Alsaadi A, Al-Kuwari MG, Ghuloum S, Al-Kuwari H, Darzi A, Ahmedna M. Testing a multicomponent lifestyle intervention for combatting childhood obesity. BMC Public Health 2021; 21:824. [PMID: 33926412 PMCID: PMC8082655 DOI: 10.1186/s12889-021-10838-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 04/14/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Childhood obesity is a major global health concern. Weight-management camps involving delivery of a program of physical activity, health education, and healthy eating are an effective treatment, although post-intervention weight-management is less well understood. Our objective was to assess the effectiveness of a weight-management camp followed by a community intervention in supporting weight-management for overweight children and children with obesity. METHODS Participants were overweight Qatari schoolchildren or schoolchildren with obesity, ages 8-14 years, (n = 300) recruited over a three-year period across 14 randomly selected schools in the Doha area. They attended a two-week weight management camp, then a 10-week program of weekly lifestyle education and physical activity sessions, which also included behavior change techniques. The programme was cognitive behavioural therapy (CBT)-focused with a strong element of behavioural economics blended in. RESULTS Participants saw a significant BMI SDS reduction as a result of the entire intervention (camp + education and activity sessions) both at the individual (p < 0.0001) and cluster/school (p = 0.0002) levels, and weight loss occurred during each intervention stage separately for the camp (p < 0.0001 for both the individual and cluster/school levels) and the lifestyle education and activity phase (p < 0.0001 and p = 0.0220 at the individual and cluster/school levels, respectively). CONCLUSIONS Weekly lifestyle education and activity sessions which include behavior change techniques may be useful in promoting continued weight management in the period following intensive, immersive childhood obesity interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT02972164 , November 23, 2016.
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Affiliation(s)
- Ivo Vlaev
- Warwick Business School, University of Warwick, Coventry, UK.
| | - Michael J Taylor
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - David Taylor
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Laura H Gunn
- Department of Public Health Sciences & School of Data Science, University of North Carolina at Charlotte, Charlotte, USA.,School of Public Health, Imperial College London, London, UK
| | - Aliza Abeles
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Abdelhamid Kerkadi
- Human Nutrition Department, College of Health Sciences, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | - Ara Darzi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Mohamed Ahmedna
- North Carolina Agricultural and Technical State University, Greensboro, USA
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Motivation, Self-Concept and Discipline in Young Adolescents Who Practice Rhythmic Gymnastics. An Intervention. CHILDREN-BASEL 2020; 7:children7090135. [PMID: 32937905 PMCID: PMC7552725 DOI: 10.3390/children7090135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 12/19/2022]
Abstract
This study aims to develop an intervention based on TARGET strategies in young people practicing rhythmic gymnastics, with the aim of observing whether motivation, discipline, self-concept and flexibility are improved. This research is a longitudinal study of a quasi-experimental nature. A total of 104 young adolescents between the ages of 11 and 12 years (11.66 ± 0.47) participated in the study, of which 60 belong to the control group and 44 to the experimental group. The intervention programme lasted two months (17 sessions). TARGET strategies were applied to the experimental group during training. While the experimental group continued with its routine training. To measure the psychological variables, the instrument used were the Youth Physical Self-Concept Scale (C-PSQ), Reason Scale for Discipline (RSD) and Success Perception Questionnaire (SPQ), and for flexibility, the tests were applied to the Sit and Reach and Deep trunk flexion test. The results showed that those teenagers who participated in the intervention, obtained an increased climate task, which entails an enjoyment by the practice of physical activity itself, more optimal levels of physical self-concept and discipline, subsequently, obtaining better results of flexibility. While in the control group gymnasts the ego climate and demotivation increased. TARGET strategies applied to young adolescents have positive effects, improve motivation towards physical activity, self-concept and discipline. This results in greater performance in flexibility. This will encourage young adolescents to continue to engage in physical activity in the future.
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Abstract
PURPOSE OF REVIEW There are contrasting views regarding the psychological well-being of children with obesity. Responding to limitations of existing evidence, Jane Wardle in 2005 argued for a 'myth of psychological maladjustment'. This review looks again at self-esteem. RECENT FINDINGS The different characterisations of self-esteem each offer value. Global self-esteem is reduced in nearly all studies of youth with obesity. Dimensional self-esteem reveals physical appearance, athletic and social competence as the most affected areas, confirmed by research that has operationalised low self-competence. Children with obesity are also more likely to be victimised by their peers, generally and for their fatness. Victims who bully others appear to preserve some aspects of self-esteem. A relatively small proportion of youth with obesity has low self-esteem, but those with severe and persistent obesity are especially compromised. Weight loss is only weakly associated with improved self-competence suggesting the value of resilience and asset approaches to improving well-being.
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Affiliation(s)
- Andrew J Hill
- Academic Unit of Psychiatry and Behavioural Sciences Institute of Health Sciences, University of Leeds School of Medicine, Level 10, Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK.
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