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Alkhatib A, Obita G. Childhood Obesity and Its Comorbidities in High-Risk Minority Populations: Prevalence, Prevention and Lifestyle Intervention Guidelines. Nutrients 2024; 16:1730. [PMID: 38892662 PMCID: PMC11175158 DOI: 10.3390/nu16111730] [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] [Received: 05/01/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
The prevalence of childhood obesity and its associated comorbidities is a growing global health problem that disproportionately affects populations in low- and middle-income countries (LMICs) and minority ethnicities in high-income countries (HICs). The increased childhood obesity disparities among populations reflect two concerns: one is HICs' ineffective intervention approaches in terms of lifestyle, nutrition and physical activity in minority populations, and the second is the virtually non-existent lifestyle obesity interventions in LMICs. This article provides guidelines on childhood obesity and its comorbidities in high-risk minority populations based on understanding the prevalence and effectiveness of preventative lifestyle interventions. First, we highlight how inadequate obesity screening by body mass index (BMI) can be resolved by using objective adiposity fat percentage measurements alongside anthropometric and physiological components, including lean tissue and bone density. National healthcare childhood obesity prevention initiatives should embed obesity cut-off points for minority ethnicities, especially Asian and South Asian ethnicities within UK and USA populations, whose obesity-related metabolic risks are often underestimated. Secondly, lifestyle interventions are underutilised in children and adolescents with obesity and its comorbidities, especially in minority ethnicity population groups. The overwhelming evidence on lifestyle interventions involving children with obesity comorbidities from ethnic minority populations shows that personalised physical activity and nutrition interventions are successful in reversing obesity and its secondary cardiometabolic disease risks, including those related to cardiorespiratory capacity, blood pressure and glucose/insulin levels. Interventions combining cultural contextualisation and better engagement with families are the most effective in high-risk paediatric minority populations but are non-uniform amongst different minority communities. A sustained preventative health impact can be achieved through the involvement of the community, with stakeholders comprising healthcare professionals, nutritionists, exercise science specialists and policy makers. Our guidelines for obesity assessment and primary and secondary prevention of childhood obesity and associated comorbidities in minority populations are fundamental to reducing global and local health disparities and improving quality of life.
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Affiliation(s)
- Ahmad Alkhatib
- College of Life Sciences, Birmingham City University, City South Campus, Edgbaston, Birmingham B15 3TN, UK
- School of Health and Life Sciences, Teesside University, Tees Valley, Middlesbrough TS1 3BX, UK;
| | - George Obita
- School of Health and Life Sciences, Teesside University, Tees Valley, Middlesbrough TS1 3BX, UK;
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2
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Gooey M, Skouteris H, Betts J, Hatzikiriakidis K, Sturgiss E, Bergmeier H, Bragge P. Clinical practice guidelines for the prevention of childhood obesity: A systematic review of quality and content. Obes Rev 2022; 23:e13492. [PMID: 35818135 PMCID: PMC9539478 DOI: 10.1111/obr.13492] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/17/2022] [Accepted: 06/15/2022] [Indexed: 11/28/2022]
Abstract
Obesity in childhood is a significant global issue, and prevention is key to reducing prevalence. Healthcare providers can play an important role in the prevention of obesity. The aim of this systematic review was to identify and evaluate clinical practice guidelines (CPGs) for preventing childhood obesity with a focus on the role of medical doctors. Peer-reviewed literature and gray literature sources were searched for CPGs published from 2010 to 2021. Eleven CPGs were identified. Quality was evaluated using the Appraisal of Guidelines for Research and Evaluation Collaboration (AGREE II) instrument; seven CPGs were higher quality and four lower quality. Recommendations within the CPGs covered three main areas: growth monitoring, maintaining a healthy weight, and managing overweight. The importance of involving the whole family and healthy lifestyle behaviors was emphasized. The majority of the CPGs rated poorly in guideline applicability highlighting the need for practical implementation tools. Although our review identified a number of CPGs relevant to the prevention of obesity for doctors working with children and their families, more research is needed to produce high-quality meaningful and applicable CPGs to maximize uptake, implementation, and ultimately, benefit to children and their families.
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Affiliation(s)
- Michelle Gooey
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Warwick Business School, University of Warwick, Coventry, UK
| | - Juliana Betts
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kostas Hatzikiriakidis
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Elizabeth Sturgiss
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Heidi Bergmeier
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Victoria, Australia
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3
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Abstract
The prevalence of obesity in children and adolescents worldwide has quadrupled since 1975 and is a key predictor of obesity later in life. Previous work has consistently observed relationships between macroscale measures of reward-related brain regions (e.g., the nucleus accumbens [NAcc]) and unhealthy eating behaviors and outcomes; however, the mechanisms underlying these associations remain unclear. Recent work has highlighted a potential role of neuroinflammation in the NAcc in animal models of diet-induced obesity. Here, we leverage a diffusion MRI technique, restriction spectrum imaging, to probe the microstructure (cellular density) of subcortical brain regions. More specifically, we test the hypothesis that the cell density of reward-related regions is associated with obesity-related metrics and early weight gain. In a large cohort of nine- and ten-year-olds enrolled in the Adolescent Brain Cognitive Development (ABCD) study, we demonstrate that cellular density in the NAcc is related to individual differences in waist circumference at baseline and is predictive of increases in waist circumference after 1 y. These findings suggest a neurobiological mechanism for pediatric obesity consistent with rodent work showing that high saturated fat diets increase gliosis and neuroinflammation in reward-related brain regions, which in turn lead to further unhealthy eating and obesity.
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Waist circumference as a prognostic index of childhood abdominal obesity: findings in the Spanish population. NUTR HOSP 2020; 38:85-93. [PMID: 33342218 DOI: 10.20960/nh.03197] [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: 11/02/2022] Open
Abstract
Introduction Introduction: early detection of childhood obesity plays a crucial role in the prevention of diseases during adulthood. At present, the most commonly used screening tool for detecting overweight/obesity in children is the percentile for age of body mass index, although this rate is unable to provide information about fat distribution. An emerging marker of abdominal fat distribution is waist circumference (WC). Objective: the aim of this study was to evaluate the differences between the different diagnostic criteria available to define overweight and obesity in order to establish the optimal WC cut-off values for the Spanish children population. Methods: a cross-sectional study was carried out in 8,241 schoolchildren aged 3 to 12 years from Villanueva de la Cañada (Madrid, Spain). WC (cm), weight (kg) and height (cm) were measured according to the recommendations of the Society for the Advancement of Kineanthropometry (ISAK). The values obtained for the diagnostic criteria (Spanish Orbegozo Foundation (OF), the International Obesity Task Force (IOTF), and the World Health Organization (WHO) were compared using McNemar's test for paired proportions. The kappa coefficient (κ) was used to assess the degree of agreement of the three classifications. We analyzed the validity of body mass index (BMI) and WC using the receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine cut-off values for WC that identify childhood obesity Results: overweight and obesity prevalences were calculated according to the OF, IOTF, and WHO criteria. There was a "substantial" agreement for the overweight and obesity categories between the Spanish criteria and IOTF (κ = 0.636), while agreement was "slight" between the Spanish criteria and those of WHO (κ = 0.198). The estimated cut-off WC criteria ranged from 54.5 to 88.0, varying according to sex and age. Conclusion: the proposed WC cut-off values, stated for the first time in a young Spanish population, are a simple and valid alternative as diagnostic criteria of abdominal obesity.
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Chung ST, Onuzuruike AU, Magge SN. Cardiometabolic risk in obese children. Ann N Y Acad Sci 2019; 1411:166-183. [PMID: 29377201 DOI: 10.1111/nyas.13602] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 12/29/2017] [Accepted: 12/31/2017] [Indexed: 02/06/2023]
Abstract
Obesity in childhood remains a significant and prevalent public health concern. Excess adiposity in youth is a marker of increased cardiometabolic risk (CMR) in adolescents and adults. Several longitudinal studies confirm the strong association of pediatric obesity with the persistence of adult obesity and the future development of cardiovascular disease, diabetes, and increased risk of death. The economic and social impact of childhood obesity is further exacerbated by the early onset of the chronic disease burden in young adults during their peak productivity years. Furthermore, rising prevalence rates of severe obesity in youth from disadvantaged and/or minority backgrounds have prompted the creation of additional classification schemes for severe obesity to improve CMR stratification. Current guidelines focus on primary obesity prevention efforts, as well as screening for clustering of multiple CMR factors to target interventions. This review summarizes the scope of the pediatric obesity epidemic, the new severe obesity classification scheme, and examines the association of excess adiposity with cardiovascular and metabolic risk. We will also discuss potential questions for future investigation.
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Affiliation(s)
- Stephanie T Chung
- Section on Ethnicity and Health, National Institute of Diabetes, Digestive and Kidney Diseases, NIH, Bethesda, Maryland.,Division of Pediatric Endocrinology and Diabetes, Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Anthony U Onuzuruike
- Section on Ethnicity and Health, National Institute of Diabetes, Digestive and Kidney Diseases, NIH, Bethesda, Maryland
| | - Sheela N Magge
- Division of Pediatric Endocrinology and Diabetes, Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington, DC
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Byberg KK, Mikalsen IB, Eide GE, Forman MR, Júlíusson PB, Øymar K. The associations between weight-related anthropometrics during childhood and lung function in late childhood: a retrospective cohort study. BMC Pulm Med 2018; 18:10. [PMID: 29351745 PMCID: PMC5775530 DOI: 10.1186/s12890-017-0567-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/21/2017] [Indexed: 02/08/2023] Open
Abstract
Background An association between body weight in childhood and subsequent lung function and asthma has been suggested, but few longitudinal studies exist. Our aim was to explore whether weight-related anthropometric measurements through childhood were associated with lung function in late childhood. Methods From an original nested case-control study, a cohort study was conducted, where lung function was measured in 463 children aged 12.8 years, and anthropometry was measured at several ages from birth through 12.8 years of age. Associations between anthropometrics and lung function were analysed using multiple linear and fractional polynomial regression analysis. Results Birthweight and body mass index (BMI; kg/m2) at different ages through childhood were positively associated with forced vital capacity in percent of predicted (FVC %) and forced expiratory volume in the first second in percent of predicted (FEV1%) at 12.8 years of age. BMI, waist circumference, waist-to-height ratio and skinfolds at 12.8 years of age and the change in BMI from early to late childhood were positively associated with FVC % and FEV1% and negatively associated with FEV1/FVC and forced expiratory flow at 25–75% of FVC/FVC. Interaction analyses showed that positive associations between anthropometrics other than BMI and lung function were mainly found in girls. Inverse U-shaped associations were found between BMI at the ages of 10.8/11.8 (girls/boys) and 12.8 years (both genders) and FVC % and FEV1% at 12.8 years of age. Conclusions Weight-related anthropometrics through childhood may influence lung function in late childhood. These findings may be physiological or associated with air flow limitation. Inverse U-shaped associations suggest a differential impact on lung function in normal-weight and overweight children. Trial registration This study was observational without any health care intervention for the participants. Therefore, no trial registration number is available. Electronic supplementary material The online version of this article (doi: 10.1186/s12890-017-0567-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristine Kjer Byberg
- Department of Paediatrics, Stavanger University Hospital, POB 8100, N-4068, Stavanger, Norway.
| | - Ingvild Bruun Mikalsen
- Department of Paediatrics, Stavanger University Hospital, POB 8100, N-4068, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Geir Egil Eide
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Michele R Forman
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Pétur Benedikt Júlíusson
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Knut Øymar
- Department of Paediatrics, Stavanger University Hospital, POB 8100, N-4068, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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Ma YC, Peng CT, Huang YC, Lin HY, Lin JG. Safe needling depths of upper back acupoints in children: a retrospective study. Altern Ther Health Med 2016; 16:85. [PMID: 26922245 PMCID: PMC4769822 DOI: 10.1186/s12906-016-1060-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 02/19/2016] [Indexed: 11/10/2022]
Abstract
Background Acupuncture is applied for treating numerous conditions in children, but few studies have examined the safe needling depth of acupoints in the pediatric population. In this study, we investigated the depths to which acupuncture needles can be inserted safely in the upper back acupoints of children and the variations in safe depth according to sex, age, weight, and body mass index (BMI). Methods We retrospectively studied computed tomography (CT) images of patients aged 4 to 18 years who underwent chest CT at China Medical University Hospital between December 2004 and May 2013. The safe depths of 23 upper back acupoints in the Governor Vessel (GV), Bladder Meridian (BL), Small Intestine Meridian (SI), Gallbladder Meridian (GB) and Spleen Meridian (SP) were measured directly from the CT images. The relationships between the safe depths of these acupoints and sex, age, body weight, and BMI were analyzed. Results The results indicated significant differences in safe needling depth between boys and girls in most upper back acupoints, except at BL42, BL44, BL45, BL46, GB21 and SP21. Safe depths differed significantly depending on age (p < 0.001), weight (p ≤ 0.01), and BMI (p < 0.05). Multiple regression analysis revealed that weight was the most crucial factor in determining the safe depth. Conclusions Sex, age, weight, and BMI are relevant factors in determining the safe needling depths of upper back acupoints in children. Physicians should pay attention to wide variations in needle depth when performing acupuncture.
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The Depths from Skin to the Major Organs at Chest Acupoints of Pediatric Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:126028. [PMID: 26457105 PMCID: PMC4592721 DOI: 10.1155/2015/126028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 08/28/2015] [Accepted: 09/06/2015] [Indexed: 11/25/2022]
Abstract
Background. Acupuncture is applied to treat numerous diseases in pediatric patients. Few reports have been published on the depth to which it is safe to insert needle acupoints in pediatric patients.
We evaluated the depths to which acupuncture needles can be inserted safely in chest acupoints in pediatric patients and the variations in safe depth according to sex, age, body weight, and body mass index (BMI). Methods. We retrospectively studied computed tomography (CT) images of pediatric patients aged 4 to 18 years who had undergone chest CT at China Medical University Hospital from December 2004 to May 2013. The safe depth of chest acupoints was directly measured from the CT images. The relationships between the safe depth of these acupoints and sex, age, body weight, and BMI were analyzed. Results. The results demonstrated significant differences in depth among boys and girls at KI25 (kidney meridian), ST16 (stomach meridian), ST18, SP17 (spleen meridian), SP19, SP20, PC1 (pericardium meridian), LU2 (lung meridian), and GB22 (gallbladder meridian). Safe depth significantly differed among the age groups (P < 0.001), weight groups (P < 0.05), and BMI groups (P < 0.05). Conclusion. Physicians should focus on large variations in needle depth during acupuncture for achieving optimal therapeutic effect and preventing complications.
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9
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Estimation of waist and hip circumferences using body mass index in Delhi school girls (6-11 years). J Biosoc Sci 2015. [PMID: 26199968 DOI: 10.1017/s0021932014000273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Central obesity has been associated with the risk of cardiovascular and metabolic disease in children. A total of 358 Delhi school girls aged 6–11 years were measured for height, weight, waist circumference and hip circumference. The study demonstrates a linear correlation between body mass index (BMI) and waist and hip circumference and suggests an indirect method of estimating waist and hip circumferences, whose high values may be used for the diagnosis of metabolic syndrome and cardiovascular disease. Further investigations on different groups are needed to substantiate these results and attribute BMI a predictive value in the clinical setting for the risk and diagnosis of childhood obesity-related metabolic disorders.
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10
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McCrindle BW. Cardiovascular Consequences of Childhood Obesity. Can J Cardiol 2015; 31:124-30. [DOI: 10.1016/j.cjca.2014.08.017] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 08/22/2014] [Accepted: 08/22/2014] [Indexed: 12/11/2022] Open
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Flechtner-Mors M, Schwab KO, Fröhlich-Reiterer EE, Kapellen TM, Meissner T, Rosenbauer J, Stachow R, Holl RW. Overweight and Obesity Based on Four Reference Systems in 18,382 Paediatric Patients with Type 1 Diabetes from Germany and Austria. J Diabetes Res 2015; 2015:370753. [PMID: 26125029 PMCID: PMC4466469 DOI: 10.1155/2015/370753] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 05/02/2015] [Accepted: 05/05/2015] [Indexed: 12/13/2022] Open
Abstract
AIM To evaluate the prevalence of overweight and obesity in paediatric type 1 diabetes (T1D) subjects, based on four commonly used reference populations. METHODS Using WHO, IOTF, AGA (German pediatric obesity), and KiGGS (German Health Interview and Examination Survey for Children and Adolescents) reference populations, prevalence of overweight (≥90th percentile) and obesity (≥97th percentile) and time trend between 2000 (n = 9,461) and 2013 (n = 18,382) were determined in 2-18-year-old T1D patients documented in the German/Austrian DPV database. RESULTS In 2000, the overweight prevalence was the highest according to IOTF (22.3%), followed by WHO (20.8%), AGA (15.5%), and KiGGS (9.4%). The respective rates in 2013 were IOTF (24.8%), WHO (22.9%), AGA (18.2%), and KiGGS (11.7%). Obesity prevalence in 2000 was the highest according to WHO (7.9%), followed by AGA (4.5%), IOTF (3.1%), and KiGGS (1.8%). In 2013, the respective rates were WHO (9.6%), AGA (6.2%), IOTF (4.5%), and KiGGS (2.6%). Overall, the prevalence of overweight and obesity increased from 2000 to 2006 (p < 0.001) but showed stabilization thereafter in girls and overweight in boys. CONCLUSION Overweight and obesity prevalence in T1D subjects differs significantly if it is assessed by four separate reference populations. More detailed assessment of each child is required to determine obesity-related risks.
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Affiliation(s)
- M. Flechtner-Mors
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, 89081 Ulm, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
- *M. Flechtner-Mors:
| | - K. O. Schwab
- Department of Pediatrics and Adolescent Medicine, University Hospital Freiburg, 79106 Freiburg, Germany
| | | | - T. M. Kapellen
- Hospital for Children and Adolescents, University of Leipzig, 04317 Leipzig, Germany
| | - T. Meissner
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, 40225 Düsseldorf, Germany
| | - J. Rosenbauer
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center at University of Düsseldorf, 40225 Düsseldorf, Germany
| | - R. Stachow
- Rehabilitation Clinic for Children and Adolescents, Westerland, 25980 Sylt, Germany
| | - R. W. Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, 89081 Ulm, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
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Follow-up of a healthy lifestyle education program (the Educació en Alimentació Study): 2 years after cessation of intervention. J Adolesc Health 2014; 55:782-9. [PMID: 25193385 DOI: 10.1016/j.jadohealth.2014.06.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 06/27/2014] [Accepted: 06/27/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE The Educació en Alimentació (EdAl) program conducted over 28 months in primary school children reduced obesity (OB) prevalence in boys and increased voluntary physical activity (PA). The continued benefit after cessation of EdAl is unknown. We assessed the changes in OB prevalence and healthy lifestyle in 11- to 13-year-old adolescents, the age group that had complete inclusion data available 2 years after the EdAl program's conclusion. METHODS Adolescents (n = 421 intervention; n = 198 control) with data at baseline and 2-year follow-up were recruited. Analyses included body mass index (BMI), BMI z-score, and lifestyle data (from questionnaires). RESULTS Between baseline and 2-year follow-up, OB prevalence was reduced (-5.5%; p < .01) and BMI z-score (-.29; p < .001) in intervention compared with control group. BMI z-score was effectively reduced in intervention in both genders: -.26 units in boys and -.32 units in girls, compared with control group. The ≥4 hours/week after-school PA was increased significantly by 13.1% in adolescents of intervention group compared with control group (p = .023); a tendency toward increased PA in intervention girls was observed (p = .062). At 2-year follow-up, participating in ≥4 hours/week after-school PA (odds ratio, .240; p = .002) and daily fruit consumption (odds ratio, .447; p = .025) were protective factors against OB, whereas ≤2 hours/week after-school PA was a risk factor for OB. CONCLUSIONS At 2-year follow-up, the EdAl program induced a lowering of BMI z-score and OB prevalence, compared with control group. After-school PA practice can be stimulated in primary school as part of a healthy lifestyle and maintained subsequently despite cessation of the intervention program.
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Eyre ELJ, Duncan MJ, Birch SL, Fisher JP. The influence of age and weight status on cardiac autonomic control in healthy children: a review. Auton Neurosci 2014; 186:8-21. [PMID: 25458714 DOI: 10.1016/j.autneu.2014.09.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 08/12/2014] [Accepted: 09/25/2014] [Indexed: 01/01/2023]
Abstract
Heart rate variability (HRV) analyses can provide a non-invasive evaluation of cardiac autonomic activity. How autonomic control normally develops in childhood and how this is affected by obesity remain incompletely understood. In this review we examine the evidence that childhood age and weight status influence autonomic control of the heart as assessed using HRV. Electronic databases (Pubmed, EMBASE and Cochrane Library) were searched for studies examining HRV in healthy children from birth to 18 years who adhered to the Task Force (1996) guidelines. Twenty-four studies met our inclusion criteria. Seven examined childhood age and HRV. A reduction in 24-hour LF:HF was reported from birth to infancy (1 year), while overall HRV (SDNN) showed a marked and progressive increase. From infancy to early-to-late childhood (from 12 months to 15 years) LF:HF ratio was reported to decline further albeit at a slower rate, while RMSSD and SDNN increased. Twenty studies examined the effects of weight status and body composition on HRV. In a majority of studies, obese children exhibited reductions in RMSSD (n = 8/13), pNN50% (n = 7/9) and HF power (n = 14/18), no difference was reported for LF (n = 10/18), while LF:HF ratio was elevated (n = 10/15). HRV changes during childhood are consistent with a marked and progressive increase in cardiac parasympathetic activity relative to sympathetic activity. Obesity disrupts the normal maturation of cardiac autonomic control.
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Affiliation(s)
- E L J Eyre
- Department of Applied Science and Health, Biological and Exercise Sciences, Coventry University, James Starley Building, Priory Street, Coventry CV1 5FB, United Kingdom.
| | - M J Duncan
- Department of Applied Science and Health, Biological and Exercise Sciences, Coventry University, James Starley Building, Priory Street, Coventry CV1 5FB, United Kingdom
| | - S L Birch
- Department of Applied Science and Health, Biological and Exercise Sciences, Coventry University, James Starley Building, Priory Street, Coventry CV1 5FB, United Kingdom
| | - J P Fisher
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom
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Moraes LID, Nicola TC, Jesus JSAD, Alves ERB, Giovaninni NPB, Marcato DG, Sampaio JD, Fuly JTB, Costalonga EF. High blood pressure in children and its correlation with three definitions of obesity in childhood. Arq Bras Cardiol 2014; 102:175-80. [PMID: 24676372 PMCID: PMC3987328 DOI: 10.5935/abc.20130233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Accepted: 09/16/2013] [Indexed: 12/02/2022] Open
Abstract
Background Several authors have correlated the increase of cardiovascular risk with the
nutritional status, however there are different criteria for the classification of
overweight and obesity in children. Objectives To evaluate the performance of three nutritional classification criteria in
children, as definers of the presence of obesity and predictors of high blood
pressure in schoolchildren. Methods Eight hundred and seventeen children ranging 6 to 13 years old, enrolled in public
schools in the municipality of Vila Velha (ES) were submitted to anthropometric
evaluation and blood pressure measurement. The classification of the nutritional
status was established by two international criteria (CDC/NCHS 2000 and IOTF 2000)
and one Brazilian criterion (Conde e Monteiro 2006). Results The prevalence of overweight was higher when the criterion of Conde e Monteiro
(27%) was used, and inferior by the IOTF (15%) criteria. High blood pressure was
observed in 7.3% of children. It was identified a strong association between the
presence of overweight and the occurrence of high blood pressure, regardless of
the test used (p < 0.001). The test showing the highest sensitivity in
predicting elevated BP was the Conde e Monteiro (44%), while the highest
specificity (94%) and greater overall accuracy (63%), was the CDC criterion. Conclusions The prevalence of overweight in Brazilian children is higher when using the
classification criterion of Conde e Monteiro, and lower when the criterion used is
IOTF. The Brazilian classification criterion proved to be the most sensitive
predictor of high BP risk in this sample.
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Champion JD, Pierce S, Collins JL. Retrospective chart review of obesity and episodic and chronic illness among rural Mexican-American adolescents accessing rural health clinic services. Int J Nurs Pract 2014; 21:328-36. [DOI: 10.1111/ijn.12261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | - Sherrie Pierce
- School of Nursing; Texas Tech University Health Science Center; Lubbock Texas USA
| | - Jennifer L Collins
- School of Nursing; Texas Tech University Health Science Center; Lubbock Texas USA
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Are field measures of adiposity sufficient to establish fatness-related linkages with metabolic outcomes in adolescents? Eur J Clin Nutr 2014; 68:671-6. [PMID: 24569541 DOI: 10.1038/ejcn.2014.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 11/12/2013] [Accepted: 11/20/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the associations between the adiposity-related information conveyed by field fatness measures: body mass index (BMI), waist circumference (WC) and sum of triceps and subscapular skinfolds (SUM SF) relative to dual-energy X-ray absorptiometry (DXA), beyond their common intercorrelations, with three important metabolic variables in US adolescents. METHODS We analyzed data on adiposity and insulin resistance (HOMA-IR), serum triglycerides (TGs) and total cholesterol (TC) from three US national surveys. In two-stage least-square modeling, we first calculated the common adiposity variance, and then used multivariate linear and quantile regressions to access residual associations with each measure. RESULTS Basic associations for each of the adiposity measures were similar but differences emerged in residual adiposity analyses scaled by s.d. units. While a 1 s.d. change in residual variance in DXA total fat beyond that accounted for by BMI (DXA|BMI) was strongly and significantly associated with all outcomes, associations with DXA accounting for SUM SF (DXA|SUM SF) and WC (DXA|WC) were weak or nonsignificant. Contrasted amongst themselves, the residual score association between BMI|SUM SF (β=0.06, P<0.0001) and HOMA-IR was weaker, and half as strong as that for the converse, SUM SF|BMI (β=0.13, P=0.020). SUM SF|WC was stronger than WC|SUM SF (β=0.08, P<0.0001 vs SUM SF|WC β=0.13, P<0.0001). Associations were similar for TGs and TC. CONCLUSIONS Laboratory methods like DXA offer minimal explanatory advantage over field methods in assessing adiposity-related contributions to metabolic outcomes in adolescents. Among the simple fatness measures, skinfolds convey additional information beyond BMI and WC when estimating associations both at the population mean and at the upper extremes of metabolic factors.
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Abstract
Obesity in the child and adolescent population is a growing problem. This article discusses the identification of obesity and overweight youth using body mass index and anthropometry and reviews literature to show the relationship between obesity and premature cardiovascular disease.
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Martínez-Costa C, Núñez F, Montal A, Brines J. Relationship between childhood obesity cut-offs and metabolic and vascular comorbidities: comparative analysis of three growth standards. J Hum Nutr Diet 2013; 27 Suppl 2:75-83. [DOI: 10.1111/jhn.12140] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C. Martínez-Costa
- Pediatric Gastroenterology and Nutrition Unit; Department of Pediatrics; Hospital Clínico Universitario of Valencia; University of Valencia; Valencia Spain
| | - F. Núñez
- Pediatric Cardiology Unit; Hospital Clínico Universitario of Valencia; Valencia Spain
| | - A. Montal
- Hospital Clínico Universitario of Valencia; Valencia Spain
| | - J. Brines
- Department of Pediatrics; Hospital Clínico Universitario of Valencia; University of Valencia; Valencia Spain
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19
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Aldhafiri FK, McColl JH, Reilly JJ. Prevalence of being underweight and overweight and obesity at diagnosis in UK patients with childhood acute lymphoblastic leukaemia 1985-2002. J Hum Nutr Diet 2013; 27:76-9. [DOI: 10.1111/jhn.12112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - J. H. McColl
- School of Mathematics and Statistics; University of Glasgow; Glasgow UK
| | - J. J. Reilly
- Physical Activity for Health Group; School of Psychological Sciences and Health; University of Strathclyde; Glasgow UK
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20
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Jinks A, English S, Coufopoulos A. Evaluation of a family‐centred children's weight management intervention. HEALTH EDUCATION 2013. [DOI: 10.1108/09654281311298786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Magnussen CG, Koskinen J, Juonala M, Chen W, Srinivasan SR, Sabin MA, Thomson R, Schmidt MD, Nguyen QM, Xu JH, Skilton MR, Kähönen M, Laitinen T, Taittonen L, Lehtimäki T, Rönnemaa T, Viikari JS, Berenson GS, Raitakari OT. A Diagnosis of the Metabolic Syndrome in Youth That Resolves by Adult Life Is Associated With a Normalization of High Carotid Intima-Media Thickness and Type 2 Diabetes Mellitus Risk. J Am Coll Cardiol 2012; 60:1631-9. [DOI: 10.1016/j.jacc.2012.05.056] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 04/16/2012] [Accepted: 05/11/2012] [Indexed: 10/27/2022]
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22
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Modeling interindividual variability in physiologically based pharmacokinetics and its link to mechanistic covariate modeling. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2012; 1:e4. [PMID: 23835884 PMCID: PMC3603474 DOI: 10.1038/psp.2012.3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Covariate modeling is a key step in the analysis of clinical data and is essential for establishing dosing recommendations for specific populations, e.g., in obese individuals and children. So far, no systematic approach exists to leverage the knowledge inherent in physiologically based pharmacokinetic (PBPK) models in this context. We introduce (i) a novel approach to model interindividual variability in PBPK models based on lean body weight (LBW); and (ii) a systematic approach to translate interindividual variability into the design of mechanistic covariate models. We derive a new covariate relation for the volume of distribution at steady state (Vss) that seamlessly integrates body weight and LBW as covariates, with a weighting factor depending on the physicochemical properties of the drug. We further show that for children, PBPK-based extrapolation and allometric scaling result in very similar predictions for Vss and blood clearance.
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23
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Schmeer KK. Family structure and obesity in early childhood. SOCIAL SCIENCE RESEARCH 2012; 41:820-832. [PMID: 23017853 DOI: 10.1016/j.ssresearch.2012.01.007] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 01/20/2012] [Accepted: 01/23/2012] [Indexed: 06/01/2023]
Abstract
This study informs family and child health research by using longitudinal Fragile Families data to assess how family structure and transitions are associated with changes in children's BMI and weight status between ages three and five. Concerns in family structure literature about biases due to selectivity are reduced through the use of change score models and by controlling for parental BMI. The findings indicate unhealthy BMI gain and an increased risk of becoming overweight/obese among children living with a mother who recently dissolved a union or had been living without a partner for at least 2years compared with those in stable married parent families. Children with single mothers who entered a new union had significantly healthier BMI trajectories than those whose mothers remained single or recently became single. These results suggest the importance of two-parent family contexts for children's healthy physical development, and that single mothers may need additional support to better manage their children's BMI.
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Affiliation(s)
- Kammi K Schmeer
- Department of Sociology, The Ohio State University, 238 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH 43210-1222, United States
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24
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Ebenegger V, Marques-Vidal PM, Munsch S, Quartier V, Nydegger A, Barral J, Hartmann T, Dubnov-Raz G, Kriemler S, Puder JJ. Relationship of hyperactivity/inattention with adiposity and lifestyle characteristics in preschool children. J Child Neurol 2012; 27:852-8. [PMID: 22209757 DOI: 10.1177/0883073811428009] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We performed a cross-sectional study in 450 nonreferred preschool children aged 4 to 6 years to assess the association between hyperactivity/inattention with adiposity and lifestyle characteristics. Measurements included scores of hyperactivity/inattention, adiposity, objectively measured physical activity, television viewing, and eating habits. Higher scores of hyperactivity/inattention were associated with lower percentage body fat, higher levels of physical activity, and less time spent in sedentary activity (all P ≤ .01). However, higher scores of hyperactivity/inattention were also associated with more television viewing and less healthy eating habits (all P ≤ .04). Except for some selected eating habits (P ≥ .07), those relationships remained significant after adjustment for age, sex, and sociodemographic confounders. To conclude, higher scores of hyperactivity/inattention are linked to different lifestyle characteristics that may in part contribute to a future development of overweight/obesity. Precise mechanisms explaining these associations and possible preventive approaches should be further investigated.
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Affiliation(s)
- Vincent Ebenegger
- Institute of Sports Sciences, University of Lausanne, Lausanne, Switzerland.
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25
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Liddle K, O'Callaghan M, Mamun A, Najman J, Williams G. Comparison of body mass index and triceps skinfold at 5 years and young adult body mass index, waist circumference and blood pressure. J Paediatr Child Health 2012; 48:424-9. [PMID: 22085415 DOI: 10.1111/j.1440-1754.2011.02247.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
AIM To examine which measure of obesity at 5 years, body mass index (BMI) or triceps skinfold thickness, is most strongly associated with 21-year risk factors for cardiovascular disease (CVD), including BMI, waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). METHODS Longitudinal birth cohort study with BMI and triceps skinfold measurements at age 5, and BMI, WC and blood pressure at 21 years. Overweight and obesity at 5 years were determined according to Cole-International Obesity Task Force standards, at 21, by World Health Organization definitions. Triceps skinfold thickness measurements were converted to a z-score, and cut-offs for overweight and obesity were chosen to reflect similar proportions to the BMI subgroups. BMI, WC, SBP and DBP were also measured at 21 years. RESULTS Five-year BMI and triceps skinfold thickness were both significantly associated with the CVD risk measures at 21 years. For overweight/obesity at 5 years, the adjusted odds ratio (95% confidence interval) for 21-year overweight/obesity was 5.6 (4.2, 7.4), for 21-year WC was 1.5 (1.2, 2.0). Mean difference (95% CI) in BMI was 4.4 (3.9, 5.0), in WC 8.3 cm (6.8, 9.8), in SBP 2.4 mm Hg (0.5, 4.3), in DBP 1.1 mm Hg (0.1, 2.2). For skinfold, the similar findings were odds ratio 2.6 (2.0, 3.4) and 1.2 (0.9, 1.6) for 21-year BMI and WC, and mean differences of 2.6 (2.0, 3.2), WC 4.8 cm (3.3, 6.3), SBP 2.3 mm Hg (0.5, 4.2) and DBP 0.7 mm Hg (-0.4, 1.8). CONCLUSIONS In children with overweight/obesity, BMI rather than triceps skinfold is the preferred epidemiological measure for identifying young adult CVD risk markers of BMI, WC and blood pressure.
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Affiliation(s)
- Karen Liddle
- Children's Developmental Service, Child, Youth and Family Health, Mater Children's Hospital, Brisbane, Queensland, Australia.
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26
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Pratesi S, Paternostro F, Tani A, Sassoli C, Cappellini AC. Body mass index correlates with waist circumference in school aged Italian children. Diabetes Res Clin Pract 2012; 96:e7-9. [PMID: 22226511 DOI: 10.1016/j.diabres.2011.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 12/01/2011] [Indexed: 11/29/2022]
Abstract
This study demonstrates the existence of a linear correlation between Body Mass Index (BMI) and waist circumference in Italian school aged children and suggests an indirect method (from weight and height) to estimate waist circumference, whose increase may be indicative for the diagnosis of the metabolic syndrome.
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Affiliation(s)
- Simone Pratesi
- Department of Anatomy, Histology and Forensic Medicine, University of Florence, Largo Brambilla 3, Florence, Italy
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27
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Aeberli I, Gut-Knabenhans M, Kusche-Ammann RS, Molinari L, Zimmermann MB. A composite score combining waist circumference and body mass index more accurately predicts body fat percentage in 6- to 13-year-old children. Eur J Nutr 2012; 52:247-53. [DOI: 10.1007/s00394-012-0317-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 01/24/2012] [Indexed: 11/29/2022]
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28
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Ebenegger V, Marques-Vidal P, Kriemler S, Nydegger A, Zahner L, Niederer I, Bürgi F, Puder JJ. Differences in aerobic fitness and lifestyle characteristics in preschoolers according to their weight status and sports club participation. Obes Facts 2012; 5:23-33. [PMID: 22433614 DOI: 10.1159/000336603] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 09/06/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study assesses differences in adiposity, aerobic fitness, and lifestyle characteristics in preschoolers according to their weight status and sports club (SC) participation. METHOD As part of the Ballabeina study, 600 randomly selected preschoolers (mean age 5.1 ± 0.6 years; 50.2% girls) were analyzed. Body composition was measured by bioelectrical impedance, aerobic fitness by the 20-meter shuttle run test, and physical activity by accelerometers. Eating habits, media use, and SC participation were assessed by questionnaires. RESULTS Overweight children (Swiss national percentiles) and children not participating in SC had both lower aerobic fitness and higher % body fat compared to their respective counterparts (all p ≤ 0.028). In addition, children not participating in SC were less physically active, had more media use, and ate less healthy compared to children participating in SC (all p ≤ 0.023). Controlling for parental sociocultural determinants attenuated differences in % body fat, in physical activity, and in eating habits. CONCLUSION Aerobic fitness differs both according to weight status and SC participation in preschoolers. Furthermore, in view of the many differences in lifestyle behaviors, SC participation at this age could represent a more discriminatory indicator of healthy lifestyle characteristics than weight status.
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Affiliation(s)
- Vincent Ebenegger
- Institute of Sports Sciences, University of Lausanne, Route de Chavannes 33, Lausanne, Switzerland.
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Eiler WJA, Baez M, Yu J, Witkin JM. mGlu5 receptor deletion reduces relapse to food-seeking and prevents the anti-relapse effects of mGlu5 receptor blockade in mice. Life Sci 2011; 89:862-7. [PMID: 21983299 DOI: 10.1016/j.lfs.2011.09.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 07/15/2011] [Accepted: 09/10/2011] [Indexed: 12/21/2022]
Abstract
AIMS Convergent data suggest that there is a hyperglutamatergic state that arises during relapse to drug seeking. Blockade of mGlu5 receptors provides one approach to dampening glutamate tone. However, the role of mGlu5 receptors in relapse to food seeking behavior has not been explored extensively and has not been scrutinized using receptor null mice. MAIN METHODS Wild-type (WT) and mGlu5 receptor knockout (KO) mice were compared under the acquisition of a discriminated operant response maintained by food, during extinction of the response, and during the reinstatement of the response by food and food-associated stimuli. The impact of the mGlu5 receptor antagonist MTEP was investigated. KEY FINDINGS Acquisition and extinction were not markedly different in WT and KO mice. MTEP decreased response reinstatement in WT mice. This behavioral effect of MTEP was not present in the KO mice, demonstrating the dependence of the effect of MTEP on mGlu5 receptors. As with the effect of MTEP in WT mice, receptor deletion reduced response reinstatement in KO mice. SIGNIFICANCE This is the first report to evaluate the reinstatement of food-seeking in mGlu5 receptor KO mice. The data reported here add to those in the literature that support a role for mGlu5 receptors in the control of this relapse effect. The data also reinforce the potential utility of mGlu5 receptor antagonists in relapse prevention to food-seeking behaviors.
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Affiliation(s)
- William J A Eiler
- Neuroscience Discovery Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285-0510, USA
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30
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Pilkington J. Addressing malnutrition: is it time for new approaches? J Hum Nutr Diet 2011; 24:311-2. [DOI: 10.1111/j.1365-277x.2011.01192.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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31
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2011; 18:83-98. [PMID: 21178692 DOI: 10.1097/med.0b013e3283432fa7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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