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Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2021; 9:CD007651. [PMID: 34555181 PMCID: PMC8459921 DOI: 10.1002/14651858.cd007651.pub3] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school. OBJECTIVES The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information. SELECTION CRITERIA Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update. DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type. MAIN RESULTS Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias. Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events. AUTHORS' CONCLUSIONS Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.
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Affiliation(s)
| | - Hilary Caldwell
- Department of Kinesiology, Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, Canada
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Long Q, Zhang T, Chen F, Wang W, Chen X, Ma M. Effectiveness of dietary interventions on weight outcomes in childhood: a systematic review meta-analysis of randomized controlled trials. Transl Pediatr 2021; 10:701-714. [PMID: 34012820 PMCID: PMC8107859 DOI: 10.21037/tp-20-183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Rapid growth and elevated weight in childhood are significantly associated with obesity in later life, but evidence regarding dietary interventions and weight outcomes is lacking. This study aimed to determine the effectiveness of dietary interventions on body mass index (BMI) and BMI z-score in childhood. METHODS PubMed, EmBase, and the Cochrane library were searched from inception till June 2019. Studies that investigated the effectiveness of dietary interventions on BMI and BMI z-score in childhood were considered eligible in our study. The changes in BMI and BMI z-score between dietary interventions and control were calculated by pooled weighted mean differences (WMDs) and 95% CIs were evaluated using random-effects model. RESULTS Twenty-eight randomized controlled trials involving a total of 17,488 children were included. The summary WMDs indicated that children who received dietary interventions had greater reduction in BMI (WMD: -0.12; 95% CI: -0.20 to -0.05; P=0.001) and BMI z-score (WMD: -0.04; 95% CI: -0.06 to -0.02; P=0.001) when compared to the usual controls. Subgroup analyses revealed that the sample size, mean age, duration of interventions, and study quality could affect the effectiveness of dietary interventions in children. CONCLUSIONS The findings of this meta-analysis suggested that dietary interventions improved BMI and BMI z-score, whereas these results are limited due to substantial heterogeneity and study quality of the included studies.
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Affiliation(s)
- Qi Long
- Department of Clinical Nutrition, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Ting Zhang
- Department of Clinical Nutrition, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Fei Chen
- Department of Clinical Nutrition, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Wenqiao Wang
- Department of Clinical Nutrition, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Xia Chen
- Department of Clinical Nutrition, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Ming Ma
- Department of Clinical Nutrition, Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,Department of Pediatrics, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Schneiders LDB, Brand C, Borfe L, Gaya AR, Brazo-Sayavera J, Renner JDP, Reuter CP. A Multicomponent Intervention Program With Overweight and Obese Adolescents Improves Body Composition and Cardiorespiratory Fitness, but Not Insulin Biomarkers. Front Sports Act Living 2021; 3:621055. [PMID: 33693430 PMCID: PMC7937702 DOI: 10.3389/fspor.2021.621055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/07/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: To verify the effect of a multicomponent intervention with overweight/obese adolescents on physical fitness, body composition, and insulin biomarkers. Methods: A quasi-experimental study with 37 adolescents, aged 10 to 17 years, of both sexes, overweight and obese, allocated in two groups (Intervention—IG Group, n = 17; Control—GC Group, n = 20). The IGs were submitted to a multicomponent intervention for 6 months (three weekly sessions) consisting of physical exercises (sports, functional circuit, recreational, and water activities) and nutritional and psychological guidance. Participants were assessed before and after intervention on body composition [body mass index (BMI), body fat, waist circumference, and waist-to-hip ratio (WHR)], physical fitness [cardiorespiratory fitness (CRF) and abdominal strength], and biomarkers of insulin (glucose, insulin, evaluation of the homeostasis model of insulin, and resistin resistance). The prevalence of responders in both groups was obtained according to the theoretical model applied in previous studies similar to this one to determine the cutoff points for response to intervention. Poisson regression was used to verify the difference in the prevalence ratio (PR) of the interviewees between the groups. Results: The responders' prevalence between groups CG and IG showed significant differences for body fat (CG = 30.0%; IG = 70.6%; PR = 1.396; p < 0.001), WHR (CG = 30.0%; IG = 76.5%; PR = 1.730; p < 0.001), and CRF (CG = 15.0%; IG = 52.5%; PR = 1.580; p < 0.001). Conclusions: A 6-month multicomponent intervention program improved certain body composition parameters and the CRF of overweight and obese adolescents but did not improve insulin biomarkers. Clinical Trial Registration: Clinical Trials under Protocol ID: 54985316.0.0000.5343.
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Affiliation(s)
- Letícia de Borba Schneiders
- Postgraduate Program Master and Doctorate in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Caroline Brand
- Postgraduate Program Master and Doctorate in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Leticia Borfe
- Postgraduate Program Master and Doctorate in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Anelise Reis Gaya
- Postgraduate Program Master and Doctorate in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Javier Brazo-Sayavera
- Department of Sports and Computer Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - Jane Dagmar Pollo Renner
- Postgraduate Program Master and Doctorate in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Cézane Priscila Reuter
- Postgraduate Program Master and Doctorate in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
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Wolf VLW, Samur-San-Martin JE, de Sousa SF, Santos HDO, Folmann AG, Ribeiro RR, Guerra-Júnior G. EFFECTIVENESS OF OBESITY INTERVENTION PROGRAMS BASED ON GUIDELINES FOR ADOLESCENT STUDENTS: SYSTEMATIC REVIEW. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2019; 37:110-120. [PMID: 30110114 PMCID: PMC6362366 DOI: 10.1590/1984-0462/;2019;37;1;00015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/04/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To verify the effectiveness of educational interventions based on guidance on physical activity and nutrition in schoolchildren. DATA SOURCES A systematic search was carried out in four electronic databases containing articles published between October 2007 and January 2017 and addressing educational interventions with emphasis on both nutritional education and physical activity in schoolchildren and adolescents aged 10 to 19 years. DATA SYNTHESIS Twelve articles were selected for this review, of which four included only educational interventions; four made and association between educational interventions, inclusion of healthy foods and physical activity; two made a relation between guidelines and physical activity; and finally, two associated guidelines with consumption of healthy foods. CONCLUSIONS Interventions based on physical activity and/or nutrition counseling were efficient and showed superior results in studies that associated the practice of physical activity with counseling. However, the need for new studies on educational interventions among schoolchildren and adolescents was made evident.
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Reesor L, Moreno JP, Johnston CA, Hernandez DC. School-Based Weight Management Program Curbs Summer Weight Gain Among Low-Income Hispanic Middle School Students. THE JOURNAL OF SCHOOL HEALTH 2019; 89:59-67. [PMID: 30506696 PMCID: PMC9912972 DOI: 10.1111/josh.12713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Research shows that elementary students gain weight over the summer. It is unknown if these findings apply to Hispanic adolescents. We evaluated school and summer standardized body mass index (zBMI) changes in Hispanic middle school students. METHODS Hispanic middle school students were randomly assigned to a weight management program (N = 230) or control condition (N = 195). Paired sample t-tests compared zBMI change scores during the school year versus summer when not enrolled in a weight management program (eg, control group). We used 2 × 2 repeated measures analysis of variances to determine program group differences in zBMI scores across school versus summer periods separately for normal and overweight/obese students. RESULTS In the control group, students' zBMI change scores decreased during the school year, but increased during summer for both normal weight and overweight/obese students. Program effects on zBMI indicated school year decreases and summer increases for both normal and overweight/obese students. However, zBMI scores did not differ by program status for normal weight students. Overweight/obese students in the program compared to the control group increased zBMI to a lesser extent over the summer. CONCLUSION For all students, zBMI increased during the summer. A school-based weight management program protected overweight/obese students against potentially greater summer weight gain.
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Affiliation(s)
- Layton Reesor
- Department of Health and Human Performance, University of Houston, 3875 Holman St., Rm 104 Garrison, Houston, TX 77204-6015
| | - Jennette P Moreno
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, 3875 Holman St., Rm 104 Garrison, Houston, TX 77204-6015
| | - Daphne C Hernandez
- Department of Health and Human Performance, HEALTH Research Institute, University of Houston, 3875 Holman St., Rm 104 Garrison, Houston, TX 77204-6015
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Effect of educational interventions on health in childhood: a meta-analysis of randomized controlled trials. Public Health 2018; 164:134-147. [PMID: 30321761 DOI: 10.1016/j.puhe.2018.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/22/2018] [Accepted: 04/19/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The purpose of this study was to summarize the findings of randomized controlled trials (RCTs) investigating any potential effects of educational interventions on health in childhood. STUDY DESIGN Meta-analysis. METHODS PubMed, Embase, and the Cochrane Library databases were searched to identify all RCTs that fit our analysis through May 2016. Weighted mean difference (WMD) was used to measure the effect of educational interventions in childhood by using a random effects model. RESULTS Thirty RCTs reporting data on 35,296 children were included in the meta-analysis. The summary WMD indicated that children who received educational interventions had lower levels of body mass index (BMI) (WMD: -0.15; 95% CI: -0.24 to -0.05; P = 0.003), BMI z-score (WMD: -0.03; 95% CI: -0.05 to -0.02; P < 0.001), waist circumference (WMD: -0.97; 95% CI: -1.95 to -0.00; P = 0.050), triceps skinfold (WMD: -1.39; 95% CI: -2.41 to -0.37; P = 0.008), systolic blood pressure (WMD: -1.13; 95% CI: -2.20 to -0.07; P = 0.037), total cholesterol (WMD: -4.04; 95% CI: -7.18 to -0.90; P = 0.012), and triglyceride (WMD: -2.62; 95% CI: -4.33 to -0.90; P = 0.003). However, educational interventions were found to have little or no significant impact on the waist-to-hip ratio, diastolic blood pressure, high-density lipoprotein, and low-density lipoprotein. CONCLUSIONS The study findings prove the positive effects of educational interventions on BMI, BMI z-score, waist circumference, triceps skinfold, systolic blood pressure, total cholesterol, and triglyceride.
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Wang X, Zhou G, Zeng J, Yang T, Chen J, Li T. Effect of educational interventions on health in childhood: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e11849. [PMID: 30200070 PMCID: PMC6133573 DOI: 10.1097/md.0000000000011849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The purpose of this study was to summarize the evidences from randomized controlled trials (RCTs) investigating the effects of educational interventions in overweight/obesity childhood by using meta-analytic approach. METHODS PubMed, Embase, and the Cochrane Library databases were searched from the inception to April 2018. Weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were used to measure the effects of educational interventions during childhood in the random-effects models. RESULTS Thirty RCTs reporting data on 35,296 children were included in the meta-analysis. The summary WMD indicated that children received educational interventions had lower levels of body mass index (BMI) (WMD: -0.15; 95% CI: -0.24 to -0.05; P = .003), BMI z-score (WMD: -0.03; 95% CI: -0.05 to -0.02; P < .001), waist circumference (WMD: -0.97; 95% CI: -1.95 to -0.00; P = 0.050), triceps skinfold (WMD: -1.39; 95% CI: -2.41 to -0.37; P = .008), systolic blood pressure (WMD: -1.13; 95% CI: -2.20 to -0.07; P = .037), total cholesterol (WMD: -4.04; 95% CI: -7.18 to -0.90; P = .012), and triglyceride (WMD: -2.62; 95% CI: -4.33 to -0.90; P = .003). However, educational interventions were not associated with the levels of waist-to-hip ratio, diastolic blood pressure, high-density lipoprotein, and low-density lipoprotein. CONCLUSION The study findings elucidate the positive effects of educational interventions on BMI, BMI z-score, waist circumference, triceps skinfold, systolic blood pressure, total cholesterol, and triglyceride.
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Affiliation(s)
- Xuqin Wang
- Children's Nutrition Research Center
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing
- Third Affiliated Hospital of Zunyi Medical College, Guizhou, PR China
| | - Guoqi Zhou
- Third Affiliated Hospital of Zunyi Medical College, Guizhou, PR China
| | - Jiaying Zeng
- Children's Nutrition Research Center
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing
| | - Ting Yang
- Children's Nutrition Research Center
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing
| | - Jie Chen
- Children's Nutrition Research Center
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing
| | - Tingyu Li
- Children's Nutrition Research Center
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing
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Shores DR, Everett AD. Children as Biomarker Orphans: Progress in the Field of Pediatric Biomarkers. J Pediatr 2018; 193:14-20.e31. [PMID: 29031860 PMCID: PMC5794519 DOI: 10.1016/j.jpeds.2017.08.077] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/04/2017] [Accepted: 08/30/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Darla R Shores
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Allen D Everett
- Division of Cardiology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
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Lewis KA, Brown SA. Searching for Evidence of an Anti-Inflammatory Diet in Children: A Systematic Review of Randomized Controlled Trials for Pediatric Obesity Interventions With a Focus on Leptin, Ghrelin, and Adiponectin. Biol Res Nurs 2017; 19:511-530. [PMID: 28743192 DOI: 10.1177/1099800417715734] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PROBLEM To address the complex phenomenon of pediatric obesity, one must understand the physiological mechanisms regulating energy intake and inflammation. The peptide hormones leptin, ghrelin, and adiponectin are involved in both, but their functions are dysregulated in obesity. The purpose of this systematic review is (1) to characterize studies of nutrition interventions for weight management in children who measure these peptides as outcomes, (2) to assess risk of bias in the studies, and (3) to determine the relationships between these peptides and body mass index (BMI). Eligibility Criteria: Peer-reviewed articles written in English, published in 2001-2016, and describing randomized controlled trials of pediatric interventions involving a nutrition component with the outcome measures leptin, ghrelin, and/or adiponectin were included. Articles were excluded if the intervention involved pharmaceuticals, supplements, infant formula, breastfeeding, or surgery. SAMPLE The 25 international studies represented 2,153 obese children. RESULTS Ten diets were identified. Successful interventions included both structured exercise and hypocaloric dietary components, with or without counseling, resistance training, or medical components. Direct measures of adiposity were used in 69% of studies. Comparison group designs were disparate. Leptin levels decreased as BMI decreased. Evidence regarding the relationships of ghrelin and adiponectin with BMI was inconclusive. CONCLUSIONS Despite known effects of maturation on hormones, studies did not consistently differentiate findings by maturational stage. Common anti-inflammatory and disease risk modification diets were missing or underrepresented. Studies that include children with comorbidities are needed. BMI and leptin levels have a positive relationship, but evidence on ghrelin and adiponectin was inconclusive.
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Affiliation(s)
- Kimberly A Lewis
- 1 School of Nursing, The University of Texas at Austin, Austin, TX, USA.,2 Pediatric Clinical Research Enterprise, Dell Children's Medical Center, Seton Family of Hospitals, Austin, TX, USA
| | - Sharon A Brown
- 1 School of Nursing, The University of Texas at Austin, Austin, TX, USA
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Gori D, Guaraldi F, Cinocca S, Moser G, Rucci P, Fantini MP. Effectiveness of educational and lifestyle interventions to prevent paediatric obesity: systematic review and meta-analyses of randomized and non-randomized controlled trials. Obes Sci Pract 2017; 3:235-248. [PMID: 29071100 PMCID: PMC5649699 DOI: 10.1002/osp4.111] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This review and meta-analysis aim at updating a previous meta-analysis carried out by Waters et al. on the efficacy of interventions aimed at preventing childhood obesity and at identifying predictors of outcome. METHODS Using an ad-hoc search string, PubMed database was searched for studies assessing body mass index reduction associated with programmes lasting ≥12 weeks in overweight and obese children aged 2-18 years. Studies designed for children with eating disorders or relevant comorbidities were excluded. Studies meeting inclusion criteria were classified according to patient age (<6, 6-12 and 13-18 years), and intervention type (physical activity, diet or both), setting (educational, family or both) and duration (≤1 or >1 year). The search was also extended to other databases. Hand-searching techniques were also applied. The Cochrane 'risk of bias' was applied for quality assessment. RESULTS Seventy-two studies were meta-analysed. Overall, the best results were achieved by programmes combining diet and physical activity (n = 39). With regard to the setting, programmes involving both school and family and lasting ≤1 year were the most efficacious for 6- to 12-year-old children (n = 26); family-based-only interventions were also effective in children <6 years old (n = 2), although results have to be interpreted cautiously because of the small number of patients enrolled and the high study heterogeneity. In 13- to 18-year-old patients, interventions delivered at school (n = 8) were substantially unsuccessful. CONCLUSIONS Interventions for childhood obesity prevention should include both diet and physical activity, be preferentially targeted towards school age children and involve both the school and family setting. However, because of the important methodological limitations associated with currently available literature, additional studies are needed to draw definite conclusions.
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Affiliation(s)
- D Gori
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
| | - F Guaraldi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences University of Turin Turin Italy
| | - S Cinocca
- School of Hygiene and Preventive Medicine University of Bologna Bologna Italy
| | - G Moser
- School of Hygiene and Preventive Medicine University of Bologna Bologna Italy
| | - P Rucci
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
| | - M P Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
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Sadeghi B, Kaiser LL, Schaefer S, Tseregounis IE, Martinez L, Gomez-Camacho R, de la Torre A. Multifaceted community-based intervention reduces rate of BMI growth in obese Mexican-origin boys. Pediatr Obes 2017; 12:247-256. [PMID: 27071684 DOI: 10.1111/ijpo.12135] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 02/18/2016] [Accepted: 02/21/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Latino children and youth have some of the highest rates of overweight and obesity. Early intervention is important to prevent future obesity and illness in this population. METHODS A 3-year, multifaceted intervention was designed to reduce the rate of growth of body mass index (BMI) among Mexican-origin children. Two communities in California's agricultural Central Valley were targeted for intervention and comparison. To assess impact, anthropometric measures of participating children (N = 422) were collected and analysed at baseline and after 1 year of intervention. RESULTS After 1 year of intervention, triceps skin-fold thickness in girls showed a significant decrease in unadjusted analysis between children in the two communities. In multivariate analysis, a reduction in BMI growth was seen among obese boys in the intervention community (ß-coefficient = -1.94, P = 0.05). Obese boys in the intervention community also had a smaller increase in waist circumference (ß-coefficient = -5.2, P = 0.04) than the comparison community. CONCLUSIONS These early findings indicate the intervention's effectiveness for preventing BMI growth among obese boys. Longitudinal follow-up is needed to determine the sustainability of results and whether similar results extend to obese girls and overweight boys or girls.
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Affiliation(s)
- B Sadeghi
- UC Davis Department of Internal Medicine, Sacramento, CA, USA
| | - L L Kaiser
- Department of Nutrition, University of California, Davis, CA, USA
| | - S Schaefer
- Foods for Health Institute, Food Science & Technology Department, University of California, Davis, CA, USA
| | - I E Tseregounis
- Center for Transnational Health, University of California, Davis, CA, USA
| | - L Martinez
- Center for Transnational Health, University of California, Davis, CA, USA
| | - R Gomez-Camacho
- Center for Transnational Health, University of California, Davis, CA, USA
| | - A de la Torre
- Center for Transnational Health, University of California, Davis, CA, USA
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McFarlin BK, Carpenter KC, Henning AL, Venable AS. Consumption of a high-fat breakfast on consecutive days alters preclinical biomarkers for atherosclerosis. Eur J Clin Nutr 2016; 71:239-244. [PMID: 28000693 DOI: 10.1038/ejcn.2016.242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/11/2016] [Accepted: 09/13/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND/OBJECTIVES Recent research has speculated that the risk of developing atherosclerosis is due to the accumulation of the effects of daily diet choices. The purpose of this study was to examine which of our previously identified preclinical disease risk biomarkers were further elevated when consuming a high-fat (644±50 kcal; 100% recommended dietary allowance for fat), high-calorie (1118±100 kcal; 70% daily caloric needs) breakfast on consecutive days. Young, normal weight females (N=7) participated in this study. SUBJECTS/METHODS Blood samples were taken premeal and hourly for 5-h postprandial. Serum biomarkers (C-peptide, eotaxin, gastric inhibitory polypeptide, granulocyte colony-stimulating factor (G-CSF), granulocyte-monocyte colony-stimulating factor (GM-CSF), insulin, leptin, monocyte chemoattractant protein 1, pancreatic polypeptide (PPY) and tumor necrosis factor-α), monocyte concentration, and adhesion molecule expression (CD11a, CD18 and CD54) were measured. Area under the curve was calculated for each outcome variable as a function of day and data were analyzed for significance. RESULTS We found significant (P<0.05) increases on Day 2 for: GM-CSF (+47%; P=0.041), G-CSF (+31%; P=0.012), PPY (+51%; P=0.049), total monocyte (+110%; P=0.043), pro-inflammatory (PI) monocyte (+60%; P=0.012), PI monocyte CD18 (+960%; P=0.003), PI monocyte CD11a (+230%; P=0.006), and PI monocyte CD54 (+208%; P=0.015). CONCLUSIONS To our knowledge, the present study is the first to report changes in selected biomarkers and monocytes following eating a high-fat, high-calorie breakfast on consecutive days in humans. More research is needed to determine how transient the observed changes are and what the long-term implications for disease risk are.
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Affiliation(s)
- B K McFarlin
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA.,Department of Biological Sciences, University of North Texas, Denton, TX, USA
| | - K C Carpenter
- Native American Community Health Center, Inc., Phoenix, AZ, USA
| | - A L Henning
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA.,Department of Biological Sciences, University of North Texas, Denton, TX, USA
| | - A S Venable
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA.,Department of Biological Sciences, University of North Texas, Denton, TX, USA
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McFarlin BK, Gary MA. Flow cytometry what you see matters: Enhanced clinical detection using image-based flow cytometry. Methods 2016; 112:1-8. [PMID: 27620330 DOI: 10.1016/j.ymeth.2016.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/01/2016] [Accepted: 09/08/2016] [Indexed: 02/08/2023] Open
Abstract
Image-based flow cytometry combines the throughput of traditional flow cytometry with the ability to visually confirm findings and collect novel data that would not be possible otherwise. Since image-based flow cytometry borrows measurement parameters and analysis techniques from microscopy, it is possible to collect unique measures (i.e. nuclear translocation, co-localization, cellular synapse, cellular endocytosis, etc.) that would not be possible with traditional flow cytometry. The ability to collect unique outcomes has led many researchers to develop novel assays for the monitoring and detection of a variety of clinical conditions and diseases. In many cases, investigators have innovated and expanded classical assays to provide new insight regarding clinical conditions and chronic disease. Beyond human clinical applications, image-based flow cytometry has been used to monitor marine biology changes, nano-particles for solar cell production, and particle quality in pharmaceuticals. This review article summarizes work from the major scientists working in the field of image-based flow cytometry.
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Affiliation(s)
- Brian K McFarlin
- University of North Texas, Applied Physiology Laboratory, United States; University of North Texas, Department of Biological Sciences, United States.
| | - Melody A Gary
- University of North Texas, Applied Physiology Laboratory, United States
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14
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Using image-based flow cytometry to measure monocyte oxidized LDL phagocytosis: A potential risk factor for CVD? J Immunol Methods 2015; 423:78-84. [DOI: 10.1016/j.jim.2015.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 03/16/2015] [Accepted: 03/28/2015] [Indexed: 11/22/2022]
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Momesso dos Santos CM, Sato FT, Cury-Boaventura MF, Guirado-Rodrigues SH, Caçula KG, Gonçalves Santos CC, Hatanaka E, de Oliveira HH, Santos VC, Murata G, Borges-Silva CN, Hirabara SM, Pithon-Curi TC, Gorjão R. Effect of regular circus physical exercises on lymphocytes in overweight children. PLoS One 2015; 10:e0120262. [PMID: 25826263 PMCID: PMC4380297 DOI: 10.1371/journal.pone.0120262] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/21/2015] [Indexed: 12/26/2022] Open
Abstract
Obesity associated with a sedentary lifestyle can lead to changes in the immune system balance resulting in the development of inflammatory diseases. The aim of this study was to compare lymphocyte activation mechanisms between overweight children practicing regular circus physical exercises with non-exercised children. The study comprised 60 pubescent children randomly divided into 4 groups: Overweight Children (OWC) (10.67 ± 0.22 years old), Overweight Exercised Children (OWE) (10.00 ± 0.41 years old), Eutrophic Children (EC) (11.00 ± 0.29 years old) and Eutrophic Exercised Children (EE) (10.60 ± 0.29 years old). OWE and EE groups practiced circus activities twice a week, for 4.3 ± 0.5 and 4.4 ± 0.5 months, respectively. Percentage of T regulatory cells (Treg) and the expression of CD95 and CD25 in CD4+ lymphocytes were evaluated by flow cytometry. Lymphocyte proliferation capacity was measured by [14C]-thymidine incorporation and mRNA expression of IL-35, TGF-beta, IL-2 and IL-10 by real-time PCR. Lymphocyte proliferation was higher in OWC and OWE groups compared with the EC (3509 ± 887; 2694 ± 560, and 1768 ± 208 cpm, respectively) and EE (2313 ± 111 cpm) groups. CD95 expression on lymphocytes was augmented in the EC (953.9 ± 101.2) and EE groups (736.7 ± 194.6) compared with the OWC (522.1 ± 125.2) and OWE groups (551.6 ± 144.5). CTLA-4 expression was also lower in the OWC and OWE groups compared with the EC and EE groups. Percentage of Treg, IL-35, and IL-10 mRNA expression were lower in the OWC and OWE groups compared with the EC and EE groups. In conclusion, overweight children present altered immune system balance characterized by elevated lymphocyte proliferation due to a decrease in T regulatory cell percentage. These effects were partially reverted by moderate physical exercise, as demonstrated by decreased lymphocyte proliferation.
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Affiliation(s)
- Cesar Miguel Momesso dos Santos
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Fábio Takeo Sato
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Maria Fernanda Cury-Boaventura
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Silvia Helena Guirado-Rodrigues
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Kim Guimaraes Caçula
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Cristiane Cassoni Gonçalves Santos
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Elaine Hatanaka
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Heloisa Helena de Oliveira
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Vinicius Coneglian Santos
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Gilson Murata
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Cristina Neves Borges-Silva
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Sandro Massao Hirabara
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Tania Cristina Pithon-Curi
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Renata Gorjão
- Institute of Physical Activity Sciences and Sports, Post-Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil
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McFarlin BK, Venable AS, Henning AL, Prado EA, Best Sampson JN, Vingren JL, Hill DW. Natural cocoa consumption: Potential to reduce atherogenic factors? J Nutr Biochem 2015; 26:626-32. [PMID: 25769436 DOI: 10.1016/j.jnutbio.2014.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 12/19/2014] [Accepted: 12/19/2014] [Indexed: 12/16/2022]
Abstract
Short-term consumption of flavanol-rich cocoa has been demonstrated to improve various facets of vascular health. The purpose of the present study was to determine the effect of 4 weeks of natural cocoa consumption on selected cardiovascular disease (CVD) biomarkers in young (19-35 years) women of differing body mass indices (BMI; normal, overweight or obese). Subjects (n = 24) consumed a natural cocoa-containing product (12.7 g natural cocoa, 148 kcal/serving) or an isocaloric cocoa-free placebo daily for 4 weeks in a random, double-blind manner with a 2-week washout period between treatment arms. Fasted (>8-h) blood samples were collected before and after each 4-week period. Serum was analyzed to determine lipid profile (chemistry analyzer) and CVD biomarkers (26 biomarkers). EDTA-treated blood was used to assess monocytes (CD14, CD16, v11b and CD62L), while citrate-treated blood was used to measure changes in endothelial microparticles (EMPs; CD42a-/45-/144+) by flow cytometry. Natural cocoa consumption resulted in a significant decrease in haptoglobin (P = .034), EMP concentration (P = .017) and monocyte CD62L (P = .047) in obese compared to overweight and normal-weight subjects. Natural cocoa consumption regardless of BMI group was associated with an 18% increase in high-density lipoprotein (P = .020) and a 60% decrease in EMPs (P = .047). Also, obese subjects experienced a 21% decrease in haptoglobin (P = .034) and a 24% decrease in monocyte CD62L expression in (P = .047) following 4 weeks of natural cocoa consumption. Collectively, these findings indicate that acute natural cocoa consumption was associated with decreased obesity-related disease risk. More research is needed to assess the stability of the observed short-term changes.
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Affiliation(s)
- Brian K McFarlin
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA; Department of Biological Sciences, University of North Texas, Denton, TX, USA.
| | - Adam S Venable
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA; Department of Biological Sciences, University of North Texas, Denton, TX, USA
| | - Andrea L Henning
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA; Department of Biological Sciences, University of North Texas, Denton, TX, USA
| | - Eric A Prado
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA; Department of Biological Sciences, University of North Texas, Denton, TX, USA
| | - Jill N Best Sampson
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA; Department of Biological Sciences, University of North Texas, Denton, TX, USA
| | - Jakob L Vingren
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA; Department of Biological Sciences, University of North Texas, Denton, TX, USA
| | - David W Hill
- Applied Physiology Laboratory, University of North Texas, Denton, TX, USA
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McFarlin BK, Venable AS, Prado EA, Henning AL, Williams RR. Image-based flow cytometry technique to evaluate changes in granulocyte function in vitro. J Vis Exp 2014:52201. [PMID: 25591001 PMCID: PMC4354483 DOI: 10.3791/52201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Granulocytes play a key role in the body's innate immune response to bacterial and viral infections. While methods exist to measure granulocyte function, in general these are limited in terms of the information they can provide. For example, most existing assays merely provide a percentage of how many granulocytes are activated following a single, fixed length incubation. Complicating matters, most assays focus on only one aspect of function due to limitations in detection technology. This report demonstrates a technique for simultaneous measurement of granulocyte phagocytosis of bacteria and oxidative burst. By measuring both of these functions at the same time, three unique phenotypes of activated granulocytes were identified: 1) Low Activation (minimal phagocytosis, no oxidative burst), 2) Moderate Activation (moderate phagocytosis, some oxidative burst, but no co-localization of the two functional events), and 3) High Activation (high phagocytosis, high oxidative burst, co-localization of phagocytosis and oxidative burst). A fourth population that consisted of inactivated granulocytes was also identified. Using assay incubations of 10, 20, and 40-min the effect of assay incubation duration on the redistribution of activated granulocyte phenotypes was assessed. A fourth incubation was completed on ice as a control. By using serial time incubations, the assay may be able to able to detect how a treatment spatially affects granulocyte function. All samples were measured using an image-based flow cytometer equipped with a quantitative imaging (QI) option, autosampler, and multiple lasers (488, 642, and 785 nm).
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Affiliation(s)
| | - Adam S Venable
- Applied Physiology Laboratory, University of North Texas
| | - Eric A Prado
- Applied Physiology Laboratory, University of North Texas
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Langley‐Evans SC, Moran VH. Childhood obesity: risk factors, prevention and management. MATERNAL & CHILD NUTRITION 2014; 10:453-455. [PMID: 25263514 PMCID: PMC6860209 DOI: 10.1111/mcn.12140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Langley-Evans SC, Moran VH. Childhood obesity: risk factors, prevention and management. J Hum Nutr Diet 2014; 27:411-2. [PMID: 25250902 DOI: 10.1111/jhn.12254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S C Langley-Evans
- School of Biosciences, University of Nottingham. Sutton Bonington, Loughborough, UK.
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Herman DR, Taylor Baer M, Adams E, Cunningham-Sabo L, Duran N, Johnson DB, Yakes E. Life Course Perspective: evidence for the role of nutrition. Matern Child Health J 2014; 18:450-61. [PMID: 23780476 DOI: 10.1007/s10995-013-1280-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The "Life Course Perspective" proposes that environmental exposures, including biological, physical, social, and behavioral factors, as well as life experiences, throughout the entire life span, influence health outcomes in current and future generations. Nutrition, from preconception to adulthood, encompasses all of these factors and has the potential to positively or negatively shape the individual or population health trajectories and their intergenerational differences. This paper applies the T2E2 model (timing, timeline, equity and environment), developed by Fine and Kotelchuck, as an overlay to examine advances in nutritional science, as well as the complex associations between life stages, nutrients, nutrigenomics, and access to healthy foods, that support the life course perspective. Examples of the application of nutrition to each of the four constructs are provided, as well as a strong recommendation for inclusion of nutrition as a key focal point for all health professionals as they address solutions to optimize health outcomes, both domestically and internationally. The science of nutrition provides strong evidence to support the concepts of the life course perspective. These findings lend urgency to the need to improve population health across the life span and over generations by ensuring ready access to micronutrient-dense foods, opportunities to balance energy intake with adequate physical activity and the need for biological, social, physical, and macro-level environments that support critical phases of human development. Recommendations for the application of the life course perspective, with a focus on the emerging knowledge of nutritional science, are offered in an effort to improve current maternal and child health programs, policies, and service delivery.
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Affiliation(s)
- Dena R Herman
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA,
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Mexican American children have differential elevation of metabolic biomarkers proportional to obesity status. J Pediatr Gastroenterol Nutr 2013; 57:718-21. [PMID: 23945313 DOI: 10.1097/mpg.0b013e3182a6993d] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES There is a health disparity for obesity among Mexican Americans compared with other racial/ethnic groups. In particular, Mexican American children who are obese are likely to become obese adults. The purpose of this study was to examine traditional and nontraditional risk factors in a subset of Mexican American children before their participation in a larger clinical weight loss study. METHODS Venous blood samples were collected from self-identified Mexican American children (12-14 years old) who were assigned to 1 of 3 weight groups based on their standardized body mass index; normal weight (N = 66), overweight (N = 23), or obese (N = 39). Serum was analyzed for interleukin-6, tumor necrosis factor-α, C-peptide, ghrelin, glucagon-like protein, gastric inhibitory polypeptide-1, glucagon, insulin, leptin, macrophage chemoattractant protein 1, and pancreatic polypeptide using a Luminex MagPix-based assay. Total cholesterol, high-density lipoprotein-cholesterol, triglycerides, and glucose were analyzed using enzymatic assays. Data were analyzed for significance using separate analysis of variance tests, with significance set at P < 0.05. RESULTS Relative to normal weight and overweight children, obese children had significantly elevated C-peptide (P < 0.0001), insulin (P < 0.0001), leptin (P < 0.0001), macrophage chemoattractant protein 1 (P = 0.005), and tumor necrosis factor-α (P = 0.006). CONCLUSIONS We observed that Mexican American children as a function of body weight had elevated serum concentrations of several biomarkers that have been linked to chronic disease development in adults. More research is needed to understand how these differences affect disease risk in adulthood.
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