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Zeljkovic A, Vekic J, Stefanovic A. Obesity and dyslipidemia in early life: Impact on cardiometabolic risk. Metabolism 2024; 156:155919. [PMID: 38653373 DOI: 10.1016/j.metabol.2024.155919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/19/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
Childhood obesity with its growing prevalence worldwide presents one of the most important health challenges nowadays. Multiple mechanisms are involved in the development of this condition, as well as in its associations with various cardiometabolic complications, such as insulin resistance, diabetes, metabolic dysfunction-associated steatotic liver disease and cardiovascular diseases. Recent findings suggest that childhood obesity and associated dyslipidemia at least partly originate from epigenetic modifications that take place in the earliest periods of life, namely prenatal and perinatal periods. Hence, alterations of maternal metabolism could be fundamentally responsible for fetal and neonatal metabolic programming and consequently, for metabolic health of offspring in later life. In this paper, we will review recent findings on the associations among intrauterine and early postnatal exposure to undesirable modulators of metabolism, development of childhood obesity and later cardiometabolic complications. Special attention will be given to maternal dyslipidemia as a driven force for undesirable epigenetic modulations in offspring. In addition, newly proposed lipid biomarkers of increased cardiometabolic risk in obese children and adolescents will be analyzed, with respect to their predictive potential and clinical applicability.
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Affiliation(s)
- Aleksandra Zeljkovic
- Department of Medical Biochemistry, University of Belgrade-Faculty of Pharmacy, Belgrade, Serbia
| | - Jelena Vekic
- Department of Medical Biochemistry, University of Belgrade-Faculty of Pharmacy, Belgrade, Serbia.
| | - Aleksandra Stefanovic
- Department of Medical Biochemistry, University of Belgrade-Faculty of Pharmacy, Belgrade, Serbia
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Sohn S, Lee JH, Joung H, Lee M, Ha MS. Effect of physical activity levels on blood lipids, insulin resistance, and adipokines in children with obesity. Phys Act Nutr 2023; 27:34-40. [PMID: 38297474 PMCID: PMC10844725 DOI: 10.20463/pan.2023.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 02/02/2024] Open
Abstract
PURPOSE Our study was performed to observe children with obesity by using accelerometers and identify their differences in blood lipid levels, insulin resistance, and adipokines based on their physical activity levels. METHODS 197 obese children were classified into three groups based on their physical activity levels over a period of 7 days, using the average counts per minute: Sedentary Time (ST), Light Physical Activity (LPA), and Moderate to Vigorous Intensity Physical Activity (MVPA). Blood lipids, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were analyzed. Insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) formula. Adipokines, including leptin and resistin, were measured. Our results were obtained through one-way analysis of variance was employed, with Scheffe post-hoc analysis. The statistical significance level was set at p < 0.05 for all analyses. RESULTS Results showed that the levels of blood lipids (TG: p<0.001, TC: p<0.01, LDL-C: p<0.001, HDL-C: p< 0.05) and adipokines (Leptin, Resistin: p<0.01) of children who had obesity and maintained moderate to vigorous physical activity were healthier than those who engaged in ST or LPA. Specifically, children with obesity engaging in MVPA demonstrated blood lipid and adipokine levels that were normal or close to normal. However, no significant differences in insulin resistance were observed in all groups. CONCLUSION In summary, encouraging moderate to vigorous physical activity in children with obesity could help improve obesity indicators, such as blood lipids and adipokines.
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Affiliation(s)
- Seongmin Sohn
- Public Health Nutrition, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jae-Hoon Lee
- Laboratory of Sports Conditioning, Nutrition Biochemistry and Neuroscience, Department of Sport Science, College of Arts and Sports, University of Seoul, Seoul, Republic of Korea
| | - Hyojee Joung
- Public Health Nutrition, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Minchul Lee
- Department of Sports Medicine, College of Health Science, CHA University, Gyeonggi-do, Republic of Korea
| | - Min-Seong Ha
- Laboratory of Sports Conditioning, Nutrition Biochemistry and Neuroscience, Department of Sport Science, College of Arts and Sports, University of Seoul, Seoul, Republic of Korea
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von Ah Morano AE, Torres W, Zancheti E, Wigna Pereira de Jesus A, Bexiga Urban J, Fernandes RA. Impact of Moderate-To-Vigorous Sports Participation Combined with Resistance Training on Metabolic and Cardiovascular Outcomes among Lean Adolescents: ABCD Growth Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:444. [PMID: 36612768 PMCID: PMC9819514 DOI: 10.3390/ijerph20010444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND To investigate the combined impact of being engaged in resistance training (RT) and meeting the physical activity guidelines through sports participation (SP) on cardiovascular and metabolic parameters in lean adolescents. METHODS A longitudinal study, part of the ongoing study entitled "ABCD Growth Study" (Analysis of Behaviors of Children During Growth), assessed data from 64 adolescents (23 from the sport group, 11 from the sport + RT group, and 30 from the control group). Metabolic and cardiovascular outcomes were analyzed as dependent variables. For the independent variables, sports participation and resistance training were considered, and for the covariates, sex, chronological age, body weight, height, and somatic maturation. RESULTS After 12 months of follow-up, the RT + SP presented improvements in triglycerides (TG) and the SP presented a reduction in LDL-c, TG, and glucose when compared to the control group. CONCLUSIONS Being engaged in RT and SP is a good strategy to improve health in eutrophic adolescents, with a great impact on TG from the lipid profile.
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Primordial Prevention of Atherosclerotic Cardiovascular Disease. J Cardiopulm Rehabil Prev 2022; 42:389-396. [DOI: 10.1097/hcr.0000000000000748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Karate Training Improves Metabolic Health in Overweight and Obese Adolescents: A Randomized Clinical Trial. Pediatr Exerc Sci 2022; 34:108-118. [PMID: 34936984 DOI: 10.1123/pes.2020-0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/22/2021] [Accepted: 11/14/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE This study evaluated the effects of 12 weeks of karate training on cardiometabolic parameters, oxidative stress, and inflammation in adolescents with overweight and obesity. METHOD Seventy adolescents were randomized into 2 groups: control received nutritional and psychological interventions once a week for 12 weeks, and treatment received nutritional and psychological interventions once a week, plus 3 karate sessions per week, for 12 weeks. The main outcome measure was improvement in cardiometabolic parameters, oxidative stress, and inflammation. RESULTS After the intervention period, the treatment group showed a reduction in resting heart rate (77.86 [10.89]), high-density lipoprotein cholesterol (40.86 [8.31]), and triglycerides (75.18 [32.29]) and an increase in low-density lipoprotein cholesterol (95.64 [42.53]) in relation to pretraining. Regarding oxidative stress markers, there was a reduction in protein carbonylation (0.07 [0.06]) and nitric oxide (1.39 [1.11]) and an increase in superoxide dismutase (0.68 [0.31]) and glutathione (0.11 [0.08]) compared with pretraining. With respect to inflammation, adiponectin increased (14.54 [5.36]) after the intervention when compared with preintervention. CONCLUSION The study concluded that the intervention may improve cardiometabolic parameters, oxidative stress, and inflammation in adolescents with overweight and obesity. Long-term effects need to be evaluated.
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Nunes HEG, Faria EA, Martinez PF, Oliveira-Júnior SAD. Cardiovascular health indicators in soccer exercise during adolescence: systematic review. Int J Adolesc Med Health 2021; 33:53-63. [PMID: 33823092 DOI: 10.1515/ijamh-2020-0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/07/2021] [Indexed: 11/15/2022]
Abstract
This review analyzed the studies that evaluated cardiovascular health indicators (blood pressure, waist circumference, heart rate, glucose index and lipid blood) in recreational soccer players during adolescence, and identify possible associated factors. The search was performed in the electronic databases (PubMED, SciELO, LILACS, Scopus, SPORTDiscus and Web of Science). Inclusion criteria were: population composed of children and/or adolescents (10-19 years or average age up to 19 years); studies adolescents engaged in recreational soccer regularly and observational studies with cross-sectional or longitudinal design. The process of analysis of studies involved reading titles, abstracts and full texts. After these phases, seven articles were eligible. Regarding the design, all studies were cross-sectional. Of the total studies included, five presented moderate methodological quality values and two presented low methodological quality values, according to National Heart, Lung, and Blood Institute instrument. The most cardiovascular health indicators used in recreational soccer players during adolescence was waist circumference; three studies analyzed heart rate, two evaluated blood pressure, one analyzed insulin resistance and none of the included studies analyzed lipid profile. Factors associated were analyzed in four studies, being that sedentary time and body mass index (BMI) present association with at least one indicator of cardiovascular health.
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Affiliation(s)
- Heloyse Elaine Gimenes Nunes
- Laboratory of Striated Muscle Study (LEME/INISA), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
| | - Evelinn Amarilha Faria
- Laboratory of Striated Muscle Study (LEME/INISA), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
| | - Paula Felippe Martinez
- Laboratory of Striated Muscle Study (LEME/INISA), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
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Grace J, Biggs C, Naicker A, Moss S. Effect of Physical Activity and Nutrition Education on Body Mass Index, Blood Pressure and Biochemical Variables in Overweight and Obese Adolescents. Ann Glob Health 2021; 87:9. [PMID: 33569283 PMCID: PMC7845469 DOI: 10.5334/aogh.3147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background The majority of obese children lives in developing countries. The ten-fold increase in obesity during the last four decades necessitates the implementation of interventions to mitigate the longterm effect of obesity into adulthood. The study aimed to determine the impact of physical activity and nutrition intervention on the body mass index (BMI), blood pressure and selected biochemical factors of overweight and obese children aged 13.0 to 16.1 years from eThekweni, South Africa. Methods Participants (N = 41) with a BMI >85th percentile were included in the 10-week controlled trial of physical activity and nutrition education intervention. Baseline and end measurements included BMI, blood pressure, and fasting biochemical variables (glucose, cholesterol, insulin resistance and alanine aminotransferase). BMI was classified according to the WHO BMI z-scores. The 10-week intervention entailed combined aerobic and resistance exercises supervised twice a week together with a once a week nutrition intervention. Participants performed additional unsupervised aerobic exercises three times a week. Findings Elevated systolic blood pressure (52%), low-density lipoprotein levels (29%), insulin (17%) and insulin resistance values (15%) were identified. The 10-week intervention programme significantly decreased BMI (30.8 ± 5.4 kg/m2 to 29.8 ± 5.7 kg/m2; p < 0.01), systolic blood pressure (125.9 ± 15.7 mmHg to 115.2 ± 12.4 mmHg; p < 0.05), and low-density lipoprotein cholesterol (2.63 mmol/L to 2.37 mmol/L; p < 0.05). Controlling for pre-testing variables as covariates, additional ANCOVA analysis highlighted significantly lower BMI (M = 28.33, F = 7.88, p < 0.05) and BMI z-scores (M = 2.08, F = 4.99, p < 0.05) in the intervention group post-testing. Conclusion A 10-week physical activity and nutrition education intervention in overweight and obese adolescents significantly reduced BMI and showed trends of a decrease in blood pressure and low-density lipoprotein cholesterol.
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Costa R, Barroso B, Reichert T, Vieira A, Kruel L. Effects of supervised exercise training on lipid profile of children and adolescents: Systematic review, meta-analysis and meta-regression. Sci Sports 2020. [DOI: 10.1016/j.scispo.2020.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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López-Contreras IN, Vilchis-Gil J, Klünder-Klünder M, Villalpando-Carrión S, Flores-Huerta S. Dietary habits and metabolic response improve in obese children whose mothers received an intervention to promote healthy eating: randomized clinical trial. BMC Public Health 2020; 20:1240. [PMID: 32795294 PMCID: PMC7427732 DOI: 10.1186/s12889-020-09339-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lifestyles habits such as eating unhealthy foodscommence at home and are associated with the development of obesity and comorbidities such as insulin resistance, metabolic syndrome, and chronic degenerative diseases, which are the main causes of death in adults. The present study compared changes in dietary habits, behaviors and metabolic profiles of obese children whose mothers attended at the hospital to group sessions, with those who received the usual nutritional consultation. METHODS Randomized clinical trial, 177 mother/obese child pairs participated, 90 in the intervention group and 87 in the control group. The intervention group attended six group education sessions to promote healthy eating, being this an alternative of change of habits in children with obesity. The control group received the usual nutritional consultation; both groups were followed up for 3 months. Frequency of food consumption, behaviors during feeding in the house and metabolic profile was evaluated. Mixed effect linear regression models were used to evaluate the effect of the intervention on the variables of interest, especially in HOMA-IR. RESULTS The intervention group reduced the filling of their dishes (p = 0.009), forcing the children to finish meals (p = 0.003) and food substitution (p < 0.001), moreover increased the consumption of roasted foods (p = 0.046), fruits (p = 0.002) and vegetables (p < 0.001). The children in the control group slightly increased HOMA-IR levels (0.51; 95% CI - 0.48 to 1.50), while the children in the intervention group significantly decreased (- 1.22; 95% CI - 2.28 to - 1.16). The difference in HOMA-IR between the control and intervention group at the end of the follow-up was - 1.67; 95% CI: - 3.11 to - 0.24. CONCLUSIONS The educational intervention improved some eating habits at home, as well as HOMA-IR levels; why we consider that it can be an extra resource in the management of childhood obesity. TRIAL REGISTRATION Clinicaltrials.gov, NCT04374292 (Date assigned: May 5, 2020). Retrospectively registered.
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Affiliation(s)
- Iris Nallely López-Contreras
- Gastroenterology and Nutrition Department, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - Jenny Vilchis-Gil
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Dr. Márquez No 162, 06720, Mexico City, Mexico.,Medicine Faculty, National Autonomous University of Mexico, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Deputy Director of Research, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico.,Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), Mexico City, Mexico
| | - Salvador Villalpando-Carrión
- Gastroenterology and Nutrition Department, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - Samuel Flores-Huerta
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Dr. Márquez No 162, 06720, Mexico City, Mexico.
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Shang X, Li Y, Xu H, Zhang Q, Hu X, Liu A, Du S, Li T, Guo H, Li Y, Xu G, Liu W, Ma J, Ma G. Effect of multidimensional lifestyle interventions on metabolic risk reduction in children: a cluster randomised controlled trial. Prev Med 2020; 133:106010. [PMID: 32027918 DOI: 10.1016/j.ypmed.2020.106010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 01/27/2020] [Accepted: 02/01/2020] [Indexed: 11/24/2022]
Abstract
Few clinical trials have investigated lifestyle intervention effect on metabolic health in children. The study aimed to examine the effect of diet and physical activity intervention on the reduction of clustered metabolic risk score (CMRS) in children and moderators and mediators of the intervention effect. A multicentre, clustered randomised controlled trial was conducted with examination conducted at baseline and after intervention over one year. 7110 children (49.7% girls) with a mean of 9.06 (95% CI: 9.03, 9.09) years were included in the analysis. In Beijing, each three schools were randomly assigned to diet-only, physical activity-only intervention and control groups. In five other urban cities, each 15 schools were randomly assigned to comprehensive intervention and control groups. CMRS was computed by summing the Z scores of % fat mass, systolic blood pressure, fasting glucose, ratio of cholesterol to high-density lipoprotein, and triglyceride. Compared with controls (n = 2808), children in the comprehensive intervention group (n = 2848) had more reduction in CMRS (multivariate-adjusted mean difference (95% CI): -0.49 (-0.85, -0.14)). The body mass index (BMI) reduction explained 7.3% (95% CI 2.8%-18.1%) of the total intervention effect. The intervention was more effective in children with higher birthweight, lower parental BMI, or complete parental data. Diet-only or physical activity-only intervention had non-significant effects on CMRS reduction. Our multidimensional comprehensive intervention resulted in significant reduction in CMRS in primary school children and this effect was modified by birthweight, parental BMI, and parental involvement. A minority of metabolic risk reduction was mediated through BMI. Clinical Trial Registry number and website: ChiCTR-PRC-09000402, URL: http://www.chictr.org.cn.
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Affiliation(s)
- Xianwen Shang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Yanping Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Haiquan Xu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China; Institute of food and nutrition development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Qian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoqi Hu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailing Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Songming Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tingyu Li
- Chongqing Children's Hospital, Chongqing, China
| | - Hongwei Guo
- School of Public Health, Fudan University, Shanghai, China
| | - Ying Li
- Harbin Medical University, Harbin, China
| | - Guifa Xu
- Department of Public Health, Shandong University, Jinan, China
| | - Weijia Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China.
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Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China. Nutrients 2020; 12:nu12010194. [PMID: 31936767 PMCID: PMC7019828 DOI: 10.3390/nu12010194] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/31/2019] [Accepted: 01/07/2020] [Indexed: 02/07/2023] Open
Abstract
This study aimed to evaluate the effectiveness of a school-based nutrition education and physical activity intervention on cardiovascular risk profile and mental health outcomes among Chinese children with obesity. Two primary schools were randomly allocated to the control group (CG) and the intervention group (IG). We selected children with obesity from 1340 students in the third and fourth grades as participants. The IG received 8 months of nutrition education and physical activity intervention, while the CG was waitlisted. A generalized estimating equation model was applied to assess repeated variables over time. A total of 171 children with obesity (99 IG and 72 CG) aged 9.8 ± 0.7 years completed the post-intervention stage. Compared with baseline, significant reductions were observed within the IG for depression and fasting plasma glucose at post-intervention. After adjusting for confounders, group and time interaction effects showed that the IG achieved improvements in the risk of poor well-being (p = 0.051) and social anxiety (p = 0.029), had decreased diastolic blood pressure (p = 0.020) and fasting plasma glucose (p < 0.001), and had significantly increased high-density lipoprotein (p < 0.001) from baseline to post-intervention relative to the CG. The effects of school-based nutrition education and physical activity intervention on children with obesity are diverse, including not only the improvement of metabolic health but also mental health promotion.
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Cayres‐Santos SU, Urban JB, Barbosa MF, Lemes IR, Kemper HCG, Fernandes RA. Sports participation improves metabolic profile in adolescents: ABCD growth study. Am J Hum Biol 2019; 32:e23387. [DOI: 10.1002/ajhb.23387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Suziane Ungari Cayres‐Santos
- Laboratory of Investigation in Exercise ‐ LIVE, Department of Physical Education UNESP Presidente Prudente Brazil
| | | | - Maurício Fregonesi Barbosa
- Post‐Graduate Program in Radiology, Federal University of São Paulo UNIFESP Presidente Prudente São Paulo Brazil
| | - Italo Ribeiro Lemes
- Post‐Graduate Program in Physiotherapy UNESP Presidente Prudente São Paulo Brazil
| | - Han C. G. Kemper
- Amsterdam UMC, Amsterdam Public Health Research Institute Amsterdam The Netherlands
| | - Romulo Araújo Fernandes
- Laboratory of Investigation in Exercise ‐ LIVE, Department of Physical Education UNESP Presidente Prudente Brazil
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Garza C, Martinez DA, Yoon J, Nickerson BS, Park KS. Effects of Telephone Aftercare Intervention for Obese Hispanic Children on Body Fat Percentage, Physical Fitness, and Blood Lipid Profiles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245133. [PMID: 31888169 PMCID: PMC6950203 DOI: 10.3390/ijerph16245133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/04/2019] [Accepted: 12/13/2019] [Indexed: 02/02/2023]
Abstract
We investigated effects of 10-month telephone aftercare intervention following primary obesity intervention on changes in body fat percentage, physical fitness, and lipid profiles in obese Hispanic children. Seventy-one obese children were randomly assigned to (1) primary intervention and 10-month telephone aftercare intervention (PITI; N = 26), (2) primary intervention only (PI; n = 25), and (3) control (CON; N = 20). Anthropometric data, physical fitness, and blood samples were obtained before (PRE) and after (POST) eight-week primary intervention, and 10-month telephone aftercare intervention (1YEAR). Eight weeks of primary intervention significantly reduced body fat percentage, total cholesterol, triglycerides, and low-density lipoprotein (LDL-C) with increases in VO2max, flexibility, muscular strength, and HDL-C (PITI and PI, p < 0.05). 1YEAR measurements returned to baseline for the PI whereas those measurements in PITI remained significantly different when compared to PRE (p < 0.05). CON observed negative changes in all variables at POST, which were improved slightly during the subsequent school year. Levels of cholesterol, triglycerides, and LDL-C are correlated to changes in body fat percentage, suggesting that fat loss is effective in preventing and managing obesity-related disorders. Results indicate that telephone intervention is an effective aftercare in stabilizing positive changes obtained from a short-term intensive intervention.
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Affiliation(s)
- Carlos Garza
- College of Art and Science, Texas A & M International University, Laredo, TX 78041, USA;
| | - David A. Martinez
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, TX 78209, USA;
| | - Jihyung Yoon
- College of Dentistry, New York University, NewYork, NY 10010, USA;
| | - Brett S. Nickerson
- College of Nursing and Health Sciences, Texas A & M International University, Laredo, TX 78041, USA;
| | - Kyung-Shin Park
- College of Nursing and Health Sciences, Texas A & M International University, Laredo, TX 78041, USA;
- Correspondence: ; Tel.: +1-956-326-3158
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NASA Mission X Program for Healthy Eating and Active Living among Taiwanese Elementary School Students. J Pediatr Nurs 2019; 49:e8-e14. [PMID: 31307856 DOI: 10.1016/j.pedn.2019.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE This study assessed the effects of an intervention program adapted from the NASA Mission X (MX) program on children's Healthy Eating Active Living (HEAL) knowledge and behaviors and anthropometry. METHODS This clustered randomized control trial recruited 8 elementary schools in remote rural areas of Northern Taiwan. The intervention was the 8-week MX program. All the 3rd and 4th graders were invited to the study (n = 245). Children's weight, height, HEAL knowledge and behaviors were measured pre- and post-intervention. RESULTS The intervention group had significantly more improvements than control group in physical activity knowledge score (+0.91 vs. +0.25, p = 0.002), diet knowledge score (+0.62 vs. +0.17, p = 0.044), and score of interests in NASA and space exploration (+0.34 vs. -0.07, p < 0.0001). BMI increased from 18.4 to 18.6 (p < 0.05) for the control group but did not change for the intervention group. The changes in BMI between groups did not differ significantly. CONCLUSION AND PRACTICE IMPLICATIONS This randomized controlled trial showed that the NASA MX program was feasible and acceptable among children in Taiwan, and improved children's HEAL knowledge. (ClinicalTrials.gov registration: NCT03355131).
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Yan Y, Bazzano LA, Juonala M, Raitakari OT, Viikari JSA, Prineas R, Dwyer T, Sinaiko A, Burns TL, Daniels SR, Woo JG, Khoury PR, Urbina EM, Jacobs DR, Hu T, Steinberger J, Venn A, Chen W. Long-Term Burden of Increased Body Mass Index from Childhood on Adult Dyslipidemia: The i3C Consortium Study. J Clin Med 2019; 8:jcm8101725. [PMID: 31635325 PMCID: PMC6832308 DOI: 10.3390/jcm8101725] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/08/2019] [Accepted: 10/15/2019] [Indexed: 02/07/2023] Open
Abstract
Background: Data are limited regarding the association of cumulative burden and trajectory of body mass index (BMI) from early life with adult lipid disorders. Methods: The study cohort consisted of 5195 adults who had BMI repeatedly measured 4 to 21 times from childhood and had blood lipid measurements of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) and information on lipid-lowering medications in the last adult survey. The area under the curve (AUC) was calculated as a measure of long-term burden (total AUC) and trends (incremental AUC) of BMI. Results: Participants with dyslipidemia, high LDL-C, low HDL-C and high TG had consistently and significantly higher BMI levels from childhood to adulthood compared to those with normal lipid levels. After adjusting for age, race, sex, and cohort, increased risk of adult dyslipidemia was significantly associated with higher values of childhood BMI, adulthood BMI, total AUC and incremental AUC, with odds ratio (95% confidence interval) = 1.22 (1.15–1.29), 1.85 (1.74–1.97), 1.61 (1.52–1.71), and 1.59 (1.50–1.69), respectively, and p < 0.001 for all. The association patterns were similar in most race–sex subgroups. Conclusions: Adults with dyslipidemia versus normal lipid levels have consistently higher levels and distinct life-course trajectories of BMI, suggesting that the impact of excessive body weight on dyslipidemia originates in early life.
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Affiliation(s)
- Yinkun Yan
- Department of Epidemiology, School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Lydia A Bazzano
- Department of Epidemiology, School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku 20500, Finland.
- Division of Medicine, Turku University Hospital, Turku 20521, Finland.
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku FI-20520, Finland.
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku 20521, Finland.
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku 20500, Finland.
- Division of Medicine, Turku University Hospital, Turku 20521, Finland.
| | - Ronald Prineas
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA.
| | - Terence Dwyer
- George Institute, University of Oxford, Oxford OX1 2BQ, UK.
| | - Alan Sinaiko
- Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Trudy L Burns
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52246, USA.
| | - Stephen R Daniels
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA.
| | - Jessica G Woo
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
| | - Philip R Khoury
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
| | - Elaine M Urbina
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Tian Hu
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Julia Steinberger
- Division of Pediatric Cardiology, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart TAS 7000, Australia.
| | - Wei Chen
- Department of Epidemiology, School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
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16
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Zhao Q, Jiang Y, Zhang M, Chu Y, Ji B, Pan H, Ban B. Low-density lipoprotein cholesterol levels are associated with insulin-like growth factor-1 in short-stature children and adolescents: a cross-sectional study. Lipids Health Dis 2019; 18:120. [PMID: 31122262 PMCID: PMC6533685 DOI: 10.1186/s12944-019-1062-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/29/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Elevated low-density lipoprotein cholesterol (LDL-C) levels in childhood have recently been found to be the strongest predictive risk factor for coronary artery disease in adulthood. There is an increased level of LDL-C in children and adolescents with short stature. However, the underlying factors associated with increased LDL-C levels in children and adolescents with short stature are unknown. In addition, the insulin-like growth factor 1 (IGF-1) level in the short-stature population is usually below the normal reference range. The aim of this study was to investigate the relationship between IGF-1 standard deviation score (IGF-1 SDS) and LDL-C level in children and adolescents with short stature. METHODS A cross-sectional study was conducted in a single centre of China, 557 short-stature children and adolescents whose height SDS was lower than - 2 SD after adjustment for age and gender were included. The related clinical and laboratory examinations, including anthropometric parameters, lipid profiles, IGF-1 levels and the levels of other cofactors, were assessed in all participants. RESULTS The univariate analysis results showed a significant negative correlation between IGF-1 SDS and LDL-C levels (P = 0.006). Furthermore, a nonlinear relationship was observed between IGF-1 SDS and LDL-C by smooth curve fitting after adjusting for possible confounders. A multivariate piecewise linear regression model revealed a significant negative correlation between IGF-1 SDS and LDL-C when the IGF-1 level was greater than - 2 SDS (β - 0.07, 95% CI -0.12, - 0.02; P = 0.006). However, we did not observe a significant relationship between IGF-1 SDS and LDL-C when the IGF-1 level was lower than - 2 SDS (β 0.08, 95% CI -0.02, 0.17; P = 0.119). CONCLUSION This study demonstrated a nonlinear relationship between IGF-1 and LDL-C independent of other potential confounding factors, suggesting that circulating IGF-1 may contribute to the regulation of LDL-C levels, thus meriting further investigation.
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Affiliation(s)
- Qianqian Zhao
- Department of Clinical Medicine, Jining Medical University, 16 Hehua Road, Beihu New District, Jining, Shandong 272067 People’s Republic of China
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Yingzhe Jiang
- Department of Clinical Medicine, Jining Medical University, 16 Hehua Road, Beihu New District, Jining, Shandong 272067 People’s Republic of China
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Yuntian Chu
- School of Health Management and Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Baolan Ji
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
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17
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Methodological and reporting quality of systematic reviews referenced in the clinical practice guideline for pediatric high-blood pressure. J Hypertens 2019; 37:488-495. [DOI: 10.1097/hjh.0000000000001870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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18
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de Assumpção PK, Heinzmann-Filho JP, Isaia HA, Holzschuh F, Dalcul T, Donadio MVF. Exercise Capacity Assessment by the Modified Shuttle Walk Test and its Correlation with Biochemical Parameters in Obese Children and Adolescents. Indian J Pediatr 2018; 85:1079-1085. [PMID: 29569079 DOI: 10.1007/s12098-018-2649-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/26/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate exercise capacity of obese children and adolescents compared with normal-weight individuals and to investigate possible correlations with blood biochemical parameters. METHODS In this study, children and adolescents between 6 and 18 y were included and divided into control (eutrophic) and obese groups according to body mass index (BMI). Data were collected regarding demographic, anthropometric, waist circumference and exercise capacity through the Modified Shuttle Walk Test (MSWT). In the obese group, biochemical parameters in the blood (total cholesterol, HDL, LDL, triglycerides and glucose) were evaluated, and a physical activity questionnaire was applied. RESULTS Seventy seven participants were included; 27 in the control group and 50 obese. There was no significant difference between the two groups regarding sample characteristics, except for body weight, BMI and waist circumference. Most obese children presented results of biochemical tests within the desirable limit, though none were considered active. There was a significant exercise capacity reduction (p < 0.001) in the obese group compared to control subjects. Positive correlations were identified for the MSWT with age and height, and a negative correlation with BMI. However, there were no correlations with the biochemical parameters analyzed. CONCLUSIONS Obese children and adolescents have reduced exercise capacity when compared to normal individuals. The MSWT performance seems to have a negative association with BMI, but is not correlated with blood biochemical parameters.
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Affiliation(s)
- Priscila Kurz de Assumpção
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Integrated School of Santa Maria (FISMA), Santa Maria, Brazil
| | - João Paulo Heinzmann-Filho
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Ipiranga Ave. 6690 - 2° floor, Lab. 27, Porto Alegre, Rio Grande do Sul, RS, 90610-000, Brazil
| | | | | | - Tiéle Dalcul
- Integrated School of Santa Maria (FISMA), Santa Maria, Brazil
| | - Márcio Vinícius Fagundes Donadio
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Ipiranga Ave. 6690 - 2° floor, Lab. 27, Porto Alegre, Rio Grande do Sul, RS, 90610-000, Brazil.
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19
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Pozuelo-Carrascosa DP, Cavero-Redondo I, Herráiz-Adillo Á, Díez-Fernández A, Sánchez-López M, Martínez-Vizcaíno V. School-Based Exercise Programs and Cardiometabolic Risk Factors: A Meta-analysis. Pediatrics 2018; 142:peds.2018-1033. [PMID: 30337478 DOI: 10.1542/peds.2018-1033] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT The effects of school-based physical activity (PA) programs on different cardiometabolic risk factors and the most appropriate features of PA programs to achieve maximum effectiveness are unclear. OBJECTIVE To provide a comprehensive synthesis of the effectiveness of school-based PA interventions on cardiometabolic risk factors in children. DATA SOURCES We identified studies from database inception to February 22, 2018. STUDY SELECTION We selected studies that were focused on examining the effect of school-based PA interventions on cardiometabolic risk factors in children. DATA EXTRACTION Random-effects models were used to calculate the pooled effect size (ES) for the included cardiometabolic risk factors (waist circumference [WC], triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure and diastolic blood pressure (DBP), and fasting insulin and glucose). RESULTS Nineteen randomized controlled trials (which included 11 988 children aged 3-12 years) were included in the meta-analysis. School-based PA programs were associated with a significant small improvement in WC (ES = -0.14; 95% confidence interval [CI]: -0.22 to -0.07; P < .001), DBP (ES = -0.21; 95% CI: -0.42 to -0.01; P = .040), and fasting insulin (ES = -0.12; 95% CI: -0.20 to -0.04; P = .003). LIMITATIONS Authors of few studies described the implementation conditions of their interventions in detail, and compliance rates were lacking in most studies. In addition, results by sex were provided in a small number of studies. CONCLUSIONS School-based PA interventions improve some cardiometabolic risk factors in children, such as WC, DBP, and fasting insulin.
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Affiliation(s)
| | | | - Ángel Herráiz-Adillo
- Social and Health Care Research Center and.,Department of Primary Care, Health Service of Castilla-La Mancha, Tragacete, Cuenca, Spain
| | - Ana Díez-Fernández
- Social and Health Care Research Center and.,Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center and.,Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain; and
| | - Vicente Martínez-Vizcaíno
- Social and Health Care Research Center and.,Faculty of Health Science, Universidad Autónoma de Chile, Talca, Chile
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20
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Tarp J, Jespersen E, Møller NC, Klakk H, Wessner B, Wedderkopp N, Bugge A. Long-term follow-up on biological risk factors, adiposity, and cardiorespiratory fitness development in a physical education intervention: a natural experiment (CHAMPS-study DK). BMC Public Health 2018; 18:605. [PMID: 29739385 PMCID: PMC5941623 DOI: 10.1186/s12889-018-5524-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/27/2018] [Indexed: 12/18/2022] Open
Abstract
Background Schools are a key setting for large-scale primordial non-communicable disease prevention in young people, but little data on sustainability of impacts on cardiometabolic risk markers is available. Methods Six and a half year follow-up of a natural experiment. In 2008, six public schools in the municipality of Svendborg (Denmark) augmented their curricular physical education (intervention) and four matched schools served as controls. At long term follow up in 2015 n = 312 participants aged 5–11 years had complete data (33% of children providing necessary baseline data). The intervention, that consisted of a trebling of weekly physical education lessons and courses provided to physical education teachers, was provided at intervention schools up until 6th grade. Participants attended 6th to 10th grade at follow-up. Differences in the homeostasis model assessment of insulin resistance, blood pressure, triglycerides, cholesterol ratios, cardiorespiratory fitness, waist-circumference, and a composite score of these, between participants attending intervention and control schools were analysed by mixed linear regression models. Differences in physical activity at follow-up was analysed cross-sectionally (no baseline available) in n = 495. Results Compared to controls, children at intervention schools had a non-significant − 0.07 (− 0.32 to 0.18) standard deviations lower composite risk score 6.5 years after project initiation. Likewise, no statistically significant differences between intervention and control schools were found for any of the other outcomes (p-values ≥ 0.41). However, six of seven outcomes were in a direction favouring intervention schools. No statistically significant differences between intervention and control schools were observed for physical activity outcomes (p-values ≥ 0.13). Conclusions An augmented physical activity program including 270 min of weekly physical education provided for three to seven years did not materialize in statistically significant differences in established risk markers in children from intervention compared to control schools. As the intervention was discontinued after 6th grade, the post-intervention effect of augmented physical education throughout adolescence is unknown. School-based physical activity programs may benefit from incorporating instruments for behaviour translation to leisure time in their intervention models to increase the probability of achieving public health relevance. Trial registration ClinicalTrials.gov Identifier: NCT03510494. Electronic supplementary material The online version of this article (10.1186/s12889-018-5524-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jakob Tarp
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Eva Jespersen
- Department of Rehabilitation, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Niels Christian Møller
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Heidi Klakk
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,University College Lillebælt, Odense, Denmark
| | - Barbara Wessner
- Centre for Sport Science and University Sports, Department of Sports and Exercise Physiology, University of Vienna, Vienna, Austria
| | - Niels Wedderkopp
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Sports Medicine Clinic, The Orthopedic Department, Hospital of Lillebaelt Middelfart, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Anna Bugge
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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21
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Vilchis-Gil J, Klünder-Klünder M, Flores-Huerta S. Effect on the Metabolic Biomarkers in Schoolchildren After a Comprehensive Intervention Using Electronic Media and In-Person Sessions to Change Lifestyles: Community Trial. J Med Internet Res 2018; 20:e44. [PMID: 29402762 PMCID: PMC5818679 DOI: 10.2196/jmir.9052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/07/2017] [Accepted: 12/01/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Obesity is a chronic low-intensity state of inflammation with metabolic alterations that, when acquired during childhood, lead to severe illness in adults. Encouraging healthy eating habits and physical activity is the basis for preventing and treating obesity and its complications. OBJECTIVE To evaluate how a comprehensive intervention promoting healthy eating habits and physical activities in schools affects children's metabolic biomarkers. METHODS Of four Mexico City primary schools in this study, two groups of children that were recruited at their schools were assigned to a 12-month intervention group (IG) and the other two were assigned to control groups (CGs). The intervention had two components: (1) parents/schoolchildren attended in-person educational sessions promoting healthy eating and physical activity habits, and were provided printed information; and (2) parents were able to seek information through a website, and also received brief weekly mobile phone text messages. Anthropometric measurements and fasting blood samples were taken from both groups of children at baseline and again after 12 months. RESULTS The study involved 187 children in the IG and 128 in the CG. Regardless of each child's nutritional status at the beginning of the study, the intervention improved metabolic parameters; the IG showed a negative effect on glucose concentrations (-1.83; CI 95% -3.06 to -0.60), low-density lipoprotein-cholesterol (-2.59; CI 95% -5.12 to -0.06), insulin (-0.84; CI 95% -1.31 to -0.37), and homeostasis model to assess the insulin resistance index (HOMA-IR; -0.21; CI 95% -0.32 to -0.09) in comparison to the CG. HOMA-IR improved in children who had higher than baseline body mass index z-scores. CONCLUSIONS Intervention through multiple components that promoted healthier eating and physical activity habits improved the metabolic parameters of the children in the study after one year, regardless of their nutritional status.
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Affiliation(s)
- Jenny Vilchis-Gil
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
| | - Miguel Klünder-Klünder
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
- Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Ciudad de México, Mexico
| | - Samuel Flores-Huerta
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
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22
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Wang Z, Xu F, Ye Q, Tse LA, Xue H, Tan Z, Leslie E, Owen N, Wang Y. Childhood obesity prevention through a community-based cluster randomized controlled physical activity intervention among schools in china: the health legacy project of the 2nd world summer youth olympic Games (YOG-Obesity study). Int J Obes (Lond) 2017; 42:625-633. [PMID: 28978975 PMCID: PMC5984083 DOI: 10.1038/ijo.2017.243] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 09/04/2017] [Accepted: 09/17/2017] [Indexed: 01/22/2023]
Abstract
Background: Childhood obesity has been becoming a worldwide public health problem. We conducted a community-based physical activity (PA) intervention program aiming at childhood obesity prevention in general student population in Nanjing of China, the host city of the 2nd World Summer Youth Olympic Games (YOG-Obesity study). Methods: This was a cluster randomized controlled intervention study. Participants were the 4th (mean age±s.e.: 9.0±0.01) and 7th (mean age±s.e.: 12.0±0.01) grade students (mean age±s.e.: 10.5±0.02) from 48 schools and randomly allocated (1:1) to intervention or control groups at school level. Routine health education was provided to all schools, whereas the intervention schools additionally received an 1-year tailored multi-component PA intervention program, including classroom curricula, school environment support, family involvement and fun programs/events. The primary outcome measures were changes in body mass index, obesity occurrence and PA. Results: Overall, 9858 (97.7%) of the 10091 enrolled students completed the follow-up survey. Compared with the baseline, PA level increased by 33.13 min per week (s.e. 10.86) in the intervention group but decreased by 1.76 min per week (s.e. 11.53) in the control group (P=0.028). After adjustment for potential confounders, compared with the control group, the intervention group were more likely to have increased time of PA (adj. Odds ratio=1.15, 95% confidence interval=1.06–1.25), but had a smaller increase in mean body mass index (BMI) (0.22 (s.e. 0.02) vs 0.46 (0.02), P=0.01) and BMI z-score (0.07 (0.01) vs 0.16 (0.01), P=0.01), and were less likely to be obese (adj. Odds ratio=0.7, 95% confidence interval=0.6, 0.9) at study end. The intervention group had fewer new events of obesity/overweight but a larger proportion of formerly overweight/obese students having normal weight by study end. Conclusions: This large community-based PA intervention was feasible and effective in promoting PA and preventing obesity among the general student population in a large city in China. Experiences from this study are the lessons for China to control the childhood obesity epidemic.
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Affiliation(s)
- Z Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - F Xu
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Q Ye
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - L A Tse
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - H Xue
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Z Tan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - E Leslie
- Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-Being, College of Health, Ball State University, Muncie, IN, USA
| | - N Owen
- School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Y Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.,Swinburne University of Technology and the Baker IDI Heart and Diabetes Institute, Melbourne, Victoria Australia
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23
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Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, de Ferranti SD, Dionne JM, Falkner B, Flinn SK, Gidding SS, Goodwin C, Leu MG, Powers ME, Rea C, Samuels J, Simasek M, Thaker VV, Urbina EM. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics 2017; 140:peds.2017-1904. [PMID: 28827377 DOI: 10.1542/peds.2017-1904] [Citation(s) in RCA: 1898] [Impact Index Per Article: 271.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy. These guidelines include 30 Key Action Statements and 27 additional recommendations derived from a comprehensive review of almost 15 000 published articles between January 2004 and July 2016. Each Key Action Statement includes level of evidence, benefit-harm relationship, and strength of recommendation. This clinical practice guideline, endorsed by the American Heart Association, is intended to foster a patient- and family-centered approach to care, reduce unnecessary and costly medical interventions, improve patient diagnoses and outcomes, support implementation, and provide direction for future research.
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Affiliation(s)
- Joseph T Flynn
- Dr. Robert O. Hickman Endowed Chair in Pediatric Nephrology, Division of Nephrology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington;
| | - David C Kaelber
- Departments of Pediatrics, Internal Medicine, Population and Quantitative Health Sciences, Center for Clinical Informatics Research and Education, Case Western Reserve University and MetroHealth System, Cleveland, Ohio
| | - Carissa M Baker-Smith
- Division of Pediatric Cardiology, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Douglas Blowey
- Children's Mercy Hospital, University of Missouri-Kansas City and Children's Mercy Integrated Care Solutions, Kansas City, Missouri
| | - Aaron E Carroll
- Department of Pediatrics, School of Medicine, Indiana University, Bloomington, Indiana
| | - Stephen R Daniels
- Department of Pediatrics, School of Medicine, University of Colorado-Denver and Pediatrician in Chief, Children's Hospital Colorado, Aurora, Colorado
| | - Sarah D de Ferranti
- Director, Preventive Cardiology Clinic, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Janis M Dionne
- Division of Nephrology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Bonita Falkner
- Departments of Medicine and Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Susan K Flinn
- Consultant, American Academy of Pediatrics, Washington, District of Columbia
| | - Samuel S Gidding
- Cardiology Division Head, Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Celeste Goodwin
- National Pediatric Blood Pressure Awareness Foundation, Prairieville, Louisiana
| | - Michael G Leu
- Departments of Pediatrics and Biomedical Informatics and Medical Education, University of Washington, University of Washington Medicine and Information Technology Services, and Seattle Children's Hospital, Seattle, Washington
| | - Makia E Powers
- Department of Pediatrics, School of Medicine, Morehouse College, Atlanta, Georgia
| | - Corinna Rea
- Associate Director, General Academic Pediatric Fellowship, Staff Physician, Boston's Children's Hospital Primary Care at Longwood, Instructor, Harvard Medical School, Boston, Massachusetts
| | - Joshua Samuels
- Departments of Pediatrics and Internal Medicine, McGovern Medical School, University of Texas, Houston, Texas
| | - Madeline Simasek
- Pediatric Education, University of Pittsburgh Medical Center Shadyside Family Medicine Residency, Clinical Associate Professor of Pediatrics, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, and School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Vidhu V Thaker
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Medical Center, New York, New York; and
| | - Elaine M Urbina
- Preventive Cardiology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
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Øverby NC, Hernes S, Haugen M. Effect of dietary interventions during weaning period on parental practice and lipoproteins and vitamin D status in two-year-old children. Food Nutr Res 2017; 61:1350127. [PMID: 28804440 PMCID: PMC5533129 DOI: 10.1080/16546628.2017.1350127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 06/23/2017] [Indexed: 01/07/2023] Open
Abstract
Objective: Evaluate if a two-day course for parents on nutrition and applied baby food preparation had an effect on child’s intake of home-made foods, lipid concentration, and vitamin D status. Design: Randomized controlled trial at age 6 months and follow-up at ages 15 and 24 months. Setting: Four health care clinics in Kristiansand, Norway. Subjects: Thirty-nine pairs of 6-month-old children and their parents in the intervention group and 20 pairs in the control group. Results: At age 15 months, the intervention group had lower intakes of ready-made porridge (2.0 vs. 5.8 servings per week (p < 0.05)), lower intake of canned baby food (2.9 vs. 6.3 servings per week (p < 0.05)) and higher intakes of home-made porridge (4.8 servings vs. 0.9 servings per week (p < 0.001)) compared with the control group. The intervention group had higher HDL cholesterol concentrations at 2 years than the control group, 1.08 mol/l compared to 0.89 mol/l (p < 0.05). Conclusions: This is the first study to show that providing dietary information and applied baby food preparation to parents during the weaning period may have impact on the children’s diet at 15 and 24 months and improve their lipid profile. Our results call for studies with more power and longer follow-up.
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Affiliation(s)
- Nina Cecilie Øverby
- Department of Public health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Sigrunn Hernes
- Department of Public health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Margaretha Haugen
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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25
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Hardy LL, Mihrshahi S, Gale J, Drayton BA, Bauman A, Mitchell J. 30-year trends in overweight, obesity and waist-to-height ratio by socioeconomic status in Australian children, 1985 to 2015. Int J Obes (Lond) 2017; 41:76-82. [PMID: 27847388 PMCID: PMC5220161 DOI: 10.1038/ijo.2016.204] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/15/2016] [Accepted: 10/23/2016] [Indexed: 01/25/2023]
Abstract
BACKGROUND/OBJECTIVE To report 30-year (1985-2015) prevalence trends in overweight, obesity and abdominal obesity among children by school level and socioeconomic status (SES). SUBJECTS/METHODS Five cross-sectional, population child surveys (age 4-18 years; n=27 808) conducted in 1985-1997-2004-2010-2015 in New South Wales, Australia. Outcomes were prevalence of measured overweight, obesity and waist-to-height ratio (WHtR⩾0.5) by sex, school level (children (primary) and adolescents (high)) and SES tertile. RESULTS In 2015, the prevalences of overweight, obesity and WHtR⩾0.5 in children were 16.4%, 7.0% and 14.6%, respectively, and in adolescents 21.9%, 17.2% and 4.6%, respectively. Obesity prevalence has not significantly changed in children or adolescents since 1997, nor since 2010 (children, P=0.681; adolescents, P=0.21). Overweight has not significantly changed in children since 1997, but has in adolescents since 1985, with a relative increase of 16 percentage points (P<0.001) between 2010 and 2015. WHtR⩾0.5 prevalence has significantly changed since 1985, except in adolescent girls between 2010 and 2015. Between 2010 and 2015 the relative increase in WHtR⩾0.5 was 17 and 40 percentage points in children and adolescent boys, respectively. Significant disparities in prevalence rates between children and adolescents from low and high SES backgrounds began in 2010 for overweight, since 1997 for obesity and since 2004 for WHtR⩾0.5. Differences between SES groups have become larger over the past 18 years. CONCLUSIONS Since 1997, obesity has remained stable, and overweight has stabilized in children, not in adolescents. WHtR⩾0.5 significantly increased between 1985 and 2015, with prevalence rates at each survey around twice the obesity prevalence. Compared with high SES children and adolescents, the risk of overweight, obesity and WHtR⩾0.5 was significantly higher for low SES children and adolescents. The findings are highly relevant to policy makers involved in child obesity prevention interventions and highlight the need for better targeted interventions among children and adolescents from low SES backgrounds, and adolescents in particular.
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Affiliation(s)
- L L Hardy
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - S Mihrshahi
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - J Gale
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - B A Drayton
- NSW Ministry of Health, North Sydney, NSW, Australia
| | - A Bauman
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - J Mitchell
- NSW Ministry of Health, North Sydney, NSW, Australia
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26
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Abstract
Prevalence rates of childhood obesity have risen steeply over the last 3 decades. Given the increased national focus, the frequency of this clinical problem, and the multiple mental health factors that coexist with it, make obesity a public health concern. The complex relationships between mental health and obesity serve to potentiate the severity and interdependency of each. The purpose of this review is to create a contextual connection for the 2 conditions as outlined by the research literature and consider treatment options that affect both health problems.
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Affiliation(s)
- Leigh Small
- Family and Community Health Nursing Department, Virginia Commonwealth University School of Nursing, 1100 East Leigh Street, PO Box 980567, Richmond, VA 23298, USA.
| | - Alexis Aplasca
- Pediatrics and Psychiatry, Children's Hospital of Richmond/Virginia Treatment Center for Children, Virginia Commonwealth University School of Medicine, 515 North 10th Street, Richmond, VA 23298, USA
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27
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Samouda H, de Beaufort C, Stranges S, Guinhouya BC, Gilson G, Hirsch M, Jacobs J, Leite S, Vaillant M, Dadoun F. Adding anthropometric measures of regional adiposity to BMI improves prediction of cardiometabolic, inflammatory and adipokines profiles in youths: a cross-sectional study. BMC Pediatr 2015; 15:168. [PMID: 26497052 PMCID: PMC4620021 DOI: 10.1186/s12887-015-0486-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 10/13/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Paediatric research analysing the relationship between the easy-to-use anthropometric measures for adiposity and cardiometabolic risk factors remains highly controversial in youth. Several studies suggest that only body mass index (BMI), a measure of relative weight, constitutes an accurate predictor, whereas others highlight the potential role of waist-to-hip ratio (WHR), waist circumference (Waist C), and waist-to-height ratio (WHtR). In this study, we examined the effectiveness of adding anthropometric measures of body fat distribution (Waist C Z Score, WHR Z Score and/or WHtR) to BMI Z Score to predict cardiometabolic risk factors in overweight and obese youth. We also examined the consistency of these associations with the "total fat mass + trunk/legs fat mass" and/or the "total fat mass + trunk fat mass" combinations, as assessed by dual energy X-ray absorptiometry (DXA), the gold standard measurement of body composition. METHODS Anthropometric and DXA measurements of total and regional adiposity, as well as a comprehensive assessment of cardiometabolic, inflammatory and adipokines profiles were performed in 203 overweight and obese 7-17 year-old youths from the Paediatrics Clinic, Centre Hospitalier de Luxembourg. RESULTS Adding only one anthropometric surrogate of regional fat to BMI Z Score improved the prediction of insulin resistance (WHR Z Score, R(2): 45.9%. Waist C Z Score, R(2): 45.5%), HDL-cholesterol (WHR Z Score, R(2): 9.6%. Waist C Z Score, R(2): 10.8%. WHtR, R(2): 6.5%), triglycerides (WHR Z Score, R(2): 11.7%. Waist C Z Score, R(2): 12.2%), adiponectin (WHR Z Score, R(2): 14.3%. Waist C Z Score, R(2): 17.7%), CRP (WHR Z Score, R(2): 18.2%. WHtR, R(2): 23.3%), systolic (WHtR, R(2): 22.4%), diastolic blood pressure (WHtR, R(2): 20%) and fibrinogen (WHtR, R(2): 21.8%). Moreover, WHR Z Score, Waist C Z Score and/or WHtR showed an independent significant contribution according to these models. These results were in line with the DXA findings. CONCLUSIONS Adding anthropometric measures of regional adiposity to BMI Z Score improves the prediction of cardiometabolic, inflammatory and adipokines profiles in youth.
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Affiliation(s)
- Hanen Samouda
- Population Health Department, Epidemiology and Public Health Research Unit, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445, Strassen, Luxembourg.
| | - Carine de Beaufort
- Centre Hospitalier de Luxembourg, Diabetes & Endocrinology Care Clinique Pédiatrique (DECCP), L-1210, Luxembourg, Luxembourg.
| | - Saverio Stranges
- Population Health Department, Epidemiology and Public Health Research Unit, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445, Strassen, Luxembourg.
| | - Benjamin C Guinhouya
- Faculty for Health engineering and management, UDSL/ILIS, University Lille-Northern France, EA 2694, Laboratory of Public Health, F-59120, Loos, France.
| | - Georges Gilson
- Department of Clinical Biology, Centre Hospitalier de Luxembourg, L-1210, Luxembourg, Luxembourg.
| | - Marco Hirsch
- ZithaKlinik, Rheumatology Department, L-2763, Luxembourg, Luxembourg.
| | - Julien Jacobs
- Population Health Department, Epidemiology and Public Health Research Unit, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445, Strassen, Luxembourg.
| | - Sonia Leite
- Luxembourg Institute of Health, Centre of Competence for Methodology and Statistics (CCMS), L-1445, Strassen, Luxembourg.
| | - Michel Vaillant
- Luxembourg Institute of Health, Centre of Competence for Methodology and Statistics (CCMS), L-1445, Strassen, Luxembourg.
| | - Frédéric Dadoun
- Population Health Department, Epidemiology and Public Health Research Unit, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445, Strassen, Luxembourg. .,Endocrinology and Diabetology Department, Centre Hospitalier de Luxembourg, L-1210, Luxembourg, Luxembourg.
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28
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Aires L, Silva G, Martins C, Marques E, Lagoa MJ, Ribeiro JC, Rêgo C, Nascimento H, Pereira PR, Santos-Silva A, Belo L, Mota J. Exercise intervention and cardiovascular risk factors in obese children. Comparison between obese youngsters taking part in a physical activity school-based programme with and without individualised diet counselling: the ACORDA project. Ann Hum Biol 2015; 43:183-90. [PMID: 26193775 DOI: 10.3109/03014460.2015.1059889] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIM To determine the effects of a school-based exercise intervention programme on cardiovascular risk factors, including body fat (BF), metabolic profile and physical activity (PA) in children with and without individualised dietary counselling approach (IDC and WIDC). SUBJECTS AND METHODS Forty-six overweight children from 6-16 years old (25 girls, 54.3%; age = 10.3 ± 2.8) of six schools took part in an 8-month interdisciplinary, school-based intervention programme. All children were engaged in PA classes, but only one group was exposed to individualised counselling. Blood pressure (BP), lipids and lipoproteins, accelerometer-based PA, percentage of body fat (%BF) and trunk fat (%TF) measures were taken before and after intervention. General Linear Model (Repeated Measures ANOVA) adjusted for age, maturation and height change was used to analyse the longitudinal effect of individualised counselling between two evaluations in each group. RESULTS Favourable changes were observed for %BF, %TF, systolic BP and total cholesterol in the IDC group. Subjects WIDC only increased light and moderate-vigorous PA. In IDC, significant effects for time * group interactions were found for systolic BP, total cholesterol and LDL-cholesterol, indicating that counselling might add favourable changes in these markers, beyond those explained by PA and growth. CONCLUSION School-based interventions can contribute to counteracting obesity in youth, particularly when individualised dietary counselling is provided. Therefore, the link between schools and professional counselling should be strengthened to ensure consolidated changes towards healthy behaviours.
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Affiliation(s)
- Luísa Aires
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL) Faculty of Sports , University of Porto, Rua Dr Plácido Costa , Porto , Portugal .,b University Institute of Maia (ISMAI), Av. Carlos Oliveira Campos, Castêlo da Maia , Maia , Portugal
| | - Gustavo Silva
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL) Faculty of Sports , University of Porto, Rua Dr Plácido Costa , Porto , Portugal
| | - Clarice Martins
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL) Faculty of Sports , University of Porto, Rua Dr Plácido Costa , Porto , Portugal .,c Department of Physical Education - Federal Rural University of Pernambuco, CEP: 52171-900 , Recife/PE , Brazil
| | - Elisa Marques
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL) Faculty of Sports , University of Porto, Rua Dr Plácido Costa , Porto , Portugal .,b University Institute of Maia (ISMAI), Av. Carlos Oliveira Campos, Castêlo da Maia , Maia , Portugal
| | - Maria João Lagoa
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL) Faculty of Sports , University of Porto, Rua Dr Plácido Costa , Porto , Portugal .,b University Institute of Maia (ISMAI), Av. Carlos Oliveira Campos, Castêlo da Maia , Maia , Portugal
| | - José Carlos Ribeiro
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL) Faculty of Sports , University of Porto, Rua Dr Plácido Costa , Porto , Portugal
| | - Carla Rêgo
- d Child and Adolescent Center, CUF Hospital, Department of Pediatrics, Faculty of Medicine, University of Porto , Porto , Portugal
| | - Henrique Nascimento
- e Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal .,f Institute for Molecular and Cell Biology (IBMC), University of Porto , Porto , Portugal , and
| | - Petronila Rocha Pereira
- g Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior , Covilhã , Portugal
| | - Alice Santos-Silva
- e Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal .,f Institute for Molecular and Cell Biology (IBMC), University of Porto , Porto , Portugal , and
| | - Luís Belo
- e Department of Biological Sciences, Faculty of Pharmacy , University of Porto , Porto , Portugal .,f Institute for Molecular and Cell Biology (IBMC), University of Porto , Porto , Portugal , and
| | - Jorge Mota
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL) Faculty of Sports , University of Porto, Rua Dr Plácido Costa , Porto , Portugal
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29
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Wang Y, Cai L, Wu Y, Wilson RF, Weston C, Fawole O, Bleich SN, Cheskin LJ, Showell NN, Lau BD, Chiu DT, Zhang A, Segal J. What childhood obesity prevention programmes work? A systematic review and meta-analysis. Obes Rev 2015; 16:547-65. [PMID: 25893796 PMCID: PMC4561621 DOI: 10.1111/obr.12277] [Citation(s) in RCA: 366] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/11/2015] [Accepted: 02/13/2015] [Indexed: 01/28/2023]
Abstract
Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high-income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi-experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2-18 in high-income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta-analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity-related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity-only interventions delivered in schools with home involvement or combined diet-physical activity interventions delivered in schools with both home and community components. SOE was moderate for school-based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school-based interventions for preventing childhood obesity. More research is needed to evaluate programmes in other settings or of other design types, especially environmental, policy and consumer health informatics-oriented interventions.
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Affiliation(s)
- Y Wang
- Department of Epidemiology and Environmental Health (formerly the Department of Social and Preventive Medicine), School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - L Cai
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Y Wu
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - R F Wilson
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - C Weston
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - O Fawole
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - S N Bleich
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - L J Cheskin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - N N Showell
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - B D Lau
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D T Chiu
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - A Zhang
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - J Segal
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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