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Kim CN, Messito MJ, Duh-Leong C, Katzow M, Teli R, Gross RS. The effects of parent-child dysfunctional interactions on early childhood weight: A serial mediation model through emotional feeding and child appetite traits. Appetite 2024; 200:107564. [PMID: 38897417 DOI: 10.1016/j.appet.2024.107564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/22/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
Parent-child dysfunctional interactions (PCDI) are known to contribute to children's weight status. However, the underlying mechanisms in how dysfunctional interactions between parent and child influence child weight are not clear. This study investigates the impact of PCDI on toddlers' weight, focusing on the potential serial mediation by maternal emotional feeding and child appetite traits. We conducted a secondary analysis of longitudinal data from a larger intervention trial to prevent childhood obesity in low-income Hispanic families. A total of 241 mother-child dyads were included in these analyses. Measurements were taken at various stages: PCDI at child age 19 months, maternal emotional feeding at 28 months, and both child appetite traits and weight-for-age z-score (WFAz) at 36 months. Serial mediation analyses revealed a significant indirect effect of early PCDI on later child WFAz through maternal emotional feeding and two child food approach traits (food responsiveness, emotional overeating) out of the eight child appetite traits assessed. PCDI at 19 months was associated with increased use of emotional feeding in mothers at 28 months, which was associated with heightened food responsiveness and emotional overeating in children at 36 months, which in turn was linked to greater child WFAz at 36 months. The findings of this study expand the understanding of the mechanisms underlying PCDI and child weight, emphasizing the interplay between maternal feeding practices and child appetite in the context of adverse parent-child interactions during early childhood.
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Affiliation(s)
| | | | | | | | - Radhika Teli
- New York University Grossman School of Medicine, USA
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2
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Rajeev D, MacIver NJ. Metformin as a therapeutic agent for obesity-associated immune dysfunction. J Nutr 2024:S0022-3166(24)00381-X. [PMID: 38972391 DOI: 10.1016/j.tjnut.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/16/2024] [Accepted: 07/02/2024] [Indexed: 07/09/2024] Open
Abstract
Obesity is associated with impaired immune function, characterized by inflammation, and leading to poor response to infection, impaired vaccine response, increased susceptibility to autoimmune disease, and increased risk of cancer and cancer mortality. Worse, there is evidence that weight loss alone may be insufficient to reverse the immune dysfunction caused by obesity. It is therefore critically important to identify alternative therapeutic approaches to decrease the negative effects of obesity-associated inflammation. Here, we will review evidence that the antidiabetic drug metformin may be considered as a therapeutic agent for obesity-associated immune dysfunction. Metformin has immune-modulatory effects, stimulating or suppressing the immune response in both a cell-specific and disease-specific manner. Although the mechanism of action of metformin on the immune system remains to be fully elucidated, there is strong evidence that metformin enters select immune cells and disrupts electron transport, leading to both AMPK-dependent and AMPK-independent effects on immune cell differentiation and cytokine production. These effects of metformin on immune cells have been shown to improve immune responses to infection, autoimmunity, and cancer.
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Affiliation(s)
- Devika Rajeev
- Department of Nutrition, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Nancie J MacIver
- Department of Nutrition, University of North Carolina at Chapel Hill, North Carolina, USA; Department of Pediatrics, University of North Carolina at Chapel Hill, North Carolina, USA; Department of Microbiology and Immunology, North Carolina, North Carolina, USA.
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Zhao F, Wang Y, Liu Z, Wang J, Xia Y, Jiang X, Zhou L, Khan A, Cheng S, Zou Z, Chen C, Qiu J. Association between protein-to-energy ratio and overweight/obesity in children and adolescents in the United States: a cross-sectional study based on NHANES. Front Pediatr 2024; 12:1383602. [PMID: 38983459 PMCID: PMC11232357 DOI: 10.3389/fped.2024.1383602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/11/2024] [Indexed: 07/11/2024] Open
Abstract
Background The dietary protein proportion may be crucial in triggering overweight and obesity among children and adolescents. Methods Cross-sectional data from 4,336 children and adolescents who participated in the National Health and Nutrition Survey (NHANES) between 2011 and March 2020 were analyzed. Multivariate logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI). Restricted cubic splines assessed the nonlinear relationships between dietary protein intake and the prevalence of overweight and obesity. Results Adjusted logistic regression models showed that each 1% increase in dietary protein proportion was associated with a 4% higher risk of overweight and obesity (OR = 1.04, 95% CI: 1.01-1.07). A nonlinear relationship was noted in children aged 6-11 years (P < 0.05), as demonstrated by restricted cubic spline analysis. After dividing dietary protein intake into quartiles, the highest quartile had an adjusted OR of 2.07 (95% CI: 1.35, 3.16, P = 0.001) compared to the lowest, among children aged 6-11 years. Conclusion Dietary protein intake is positively linked to overweight and obesity in American children, irrespective of individual characteristics and total energy consumption.
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Affiliation(s)
- Feng Zhao
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yudan Wang
- Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhaoyi Liu
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jiao Wang
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yinyin Xia
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xuejun Jiang
- Center of Experimental Teaching for Public Health, Experimental Teaching and Management Center, Chongqing Medical University, Chongqing, China
| | - Lixiao Zhou
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Ahmad Khan
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Shuqun Cheng
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Zhen Zou
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Molecular Biology Laboratory of Respiratory Diseases, Institute of Life Sciences, Chongqing Medical University, Chongqing, China
| | - Chengzhi Chen
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jingfu Qiu
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, China
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Kondo MC, Locke D, Hazer M, Mendelson T, Fix RL, Joshi A, Latshaw M, Fry D, Mmari K. A greening theory of change: How neighborhood greening impacts adolescent health disparities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 73:541-553. [PMID: 38303603 DOI: 10.1002/ajcp.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024]
Abstract
Neighborhoods are one of the key determinants of health disparities among young people in the United States. While neighborhood deprivation can exacerbate health disparities, amenities such as quality parks and greenspace can support adolescent health. Existing conceptual frameworks of greening-health largely focus on greenspace exposures, rather than greening interventions. In this paper, we develop and propose a Greening Theory of Change that explains how greening initiatives might affect adolescent health in deprived neighborhoods. The theory situates greening activities and possible mechanisms of change in the context of their ability to modify distal social determinants of health factors, stemming from macrostructural and historical processes that lead to resource inequalities, affecting both the social and built environment in which adolescents live and develop. The framework illustrates both short- and long-term health, economic, and security effects of greening. We also describe how the theory informed the development of Project VITAL (Vacant lot Improvement to Transform Adolescent Lives) in Baltimore, MD, which aims to (1) build a citywide sharable database on vacant lot restoration activities, (2) evaluate the impact of greening initiatives on adolescent health outcomes, (3) conduct cost-effectiveness analyses, and (4) develop best practices for greening programs for improved adolescent health.
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Affiliation(s)
- Michelle C Kondo
- USDA Forest Service, Northern Research Station, Philadelphia, Pennsylvania, USA
| | - Dexter Locke
- USDA Forest Service, Northern Research Station, Baltimore, Maryland, USA
| | - Meghan Hazer
- Baltimore City Department of Public Works, Office of Research and Environmental Protection, Watershed Planning + Partnerships, Baltimore, Maryland, USA
| | - Tamar Mendelson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rebecca L Fix
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ashley Joshi
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Megan Latshaw
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dustin Fry
- USDA Forest Service, Northern Research Station, Philadelphia, Pennsylvania, USA
| | - Kristin Mmari
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Wang AP, Ward K, Griffith G, Gambetta K. Effect of body mass index on exercise capacity following pediatric heart transplantation. Pediatr Transplant 2024; 28:e14772. [PMID: 38702928 DOI: 10.1111/petr.14772] [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: 01/27/2024] [Accepted: 04/15/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Obesity and impaired exercise tolerance following heart transplantation increase the risk of post-transplant morbidity and mortality. The aim of this study was to evaluate the effect of body mass index on markers of exercise capacity in pediatric heart transplant recipients and compare this effect with a healthy pediatric cohort. METHODS A retrospective analysis of cardiopulmonary exercise test data between 2004 and 2022 was performed. All patients exercised on a treadmill using the Bruce protocol. Inclusion criteria included patients aged 6-21 years, history of heart transplantation (transplant cohort) or no cardiac diagnosis (control cohort) at the time of testing, and a maximal effort test. Patients were further stratified within these two cohorts as underweight, normal, overweight, and obese based on body mass index groups. Two-way analyses of variance were performed with diagnosis and body mass index category as the independent variables. RESULTS A total of 250 exercise tests following heart transplant and 1963 exercise tests of healthy patients were included. Heart transplant patients across all body mass index groups had higher resting heart rate and lower maximal heart rate, heart rate recovery at 1 min, exercise duration, and peak aerobic capacity (VO2peak). Heart transplant patients in the normal and overweight body mass index categories had higher VO2peak and exercise duration when compared to underweight and obese patients. CONCLUSION Underweight status and obesity are strongly associated with lower VO2peak and exercise duration in heart transplant patients. Normal and overweight heart transplant patients had the best markers of exercise capacity.
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Affiliation(s)
- Alan P Wang
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Kendra Ward
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Garett Griffith
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Evanston, IL, USA
| | - Katheryn Gambetta
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Shapiro WL, Kunani P, Sidell MA, Li X, Anderson SR, Slezak JM, Koebnick C, Schwimmer JB. Prevalence of Adolescents Meeting Criteria for Metabolic and Bariatric Surgery. Pediatrics 2024; 153:e2023063916. [PMID: 38410833 DOI: 10.1542/peds.2023-063916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The American Academy of Pediatrics endorses metabolic and bariatric surgery (MBS) as a safe and effective treatment of severe obesity in children with class 3 obesity or with class 2 obesity and qualifying comorbidities. The study objective was to determine eligibility and characteristics of adolescents who qualify for MBS based on American Academy of Pediatrics guidelines. METHODS This retrospective cohort study analyzed electronic health record data of 603 051 adolescents aged 13 to 17 years between January 1, 2018, and December 31, 2021. Centers for Disease Control and Prevention criteria were used to define obesity classes 2 and 3. Multivariable logistic regression was used to evaluate the factors associated with meeting MBS eligibility criteria. RESULTS Of the 603 041 adolescents evaluated, 22.2% had obesity (12.9% class 1, 5.4% class 2, and 3.9% class 3). The most frequently diagnosed comorbid conditions were gastroesophageal reflux disease (3.2%), hypertension (0.5%), and nonalcoholic fatty liver disease (0.5%). Among adolescents with class 2 obesity, 9.1% had 1 or more comorbidities qualifying for MBS, and 4.4% of all adolescents met the eligibility criteria for MBS. In multivariable modeling, males, Black and Hispanic adolescents, and those living in more deprived neighborhoods were more likely to meet MBS eligibility criteria. CONCLUSIONS Overall, 1 in 23 adolescents met the eligibility criteria for MBS. Demographic and social determinants were associated with a higher risk for meeting these criteria. The study suggests that the health care system may face challenges in accommodating the demand for MBS among eligible adolescents.
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Affiliation(s)
- Warren L Shapiro
- Department of Pediatrics, Southern California Permanente Medical Group, San Diego, California
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California, San Diego School of Medicine, San Diego, California
- Department of Gastroenterology, Rady Children's Hospital, San Diego, California
| | - Poornima Kunani
- Department of Pediatrics, Kaiser Permanente South Bay Medical Center, Southern California Permanente Medical Group, Manhattan Beach, California
| | - Margo A Sidell
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Xia Li
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Sabina R Anderson
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California, San Diego School of Medicine, San Diego, California
- Amherst College, Amherst, Massachusetts
| | - Jeffrey M Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Corinna Koebnick
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Jeffrey B Schwimmer
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California, San Diego School of Medicine, San Diego, California
- Department of Gastroenterology, Rady Children's Hospital, San Diego, California
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Alvarado C, Nguyen-Rodriguez ST, Frank GC, Garcia M, Gatdula N. Influence of Home Language Use on the Association Between Parent Education and Child Adiposity in Latino Families. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01935-z. [PMID: 38381326 DOI: 10.1007/s40615-024-01935-z] [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: 10/05/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Parent education and language use are associated with child obesity, but the impact of their interaction is less known. This study assessed whether parent education was associated with child adiposity and if this association was moderated by home language use in Latino families. METHODS Participants (n = 415) were Latino families from the Long Beach area. Demographic data were obtained by self-report parent surveys, and children's body size was objectively assessed via bioelectric impedance. Independent t-tests and hierarchical linear regressions were performed on baseline data from a larger intervention study. RESULTS In the overall sample, parent education and child body mass index (BMI) percentile were not related (p = .050). However, stratification by home language use revealed that parent education was inversely associated with child BMI percentile among those whose primary home language was Spanish (p = .049), but not English/bilingual homes (p = .296). There were no significant associations with child percent body fat. CONCLUSION Higher education was associated with a lower BMI percentile only in Spanish-speaking homes. Research to understand how home language influences this relationship is warranted, particularly as it relates to a subset of education and health literacy. Significant results with BMI percentile but not percent body fat highlight the fact that these distinct markers of obesity are not interchangeable.
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Affiliation(s)
- Carina Alvarado
- Department of Health Science, California State University, Long Beach, CA, USA
- School of Public Health, University of California, Berkeley, CA, USA
| | - Selena T Nguyen-Rodriguez
- Department of Health Science, California State University, Long Beach, CA, USA.
- Center forLatino Community Health, Evaluation, and Leadership Training, Long Beach, CA, USA.
| | - Gail C Frank
- Department of Health Science, California State University, Long Beach, CA, USA
- Center forLatino Community Health, Evaluation, and Leadership Training, Long Beach, CA, USA
- Department of Family & Consumer Sciences, California State University, Long Beach, CA, USA
| | - Melawhy Garcia
- Department of Health Science, California State University, Long Beach, CA, USA
- Center forLatino Community Health, Evaluation, and Leadership Training, Long Beach, CA, USA
| | - Natalia Gatdula
- Department of Health Science, California State University, Long Beach, CA, USA
- Center forLatino Community Health, Evaluation, and Leadership Training, Long Beach, CA, USA
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Deng Q, Wong HM, Peng S. Salivary and gingival crevicular fluid biomarkers of periodontal health and/or obesity among children and adolescents: A systematic review and meta-analysis. Heliyon 2024; 10:e23782. [PMID: 38226238 PMCID: PMC10788453 DOI: 10.1016/j.heliyon.2023.e23782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/30/2023] [Accepted: 12/13/2023] [Indexed: 01/17/2024] Open
Abstract
Objectives To investigate the association of salivary and gingival crevicular fluid (GCF) biomarkers with periodontal status and obesity in children and adolescents. Data/sources A literature search up to July 2023 was conducted through PubMed, Web of Science, Embase, ProQuest Medical Database, ProQuest SciTech Premium Collection, and the Cochrane Library. Observational studies comparing salivary and GCF biomarkers in children and adolescents with compromised periodontal status and/or obesity were included for data extraction. A meta-analysis was performed to estimate the overall standardised mean difference. Study selection Fifteen observational studies met the inclusion criteria and were included in this systematic review. Meta-analysis was only applicable in synthesising the dyadic relationship between GCF biomarkers and obesity. The results demonstrated that children and adolescents with obesity had significantly higher GCF levels of tumour necrosis factor-alpha (SMD:0.56; 95% CI:0.07, 1.04), adiponectin (SMD:0.33; 95% CI:0.06, 0.60), leptin (SMD:0.52; 95% CI:0.15, 0.90), and interleukin-1 beta (SMD:0.71; 95% CI:0.44, 0.99) than those with normal weight. Conclusion To date, no study has well addressed the triadic association between salivary or GCF biomarkers, periodontal status, and obesity among children and adolescents. Further in-depth, high-quality studies are required to investigate these associations. Clinical significance Periodontal disease and obesity are growing public health crises worldwide. Their relationship has been intensively studied. Investigating the salivary or GCF biomarkers alterations could help better understand the relationship between periodontal disease and obesity, which would assist in tailoring future oral health promotion programs.
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Affiliation(s)
- Qianyi Deng
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Hai Ming Wong
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Simin Peng
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Zhao L, Freedman DS, Blanck HM, Park S. Trends in Severe Obesity Among Children Aged 2 to 4 Years in WIC: 2010 to 2020. Pediatrics 2024; 153:e2023062461. [PMID: 38105679 PMCID: PMC10863498 DOI: 10.1542/peds.2023-062461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVES To examine the prevalence and trends in severe obesity among 16.6 million children aged 2 to 4 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from 2010 to 2020. METHODS Severe obesity was defined as a sex-specific BMI for age ≥120% of the 95th percentile on the Centers for Disease Control and Prevention growth charts or BMI ≥35 kg/m2. Joinpoint regression was used to identify when changes occurred in the overall trend. Logistic regression was used to compute the adjusted prevalence differences between years controlling for sex, age, and race and ethnicity. RESULTS The prevalence of severe obesity significantly decreased from 2.1% in 2010 to 1.8% in 2016 and then increased to 2.0% in 2020. From 2010 to 2016, the prevalence decreased significantly among all sociodemographic subgroups except for American Indian/Alaska Native (AI/AN) children. The largest decreases were among 4-year-olds, Asian/Pacific Islander and Hispanic children, and children from higher-income households. However, from 2016 to 2020, the prevalence increased significantly overall and among sociodemographic subgroups, except for AI/AN and non-Hispanic white children. The largest increases occurred in 4-year-olds and Hispanic children. Among 56 WIC agencies, the prevalence significantly declined in 17 agencies, and 1 agency (Mississippi) showed a significant increase from 2010 to 2016. In contrast, 21 agencies had significant increases, and only Alaska had a significant decrease from 2016 to 2020. CONCLUSIONS Although severe obesity prevalence in toddlers declined from 2010 to 2016, recent trends are upward. Early identification and access to evidence-based family healthy weight programs for at-risk children can support families and child health.
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Affiliation(s)
- Lixia Zhao
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David S Freedman
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Heidi M Blanck
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
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Luo Y, Zhang L, Lu Y, Lin X, Weng Z, Xu Y. Association Between the Serum Copper Levels and Environmental Tobacco Exposure on the Risk of Overweight and Obesity in Children: a Study Based on the National Health and Nutrition Examination Survey. Biol Trace Elem Res 2023:10.1007/s12011-023-04037-9. [PMID: 38158458 DOI: 10.1007/s12011-023-04037-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
This study was to assess the individual effects of serum copper levels and environmental tobacco exposure and their joint effects on the risk of overweight and obesity among children and adolescents of 6 to 19 year olds. We analyzed cross-sectional data from 1849 children and adolescents participating in the National Health and Nutrition Examination Survey (NHANES) collected between 2011 and 2016. Environmental tobacco exposure was determined by cotinine levels. The serum copper level was divided into < median group and ≥ median groups according to the median of 109.81 µg/dL. The outcome was overweight/obese in children and adolescents. Weighted multinomial multivariate logistic regression models were used to assess the association of serum copper and cotinine levels, with the risk of overweight/obesity, and the joint effects on the risk of overweight and obesity among children and adolescents. The subgroup analyses based on age, gender, and household smoking status were conducted. Among 1849 children and adolescents, 332 children and adolescents had overweight BMI, and 450 children and adolescents had obese BMI. Higher serum copper levels were associated with the risk of obesity in children and adolescents (odds ratio (OR) 2.96, 95% confidence interval (CI) 1.39-6.31, P = 0.006). A positive association between increasing levels of cotinine levels and the risk of overweight (OR 1.83, 95% CI 1.16-2.87, P = 0.010) and obesity (OR 2.56, 95% CI 1.03-6.40, P = 0.044) in children and adolescents was observed. A remarkable association was found between higher serum copper in combination with higher cotinine levels and the risk of overweight (OR 3.23, 95% CI 1.19-8.83, P = 0.023) and obesity (OR 8.76, 95% CI 2.14-35.87, P = 0.003) in children and adolescents. The subgroup analyses revealed positive associations between high serum copper levels in combination with high cotinine levels and overweight and obesity in children and adolescents aged ≥ 12 years, of female sex, and without smoking family members. There may exist a joint effect of serum copper levels and environmental tobacco exposure on overweight/obesity among children and adolescents. These findings offer an insight that early weight control and reduction of tobacco exposure and the detection of serum copper levels may be important in reducing the risk of obesity in children.
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Affiliation(s)
- Yujun Luo
- Department of Pediatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, People's Republic of China
- Xiaorong Luo's Renowned Expert Inheritance Studio, 3Rd Floor, East District, Guangdong Provincial Hospital of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, Guangdong Province, 510120, People's Republic of China
| | - Linzhu Zhang
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510405, People's Republic of China
| | - Yanting Lu
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510405, People's Republic of China
| | - Xiaohong Lin
- Department of Pediatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, People's Republic of China
- Xiaorong Luo's Renowned Expert Inheritance Studio, 3Rd Floor, East District, Guangdong Provincial Hospital of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, Guangdong Province, 510120, People's Republic of China
| | - Zelin Weng
- Department of Pediatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, People's Republic of China.
- Xiaorong Luo's Renowned Expert Inheritance Studio, 3Rd Floor, East District, Guangdong Provincial Hospital of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, Guangdong Province, 510120, People's Republic of China.
| | - Youjia Xu
- Department of Pediatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, People's Republic of China.
- Xiaorong Luo's Renowned Expert Inheritance Studio, 3Rd Floor, East District, Guangdong Provincial Hospital of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, Guangdong Province, 510120, People's Republic of China.
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Yu T, Jiang Y, Fan J, Guo X, Hua H, Xu D, Wang Y, Yan C, Xu J. Rapid increases in BMI waist to height ratio during adolescence and subsequent neurobehavioral deficits. Obesity (Silver Spring) 2023; 31:2822-2833. [PMID: 37735781 DOI: 10.1002/oby.23881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/05/2023] [Accepted: 07/13/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE The aim of this study was to explore prospective relationships between changing patterns of BMI/waist to height ratio (WHtR) during adolescence and subsequent neurobehavioral development. METHODS In this prospective cohort study, randomized stratified sampling was used to recruit six middle schools and 609 students in Shanghai, China. In Grades 6, 7, and 9, the Youth Self Report scale was used to assess student neurobehavioral status and anthropometric measurements were conducted to calculate BMI z scores and WHtRs. Longitudinal data were analyzed using latent class mixture modeling to delineate trajectories of BMI z scores ("stable," "decreasing," "rapidly increasing") and WHtRs ("stable," "rapidly increasing"), and their associations with neurobehavioral status in Grade 9 were assessed. RESULTS In Grades 6 through 9 (ages 11-15 years), the prevalence of overall obesity and abdominal obesity ranged from 10.7% to 13.0% and 13.0% to 19.8%, respectively. Compared with the stable BMI z score trajectory, the rapidly increasing BMI z score trajectory was longitudinally associated with delinquent behavior, aggressive behavior, and externalizing problems (incidence rate ratio: 1.564-1.613, adjusted p < 0.05). Compared with the stable WHtR trajectory, the rapidly increasing WHtR trajectory significantly predicted increased risks of social problems and delinquent behavior (incidence rate ratios: 1.776-1.967, adjusted p < 0.05). Significant associations of the rapidly increasing BMI z score/WHtR trajectories with subsequent neurobehavioral deficits were observed among girls (adjusted p < 0.05) but not among boys (adjusted p > 0.05). CONCLUSIONS Rapid increases in BMI or WHtR during adolescence could predict subsequent neurobehavioral deficits, especially for externalizing behaviors. Timely intervention for weight control may be considered to promote adolescent mental health.
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Affiliation(s)
- Ting Yu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yining Jiang
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jue Fan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Changning Maternity & Infant Health Institute, Shanghai, China
| | - Xiangrong Guo
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Hua
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongqing Xu
- Institute of Higher Education, Fudan University, Shanghai, China
| | - Yuefen Wang
- Shanghai Municipal Education Commission Department, Shanghai, China
| | - Chonghuai Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Xu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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12
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Basu A. Carotenoid Status in Children: A Biomarker for Eye Health and Fruit and Vegetable Intake. J Nutr 2023; 153:2775-2777. [PMID: 37573013 DOI: 10.1016/j.tjnut.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/04/2023] [Accepted: 08/01/2023] [Indexed: 08/14/2023] Open
Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, NV, United States.
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13
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Yu J, Huang F, Zhang X, Xue H, Ni X, Yang J, Zou Z, Du W. Association of Sugar-Sweetened Beverage Consumption and Moderate-to-Vigorous Physical Activity with Childhood and Adolescent Overweight/Obesity: Findings from a Surveillance Project in Jiangsu Province of China. Nutrients 2023; 15:4164. [PMID: 37836448 PMCID: PMC10574764 DOI: 10.3390/nu15194164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Sugar-sweetened beverage (SSB) consumption and inadequate moderate-to-vigorous physical activity (MVPA) have been suggested as potential contributors to overweight/obesity during childhood or adolescence; however, the results of previous studies are inconsistent. It was crucial to estimate the independent and joint association of SSB consumption and inadequate MVPA for childhood and adolescent overweight/obesity. The "Surveillance for Common Disease and Health Risk Factors Among Students in Jiangsu Province 2021-2022" initiative provided us with representative population-based data that we studied. SSB consumption and inadequate MVPA were determined by self-reported SSB habit and MVPA frequency (days/week). The body mass index for each gender and age subgroup was used to identify those who were overweight or obese. With stratified analyses to ascertain differences in age or gender, we employed the logistic regression model to assess the association of SSB and MVPA with overweight/obesity and applied the likelihood ratio test to explore the interactions. Approximately 38.2% of the study population (119,467 students aged 8-17) were overweight/obese. After adjusting covariates, SSB consumption or inadequate MVPA was associated with overweight/obesity (OR = 1.05, 95% CI = 1.02-1.07; and OR = 1.07, 95% CI = 1.03-1.10). In comparison to students with "no SSB consumption and adequate MVPA", those with "SSB consumption and inadequate MVPA" had a higher risk of being overweight/obese (OR = 1.13, 95% CI = 1.08-1.18). Regardless of age and gender subgroups, the correlation of SSB and MVPA alone and together with being overweight/obese was generally similar, with the adolescent group aged 13-17 years (OR = 1.15, 95% CI = 1.09-1.22) and females (OR = 1.09, 95% CI = 1.02-1.17) being more susceptible. Moreover, there was a significant interaction between SSB consumption and gender (p < 0.001), as well as between SSB consumption and inadequate MVPA (p = 0.008). Hence, SSB consumption in students is significantly associated with overweight/obesity, especially when MVPA is inadequate. In light of the rapidly expanding childhood and adolescent obesity epidemic, proper attention should be given to these modifiable behaviors, particularly SSB and MVPA.
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Affiliation(s)
- Jinxia Yu
- School of Public Health, Southeast University, Nanjing 210009, China; (J.Y.); (H.X.); (X.N.)
| | - Feng Huang
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China;
| | - Xiyan Zhang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China;
| | - Hui Xue
- School of Public Health, Southeast University, Nanjing 210009, China; (J.Y.); (H.X.); (X.N.)
| | - Xiaoyan Ni
- School of Public Health, Southeast University, Nanjing 210009, China; (J.Y.); (H.X.); (X.N.)
| | - Jie Yang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China;
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Wei Du
- School of Public Health, Southeast University, Nanjing 210009, China; (J.Y.); (H.X.); (X.N.)
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14
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Tokarek J, Budny E, Saar M, Stańczak K, Wojtanowska E, Młynarska E, Rysz J, Franczyk B. Molecular Processes Involved in the Shared Pathways between Cardiovascular Diseases and Diabetes. Biomedicines 2023; 11:2611. [PMID: 37892985 PMCID: PMC10604380 DOI: 10.3390/biomedicines11102611] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 10/29/2023] Open
Abstract
Cardiovascular diseases and diabetes mellitus are currently among the diseases with the highest morbidity and mortality. The pathogenesis and development of these diseases remain strongly connected, along with inflammation playing a major role. Therefore, the treatment possibilities showing a positive impact on both of these diseases could be especially beneficial for patients. SGLT-2 inhibitors and GLP-1 receptor agonists present this dual effect. Moreover, the hostile composition of the gut microbiota could influence the progression of these conditions. In this review, the authors present the latest knowledge on and innovations in diabetes mellitus and CVD-with the focus on the molecular mechanisms and the role of the microbiota.
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Affiliation(s)
- Julita Tokarek
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland (K.S.); (E.W.)
| | - Emilian Budny
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland (K.S.); (E.W.)
| | - Maciej Saar
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland (K.S.); (E.W.)
| | - Kamila Stańczak
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland (K.S.); (E.W.)
| | - Ewa Wojtanowska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland (K.S.); (E.W.)
| | - Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland (K.S.); (E.W.)
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland (K.S.); (E.W.)
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15
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Li Q, Gao J, Luo J, Lin D, Wu X. Mendelian randomization analyses support causal relationship between gut microbiota and childhood obesity. Front Pediatr 2023; 11:1229236. [PMID: 37593447 PMCID: PMC10427879 DOI: 10.3389/fped.2023.1229236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/13/2023] [Indexed: 08/19/2023] Open
Abstract
Background Childhood obesity (CO) is an increasing public health issue. Mounting evidence has shown that gut microbiota (GM) is closely related to CO. However, the causal association needs to be treated with caution due to confounding factors and reverse causation. Methods Data were obtained from the Microbiome Genome Consortium for GM as well as the Early Growth Genetics Consortium for childhood obesity and childhood body mass index (CBMI). Inverse variance weighted, maximum likelihood, weighted median, and MR.RAPS methods were applied to examine the causal association. Then replication dataset was used to validate the results and reverse Mendelian randomization analysis was performed to confirm the causal direction. Additionally, sensitivity analyses including Cochran's Q statistics, MR-Egger intercept, MR-PRESSO global test, and the leave-one-out analysis were conducted to detect the potential heterogeneity and horizontal pleiotropy. Results Our study found suggestive causal relationships between eight bacterial genera and the risk of childhood obesity (five for CO and four for CBMI). After validating the results in the replication dataset, we finally identified three childhood obesity-related GM including the genera Akkermansia, Intestinibacter, and Butyricimonas. Amongst these, the genus Akkermansia was both negatively associated with the risk of CO (OR = 0.574; 95% CI: 0.417, 0.789) and CBMI (β = -0.172; 95% CI: -0.306, -0.039). Conclusions In this study, we employed the MR approach to investigate the causal relationship between GM and CO, and discovered that the genus Akkermansia has a protective effect on both childhood obesity and BMI. Our findings may provide a potential strategy for preventing and intervening in CO, while also offering novel insights into the pathogenesis of CO from the perspective of GM.
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Affiliation(s)
- Qi Li
- School of Medicine, Jishou University, Jishou, China
- Department for Infectious Disease Control and Prevention, Xiangxi Center for Disease Control and Prevention, Jishou, China
| | - Jiawei Gao
- School of Medicine, Jishou University, Jishou, China
| | - Jiashun Luo
- School of Medicine, Jishou University, Jishou, China
| | - Dihui Lin
- School of Medicine, Jishou University, Jishou, China
| | - Xinrui Wu
- School of Medicine, Jishou University, Jishou, China
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16
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Magaña S, Errisuriz VL, Yu APL, Heydaria N, Zeng W, Mirza M, Vanegas S, Brown S, Parra-Medina D, Suarez-Balcazar Y. Associations between parenting strategies and BMI percentile among Latino children and youth with intellectual and developmental disabilities. Front Pediatr 2023; 11:1189686. [PMID: 37576140 PMCID: PMC10413978 DOI: 10.3389/fped.2023.1189686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Maintaining healthy weight is a challenge for all children, and particularly for children with IDD compared to nondisabled children and for Latino children compared to non-Latino White children. Parenting practices related to food intake and physical activity have been found to be important in maintaining children's weight. In this study, we describe the prevalence of overweight and obesity status among Latino children with IDD and their maternal caregivers and determine the relationship between food and physical activity parenting practices and childhood obesity among Latino children with IDD. Methods We interviewed 94 Latino parent/child dyads and collected information about parenting practices, home environment, and parent and child height and weight using standardized measures. Parent body mass index (BMI) and child BMI percentile were calculated from height and weight. Results The combined overweight/obesity status for children in our sample was high (60.3%) compared to national rates among nondisabled Latino children (56%) and non-Latino White children with autism (37%). Contrary to research on nondisabled children, we found that greater parental use of controlling dietary strategies was associated with lower BMI percentile in Latino children with IDD. These findings may be indicative of the fact that children with IDD tend to have unique dietary behaviors that warrant more disability and culturally sensitive strategies. Discussion Our findings suggest that overweight and obesity is especially prevalent for Latino children with IDD and that more research is needed on family factors that promote health in Latino families of children with IDD.
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Affiliation(s)
- Sandy Magaña
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Vanessa L. Errisuriz
- Latino Research Institute, University of Texas at Austin, Austin, TX, United States
| | - Amy Pei-Lung Yu
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Nazanin Heydaria
- School of Social Work, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - Weiwen Zeng
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Mansha Mirza
- Department of Occupational Therapy, Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL, United States
| | - Sandra Vanegas
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Stephany Brown
- Texas Center for Disability Studies, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Deborah Parra-Medina
- Latino Research Institute, University of Texas at Austin, Austin, TX, United States
| | - Yolanda Suarez-Balcazar
- Department of Occupational Therapy, Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL, United States
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17
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Ma J, McGlade EC, Huber RS, Lyoo IK, Renshaw PF, Yurgelun-Todd DA. Overweight/Obesity-related microstructural alterations of the fimbria-fornix in the ABCD study: The role of aerobic physical activity. PLoS One 2023; 18:e0287682. [PMID: 37437033 PMCID: PMC10337868 DOI: 10.1371/journal.pone.0287682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/08/2023] [Indexed: 07/14/2023] Open
Abstract
Childhood overweight/obesity has been associated with negative consequences related to brain function and may involve alterations in white matter pathways important for cognitive and emotional processing. Aerobic physical activity is a promising lifestyle factor that could restore white matter alterations. However, little is known about either regional white matter alterations in children with overweight/obesity or the effects of aerobic physical activity targeting the obesity-related brain alterations in children. Using a large-scale cross-sectional population-based dataset of US children aged 9 to 10 years (n = 8019), this study explored the associations between overweight/obesity and microstructure of limbic white matter tracts, and examined whether aerobic physical activity may reduce the overweight/obesity-related white matter alterations in children. The primary outcome measure was restriction spectrum imaging (RSI)-derived white matter microstructural integrity measures. The number of days in a week that children engaged in aerobic physical activity for at least 60 minutes per day was assessed. We found that females with overweight/obesity had lower measures of integrity of the fimbria-fornix, a major limbic-hippocampal white matter tract, than their lean peers, while this difference was not significant in males. We also found a positive relationship between the number of days of aerobic physical activity completed in a week and integrity measures of the fimbria-fornix in females with overweight/obesity. Our results provide cross-sectional evidence of sex-specific microstructural alteration in the fimbria-fornix in children with overweight/obesity and suggest that aerobic physical activity may play a role in reducing this alteration. Future work should examine the causal direction of the relationship between childhood overweight/obesity and brain alterations and evaluate potential interventions to validate the effects of aerobic physical activity on this relationship.
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Affiliation(s)
- Jiyoung Ma
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Diagnostic Neuroimaging Laboratory, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Erin C. McGlade
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Diagnostic Neuroimaging Laboratory, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- George E. Wahlen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah, United States of America
| | - Rebekah S. Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Diagnostic Neuroimaging Laboratory, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - In Kyoon Lyoo
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Diagnostic Neuroimaging Laboratory, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea
| | - Perry F. Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Diagnostic Neuroimaging Laboratory, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- George E. Wahlen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah, United States of America
| | - Deborah A. Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Diagnostic Neuroimaging Laboratory, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- George E. Wahlen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah, United States of America
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Paul ME, Wallace JG, Coakley BA. An Assessment of the Relationship Between BMI and Children Undergoing Surgical Procedures: A Retrospective Study. Child Obes 2023; 19:249-257. [PMID: 35776521 PMCID: PMC10398724 DOI: 10.1089/chi.2022.0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: While multiple studies have documented that obesity increases the risk of operative complications among adults, little data exist on how obesity impacts surgical outcomes among children. We aimed to determine if children with obesity have different postoperative outcomes than their peers. Methods: A retrospective chart review was conducted of 875 patients aged between 2 and 18 years who underwent surgery during 2018. Patients were stratified, based on BMI percentile for age, as having less than healthy weight (<5th percentile), healthy weight (5th-84th percentile), excess weight (85th-94th percentile), or obesity (≥95th percentile). Demographic information and data on medical comorbidities and postoperative complications were collected. All analyses were conducted using chi-square or Kruskal-Wallis testing. Results: Eighty-two patients were excluded due to lack of BMI data and 56 were excluded as they had below healthy weight. Of the remaining 737 patients, 475 (64.4%) had healthy weight, 124 (16.8%) had excess weight, and 138 (18.70%) had obesity. Children with obesity had more tonsillectomy/adenoidectomy (p < 0.01) and vascular access (p = 0.04) procedures compared with peers. Additionally, patients with obesity were more likely to have a pre-existing history of liver disease (p < 0.01) and more frequently developed postoperative wound dehiscence (p < 0.01). No other complications occurred more frequently among children with obesity. Conclusions: Children with obesity required more tonsillectomy/adenoidectomy and vascular access procedures. Wound dehiscence was the only complication that was associated with obesity. This suggests that children with obesity are not inherently more prone to experience surgical complications and therefore elective procedures should likely not be deferred until preoperative weight loss is achieved.
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Affiliation(s)
- Megan E. Paul
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Brian A. Coakley
- Departments of Pediatrics and Surgery, Mount Sinai Health System, New York, NY, USA
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Fitch A, Horn DB, Still CD, Alexander LC, Christensen S, Pennings N, Bays HE. Obesity medicine as a subspecialty and United States certification - A review. OBESITY PILLARS (ONLINE) 2023; 6:100062. [PMID: 37990658 PMCID: PMC10661990 DOI: 10.1016/j.obpill.2023.100062] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 11/23/2023]
Abstract
Background Certification of obesity medicine for physicians in the United States occurs mainly via the American Board of Obesity Medicine (ABOM). Obesity medicine is not recognized as a subspecialty by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA). This review examines the value of specialization, status of current ABOM Diplomates, governing bodies involved in ABMS/AOA Board Certification, and the advantages and disadvantages of an ABMS/AOA recognized obesity medicine subspecialty. Methods Data for this review were derived from PubMed and appliable websites. Content was driven by the expertise, insights, and perspectives of the authors. Results The existing ABOM obesity medicine certification process has resulted in a dramatic increase in the number of Obesity Medicine Diplomates. If ABMS/AOA were to recognize obesity medicine as a subspecialty under an existing ABMS Member Board, then Obesity Medicine would achieve a status like other ABMS recognized subspecialities. However, the transition of ABOM Diplomates to ABMS recognized subspecialists may affect the kinds and the number of physicians having an acknowledged focus on obesity medicine care. Among transition issues to consider include: (1) How many ABMS Member Boards would oversee Obesity Medicine as a subspecialty and which physicians would be eligible? (2) Would current ABOM Diplomates be required to complete an Obesity Medicine Fellowship? If not, then what would be the process for a current ABOM Diplomate to transition to an ABMS-recognized Obesity Medicine subspecialist (i.e., "grandfathering criteria")? and (3) According to the ABMS, do enough Obesity Medicine Fellowship programs exist to recognize Obesity Medicine as a subspecialty? Conclusions Decisions regarding a transition to an ABMS recognized Obesity Medicine Subspecialty versus retention of the current ABOM Diplomate Certification should consider which best facilitates medical access and care to patients with obesity, and which best helps obesity medicine clinicians be recognized for their expertise.
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Affiliation(s)
- Angela Fitch
- Diplomate of American Board of Obesity Medicine, Knownwell, 15 Oak St Suite 3, Needham, MA, 02492, USA
| | - Deborah B. Horn
- Diplomate of American Board of Obesity Medicine, UT Center for Obesity Medicine and Metabolic Performance, University of Texas McGovern Medical School, 6348 Sewanee Ave, Houston, TX, 77005, USA
| | - Christopher D. Still
- Diplomate of American Board of Obesity Medicine, Department of Clinical Sciences, Geisinger Commonwealth School of Medicine, Center for Nutrition & Weight Management, Geisinger Obesity Institute, Geisinger Health System, 100 North Academy Avenue, MC 21-11, USA
| | - Lydia C. Alexander
- Diplomate of American Board of Obesity Medicine, Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
| | - Sandra Christensen
- Certificate of Advanced Education in Obesity Medicine, Integrative Medical Weight Management, 2611 NE 125th St, Suite 100B, Seattle, WA, 98125, USA
| | - Nicholas Pennings
- Diplomate of American Board of Obesity Medicine, Campbell University School of Osteopathic Medicine, 4350 US Hwy 421 S, Lillington, NC, 27546, USA
| | - Harold Edward Bays
- Diplomate of American Board of Obesity Medicine, Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA
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20
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Zheng X, Wang H, Wu H. Association between diet quality scores and risk of overweight and obesity in children and adolescents. BMC Pediatr 2023; 23:169. [PMID: 37046233 PMCID: PMC10100112 DOI: 10.1186/s12887-023-03966-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND This study examined the associations of diet quality assessed by Healthy Eating Index 2015 (HEI-2015), Alternative Healthy Eating Index 2010 (AHEI-2010), Mediterranean Diet (MedDiet) and overweight/obesity in children and adolescents. METHODS This cross-sectional study used data of participants aged 2-19 years from National Health and Nutrition Examination Survey (NHANES) 2005-2018. The weighted logistic regression model was adopted to explore the association between diet quality scores and overweight, obesity in children and adolescents. Subgroup analysis was also performed based on sex. RESULTS A total of 9,724 participants were included in children group (2-11 years old), and 5,934 were adolescent group (12-19 years old). All participants were divided into based on the BMI-for-age: underweight and normal, overweight and obesity groups. After adjusting for age, race, poverty-income ratio, maternal smoking during pregnancy and total energy, HEI-2015 and MedDiet scores were related to the risk of overweight in children, and only MedDiet scores remained associated with a decreased risk of obesity in children. MedDiet scores were associated with a decreased risk of overweight, obesity in adolescents, respectively, after adjusting age, sex, race, poverty-income ratio, cotinine, total energy and physical activity. The similar results in male participants were also found. CONCLUSION Higher MedDiet scores were associated with lower the risk of overweight and obesity, respectively, particularly for male children and adolescents. The higher HEI-2015 scores were also related to the risk of overweight in children.
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Affiliation(s)
- Xiaoyun Zheng
- Department of Child Health, Maternal and Child Health Hospital of Hubei Province, No.745 Wuluo Road, Hongshan District, Wuhan, Hubei Province, 430070, People's Republic of China.
| | - Hong Wang
- Department of Child Health, Maternal and Child Health Hospital of Hubei Province, No.745 Wuluo Road, Hongshan District, Wuhan, Hubei Province, 430070, People's Republic of China
| | - Huiwen Wu
- Department of Child Health, Maternal and Child Health Hospital of Hubei Province, No.745 Wuluo Road, Hongshan District, Wuhan, Hubei Province, 430070, People's Republic of China
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21
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Hawkins MD. Investigating the Effects of the COVID-19 Pandemic on Pediatric Body Mass Index, and Health Status in an Inner-City, Low-Income Setting. J Pediatr Health Care 2023; 37:193-199. [PMID: 36243619 PMCID: PMC9492503 DOI: 10.1016/j.pedhc.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/29/2022] [Accepted: 09/18/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The COVID-19 pandemic required unprecedented containment measures, including prolonged stay-at-home orders, to combat spread and prevent loss of life. One of the consequences of these mandates was the closure of schools. Children in resource-limited communities already experiencing disparities were placed at a significant disadvantage by the closure of schools. Many depended on the school systems as their primary source of nutrient-rich food. Additionally, for many, schools provide the only safe place for outdoor play and physical activity. The unintended consequences of the COVID-19 stay-at-home orders for these high-risk children are now being investigated. METHOD This article reports a retrospective chart review of children aged 9-11 years in a low-income, inner-city practice in a moderately sized Southeastern city. Baseline data were obtainef fro 2019 and compared to 2020 and/or 2021. RESULTS Findings indicate statistically significant increases in body mass index in this high-risk population of children. Additionally. chronic condistion associate with obesity were identified in many of the unhealthy weight children in the study. DISCUSSION This study identifies unintended consequences form the pandemic containment measures that are consistent with other emerging research related to the pandemic's effects on body mass index in children.
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Affiliation(s)
- Martha D Hawkins
- Associate Professor of Nursing, Pediatric Nurse Practitioner, National & Global, Indiana Wesleyan University, Marion, Indiana.
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22
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Self-Reported Parental Healthy Dietary Behavior Relates to Views on Child Feeding and Health and Diet Quality. Nutrients 2023; 15:nu15041024. [PMID: 36839382 PMCID: PMC9959008 DOI: 10.3390/nu15041024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
The aim of this cross-sectional study was to investigate whether parental views on child feeding and its impact on health differ between those parents whose self-perception was that they followed a healthy diet to those who do not. Furthermore, differences in the child's diet quality and weight were compared between the groups. Parents of 2-6-year-old children (n = 738), recruited from child health clinics throughout Finland, answered semi-structured questionnaires on their views on child feeding and health as well as their child's diet quality. Participants were divided into two groups based on their self-perceived report of following a healthy diet: health-conscious (HC, n = 396) and non-health-conscious (non-HC, n = 342) parents. HC parents considered health, eating behavior, and nutrient-related factors more often when feeding their child than non-HC parents (<0.001 < p < 0.03). Moreover, they more commonly considered diet to have an important impact on their child's long-term health than the non-HC parents (<0.001 < p < 0.05). Children of HC parents were more likely to have a good diet quality (p = 0.01) and lower BMI-SDS values (p = 0.015) than those of non-HC parents. Parental health consciousness was linked with better diet quality and healthier weight in their children. This information may be useful in the regular clinical monitoring of children's health.
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23
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Sun X, Haydel KF, Matheson D, Desai M, Robinson TN. Are mobile phone ownership and age of acquisition associated with child adjustment? A 5-year prospective study among low-income Latinx children. Child Dev 2023; 94:303-314. [PMID: 36056573 PMCID: PMC9780147 DOI: 10.1111/cdev.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 12/25/2022]
Abstract
This prospective, longitudinal study examined associations between whether and when children first acquire a mobile phone and their adjustment measures, among low-income Latinx children. Children (N = 263; 55% female; baseline Mage = 9.5) and their parents were assessed annually for 5 years from 2012. Children first acquired a mobile phone at a mean (SD) age of 11.62 (1.41) years. Pre-registered multilevel models tested associations linking phone ownership, phone acquisition age, and the interaction between ownership and acquisition age to levels and changing trends of depressive symptoms, school grades, and reported and objectively assessed sleep. Results showed no statistically significant associations, controlling the False Discovery Rate. Findings suggest an absence of meaningful links from mobile phone ownership and acquisition age to child adjustment.
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24
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Alqahtani A, Alhousari D, Ali A, Yaghmour G, Orgel E, Curran E, Stock W, Bhojwani D, Alachkar H. Asparaginase toxicity in Hispanic adult and pediatric patients with acute lymphoblastic leukemia: current understanding. Expert Opin Drug Metab Toxicol 2023; 19:357-366. [PMID: 37410014 DOI: 10.1080/17425255.2023.2233412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 07/03/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION Asparaginase is essential to chemotherapy regimens for acute lymphoblastic leukemia (ALL). Survival of patients with ALL has improved since incorporating asparaginase into chemotherapy backbones. Hispanic patients have a higher incidence of ALL than other ethnicities and suffer inferior outcomes. The inferior outcome of Hispanics is due to several factors, including the increased incidence of high-risk genetic subtypes and susceptibility to treatment-related toxicity. AREAS COVERED We summarize the current knowledge of asparaginase-related toxicity by comparing their incidence between Hispanic and non-Hispanic patients. These toxicities include hypersensitivity, hepatotoxicity, pancreatitis, thrombosis, and hypertriglyceridemia. The PubMed database and Google Scholar were used to search for this review from October 2022 to June 2023. EXPERT OPINION Except for hepatotoxicity and hypertriglyceridemia secondary to asparaginase-based treatments, which may develop more frequently among Hispanic patients with ALL, other toxicities were comparable between Hispanic and non-Hispanic patients. Nevertheless, studies with larger cohorts and more accurate capturing of Hispanic ethnicity should be conducted to fill the gaps in the current knowledge.
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Affiliation(s)
- Amani Alqahtani
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
- Department of Clinical Pharmacy, School of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Diala Alhousari
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Amir Ali
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - George Yaghmour
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - Etan Orgel
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
- Cancer and Blood Disease Institute, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Emily Curran
- The Department of Medicine, Section of Hematology & Oncology at the University of Cincinnati College of Medicine
| | - Wendy Stock
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Deepa Bhojwani
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
- Cancer and Blood Disease Institute, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Houda Alachkar
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
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25
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Teoh CM, Cooper A, Renteria KM, Lane M, Zhu J, Koh GY. Supplementation of Methyl-Donor Nutrients to a High-Fat, High-Sucrose Diet during Pregnancy and Lactation Normalizes Circulating 25-Dihydroxycholecalciferol Levels and Alleviates Inflammation in Offspring. Metabolites 2022; 12:metabo12121252. [PMID: 36557290 PMCID: PMC9783000 DOI: 10.3390/metabo12121252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
A Western-style diet that is high in fat and sucrose has been shown to alter DNA methylation and epigenetically modify genes related to health risk in offspring. Here, we investigated the effect of a methyl-donor nutrient (MS) supplemented to a high-fat, high-sucrose (HFS) diet during pregnancy and lactation on vitamin D (VD) status and inflammatory response in offspring. After mating, 10-week-old female Sprague-Dawley (SD) rats (n = 10/group) were randomly assigned to one of the four dietary groups during pregnancy and lactation: (1) control diet (CON), (2) CON with MS (CON-MS), (3) HFS, and (4) HFS with MS (HFS-MS). Weanling offspring (three weeks old) were euthanized and sacrificed (n = 8-10/sex/group). The remaining offspring (n = 10/sex/group) were randomly assigned to either a CON or an HFS diet for 12 weeks and sacrificed at 15 weeks of age. Our results indicated that prenatal MS supplementation, but not postnatal diet, restored low vitamin D status and suppressed elevation of proinflammatory cytokine induced by maternal HFS in the offspring. Furthermore, both prenatal and postnatal diets modulated the abundance of Lactobacillus spp. and Bacteroides spp. in the offspring, a shift that was independent of vitamin D status. Collectively, our data support a role for MS in restoring the perturbation of VD status and normalizing maternal HFS-induced inflammation in the offspring. Further investigation is warranted to elucidate the methylation status of VD metabolism-related pathways in the offspring, as well as the immunomodulatory role of vitamin D during the progression of obesity.
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The Role of the Gut Microbiome in Pediatric Obesity and Bariatric Surgery. Int J Mol Sci 2022; 23:ijms232315421. [PMID: 36499739 PMCID: PMC9740713 DOI: 10.3390/ijms232315421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022] Open
Abstract
Obesity affects 42.4% of adults and 19.3% of children in the United States. Childhood obesity drives many comorbidities including hypertension, fatty liver disease, and type 2 diabetes mellitus. Prior research suggests that aberrant compositional development of the gut microbiome, with low-grade inflammation, precedes being overweight. Therefore, childhood may provide opportunities for interventions that shape the microbiome to mitigate obesity-related diseases. Children with obesity have gut microbiota compositional and functional differences, including increased proinflammatory bacterial taxa, compared to lean controls. Restoration of the gut microbiota to a healthy state may ameliorate conditions associated with obesity and help maintain a healthy weight. Pediatric bariatric (weight-loss) surgery is an effective treatment for childhood obesity; however, there is limited research into the role of the gut microbiome after weight-loss surgery in children. This review will discuss the magnitude of childhood obesity, the importance of the developing microbiome in establishing metabolic pathways, interventions such as bariatric surgery that may modulate the gut microbiome, and future directions for the potential development of microbiome-based therapeutics to treat obesity.
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27
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Bhattacharya P, Klein MD, Beck AF, Xu Y, Kharofa RY. Associations Between Age of Onset of Pediatric Overweight/Obesity, a Child’s Sociodemographic Characteristics, and Characteristics of a Child’s Home Census Tract. Am J Health Promot 2022:8901171221138276. [DOI: 10.1177/08901171221138276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose To identify associations between age of onset of overweight/obesity, a child’s sociodemographic characteristics, and characteristics of a child’s home census tract. Design Retrospective electronic health record review of children with overweight/obesity. Setting Three primary care centers associated with a free-standing, tertiary-care pediatric institution in Cincinnati. Subjects Patients born between August 1, 2013 and July 31, 2014, who had a body mass index (BMI) ≥85th percentile before 5 years of age (n = 794). Measures Primary outcome was the patient’s age at the first encounter when BMI was ≥85th percentile. Patient-level predictors were sex, age, race/ethnicity, health insurance, and number of moves captured in the health record. Census tract-level predictors were density of bus stops, presence of grocery stores, and a Socioeconomic Deprivation Index. Analysis Multivariable linear regression models assessed for independent associations between age of onset of overweight/obesity and predictors. Results Patients were 55.8% female, 73.6% black, and 79.1% publicly insured. Each additional move per year was associated with onset of overweight/obesity occurring 4.05 months earlier ( P < .0001). No significant associations between age of onset of overweight/obesity and census tract-level density of bus stops ( P = .82), presence of grocery stores ( P = .39), and socioeconomic deprivation ( P = .53) were demonstrated. Conclusion Public policy efforts toward improving access to grocery stores or public transportation may not be sufficient to prevent childhood obesity. Population-level interventions related to improving housing may also reduce obesity.
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Affiliation(s)
| | - Melissa D. Klein
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrew F. Beck
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Yingying Xu
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Roohi Y. Kharofa
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
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