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Rossi PAQ, Gomes R, Nascimento Salazar TCD, Lustosa Barros EM, Vasconcelos S, da Silva AS, Pereira EM, Melo VB, Fonseca MHG, Teixeira CR, Furtado GP, Pontes LQ, Khouri R, Vasconcelos B, Almeida SSD, Werneck GL, Rossi FE, Santos MAPD. Physical Activity at Different Life Stages and Its Consequence on the Initial Immunization and Inflammatory Response Against COVID-19. J Phys Act Health 2024; 21:717-725. [PMID: 38663845 DOI: 10.1123/jpah.2023-0370] [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: 07/18/2023] [Revised: 02/16/2024] [Accepted: 03/08/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND To evaluate the influence of previous physical activity (PA) during childhood, adolescence, and current PA practice on the production of antibodies and inflammatory response between the first and second doses of the COVID-19 vaccine. METHODS Fifty-nine men and 56 women were evaluated before the first vaccine, and 12 weeks later, blood samples were taken to quantify production of anti-severe acute respiratory syndrome coronavirus-2 immunoglobulin G antibodies and cytokines. Previous PA during childhood and adolescence was self-referred, and current PA was assessed using the International Physical Activity Questionnaire. RESULTS A positive and significant association was observed only between PA practice during adolescence and an increase in antibody production in adulthood (β = 2012.077, 95% confidence interval, 257.7953-3766.358, P = .025). Individuals who practiced PA during adolescence showed higher production of antibodies between the first and second vaccine dose compared to nonpractitioners (P = .025) and those that accumulated ≥150 minutes per week of current moderate-vigorous PA (MVPA), and presented higher antibody production in relation to who did <150 minutes per week of MVPA (P = .046). Individuals that were practitioners during childhood produced higher G-CSF (P = .047), and those that accumulated ≥150 minutes per week of current MVPA demonstrated lower IP-10 levels (P = .033). However, PA practitioners during adolescence presented higher G-CSF (P = .025), IL-17 (P = .038), IL-1RA (P = .005), IL-1β (P = .020), and IL-2 (P = .026) levels. CONCLUSION Our results suggest that adults that accumulated at least 150 minutes of MVPA per week or practiced PA during adolescence developed an improved immune and inflammatory response against COVID-19 vaccination.
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Affiliation(s)
- Priscila Almeida Queiroz Rossi
- Postgraduation Student in Science and Health, Federal University of Piaui, Teresina, PI, Brazil
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| | - Regis Gomes
- Biotecnologia, Escritório Técnico da Fiocruz Ceará, Eusébio, CE, Brazil
| | - Teresa Cristina do Nascimento Salazar
- Postgraduation Student in Science and Health, Federal University of Piaui, Teresina, PI, Brazil
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| | - Esmeralda Maria Lustosa Barros
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| | | | | | | | - Vitoria Braga Melo
- Unidade de Apoio ao Diagnóstico de Covid-19 (UNADIG), Fiocruz Ceará, Eusébio, CE, Brazil
| | | | | | | | | | - Ricardo Khouri
- Gonçalo Moniz Institute, Fiocruz Bahia, Salvador, BA, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador,BA, Brazil
| | - Beatriz Vasconcelos
- Gonçalo Moniz Institute, Fiocruz Bahia, Salvador, BA, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador,BA, Brazil
| | - Sandro Soares de Almeida
- Department of Obstetrician, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo,SP, Brazil
- Faculdade Anhanguera de Guarulhos, Guarulhos,SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Fabrício Eduardo Rossi
- Department of Physical Education, Immunometabolism of Skeletal Muscle and Exercise Research Group, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
- Graduate Program in Science and Health, Federal University of Piauí (UFPI), Teresina, PI, Brazil
- Graduate Program in Movement Science, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Marcos Antonio Pereira Dos Santos
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
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Chivate R, Schoemer P, Ragavan MI, Ray K, Bensignor MO, Goldschmidt AB, Vajravelu ME. Primary care perspectives on prescribing anti-obesity medication for adolescents. Pediatr Obes 2024:e13146. [PMID: 38880989 DOI: 10.1111/ijpo.13146] [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: 02/13/2024] [Revised: 04/23/2024] [Accepted: 05/17/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Recent pediatric guidelines recommend clinicians offer anti-obesity medication (AOM) as an adjunct to intensive lifestyle intervention. OBJECTIVE To investigate pediatricians' perspectives about prescribing AOM, including barriers and facilitators. METHODS An investigator-developed survey was emailed to primary care pediatric physicians (n = 187) and advanced practice providers (n = 190) within an academic-affiliated network. The survey evaluated how willing clinicians were to prescribe AOM and their agreement with 25 statements about barriers and facilitators. Three vignettes explored AOM decision-making. Multinomial logistic regression was used to determine relative risk ratios for willingness to prescribe by agreement with each statement. RESULTS Among 74 respondents (20% response rate), 24% were willing, 42% uncertain and 34% unwilling to prescribe. Most (64%) agreed that AOM should be managed only by specialists. Willingness to prescribe was associated with clinician motivation and belief in guideline practicality and applicability. Unwillingness was associated with beliefs that patients would not continue AOM long enough for benefit and that there was insufficient time or resources to implement. In vignettes, 52% were willing to prescribe AOM for a patient with severe obesity and metabolic complications, versus 11% for a patient with obesity and possible disordered eating. CONCLUSIONS Willingness to prescribe AOM was low and was associated with perceived practicality and appropriateness for patients.
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Affiliation(s)
- Rutha Chivate
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Pamela Schoemer
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- UPMC Children's Community Pediatrics, Pittsburgh, Pennsylvania, USA
| | - Maya I Ragavan
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Division of General Academic Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kristin Ray
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- UPMC Children's Community Pediatrics, Pittsburgh, Pennsylvania, USA
- Division of General Academic Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Megan O Bensignor
- Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Division of Pediatric Endocrinology and Diabetes, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | | | - Mary Ellen Vajravelu
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, Center for Pediatric Research in Obesity and Metabolism, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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3
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Dugandzic R, Konstantelos N, Yu Y, Lavigne E, Srugo S, Lang JJ, Larsen K, Pollock T, Villeneuve P, Thomson EM, MacPherson M, Dales R, Cakmak S. Associations between paediatric obesity, chemical mixtures and environmental factors, in a national cross-sectional study of Canadian children. Pediatr Obes 2024:e13117. [PMID: 38872449 DOI: 10.1111/ijpo.13117] [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: 03/02/2023] [Revised: 12/19/2023] [Accepted: 02/19/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Whilst single chemical exposures are suspected to be obesogenic, the combined role of chemical mixtures in paediatric obesity is not well understood. OBJECTIVES We aimed to evaluate the potential associations between chemical mixtures and obesity in a population-based sample of Canadian children. METHODS We ascertained biomonitoring and health data for children aged 3-11 from the cross-sectional Canadian Health Measures Survey from 2007 to 2019. Several chemicals of interest were measured in blood or urine and paediatric obesity was defined based on measured anthropometrics. Using quantile-based G computational analysis, we quantified the effects of three chemical mixtures selected a priori. Models were adjusted for sociodemographic and environmental factors identified through a directed acyclic graph. Results are presented through adjusted relative risks (RR) with 95% confidence intervals (95% CI). RESULTS We included 9147 children. Of these, 24.1% were overweight or obese. Exposure to the mixture of bisphenol A, acrylamide, glycidamide, metals, parabens and arsenic increased the risk of childhood overweight or obesity by 45% (95% CI 1.09, 1.93), obesity by 109% (95% CI 1.27, 3.42) and central obesity by 82% (95% CI 1.30, 2.56). CONCLUSIONS Our findings support the role of early childhood chemical exposures in paediatric obesity and the potential combined effects of chemicals.
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Affiliation(s)
- Rose Dugandzic
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
| | - Natalia Konstantelos
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Yamei Yu
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Eric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Sebastian Srugo
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Justin J Lang
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kristian Larsen
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Geography and Planning, University of Toronto, Toronto, Ontario, Canada
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Tyler Pollock
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Paul Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
| | - Errol M Thomson
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Robert Dales
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Sabit Cakmak
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
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Richardson KA, Punke ELA, Dabrowski BS, Teply AL, Walker J, McKibbin CL. Parent Intention to Participate in an Online Intervention to Enhance Health Behavior Change Among Youth Treated with Psychotropic Medication Who are Overweight or Obese: An Application of the Theory of Planned Behavior. JOURNAL OF PREVENTION (2022) 2024; 45:431-450. [PMID: 38446270 DOI: 10.1007/s10935-024-00773-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/07/2024]
Abstract
Youth with mental health disorders (MHD), particularly those who take psychotropic medications, are at increased risk of being overweight or obese (OW/OB) when compared to typical youth. Parents are important resources for interventions addressing OW/OB. However, parents of youth with MHD may face challenges that require interventions designed to address their needs. Prior to investing research funding in the development of interventions for this group, research is needed to understand factors associated with parents' decisions to enroll in these programs. The theory of planned behavior (TPB) provided a framework for examining parents' salient beliefs, direct attitudes, and intention to enroll in a hypothetical online healthy lifestyle intervention for their youth (ages 11-17) with OW/OB and treated with psychotropic medication. Parents who were enrolled in the study (n = 84) completed demographic questionnaires and a TPB questionnaire which was constructed for this study. A confirmatory factor analysis (CFA) of the direct attitude (i.e., attitude toward the behavior, subjective norm, perceived behavioral control) questions generally supported the three-factor model (i.e., RMSEA = .07, 90% CI .03-.11, p = .18; CFI = .96, SRMR = .06). Results from a multiple regression analysis demonstrated that direct attitudes predicted parent intention to participate in an online healthy lifestyle intervention for this sample of youth accounting for 84% of variance. In this preliminary study, the TPB appears to be a promising framework for understanding direct attitudes associated with parent intentions toward intervention participation in this population of youth. Interventions for parents of youth with OW/OB who are prescribed psychotropic medication should consider addressing these direct attitudes to improve intention.
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Affiliation(s)
| | | | | | - Abby L Teply
- Department of Psychology, University of Wyoming, Laramie, WY, 82072, USA
| | - Johnathan Walker
- Department of Psychology, University of Wyoming, Laramie, WY, 82072, USA
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Negrea MO, Negrea GO, Săndulescu G, Neamtu B, Solomon A, Popa ML, Stoia O, Domnariu CD, Teodoru M. Assessing Lifestyle Patterns and Their Influence on Weight Status in Students from a High School in Sibiu, Romania: An Adaptation of ISCOLE Questionnaires and the Child Feeding Questionnaire. Nutrients 2024; 16:1532. [PMID: 38794770 PMCID: PMC11123863 DOI: 10.3390/nu16101532] [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: 03/25/2024] [Revised: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
The escalation of global obesity is driving research to understand environmental influences on this process, particularly during vulnerable developmental stages such as childhood and adolescence. Efforts include the development of various structured data collection tools. We aimed to adapt a series of previously validated questionnaires from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), the Child Feeding Questionnaire, and elements from the World Health Organization Childhood Obesity Surveillance Initiative (COSI) in order to assess local lifestyle patterns among Romanian high school students and their families that may predispose them to obesity. To this goal, an expert committee was formed as part of a research partnership to oversee the questionnaire's translation and adaptation. It consisted of education and school management specialists, clinical research professionals, language experts, and public health experts. The adapted questionnaires were then applied to 114 students enrolled in the 9th and 10th grades attending a high school situated in Sibiu, and their parents. The variables measured were investigated for correlations with overweight and obesity and, as a secondary objective, academic performance. The study revealed several critical findings, including suboptimal sleep durations and physical activity levels among students, a significant amount of screen time, and correlations between weight status and physical activity, sedentary time, and maternal weight status and education levels. The adapted questionnaires proved to be effective tools in capturing the multifaceted factors implicated in adolescent obesity, providing a foundation for targeted interventions and broader public health strategies to address this issue.
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Affiliation(s)
- Mihai Octavian Negrea
- Clinical Medical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (A.S.); (M.L.P.); (O.S.); (M.T.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | | | - Gabriela Săndulescu
- “Gheorghe Lazăr” National College, 1–3 Gheorghe Lazăr Str., 550165 Sibiu, Romania;
| | - Bogdan Neamtu
- Clinical Medical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (A.S.); (M.L.P.); (O.S.); (M.T.)
- Department of Clinical Research, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania
| | - Adelaida Solomon
- Clinical Medical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (A.S.); (M.L.P.); (O.S.); (M.T.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | - Mirela Livia Popa
- Clinical Medical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (A.S.); (M.L.P.); (O.S.); (M.T.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | - Oana Stoia
- Clinical Medical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (A.S.); (M.L.P.); (O.S.); (M.T.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | - Carmen Daniela Domnariu
- Department of Dental Medicine and Nursing, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania;
| | - Minodora Teodoru
- Clinical Medical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (A.S.); (M.L.P.); (O.S.); (M.T.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
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Roumi Z, Salimi Z, Mahmoudi Z, Mobarakeh KA, Ladaninezhad M, Zeinalabedini M, Keshavarz Mohammadian M, Shamsi‐Goushki A, Saeedirad Z, Bahar B, Khoshdooz S, Kalantari N, Azizi Tabesh G, Doaei S, Gholamalizadeh M. Efficacy of a Comprehensive Weight Reduction Intervention in Male Adolescents With Different FTO Genotypes. Endocrinol Diabetes Metab 2024; 7:e00483. [PMID: 38556726 PMCID: PMC10982462 DOI: 10.1002/edm2.483] [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: 12/20/2023] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The FTO gene polymorphisms may influence the effects of lifestyle interventions on obesity. The present study aimed to assess the influence of the rs9930506 FTO gene polymorphism on the success of a comprehensive weight loss intervention in male adolescents with overweight and obesity. METHODS This study was carried out on 96 adolescent boys with overweight and obesity who were randomly assigned to the intervention (n = 53) and control (n = 43) groups. The blood samples of the participants were collected, and the FTO gene was genotyped for the rs9930506 polymorphism. A comprehensive lifestyle intervention including changes in diet and physical activity was performed for 8 weeks in the intervention group. RESULTS Following the lifestyle intervention, BMI and fat mass decreased significantly in the intervention group compared with the control group (both p < 0.05), while no change was found in weight, height or body muscle percentage between the groups. The participants in the intervention group with the AA/AG genotype and not in carriers of the GG genotype had a significantly higher reduction in BMI (-1.21 vs. 1.87 kg/m2, F = 4.07, p < 0.05) compared with the control group. CONCLUSION The intervention in individuals with the AA/AG genotype has been significantly effective in weight loss compared with the control group. The intervention had no association effect on anthropometric indices in adolescents with the GG genotype of the FTO rs9930506 polymorphism. TRIAL REGISTRATION Name of the registry: National Nutrition and Food Technology Research Institute; Trial registration number: IRCT2016020925699N2; Date of registration: 24/04/2016; URL of trial registry record: https://www.irct.ir/trial/21447.
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Affiliation(s)
- Zahra Roumi
- Department of Nutrition, Science and Research BranchIslamic Azad UniversityTehranIran
| | - Zahra Salimi
- Nutrition and Metabolic Diseases Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Zahra Mahmoudi
- Department of Nutrition, Science and Research BranchIslamic Azad UniversityTehranIran
| | - Khadijeh Abbasi Mobarakeh
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
| | - Maryam Ladaninezhad
- School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
| | - Mobina Zeinalabedini
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical SciencesTehranIran
| | | | - Ali Shamsi‐Goushki
- Department of Nutrition, School of MedicineMashhad University of Medical SciencesMashhadIran
| | - Zahra Saeedirad
- Department of Clinical Nutrition and DieteticsTehran University of Medical SciencesTehranIran
| | - Bojlul Bahar
- Nutrition Sciences and Applied Food Safety Studies, Research Centre for Global Development, School of Sport & Health SciencesUniversity of Central LancashirePrestonUK
| | - Sara Khoshdooz
- Faculty of MedicineGuilan University of Medical ScienceRashtIran
| | - Naser Kalantari
- Department of Community Nutrition, Faculty of Nutrition and Food TechnologyNational Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical SciencesTehranIran
| | - Ghasem Azizi Tabesh
- Genomic Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Saeid Doaei
- Department of Community Nutrition, Faculty of Nutrition and Food TechnologyNational Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical SciencesTehranIran
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Ng NBH, Lim CYS, Tan SCHL, Foo YW, Tok CLX, Lim YY, Goh DYT, Loke KY, Lee YS. Screening for obstructive sleep apnea (OSA) in children and adolescents with obesity: A scoping review of national and international pediatric obesity and pediatric OSA management guidelines. Obes Rev 2024; 25:e13712. [PMID: 38355893 DOI: 10.1111/obr.13712] [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: 03/14/2023] [Revised: 01/08/2024] [Accepted: 01/13/2024] [Indexed: 02/16/2024]
Abstract
Obstructive sleep apnea (OSA) is a prevalent complication that affects up to 60% of children and adolescents with obesity. It is associated with poorer cardiometabolic outcomes and neurocognitive deficits. Appropriate screening and intervention for OSA are crucial in the management of children with obesity. We performed a scoping review of international and national pediatric obesity (n = 30) and pediatric OSA (n = 10) management guidelines to evaluate the recommendations on OSA screening in pediatric obesity. Sixteen (53%) of the pediatric obesity guidelines had incorporated OSA screening to varying extents, with no consistent recommendations on when and how to screen for OSA, and subsequent management of OSA in children with obesity. We provide our recommendations that are based on the strength and certainty of evidence presented. These include a clinical-based screening for OSA in all children with body mass index (BMI) ≥ 85th percentile or those with rapid BMI gain (upward crossing of 2 BMI percentiles) and the use of overnight polysomnography to confirm the diagnosis of OSA in those with high clinical suspicion. We discuss further management of OSA unique to children with obesity. An appropriate screening strategy for OSA would facilitate timely intervention that has been shown to improve cardiometabolic and neurocognitive outcomes.
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Affiliation(s)
- Nicholas Beng Hui Ng
- Khoo Teck Puat-National University Children's Medical Institute, Department of Paediatrics, National University Health Systems, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Carey Yun Shan Lim
- Khoo Teck Puat-National University Children's Medical Institute, Department of Paediatrics, National University Health Systems, Singapore, Singapore
| | - Sarah Caellainn Hui Lin Tan
- Khoo Teck Puat-National University Children's Medical Institute, Department of Paediatrics, National University Health Systems, Singapore, Singapore
| | | | | | - Yvonne Yijuan Lim
- Khoo Teck Puat-National University Children's Medical Institute, Department of Paediatrics, National University Health Systems, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Daniel Yam Thiam Goh
- Khoo Teck Puat-National University Children's Medical Institute, Department of Paediatrics, National University Health Systems, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kah Yin Loke
- Khoo Teck Puat-National University Children's Medical Institute, Department of Paediatrics, National University Health Systems, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yung Seng Lee
- Khoo Teck Puat-National University Children's Medical Institute, Department of Paediatrics, National University Health Systems, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Tambalis KD, Panagiotakos DB, Sidossis LS. Dietary habits among 177,091 Greek schoolchildren by age, sex, weight status, region, and living area. A cross-sectional study. Hellenic J Cardiol 2024:S1109-9666(24)00079-4. [PMID: 38636777 DOI: 10.1016/j.hjc.2024.04.004] [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: 02/05/2024] [Revised: 03/19/2024] [Accepted: 04/13/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND This study aimed to investigate the dietary habits from early childhood to adolescence among participants from all regions of the country and living areas (rural/urban) and assess potential associations between dietary habits and obesity in both sexes. METHODS Population data were derived from a cross-sectional health survey on a representative sample of 177,091 children aged 6-18 years. Dietary habits were considered via a self-completed questionnaire (Mediterranean diet quality index for children and adolescents [KIDMED]). Trained investigators assessed the anthropometric data. RESULTS KIDMED scores were 6.7 ± 2.4 and 6.8 ± 2.3 for boys and girls, respectively, whereas a percentage of almost 10% of the total study population had insufficient dietary habits. Dietary habits peaked around age 11 years and then gradually worsened until the end of adolescence in both sexes, with an annual trend equal to -0.28 ± 0.02 (p < 0.001) for boys and -0.31 ± 0.03 (p < 0.001) for girls. Schoolchildren who are overweight/obese presented higher percentages in all unhealthy dietary habits (e.g., skipping breakfast, going often to a fast food restaurant, and consuming a lot of sweets) than children with a normal weight (all p-values < 0.001). Dietary habits did not noteworthy differ by area of living, that is, urban versus rural, of participants in both sexes. In addition, no noticeable differences in the values of the KIDMED index were found among all regions of Greece, with the highest values in Attica and Crete in both sexes. CONCLUSIONS Because Greek schoolchildren do not fully adopt the traditional cardio-protective Mediterranean diet, it could be helpful to provide certain recommendations, especially for adolescents, to decrease the risk for future adverse health consequences.
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Affiliation(s)
- Konstantinos D Tambalis
- Department of Physical Education and Sport Science, National and Kapodistrian University of Athens, Greece.
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Labros S Sidossis
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ 08901, USA
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Wu T, Santos S, Quezada-Pinedo HG, Vernooij MW, Jaddoe VWV, Klein S, Duijts L, Oei EHG. Body composition and respiratory outcomes in children: a population-based prospective cohort study. Thorax 2024; 79:448-456. [PMID: 38182426 DOI: 10.1136/thorax-2023-220014] [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: 01/13/2023] [Accepted: 12/09/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Body composition might influence lung function and asthma in children, but its longitudinal relations are unclear. We aimed to identify critical periods for body composition changes during childhood and adolescence in relation to respiratory outcomes in adolescents. METHODS In a population-based prospective cohort study, we measured body mass index, fat mass index (FMI), lean mass index (LMI) and the ratio of android fat mass divided by gynoid fat mass (A/G ratio) by dual-energy X-ray absorptiometry at 6, 10 and 13 years. At 13 years, lung function was measured by spirometry, and current asthma was assessed by questionnaire. RESULTS Most prominently and consistently, higher FMI and A/G ratio at age 13 years were associated with lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and forced expiratory flow after exhaling 75% of FVC (FEF75) (range Z-score difference -0.13 (95% CI -0.16 to -0.10) to -0.08 (95% CI -0.11 to -0.05) per SD score increase), and higher LMI at all ages was associated with higher FEF75 (range Z-score difference 0.05 (95% CI 0.01 to 0.08) to 0.09 (95% CI 0.06 to 0.13)). Between the ages of 6 and 13 years, normal to high FMI and A/G ratio were associated with lower FEV1/FVC and FEF75 (range Z-score difference -0.20 (95% CI -0.30 to -0.10) to -0.17 (95% CI -0.28 to -0.06)) and high to high LMI with higher FEF75 (range Z-score difference0.32 (95% CI 0.23 to 0.41)). Body composition changes were not associated with asthma. CONCLUSION Adolescents with higher total and abdominal fat indices may have impaired lung function, while those with a higher lean mass during childhood and adolescence may have better small airway function. Public health measures should focus on a healthy body composition in adolescents to minimise respiratory morbidity.
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Affiliation(s)
- Tong Wu
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hugo G Quezada-Pinedo
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Stefan Klein
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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10
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Brand J, Yeum D, Stewart T, Emond JA, Gilbert-Diamond D. The associations between attentional bias to food cues, parent-report appetitive traits, and concurrent adiposity among adolescents. Eat Behav 2024; 53:101874. [PMID: 38636439 PMCID: PMC11144077 DOI: 10.1016/j.eatbeh.2024.101874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE To assess whether attentional bias to food cues and appetitive traits are independently and interactively associated with adiposity in adolescents. METHOD Eighty-five adolescents, 14-17-years had their attentional bias to food images measured in a sated state by computing eye tracking measures of attention (first fixation duration, cumulative fixation duration) to food and control distractor images that bordered a computer game. Parents reported adolescent appetitive traits including the food approach domains of enjoyment of food, food responsiveness, emotional overeating, and the food avoidance domains of satiety responsiveness and emotional overeating through the Children's Eating Behavior Questionnaire. RESULTS First fixation bias to food cues was positively associated with enjoyment of food, and negatively associated with satiety responsiveness. In a series of regression models adjusted for relevant covariates, first fixation bias to food cues (β = 0.83, p = 0.007), higher food responsiveness (β = 0.74, p < 0.001), higher emotional overeating (β = 0.51, p = 0.002), and a composite appetite score (β = 1.42, p < 0.001) were each significantly associated with greater BMI z-scores. In models assessing the interactive effects between attentional bias and appetitive traits, higher first fixation bias to food cues interacted synergistically with food responsiveness and emotional overeating in relation to BMI z-score. A synergistic interaction between first fixation bias to food cues and the composite appetite score in relation to BMI z-score was also observed. CONCLUSION Individuals with high attentional bias to food cues and obesogenic appetitive traits may be particularly susceptible to weight gain.
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Affiliation(s)
- John Brand
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States; Dartmouth Cancer Center, Lebanon, NH, United States.
| | - Dabin Yeum
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
| | - Tessa Stewart
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
| | - Jennifer A Emond
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States; Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States; Dartmouth Cancer Center, Lebanon, NH, United States; Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States; Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
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11
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Banany M, Kang M, Gebel K, Sibbritt D. A systematic review of school-based weight-related interventions in the Gulf Cooperation Council countries. Syst Rev 2024; 13:66. [PMID: 38355590 PMCID: PMC10865693 DOI: 10.1186/s13643-024-02475-7] [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: 03/08/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The prevalence of childhood overweight and obesity has increased at alarming levels in the Gulf Cooperation Council (GCC) countries (Saudi Arabia, United Arab Emirates (UAE), Kuwait, Bahrain, Oman, and Qatar). Weight-related interventions are urgently required in these countries to tackle childhood overweight and obesity and their-related consequences. To date, no systematic review has synthesised school-based weight-related interventions in the six GCC countries. This study aims to systematically review school-based, weight-related interventions conducted in the GCC countries, investigating the intervention characteristics, components, and outcomes. METHODS Medline, Scopus, and ProQuest databases were searched for peer-reviewed literature published in English without date restriction and Google Scholar for grey literature using combined Medical Subject Heading (MeSH) terms and keywords under five relevant concepts including population, setting, interventions, outcomes, and geographical location. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), records were identified, screened for eligibility, and included in this review. Using the Effective Public Health Practice Project tool, the methodological quality of the included studies was assessed independently by two authors. RESULTS Out of 1303 initially identified records, eight peer-reviewed articles and three doctoral theses were included in this review. The age of the students in the included studies ranged between 5 to 19 years, and the sample sizes between 28 and 3,967 students. The studies included between one and thirty public and private schools. Of the included studies, six were randomised controlled trials, four pre-post studies and one used a post-study design. Only four of the eleven studies were theory based. The included studies reported various improvements in the students' weight or weight-related lifestyle behaviours, such as healthier dietary choices, increased physical activity, and decreased sedentary behaviour. CONCLUSIONS This review suggests the potential effectiveness of school-based interventions in the GCC countries. However, a thorough evaluation of these studies revealed significant methodological limitations that must be acknowledged in interpreting these results. Future studies in this field should be theory-based and use more rigorous evaluation methods. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42020156535.
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Affiliation(s)
- Mohammed Banany
- School of Public Health, Faculty of Health, University of Technology Sydney, City Campus, PO Box 123, Broadway, NSW, 2007, Australia.
| | - Melissa Kang
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Klaus Gebel
- School of Public Health, Faculty of Health, University of Technology Sydney, City Campus, PO Box 123, Broadway, NSW, 2007, Australia
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - David Sibbritt
- School of Public Health, Faculty of Health, University of Technology Sydney, City Campus, PO Box 123, Broadway, NSW, 2007, Australia
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12
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Gou H, Song H, Tian Z, Liu Y. Prediction models for children/adolescents with obesity/overweight: A systematic review and meta-analysis. Prev Med 2024; 179:107823. [PMID: 38103795 DOI: 10.1016/j.ypmed.2023.107823] [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: 08/10/2023] [Revised: 11/12/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
The incidence of obesity and overweight in children and adolescents is increasing worldwide and becomes a global health concern. This study aims to evaluate the accuracy of available prediction models in early identification of obesity and overweight in general children or adolescents and identify predictive factors for the models, thus provide a reference for subsequent development of risk prediction tools for obesity and overweight in children or adolescents. Related publications were obtained from several databases such as PubMed, Embase, Cochrane Library, and Web of Science from their inception to September 18th, 2022. The novel Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed to assess the bias risk of the included studies. R4.2.0 and Stata15.1 softwares were used to conduct meta-analysis. This study involved 45 cross-sectional and/or prospective studies with 126 models. Meta-analyses showed that the overall pooled index of concordance (c-index) of prediction models for children/adolescents with obesity and overweight in the training set was 0.769 (95% CI 0.754-0.785) and 0.835(95% CI 0.792-0.879), respectively. Additionally, a large number of predictors were found to be related to children's lifestyles, such as sleep duration, sleep quality, and eating speed. In conclusions, prediction models can be employed to predict obesity/overweight in children and adolescents. Most predictors are controllable factors and are associated with lifestyle. Therefore, the prediction model serves as an excellent tool to formulate effective strategies for combating obesity/overweight in pediatric patients.
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Affiliation(s)
- Hao Gou
- Department of Pediatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Huiling Song
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Zhiqing Tian
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Yan Liu
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China.
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13
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Stea TH, Vettore MV, Øvrebø B, Abildsnes E. Changes in dietary habits and BMI z-score after a 6-month non-randomized cluster-controlled trial among 6-12 years old overweight and obese Norwegian children. Food Nutr Res 2023; 67:9617. [PMID: 38187797 PMCID: PMC10770647 DOI: 10.29219/fnr.v67.9617] [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: 04/20/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 01/09/2024] Open
Abstract
Background Effective prevention programs to address the high prevalence of childhood overweight and obesity and the concomitant health consequences have been warranted. Objective To improve dietary habits and weight status among Norwegian children with overweight/obesity in the primary care setting. Design A 6-month non-randomized cluster-controlled intervention among 137 children, aged 6-12 years, with overweight/obesity and their parents. Intervention and control groups were recruited by public health nurses and followed-up by 12 Healthy Life Centers across Norway. The intervention group received individual family counseling and participated in nutrition courses and physical activity groups. A frequency questionnaire assessing sociodemographic characteristics and dietary habits was completed by the parents. Trained public health nurses measured height and weight using standardized methods to calculate body mass index (BMI) and BMI z-scores. Results The intervention resulted in an increased odds of consuming evening meals (OR: 3.42), a decreased availability of salty snacks (β = -0.17), a decreased intake of salty snacks (-0.18), an increased consumption of water (β = 0.20), and a decreased estimated total intake of energy (β = -0.17), carbohydrates (β = -0.17), mono- and disaccharides (β = -0.21), sucrose (β = -0.24), and saturated fatty acids (β = -0.17). The intervention directly predicted lower BMI z-score (β = -0.17), and post-treatment levels of energy (β = -0.65), saturated fat (β = 0.43), and total carbohydrates (β = 0.41) were directly linked to BMI z-score after intervention. Age and sex were indirectly associated with BMI after intervention through energy and saturated fat intake. Conclusions The intervention had a beneficial impact on nutrient intake and weight status among children with overweight/obesity. These findings provide support for implementing complex intervention programs tailored to local primary care settings. Trial registration Clinicaltrials.gov, NCT02290171. Registered 13. November 2014, https://clinicaltrials.gov/ct2/show/NCT02290171.
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Affiliation(s)
- Tonje Holte Stea
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Mario Vianna Vettore
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Bente Øvrebø
- Department of Health and Inequalities, Norwegian Institute of Public Health, Oslo, Norway
| | - Eirik Abildsnes
- Department of Psychosocial Health, University of Agder, Grimstad, Norway
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14
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Newsome FA, Cardel MI, Chi X, Lee AM, Miller D, Menon S, Janicke DM, Gurka MJ, Butryn ML, Manasse S. Wellness Achieved Through Changing Habits: A Randomized Controlled Trial of an Acceptance-Based Intervention for Adolescent Girls With Overweight or Obesity. Child Obes 2023; 19:525-534. [PMID: 36394498 PMCID: PMC10734897 DOI: 10.1089/chi.2022.0116] [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] [Indexed: 11/18/2022]
Abstract
Background: Obesity prevalence among adolescent girls continues to rise. Acceptance-based therapy (ABT) is effective for weight loss in adults and feasible and acceptable for weight loss among adolescents. This pilot randomized controlled trial (RCT) assessed effectiveness of an adolescent-tailored ABT intervention on decreasing weight-related outcomes and improving psychological outcomes compared with enhanced care. Methods: In this 6-month, two-arm pilot RCT, participants were randomized to the ABT intervention or to enhanced care. The ABT intervention condition attended 15 virtual, 90-minute group sessions. The enhanced care comparison received 15 healthy lifestyle handouts and virtually met twice with a registered dietitian. The primary outcome assessed was change in BMI expressed as a percentage of the 95th percentile (%BMIp95). Results: Participants included 40 girls (ages 14-19) assigned to ABT (n = 20) or enhanced care (n = 20). A decrease in %BMIp95 was observed within the ABT intervention [d = -0.19, 95% confidence interval, CI: (-0.36 to -0.02)], however, not within the enhanced care comparison [d = -0.01, 95% CI: (-0.09 to 0.07)]. The ABT group showed slight changes in psychological flexibility [d = -0.34, 95% CI: (-0.62 to -0.06)] over enhanced care [d = -0.11, 95% CI: (-0.58 to 0.37)]. There was no significant intervention effect noted between groups. Conclusion: In this pilot RCT, the ABT intervention was as effective as enhanced care for weight loss. However, previous ABT studies occurred in person, and this study was conducted virtually due to COVID-19. Thus, future research investigating the potential effectiveness of ABT in-person among adolescents and optimization of virtual interventions is needed.
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Affiliation(s)
- Faith A. Newsome
- Department of Health Outcomes and Biomedical Informatics and University of Florida, Gainesville, FL, USA
| | - Michelle I. Cardel
- Department of Health Outcomes and Biomedical Informatics and University of Florida, Gainesville, FL, USA
- WW International, Inc., New York, NY, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Xiaofei Chi
- Department of Health Outcomes and Biomedical Informatics and University of Florida, Gainesville, FL, USA
| | - Alexandra M. Lee
- Department of Health Outcomes and Biomedical Informatics and University of Florida, Gainesville, FL, USA
- WW International, Inc., New York, NY, USA
| | - Darci Miller
- Department of Health Outcomes and Biomedical Informatics and University of Florida, Gainesville, FL, USA
| | - Sarada Menon
- Department of Health Outcomes and Biomedical Informatics and University of Florida, Gainesville, FL, USA
| | - David M. Janicke
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Matthew J. Gurka
- Department of Health Outcomes and Biomedical Informatics and University of Florida, Gainesville, FL, USA
| | - Meghan L. Butryn
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
- Center for Weight, Eating and Lifestyle Science, Drexel University, Philadelphia PA, USA
| | - Stephanie Manasse
- Center for Weight, Eating and Lifestyle Science, Drexel University, Philadelphia PA, USA
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15
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Hopkins L, Schier H, May L, Westrick M, O'Piela D, Mazurek Melnyk B, Smith L, Gunther C. Patterns of participation in summer programming among United States' elementary children from low-income urban households: Results from the project SWEAT study. Prev Med Rep 2023; 36:102475. [PMID: 37886725 PMCID: PMC10598049 DOI: 10.1016/j.pmedr.2023.102475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
Food insecurity increases among marginalized children during the summer when school is out of session. Summer programming that offers access to healthy meals and snacks may reduce the risk. There is a national call in the US for more research to assure equitable access to summer programming. The objective of this prospective observational study was to characterize patterns of participation in summer programming among elementary children from low-income urban neighborhoods of metropolitan[Blinded]. Summer programming was broadly defined (e.g., church, school, recreation center, community center). Caregivers(n = 100) received weekly text messages via TextIt during the summer (Jun-Aug 2017). They were asked: "How many days this week did [ChildName] attend a summer program? Please respond with a number from 0 to 5, where 0 - no days, 2 - 2 days, etc." Weekly counts were summed. Stepwise logistic and linear regression models were conducted to examine differences in patterns of attendance according to key sociodemographic characteristics. Mean age was 7.03 ± 0.23. 52 % identified as female, 70 % were low-income, and 80.0 % identified as Black. 51 % attended summer programming at least once; 49 % never attended. Those who attended at least once vs. not at all were more likely to be male(p < 0.01); 62.75 % males vs. 37.25 % females attended summer programming at least once, whereas 67.35 % females compared to 32.65 % males never attended. Overall mean attendance was 10.40 ± 1.43 days(out of 50). Mean + SE attendance was lower for females (7.52 + 1.76) vs. males (13.52 + 2.21)(p < 0.05), and non-Black (4.30 + 1.97) vs. Black (11.93 + 1.67)(p = 0.01) children. Future research is needed to understand barriers to participation in summer programming.
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Affiliation(s)
- Laura Hopkins
- Department of Public Health and Prevention Science, College of Education and Health Sciences, Baldwin Wallace University, USA
| | - Heather Schier
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Leah May
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Miranda Westrick
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Devin O'Piela
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Bernadette Mazurek Melnyk
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Laureen Smith
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Carolyn Gunther
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
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16
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Sharkey JR, Smith A. Cooking with the Seasons for Health (CwS4H): An Innovative Intervention That Links Nutrition Education, Cooking Skills, and Locally Grown Produce to Increase Vegetable Intake among Limited-Resource Parent-Child Dyads in Rural Washington. Nutrients 2023; 15:4851. [PMID: 38004245 PMCID: PMC10674718 DOI: 10.3390/nu15224851] [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: 10/07/2023] [Revised: 11/12/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023] Open
Abstract
Although children from limited-resource families in rural areas are at great risk for nutrition-related chronic diseases, few hands-on programs have been implemented that simultaneously engage both parents and children and include local produce in a single program. This study reports on the development, implementation, and evaluation of Cooking with the Seasons for Health (CwS4H). Parent-child pairs participated in six sessions (two weekly sessions during each of three growing seasons), which included food tasting, a spotlight vegetable, interactive mini nutrition lesson, a child-focused cooking lesson, hands-on meal preparation, distribution of materials as family guides, and a take-home bag of fresh produce. Pre- and postprogram survey data were collected from 23 parents and 22 children. Children reported improvements in nutrition knowledge, vegetable preference, and self-efficacy in food preparation and cooking. Parents reported gains in nutrition knowledge, nutritional behaviors, vegetable preference, attitude toward food preparation/cooking, involvement of the child in food preparation/cooking, confidence in preparing vegetables, and the child's vegetable intake. Parents commented on the value children placed on food preparation and produce selection and how the program enhanced the parent-child relationship. By focusing CwS4H on a variety of fresh vegetables, this intervention helped to impact children's vegetable intake behaviors by engaging children in preparing and choosing the food they eat.
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Affiliation(s)
- Joseph R. Sharkey
- School of Public Health, Texas A&M University, College Station, TX 77843, USA
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17
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Crouch E, Abshire DA, Wirth MD, Hung P, Benavidez GA. Rural-Urban Differences in Overweight and Obesity, Physical Activity, and Food Security Among Children and Adolescents. Prev Chronic Dis 2023; 20:E92. [PMID: 37857462 PMCID: PMC10599326 DOI: 10.5888/pcd20.230136] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Childhood obesity has been associated with numerous poor health conditions, with geographic disparities demonstrated. Limited research has examined the association between rurality and food security, physical activity, and overweight or obesity among children. We examined rates of food security, physical inactivity, and overweight or obesity among rural and urban children and adolescents, and associations between rurality and these 3 outcomes. METHODS We used cross-sectional data from a nationally representative sample of children and adolescents aged 10 to 17 years from the 2019-2020 National Survey of Children's Health (N = 23,199). We calculated frequencies, proportions, and unadjusted associations for each variable by using descriptive statistics and bivariate analyses. We used multivariable logistic regression models to examine the association between rurality and food security, physical activity, and overweight or obesity. RESULTS After adjusting for sociodemographic factors, rural children and adolescents had higher odds than urban children and adolescents of being overweight or obese (adjusted odds ratio = 1.30; 95% CI, 1.11-1.52); associations between rurality and physical inactivity and food insecurity were not significant. CONCLUSION The information from this study is timely for policy makers and community partners to make informed decisions on the allocation of healthy weight and obesity prevention programs for children and adolescents in rural settings. Our study provides information for public health programming and the designing of appropriate dietary and physical activity interventions needed to reduce disparities in obesity prevention among children and adolescents.
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Affiliation(s)
- Elizabeth Crouch
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia
- Rural and Minority Health Research Center, Department of Health Services Policy and Management, University of South Carolina, Discovery Bldg, Ste 345, 915 Greene St, Columbia, SC 29208
| | - Demetrius A Abshire
- Biobehavioral Health and Nursing Science, College of Nursing, University of South Carolina, Columbia
| | - Michael D Wirth
- Biobehavioral Health and Nursing Science, College of Nursing, University of South Carolina, Columbia
| | - Peiyin Hung
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia
| | - Gabriel A Benavidez
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia
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18
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Felix JF, Grant SF. Keeping It in the Family: Consanguinity Reveals P4HTM as a Novel Syndromic Obesity Gene. Diabetes 2023; 72:1184-1186. [PMID: 37603723 PMCID: PMC10450820 DOI: 10.2337/dbi23-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/07/2023] [Indexed: 08/23/2023]
Affiliation(s)
- Janine F. Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Struan F.A. Grant
- Divisions of Human Genetics and Endocrinology & Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Center for Spatial and Functional Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA
- Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Park M, Kim D, Choi M, Shin J. Difference in Sugar-Sweetened Beverage Consumption before and during the COVID-19 Pandemic among Korean Adolescents. J Nutr 2023; 153:2147-2153. [PMID: 37149286 PMCID: PMC10159663 DOI: 10.1016/j.tjnut.2023.05.007] [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: 11/10/2022] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Previous studies have identified various factors associated with sugar-sweetened beverage (SSB) consumption among children and adolescents. Recent studies attempted to analyze changes in SSB consumption of adolescents during the COVID-19 pandemic and showed conflicting results. OBJECTIVES This study aimed to estimate the difference in SSB consumption before (2018-2019) and during (2020-2021) the COVID-19 pandemic among Korean adolescents. METHODS The study population consisted of students (n = 227,139) aged 12-18 y from the Korean Youth Risk Behavior Web-based Survey (KYRBWS). Data collection was done between 2018 and 2021. The primary outcome was the difference in the SSB consumption status (none/<7 times/wk, ≥7 times/wk) before and during the COVID-19 pandemic. Multinomial logistic regression was used to examine the association. Additional analysises were also conducted by gender, school grades, household income, grade point average, region, household members, fast-food intake, and fruit intake. RESULTS The COVID-19 pandemic was associated with a decrease in adolescents' SSB intake. [(<7 times/wk) 2019: 59.4, 2020: 58.8, (≥7 times/wk) 2019: 35.3, 2020: 33.4]. CONCLUSIONS The study found a difference in SSB consumption among Korean adolescents between before and during the COVID-19 pandemic. These findings are noteworthy considering the importance of continuous care in managing SSB intake.
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Affiliation(s)
- Munsu Park
- Department of Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Dahyun Kim
- Department of Statistics, Sungshin Women's University, Seongbuk-gu, Seoul, Republic of Korea
| | - Mingee Choi
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
| | - Jaeyong Shin
- Institute of Health Policy and Management, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea.
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20
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Herouvi D, Paltoglou G, Soldatou A, Kalpia C, Karanasios S, Karavanaki K. Lifestyle and Pharmacological Interventions and Treatment Indications for the Management of Obesity in Children and Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1230. [PMID: 37508727 PMCID: PMC10378563 DOI: 10.3390/children10071230] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
Obesity is a multifactorial chronic impairment that further decreases quality of life and life expectancy. Worldwide, childhood obesity has become a pandemic health issue causing several comorbidities that frequently present already in childhood, including cardiovascular (hypertension, dyslipidemia), metabolic (Type 2 diabetes mellitus, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal and musculoskeletal disorders. In addition, obese children frequently experience stress and psychosocial symptoms, including mood disorders, anxiety, prejudice and low self-esteem. Given that cardiovascular risk factors and pediatric obesity have the tendency to pertain into adulthood, obesity management, including weight control and physical activity, should start before the late teens and certainly before the first signs of atherosclerosis can be detected. This review aims to concisely present options for childhood obesity management, including lifestyle modification strategies and pharmacological treatment, as well as the respective treatment indications for the general practitioner.
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Affiliation(s)
- Despina Herouvi
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - George Paltoglou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Alexandra Soldatou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Christina Kalpia
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Spyridon Karanasios
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
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21
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Huang Z, Li J, Liu Y, Zhou Y. Effects of different exercise modalities and intensities on body composition in overweight and obese children and adolescents: a systematic review and network meta-analysis. Front Physiol 2023; 14:1193223. [PMID: 37497435 PMCID: PMC10366610 DOI: 10.3389/fphys.2023.1193223] [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: 03/24/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction: Childhood and adolescent overweight and obesity are global public health issues. Previous studies on exercise and overweight and obese children have produced inconsistent findings and lacked comparisons between different exercise modalities and intensities. Therefore, a network meta-analysis is necessary to provide evidence-based intervention programs. This study aims to identify the effects of different exercise modalities and intensities on changes in body composition in overweight and obese children and adolescents. Methods: A search for randomized controlled trials was conducted on Web of Science, PubMed, Scopus, and Embase involving exercise interventions aimed at improving body composition (body fat percentage, BMI, fat mass, fat-free mass, body weight) in overweight and obese children and adolescents. A random effects network meta-analysis was performed using STATA 14.0 software within a frequentist framework. The literature quality was assessed using the Cochrane Risk of Bias Tool 2.0. Results: Thirty-two papers involving 1,452 participants were included. There were six types of intervention involved in the study, including moderate intensity aerobic exercise, high-intensity aerobic exercise, moderate intensity resistance exercise, high-intensity resistance exercise, moderate intensity combined exercise, and high-intensity combined exercise. The network meta-analysis results revealed that high-intensity combined exercise was the best exercise mode for improving BMI [mean difference in kg/m2 = -1.65, 95% CI (-3.27, -0.02)] and reducing fat mass [mean difference in kg = -2.87, 95% CI (-4.84, -0.91)]. Moderate intensity combined exercise was the best mode for weight loss [mean difference in kg = -4.58, 95% CI (-5.94, -3.22)] and improvement in body fat percentage [mean difference in% = -2.52, 95% CI (-3.83, -1.20)]. High-intensity resistance exercise had the optimal effect in increasing fat-free mass [mean difference in kg = 1.10, 95% CI (0.22, 1.99)]. Conclusion: In conclusion, the study found that combined exercise, whether moderate or high intensity, was more effective than any other exercise modality in improving body fat percentage and BMI, reducing fat mass and weight. Resistance exercise was the most effective in increasing fat-free mass.
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Abstract
Obesity in the pediatric population is increasing in the United States and globally. Childhood obesity is associated with cardiometabolic and psychosocial comorbidities and decreased overall life span. The cause of pediatric obesity is multifactorial and includes genetic predisposition, lifestyle, behavioral patterns, and consequences of social determinants of health. Routine screening of BMI and comorbid conditions is essential to identifying patients who require treatment. The AAP recommends immediate Intensive Health Behavior and Lifestyle Treatment for children with obesity, encompassing lifestyle changes, behavioral changes, and mental health treatments. Pharmacologic interventions and metabolic and bariatric surgery are also available when indicated.
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Affiliation(s)
- Gunther Wong
- Department of Medicine, Division of Diabetes, Endocrinology & Metabolism, Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Surgery, Vanderbilt University School of Medicine; Department of Pediatrics, Vanderbilt University School of Medicine; Vanderbilt Weight Loss Center, Vanderbilt University Medical Center, Thompson Lane, Suite 22200, Nashville, TN 37204, USA
| | - Gitanjali Srivastava
- Department of Medicine, Division of Diabetes, Endocrinology & Metabolism, Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Surgery, Vanderbilt University School of Medicine; Department of Pediatrics, Vanderbilt University School of Medicine; Vanderbilt Weight Loss Center, Vanderbilt University Medical Center, Thompson Lane, Suite 22200, Nashville, TN 37204, USA.
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23
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Lister NB, Baur LA, Felix JF, Hill AJ, Marcus C, Reinehr T, Summerbell C, Wabitsch M. Child and adolescent obesity. Nat Rev Dis Primers 2023; 9:24. [PMID: 37202378 DOI: 10.1038/s41572-023-00435-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/20/2023]
Abstract
The prevalence of child and adolescent obesity has plateaued at high levels in most high-income countries and is increasing in many low-income and middle-income countries. Obesity arises when a mix of genetic and epigenetic factors, behavioural risk patterns and broader environmental and sociocultural influences affect the two body weight regulation systems: energy homeostasis, including leptin and gastrointestinal tract signals, operating predominantly at an unconscious level, and cognitive-emotional control that is regulated by higher brain centres, operating at a conscious level. Health-related quality of life is reduced in those with obesity. Comorbidities of obesity, including type 2 diabetes mellitus, fatty liver disease and depression, are more likely in adolescents and in those with severe obesity. Treatment incorporates a respectful, stigma-free and family-based approach involving multiple components, and addresses dietary, physical activity, sedentary and sleep behaviours. In adolescents in particular, adjunctive therapies can be valuable, such as more intensive dietary therapies, pharmacotherapy and bariatric surgery. Prevention of obesity requires a whole-system approach and joined-up policy initiatives across government departments. Development and implementation of interventions to prevent paediatric obesity in children should focus on interventions that are feasible, effective and likely to reduce gaps in health inequalities.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
- Weight Management Services, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Andrew J Hill
- Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Claude Marcus
- Division of Paediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Reinehr
- Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Martin Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Centre, Ulm, Germany
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Hartz J, Bucholz E, Phipatanakul W, de Ferranti S, Powell-Wiley T. The association of objectively measured sedentary time with asthma in US youth: A glimpse into the connection between obesity and asthma. Pediatr Pulmonol 2023; 58:1582-1591. [PMID: 36825385 PMCID: PMC10121908 DOI: 10.1002/ppul.26367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 02/15/2023] [Accepted: 02/19/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Evidence suggests that asthma and obesity may share a common pathway, possibly through an increase in inflammation. Sedentary time is thought to promote both inflammation and obesity and previous studies have found a relationship between self-reported sedentary and asthma. However, the relationship between objectively measured sedentary time and asthma is not well described. We hypothesized that the association between asthma and sedentary time would not be present when physical activity was measured objectively, nor would objectively-measured sedentary time play an important role in the relationship between asthma and obesity. OBJECTIVE To determine if there is an association between asthma and objectively measured sedentary time in a large, nationally representative sample of the United States youth. METHODS Using the National Health and Nutrition Examination Survey 2003-2006, we assessed the relationship between asthma and sedentary time using objectively measured and self-reported measures of sedentary time, in 6-19 years-old subjects with available accelerometry data. We used multivariate logistic regression analysis to determine associations between the risk of asthma and sedentary time controlling for accelerometer wear time, gender, age, race/ethnicity, body mass index percentile, and moderate-to-vigorous physical activity (MVPA). RESULTS In this cohort, youth with asthma self-reported more time in sedentary behavior, specifically computer time, than those without asthma (p = 0.01). However, when sedentary time was measured objectively by accelerometry, sedentary time did not differ between youth with and without asthma (421 min [standard deviation 4.2] versus. 414 min [standard deviation 7.8] [p = 0.38]). Controlling for measures of activity, such as MVPA, or time spent in long versus short bouts of sedentary time did not modify our results. CONCLUSIONS Differences in sedentary time by self-report between those with and without asthma were not born out by examining sedentary time using objective measures. Further work is necessary to examine the complex interaction among inactivity, obesity, and asthma over time, specifically focusing on whether the type of sedentary activity (e.g., computer vs. television time) is important.
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Affiliation(s)
- Jacob Hartz
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115
- Department of Cardiology, Boston Children’s Hospital, Boston, MA 02115
| | - Emily Bucholz
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115
- Department of Cardiology, Boston Children’s Hospital, Boston, MA 02115
| | - Wanda Phipatanakul
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115
- Department of Pediatrics, Harvard Medical School, Division Allergy and Immunology, Boston Children’s Hospital, Boston, MA 02115
| | - Sarah de Ferranti
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115
- Department of Cardiology, Boston Children’s Hospital, Boston, MA 02115
| | - Tiffany Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Building 10-CRC 5-5332, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892
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25
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Liu Y, Sun X, Zhang E, Li H, Ge X, Hu F, Cai Y, Xiang M. Association between Types of Screen Time and Weight Status during the COVID-19 Pandemic: A Longitudinal Study in Children and Adolescents. Nutrients 2023; 15:2055. [PMID: 37432199 DOI: 10.3390/nu15092055] [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: 03/13/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND This study aimed to investigate the changes in distinct types of screen time and explore their longitudinal association with children and adolescents' weight status. METHODS A two-wave longitudinal study was conducted among 2228 children and adolescents (6-19 years) in Shanghai, China, before and during the pandemic. Recreational screen time (watching TV/videos, online gaming, using social media, and browsing webpages), educational screen time (online homework and online class), and BMI were measured using a self-reported questionnaire. Mixed-effects models were constructed to assess the associations between screen time and weight status. RESULTS The prevalence of overweight and obesity was 20.5% and 10.2% at baseline, respectively. Both recreational and educational screen time increased significantly over two months. While recreational screen time was found to be a risk factor for obesity, it was not the case for educational screen use. Specifically, adolescents who spent more time watching TV/videos had a higher obesity risk (OR = 1.576). No significant associations were found in children. CONCLUSIONS Overweight and obesity were prevalent among children and adolescents in China. Reducing screen-based activities is a promising strategy to prevent unhealthy weight gain in Chinese children and adolescents, while it is necessary to consider the content and distinguish between educational and recreational screen use.
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Affiliation(s)
- Yujie Liu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Xiaomin Sun
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Erliang Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Huilun Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Xin Ge
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Fan Hu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Mi Xiang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
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26
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Yeum D, Jimenez CA, Emond JA, Meyer ML, Lansigan RK, Carlson DD, Ballarino GA, Gilbert-Diamond D, Masterson TD. Differential neural reward reactivity in response to food advertising medium in children. Front Neurosci 2023; 17:1052384. [PMID: 36816130 PMCID: PMC9933514 DOI: 10.3389/fnins.2023.1052384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Food cues including food advertisements (ads) activate brain regions related to motivation and reward. These responses are known to correlate with eating behaviors and future weight gain. The objective of this study was to compare brain responses to food ads by different types of ad mediums, dynamic (video) and static (images), to better understand how medium type impacts food cue response. Methods Children aged 9-12 years old were recruited to complete a functional magnetic resonance imaging (fMRI) paradigm that included both food and non-food dynamic and static ads. Anatomical and functional images were preprocessed using the fMRIPrep pipeline. A whole-brain analysis and a targeted region-of-interest (ROI) analysis for reward regions (nucleus accumbens, orbitofrontal cortex, amygdala, insula, hypothalamus, ventral tegmental area, substantia nigra) were conducted. Individual neural responses to dynamic and static conditions were compared using a paired t-test. Linear mixed-effects models were then constructed to test the differential response by ad condition after controlling for age, sex, BMI-z, physical activity, and % of kcal consumed of a participant's estimated energy expenditure in the pre-load prior to the MRI scan. Results A total of 115 children (mean=10.9 years) completed the fMRI paradigm. From the ROI analyses, the right and left hemispheres of the amygdala and insula, and the right hemisphere of the ventral tegmental area and substantia nigra showed significantly higher responses for the dynamic food ad medium after controlling for covariates and a false discovery rate correction. From the whole-brain analysis, 21 clusters showed significant differential responses between food ad medium including the precuneus, middle temporal gyrus, superior temporal gyrus, and inferior frontal gyrus, and all regions remained significant after controlling for covariates. Discussion Advertising medium has unique effects on neural response to food cues. Further research is needed to understand how this differential activation by ad medium ultimately affects eating behaviors and weight outcomes.
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Affiliation(s)
- Dabin Yeum
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Courtney A. Jimenez
- Department of Psychological and Brain Science at Dartmouth College, Hanover, NH, United States
| | - Jennifer A. Emond
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Meghan L. Meyer
- Department of Psychology, Columbia University, New York, NY, United States
| | - Reina K. Lansigan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Delaina D. Carlson
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Grace A. Ballarino
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
- Department of Medicine, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Travis D. Masterson
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
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Moreland Russell S, Jabbari J, Farah Saliba L, Ferris D, Jost E, Frank T, Chun Y. Implementation of Flexibilities to the National School Lunch and Breakfast Programs and Their Impact on Schools in Missouri. Nutrients 2023; 15:720. [PMID: 36771426 PMCID: PMC9920473 DOI: 10.3390/nu15030720] [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: 01/17/2023] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND In 2018, the United States Department of Agriculture (USDA) issued flexibilities to the National School Lunch and Breakfast Programs, relaxing the nutrition standards for milk, whole grains, and sodium. This study examines the implementation decision-making among Missouri school food services and the impact of implementing these flexibilities on the meals served. METHODS We developed a survey using the Consolidated Framework of Implementation to determine schools' implementation of the flexibilities and factors related to implementation. To determine how the implementation of flexibilities affected participation, we merged the survey results with school-level meal county data from the Missouri Department of Elementary and Secondary Education. We used ordinary least squares regression to examine how flexibility adoption related to the number of meals served. RESULTS Most schools implemented the wheat, milk, and sodium flexibilities. Common reasons for implementation were increasing participation, meeting students' preferences, expanding menu variety, and saving money. The implementation of flexibilities was associated with more lunches and breakfasts being served per month, particularly among free and reduced-price meals. CONCLUSIONS Continued research is needed to determine how the increased uptake of school meals that do not fully meet dietary guidelines by low-income students results in inequities in health outcomes. The findings can inform the design and implementation of future policies, especially as new rules related to flexibility design are determined.
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Affiliation(s)
- Sarah Moreland Russell
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Jason Jabbari
- Social Policy Institute, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Louise Farah Saliba
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Dan Ferris
- Social Policy Institute, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Eliot Jost
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Tyler Frank
- Social Policy Institute, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Yung Chun
- Social Policy Institute, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
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Calcaterra V, Magenes VC, Hruby C, Siccardo F, Mari A, Cordaro E, Fabiano V, Zuccotti G. Links between Childhood Obesity, High-Fat Diet, and Central Precocious Puberty. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020241. [PMID: 36832370 PMCID: PMC9954755 DOI: 10.3390/children10020241] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 01/31/2023]
Abstract
In recent years, the existing relationship between excess overweight and central precocious puberty (CPP) has been reported, especially in girls. Different nutritional choices have been associated with different patterns of puberty. In particular, the involvement of altered biochemical and neuroendocrine pathways and a proinflammatory status has been described in connection with a high-fat diet (HFD). In this narrative review, we present an overview on the relationship between obesity and precocious pubertal development, focusing on the role of HFDs as a contributor to activating the hypothalamus-pituitary-gonadal axis. Although evidence is scarce and studies limited, especially in the paediatric field, the harm of HFDs on PP is a relevant problem that cannot be ignored. Increased knowledge about HFD effects will be useful in developing strategies preventing precocious puberty in children with obesity. Promoting HFD-avoiding behavior may be useful in preserving children's physiological development and protecting reproductive health. Controlling HFDs may represent a target for policy action to improve global health.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy
- Correspondence:
| | | | - Chiara Hruby
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy
| | | | - Alessandra Mari
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy
| | - Erika Cordaro
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy
| | - Valentina Fabiano
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milano, 20157 Milano, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milano, 20157 Milano, Italy
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Mihuta MS, Stoian D, Borlea A, Roi CM, Velea-Barta OA, Mozos I, Paul C. Evaluating the Arterial Stiffness as a Useful Tool in the Management of Obese Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020183. [PMID: 36832311 PMCID: PMC9955158 DOI: 10.3390/children10020183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/28/2022] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
Childhood obesity speeds up the development of arterial stiffness and progressively increases the values of arterial pressure. The purpose of this study is to investigate the value of using pulse wave analysis (PWA) to measure arterial stiffness as a sign of vascular wall impairment in obese children. The research was focused on 60 subjects: 33 obese and 27 normal-weight. Ages ranged from 6 to 18 years old. PWA includes parameters such as pulse wave velocity (PWV), augmentation index (AIx), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP), heart rate, and central pulse pressure (cPP). The device used was a Mobil-O-Graph. Blood parameters were taken from the subject's medical history, not older than 6 months. A high BMI and a large waist circumference are linked to a high PWV. The levels of LDL-c, triglycerides (TG), non-HDL-c, TG/HDL-c ratio, and total cholesterol-HDL-c ratio significantly correlate to PWV, SBP, and cSBP. Alanine aminotransferase is a reliable predictor of PWV, AIx, SBP, DBP, and cDBP, while aspartate aminotransferase is a significant predictor of AIx, mean arterial pressure (MAP), cSBP, and cPP. 25-OH-Vitamin D negatively correlates with PWV, SBP, and MAP and significantly predicts the MAP. Cortisol and TSH levels are not significant to arterial stiffness in obese children without specific comorbidities and neither is fasting glucose in obese children without impaired glucose tolerance. We conclude that PWA contributes valuable data regarding patients' vascular health and should be considered a reliable tool in the management of obese children.
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Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dana Stoian
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence:
| | - Andreea Borlea
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Oana-Alexandra Velea-Barta
- 3rd Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences—Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Abiri B, Valizadeh M, Amini S, Kelishadi R, Hosseinpanah F. Risk factors, cutoff points, and definition of metabolically healthy/unhealthy obesity in children and adolescents: A scoping review of the literature. Obes Rev 2023; 24:e13548. [PMID: 36624970 DOI: 10.1111/obr.13548] [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: 07/24/2022] [Revised: 11/29/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023]
Abstract
Diagnosis of metabolically healthy obesity (MHO) and its definition do not have universal criteria in the pediatric age group. Hence, this scoping review aims to identify the components, the cutoff points, and the definition of MHO in children and adolescents. A comprehensive, systematic search was conducted in PubMed, Scopus, EMBASE, and Google Scholar databases. A consensus-based definition of MHO was developed through a Delphi process involving an international panel of 23 experts. This review included a total of 63 non-randomized studies, published between 2007 and 2022. According to our consensus (≥80% agreement), the proposed definition for MHO included the following components: high-density lipoprotein cholesterol >40 mg/dl (or >1.03 mmol/l), triglycerides ≤150 mg/dl (or ≤1.7 mmol/l), fasting plasma glucose <100 mg/dl (or <5.6 mmol/l), a measure of insulin, and systolic and diastolic blood pressure ≤90th percentile. Therefore, MHO was defined as the absence of the above metabolic risk factors; and those children and adolescents with one or more criteria were considered as metabolically unhealthy. A universal definition of MHO will allow comparisons between studies in the field of childhood obesity and can be useful in clinical practice.
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Affiliation(s)
- Behnaz Abiri
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Amini
- Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kim D, Kim W, Choi M, Shin J. Did the increase in sitting time due to COVID-19 lead to obesity in adolescents? BMC Pediatr 2023; 23:5. [PMID: 36597058 PMCID: PMC9810512 DOI: 10.1186/s12887-022-03807-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/15/2022] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Since adolescent with obesity is closely linked with the incidence of cardiovascular disease, it is important to identify the factors that increase the prevalence of adolescent with obesity and prevent it early. This study aimed to examine which of the demographic and lifestyle factors including sitting hours per week for purposes other than study had the greatest influence on Korean adolescents with obesity during the coronavirus disease 2019 (COVID-19) pandemic. METHODS We used the Korean Youth Risk Behavior Web-based Survey (KYRBWS) data. The primary outcome was the relationship between sitting hours and obesity during and after the COVID-19 pandemic. Multiple logistic regression analysis was performed to examine which of the demographic and lifestyle factors including sitting hours per week for purposes other than study had the greatest influence on Korean adolescents' obesity status. RESULTS The prevalence of obesity was significantly higher during the COVID-19 than before the COVID-19 (OR, 1.268, CI:1.232-1.305). There was a significant increase in the OR for sitting hours per week for purposes other than study (OR, 1.021, 95% CI, 1.019-1.024). Compared to low household income, the OR decreased for middle (OR = 0.798, 95% CI:0.77, 0.826) and high-income household students (OR, 0.833, 95% CI: 0.803-0.865). DISCUSSION/CONCLUSION The results of this study confirmed the relationship between sit-ting hours and obesity in adolescents during the pandemic. To prevent adolescent with obesity, further studies are needed to focus on the importance of promoting health policy in adolescents to avoid the continuous rising of its prevalence and needed to understand whether the increase in obesity rates during the pandemic is a temporary trend.
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Affiliation(s)
- Dahyun Kim
- grid.264383.80000 0001 2175 669XDepartment of Statistics, Sungshin Women’s University, Seoul, Republic of Korea
| | - Woorim Kim
- grid.410914.90000 0004 0628 9810Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Mingee Choi
- grid.410914.90000 0004 0628 9810Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea ,grid.15444.300000 0004 0470 5454Office of Research Affairs and University - Industry Foundation, Yonsei University, Seodaaemun-Gu, Seoul, Republic of Korea
| | - Jaeyong Shin
- grid.15444.300000 0004 0470 5454Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 Republic of Korea
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Clasey JL, Easley EA, Murphy MO, Kiessling SG, Stromberg A, Schadler A, Huang H, Bauer JA. Body mass index percentiles versus body composition assessments: Challenges for disease risk classifications in children. Front Pediatr 2023; 11:1112920. [PMID: 36937977 PMCID: PMC10020489 DOI: 10.3389/fped.2023.1112920] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/31/2023] [Indexed: 03/06/2023] Open
Abstract
Background Identifying at-risk children with optimal specificity and sensitivity to allow for the appropriate intervention strategies to be implemented is crucial to improving the health and well-being of children. We determined relationships of body mass indexes for age and sex percentile (BMI%) classifications to actual body composition using validated and convenient methodologies and compared fat and non-fat mass estimates to normative cut-off reference values to determine guideline reliability. We hypothesized that we would achieve an improved ability to identify at-risk children using simple, non-invasive body composition and index measures. Methods Cross-sectional study of a volunteer convenience sample of 1,064 (537 boys) young children comparing Body Fat Percentage (BF%), Fat Mass Index (FMI), Fat-Free Mass Index (FFMI), determined via rapid bioimpedance methods vs. BMI% in children. Comparisons determined among weight classifications and boys vs. girls. Results Amongst all subjects BMI% was generally correlated to body composition measures and indexes but nearly one quarter of children in the low-risk classifications (healthy weight or overweight BMI%) had higher BF% and/or lower FFMI than recommended standards. Substantial evidence of higher than expected fatness and or sarcopenia was found relative to risk status. Inaccuracies were more common in girls than boys and girls were found to have consistently higher BF% at any BMI%. Conclusions The population studied raises concerns regarding actual risks for children of healthy or overweight categorized BMI% since many had higher than expected BF% and potential sarcopenia. When body composition and FMI and FFMI are used in conjunction with BMI% improved sensitivity, and accuracy of identifying children who may benefit from appropriate interventions results. These additional measures could help guide clinical decision making in settings of disease-risks stratifications and interventions.
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Affiliation(s)
- Jody L. Clasey
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, United States
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
- Correspondence: Jody L. Clasey
| | - Elizabeth A. Easley
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, United States
- Department of Math, Science, Nursing, Public Health, University of South Carolina Lancaster, Lancaster, SC, United States
| | - Margaret O. Murphy
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
| | - Stefan G. Kiessling
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
| | - Arnold Stromberg
- Department of Statistics, University of Kentucky, Lexington, KY, United States
| | - Aric Schadler
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
| | - Hong Huang
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
| | - John A. Bauer
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
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Wang S, Liu B, Liu J. EFFECTS OF SCHOOL SOCCER TRAINING ON THE HEALTH AND FITNESS OF OBESE CHILDREN. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
ABSTRACT Introduction Based on the representative data reflecting the level of physical development and athletic quality, such as the “National Physical Health Test for Students”, it is shown that the physical health status of adolescents and children in China is decreasing annually, and the trend of obesity is gradually increasing. Objective Analyze and study the effect of training on the physical fitness of obese children aged 12 to 14 through school soccer training. Methods The effect of school soccer training on the health and physical fitness of obese children aged 12-14 years was studied, and conclusions were drawn by the literature method, experimental method, mathematical statistical method, and logical analysis method. Forty-eight screened obese children were randomly assigned to the experimental and control groups, 24 in each group. The experimental group underwent 12 weeks of soccer training, and the control group underwent 12 weeks of no training control. The subjects’ body composition and flexibility quality indices were measured post-intervention. Results The visceral fat index, body fat rate, and muscle rate of boys and girls progressed expressively, with a significant difference (P <0.05). Muscle weight is also known as lean body weight, with an expressive increase in muscle tone. In comparison, the increase in fat weight and muscle ratio in boys was expressively higher than in girls. Conclusion Regular long-term school soccer training can increase mobility in obese children, increase physical flexibility, and help promote physical health and prevent injury. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
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Affiliation(s)
| | - Baiqing Liu
- Zhongnan University of Economics and Law, China
| | - Jingle Liu
- Zhongnan University of Economics and Law, China
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Hahn-Holbrook J, Davis EP, Sandman CA, Glynn LM. Maternal prenatal cortisol trajectories predict accelerated growth in infancy. Psychoneuroendocrinology 2023; 147:105957. [PMID: 36371954 PMCID: PMC10710294 DOI: 10.1016/j.psyneuen.2022.105957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022]
Abstract
Higher maternal cortisol in pregnancy has been linked to childhood obesity. Much of the previous research has been limited in that cortisol in pregnancy is only measured at one time-point, precluding the ability to examine critical timing effects of prenatal maternal cortisol. To fill this gap, this longitudinal study measured maternal plasma cortisol at 15, 19, 25, and 31 weeks of pregnancy, and assessed infant body mass index percentile (BMIP)1 at birth, 3, 6, 12, and 24 months in 189 mother-infant pairs. Three distinct patterns of maternal cortisol in pregnancy (typical, steep, and flat trajectories) were identified using general growth mixture modeling (GGMM)2 and then used to predict child growth patterns using multilevel modeling. Infants of mothers who had flat cortisol trajectories, characterized by relatively high cortisol in early gestation that plateaus by mid-gestation, experienced more rapid increases in BMIP from birth to 6 months, and had higher BMIPs at 3 and 6 months, than infants whose mothers had the typical slow cortisol rise over gestation, or steep (rapidly accelerating) trajectories. These results suggest that it is not just the total amount of maternal cortisol in pregnancy that shapes early infant growth, but instead the timing and trajectory of prenatal cortisol exposure. To better understand the early origins of obesity risk, future research is needed to investigate the factors that shape mothers' prenatal cortisol trajectories.
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Affiliation(s)
- Jennifer Hahn-Holbrook
- Department of Psychology, University of California, 5200 Lake Rd, Merced, CA 95343, the United States of America.
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, 2155 S Race St, Denver, CO 80210, the United States of America; Department of Pediatrics, University of California, Irvine, CA 333 The City Blvd. West, Suite 800, Orange, CA 92868-4482, the United States of America.
| | - Curt A Sandman
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA UCI School of Medicine Medical Education, 1001 Health Sciences Road, Irvine, CA 92697-4089, the United States of America.
| | - Laura M Glynn
- Department of Psychology, Chapman University, One University Drive, Orange, CA 92866, the United States of America.
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Weghuber D, Barrett T, Barrientos-Pérez M, Gies I, Hesse D, Jeppesen OK, Kelly AS, Mastrandrea LD, Sørrig R, Arslanian S. Once-Weekly Semaglutide in Adolescents with Obesity. N Engl J Med 2022; 387:2245-2257. [PMID: 36322838 PMCID: PMC9997064 DOI: 10.1056/nejmoa2208601] [Citation(s) in RCA: 132] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND A once-weekly, 2.4-mg dose of subcutaneous semaglutide, a glucagon-like peptide-1 receptor agonist, is used to treat obesity in adults, but assessment of the drug in adolescents has been lacking. METHODS In this double-blind, parallel-group, randomized, placebo-controlled trial, we enrolled adolescents (12 to <18 years of age) with obesity (a body-mass index [BMI] in the 95th percentile or higher) or with overweight (a BMI in the 85th percentile or higher) and at least one weight-related coexisting condition. Participants were randomly assigned in a 2:1 ratio to receive once-weekly subcutaneous semaglutide (at a dose of 2.4 mg) or placebo for 68 weeks, plus lifestyle intervention. The primary end point was the percentage change in BMI from baseline to week 68; the secondary confirmatory end point was weight loss of at least 5% at week 68. RESULTS A total of 201 participants underwent randomization, and 180 (90%) completed treatment. All but one of the participants had obesity. The mean change in BMI from baseline to week 68 was -16.1% with semaglutide and 0.6% with placebo (estimated difference, -16.7 percentage points; 95% confidence interval [CI], -20.3 to -13.2; P<0.001). At week 68, a total of 95 of 131 participants (73%) in the semaglutide group had weight loss of 5% or more, as compared with 11 of 62 participants (18%) in the placebo group (estimated odds ratio, 14.0; 95% CI, 6.3 to 31.0; P<0.001). Reductions in body weight and improvement with respect to cardiometabolic risk factors (waist circumference and levels of glycated hemoglobin, lipids [except high-density lipoprotein cholesterol], and alanine aminotransferase) were greater with semaglutide than with placebo. The incidence of gastrointestinal adverse events was greater with semaglutide than with placebo (62% vs. 42%). Five participants (4%) in the semaglutide group and no participants in the placebo group had cholelithiasis. Serious adverse events were reported in 15 of 133 participants (11%) in the semaglutide group and in 6 of 67 participants (9%) in the placebo group. CONCLUSIONS Among adolescents with obesity, once-weekly treatment with a 2.4-mg dose of semaglutide plus lifestyle intervention resulted in a greater reduction in BMI than lifestyle intervention alone. (Funded by Novo Nordisk; STEP TEENS ClinicalTrials.gov number, NCT04102189.).
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Affiliation(s)
- Daniel Weghuber
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
| | - Timothy Barrett
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
| | - Margarita Barrientos-Pérez
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
| | - Inge Gies
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
| | - Dan Hesse
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
| | - Ole K Jeppesen
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
| | - Aaron S Kelly
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
| | - Lucy D Mastrandrea
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
| | - Rasmus Sørrig
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
| | - Silva Arslanian
- From the Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria (D.W.); the Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (T.B.); the Division of Pediatric Endocrinology, Hospital Ángeles Puebla, Puebla City, Mexico (M.B.-P.); the Department of Pediatrics, Division of Pediatric Endocrinology, Universitair Ziekenhuis Brussel, Brussels (I.G.); Novo Nordisk, Søborg, Denmark (D.H., O.K.J., R.S.); the Department of Pediatrics and the Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis (A.S.K.); the Division of Pediatric Endocrinology and Diabetes, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (L.D.M.); and the Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine, and UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.)
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Lim CYS, Foo YW, Tok CLX, Lim YY, Loke KY, Lee YS, Ng NBH. Screening for metabolic complications of childhood and adolescent obesity: A scoping review of national and international guidelines. Obes Rev 2022; 23:e13513. [PMID: 36286080 DOI: 10.1111/obr.13513] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/14/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022]
Abstract
The rise in prevalence of childhood obesity is paralleled by an increase in obesity-related metabolic complications, which add significantly to the population burden of cardiovascular morbidity in the long term. Early detection of obesity-related metabolic complications through appropriate screening strategies forms a crucial aspect of obesity management. We performed a scoping review of international and national guidelines on the management of pediatric obesity to evaluate the recommendations on screening for metabolic complications, namely, hypertension, diabetes, dyslipidemia, and non-alcoholic fatty liver disease. Thirty guidelines were included, 23 (76.7%) of which had some guidance on screening for metabolic complications. However, there were significant variations in the extent and details of recommendations for screening for these metabolic complications. There has been no consensus on the body mass index (BMI) thresholds, age of onset, frequency, and screening tests recommended for detecting hypertension, diabetes, dyslipidemia, and non-alcoholic fatty liver disease between guidelines. These variations did not appear to be polarized based on geographical location or population ethnicity. We provide our recommendations on metabolic screening based on the strength of evidence in the guidelines, also incorporating recommendations from key childhood hypertension, diabetes, and lipid guidelines. Appropriate implementation of screening strategies is crucial to improve detection of metabolic complications, to allow for earlier or more intensified interventions for affected children with obesity.
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Affiliation(s)
- Carey Yun Shan Lim
- Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Yu Wah Foo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chanel Li Xuan Tok
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yvonne Yijuan Lim
- Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kah Yin Loke
- Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicholas Beng Hui Ng
- Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Sun G, Li L, Zhang X. A visualized and scientometric analysis of research trends of weight loss in overweight/obese children and adolescents (1958-2021). Front Public Health 2022; 10:928720. [PMID: 36339176 PMCID: PMC9632180 DOI: 10.3389/fpubh.2022.928720] [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: 04/26/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
Background Weight loss is an appropriate approach to reduce the health risks associated with overweight/obese children and adolescents, and the optimal method of weight loss requires further research. This study systematically explores scientific co-operation, disciplinary interaction, hotspots and trends in the field of weight loss in overweight/obese children and adolescents (WLOCA), and provides references for further research. Methods Citespace 5.8.R1 (64-bit) was adopted to conduct a comprehensive visualization analysis of the literature on WLOCA from Web of Science Core Collection, including publication, institution, country/region, author, journal, keywords and reference. Results 2,513 papers were found in the Web of Science Core Collection, and the annual number of papers published has increased significantly since 2003. Cincinnati Children's Hospital is the institution with the largest number of publications, while Washington University plays a pivotal role in the collaboration network. In terms of nations, USA has made greater contributions than the rest in terms of the number of publications and global co-operation research. The most influential authors in this field are Thomas H. Inge, Thomas Reinehr, Todd M. Jenkins, Epstein LH, Ogden CL, etc. The most active journals are "Obesity," "International Journal of Obesity," "Obesity Surgery," "Pediatrics," etc. which are characterized by interdisciplinary interactions. Research hot topics mainly include "assessment of obesity and pathophysiological mechanism," "comprehensive intervention," and "bariatric surgery," and there's a gradual shift from "lifestyle intervention" and "pathophysiological mechanism" to "clinical surgical application." In addition, disciplinary integration and comprehensive research, targeted intervention and treatment, and prospective research are the future research trends. Conclusion The overall trend in WLOCA study is positive. The main contribution of this study is to reveal the overall picture of the research in this field with visual maps and detailed data by combining quantitative with qualitative approaches, which can provide valuable references for relevant researchers to quickly understand the status of studies on WLOCA, to seek co-operation, and grasp research hotspots and frontier trends.
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Affiliation(s)
- Guotao Sun
- School of Physical Education, Chengdu Sport University, Chengdu, China,College of Education and Sports Science, Yangtze University, Jingzhou, China
| | - Long Li
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China,School of Physical Education, Xichang University, Xichang, China
| | - Xiaolin Zhang
- Sport Research Office, Chengdu Sport University, Chengdu, China,*Correspondence: Xiaolin Zhang
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Vincze L, Boswell M, Atkins H, Littlewood R, Williams L. Addressing childhood obesity in Queensland: Aboriginal and Torres Strait Islander Health Worker perspectives and practices. Health Promot J Austr 2022; 33 Suppl 1:163-173. [PMID: 35224795 PMCID: PMC9790716 DOI: 10.1002/hpja.585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED Obesity disproportionately impacts Aboriginal and Torres Strait Islander children compared to non-Indigenous children. Aboriginal and Torres Strait Islander Health Workers (AHWs) in Queensland support the health of Aboriginal and Torres Strait Islander peoples. However, little is known about their perspectives and practices on addressing childhood obesity. The aim of this study was to investigate AHW perspectives and clinical practice behaviours with Aboriginal and Torres Strait Islander children and their families. METHODS In a cross-sectional mixed-methods approach, a purpose-developed online survey (25 items) was distributed to the AHW workforce in Queensland (~100 AHWs). The survey explored [1] role characteristics, [2] current attitudes and beliefs about childhood obesity, [3] barriers to discussing weight management, [4] clinical practice behaviours and [5] demographic characteristics. Eight AHWs responding to the survey also participated in semi-structured telephone interviews to discuss their survey responses. RESULTS Fifty-five AHWs responded and 45 completed the survey. While the majority of respondents (91%) agreed that addressing childhood obesity was an important part of their role, fewer (67%) agreed that obesity was an issue in Aboriginal and Torres Strait Islander peoples. Over half (55%) found it difficult to discuss overweight and obesity with children and families and only 22.5% reported measuring height and weight often. Key themes included a willingness to address childhood obesity, with experience and training being key enablers to discussing the issue. There was a perceived lack of culturally appropriate programs to support AHWs working with families. CONCLUSIONS AHWs report a willingness to address childhood obesity within their roles, however many find it difficult to raise the issue with families, with even fewer routinely undertaking obesity assessment practices. SO WHAT?: These findings could inform training initiatives for AHWs to optimise screening, identification, referral, and treatment of childhood obesity in Aboriginal and Torres Strait Islander communities.
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Affiliation(s)
- Lisa Vincze
- School of Health Sciences & Social WorkGriffith UniversityGold CoastQueenslandAustralia,Menzies Health Institute QueenslandGriffith UniversityGold CoastQueenslandAustralia
| | - Megan Boswell
- School of Health Sciences & Social WorkGriffith UniversityGold CoastQueenslandAustralia
| | - Heidi Atkins
- Queensland Child and Youth Clinical NetworkBrisbaneQueenslandAustralia
| | - Robyn Littlewood
- Health and Wellbeing QueenslandQueensland GovernmentBrisbaneQueenslandAustralia
| | - Lauren Williams
- School of Health Sciences & Social WorkGriffith UniversityGold CoastQueenslandAustralia,Menzies Health Institute QueenslandGriffith UniversityGold CoastQueenslandAustralia
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La Marra M, Messina A, Ilardi CR, Staiano M, Di Maio G, Messina G, Polito R, Valenzano A, Cibelli G, Monda V, Chieffi S, Iavarone A, Villano I. Factorial Model of Obese Adolescents: The Role of Body Image Concerns and Selective Depersonalization-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11501. [PMID: 36141782 PMCID: PMC9517425 DOI: 10.3390/ijerph191811501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The relationship binding body weight to psychological well-being is unclear. The present study aims at identifying the contribution, and specificity, of some dimensions (i.e., eating-related symptoms, body image disorders, eating habits, personality traits, and emotional difficulties) characterizing the psychological profile of obese adolescents (749 participants, 325 females; 58.3% normal-weight, 29.9% overweight, and 11.7% obese; mean age = 16.05, SD = 0.82). METHODS By introducing the scores obtained by standardized self-report tools into a generalized linear model, a factorial reduction design was used to detect the best fitting discriminant functions and the principal components explaining the higher proportion of the variance. RESULTS We found two discriminant functions correctly classifying 87.1% of normal-weight, 57.2% of overweight, and 68.2% of obese adolescents. Furthermore, two independent factors, explaining 69.68% of the total variance, emerged. CONCLUSIONS The first factor, "Body Image Concerns", included the drive for thinness, body dissatisfaction, and interpersonal distrust. The second factor, "Selective Depersonalization", included a trend toward depersonalization and dissatisfaction with the torso. The neurophysiological implications of our findings will be discussed.
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Affiliation(s)
- Marco La Marra
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Ciro Rosario Ilardi
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Maria Staiano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Girolamo Di Maio
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy
| | - Rita Polito
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy
| | - Anna Valenzano
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy
| | - Vincenzo Monda
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy
| | - Sergio Chieffi
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Alessandro Iavarone
- Neurological Unit, CTO Hospital, AORN “Ospedali dei Colli”, 80131 Naples, Italy
| | - Ines Villano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Knapp EA, Dong Y, Dunlop AL, Aschner JL, Stanford JB, Hartert T, Teitelbaum SL, Hudak ML, Carroll K, O’Connor TG, McEvoy CT, O’Shea TM, Carnell S, Karagas MR, Herbstman JB, Dabelea D, Ganiban JM, Ferrara A, Hedderson M, Bekelman TA, Rundle AG, Alshawabkeh A, Gilbert-Diamond D, Fry RC, Chen Z, Gilliland FD, Wright RJ, Camargo CA, Jacobson L, Lester BM, Hockett CW, Hodges ML, Chandran A. Changes in BMI During the COVID-19 Pandemic. Pediatrics 2022; 150:e2022056552. [PMID: 35768891 PMCID: PMC9444980 DOI: 10.1542/peds.2022-056552] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Experts hypothesized increased weight gain in children associated with the coronavirus disease 2019 (COVID-19) pandemic. Our objective was to evaluate whether the rate of change of child body mass index (BMI) increased during the COVID-19 pandemic compared with prepandemic years. METHODS The study population of 1996 children ages 2 to 19 years with at least 1 BMI measure before and during the COVID-19 pandemic was drawn from 38 pediatric cohorts across the United States participating in the Environmental Influences on Child Health Outcomes-wide cohort study. We modeled change in BMI using linear mixed models, adjusting for age, sex, race, ethnicity, maternal education, income, baseline BMI category, and type of BMI measure. Data collection and analysis were approved by the local institutional review board of each institution or by the central Environmental Influences on Child Health Outcomes institutional review board. RESULTS BMI increased during the COVID-19 pandemic compared with previous years (0.24 higher annual gain in BMI during the pandemic compared with previous years, 95% confidence interval 0.02 to 0.45). Children with BMI in the obese range compared with the healthy weight range were at higher risk for excess BMI gain during the pandemic, whereas children in higher-income households were at decreased risk of BMI gain. CONCLUSIONS One effect of the COVID-19 pandemic is an increase in annual BMI gain during the COVID-19 pandemic compared with the 3 previous years among children in our national cohort. This increased risk among US children may worsen a critical threat to public health and health equity.
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Affiliation(s)
| | - Yanan Dong
- Johns Hopkins School of Public Health, Baltimore, MD
| | | | - Judy L. Aschner
- Hackensack Meridian School of Medicine and Albert Einstein
College of Medicine, Bronx, NY
| | | | - Tina Hartert
- Vanderbilt University School of Medicine, Nashville,
TN
| | | | - Mark L. Hudak
- University of Florida College of Medicine –
Jacksonville, Jacksonville, FL
| | - Kecia Carroll
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | | | - Susan Carnell
- Johns Hopkins University School of Medicine, Baltimore,
MD
| | | | | | | | | | | | | | | | - Andrew G. Rundle
- Columbia University Mailman School of Public Health, New
York, New York
| | - Akram Alshawabkeh
- Civil and Environmental Engineering, Northeastern
University, Boston, MA
| | | | | | - Zhanghua Chen
- University of Southern California, Keck School of
Medicine, Los Angeles, CA
| | - Frank D. Gilliland
- University of Southern California, Keck School of
Medicine, Los Angeles, CA
| | | | | | - Lisa Jacobson
- Johns Hopkins School of Public Health, Baltimore, MD
| | | | - Christine W. Hockett
- Avera Research Institute; University of South Dakota
School of Medicine, Sioux Falls, SD
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Espinosa-Jiménez T, Busquets O, Cano A, Sánchez-López E, Verdaguer E, Parcerisas A, Olloquequi J, Auladell C, Folch J, Wahli W, Vázquez-Carrera M, Camins A, Ettcheto M. Peroxisomal Proliferator-Activated Receptor β/δ Deficiency Induces Cognitive Alterations. Front Pharmacol 2022; 13:902047. [PMID: 35899125 PMCID: PMC9310104 DOI: 10.3389/fphar.2022.902047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Peroxisome proliferator-activated receptor β/δ (PPARβ/δ), the most PPAR abundant isotype in the central nervous system, is involved in microglial homeostasis and metabolism, whose disturbances have been demonstrated to play a key role in memory impairment. Although PPARβ/δ function is well-established in metabolism, its contribution to neuronal and specifically memory process is underexplored. Therefore, the aim of the study is to determine the role of PPARβ/δ in the neuropathological pathways involved in memory impairment and as to whether a risk factor implicated in memory loss such as obesity modulates neuropathological markers. To carry out this study, 6-month-old total knock-out for the Ppard gene male mice with C57BL/6X129/SV background (PPARβ/δ-/-) and wild-type (WT) littermates with the same genetic background were used. Animals were fed, after the weaning (at 21 days old), and throughout their growth, either conventional chow (CT) or a palmitic acid-enriched diet (HFD). Thus, four groups were defined: WT CT, WT HFD, PPARβ/δ-/- CT, and PPARβ/δ-/- HFD. Before sacrifice, novel object recognition test (NORT) and glucose and insulin tolerance tests were performed. After that, animals were sacrificed by intracardiac perfusion or cervical dislocation. Different techniques, such as GolgiStain kit or immunofluorescence, were used to evaluate the role of PPARβ/δ in memory dysfunction. Our results showed a decrease in dendritic spine density and synaptic markers in PPARβ/δ-/- mice, which were corroborated in the NORT. Likewise, our study demonstrated that the lack of PPARβ/δ receptor enhances gliosis in the hippocampus, contributing to astrocyte and microglial activation and to the increase in neuroinflammatory biomarkers. Additionally, alterations in the hippocampal insulin receptor pathway were found. Interestingly, while some of the disturbances caused by the lack of PPARβ/δ were not affected by feeding the HFD, others were exacerbated or required the combination of both factors. Taken together, the loss of PPARβ/δ-/- affects neuronal and synaptic structure, contributing to memory dysfunction, and they also present this receptor as a possible new target for the treatment of memory impairment.
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Affiliation(s)
- Triana Espinosa-Jiménez
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Oriol Busquets
- Dominick P. Purpura Department of Neurosciences, Albert Einstein College of Medicine, New York City, NY, United States
| | - Amanda Cano
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, Spain
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
- Research Center and Memory Clinic, Fundació ACE Institut Català de Neurociències Aplicades—International University of Catalunya (UIC), Barcelona, Spain
| | - Elena Sánchez-López
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, Spain
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
- Unit of Synthesis and Biomedical Applications of Peptides, IQAC-CSIC, Barcelona, Spain
| | - Ester Verdaguer
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Department of Cellular Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Antoni Parcerisas
- Departament of Basic Sciences, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Spain
| | - Jordi Olloquequi
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Carme Auladell
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Department of Cellular Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Jaume Folch
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Department of Biochemistry and Biotechnology, Faculty of Medicine and Life Science, University Rovira i Virgili, Reus, Spain
| | - Walter Wahli
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- ToxAlim (Research Center in Food Toxicology), INRAE, Toulouse Cedex, France
| | - Manuel Vázquez-Carrera
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedicine of the University of Barcelona (IBUB), University of Barcelona, Barcelona, Spain
- Spanish Biomedical Research Center in Diabetes and Associated Metabolic Diseases (CIBERDEM)-Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni Camins
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Miren Ettcheto
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- *Correspondence: Miren Ettcheto,
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Chen W, Liu L, Li Y, Li S, Li Z, Zhang W, Zhang X, Wu R, Hu D, Sun H, Zhou Y, Fan W, Zhao Y, Zhang Y, Hu Y. Evaluation of pediatric malignancies using total-body PET/CT with half-dose [ 18F]-FDG. Eur J Nucl Med Mol Imaging 2022; 49:4145-4155. [PMID: 35788704 DOI: 10.1007/s00259-022-05893-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/25/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To explore the impact of a true half dose of [18F]-FDG on image quality in pediatric oncological patients undergoing total-body PET/CT and investigate short acquisition times with half-dose injected activity. METHODS One hundred pediatric oncological patients who underwent total-body PET/CT using the uEXPLORER scanner after receiving a true half dose of [18F]-FDG (1.85 MBq/kg) were retrospectively enrolled. The PET images were first reconstructed using complete 600-s data and then split into 300-s, 180-s, 60-s, 40-s, and 20-s duration groups (G600 to G20). The subjective analysis was performed using 5-point Likert scales. Objective quantitative metrics included the maximum standard uptake value (SUVmax), SUVmean, standard deviation (SD), signal-to-noise ratio (SNR), and SNRnorm of the background. The variabilities in lesion SUVmean, SUVmax, and tumor-to-background ratio (TBR) were also calculated. RESULTS The overall image quality scores in the G600, G300, G180, and G60 groups were 4.9 ± 0.2, 4.9 ± 0.3, 4.4 ± 0.5, and 3.5 ± 0.5 points, respectively. All the lesions identified in the half-dose images were localized in the G60 images, while 56% of the lesions could be clearly identified in the G20 images. With reduced acquisition time, the SUVmax and SD of the backgrounds were gradually increased, while the TBR values showed no statistically significant differences among the groups (all p > 0.1). Using the half-dose images as a reference, the variability in the lesion SUVmax gradually increased from the G180 to G20 images, while the lesion SUVmean remained stable across all age groups. SNRnorm was highly negatively correlated with age. CONCLUSION Total-body PET/CT with a half dose of [18F]-FDG (1.85 MBq/kg, estimated whole-body effective dose: 1.76-2.57 mSv) achieved good performance in pediatric patients, with sufficient image quality and good lesion conspicuity. Sufficient image quality and lesion conspicuity could be maintained at a fast scanning time of 60 s with half-dose activity.
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Affiliation(s)
- Wanqi Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Lei Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Yinghe Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Shatong Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Zhijian Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Weiguang Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Xu Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Runze Wu
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Debin Hu
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Hongyan Sun
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Wei Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Yumo Zhao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China.
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
| | - Yizhuo Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China.
- Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
| | - Yingying Hu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China.
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
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Richardson KA, McKibbin CL, Dabrowski BS, Punke ELA, Hartung CM. Parent Intention to Enroll in an Online Intervention to Enhance Health Behavior Change among Youth Treated with Psychotropic Medication Who Are Overweight or Obese: An Elicitation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138057. [PMID: 35805722 PMCID: PMC9266077 DOI: 10.3390/ijerph19138057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
Youth who are prescribed psychotropic medication are disproportionally affected by overweight/obesity (OW/OB), yet few interventions have been tailored to their needs. To develop new interventions, it is important to address the needs, preferences, and intentions of target users. Qualitative methods within the theory of planned behavior (TPB) framework were used in this study to identify salient beliefs which may influence attitudes associated with parents’ intentions to participate in a future online intervention designed to develop behavioral health coaching skills among parents and guardians. Twenty parents and guardians of youth with OW/OB who were taking psychotropic medications, and were eligible for the study, were recruited through TurkPrime. Parents and guardians identified key salient beliefs consistent with the theory of planned behavior including behavioral beliefs (e.g., access and convenience), normative beliefs (e.g., family), and control beliefs (e.g., cost) that may influence their decision to enroll in a future, parent-oriented intervention. The results of this study suggest important salient beliefs which may be included in future research, as well as specific preferences which may be used to guide the development of a future intervention. Future work should focus on the creation of a salient belief quantitative measure and assess the relationships of these beliefs to attitudinal constructs and behaviors.
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Trends in BMI Percentile and Body Fat Percentage in Children 12 to 17 Years of Age. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050744. [PMID: 35626921 PMCID: PMC9140085 DOI: 10.3390/children9050744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 12/15/2022]
Abstract
This study evaluates the cross-sectional trends in body fat percentage (BF%) and body mass index (BMI) percentile rank, and the relationship between the two in 332 (177 boys, 155 girls) 12- to 17-year-old children. Body mass index (BMI) was calculated using measured height and body mass, and sex-specific BMI for age percentile rank was determined using CDC growth charts. Body fat percentage (BF%) was measured with DEXA. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated by normalizing the fat mass and fat-free mass for height. Compared to boys of the same age, girls had significantly higher BF% and FMI values and lower FFMI values. Compared to boys, at a given BMI percentile rank, females had a higher BF% and FMI, and a lower FFMI. In both boys and girls, there was an exponential increase in adiposity above the 70th percentile rank. BMI percentile rank is not an equivalent indicator of body fatness in boys and girls. Other measures of body composition can further inform the practitioner of a child’s adiposity.
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Verma AK, Singh G, Patwardhan K. Patterns of Physical Activity Among University Students and Their Perceptions About the Curricular Content Concerned With Health: Cross-sectional Study. JMIRX MED 2022; 3:e31521. [PMID: 37725547 PMCID: PMC10414421 DOI: 10.2196/31521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/06/2021] [Accepted: 01/29/2022] [Indexed: 09/21/2023]
Abstract
BACKGROUND University students are at risk of losing their focus on maintaining healthy levels of physical activity because of their engagements with curricular and cocurricular activities. In India, the physical activity levels of the adult population have been reported to be declining in the recent years. However, studies focusing on university students pertaining to their physical activity are lacking in the Indian context. Moreover, a question that has not been properly addressed is the following: "do the curricula in higher education promote physical activity?" OBJECTIVE Our paper aims at describing the physical activity levels of the students in a large public-funded central university located in northern India. The study also aims at capturing the student perceptions about the emphasis they receive on leading a physically active lifestyle during their routine curricular activities. METHODS This is a cross-sectional descriptive study and uses International Physical Activity Questionnaire-Long Form to record physical activity among 4586 students. Stratified sampling method was used to enroll the students from each stream (faculty). Out of 30,667 students, about 15% were included from each faculty. The study was conducted between 2016 and 2019. To capture the student perceptions, we used a newly developed 5-item scale. RESULTS From a total of 4586 participants in the study, 2828 (61.7%) were male and 1758 (38.3%) were female students. The mean age of our sample was 22.34 (SD 3.12) years. Our results indicate that about 14.5% (n=666) of all students in the study fall under the "Inactive" category. Furthermore, the perception about the curricular content pertaining to physical activity varied widely between the students of different streams. CONCLUSIONS Our sample reported a better physical activity pattern in comparison to the reported overall physical activity levels of the adult population of India. Our results also suggest that health-related topics are inadequately represented in many of the streams of higher education in the university.
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Affiliation(s)
- Arun Kumar Verma
- Department of Kriya Sharir, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Girish Singh
- Centre of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Kishor Patwardhan
- Department of Kriya Sharir, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Carpena Lucas PJ, Sánchez-Cubo F, Vargas Vargas M, Mondéjar Jiménez J. Influence of Lifestyle Habits in the Development of Obesity during Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4124. [PMID: 35409807 PMCID: PMC8998286 DOI: 10.3390/ijerph19074124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 12/18/2022]
Abstract
Background: The alarming increase in childhood obesity is a global public health problem since it has significant health consequences. This cross-sectional study aimed to identify the potentially modifiable risk factors for developing excess weight and determine the importance of developing certain habits to prevent childhood overweight and obesity. Methods: The sample included 416 students between the ages of 12 and 14 (12.8 ± 0.62) first-year high school students from Murcia in Spain. Data were collected on their lifestyle habits through the ENHASA questionnaire, and the somatometry of the participants was measured. Such data were studied through structural equation modeling and importance-performance map analyses. Results: The modifiable risk factors that presented the greatest potency directly regarding when developing excess weight in adolescents were ‘use of electronic devices’ and ‘not performing physical activity’ (p < 0.001). ‘Social and school environment’ and ‘diet’ showed relationships but no significant differences with overweight or obesity. Globally, the lifestyle habit of the greatest importance for not being overweight was ‘engagement in extracurricular physical activities’. On the other hand, the habits related to using new technologies in a sedentary way showed the best capacity for improvement. Therefore, it would be very efficient to focus on them to control excess weight. Conclusion: Responsible and limited use of screens and engaging in extracurricular physical activities may be the most remarkable and cost-effective strategies for obesity prevention programs.
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Affiliation(s)
| | - Francisco Sánchez-Cubo
- Department of Political Economy and Public Finance, Economic and Business Statistics and Economic Policy, Faculty of Social Sciences, University of Castilla-La Mancha, 16007 Cuenca, Spain;
| | - Manuel Vargas Vargas
- Faculty of Economic and Business Sciences, University of Castilla-La Mancha, 02006 Albacete, Spain;
| | - José Mondéjar Jiménez
- Department of Statistics, Faculty of Social Sciences in Cuenca, University of Castilla-La Mancha, 16007 Cuenca, Spain;
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Bethmann D, Cho JI. The impacts of free school lunch policies on adolescent BMI and mental health: Evidence from a natural experiment in South Korea. SSM Popul Health 2022; 18:101072. [PMID: 35402684 PMCID: PMC8987994 DOI: 10.1016/j.ssmph.2022.101072] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/26/2022] Open
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Laugesen K, Sørensen HT, Jorgensen JOL, Petersen I. Prenatal exposure to glucocorticoids and the prevalence of overweight or obesity in childhood. Eur J Endocrinol 2022; 186:429-440. [PMID: 35104239 PMCID: PMC8942335 DOI: 10.1530/eje-21-0846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/01/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Prenatal exposure to excess cortisol can affect postnatal metabolic health by epigenetic mechanisms. We aimed to investigate if prenatal exposure to pharmacological glucocorticoids increases the risk of overweight/obesity in childhood. DESIGN A nationwide population registry-based cohort study. METHODS We identified 383 877 children born in Denmark (2007-2012), who underwent routine anthropometric evaluation at 5-8 years of age. Prenatal exposure to glucocorticoids was divided into systemic and topical glucocorticoids, cumulative systemic dose, and use by trimester. The comparison cohort included children without exposure, born to maternal never-users. Negative control exposures were used to investigate confounding from an underlying disease or unmeasured characteristics. Such exposures included children without glucocorticoid exposure born to maternal users of non-steroidal anti-inflammatory drugs or immunotherapy during pregnancy, maternal former users of glucocorticoids, or paternal users of glucocorticoids during the pregnancy of their partner. We estimated sex-stratified adjusted prevalence ratios (aPR) of overweight/obesity at 5-8 years of age, as epigenetic modifications have shown to be sex-specific. RESULTS In the study, 21 246 (11%) boys and 27 851 (15%) girls were overweight/obese at 5-8 years of age. Overall, neither systemic nor topical glucocorticoids were associated with overweight/obesity. In boys, high-dose systemic glucocorticoids was associated with higher prevalence of overweight/obesity vs the comparison cohort (aPR: 1.41 (95% CI: 1.07-1.86), prevalence: 16% vs 11%). Negative control exposures indicated robustness to confounding. CONCLUSION Overweight/obesity might be an adverse effect of prenatal exposure to high-dose systemic glucocorticoids in boys. We found no association for neither prenatal exposure to lower doses of systemic nor topical glucocorticoids. These results merit clinical attention.
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Affiliation(s)
- Kristina Laugesen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Correspondence should be addressed to K Laugesen;
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jens Otto L Jorgensen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Irene Petersen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Primary Care and Population Health, University College London, London, UK
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Girela-Serrano BM, Guerrero-Jiménez M, Spiers ADV, Gutiérrez-Rojas L. Obesity and overweight among children and adolescents with bipolar disorder from the general population: A review of the scientific literature and a meta-analysis. Early Interv Psychiatry 2022; 16:113-125. [PMID: 33735937 DOI: 10.1111/eip.13137] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/05/2021] [Accepted: 03/06/2021] [Indexed: 11/27/2022]
Abstract
There is substantial evidence of the high prevalence of obesity (OB) and overweight (OW) and their association with increased medical and psychiatric burden among adults with bipolar disorder (BD). However, little is known regarding its prevalence among young people with BD, other than the risk from psychotropic medication, which has been the focus of research in this population. We present a systematic review and meta-analysis of the literature on prevalence and correlates of OB and OW children and adolescents with BD using a different perspective than impact of medication. Four studies met inclusion criteria. The prevalence of OB in children and adolescents with BD was 15% (95% CI 11-20%). We observed a higher prevalence of OB in comparison to the general population. Different studies found significant associations between OB, OW, and BD in young populations including non-Caucasian race, physical abuse, suicide attempts, self-injurious behaviours, psychotropic medication, and psychiatric hospitalizations.
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Affiliation(s)
| | - Margarita Guerrero-Jiménez
- Department of Psychiatry, University of Granada, Granada, Spain.,Virgen de las Nieves University Hospital, Granada, Spain
| | - Alexander D V Spiers
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, London, UK
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain.,Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain.,San Cecilio University Hospital, Granada, Spain
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Laforest-Lapointe I, Becker AB, Mandhane PJ, Turvey SE, Moraes TJ, Sears MR, Subbarao P, Sycuro LK, Azad MB, Arrieta MC. Maternal consumption of artificially sweetened beverages during pregnancy is associated with infant gut microbiota and metabolic modifications and increased infant body mass index. Gut Microbes 2022; 13:1-15. [PMID: 33382954 PMCID: PMC7781635 DOI: 10.1080/19490976.2020.1857513] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Artificial sweetener consumption by pregnant women has been associated with an increased risk of infant obesity, but the underlying mechanisms are unknown. We aimed to determine if maternal consumption of artificially sweetened beverages (ASB) during pregnancy is associated with modifications of infant gut bacterial community composition and function during the first year of life, and whether these alterations are linked with infant body mass index (BMI) at one year of age. We studied 100 infants from the prospective Canadian CHILD Cohort Study, selected based on maternal ASB consumption during pregnancy (50 non-consumers and 50 daily consumers). BMI was higher among ASB-exposed infants. Infant stool (16S rRNA gene sequencing) and urine (untargeted metabolomics) were acquired in early (3-4 months) and late (12 months) infancy. We identified four microbiome clusters, of which two recapitulated the maturation trajectory of the infant gut bacterial communities from immature (Cluster 1) to mature (Cluster 4) and two deviated from this trajectory (Clusters 2 and 3). Maternal ASB consumption did not differ between clusters, but was associated with community-level shifts in infant gut bacterial taxonomy structure and depletion of several Bacteroides sp. in Cluster 2. In the complete dataset, urine succinate and spermidine levels at 3 months were higher in ASB-exposed infants, and urine succinate was positively associated with BMI at one-year-old. Overall, gestational exposure to ASB was associated with gut microbiota structure in infants from Cluster 2, and gut microbiota structure was associated with infant BMI. Gestational exposure to ASB was positively associated with infant urine succinate and spermidine. Succinate was found to mediate 29% of the effect of ASB exposure on BMI at one-year-old, revealing a potential role of this metabolite in increased infant weight linked to gestational ASB consumption. As we face an unprecedented rise in childhood obesity, future studies should evaluate the causal relationships between maternal ASB consumption (a modifiable exposure), gut microbiota and metabolites, infant metabolism, and body composition.
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Affiliation(s)
- Isabelle Laforest-Lapointe
- Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada,Pediatrics, University of Calgary, Calgary, Alberta, Canada,Biologie, Université De Sherbrooke, Sherbrooke, Québec, Canada,Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta, Canada,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Allan B. Becker
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta, Canada,Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Stuart E. Turvey
- British Columbia Children’s Hospital, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Theo J. Moraes
- Hospital for Sick Children, Toronto, Ontario, Canada,Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | | | - Padmaja Subbarao
- Hospital for Sick Children, Toronto, Ontario, Canada,Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Laura K. Sycuro
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada,Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Meghan B. Azad
- Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta, Canada,Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada,Meghan B. Azad University of Calgary, Health Research Innovation Centre, 3330 Hospital Drive N.W., Calgary, Alberta, Canada T2N 4N1
| | - Marie-Claire Arrieta
- Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada,Pediatrics, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute (ACHRI), Calgary, Alberta, Canada,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada,CONTACT Marie-Claire Arrieta
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