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Bakhoda MR, Haghighat Lari MM, Khosravi G, Khademi Z, Abbasi F, Milajerdi A. Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and meta-analysis. BMC Oral Health 2024; 24:966. [PMID: 39164714 PMCID: PMC11334321 DOI: 10.1186/s12903-024-04733-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 08/09/2024] [Indexed: 08/22/2024] Open
Abstract
INTRODUCTION Earlier studies reported inconsistent findings for the association of childhood obesity with the risk of dental caries. In this systematic review and meta-analysis, we aimed to summarize earlier studies on the association of overweight and obesity with risk of dental caries in children. METHODS Relevant studies published up to December 2023 were identified through searches in PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar, using suitable keywords. All observational studies, including cross-sectional or cohort or case-control studies, about the association of each obesity index with risk of dental caries in children which reported odds ratio (OR), hazard ratio (HR), or relative risk (RR) and 95% CIs, were included. Studies involving adults, randomized clinical trials, studies on animals or pregnant women, and studies on other dental disorders were excluded. Risk of bias was assessed using standard methods for observational studies. A total of 22 studies including 40673 participants were included. Studies were pooled using the random-effect model, and results were synthesized with subgroup analyses and assessments of heterogeneity. Limitations included potential publication bias and heterogeneity among study designs. The quality of the included studies was assessed using the Newcastle-Ottawa scale (NOS). RESULTS Children at the highest category of BMI were 44% more likely to have early childhood caries (ECC) than those at the bottom (OR: 1.44; 95% CI: 1.16 to 1.78). Moreover, combined analysis also showed no significant association between waist circumference (WC) and risk of dental caries in children. However, significant linear and non-linear associations were found between BMI and risk of childhood dental caries. No publication bias was found for the relationship between BMI and the risk of ECC based on visual inspection of a funnel plot and Egger's test. CONCLUSIONS This study showed a significant direct association between BMI and the risk of dental caries in children. Non-linear analysis showed higher risk of dental caries in children with higher BMI and also among underweight children. Further prospective studies are required to expand current knowledge in this issue. IMPACT STATEMENT The findings of this study have significant implications for public health and dental care, suggesting association between BMI and the risk of dental caries in children. This comprehensive meta-analysis is among the first to summarize earlier publications on the association of obesity with risk of dental caries in children, highlighting the need for more accurate methods of obesity assessment and further research to understand this relationship better. These findings can help inform public health policies and interventions to reduce the prevalence of childhood obesity and dental caries.
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Affiliation(s)
- Mohammad Reza Bakhoda
- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Mehdi Haghighat Lari
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Zeinab Khademi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abbasi
- Department of Sport Injuries, Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.
- Department of Health, School of Medicine, AJA University of Medical Sciences, Tehran, Iran.
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Greve KT, Foster TL, Pancoast R, Yarber C, Adams H, Patel R. Change in BMI in Children Over the First 30 Months After the Start of the SARS-CoV-2 Pandemic. Clin Pediatr (Phila) 2024; 63:902-913. [PMID: 37840288 DOI: 10.1177/00099228231204481] [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: 10/17/2023]
Abstract
Our study aim was to assess body mass index (BMI) change in children in the immediate 6 months of the pandemic, to follow longitudinal BMI change up to 30 months after the pandemic start, and to identify sociodemographic factors associated with these changes. Our study included a retrospective chart review of 1298 children 2 to 18 years old with office visits at an Indianapolis primary care clinic. Body mass index and sociodemographic information were collected at visits during 3 time periods: Prepandemic (March 1, 2019-February 28, 2020), Early Pandemic (June 1, 2020-November 30, 2020), and Late Pandemic (December 1, 2020-September 30, 2022). Data analysis indicated statistically significant increases in BMI monthly rate of change from Prepandemic to Early Pandemic periods. Interestingly, BMI rate of change stabilized from Early Pandemic to Late Pandemic periods but remained positive, suggesting children had slower, but persistent, continued BMI increase after the pandemic initiation.
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Affiliation(s)
- Katherynne T Greve
- Peyton Manning Children's Hospital at Ascension St. Vincent, Ascension, Indianapolis, IN, USA
- Ascension St. Vincent Hospital-Indianapolis, Ascension, Indianapolis, IN, USA
| | - Todd L Foster
- Ascension St. Vincent Hospital-Indianapolis, Ascension, Indianapolis, IN, USA
| | - Rayanne Pancoast
- College of Osteopathic Medicine, Marian University, Indianapolis, IN, USA
| | - Courtney Yarber
- College of Osteopathic Medicine, Marian University, Indianapolis, IN, USA
| | - Heather Adams
- Adams Statistics & Risk Consulting, LLC, Indianapolis, IN, USA
| | - Rita Patel
- Peyton Manning Children's Hospital at Ascension St. Vincent, Ascension, Indianapolis, IN, USA
- Ascension St. Vincent Hospital-Indianapolis, Ascension, Indianapolis, IN, USA
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Zhu Q, Wada H, Ueda Y, Onuki K, Miyakawa M, Sato S, Kameda Y, Matsumoto F, Inoshita A, Nakano H, Tanigawa T. Association between habitual snoring and vigilant attention in elementary school children. Sleep Med 2024; 118:9-15. [PMID: 38579378 DOI: 10.1016/j.sleep.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVES Vigilant attention (VA) is a fundamental neurocognitive function. However, the association between habitual snoring (HS) and VA in community-based children remains unclear. Therefore, this study aimed to elucidate the association. METHODS The study included 2014 children from grades 1-6 across six elementary schools. Snoring frequency was evaluated using a questionnaire administered to parents. VA was assessed using a brief 3-min psychomotor vigilance test (PVT-B). Generalized linear models and multivariate logistic regression analysis were utilized to examine the association between snoring frequency and PVT-B performance. Impaired PVT-B performance was defined as the worst quartile of PVT-B metrics. RESULTS The PVT-B performance significantly improved with advancing school grade level (p trend < 0.0001). A significant negative correlation was observed between snoring frequency and PVT-B performance. Particularly, in grade 1, HS was associated with a higher risk of impaired PVT-B performance, including response speed (mean reciprocal reaction time) (adjusted odds ratio [aOR] 2.56, 95% confidence interval [CI]: 1.20-5.50), more slowest 10% RT (aOR 3.28, 95% CI: 1.51-6.88), and more lapse500 (number of lapse of reaction time ≥ 500 ms) (aOR 3.18, 95% CI: 1.45-6.80) compared to children without snoring. CONCLUSIONS Our findings show that VA rapidly improves throughout elementary school. Additionally, younger children with HS are at risk of VA deficits, emphasizing the importance of early intervention for HS.
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Affiliation(s)
- Qinye Zhu
- Department of Public Health, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Hiroo Wada
- Department of Public Health, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Yuito Ueda
- Department of Public Health, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Keisuke Onuki
- Department of Public Health, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Mariko Miyakawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Setsuko Sato
- Department of Public Health, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Yosihito Kameda
- Department of Public Health, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Fumihiko Matsumoto
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Ayako Inoshita
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Hiroshi Nakano
- Sleep Disorders Centre, National Hospital Organization Fukuoka National Hospital, Yakatabaru, Minami-Ku, Fukuoka City, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-Ku, Tokyo, Japan.
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Azevedo-Martins AK, Santos MP, Abayomi J, Ferreira NJR, Evangelista FS. The Impact of Excessive Fructose Intake on Adipose Tissue and the Development of Childhood Obesity. Nutrients 2024; 16:939. [PMID: 38612973 PMCID: PMC11013923 DOI: 10.3390/nu16070939] [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: 12/08/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 04/14/2024] Open
Abstract
Worldwide, childhood obesity cases continue to rise, and its prevalence is known to increase the risk of non-communicable diseases typically found in adults, such as cardiovascular disease and type 2 diabetes mellitus. Thus, comprehending its multiple causes to build healthier approaches and revert this scenario is urgent. Obesity development is strongly associated with high fructose intake since the excessive consumption of this highly lipogenic sugar leads to white fat accumulation and causes white adipose tissue (WAT) inflammation, oxidative stress, and dysregulated adipokine release. Unfortunately, the global consumption of fructose has increased dramatically in recent years, which is associated with the fact that fructose is not always evident to consumers, as it is commonly added as a sweetener in food and sugar-sweetened beverages (SSB). Therefore, here, we discuss the impact of excessive fructose intake on adipose tissue biology, its contribution to childhood obesity, and current strategies for reducing high fructose and/or free sugar intake. To achieve such reductions, we conclude that it is important that the population has access to reliable information about food ingredients via food labels. Consumers also need scientific education to understand potential health risks to themselves and their children.
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Affiliation(s)
- Anna Karenina Azevedo-Martins
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
| | - Matheus Pedro Santos
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
| | - Julie Abayomi
- School of Medicine and Nutrition, Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk L39 4QP, UK;
| | - Natália Juliana Ramos Ferreira
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
| | - Fabiana S. Evangelista
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
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Moura PC, Raposo M, Vassilenko V. Breath biomarkers in Non-Carcinogenic diseases. Clin Chim Acta 2024; 552:117692. [PMID: 38065379 DOI: 10.1016/j.cca.2023.117692] [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: 11/10/2023] [Revised: 12/02/2023] [Accepted: 12/03/2023] [Indexed: 12/19/2023]
Abstract
The analysis of volatile organic compounds (VOCs) from human matrices like breath, perspiration, and urine has received increasing attention from academic and medical researchers worldwide. These biological-borne VOCs molecules have characteristics that can be directly related to physiologic and pathophysiologic metabolic processes. In this work, gathers a total of 292 analytes that have been identified as potential biomarkers for the diagnosis of various non-carcinogenic diseases. Herein we review the advances in VOCs with a focus on breath biomarkers and their potential role as minimally invasive tools to improve diagnosis prognosis and therapeutic monitoring.
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Affiliation(s)
- Pedro Catalão Moura
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516, Caparica, Portugal.
| | - Maria Raposo
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516, Caparica, Portugal.
| | - Valentina Vassilenko
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516, Caparica, Portugal.
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Dou N, Deitch R, Kowalski AJ, Kuhn A, Lane H, Parker EA, Wang Y, Zafari Z, Black MM, Hager ER. Studying the impact of COVID-19 mitigation policies on childhood obesity, health behaviors, and disparities in an observational cohort: Protocol for the COVID-19 Family Study. Contemp Clin Trials 2024; 136:107408. [PMID: 38072192 PMCID: PMC10922699 DOI: 10.1016/j.cct.2023.107408] [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: 06/01/2023] [Revised: 11/13/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND COVID-19 pandemic control policies, including school closures, suspended extra-curricular activities, and social distancing, were introduced to prevent viral transmission, and disrupted children's daily routines, health behaviors, and wellness. This observational cohort study among 697 families with children or adolescents, based on the Family Stress Model, aims to: 1) evaluate pre- to during-pandemic changes in child health behaviors (diet, physical activity, sleep) and weight gain, 2) identify mechanisms explaining the changes, and 3) determine projected healthcare costs on weight gain and obesity. Each aim includes an examination by racial and ethnic, socioeconomic, and geographic disparities. METHODS The study employs a mixed methods design, recruiting children and their caregivers from two obesity prevention trials halted in 2020. Enrolled participants complete annual surveys to assess child health behaviors, family resources, routines, and demographics, and home environment in 2020-2022. Height and weight are measured annually in 2021-2022. Annual semi-structured interviews are conducted within a subsample to understand mechanisms of observed changes. Multilevel mixed models and mediation analyses are used to examine changes in child health behaviors and weight gain and mechanisms underlying the changes. Qualitative data are analyzed within and across time points and integrated with quantitative findings to further explain mechanisms. Markov models are used to determine healthcare costs for unhealthy child behaviors and weight gain. CONCLUSION Findings from this study will aid in understanding pandemic-related changes in child health behaviors and weight status and will provide insights for the implementation of future programs and policies to improve child and family wellness.
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Affiliation(s)
- Nan Dou
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
| | - Rachel Deitch
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
| | - Alysse J Kowalski
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
| | - Ann Kuhn
- Department of Exercise and Nutrition Sciences, University at Buffalo, The State University of New York, 401 Kimball Tower, Buffalo, NY 14214, USA.
| | - Hannah Lane
- Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC 27701, USA.
| | - Elizabeth A Parker
- University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science, 100 Penn Street, Baltimore, MD 21201, USA.
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Washington, DC 20052, USA.
| | - Zafar Zafari
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, 20 North Pine Street, Baltimore, MD 21201, USA.
| | - Maureen M Black
- University of Maryland School of Medicine, Department of Pediatrics, 737 West Lombard Street, Baltimore, MD 21201, USA; RTI International, Research Triangle Park, NC 27709, USA.
| | - Erin R Hager
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, 615 N Wolfe St, MD 21205, USA.
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Chen LW, Ng S, Tint MT, Michael N, Sadananthan SA, Ong YY, Yuan WL, Chen ZY, Chen CY, Godfrey KM, Tan KH, Gluckman PD, Chong YS, Eriksson JG, Yap F, Lee YS, Fortier MV, Velan SS, Chan SY. Associations of cord plasma per- and polyfluoroakyl substances (PFAS) with neonatal and child body composition and adiposity: The GUSTO study. ENVIRONMENT INTERNATIONAL 2024; 183:108340. [PMID: 38043321 DOI: 10.1016/j.envint.2023.108340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/26/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The influence of prenatal exposure to per- and poly- fluoroalkyl substances (PFAS) on birth size and offspring adiposity is unclear, especially for the newer, shorter-chained replacement PFAS. METHODS In the GUSTO multi-ethnic Singaporean mother-offspring cohort, 12 PFAS were measured in 783 cord plasma samples using ultra-performance-liquid chromatography-tandem-mass-spectrometer (UPLC-MS/MS). Outcomes included offspring anthropometry, other indicators of body composition/metabolic health, and MRI-derived abdominal adiposity (subset) at birth and 6 years of age. PFAS were modeled individually, in categories of long-chain and short-chain PFAS, and as scores of three principal components (PC) derived using PC analysis (PC1, PC2, and PC3 reflect predominant exposure patterns to "very-long-PFAS", "long-PFAS", and "short-PFAS", respectively). Associations with outcomes were assessed using multivariable linear regressions, adjusted for important covariates such as maternal sociodemographic and lifestyle factors. RESULTS Overall, cord PFAS levels showed either no or positive associations (mostly for long-chain PFAS) with birth weight, length and head circumference. In general, PFAS were associated with higher neonatal abdominal adiposity, driven by shorter-chain PFAS. Perfluoroheptanoic acid (PFHpA) was associated with higher volumes of superficial subcutaneous adipose tissue (sSAT) (3.75 [1.13, 6.37] mL per SD increase in PFAS) and internal adipose tissue (IAT) (1.39 [0.41, 2.38] mL). Higher levels of perfluorobutanesulfonic acid (PFBS), short-chain PFAS, and PC3 were associated with higher IAT volume (β range 1.22-1.41 mL/SD, all P < 0.02), especially in girls. Higher PC3 score was additionally associated with higher sSAT (3.12 [0.45, 5.80] mL) volume. At age 6 years, most observed associations did not persist. No consistent associations were observed between PFAS and whole-body adiposity measures. CONCLUSIONS Fetal exposure to emerging short-chain PFAS was associated with higher abdominal adiposity at birth but not at age 6 years. Further research is needed to replicate the findings and to determine if these effects may reappear beyond early childhood. Population exposure to newer PFAS and consequent health impact must be monitored.
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Affiliation(s)
- Ling-Wei Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan; Master of Public Health Program, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Sharon Ng
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Yi Ying Ong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wen Lun Yuan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Ze-Ying Chen
- Institute of Food Safety and Health, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan
| | - Chia-Yang Chen
- Institute of Food Safety and Health, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Tremona Road, SO16 6YD Southampton, UK
| | - Kok Hian Tan
- Duke-NUS Medical School, 8 College Road, 169857, Singapore; Department of Reproductive Medicine, KK Women's and Children Hospital, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland 1023, New Zealand
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore; Department of General Practice and Primary Health Care, University of Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland; Folkhälsan Research Center, Topeliusgatan 20, 00250 Helsinki, Finland
| | - Fabian Yap
- Duke-NUS Medical School, 8 College Road, 169857, Singapore; Department of Pediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, 1E Kent Ridge Road, 119228, Singapore
| | - Marielle V Fortier
- Department of Diagnostic & Interventional Imaging, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Sendhil S Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore.
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Pavlidou E, Papadopoulou SK, Alexatou O, Voulgaridou G, Mentzelou M, Biskanaki F, Psara E, Tsourouflis G, Lefantzis N, Dimoliani S, Apostolou T, Sampani A, Chatziprodromidou IP, Angelakou EP, Giaginis C. Childhood Mediterranean Diet Adherence Is Associated with Lower Prevalence of Childhood Obesity, Specific Sociodemographic, and Lifestyle Factors: A Cross-Sectional Study in Pre-School Children. EPIDEMIOLOGIA 2023; 5:11-28. [PMID: 38247997 PMCID: PMC10801514 DOI: 10.3390/epidemiologia5010002] [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: 11/13/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2-5 years old. METHODS This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I. RESULTS Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002). CONCLUSIONS A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2-5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | | | - Evmorfia Psara
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Nikos Lefantzis
- Department of Oral and Maxillofacial Surgery, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sophia Dimoliani
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Thomas Apostolou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | | | - Exakousti-Petroula Angelakou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
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Bleiweiss-Sande R, Skelton K, Zaltz D, Bacardí-Gascón M, Jiménez-Cruz A, Benjamin-Neelon SE. Interventions to prevent obesity in Latinx children birth to 6 years globally: a systematic review. Public Health Nutr 2023; 26:2498-2513. [PMID: 37622420 PMCID: PMC10641617 DOI: 10.1017/s1368980023001283] [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: 12/25/2021] [Revised: 04/03/2023] [Accepted: 06/20/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To conduct a systematic review of obesity prevention interventions in Latinx children ages birth to 6 years published in any language from 2010-2020. DESIGN We used PubMed, ERIC, PsycINFO, Scopus, Scientific Electronic Library Online (SciELO) and Google Scholar databases to conduct a search on May 1 2020, January 1 2021 and November 1 2022. We included randomised controlled trials, quasi-experimental studies and non-randomised interventions with a control or comparison group that reported measures of adiposity. SETTING Interventions taking place in the United States, Latin America or the Caribbean. PARTICIPANTS Latinx children ages birth to 6 years. RESULTS Of 8601 unique records identified, forty manuscripts about thirty-nine unique studies describing thirty distinct interventions in the United States and nine interventions in Latin America and the Caribbean met our inclusion criteria. Interventions were primarily based in early care and education centres (n 13) or combined home settings, for example home and community (n 7). Randomised interventions taking place in community or home settings were more likely to report significant reductions in adiposity or weight-related outcomes compared to other settings. Using the Cochrane risk of bias tools for randomised and non-randomised studies, we judged thirty-eight randomised trials and nine non-randomised interventions to have a high or unclear risk of bias. CONCLUSIONS The results highlight a need for more rigorous designs and more effective intervention strategies in Latinx children at risk for having overweight and obesity. Registered with the PROSPERO database for systematic reviews under registration number CRD42020161339.
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Affiliation(s)
- Rachel Bleiweiss-Sande
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N Broadway, Baltimore, MD21205, USA
| | - Kara Skelton
- Department of Health Sciences, Towson University, Towson, MD, USA
| | - Daniel Zaltz
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N Broadway, Baltimore, MD21205, USA
| | | | - Arturo Jiménez-Cruz
- Universidad Autónoma de Baja California, Department of Medicine and Psychology, Tijuana, Mexico
| | - Sara E Benjamin-Neelon
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N Broadway, Baltimore, MD21205, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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10
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Demir HP, Bayram HM. The Association between BMI and Body Weight Perception among Children in Turkey: A Cross-Sectional Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:2372-2379. [PMID: 38106836 PMCID: PMC10719712 DOI: 10.18502/ijph.v52i11.14037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/14/2023] [Indexed: 12/19/2023]
Abstract
Background There is a complex relationship between body mass index (BMI) and body weight perception. The present study aimed to determine the relationship between BMI and body weight perception among middle-aged children. Methods This study was cross-sectional, and conducted among 333 children (9-11 yr) from the largest public school in Istanbul, Turkey between Oct 2019 and Jan 2020. BMI was calculated as weight divided by height squared (kg/m2). Body weight perception was determined using a photograph figure rating scale. Data were analyzed using SPSS version 24.0. Results Overall, 325 children (mean age 10.01 ± 0.99 yr) completed the study. According to the BMI classification, 8.6% of children were severely underweight, 4.9% underweight, 68.0% normal weight, 8.3% overweight, and 10.2% obese. However, 38.8% of the children perceived themselves as overweight, 21.2% as underweight, 20.3% as normal, 10.3% as overweight, and 9.4% as obese. 59.1% of children underestimated their current body weight. On the other hand, 14.2% of children overestimated their current body weight. There were statistical differences between body weight perception and BMI (P<0.001). Conclusion There was a discrepancy between body weight perception and BMI among middle-aged children. More than half of the children tend to underestimate their actual body weight. Therefore, evaluating the nutritional status of children and learning which body type children perceive can guide the preparation of individual nutrition programs.
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Affiliation(s)
- Halime Pulat Demir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Gelisim University, Istanbul, Turkey
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Beykent University, Istanbul, Turkey
| | - Hatice Merve Bayram
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Beykent University, Istanbul, Turkey
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11
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Lee YTH, Zhang Q, Elmontser M, Stevenson E, Gazmararian JA. Association between early care and education centres policies and practices and children's healthy behaviours. Int J Health Plann Manage 2023; 38:1743-1756. [PMID: 37556382 DOI: 10.1002/hpm.3698] [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: 08/24/2021] [Revised: 04/17/2023] [Accepted: 07/07/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE To examine the impact of nutritional and physical activity (PA) policies and practices at early care and education centres on behavioural changes among children ages 2-5. METHODS The study population included 586 children from 25 education centres throughout the state of Georgia. Policies and practices were measured using the Georgia Nutrition and PA Assessment at the start of school year in Fall 2017. Survey data were collected at the beginning of school year September/October 2017 and at the end of school year April/May 2018 to measure changes in children's nutritional and PA behaviour over the school year. We used generalised estimating equations to estimate odds ratios and 95% confidence intervals. RESULTS Children at centres with a high nutrition assessment score had higher odds of increasing vegetable consumption (OR = 2.1; 95% CI: 1.1, 4.0) while the odds of increasing fruit (OR = 1.4; 95% CI: 0.8, 2.4) and water (OR = 1.2; 95% CI: 0.5, 2.7) consumption increased non-significantly. The odds of improving PA were similar between children at centres with a high versus a low PA assessment score. CONCLUSION The results, though insignificant, indicate that policies and practices could influence children's health behaviours. Further research is warranted to examine whether improvements in policies and practices could explain changes in children's health behaviours, the impact of educator's knowledge on children's health behaviours and the implementation of and adherence to policy and practice improvement plans.
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Affiliation(s)
- Yi-Ting Hana Lee
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Qi Zhang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mohnd Elmontser
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | | | - Julie A Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Oranika US, Adeola OL, Egbuchua TO, Okobi OE, Alrowaili DG, Kajero A, Koleowo OM, Okobi E, David AB, Ezeamii JC. The Role of Childhood Obesity in Early-Onset Type 2 Diabetes Mellitus: A Scoping Review. Cureus 2023; 15:e48037. [PMID: 38034219 PMCID: PMC10687489 DOI: 10.7759/cureus.48037] [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] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Childhood obesity is a growing concern worldwide, with significant implications for public health. Of particular interest is its association with the early onset of type 2 diabetes mellitus in children. Exploring this relationship and identifying contributing factors may help strengthen understanding of this complex relationship. Factors such as family history, gender, and sedentary lifestyle, and poor dietary habits, insulin resistance in adipose tissue have been identified as significant contributors to early-onset type 2 diabetes. The rising prevalence of childhood obesity and its association with diabetes necessitates early interventions to mitigate this concerning trend and ensure a lasting impact on public health. This scoping review aims to investigate the relationship between childhood obesity and early-onset type 2 diabetes mellitus while also exploring other contributing factors. We employed a standardized framework for reviews to analyze relevant literature published in English between 2000 and 2021. Only primary research, systematic reviews, and meta-analyses addressing the association between childhood obesity and early-onset type 2 diabetes mellitus were included. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format. Out of the 3614 articles assessed, 17 were ultimately incorporated into this scoping review as they met the inclusion criteria. The majority of the literature primarily represented North American studies, with no inclusion of studies from South America. The findings from these studies have highlighted several factors contributing to type 2 diabetes mellitus development. Most of the studies associated obesity development with hypertension and unfavorable lipid profiles. It is important to acknowledge that these findings are derived from the available literature and may not encompass the entirety of research on childhood obesity and early-onset type 2 diabetes mellitus. Furthermore, the limited regional diversity in the selected studies may restrict the generalizability of these findings to other geographic regions. Additional research involving diverse populations is imperative for a comprehensive understanding of the link between childhood obesity and early-onset type 2 diabetes mellitus. Insulin resistance in adipose tissue among obese individuals contributes to the transition from obesity to type 2 diabetes mellitus. Notably, this transition occurs at approximately half the duration in obese youths compared to obese adults, where it typically takes around a decade. The increasing prevalence of childhood obesity and diabetes mellitus in high-income, low-income, and middle-income countries necessitate collective efforts to reduce the increasing rates of early-onset type 2 diabetes in children. This scoping review, therefore, seeks to underscore the importance of early interventions with regard to ensuring a lasting impact capable of extending into adulthood.
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Affiliation(s)
| | | | - Thelma O Egbuchua
- Pediatrics and Neonatology, Delta State University Teaching Hospital, Oghara, NGA
| | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Hialeah, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | | | - Ayokunle Kajero
- Sexual and Reproductive Health/Adolescent Health, Ondo State Primary Health Care Development Agency, Akure, NGA
| | | | - Emeka Okobi
- Dentistry, Ahmadu Bello University Teaching Hospital, Zaria, NGA
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Pinto-Silva C, Correia-Costa A, Moura C, Mota C, Guerra A, Areias JC, Schaefer F, Afonso AC, Wühl E, Azevedo A, Correia-Costa L. Cardiovascular rhythmicity in overweight and obese children. J Bras Nefrol 2023; 45:449-457. [PMID: 37527530 PMCID: PMC10726656 DOI: 10.1590/2175-8239-jbn-2022-0138en] [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: 11/16/2022] [Accepted: 05/17/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Obesity is thought to play a role in the disruption of cardiac rhythmicity in obese children, but this is mostly an unexplored field of investigation. We aimed to evaluate the impact of overweight and obesity on circadian and ultradian cardiovascular rhythmicity of prepubertal children, in comparison with normal weight counterparts. METHODS We performed a cross sectional study of 316 children, followed in the birth cohort Generation XXI (Portugal). Anthropometrics and 24-hour ambulatory blood pressure were measured and profiles were examined with Fourier analysis for circadian and ultradian blood pressure (BP) and heart rate (HR) rhythms. RESULTS Overweight/obese children presented more frequently a non-dipping BP pattern than normal weight counterparts (31.5% vs. 21.6%, p = 0.047). The prevalence of 24-hour mean arterial pressure (MAP) and 8-hour HR rhythmicity was significantly lower in obese children (79.3% vs. 88.0%, p = 0.038 and 33.3% vs. 45.2%, p = 0.031, respectively). The prevalence of the remaining MAP and HR rhythmicity was similar in both groups. No differences were found in the median values of amplitudes and acrophases of MAP and HR rhythms. DISCUSSION The alterations found in rhythmicity suggest that circadian and ultradian rhythmicity analysis might be sensitive in detecting early cardiovascular dysregulations, but future studies are needed to reinforce our findings and to better understand their long-term implications.
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Affiliation(s)
- Catarina Pinto-Silva
- Centro Hospitalar Universitário de Coimbra, Divisão de Pediatria, Coimbra, Portugal
| | - Ana Correia-Costa
- Universidade do Porto, Faculdade de Medicina da Universidade do Porto, Divisão de Pediatria, Porto, Portugal
- Centro Hospitalar e Universitário de São João, Divisão de Cardiologia Pediátrica, Porto, Portugal
| | - Cláudia Moura
- Universidade do Porto, Faculdade de Medicina da Universidade do Porto, Divisão de Pediatria, Porto, Portugal
- Centro Hospitalar e Universitário de São João, Divisão de Cardiologia Pediátrica, Porto, Portugal
| | - Cláudia Mota
- Universidade do Porto, Faculdade de Medicina da Universidade do Porto, Divisão de Pediatria, Porto, Portugal
| | - António Guerra
- Centro Hospitalar e Universitário de São João, Divisão de Cardiologia Pediátrica, Porto, Portugal
- Centro Hospitalar Universitário de São João, Serviço de Pediatria, Unidade de Nutrição Pediátrica, Porto, Portugal
| | - José Carlos Areias
- Universidade do Porto, Faculdade de Medicina da Universidade do Porto, Divisão de Pediatria, Porto, Portugal
- Centro Hospitalar e Universitário de São João, Divisão de Cardiologia Pediátrica, Porto, Portugal
| | - Franz Schaefer
- Universidade de Heidelberg, Centro de Pediatria e Medicina do Adolescente, Divisão de Nefrologia Pediátrica, Heidelberg, Alemanha
| | - Alberto Caldas Afonso
- Centro Hospitalar Universitário de Santo António, Centro Materno-Infantil do Norte, Unidade de Nefrologia Pediátrica, Porto, Portugal
- Universidade do Porto, Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
- Universidade do Porto, Instituto de Saúde Pública, Unidade de Investigação em Epidemiologia, Porto, Portugal
| | - Elke Wühl
- Universidade de Heidelberg, Centro de Pediatria e Medicina do Adolescente, Divisão de Nefrologia Pediátrica, Heidelberg, Alemanha
| | - Ana Azevedo
- Universidade do Porto, Instituto de Saúde Pública, Unidade de Investigação em Epidemiologia, Porto, Portugal
- Universidade do Porto, Faculdade de Medicina, Saúde Pública e Ciências Forenses, Departamento de Educação Médica, Porto, Portugal
| | - Liane Correia-Costa
- Centro Hospitalar Universitário de Santo António, Centro Materno-Infantil do Norte, Unidade de Nefrologia Pediátrica, Porto, Portugal
- Universidade do Porto, Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
- Universidade do Porto, Instituto de Saúde Pública, Unidade de Investigação em Epidemiologia, Porto, Portugal
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Kim Y, Kim J, Lee B, Jung S, Chung SJ, Kim H, Shin N, Kim Y. Early childhood eating behaviors associated with risk of overweight and its socio-ecological determinants in Korean preschool children. Nutr Res Pract 2023; 17:717-734. [PMID: 37529267 PMCID: PMC10375334 DOI: 10.4162/nrp.2023.17.4.717] [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: 07/04/2022] [Revised: 12/31/2022] [Accepted: 01/09/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to identify preschool children's eating behaviors associated with early childhood obesity and its multi-level, socio-ecological determinants. SUBJECTS/METHODS In a cross-sectional study of 364 mothers of preschool children aged 3-5 years, these children's healthy eating behaviors were assessed using a validated preschool nutrition quotient (NQ-P) questionnaire. The children's overweight or obesity statuses were determined based on body mass index percentiles from the 2017 Korean National Growth Chart. The associations between the NQ-P score and risk of overweight or obesity were examined using multivariable logistic regression. The associations of individual, maternal, physical, and media environmental factors with the NQ-P score were also examined using multivariable linear regression. RESULTS Preschool children with greater NQ-P scores were at a significantly lower risk of overweight or obesity (P < 0.01). The NQ-P score had a significantly positive association with maternal body mass index and an inverse association with household income (all P < 0.05). Maternal parenting and feeding practices exhibited associations with the NQ-P score. Positive associations were observed with "warm," "structured," and "autonomy-supportive" parenting as well as monitoring feeding practices (all P < 0.05). In addition, the NQ-P score had a significantly positive association with the childcare center's anti-obesogenic environment, such as the provision of nutritional and physical-activity support and vicinity of the built food environment to the home, including access to good-quality food, fruits and vegetables, and low-fat foods (all P < 0.05). Regarding media environments, the NQ-P score demonstrated more significant associations with viewing and eating and/or cooking content displayed on online video platforms (all P < 0.05) than with that on television. CONCLUSIONS Our findings confirm the significance of healthy eating behaviors in early-childhood-obesity prevention and underscore the importance of multilevel maternal, physical, and media environmental interventions that effectively guide eating behaviors in preschool children.
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Affiliation(s)
- Yeri Kim
- Department of Nutritional Science & Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Jiye Kim
- Department of Health Convergence, Ewha Womans University, Seoul 03760, Korea
| | - Bomi Lee
- Department of Child Development & Intervention, Ewha Womans University, Seoul 03760, Korea
| | - Seungyoun Jung
- Department of Nutritional Science & Food Management, Ewha Womans University, Seoul 03760, Korea
- Department of Nutritional Science & Food Management, Graduate Program in System Health Science & Engineering, Ewha Womans University, Seoul 03760, Korea
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Seo-Jin Chung
- Department of Nutritional Science & Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Hyekyeong Kim
- Department of Health Convergence, Ewha Womans University, Seoul 03760, Korea
| | - Nana Shin
- Department of Child Development & Intervention, Ewha Womans University, Seoul 03760, Korea
| | - Yuri Kim
- Department of Nutritional Science & Food Management, Ewha Womans University, Seoul 03760, Korea
- Department of Nutritional Science & Food Management, Graduate Program in System Health Science & Engineering, Ewha Womans University, Seoul 03760, Korea
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Artymiak P, Żegleń M, Kowal M, Woronkowicz A, Kryst Ł. Changes in the prevalence of underweight, overweight, obesity and excessive adiposity among adolescents from Kraków (Poland) in the years 1983-2020. Am J Hum Biol 2023; 35:e23866. [PMID: 36695477 DOI: 10.1002/ajhb.23866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Improved living conditions affect lifestyles and may contribute to the increased prevalence of overweight and obesity among adolescents. The aim of the study was to analyze changes in the prevalence of underweight, overweight, obesity as well as excessive adiposity among teenagers from Kraków (Poland). METHODS The study was conducted in four series in the years: 1983, 2000, 2010, and 2020. The study group included 1759 boys and 1699 girls aged 16-18 years. body mass index (BMI) was calculated on the basis of body height and weight. Adiposity was measured by bioimpedance method. Participants were grouped according to BMI categories using Cole's cut-off points and according to adiposity based on mean and standard deviations values. The significance of the differences between cohorts was assessed by the Chi-square test. RESULTS Secular increase in the prevalence of underweight and overweight was observed among girls in most age groups. An increase in the prevalence of high body fat was also observed among 16- and 17-year-old girls - the opposite trend was noted in 18-year-old girls. Contemporary boys had an increased prevalence of overweight and obesity in each age group. CONCLUSION There was a significant increase in the prevalence of body weight abnormalities in the study population. The observed results may be related to socio-economic changes that adversely affect the lifestyle of the society. The results are also important in terms of the health of future generations and may be helpful in the development of new prevention and intervention programs.
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Affiliation(s)
- Paulina Artymiak
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
| | - Magdalena Żegleń
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
| | - Agnieszka Woronkowicz
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
| | - Łukasz Kryst
- Department of Anthropology, Faculty of Physical Education and Sport, University of Physical Education, Kraków, Poland
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Nandi N, Charles D, Rivell A, Gore J, Kay C, Gazmararian JA. Examining the Relationship Between Health Behaviors of Adults and Preschool Children. Matern Child Health J 2023:10.1007/s10995-023-03665-w. [PMID: 37191740 DOI: 10.1007/s10995-023-03665-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Children aged two to five years old are influenced by the behaviors of their guardians and Early Care Education (ECE) teachers. This study aims to determine the relationship between adults' and children's health behaviors in home and ECE settings. This study is novel in examining this correlation between multiple environments. METHOD Surveys were conducted across 32 ECE centers. Guardians and teachers reported on their and their children's health behaviors within the home and ECE. Matched child-adult responses (n = 1,140) were analyzed from a representative sample of 32 ECE centers throughout Georgia. Frequency of consumption of fruits, vegetables, and water, as well as frequency of physical activity were measured. Spearman rho correlations were analyzed using SPSS software, with p < 0.05 indicating significance. RESULTS Spearman rho correlations indicated significant positive correlations between guardian and child behavior (rho = 0.49 to 0.70, p < 0.001) for all data. Teacher and child correlations were inconsistently significant across categories (rho = -0.11 to 0.17, p < 0.001). DISCUSSION The influence of guardian behavior modeling on child health outcomes is critical for improving ECE programming and child obesity outcomes. This research can be used to inform future health interventions for young children.
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Affiliation(s)
- Nina Nandi
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dannelle Charles
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30033, USA
| | - Aileen Rivell
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Janelle Gore
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Julie A Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30033, USA.
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Angolile CM, Max BL, Mushemba J, Mashauri HL. Global increased cesarean section rates and public health implications: A call to action. Health Sci Rep 2023; 6:e1274. [PMID: 37216058 PMCID: PMC10196217 DOI: 10.1002/hsr2.1274] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
Over the years; global caesarian section (CS) rates have significantly increased from around 7% in 1990 to 21% today surpassing the ideal acceptable CS rate which is around 10%-15% according to the WHO. However, currently, not all CS are done for medical reasons with rapidly increasing rate of nonmedically indicated CS and the so-called "caesarian on maternal request." These trends are projected to continue increasing over this current decade where both unmet needs and overuse are expected to coexist with the projected global rate of 29% by 2030. CS reduces both maternal and neonatal morbidity and mortality significantly when it is done under proper indications while at the same time, it can be of harm to the mother and the child when performed contrary. The later exposes both the mother and the baby to a number of unnecessary short and long-term complications and increase the chances of developing different noncommunicable diseases and immune-related conditions among babies later in life. The implications of lowering SC rate will ultimately lower healthcare expenditures. This challenge can be addressed by several ways including provision of intensive public health education regarding public health implications of increased CS rate. Assisted vaginal delivery approaches like the use of vacuum and forceps and other methods should be considered and encouraged during delivery as long as their indications for implementation are met. Conducting frequent external review and audits to the health facilities and providing feedback regarding the rates of CS deliveries can help to keep in check the rising CS trends as well as identifying the settings with unmet surgical needs. Moreover, the public especially expectant mothers during clinic visits and clinicians should be educated and be informed on the WHO recommendations on nonclinical interventions towards reduction of unnecessary CS procedures.
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Affiliation(s)
- Cornel M. Angolile
- Department of Epidemiology and Biostatistics, Institute of Public HealthKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of Community Medicine, Institute of Public HealthKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of Obstetrics and GynaecologyKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Baraka L. Max
- Department of Epidemiology and Biostatistics, Institute of Public HealthKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Justice Mushemba
- Department of Epidemiology and Biostatistics, Institute of Public HealthKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of Community Medicine, Institute of Public HealthKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of Obstetrics and GynaecologyKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Harold L. Mashauri
- Department of Epidemiology and Biostatistics, Institute of Public HealthKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of Community Medicine, Institute of Public HealthKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of General SurgeryKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of Obstetrics and GynaecologyKilimanjaro Christian Medical University CollegeMoshiTanzania
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D’Agata MN, Matias AA, Witman MA. We like to move it, move it: A perspective on performing passive leg movement as a non-invasive assessment of vascular function in pediatric populations. Front Physiol 2023; 14:1165800. [PMID: 37179828 PMCID: PMC10169695 DOI: 10.3389/fphys.2023.1165800] [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: 02/14/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
The passive leg movement (PLM) technique is a non-invasive assessment of lower-limb vascular function. PLM is methodologically simple to perform and utilizes Doppler ultrasound to determine leg blood flow (LBF) through the common femoral artery at rest and in response to passive movement of the lower leg. LBF responses to PLM have been reported to be mostly nitric oxide (NO)-mediated when performed in young adults. Moreover, PLM-induced LBF responses, as well as the NO contribution to PLM-induced LBF responses, are reduced with age and in various diseased populations, demonstrating the clinical utility of this non-invasive test. However, no PLM studies to date have included children or adolescents. Since its conception in 2015, our laboratory has performed PLM on hundreds of individuals including a large cohort of children and adolescents. Thus, the purpose of this perspective article is threefold: 1) to uniquely discuss the feasibility of performing PLM in children and adolescents, 2) to report PLM-induced LBF values from our laboratory in 7-17-year-olds, and 3) to discuss considerations for making comparisons among pediatric populations. Based on our experiences performing PLM in children and adolescents (among various other age groups), it is our perspective that PLM can feasibly be performed in this population. Further, data from our laboratory may be used to provide context for typical PLM-induced LBF values that could be observed in children and adolescents, as well as across the lifespan.
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Affiliation(s)
| | | | - Melissa A. Witman
- Vascular Function in Chronic Disease Research Laboratory, Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
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19
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Parental mindful eating practices and mindful eating interventions are associated with child emotional eating. Nutr Res 2023; 111:34-43. [PMID: 36822078 DOI: 10.1016/j.nutres.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/18/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
The family environment, which involves parent eating behaviors and feeding practices, influences child intake and eating behaviors. Specifically, parental emotional eating or emotional feeding practices may lead to emotional eating in the child. Mindful eating practices may decrease emotional eating behaviors. The purpose of this narrative review was to investigate the influence of parental mindful eating on emotional eating behaviors of their children or adolescents. A secondary purpose of this review was to determine whether a family-based or child mindful eating intervention improves child emotional eating directly or through the improvements of the parent and parental role modeling. EBSCOhost was used to simultaneously search 5 databases. The search was limited to full-text, peer-reviewed articles in the English language. Seven studies, 4 cross-sectional studies and 3 intervention studies, were identified. Across studies, measures of mindful and emotional eating differed. Among the cross-sectional studies, parental mindful eating/feeding or mindful parenting were either directly or indirectly related to decreased emotional eating in the child or adolescent. The effect was unclear among the intervention studies; however, these were pilot feasibility studies. Overall, parental mindful eating is associated with emotional eating behaviors among children and adolescents. Additional studies with a randomized controlled design are needed to evaluate parent mindful eating interventions on child and adolescent eating behaviors. Additionally, future trials need to use similar validated measures to ensure consistent quality data collection and allow for comparison of findings across studies.
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Khanijahani A, Pawcio S. Household food insecurity and childhood obesity/overweight among children with special healthcare needs: Results from a nationally representative sample of 10-17 years old U.S. children. Pediatr Obes 2023; 18:e13015. [PMID: 36825692 DOI: 10.1111/ijpo.13015] [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: 05/17/2022] [Revised: 12/17/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Food insecurity is linked to an increased risk of childhood obesity and other adverse health issues. OBJECTIVES To examine the disproportionate impact of food insecurity on childhood obesity among children with special healthcare needs (CSHCN). METHODS In this cross-sectional study, we pooled data from 4 years (2016 to 2019) of the National Survey of Children's Health (NSCH) for a nationally representative sample of 10 to 17 years old noninstitutionalized U.S. children (N = 68 942). Using logistic regression models, we examined the odds of childhood obesity or overweight by including an interaction between family food situation and CSHCN status. RESULTS Among 10-17 years old U.S. children, 31% (95% confidence interval [CI]: 30.1%-31.9%) had obesity or overweight, 24.1% had special healthcare needs, 27.2% were from families with food insecurity, and 6.4% were from families with food insufficiency. CSHCN were more likely to be impacted by obesity or overweight than non-CSHCN (Odds Ratio [OR] = 1.29, 95% CI = 1.18-1.141). Moreover, children living in food insecurity (OR = 1.75, 95% CI = 1.52-1.92) and food insufficiency (OR = 2, 95% CI = 1.67-2.4) were more likely than those living in food-secure families to be impacted by obesity or overweight. CSHCN living in food insecurity were significantly more likely to be impacted by obesity or overweight than non-CSHCN in similar households. CONCLUSIONS It appears that food insecurity can put CSHCN at disproportionately greater risk of obesity or overweight than non-CSHCN. The findings underscore considering CSHCN status in conjunction with household food insecurity in designing and implementing medical interventions or public policies targeted at childhood obesity or overweight.
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Affiliation(s)
- Ahmad Khanijahani
- John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Sheridyn Pawcio
- John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA
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21
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King KP, Keller CV, Evans CT, Murdaugh DL, Gower BA, Gowey MA. Inflammation, Executive Function, and Adiposity in Children With or at Risk for Obesity: A Pilot Study. J Pediatr Psychol 2023; 48:134-143. [PMID: 36111823 PMCID: PMC10167924 DOI: 10.1093/jpepsy/jsac071] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Obesity is associated with executive function (EF) deficits across the lifespan. Higher body mass index (BMI), obesity severity, and poorer adherence and weight outcomes in obesity treatment have all been associated with EF deficits. Adult literature has begun to emphasize neuroinflammation in obesity as a possible pathway to later cognitive impairment in EF. However, pediatric obesity literature has yet to establish associations between peripheral inflammation and EF. Thus, the present study examined associations and variability in inflammation, EF, and adiposity in children with or at risk for obesity. Additionally, inflammation was examined as a mediator of the relationship between adiposity and EF. METHODS Children (N = 39) aged 8-12 years with BMI ≥ 50th percentile were recruited. The NIH Toolbox Cognitive Battery was used to assess performance-based EF. Peripheral inflammation was assessed in fasted sera. Dual-energy X-ray absorptiometry scans were conducted to assess body composition. Linear regression and Hayes' PROCESS Model 4 (Hayes, 2017) were used to evaluate associations between adiposity and inflammation, inflammation and EF, and whether adiposity effects EF through its effect on inflammation. RESULTS Positive associations were identified between adiposity and inflammation, and negative to null associations were identified between inflammation and EF. Medium indirect effects of adiposity on EF through inflammation were detected. CONCLUSION Pilot evidence suggests greater adiposity is linked with greater inflammation, which in turn is associated with less EF in some domains. Directionality and causality cannot yet be established, but with replication, findings may inform efforts to target EF in pediatric obesity.
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Affiliation(s)
- Kathryn P King
- Department of Psychology, University of Alabama at Birmingham, USA
| | | | - Corinne T Evans
- Department of Psychology, University of Alabama at Birmingham, USA
| | - Donna L Murdaugh
- Department of Pediatrics, University of Alabama at Birmingham, USA
| | - Barbara A Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, USA
| | - Marissa A Gowey
- Department of Pediatrics, University of Alabama at Birmingham, USA
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22
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Lourenço LP, Viola PCDAF, Franceschini SDCC, Rosa CDOB, Ribeiro SAV. Metabolic syndrome and risk factors in children: a risk score proposal. Eur J Clin Nutr 2023; 77:278-282. [PMID: 36203009 DOI: 10.1038/s41430-022-01217-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/04/2022] [Accepted: 09/08/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION/OBJECTIVE The lack of international consensus on the definition of Metabolic Syndrome (MS) in the pediatric population makes it difficult to estimate its prevalence. In this study, we intend to identify MS prevalence and a cutoff point based on a continuous score in children aged four to seven years. METHODS A cross-sectional study of 402 children (4-7 years) monitored by the Lactation Support Program (PROLAC). A continuous MS risk score was assessed using Principal Component Analysis (PCA). In order to calculate the score, the following MS risk factors were considered: Waist circumference (WC), High Density Lipoprotein (HDL), Triglycerides (TG), Blood Pressure (BP) and Blood sugar. Using a Receiver Operating Characteristics (ROC) curve, the cutoff point for predicting MS risk based on continuous score was evaluated. RESULTS A progressive increase in MS scores was observed according to increase in the number of risk factors. This increase was also observed when comparing boys and girls (p < 0.001). In the absence of MS, the median score among the children was -0.0486 (-0.2929-0.2151). For children with MS, the median score was 0.5237 (0.2286-0.7104) (p < 0.001). The best cutoff score for predicting MS in children aged four to five years was >0.09 (100% sensitivity and specificity 72.67%). For children aged six to seven years, this value was >0.14 (100% sensitivity and 64.65% specificity). CONCLUSION The calculated continuous risk score can predict MS with good accuracy and high sensitivity and reasonable specificity.
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Affiliation(s)
- Larissa Pereira Lourenço
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Viçosa, Minas Gerais, Brazil.
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23
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Cornejo-Estrada A, Nieto-Rodríguez C, León-Figueroa DA, Moreno-Ramos E, Cabanillas-Ramirez C, Barboza JJ. Efficacy of Liraglutide in Obesity in Children and Adolescents: Systematic Review and Meta-Analysis of Randomized Controlled Trials. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020208. [PMID: 36832337 PMCID: PMC10010327 DOI: 10.3390/children10020208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/10/2022] [Accepted: 12/25/2022] [Indexed: 01/27/2023]
Abstract
In the past few decades, childhood obesity has become a significant global health issue, impacting around 107.7 million children and adolescents globally. There is currently minimal usage of pharmacological therapies for childhood obesity in the pediatric population. This research assessed the efficacy of liraglutide in treating childhood and adolescent obesity. Until 20 October 2022, a systematic literature review was done utilizing PubMed, Scopus, Web of Science, and Embase databases. The search phrases "liraglutide", "pediatric obesity", "children", and "adolescents" were utilized. Using the search method, a total of 185 articles were found. Three studies demonstrating liraglutide's effectiveness in treating child and adolescent obesity were included. The selected research was done in the United States. As an intervention, liraglutide was administered to 296 participants at a maximal dosage of 3.0 mg. All examined trials were in phase 3. This comprehensive analysis revealed no clinically significant differences between liraglutide and body weight (kg; MD -2.62; 95%CI -6.35 to 1.12; p = 0.17) and body mass index (kg/m2; MD -0.80; 95%CI -2.33 to 0.73, p = 0.31). There was no evidence that liraglutide increased hypoglycemia episodes (RR 1.08; 95%CI 0.37 to 3.15; p = 0.79), or side consequences. However, it was shown that the medicine might help reduce BMI and weight combined with a healthy diet and regular exercise. A lifestyle change may have favorable consequences that will be assessed in the future for adjunctive therapy. PROSPERO database (CRD42022347472).
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Affiliation(s)
- Alejandra Cornejo-Estrada
- School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima 15067, Peru; (A.C.-E.); (C.N.-R.); (C.C.-R.)
| | - Carlos Nieto-Rodríguez
- School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima 15067, Peru; (A.C.-E.); (C.N.-R.); (C.C.-R.)
| | - Darwin A. León-Figueroa
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo 15011, Peru;
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13007, Peru;
| | - Emilly Moreno-Ramos
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13007, Peru;
- Vicerrectorado de Investigacion, Universidad San Ignacio de Loyola, Lima 15046, Peru
| | - Cielo Cabanillas-Ramirez
- School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima 15067, Peru; (A.C.-E.); (C.N.-R.); (C.C.-R.)
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13007, Peru;
| | - Joshuan J. Barboza
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13007, Peru;
- Vicerrectorado de Investigacion, Universidad San Ignacio de Loyola, Lima 15046, Peru
- Correspondence: ; Tel.: +51-992108520
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Mondal PK, Foysal KH, Norman BA, Gittner LS. Predicting Childhood Obesity Based on Single and Multiple Well-Child Visit Data Using Machine Learning Classifiers. SENSORS (BASEL, SWITZERLAND) 2023; 23:759. [PMID: 36679555 PMCID: PMC9865403 DOI: 10.3390/s23020759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Childhood obesity is a public health concern in the United States. Consequences of childhood obesity include metabolic disease and heart, lung, kidney, and other health-related comorbidities. Therefore, the early determination of obesity risk is needed and predicting the trend of a child's body mass index (BMI) at an early age is crucial. Early identification of obesity can lead to early prevention. Multiple methods have been tested and evaluated to assess obesity trends in children. Available growth charts help determine a child's current obesity level but do not predict future obesity risk. The present methods of predicting obesity include regression analysis and machine learning-based classifications and risk factor (threshold)-based categorizations based on specific criteria. All the present techniques, especially current machine learning-based methods, require longitudinal data and information on a large number of variables related to a child's growth (e.g., socioeconomic, family-related factors) in order to predict future obesity-risk. In this paper, we propose three different techniques for three different scenarios to predict childhood obesity based on machine learning approaches and apply them to real data. Our proposed methods predict obesity for children at five years of age using the following three data sets: (1) a single well-child visit, (2) multiple well-child visits under the age of two, and (3) multiple random well-child visits under the age of five. Our models are especially important for situations where only the current patient information is available rather than having multiple data points from regular spaced well-child visits. Our models predict obesity using basic information such as birth BMI, gestational age, BMI measures from well-child visits, and gender. Our models can predict a child's obesity category (normal, overweight, or obese) at five years of age with an accuracy of 89%, 77%, and 89%, for the three application scenarios, respectively. Therefore, our proposed models can assist healthcare professionals by acting as a decision support tool to aid in predicting childhood obesity early in order to reduce obesity-related complications, and in turn, improve healthcare.
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Affiliation(s)
- Pritom Kumar Mondal
- Department of Industrial, Manufacturing & Systems Engineering, Texas Tech University, Lubbock, TX 79409, USA
| | - Kamrul H. Foysal
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, TX 79409, USA
| | - Bryan A. Norman
- Department of Industrial, Manufacturing & Systems Engineering, Texas Tech University, Lubbock, TX 79409, USA
| | - Lisaann S. Gittner
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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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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Pereyra González I, Farías-Antúnez S, Buffarini R, Gómez Ayora A, Fletcher AM, Rodrigues Domingues M, Freitas da Silveira M, Ferreira Umpiérrez AH. Ultra-processed food consumption and the incidence of obesity in two cohorts of Latin-American young children: A longitudinal study. J Pediatr Nurs 2023; 69:e120-e126. [PMID: 36604255 DOI: 10.1016/j.pedn.2022.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/03/2022] [Accepted: 12/19/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE We evaluated the potential associations between the consumption of ultra-processed food (UPF) and the incidence of obesity among Uruguayan and Brazilian preschoolers. DESIGN AND METHODS We conducted a longitudinal analysis using data from preschool children from Uruguay and Brazil. The "Health, child development and nutritional survey" (ENDIS) was conducted in Uruguay in 2013-2014 and 2015-2016. The Brazilian survey (Pelotas 2015 Birth Cohort) has measures from 2017 and 2019. The main outcome measure was obesity defined as body mass index (BMI) for age and sex ≥ +3 z-scores. The score of UPF consumption was the main exposure measured. Multilevel crude and adjusted Poisson regressions were performed to estimate risk ratios and the respective 95% Confidence Intervals (95% CI). RESULTS The overall incidence of obesity in this group of young Latin-American children with a mean age of 48 months was 4.1%. We observed a relationship between UPF and obesity with statistical significance (RR: 1.10 (95% CI, 1.02-1.18). Adjustment for weight at birth, age, sex, breastfeeding, country, and time between waves resulted in a similar relationship but lack of statistical significance. CONCLUSIONS Whilst in this study we did not find strong evidence of an association between the incidence of obesity and the intake at baseline and currently of UPF, results suggest that higher UPF consumption is more favorable than reduced consumption for the development of obesity. PRACTICE IMPLICATIONS The present study reinforces the importance of nutrition education and more effective public policies for promoting healthier food choices in early childhood.
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Affiliation(s)
- Isabel Pereyra González
- Faculty of Health Sciences, Catholic University of Uruguay, Uruguay; Faculty of Health Sciences, Catholic University of Maule, Chile.
| | | | - Romina Buffarini
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Andrea Gómez Ayora
- Faculty of Medicine, Center for Interdisciplinary Ethnography - Kaleidos, University of Cuenca, Ecuador
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Risk Factors, Clinical Consequences, Prevention, and Treatment of Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121975. [PMID: 36553418 PMCID: PMC9776766 DOI: 10.3390/children9121975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/03/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Obesity might adversely affect the health and well-being of children and their families. Childhood obesity has crucial implications for health, both during childhood and as they age. It is highly associated with many acute problems and is commonly present during childhood, making visits and hospital admissions polarized in this group of children. The problems that may affect these children can be medical, such as asthma, chronic inflammation, orthopedic abnormalities, liver disease, diabetes mellitus or dyslipidemia. Long-term consequences of cardiovascular risk factors, the persistence of obesity and premature mortality are common among adults who had obesity during their early lives. Additionally, they could also suffer from psychological issues, such as low self-esteem, which puts them at risk of a much more serious psychosocial problem that may lead to depression, as well as a disruption in educational achievements and social relationships. A healthy diet, physical activity, adequate sleep, and limited screen time are all preventive measures that should be implemented at the family and community levels, preferably through well-structured programs. Furthermore, pharmacological management of childhood obesity is limited and only used after non-pharmacological interventions have failed or in the late stages of obesity. However, recent guidelines advocate the early use of medical interventions. Approved pharmacotherapeutic options include orlistat, phentermine/topiramate combination and liraglutide. There are several other options approved primarily for other specific forms of obesity or for other indications, including setmelanotide, metformin, lisdexamfetamine, zonisamide and fluoxetine. Bariatric surgery is a safe and effective option in cases with extreme obesity and comorbidities considering the need for long-term monitoring and support for cases and their families post-surgery. This review aims to discuss and highlight the recent evidence regarding risk factors, clinical consequences, prevention, and treatment of childhood obesity.
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Mannino A, Sarapis K, Moschonis G. The Effect of Maternal Overweight and Obesity Pre-Pregnancy and During Childhood in the Development of Obesity in Children and Adolescents: A Systematic Literature Review. Nutrients 2022; 14:nu14235125. [PMID: 36501155 PMCID: PMC9739272 DOI: 10.3390/nu14235125] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/21/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022] Open
Abstract
Maternal overweight/obesity has been associated with an increased risk of obesity in childhood. We investigated the effect of maternal overweight/obesity during pre-pregnancy and whether it is a stronger predictor of child obesity, compared to maternal overweight/obesity during childhood. Prospective or retrospective cohort studies published in English, reporting on obese children and adolescents (2-18 years), with overweight/obese mothers in either pre-pregnancy or during childhood were included. A search was conducted from 2012 to April 2022 in MEDLINE, Web of Science, CINAHL, and EMBASE, followed by screening, data extraction, quality assessment and narrative synthesis. Eleven eligible studies (9 prospective and 2 retrospective cohort studies; total sample, n = 27,505) were identified. Eight studies examined maternal overweight/obesity in pre-conception, presenting consistent positive associations with childhood obesity, three reported positive associations between childhood obesity and maternal overweight/obesity during childhood, and one presented positive associations between both maternal exposures. The narrative synthesis failed to identify which maternal exposure is the strongest predictor of childhood obesity, with studies reporting significant associations between maternal overweight/obesity and child obesity in both time points. Intervention programs aiming to reduce childhood obesity should focus on supporting women of childbearing age with weight management from preconception and throughout their life-course.
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Chen Y, Cai C, Tan J, Lei X, Chen Q, Zhang J, Zhang Y. High-risk Growth Trajectory Related to Childhood Overweight/Obesity and Its Predictive Model at Birth. J Clin Endocrinol Metab 2022; 107:e4015-e4026. [PMID: 35862057 DOI: 10.1210/clinem/dgac441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Childhood obesity increases the risk of chronic disease in adulthood. OBJECTIVE To construct an early predictive model for a growth trajectory that is highly related to childhood overweight/obesity. DESIGN Prospective cohort study. SETTINGS Shanghai Birth Cohort (SBC) and US Collaborative Perinatal Project (CPP). PARTICIPANTS A total of 848 mother-child pairs in the SBC (2013-2016) and 22 691 pairs in the CPP (1959-1965) with 2- and 7-year follow-up, respectively. MAIN OUTCOME MEASURES A high-risk postnatal growth trajectory intimately associated with childhood overweight/obesity and its predictive model. RESULTS We demonstrated that the shifts of postnatal body mass index (BMI) percentile had been completed around 1 year of age and identified a high-risk growth trajectory that was closely related to overweight/obesity [odds ratio 6.5 (95% CI 5.9, 7.2)] at 7 years old. Children with this trajectory presented with a consistent BMI around the 85th percentile after the age of 1 year. It could be recognized early after birth using a predictive model with 4 metabolites (tyrosine, glycine, octenoylcarnitine, and stearoylcarnitine), combined with sex, birth weight, and maternal prepregnancy BMI. The model had an area under the receiver operating characteristic curve of 0.869 (95% CI 0.779, 0.932), a sensitivity of 83.3% (95% CI 51.6%, 97.9%), and a specificity of 81.1% (95% CI 70.3%, 89.3%) in the validation data set. CONCLUSION Children with postnatal high-risk growth trajectories were significantly associated with subsequent overweight/obesity at 7 years old. Metabolite profiles at birth combined with clinical measures were able to predict at-risk children before overweight/obesity occurrence.
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Affiliation(s)
- Yan Chen
- Department of Neonatology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chen Cai
- Department of Neonatology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jintong Tan
- Department of Neonatology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoping Lei
- Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, Shanghai, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, Shanghai, China
| | - Yongjun Zhang
- Department of Neonatology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Koivusilta L, Alanne S, Kamila M, Ståhl T. A qualitative study on multisector activities to prevent childhood obesity in the municipality of Seinäjoki, Finland. BMC Public Health 2022; 22:1298. [PMID: 35794541 PMCID: PMC9258052 DOI: 10.1186/s12889-022-13658-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/16/2022] [Indexed: 11/26/2022] Open
Abstract
Background Multisector activities are needed to prevent childhood obesity due to its multifactorial background. The first aim was to identify the activities that had been undertaken for obesity prevention and deduce their main targets. Second, we analyzed the public health policy approaches (upstream, midstream, and downstream) which were followed. Finally, we studied the perception of interviewees regarding their sectors’ roles in implementing the local obesity program. Methods Deductive content analysis was used to analyze semi-structured interviews with 34 key professionals (from seven administrative sectors) who had participated in multisector health promotion during 2009–2016 and five representatives of other core parties. Results Several midstream and upstream activities were targeted at making physical activity (PA) and healthy eating (HE) integral parts of children’s lifestyle. One long-term strategy was to create environments for PA accessible to every inhabitant and build and renovate the interiors and yards of schools and day-care centers. The healthiness of meals was increased progressively. In addition to midstream and upstream activities, as a downstream activity, an intervention targeting children at risk of obesity was implemented. The impact of management on the activities was considerable; childhood obesity prevention was included in the city strategy and systematically coordinated at the highest managerial level. Altogether, various sectors operated efficiently to promote obesity-preventing lifestyles; however, not all (important) sectors recognized their role in the multisector process. Conclusion Most of the activities to guide children towards obesity-preventing lifestyles were either at the midstream or upstream level. Among the latter, considerable work is aimed at creating opportunities to practice PA and making it a natural part of the daily life. The aim of familiarizing children with lifestyles that include PA and HE was shared across sectors, including sectors that had not yet acknowledged their role in obesity prevention. Strong support from city management and systematic coordination of the activity are important factors that contribute to the engagement of several administrative sectors in working towards a shared aim, such as the prevention of childhood obesity.
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Tran DMT, Silvestri-Elmore A, Sojobi A. Lifestyle Choices and Risk of Developing Cardiovascular Disease in College Students. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2022; 15:808-819. [PMID: 35992186 PMCID: PMC9362881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The purpose of the study was to examine and evaluate the cardiovascular risk factors in college students including their nutritional and social choices and how those choices related to their cardiovascular health. A descriptive, cross-sectional study of 148 college students, obtaining their blood pressure, body mass index, fasting lipid panel, fasting glucose, hemoglobin A1c, serum cotinine levels, physical activity, alcohol consumption, and dietary habits. A high prevalence of cardiovascular disease risk factors was found: 23.8% were current or past smokers with more male than female smokers (p = .009); 65.5% consumed alcoholic beverages; 13.5% had elevated blood pressure; 25.7% had hypertension stage I; 3.4% had hypertension stage II; 36.5% were overweight while 19.9% were obese; 14.2% had prediabetes and 2% had diabetes; and 40.5% had borderline high cholesterol levels while 3.4% had hyperlipidemia. Elevated blood pressure and hypertension were most prevalent between the ages of 18 and 23 years and among males (p = .001). The top three risk factor co-occurrences were overweight and drinking alcohol (33.78%), followed by family history of heart disease and drinks alcohol (27.70%), and overweight and history of heart disease (25.68%). Of the 148 participants, 108 of them had at least two cardiovascular risk factors. The results of this study indicate that college students participate in risky behaviors that predispose them to develop CVD in the future.
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Affiliation(s)
- Dieu-My T Tran
- School of Nursing, University of Nevada-Las Vegas, Las Vegas, NV, USA
| | | | - Angela Sojobi
- School of Nursing, University of Nevada-Las Vegas, Las Vegas, NV, USA
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Odusanya AO, Reid KS, Amutah-Onukagha N, Robinson K, Kalu OU, Lawrence WR, Lin Z. Association between sociodemographic characteristics and age stopped breastfeeding on early childhood weight status. Obes Res Clin Pract 2022; 16:214-219. [PMID: 35550119 DOI: 10.1016/j.orcp.2022.05.001] [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: 10/29/2021] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Epidemiological studies have suggested that breastfeeding is associated with child weight status. However, the length of breastfeeding in relation to child weight remains poorly understood. Therefore, this study investigated the association between age stopped breastfeeding and child weight status by sociodemographic characteristics. METHODS This cross-sectional analysis utilized a nationally representative sample of 3248 U.S. children ages 2-6 years from 2009 to 2018, from parents interviewed as part of the National Health and Nutrition Examination Survey. Child body weight and height were measured during physical examination. Information on age stopped breastfeeding and other demographic characteristics were assessed using questionnaires. Multivariable logistic regression models were performed to examine the association between age stopped breastfeeding and child weight status, adjusting for potential confounders. RESULTS Children breastfed for ≤ 11 months had an increased odds of being overweight and obese with the strongest association observed among those classified as obese (OR=2.12; 95%CI 1.23, 3.64) compared with children breastfed for > 11-24 months. The association between breastfeeding and child weight status was observed by racial/ethnic groups. Non-Hispanic white and Black children breastfed for ≤ 11 months had an associated increased likelihood of being overweight than their counterparts breastfed for > 11-24 months. Among Hispanic children, we observed elevated odds of being obese when breastfed for ≤ 11 months (OR=1.98; 95%CI 1.00, 3.91) than those breastfed for > 11-24 months. CONCLUSION Child weight status was associated with age stopped breastfeeding, where likelihood of being overweight and obese were greatest among children breastfed for ≤ 11 months.
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Affiliation(s)
- Anne O Odusanya
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Kaydian S Reid
- Department of Nutrition and Public Health, University of Saint Joseph, West Hartford, CT, USA
| | - Ndidiamaka Amutah-Onukagha
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | | | - Ola U Kalu
- Department of Sociology, College of Arts & Sciences, State University of New York at Albany, Albany, NY, USA
| | - Wayne R Lawrence
- Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Albany, NY, USA
| | - Ziqiang Lin
- Department of Psychiatry, New York University Langone Health School of Medicine, New York, NY, USA.
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Richardson AS, Weden MM, Cabreros I, Datar A. Association of the Healthy, Hunger-Free Kids Act of 2010 With Body Mass Trajectories of Children in Low-Income Families. JAMA Netw Open 2022; 5:e2210480. [PMID: 35511177 PMCID: PMC9073566 DOI: 10.1001/jamanetworkopen.2022.10480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/18/2022] [Indexed: 01/13/2023] Open
Abstract
Importance Implemented in 2012, the Healthy, Hunger-Free Kids Act of 2010 (HHFKA) increased nutritional requirements of the National School Lunch Program (NSLP) to reverse the potential role of the NSLP in childhood obesity. Objective To evaluate whether associations between the free or reduced-price NSLP and body mass growth differed after implementation of the HHFKA. Design, Setting, and Participants This cohort study used data from 2 nationally representative cohorts of US kindergarteners sampled in 1998 to 1999 and 2010 to 2011 and followed up for 6 years, through grade 5, in the Early Childhood Longitudinal Study Kindergarten Class of 1998-1999 (ECLS-K:1999, in 2003-2004) and Kindergarten Class of 2010-2011 (ECLS-K:2011, in 2015-2016). In total, 5958 children were selected for analysis from low-income families eligible for the free or reduced-price NSLP (household income <185% of the federal poverty level) who attended public schools and had no missing data on free or reduced-price NSLP participation or on body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) at kindergarten or grades 1 and 5. Data were analyzed from January 1 to September 7, 2021. Exposures Cross-cohort comparison of before vs after implementation of the HHFKA for free or reduced-price NSLP participation at kindergarten and grades 1 and 5. Main Outcomes and Measures Body mass index difference (BMID) from obesity threshold was the difference in BMI units from the age- and sex-specific obesity thresholds (95th percentile) and is sensitive to change at high BMI. Multigroup models by cohort included weights to balance the distribution of the 2 cohorts across a wide range of covariates. A Wald test was used to assess whether associations differed between the cohorts. Results In the final analysis, 3388 children in ECLS-K:1999 (1696 girls [50.1%]; mean [SD] age at baseline, 74.6 [4.3] months) and 2570 children in ECLS-K:2011 (1348 males [52.5%]; mean [SD] age at baseline, 73.6 [4.2] months) were included. The best fitting model for BMID change by free or reduced-price NSLP participation across the cohorts included fixed and time-varying associations. Before HHFKA implementation, grade 5 free or reduced-price NSLP participants had higher BMID, adjusted for their prior BMID trajectory, than nonparticipants (β = 0.54; 95% CI, 0.27-0.81). After HHFKA implementation, this association was attenuated (β = -0.07; 95% CI, -0.58 to 0.45), and grade 5 associations were different across cohorts (χ21 = 4.29, P = .04). Conclusions and Relevance In this cohort study using cross-cohort comparisons, children from low-income families who participated in the free or reduced-price NSLP had a higher likelihood of progression to high BMI that was no longer observed after HHFKA implementation. This finding suggests that the HHFKA may have attenuated the previous association of the NSLP with child obesity disparities.
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Affiliation(s)
- Andrea S. Richardson
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, Pennsylvania
| | - Margaret M. Weden
- Department of Economics, Sociology, and Statistics, RAND Corporation, Santa Monica, California
| | - Irineo Cabreros
- Department of Economics, Sociology, and Statistics, RAND Corporation, Boston, Massachusetts
| | - Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, Los Angeles
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Cancelier ACL, Schuelter-Trevisol F, Trevisol DJ, Atkinson RL. Adenovirus 36 infection and obesity risk: current understanding and future therapeutic strategies. Expert Rev Endocrinol Metab 2022; 17:143-152. [PMID: 35255768 DOI: 10.1080/17446651.2022.2044303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Obesity, a multifactorial disease caused by the interaction between genetic characteristics, metabolism, lifestyle, and environmental factors, is a major global health problem and is currently defined as a pandemic phenomenon. This disease is determined by an interaction of several factors, but the imbalance between energy consumption and expenditure seems to be the crucial point. In some cases, there is no linearity between exposure to those factors that cause the onset of obesity. A striking example of the occurrence of obesity despite no obvious risk factors is that of obesity induced by viral infections. The most important of such viruses appears to be human adenovirus 36 (Adv36). AREAS COVERED This review covers the relation between obesity and infection by Adv36 in humans. Also, discussed are the opportunities of prevention or treatment for the effects of Adv36 in human body. EXPERT OPINION The role of Ad36 in the development of obesity has already been established. Future research should focus on the development of vaccines against this agent, drug discovery for infected individuals, and effective therapeutic uses of E4orf1 gene protein for diabetes and other diseases in clinical practice.
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Affiliation(s)
| | | | - Daisson José Trevisol
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Brazil
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Jochum F, Abdellatif M, Adel A, Alhammadi A, Alnemri A, Alohali E, AlSarraf K, Al Said K, Elzalabany M, Isa HMA, Kalyanasundaram S, Reheim NA, Saadah O. Burden of Early Life Obesity and Its Relationship with Protein Intake in Infancy: The Middle East Expert Consensus. Pediatr Gastroenterol Hepatol Nutr 2022; 25:93-108. [PMID: 35360379 PMCID: PMC8958054 DOI: 10.5223/pghn.2022.25.2.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 12/13/2021] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
Adequate nutrition in early life is proposed to shape a child's future health by launching the growth trajectory in the proper direction, which helps to avoid negative metabolic programming effects. Protein intake during infancy and early childhood is of great importance, as it plays a key role in infant metabolic programming and the future risk of obesity. Breastfeeding provides the best nutrition in early life, with many benefits tailored for the baby, including the appropriate quantity and quality of proteins. Considering the high prevalence of childhood, and subsequent adult, obesity in the region, a virtual Middle East expert consensus meeting was held to discuss an effective approach for managing childhood obesity. Leading pediatric experts from Bahrain, Egypt, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates participated in the meeting. The experts discussed, debated, and agreed on certain directions, including the importance of educating parents, endorsing breastfeeding, and ensuring optimum quantity and quality intake of proteins in early life. This expert consensus may serve as the starting point for healthcare professionals in the region who are interested in shaping a healthy future for the generations to come.
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Affiliation(s)
- Frank Jochum
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany.,Pediatric Medicine, Brandenburg Medical School (MHB) Theodor Fontane, Neuruppin, Germany
| | | | - Ashraf Adel
- Department of General Pediatrics, Sidra Medicine, Doha, Qatar
| | - Ahmed Alhammadi
- Department of General Pediatrics, Sidra Medicine, Doha, Qatar
| | | | - Eman Alohali
- Dietetics Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Khaled AlSarraf
- Department of Pediatrics-Pediatric Gastroenterology, Amiri Hospital, Sharq, Kuwait
| | - Khoula Al Said
- Department of Child Health, Royal Hospital, Muscat, Oman
| | - Mahmoud Elzalabany
- Pediatrics Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Hasan M A Isa
- Pediatric Department, Salmaniya Medical Complex/Arabian Gulf University, Manama, Bahrain
| | | | | | - Omar Saadah
- Pediatrics Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Fu Y, Burns RD, Hsu YW, Zhang P. Motivation, Segmented Physical Activity, Sedentary Behavior, and Weight Status in Adolescents: A Path Analysis. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:204-209. [PMID: 32897846 DOI: 10.1080/02701367.2020.1804520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
Purpose: The purpose of this study was to examine the relationships linking motivational variables with BMI percentile (BMI%) via segmented physical activity (PA) and sedentary behavior (SB) in adolescents using path analysis. Method: Secondary data analysis was performed using participants from the Family, Life, Activity, Sun, Health, and Eating (FLASHE) study. A non-probability panel balanced to the US population on sex, Census division, household income and size, and race/ethnicity were screened for eligibility. The final sample consisted of 1,643 adolescents (822 girls, 821 boys). Motivational variables consisted of PA enjoyment, self-efficacy, and peer social support. Mediator variables consisted of segmented weekly PA and SB assessed using the Youth Activity Profile (YAP). BMI% was the outcome. A recursive bootstrapped path analysis was conducted to examine the relationships between motivational variables, segmented PA and SB, and BMI% with indirect effects calculated via bootstrapped mediation analyses. Results: The relationships between motivational variables and segmented PA and SB were stronger than relationships between segmented PA and SB and BMI%. Three mediated paths were observed: self-efficacy and BMI% using sedentary YAP as the mediator (IE = -0.38, 95%CI: -0.65, -0.18), enjoyment and BMI% using weekend YAP as the mediator (IE = -0.62, 95%CI: -1.14, -0.12) and social support and BMI% using weekend YAP as the mediator (IE = -0.53, 95%CI: -1.00, -0.07). Conclusion: The relationship between adolescent motivational variables and segmented PA and SB is relatively strong and specific motivational variables' relationships with BMI% is mediated through segmented PA and SB.
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Affiliation(s)
- You Fu
- University of Nevada, Reno
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Cai S, Dang J, Zhong P, Ma N, Liu Y, Shi D, Zou Z, Dong Y, Ma J, Song Y. Sex differences in metabolically healthy and metabolically unhealthy obesity among Chinese children and adolescents. Front Endocrinol (Lausanne) 2022; 13:980332. [PMID: 36313785 PMCID: PMC9613922 DOI: 10.3389/fendo.2022.980332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/12/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To analyze sex differences in the prevalence of obesity phenotypes and their risk factors among children and adolescents aged 7-18 years in China. METHODS We enrolled 15,114 children and adolescents aged 7-18 years into the final analysis. Obesity phenotypes were classified by body mass index (BMI) and metabolic status as metabolically healthy or unhealthy obesity. In addition, we collected four possible influencing factors on obesity phenotypes through questionnaires, including demographic, parental, early life, and lifestyle indicators. Multinomial logistic regression analysis in a generalized linear mixed model (GLMM) was selected to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for identifying risk factors and control the cluster effects of schools. More importantly, the interaction terms of sex and each indicator were established to demonstrate the sex differences. RESULTS The prevalence of metabolically healthy obesity (MHO), metabolically unhealthy obesity (MUO), metabolically healthy overweight and obesity (MHOO), and metabolically unhealthy overweight and obesity (MUOO) were 3.5%, 5.6%, 11.1%, and 13.0% respectively, with higher prevalence in boys (5.3% vs. 1.6%, 7.9% vs. 3.1%, 14.3% vs. 7.7%, 15.6% vs. 10.1%). In addition, younger ages, single children, parental smoking, parental history of diseases (overweight, hypertension, diabetes), caesarean, premature, and delayed delivery time, high birth weight, insufficient sleep time, and excessive screen time were considered as important risk factors of MHO and MUO among children and adolescents (p < 0.05). More notably, boys were at higher risks of MUO when they were single children (boys: OR = 1.56, 95% CI: 1.24-1.96; girls: OR = 1.12, 95% CI: 0.82-1.54), while girls were more sensitive to MUO with parental smoking (girls: OR = 1.34, 95% CI: 1.02-1.76; boys: OR = 1.16, 95% CI: 0.97-1.39), premature delivery (girls: OR = 3.11, 95% CI: 1.59-6.07; boys: OR = 1.22, 95% CI: 0.67-2.22), high birth weight (girls: OR = 2.45, 95% CI: 1.63-3.69; boys: OR = 1.28, 95% CI: 0.96-1.70), and excessive screen time (girls: OR = 1.47, 95% CI: 1.06-2.04; boys: OR = 0.97, 95% CI: 0.79-1.20), with significant interaction term for sex difference (pinteraction < 0.05). CONCLUSIONS MHO and MUO are becoming prevalent among Chinese children and adolescents. Significant sex differences in the prevalence of obesity phenotypes as well as their environmental and genetic risk factors suggest it might be necessary to manage obesity phenotypes problems from a sex perspective.
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Affiliation(s)
- Shan Cai
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jiajia Dang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Panliang Zhong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Ning Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yunfei Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Di Shi
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- *Correspondence: Yi Song, ; Jun Ma,
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- *Correspondence: Yi Song, ; Jun Ma,
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Bloom MS, Commodore S, Ferguson PL, Neelon B, Pearce JL, Baumer A, Newman RB, Grobman W, Tita A, Roberts J, Skupski D, Palomares K, Nageotte M, Kannan K, Zhang C, Wapner R, Vena JE, Hunt KJ. Association between gestational PFAS exposure and Children's adiposity in a diverse population. ENVIRONMENTAL RESEARCH 2022; 203:111820. [PMID: 34343551 PMCID: PMC8616804 DOI: 10.1016/j.envres.2021.111820] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/21/2021] [Accepted: 07/29/2021] [Indexed: 05/05/2023]
Abstract
Perfluoroalkyl substances (PFAS) are widely distributed suspected obesogens that cross the placenta. However, few data are available to assess potential fetal effects of PFAS exposure on children's adiposity in diverse populations. To address the data gap, we estimated associations between gestational PFAS concentrations and childhood adiposity in a diverse mother-child cohort. We considered 6 PFAS in first trimester blood plasma, measured using ultra-high-performance liquid chromatography with tandem mass spectrometry, collected from non-smoking women with low-risk singleton pregnancies (n = 803). Body mass index (BMI), waist circumference (WC), fat mass, fat-free mass, and % body fat were ascertained in 4-8 year old children as measures of adiposity. We estimated associations of individual gestational PFAS with children's adiposity and overweight/obesity, adjusted for confounders. There were more non-Hispanic Black (31.7 %) and Hispanic (42.6 %) children with overweight/obesity, than non-Hispanic white (18.2 %) and Asian/Pacific Islander (16.4 %) children (p < 0.0001). Perfluorooctane sulfonate (PFOS; 5.3 ng/mL) and perfluorooctanoic acid (2.0 ng/mL) had the highest median concentrations in maternal blood. Among women without obesity (n = 667), greater perfluoroundecanoic acid (PFUnDA) was associated with their children having higher WC z-score (β = 0.08, 95%CI: 0.01, 0.14; p = 0.02), fat mass (β = 0.55 kg, 95%CI: 0.21, 0.90; p = 0.002), and % body fat (β = 0.01 %; 95%CI: 0.003, 0.01; p = 0.004), although the association of PFUnDA with fat mass attenuated at the highest concentrations. Among women without obesity, the associations of PFAS and their children's adiposity varied significantly by self-reported race-ethnicity, although the direction of the associations was inconsistent. In contrast, among the children of women with obesity, greater, PFOS, perfluorononanoic acid, and perfluorodecanoic acid concentrations were associated with less adiposity (n = 136). Our results suggest that specific PFAS may be developmental obesogens, and that maternal race-ethnicity may be an important modifier of the associations among women without obesity.
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Affiliation(s)
- Michael S Bloom
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA.
| | - Sarah Commodore
- Department of Environmental and Occupational Health, Indiana University, Bloomington, IN, USA
| | - Pamela L Ferguson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - John L Pearce
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Anna Baumer
- Department of Biological Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Roger B Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - William Grobman
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
| | - Alan Tita
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James Roberts
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Daniel Skupski
- Department of Obstetrics and Gynecology, New York-Presbyterian Queens Hospital, Queens, New York, USA; Department of Obstetrics and Gynecology, Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, NY, USA
| | - Kristy Palomares
- Department of Obstetrics and Gynecology, Saint Peter's University Hospital, New Brunswick, NJ, USA
| | - Michael Nageotte
- Department of Perinatology, Long Beach Memorial Medical Center, Long Beach, CA, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Cuilin Zhang
- Division of Intramural Population Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, Columbia University, New York, NY, USA
| | - John E Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kelly J Hunt
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
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Vergani E, Bruno C, Cipolla C, Currò D, Mancini A. Plasma Levels of Neudesin and Glucose Metabolism in Obese and Overweight Children. Front Endocrinol (Lausanne) 2022; 13:881524. [PMID: 35909572 PMCID: PMC9331476 DOI: 10.3389/fendo.2022.881524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022] Open
Abstract
Childhood overweight and obesity are among the major health problems of modern times, especially in Western countries, due to their association with increased cardiovascular and cancer risk in adulthood. Neudesin, a recently discovered peptide secreted mainly in the brain and adipose tissue, is being investigated for its possible activity as a negative regulator of energy expenditure. We conducted a cross-sectional observational preliminary study with the aim of testing the hypothesis that plasma levels of neudesin can be modified in obese and overweight children and to evaluate any possible relationship between plasma neudesin levels and metabolic and anthropometric parameters. 34 Children (Tanner's stage 1) were included and divided in two groups according to Cole's criteria. Group A included obese and overweight children (23 patients, 17 females and 6 males, aged 4-10 years); Group B included healthy normal-weight children (11 subjects, 7 females and 4 males, aged 3-10 years). Metabolic (glucose and insulin, total, LDL- and HDL-cholesterol, triglycerides, uric acid) and hormonal (fT3, fT4, TSH, IGF-1, leptin) parameters were evaluated. HOMA-IR and QUICKI index and the area under the curve (AUC) of glucose and insulin after oral glucose load were calculated in obese and overweight children. Neudesin was measured by ELISA. Neudesin levels were significantly higher in obese/overweight children than in controls. In obese and overweight children, plasma neudesin levels were significantly directly correlated with blood glucose and glucose AUC. Taken together, these results, although preliminary, may suggest a possible age-related role of neudesin in glucose homeostasis in obese/overweight children.
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Affiliation(s)
- Edoardo Vergani
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Carmine Bruno
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Clelia Cipolla
- Dipartimento di Scienza e Salute della donna e del bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Diego Currò
- Dipartimento di Sicurezza e Bioetica, Sezione di Farmacologia, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- *Correspondence: Antonio Mancini, ; Diego Currò,
| | - Antonio Mancini
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
- *Correspondence: Antonio Mancini, ; Diego Currò,
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Karalus MA, Sullivan TA, Wild CE, Cave TL, O'Sullivan NA, Hofman PL, Edwards EA, Mouat S, Wong W, Anderson YC. The cost of investigating weight-related comorbidities in children and adolescents in Aotearoa/New Zealand. J Paediatr Child Health 2021; 57:1942-1948. [PMID: 34196427 DOI: 10.1111/jpc.15618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 04/22/2021] [Accepted: 05/27/2021] [Indexed: 12/14/2022]
Abstract
AIM Expert recommendations for child/adolescent obesity include extensive investigation for weight-related comorbidities, based on body mass index (BMI) percentile cut-offs. This study aimed to estimate the cost of initial investigations for weight-related comorbidities in children/adolescents with obesity, according to international expert guidelines. METHODS The annual mean cost of investigations for weight-related comorbidities in children/adolescents was calculated from a health-funder perspective using 2019 cost data obtained from three New Zealand District Health Boards. Prevalence data for child/adolescent obesity (aged 2-14 years) were obtained from the New Zealand Health Survey (2017/2018), and prevalence of weight-related comorbidities requiring further investigation were obtained from a previous New Zealand study of a cohort of children with obesity. RESULTS The cost of initial laboratory screening for weight-related comorbidities per child was NZD 28.36. Based on national prevalence data from 2018/2019 for children with BMI greater than the 98th percentile (obesity cut-off), the total annual cost for initial laboratory screening for weight-related comorbidities in children/adolescents aged 2-14 years with obesity was estimated at NZD 2,665,840. The cost of further investigation in the presence of risk factors was estimated at NZD 2,972,934. CONCLUSIONS Investigating weight-related comorbidities in New Zealand according to international expert guidelines is resource-intensive. Ways to further determine who warrants investigation with an individualised approach are required.
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Affiliation(s)
- Miriam A Karalus
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Trudy A Sullivan
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Cervantée E Wild
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Tamariki Pakari Child Health and Wellbeing Trust, Taranaki, New Zealand
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Niamh A O'Sullivan
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Elizabeth A Edwards
- Department of Respiratory Medicine, Starship Children's Health, Auckland, New Zealand
| | - Stephen Mouat
- Department of Gastroenterology and Hepatology, Starship Children's Health, Auckland, New Zealand
| | - William Wong
- Department of Nephrology, Starship Children's Health, Auckland, New Zealand
| | - Yvonne C Anderson
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Tamariki Pakari Child Health and Wellbeing Trust, Taranaki, New Zealand.,Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
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Velázquez AL, Alcaire F, Vidal L, Varela P, Næs T, Ares G. The influence of label information on the snacks parents choose for their children: Individual differences in a choice based conjoint test. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Yin R, Wang X, Li K, Yu K, Yang L. Lipidomic profiling reveals distinct differences in plasma lipid composition in overweight or obese adolescent students. BMC Endocr Disord 2021; 21:201. [PMID: 34641844 PMCID: PMC8513241 DOI: 10.1186/s12902-021-00859-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/31/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The relationship between dyslipidemia and obesity has been widely reported, but the global lipid profiles associated with the development of obesity still need to be clarified. An investigation into the association between the lipidomic plasma profile and adolescent obesity may provide new insights into the development of obesity. METHODS Mass spectrometry coupled with liquid chromatography was applied to detect the global lipidome in the fasting plasma from 90 Chinese adolescents, including 34 obese adolescents, 26 overweight adolescents, and 30 adolescents with a normal body mass index (BMI). All participants underwent anthropometric measurements by using InBody. Clinical biochemical indicators were measured by Cobas Elecsys. RESULTS Both qualitative and quantitative analyses revealed a gradual change in plasma lipid features among obese students, exhibiting characteristics close to overweight students, but differing significantly from normal students. Compared with normal and overweight students, levels of triglyceride (TG), 18-hydroxycortisol, isohumulinone A, and 11-dihydro-12-norneoquassin were up-regulated in the obese group, while phosphatidylcholine (PC), phosphatidylethanolamine (PE), lysoPC (LPC), lysoPE (LPE), and phosphatidylinositol (PI) were significantly down-regulated in the obese group. Then, we conducted Venn diagrams and selected 8 significant metabolites from the 3 paired comparisons. Most of the selected features were significantly correlated with the anthropometric measurements. CONCLUSIONS This study demonstrated evidence for a relationship between the eight significant metabolites with obese adolescents. These lipid features may provide a basis for evaluating risk and monitoring the development of obesity.
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Affiliation(s)
- Ruili Yin
- Beijing Key Laboratory of Diabetes Prevention and Research, Center for Endocrine Metabolic and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China
| | - Xiaojing Wang
- Beijing Key Laboratory of Diabetes Prevention and Research, Center for Endocrine Metabolic and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China
| | - Kun Li
- Beijing Key Laboratory of Diabetes Prevention and Research, Center for Endocrine Metabolic and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China
| | - Ke Yu
- Beijing Key Laboratory of Diabetes Prevention and Research, Center for Endocrine Metabolic and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China.
| | - Longyan Yang
- Beijing Key Laboratory of Diabetes Prevention and Research, Center for Endocrine Metabolic and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China.
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Eslam M, Alkhouri N, Vajro P, Baumann U, Weiss R, Socha P, Marcus C, Lee WS, Kelly D, Porta G, El-Guindi MA, Alisi A, Mann JP, Mouane N, Baur LA, Dhawan A, George J. Defining paediatric metabolic (dysfunction)-associated fatty liver disease: an international expert consensus statement. Lancet Gastroenterol Hepatol 2021; 6:864-873. [PMID: 34364544 DOI: 10.1016/s2468-1253(21)00183-7] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 12/11/2022]
Abstract
The term non-alcoholic fatty liver disease (NAFLD), and its definition, have limitations for both adults and children. The definition is most problematic for children, for whom alcohol consumption is usually not a concern. This problematic definition has prompted a consensus to rename and redefine adult NAFLD associated with metabolic dysregulation to metabolic (dysfunction)-associated fatty liver disease (MAFLD). Similarities, distinctions, and differences exist in the causes, natural history, and prognosis of fatty liver diseases in children compared with adults. In this Viewpoint we, an international panel, propose an overarching framework for paediatric fatty liver diseases and an age-appropriate MAFLD definition based on sex and age percentiles. The framework recognises the possibility of other coexisting systemic fatty liver diseases in children. The new MAFLD diagnostic criteria provide paediatricians with a conceptual scaffold for disease diagnosis, risk stratification, and improved clinical and multidisciplinary care, and they align with a definition that is valid across the lifespan.
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Affiliation(s)
- Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, Australia.
| | - Naim Alkhouri
- Department of Hepatology, Arizona Liver Health, Chandler, AZ, USA
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
| | - Ulrich Baumann
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Ram Weiss
- Department of Pediatrics, Ruth Rappaport Children's Hospital, Rambam Medical Center, Technion School of Medicine, Haifa, Israel
| | - Piotr Socha
- Department of Gastroenterology, Hepatology, Nutritional Disorders and Paediatrics, Children's Memorial Health Institute, Warsaw, Poland
| | - Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Way Seah Lee
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Deirdre Kelly
- The Liver Unit, Birmingham Women's & Children's Hospital, University of Birmingham, Birmingham, UK
| | - Gilda Porta
- Pediatric Hepatology, Transplant Unit, Hospital Sírio-Libanês, Hospital Municipal Infantil Menino Jesus, San Paulo, Brazil
| | - Mohamed A El-Guindi
- Department of Pediatric Hepatology, Gastroenterology and Nutrition, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Anna Alisi
- Research Unit of Molecular Genetics and Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Jake P Mann
- Metabolic Research Laboratories, Institute of Metabolic Science, and Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Nezha Mouane
- Department of Pediatric Hepatology, Gastroenterology and Nutrition, Academic Children's Hospital, Mohammed V University, Rabat, Morocco; Department of Pediatric Hepatology, Gastroenterology and Nutrition, Children's Hospital of Rabat, Rabat, Morocco
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Anil Dhawan
- Paediatric Liver, GI and Nutrition Centre, and MowatLabs, King's College Hospital, London, UK
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, Australia
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Carlsson Petri KC, Hale PM, Hesse D, Rathor N, Mastrandrea LD. Liraglutide pharmacokinetics and exposure-response in adolescents with obesity. Pediatr Obes 2021; 16:e12799. [PMID: 33963681 PMCID: PMC8519033 DOI: 10.1111/ijpo.12799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/12/2021] [Accepted: 04/26/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Obesity in adolescence presents a major public health challenge, often leading to obesity in adulthood with associated chronic disease. OBJECTIVES This study aimed to perform a population pharmacokinetic and exposure-response analysis of liraglutide by meta-analysis of data from trials conducted in children, adolescents and adults with obesity. METHODS The population pharmacokinetic analysis investigated the effect of covariates body weight, age group (children, adolescents and adults) and sex on liraglutide exposure in adolescents compared with previous results in adults. The exposure-response relationship of liraglutide for the change from baseline in body mass index standard deviation score (BMI SDS) was evaluated in adolescents and compared to that in adults. RESULTS Body weight was the main covariate affecting liraglutide exposure, with lower exposures at higher body weights, whereas age group was of no importance and sex was of little importance. An exposure-response relationship was demonstrated for liraglutide in both adolescents and adults as the decrease in BMI SDS from baseline increased in an exposure-dependent manner with increasing liraglutide exposure. CONCLUSIONS The population pharmacokinetic analysis supported similar liraglutide exposures in adolescents and adults; body weight was the most important covariate affecting exposure. An exposure-response relationship was established for liraglutide.
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Affiliation(s)
| | - Paula M. Hale
- Clinical Development, Medical & Regulatory AffairsNovo Nordisk IncPlainsboroNew JerseyUSA
| | - Dan Hesse
- Department of Medical & Science – Obesity and MetabolismNovo Nordisk A/SSøborgDenmark
| | - Naveen Rathor
- Department of Global Medical AffairsNovo Nordisk A/SSøborgDenmark
| | - Lucy D. Mastrandrea
- Division of Pediatric Endocrinology/Diabetes, Jacobs School of Medicine and Biomedical SciencesUniversity at BuffaloBuffaloNew YorkUSA
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The "Adipo-Cerebral" Dialogue in Childhood Obesity: Focus on Growth and Puberty. Physiopathological and Nutritional Aspects. Nutrients 2021; 13:nu13103434. [PMID: 34684432 PMCID: PMC8539184 DOI: 10.3390/nu13103434] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 01/08/2023] Open
Abstract
Overweight and obesity in children and adolescents are overwhelming problems in western countries. Adipocytes, far from being only fat deposits, are capable of endocrine functions, and the endocrine activity of adipose tissue, resumable in adipokines production, seems to be a key modulator of central nervous system function, suggesting the existence of an “adipo-cerebral axis.” This connection exerts a key role in children growth and puberty development, and it is exemplified by the leptin–kisspeptin interaction. The aim of this review was to describe recent advances in the knowledge of adipose tissue endocrine functions and their relations with nutrition and growth. The peculiarities of major adipokines are briefly summarized in the first paragraph; leptin and its interaction with kisspeptin are focused on in the second paragraph; the third paragraph deals with the regulation of the GH-IGF axis, with a special focus on the model represented by growth hormone deficiency (GHD); finally, old and new nutritional aspects are described in the last paragraph.
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Domingo-Bolio V, Medina-Vera I, Shamah-Levy T, Moreno-Macías L, Avila-Nava A. Evaluation of Cardiovascular Risk by Waist-to-Height Ratio in School-Age Children. Metab Syndr Relat Disord 2021; 19:531-536. [PMID: 34520256 DOI: 10.1089/met.2021.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Childhood overweight and obesity are among the major public health problems worldwide. In Mexico, it has been reported in 2018 that 35.6% of children between 5 and 11 years old were overweight or obese. Central obesity is associated with the development of different complications, such as cardiovascular diseases (CVDs). An important tool used to evaluate obesity is the waist-to-height ratio (WHtR), and values higher than 0.5 suggest the existence of cardiovascular risk (CVR). The aim of this study was to evaluate CVR by the WHtR in school-age children from Yucatan, Mexico. Methods: This study included a sample of school-age children between the ages of 10 and 13 years from public schools in Yucatan, Mexico. Anthropometric parameters such as body weight, height, body mass index z-score (zBMI), waist circumference, WHtR, and CVR were evaluated. Results: A total of 2559 children with a median age of 12.1 ± 0.57 years old were evaluated. The classification by height z score showed that 26.8% were of short height, 73.1% were of normal height, and 0.1% were of tall height. The prevalence of body weight excess determined by zBMI was 48%. The prevalence of normal weight was 44%, and the prevalence of body weight deficiencies was 8%. The CVR determined by WHtR was 47.5%. In the population with obesity, 63.3% had an increased risk of CVDs and 30.7% had a very high risk. Moreover, it was observed that 13.2% of the population with normal weight had an increased risk of CVDs. Conclusion: One out of two child 10 to 13 years of age is overweight or obese as defined with zBMI in Mexico. According to WHtR, almost half of this population is at increased CVR, while near two-third of child with obesity are at high or very high CVR.
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Affiliation(s)
- Vanessa Domingo-Bolio
- Dirección de Nutrición de los Servicios de Salud de Yucatán, Mérida, Yucatán, México.,Escuela de Salud, Universidad Modelo, Mérida, Yucatán, México
| | - Isabel Medina-Vera
- Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, CDMX, México
| | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Lidia Moreno-Macías
- Facultad de Medicina, Universidad Autónoma de Yucatán, Merida, Yucatán, México
| | - Azalia Avila-Nava
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Yucatán, México
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Serbis A, Giapros V, Paschou SA, Siomou E. Children with metabolically healthy obesity have a worse metabolic profile compared to normal-weight peers: a cross-sectional study. Endocrine 2021; 73:580-587. [PMID: 34023981 DOI: 10.1007/s12020-021-02762-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/10/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE A phenotype of metabolically healthy obesity (MHO) has been described in youth with obesity, but data are still scarce in this age group. The aim of the current study was to describe and compare clinical and laboratory parameters related to obesity among three different groups of youth, namely youth with normal weight (NW), with MHO, and with metabolically unhealthy obesity (MUO). METHODS One hundred and three youngsters with obesity were divided according to 2018 consensus-based criteria into those with MHO [n = 49, age (±SD): 10.9 ± 2.9 years] and those with MUO [n = 54, 11.5 ± 2.7 years] and were compared to age-, sex- and Tanner-matched NW [n = 69, 11.3 ± 2.9 years]. Several obesity-related parameters were investigated for all three groups of children. Comparisons were made by analysis of variance (ANOVA) followed by the Fisher's PLSD test. RESULTS Youth with MHO had lower systolic (p < 0.001) and diastolic (p < 0.01) blood pressure z-score and triglycerides (p < 0.01), but higher HDL-C (p < 0.001), total cholesterol (p < 0.05), and apo-A1 (p < 0.05) compared to those with MUO. Compared to controls, both children with MHO and MUO showed higher fasting insulin (p < 0.05), HOMA-IR (p < 0.05), and QUICKI (p < 0.001). Similarly, both groups had higher hsCRP, fibrinogen, uric acid, and leptin compared to controls (for all, p < 0.001), while their adiponectin was lower (p < 0.05). Visfatin was higher in children with MUO compared to controls (p < 0.01), and it showed a trend to be lower in children with MHO compared to those with MUO (p = 0.1). CONCLUSION This study provides evidence that children identified as having MHO by the consensus-based criteria had better metabolic profiles than youth with MUO, but worse than NW. Further research is needed in pediatric populations both regarding MHO criteria and the nature of the MHO phenotype per se.
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Affiliation(s)
- Anastasios Serbis
- Child Health Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece.
| | - Vasilieios Giapros
- Child Health Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Stavroula A Paschou
- Division of Endocrinology, Diabetes and Metabolism, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ekaterini Siomou
- Child Health Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
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Left Ventricular Diastolic Dysfunction Among Youth with Obesity and History of Elevated Blood Pressure. J Pediatr 2021; 235:130-137. [PMID: 33812920 PMCID: PMC8383194 DOI: 10.1016/j.jpeds.2021.03.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To assess prevalence of and factors associated with left ventricular diastolic dysfunction (LVDD) in youth with obesity and elevated blood pressure (BP). STUDY DESIGN This was a cross-sectional analysis of baseline and follow-up visits of 83 youth, 5-21 years, evaluated for overweight/obesity and elevated BP in a multidisciplinary clinic. LVDD was defined according to established adult criteria (LVDDadult; E/A < 1, E/e' > 14, or e'/a' < 0.8) and pediatric criteria (LVDDpeds; E/A <10th percentile, E/e' >99th percentile, or e'/a' <1st percentile) based on data from 103 age-sex matched healthy controls. Baseline factors associated with LVDDpeds were examined using Wilcoxon rank sum and χ2 tests. Multiple logistic regression analyses using generalized estimating equations to account for repeated measures evaluated the associations of adiposity and BP with LVDDpeds. RESULTS The prevalence of LVDD ranged from 1.2% to 2.7% when we used adult criteria and 19% to 28% when we used pediatric criteria. Those with LVDDpeds were older, predominantly male, and non-African American and had greater weight, BP, BP medication use, and non-high-density lipoprotein cholesterol than those without LVDDpeds. Diastolic BP z score was associated with LVDDpeds by E/A (OR 1.95, 95% CI 1.15-3.32, P = .014) after we adjusted for age, sex, race, BP medications, and body mass index z score. CONCLUSIONS LVDD was present in a substantial proportion of youth with overweight/obesity and elevated BP using pediatric criteria. Those with LVDDpeds had significantly greater measures of adiposity and BP compared with those without LVDDpeds, and diastolic BP z score was an independent predictor of LVDDpeds by E/A. These data emphasize the importance of prevention and treatment of cardiovascular disease risk factors in childhood.
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Yuan YQ, Liu Y, Wang MJ, Hou X, Zhang SH, Wang XL, Han YN, Sang P, Bian Y, Roswal G. Prevalence of overweight and obesity in children and adolescents with intellectual disabilities in China. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:655-665. [PMID: 33851750 DOI: 10.1111/jir.12840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/04/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Overweight and obesity in children and adolescents has become a worldwide epidemic. There are several studies that have concentrated on the prevalence rate of children and adolescents with intellectual disabilities (ID), whereas data on such a population on the mainland of China remain unclear. The purpose of this study was to investigate the prevalence rate of overweight and obesity among school-aged children and adolescents with ID on China's mainland. METHODS This study employed a cross-sectional design to examine the body weight status of 1873 children and adolescents (ages 6-18 years old) with ID in 35 special education schools. Body mass index was calculated, and the concepts of overweight and obesity were defined according to the standard of the Working Group for Obesity in China. RESULTS Data indicated that 18.2% (95% CI: 16.5%-20.0%) of children and adolescents with ID were overweight and 14.4% (95% CI: 12.8%-16.0%) were obese. Boys with ID were more likely to be overweight than girls with ID (OR = 1.48[95% CI: 1.13-1.94], P < 0.05). Children and adolescents with Down syndrome or autism spectrum disorder had a trend to be classified as overweight (OR = 1.76[95% CI: 1.22-2.54], P < 0.05; OR = 1.57[95% CI: 1.17-2.09], P < 0.05, respectively) or obesity (OR = 1.82[95% CI: 1.23-2.69], P < 0.05; OR = 1.40 [95% CI: 1.02-1.93], P < 0.05, respectively) compared with those with ID without these conditions. Moreover, children and teenagers with ID living in urban areas had a predisposition to be overweight (OR = 2.16[95% CI: 1.14-4.09], P < 0.05) or obese (OR = 3.25[95% CI: 1.41-7.50], P < 0.05) relative to those who lived in rural areas. CONCLUSION Results indicated that in China, the prevalence rate of overweight and obesity among school-aged children and adolescents with ID was remarkably high. Therefore, future research should make every effort to focus on reducing and preventing overweight and obesity of this population in China.
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Affiliation(s)
- Y Q Yuan
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Y Liu
- Department of Physical Education, Shandong Jianzhu University, Jinan, China
| | - M J Wang
- School of Chinese WuShu, Shandong Sport University, Rizhao, China
| | - X Hou
- Department of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - S H Zhang
- Department of Physical Education, China Disabled Persons' Federation, Beijing, China
| | - X L Wang
- Graduate School, Harbin Sport University, Harbin, China
| | - Y N Han
- Beijing Xuanwu District Special Education School, Beijing, China
| | - P Sang
- Shaanxi Xi'an Special Education School, Xi'an, China
| | - Y Bian
- Tianjin Hebei District Special Education School, Tianjin, China
| | - G Roswal
- School of Health Professions and Wellness, Jacksonville State University, Jacksonville, AL, USA
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Truong K, Park S, Tsiros MD, Milne N. Physiotherapy and related management for childhood obesity: A systematic scoping review. PLoS One 2021; 16:e0252572. [PMID: 34125850 PMCID: PMC8202913 DOI: 10.1371/journal.pone.0252572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 05/18/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Despite targeted efforts globally to address childhood overweight/obesity, it remains poorly understood and challenging to manage. Physiotherapists have the potential to manage children with obesity as they are experts in movement and physical activity. However, their role remains unclear due to a lack of physiotherapy-specific guidelines. This scoping review aims to explore existing literature, critically appraising and synthesising findings to guide physiotherapists in the evidence-based management of childhood overweight/obesity. METHOD A scoping review was conducted, including literature up to May 2020. A review protocol exists on Open Science Framework at https://osf.io/fap8g/. Four databases were accessed including PubMed, Embase, CINAHL, Medline via OVID, with grey literature searched through google via "file:pdf". A descriptive synthesis was undertaken to explore the impact of existing interventions and their efficacy. RESULTS From the initial capture of 1871 articles, 263 intervention-based articles were included. Interventions included qualitative focused physical activity, quantitative focused physical activity and multicomponent interventions. Various outcome measures were utilised including health-, performance- and behaviour-related outcomes. The general trend for physiotherapy involvement with children who are obese appears to favour: 1) multicomponent interventions, implementing more than one component with environmental modification and parental involvement and 2) quantitative physical activity interventions, focusing on the quantity of bodily movement. These approaches most consistently demonstrated desirable changes across behavioural and health-related outcome measures for multicomponent and quantitative physical activity interventions respectively. CONCLUSION When managing children with obesity, physiotherapists should consider multicomponent approaches and increasing the quantity of physical activity, given consistent improvements in various obesity-related outcomes. Such approaches are well suited to the scope of physiotherapists and their expertise in physical activity prescription for the management of childhood obesity. Future research should examine the effect of motor skill interventions and consider the role of environmental modification/parental involvement as factors contributing to intervention success.
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Affiliation(s)
- Kim Truong
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Sandra Park
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Margarita D. Tsiros
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Nikki Milne
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
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