Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis

Understanding family dynamics of obesity: Do parents and children lose and gain weight together?

BACKGROUND

Obesity is prevalent among children and adults. Yet, understanding the relationship between parent and child weight trajectories is limited.

OBJECTIVE

(1) Examine the association between parent/child undesirable body mass index (BMI) category change. (2) Assess whether parental BMI category predicts child modified BMI z-score (mBMIz) annual change.

METHODS

We conducted a cross-sectional study of weight trajectories of 3821 parent-child dyads between March 2020 and December 2021 within the NYC Health + Hospitals system. Undesirability of child and parental BMI category change and the magnitude of mBMIz change by parental BMI are analysed.

RESULTS

Of 3821 children (mean [SD] baseline age, 9.84 [3.51]), 1889 were female. Of the 3220 parents (mean [SD] baseline age, 39.9 [8.51]), 2988 were female. Most children (53.52%) and parents (81.94%) presented with overweight and obesity. Undesirable BMI change in children was associated with concordant change in parents (adjusted OR: 1.7, 95% CI [1.45, 2.01], adjusted p < 0.001). Children of parents with obesity (adjusted coef: 0.076, 95% CI [0.004, 0.147], p < 0.038) and severe obesity (adjusted coef: 0.1317, 95% CI [0.024, 0.239], adjusted p < 0.016) demonstrated greater change in mBMIz than those of parents with normal weight or underweight.

CONCLUSION

Parents and children have concordant weight trajectories, and public health interventions targeting both populations are essential.

Life-course trajectories of body mass index and cardiovascular disease risks and health outcomes in adulthood: Systematic review and meta-analysis

OBJECTIVE

This systematic review aimed to assess the effect of life course body mass index (BMI) trajectories (childhood to adulthood) on cardiovascular disease (CVD) risk factors and outcomes.

METHODS

Prospective or retrospective cohort studies were identified that assessed the association of BMI trajectories with CVD risks and outcomes from databases published in English. The pooled effect sizes were estimated using a random-effects model.

FINDINGS

Seventeen eligible studies were included in this systematic review. The results revealed that a persistently overweight trajectory from childhood to adulthood was associated with a higher risk of hypertension (RR: 2.49; 95% CI: 1.9, 3.28) and type 2 diabetes (RR: 4.62; 95% CI: 2.36, 9.04) compared with a trajectory characterized by a normal BMI throughout both childhood and adulthood. Similarly, the risk of hypertension (RR: 2.38; 95% CI: 1.70, 3.33) and type 2 diabetes (RR: 3.66; 95% CI: 2.57, 5.19) was higher in those with normal-to-overweight trajectory compared with participants with a stable normal weight trajectory.

CONCLUSION

The findings suggest that lifetime BMI trajectories may be influential on health outcomes, and preventive strategies should be designed accordingly. Implementing appropriate preventive strategies at all life stages may reduce CVD risks and adverse outcomes later in life.

A scoping review of school-based anthropometric measurement

Though anthropometric measurement (AM) frequently occurs in school settings, it is not without risks to child wellbeing. The aim of this scoping review was to examine how AM in school settings takes place and is reported on to make recommendations on best practices. We identified and extracted data from 440 studies published since 2005 that conducted AM in school (pre-school through secondary/high school) settings. Privacy and sensitivity of AM were unclear in over 90% of studies. Thirty-one studies (7.0%) reported protecting student privacy, while nine (2.0%) reported public measurement. Only five studies reported sensitivity regarding AM (1.1%). Exactly who conducted AM was not specified in 201 studies (45.7%). Sixty-nine studies did not provide a weight status criteria citation (19.2%), and 10 used an incorrect citation (2.7%). In summary, serious shortcomings in the reporting of how AM is conducted and by whom, along with details concerning weight status classification, are evident. There is considerable room for improvement regarding the reporting of key methodological details. We propose best practices for AM in school settings, which also double as conditions that should be met before AM takes place in school settings.

MicroRNAs as the promising markers of comorbidities in childhood obesity-A systematic review

INTRODUCTION

Rising child obesity rate creates a need for tools quantifying changes in children suffering from obesity, for purposes of detection or prevention of comorbidities. A candidate for such a role seems to be microRNAs, which in vivo serve as the suppressing factors in gene expression.

OBJECTIVES

This study aimed at reviewing recent discoveries in this field and concluding directions of research or application of studied molecules.

METHODS

Repeated browsing of databases and screening of results, led to final approval of 16 articles. Filtered studies examined differences in microRNA expression between subjects with obesity and children suffering from its comorbidities.

RESULTS

Studies concerning endothelial dysfunction identified molecules miR-320a and miR-630 as a possible diagnosis and treatment option. Search for the alternative markers in diagnosis of non-alcoholic fatty liver disease suggested value of molecules: miR-199a-5p and miR-122. miR-486, miR-146b, and miR-15b may serve in grading the development of type 2 diabetes in children, although further research raised doubts. Panel of molecules was indicated as useful in early detection of metabolic syndrome and insulin resistance associated alterations. No valid link between studied microRNAs and atherosclerosis was found.

CONCLUSIONS

MicroRNAs seem to be promising prognostic markers for diagnosis of endothelial dysfunction, non-alcoholic fatty liver disease, type 2 diabetes, metabolic syndrome and insulin resistance in children.

Acceleration in BMI gain following COVID-19 restrictions. A longitudinal study with 7- to 10-year-old primary school children

BACKGROUND

The ramifications of COVID-19 restrictions might accelerate the already rising proportion of children with overweight or obesity.

OBJECTIVES

To assess the association between COVID-19 restrictions and changes in body mass index (BMI) and the proportion of children with overweight or obesity.

METHODS

Cohort study with baseline measurements in September 2019 (prior to COVID-19 restrictions) and follow-up in June 2020, September 2020, and March 2021 at 12 primary schools in Austria. The height and weight of 738 children aged 7 to 10 years were measured and age- and sex-specific national and international standardized values were calculated. Changes over time were analysed by analysis of variance.

RESULTS

Mean BMI_IOTF standard deviation scores (SDS) increased by 0.24 (95% CI, 0.21-0.28) between September 2019 and March 2021. The proportion of children with overweight or obesity increased from 20.7% to 26.2% during this period (p < 0.001) using national reference values-EQUI BMI_AUT -comparable results were observed. Simultaneously, the height_AUT SDS increased by 0.06 (95% CI, 0.05-0.08) with a larger increase in girls (+0.11; p < 0.001) than in boys (+0.03; p = 0.19).

CONCLUSIONS

COVID-19 restrictions were associated with accelerated increases in mean BMI and the proportion of children with overweight or obesity. The increase in height SDS in girls calls for further investigations.

Intergenerational cardiovascular disease risks among Hispanics living in the United States

BACKGROUND

Few studies have assessed intergenerational associations of obesity and cardiovascular disease risks from parents to their children among Hispanic Americans.

OBJECTIVES

To assess intergenerational cardiovascular associations among Hispanic families.

METHODS

Using baseline data from an obesity-focused efficacy trial targeting Hispanic adolescents (n = 280) and their parents, we conducted a series of logistic regression analyses to investigate the effects of parental BMI and blood pressure on adolescents' BMI and blood pressure, respectively.

RESULTS

After adjusting for significant socio-demographic variables and adolescents' lifestyle behaviours, adolescents were more than twice as likely to be in the severely obese versus overweight range when their parents had obesity (vs. non-obese; OR = 2.55, 95% CI = 1.20, 5.39) and more than twice as likely to be in the severely obese versus obese weight range (OR = 2.44, 95% CI = 1.22, 4.87) when their parents had obesity. When compared to those with normal blood pressure, adolescents who had parents with elevated blood pressure/hypertension were more than twice as likely to have elevated blood pressure (OR = 2.05, 95% CI = 1.04, 4.00) or be classified as hypertensive stage 1/2 (OR = 2.81, 95% CI = 1.31, 6.01).

CONCLUSIONS

Both severe obesity and elevated blood pressure are highly associated among Hispanic parent-child dyads. Findings underscore the potential benefits of intervening with the family system.