1
|
Hahn H, Friedel M, Niessner C, Zipfel S, Mack I. Impact of physical activity on caloric and macronutrient intake in children and adolescents: a systematic review and meta-analysis of randomized controlled trials. Int J Behav Nutr Phys Act 2024; 21:76. [PMID: 39010114 PMCID: PMC11247817 DOI: 10.1186/s12966-024-01620-8] [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: 07/06/2023] [Accepted: 06/27/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Physical activity is widely promoted to maintain and improve health across all ages. Investigating how physical activity affects subsequent food intake provides insight into the factors that contribute to maintaining energy balance and effective weight management. OBJECTIVE This systematic review and meta-analysis summarizes the evidence on the effect of acute physical activity on subsequent food intake in children and adolescents. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) were applied. Randomized controlled trials (RCTs) objectively measuring post-exercise energy intake in children and adolescents aged 5 to 18 years were included. Studies with self-reported food intake were excluded. The databases PubMed, Web of Science and Cochrane Library were searched for RCTs, and the data were summarized at a qualitative and quantitative level. Version 2 of the Cochrane risk-of-bias tool for randomized trials was used to assess risk of bias. Changes in energy intake were examined with random effects meta-analysis. (PROSPERO: CRD42022324259). RESULTS Out of 9582 studies, 22 RCTs with cross-over design remained eligible for meta-analysis. The primary outcome was post-intervention energy intake up to the next 24 h. Heterogeneity of studies was moderate, with an I2 of 57%. The median (interquartile range, IQR) energy expended while exercising was 240 (158) kcal. Meta-analysis of 41 study arms (exercise n = 780 and control n = 478) showed no differences in total energy intake between the exercise and control group with a mean difference MD = 23.31 [-27.54, 74.15] kcal. No subgroup differences were found. Macronutrient intake and appetite sensations where not substantially affected. CONCLUSION Engaging in exercise is a suitable means of raising activity-induced energy expenditure, without causing any noticeable changes in food intake or hunger within a single day.
Collapse
Affiliation(s)
- Heiko Hahn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Osianderstr. 5, Tübingen, 72076, Germany
| | - Manuel Friedel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Osianderstr. 5, Tübingen, 72076, Germany
| | - Claudia Niessner
- Institute of Sports and Sport Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, Karlsruhe, 76131, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Osianderstr. 5, Tübingen, 72076, Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Osianderstr. 5, Tübingen, 72076, Germany.
| |
Collapse
|
2
|
Schladitz K, Luppa M, Riedel-Heller SG, Loebner M. Effectiveness of internet-based and mobile-based interventions for adults with overweight or obesity experiencing symptoms of depression: a systematic review protocol. BMJ Open 2023; 13:e067930. [PMID: 37339836 DOI: 10.1136/bmjopen-2022-067930] [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] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION Internet-based and mobile-based interventions (IMIs) provide innovative low-threshold and cost-effective prevention and self-management options for mental health problems complementary to standard treatment. The objective of this systematic review is to summarise the effectiveness and to critically evaluate studies on IMIs addressing comorbid depressive symptoms in adults with overweight or obesity. METHODS AND ANALYSIS The study authors will systematically search the databases MEDLINE, Cochrane Library, PsycINFO, Web of Science, Embase and Google Scholar (for grey literature) for randomised controlled trials (RCTs) of IMIs for individuals with overweight or obesity and comorbid depressive symptoms without restrictions on publication date (planned inception 1 June 2023 to 1 December 2023). Two reviewers will independently extract and evaluate data from studies eligible for inclusion by assessing quality of evidence and qualitatively synthesising results. Preferred Reporting Items for Systematic reviews Meta-Analyses (PRISMA) standards and the revised Cochrane Risk of Bias tool in RCTs (RoB 2) will be applied. ETHICS AND DISSEMINATION Ethical approval is not required as no primary data will be collected. Study results will be disseminated through publication in a peer-reviewed journal and presentations on conferences. PROSPERO REGISTRATION NUMBER CRD42023361771.
Collapse
Affiliation(s)
- Katja Schladitz
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Sachsen, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Sachsen, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Sachsen, Germany
| | - Margrit Loebner
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Sachsen, Germany
| |
Collapse
|
3
|
Páscoa R, Teixeira A, Henriques TS, Monteiro H, Monteiro R, Martins C. Characterization of an obese population: a retrospective longitudinal study from real-world data in northern Portugal. BMC PRIMARY CARE 2023; 24:99. [PMID: 37061669 PMCID: PMC10105387 DOI: 10.1186/s12875-023-02023-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 02/28/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Obesity is a serious and largely preventable global health problem. Obesity-related electronic health records can be a useful resource to identify and address obesity. The analysis of real-world data from T82-coded (International Classification of Primary Care coding, for obesity) primary care individuals can be an excellent national source of data on obesity's prevalence, characteristics, and impact on the National Health Service. METHODS Retrospective longitudinal study, based on a database of electronic medical records, from the Regional Health Administration of northern Portugal. The study objectives were to determine the prevalence of obesity and to characterize an adult obese population in northern Portugal from a bio-demographic point of view along with profiles of comorbidities and the use of health resources. This study used a database of 266,872 patients in December 2019 and screened for diagnostic code T82 from the International Classification of Primary Care. RESULTS The prevalence of obesity was 10.2% and the highest prevalence of obesity was in the 65-74 age group (16.1%). The most prevalent morbidities in patients with obesity as coded through ICPC-2 were K86 (uncomplicated hypertension), T90 (non-insulin-dependent diabetes), and K87 (complicated hypertension). Descriptive information showed that T82 subjects used more consultations, medications, and diagnostic tests than non-T82 subjects. CONCLUSIONS Routine recording of weight and height deserves special attention to allow obesity recognition at an early stage and move on to the appropriate intervention. Future work is necessary to automate the codification of obesity for subjects under 18 years of age, to raise awareness and anticipate the prevention of problems associated with obesity. Practical strategies need to be implemented, such as the creation of a specific program consultation with truly targeted approaches to obesity.
Collapse
Affiliation(s)
- Rosália Páscoa
- Faculty of Medicine, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), University of Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal.
- University of Porto, Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal.
- Administração Regional de Saúde do Norte IP, Health Centre Grouping Porto Ocidental, Family Health Unit Homem do Leme, Porto, Portugal.
| | - Andreia Teixeira
- Faculty of Medicine, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), University of Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal
- University of Porto, Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Instituto Politécnico de Viana do Castelo (IPVC), ADiT-LAB, Viana do Castelo, Portugal
| | - Teresa S Henriques
- Faculty of Medicine, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), University of Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal
- University of Porto, Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Hugo Monteiro
- Studies and Planning Department, Administração Regional de Saúde do Norte IP, Porto, Portugal
| | - Rosário Monteiro
- Faculty of Medicine, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), University of Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal
- University of Porto, Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Administração Regional de Saúde do Norte IP, Health Centre Grouping Porto Ocidental, Family Health Unit Homem do Leme, Porto, Portugal
| | - Carlos Martins
- University of Porto, Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal
- #H4A Primary Healthcare Research Network, Porto, Portugal
| |
Collapse
|
4
|
Livelo C, Guo Y, Abou Daya F, Rajasekaran V, Varshney S, Le HD, Barnes S, Panda S, Melkani GC. Time-restricted feeding promotes muscle function through purine cycle and AMPK signaling in Drosophila obesity models. Nat Commun 2023; 14:949. [PMID: 36810287 PMCID: PMC9944249 DOI: 10.1038/s41467-023-36474-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/01/2023] [Indexed: 02/23/2023] Open
Abstract
Obesity caused by genetic and environmental factors can lead to compromised skeletal muscle function. Time-restricted feeding (TRF) has been shown to prevent muscle function decline from obesogenic challenges; however, its mechanism remains unclear. Here we demonstrate that TRF upregulates genes involved in glycine production (Sardh and CG5955) and utilization (Gnmt), while Dgat2, involved in triglyceride synthesis is downregulated in Drosophila models of diet- and genetic-induced obesity. Muscle-specific knockdown of Gnmt, Sardh, and CG5955 lead to muscle dysfunction, ectopic lipid accumulation, and loss of TRF-mediated benefits, while knockdown of Dgat2 retains muscle function during aging and reduces ectopic lipid accumulation. Further analyses demonstrate that TRF upregulates the purine cycle in a diet-induced obesity model and AMPK signaling-associated pathways in a genetic-induced obesity model. Overall, our data suggest that TRF improves muscle function through modulations of common and distinct pathways under different obesogenic challenges and provides potential targets for obesity treatments.
Collapse
Affiliation(s)
- Christopher Livelo
- Department of Pathology, Division of Molecular and Cellular Pathology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Yiming Guo
- Department of Pathology, Division of Molecular and Cellular Pathology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Farah Abou Daya
- Department of Pathology, Division of Molecular and Cellular Pathology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Vasanthi Rajasekaran
- Department of Pathology, Division of Molecular and Cellular Pathology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Shweta Varshney
- Regulatory Biology Laboratory, Salk Institute for Biological Studies, La Jolla, CA, 92037, USA
- Department of Biology, Molecular Biology Institute, San Diego State University, San Diego, CA, 92182, USA
| | - Hiep D Le
- Regulatory Biology Laboratory, Salk Institute for Biological Studies, La Jolla, CA, 92037, USA
| | - Stephen Barnes
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Satchidananda Panda
- Regulatory Biology Laboratory, Salk Institute for Biological Studies, La Jolla, CA, 92037, USA
| | - Girish C Melkani
- Department of Pathology, Division of Molecular and Cellular Pathology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
- Department of Biology, Molecular Biology Institute, San Diego State University, San Diego, CA, 92182, USA.
| |
Collapse
|
5
|
Gomahr J, Julian V, Thivel D, Maruszczak K, Schneider AM, Weghuber D. Childhood obesity prevention: what can be achieved? Curr Opin Clin Nutr Metab Care 2022; 25:223-231. [PMID: 35256565 DOI: 10.1097/mco.0000000000000831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Childhood obesity is a pandemic generating an enormous individual and socioeconomic burden worldwide. This narrative review summarizes recent evidence on successful and recommended prevention strategies according to age groups and different levels of interventions. RECENT FINDINGS Effective prevention of childhood obesity is feasible and most successful early in life up to preschool age, and it should include a multicomponent approach, integrating individuals, family and society. Trials that improve nutrition and/or enhance physical activity are the cornerstones of childhood obesity prevention on an individual level. However, their efficacy is determined by the combination of interventions for the target age group. Further, improving family support and sleep, as well as reducing screen time, lead to favourable results. Many research gaps remain, including a lack of effective interventions for high-risk groups. SUMMARY As a multifactorial condition, childhood obesity requires a multicomponent approach. Interventions should be developmental stage-specific and adjusted to the setting. Current research gaps need to be targeted by future trials, with a special focus on the benefit of the most vulnerable groups. From a systems response perspective, a paradigm shift from interventions focusing on the individual to approaches that target society as a whole is warranted.
Collapse
Affiliation(s)
- Julian Gomahr
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand
| | - David Thivel
- Laboratory AME2P, University of Clermont Auvergne, Aubiere, Franoe
| | - Katharina Maruszczak
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Anna-Maria Schneider
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Weghuber
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
6
|
Nussbaum BM, Mathew MS, Atem F, Barlow SE, Gupta OT, Messiah SE. Distribution of comorbidities as primary diagnoses by obesity class among patients in a large US paediatric healthcare system. Clin Obes 2021; 11:e12478. [PMID: 34250735 DOI: 10.1111/cob.12478] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
There is little documentation of the distribution of specific health conditions across obesity classes (I, II, III), especially for paediatric populations who are seen for routine care in large United States US healthcare systems. The aim of this study was to assess the odds of presenting ≥2 obesity-related comorbidities as well as assess the overall distribution of these co-morbidities in children by class I/II/III obesity status controlling for key sociodemographic characteristics. This retrospective (2015-2019) electronic health record review analysed 49 276 patients from the Children's Health System of Texas diagnosed with obesity-related health conditions by obesity status (no obesity, class I, II, III). Crude and adjusted logistic regression models examined the association between obesity class and the likelihood of ≥2 comorbidities as primary diagnoses. Patients with class I obesity were 22% more likely (OR 1.22, 95% CI, 1.16, 1.27), patients with class II obesity were almost 50% more likely (OR 1.44, 95% CI, 1.35, 1.53) and those with class III obesity twice as likely (OR 2.04, 95% CI 1.91, 2.18) to be diagnosed with ≥2 comorbidities as primary diagnoses, compared with patients classified with no obesity. Children with obesity, particularly severe obesity, should be monitored closely by paediatricians for possible diagnoses of risk factors that could lead to adult chronic disease.
Collapse
Affiliation(s)
- Brandon M Nussbaum
- University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA
| | - Matthew Sunil Mathew
- Center for Pediatric Population Health, UTHealth School of Public Health, Children's Health System of Texas, Dallas, Texas, USA
| | - Folefac Atem
- Center for Pediatric Population Health, UTHealth School of Public Health, Children's Health System of Texas, Dallas, Texas, USA
| | - Sarah E Barlow
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Olga T Gupta
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sarah E Messiah
- University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA
- Center for Pediatric Population Health, UTHealth School of Public Health, Children's Health System of Texas, Dallas, Texas, USA
| |
Collapse
|
7
|
Reges O, Dicker D, Haase CL, Finer N, Karpati T, Leibowitz M, Satylganova A, Feldman B. Body mass index trajectories among people with obesity and association with mortality: Evidence from a large Israeli database. Obes Sci Pract 2020; 7:148-158. [PMID: 33841884 PMCID: PMC8019279 DOI: 10.1002/osp4.475] [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: 10/08/2020] [Revised: 11/13/2020] [Accepted: 11/28/2020] [Indexed: 11/10/2022] Open
Abstract
Objective Previous studies using longitudinal weight data to characterize obesity are based on populations of limited size and mostly include individuals of all body mass index (BMI) levels, without focusing on weight changes among people with obesity. This study aimed to identify BMI trajectories over 5 years in a large population with obesity, and to determine the trajectories' association with mortality. Methods For inclusion, individuals aged 30–74 years at index date (1 January 2013) with continuous membership in Clalit Health Services from 2008 to 2012 were required to have ≥1 BMI measurement per year in ≥3 calendar years during this period, of which at least one was ≥30 kg/m2. Latent class analysis was used to generate BMI trajectories over 5 years (2008–2012). Cox proportional hazards models were used to assess the association between BMI trajectories and all‐cause mortality during follow‐up (2013–2017). Results In total, 367,141 individuals met all inclusion criteria. Mean age was 57.2 years; 41% were men. The optimal model was a quadratic model with four classes of BMI clusters. Most individuals (90.0%) had stable high BMI over time. Individuals in this cluster had significantly lower mortality than individuals in the other trajectory clusters (p < 0.01), including clusters of people with dynamic weight trajectories. Conclusions The results of the current study show that people with stable high weight had the lowest mortality of all four BMI trajectories identified. These findings help to expand the scientific understanding of the impact that weight trajectories have on health outcomes, while demonstrating the challenges of discerning the cumulative effects of obesity and weight change, and suggest that dynamic historical measures of BMI should be considered when assessing patients' future risk of obesity‐related morbidity and mortality, and when choosing a treatment strategy.
Collapse
Affiliation(s)
- Orna Reges
- Clalit Research Institute Clalit Health Services Ramat Gan Israel.,Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago Illinois USA
| | - Dror Dicker
- Internal Medicine D Department and EASO Collaborating Center for Obesity Management Rabin Medical Center Hasharon Hospital Petach Tikva Israel.,Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | | | | | - Tomas Karpati
- Clalit Research Institute Clalit Health Services Ramat Gan Israel.,Holon Institute of Technology Holon Israel
| | - Morton Leibowitz
- Clalit Research Institute Clalit Health Services Ramat Gan Israel
| | | | - Becca Feldman
- Clalit Research Institute Clalit Health Services Ramat Gan Israel
| |
Collapse
|