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Matsudaira T, Sano H, Miyashita Y, Tajima N, Shirasawa T, Ochiai H, Kokaze A, Nishimura R. Association of adipocytokines and adipocytokine ratios with cardiovascular risk factors in Japanese preadolescents. J Pediatr Endocrinol Metab 2023:jpem-2022-0542. [PMID: 37293998 DOI: 10.1515/jpem-2022-0542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Asians are particularly susceptible to obesity-associated disorders and rapid progression of obesity from childhood to adulthood. Data on the association between adipocytokine parameters, particularly adipocytokine ratios, and cardiovascular risk factors in childhood remain limited. Herein, we assessed the association of resistin, adiponectin, and leptin levels and leptin/adiponectin and resistin/adiponectin ratios with selected cardiovascular risk factors and the influence of unhealthy weight on such associations in children aged 9-10 years. METHODS We included 380 children aged 9-10 years from three public elementary schools in Japan. RESULTS The body mass index (BMI) was significantly higher in male preadolescents than in female adolescents (median 16.5 kg/m2 vs. 16.2 kg/m2, p=0.032). No differences in height, weight, waist circumference (WC), waist/height ratio (W/Hr), total cholesterol and high-density lipoprotein cholesterol levels, or atherosclerosis index (AI) were observed between the sexes. Of the adipocytokine levels and ratios analyzed, only the leptin level and leptin/adiponectin ratio (L/Ar) were strongly and significantly positively correlated with the cardiovascular risk factors WC, W/Hr, and BMI (all p<0.05). The AI was not strongly correlated with any adipocytokine levels or ratios. Apart from the strong positive correlation between the L/Ar and W/Hr, no other significant associations were observed between any of the adipocytokine levels or ratios and the selected cardiovascular risk factors. CONCLUSIONS Our findings confirmed the value of adipocytokine ratios in risk assessment in pediatric populations, with leptin levels and leptin/adiponectin ratios strongly correlating with risk factors in children aged 9-10 years.
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Affiliation(s)
- Toru Matsudaira
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Hironari Sano
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Yumi Miyashita
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Naoko Tajima
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Takako Shirasawa
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hirotaka Ochiai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Rimei Nishimura
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
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van Minderhout HM, Joosse MV, Klaassen ES, Schalij-Delfos NE. EEG changes as an indication of central nervous system involvement following cyclopentolate 1% eye drops; a randomized placebo-controlled pilot study in a pediatric population. Strabismus 2023; 31:82-96. [PMID: 37282618 DOI: 10.1080/09273972.2023.2218455] [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: 06/08/2023]
Abstract
To compare EEG-patterns after instillation of cyclopentolate versus placebo eye drops. Prospective, randomized, placebo-controlled, and observational pilot study is presented. Ophthalmology outpatient clinic Dutch metropolitan hospital. Healthy 6- to 15-year-old volunteers with normal or low BMI requiring a cycloplegic refraction/retinoscopy. Randomized; 1 visit 2 drops cyclopentolate-1% and 1 visit 2 drops placebo (saline-0.9%). Single-blind: conducting researcher. Double blind: subjects, parents, clinical-neurophysiology staff, neurologist, and statistician. A 10-min baseline EEG-recording, drop-application, and follow-up to at least 45 min. Primary outcome: Detection of CNS changes, i.e. EEG-pattern changes, following two drops of cyclopentolate-1%. Secondary outcome: Determination of the extent of these pattern changes. Thirty-six cyclopentolate-1% saline-0.9% EEG registrations were made in 33 subjects; 18 males and 15 females. Three subjects were tested twice (interval 7 months). Nine out of fourteen (64%) of the 11- to 15-year-old children reported impaired memory, attention, alertness, as well as mind wandering following cyclopentolate. Drowsiness and sleep were seen in EEG-recordings of 11 subjects (33%) following cyclopentolate. We observed no drowsiness nor sleep during placebo recordings. The mean time to drowsiness was 23 min. Nine subjects arrived in stage-3 sleep but none arrived in REM-sleep. In subjects without sleep (N=24), significant changes compared to placebo-EEG were present for many leads and parameters. The main findings during awake eye-open recording were as follows: 1) a significant increase of temporal Beta-1,2 and 3-power, and 2) a significant decrease in: a) the parietal and occipital Alpha-2-power, b) the frontal Delta-1-power, c) the frontal total power, and d) the occipital and parietal activation synchrony index. The former finding reflects cyclopentolate uptake in the CNS, and the latter findings provide evidence for CNS suppression. Cyclopentolate-1% eye drops can affect the CNS and may cause altered consciousness, drowsiness, and sleep with concomitant EEG results in both young children and children in puberty. There is evidence that cyclopentolate has the potency to act as a short acting CNS depressant. Nevertheless, however, cyclopentolate-1% can safely be used in children and young adolescents.
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Affiliation(s)
- Helena Maria van Minderhout
- Department of Ophthalmology, Haaglanden Medical Centre, The Hague
- Department of Ophthalmology, Paediatric Ophthalmology, Leiden University Medical Centre, Leiden
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Draijer L, Voorhoeve M, Benninga M, Koot B. Evaluation of the feasibility of screening for paediatric non-alcoholic fatty liver disease. Acta Paediatr 2022; 111:2408-2415. [PMID: 35899429 PMCID: PMC9804620 DOI: 10.1111/apa.16502] [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: 02/16/2022] [Revised: 06/09/2022] [Accepted: 07/26/2022] [Indexed: 01/05/2023]
Abstract
AIM To evaluate the feasibility of screening for non-alcoholic fatty liver disease (NAFLD) in clinical practice and the acceptance of a screening strategy, and to identify factors that determine compliance. METHODS A screening protocol, based on alanine aminotransferase measurement and introduced to healthcare workers of Dutch outpatient obesity clinics in 2017, was evaluated. Medical files of children who visited the largest outpatient obesity clinic between 2017 and 2020 were evaluated. Focus group discussions (FGDs) were conducted with 14 healthcare workers who had been using the screening protocol. RESULTS Screening for NAFLD was performed in 477/571 (84%) of the children. Loss of follow-up was the major reason for inadequate screening. Follow-up was performed in 81/134 children with an abnormal screening result (61%). The FGDs indicated 13 barriers for screening, regarding guideline- and knowledge-related issues. CONCLUSION Screening for NAFLD was performed in the vast majority of the children. However, adherence to the guideline after an abnormal initial screening result needs to be improved. This can be achieved by improving the loss of follow-up of patients' and physicians' awareness of the relevance of mildly elevated ALT levels.
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Affiliation(s)
- Laura Draijer
- Department of Paediatric Gastroenterology and NutritionAmsterdam University Medical Centers, Location Academic Medical Center/Emma Children's Hospital, University of AmsterdamAmsterdamThe Netherlands,Amsterdam Reproduction & Development Research InstituteAmsterdam University Medical Centers, Location Academic Medical Center/Emma Children's HospitalAmsterdamThe Netherlands,Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism Research InstituteAmsterdam UMC, University of AmsterdamAmsterdamThe Netherlands
| | - Maaike Voorhoeve
- Department of Paediatric Gastroenterology and NutritionAmsterdam University Medical Centers, Location Academic Medical Center/Emma Children's Hospital, University of AmsterdamAmsterdamThe Netherlands
| | | | - Marc Benninga
- Department of Paediatric Gastroenterology and NutritionAmsterdam University Medical Centers, Location Academic Medical Center/Emma Children's Hospital, University of AmsterdamAmsterdamThe Netherlands
| | - Bart Koot
- Department of Paediatric Gastroenterology and NutritionAmsterdam University Medical Centers, Location Academic Medical Center/Emma Children's Hospital, University of AmsterdamAmsterdamThe Netherlands
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Resistance training reduces pain indices and improves quality of life and body strength in women with migraine disorders. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00822-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hypertension in Children with Obstructive Sleep Apnea Syndrome-Age, Weight Status, and Disease Severity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189602. [PMID: 34574528 PMCID: PMC8471072 DOI: 10.3390/ijerph18189602] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/03/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022]
Abstract
Older age, obesity, and obstructive sleep apnea syndrome (OSAS) are known to increase the risk of hypertension in adults. However, data for children are scarce. This study aimed to investigate the relationships between hypertension, age, weight status, and disease severity in 396 children with OSAS. The prevalence rates of hypertension, obesity, and severe OSAS (apnea-hypopnea index ≥10) were 27.0%, 28.0%, and 42.9%, respectively. Weight z-score and apnea-hypopnea index were independently correlated with systolic blood pressure z-score, and minimal blood oxygen saturation (SpO2) was independently associated with diastolic blood pressure z-score. Overall, late childhood/adolescence (odds ratio (OR) = 1.72, 95% CI = 1.05–2.81), obesity (OR, 2.58, 95% CI = 1.58–4.22), and severe OSAS (OR = 2.38, 95% CI = 1.48–3.81) were independent predictors of pediatric hypertension. Furthermore, late childhood/adolescence (OR = 2.50, 95% CI = 1.10–5.71) and abnormal SpO2 (mean SpO2 < 95%; OR = 4.91, 95% CI = 1.81–13.27) independently predicted hypertension in obese children, and severe OSAS (OR = 2.28, 95% CI = 1.27–4.10) independently predicted hypertension in non-obese children. In conclusion, obesity, OSAS severity, and abnormal SpO2 are potentially modifiable targets to improve hypertension while treating children with OSAS.
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Effect of Food Sensitivity on Overweight Assessed Using Food-Specific Serum Immunoglobulin G Levels. BIOCHIP JOURNAL 2021. [DOI: 10.1007/s13206-021-00028-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Misclassification of stunting, underweight and wasting in children 0-5 years of South Asian and Dutch descent: ethnic-specific v. WHO criteria. Public Health Nutr 2020; 23:2078-2087. [PMID: 32476641 PMCID: PMC7358702 DOI: 10.1017/s1368980019004464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Several authors have questioned the suitability of WHO Child Growth Standards (WHO-CGS) for all ethnic groups. The aim of this study was to identify potential misclassification of stunting, underweight and wasting in children of Surinamese Asian Indian, South Asian (Pakistan/India) and Dutch descent. DESIGN A series of routine cross-sectional measurements, collected 2012-2015. South Asian-specific normative growth references for weight-for-age and weight-for-length/height were constructed using the LMS method based on historic growth data of Surinamese Asian Indians born between 1974 and 1976. WHO-CGS and ethnic-specific references were applied to calculate z-scores and prevalence of stunting, underweight and wasting. SETTING Youth HealthCare, providing periodical preventive health check-ups. PARTICIPANTS 11 935 children aged 0-5 years. RESULTS Considerable deviations from WHO-CGS were found, with higher-than-expected stunting rates, especially in the first 6 months of life. Surinamese Asian Indian children showed stunting rates up to 16·0 % and high underweight and wasting over the whole age range (up to 7·2 and 6·7 %, respectively). Dutch children consistently had mean WHO-CGS z-scores 0·3-0·5 sd above the WHO baseline (>6 months). The application of ethnic-specific references showed low rates for all studied indicators, although South Asian children were taller and larger than their Surinamese Asian Indian counterparts. CONCLUSIONS WHO-CGS misclassify a considerable proportion of children from all ethnic groups as stunted in the first 6 months of life. Underweight and wasting are considerably overestimated in Surinamese Asian Indian children. Ethnic-specific growth references are recommended for Surinamese Asian Indian and Dutch children. The considerable differences found between South Asian subpopulations requires further research.
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Daga S, Mhatre S, Kasbe A, Dsouza E. Double burden of malnutrition among Indian schoolchildren and its measurement: a cross-sectional study in a single school. BMJ Paediatr Open 2020; 4:e000505. [PMID: 32099905 PMCID: PMC7015044 DOI: 10.1136/bmjpo-2019-000505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 12/02/2019] [Accepted: 12/10/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This cross-sectional study set in a single school on the outskirts of a large city aimed to document the extent of double burden of malnutrition (coexistence of overnutrition and undernutrition) among Indian schoolchildren from lower socioeconomic groups, and to determine if mid-upper arm circumference (MUAC) can be used as a proxy for body mass index (BMI). SUBJECTS The total number of participants was 1444, comprising 424 girls and 1020 boys belonging to playgroups and grades 1 to 7. MEASUREMENTS Anthropometric measurements, such as participants' MUAC, height and weight were measured using standard techniques. Descriptive statistics for BMI and MUAC were obtained based on gender; z-scores were computed using age-specific and sex-specific WHO reference data. The distribution of variables was calculated for three groups: girls, boys and all participants. Homogeneous subsets for BMI and MUAC were identified in the three groups. Age-wise comparisons of BMI and MUAC were conducted for each gender. MAIN OUTCOME MEASURES (1) To know if MUAC and BMI are correlated among boys and girls. (2) To study BMI and MUAC z-score distribution among the participants. RESULTS MUAC was positively correlated with BMI in both boys and girls. The following BMI z-score distribution was observed: severe acute malnutrition (SAM), 5 (0.3%); moderate acute malnutrition (MAM), 146 (10.1%) and undernourished, at risk of MAM/SAM, 141 (9.8%); obese, 21 (1.5%); overweight, 36 (2.5%) and pre-obese, 136 (9.4%). The distribution of categories of children based on MUAC z-scores was: SAM, 7 (0.5%); MAM, 181 (12.5%) and undernourished, at risk of MAM/SAM, 181 (12.5%); obese, 19 (1.3%); overweight, 178 (12.3%) and pre-obese, 135 (9.3%). CONCLUSIONS SAM/MAM/undernourished states and obesity/overweight/pre-obese states, indicating undernutrition more than overweight, coexist among Indian schoolchildren from lower middle/lower socioeconomic categories. BMI and MUAC were significantly correlated. MUAC identifies both undernutrition and overnutrition by early detection of aberrant growth.
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Affiliation(s)
| | - Sameer Mhatre
- Paediatrics, Smt Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
| | - Abhiram Kasbe
- Community Health, Topiwala National Medical College, Mumbai, Maharashtra, India
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de Wilde JA, Eilander M, Middelkoop BJC. Effect of neighbourhood socioeconomic status on overweight and obesity in children 2-15 years of different ethnic groups. Eur J Public Health 2019; 29:796-801. [PMID: 30698695 DOI: 10.1093/eurpub/cky277] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Studies on the influence of neighbourhood socioeconomic status (N-SES) on overweight and obesity rates in children from different ethnic backgrounds are scarce. This study investigated the differential effect of N-SES on overweight (including obesity) and obesity prevalence in different ethnic groups, and if N-SES explains ethnic differences in the prevalence of overweight and obesity. DESIGN A population based study of 109 766 body mass index (BMI) measurements of 86 209 children 2-15 years of Dutch, Turkish, Moroccan and South Asian descent. BMI class was determined with The International Obesity Task Force, and South Asian specific BMI cut-offs. WHO BMI criteria were applied for reference purposes. The effect of N-SES on prevalence rates was studied with generalized linear mixed models. RESULTS Neighbourhood SES was negatively associated with overweight and obesity. However, the effect of N-SES on overweight was stronger in Dutch children (OR 0.75, 95% CI 0.73-0.77) than in Turkish (OR 0.86, 95% CI 0.82-0.90), Moroccan (OR 0.91, 95% CI 0.86-0.97) and South Asian (OR 0.90, 95% CI 0.84-0.96) children. The influence of N-SES on obesity showed a similar pattern, except for Moroccan children in whom obesity prevalence remained stable over the whole N-SES range. At the same N-SES, overweight and obesity prevalence was significantly higher in Turkish, Moroccan and especially South Asian children compared with Dutch children. Adjusting for N-SES attenuated the ethnic differences. CONCLUSIONS Neighbourhood SES was negatively associated with overweight and obesity rates in all ethnic groups, but only partly explained the ethnic differences in overweight and obesity prevalence.
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Affiliation(s)
- J A de Wilde
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Child Health, TNO, Leiden, The Netherlands
| | - M Eilander
- Department of Youth Health Care, Centrum Jeugd en Gezin (Center for Youth and Family), The Hague, The Netherlands
| | - B J C Middelkoop
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Epidemiology, Municipal Health Service The Hague (GGD Haaglanden), The Hague, The Netherlands
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de Wilde JA, Meeuwsen RC, Middelkoop BJ. Growing ethnic disparities in prevalence of overweight and obesity in children 2-15 years in the Netherlands. Eur J Public Health 2019; 28:1023-1028. [PMID: 29893809 DOI: 10.1093/eurpub/cky104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Overweight and obesity rates stabilized or declined in the largest ethnic groups in the Netherlands, while reports on thinness are conflicting. Ethnic inequalities in time trends are unknown. The aim of this study was to examine (differences in) trends in overweight (including obesity), obesity, severe obesity and thinness in children of Dutch, Turkish, Moroccan and South Asian descent. Methods A retrospective cross-sectional study based on 135 150 height and weight measurements, taken between 2007 and 2015 in 77 058 children, aged 2-15 years, living in the city of The Hague (the Netherlands). Trends were determined with logistic regression. An interaction term was added to the model to test for effects of ethnicity on time trends. Results In Dutch children, overweight, obesity and severe obesity rates declined between 2007 and 2015, while overweight remained stable in Turkish, Moroccan and South Asian children. Turkish children showed a decrease in obesity (OR 0.981; 95% confidence interval 0.965-0.998), and Moroccan children in severe obesity (OR 0.918; 95% CI 0.877-0.962). South Asian children had the highest overweight and obesity rates of all ethnic groups (32.7 and 21.5% in 2015, respectively). Thinness rates were generally low and only decreased in South Asian children (0.940; 95% CI 0.886-0.997). Conclusions Ethnic inequalities in overweight and obesity rates widened since 2007, despite a decline in overweight and/or obesity in most ethnic groups. Ethnic specific interventions are highly needed, especially for South Asian children.
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Affiliation(s)
- Jeroen A de Wilde
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Child Health, TNO, Leiden, The Netherlands
| | - Rianne C Meeuwsen
- Department of Epidemiology, GGD (Municipal Health Service) Haaglanden, The Hague, The Netherlands
| | - Barend J Middelkoop
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Epidemiology, GGD (Municipal Health Service) Haaglanden, The Hague, The Netherlands
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Liao XP, Yu Y, Marc I, Dubois L, Abdelouahab N, Bouchard L, Wu YT, Ouyang F, Huang HF, Fraser WD. Prenatal determinants of childhood obesity: a review of risk factors 1. Can J Physiol Pharmacol 2019; 97:147-154. [PMID: 30661367 DOI: 10.1139/cjpp-2018-0403] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Childhood obesity is a predictor of adult obesity and has its roots in the pre-pregnancy or pregnancy period. This review presents an overview of the prenatal risk factors for childhood obesity, which were categorized into 2 groups: biological risk factors (maternal pre-pregnancy body mass index, gestational weight gain, diabetes in pregnancy, and caesarean section), and environmental and behavioural risk factors (maternal smoking and exposure to obesogens, maternal dietary patterns, maternal intestinal microbiome and antibiotics exposure, and maternal psychosocial stress). Identifying modifiable predisposing prenatal factors for obesity will inform further development of inventions to prevent obesity over the life course, and future directions for research and intervention are discussed.
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Affiliation(s)
- Xiang-Peng Liao
- a Department of Pediatrics, Shanghai Gongli Hospital, The Second Military Medical University, Shanghai, China.,b Centre de recherche de Centre Hospitalier Universitaire de Sherbrooke (CRCHUS) and Department of Obstetrics and Gynecology, Université de Sherbrooke, Quebec, QC J1H 5N4, Canada
| | - Yamei Yu
- c School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Isabelle Marc
- d Centre Hospitalier Universitaire de Québec Research Centre and Department of Pediatrics, Faculty of Medicine, Université Laval, Quebec, QC G1V 4G2, Canada
| | - Lise Dubois
- c School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Nadia Abdelouahab
- b Centre de recherche de Centre Hospitalier Universitaire de Sherbrooke (CRCHUS) and Department of Obstetrics and Gynecology, Université de Sherbrooke, Quebec, QC J1H 5N4, Canada
| | - Luigi Bouchard
- e Department of Medical Biology, CIUSSS-SLSJ, Université de Sherbrooke, Saguenay, QC G7H 7K9, Canada
| | - Yan-Ting Wu
- f International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,g Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fengxiu Ouyang
- h Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital and Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Heng-Feng Huang
- f International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,g Institute of Embryo-Fetal Original Adult Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - William D Fraser
- b Centre de recherche de Centre Hospitalier Universitaire de Sherbrooke (CRCHUS) and Department of Obstetrics and Gynecology, Université de Sherbrooke, Quebec, QC J1H 5N4, Canada
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Hudda MT, Donin AS, Owen CG, Rudnicka AR, Sattar N, Cook DG, Whincup PH, Nightingale CM. Exploring the use of adjusted body mass index thresholds based on equivalent insulin resistance for defining overweight and obesity in UK South Asian children. Int J Obes (Lond) 2018; 43:1440-1443. [PMID: 30546135 PMCID: PMC6451638 DOI: 10.1038/s41366-018-0279-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/12/2018] [Accepted: 11/04/2018] [Indexed: 11/09/2022]
Abstract
Background Body mass index (BMI) overweight/obesity thresholds in South Asian (SA) adults, at equivalent type-2 diabetes risk are lower than for white Europeans (WE). We aimed to define adjusted overweight/obesity thresholds for UK–SA children based on equivalent insulin resistance (HOMA-IR) to WE children. Methods In 1138 WE and 1292 SA children aged 9.0–10.9 years, multi-level regression models quantified associations between BMI and HOMA-IR by ethnic group. HOMA-IR levels for WE children were calculated at established overweight/obesity thresholds (at 9.5 years and 10.5 years), based on UK90 BMI cut-offs. Quantified associations in SA children were then used to estimate adjusted SA weight-status thresholds at the calculated HOMA-IR levels. Results At 9.5 years, current WE BMI overweight and obesity thresholds were 19.2 kg/m2, 21.3 kg/m2 (boys) and 20.0 kg/m2, 22.5 kg/m2 (girls). At equivalent HOMA-IR, SA overweight and obesity thresholds were lower by 2.9 kg/m2 (95% CI: 2.5–3.3 kg/m2) and 3.2 kg/m2 (95% CI: 2.7–3.6 kg/m2) in boys and 3.0 kg/m2 (95% CI: 2.6–3.4 kg/m2) and 3.3 kg/m2 (95% CI: 2.8–3.8 kg/m2) in girls, respectively. At these lower thresholds, overweight/obesity prevalences in SA children were approximately doubled (boys: 61%, girls: 56%). Patterns at 10.5 years were similar. Conclusions SA adjusted overweight/obesity thresholds based on equivalent IR were markedly lower than BMI thresholds for WE children, and defined more than half of SA children as overweight/obese.
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Affiliation(s)
- Mohammed T Hudda
- Population Health Research Institute, St George's, University of London, London, UK.
| | - Angela S Donin
- Population Health Research Institute, St George's, University of London, London, UK
| | - Christopher G Owen
- Population Health Research Institute, St George's, University of London, London, UK
| | - Alicja R Rudnicka
- Population Health Research Institute, St George's, University of London, London, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK
| | - Derek G Cook
- Population Health Research Institute, St George's, University of London, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK.
| | - Claire M Nightingale
- Population Health Research Institute, St George's, University of London, London, UK.
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de Wilde JA, Middelkoop B, Verkerk PH. Tracking of thinness and overweight in children of Dutch, Turkish, Moroccan and South Asian descent from 3 through 15 years of age: a historical cohort study. Int J Obes (Lond) 2018; 42:1230-1238. [PMID: 29892040 DOI: 10.1038/s41366-018-0135-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/27/2018] [Accepted: 05/18/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Overweight is shown to track (= to maintain a relative position in a distribution) from childhood to adulthood, but is mostly studied in preobesogenic cohorts and in single ethnic groups. Little is known about tracking of thinness by ethnicity. OBJECTIVES to determine (differences in) tracking of BMI (class) from 3 through 15 years and the prediction of BMI class at 13-15 years of age in contemporary Dutch, Turkish, Moroccan and South Asian children living in the Netherlands. METHODS Historical cohort of 7625 children, born 1994-1997, with 24,376 measurements of BMI. BMI z-score and BMI class was analysed using universal criteria. South Asian children were also assessed using ethnic specific BMI criteria. Diagnostic odds ratios (OR) and test properties were calculated to estimate the ability of BMI class at 3-4 years to predict BMI class at 13-15 years. RESULTS Tracking of thinness between 3 and 15 years was stronger than that of overweight, as indicated by a generally higher diagnostic OR. BMI trajectories between 3 and 15 years of age of thin, normal weight and overweight adolescents were, although significantly different, quite similarly shaped in children of Dutch, Turkish and Moroccan descent. The South Asian BMI trajectory deviated considerably from the other ethnic groups, but the differences disappeared when South Asian specific BMI criteria were applied. A substantial proportion of overweight developed between 5-10 years, after which less children shifted to other BMI classes. A total of 55-78% of children with overweight at 3-4 years retained their overweight at 13-15 years, and 10-20% of 3-4 year olds with thinness remained thin. CONCLUSIONS In all ethnic groups, overweight and especially thinness highly tracked into adolescence. South Asian children differed from the other ethnic groups when universal BMI criteria were applied, but with South Asian specific BMI criteria tracking patterns became more concordant.
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Affiliation(s)
- J A de Wilde
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. .,Department of Child Health, TNO, Leiden, The Netherlands.
| | - Bjc Middelkoop
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Epidemiology, Community Health Service Haaglanden (GGD Haaglanden), The Hague, The Netherlands
| | - P H Verkerk
- Department of Child Health, TNO, Leiden, The Netherlands
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Body weight and BMI percentiles for children in the South-East Asian Nutrition Surveys (SEANUTS). Public Health Nutr 2018; 21:2972-2981. [PMID: 29852879 DOI: 10.1017/s1368980018001349] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study aimed to (i) calculate body-weight- and BMI-for-age percentile values for children aged 0·5-12 years participating in the South-East Asian Nutrition Survey (SEANUTS); (ii) investigate whether the pooled (i.e. including all countries) SEANUTS weight- and BMI-for-age percentile values can be used for all SEANUTS countries instead of country-specific ones; and (iii) examine whether the pooled SEANUTS percentile values differ from the WHO growth references. DESIGN Body weight and length/height were measured. The LMS method was used for calculating smoothened body-weight- and BMI-for-age percentile values. The standardized site effect (SSE) values were used for identifying large differences (i.e. $\left| {{\rm SSE}} \right|$ >0·5) between the pooled SEANUTS sample and the remaining pooled SEANUTS samples after excluding one single country each time, as well as with WHO growth references. SETTING Malaysia, Thailand, Vietnam and Indonesia. SUBJECTS Data from 14 202 eligible children. RESULTS The SSE derived from the comparisons of the percentile values between the pooled and the remaining pooled SEANUTS samples were indicative of small/acceptable (i.e. $\left| {{\rm SSE}} \right|$ ≤0·5) differences. In contrast, the comparisons of the pooled SEANUTS sample with WHO revealed large differences in certain percentiles. CONCLUSIONS The findings of the present study support the use of percentile values derived from the pooled SEANUTS sample for evaluating the weight status of children in each SEANUTS country. Nevertheless, large differences were observed in certain percentiles values when SEANUTS and WHO reference values were compared.
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Koning M, de Jong A, de Jong E, Visscher TLS, Seidell JC, Renders CM. Agreement between parent and child report of physical activity, sedentary and dietary behaviours in 9-12-year-old children and associations with children's weight status. BMC Psychol 2018; 6:14. [PMID: 29631618 PMCID: PMC5891979 DOI: 10.1186/s40359-018-0227-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 03/26/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND To date, population based surveys aimed at gaining insight in health related behaviour of children have often used either child self-reports or parent proxy reports. It remains unclear however, if surveys using different sources of information from either parents or children are comparable. In addition, (over)weight status of children can lead to under- and over reporting by parents and children as a result of social desirability bias. We aimed at gaining insight in the level of agreement between parents and child reports regarding aspects of certain dietary, physical activity and sedentary behaviours, and whether there are differences in agreement between parents and child reports in healthy-weight and overweight children. METHODS Weighted kappa was used to determine the level of agreement between child and parent reports on health-related behaviour in 1998 parent-child dyads. We also stratified for weight status of the children. Information on children's health related behaviours was obtained by parental and children's questionnaires, and children's height and weight were measured. Associations between children's weight status and children reporting less, reporting more and reporting the same amount of health behaviour as their parents were investigated with multinomial logistic regression analysis. RESULTS The Cohen's kappa coefficients ranged from almost perfect agreement for the variable means of transportation, fair for the variables breakfast consumption and frequency of outside play to slight for the variables duration of outside play, frequency and duration of TV/DVD viewing and family dinner. Overweight children were significantly more likely to report less breakfast consumption (OR = 2.6 (95% CI: 1.3 - 5.1)) and lower frequency of outside play than their parents (OR = 1.8 (95% CI: 1.1 - 2.9)). CONCLUSION There can be considerable disagreement between the health related behaviours of children as reported by parents or the children themselves. Based on the present study, it cannot be concluded whether parents' or children's reports are more accurate. For future studies, social desirability and recall bias would be best demonstrated in a validation study comparing child and parent self-reports with more objective measures of physical activity and food intake.
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Affiliation(s)
- Maaike Koning
- Research Centre Healthy Cities, Knowledge Centre for Health and Social work, Windesheim University of Applied Sciences, PO box 10090, 8000 GB Zwolle, the Netherlands
| | - Astrid de Jong
- Research Centre Healthy Cities, Knowledge Centre for Health and Social work, Windesheim University of Applied Sciences, PO box 10090, 8000 GB Zwolle, the Netherlands
- Department of Health Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Elske de Jong
- Research Centre Healthy Cities, Knowledge Centre for Health and Social work, Windesheim University of Applied Sciences, PO box 10090, 8000 GB Zwolle, the Netherlands
- Pedagogical Studies, Department for Health and Social Work, Windesheim University of Applied Sciences, Zwolle, The Netherlands
| | - Tommy L. S. Visscher
- Research Centre Healthy Cities, Knowledge Centre for Health and Social work, Windesheim University of Applied Sciences, PO box 10090, 8000 GB Zwolle, the Netherlands
| | - Jacob C. Seidell
- Research Centre Healthy Cities, Knowledge Centre for Health and Social work, Windesheim University of Applied Sciences, PO box 10090, 8000 GB Zwolle, the Netherlands
- Department of Health Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Carry M. Renders
- Research Centre Healthy Cities, Knowledge Centre for Health and Social work, Windesheim University of Applied Sciences, PO box 10090, 8000 GB Zwolle, the Netherlands
- Department of Health Sciences, Vrije Universiteit, Amsterdam, the Netherlands
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de Wilde JA, Dekker M, Middelkoop BJC. BMI-for-age in South Asian children of 0-20 years in the Netherlands: secular changes and misclassification by WHO growth references. Ann Hum Biol 2018. [PMID: 29540065 DOI: 10.1080/03014460.2018.1445288] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND South Asians are prone to cardiometabolic disease at lower BMI levels than most other ethnic groups, starting in childhood. The magnitude of BMI misclassifications is unknown. AIM To compare the BMI distribution of contemporary South Asian 0-20 year olds in the Netherlands with: (1) The South Asian norm reference (secular trends); and (2) The WHO child growth standard and reference. SUBJECTS AND METHODS The BMI-for-age distribution of 6677 routine measurements of 3322 South Asian children, aged 0-20 years, was described with the LMS method and BMI z-scores. RESULTS The BMI distribution in South Asian 0-4 year olds was almost similar to the norm reference (mean BMI z-score = 0.11, skewness = 0.31, SD = 1.0), whereas in 5-19 year olds the distribution had shifted upwards (mean = 0.53) and widened (skewness = -0.12, SD = 1.08). Overweight (incl. obesity) and obesity peaked at 8-10 years, at 45-48% and 35-37%, respectively. Relative to the WHO references, the BMI distribution was left-shifted at ages 0-4 years (mean BMI z-score = -0.46, skewness = 0.23, SD = 0.98) and widened at ages 5-20 years (mean = 0.05; skewness = -0.02, SD = 1.40). At most ages, thinness rates were significantly higher and obesity rates lower than based on South Asian norms. CONCLUSIONS A secular change of BMI-for-age in South Asian children mostly affected children >4 years. WHO references likely under-estimate overweight and obesity rates in South Asian children.
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Affiliation(s)
- J A de Wilde
- a Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , the Netherlands.,b Department of Child Health , TNO , Leiden , the Netherlands
| | - M Dekker
- a Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , the Netherlands
| | - B J C Middelkoop
- a Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , the Netherlands.,c Department of Epidemiology , Community Health Service Haaglanden (GGD Haaglanden) , The Hague , the Netherlands
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17
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Rashid V, Engberink MF, van Eijsden M, Nicolaou M, Dekker LH, Verhoeff AP, Weijs PJM. Ethnicity and socioeconomic status are related to dietary patterns at age 5 in the Amsterdam born children and their development (ABCD) cohort. BMC Public Health 2018; 18:115. [PMID: 29310648 PMCID: PMC5759294 DOI: 10.1186/s12889-017-5014-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health inequalities are already present at young age and tend to vary with ethnicity and socioeconomic status (SES). Diet is a major determinant of overweight, and studying dietary patterns as a whole in relation to overweight rather than single nutrients or foods has been suggested. We derived dietary patterns at age 5 and determined whether ethnicity and SES were both related to these dietary patterns. METHODS We analysed 2769 validated Food Frequency Questionnaires filled in by mothers of children (5.7 ± 0.5y) in the Amsterdam Born Children and their Development (ABCD) cohort. Food items were reduced to 41 food groups. Energy adjusted intake per food group (g/d) was used to derive dietary patterns using Principal Component Analysis and children were given a pattern score for each dietary pattern. We defined 5 ethnic groups (Dutch, Surinamese, Turkish, Moroccan, other ethnicities) and 3 SES groups (low, middle, high, based on maternal education). Multivariate ANOVA, with adjustment for age, gender and maternal age, was used to test potential associations between ethnicity or SES and dietary pattern scores. Post-hoc analyses with Bonferroni adjustment were used to examine differences between groups. RESULTS Principal Component Analysis identified 4 dietary patterns: a snacking, full-fat, meat and healthy dietary pattern, explaining 21% of the variation in dietary intake. Ethnicity was related to the dietary pattern scores (p < 0.01): non-Dutch children scored high on snacking and healthy pattern, whereas Turkish children scored high on full-fat and Surinamese children on the meat pattern. SES was related to the snacking, full-fat and meat patterns (p < 0.01): low SES children scored high on the snacking and meat pattern and low on the full-fat pattern. CONCLUSIONS This study indicates that both ethnicity and SES are relevant for dietary patterns at age 5 and may enable more specific nutrition education to specific ethnic and low socioeconomic status target groups.
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Affiliation(s)
- Viyan Rashid
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067, SM, Amsterdam, The Netherlands.
| | - Marielle F Engberink
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067, SM, Amsterdam, The Netherlands
| | - Manon van Eijsden
- Department of Epidemiology, Health Promotion and Health Care Innovation, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Mary Nicolaou
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Institute, The Netherlands
| | - Louise H Dekker
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Institute, The Netherlands
| | - Arnoud P Verhoeff
- Department of Epidemiology, Health Promotion and Health Care Innovation, Public Health Service Amsterdam, Amsterdam, The Netherlands.,Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter J M Weijs
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067, SM, Amsterdam, The Netherlands.,Nutrition and Dietetics, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
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The Latent Class Structure of Chinese Patients with Eating Disorders in Shanghai. SHANGHAI ARCHIVES OF PSYCHIATRY 2017; 29:200-207. [PMID: 28955139 PMCID: PMC5608992 DOI: 10.11919/j.issn.1002-0829.217012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Eating disorder is culture related, and the clinical symptoms are different between eastern and western patients. So the validity of feeding and eating disorders in the upcoming ICD-11 guide for Chinese patients is unclear. AIMS To explore the latent class structure of Chinese patients with eating disorder and the cross-cultural validity of the eating disorder section of the new ICD-11 guide in China. METHODS A total of 379 patients with eating disorders at Shanghai Mental Health Center were evaluated using the EDI questionnaire and a questionnaire developed by researchers from 2010 to 2016. SPSS 20.0 was used to enter data and analyze demographic data, and Latent GOLD was employed to conduct latent profile analysis. RESULTS According to the results of latent profile analysis, patients with eating disorder were divided into five classes: low-weight fasting class (23.1%), non-fat-phobic binge/purge class (21.54%), low-fat-phobic binge class (19.27%), fat-phobic binge class (19.27%), and non-fat-phobic low-weight class (16.76%). Among the clinical symptoms extracted, there were significant differences in Body Mass Index (BMI), binge eating behavior, self-induced vomiting, laxative use and fat-phobic opinion; while there was no significant difference in restrictive food intake. CONCLUSIONS Based on the clinical symptoms, there are five latent classes in Chinese patients with eating disorder, which is in accordance with the diagnostic categories of feeding and eating disorder in ICD-11. However, further work is needed in improving the fat-phobic opinion of patients with eating disorder and clarifying the BMI standard of thinness in the Chinese population.
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Pediatric-specific reference intervals in a nationally representative sample of Iranian children and adolescents: the CASPIAN-III study. World J Pediatr 2016; 12:335-342. [PMID: 26684311 DOI: 10.1007/s12519-015-0065-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 10/15/2014] [Indexed: 10/22/2022]
Abstract
BACKGROUND This study aimed to determine for the first time the age- and gender-specific reference intervals for biomarkers of bone, metabolism, nutrition, and obesity in a nationally representative sample of the Iranian children and adolescents. METHODS We assessed the data of blood samples obtained from healthy Iranian children and adolescents, aged 7 to 19 years. The reference intervals of glucose, lipid profile, liver enzymes, zinc, copper, chromium, magnesium, and 25-hydroxy vitamin D [25(OH)D] were determined according to the Clinical & Laboratory Standards Institute C28-A3 guidelines. The reference intervals were partitioned using the Harris-Boyd method according to age and gender. RESULTS The study population consisted of 4800 school students (50% boys, mean age of 13.8 years). Twelve chemistry analyses were partitioned by age and gender, displaying the range of results between the 2.5th to 97.5th percentiles. Significant differences existed only between boys and girls at 18 to 19 years of age for low density lipoprotein-cholesterol. 25(OH)D had the only reference interval that was similar to all age groups and both sexes. CONCLUSIONS This study presented the first national database of reference intervals for a number of biochemical markers in Iranian children and adolescents. It is the first report of its kind from the Middle East and North Africa. The findings underscore the importance of providing reference intervals in different ethnicities and in various regions.
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20
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van Minderhout HM, Joosse MV, Grootendorst DC, Schalij-Delfos NE. Adverse reactions following routine anticholinergic eye drops in a paediatric population: an observational cohort study. BMJ Open 2015; 5:e008798. [PMID: 26700273 PMCID: PMC4691733 DOI: 10.1136/bmjopen-2015-008798] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 10/15/2015] [Accepted: 10/16/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the presence, nature and relationship to age, sex, ethnicity and body mass index (BMI) of adverse reactions following routine cycloplegic eye drops in children. DESIGN Prospective observational cohort study. SETTING Ophthalmology outpatient clinic Dutch metropolitan hospital; February, March and April 2009. PARTICIPANTS Children aged 3-14-year-old children receiving two drops of cyclopentolate 1% (C+C) or one drop of cyclopentolate 1% and one drop of tropicamide 1% (C+T). Patients were categorised by age (3-6, 7-10 and 11-14 years), sex, ethnicity and body mass index (BMI) (low, normal or high). OUTCOME MEASURES Rate and nature of adverse reactions reported at 45 min following treatment. Crude and adjusted ORs for reporting an adverse reaction using stepwise regression analysis with BMI, age, ethnicity and sex. RESULTS 912 of 915 eligible patients participated (99.7%). Adverse reactions were reported for C+C in 10.3% and in C+T in 4.8% (42/408 and 24/504, p=0.002), respectively. Central effects were present in 95% in C+C and in 92% in C+T. Compared to C+T, an increased risk was present in C+C (crude OR 2.3 (1.4 to 3.9), p=0.002). Forward adjustment showed BMI to be an influencing factor in treatment (OR 3.1 (1.7 to 5.6), p<0.001). In a multivariate model, a dose of cyclopentolate remained associated with adverse reactions. Analysis per BMI and regime and age category and regime, indicated associations with low BMI (OR C+C 21.4 (6.7 to 67.96), p<0.001, respectively, C+T 5.2 (2.1 to 12.8), p<0.001) and young age (OR C+C 8.1 (2.7 to 24.8), p<0.001). CONCLUSIONS Adverse reactions were common and almost exclusively involved the central nervous system. Both presence and severity were associated with repeated instillation of cyclopentolate 1%, low BMI and young age. In specific paediatric populations, a single dose of cyclopentolate must be considered. Vital function monitoring facilities are advisable. Adjustment of guidelines is recommended.
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Affiliation(s)
| | - Maurits V Joosse
- Department of Ophthalmology, Medical Centre Haaglanden, The Hague, The Netherlands
| | - Diana C Grootendorst
- Department of Research and Development, Landsteiner Institute, Medical Centre Haaglanden, The Hague, The Netherlands
| | - Nicoline E Schalij-Delfos
- Department of Ophthalmology, Pediatric Ophthalmology, Leiden University Medical Centre, Leiden, The Netherlands
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Length and height percentiles for children in the South-East Asian Nutrition Surveys (SEANUTS). Public Health Nutr 2015; 19:1741-50. [PMID: 26592313 DOI: 10.1017/s1368980015003316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Health and nutritional information for many countries in the South-East Asian region is either lacking or no longer up to date. The present study aimed to calculate length/height percentile values for the South-East Asian Nutrition Survey (SEANUTS) populations aged 0·5-12 years, examine the appropriateness of pooling SEANUTS data for calculating common length/height percentile values for all SEANUTS countries and whether these values differ from the WHO growth references. DESIGN Data on length/height-for-age percentile values were collected. The LMS method was used for calculating smoothened percentile values. Standardized site effects (SSE) were used for identifying large or unacceptable differences (i.e. $\mid\! \rm SSE \!\mid$ >0·5) between the pooled SEANUTS sample (including all countries) and the remaining pooled SEANUTS samples (including three countries) after weighting sample sizes and excluding one single country each time, as well as with WHO growth references. SETTING Malaysia, Thailand, Vietnam and Indonesia. SUBJECTS Data from 14202 eligible children were used. RESULTS From pair-wise comparisons of percentile values between the pooled SEANUTS sample and the remaining pooled SEANUTS samples, the vast majority of differences were acceptable (i.e. $\mid\! \rm SSE \!\mid$ ≤0·5). In contrast, pair-wise comparisons of percentile values between the pooled SEANUTS sample and WHO revealed large differences. CONCLUSIONS The current study calculated length/height percentile values for South East Asian children aged 0·5-12 years and supported the appropriateness of using pooled SEANUTS length/height percentile values for assessing children's growth instead of country-specific ones. Pooled SEANUTS percentile values were found to differ from the WHO growth references and therefore this should be kept in mind when using WHO growth curves to assess length/height in these populations.
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Tomaszewski P, Żmijewski P, Milde K, Sienkiewicz-Dianzenza E. Weight-height relationships and central obesity in 7-year-old to 10-year-old Polish urban children: a comparison of different BMI and WHtR standards. J Physiol Anthropol 2015; 34:34. [PMID: 26445974 PMCID: PMC4597461 DOI: 10.1186/s40101-015-0073-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 09/22/2015] [Indexed: 12/03/2022] Open
Abstract
Background An increase in overweight and obesity rates among children is a major social problem; however, interpretation and comparability of estimations may be affected by the reference values and cut-off points used. The aim of the study was to assess the prevalence of underweight, overweight, obesity and central obesity in 7-year-old to 10-year-old urban children and to compare the results obtained through various standards of BMI or waist-to-height ratio (WHtR) indicators. Methods The research was conducted on a sample group of 367 girls and 424 boys aged 6.5–10.5 years, randomly chosen from a number of primary schools in Warsaw, Poland. In all participants, basic somatic features were assessed, and based on BMI and WHtR values, participants were then classified according to different standards. The prevalence of underweight, overweight, obesity and central obesity in boys and girls was compared using the chi-square test; fractions obtained from various BMI and WHtR standards were compared through a test for proportions; and the conformity of classification methods was assessed using Cohen’s kappa coefficient. Results Approximately 9 % of girls and 6 % of boys were underweight, 15 % of all participants was classified as overweight, and approximately 4 % of girls and 6 % of boys aged 7–10 were obese. Central obesity was diagnosed in 18.6–20.9 % of all participants, while another 7.1 % of girls and 7.5 % of boys displayed symptoms of excessive fat deposition characterized by elevated body fat percentages. Even though the prevalence estimations varied depending on the standards used, the overall classification compliance reached 86–94 % with a Cohen’s kappa coefficient ranging from 0.676 to 0.841. Conclusion The prevalence of underweight, overweight and obesity among urban children is comparable to estimates for the general population. Of particular concern, in terms of health and proper physical development, is the problem of central obesity that affects one out of five children. The use of reference values representing body fat percentage seems justified as it allows for a more precise diagnosis of weight-related disorders, including the particularly threatening abdominal obesity.
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Affiliation(s)
- Paweł Tomaszewski
- Department of Statistics and Computer Science, Jozef Pilsudski University of Physical Education, Marymoncka 34, 00-968, Warsaw, Poland.
| | - Piotr Żmijewski
- Department of Physiology, Institute of Sport, Trylogii 2, 01-982, Warsaw, Poland.
| | - Katarzyna Milde
- Department of Statistics and Computer Science, Jozef Pilsudski University of Physical Education, Marymoncka 34, 00-968, Warsaw, Poland.
| | - Edyta Sienkiewicz-Dianzenza
- Department of Statistics and Computer Science, Jozef Pilsudski University of Physical Education, Marymoncka 34, 00-968, Warsaw, Poland.
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Physical activity patterns among school children in India. Indian J Pediatr 2014; 81 Suppl 1:47-54. [PMID: 24944142 DOI: 10.1007/s12098-014-1472-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 04/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the prevalence of physical activity and its relation with socio-demographic variables and eating habits among school-aged children in India. METHODS The study incorporated secondary analysis of anthropometric measurements and questionnaires on lifestyle and dietary habits of 1,680 school children aged between 3 and 11 y, obtained while carrying out the OBEY-AD project. The inventory contained questions about several variables concerning to physical activity, educational background, lifestyles and eating habits for both children and parents. Questions were organized along specific contents, which could be informative topics, picture choices and multiple answers choices. RESULTS Prevalence of inactivity was 21% and exhibited significant variations between cities. Physical activity was significantly associated to socio-economic status and consumption of fruits and vegetables. No association could be revealed with children's BMI. CONCLUSIONS Health-promotion interventions aimed at improving healthy lifestyles in Indian children should focus on population strata with low socio-economic status.
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