Obesogenic environments: environmental approaches to obesity prevention

Does School Health Promotion Have Additional Value for Educational Performance? A Repeated Cross-Sectional Multilevel Study

Little information is available regarding the influence of the interplay between the school context and school health promotion on educational performance. Therefore, we examined whether the variation between primary and secondary schools regarding the educational performance of students could be explained by general school characteristics, school population characteristics, and school health promotion and to what extent these factors interact. We performed multilevel analyses using existing data on 7021 primary schools and 1315 secondary schools in the Netherlands from the school years 2010-2011 till 2018-2019. Our outcomes were the final test score from primary education and the average grade of standardized final exams from secondary education. School health promotion was operationalized as having obtained Healthy School (HS) certification. For the test score, 7.17% of the total variation was accounted for by differences at the school level and 4.02% for the average grade. For both outcomes, the percentage of disadvantaged students in a school explained most variation. HS certification did not explain variation, but moderated some associations. We found small to moderate differences between schools regarding educational performance. Compositional differences of school populations, especially socioeconomic status, seemed more important in explaining variation in educational performance than general school characteristics and HS certification. Some associations were moderated by HS certification, but differences remained small in most cases.

The Thai Health Promotion Foundation: Two Decades of Joint Contributions to Addressing Noncommunicable Diseases and Creating Healthy Populations

Globally, the current investment in preventive care is inadequate and ineffective for addressing noncommunicable diseases and their causes. The Thai Health Promotion Foundation, with its sustainable funding from 2% levies on tobacco and alcohol, together with partners, has been used to address noncommunicable diseases effectively.

Challenges and Opportunities in Diagnosis and Management of Cardiometabolic Risk in Adolescents

PURPOSE OF REVIEW

This review aims to elucidate the limitations of diagnosing metabolic syndrome in adolescents as well as challenges and opportunities in the identification and reduction of cardiometabolic risk in this population.

RECENT FINDINGS

There are multiple criticisms of how we define and approach obesity in clinical practice and scientific research, and weight stigma further complicates the process of making and communicating weight-related diagnoses. While the goal of diagnosing and managing metabolic syndrome in adolescents would be to identify individuals at elevated future cardiometabolic risk and intervene to reduce the modifiable component of this risk, there is evidence that identifying cardiometabolic risk factor clustering may be more useful in adolescents than establishing a cutoff-based diagnosis of metabolic syndrome. It has also become clear that many heritable factors and social and structural determinants of health contribute more to weight and body mass index than do individual behavioral choices about nutrition and physical activity. Promoting cardiometabolic health equity requires that we intervene on the obesogenic environment and mitigate the compounding effects of weight stigma and systemic racism. The existing options to diagnose and manage future cardiometabolic risk in children and adolescents are flawed and limited. While striving to improve population health through policy and societal interventions, there are opportunities to intervene at all levels of the socioecological model in order to decrease future morbidity and mortality from the chronic cardiometabolic diseases associated with central adiposity in both children and adults. More research is needed to identify the most effective interventions.

Alterations of SOCS1 and SOCS3 transcript levels, but not promoter methylation levels in subcutaneous adipose tissues in obese women

BACKGROUND

Animal model studies suggest that change in the members of the suppressor of the cytokine signaling (SOCS) family (mainly SOCS1 and SOCS3) is linked to the pathogenesis of obesity-related metabolic disorders. Moreover, epigenetic modification is involved in the transcriptional regulation of the SOCS gene family. Here, we aimed to evaluate the mRNA expression as well as gene promoter methylation of SOCS1 and SOCS3 in subcutaneous adipose tissue (SAT) from obese women compared to normal-weight subjects. We also intend to identify the possible association of SOCS1 and SOCS3 transcript levels with metabolic parameters in the context of obesity.

METHODS

This study was conducted on women with obesity (n = 24) [body mass index (BMI) ≥ 30 kg/m ²] and women with normal-weight (n = 22) (BMI < 25 kg/m ²). Transcript levels of SOCS1 and SOCS3 were evaluated by real-time PCR in SAT from all participants. After bisulfite treatment of DNA, methylation-specific PCR was used to assess the putative methylation of 10 CpG sites in the promoter of SOCS1 and 13 CpG sites in SOCS3 in SAT from women with obesity and normal weight.

RESULTS

It was found that unlike SOCS3, which disclosed an elevating expression pattern, the expression level of SOCS1 was lower in the women with obesity as compared with their non-obese counterparts (P-value = 0.03 for SOCS1 transcript level and P-value = 0.011 for SOCS3 transcript level). As for the analysis of promoter methylation, it was found that SOCS1 and SOCS3 methylation were not significantly different between the individuals with obesity and normal weight (P-value = 0.45 and P-value = 0.89). Correlation analysis indicated that the transcript level of SOCS1 mRNA expression had an inverse correlation with BMI, hs-CRP levels, HOMA-IR, and insulin levels. However, the SOCS3 transcript level showed a positive correlation with BMI, waist-to-height ratio, waist circumference, hip circumference, hs-CRP, HOMA-IR, insulin, fasting blood glucose, and total cholesterol. Interestingly, HOMA-IR is the predictor of the transcript level of SOCS1 (β =  - 0.448, P-value = 0.003) and SOCS3 (β = 0.465, P-value = 0.002) in SAT of all participants.

CONCLUSIONS

Our findings point to alterations of SOCS1 and SOCS3 transcript levels, but not promoter methylation levels in subcutaneous adipose tissues from women with obesity. Moreover, mRNA expression of SOCS1 and SOCS3 in SAT was associated with known obesity indices, insulin resistance, and hs-CRP, suggesting the contribution of SOCS1 and SOCS3 in the pathogenesis of obesity-related metabolic abnormalities. However, further studies are required to establish this concept.

Exclusive Breastfeeding for at Least Four Months Is Associated with a Lower Prevalence of Overweight and Obesity in Mothers and Their Children after 2-5 Years from Delivery

Introduction: Obesity is a current public health concern. Higher body weight is influenced by genetic and environmental parameters, and their interplay and is associated with a greater risk for several chronic diseases. Breastfeeding has been suggested as a preventive measure against obesity, which can further reduce long-term negative health outcomes for both women and children. Aim: The aim of the present study was to evaluate the role of breastfeeding on maternal and childhood overweight and obesity. Materials and Methods: This is a cross-sectional study conducted on 2515 healthy mothers and their children, aged 2−5 years, enrolled from nine different Greek rural and urban regions. Validated, standardized questionnaires were administrated that included anthropometric indices, socio-demographic characteristics of mothers and children, as well as breastfeeding practices. Results: Overall, 68% of participated women exclusively breastfed their children for at least 4 months. Mothers that exclusively breastfed showed a significantly lower prevalence of overweight and obesity after 2−5 years from delivery (p < 0.0001). Children that had exclusively been breastfed showed a significantly lower prevalence of overweight and obesity at the age of 2−5 years (p < 0.0001). Using multivariate regression analysis, exclusive breastfeeding for at least 4 months was associated with a two-fold lower risk for maternal and childhood overweight and obesity after 2−5 years from delivery, independent from maternal age, educational and economic status, and smoking habits (p < 0.0001). Conclusion: Exclusive breastfeeding for at least 4 months had a positive effect on childhood overweight and obesity, also contributing beneficially to post-natal maternal weight control. The beneficial effects of breastfeeding should be communicated to future and new mothers, while supportive actions for all mothers to initiate and continue breastfeeding their offspring should be implemented.

Food and Nutrition Education Using Intuitive Method and NOVA Food Classification: Implications for Food Practices of Children and Adolescents Intuitive Method in Food and Nutrition Education

PURPOSE

To evaluate the impact of food and nutrition education interventions based on the intuitive method (IM) proposed by Johaan Henrich Pestalozzi (1746-1827) at different time periods on the food practices of children and adolescents.

DESIGN

This was a prospective comparative intervention program assessed by a pre-post survey at shorter term (3 months) and longer term (6 months).

SETTING

Two institutions that provide extracurricular social support for children and adolescents with social and economic vulnerabilities in the city of Lavras, Minas Gerais, Brazil. The shorter-term intervention was conducted in Institution A and the longer term one conducted in Institution B.

SUBJECTS

The sample consisted of 245 students aged between 5 and 14 years who attended the institutions. For each institution, they were divided into two groups (control and IM).

INTERVENTION

We compared the effectiveness of the interventions performed by the IM or by expository actions (control) in both institutions. Interventions were focused on the guidelines of the Food Guide for the Brazilian Population and dealt with food choices, meal preparation, commensality, and obstacles to healthy eating.

MEASURES

The assessed outcomes were food consumption according to NOVA food classification, cooking self-efficacy, and knowledge about food and nutrition.

ANALYSIS

Paired t-tests were used to compare food consumption before and after interventions. Adjusted logistic regression models were used to analyze the outcomes on food and nutrition knowledge and cooking self-efficacy.

RESULTS

Subjects receiving IM interventions decreased mean intake of ultra-processed food (3.56 to 1.50 portions; P< .001) and had greater odds of increasing self-efficacy with cooking (OR = 2,33-4,17). Both methods were effective regarding teaching about food and nutrition. Intervention period did not homogeneously impact these outcomes.

CONCLUSIONS

The use of food and nutrition education interventions presented positive outcomes on the food practices of the participants. The IM is an alternative method to educate children and adolescents about healthy eating practices.

The Analysis of Trends of Preschool Child Stunting, Wasting and Overweight in the Eastern Mediterranean Region: Still More Effort Needed to Reach Global Targets 2025

BACKGROUND

This study was undertaken to analyze and compare Eastern Mediterranean (EM) countries in achievement of WHO nutrition global targets for children growth indicators by 2025.

METHODS

A total of 108 national surveys from 20 countries in EM region were analyzed to estimate the prevalence of stunting and wasting and 93 surveys to estimate the prevalence of overweight/obesity in children. These data were obtained from national surveys included in the WHO Global Database on Child Growth and Malnutrition.

RESULTS

In EM region, the prevalence of childhood stunting was estimated to have a 38% decline from 2000 (34.7%) to 2025 (21.2%). Only three countries in EM region (Iran and Jordan, Saudi Arabia) were anticipated to achieve the expected WHO target by 2025. From 2000 to 2020, the prevalence of wasting decreased from 6.9 to 5.3. Six countries were presumed to achieve the expected WHO target by 2025. Nine countries will presumably have overweight rates >5% (Djibouti, Egypt, Iraq, Kuwait, Lebanon, Libya, Morocco, Syrian Arab Republic and Tunisia) in 2025 whereas five countries will have overweight rates above 10% (Egypt, Libya, Morocco, Syrian Arab Republic and Tunisia).

CONCLUSION

Despite descending trends of child stunting and wasting and a secular trend of child obesity in EM region, it is expected that WHO targets will not be achieved by 2025. A diverse socio-economic condition in EM countries necessitates different action plans. International determination, political commitment and, above all, involvement of the families are needed to achieve 2025 targets for child stunting, wasting and overweight/obesity.

Dietary habits, shopping behavior and weight gain during COVID-19 pandemic lockdown among students in a private university in Selangor, Malaysia

Background

Due to the global surge in COVID-19 cases, numerous countries have enforced lockdowns of varying stringency. Social isolation and stay-at-home orders have detrimental effects on one's lifestyle and dietary habits. This study aimed to assess the dietary patterns, food preferences, shopping behavior and weight gain during the lockdown among students in a private university in Malaysia.

Design and Methods

We conducted a cross-sectional study among 426 students using convenience sampling method one-month after initiating the Conditional Movement Control Order (November 15-30, 2020), using a validated self-administered web-based survey. Chi-square test with post-hoc and planned comparison procedures were performed.

Results

Of the 426 participants, more than half were females (55.9%). Over half of the surveyed students reported increased eating (51.2%), snacking (55.2%) and online food ordering (71.1%) during the lockdown. Meat products and sweet drinks (both >90%) were the most consumed food among individuals with higher BMI. 45.5% of the participants reported weight gain (mean 3.36, SD 1.61kg) one month after the lockdown. Female, youth (aged 19-24), working remotely, increased eating, snacking, cooking, and online food ordering were positively associated with weight gain.

Conclusions

Findings suggested that unintended consequences of lockdown have negative impacts on dietary habits and food preferences among university students. Advocacy and public health measures for nutritional support amidst the pandemic are crucial, especially for at-risk groups such as overweight and obese individuals.

The Specific Impact of Nutrition and Physical Activity on Adolescents' Body Composition and Energy Balance

Purpose: The aim of the present study was to identify the contribution of nutrition, physical activity (PA), and total energy intake and expenditure on body weight and composition in adolescents. Methods: Body composition, PA, and dietary intakes from 904 Greek adolescents (446 boys and 458 girls; Age: 14.6 ± 1.5 yrs), were evaluated. All participants were assigned into three groups according to their age-sex adjusted Fat Mass Index: (A) Normal weight (N; N = 503), (B) Overweight (OW; N = 253), and (C) Obese (O; N = 148). Results: Significant differences were found for body weight and composition, basal metabolic rate (BMR) expressed per kg of body mass (normal weight children exhibited the highest values), physical-total energy expenditure, and energy balances between the groups (η²: 0.138 to 0.657; p < .05). In contrast, no differences were found for macronutrients' and total energy intakes, food consumption and quality (η²: 0.002 to 0.099; p > .05) between the three examined groups. Strong, negative correlations were observed between body weight, body fat percentage, PA, and total energy expenditure (r: -0.311 to -0.810; p < .001). Lower, negative correlations were found between body weight, body fat percentage, and macronutrients' daily intakes (r:-0.235 to -0.432; p < .05). BMR and total energy expenditure had strong, negative relative strengths for the determination of body weight and fat percentage. Conclusions: In conclusion, it seems that BMR, PA, and total daily energy expenditure expressed per body weight and not the nutritional and total energy intakes, were the primary determinant parameters of body composition and weight in adolescents.

Endocrine-disrupting chemicals and child health

Endocrine-disrupting chemicals (EDCs) are chemicals which are introduced into the environment by human activities. In many cases it has been proven that EDCs can cause adverse health effects in the human. EDCs are classified by their chemical structure, putative direct or indirect effects on endocrine glands and systems, may accumulate and persist in organisms and in the environment, and/or they may exert clinically observable and measurable effects. Often, EDCs may act in concert and as mixtures. Legislation to ban EDCs and protect especially pregnant women and children at young age are needed and needs to be revised and adjusted to new developments on a regular basis. Putative associations, in spite of sometimes conflicting results, have to be analyzed in in vitro model systems be it in cell biology, in vitro settings or animal studies in more detail. This chapter depicts the mainly positive albeit detrimental epidemiological findings for EDC-caused effects in the fields of growth and metabolism, neurocognitive development and sexual development and reproduction.

Percepção corporal em pré-adolescentes e adolescentes com sobrepeso e obesidade

O enfrentamento da obesidade demanda suporte psicossocial diante da alta prevalência de psicopatologias associadas ao viés do peso na adolescência. Analisou-se percepção corporal em 63 sujeitos, 37 meninos e 26 meninas, de 9 a 14 anos, de Monteiro Lobato, São Paulo, por meio do Desenho de Percepção Corporal. Avaliou-se, a consciência e a persona corporal, correlacionadas a sexo, idade e IMC pelo SPSS. Observou-se nos desenhos: redução da consciência corporal em meninas obesas: indeterminação, desintegração e instabilidade; regressão da persona: postura fechada em meninas com sobrepeso e obesas e rigidez em meninos com sobrepeso desde a pré-adolescência. Para a psicologia junguiana, nesta fase, a obesidade ativa conflitos inconscientes, desestrutura o ego e o isolamento, realimenta a crise identitária. Percepção corporal, tema pouco explorado; demanda pesquisa e validação de instrumentos para a compreensão da obesidade na adolescência.

Income and obesity in an urban poor community: a cross-sectional study

Background: Recent studies have shown that higher income is associated with a higher risk for subsequent obesity in low- and middle-income countries, while in high-income countries there is a reversal of the association - higher-income individuals have a lower risk of obesity. The concept of being able to afford to overeat is no longer a predictor of obesity in developed countries. In Malaysia, a trend has been observed that the prevalence of obesity increases with an increase in income among the low-income (B40) group. This trend, however, was not further investigated. Therefore, this study was performed to investigate the association of income and other sociodemographic factors with obesity among residents within the B40 income group in an urban community.  Methods: This cross-sectional study used a systematic sampling technique to recruit participants residing in a Program Perumahan Rakyat (PPR), Kuala Lumpur, Malaysia. The sociodemographic characteristics were investigated through face-to-face interviews. Weight and height were measured, and body mass index (BMI) was calculated and coded as underweight, normal, overweight and obese according to the cut-off points for the Asian population. A chi-squared test was used to compare the prevalence of obesity in this study with the national prevalence. A generalized linear model was introduced to identify BMI predictors. Results: Among the 341 participants, 25 (7.3%) were underweight, 94 (27.6%) had normal weight, 87 (25.5%) were overweight, and 135 (39.6%) were obese. The proportion of obese adults (45.8%) was significantly higher than the national prevalence of 30.6% (p<0.001). Among all the tested variables, only income was significantly associated with BMI (p=0.046). Conclusion: The proportion of obesity in this urban poor community was higher compared with the national average. BMI increased as the average monthly household income decreased.

Neighbourhood socioeconomic status and overweight/obesity: a systematic review and meta-analysis of epidemiological studies

OBJECTIVE

Low neighbourhood socioeconomic status (NSES) has been linked to a higher risk of overweight/obesity, irrespective of the individual's own socioeconomic status. No meta-analysis study has been done on the association. Thus, this study was done to synthesise the existing evidence on the association of NSES with overweight, obesity and body mass index (BMI).

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed, Embase, Scopus, Cochrane Library, Web of Sciences and Google Scholar databases were searched for articles published until 25 September 2019.

ELIGIBILITY CRITERIA

Epidemiological studies, both longitudinal and cross-sectional ones, which examined the link of NSES to overweight, obesity or BMI, were included.

DATA EXTRACTION AND SYNTHESIS

Data extraction was done by two reviewers, working independently. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale for the observational studies. The summary estimates of the relationships of NSES with overweight, obesity and BMI statuses were calculated with random-effects meta-analysis models. Heterogeneity was assessed by Cochran's Q and I² statistics. Subgroup analyses were done by age categories, continents, study designs and NSES measures. Publication bias was assessed by visual inspection of funnel plots and Egger's regression test.

RESULT

A total of 21 observational studies, covering 1 244 438 individuals, were included in this meta-analysis. Low NSES, compared with high NSES, was found to be associated with a 31% higher odds of overweight (pooled OR 1.31, 95% CI 1.16 to 1.47, p<0.001), a 45% higher odds of obesity (pooled OR 1.45, 95% CI 1.21 to 1.74, p<0.001) and a 1.09 kg/m² increase in mean BMI (pooled beta=1.09, 95% CI 0.67 to 1.50, p<0.001).

CONCLUSION

NSES disparity might be contributing to the burden of overweight/obesity. Further studies are warranted, including whether addressing NSES disparity could reduce the risk of overweight/obesity.

PROSPERO REGISTRATION NUMBER

CRD42017063889.

The indelible weight of place: Childhood neighborhood disadvantage, timing of exposure, and obesity across adulthood

I use 28 (1986-2014) years of restricted geocoded NLSY tract-level data and find positive associations between exposure to childhood neighborhood disadvantage and adult obesity and BMI among individuals growing up and entering adulthood during the rise of obesity in the United States. Sibling fixed effects and cousin fixed effects models partially address unobserved confounding nested in the nuclear as well as extended family. Furthermore, exposure to neighborhood disadvantage in adolescence is most salient, providing insight into when policy intervention may be most effective. Results are robust to alternative specifications for neighborhood disadvantage, ages of exposure, and to alternative sampling strategies.

SOCS3 as a future target to treat metabolic disorders

The suppressors of cytokine signaling (SOCS) are a group of eight proteins responsible for preventing excessive cytokine signaling. Among this protein family, SOCS3 has received special attention. SOCS3 expression is important to control certain allergy autoimmune diseases. Furthermore, SOCS3 expression is elevated in obesity and it is involved in the inhibition of leptin and insulin signaling, two important hormones involved in the control of energy metabolism. Therefore, increased SOCS3 expression in obese individuals is associated with several metabolic disorders, including reduced energy expenditure, increased food intake and adiposity, and insulin and leptin resistance. In addition, recent studies found that SOCS3 expression regulates energy and glucose homeostasis in several metabolic conditions, such as pregnancy, caloric restriction, and refeeding. Importantly, attenuation of SOCS3 expression in most cases improves leptin and insulin sensitivity, leading to beneficial metabolic effects. This review aims to discuss the role of SOCS3 in the control of blood glucose levels as well as in energy homeostasis. The development of pharmacological compounds to inhibit SOCS3 activity and/or expression may represent a promising therapeutic approach to treat type 2 diabetes mellitus, obesity, and other metabolic imbalances.

Status report - Geographic retail food environment measures for use in public health

The Association of Public Health Epidemiologists in Ontario (APHEO) Core Indicators Work Group standardizes definitions and calculation methods for over 120 public health indicators to enhance accurate and standardized community health status reporting across public health units in Ontario. The Built Environment Subgroup is a multi-disciplinary group made up of planners, researchers, policy analysts, registered dietitians, geographic information systems (GIS) analysts and epidemiologists. The Subgroup selected and operationalized a suite of objective, standardized indicators intended to help public health units and regional health authorities assess their community retail food environments. The Subgroup proposed three indicators that use readily available data sources and GIS tools to characterize geographic access to various types of retail food outlets within neighbourhoods in urban settings. This article provides a status report on the development of these food environment indicators.

Current Guidelines for Obesity Prevention in Childhood and Adolescence

OBJECTIVE

Current guidelines for prevention of obesity in childhood and adolescence are discussed.

METHODS

A literature search was performed in Medline via PubMed, and appropriate studies were analyzed.

RESULTS

Programs to prevent childhood obesity have so far remained mainly school-based and effects have been limited. Analyses by age group show that prevention programs have the best results in younger children (<12 years). Evidence-based recommendations for pre-school- and early school-aged children indicate the need for interventions that address parents and teachers alike. During adolescence, school-based interventions proved most effective when adolescents were addressed directly. To date, obesity prevention programs have mainly focused on behavior-oriented prevention. Recommendations for community- or environment-based prevention have been suggested by the German Alliance of Noncommunicable Diseases and include a minimum of 1 h of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals at kindergartens and schools as well as a ban on unhealthy food advertisement aimed at children.

CONCLUSION

Behavior-oriented prevention programs showed only limited long-term effects. Certain groups at risk for the development of obesity are not reached effectively by current programs. Although universally valid conclusions cannot be drawn given the heterogeneity of available studies, clearly combining behavior-based programs with community-based prevention to counteract an 'obesogenic environment' is crucial for sustainable success of future obesity prevention programs.

Weight suppression as a predictor variable in the treatment of eating disorders: A systematic review

WHAT IS KNOWN ON THE SUBJECT?: Weight suppression (WS) has been suggested to predict outcome following psychological treatment for an eating disorder (ED). Some findings are contradictory and have not been considered systematically. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The review suggests that weight gain at post-treatment is reliably predicted by pretreatment WS, but findings regarding other outcomes (e.g., treatment dropout) are less consistent. Approximate effect sizes for observed relationships are identified, alongside support for biobehavioural theories of metabolic adaptation to weight loss. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Degree of WS at pretreatment is associated with weight gain and is important for clinicians to consider before offering treatment to patients with EDs. Patients high in WS might benefit from further support (e.g., psychoeducation) prior to beginning treatment. ABSTRACT: Introduction Weight suppression (WS-the difference between highest body weight and current body weight) has been proposed as a predictor of treatment outcome within eating disorders (EDs), although this hypothesis has not been consistently supported. Aim/Question Review the association between pretreatment WS and outcome following psychological treatment for EDs. Method A comprehensive electronic database search for published and unpublished literature from 1979 to 2017. Reference lists were also inspected. Eligibility criteria were determined according to relevant guidelines and a quality appraisal was conducted. Results Twelve studies met inclusion criteria (one was subsequently excluded based on insufficient data). Greater WS was generally associated with weight gain at post-treatment although not with other treatment outcomes. Discussion The existing evidence, with data from 1,566 participants, is summarized according to three main post-treatment outcomes: weight change; treatment completion; and symptom abstinence. Patients with disordered eating and greater WS may need to gain more weight than others during treatment to achieve good outcomes. Recommendations for future studies are provided. Implications for practice Evidence-based treatments for EDs may benefit from considering WS when planning treatment, such as further psychoeducation on weight changes. Societal interventions regarding promotion of healthy eating may also draw on these findings.

Dysregulation of mitochondrial function and biogenesis modulators in adipose tissue of obese children

BACKGROUND/OBJECTIVES

We aimed to evaluate mitochondrial biogenesis (MB), structure, metabolism and dysfunction in abdominal adipose tissue from male pediatric patients with obesity.

SUBJECTS/METHODS

Samples were collected from five children with obesity (percentile ⩾95) and five eutrophic boys (percentile ⩾5/⩽85) (8-12 years old) following parental informed consent. We analyzed the expression of key genes involved in MB (sirtuin-1 (SIRT1), peroxisome proliferator-activated receptor-γ (PPARγ), PPARγ coactivator-1α (PGC1α), nuclear respiratory factors 1 and 2 (NRF1, NRF2) and mitochondrial transcription factor A (TFAM) and surrogates for mitochondrial function/structure/metabolism (porin, TOMM20, complex I and V, UCP1, UCP2, SIRT3, SOD2) by western blot. Citrate synthase (CS), complex I (CI) activity, adenosine triphosphate (ATP) levels, mitochondrial DNA (mtDNA) content and oxidative stress end points were also determined.

RESULTS

Most MB proteins were significantly decreased in samples from children with obesity except complex I, V and superoxide dismutase-2 (SOD2). Similarly, CS and CI activity showed a significant reduction, as well as ATP levels and mtDNA content. PPARγ, PGC1α, complex I and V and SOD2 were hyperacetylated compared with lean samples. Concurrently, in samples from children with obesity, we found decreased SOD2 activity and redox state imbalance highlighted by decreased reduced glutathione/oxidized glutathione (GSH/GSSG) ratio and significant increases in protein carbonylation.

CONCLUSIONS

Adipose tissue from children with obesity demonstrates a dysregulation of key modulators of MB and organelle structure, and displays hyperacetylation of key proteins and altered expression of upstream regulators of cell metabolism.

Temporal changes in sugar-sweetened soft drink intake and variation across municipalities in the Capital Region of Denmark

We aimed to examine the changes in sugar-sweetened soft drink intake across the Capital Region of Denmark from 2007 to 2013 and to examine the association between intake and neighbourhood socioeconomic status. The study included data from three health surveys in 2007 (n = 30,426), 2010 (n = 42,218) and 2013 (n = 34,330) in the Capital Region of Denmark. Frequency of soft drink intake was derived from questionnaires among residents aged 25-79 years and linked with information from central registers. Municipality social groups (MSG) 1-4 of decreasing affluence were defined as a composite measure. Logistic regression analyses were conducted for individuals with an appropriate soft drink intake (< once/week) and for individuals with a frequent soft drink intake (≥ 3 times/week). The proportion of individuals reporting an appropriate soft drink intake increased by 71% during 2007-2013 (p < 0.0001). A corresponding decrease was found in the proportion of individuals reporting a frequent soft drink intake. Compared to MSG 1, odds of an appropriate soft drink intake were significantly lower in MSG 3-4: OR = 0.87 (95%CI 0.83-0.91) and OR = 0.89 (95%CI 0.85-0.92), respectively. Compared to MSG 1, odds of a frequent soft drink intake were significantly higher in MSG 3-4: OR = 1.24 (95%CI 1.63-1.31) and 1.17 (95%CI 1.10-1.25), respectively. A significant interaction between MSG and educational level was found among individuals reporting a frequent soft drink intake (p = 0.02). The results show an encouraging reduction in frequency of soft drink intake among capital residents in the period of 2007-2013. A social gradient was observed in soft drink intake across MSG.

Association between high consumption of phytochemical-rich foods and anthropometric measures: a systematic review

Phytochemical-rich foods consumption may be a valid nutritional strategy to reduce the risk of weight gain and obesity. The phytochemical index (PI) is a simple and nonspecific method to evaluate the phytochemical intake, defined as the percentage of dietary calories derived from foods rich in phytochemicals. We aimed to conduct a systematic review to evaluate whether high consumption of phytochemical-rich foods evaluated by the PI is associated with lower values of anthropometric measurements. The available literature suggests that the PI seems to be inversely associated with body weight and waist circumference. Analyzing the longitudinal changes in anthropometric variables, individuals with high intake of phytochemicals gained less weight and fat mass when compared to those with lower PI. Our findings suggest that higher PI is associated with lower body mass index, waist circumference and adiposity. Whether the results are a reflex of a lower calorie intake or the anti-obesity properties of phytochemicals remains to be elucidated.

Craniopharyngioma and hypothalamic injury: latest insights into consequent eating disorders and obesity

PURPOSE OF REVIEW

Hypothalamic alterations, pathological or treatment induced, have major impact on prognosis in craniopharyngioma patients mainly because of consequent hypothalamic obesity. Recent insight in molecular genetics, treatment strategies, risk factors and outcomes associated with hypothalamic obesity provide novel therapeutic perspectives. This review includes relevant publications since 2013.

RECENT FINDINGS

Recent findings confirm that alterations in posterior hypothalamic areas because of tumour location and/or treatment-related injuries are associated with severe hypothalamic obesity, reduced overall survival and impaired quality of life in long-term survivors of childhood-onset craniopharyngioma. However, eating disorders are observed because of hypothalamic obesity without clear disease-specific patterns. Treatment options for hypothalamic obesity are very limited. Treatment with invasive, nonreversible bariatric methods such as Roux-en-Y gastric bypass is most efficient in weight reduction, but controversial in the paediatric population because of medical, ethical, and legal considerations. Accordingly, treatment in craniopharyngioma should focus on prevention of (further) hypothalamic injury. Presurgical imaging for grading of hypothalamic involvement should be the basis for hypothalamus-sparing strategies conducted by experienced multidisciplinary teams.

SUMMARY

Until a nonsurgical therapeutic option for hypothalamic obesity for paediatric patients is found, prevention of hypothalamic injury should be the preferred treatment strategy, conducted exclusively by experienced multidisciplinary teams.

Male Obesity

Many cross-sectional analyses and longitudinal studies have examined the association between adiposity and pubertal development. In addition, the impact of an increased fat mass on reproduction and fertility in human obese men and in male animal models of obesity has been studied. A trend toward earlier pubertal development and maturation in both sexes has been shown, and the notion that obese boys might progress to puberty at a slower pace than their nonobese peers can no longer be substantiated. Impaired fertility markers and reduced reproductive functions have been observed in obesity. Obesity affects both pubertal development and fertility in men.