1
|
Middelkoop K, Micklesfield L, Stewart J, Walker N, Jolliffe DA, Mendham AE, Coussens AK, Nuttall J, Tang J, Fraser WD, Momand W, Cooper C, Harvey NC, Wilkinson RJ, Bekker LG, Martineau AR. Influence of vitamin D supplementation on growth, body composition, pubertal development and spirometry in South African schoolchildren: a randomised controlled trial (ViDiKids). BMJ Paediatr Open 2024; 8:e002495. [PMID: 38599800 PMCID: PMC11015302 DOI: 10.1136/bmjpo-2024-002495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/29/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE To determine whether weekly oral vitamin D supplementation influences growth, body composition, pubertal development or spirometric outcomes in South African schoolchildren. DESIGN Phase 3 double-blind randomised placebo-controlled trial. SETTING Socioeconomically disadvantaged peri-urban district of Cape Town, South Africa. PARTICIPANTS 1682 children of black African ancestry attending government primary schools and aged 6-11 years at baseline. INTERVENTIONS Oral vitamin D3 (10 000 IU/week) versus placebo for 3 years. MAIN OUTCOME MEASURES Height-for-age and body mass index-for-age, measured in all participants; Tanner scores for pubertal development, spirometric lung volumes and body composition, measured in a subset of 450 children who additionally took part in a nested substudy. RESULTS Mean serum 25-hydroxyvitamin D3 concentration at 3-year follow-up was higher among children randomised to receive vitamin D versus placebo (104.3 vs 64.7 nmol/L, respectively; mean difference (MD) 39.7 nmol/L, 95% CI 37.6 to 41.9 nmol/L). No statistically significant differences in height-for-age z-score (adjusted MD (aMD) -0.08, 95% CI -0.19 to 0.03) or body mass index-for-age z-score (aMD -0.04, 95% CI -0.16 to 0.07) were seen between vitamin D versus placebo groups at follow-up. Among substudy participants, allocation to vitamin D versus placebo did not influence pubertal development scores, % predicted forced expiratory volume in 1 s (FEV1), % predicted forced vital capacity (FVC), % predicted FEV1/FVC, fat mass or fat-free mass. CONCLUSIONS Weekly oral administration of 10 000 IU vitamin D3 boosted vitamin D status but did not influence growth, body composition, pubertal development or spirometric outcomes in South African schoolchildren. TRIAL REGISTRATION NUMBERS ClinicalTrials.gov NCT02880982, South African National Clinical Trials Register DOH-27-0916-5527.
Collapse
Affiliation(s)
- Keren Middelkoop
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Lisa Micklesfield
- Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences University of Cape Town, Cape Town, South Africa
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
| | - Justine Stewart
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Neil Walker
- Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David A Jolliffe
- Blizard Institiute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Amy E Mendham
- Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences University of Cape Town, Cape Town, South Africa
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
| | - Anna K Coussens
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease & Molecular Medicine, Faculty of Health Sciences University of Cape Town, Cape Town, South Africa
- Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - James Nuttall
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Jonathan Tang
- Norwich Medical School, University of East Anglia, Norwich, UK
- Department of Laboratory Medicine, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - William D Fraser
- Norwich Medical School, University of East Anglia, Norwich, UK
- Department of Laboratory Medicine, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - Waheedullah Momand
- Blizard Institiute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Robert J Wilkinson
- Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease & Molecular Medicine, Faculty of Health Sciences University of Cape Town, Cape Town, South Africa
- The Francis Crick Institute, London, UK
- Department of Infectious Diseases, Imperial College London, London, UK
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Adrian R Martineau
- Blizard Institiute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
2
|
Cuenca Alcocel J, Villalba-Heredia L, Martínez Redondo I, Berrozpe-Villabona C, Casajús JA, Arbonés-Mainar JM, Calmarza P. Bone metabolism in children with normal weight and overweight/obesity in a northeastern region of Spain. ADVANCES IN LABORATORY MEDICINE 2024; 5:66-74. [PMID: 38634087 PMCID: PMC11019894 DOI: 10.1515/almed-2024-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/28/2023] [Indexed: 04/19/2024]
Abstract
Objectives Bone mass progressively increases to peak during childhood and adolescence, which determines future bone health. Bone formation-resorption processes are assessed using bone markers. However, studies on the impact of obesity on bone turnover markers at this age are limited, and results are inconsistent. The objective of this study was to examine the potential impact of overweight/obesity on bone metabolism. Methods A study was performed to compare parameters of bone metabolism in 45 girls and boys with normal weight (controls) and in a group of 612 girls and boys with overweight/obesity (cases) from the Exergames study (University of Zaragoza). Ages ranged from 8 to 12 years. Results Higher values of phosphorus and IGFBP-3 were observed in children with overweight/obesity, as compared to children with normal weight, (p=0.042) and (p=0.042), respectively. BAP, osteocalcin, magnesium, vitamin D and IGF-I concentrations were lower in the group with overweight/obesity, whereas calcium concentrations were higher in this group, although differences were not statistically significant. A negative correlation was found (r=-0.193) (p=0.049) between BAP and BMI. Conclusions Although differences did not reach statistical significance, BAP and osteocalcin concentrations were lower in children with overweight/obesity. This added to the negative correlation found between BAP and MIC may demonstrate that overweight/obesity may negatively affect bone health already at a young age.
Collapse
Affiliation(s)
| | | | | | | | - José Antonio Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Healthcare Research Institute of Aragon (IIS Aragón), Zaragoza, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
- Department of Physiatry and Nursing, Faculty of Health and Sports Sciences, University of Zaragoza, Zaragoza, Spain
| | - José Miguel Arbonés-Mainar
- Adipocyte and Fat Biology Laboratory (AdipoFat), Transversal Research Unit, Miguel Servet University Hospital, Health Research Institute (IIS) Aragón, Zaragoza, Spain
- Aragonese Institute of Health Sciences (IACS), Zaragoza, Spain
- CIBER Pathophysiology Obesity and Nutrition (CIBERObn), Carlos III Health Institute, Madrid, Spain
| | - Pilar Calmarza
- Service of Clinical Biochemistry, Miguel Servet University Hospital, Zaragoza, Spain
- Network Research Center for Cardiovascular Diseases (CIBERCV), University of Zaragoza, Healthcare Research Institute of Aragon (IIS Aragón), Zaragoza, Spain
| |
Collapse
|
3
|
Devulapalli CS. Vitamin D concentrations were often insufficient among native Norwegian adolescents and children with a non-Western immigrant background. Acta Paediatr 2024; 113:411-416. [PMID: 38116881 DOI: 10.1111/apa.17078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 12/21/2023]
Abstract
AIM The aim of this study was to review papers that assessed the vitamin D intake of children living in Norway, as research has suggested that it has remained below the recommended daily allowance of 10 μg/day. METHODS This mini review examined the vitamin D status of Norwegian children aged 0-18 years by systematically searching the PubMed, Google Scholar and Scopus databases from 1 January 2009 to 1 July 2020. RESULTS The review comprised six studies published in English between 2009 and 2020 on native-born and non-Western immigrant children. Most studies defined satisfactory vitamin D status as a plasma 25-hydroxyvitamin D (25(OH)D) concentration of 50 nmol/L, with 25-50 nmol/L being classified as insufficient and below 25 nmol/L being classified as deficient. A study of healthy children found that 21% had insufficient levels and a further 1% were deficient, but this second finding was only among adolescents. Other studies showed that 47% of Norwegian children with a non-Western immigrant background were deficient, and so were 19% of overweight children, mainly adolescents. CONCLUSION Vitamin D concentrations were often insufficient among children living in Norway, particularly adolescents and those with a non-Western immigrant background. Higher recommended supplements may be needed.
Collapse
|
4
|
Cuenca Alcocel J, Villalba-Heredia L, Martínez Redondo I, Berrozpe-Villabona C, Casajús JA, Arbonés-Mainar JM, Calmarza P. Metabolismo óseo en niños aragoneses con normopeso y niños con sobrepeso/obesidad. ADVANCES IN LABORATORY MEDICINE 2024; 5:75-84. [PMID: 38634080 PMCID: PMC11019878 DOI: 10.1515/almed-2023-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/28/2023] [Indexed: 04/19/2024]
Abstract
Objetivos En la infancia y adolescencia se produce un aumento de masa ósea, hasta alcanzar un pico máximo, determinante para la salud ósea. Los marcadores óseos evalúan los procesos de formación-resorción ósea. Sin embargo, los estudios sobre la influencia de la obesidad en los marcadores de recambio óseo en esta edad, son escasos y los resultados contradictorios. El objetivo de nuestro estudio fue evaluar si el sobrepeso/obesidad influían en el metabolismo óseo. Métodos Se compararon parámetros relacionados con el metabolismo óseo, en 45 niños y niñas normopeso (controles) y en un grupo de 61 niños y niñas con sobrepeso/obesidad (casos), procedentes del estudio Exergames (Universidad de Zaragoza), de edades comprendidas, todos ellos, entre 8 y 12 años. Resultados La concentración de fósforo y la de IGFBP-3 fueron superiores en los niños con sobrepeso/obesidad, respecto a la de los niños normopeso, (p=0,042) y (p=0,042), respectivamente. Las concentraciones de BAP, osteocalcina, magnesio, vitamina D e IGF-I fueron más bajas en el grupo de los niños con sobrepeso/obesidad y la de calcio más elevada, pero las diferencias no fueron estadísticamente significativas. Existe correlación negativa (r=−0,193) (p=0,049) entre BAP e IMC. Conclusiones En los niños con sobrepeso/obesidad pese a que no se llegó a alcanzar significación estadística, la concentración de BAP y osteocalcina fue inferior a la de los niños normopeso, lo cual junto con la correlación negativa de BAP respecto al IMC encontrada, puede indicar que ya en edades tan tempranas el sobrepeso/obesidad puede afectar a la salud ósea.
Collapse
Affiliation(s)
| | | | | | | | - José Antonio Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón)Zaragoza, España
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos IIIMadrid, España
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud y el Deporte, Universidad de ZaragozaZaragoza, España
| | - José Miguel Arbonés-Mainar
- Adipocyte and Fat Biology Laboratory (AdipoFat), Unidad de Investigación Transversal, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria (IIS), Zaragoza, Aragón, España
- Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, España
| | - Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón)Zaragoza, España
- Miembro de las Comisiones de Estrés Oxidativo y Lipoproteínas y Enfermedades vasculares de la SEQC-ML, Servicio de Bioquímica Clínica, Hospital Universitario Miguel ServetZaragoza, España
| |
Collapse
|
5
|
Raiten DJ, Steiber AL, Dary O, Bremer AA. The Value of an Ecological Approach to Improve the Precision of Nutritional Assessment: Addressing Contributors and Implications of the "Multiple Burdens of Malnutrition". Nutrients 2024; 16:421. [PMID: 38337706 PMCID: PMC10857452 DOI: 10.3390/nu16030421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Globally, children are exposed to multiple health risks associated with diet and nutrition. Rather than simply being a condition of having too much or too little food, malnutrition is more a syndrome comprising multiple burdens of coexisting and reciprocal malnutrition, infection, or other conditions. Importantly, children with such syndromes (e.g., stunting and anemia, which are neither specific nor necessarily sensitive to nutritional status) are more likely to also have irreversible functional outcomes such as poor growth, impaired immune function, or cognitive delays. The global health community has identified nutrition-related targets (e.g., Sustainable Development Goals (SDGs) and World Health Organization (WHO) Global Nutrition Targets) that, for multiple reasons, are difficult to address. Moreover, as the complexity of the global health context increases with persistent pandemics of infectious diseases and the rising prevalence of noncommunicable diseases, there is a growing appreciation that conditions selected as nutrition/health targets indeed represent syndromes for which nutritional status serves as both an input and outcome. In recognition of the impact of these combined challenges and the role of the multiple manifestations of malnutrition, we suggest an approach to nutritional assessment that is intended to improve the precision of context-specific, equitable approaches to health promotion, disease prevention, and treatment.
Collapse
Affiliation(s)
- Daniel J. Raiten
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA;
| | | | - Omar Dary
- USAID, Bureau for Global Health, Division of Nutrition and Environmental Health, Washington, DC 20523, USA;
| | - Andrew A. Bremer
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA;
| |
Collapse
|
6
|
Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev 2024; 20:2-26. [PMID: 35927921 DOI: 10.2174/1573396318666220801093225] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Childhood obesity is an important and serious public health problem worldwide. OBJECTIVE This article aims to familiarize physicians with the evaluation, management, and prevention of childhood. METHODS A PubMed search was conducted in May, 2021, in Clinical Queries using the key terms "obesity" OR "obese". The search included clinical trials, randomized controlled trials, case-control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article. RESULTS Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition. CONCLUSION Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss, followed by rapid re-accumulation of the lost weight after the termination of therapy. As such, preventive activity is the key to solving the problem of childhood obesity. Childhood obesity can be prevented by promoting a healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to get involved in school and community programs that improve their children's nutritional status and physical activity.
Collapse
Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex H C Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong, China
| |
Collapse
|
7
|
Deruyter S, Van Biervliet S, De Guchtenaere A. Response to vitamin D replacement therapy in obese children and adolescents with vitamin D deficiency: a randomized controlled trial. J Pediatr Endocrinol Metab 2023; 36:458-465. [PMID: 36913250 DOI: 10.1515/jpem-2022-0598] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVES Vitamin D deficiency is common in the pediatric group with obesity and is a risk factor for metabolic syndrome. Supplementation of vitamin D may require higher dosing than in normal-weight children. The aim of our study was to investigate the response of supplementation on vitamin D levels and the metabolic profile in youths with obesity. METHODS Children and adolescents with obesity (Body mass index >2.3 SDS, age ≤18 years) and hypovitaminosis D (level <20 μg/L) who entered a residential weight-loss program in Belgium, were included during summer. Subjects were randomized: Group 1 received 6,000 IU vitamin D daily for 12 weeks, whereas Group 2 simultaneously participating in the weight-loss program received no supplementation. Differences in vitamin D levels, weight, insulin resistance, lipid patterns, and blood pressure after 12 weeks were assessed. RESULTS A total of 42 subjects (12-18 years) with hypovitaminosis D were included, group 1 (n=22) received supplementation after randomization. After 12 weeks, a median increase in vitamin D levels of 28.2 (24.1-33.0) and 6.7 (4.1-8.4) µg/L was observed in group 1 and group 2, respectively (p-value<0.001), resulting in vitamin D sufficiency in 100 and 60% of subjects. No significant differences in weight loss (p-value 0.695), insulin resistance (p-value 0.078), lipid patterns (p-value 0.438), or blood pressure (p-value 0.511) were observed between both groups after 12 weeks of treatment. CONCLUSIONS Supplementation with 6,000 IU vitamin D daily during 12 weeks in children and adolescents with obesity and hypovitaminosis D is safe and sufficient to reach vitamin D sufficiency. However, no positive effects on weight loss, insulin resistance, lipid patterns, or blood pressure were observed.
Collapse
Affiliation(s)
- Sarah Deruyter
- Department of Pediatrics, Ghent University Hospital, Gent, Belgium
| | | | | |
Collapse
|
8
|
Zhao Y, Qin R, Hong H, Lv H, Ye K, Wei Y, Zheng W, Qi H, Ni Y, Zhang L, Yang G, Liu G, Wu A. Is vitamin D deficiency influenced by obesity during the first 5 years of life? A cross-sectional multicenter study. Food Sci Nutr 2023; 11:1084-1095. [PMID: 36789058 PMCID: PMC9922117 DOI: 10.1002/fsn3.3145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Evidence on the association of 25-hydroxyvitamin D (25[OH]D) and obesity during the first 5 years of life is limited in China. The objective of this study was to examine the associations between weight, weight for age z score (ZWAZ), weight for length/height z score (ZWHZ), and body mass index for age z score (ZBMI) and 25(OH)D. This was a large population-based cross-sectional multicenter study in which the children aged 0-5 years were recruited from 12 children's healthcare centers by a stratified cluster random-sampling method in 10 cities of the Jiangsu province, China. The 25(OH)D concentration was determined by ELISA. A total of 5289 children were investigated. For 0-71 months children with obesity and nonobesity, the prevalence of vitamin D deficiency was 36.0% and 29.8%, and the 25(OH)D level was 59.8 and 64.0 nmol/L, respectively, and there were all significant difference. Compared with children with nonobesity, children with obesity had higher risk of vitamin D deficiency (OR [95% CI]: 1.33 [1.02, 1.72], p < .05), and had lower 25(OH)D level (β = -3.84, 95% CI = -7.58, -0.09, p < .05). The results for children aged 24-71 months were similar to those for children aged 0-71 months. However, no significant difference was observed in children aged 0-23 months. Vitamin D deficiency was observed in children with greater adiposity during the first 5 years of life. However, the results mainly came from those in the age group of 2 to 5 years instead of the first 2 years in their lives.
Collapse
Affiliation(s)
- Yan Zhao
- Department of Clinical NutritionJiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Rui Qin
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province HospitalThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Hong Hong
- Department of Child Health CareDrum Tower Maternity and Child Health Care InstituteNanjingChina
| | - Heyu Lv
- Department of Child Health CareJiangning Maternity and Child Health Care InstituteNanjingChina
| | - Kan Ye
- Department of Child Health CareSuzhou Municipal HospitalSuzhouChina
| | - Yarong Wei
- Department of Child Health CareWuxi Maternity and Child Health Care HospitalWuxiChina
| | - Wen Zheng
- Department of Child Health CareYancheng Maternity and Child Health Care InstituteYanchengChina
| | - Hongxia Qi
- Department of Child Health CareXuzhou Children's HospitalXuzhouChina
| | - Yufei Ni
- Department of Child Health CareNantong Maternity and Child Health Care HospitalNantongChina
| | - Li Zhang
- Department of Child Health CareHuai'an Maternity and Child Health Care HospitalHuai'anChina
| | - Guoqiang Yang
- Department of Child Health CareKunshan Maternity and Child Health Care InstituteKunshanChina
| | - Guoqin Liu
- Department of Child Health CareDafeng Maternity and Child Health Care HospitalDafengChina
| | - Aiping Wu
- Department of Child Health CareXinghua Maternity and Child Health Care HospitalXinghuaChina
| |
Collapse
|
9
|
Snelder SM, Aga Y, de Groot - de Laat LE, Biter LU, Cabezas MC, Pouw N, Birnie E, Boxma - de Klerk B, Klaassen RA, Zijlstra F, van Dalen BM. Normalization of Cardiac Function After Bariatric Surgery Is Related to Autonomic Function and Vitamin D. Obes Surg 2023; 33:47-56. [PMID: 36334252 PMCID: PMC9834145 DOI: 10.1007/s11695-022-06336-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE Subclinical cardiac dysfunction is common in patients with obesity. Bariatric surgery is associated with normalization of subclinical cardiac function in 50% of the patients with obesity. The aim of this study was to identify predictors for a lack of improvement of subclinical cardiac dysfunction 1-year post-bariatric surgery. METHODS Patients who were referred for bariatric surgery were enrolled in a longitudinal study. Inclusion criteria were age 35-65 years and BMI ≥ 35 kg/m2. Patients with a suspicion of or known cardiovascular disease were excluded. Conventional and advanced echocardiography, Holter monitoring, and blood tests were performed pre- and 1-year post-bariatric surgery. Subclinical cardiac dysfunction was defined as either a reduced left ventricular ejection fraction, decreased global longitudinal strain (GLS), diastolic dysfunction, arrhythmia, or an increased BNP or hs Troponin I. RESULTS A total of 99 patients were included of whom 59 patients had cardiac dysfunction at baseline. Seventy-two patients completed the 1-year follow-up after bariatric surgery. There was a significant reduction in weight and cardiovascular risk factors. Parameters of cardiac function, such as GLS, improved. However, in 20 patients cardiac dysfunction persisted. Multivariate analysis identified a decreased heart rate variability (which is a measure of autonomic function), and a decreased vitamin D pre-surgery as predictors for subclinical cardiac dysfunction after bariatric surgery. CONCLUSION Although there was an overall improvement of cardiac function 1-year post-bariatric surgery, autonomic dysfunction and a decreased vitamin D pre-bariatric surgery were predictors for a lack of improvement of subclinical cardiac dysfunction.
Collapse
Affiliation(s)
- Sanne M. Snelder
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Yaar Aga
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | | | - L. Ulas Biter
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands ,Department of Internal Medicine, Erasmus University Medical Centre, ’s Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
| | - Nadine Pouw
- Department of Clinical Chemistry, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Erwin Birnie
- Department of Statistics and Education, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Bianca Boxma - de Klerk
- Department of Statistics and Education, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - René A. Klaassen
- Department of Surgery, Maasstad Ziekenhuis, Rotterdam, the Netherlands
| | - Felix Zijlstra
- Department of Cardiology, the Thoraxcenter, Erasmus University Medical Centre, ’s Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
| | - Bas M. van Dalen
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands ,Department of Cardiology, the Thoraxcenter, Erasmus University Medical Centre, ’s Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
| |
Collapse
|
10
|
Ganmaa D, Bromage S, Khudyakov P, Erdenenbaatar S, Delgererekh B, Martineau AR. Influence of Vitamin D Supplementation on Growth, Body Composition, and Pubertal Development Among School-aged Children in an Area With a High Prevalence of Vitamin D Deficiency: A Randomized Clinical Trial. JAMA Pediatr 2023; 177:32-41. [PMID: 36441522 PMCID: PMC9706398 DOI: 10.1001/jamapediatrics.2022.4581] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022]
Abstract
Importance Vitamin D deficiency (defined as 25-hydroxyvitamin D [25(OH)D] <20 ng/mL) is prevalent among children living in temperate climates and has been reported to associate independently with stunting, obesity, and early activation of the hypothalamic-pituitary-gonadal axis. Phase 3 randomized clinical trials to investigate the influence of long-term vitamin D replacement on growth, body composition, and pubertal development of school-aged children with vitamin D deficiency are lacking. Objective To determine whether weekly oral vitamin D supplementation influences linear growth, body composition, or pubertal development in school-aged children living in a setting where vitamin D deficiency is highly prevalent. Design, Setting, and Participants This secondary analysis of a double-blind, placebo-controlled randomized clinical trial was conducted from June 2016 to June 2019 at 18 grade schools in Ulaanbaatar, Mongolia. School-aged children (6 to 13 years at baseline) attending participating schools were included. Exclusion criteria included a positive QuantiFERON-TB Gold in-tube assay result, conditions or medications associated with altered vitamin D metabolism, use of vitamin D supplements, signs of rickets, or intention to move from Ulaanbaatar within 4 years. Of 11 475 children invited to participate in the study, 9814 underwent QFT testing, and 8851 with negative results were included in the study. All but 1 participant in the placebo group completed follow-up and were included in the present analysis. Data were analyzed from November 2021 to February 2022. Interventions Weekly oral doses of vitamin D3, 14 000 IU, (n = 4418), or placebo (n = 4433) for 3 years. Main Outcomes and Measures Mean z scores for height for age, body mass index for age, and waist-to-height ratio; mean percentage body fat, fat mass, and fat-free mass; and mean Tanner scores for pubertal development. Results Of 8851 participants, 4366 (49.3%) were female, and 8165 (92.2%) were of Khalkh ethnicity; the mean (SD) age was 9.4 (1.6) years. A total of 8453 participants (95.5%) were vitamin D deficient at baseline, and mean end-of-study 25(OH)D concentrations among participants randomized to vitamin D vs placebo were 31.0 vs 10.7 ng/mL (mean difference, 20.3; 95% CI; 19.9-20.6). However, vitamin D supplementation did not influence mean height for age, body mass index for age, waist-to-height ratio, percentage body fat, fat mass, fat-free mass, or Tanner scores, either overall or within subgroups defined by baseline 25(OH)D concentration less than 10 ng/mL vs 10 ng/mL or greater, estimated calcium intake less than 500 mg/d vs 500 mg/d or greater, or male vs female sex. Conclusions and Relevance In school-aged children in this study with low baseline vitamin D status, oral vitamin D3 supplementation at a dose of 14 000 IU per week for 3 years was effective in elevating 25(OH)D concentrations but did not influence growth, body composition, or pubertal development. Trial Registration ClinicalTrials.gov Identifier: NCT02276755.
Collapse
Affiliation(s)
- Davaasambuu Ganmaa
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Sumiya Erdenenbaatar
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Baigal Delgererekh
- Global Laboratory, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Adrian R. Martineau
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
11
|
Guardiola-Márquez CE, Santos-Ramírez MT, Segura-Jiménez ME, Figueroa-Montes ML, Jacobo-Velázquez DA. Fighting Obesity-Related Micronutrient Deficiencies through Biofortification of Agri-Food Crops with Sustainable Fertilization Practices. PLANTS (BASEL, SWITZERLAND) 2022; 11:3477. [PMID: 36559589 PMCID: PMC9784404 DOI: 10.3390/plants11243477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Obesity is a critical medical condition worldwide that is increasingly involved with nutritional derangements associated with micronutrient deficiencies, including iron, zinc, calcium, magnesium, selenium, and vitamins A, C, D, and E. Nutritional deficiencies in obesity are mainly caused by poor-quality diets, higher nutrient requirements, alterations in micronutrient metabolism, and invasive obesity treatments. The current conventional agricultural system is designed for intensive food production, focusing on food quantity rather than food quality, consuming excessive agricultural inputs, and producing nutrient-deficient foods, thus generating severe health and environmental problems; agricultural food products may worsen obesity-related malnutrition. Therefore, modern agriculture is adopting new biofortification technologies to combat micronutrient deficiencies and improve agricultural productivity and sustainability. Biofertilization and nanofertilization practices are increasingly used due to their efficiency, safety, and reduced environmental impact. Biofertilizers are preparations of PGP-microorganisms that promote plant growth by influencing plant metabolism and improving the nutrient uptake, and nanofertilizers consist of synthesized nanoparticles with unique physicochemical properties that are capable of increasing plant nutrition and enriching agricultural products. This review presents the current micronutrient deficiencies associated with obesity, the modern unsustainable agri-food system contributing to obesity progression, and the development of bio- and nanofertilizers capable of biofortifying agri-food crops with micronutrients commonly deficient in patients with obesity.
Collapse
Affiliation(s)
| | - María Teresa Santos-Ramírez
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - M. Eugenia Segura-Jiménez
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - Melina Lizeth Figueroa-Montes
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - Daniel A. Jacobo-Velázquez
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
- Tecnologico de Monterrey, The Institute for Obesity Research, Ave. General Ramon Corona 2514, Zapopan 45201, Jalisco, Mexico
| |
Collapse
|
12
|
Vitamin D Status for Chinese Children and Adolescents in CNNHS 2016-2017. Nutrients 2022; 14:nu14224928. [PMID: 36432613 PMCID: PMC9693967 DOI: 10.3390/nu14224928] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
Vitamin D is very important in maintaining children's bone health because of its regulatory role in calcium and phosphate metabolism. To better understand vitamin D status and related risk factors of children and adolescents in China, this study analyzed the 25-hydroxyvitamin-D (25(OH)D) concentration of children and adolescents aged 6-17 years in China and assessed the risk factors of vitamin D deficiency and insufficiency. We analyzed the data of 25(OH)D concentration collected from the China National Nutrition and Health Survey of Children and Lactating Mothers in 2016-2017 (CNNHS 2016-2017). The age, sex, region type, ethnicities, season, weight and height were recorded, measured by unified questionnaire, equipment and standards. The concentration of 25(OH)D was detected by LC-MS/MS. A total of 64,391 participants from the cross-sectional study of CNNHS in 2016-2017 were included in this study. The median serum 25(OH)D concentration was 17.70 (13.20-22.68) ng/mL, 18.70 (14.10-23.80) ng/mL in boys and 16.60 (12.40-21.40) ng/mL in girls. The total prevalence rate of vitamin D deficiency and insufficiency was 65.98% when the cut-off was 20 ng/mL, 60.42% for boys and 71.99% for girls. According to the results of logistic regression analysis, girls aged above 12 y, living in midlands and northern regions, in spring and winter seasons and with abdominal obesity will have a significantly increased risk of vitamin D deficiency and insufficiency among Chinese children and adolescents. The results showed that vitamin D deficiency and insufficiency are very common among children and adolescents aged 6-17 y in China. They should be encouraged to have more effective sunlight exposure, increased intake of vitamin D from food or supplements in their diet, especially for those aged above 12 y, living in the northern or midlands areas, in spring and winter, and abdominally obese.
Collapse
|
13
|
Chen C, Zhou C, Liu S, Jiao X, Wang X, Zhang Y, Yu X. Association between Suboptimal 25-Hydroxyvitamin D Status and Overweight/Obesity in Infants: A Prospective Cohort Study in China. Nutrients 2022; 14:nu14224897. [PMID: 36432582 PMCID: PMC9698418 DOI: 10.3390/nu14224897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate whether 25-hydroxyvitamin D (25(OH)D) concentrations are correlated to overweight/obesity in infants and to explore a threshold of 25(OH)D. A total of 1205 six-month-old infants from two community hospitals in Shanghai were randomly recruited, and 925 of them were followed up at 12 months. Concentration of 25(OH)D, weight, and length were measured at two time points. Overweight/obesity was defined as a weight-for-length Z-score >97th percentile. The prevalence of overweight/obesity at 6 and 12 months was 6.88% and 5.26%, respectively. The occurrence of vitamin D (VitD) deficiency (<20 ng/mL) at 6 and 12 months was 6.56% and 2.05%, respectively. Concentration of 25(OH)D at the corresponding age was negatively associated with weight-for-length percentile (WLP) at both 6 (adjusted β: −0.14; 95% CI: −0.27, −0.02; p = 0.02) and 12 months (adjusted β: −0.22; 95% CI: −0.41, −0.02; p = 0.03), while the relationship between 25(OH)D at 6 months and WLP at 12 months was nonlinear, where 35 ng/mL was identified as an inflection point. Those with a concentration of 25(OH)D <35 ng/mL at 6 months had a higher risk of overweight/obesity (adjusted OR: 1.42; 95% CI: 1.06, 1.91; p = 0.02) compared to the group with a concentration of 25(OH)D ≥35 ng/mL. Moreover, a concentration of 25(OH)D <35 ng/mL at two time points significantly increased the risk of overweight/obesity at 12 months compared to the group with 25(OH)D concentration ≥35 ng/mL at two time points (adjusted OR: 2.91; 95% CI: 1.13, 7.46; p = 0.03). A suboptimal 25(OH)D concentration <35 ng/mL significantly increases the risk of overweight/obesity in infants.
Collapse
Affiliation(s)
- Chen Chen
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Chunyan Zhou
- Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xianting Jiao
- Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Xirui Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Yue Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xiaodan Yu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- MOE-Shanghai Key Lab of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
- Correspondence:
| |
Collapse
|
14
|
Patriota P, Borloz S, Ruiz I, Bouthors T, Rezzi S, Marques-Vidal P, Hauschild M. High Prevalence of Hypovitaminosis D in Adolescents Attending a Reference Centre for the Treatment of Obesity in Switzerland. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101527. [PMID: 36291463 PMCID: PMC9601272 DOI: 10.3390/children9101527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022]
Abstract
Background: Hypovitaminosis D is common in populations with obesity. This study aimed at assessing (1) the prevalence of hypovitaminosis D and (2) the associations between vitamin D levels and cardiovascular risk factors in adolescents attending a reference centre for the treatment of obesity. Design: Cross-sectional pilot study conducted in the paediatric obesity unit of the Lausanne university hospital, Switzerland. Methods: Participants were considered eligible if they (1) were aged between 10 to 16.9 years and (2) consulted between 2017 and 2021. Participants were excluded if (1) they lacked vitamin D measurements or (2) the vitamin D measurement was performed one month after the base anthropometric assessment. Hypovitaminosis D was considered if the vitamin D level was <30 ng/mL (<75 nmol/L). Severe obesity was defined as a BMI z-score > 3 SD. Results: We included 52 adolescents (31% girls, mean age 13 ± 2 years, 33% with severe obesity). The prevalence of hypovitaminosis D was 87.5% in girls and 88.9% in boys. The vitamin D levels were inversely associated with BMI, Spearman r and 95% CI: −0.286 (−0.555; −0.017), p = 0.037; they were not associated with the BMI z-score: −0.052 (−0.327; 0.224), p = 0.713. The vitamin D levels were negatively associated with the parathormone levels (−0.353 (−0.667; −0.039), p = 0.028) and positively associated with the calcium levels (0.385 (0.061; 0.708), p = 0.020), while no association was found between vitamin D levels and blood pressure and lipid or glucose levels. Conclusion: almost 9 out of 10 adolescents with obesity in our cohort presented with hypovitaminosis D. Hypovitaminosis D does not seem to be associated with a higher cardiovascular risk profile in this group.
Collapse
Affiliation(s)
| | - Sylvie Borloz
- Paediatric Endocrinology and Diabetology Unit, Service of Pediatrics, Department Women-Mother-Child—CHUV, Children’s Hospital—CHUV, Chem. de Montétan 16, 1004 Lausanne, Switzerland
| | - Inge Ruiz
- Paediatric Endocrinology and Diabetology Unit, Service of Pediatrics, Department Women-Mother-Child—CHUV, Children’s Hospital—CHUV, Chem. de Montétan 16, 1004 Lausanne, Switzerland
| | - Thérèse Bouthors
- Paediatric Endocrinology and Diabetology Unit, Service of Pediatrics, Department Women-Mother-Child—CHUV, Children’s Hospital—CHUV, Chem. de Montétan 16, 1004 Lausanne, Switzerland
| | - Serge Rezzi
- Swiss Nutrition and Health Foundation, 1066 Epalinges, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 1015 Lausanne, Switzerland
| | - Michael Hauschild
- Paediatric Endocrinology and Diabetology Unit, Service of Pediatrics, Department Women-Mother-Child—CHUV, Children’s Hospital—CHUV, Chem. de Montétan 16, 1004 Lausanne, Switzerland
- Correspondence: ; Tel.: +41-021-314-87-73
| |
Collapse
|
15
|
Liu YY, Zhou XJ, Li YC. The relationship between vitamin D levels in umbilical cord blood and infantile eczema. J OBSTET GYNAECOL 2022; 42:2813-2817. [PMID: 35980725 DOI: 10.1080/01443615.2022.2109948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A total of 179 normal full-term pregnant women and their newborns were randomly selected. Umbilical venous blood was extracted after the delivery, and the serum level of 25(OH)D3 was measured. Forty 2 days, 3 months, 6 months, and one year after the birth to be asked about the occurrence and development of infant eczema. Thirteen cases were lost to follow-up. The median concentration of 25(OH)D3 in the cord blood was 25.40 ng/mL. Thirty eight cases (22.9%) were vitamin D deficient (<20 ng/mL), 77 cases (46.4%) were vitamin D insufficient (20-30 ng/mL), and 51 cases (30.7%) were vitamin D sufficient (≥30 ng/mL). The incidence of eczema in the umbilical cord blood vitamin D sufficient group was lower than that in the deficient and insufficient groups (p < .05). Sufficient umbilical cord blood vitamin D levels are associated with a lower incidence of eczema in infants up to one year of age. IMPACT STATEMENTWhat is already known on this subject? A number of studies have suggested that vitamin D levels in early life are related to the occurrence of allergic diseases, but the conclusions are not uniform.What do the results of this study add? The rate of sufficient umbilical cord blood vitamin D was low in the Songjiang area of Shanghai. Sufficient umbilical cord blood vitamin D levels (≥30 ng/mL) are associated with a lower incidence of eczema in infants up to 1 year of age.What are the implications of these findings for clinical practice and/or further research? At present, the dose of vitamin D for pregnant women at home and abroad is not consistent, so the specific dose of vitamin D for pregnant women to maintain the foetus needs further discussion. It is expected that a reasonable recommended dose can be developed to reduce the risk of allergic diseases in future generations from a primary prevention perspective.
Collapse
Affiliation(s)
- Yuan-Yuan Liu
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Xiao-Jian Zhou
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Ya-Chun Li
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| |
Collapse
|
16
|
Lopes KG, Rodrigues EL, da Silva Lopes MR, do Nascimento VA, Pott A, Guimarães RDCA, Pegolo GE, Freitas KDC. Adiposity Metabolic Consequences for Adolescent Bone Health. Nutrients 2022; 14:3260. [PMID: 36014768 PMCID: PMC9414751 DOI: 10.3390/nu14163260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 12/20/2022] Open
Abstract
Infancy and adolescence are crucial periods for bone health, since they are characterized by intense physical growth and bone development. The unsatisfactory acquisition of bone mass in this phase has consequences in adult life and increases the risk of developing bone diseases at more advanced ages. Nutrient deficiencies, especially calcium and vitamin D, associated with a sedentary lifestyle; lack of sun exposure; and epigenetic aspects represent some of the main risk factors for poor bone quality. In addition, recent studies relate childhood obesity to impaired bone health; however, studies on the adiposity effects on bone health are scarce and inconclusive. Another gap concerns the implications of obesity on child sexual maturity, which can jeopardize their genetic potential bone mass and increase fracture risk. Therefore, we reviewed the analyzed factors related to bone health and their association with obesity and metabolic syndrome in adolescents. We concluded that obesity (specifically, accumulated visceral fat) harms bones in the infant-juvenile phase, thereby increasing osteopenia/osteoporosis in adults and the elderly. Thus, it becomes evident that forming and maintaining healthy eating habits is necessary during infancy and adolescence to reduce the risk of fractures caused by bone-metabolic diseases in adulthood and to promote healthy ageing.
Collapse
Affiliation(s)
- Kátia Gianlupi Lopes
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Elisana Lima Rodrigues
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Mariana Rodrigues da Silva Lopes
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Valter Aragão do Nascimento
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Arnildo Pott
- Institute of Biosciences, Federal University of Mato Grosso do Sul-UFMS, Campo Grande 79079-900, Brazil
| | - Rita de Cássia Avellaneda Guimarães
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Giovana Eliza Pegolo
- Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Karine de Cássia Freitas
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| |
Collapse
|
17
|
Low socioeconomic status predicts vitamin D status in a cross-section of Irish children. J Nutr Sci 2022; 11:e61. [PMID: 35912305 PMCID: PMC9334117 DOI: 10.1017/jns.2022.57] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 11/06/2022] Open
Abstract
Vitamin D is essential for bone and muscle health with adequate status in childhood crucial for normal skeletal development. We aimed to investigate vitamin D status in a convenience sample (n = 1226) of Irish children (aged 1-17 years) who had serum 25-hydroxyvitamin D (25(OH)D) tested by request of their GP at a Dublin Hospital between 2014 and 2020. We examined predictors including age, sex, season and socioeconomic status (SES). Vitamin D deficiency (<30 nmol/l) was prevalent affecting 23 % and was more common in disadvantaged areas (34 %) and in those aged >12 v. ≤12 years (24 % v. 16 %, P = 0⋅033). The greatest predictor was SES (disadvantaged v. affluent, OR 2⋅18, CI 1⋅34, 3⋅53, P = 0⋅002), followed by female sex (OR 1⋅57, CI 1⋅15, 2⋅14, P = 0⋅005) and winter season (October to February, OR 1⋅40, CI 1⋅07, 1⋅84, P = 0⋅015). A quarter of our sample of children were deficient, rising to one-third in those in disadvantaged areas. Females and those aged over 12 years had a higher prevalence of deficiency. Public health strategies to improve vitamin D status in Irish children, including systematic food fortification may need to be considered to address this issue.
Collapse
|
18
|
Akter R, Afrose A, Sharmin S, Rezwan R, Rahman MR, Neelotpol S. A comprehensive look into the association of vitamin D levels and vitamin D receptor gene polymorphism with obesity in children. Biomed Pharmacother 2022; 153:113285. [PMID: 35728355 DOI: 10.1016/j.biopha.2022.113285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/27/2022] [Accepted: 06/09/2022] [Indexed: 11/02/2022] Open
Abstract
Childhood obesity accounts for several psychosocial and clinical consequences. Psychosocial consequences include lower self-esteem, social isolation, poor academic achievement, peer problems, and depression, whereas clinical consequences are cardiovascular diseases, type 2 diabetes, dyslipidemia, cancer, autoimmune diseases, girls early polycystic ovarian syndrome (PCOS), asthma, bone deformities, etc. A growing number of studies have uncovered the association of childhood obesity and its consequences with vitamin-D (vit-D) deficiency and vitamin-D receptor (VDR) gene polymorphisms such as single nucleotide polymorphisms (SNPs), e.g., TaqI, BsmI, ApaI, FokI, and Cdx2. Considering the impact of vit-D deficiency and VDR gene polymorphisms, identifying associated factors and risk groups linked to lower serum vit-D levels and prevention of obesity-related syndromes in children is of utmost importance. Previously published review articles mainly focused on the association of vit-D deficiency with obesity or other non-communicable diseases in children. The nature of the correlation between vit-D deficiency and VDR gene polymorphisms with obesity in children is yet to be clarified. Therefore, this review attempts to delineate the association of obesity with these two factors by identifying the molecular mechanism of the relationship.
Collapse
Affiliation(s)
- Raushanara Akter
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Afrina Afrose
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Shahana Sharmin
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Rifat Rezwan
- School of Pharmacy, Brac University, 66 Mohakhali, Dhaka, Bangladesh
| | - Md Rashidur Rahman
- Department of Pharmacy, Jashore University of Science and Technology, Jashore 7408, Bangladesh
| | | |
Collapse
|
19
|
Predictive Ability of Machine-Learning Methods for Vitamin D Deficiency Prediction by Anthropometric Parameters. MATHEMATICS 2022. [DOI: 10.3390/math10040616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background: Vitamin D deficiency affects the general population and is very common among elderly Europeans. This study compared different supervised learning algorithms in a cohort of Spanish individuals aged 35–75 years to predict which anthropometric parameter was most strongly associated with vitamin D deficiency. Methods: A total of 501 participants were recruited by simple random sampling with replacement (reference population: 43,946). The analyzed anthropometric parameters were waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), body roundness index (BRI), visceral adiposity index (VAI), and the Clinical University of Navarra body adiposity estimator (CUN-BAE) for body fat percentage. Results: All the anthropometric indices were associated, in males, with vitamin D deficiency (p < 0.01 for the entire sample) after controlling for possible confounding factors, except for CUN-BAE, which was the only parameter that showed a correlation in females. Conclusions: The capacity of anthropometric parameters to predict vitamin D deficiency differed according to sex; thus, WC, BMI, WHtR, VAI, and BRI were most useful for prediction in males, while CUN-BAE was more useful in females. The naïve Bayes approach for machine learning showed the best area under the curve with WC, BMI, WHtR, and BRI, while the logistic regression model did so in VAI and CUN-BAE.
Collapse
|
20
|
Ladang A, Rousselle O, Huyghebaert L, Bekaert AC, Kovacs S, Le Goff C, Cavalier E. Parathormone, bone alkaline phosphatase and 25-hydroxyvitamin D status in a large cohort of 1200 children and teenagers. Acta Clin Belg 2022; 77:4-9. [PMID: 32441564 DOI: 10.1080/17843286.2020.1769285] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives: 25-Hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH) and bone alkaline phosphatase (BALP) are biomarkers of calcium/phosphate metabolism and bone turnover. Although vitamin D deficiency is a well-known cause of secondary hyperparathyroidism, few studies have considered vitamin D status when establishing reference ranges. In this study, we report PTH levels according to the vitamin D status and BALP levels in a large cohort of 1200 children. Additionally, we provide PTH pediatric reference values according to 25(OH)D status as well as BALP pediatric reference ranges.Methods: Serum samples from 1200 children (equally distributed from 5 months to 20 years old) who underwent blood sampling for allergy exploration were used to quantify 25(OH)D, PTH and BALP.Results: The percentage of vitamin D deficient children (<20 ng/ml) progressively increased during childhood starting from 7% in the 0 to 2 year-old subgroup to a mean of at least 50% among teenagers. PTH levels inversely mirrored 25(OH)D concentrations for all age and gender subgroups, and 25(OH)D deficient subgroups presented higher PTH levels than their non-deficient counterparts. In the non-deficient 25(OH)D population, PTH levels were the highest at 11 years old for girls and 14 years old for boys. BALP results were slightly increased during childhood and showed a constant decrease during teenage years starting from 12 years old for girls and 14 years old for boys.Conclusion: Our results highlight the inverse relationship between PTH and 25(OH)D in children and the need for a well characterized 25(OH)D population to establish pediatric reference ranges for PTH.
Collapse
Affiliation(s)
- Aurélie Ladang
- Clinical Chemistry Department, CHU De Liège, Liège, Belgium
| | | | | | | | | | | | | |
Collapse
|
21
|
WANG G, ZHANG J, ZHANG K, ZHAO Q, ZHOU F, XU J, XUE W, ZHANG C, FU C. Possible action mechanisms of vitamin D supplementation in combating obesity and obesity-related issues of bone health: a mini review. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.114621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Guiqing WANG
- the Sixth Hospital affiliated to Guangzhou Medical University, China
| | - Jie ZHANG
- Beijing Zhongwei Research Center of Biological and Translational Medicine, China
| | - Kailong ZHANG
- Beijing Zhongwei Research Center of Biological and Translational Medicine, China
| | - Qingqing ZHAO
- Beijing Zhongwei Research Center of Biological and Translational Medicine, China
| | - Fang ZHOU
- National University of Singapore (Suzhou) Research Institude, China
| | - Jie XU
- National University of Singapore (Suzhou) Research Institude, China
| | - Wenshuang XUE
- National University of Singapore (Suzhou) Research Institude, China
| | - Chunye ZHANG
- Beijing Zhongwei Research Center of Biological and Translational Medicine, China
| | - Caili FU
- National University of Singapore (Suzhou) Research Institude, China
| |
Collapse
|
22
|
Zheng C, Li H, Rong S, Liu L, Zhen K, Li K. Vitamin D level and fractures in children and adolescents: a systematic review and meta-analysis. J Bone Miner Metab 2021; 39:851-857. [PMID: 34115219 DOI: 10.1007/s00774-021-01238-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The aim of the study was to determine the relationship between vitamin D levels and the risk of bone fractures in children and adolescents. MATERIALS AND METHODS PubMed, Embase, and Cochrane library databases were searched using subject and free words. The Newcastle-Ottawa scale form was used to assess literature quality. ReVman 5.2 and Stata 13.0 were used for statistical analyses. The results were expressed as the mean difference (MD)/odds ratio (OR) and 95% confidence interval (95% CI). The heterogeneity test was conducted according to I2 and Q tests. Egger's test was used to evaluate publication bias. RESULTS Thirteen studies (3943 participants ≤ 18 years old) were included, and the quality of the literature was acceptable. Regarding the 25-hydroxyvitamin D (25OHD) level in the random effects model, the MD = - 0.12 ng/mL (95% CI: -1.93, 1.69), I2 = 83%, and P < 0.00001, indicating large heterogeneity. Subgroup analyses were conducted according to vitamin D supplementation and 25OHD level, the sources of heterogeneity were not found. Regarding the proportion of subjects with vitamin D deficiency in the random effects model, OR = 1.09 (95% CI: 0.67, 1.79), I2 = 79%, and P < 0.0001. By sensitivity analysis, after removing Al-Daghri's study, OR = 1.22 (95% CI: 0.96, 1.56), I2 = 0%, and P = 0.64. CONCLUSION There is no relationship between vitamin D level and the risk of bone fractures in children and adolescents.
Collapse
Affiliation(s)
- Chong Zheng
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Hao Li
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Shuai Rong
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Liantao Liu
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Kepei Zhen
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Kewei Li
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China.
| |
Collapse
|
23
|
Sherief LM, Ali A, Gaballa A, Abdellatif GM, Kamal NM, Afify MR, Abdelmalek DH, El-Emari SA, Soliman AS, Mokhtar WA. Vitamin D status and healthy Egyptian adolescents: Where do we stand? Medicine (Baltimore) 2021; 100:e26661. [PMID: 34398026 PMCID: PMC8294863 DOI: 10.1097/md.0000000000026661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 06/25/2021] [Indexed: 01/04/2023] Open
Abstract
Vitamin D deficiency is a worldwide public health problem. Low vitamin D and its consequences among children and adolescents could be considered as one of the most important health-related problems. This study aimed to estimate the prevalence of vitamin D deficiency in healthy Egyptian adolescents and investigate factors associated with vitamin D status.A cross-sectional study was conducted on 572 school children (270 males and 302 females) aged 14 to 18 years, who were randomly selected from high schools in one governorate in Egypt. Data were collected through a self-administered questionnaire. Vitamin D level, serum calcium, phosphorus, alkaline phosphates were measured.Vitamin D deficiency was almost present in all the studied Egyptian healthy adolescents (99%), 94.8% had vitamin D deficiency and 4.2% had vitamin D insufficiency. Girls had a higher prevalence of vitamin D deficiency than boys. There was a significant association between lack of physical activity, sun exposure, and vitamin D deficiency.Vitamin D deficiency and insufficiency are highly prevalent. In sunny countries, the special pattern of conservative clothing and the lack of outdoor physical activity might be the underlying factors for the high prevalence in females. Vitamin D supplementation seems to be mandatory to halt the problem.
Collapse
Affiliation(s)
| | - Adel Ali
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Gaballa
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | | | - Mona R. Afify
- Department of Medical Microbiology & Parasitology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | | | | | | | | |
Collapse
|
24
|
Chee WSS, Chang CY, Arasu K, Wong SY, Ong SH, Yang WY, Chong MHZ, Mavinkurve M, Khoo EJ, Chinna K, Weaver CM. Vitamin D Status Is Associated with Modifiable Lifestyle Factors in Pre-Adolescent Children Living in Urban Kuala Lumpur, Malaysia. Nutrients 2021; 13:2175. [PMID: 34202743 PMCID: PMC8308301 DOI: 10.3390/nu13072175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/19/2022] Open
Abstract
Studies on vitamin D status and its determinants in growing children in countries with ample sunshine such as Malaysia have been limited. The aim of our study was to determine factors associated with serum 25(OH)D concentrations such as lifestyle, dietary intake, anthropometry, and body composition in 243 pre-adolescent Malaysian children from low-income families living in Kuala Lumpur. This cross-sectional study measured bone density and body composition using dual-energy X-ray absorptiometry (DXA), while serum 25(OH)D was measured using LC-MS/MS. Time spent outdoors, body surface area exposed to sunlight, dietary intake, and physical activity level were assessed using questionnaires. Multiple linear regression and stepwise analysis were performed to identify significant predictors for serum 25(OH)D. About 69.4% had 25(OH)D < 50 nmol/L, and 18.9% were vitamin-D-deficient with 25(OH)D < 30 nmol/L. Girls had a nine-fold higher prevalence of vitamin D deficiency than boys. Body surface area exposed to sunlight, Sun Index, and fat mass were significant predictors of 25(OH)D concentrations in this population. Modifiable lifestyle factors such as sun exposure and reducing obesity are important public health guidance to ensure optimal vitamin D status in these children.
Collapse
Affiliation(s)
- Winnie Siew Swee Chee
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Chung Yuan Chang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Kanimolli Arasu
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Soon Yee Wong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Shu Hwa Ong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Wai Yew Yang
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Megan Hueh Zan Chong
- Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (C.Y.C.); (K.A.); (S.Y.W.); (S.H.O.); (W.Y.Y.); (M.H.Z.C.)
| | - Meenal Mavinkurve
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Seremban 70300, Malaysia; (M.M.); (E.J.K.)
| | - Erwin Jiayuan Khoo
- Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, Seremban 70300, Malaysia; (M.M.); (E.J.K.)
| | - Karuthan Chinna
- Faculty of Health & Medical Sciences, School of Medicine, Taylor’s University, No. 1, Jalan Taylor’s, Subang Jaya 47500, Malaysia;
| | - Connie M. Weaver
- Distinguished Professor Emerita, Purdue University, West Lafayette, IN 47907, USA;
| |
Collapse
|
25
|
Ma S, Hou D, Zhang Y, Yang L, Sun J, Zhao M, Magnussen CG, Xi B. Trends in abdominal obesity among Chinese children and adolescents, 1993-2015. J Pediatr Endocrinol Metab 2021; 34:163-169. [PMID: 33544542 DOI: 10.1515/jpem-2020-0461] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/04/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The prevalence of general overweight and obesity defined by body mass index criteria has greatly increased in Chinese children and adolescents in recent decades. However, few studies have considered the trend in abdominal obesity in Chinese children and adolescents. This study aimed to examine the secular trends in waist circumference (WC), waist-to-height ratio (WHtR) and the prevalence of abdominal obesity among Chinese children and adolescents aged 6-17 years from 1993 to 2015. METHODS A total of 11,985 children and adolescents aged 6-17 years participated in the China Health and Nutrition Survey, a continuous cross-sectional survey, conducted from 1993 to 2015. Abdominal obesity was defined as WC≥age- and sex-specific 90th percentile based on the reference from Chinese children and adolescents or WHtR≥0.50. RESULTS After adjustment for age, sex and region, mean WC increased from 60.27 cm in 1993 to 64.31 cm in 2015 (p for trend <0.001), and mean WHtR increased from 0.430 to 0.434 (p for trend <0.05). The prevalence of abdominal obesity defined by WC reference increased from 5.0% in 1993 to 19.3% in 2015 and defined by WHtR reference increased from 6.4% in 1993 to 14.5% in 2015 (p for trend <0.001). CONCLUSIONS The prevalence of abdominal obesity among Chinese children and adolescents aged 6-17 years has increased between 1993 and 2015.
Collapse
Affiliation(s)
- Shujing Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dongqing Hou
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Yanqing Zhang
- Zibo Center for Disease Control and Prevention, Zibo, China
| | - Liu Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiahong Sun
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| |
Collapse
|
26
|
Hoang NTD, Orellana L, Gibson RS, Le TD, Worsley A, Sinclair AJ, Hoang NTT, Szymlek-Gay EA. Multiple micronutrient supplementation improves micronutrient status in primary school children in Hai Phong City, Vietnam: a randomised controlled trial. Sci Rep 2021; 11:3728. [PMID: 33580103 PMCID: PMC7881239 DOI: 10.1038/s41598-021-83129-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/28/2021] [Indexed: 01/21/2023] Open
Abstract
We aimed to determine the efficacy of multiple micronutrient supplementation on the biomarkers of iron, zinc, and vitamin A status across anthropometric status categories in Vietnamese school children. In this 22-week randomised controlled trial, 347 undernourished, normal weight, or overweight/obese children aged 6-9 years were allocated to receive every school day a multiple micronutrient supplement (10 mg iron, 10 mg zinc, 400 µg vitamin A) or a placebo. Haematological indices; circulating ferritin, zinc, and retinol (corrected for inflammation); and C-reactive protein were measured at baseline and 22 weeks. At week 22, linear mixed models showed that mean corpuscular volume increased by 0.3 fL, serum ferritin by 9.1 µg/L, plasma zinc by 0.9 µmol/L, and plasma retinol by 15%, and the prevalence of zinc deficiency decreased by 17.3% points in the intervention group compared to placebo. No intervention effects were found for other haematological indices, or the prevalence of anaemia. Multiple micronutrient supplementation for 22 weeks improved the biomarkers of zinc and vitamin A status and some biomarkers of iron status, and reduced the prevalence of zinc deficiency in Vietnamese school children.Trial registration: This trial was registered on 06/09/2016 at www.anzctr.org.au as ACTRN12616001245482.
Collapse
Affiliation(s)
- Ngan T D Hoang
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
| | - Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Tuyen D Le
- National Institute of Nutrition, Hanoi, Vietnam
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | | | | | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| |
Collapse
|
27
|
Radzki RP, Bienko M, Wolski D, Ostapiuk M, Polak P, Manastyrska M, Kimicka A, Wolska J. Programming Effect of the Parental Obesity on the Skeletal System of Offspring at Weaning Day. Animals (Basel) 2021; 11:ani11020424. [PMID: 33562167 PMCID: PMC7914703 DOI: 10.3390/ani11020424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 01/01/2023] Open
Abstract
Simple Summary Overweight and obesity can cause many diseases, and several studies indicate a close relationship between the obesity of parents and the health of their offspring. Our aim was to investigate whether there is a programming influence of parental obesity on the skeletal system in weaned female and male offspring rats. In undertaking this, analysis of bone material was carried out using isolated tibia, and densitometry (DXA), peripheral (pQCT) and micro (µCT) computed tomography were performed. Mechanical tests and blood serum biochemistry were also carried out. Our work showed a significant programming influence of parental obesity on neonatal skeletal development. The tibiae isolated from offspring originating from obese parents were characterized by more intense mineralization and higher fracture resistance. However, numerous studies demonstrate the destructive effect of obesity on the skeletal system. Our research and the available literature suggest the existence of a “fat threshold”, the exceeding of which changes of the osteotropic effect of adipose tissue to become unfavorable. Therefore, there is a need for further research to determine the time-dependent metabolic relationship between adipose tissue and bone in both animals and humans. Abstract Our study aimed to verify the hypothesis of the existence of a programming effect of parental obesity on the growth, development and mineralization of the skeletal system in female and male rat offspring on the day of weaning. The study began with the induction of obesity in female and male rats of the parental generation, using a high-energy diet (group F). Females and males of the control group received the standard diet (group S). After 90 days of dietary-induced obesity, the diet in group F was changed into the standard. Rats from groups F and S were mated to obtain offspring which stayed with their mothers until 21 days of age. Tibia was tested using dual-energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT), micro-computed tomography (µCT) and mechanical strength using the three-point bending test. Biochemical analysis of blood serum bone metabolism markers was performed. DXA analysis showed higher tibia bone mineral content (BMC) and area. pQCT measurements of cortical and trabecular tissue documented the increase of the volumetric bone mineral density and BMC of both bone compartments in offspring from the F group, while µCT of the trabecular tissue showed an increase in trabecular thickness and a decrease of its separation. Parental obesity, hence, exerts a programming influence on the development of the skeletal system of the offspring on the day of the weaning, which was reflected in the intensification of mineralization and increased bone strength.
Collapse
Affiliation(s)
- Radoslaw Piotr Radzki
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Akademicka 12, 20-033 Lublin, Poland; (D.W.); (M.M.); (A.K.)
- Correspondence: (R.P.R.); (M.B.); Tel.: +48-81-445-60-69 (R.P.R.); +48-81-445-69-30 (M.B.)
| | - Marek Bienko
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Akademicka 12, 20-033 Lublin, Poland; (D.W.); (M.M.); (A.K.)
- Correspondence: (R.P.R.); (M.B.); Tel.: +48-81-445-60-69 (R.P.R.); +48-81-445-69-30 (M.B.)
| | - Dariusz Wolski
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Akademicka 12, 20-033 Lublin, Poland; (D.W.); (M.M.); (A.K.)
| | - Monika Ostapiuk
- Department of Materials Engineering, Lublin University of Technology, Nadbystrzycka 36, 20-618 Lublin, Poland;
| | - Pawel Polak
- St Johns’ Oncology Center in Lublin (COZL) Trauma, Orthopaedic Surgery Department, ul. Jaczewskiego 7, 20-090 Lublin, Poland;
| | - Malgorzata Manastyrska
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Akademicka 12, 20-033 Lublin, Poland; (D.W.); (M.M.); (A.K.)
| | - Aleksandra Kimicka
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Akademicka 12, 20-033 Lublin, Poland; (D.W.); (M.M.); (A.K.)
| | - Joanna Wolska
- Department of Oncology, Chair of Oncology and Environmental Health, Faculty of Health Sciences, Medical University of Lublin, 20-090 Lublin, Poland;
| |
Collapse
|
28
|
Obesity, oxidative DNA damage and vitamin D as predictors of genomic instability in children and adolescents. Int J Obes (Lond) 2021; 45:2095-2107. [PMID: 34158611 PMCID: PMC8380542 DOI: 10.1038/s41366-021-00879-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/18/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND/OBJECTIVES Epidemiological evidence indicates obesity in childhood and adolescence to be an independent risk factor for cancer and premature mortality in adulthood. Pathological implications from excess adiposity may begin early in life. Obesity is concurrent with a state of chronic inflammation, a well-known aetiological factor for DNA damage. In addition, obesity has been associated with micro-nutritional deficiencies. Vitamin D has attracted attention for its anti-inflammatory properties and role in genomic integrity and stability. The aim of this study was to determine a novel approach for predicting genomic instability via the combined assessment of adiposity, DNA damage, systemic inflammation, and vitamin D status. SUBJECTS/METHODS We carried out a cross-sectional study with 132 participants, aged 10-18, recruited from schools and paediatric obesity clinics in London. Anthropometric assessments included BMI Z-score, waist and hip circumference, and body fat percentage via bioelectrical impedance. Inflammation and vitamin D levels in saliva were assessed by enzyme-linked immunosorbent assay. Oxidative DNA damage was determined via quantification of 8-hydroxy-2'-deoxyguanosine in urine. Exfoliated cells from the oral cavity were scored for genomic instability via the buccal cytome assay. RESULTS As expected, comparisons between participants with obesity and normal range BMI showed significant differences in anthropometric measures (p < 0.001). Significant differences were also observed in some measures of genomic instability (p < 0.001). When examining relationships between variables for all participants, markers of adiposity positively correlated with acquired oxidative DNA damage (p < 0.01) and genomic instability (p < 0.001), and negatively correlated with vitamin D (p < 0.01). Multiple regression analyses identified obesity (p < 0.001), vitamin D (p < 0.001), and oxidative DNA damage (p < 0.05) as the three significant predictors of genomic instability. CONCLUSIONS Obesity, oxidative DNA damage, and vitamin D deficiency are significant predictors of genomic instability. Non-invasive biomonitoring and predictive modelling of genomic instability in young patients with obesity may contribute to the prioritisation and severity of clinical intervention measures.
Collapse
|
29
|
Tang W, Zhan W, Wei M, Chen Q. Associations Between Different Dietary Vitamins and the Risk of Obesity in Children and Adolescents: A Machine Learning Approach. Front Endocrinol (Lausanne) 2021; 12:816975. [PMID: 35250848 PMCID: PMC8893992 DOI: 10.3389/fendo.2021.816975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/29/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUNDS Simultaneous dietary intake of vitamins is considered as a common and real scenario in daily life. However, limited prospective studies have evaluated the association between multivitamins intake and obesity in children and adolescents. OBJECTIVES This study aimed to evaluate the relationship between the intake of different dietary vitamins and the risk of obesity in children (6-11 years) and adolescents (12-19 years). METHODS We conducted a cross-sectional study based on data from U.S. National Health and Nutrition Examination Survey, 2013-2016. A total of 3634 children and adolescents were included who had available data on dietary vitamins, obesity and covariates. We analyzed the dietary intake levels of nine vitamins, including vitamin A, vitamin B1, vitamin B2, vitamin B6, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K. Multivariate logistic regression was used to model the associations between vitamins and obesity. Bayesian kernel machine regression (BKMR) was employed to explore the joint and independent effects of vitamins on obesity among children and adolescents. RESULTS In the multivariate logistic regression model, five vitamins (vitamin A, vitamin B1, vitamin B2, vitamin B12, and vitamin D) were negatively associated with obesity in children and adolescents. BKMR analysis showed that when the concentration of the nine vitamins was at or above the 55th percentile compared with the median value, the combined intake of these vitamins could significantly reduce the risk of obesity in children and adolescents. Potential interactions between vitamin B2 and vitamin B12 in increasing the risk of obesity in children and adolescents were observed. CONCLUSIONS We determine the combined effects of multivitamins on obesity in children and adolescents, and observe a significant interaction between vitamin B2 and vitamin B12. Further cohort studies are needed to clarify the health effects of multivitamins intake in a larger population.
Collapse
Affiliation(s)
- Weifeng Tang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenqiang Zhan
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengdan Wei
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Qian Chen,
| |
Collapse
|
30
|
Simunovic M, Supe-Domic D, Karin Z, Degoricija M, Paradzik M, Skrabic R, Jukic A, Bozic J, Skrabic V. The Relationship of Vitamin D Status, Adherence to the Mediterranean Diet, and Physical Activity in Obese Children and Adolescents. J Med Food 2020; 24:385-393. [PMID: 32783677 DOI: 10.1089/jmf.2020.0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Vitamin D deficiency is associated with a range of chronic diseases, including childhood obesity. Prevalence of vitamin D deficiency in obese children and adolescents ranges from 6.5% to 57%. This cross-sectional study included 92 obese patients with body mass index z-score >2 and 39 subjects in the control group. Anthropometric and laboratory patient assessment were performed, including the fasting 25-hydroxyvitamin D (25(OH)D). Adherence to the Mediterranean diet was assessed by Mediterranean Diet Quality Index for children and adolescents (KIDMED index), while physical activity was evaluated by Physical Activity Questionnaire (PAQ). Serum levels of 25(OH)D were significantly lower in obese subjects compared to the control group (52.0 ± 17.93 vs. 64.09 ± 25.82 nmol/L, P = .003). The subgroup of obese patients with metabolic syndrome (MS) had significantly lower levels of serum vitamin D when compared to the subgroup of obese patients without MS and the control group (46.99 ± 17.11 vs. 54.58 ± 17.93 vs. 64.09 ± 25.82 nmol/L, P = .003). Obese patients with MS had lower PAQ score when compared to obese without MS and the control group (2.32 ± 0.55 vs. 2.49 ± 0.67 vs. 2.85 ± 0.63 nmol/L, P = .002), while no significant differences were observed in the KIDMED index (4.23 ± 1.81 vs. 4.21 ± 2.13 vs. 4.87 ± 2.29, P = .251), respectively. PAQ score was in positive correlation with serum levels of 25(OH)D (r = 0.305, P < .001). This study demonstrated that obese children and adolescents have significantly lower values of serum 25(OH)D. The positive correlation between vitamin D and PAQ score points to the importance of physical activity in the prevention of further cardiovascular complications and MS.
Collapse
Affiliation(s)
- Marko Simunovic
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia.,Department of Health Studies, University of Split, Split, Croatia
| | - Zeljka Karin
- Public Health Institute of Split and Dalmatia County, Split, Croatia
| | - Marina Degoricija
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - Martina Paradzik
- Department of Ophthalmology, University Hospital of Split, Split, Croatia
| | - Roko Skrabic
- University of Split School of Medicine, Split, Croatia
| | - Andrija Jukic
- University of Split School of Medicine, Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
| | - Veselin Skrabic
- Department of Pediatrics, University Hospital of Split, Split, Croatia.,Department of Pediatrics, University of Split School of Medicine, Split, Croatia
| |
Collapse
|
31
|
Moreira CA, Ferreira CEDS, Madeira M, Silva BCC, Maeda SS, Batista MC, Bandeira F, Borba VZC, Lazaretti-Castro M. Reference values of 25-hydroxyvitamin D revisited: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society of Clinical Pathology/Laboratory Medicine (SBPC). ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:462-478. [PMID: 32813765 PMCID: PMC10522078 DOI: 10.20945/2359-3997000000258] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 03/01/2020] [Indexed: 11/23/2022]
Abstract
Hypovitaminosis D is a common condition with a negative impact on health. This statement, prepared by experts from the Brazilian Society of Endocrinology and Metabolism and the Brazilian Society of Clinical Pathology/Laboratory Medicine, includes methodological aspects and limitations of the measurement of 25-hydroxyvitamin D [25(OH)D] for identification of vitamin D status, and identifies individuals at increased risk for deficiency of this vitamin in whom 25(OH)D measurement is recommended. For the general population, 25(OH)D levels between 20 and 60 ng/mL are considered normal, while individuals with levels below 20 ng/mL are considered to be vitamin D deficient. This statement identifies potential benefits of maintaining 25(OH)D levels > 30 ng/mL in specific conditions, including patients aged > 65 years or pregnant, those with recurrent falls, fragility fractures, osteoporosis, secondary hyperparathyroidism, chronic kidney disease, or cancer, and individuals using drugs with the potential to affect the vitamin D metabolism. This statement also calls attention to the risk of vitamin D intoxication, a life-threatening condition that occurs at 25(OH)D levels above 100 ng/mL.
Collapse
Affiliation(s)
- Carolina Aguiar Moreira
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Miguel Madeira
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Sergio Setsuo Maeda
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Francisco Bandeira
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Marise Lazaretti-Castro
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| |
Collapse
|
32
|
Holten-Andersen MN, Haugen J, Oma I, Strand TA. Vitamin D Status and Its Determinants in A Paediatric Population in Norway. Nutrients 2020; 12:nu12051385. [PMID: 32408637 PMCID: PMC7285155 DOI: 10.3390/nu12051385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/08/2020] [Accepted: 05/09/2020] [Indexed: 12/03/2022] Open
Abstract
Recommendations for sufficient vitamin D intake in children were recently revised in Norway. However, optimal levels of vitamin D are still debated and knowledge on supplementation and vitamin D levels in healthy children in Norway is scarce. Therefore, we measured the plasma-concentration of 25-hydroxyvitamin D (25(OH)D) in children and adolescents attending the outpatient paediatric clinics in Innlandet Hospital Trust, Norway during two consecutive years (2015–2017). We recruited 301 children and adolescents aged 5 months to 18 years (mean 7.8, SD 4.4 years) for the study and obtained sample material for 25(OH)D measurements from 295 (98%). Information on diet, vitamin D supplementation, sun exposure, ethnicity, parental education and general health was collected by questionnaire. 25(OH)D levels were analysed and determinants for 25(OH)D were estimated by linear regression. 1.0% of the children had deficient levels (25(OH)D < 25 nmol/L) and 21.0% had insufficient levels (25–50 nmol/L). 25(OH)D levels ranging from 50 to 75 nmol/L were found among 38.3%, while 39.7% had levels above 75 nmol/L. The mean 25(OH)D level was 70.0 nmol/L (SD 23.4, range 17–142 nmol/L) with a significant seasonal variation with lowest levels in mid-winter and highest in late summer. In addition to seasonal variation independent determinants for 25(OH)D-levels were age of the child, parental ethnicity, vitamin D supplementation and soda consumption. Along with parental ethnicity other than Nordic, age was the strongest determinant of 25(OH)D, with adolescents having the lowest levels.
Collapse
Affiliation(s)
- Mads N Holten-Andersen
- Department of Paediatrics, Lillehammer Hospital, Innlandet Hospital Trust, 2626 Lillehammer, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
- Correspondence: ; Tel.: +47-61272013
| | - Johanne Haugen
- Department of Medical Microbiology, Innlandet Hospital Trust, 2626 Lillehammer, Norway; (J.H.); (I.O.)
| | - Ingvild Oma
- Department of Medical Microbiology, Innlandet Hospital Trust, 2626 Lillehammer, Norway; (J.H.); (I.O.)
| | - Tor A Strand
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, P.O. Box 7800, 7803 Bergen, Norway;
- Department of Research, Innlandet Hospital Trust, 2381 Brumunddal, Norway
| |
Collapse
|
33
|
de Oliveira CL, Cureau FV, Cople-Rodrigues CDS, Giannini DT, Bloch KV, Kuschnir MCC, de Carvalho KMB, Schaan BD. Prevalence and factors associated with hypovitaminosis D in adolescents from a sunny country: Findings from the ERICA survey. J Steroid Biochem Mol Biol 2020; 199:105609. [PMID: 32006587 DOI: 10.1016/j.jsbmb.2020.105609] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
Vitamin D plays a role in bone and metabolic health in life long, however hypovitaminosis D is common in different settings. The aim of this study was to describe vitamin D status among adolescents from a large sunny country and analyze associated factors. This was a multicenter, cross-sectional, school-based study. A total of 1152 adolescents age 12-17 from four Brazilian cities, Rio de Janeiro, Fortaleza, Brasília, and Porto Alegre, were included. Anthropometric variables, diet, type of school, race and season of data collection were evaluated. Serum concentrations of 25-hydroxyvitamin D [25(OH)D] were measured and categorized into three levels: ≤ 20 ng/mL, 21-29 ng/mL and ≥ 30 ng/mL. Ordered logistic regression models were used to explore the factors associated with hypovitaminosis D. The prevalence of vitamin D levels below 20 ng/mL, between 21 and 29 ng/mL and above 30 ng/mL was 21 % (95 %CI: 19 %-24 %), 42 % (95 %CI: 39 %-46 %) and 37 % (95 %CI: 33 %-40 %), respectively. In the final adjusted model, hypovitaminosis D was positively associated with gender, center (latitudes), data collected in winter or spring, non-whites, and private school students. A higher proportional odds ratio (POR) for hypovitaminosis D was found among obese boys (POR = 2.2, 95 %CI: 1.1-4.5), but not girls. Adequate dietary intake of vitamin D was a protective factor (POR = 0.4, 95 %CI: 0.2-0.6) against hypovitaminosis D. In conclusion, there is a high prevalence of Brazilian adolescents at risk of hypovitaminosis D, independent of region. Due to their potential benefits, lifestyle changes should be stimulated, including healthier food choices and spending more time outdoors (with sun protection).
Collapse
Affiliation(s)
| | - Felipe Vogt Cureau
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | - Denise Tavares Giannini
- Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Katia Vergetti Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Beatriz D Schaan
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Endocrine division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Faculty of Medicine, Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Brazil
| |
Collapse
|
34
|
Öhlund I, Lind T, Hernell O, Silfverdal SA, Liv P, Karlsland Åkeson P. Vitamin D status and cardiometabolic risk markers in young Swedish children: a double-blind randomized clinical trial comparing different doses of vitamin D supplements. Am J Clin Nutr 2020; 111:779-786. [PMID: 32140704 PMCID: PMC7138658 DOI: 10.1093/ajcn/nqaa031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 02/03/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Observational studies have linked low vitamin D status to unfavorable cardiometabolic risk markers, but double-blinded vitamin D intervention studies in children are scarce. OBJECTIVES The aim was to evaluate the effect of different doses of a vitamin D supplement on cardiometabolic risk markers in young healthy Swedish children with fair and dark skin. METHODS Cardiometabolic risk markers were analyzed as secondary outcomes of a double-blind, randomized, milk-based vitamin D intervention trial conducted during late fall and winter in 2 areas of Sweden (latitude 63°N and 55°N, respectively) in both fair- and dark-skinned 5- to 7-y-old children. During the 3-mo intervention, 206 children were randomly assigned to a daily milk-based vitamin D3 supplement of either 10 or 25 µg or placebo (2 µg; only at 55°N). Anthropometric measures, blood pressure, serum 25-hydroxyvitamin D [25(OH)D], total cholesterol, HDL cholesterol, apoA-I, apoB, and C-reactive protein (CRP) were analyzed and non-HDL cholesterol calculated at baseline and after the intervention. RESULTS At baseline, serum 25(OH)D was negatively associated with systolic and diastolic blood pressure (β = -0.194; 95% CI: -0.153, -0.013; and β = -0.187; 95% CI: -0.150, -0.011, respectively). At follow-up, there was no statistically significant difference in any of the cardiometabolic markers between groups. CONCLUSIONS We could not confirm any effect of vitamin D supplementation on serum lipids, blood pressure, or CRP in healthy 5- to 7-y-old children. The study was registered at clinicaltrials.gov (NCT01741324).
Collapse
Affiliation(s)
- Inger Öhlund
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden,Address correspondence to IO (e-mail: )
| | - Torbjörn Lind
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Olle Hernell
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | | | - Per Liv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | |
Collapse
|
35
|
Liang X, He Y, Chen M, Ping Q, Chen J. The association of lecithin retinol acyltransferase and the 25(OH)D receptor with pediatric overweight and obesity. Eur J Clin Nutr 2019; 73:1626-1629. [PMID: 30967641 DOI: 10.1038/s41430-019-0422-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 03/24/2019] [Accepted: 03/25/2019] [Indexed: 02/07/2023]
Abstract
The aim of this study is to determine whether lecithin retinol acyltransferase (LRAT) as well as biomarkers of vitamin A (VA) and vitamin D are related to indices of obesity in childhood. A total of 164 children (aged 6-12 years, female 49.39%), comprising 66 children in the overweight/obese group and 98 children in the lean group, were included. LRAT expression was remarkably lower in the overweight/obese group than in the lean group (P < 0.01). Compared with the lean group, the overweight/obese group had elevated VA (0.95 ± 0.25 vs. 0.83 ± 0.21 µmol/L, P < 0.01). Moreover, the levels of 25(OH)D (25-hydroxyvitamin D) and its receptor were lower in overweight/obese subjects than in lean subjects (P = 0.06 and <0.05). LRAT was negatively correlated with body mass index and waist circumference (R = -0.27, P < 0.01, and R = -0.18, P < 0.05, respectively) and positively correlated with high-density lipoprotein (R = 0.18, P < 0.05). VA metabolism may be disordered in obese children, although children with obesity have higher VA levels than lean children.
Collapse
Affiliation(s)
- Xiaohua Liang
- Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Paediatrics in Chongqing, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing, China.
| | - Yun He
- Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Paediatrics in Chongqing, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing, China
| | - Min Chen
- Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Paediatrics in Chongqing, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing, China
| | - Qu Ping
- Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Paediatrics in Chongqing, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing, China
| | - Jie Chen
- Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Paediatrics in Chongqing, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Chongqing, China
| |
Collapse
|
36
|
The relation between circulating levels of vitamin D and parathyroid hormone in children and adolescents with overweight or obesity: Quest for a threshold. PLoS One 2019; 14:e0225717. [PMID: 31770397 PMCID: PMC6879169 DOI: 10.1371/journal.pone.0225717] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 11/11/2019] [Indexed: 12/31/2022] Open
Abstract
The level of serum 25-hydroxyvitamin D (25(OH)D) at which intact parathyroid hormone (iPTH) is maximally suppressed (suppression point) and below which PTH begins to rise (inflection point) has been used to define optimum 25(OH)D concentration. We aimed to study the association of circulating iPTH with 25(OH)D concentrations and to determine a 25(OH)D threshold associated with a significant iPTH suppression. This cross-sectional study was conducted on 198 boys and 180 girls, aged 6–13 years with BMI ≥ 1SD (WHO criteria) recruited from primary schools. Adjusted iPTH for BMI z-score, pubertal status, and dietary calcium was used. Nonlinear regression was used to model the relationship between 25(OH)D and iPTH and identify a suppression point for 25(OH)D at which iPTH reached a plateau. Piecewise regression analysis with a single knot for all possible values of 25(OH)D were fitted. Furthermore, 95% confidence intervals (95%CI) for those point had been calculated. The mean age (SD) of girls and boys was 9.1 (1.6) and 9.4 (1.7) years, respectively. Median 25(OH)D and iPTH were 13.8 ng/mL and 33.9 pg/mL in boys and 9.9 ng/mL and 47.8 ng/mL in girls, respectively. The equation in girls was: log-iPTH = 3.598+0.868 exp[(-0.190×25(OH)D. The point for near maximal suppression of iPTH by 25(OH)D for girls occurred at a 25(OH)D concentration of 20 ng/mL (95% CI: 7.1 to 32.2). No point of maximal suppression was found for boys. We also found a 25(OH)D threshold of 10 ng/mL (95% CI: 4.6 to 22.5) for girls (f: 9.8) by linear piecewise regression modeling of adjusted iPTH. No significant inflection point for boys was observed. In overweight/obese girls, when the concentration of 25(OH)D was higher than 20 ng/mL, an iPTH mean plateau level is reached, and when its concentrations approach 10 ng/mL, the slope of iPTH concentration has been accelerated.
Collapse
|
37
|
The Impact of Obesity on the Association between Vitamin D Deficiency and Cardiovascular Disease. Nutrients 2019; 11:nu11102458. [PMID: 31615154 PMCID: PMC6835874 DOI: 10.3390/nu11102458] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 12/22/2022] Open
Abstract
The aim of this article is to review the literature regarding the relationship between vitamin D deficiency and cardiovascular disease (CVD) and its modification in the presence of obesity. Despite the strong association between vitamin D status and cardiovascular outcomes, vitamin D supplementation trials in the general population have failed to decrease the incidence of cardiovascular events and mortality. A comprehensive study of the published literature and a comparison with experimental data lead to the conclusion that obesity, due to its high prevalence and strong association with both vitamin D deficiency and CVD, may act as a critical confounder, which is responsible for the different results on this association. Adoption of a vitamin D preventive supplementation strategy for CVD is unlikely to yield any benefit to the general population. However, it might be particularly useful in obese adults with increased risk for CVD.
Collapse
|
38
|
Paes‐Silva RP, Gadelha PCFP, Lemos MDCCD, Castro CMMBD, Arruda IKGD, Diniz ADS. Adiposity, inflammation and fat‐soluble vitamins in adolescents. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
39
|
Maia-Ceciliano TC, Dutra RR, Aguila MB, Mandarim-De-Lacerda CA. The deficiency and the supplementation of vitamin D and liver: Lessons of chronic fructose-rich diet in mice. J Steroid Biochem Mol Biol 2019; 192:105399. [PMID: 31175967 DOI: 10.1016/j.jsbmb.2019.105399] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/25/2019] [Accepted: 06/05/2019] [Indexed: 01/01/2023]
Abstract
The fructose added to soft drinks and processed food, as well as frequent detection of vitamin D deficiency in the body, are two insults increasingly considered to cause lesions in target organs. We studied the liver after a chronic high-fructose diet deficient and supplemented with vitamin D. Sixty C57BL/6 mature male mice were allocated into six groups (n = 10) for ten weeks: control (C), control deficient in vitamin D (CDD), control supplemented with vitamin D (CDS), fructose (F), fructose deficient in vitamin D (FDD), and fructose supplemented with vitamin D (FDS). The gene expressions of vitamin D receptor and CYP27B1 and 25 hydroxyvitamin D plasma level ensured that the diets caused vitamin D deficiency or supplementation. Body mass did not change, but blood pressure (BP) increased in CDD, F, and FDD, whereas BP was controlled in FDS. Insulinemia, insulin tolerance and resistance were seen in both vitamin D deficiency and fructose groups but improved with vitamin D supplementation. The steatosis and fibrosis were observed in the CDD, F and FDD groups. Also, F and FDD showed activation of stellate cells (HSC). Lipogenesis and inflammation gene expressions were enhanced in the CDD, F and FDD groups, but diminished with vitamin D supplementation. In conclusion, we demonstrated the adverse effects of vitamin D deficiency on metabolism, liver steatosis and, combined with fructose intake, liver interstitial fibrosis with hepatic stellate cell activation, and alteration of the lipogenesis, beta-oxidation, and liver inflammation. All these data improved when vitamin D was supplemented in the animals.
Collapse
Affiliation(s)
- Thais C Maia-Ceciliano
- Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Rafaela R Dutra
- Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Marcia B Aguila
- Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Carlos A Mandarim-De-Lacerda
- Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
| |
Collapse
|
40
|
Paes-Silva RP, Gadelha PCFP, Lemos MDCCD, Castro CMMBD, Arruda IKGD, Diniz ADS. Adiposity, inflammation and fat-soluble vitamins in adolescents. J Pediatr (Rio J) 2019; 95:575-583. [PMID: 29963989 DOI: 10.1016/j.jped.2018.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/04/2018] [Accepted: 05/04/2018] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Evaluate the association between inflammatory process, adiposity, and vitamins A, D, and E in adolescents, according to gender. METHODS Cross-sectional study with adolescents aged 12-19 years old of both genders attending public schools in Recife. A questionnaire was used to collect data on socioeconomic level, lifestyle, and food intake of adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of α-1-acid glycoprotein, retinol, β-carotene, α-tocopherol, and 25-hydroxy-vitamin D. RESULTS The levels of α-1-acid glycoprotein were higher for abdominal obesity in both genders. Male adolescents with insufficient serum α-tocopherol levels had low levels of α-1-acid glycoprotein (p=0.03) and an increased risk of 25-hydroxy-vitamin D and β-carotene deficiency in relation to total and abdominal fat; female adolescents had an increased risk of insufficient β-carotene with abdominal obesity (PR: 1.33; 95% CI: 1.2-1.5). CONCLUSION Abdominal adiposity implies a higher risk of inflammation and causes different changes to the levels of fat-soluble vitamins according to gender.
Collapse
|
41
|
Larsen SD, Christensen ME, Dalgård C, Lykkedegn S, Andersen LB, Andersen MS, Glintborg D, Christesen HT. Pregnancy or cord 25-hydroxyvitamin D is not associated with measures of body fat or adiposity in children from three months to three years of age. An Odense Child Cohort study. Clin Nutr 2019; 39:1832-1839. [PMID: 31471164 DOI: 10.1016/j.clnu.2019.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/09/2019] [Accepted: 07/25/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND & AIMS The susceptibility to overweight in adults born during winter season may suggest foetal programming of prenatal vitamin D levels on adiposity. We investigated whether cord or pregnancy serum 25-hydroxyvitamin D (s-25OHD) was associated with infant and child body fat measures in a Danish population-based prospective cohort. METHODS In the Odense Child Cohort, 1905 singletons had cord s-25OHD and data on waist circumference (WC), weight, body mass index (BMI), and sum of skin folds (SSF) at median 3.7 months, 18.9 months and three years' age. Early and late pregnancy samples of s-25OHD (mean gestational age 12 and 29 weeks) were chosen as secondary exposures. Multiple linear and logistic regression as well as linear mixed models was applied testing the relation between cord and pregnancy s-25OHD and body fat outcomes and their Z-scores by use of updated national reference populations. Models were adjusted for maternal educational level, maternal ethnicity, pre-gestational BMI and season of birth, a priori stratified by sex. RESULTS The median [IQR] cord s-25OHD was 45.5 [31.1; 60.9] nmol/L. Cord s-25OHD <50 nmol/L was found in 57.5%; values < 25 nmol/L in 16.3%. The mean Z-scores of body fat measures at all ages were in the range of -0.32 to +0.42. No consistent associations were found between s-25OHD in cord, early pregnancy or late pregnancy and WC, weight, BMI, SSF, or their Z-scores at ages 3.7 months, 18.9 months, or 3 years. Neither did a computed composite outcome (WC, SSF, BMI, or weight >90th vs. ≤90 percentile) associate with cord or pregnancy s-25OHD. CONCLUSION Cord or pregnancy s-25OHD was not associated with measures of body fat or adiposity in children up to three years of age. Our data suggested no programming effect of maternal s-25OHD on offspring obesity in a relatively lean and healthy population of mothers.
Collapse
Affiliation(s)
- Søs Dragsbæk Larsen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Mathilde Egelund Christensen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Christine Dalgård
- Department of Public Health, Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Sine Lykkedegn
- Department of Paediatrics, Hospital South West Jutland, Esbjerg, Denmark
| | - Louise Bjørkholt Andersen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Obstetrics and Gynaecology, Herlev Hospital, Copenhagen, Denmark; Department of Obstetrics and Gynaecology, Odense University Hospital, Denmark
| | - Marianne Skovsager Andersen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Medical Endocrinology, Odense University Hospital, Odense, Denmark
| | - Dorte Glintborg
- Department of Medical Endocrinology, Odense University Hospital, Odense, Denmark
| | - Henrik Thybo Christesen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
| |
Collapse
|
42
|
Serum 25-hydroxyvitamin D is associated with obesity and metabolic parameters in US children. Public Health Nutr 2019; 23:1214-1222. [PMID: 31120008 DOI: 10.1017/s1368980019001137] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To explore the relationships of serum 25-hydroxyvitamin D (25(OH)D) with obesity and metabolic parameters in US children. DESIGN Cross-sectional analysis. We evaluated the associations between serum 25(OH)D and multiple measurements of adiposity, serum lipid concentrations, fasting glucose and insulin resistance in children aged 6-18 years with adjustments for multiple covariates. SETTING The National Health and Nutrition Examination Survey, 2001-2006. PARTICIPANTS A nationally representative sample of 6311 children and adolescents aged 6-18 years. RESULTS Among US children and adolescents, the prevalence of vitamin D deficiency has been especially high in older children, girls and the non-Hispanic Black population. Higher odds of obesity were found at a 25(OH)D concentration of <30 nmol/l (deficiency) than at >50 nmol/l under both criteria for obesity in children (OR = 3·27, Ptrend ≤ 0.001). Moreover, increased odds of having abnormal HDL-cholesterol (OR = 1·71, Ptrend ≤ 0.001) and impaired insulin resistance (OR = 4·15, Ptrend ≤ 0·001) were found for children deficient in 25(OH)D compared with those with normal 25(OH)D concentrations. When the children and adolescents were stratified by gender, we found stronger associations between serum 25(OH)D concentration and both HDL-cholesterol and insulin resistance in girls. No association of 25(OH)D with any other metabolic parameter was found. CONCLUSIONS Our results suggest a potential harmful association between low serum 25(OH)D concentration and the risk of obesity among children. However, the underlying mechanisms require further investigation.
Collapse
|
43
|
Zakharova I, Klimov L, Kuryaninova V, Nikitina I, Malyavskaya S, Dolbnya S, Kasyanova A, Atanesyan R, Stoyan M, Todieva A, Kostrova G, Lebedev A. Vitamin D Insufficiency in Overweight and Obese Children and Adolescents. Front Endocrinol (Lausanne) 2019; 10:103. [PMID: 30881343 PMCID: PMC6406072 DOI: 10.3389/fendo.2019.00103] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 02/04/2019] [Indexed: 12/11/2022] Open
Abstract
Excessive body weight and obesity in childhood and adolescence are becoming more and more important unfavorable factors that entail extremely adverse consequences and require close attention of physicians of any specialty. Along with the high prevalence of obesity and metabolic syndrome in pediatric patients, children and adolescents in the majority of countries are diagnosed with vitamin D deficiency. Among the non-calcaemic effects of vitamin D, a significant role is played by its impact on the hormonal regulation of glucose metabolism and the synthesis of adipokines by fat tissue. The review presents literature data indicative of a close pathogenic relationship between vitamin D insufficiency and impaired tissue insulin sensitivity. It demonstrates the role of vitamin D insufficiency in immune reactions resulting in development of subclinical inflammation in fat tissue infiltrated with macrophages and lymphocytes. It also shows the role of adipokines, immune system cells and pro-inflammatory cytokines produced by them in the pathogenesis of obesity, as well as the function of vitamin D as an endocrine and paracrine regulator of the process of inflammation in adipose tissue. The relationships between the principal adipokines (leptin, adiponectin, resistin) are revealed in the presence of normal vitamin D content and in vitamin D deficiency. The carbohydrate and lipid metabolism parameters in overweight children and adolescents with vitamin D insufficiency are analyzed. A high prevalence of vitamin D insufficiency in overweight and obese children and adolescents (increasing along with the severity of obesity) is demonstrated. The review also presents the current recommendations for the correction of vitamin D insufficiency and underlines the need for higher cholecalciferol doses to achieve serum calcifediol targets in overweight and obese children and adolescents.
Collapse
Affiliation(s)
- Irina Zakharova
- Department of Paediatrics, Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - Leonid Klimov
- Department of Paediatrics, Stavropol State Medical University, Stavropol, Russia
| | - Victoria Kuryaninova
- Department of Paediatrics, Stavropol State Medical University, Stavropol, Russia
- *Correspondence: Victoria Kuryaninova
| | - Irina Nikitina
- Department of Paediatrics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Svetlana Malyavskaya
- Department of Paediatrics, Northern State Medical University, Arkhangelsk, Russia
| | - Svetlana Dolbnya
- Department of Paediatrics, Stavropol State Medical University, Stavropol, Russia
| | - Anna Kasyanova
- Department of Paediatrics, Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russia
| | - Roza Atanesyan
- Department of Paediatrics, Stavropol State Medical University, Stavropol, Russia
| | - Marina Stoyan
- Department of Paediatrics, Stavropol State Medical University, Stavropol, Russia
| | - Anastasiya Todieva
- Department of Paediatrics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Galina Kostrova
- Department of Paediatrics, Northern State Medical University, Arkhangelsk, Russia
| | - Andrey Lebedev
- Department of Paediatrics, Northern State Medical University, Arkhangelsk, Russia
| |
Collapse
|
44
|
Rampelli S, Guenther K, Turroni S, Wolters M, Veidebaum T, Kourides Y, Molnár D, Lissner L, Benitez-Paez A, Sanz Y, Fraterman A, Michels N, Brigidi P, Candela M, Ahrens W. Pre-obese children's dysbiotic gut microbiome and unhealthy diets may predict the development of obesity. Commun Biol 2018; 1:222. [PMID: 30534614 PMCID: PMC6286349 DOI: 10.1038/s42003-018-0221-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/26/2018] [Indexed: 12/12/2022] Open
Abstract
It is widely accepted that the intestinal microbiome is connected to obesity, as key mediator of the diet impact on the host metabolic and immunological status. To investigate whether the individual gut microbiome has a potential in predicting the onset and progression of diseases, here we characterized the faecal microbiota of 70 children in a two-time point prospective study, within a four-year window. All children had normal weight at the beginning of this study, but 36 of them gained excessive weight at the subsequent check-up. Microbiome data were analysed together with the hosts' diet information, physical activity, and inflammatory parameters. We find that the gut microbiota structures were stratified into a discrete number of groups, characterized by different biodiversity that correlates with inflammatory markers and dietary habits, regardless of age, gender, and body weight. Collectively, our data underscore the importance of the microbiome-host-diet configuration as a possible predictor of obesity.
Collapse
Affiliation(s)
- Simone Rampelli
- Microbial Ecology of Health Unit, Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
| | - Kathrin Guenther
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Achterstraße 30, 28359 Bremen, Germany
| | - Silvia Turroni
- Microbial Ecology of Health Unit, Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
| | - Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Achterstraße 30, 28359 Bremen, Germany
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Hiiu 42, 11619 Tallinn, Estonia
| | - Yiannis Kourides
- Research and Education Institute of Child Health, Stavrou Street 56, 2035 Strovolos, Cyprus
| | - Dénes Molnár
- Department of Paediatrics, Clinical Center, University of Pécs, József Attila u. 7, 7623 Pecs, Hungary
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine, University of Gothenburg, Medicinaregatan 16, 40530 Gothenburg, Sweden
| | - Alfonso Benitez-Paez
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Avda. Catedrático Agustín Escardino 7, 46980 Valencia, Spain
| | - Yolanda Sanz
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Avda. Catedrático Agustín Escardino 7, 46980 Valencia, Spain
| | - Arno Fraterman
- Medizinisches Versorgungszentrum Dr. Eberhard & Partner Dortmund, Laboratoriumsmedizin Dortmund, Brauhausstraße 4, 44137 Dortmund, Germany
| | - Nathalie Michels
- Department of Public Health, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Patrizia Brigidi
- Microbial Ecology of Health Unit, Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
| | - Marco Candela
- Microbial Ecology of Health Unit, Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Achterstraße 30, 28359 Bremen, Germany
| |
Collapse
|
45
|
Dimitri P. Fat and bone in children - where are we now? Ann Pediatr Endocrinol Metab 2018; 23:62-69. [PMID: 29969876 PMCID: PMC6057021 DOI: 10.6065/apem.2018.23.2.62] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/19/2018] [Indexed: 12/16/2022] Open
Abstract
The risk of fracture secondary to low-impact trauma is greater in obese children, suggesting obese children are at risk of skeletal fragility. However, despite this finding, there is a lack of agreement about the impact of excessive adiposity on skeletal development. The combination of poor diet, sedentary lifestyle, greater force generated on impact through falls, and greater propensity to falls may in part explain the increased risk of fracture in obese children. To date, evidence suggests that in early childhood years, obesity confers a structural advantage to the developing skeleton. However, in time, this relationship attenuates and then reverses, such that there is a critical period during skeletal development when obesity has a detrimental effect on skeletal structure and strength. Fat mass may be important to the developing cortical and trabecular bone compartments, provided that gains in fat mass are not excessive. However, when fat accumulation reaches excessive levels, unfavorable metabolic changes may impede skeletal development. Evidence from studies examining bone microstructure suggests skeletal adaption to excessive load fails, and bone strength is relatively diminished in relation to body size in obese children. Mechanisms that may explain these changes include changes in the hormonal environment, particularly in relation to alterations in adipokines and fat distribution. Given the concomitant rise in the prevalence of childhood obesity and fractures, as well as adult osteoporosis, further work is required to understand the relationship between obesity and skeletal development.
Collapse
Affiliation(s)
- Paul Dimitri
- Address for correspondence: Paul Dimitri The Academic Unit of Child Health, Sheffield Children’s NHS Foundation Trust, Western Bank, Sheffield S10 2TH, United Kingdom Tel: +44-271-7118 Fax: +44-275-5364 E-mail:
| |
Collapse
|