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Ruggiero CF, Trexberg KM, Moore AM, Savage JS. Applying the Family Stress Model to responsive feeding and early obesity prevention. Appetite 2024; 200:107515. [PMID: 38797237 PMCID: PMC11227407 DOI: 10.1016/j.appet.2024.107515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Rapid weight gain during infancy and obesity during early childhood may lead to adverse health outcomes during later childhood and into adulthood, especially in families experiencing economic hardship. Families experiencing economic hardship may also experience food insecurity, which can impact child development and responsive feeding, an important target for obesity prevention in early life. The Family Stress Model suggests that stress, particularly economic hardship, can negatively impact parents' mental health, parenting, and quality of family relationships. This review proposes a conceptual model that expands upon the original Family Stress Model by including parent-child dyadic interactions during feeding (i.e., responsive feeding) as well as the coparenting relationship around feeding. Our conceptual model integrates responsive feeding into the Family Stress Model and includes the impact of food insecurity on feeding and child health outcomes. Such models that consider multiple influences on child development have implications for the design of effective interventions to promote healthy growth for entire families. Future directions in this research will empirically test the model and explore early intervention strategies that aim to promote responsive feeding, nutrition security, and health within families. Continuing interdisciplinary research between the fields of nutrition and family development will be key to addressing the complex interplay of family stressors, parent responsiveness, and childhood obesity.
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Affiliation(s)
- Cara F Ruggiero
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Kaitlin M Trexberg
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA.
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Kartiosuo N, Raitakari OT, Juonala M, Viikari JSA, Sinaiko AR, Venn AJ, Jacobs DR, Urbina EM, Woo JG, Steinberger J, Bazzano LA, Daniels SR, Magnussen CG, Rahimi K, Dwyer T. Cardiovascular Risk Factors in Childhood and Adulthood and Cardiovascular Disease in Middle Age. JAMA Netw Open 2024; 7:e2418148. [PMID: 38913374 PMCID: PMC11197443 DOI: 10.1001/jamanetworkopen.2024.18148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/18/2024] [Indexed: 06/25/2024] Open
Abstract
Importance Recent evidence suggests that childhood levels of serum lipids, blood pressure, body mass index (BMI), and smoking contribute to adult risk of cardiovascular disease (CVD). Evidence is lacking on whether this is independent of adult risk levels. Objective To quantify direct and indirect effects of childhood risk factors on adult CVD via adulthood risk factors using mediation analysis, and to quantify their relative importance during different life-course stages using a life-course approach. Design, Setting, and Participants This prospective cohort study followed participants from the US, Finland, and Australia from childhood (1970s-1990s) until 2019, with data on CVD risk factors in childhood and adulthood. Longitudinal childhood and adulthood risk factors were summarized to describe BMI, lipids, and blood pressure cumulatively. Childhood and adulthood smoking were assessed with questionnaires. Data analysis was performed May 2022 to August 2023. Main Outcomes and Measures The primary outcomes were fatal and nonfatal cardiovascular events in adulthood. Mediation analysis was used to estimate the direct and indirect effects of the childhood risk factors with CVD events, reported as incidence rate ratios (RRs) and 95% CIs. Results A total of 10 634 participants (4506 male participants [42.4%]; mean [SD] age at childhood visit, 13.3 [3.0] years; mean [SD] age at adulthood visit, 32.3 [6.0] years) were included in the cohort. The mean (SD) age at CVD event or censoring was 49.2 (7.0) years. The median (IQR) follow-up time was 23.6 (18.7-30.2) years. Childhood risk factors, (low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC], triglycerides, systolic blood pressure [SBP], smoking, BMI, and a combined score of these) were associated with CVD. BMI (direct effect for incidence RR per 1 SD unit, 1.18; 95% CI, 1.05-1.34) and LDL-C (direct effect incidence RR, 1.16; 95% CI, 1.01-1.34) in particular were found to play an important role via direct pathways, whereas the indirect effects were larger for TC, triglycerides, SBP, and the combined score. Childhood smoking only affected CVD via adulthood smoking. Life-course models confirmed that for the risk of CVD, childhood BMI plays nearly as important role as adulthood BMI, whereas for the other risk factors and the combined score, adulthood was the more important period. Conclusions and Relevance In this cohort study of 10 634 participants, childhood risk factors were found to be associated both directly and indirectly to adult CVD, with the largest direct effect seen for BMI and LDL-C. These findings suggest that intervention for childhood risk factors, in particular BMI, is warranted to reduce incidence of adult CVD as it cannot be fully mitigated by risk factor management in adulthood.
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Affiliation(s)
- Noora Kartiosuo
- 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
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Olli T. Raitakari
- 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
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Division of Medicine, Turku University Hospital, Turku, Finland
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Internal Medicine, University of Turku, Turku, Finland
| | - Jorma S. A. Viikari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
- Department of Internal Medicine, University of Turku, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
| | - Alan R. Sinaiko
- Department of Pediatrics, University of Minnesota Medical School, University of Minnesota, Minneapolis
| | - Alison J. Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - David R. Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Elaine M. Urbina
- Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jessica G. Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Medical School, University of Minnesota, Minneapolis
| | - Lydia A. Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Stephen R. Daniels
- University of Colorado School of Medicine, and Anschutz Medical Campus, Children’s Hospital Colorado, Aurora
| | - Costan G. Magnussen
- 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
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | - Kazem Rahimi
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Terence Dwyer
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
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Spiga F, Davies AL, Tomlinson E, Moore TH, Dawson S, Breheny K, Savović J, Gao Y, Phillips SM, Hillier-Brown F, Hodder RK, Wolfenden L, Higgins JP, Summerbell CD. Interventions to prevent obesity in children aged 5 to 11 years old. Cochrane Database Syst Rev 2024; 5:CD015328. [PMID: 38763517 PMCID: PMC11102828 DOI: 10.1002/14651858.cd015328.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
BACKGROUND Prevention of obesity in children is an international public health priority given the prevalence of the condition (and its significant impact on health, development and well-being). Interventions that aim to prevent obesity involve behavioural change strategies that promote healthy eating or 'activity' levels (physical activity, sedentary behaviour and/or sleep) or both, and work by reducing energy intake and/or increasing energy expenditure, respectively. There is uncertainty over which approaches are more effective and numerous new studies have been published over the last five years, since the previous version of this Cochrane review. OBJECTIVES To assess the effects of interventions that aim to prevent obesity in children by modifying dietary intake or 'activity' levels, or a combination of both, on changes in BMI, zBMI score and serious adverse events. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was February 2023. SELECTION CRITERIA Randomised controlled trials in children (mean age 5 years and above but less than 12 years), comparing diet or 'activity' interventions (or both) to prevent obesity with no intervention, usual care, or with another eligible intervention, in any setting. Studies had to measure outcomes at a minimum of 12 weeks post baseline. We excluded interventions designed primarily to improve sporting performance. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our outcomes were body mass index (BMI), zBMI score and serious adverse events, assessed at short- (12 weeks to < 9 months from baseline), medium- (9 months to < 15 months) and long-term (≥ 15 months) follow-up. We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS This review includes 172 studies (189,707 participants); 149 studies (160,267 participants) were included in meta-analyses. One hundred forty-six studies were based in high-income countries. The main setting for intervention delivery was schools (111 studies), followed by the community (15 studies), the home (eight studies) and a clinical setting (seven studies); one intervention was conducted by telehealth and 31 studies were conducted in more than one setting. Eighty-six interventions were implemented for less than nine months; the shortest was conducted over one visit and the longest over four years. Non-industry funding was declared by 132 studies; 24 studies were funded in part or wholly by industry. Dietary interventions versus control Dietary interventions, compared with control, may have little to no effect on BMI at short-term follow-up (mean difference (MD) 0, 95% confidence interval (CI) -0.10 to 0.10; 5 studies, 2107 participants; low-certainty evidence) and at medium-term follow-up (MD -0.01, 95% CI -0.15 to 0.12; 9 studies, 6815 participants; low-certainty evidence) or zBMI at long-term follow-up (MD -0.05, 95% CI -0.10 to 0.01; 7 studies, 5285 participants; low-certainty evidence). Dietary interventions, compared with control, probably have little to no effect on BMI at long-term follow-up (MD -0.17, 95% CI -0.48 to 0.13; 2 studies, 945 participants; moderate-certainty evidence) and zBMI at short- or medium-term follow-up (MD -0.06, 95% CI -0.13 to 0.01; 8 studies, 3695 participants; MD -0.04, 95% CI -0.10 to 0.02; 9 studies, 7048 participants; moderate-certainty evidence). Five studies (1913 participants; very low-certainty evidence) reported data on serious adverse events: one reported serious adverse events (e.g. allergy, behavioural problems and abdominal discomfort) that may have occurred as a result of the intervention; four reported no effect. Activity interventions versus control Activity interventions, compared with control, may have little to no effect on BMI and zBMI at short-term or long-term follow-up (BMI short-term: MD -0.02, 95% CI -0.17 to 0.13; 14 studies, 4069 participants; zBMI short-term: MD -0.02, 95% CI -0.07 to 0.02; 6 studies, 3580 participants; low-certainty evidence; BMI long-term: MD -0.07, 95% CI -0.24 to 0.10; 8 studies, 8302 participants; zBMI long-term: MD -0.02, 95% CI -0.09 to 0.04; 6 studies, 6940 participants; low-certainty evidence). Activity interventions likely result in a slight reduction of BMI and zBMI at medium-term follow-up (BMI: MD -0.11, 95% CI -0.18 to -0.05; 16 studies, 21,286 participants; zBMI: MD -0.05, 95% CI -0.09 to -0.02; 13 studies, 20,600 participants; moderate-certainty evidence). Eleven studies (21,278 participants; low-certainty evidence) reported data on serious adverse events; one study reported two minor ankle sprains and one study reported the incident rate of adverse events (e.g. musculoskeletal injuries) that may have occurred as a result of the intervention; nine studies reported no effect. Dietary and activity interventions versus control Dietary and activity interventions, compared with control, may result in a slight reduction in BMI and zBMI at short-term follow-up (BMI: MD -0.11, 95% CI -0.21 to -0.01; 27 studies, 16,066 participants; zBMI: MD -0.03, 95% CI -0.06 to 0.00; 26 studies, 12,784 participants; low-certainty evidence) and likely result in a reduction of BMI and zBMI at medium-term follow-up (BMI: MD -0.11, 95% CI -0.21 to 0.00; 21 studies, 17,547 participants; zBMI: MD -0.05, 95% CI -0.07 to -0.02; 24 studies, 20,998 participants; moderate-certainty evidence). Dietary and activity interventions compared with control may result in little to no difference in BMI and zBMI at long-term follow-up (BMI: MD 0.03, 95% CI -0.11 to 0.16; 16 studies, 22,098 participants; zBMI: MD -0.02, 95% CI -0.06 to 0.01; 22 studies, 23,594 participants; low-certainty evidence). Nineteen studies (27,882 participants; low-certainty evidence) reported data on serious adverse events: four studies reported occurrence of serious adverse events (e.g. injuries, low levels of extreme dieting behaviour); 15 studies reported no effect. Heterogeneity was apparent in the results for all outcomes at the three follow-up times, which could not be explained by the main setting of the interventions (school, home, school and home, other), country income status (high-income versus non-high-income), participants' socioeconomic status (low versus mixed) and duration of the intervention. Most studies excluded children with a mental or physical disability. AUTHORS' CONCLUSIONS The body of evidence in this review demonstrates that a range of school-based 'activity' interventions, alone or in combination with dietary interventions, may have a modest beneficial effect on obesity in childhood at short- and medium-term, but not at long-term follow-up. Dietary interventions alone may result in little to no difference. Limited evidence of low quality was identified on the effect of dietary and/or activity interventions on severe adverse events and health inequalities; exploratory analyses of these data suggest no meaningful impact. We identified a dearth of evidence for home and community-based settings (e.g. delivered through local youth groups), for children living with disabilities and indicators of health inequities.
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Affiliation(s)
- Francesca Spiga
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Annabel L Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Theresa Hm Moore
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Dawson
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jelena Savović
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Sophie M Phillips
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Child Health and Physical Activity Laboratory, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Human Nutrition Research Centre and Population Health Sciences Institute, University of Newcastle, Newcastle, UK
| | - Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Julian Pt Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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Spiga F, Tomlinson E, Davies AL, Moore TH, Dawson S, Breheny K, Savović J, Hodder RK, Wolfenden L, Higgins JP, Summerbell CD. Interventions to prevent obesity in children aged 12 to 18 years old. Cochrane Database Syst Rev 2024; 5:CD015330. [PMID: 38763518 PMCID: PMC11102824 DOI: 10.1002/14651858.cd015330.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
BACKGROUND Prevention of obesity in adolescents is an international public health priority. The prevalence of overweight and obesity is over 25% in North and South America, Australia, most of Europe, and the Gulf region. Interventions that aim to prevent obesity involve strategies that promote healthy diets or 'activity' levels (physical activity, sedentary behaviour and/or sleep) or both, and work by reducing energy intake and/or increasing energy expenditure, respectively. There is uncertainty over which approaches are more effective, and numerous new studies have been published over the last five years since the previous version of this Cochrane Review. OBJECTIVES To assess the effects of interventions that aim to prevent obesity in adolescents by modifying dietary intake or 'activity' levels, or a combination of both, on changes in BMI, zBMI score and serious adverse events. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was February 2023. SELECTION CRITERIA Randomised controlled trials in adolescents (mean age 12 years and above but less than 19 years), comparing diet or 'activity' interventions (or both) to prevent obesity with no intervention, usual care, or with another eligible intervention, in any setting. Studies had to measure outcomes at a minimum of 12 weeks post baseline. We excluded interventions designed primarily to improve sporting performance. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our outcomes were BMI, zBMI score and serious adverse events, assessed at short- (12 weeks to < 9 months from baseline), medium- (9 months to < 15 months) and long-term (≥ 15 months) follow-up. We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS This review includes 74 studies (83,407 participants); 54 studies (46,358 participants) were included in meta-analyses. Sixty studies were based in high-income countries. The main setting for intervention delivery was schools (57 studies), followed by home (nine studies), the community (five studies) and a primary care setting (three studies). Fifty-one interventions were implemented for less than nine months; the shortest was conducted over one visit and the longest over 28 months. Sixty-two studies declared non-industry funding; five were funded in part by industry. Dietary interventions versus control The evidence is very uncertain about the effects of dietary interventions on body mass index (BMI) at short-term follow-up (mean difference (MD) -0.18, 95% confidence interval (CI) -0.41 to 0.06; 3 studies, 605 participants), medium-term follow-up (MD -0.65, 95% CI -1.18 to -0.11; 3 studies, 900 participants), and standardised BMI (zBMI) at long-term follow-up (MD -0.14, 95% CI -0.38 to 0.10; 2 studies, 1089 participants); all very low-certainty evidence. Compared with control, dietary interventions may have little to no effect on BMI at long-term follow-up (MD -0.30, 95% CI -1.67 to 1.07; 1 study, 44 participants); zBMI at short-term (MD -0.06, 95% CI -0.12 to 0.01; 5 studies, 3154 participants); and zBMI at medium-term (MD 0.02, 95% CI -0.17 to 0.21; 1 study, 112 participants) follow-up; all low-certainty evidence. Dietary interventions may have little to no effect on serious adverse events (two studies, 377 participants; low-certainty evidence). Activity interventions versus control Compared with control, activity interventions do not reduce BMI at short-term follow-up (MD -0.64, 95% CI -1.86 to 0.58; 6 studies, 1780 participants; low-certainty evidence) and probably do not reduce zBMI at medium- (MD 0, 95% CI -0.04 to 0.05; 6 studies, 5335 participants) or long-term (MD -0.05, 95% CI -0.12 to 0.02; 1 study, 985 participants) follow-up; both moderate-certainty evidence. Activity interventions do not reduce zBMI at short-term follow-up (MD 0.02, 95% CI -0.01 to 0.05; 7 studies, 4718 participants; high-certainty evidence), but may reduce BMI slightly at medium-term (MD -0.32, 95% CI -0.53 to -0.11; 3 studies, 2143 participants) and long-term (MD -0.28, 95% CI -0.51 to -0.05; 1 study, 985 participants) follow-up; both low-certainty evidence. Seven studies (5428 participants; low-certainty evidence) reported data on serious adverse events: two reported injuries relating to the exercise component of the intervention and five reported no effect of intervention on reported serious adverse events. Dietary and activity interventions versus control Dietary and activity interventions, compared with control, do not reduce BMI at short-term follow-up (MD 0.03, 95% CI -0.07 to 0.13; 11 studies, 3429 participants; high-certainty evidence), and probably do not reduce BMI at medium-term (MD 0.01, 95% CI -0.09 to 0.11; 8 studies, 5612 participants; moderate-certainty evidence) or long-term (MD 0.06, 95% CI -0.04 to 0.16; 6 studies, 8736 participants; moderate-certainty evidence) follow-up. They may have little to no effect on zBMI in the short term, but the evidence is very uncertain (MD -0.09, 95% CI -0.2 to 0.02; 3 studies, 515 participants; very low-certainty evidence), and they may not reduce zBMI at medium-term (MD -0.05, 95% CI -0.1 to 0.01; 6 studies, 3511 participants; low-certainty evidence) or long-term (MD -0.02, 95% CI -0.05 to 0.01; 7 studies, 8430 participants; low-certainty evidence) follow-up. Four studies (2394 participants) reported data on serious adverse events (very low-certainty evidence): one reported an increase in weight concern in a few adolescents and three reported no effect. AUTHORS' CONCLUSIONS The evidence demonstrates that dietary interventions may have little to no effect on obesity in adolescents. There is low-certainty evidence that activity interventions may have a small beneficial effect on BMI at medium- and long-term follow-up. Diet plus activity interventions may result in little to no difference. Importantly, this updated review also suggests that interventions to prevent obesity in this age group may result in little to no difference in serious adverse effects. Limitations of the evidence include inconsistent results across studies, lack of methodological rigour in some studies and small sample sizes. Further research is justified to investigate the effects of diet and activity interventions to prevent childhood obesity in community settings, and in young people with disabilities, since very few ongoing studies are likely to address these. Further randomised trials to address the remaining uncertainty about the effects of diet, activity interventions, or both, to prevent childhood obesity in schools (ideally with zBMI as the measured outcome) would need to have larger samples.
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Affiliation(s)
- Francesca Spiga
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Annabel L Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Theresa Hm Moore
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jelena Savović
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Julian Pt Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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Messner A, Nairz J, Kiechl S, Winder B, Pechlaner R, Geiger R, Knoflach M, Kiechl-Kohlendorfer U. Comparison of body mass index and fat mass index to classify body composition in adolescents-The EVA4YOU study. Eur J Pediatr 2024; 183:2203-2214. [PMID: 38386029 PMCID: PMC11035421 DOI: 10.1007/s00431-024-05474-x] [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: 01/15/2024] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
The objectives of this study were to develop age- and sex-specific reference percentiles for fat mass index (FMI) and fat-free mass index (FFMI) in adolescents aged 14 to 19 years and to determine differences in overweight/obesity classification by FMI and body mass index (BMI). The EVA4YOU study is a single-center cross-sectional study conducted in western Austria. Cardiovascular risks including anthropometric measurements and bioelectrical impedance analysis were assessed in adolescents (mean age 17 years). FMI and FFMI were calculated as the ratio of fat mass (FM) and fat-free mass (FFM) to the square of height and compared to study population-specific BMI percentiles. One thousand four hundred twenty-two adolescents were included in the analysis. Girls had a significantly higher mean FM and FMI and a significantly lower mean FFM, FFMI (p < 0.001, each), and mean BMI (p = 0.020) than boys. Body composition classification by FMI and BMI percentiles shows a concordance for the < 75th and > 97th percentile, but a significant difference in percentile rank classifications between these two cut-off values (all p < 0.05). Based on FMI, 15.5% (221/1422) of the whole population and 29.4% (92/313) of those between the 75th and 97th percentiles are classified one category higher or lower than those assigned by BMI. CONCLUSION Classification of normal or pathologic body composition based on BMI and FMI shows good accordance in the clearly normal or pathologic range. In an intermediate range, FMI reclassifies categories based on BMI in more than a quarter of adolescents. Cut-off values to differentiate normal from pathologic FMI values on a biological basis are needed. TRIAL REGISTRATION The study is registered at www. CLINICALTRIALS gov (Identifier: NCT04598685; Date of registration: October 22, 2020). WHAT IS KNOWN • Chronic non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally, with major risk factors including unhealthy diets, harmful behaviors, and obesity. Obesity in children and adolescents is a key risk factor for later NCDs, which is commonly measured by Body Mass Index (BMI). • BMI can be misleading as it doesn't distinguish between fat mass (FM) and fat-free mass (FFM), leading to potential misclassification of obesity in children. Previous studies have already suggested the use of the Fat Mass Index (FMI) and Fat-Free Mass Index (FFMI) as a more accurate measures of body composition. WHAT IS NEW • This study adds the first age- and sex-specific reference values for FMI and FFMI in Austrian adolescents using bioelectrical impedance analysis (BIA) as a safe and secure measurement method of a large representative cohort. • We found percentile misclassification between BMI and FMI when categorizing for obesity, especially in intermediate categories of body composition. Furthermore, when comparing the new reference values for FMI and FFMI to existing ones from the US, UK, and Germany we could show a good alignment within the European cohorts and major differences with American values, indicating and confirming the difference of FMI and FFMI for different populations of different ethnical background, living on different continents.
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Affiliation(s)
- Alex Messner
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria
- Department of Pediatrics II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Johannes Nairz
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria
- Department of Pediatrics II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
- Department of Pediatrics III, Medical University of Innsbruck, Innsbruck, Austria
| | - Sophia Kiechl
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Hochzirl Hospital, Zirl, Austria
| | - Bernhard Winder
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria
- Department of Vascular Surgery, Feldkirch Hospital, Feldkirch, Austria
| | - Raimund Pechlaner
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Ralf Geiger
- Department of Pediatrics III, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Knoflach
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria.
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
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Hurley SK, Vizthum D, Ducharme-Smith K, Kamath-Rayne BD, Brady TM. Birth History and Cardiovascular Disease Risk Among Youth With Significant Obesity. Clin Pediatr (Phila) 2024; 63:365-374. [PMID: 37326064 DOI: 10.1177/00099228231177286] [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] [Indexed: 06/17/2023]
Abstract
Children born prematurely have greater lifetime risk for hypertension. We aimed to determine (1) the association between prematurity and cardiovascular disease (CVD) risk factors among 90 children with obesity and elevated blood pressure and (2) if dietary sodium intake modified these associations. Multivariable regression analysis explored for associations between prematurity (<37 weeks gestation; early gestational age) and low birth weight (<2.5 kg) with hypertension, left ventricular mass index (LVMI), and left ventricular hypertrophy (LVH). Effect modification by dietary sodium intake was also explored. Patients were predominately male (60%), black (78%), adolescents (13.3 years), and with substantial obesity (body mass index: 36.5 kg/m2). Early gestational age/low birth weight was not an independent predictor for hypertension, LVMI, or LVH. There was no effect modification by sodium load. Our results suggest the increased CVD risk conferred by prematurity is less significant at certain cardiometabolic profiles. Promoting heart-healthy lifestyles to prevent pediatric obesity remains of utmost importance to foster cardiovascular health.
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Affiliation(s)
- Sara K Hurley
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Diane Vizthum
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Tammy M Brady
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Pediatrics, Baltimore, MD, USA
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7
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Qi Y, Lv R, Zhao M, Huang Y, Zhang Y, Zhang H, Li Z, Jia P, Zhang H, Yang Z, Lai J, Song P, Yuan C. Parental adherence to healthy lifestyles in relation to the risk of obesity in offspring: A prospective cohort study in China. J Glob Health 2023; 13:04181. [PMID: 38115717 PMCID: PMC10731135 DOI: 10.7189/jogh.13.04181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Background While maternal adherence to a healthy lifestyle was shown to be associated with a lower risk of obesity in offspring, the potential role of overall parental lifestyles has not yet been explored. We aimed to address this gap by exploring whether parental adherence to an overall healthy lifestyle was associated with a lower risk of obesity in offspring. Methods We included 5881 children and adolescents aged 6-15 years at enrolment in the 2010, 2012, and 2014 waves of the China Family Panel Studies (CFPS) who were free of obesity and followed them until 2020. Parental healthy lifestyle score at study baseline was composed of five modifiable lifestyle factors (0-5; 1 for each): never smoking, non-habitual drinking, weekly exercise, modified dietary diversity score ≥5 points, and body mass index (BMI) of 18.5-23.9 kg/m2. We defined obesity according to the age- and gender-specific cutoffs by the BMI percentile curves for Chinese children aged 6-18 years. We used multivariable Cox proportional hazard models to examine the association between parental healthy lifestyle score (both as continuous and categorical variables) and risk of offspring obesity. Results Overall, 597 (10.2%) offspring developed obesity during a median follow-up of 6 years. Compared to the lowest tertile of parental healthy lifestyle score, participants in the highest tertile had a 42% (hazard ratio (HR) = 0.58; 95% confidence interval (CI) = 0.45-0.74) lower risk of obesity. Both maternal (HR = 0.75; 95% CI = 0.61-0.92) and paternal (HR = 0.73; 95% CI = 0.60-0.89) healthy lifestyle scores were associated with lower risks of obesity in offspring. For specific lifestyle factors, we observed beneficial associations for paternal diverse diet (HR = 0.73; 95% CI = 0.60-0.88) and healthy BMI (HR = 0.65; 95% CI = 0.55-0.78). Conclusions Adherence to an overall parental healthier lifestyle was associated with a lower risk of obesity in childhood and adolescence. This finding highlights the potential benefits of promoting a healthy lifestyle among parents for the primary prevention of offspring obesity.
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Affiliation(s)
- Ye Qi
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Rongxia Lv
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Mengjia Zhao
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yuhui Huang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yaodan Zhang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hangrui Zhang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan, China
| | - Huanmei Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenyu Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianqiang Lai
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peige Song
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Changzheng Yuan
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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8
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Jørgensen RM, Bjørn A, Bjørn V, Bruun JM. The younger the better: importance of age in treatment of childhood obesity. Eur J Pediatr 2023; 182:5417-5425. [PMID: 37752359 PMCID: PMC10746784 DOI: 10.1007/s00431-023-05218-3] [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: 04/11/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023]
Abstract
Children living with obesity are prevalent worldwide. It is an established finding that many children who start a lifestyle intervention tend to leave prematurely. The aim of this study was to identify characteristics in children with obesity who prematurely leave a lifestyle intervention. The cohort study includes children living with obesity aged 4-17, treated in a Danish family-centered lifestyle intervention between 2014 and 2017. Data were collected from patient records. BMI-SDS was calculated using an external Danish reference population and multivariable regression analysis was used to answer the research question. Of the 159 children included, 64 children who left the intervention within the first 1.5 years were older compared to those who stayed in the intervention (10.2 years ± 2.9 vs 11.5 years ± 3.1, p = 0.005). Older participants (> 66.6th percentile) had a shorter treatment duration (489 days) compared to the youngest (190 days 95% CI: 60; 320, p = 0.005) and middle third (224 days 95% CI: 89; 358, p = 0.001). Additionally, an inverse association was found between duration of treatment and age at baseline (-31 days, 95% CI (-50; -13), p = 0.001). Conclusion: The risk of leaving a lifestyle intervention prematurely was primarily dependent on the age of the participants, emphasizing the importance of including children early in lifestyle interventions. What is Known: • Lifestyle interventions for childhood obesity that are shorter in duration often lead to short-term weight reductions only. Limited knowledge exists on why some children prematurely leave these interventions. What is New: • This study observes a solid inverse correlation and association between age and time spent in the interventions, when treating childhood obesity. We hereby suggest age as an important determinant for the adherence to lifestyle interventions and emphasize the importance of treatment early in life.
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Affiliation(s)
- Rasmus Møller Jørgensen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Blvd 11, 8200, Aarhus, Denmark.
- Institute of Clinical Medicine, University of Aarhus, Aarhus, Palle Juul-Jensens Blvd 11., Denmark.
- Danish National Center for Obesity, Palle Juul-Jensens Blvd. 11, Aarhus, Denmark.
| | - Amanda Bjørn
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Blvd 11, 8200, Aarhus, Denmark
| | - Vitus Bjørn
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Blvd 11, 8200, Aarhus, Denmark
| | - Jens Meldgaard Bruun
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Blvd 11, 8200, Aarhus, Denmark
- Institute of Clinical Medicine, University of Aarhus, Aarhus, Palle Juul-Jensens Blvd 11., Denmark
- Danish National Center for Obesity, Palle Juul-Jensens Blvd. 11, Aarhus, Denmark
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Choe JH, Bang KS, Jang SY. Factors Affecting Dyslipidemia among Korean Adolescents: An Analysis Using the 8th Korea National Health and Nutrition Examination Survey (2021). CHILDREN (BASEL, SWITZERLAND) 2023; 10:1618. [PMID: 37892281 PMCID: PMC10605763 DOI: 10.3390/children10101618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
A high prevalence of dyslipidemia has recently been shown not only in adults, but also in adolescents. When occurring in adolescence, dyslipidemia is a risk factor for cardiovascular disease in adulthood. This study aimed to identify significant factors affecting dyslipidemia in South Korean adolescents. We used data from the third year of the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII-3) on 381 Korean adolescents aged 12-18 years. The data were analyzed using frequency analysis, descriptive statistics, the Rao-Scott χ test, the t-test, and univariate and multivariate logistic regression using complex sample analysis. On a weighted population basis, 28.1% of the adolescents among the participants were identified as the group with dyslipidemia. Obesity, waist circumference, serum uric acid, and alanine aminotransferase (ALT) were significantly related to the prevalence of dyslipidemia. Physical activity 4-7 days a week was related to a decrease in the prevalence of dyslipidemia only in male adolescents. The results of this study can be used as evidence for the risk assessment of adolescent dyslipidemia and the establishment of systematic health management guidelines according to risk factors for the prevention of adolescent dyslipidemia.
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Affiliation(s)
- Ji-Hye Choe
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Seoul National University, Seoul 03080, Republic of Korea;
| | - Kyung-Sook Bang
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul 03080, Republic of Korea
| | - Sang-Youn Jang
- College of Nursing, Seoul National University, Seoul 03080, Republic of Korea;
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Oktaviani S, Mizutani M, Nishide R, Tanimura S. Factors associated with overweight/obesity of children aged 6-12 years in Indonesia. BMC Pediatr 2023; 23:484. [PMID: 37749512 PMCID: PMC10518961 DOI: 10.1186/s12887-023-04321-6] [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: 12/30/2022] [Accepted: 09/19/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Globally, the prevalence of childhood obesity has increased considerably, including in Indonesia. Obesity results from multifactorial interactions at the personal, familial, and environmental levels. However, little is known about the factors associated with overweight/obesity among children in Indonesia. This study is intended to identify personal, familial, and environmental factors associated with overweight/obesity in children aged 6-12 years in Indonesia. METHODS Study design was a secondary data analysis using the Indonesia Family Life Survey in 2014/2015, focusing on 6,090 children aged 6-12 years. The questions covered the child's body mass index and potential personal, familial, and environmental factors. Logistic regression analysis was performed to identify the personal, familial, and environmental factors. RESULTS The mean age of participants was 8.9 years (SD = 2.0); 51.0% were boys; 9.4% were overweight; and 8.1% were obese. Overweight and obesity were associated with age [AOR 1.09 (95% CI 1.04-1.14)], having an overweight [AOR 1.93 (95% CI 1.58-2.36)] or obese [AOR 3.36 (95% CI 2.43-4.61)] father compared with a normal father, being of Chinese [AOR 9.51 (95% CI 1.43-79.43)] or Javanese [AOR 1.60 (95% CI 1.16-2.24)] ethnicity compared with Sundanese ethnicity, and residing in an urban area [AOR 1.36 (95% CI 1.10-1.70)]. A lower risk of child overweight/obesity was associated with the father's perception [AOR 0.56 (95% CI 0.38-0.80)] and mother's perception [AOR 0.66 (95% CI 0.43-0.98)] of the child's food consumption as being less than adequate compared with adequate. CONCLUSIONS Risk factors in children for overweight/obesity were older age, having an overweight/obese father, membership of certain ethnic groups, and urban residence. The main protective factor was parents' perception that a child's food consumption was less than adequate. Health promotion programs focused on these factors could help control or prevent childhood obesity in Indonesia.
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Affiliation(s)
- Sofi Oktaviani
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
- Indramayu College of Health Science, Indramayu, Indonesia
| | - Mayumi Mizutani
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Ritsuko Nishide
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Susumu Tanimura
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
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Davison GM, Monocello LT, Lipsey K, Wilfley DE. Evidence Base Update on Behavioral Treatments for Overweight and Obesity in Children and Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:589-603. [PMID: 37683261 PMCID: PMC10586458 DOI: 10.1080/15374416.2023.2251164] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE This review provides an update to a previous Evidence Base Update addressing behavioral treatments for overweight and obesity in children and adolescents. METHOD Articles were identified through a systematic search of the biomedical literature in PubMed/MEDLINE (1946-), Elsevier EMBASE (1947-), SCOPUS (1823-), Clarivate Web of Science Core Collection (WOS, 1900-), PsycINFO (1800-), The Cochrane Library and Clinicaltrials.gov published between June 2014 and August 2022. RESULTS Family-based treatment (FBT) remains a well-established treatment for overweight and obesity in children and is now well-established in adolescents and toddlers. Parent-only behavioral treatment remains well-established in children and is now well-established among adolescents and children. Possibly effective treatments continue to include FBT-parent only for adolescents, and behavioral weight loss (BWL) with a family component for adolescents, children, and toddlers. Several variations of FBT and BWL can now be considered possibly effective including FBT+motivational interviewing, FBT+social facilitation maintenance, group-based FBT, low-dose FBT, BWL+stress management, and camp-based BWL. Cognitive behavioral treatment (CBT) for adolescents also met criteria for possibly effective treatments. Current research has also established that behavioral treatments can be effectively delivered in alternative settings (e.g. primary care) and through alternative mediums (e.g. telehealth). CONCLUSIONS Research continues to support the use of multicomponent lifestyle interventions in accordance with recent recommendations from the American Academy of Pediatrics, the American Psychological Association, and the United State Preventative Services Task Force. However, more work is needed to ensure appropriate access for children with comorbid medical and psychiatric disorders and children from socially, politically, and economically marginalized groups.
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Affiliation(s)
- Genevieve M. Davison
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Lawrence T. Monocello
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kim Lipsey
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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12
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Emke H, Dijkstra C, Kremers S, Chinapaw MJM, Altenburg T. Is the transition from primary to secondary school a risk factor for energy balance-related behaviours? A systematic review. Public Health Nutr 2023; 26:1754-1774. [PMID: 37138344 PMCID: PMC10478069 DOI: 10.1017/s1368980023000812] [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: 05/24/2022] [Revised: 03/20/2023] [Accepted: 04/23/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The substantial changes in the physical and social environment during the transition from primary to secondary school may significantly impact adolescents' energy balance-related behaviours (i.e. dietary behaviour, sedentary behaviour, sleep behaviour and physical activity (PA)). This is the first review systematically summarising evidence on changes in four energy balance-related behaviours of adolescents across the school transition from primary to secondary school. DESIGN For this systematic review, the electronic databases Embase, PsycINFO and SPORTDiscus were searched for relevant studies from inception to August 2021. PubMed was searched for relevant studies from inception to September 2022. Inclusion criteria were: (i) longitudinal studies reporting; (ii) one or more energy balance-related behaviours; and (iii) across the school transition, that is, with measurement(s) during both primary and secondary school. SETTING Transition from primary to secondary school. PARTICIPANTS Adolescents across the transition from primary to secondary school. RESULTS Thirty-four studies were eligible. We found strong evidence for an increase in sedentary time, moderate evidence for a decrease in fruit and vegetable consumption, and inconclusive evidence for a change in total, light, and moderate-to-vigorous PA, active transport, screen time, unhealthy snack consumption, and sugar-sweetened beverages consumption among adolescents across the school transition. CONCLUSIONS During the transition from primary to secondary school, sedentary time and fruit and vegetable consumption tend to change unfavourably. More high-quality, longitudinal research is needed specifically on changes in energy balance-related behaviour across the school transition, especially regarding sleep behaviour. (Prospero registration: CRD42018084799).
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Affiliation(s)
- Helga Emke
- Vrije Universiteit Amsterdam, Department of Health Sciences, Faculty of Science, De Boelelaan 1117Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases and Methodology, Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Coosje Dijkstra
- Vrije Universiteit Amsterdam, Department of Health Sciences, Faculty of Science, De Boelelaan 1117Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases and Methodology, Amsterdam, The Netherlands
| | - Stef Kremers
- Maastricht University Medical Centre, Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, P. Debyelaan 25, Maastricht, The Netherlands
| | - Mai JM Chinapaw
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases and Methodology, Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Teatske Altenburg
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases and Methodology, Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands
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Folson GK, Bannerman B, Atadze V, Ador G, Kolt B, McCloskey P, Gangupantulu R, Arrieta A, Braga BC, Arsenault J, Kehs A, Doyle F, Tran LM, Hoang NT, Hughes D, Nguyen PH, Gelli A. Validation of Mobile Artificial Intelligence Technology-Assisted Dietary Assessment Tool Against Weighed Records and 24-Hour Recall in Adolescent Females in Ghana. J Nutr 2023; 153:2328-2338. [PMID: 37276939 DOI: 10.1016/j.tjnut.2023.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Important gaps exist in the dietary intake of adolescents in low- and middle-income countries (LMICs), partly due to expensive assessment methods and inaccuracy in portion-size estimation. Dietary assessment tools leveraging mobile technologies exist but only a few have been validated in LMICs. OBJECTIVE We validated Food Recognition Assistance and Nudging Insights (FRANI), a mobile artificial intelligence (AI) dietary assessment application in adolescent females aged 12-18 y (n = 36) in Ghana, against weighed records (WR), and multipass 24-hour recalls (24HR). METHODS Dietary intake was assessed during 3 nonconsecutive days using FRANI, WRs, and 24HRs. Equivalence of nutrient intake was tested using mixed-effect models adjusted for repeated measures, by comparing ratios (FRANI/WR and 24HR/WR) with equivalence margins at 10%, 15%, and 20% error bounds. Agreement between methods was assessed using the concordance correlation coefficient (CCC). RESULTS Equivalence for FRANI and WR was determined at the 10% bound for energy intake, 15% for 5 nutrients (iron, zinc, folate, niacin, and vitamin B6), and 20% for protein, calcium, riboflavin, and thiamine intakes. Comparisons between 24HR and WR estimated equivalence at the 20% bound for energy, carbohydrate, fiber, calcium, thiamine, and vitamin A intakes. The CCCs by nutrient between FRANI and WR ranged between 0.30 and 0.68, which was similar for CCC between 24HR and WR (ranging between 0.38 and 0.67). Comparisons of food consumption episodes from FRANI and WR found 31% omission and 16% intrusion errors. Omission and intrusion errors were lower when comparing 24HR with WR (21% and 13%, respectively). CONCLUSIONS FRANI AI-assisted dietary assessment could accurately estimate nutrient intake in adolescent females compared with WR in urban Ghana. FRANI estimates were at least as accurate as those provided through 24HR. Further improvements in food recognition and portion estimation in FRANI could reduce errors and improve overall nutrient intake estimations.
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Affiliation(s)
- Gloria K Folson
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
| | - Boateng Bannerman
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Vicentia Atadze
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Gabriel Ador
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Bastien Kolt
- International Food Policy Research Institute, Washington, DC, United States
| | | | | | - Alejandra Arrieta
- International Food Policy Research Institute, Washington, DC, United States
| | - Bianca C Braga
- Friedman School of Nutrition Policy and Science, Tufts University, Medford, MA, United States
| | - Joanne Arsenault
- Intake - Center for Dietary Assessment, FHI Solutions, Washington, DC, United States
| | - Annalyse Kehs
- Penn State University, State College, PA, United States
| | - Frank Doyle
- Penn State University, State College, PA, United States
| | | | | | - David Hughes
- Penn State University, State College, PA, United States
| | - Phuong Hong Nguyen
- International Food Policy Research Institute, Washington, DC, United States; Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Aulo Gelli
- International Food Policy Research Institute, Washington, DC, United States
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14
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Lee J, Cha SG, Lee JS, Kim ST, Song YH. Association between Obesity and Cardiovascular Disease Risk Factors in Different Age Groups of Adolescents: An Analysis of Data from the Korean National Health and Nutritional Examination Survey. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050827. [PMID: 37238375 DOI: 10.3390/children10050827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023]
Abstract
We investigated the association between obesity and cardiovascular disease risk factors (CVDRFs) in adolescents. We performed a cross-sectional study using the data from 8149 adolescents, aged 10-18 years, included in the Korean National Health and Nutrition Examination Survey (2011-2020). Using the body mass index, we defined "overweight" (≥85th to <95th percentile) and "obese" (≥95th percentile). We analyzed the associations between obesity and CVDRFs (high blood pressure, abnormal lipid profiles, and high fasting glucose levels) by sex and age groups (early [10-12 years], middle [13-15 years], and late [16-18 years] adolescence). When analyzing all the subjects, being overweight was correlated with high blood pressure and abnormal all-lipid profiles in boys and high triglyceride and low high-density lipoprotein cholesterol levels in girls, while obesity was associated with all CVDRFs in both boys and girls. Analyzing separately in the age subgroups, the correlation between obesity and CVDRFs tended to be shown earlier in boys than in girls, and obesity tended to be associated with CVDRFs earlier than being overweight. The association between obesity and CVDRFs may begin to be shown at different periods of youth, depending on the degree of obesity, CVDRF variables, and sex.
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Affiliation(s)
- Joowon Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Seul Gi Cha
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jue Seong Lee
- Department of Pediatrics, Korea University Anam Hospital, Seoul 08308, Republic of Korea
| | - Susan Taejung Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul 03080, Republic of Korea
| | - Young Hwan Song
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
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15
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Clasey JL, Easley EA, Murphy MO, Kiessling SG, Stromberg A, Schadler A, Huang H, Bauer JA. Body mass index percentiles versus body composition assessments: Challenges for disease risk classifications in children. Front Pediatr 2023; 11:1112920. [PMID: 36937977 PMCID: PMC10020489 DOI: 10.3389/fped.2023.1112920] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/31/2023] [Indexed: 03/06/2023] Open
Abstract
Background Identifying at-risk children with optimal specificity and sensitivity to allow for the appropriate intervention strategies to be implemented is crucial to improving the health and well-being of children. We determined relationships of body mass indexes for age and sex percentile (BMI%) classifications to actual body composition using validated and convenient methodologies and compared fat and non-fat mass estimates to normative cut-off reference values to determine guideline reliability. We hypothesized that we would achieve an improved ability to identify at-risk children using simple, non-invasive body composition and index measures. Methods Cross-sectional study of a volunteer convenience sample of 1,064 (537 boys) young children comparing Body Fat Percentage (BF%), Fat Mass Index (FMI), Fat-Free Mass Index (FFMI), determined via rapid bioimpedance methods vs. BMI% in children. Comparisons determined among weight classifications and boys vs. girls. Results Amongst all subjects BMI% was generally correlated to body composition measures and indexes but nearly one quarter of children in the low-risk classifications (healthy weight or overweight BMI%) had higher BF% and/or lower FFMI than recommended standards. Substantial evidence of higher than expected fatness and or sarcopenia was found relative to risk status. Inaccuracies were more common in girls than boys and girls were found to have consistently higher BF% at any BMI%. Conclusions The population studied raises concerns regarding actual risks for children of healthy or overweight categorized BMI% since many had higher than expected BF% and potential sarcopenia. When body composition and FMI and FFMI are used in conjunction with BMI% improved sensitivity, and accuracy of identifying children who may benefit from appropriate interventions results. These additional measures could help guide clinical decision making in settings of disease-risks stratifications and interventions.
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Affiliation(s)
- Jody L. Clasey
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, United States
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
- Correspondence: Jody L. Clasey
| | - Elizabeth A. Easley
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, United States
- Department of Math, Science, Nursing, Public Health, University of South Carolina Lancaster, Lancaster, SC, United States
| | - Margaret O. Murphy
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
| | - Stefan G. Kiessling
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
| | - Arnold Stromberg
- Department of Statistics, University of Kentucky, Lexington, KY, United States
| | - Aric Schadler
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
| | - Hong Huang
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
| | - John A. Bauer
- Department of Pediatrics, University of Kentucky, Lexington, KY, United States
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16
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Woroniecki R, Moritz ML. Investigating the human spirit and spirituality in pediatric patients with kidney disease. Front Pediatr 2023; 11:1104628. [PMID: 36911014 PMCID: PMC9996045 DOI: 10.3389/fped.2023.1104628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/31/2023] [Indexed: 02/25/2023] Open
Abstract
Human spirit is an integral part of the medicinal art and science trifecta: body-mind-spirit, and it is contained in the World Health Organization definition of health. Human spirit is defined as our purpose in life, relationships with all living creatures or "Higher Power", and in general our place on planet Earth. Spirituality is a required part of patient care according to Joint Commission on Accreditation of Health Care Organizations. There is an abundant medical literature that documents discrepancies in the results between studies and populations, and points to the importance of cultural, ethnic, spiritual or religious differences. Validated questionnaires used in research for last several decades demonstrated an association of spirituality with clinical outcomes, coping, and quality of life in different adult chronic diseases. There are also validated scales to measure hope in children based on the premise that children are goal directed and that their goal-related thoughts can be understood, yet their purposefulness, meaning of life and spirit in pediatric nephrology remains mostly unexamined. Although pediatric nephrology has made significant advances in molecular techniques, artificial intelligence, machine learning, and started to address more broad social issues such as racism, health equity, diversity of our work force, etc, it lacks both systematic ways of studying and philosophical approach to fostering human spirit. This mini review examines the place and knowledge gaps in human spirit and spirituality in pediatric nephrology. We review the concept of the human spirit and medical literature pertaining to its role in pediatric nephrology.
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Affiliation(s)
- Robert Woroniecki
- Stony Brook Children's, Stony Brook University, Stony Brook, NY, United States
| | - Michael L Moritz
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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17
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Nakhleh A, Sakhnini R, Furman E, Shehadeh N. Cardiometabolic risk factors among children and adolescents with overweight and Class 1 obesity: A cross-sectional study. Insights from stratification of Class 1 obesity. Front Endocrinol (Lausanne) 2023; 14:1108618. [PMID: 36798669 PMCID: PMC9927000 DOI: 10.3389/fendo.2023.1108618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
CONTEXT Severe childhood obesity is associated with increased prevalence of cardiometabolic risk factors (CMRFs). Among children with Class 1 obesity, higher BMI may indicate greater cardiometabolic risk. Class 1 obesity reflects a wide spectrum of BMI values. Each 10% increase in BMI above the 95th percentile is equivalent to an average increase of 2.15 kg/m2 and 2.75 kg/m2 in BMI among children and adolescents, respectively. Such increments may be of clinical importance. OBJECTIVES The study aimed to determine the prevalence and clustering of CMRFs in children and adolescents with BMI 110%-119% of the 95th BMI percentile. METHODS A cross-sectional analysis of data, from an Israeli health maintenance organization, of children and adolescents (5-17 years) with overweight or Class 1 obesity, and at least one measurement of lipid profile during Jan/2020-May/2021. CMRFs were defined as abnormal lipid profile, elevated alanine aminotransferase, hypertension, and prediabetes or diabetes. Study groups included overweight and Class 1 Obesity-A (BMI < 110%) and Obesity-B (BMI ≥ 110%) of the 95th BMI percentile. RESULTS Of 7211 subjects included, 40.2% were overweight, 50.3% obesity-A, and 9.5% obesity-B. Multivariable analyses showed that children and adolescents from the Obesity-B group had increased odds for higher triglycerides, LDL cholesterol, and ALT levels; and lower HDL cholesterol levels, as compared to Obesity-A. The odds of prediabetes (insignificant) tended to be higher in the Obesity-B group, which was associated with increased CMRFs clustering. CONCLUSIONS Among children and adolescents with Class 1 obesity, BMI ≥ 110% of the 95th percentile was associated with higher prevalence and clustering of CMRFs.
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Affiliation(s)
- Afif Nakhleh
- Maccabi Healthcare Services, Haifa, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- *Correspondence: Afif Nakhleh,
| | - Rizan Sakhnini
- Maccabi Healthcare Services, Haifa, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | | | - Naim Shehadeh
- Maccabi Healthcare Services, Haifa, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
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18
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Comparison of Glycosylated Haemoglobin, Blood Pressure, and Anthropometric Measurements Depending on Gender and Bodyweight State in Adolescents. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121922. [PMID: 36553365 PMCID: PMC9777222 DOI: 10.3390/children9121922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
Background/Objective: The greatest anthropometric and physiological changes occur during adolescence. Assessment of growth patterns is necessary to prevent future health risks. Aims: To describe the values of glycosylated haemoglobin (HbA1c), systolic (SBP) and diastolic (DBP) blood pressure, triceps skinfold, and abdominal circumference according to gender and age (between 12 and 17 years), as well as explore the differences between body weight conditions. Methods: A descriptive cross-sectional study was carried out, including 4130 adolescents between 12 and 17 years old. SBP and DBP, HbA1c, triceps skinfold, and abdominal circumference were evaluated. Results: Significant differences were observed between males and females for HbA1c (p < 0.001), SBP (p < 0.001), triceps curl (p < 0.001), and abdominal circumference (p < 0.001), independently of the age group. Regardless of gender and age groups, significant differences were observed between overweight/obese and normal-weight adolescents in SBP (p < 0.001), DBP (p < 0.001 to 0.009), triceps skinfold (p < 0.001), and abdominal perimeter (p < 0.001). Conclusions: Our findings revealed higher SBP, DBP, triceps skinfold, and abdominal circumference in overweight/obese adolescents compared to normal-weight adolescents in both genders.
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19
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Deniz M, Doğan M, Gül Ö, Özhan B, Agladıoğlu SY, Enli Y, Şenol H. Evaluation of cardiovascular system and determination of cardiometabolic risk using novel biomarkers in childhood obesity. PROGRESS IN PEDIATRIC CARDIOLOGY 2022. [DOI: 10.1016/j.ppedcard.2022.101605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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20
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Moore THM, Phillips S, Heslehurst N, Hodder RK, Dawson S, Gao Y, Hesketh K, Summerbell CD. Interventions to prevent obesity in children under 2 years old. Hippokratia 2022. [DOI: 10.1002/14651858.cd015324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Theresa HM Moore
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Sophie Phillips
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
| | - Nicola Heslehurst
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
- Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Rebecca K Hodder
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Yang Gao
- Department of Sport, Physical Education and Health; Hong Kong Baptist University; Kowloon Hong Kong
| | - Kathryn Hesketh
- MRC Epidemiology Unit; University of Cambridge; Cambridge UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
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21
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Molina-Giraldo P, Murillo S, Meis L, Sans O, Amat-Bou M, Llobet M, Jimenez-Chillaron JC, Ramon-Krauel M, Lerin C. A time-restricted feeding intervention in children and adolescents with obesity: The TRansForm study protocol. Front Nutr 2022; 9:1026694. [DOI: 10.3389/fnut.2022.1026694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022] Open
Abstract
Obesity during childhood is of special concern as adiposity is typically tracked into adult life and it constitutes a major risk factor for future obesity and associated metabolic disorders. Recent studies indicate that time-restricted feeding (TRF) interventions may provide a promising strategy for obesity treatment. However, TRF interventions have only been tested in adult subjects. This study aims to determine both short- and long-term effects of a TRF intervention in children and adolescents with obesity. We will also investigate potential mechanisms mediating the response to the intervention, including the circadian rhythm and the gut microbiota composition. We have designed a randomized-controlled parallel-group clinical study in which children and adolescents (age range 8–18 year-old) with obesity will be subjected to time-restricted eating or no time restrictions for 2 months. Follow-up visits will allow for long-term effect assessments. We will measure anthropometric (BMI, body composition) and metabolic parameters (glucose and lipid metabolism), indicators of the circadian rhythm, and gut microbiota composition will be analyzed. This study will (1) determine safety and effectiveness of the TRF intervention in children and adolescents; (2) assess its long-term effects; and (3) evaluate potential mechanisms involved in the response to the intervention.Clinical trial registration[www.ClinicalTrials.gov], identifier [NCT05174871].
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22
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Tabib A, Nikpajouh A, Aryafar M, Samiei N, Rezaei Y, Ziaodini H, Goodarzi A, Kazemborji B, Naderi N, Taghavi S, Bakhshandeh H, Hosseini S. Association Between Obesity and Blood Pressure Among Iranian Children and Adolescents: A Sub-analysis from the SHED LIGHT Study. Pediatr Cardiol 2022:10.1007/s00246-022-03022-8. [PMID: 36255467 DOI: 10.1007/s00246-022-03022-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/28/2022] [Indexed: 11/28/2022]
Abstract
Childhood obesity has become a major non-communicable disease worldwide. It is associated with an increased risk of cardiometabolic factors, including diabetes and hypertension (HTN). The purpose of this study was to evaluate the association between obesity and HTN among Iranian children and adolescents. Cross-sectional data from the SHED LIGHT study performed in Tehran urban area were used in this report. The anthropometric values and blood pressure were analyzed. The obesity status was identified based on body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). The blood pressure status was defined using percentiles for height, age, and sex. A total of 14,641 children with a mean age of 12.28 ± 3.1 years (6-18) were assessed, and 52.8% of them were boys. The prevalence of HTN was higher among obese compared to healthy weight subjects (p < 0.001). HTN had the strongest association with the central obesity by WC (odds ratio [OR] 4.098, 95% confidence interval [CI] 3.549-4.732), generalized obesity by BMI (OR 3.000, 95% CI 2.749-3.274), and central obesity by WHtR (OR 2.683, 95% CI 2.451-2.936). Moreover, parental university education, having studied in private schools, and the smaller number of household children increased the risk of obesity. The rate of HTN was high among children and adolescents with generalized and central obesities. HTN, elevated blood pressure, boy gender, and socioeconomic status were associated with obesity, emphasizing on the importance of screening and implementing lifestyle changes to decrease future risk of cardiovascular diseases.
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Affiliation(s)
- Avisa Tabib
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-e-Asr Avenue, 1995614331, Tehran, Iran
| | - Akbar Nikpajouh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Aryafar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Niloufar Samiei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-e-Asr Avenue, 1995614331, Tehran, Iran
| | - Yousef Rezaei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-e-Asr Avenue, 1995614331, Tehran, Iran
| | - Hassan Ziaodini
- Ministry of Education and Training, Bureau of Health and Fitness, Tehran, Iran
| | - Azam Goodarzi
- Ministry of Education and Training, Bureau of Health and Fitness, Tehran, Iran
| | - Bahareh Kazemborji
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Naderi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Taghavi
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-e-Asr Avenue, 1995614331, Tehran, Iran
| | - Hooman Bakhshandeh
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-e-Asr Avenue, 1995614331, Tehran, Iran.
| | - Saeid Hosseini
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-e-Asr Avenue, 1995614331, Tehran, Iran.
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23
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Tanous DR, Ruedl G, Kirschner W, Drenowatz C, Craddock J, Rosemann T, Wirnitzer K. School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School. PLoS One 2022; 17:e0275012. [PMID: 36201567 PMCID: PMC9536596 DOI: 10.1371/journal.pone.0275012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.
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Affiliation(s)
- Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- * E-mail:
| | - Gerhard Ruedl
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Physical Education, University of Education Upper Austria, Linz, Austria
| | - Joel Craddock
- Sydney School of Education and Social Work, The University of Sydney, Sydney, Australia
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Health and Lifestyle Science Cluster Tirol, Subcluster Health/Medicine/Psychology, Tyrolean University Conference, Verbund West, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
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24
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Contributory Factors Influencing Interdisciplinary Pediatric Weight Management Program Attendance for Racially Minoritized Youth. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09899-0. [PMID: 36129641 PMCID: PMC9490700 DOI: 10.1007/s10880-022-09899-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/03/2022]
Abstract
Childhood obesity is a complex medical condition associated with biopsychosocial complications that requires a multifaceted treatment approach. Historically weight management treatment has been challenging to access for racially minoritized youth. This study evaluated factors influencing treatment attendance for racially minoritized youth in a pediatric weight management program between 2018 and 2021. Medical information from 228 participants was collected, including demographics, insurance type, use of telehealth visits, measures of health-related quality of life (HRQOL), distance from the weight management program, and medical history. Although participants entering the weight management program came from across the state, racially minoritized participants from the Indianapolis area were more likely to attend the program. Racially minoritized participants farther from the program were comparatively underrepresented. Relative to families from majority backgrounds, racially minoritized families had the highest public health insurance rates. Specific physical and mental health comorbidities may further increase risk. Results have important implications for pediatric weight management programs to improve access and treatment opportunities for racially minoritized and underserved populations.
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25
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McIsaac JLD, MacQuarrie M, Barich R, Morris S, Turner JC, Rossiter MD. Responsive Feeding Environments in Childcare Settings: A Scoping Review of the Factors Influencing Implementation and Sustainability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11870. [PMID: 36231167 PMCID: PMC9564844 DOI: 10.3390/ijerph191911870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Children benefit from responsive feeding environments, where their internal signals of hunger and satiety are recognized and met with prompt, emotionally supportive and developmentally appropriate responses. Although there is existing research on responsive feeding environments in childcare, there is little synthesized literature on the implementation practices using a behavior change framework. This scoping review sought to explore the factors influencing the implementation and sustainability of responsive feeding interventions in the childcare environment, using the behavior change wheel (BCW). A total of 3197 articles were independently reviewed and 39 met the inclusion criteria. A thematic analysis identified the factors influencing the implementation and sustainability of responsive feeding, including the following: (1) pre-existing nutrition policies, (2) education and training, (3) provider beliefs and confidence, (4) partnership development and stakeholder engagement and (5) resource availability. The most common BCW intervention functions were education (n = 39), training (n = 38), environmental restructuring (n = 38) and enablement (n = 36). The most common policy categories included guidelines (n = 39), service provision (n = 38) and environmental/social planning (n = 38). The current literature suggests that broader policies are important for responsive feeding, along with local partnerships, training and resources, to increase confidence and efficacy among educators. Future research should consider how the use of a BCW framework may help to address the barriers to implementation and sustainability.
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Affiliation(s)
- Jessie-Lee D. McIsaac
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Madison MacQuarrie
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Rachel Barich
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | - Sarah Morris
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Joan C. Turner
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Melissa D. Rossiter
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
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26
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Moore THM, Phillips S, Hodder RK, O'Brien KM, Hillier-Brown F, Dawson S, Gao Y, Summerbell CD. Interventions to prevent obesity in children aged 2 to 4 years old. Hippokratia 2022. [DOI: 10.1002/14651858.cd015326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Theresa HM Moore
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- Methods Support Unit, Editorial Methods Department; Cochrane; London UK
| | - Sophie Phillips
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
| | - Rebecca K Hodder
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
| | - Kate M O'Brien
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
- Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Yang Gao
- Department of Sport, Physical Education and Health; Hong Kong Baptist University; Kowloon Hong Kong
| | - Carolyn D Summerbell
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
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Kawuki J, Musa TH, Ghimire U, Obore N, Papabathini SS. The 100 top-cited articles on childhood obesity: a bibliometric analysis. GLOBAL HEALTH JOURNAL 2022. [DOI: 10.1016/j.glohj.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Chrissini MK, Panagiotakos DB. Acute Myocardial Infarction in Young Patients and its Correlation with Obesity Status at Pre-adolescent Stage: A Narrative Review. Open Cardiovasc Med J 2022. [DOI: 10.2174/18741924-v16-e2206200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Cardiovascular diseases (CVD), especially acute myocardial infarction (AMI), remain a worldwide major cause of premature morbidity and mortality, with considerable health care costs. Metabolic, behavioural, environmental, and social risk factors are significant drivers of AMI, with obesity being a key determinant among them. Childhood obesity constitutes a major health threat that is considered a global epidemic of the 21st century.
Objective:
To assess whether excess weight from the first years of life acts as a predisposing factor in increasing the risk of AMI in young adults.
Methods:
This is a narrative review of the evidence concerning the epidemiology of early AMI and obesity, using PubMed and Google Scholar.
Results:
There is substantial evidence showing that excess weight during childhood multiplies the risk of AMI at an early age.
Conclusion:
Premature AMI seems to have significant drivers related to lifestyle factors, such as childhood obesity. In the era of a childhood obesity epidemic, the aforementioned relationship underlines the need for early prevention and management.
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Zafar S, Panthangi V, Cyril Kurupp AR, Raju A, Luthra G, Shahbaz M, Almatooq H, Foucambert P, Esbrand FD, Khan S. A Systematic Review on Whether an Association Exists Between Adolescent Obesity and Idiopathic Intracranial Hypertension. Cureus 2022; 14:e28071. [PMID: 36127965 PMCID: PMC9477550 DOI: 10.7759/cureus.28071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/16/2022] [Indexed: 11/19/2022] Open
Abstract
Pseudotumor cerebri syndrome (PTCS)/idiopathic intracranial hypertension (IIH) is a clinical presentation appertaining to signs/symptoms of raised intracranial pressure, like headache and papilledema. It is an uncommon but clinically significant cause of morbidity such as permanent vision loss. It is crucial to understand if idiopathic intracranial hypertension (IIH) is on the rise in adolescents, it is probably due to the rising prevalence of obesity worldwide. Our study aimed to find an association between obesity and IIH in adolescents. We utilized Preferred Reporting Items for Systematic Review and Meta-Analysis 2020 (PRISMA) guidelines to run this systematic review. Many publications related to the topic in the discussion were scrutinized through a comprehensive database search. We filtered them down to a final count of 10 articles after utilizing our inclusion/exclusion criteria and assessing the quality of work. In these final papers, we identified several possibilities to explain the link between obesity and IIH in adolescents. Overweight and obese adolescents were found to have a significantly increased risk of IIH development, with a more severe clinical picture seen in morbidly obese female patients.
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Putter KC, Jackson B, Thornton AL, Willis CE, Goh KMB, Beauchamp MR, Benjanuvatra N, Dimmock JA, Budden T. Perceptions of a family-based lifestyle intervention for children with overweight and obesity: a qualitative study on sustainability, self-regulation, and program optimization. BMC Public Health 2022; 22:1534. [PMID: 35953799 PMCID: PMC9373481 DOI: 10.1186/s12889-022-13956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family-based lifestyle interventions (FBLIs) are an important method for treating childhood weight problems. Despite being recognized as an effective intervention method, the optimal structure of these interventions for children's overweight and obesity has yet to be determined. Our aim was to better understand participants' (a) implementation of behaviour strategies and long-term outcomes, (b) perceptions regarding the optimal structure of FBLIs, and (c) insights into psychological concepts that may explain the success of these programs. METHODS Purposive sampling was used to recruit participants. We conducted focus groups as well as one-to-one interviews with parents (n = 53) and children (n = 50; aged 7-13, M = 9.4 yr, SD = 3.1) three months following their involvement in a 10-week, multi-component, FBLI involving education and activities relating to healthy nutrition, physical activity, and behavior modification. Using an interpretivist approach, a qualitative study design was employed to examine participant experiences. RESULTS We identified three higher-order categories: (a) participants' program experiences and perceptions (b) lifestyle changes post-program, and (c) recommendations for optimizing family-based programs. Themes identified within these categories included (a) support and structure & content, (b) diet and physical activity, and (c) in-program recommendations and post-program recommendations. CONCLUSIONS We identified several challenges that can impair lasting behavior change (e.g., physical activity participation) following involvement in a FBLI. On optimizing these programs, participants emphasized fun, interactive content, interpersonal support, appropriate educational content, and behavior change techniques. Concepts rooted in motivational theory could help address calls for greater theoretical and mechanistic insight in FBLIs. Findings may support research advancement and assist health professionals to more consistently realize the potential of these interventions.
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Affiliation(s)
- Kaila C Putter
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Ashleigh L Thornton
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western, Perth, Australia.,Kids Rehab WA, Perth Children's Hospital, Nedlands, Australia
| | - Claire E Willis
- Sports & Exercise Science, La Trobe University, Melbourne, Australia
| | - Kong Min Bryce Goh
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia
| | - Mark R Beauchamp
- School of Kinesiology, The University of British Columbia, Vancouver, Canada
| | - Nat Benjanuvatra
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia
| | - James A Dimmock
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Timothy Budden
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia. .,Telethon Kids Institute, Perth, WA, Australia.
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Muni Swamy G, Ramesh G, Devi Prasad R, Meriga B. Astragalin, (3-O-glucoside of kaempferol), isolated from Moringa oleifera leaves modulates leptin, adiponectin secretion and inhibits adipogenesis in 3T3-L1 adipocytes. Arch Physiol Biochem 2022; 128:938-944. [PMID: 32216601 DOI: 10.1080/13813455.2020.1740742] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Inhibition of adipogenesis is crucial and is a key area of research to develop antiobesity drugs. In this study, 3-O-glucoside of kaempferol (astragalin) was isolated from Moringa oleifera leaves and evaluated for its lipolytic and antiadipogenic activity in 3T3-L1 adipocytes. Astragalin has substantially reduced the triglycerides content and lipid accumulation in 3T3-L1 adipocytes and enhanced the glycerol release in a dose dependent manner. The assay for secreted adipocytokines confirmed that, astragalin at a concentration of 20 µg/mL significantly (p < .01) increased the secretion of adiponectin, but decreased leptin secretion in 3T3-L1 adipocytes. In molecular studies, both the mRNA expression and corresponding protein expression of PPAR-γ, C/EBP-α, FAS, and leptin genes were downregulated while that of adiponectin was upregulated in astragalin treated groups. Taken together, astragalin of M. oleifera promotes lipolysis, suppresses adipogenesis in 3T3-L1 adipocytes, and may be considered as an effective candidate to treat obesity aliments.
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Affiliation(s)
- Ganjayi Muni Swamy
- Department of Biochemistry, Sri Venkateswara University, Tirupati, Andhra Pradesh, India
| | - Gunturu Ramesh
- Department of Medicinal Chemistry, GVK Biosciences Pvt. Ltd, IDA Mallapur, Hyderabad, Telangana, India
| | - Rendedula Devi Prasad
- Department of Medicinal Chemistry, GVK Biosciences Pvt. Ltd, IDA Mallapur, Hyderabad, Telangana, India
| | - Balaji Meriga
- Department of Biochemistry, Sri Venkateswara University, Tirupati, Andhra Pradesh, India
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Moore THM, Tomlinson E, Spiga F, Higgins JPT, Gao Y, Caldwell DM, Nobles J, Dawson S, Ijaz S, Savovic J, Hodder RK, Wolfenden L, Jago R, Phillips S, Hillier-Brown F, Summerbell CD. Interventions to prevent obesity in children aged 12 to 18 years old. Hippokratia 2022. [DOI: 10.1002/14651858.cd015330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Theresa HM Moore
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Francesca Spiga
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Julian PT Higgins
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- NIHR Bristol Biomedical Research Centre; University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol; Bristol UK
| | - Yang Gao
- Department of Sport, Physical Education and Health; Hong Kong Baptist University; Kowloon Hong Kong
| | - Deborah M Caldwell
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - James Nobles
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Jelena Savovic
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Rebecca K Hodder
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
| | - Luke Wolfenden
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
| | - Russell Jago
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- NIHR Bristol Biomedical Research Centre; University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol; Bristol UK
- Centre for Exercise, Nutrition & Health Sciences; School for Policy Studies, University of Bristol; Bristol UK
| | - Sophie Phillips
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
- Department of Sport and Exercise Science; Durham University; Durham UK
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
- Human Nutrition Research Centre and Population Health Sciences Institute; University of Newcastle; Newcastle UK
| | - Carolyn D Summerbell
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
- Department of Sport and Exercise Science; Durham University; Durham UK
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Moore THM, Tomlinson E, Spiga F, Higgins JPT, Gao Y, Caldwell DM, Nobles J, Dawson S, Ijaz S, Savovic J, Hodder RK, Wolfenden L, Jago R, Phillips S, Hillier-Brown F, Summerbell CD. Interventions to prevent obesity in children aged 5 to 11 years old. Hippokratia 2022. [DOI: 10.1002/14651858.cd015328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Theresa HM Moore
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Francesca Spiga
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Julian PT Higgins
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol; Bristol UK
| | - Yang Gao
- Department of Sport, Physical Education and Health; Hong Kong Baptist University; Kowloon Hong Kong
| | - Deborah M Caldwell
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - James Nobles
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- Population Health Sciences, Bristol Medical School, University of Bristol; Bristol UK
| | - Sarah Dawson
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- Population Health Sciences, Bristol Medical School, University of Bristol; Bristol UK
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Jelena Savovic
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Rebecca K Hodder
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
| | - Luke Wolfenden
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
| | - Russell Jago
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol; Bristol UK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies; University of Bristol; Bristol UK
| | - Sophie Phillips
- Department of Sport and Exercise Science; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
- Human Nutrition Research Centre and Population Health Sciences Institute; University of Newcastle; Newcastle UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Science; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
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Associations of Gestational Diabetes Mellitus and Excessive Gestational Weight Gain with Offspring Obesity Risk. Curr Med Sci 2022; 42:520-529. [PMID: 35486298 DOI: 10.1007/s11596-022-2547-y] [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: 11/18/2020] [Accepted: 05/10/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) and gestational weight gain (GWG) are important risk factors that are known to affect offspring growth, but these outcomes are inconsistent and it remains unknown if both risk factors have a synergetic effect on early childhood growth. The present study aimed to conduct offspring body mass index-for-age Z-scores (BMIZ) trajectories and to evaluate the independent and interactive effect of the status of GDM and excessive GWG on the risks of overweight/obesity from birth to 24 months of age. METHODS A total of 7949 mother-child pairs were enrolled in this study. The weight and length of children were measured at birth, 6, 12, and 24 months of age to calculate BMIZ. RESULTS The status of GDM was positively associated with offspring BMIZ and risk of macrosomia at birth but was not associated with offspring BMIZ or the risks of overweight/obesity at 6, 12, and 24 months of age. In contrast, excessive GWG was positively linked to offspring BMIZ, the stable high BMIZ trajectory pattern, and risks of overweight/obesity in the first 24 months of age. These two risk factors also had a significant synergistic effect on macrosomia at birth, but the interactive effect was only significant in boys during the follow-up years in the sex-stratified analyses. CONCLUSION The maternal GWG was a more pronounced predictor than GDM with relation to BMIZ and risk of overweight/obesity in early childhood. The interactive effect between these risk factors on offspring overweight/obesity may vary by sex.
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Blanchard J, McCrindle BW, Longmuir PE. The Impact of Physical Activity Restrictions on Health-Related Fitness in Children with Congenital Heart Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084426. [PMID: 35457294 PMCID: PMC9028029 DOI: 10.3390/ijerph19084426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/19/2022]
Abstract
Children with congenital heart disease (CHD) are often restricted from some types of physical activity (PA) despite the lack of evidence regarding the need to restrict recreational PA, apart from those with rhythm disorders. This study retrospectively investigated the associations between parent-reported activity restrictions (on-going need to restrict exertion, body contact or competition) and measures of health-related fitness among 236 children (8.2 ± 2.1 years, range 4−12 years) treated for single ventricle (n = 104), tetralogy of Fallot (n = 48), transposition of the great arteries (n = 47) or atrial septal defect (n = 37). Body mass index (BMI), moderate-to-vigorous physical activity (MVPA; 7 day accelerometry), strength, flexibility, and movement skill assessment results were collected from the baseline assessment research records for two studies completed in Ontario, Canada. A subset of 62 children also had physician-reported activity restrictions. Regression models empirically tested the goodness of fit between the dependent and independent variables. Participants with body contact restrictions from both parents and physicians had significantly higher BMI z-scores (0.23 ± 1.19 vs. −0.32 ± 0.85; t = 2.55; p = 0.04 and 0.66 ± 1.33 vs. −0.02 ± 0.98; t = 2.25; p = 0.02 for CDC and WHO scores, respectively). Otherwise, BMI z-score was not associated with patient variables (p > 0.36; sex, cardiac diagnosis, age, or activity restriction). Children with any type of parent-reported restriction (0.98 ± 2.06 vs. −0.08 ± 1.99; t = 3.77; p = 0.0002) were less flexible. Movement skill (TGMD-2) scores were 50% lower (25.1 ± 31.2 vs. 52.6 ± 28.6; F = 6.93; p = 0.009) among children with parent-reported competitive sport restrictions. Weekly MVPA (p > 0.18) and strength (p > 0.05) were not associated with activity restriction. Children whose parents reported PA restrictions were less flexible, and had decreased movement skill and increased BMI z-scores if the restrictions impacted competitive sport or body contact, respectively. Future research is recommended to confirm these results among larger samples of children who have both parent- and physician-specified PA restrictions.
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Affiliation(s)
- Joel Blanchard
- Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada;
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Brian W. McCrindle
- The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada;
| | - Patricia E. Longmuir
- Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada;
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Correspondence: ; Tel.: +1-613-738-3908
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Kalay Senturk NG, Dagdeviren Cakir A, Yildirmak ZY, Ucar A. Assessment of Serum Spexin Levels in Obese Adolescents with Metabolic Syndrome Antecedents: Preliminary Results. Horm Res Paediatr 2022; 94:343-352. [PMID: 34839286 DOI: 10.1159/000521180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/25/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Spexin (SPX) is a novel peptide implicated in food intake and satiety. SPX levels are reduced in obese patients. AIM This study aimed to compare serum SPX levels in obese adolescents versus healthy controls and to assess the associations of metabolic syndrome (metS) antecedents with serum SPX levels. METHODS Eighty consecutive obese adolescents aged 10-18 years and 80 healthy peers were enrolled. Anthropometric measurements, pubertal examinations, and clinical blood pressure measurements were performed. Fasting blood samples were drawn for glucose, insulin, lipids, uric acid, alanine aminotransferase (ALT), and SPX. metS was diagnosed using International Diabetes Federation criteria. Associations of serum SPX with clinical and laboratory variables were assessed. RESULTS Obese adolescents had lower serum SPX levels than healthy peers (50 pg/mL [25-75% IQR: 25-98 pg/mL] and 67.0 pg/mL [25-75% IQR: 32.5-126.0 pg/mL]; respectively, p = 0.035). Twenty (25%) obese adolescents were diagnosed as having metS. Obese adolescents with metS had lower SPX than those without metS (24.5 pg/mL [25-75% IQR: 15.3-49.5 pg/mL] and 69.0 pg/mL [25-75% IQR: 42.0-142.0 pg/mL]; respectively, p < 0.0001). The frequencies of hyperuricemia, IR, and elevated ALT were similar in obese adolescents with metS and those without metS (p > 0.05 for all). Serum uric acid levels were correlated significantly with serum SPX after correcting for BMI and HOMA-IR (r = -0.41, p < 0.05). A serum SPX level at a cutoff level of 49.5 pg/mL predicted the presence of metS in obese adolescents with 75% sensitivity and 71% specificity. CONCLUSIONS Obese adolescents have reduced SPX levels, and this reduction is more pronounced in those with metS. Further research is needed to verify the utility of SPX as a biomarker in the diagnosis of metS in obese adolescents.
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Affiliation(s)
- Nida Gulderen Kalay Senturk
- Department of Pediatrics, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Aydilek Dagdeviren Cakir
- Department of Pediatric Endocrinology and Diabetes, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zeynep Yildiz Yildirmak
- Department of Pediatric Hematology and Oncology, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ahmet Ucar
- Department of Pediatric Endocrinology and Diabetes, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Cason-Wilkerson R, Scott SG, Albright K, Haemer M. Exploration of Changes in Low-Income Latino Families’ Beliefs about Obesity, Nutrition, and Physical Activity: A Qualitative Post-Intervention Study. Behav Sci (Basel) 2022; 12:bs12030073. [PMID: 35323392 PMCID: PMC8945531 DOI: 10.3390/bs12030073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/07/2022] [Accepted: 03/03/2022] [Indexed: 11/21/2022] Open
Abstract
Objective: To investigate changes in beliefs around obesity, nutrition, and physical activity among low-income majority Latino families who participated in a community-based family-inclusive obesity intervention. Methods: Six focus groups were conducted with a predominately Latino low-income population, who completed the Healthy Living Program (HeLP). Two groups were conducted in English and four groups were conducted in Spanish, and were recorded, translated, transcribed, and analyzed for thematic content. Two coders independently coded transcripts then reflexive team analysis with three members was used to reach consensus. Results: Thirty-seven caregivers representing thirty-three families participated in focus groups. A number of themes emerged around changes in beliefs about obesity, nutrition, and physical activity (PA) as a result of the HeLP curriculum. Regarding obesity, the themes that emerged focused on the acceptability of children being overweight and the importance of addressing weight at an early age. Changes in beliefs regarding nutrition emerged, noting changes in the use of food as a reward, the multiple benefits of a healthy diet, and for some participants change in their beliefs around the adaptability of traditional foods and habits. Regarding physical activity, themes emerged around the difficulty of engaging in PA due to unsafe conditions and finding creative indoor and outdoor activities with whole family participation and becoming aware of the benefits of PA. Conclusions: Parental changes in beliefs about obesity, nutrition, and physical activity as a result of a family-inclusive weight management program in a population of low-income predominately Latino families can aid and inform the development of future weight management programs for this population.
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Affiliation(s)
- Rochelle Cason-Wilkerson
- Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
- Correspondence:
| | | | - Karen Albright
- Department of Internal Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Matthew Haemer
- Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
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Park J, Ten Hoor GA, Baek S, Chung S, Kim YH, Hwang G. The Let's Eat Healthy and Move at School program for adolescents in South Korea: Program design, implementation, and evaluation plan using intervention mapping. CHILD HEALTH NURSING RESEARCH 2022; 27:225-242. [PMID: 35004512 PMCID: PMC8650854 DOI: 10.4094/chnr.2021.27.3.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/07/2021] [Accepted: 07/14/2021] [Indexed: 11/11/2022] Open
Abstract
Purpose This study aimed to systematically develop an obesity prevention program for adolescents to promote healthy eating and physical activity in schools. Methods The development of the Let's Eat Healthy and Move at School program for adolescents followed the six steps of intervention mapping (IM). IM is a widely used protocol for developing systematic and effective interventions based on theories and evidence. Results To better understand the problem and identify the needs of adolescents, interviews were conducted with teachers, school nurses, and students (step 1). In step 2, the desired behaviors and their determinants were established and combined into a matrix comprising 16 change objectives. In step 3, theoretical methods such as persuasive communication and consciousness-raising were chosen. The program was segmented into three educational activity sessions in step 4. In step 5, an implementation manual was developed for program instructors to ensure effective and accurate implementation. Finally, practices for evaluating the program's effectiveness and procedures were designed in step 6. Conclusion The Let’s Eat Healthy and Move at School program will provide adolescents with guidelines to promote healthy living and prevent obesity in everyday life using strategies for sustainable adolescent obesity prevention and management.
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Affiliation(s)
- Jiyoung Park
- Assistant Professor, College of Nursing, Institute for Health Science Research, Inje University, Busan, Korea
| | - Gill A Ten Hoor
- Assistant Professor, Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Seolhyang Baek
- Professor, College of Nursing, Dongguk University, Gyeongju, Korea
| | - Sochung Chung
- Professor, Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Yang-Hyun Kim
- Associate Professor, Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Gahui Hwang
- Graduate Student, College of Nursing, Yonsei University, Seoul, Korea
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Chehal PK, Shafer L, Cunningham SA. Examination of Sleep and Obesity in Children and Adolescents in the United States. Am J Health Promot 2022; 36:46-54. [PMID: 34247520 PMCID: PMC10870837 DOI: 10.1177/08901171211029189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study contributes to the growing literature on the association between sleep and obesity by examining the associations between hours of sleep, consistency of bedtime, and obesity among children in the US. DESIGN Analysis of a nationally representative sample of non-institutionalized children from the 2016-17 National Survey of Children's Health. SETTING US, national. SUBJECTS Children ages 10-17 years (n = 34,640). MEASURES Parent reported weeknight average hours of sleep and consistency of bedtime. Body mass index classified as underweight, normal, overweight or obesity using parent-reported child height and weight information, classified using CDC BMI-for-Age Growth Charts. ANALYSIS Multivariate logistic regression models were used to estimate associations between measures of sleep and body mass index weight category adjusting for individual, household and neighborhood characteristics. RESULTS An additional hour of sleep was associated with 10.8% lower odds of obesity, net of consistency in bedtime. After controlling for sleep duration, children who usually went to bed at the same time on weeknights had lower odds of obesity (24.8%) relative to children who always went to bed at the same time. CONCLUSION Sleep duration is predictive of lower odds of obesity in US children and adolescents. Some variability in weeknight bedtime is associated with lower odds of obesity, though there were no additional benefits to extensive variability in bedtime.
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Affiliation(s)
- Puneet Kaur Chehal
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Livvy Shafer
- National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Community Interventions for Infection Control Unit, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Pfeifer CE, Sacko RS, Ortaglia A, Monsma EV, Beattie PF, Goins J, Stodden DF. Fit to Play? Health-Related Fitness Levels of Youth Athletes: A Pilot Study. J Strength Cond Res 2022; 36:245-251. [PMID: 31809462 DOI: 10.1519/jsc.0000000000003430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Pfeifer, CE, Sacko, RS, Ortaglia, A, Monsma, EV, Beattie, PF, Goins, J, and Stodden, DF. Fit to play? Health-related fitness levels of youth athletes: A pilot study. J Strength Cond Res 36(1): 245-251, 2022-A recent National Strength and Conditioning Association position statement suggests that many youth are not prepared for the physical demands of sport. The purpose of this study was to compare health-related fitness (HRF) of youth athletes with normative findings from the general population. We recruited 136 athletes (63 male and 73 female athletes) aged 11-19 (16.01 ± 1.35) years and collected HRF (body composition, cardiorespiratory endurance, musculoskeletal strength and endurance). Results were categorized based on FITNESSGRAM® standards and compared with Canadian youth general population normative data. Most male athletes were classified as "needs improvement" for cardiorespiratory and muscular endurance, and body mass index (BMI). Conversely, most female athletes were at or above the "healthy fitness zone" for all measures. Male athletes at both age groups (11-14, 15-19; p < 0.001) and female athletes aged 11-14 (p < 0.05) demonstrated lower cardiorespiratory endurance compared with Canadian general population. Female athletes (both age groups) demonstrated greater muscular strength, and male athletes (age, 15-19 years) demonstrated lower BMI than the Canadian general population. The results are concerning as male athletes demonstrated poorer HRF compared with the general population. Although most female athletes were within healthy ranges, a portion of them were still at risk. Considering the demands sport places on the body, evaluating HRF is paramount for performance and injury prevention but more importantly for overall health. Youth sport and strength coaches should evaluate and aim to enhance HRF, as participation in sport does not guarantee adequate HRF. Promoting long-term athletic development and life-long health should be a priority in youth.
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Affiliation(s)
- Craig E Pfeifer
- Applied Sport and Exercise Sciences, University of Gloucestershire, Gloucester, United Kingdom
| | - Ryan S Sacko
- Department of Health and Human Performance, The Citadel, Charleston, South Carolina
| | | | - Eva V Monsma
- Department of Physical Education, University of South Carolina, Columbia, South Carolina
| | | | | | - David F Stodden
- Department of Physical Education, University of South Carolina, Columbia, South Carolina
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Neri D, Martínez-Steele E, Khandpur N, Levy R. Associations between ultra-processed foods consumption and indicators of adiposity in US adolescents: cross-sectional analysis of the NHANES 2011–2016. J Acad Nutr Diet 2022; 122:1474-1487.e2. [DOI: 10.1016/j.jand.2022.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 10/19/2022]
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HomeStyles-2: Randomized controlled trial protocol for a web-based obesity prevention program for families with children in middle childhood. Contemp Clin Trials 2021; 112:106644. [PMID: 34861408 DOI: 10.1016/j.cct.2021.106644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Parents are children's primary role models, are food and physical activity gatekeepers, and create the home structure/lifestyle environment. Thus, parents strongly influence children's weight-related behaviors and have the opportunity to cultivate a "culture of health" within the home. Yet, there is a dearth of evidence-based obesity prevention intervention programs, especially for families with children aged 6-11 years, commonly called middle childhood. METHODS The aim of the HomeStyles-2 online learning mode RCT is to determine whether this novel, age-appropriate, family intervention enables and motivates parents to shape home environments and weight-related lifestyle practices (i.e.,diet, exercise, sleep) to be more supportive of optimal health and reduced obesity risk in middle childhood youth more than those in the control condition. The RCT will include the experimental group and an attention control group. The participants will be parents with school-age children who are systematically randomly assigned by computer to study condition. The HomeStyles intervention is predicated on the social cognitive theory and a social ecological framework. The RCT will collect sociodemographic characteristics of the participant, child, and partner/spouse; child and parent health status; parent weight-related cognitions; weight-related behaviors of the parent and child; and weight-related characteristics of the home environment. Deliverables Enrollment for this study will begin in 2022. DISCUSSION This paper describes these aspects of the HomeStyles-2 intervention: rationale; sample eligibility criteria and recruitment; study design; experimental group intervention theoretical and philosophical underpinnings, structure, content, and development process; attention control intervention; survey instrument development and components; outcome measures; and planned analyses. TRIAL REGISTRATION ClinicalTrials.gov, Protocol #NCT04802291, Registered March 14, 2021.
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Au R, Li J, Liu C. Au et al. Respond to "Body Mass Index and Risk of Dementia". Am J Epidemiol 2021; 190:2515-2516. [PMID: 33831143 DOI: 10.1093/aje/kwab097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract
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Albakheet SS, Lee MJ, Yoon H, Shin HJ, Koh H. Psoas muscle area and paraspinal muscle fat in children and young adults with or without obesity and fatty liver. PLoS One 2021; 16:e0259948. [PMID: 34788336 PMCID: PMC8598034 DOI: 10.1371/journal.pone.0259948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/01/2021] [Indexed: 12/13/2022] Open
Abstract
Background Little is known about the muscle condition in children with obesity. Objectives To investigate the effect of obesity and fatty liver on muscle area and muscle fat in children and young adults. Materials and methods We evaluated consecutive liver fat quantification MRIs in children and young adults between June 2015 and April 2019. We obtained hepatic fat and paraspinal muscle fat at mid L2 from the fat map, psoas muscle area (PMA) at mid L3, and z-score of PMA. The patient’s age, height and weight at the time of the MRI were recorded. Body mass index (BMI) z-score was also calculated. Spearman correlation and partial correlation analyses were performed. Univariate and multivariate regression analyses were also performed using significant variables. Results A total of 132 patients (97 male) were included with a median age of 13.0 years (interquartile range 11–16 years). The median BMI was 23.7 kg/m2 (interquartile range 21.2–27.7 kg/m2). The weight, BMI, liver fat, and z-score of PMA were all higher in male patients than they were in female patients. The amount of liver fat had no correlation with muscle fat or PMA z-score after adjusting BMI. However, the BMI z-score was positively correlated with the PMA z-score (ρ = 0.432, p<0.001) even after adjusting for liver fat. On regression analyses, the BMI z-score had linear positive relationship with PMA z-score (β = 0.289, p<0.001) and muscle fat (β = 0.218, p = 0.016). Conclusions Male children and young adults have greater PMA than do female children and young adults. Obesity is associated with higher PMA and paraspinal muscle fat. However, liver fat is not related with the muscle condition in children and young adults.
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Affiliation(s)
- Salman S Albakheet
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.,Department of Radiology, King Faisal General Hospital, Al-Ahsa, Kingdom of Saudi Arabia
| | - Mi-Jung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Haesung Yoon
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Joo Shin
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hong Koh
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
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Malcolmson C, Tetzlaff D, Maguire B, Wakefield C, Carcao M, Bouskill V. Excess weight gain in the paediatric bleeding disorders population: Impact of the COVID-19 Pandemic. Haemophilia 2021; 28:91-96. [PMID: 34761485 PMCID: PMC8653224 DOI: 10.1111/hae.14449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/14/2021] [Accepted: 10/20/2021] [Indexed: 12/01/2022]
Abstract
Introduction The COVID‐19 pandemic has resulted in lifestyle changes for children. The aim of this study was to evaluate the impact of the pandemic on weight/BMI in children with severe bleeding disorders. Methods We conducted a retrospective review of patients age 3–18 years with severe bleeding disorders on prophylactic therapy treated at SickKids Hospital (Toronto, Canada) between February 01, 2018 and March 31, 2021. We evaluated the following pre‐ and post‐COVID variables: weight (kg), weight percentile, BMI (kg/m2), BMI percentile, HJHS score, and prophylactic dosing (units/kg). Results One hundred and four patients were included in the final analysis. Diagnoses were as follows: haemophilia A (n = 92; 70.8%), haemophilia B (n = 17; 13.1%), type 3 von Willebrand disease (n = 11; 8.5%), the remainder were diagnosed with rare factor deficiencies. Median interval time from pre‐COVID measurements to latest follow‐up was 12.4 months (IQR 10.32–14.52 months) during which there was a statistically significant increase in median weight percentile +5.75 centiles (from 63rdcentile to 68.75thcentile). There was a statistically significant increase in mean BMI of +1.03 kg/m2(P = < .001) while median BMI percentile increased +8.82 centiles (from 53.9thcentile to 62.72ndcentile) and mean BMI percentile increased 3.42 centiles (from 57.5 centile to 60.9 centile). The group that gained the most weight centiles, BMI and BMI centiles were 5–14 years old. Conclusion There was a trend to weight gain over the study period. More long‐term data is required to evaluate the impact of this increase in weight and BMI on children with bleeding disorders.
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Affiliation(s)
- Caroline Malcolmson
- Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Department of Paediatrics, Toronto, ON, Canada
| | - Deirdre Tetzlaff
- Department of Rehabilitation, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Bryan Maguire
- Department of Biostatistics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Cindy Wakefield
- Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Department of Nursing, Toronto, ON, Canada
| | - Manuel Carcao
- Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Department of Paediatrics, Toronto, ON, Canada.,Research Institute, The Hospital for Sick Children, University of Toronto, Child Health Evaluative Sciences, Toronto, ON, Canada
| | - Vanessa Bouskill
- Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Department of Nursing, Toronto, ON, Canada.,Research Institute, The Hospital for Sick Children, University of Toronto, Child Health Evaluative Sciences, Toronto, ON, Canada
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Buoncristiano M, Williams J, Simmonds P, Nurk E, Ahrens W, Nardone P, Rito AI, Rutter H, Bergh IH, Starc G, Jonsson KR, Spinelli A, Vandevijvere S, Mäki P, Milanović SM, Salanave B, Yardim MS, Hejgaard T, Fijałkowska A, Abdrakhmanova S, Abdurrahmonova Z, Duleva V, Farrugia Sant'Angelo V, García-Solano M, Gualtieri A, Gutiérrez-González E, Huidumac-Petrescu C, Hyska J, Kelleher CC, Kujundžić E, Peterkova V, Petrauskiene A, Pudule I, Sacchini E, Shengelia L, Tanrygulyyeva M, Taxová Braunerová R, Usupova Z, Maruszczak K, Ostojic SM, Spiroski I, Stojisavljević D, Wickramasinghe K, Breda J. Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region. Obes Rev 2021; 22 Suppl 6:e13213. [PMID: 34184399 DOI: 10.1111/obr.13213] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 01/17/2023]
Abstract
Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6-9 years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities.
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Affiliation(s)
- Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Philippa Simmonds
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | | | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Benoît Salanave
- Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | | | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zulfiya Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | | | - Constanta Huidumac-Petrescu
- National Center for Health Assessment and Promotion, National Institute of Public Health, Bucharest, Romania
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | | | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | | | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Kremlin Wickramasinghe
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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Insurance Coverage of Pediatric Bariatric Surgery: a Cross-Sectional Analysis of the USA. Obes Surg 2021; 32:123-132. [PMID: 34687410 DOI: 10.1007/s11695-021-05744-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Pediatric bariatric surgery is increasingly recognized as a safe and effective option for the management of obesity and obesity-related conditions. However, insurance coverage is a key barrier to accessing these procedures. Criteria are variable and often not evidence-based. In an effort to characterize common patterns in insurance coverage, we report coverage criteria for adolescents relative to adults. MATERIALS AND METHODS We surveyed medical policies of the 50 highest market share health insurance providers in the USA. Private insurer coverage criteria included age, Tanner staging, skeletal maturity, body mass index, procedures covered, medical weight management requirements, co-morbidities, and multidisciplinary team criteria. These were then compared to the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines. RESULTS Two thirds (n = 33, 66%) of companies provided inclusion criteria for adolescents. All policies covered RYGB (n = 33), most covered sleeve gastrectomy (n = 32, 97.0%). Obstructive sleep apnea (OSA) (n = 32, 97%), hypertension (HTN) (n = 27, 81.8%), and gastroesophageal reflux disease (GERD) (n = 11, 33.3%) were the three most commonly cited co-morbidities used as inclusion criteria. Tanner staging or skeletal maturity were most commonly used (n = 10, 30.3%). Similarly, twenty (60.6%) insurers required medical weight management programs. Multi-disciplinary teams were required by 81.8% of adolescent policies (n = 27) as described by the ASMBS. Seventeen (51.5%) policies defined providers for these teams, and 10 (30.3%) provided other defined criteria. CONCLUSION Contrary to ASMBS guidelines, companies commonly require Tanner staging and/or skeletal maturity criteria as well as participation in medical weight management programs. Also, multi-disciplinary team are frequently required but not well defined.
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Amer S, Kateeb E. Factors related to dietary habits, energy drink consumption, and physical activity in marginalized Palestinian schools: A cross-sectional study. Health Promot Perspect 2021; 11:329-336. [PMID: 34660228 PMCID: PMC8501479 DOI: 10.34172/hpp.2021.42] [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: 10/23/2020] [Accepted: 06/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The current study assessed different dietary habits, energy drinks intake, body mass index (BMI) and physical activity and associated factors among Palestinian adolescents attending marginalized schools. Methods: A cross-sectional study targeted a random sample of 1480 students in the sixth andninth grades attending 20 marginalized public schools in the West Bank area of the occupied Palestinian Territories (oPt). Students were interviewed in-person by trained senior dental students about their dietary habits, physical activity, fathers’ employment and mothers’ level of education. Weight and height were measured, and BMI percentile was calculated. Descriptive statistics were generated for the study’s main variables and the dependent variables were compared by grade, gender, mothers’ level of education and father’s employment. Results: A total of 1282 students (98% response) completed the questionnaire. Of them, 6% were ‘underweight’ (fifth percentile or under) and 34% were ‘overweight’ or ‘obese’ (85thpercentile or over). Ninth graders had more added sugar than 6th graders (P=0.002), less frequent milk consumption (P<0.001), more frequent energy drink consumption (P=0.001),and less physical activity (P<0.0001). Frequency of carbonated and sweetened drink consumption was associated with being overweight or obese (P=0.016, P=0.001). Frequency of carbonated drinks consumption was higher among children of mothers with a high school level of education or less (P<0.001). In addition, children of mothers educated to high school level or below were associated with being underweight (P=0.05). Conclusion: Dietary habits and physical activity get worse between the ages of 12 and 15. Mothers’ level of education is an important factor in being overweight or underweight. Energy drink consumption among boys and milk consumption among girls are two challenges that need to be addressed urgently and adequately.
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Affiliation(s)
- Sami Amer
- MIT Media Lab, Massachusetts Institute of Technology, 77 Massachusetts Avenue Cambridge, MA 02139, USA
| | - Elham Kateeb
- Oral Health Research and Promotion Unit, Faculty of Dentistry, Al-Quds University, Jerusalem, State of Palestine
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Burton ZA, Lewis R, Bennett T, McLernon DJ, Engelhardt T, Brooks PB, Edwards MR. Prevalence of PErioperAtive CHildhood obesitY in children undergoing general anaesthesia in the UK: a prospective, multicentre, observational cohort study. Br J Anaesth 2021; 127:953-961. [PMID: 34627621 DOI: 10.1016/j.bja.2021.07.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Childhood obesity has become a serious global healthcare challenge. No UK data currently define its anaesthetic and perioperative implications. We aimed to determine obesity prevalence amongst UK children undergoing general anaesthesia and the incidence of predefined adverse perioperative events, and to compare perioperative obesity rates with National Child Measurement Programme (NCMP) data. METHODS During a site-selected consecutive 7-day study period, all children (2-16 yr) undergoing general anaesthesia were included. Anonymised hospital, surgical, and procedural details; demographic data; and adverse perioperative events were collected prospectively by Paediatric Anaesthesia Trainee Research Network (PATRN) collaborators. RESULTS For this study, 102 UK hospitals participated and 4232 cases were included in the final analysis; 76% of hospitals did not routinely calculate BMI. In addition, 3030 (71.6%; 95% confidence interval [CI]: 70.2-73.0%) children of healthy weight were compared with 537 (12.7%; 11.7-13.7%) children who were overweight and 478 (11.3%; 10.3-12.2%) children with obesity. Children with obesity (n=71; 14.9%) more commonly underwent (adeno)tonsillectomy than children of healthy weight (n=282; 9.3%; P<0.001; odds ratio [OR] 2.15; 95% CI: 1.58-2.92). Fewer children with obesity (n=365; 77% vs n=2552; 85%) were anaesthetised by consultant anaesthetists (OR 0.62; 95% CI: 0.48-0.79). Mask ventilation was difficult for 3.7% of children with obesity vs 0.6% of children of healthy weight (difference 3.0%; 95% CI: 1.3-4.7%; P<0.001). Comparison with NCMP data demonstrated an over-representation of obesity amongst the paediatric surgical population. CONCLUSIONS This large multicentre cohort study suggests a concerning prevalence of children with obesity presenting for anaesthesia. These results should be used to inform optimal provision of care for this population and support perioperative healthcare initiatives to address the burden of childhood obesity. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03994419.
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Affiliation(s)
- Zoë A Burton
- Department of Anaesthesia, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK.
| | - Rosie Lewis
- Department of Anaesthesia, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Tom Bennett
- Department of Anaesthesia, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - David J McLernon
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Thomas Engelhardt
- McGill University Health Center, Montreal Children's Hospital, Montreal, QC, Canada
| | - Peter B Brooks
- Department of Anaesthesia, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Mark R Edwards
- Department of Anaesthesia, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Webster EK, Sur I, Stevens A, Robinson LE. Associations between body composition and fundamental motor skill competency in children. BMC Pediatr 2021; 21:444. [PMID: 34629074 PMCID: PMC8504089 DOI: 10.1186/s12887-021-02912-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/23/2021] [Indexed: 11/26/2022] Open
Abstract
Background Evidence supports an inverse relationship between weight status and motor competence, but most work utilizes body mass index as the proxy for weight status. Body mass index fails to account for essential components of body composition, which may be critical for motor performance. The purpose of this investigation was to examine the relationship between fundamental motor skills competency and body composition (i.e., fat mass, fat percentage, and fatfree mass) as measured by bio-electrical impedance analysis and body mass index in children. Methods Two hundred forty-four children from the Southeastern portion of the United States participated in this project (6.05 ± 2.01 years, 53.3% male). Fundamental motor skills were measured using the Test of Gross Motor Development – 2nd edition and body composition was assessed with the Tanita SC-331S Body Composition Analyzer (bio-electrical impedance analysis). Body mass index was calculated using CDC normative growth charts. Results Bio-electrical impedance analysis measures accounted for 23.1%, F(3, 241) = 24.10, p < .001 and 2.7%, F(3, 241) = 2.22, p = .086 variance in locomotor and object control subscales, respectively; body mass index accounted for 8.4% (locomotor) and 0.1% (object control) variance. For the Test of Gross Motor Development -2nd edition total score, bio-electrical impedance analysis measures accounted for 24.4% F(3, 241) = 25.90, p < .001 compared to body mass index which accounted for 7.9% F(1, 244) = 20.86, p < .001 of the variance. Only fat free mass (p < .001) was a significant predictor for locomotor skills and total models for the Test of Gross Motor Development – 2nd edition; BMI was also a significant predictor (p < .001) in both the locomotor and total models. Conclusions Different components of body composition (i.e., fat free mass) were associated with different aspects of fundamental motor skills competency. Excess body fat may be a morphological constraint to proficient locomotor performance when transporting the body through space. In contrast, body composition did not significantly predict object manipulation performance. More work is needed to understand the causality and directionality of this relationship; however, bio-electrical impedance analysis accounts for more variance in fundamental motor skills performance than body mass index in a field-based setting.
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Affiliation(s)
- E Kipling Webster
- Institute of Public and Preventive Health, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA.
| | - Indica Sur
- School of Kinesiology, University of Michigan, 830 North University, Ann Arbor, MI, 48109-1048, USA
| | - Alicia Stevens
- Institute of Public and Preventive Health, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Leah E Robinson
- School of Kinesiology, University of Michigan, 830 North University, Ann Arbor, MI, 48109-1048, USA
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