Prevalence of Underweight, Overweight and Obesity in School-Aged Children in the Urban Area of the Northwestern Part of Romania

Status of Healthy Choices, Attitudes and Health Education of Children and Young People in Romania-A Literature Review

Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide insights that can shape targeted interventions, policies, and educational strategies to improve this demographic's overall health and well-being. Materials and Methods: For this study, we performed a literature review of original published papers on the health status, healthy habits, health education, predisposition to making healthy choices in the future, and accessibility to the paediatric health system of Romanian children and young people, as well as the effects of different types of educational interventions on this demographic in Romania. Results: The prevalence of dental caries is high in Romania. In terms of eating habits and nutritional status, a worrying proportion of children are overweight or obese, which can lead to a variety of future physical and psychological problems. In terms of physical activity, few adolescents demonstrate regular fitness practices. Romania presents an increase in alcohol and tobacco consumption among adolescents. The mental health of students has become a pressing public health concern, exacerbated by the COVID-19 pandemic. The use of social networks is linked to mental health issues among young people. Romania still has one of the highest rates of sexually transmitted diseases and faces a high incidence of cervical cancer, with a mortality rate three times higher than the EU average. High rates of teenage pregnancies are linked to limited information about sexuality and a lack of access to family planning at a young age. There are large discrepancies in the accessibility of medical services between urban and rural areas. Conclusions: Romania faces significant obstacles to providing high-quality healthcare to children and young people. Improving nutrition, immunisation rates, and access to medical services represent essential areas for enhancing the health of children and young people in Romania.

Characteristics of the Inflammatory Bowel Disease in Children: A Croatian Single-Centre Retrospective Study

Inflammatory bowel diseases (IBDs), encompassing ulcerative colitis (UC) and Crohn's disease (CD), are chronic gastrointestinal disorders often diagnosed in youth, presenting unique features compared to adult-onset cases. We aimed to profile pediatric IBD patients in Croatia through a retrospective analysis of children up to 18 years old diagnosed with IBD at the University Hospital of Split from 1 January 2012, to 31 December 2021, utilizing data collected during hospitalization for diagnosis. Over a decade, 107 children were diagnosed, with 43.9% having UC, 55.1% CD, and 0.9% IBD-unclassified. Median age at diagnosis was 14.1 years, with UC patients being older (14.8 vs. 13.7 years, p = 0.044). Males constituted 60.7% of patients. Median symptom duration was 2.0 months, with CD patients experiencing a longer diagnostic delay (3.0 vs. 2.0 months, p = 0.003). The median incidence rate was 9.89 (95% CI 5.93-13.84) per 100,000 children/year, varying across age groups. Median (IQR) BMI z-score was -0.34 (-0.97-0.45). Common symptoms included diarrhea (60.7%) and abdominal pain (50.5%), with rectal bleeding more prevalent in UC (72.3% vs. 32.2%, p < 0.001). While our study offers valuable insights into pediatric IBD in Croatia, further prospective research is needed to clarify disease progression and development.

Dyslipidemia in Pediatric Patients: A Cross-Sectional Study

There is an increasing interest in dyslipidemia in adult patients since it is known to contribute to early cardiovascular disease. Often, dyslipidemia starts in childhood, and it is associated with aggravating lifestyle choices concerning eating habits, such as the tendency to consume processed food and fast food, as well as the tendency to be more and more sedentary. We conducted a retrospective cross-sectional study describing the prevalence of dyslipidemia in a single medical center in Romania and the associated pathology. We evaluated all lipid profiles that were ordered in our clinic over nine years. We included 2413 patients that were evaluated in our clinic in the timeframe 2011-2020. Out of them, 18.23% had high values for LDL-cholesterol. More than a quarter (25.91%) were diagnosed with obesity. 11.37% of the patients with high LDL-cholesterol levels had various metabolic disorders including primary dyslipidemia. A small number of patients with hypercholesterolemia had thyroid disorders (4.10%). Patients with high LDL-cholesterol had various diagnoses ranging from metabolic to neurologic disorders, keeping in mind that there are multiple pathologies that can lead to dyslipidemia. Evaluating children for dyslipidemia is at hand for medical professionals. Screening for dyslipidemia in children would provide the opportunity to prevent rather than treat cardiovascular events.

Effect of 11 Weeks of Physical Exercise on Physical Fitness and Executive Functions in Children

Object: The aim of our study was to evaluate and compare the effects of physical exercise interventions on physical fitness and executive functions in children. Methods: Six-year-old children participated in the study and were randomly divided into physical exercise group (PE group, n = 43) and control group (C group, n = 46). The children in the PE group participated in a physical exercise program for 45 min daily, four days a week for 11 weeks. The children in the C group continued with their usual routines. Then, all the children were tested before and after the experiment for body composition (height, weight, BMI), physical fitness (20-m shuttle run test, standing long jump test, grip strength test, 4 × 10 m shuttle run test and sit and reach tests), and executive functions test (animal go/no-go task, working memory span task, simple reaction test and flexible item selection task) before and after the 11-week period. Results: The 11 weeks of physical exercise did not significantly affect the body composition of the children (p > 0.05). The physical fitness and executive functions test results showed that 11 weeks of physical exercise interventions improves physical fitness (cardiopulmonary fitness, muscle strength, speed sensitivity and flexibility quality) and executive functions parameters (inhibitory control, working memory, the reaction time, and cognitive flexibility) in children (p < 0.05, p < 0.01). Conclusion: 11 weeks of physical exercise can improve the physical fitness and executive functions of six-year-old children.

The COVID-19 Pandemic and the Prevalence of Childhood Obesity in Turkiye

OBJECTIVES

To examine the prevalence of overweight and obesity in school-age children in Isparta Province, Turkiye, during the coronavirus disease 2019 (COVID-19) pandemic, and to compare the results with those of previous studies conducted in Isparta in 2005, 2009, and 2014.

METHODS

The study was carried out in schools in the city center of Isparta in March 2022, during which the weight and height of students were measured using a scale and stadiometer, and the body mass indices (BMI), BMI percentiles, and z scores were calculated.

RESULTS

Of the 8871 students assessed, 4547 (51.3%) were female and the mean age of the sample was 11.92 ± 3.42 (6-18.93) years. The prevalence of overweight was 12%, the prevalence of obesity was 14.5%, and the prevalence of overweight + obesity was 26.5%. A comparison of the figures since 2005 revealed the prevalence of overweight to be stable, while the prevalence of obesity and the prevalence of overweight + obesity were found to have witnessed a increase (χ 2 : 57.01, P < 0.001). The prevalence of obesity was 13% among girls under 11 years of age and 14.3% among girls over 11 years of age; and 18.2% and 12.8% among boys under and over 11 years of age, respectively (χ 2 : 23.26, P < 0.001). The prevalence of obesity was significantly higher in boys under 11 years of age.

CONCLUSIONS

The prevalence of overweight + obesity was nearly stable in the 3 studies conducted over the 17-year period, but we witnessed an increase in our most recent study conducted during the pandemic. The prevalence of obesity is significantly higher in boys under 11 years of age.

Differences in Classification Standards For the Prevalence of Overweight and Obesity in Children. A Systematic Review and Meta-Analysis

The prevalence of childhood obesity has increased dramatically all over the world in recent years. While obesity in adults can be easily measured using the BMI calculation, determining overweight and obesity in children is more controversial. The aim was to compare the three most used international classification systems (WHO 2007, CDC 2000 and Cole-IOTF) to determine overweight and obesity in infant and adolescent populations. We performed a systematic review in accordance with the PRISMA 2020 guidelines of articles comparing any of the three classification systems. The main findings were that the WHO 2007 criteria show the highest prevalence of overweight and obesity in the child and youth population. The prevalence of childhood overweight and obesity was determined to be higher in boys than in girls in most studies, when analysing the classifications of the WHO 2007, CDC 2000 and Cole-IOTF together. However, there was a higher prevalence of overweight and obesity in girls than in boys when only the CDC 2000 and Cole-IOTF criteria were considered. Both the results of the review and the great heterogeneity found in the meta-analysis show that it is necessary to unify the criteria for the classification of childhood overweight and obesity. International standards are insufficient for working with the current population. A working group should be created to address this issue and agree on the unification of a gold standard, taking into account the geographical region, the ethnic groups and the age groups of the child and youth population and above all, the secular growth.

The Incidence of Body Posture Abnormalities in Relation to the Segmental Body Composition in Early School-Aged Children

Children are exposed to multiple factors that contribute to an increase in body mass and the development of posture defects. The aim of the study is to assess the relationship between the segmental distribution of fat mass and muscle mass and the incidence of body posture abnormalities in early school-aged children. A total of 190 children aged 7-9 were included in the research project. The examined children were divided according to age (class level) into three groups. Height, weight and body composition, BMI, and body posture were determined. Thoracic and lumbar spine abnormalities occurred most frequently in the examined children (7-95%, 8-92%, 9-89.5%). During the assessment of the segmental body composition, the lowest fat-fat-free index was found in the trunk. The number of abnormalities of the cervical spine, pelvis, and lower extremities increases with age. The number of abnormalities of the thoracic and lumbar spine, as well as of upper extremities and the pectoral girdle decreases with age. Body posture abnormalities are correlated with body composition and in particular with the fat mass percentage. The segmental body com-position analyzer can be used to screen for posture defects.

Assessment of Actual Weight, Perceived Weight and Desired Weight of Romanian School Children-Opinions and Practices of Children and Their Parents

Objective: Children and parental awareness regarding weight is linked to the development and management of overweight and obesity. The aim of this study is to assess the actual weight, perceived weight, and desired weight of Romanian school children. Methods: A cross-sectional study was conducted in 2019 in seven schools from two counties of Romania and included 880 pupils aged between 10 and 15 years old and 665 parents. We administrated confidential questionnaires to the participants, and we measured children’s weight and height during school activities. Results: A total of 61.0% of pupils had normal weight, 7.4% were underweight, and 31.6% were overweight or obese. A total of 66.7% of normal weight children, 56.5% of overweight children, and 40% of underweight children perceived their weight accurately. Regarding parents, a majority correctly appreciated the weight of their normal weight children and only a third appreciated correctly the body weight of their underweight and overweight children. Factors such as body mass index, gender, weight related behaviors, parents’ estimation about their children’s weight, discussions of weight topics inside family, and bullying, cyberbullying and exclusion from groups were associated with misperceptions. Conclusion: The study provides useful information for health education activities targeting both children and their parents regarding appropriate body weight management of children.

Obesity and Mitochondrial Function in Children: A case–control study

OBJECTIVES: Childhood obesity has increased over the past years worldwide. Therefore, changes in mitochondrial function as the risk factors of obesity in children need to consider. AIM: The study aimed to evaluate the connection between obesity and mitochondrial function in obese children. PATIENTS AND METHODS: This study was a case–control study conducted in the primary school children in Mosul city. The study included 100 children, with an age ranged from 6 to 12 years. Fifty child with obesity (BMI ≥ 95th percentile) for children enrolled in this work and compared to 50 control with BMI <95th percentile. Mitochondrial function assessed by measurement of serum lactic acid, lactate/pyruvate ratio, and L-carnitine and mt-DNA copy number. RESULTS: Serum lactate and the lactate/pyruvate ratio were significantly higher in obese children than in the control group, while serum pyruvate levels in children with obesity are not significantly different from those in the control group. Serum levels of L-carnitine and mt-DNA copy number significantly reduced in obese children comparison to the control group. CONCLUSION: Changes of mitochondrial function may be involved in obesity of children.