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Bakhoda MR, Haghighat Lari MM, Khosravi G, Khademi Z, Abbasi F, Milajerdi A. Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and meta-analysis. BMC Oral Health 2024; 24:966. [PMID: 39164714 PMCID: PMC11334321 DOI: 10.1186/s12903-024-04733-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 08/09/2024] [Indexed: 08/22/2024] Open
Abstract
INTRODUCTION Earlier studies reported inconsistent findings for the association of childhood obesity with the risk of dental caries. In this systematic review and meta-analysis, we aimed to summarize earlier studies on the association of overweight and obesity with risk of dental caries in children. METHODS Relevant studies published up to December 2023 were identified through searches in PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar, using suitable keywords. All observational studies, including cross-sectional or cohort or case-control studies, about the association of each obesity index with risk of dental caries in children which reported odds ratio (OR), hazard ratio (HR), or relative risk (RR) and 95% CIs, were included. Studies involving adults, randomized clinical trials, studies on animals or pregnant women, and studies on other dental disorders were excluded. Risk of bias was assessed using standard methods for observational studies. A total of 22 studies including 40673 participants were included. Studies were pooled using the random-effect model, and results were synthesized with subgroup analyses and assessments of heterogeneity. Limitations included potential publication bias and heterogeneity among study designs. The quality of the included studies was assessed using the Newcastle-Ottawa scale (NOS). RESULTS Children at the highest category of BMI were 44% more likely to have early childhood caries (ECC) than those at the bottom (OR: 1.44; 95% CI: 1.16 to 1.78). Moreover, combined analysis also showed no significant association between waist circumference (WC) and risk of dental caries in children. However, significant linear and non-linear associations were found between BMI and risk of childhood dental caries. No publication bias was found for the relationship between BMI and the risk of ECC based on visual inspection of a funnel plot and Egger's test. CONCLUSIONS This study showed a significant direct association between BMI and the risk of dental caries in children. Non-linear analysis showed higher risk of dental caries in children with higher BMI and also among underweight children. Further prospective studies are required to expand current knowledge in this issue. IMPACT STATEMENT The findings of this study have significant implications for public health and dental care, suggesting association between BMI and the risk of dental caries in children. This comprehensive meta-analysis is among the first to summarize earlier publications on the association of obesity with risk of dental caries in children, highlighting the need for more accurate methods of obesity assessment and further research to understand this relationship better. These findings can help inform public health policies and interventions to reduce the prevalence of childhood obesity and dental caries.
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Affiliation(s)
- Mohammad Reza Bakhoda
- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Mehdi Haghighat Lari
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Zeinab Khademi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abbasi
- Department of Sport Injuries, Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.
- Department of Health, School of Medicine, AJA University of Medical Sciences, Tehran, Iran.
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Dastgerdizad H, Dombrowski RD, Bode B, Knoff KAG, Kulik N, Mallare J, Kaur R, Dillaway H. Community Solutions to Increase the Healthfulness of Grocery Stores: Perspectives of Immigrant Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6536. [PMID: 37569076 PMCID: PMC10418834 DOI: 10.3390/ijerph20156536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
Grocery store environments are recognized as one of the most crucial community settings for developing and maintaining healthy nutritional behaviors in children. This is especially true for disadvantaged ethnic minority families, such as immigrants, who reside in the Detroit Metropolitan area and have historically experienced inequities that result in poor health outcomes. Rates of obesity and type II diabetes have affected Detroit 38% more than the rest of the state and nationwide. In 2019, almost 54% of children aged 0-17 in Metro Detroit lived in poverty, and 21.6% experienced food insecurity, compared with the state level of 14.2%. Moreover, nearly 50% of ethnic minority children in Metro Detroit consume sports drinks, and 70% consume soda or pop in an average week. The primary purpose of this study was to explore immigrant parents' perspectives on (1) how in-store Sugar-Sweetened Beverage (SSB) marketing impacts the purchasing behaviors of parents and the eating behaviors of toddlers, and the secondary objective was to (2) determine strategies to reduce SSB purchases and consumption within grocery environments from the viewpoints of immigrant parents. A qualitative multiple-case study design was used to achieve the aims of this study. Semi-structured individual interviews were completed with 18 immigrant parents of children aged 2 to 5 years old who were consumers in 30 independently owned full-service grocery stores within the immigrant enclaves of Detroit, Dearborn, Hamtramck, and Warren, Michigan. Three key thematic categories emerged from the parents' narratives. These themes were: (1) non-supportive grocery store environments; (2) acculturation to the American food environment; and (3) strategies to support reduced SSB consumption among young immigrant children. The findings of this study revealed widespread SSB marketing targeting toddlers within the participating independently owned grocery stores. Even if families with young children practiced healthy nutritional behaviors, the prices, placements, and promotion of SSBs were challenges to establishing and sustaining these healthy eating habits. The parents believed that planning and implementing retail-based strategies in collaboration with families and considering families' actual demands would assist in managing children's eating patterns and reducing early childhood obesity.
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Affiliation(s)
- Hadis Dastgerdizad
- Department of Public Health, University of South Carolina, Bluffton, SC 29909, USA
| | - Rachael D. Dombrowski
- Departments of Public Health and Kinesiology, College of Education, Health and Human Services, California State University-San Marcos, San Marcos, CA 92096, USA;
| | - Bree Bode
- Michigan Fitness Foundation, Lansing, MI 48314, USA;
| | - Kathryn A. G. Knoff
- Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA 22314, USA;
| | - Noel Kulik
- Center for Health and Community Impact, Division of Kinesiology, Health & Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA;
| | - James Mallare
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48202, USA;
| | - Ravneet Kaur
- Division of Health Research and Evaluation, Department of Family and Community Medicine, College of Medicine, University of Illinois, Rockford, IL 61107, USA;
| | - Heather Dillaway
- Department of Sociology and Anthropology, Illinois State University, Normal, IL 61790, USA;
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Role of obesity and blood pressure in epicardial adipose tissue thickness in children. Pediatr Res 2022; 92:1681-1688. [PMID: 35322187 DOI: 10.1038/s41390-022-02022-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Elevated body mass index (BMI) has been associated with cardiac changes, such as higher epicardial adipose tissue (EAT) thickness. This fat has been identified as a predictive factor of cardiovascular diseases during adulthood. However, few studies have tested the association of multiple cardiovascular risk factors (high weight or blood pressure) with EAT in adolescents and children. Therefore, the main objective of this current research was to determine the impact of BMI, overweight, obesity, and blood pressure on EAT thickness in children. METHODS A descriptive cross-sectional study focused on elementary and high school students aged 6-16 years was carried out by utilizing diverse measurements and instruments, such as echocardiography. RESULTS EAT thickness (N = 228) was linked to sex (more predominant in boys 2.3 ± 0.6; p = 0.044), obesity (2.3 ± 0.6; p < 0.001), and hypertension (2.6 ± 0.6; p = 0.036). The logistic regression indicated that age, sex, and BMI seemed to be more relevant factors in EAT thickness in children (adjusted R square = 0.22; p < 0.001). CONCLUSIONS This paper examined the associations of sex, age, and cardiovascular risk factors (arthrometric measures and blood pressure) with EAT thickness, indicating that it is necessary to assess whether the findings are associated with future events. IMPACT Excessive weight gain and blood pressure in the early stages of life have been associated with adipose tissue. This increase in weight and blood pressure has been attributed to alterations in the epicardial adipose tissue linked to anthropometric markers in adults, but no related study has been implemented in Spanish children. This study revealed how higher epicardial adipose tissue is linked to body mass index, other anthropometric parameters, and blood pressure in Spanish children. These measurements are related to high epicardial adipose tissue thickness, which in early stages does not imply pathology but increases the risk of developing cardiovascular diseases.
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Traver-Ferrando C, Barcia-González J. Early permanent dental eruption in obese/overweigh schoolchildren. J Clin Exp Dent 2022; 14:e199-e204. [PMID: 35173904 PMCID: PMC8842294 DOI: 10.4317/jced.58568] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/20/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The WHO defines obesity as abnormal excessive fat accumulation. Indeed, it is the most relevant nutritional disorder in the developed countries. Nutrition turns out to be relevant for childhood development involving different systems and organs as and including teeth development. Prediction of teeth eruption results of relevance in odontopediatrics and more particularly at transitional stages with mixed dentition. Early teeth eruption can lead to dental defects and eventually to periodontal disease. In addition to this, obesity increases chronic periodontitis risk on teenagers and young-adults. Objectives: The aim of the work is to confirm the relation of weigh and dental eruption on six years old children. MATERIAL AND METHODS 519 six years old children were included on the analytic observational study. Clinical examination was conducted at school, weight and size was registered for BMI index (Kg/cm2). Permanent teeth presence was recorded during examination. RESULTS Overweight or obesity significantly doubles the probability to find both, the first permanent molars and the lower central incisors. In addition, we report herein a significant association between weight at birth and the first milk tooth eruption. CONCLUSIONS Early dental eruption is observed in obese/overweight school children compared to normal weigh children. Key words:Pediatric obesity, tooth eruption, permanent dentition.
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Affiliation(s)
- Carla Traver-Ferrando
- Department of Pediatric Dentistry, Catholic University of Valencia ¨San Vicente Mártir ¨
- Doctoral School, Catholic University of Valencia ¨San Vicente Mártir ¨
| | - Jorge Barcia-González
- Department of Anatomy and Physiology. Catholic University of Valencia ¨San Vicente Mártir ¨
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Trandafir LM, Cojocaru E, Moscalu M, Leon Constantin MM, Miron I, Mastaleru A, Teslariu O, Datcu ME, Fotea S, Frăsinariu O. Predictive Markers of Early Cardiovascular Impairment and Insulin Resistance in Obese Pediatric Patients. Diagnostics (Basel) 2021; 11:diagnostics11040735. [PMID: 33924229 PMCID: PMC8074748 DOI: 10.3390/diagnostics11040735] [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: 03/22/2021] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The increased prevalence of obesity among children determined the rising number of its comorbidities in children and adults, too. This study aimed to evaluate certain markers of inflammation and insulin resistance in obese pediatric patients, identifying those who are more likely to develop further complications. METHODS We included 115 obese pediatric patients: 85 overweight and obese patients in the study group and 30 normal-weight patients in the control group. We calculated the body mass index (BMI) and we evaluated markers (biological, inflammatory) and the hormones profile. RESULTS Low-threshold inflammation was assessed by measuring interleukin 6 IL-6 and Intercellular Adhesion Molecules (ICAM). The analysis showed that IL-6 is significantly correlated with glucose (p = 0.001) and BMI value (p = 0.031). ICAM correlates significantly with triglycerides (p = 0.001), glucose (p = 0.044) and BMI percentile (p = 0.037). For pediatric obese patients, endotoxemia has been significantly correlated only with BMI percentile (p = 0.001). Plasma cortisol did not show significant correlations with total cholesterol, triglycerides, glucose or BMI percentile. The results indicated a significant predictive power of BMI percentile on inflammatory markers: IL-6 (AUC = 0.803, p < 0.001), ICAM (AUC = 0.806, p < 0.001) and endotoxemia (AUC = 0.762, p = 0.019). Additionally, BMI percentile has a significant predictive power for metabolic markers of insulin resistance (insulin value: AUC = 0.72, p < 0.001 and HOMA index: AUC = 0.68, p = 0.003). CONCLUSIONS The study highlighted the importance of early markers of cardiovascular risk in obese pediatric patients represented by IL-6, ICAM, endotoxemia and their correlation with metabolic markers of insulin resistance represented by insulinemia, HOMA index and plasma cortisol. It can clearly be considered that the BMI percentile has significant predictive power for metabolic markers of insulin resistance.
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Affiliation(s)
- Laura Mihaela Trandafir
- Department of Mother and Child, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.M.T.); (I.M.); (O.T.); (O.F.)
| | - Elena Cojocaru
- Department of Morphofunctional Sciences I, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Mihaela Moscalu
- Department of Preventive Medicine and Interdisciplinarity, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: (M.M.); (M.M.L.C.)
| | - Maria Magdalena Leon Constantin
- Department of Medical Specialties I, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania;
- Correspondence: (M.M.); (M.M.L.C.)
| | - Ingrith Miron
- Department of Mother and Child, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.M.T.); (I.M.); (O.T.); (O.F.)
| | - Alexandra Mastaleru
- Department of Medical Specialties I, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania;
| | - Oana Teslariu
- Department of Mother and Child, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.M.T.); (I.M.); (O.T.); (O.F.)
| | - Madalina Elena Datcu
- Department of Biomedical Sciences, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Silvia Fotea
- Department of Medical Specialties, Dunarea de Jos University, 800216 Galati, Romania;
| | - Otilia Frăsinariu
- Department of Mother and Child, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.M.T.); (I.M.); (O.T.); (O.F.)
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Hammad SS, Berry DC. The Child Obesity Epidemic in Saudi Arabia: A Review of the Literature. J Transcult Nurs 2016; 28:505-515. [PMID: 27655934 DOI: 10.1177/1043659616668398] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To examine prevalence, nutrition and activity, and overweight and obesity prevention and management in Saudi Arabia. DESIGN Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria, PubMed, Web of Science, PyschINFO, Global Health, Family Studies Worldwide, Middle Eastern Studies, and Sociological Abstracts was searched from January 1, 2003 to January 31, 2016. Inclusion criteria included peer-reviewed articles published in Arabic and English that focused on prevalence, overweight or obesity in children 2 to 20 years of age, body mass index percentile, and interventions. FINDINGS Three themes were identified: epidemiological features, where the eastern region had the highest prevalence of overweight and obesity, risk factors, which included higher parental education, and lifestyle factors, which included increased consumption of calorie-dense food and a sedentary lifestyle. CONCLUSION Childhood obesity is increasing in Saudi Arabia at an alarming rate. IMPLICATIONS FOR PRACTICE Practitioners need to consider the cultural influences of the increasing obesity epidemic in Saudi Arabia.
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Affiliation(s)
- Sama S Hammad
- 1 The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Diane C Berry
- 1 The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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