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Chung YL. Effective and appropriate use of weight loss medication in pediatric obesity: a narrative review. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2024; 41:158-165. [PMID: 38952016 PMCID: PMC11294794 DOI: 10.12701/jyms.2024.00353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 07/03/2024]
Abstract
Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.
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Affiliation(s)
- Yoojin Lindsey Chung
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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Lee MS. The prevalence and prevention strategies of pediatric obesity: a narrative review. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2024; 41:141-149. [PMID: 38965682 PMCID: PMC11294797 DOI: 10.12701/jyms.2024.00346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 07/06/2024]
Abstract
Pediatric obesity has rapidly increased globally over the past few decades, including in Korea. We aimed to discuss trends in the prevalence of pediatric obesity and effective prevention strategies. Its prevalence has markedly increased in most high-income nations. According to recent reports, this increase has slowed in developed countries, but the levels remain alarmingly high. In Korea, the rate of pediatric obesity has surged notably since the 1990s; however, since the 2000s, this increase has become more gradual. According to recently published 2017 growth charts, the prevalence of pediatric obesity in Korea varies slightly depending on the data source. The National School Health Examination data showed that pediatric obesity gradually increase from 11.5% in 2014 to 15.1% in 2019, and after the coronavirus disease 2019 pandemic, it sharply increased to 19% in 2021. Based on data from the Korea National Health and Nutrition Examination Survey, the prevalence of pediatric obesity gradually increased from 10.8% in 2017 to 13.6% in 2019. This trend, which accelerated sharply to 15.9% in 2020 and 19.3% in 2021, was especially severe in boys and older children. Pediatric obesity not only affects health during childhood but also increases the risk of developing obesity and associated health conditions in adulthood. Despite ongoing research on treatment options, obesity prevention and control remain challenging. Hence, prioritizing early intervention and prevention of pediatric obesity through healthy eating habits and lifestyles is crucial. This requires intervention at the individual, family, school, and community levels.
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Affiliation(s)
- Mi Seon Lee
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Korea
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Park H, Choi JE, Jun S, Lee H, Kim HS, Lee HA, Park H. Metabolic complications of obesity in children and adolescents. Clin Exp Pediatr 2024; 67:347-355. [PMID: 37986568 PMCID: PMC11222907 DOI: 10.3345/cep.2023.00892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 11/22/2023] Open
Abstract
The global prevalence of childhood and adolescent obesity, exacerbated by the coronavirus disease 2019 pandemic, affects school-aged children and preschoolers. Early-onset obesity, which carries a high risk of metabolic complications, may contribute to a lower age at the onset of cardiovascular disease. As metabolic diseases such as diabetes, dyslipidemia, and nonalcoholic fatty liver disease observed in adulthood are increasingly recognized in the pediatric population, there is an emphasis on moving disease susceptibility assessments from adulthood to childhood to enable early detection. However, consensus is lacking regarding the definition of metabolic diseases in children. In response, various indicators such as the pediatric simple metabolic syndrome score, continuous metabolic syndrome score, single-point insulin sensitivity estimator, and fatty liver index have been proposed in several studies. These indicators may aid the early detection of metabolic complications associated with pediatric obesity, although further validation studies are needed. Obesity assessments are shifting in perspective from visual obesity to metabolic health and body composition considerations to fill the gap in health impact assessments. Sarcopenic obesity, defined as the muscle- to-fat ratio, has been proposed in pediatric populations and is associated with metabolic health in children and adolescents. The National Health Screening Program for Children in Korea has expanded but still faces limitations in laboratory testing. These tests facilitate timely intervention by identifying groups at a high risk of metabolic complications. Early detection and intervention through comprehensive health screening are critical for mitigating long-term complications of childhood obesity.
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Affiliation(s)
- Hyunjin Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Jung Eun Choi
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Seunghee Jun
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hyelim Lee
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
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Noh ES, Hwang IT. Triglyceride-glucose-alanine aminotransferase index: A noninvasive serum predictor for identifying the severity of pediatric nonalcoholic fatty liver disease. Medicine (Baltimore) 2024; 103:e38241. [PMID: 38941428 DOI: 10.1097/md.0000000000038241] [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] [Indexed: 06/30/2024] Open
Abstract
We hypothesized that the triglyceride-glucose (TyG)-alanine aminotransferase (ALT) index, which combines the TyG index with ALT, may enhance sensitivity and specificity in detecting the severity of nonalcoholic fatty liver disease (NAFLD). A total of 131 NAFLD patients with a mean age of 11.5 ± 2.29 years were enrolled, and severity was assessed by ultrasound fatty liver index (US-FLI) scoring. The TyG-ALT index was defined as ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL] × ALT [IU/L]/2). Multiple linear regression analysis revealed a significant association between the TyG-ALT index and US-FLI (β = 0.317, P < .001) after controlling for sex, age, and body mass index. The TyG-ALT index showed a more stable and superior ability to detect the severity of NAFLD compared to both ALT and the TyG index. The area under the curve values, listed in the order of ALT, TyG index, and TyG-ALT index, were as follows: 0.737 (P < .001), 0.599 (P = .055), and 0.704 (P < .001) at US-FLI ≥ 4 points; 0.717 (P < .001), 0.720 (P < .001), and 0.775 (P < .001) at US-FLI ≥ 5 points; and 0.689 (P < .05), 0.748 (P < .01), and 0.775 (P < .001) at US-FLI ≥ 6 points. The TyG-ALT index is associated with US-FLI score and superior to both ALT and the TyG index in predicting NAFLD severity. These findings indicate the potential of the TyG-ALT index in the management of pediatric NAFLD progression.
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Affiliation(s)
- Eu-Seon Noh
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
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Lee NW, Kim YM, Kim YH, Kang SJ, Jang KM, Kim HS, Moon JE, Kim JK. Clinical characteristics and outcomes of COVID-19 in children and adolescents with diabetes in Daegu, South Korea. Ann Pediatr Endocrinol Metab 2024; 29:167-173. [PMID: 38956753 PMCID: PMC11220390 DOI: 10.6065/apem.2346124.062] [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: 05/29/2023] [Revised: 10/19/2023] [Accepted: 11/14/2023] [Indexed: 07/04/2024] Open
Abstract
PURPOSE Children with comorbidities have a higher risk of severe, coronavirus disease 2019 (COVID-19). This study investigated the clinical features and outcomes of COVID-19 in children and adolescents with diabetes between January and March 2022. METHODS We retrospectively reviewed the medical records of 123 children and adolescents (73 with type 1 diabetes and 50 with type 2 diabetes, 59 males and 64 females) aged <18 years who had been diagnosed with diabetes. Data were collected from 7 academic medical centers in Daegu, South Korea. RESULTS Thirty-five children with diabetes were diagnosed with COVID-19 (18 with type 1 and 17 with type 2 diabetes). Eighteen of the 35 children with diabetes and COVID-19 and 50 of the 88 children with diabetes alone received a COVID-19 vaccination. No significant differences were observed between patients with diabetes and COVID-19 and patients with diabetes alone in the type of diabetes diagnosed, sex, age, body mass index, hemoglobin A1c, or vaccination status. All children with diabetes and COVID-19 had mild clinical features and were safely managed in their homes. Fourteen children had a fever of 38℃ or higher that lasted for more than 2 days, 11 of whom were not vaccinated (p=0.004). None experienced post-COVID-19 conditions. CONCLUSION All children and adolescents with pre-existing diabetes had mild symptoms of COVID-19 due to low disease severity, high vaccination rates, uninterrupted access to medical care, and continuous glucose monitoring. Unvaccinated children with diabetes who experienced COVID-19 presented with higher and more frequent fevers compared to vaccinated children.
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Affiliation(s)
- Na-Won Lee
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
| | - You-Min Kim
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Young-Hwan Kim
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Seok-Jin Kang
- Department of Pediatrics, Keimyung University Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Kyung-Mi Jang
- Department of Pediatrics, Yeungnam University Hospital, Yeungnam University School of Medicine, Daegu, Korea
| | - Hae-Sook Kim
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
| | - Jung-Eun Moon
- Department of Pediatrics, Kyungpook University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jin-Kyung Kim
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
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Kim MJ, Kim M, Yoon JY, Cheon CK, Yoo S. The impacts of COVID-19 on childhood obesity: prevalence, contributing factors, and implications for management. Ann Pediatr Endocrinol Metab 2024; 29:174-181. [PMID: 38291761 PMCID: PMC11220391 DOI: 10.6065/apem.2346094.047] [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: 04/29/2023] [Revised: 07/21/2023] [Accepted: 08/14/2023] [Indexed: 02/01/2024] Open
Abstract
PURPOSE This study aimed to identify changes in the prevalence of obesity and related diseases among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic. METHODS This study was conducted using data from the 2016-2021 Korean National Health and Nutrition Examination Survey and included 3,861 children and adolescents aged 10-18 years. The prevalence of obesity and related diseases was adjusted for age, sex, and income. We also analyzed the socioeconomic, nutritional, and physical activity items in the survey. RESULTS During the COVID-19 pandemic, there was a significant increase in the prevalence of obesity (p=0.02), central obesity (p=0.001), mean body mass index (BMI, p=0.03), and hemoglobin A1c (p=0.005) among children and adolescents aged 10-18 years. The intake of food and calories was significantly reduced in the normal-weight group (p=0.001 and <0.001) but not in the obese group. Incidences of skipping breakfast increased and eating out decreased, regardless of obesity status. However, the changes in health behaviors were not significant. The prevalence of central obesity and increased BMI showed a significant linear association between children and their parents, especially in the 10-12-year-old age group. A clear increase in the proportion of metabolically unhealthy children and adolescents was observed in the obese group, and the frequency of central obesity in parents also increased. CONCLUSION The number of metabolically unhealthy, obese children and adolescents increased during the COVID-19 pandemic. Age-specific strategies that consider growth, development, and genetic and social factors are required. Health strategies targeting the entire family are required to develop healthier habits.
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Affiliation(s)
- Min-Ji Kim
- Division of Pediatric Endocrinology, Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Korea
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Minji Kim
- Division of Pediatric Endocrinology, Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Korea
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Ju Young Yoon
- Division of Pediatric Endocrinology, Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Korea
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Chong Kun Cheon
- Division of Pediatric Endocrinology, Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Korea
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Sukdong Yoo
- Division of Pediatric Endocrinology, Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Korea
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
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Lee JY, Moon S, Cho SH, Kim H, Kang HJ, Kim SY, Ryu S, Kim JM, Shin IS, Kim SW. The Relationship Between Fast Food Consumption and Daily Lifestyle Changes During School Closures Following the COVID-19 Pandemic: A Cross-Sectional Study Among Adolescents in Korea. Psychiatry Investig 2024; 21:610-617. [PMID: 38960438 PMCID: PMC11222073 DOI: 10.30773/pi.2023.0283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/12/2023] [Accepted: 03/15/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE Increased fast food consumption can have adverse effects on health and well-being among adolescents, posing a significant public health concern. The school closures due to the coronavirus disease-2019 (COVID-19) pandemic have led to changes in eating patterns and disrupted a balance diet among adolescents. This study explored the factors associated with fast food consumption among adolescents during school closures due to the COVID-19 pandemic. METHODS A total of 1,710 middle and high school students in Gwangju, South Korea participated in a cross-sectional survey. The self-administered questionnaire included items assessing dietary intake, physical activity, sleep, media use, and sociodemographic information. The Patient Health Questonnaire-9, Generalized Anxiety Disorder-7, and three item version of the UCLA Loneliness Scale were also administered. Multivariable logistic regression was used to examine the factors associated with increased fast food consumption. RESULTS Approximately 34.6% of the surveyed adolescents reported increased fast food consumption during school closures, as well as increased sleep duration, increased sedentary behaviors including watching TV and using the internet, and reduced physical activity. Multivariable logistic regression analysis revealed that fast food consumption during school closures was associated with irregular patterns of main meals and sleep, decreased physical activity, increased internet use, and a lack of daytime adult supervision. CONCLUSION Our results highlight the need for dietary and lifestyle monitoring and guidelines to promote health among adolescents, especially during school closures. In conclusion, nutrition intervention programs aiming to limit fast food consumption and enhance healthy dietary habits among adolescents during long-term school closures are warranted.
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Affiliation(s)
- Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
- Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Shinhyun Moon
- Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Seo-Hyun Cho
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
- Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
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Woods N, Seabrook JA, Schaafsma H, Burke S, Tucker T, Gilliland J. Dietary Changes of Youth during the COVID-19 Pandemic: A Systematic Review. J Nutr 2024; 154:1376-1403. [PMID: 38408731 PMCID: PMC11007747 DOI: 10.1016/j.tjnut.2024.02.022] [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: 10/26/2023] [Revised: 01/24/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has taken the lives of millions and disrupted countless more worldwide. Simply living through the pandemic has had drastic effects on the health of citizens. Diet, an important aspect of health, has been uniquely affected by the pandemic, although these changes have not been sufficiently studied among youth. OBJECTIVES The objective of this systematic review was to investigate dietary changes of youth during COVID-19. METHODS A prespecified literature review was conducted using MEDLINE, EMBASE, Scopus, and CINAHL to identify studies from January 2020 to May 2023 that assessed dietary changes among youth aged ≤20 y compared with before the pandemic. Only quantitative observational studies that were published in English were included. Two authors completed all screening/study selection independently, with disagreements being resolved via discussion. Data extraction was completed by 1 author. Dietary changes were categorized into food groups and habits for analysis purposes. RESULTS In total, 67 studies met inclusion criteria. Most studies used recall to assess changes (48/67; 71.6%). Most studies found an increase in fruits and vegetables (24/46; 52.2%), grain products (6/11; 54.5%), meat, poultry, and eggs (4/8, 50.0%), diet quality indices and/or overall dietary assessments (7/13, 53.8%), and the frequency of snacking (9/12; 75.0%), whereas generally finding a decrease in ultraprocessed foods (32/53; 60.4%), compared with before the COVID-19 pandemic. Mixed findings or primarily no changes were found for fish and aquatic products, legumes, beans, seeds and nuts, milk and milk products, breakfast consumption, and nutrient intake. CONCLUSIONS Mostly favorable dietary changes appear to have occurred among youth during COVID-19, although there were several mixed findings and unclear takeaways among the foods and habits under study. The heterogeneity of defining food groups was a noted limitation in the current review.
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Affiliation(s)
- Nicolas Woods
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
| | - Jamie A Seabrook
- Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Department of Epidemiology & Biostatistics, the University of Western Ontario, London, Ontario, Canada; School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, the University of Western Ontario, London, Ontario, Canada.
| | - Holly Schaafsma
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
| | - Shauna Burke
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
| | - Trish Tucker
- Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; School of Occupational Therapy, the University of Western Ontario, London, Ontario, Canada.
| | - Jason Gilliland
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Department of Epidemiology & Biostatistics, the University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, the University of Western Ontario, London, Ontario, Canada; Department of Geography and Environment, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
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Ra JS, Huyen DTT. Combined effects of sugar-sweetened beverage consumption, screen-based sedentary behavior, and sleep duration on South Korean adolescent obesity: a cross-sectional study. CHILD HEALTH NURSING RESEARCH 2024; 30:77-86. [PMID: 38712457 PMCID: PMC11082505 DOI: 10.4094/chnr.2023.057] [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: 11/22/2023] [Revised: 12/30/2023] [Accepted: 01/09/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE This study examined the combined effects of sugar-sweetened beverage (SSB) consumption, screen-based sedentary behaviors, and sleep duration on adolescent obesity. METHODS It followed a cross-sectional study design and conducted secondary analysis on data from 20,497 high school students who participated in the 17th (2021) Korea Youth Risk Behavior Web-based Survey. This study underwent logistic regression analysis in complex sampling analysis. RESULTS The combinations of low and medium consumption of SSBs, excessive screen-based sedentary behaviors, and short sleep durations were associated with a 1.18 and 1.12 fold increased likelihood of obesity (95% confidence interval [CI]=1.03-1.35) and (95% CI=1.02-1.22), respectively. The combination of high SSB consumption, appropriate screen-based sedentary behaviors, and short sleep duration (adjusted odds ratio [aOR]=1.15, 95% CI=1.01-1.31) and high SSB consumption, excessive screen-based sedentary behaviors, and short sleep duration (aOR=1.40, 95% CI=1.16-1.69) were associated with obesity. CONCLUSION Integrated and tailored programs considering combination patterns of SSB consumption, screen-based sedentary behaviors, and short sleep duration need to be developed for preventing adolescent obesity.
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Affiliation(s)
- Jin Suk Ra
- Professor, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Do Thi Thu Huyen
- Graduate Student, College of Nursing, Chungnam National University, Daejeon, Korea
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Kim C, Lee H, Jung-Choi K, Park H. Changes in Adolescent Health Behavior and the Exacerbation of Economic Hardship During the COVID-19 Pandemic: A Cross-sectional Study From the Korea Youth Risk Behavior Survey. J Prev Med Public Health 2024; 57:18-27. [PMID: 38327013 PMCID: PMC10861325 DOI: 10.3961/jpmph.23.306] [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: 07/06/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents. METHODS We analyzed data from the 2021 Korea Youth Risk Behavior Survey and included 44 908 students (22 823 boys and 22 085 girls) as study subjects. The dependent variables included changes in health behaviors (breakfast habits, physical activity, and alcohol use) that occurred during the COVID-19 pandemic. The aggravation of economic hardship by COVID-19 and the subjective economic status of the family were used as exposure variables. Multiple logistic regression analysis was utilized to calculate the prevalence odds ratios (PORs). RESULTS Severe exacerbation of a family's economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents, including increased breakfast skipping (POR, 1.85; 95% confidence interval [CI], 1.55 to 2.21 for boys and POR, 1.56; 95% CI, 1.27 to 1.92 for girls) and decreased physical activity (POR, 1.37; 95% CI, 1.19 to 1.57 for boys and POR, 1.38; 95% CI, 1.19 to 1.60 for girls). These negative changes in health behaviors were further amplified when combined with a low subjective family economic status. CONCLUSIONS The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.
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Affiliation(s)
- Chaeeun Kim
- Ewha Womans University College of Medicine, Seoul, Korea
| | - Haeun Lee
- Ewha Womans University College of Medicine, Seoul, Korea
| | - Kyunghee Jung-Choi
- Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Graduate Program in Health System Science & Engineering, Ewha Womans University College of Medicine, Seoul, Korea
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Cheon CK. Commentary on "Glycemic control and complications of type 2 diabetes mellitus in children and adolescents during the COVID-19 outbreak". Ann Pediatr Endocrinol Metab 2023; 28:233-234. [PMID: 38173378 PMCID: PMC10765030 DOI: 10.6065/apem.2322107edi009] [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: 01/05/2024] Open
Affiliation(s)
- Chong Kun Cheon
- Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University School of Medicine, Yangsan, Korea
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12
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Kim S, Song K, Lee M, Suh J, Chae HW, Kim HS, Kwon A. Trends in HOMA-IR values among South Korean adolescents from 2007-2010 to 2019-2020: a sex-, age-, and weight status-specific analysis. Int J Obes (Lond) 2023; 47:865-872. [PMID: 37443273 PMCID: PMC10439007 DOI: 10.1038/s41366-023-01340-2] [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: 11/01/2022] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND/OBJECTIVES An increase in obesity prevalence may lead to an increase in the HOMA-IR value. This study aimed to investigate changes in age- and sex-specific homeostasis model assessment of insulin resistance (HOMA-IR) values among South Korean adolescents, using data from the Korean National Health and Nutrition Examination Survey (KNHANES) IV, V, and VIII conducted between 2007-2010 and 2019-2020. SUBJECTS/METHODS Overall, 4621 adolescents aged 10-18 years were evaluated, including 3473 from the 2007-2010 dataset and 1148 from the 2019-2020 dataset. The mean HOMA-IR values and percentile curves were evaluated by age, sex, and weight status. RESULTS The mean HOMA-IR values peaked at puberty in both sexes and further increased during puberty in the 2019-2020 dataset (boys 5.21, 95% confidence interval [CI] 4.16-6.26; girls 5.21, 95% CI 3.09-7.33) compared with the 2007-2010 dataset (boys 3.25, 95% CI 3.04-3.47; girls 3.58, 95% CI 3.31-3.85). Both groups (with normal-weight and overweight/obesity) exhibited a peak HOMA-IR value during puberty in both sexes and both datasets, although the group with overweight/obesity had a higher and wider peak age range. While the mean HOMA-IR values did not change in adolescents with normal-weight, they increased during puberty and post-puberty in boys with overweight/obesity. CONCLUSIONS HOMA-IR values should be interpreted considering sex, weight status, and pubertal stages. In particular, during the pubertal period, insulin resistance (IR) can coexist not only due to weight-related factors but also as a result of the distinct hormonal changes characteristic of puberty. Over the 10-year period, the mean HOMA-IR values increased in the group with overweight/obesity during puberty and post-puberty, highlighting the need for active intervention to prevent metabolic complications in adolescents with overweight/obesity.
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Affiliation(s)
- Sujin Kim
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Kyungchul Song
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Myeongseob Lee
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Junghwan Suh
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Ahreum Kwon
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
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Kim MR, Jung MK, Yoo EG. Slower progression of central puberty in overweight girls presenting with precocious breast development. Ann Pediatr Endocrinol Metab 2023; 28:178-183. [PMID: 35798297 PMCID: PMC10556445 DOI: 10.6065/apem.2244062.031] [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: 02/26/2022] [Revised: 04/29/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Overweight (OW)/obese girls tend to have an earlier pubertal onset than girls with normal weight. However, only a few studies have reported the progression of puberty in these girls. This study aimed to identify risk factors for rapid pubertal progression in OW/obese girls presenting with precocious breast development. METHODS This retrospective cohort study reviewed the medical records of 110 OW (body mass index [BMI] ≥85th percentile for age and sex) and 213 nonoverweight (NW, BMI <85th percentile for age and sex) girls who presented with breast budding before 8 years of age. OW girls were divided into 2 subgroups: girls with central puberty progression before 9 years of age (OW-RP) and those without (OW-SP). RESULTS Progression to central puberty before the age of 9 was more common in NW girls than in OW girls (83.8 % vs. 65.2 % in NW vs. OW group, p<0.001), and progression-free survival for 1, 2, and 3 years was higher in the OW group (p<0.001). In a subgroup analysis of OW girls, the OW-RP subgroup had more advanced bone age (BA) at the first visit (p=0.047) and higher initial luteinizing hormone (LH, p=0.010) levels than the OW-SP subgroup. Being NW (p=0.001) and having more advanced BA (p=0.023) at the initial workup were the risk factors for pubertal progression before age 9. CONCLUSION Pubertal progression seems to be slower in OW girls than in NW girls presenting with precocious breast development. However, it can progress rapidly in OW girls with particularly pronounced BA advancement and high LH levels at the initial workup.
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Affiliation(s)
- Mi Ra Kim
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Mo Kyung Jung
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Eun-Gyong Yoo
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Choi Y, Kim S, Lee M, Lee HI, Song K, Suh J, Chae HW, Kim HS, Kwon A. Effect of catch-up sleep on obesity in Korean adolescents: a nationwide cross-sectional study. Front Pediatr 2023; 11:1213558. [PMID: 37565249 PMCID: PMC10410257 DOI: 10.3389/fped.2023.1213558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/04/2023] [Indexed: 08/12/2023] Open
Abstract
Background Adolescents have weekday/weekend sleep discrepancies and may compensate for weekday sleep debt through sleep extension on weekends. Objective We investigated the effects of total sleep duration on weekdays/weekends on obesity and determined if weekend catch-up sleep has an ameliorating effect on obesity in Korean adolescents. Methods Using data from the KNHANES VII, 1,306 middle and high school students were assessed for total sleep duration on weekdays, weekends, and the entire week, as well as weekend sleep extension. Participants were classified into four groups according to weekend sleep extension. Results Total sleep duration and weekend sleep duration were negatively associated with body mass index z-score. Increased weekend sleep duration and sleep extension on weekends decreased the relative risk of overweight/obesity with each 30 min increment, reducing the risk by a factor of 0.39 and 0.93, respectively. The risk of overweight/obesity in adolescents who slept less than 6 h on weekdays increased by a factor of 1.93 when they slept for less than 3 h on weekends. Conclusion Weekend catch-up sleep had a negative dose-dependent association with obesity in Korean adolescents. Sleeping longer on weekends may be associated with a decreased risk of obesity, even if the adolescent obtains less sleep during weekdays. However, further prospective studies are needed to establish the causality between extended weekend sleep and obesity.
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Affiliation(s)
- Youngha Choi
- Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Sujin Kim
- Department of Pediatrics, Severance Children’s Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myeongseob Lee
- Department of Pediatrics, Severance Children’s Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae In Lee
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea
| | - Kyungchul Song
- Department of Pediatrics, Severance Children’s Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junghwan Suh
- Department of Pediatrics, Severance Children’s Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Severance Children’s Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children’s Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ahreum Kwon
- Department of Pediatrics, Severance Children’s Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Zaccagni L, Rinaldo N, Mazzoni G, Mandini S, Masotti S, Toselli S, De Luca F, Gualdi-Russo E. Assessing the Impact of COVID-19 Prevention Measures on Adolescent Growth in Italy. Healthcare (Basel) 2023; 11:2101. [PMID: 37510542 PMCID: PMC10379597 DOI: 10.3390/healthcare11142101] [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: 06/27/2023] [Revised: 07/18/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
COVID-19 infection has caused increased morbidity and mortality worldwide. Several strategies have been adopted around the world to prevent its spread. Italy underwent a long lockdown for face-to-face educational activities, which were replaced with online classes. This longitudinal study aimed to analyze the effects of COVID-19 prevention measures on physical growth and body image perception in a sample of Italian adolescents who experienced the pandemic-induced lockdown in 2020. In particular, we wished to ascertain how lifestyle changes had affected their growth rates and health. Special attention was paid to increases in adiposity indicators (BMI, waist circumference, waist-to-height ratio) and weight caused by reduced physical activity, and consequent possible dissatisfaction with body image. We assessed the impact of school closures by comparing the annual growth rate and body image perception changes of adolescents (n = 60; age = 11.3 ± 0.4 years) who experienced this isolation with those in the following years who did not experience these restrictions (n = 68; age = 11.4 ± 0.3 years). As a consequence of the lockdown, our results indicate a greater annual growth rate in weight and other indices of adiposity (p < 0.05). As the virus is continuing to evolve and propagate, larger population studies can verify and confirm our findings. In promoting health policy to prevent the ongoing prevalence of obesity in adolescents, an accurate assessment of whether the increase in obesity rates during the pandemic is to be considered a temporary trend is highly recommended.
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Affiliation(s)
- Luciana Zaccagni
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Natascia Rinaldo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Gianni Mazzoni
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Simona Mandini
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Sabrina Masotti
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Stefania Toselli
- Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Federica De Luca
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
| | - Emanuela Gualdi-Russo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d'Este 32, 44121 Ferrara, Italy
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16
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Choi JE, Lee HA, Park SW, Lee JW, Lee JH, Park H, Kim HS. Increase of Prevalence of Obesity and Metabolic Syndrome in Children and Adolescents in Korea during the COVID-19 Pandemic: A Cross-Sectional Study Using the KNHANES. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1105. [PMID: 37508602 PMCID: PMC10378374 DOI: 10.3390/children10071105] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023]
Abstract
(1) Background: The aim of this study was to evaluate the prevalence of obesity and metabolic syndrome since the COVID-19 pandemic outbreak utilizing representative data on youth aged 2-18 years from the Korean National Health and Nutrition Examination Surveys (KNHANES) conducted in 2019-2020. (2) Methods: The survey consists of three parts: health interviews, health examinations, and nutrition surveys. From the 2019 and 2020 surveys, 1371 (2-9 years = 702 and 10-18 years = 669) and 1124 (2-9 years = 543 and 10-18 years = 581) individuals were included in the analysis. (3) Results: The mean body mass index (BMI) increased significantly among youth aged 2-9 years from 16.53 kg/m2 in 2019 to 17.1 kg/m2 in 2020 (p < 0.01). In youth aged 10-18 years, the BMI was found to increase slightly from 21.25 kg/m2 in 2019 to 21.41 kg/m2 in 2020 (p = 0.64). The increasing prevalence of extreme obesity was significant in girls, especially those aged 2-9 years (p < 0.01). However, extreme obesity had increased in 10-18-year-old boys (p = 0.08). The overall prevalence of metabolic syndrome in adolescents increased from 3.79% to 7.79% during the COVID-19 pandemic (p = 0.01). (4) Conclusions: We observed that the prevalence of obesity and metabolic syndrome among children and adolescents has increased after the COVID-19 outbreak. This is believed to be associated with an increase in the rate of early comorbidities in adulthood. The prevention of the progression of pediatric obesity has recently become an urgent public health concern in Korea.
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Affiliation(s)
- Jung Eun Choi
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul 07985, Republic of Korea
| | - Sung Won Park
- Department of Pediatrics, MizMedi Hospital, Seoul 07639, Republic of Korea
| | - Jung Won Lee
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Ji Hyen Lee
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Hyesook Park
- Graduate Program in System Health Science and Engineering, Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Hae Soon Kim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
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17
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Yoon JS, Lim KJ, Hwang IT. Usefulness of two-dimensional shear wave elastography in the assessment of non-alcoholic fatty liver disease in children and adolescents. Sci Rep 2023; 13:10062. [PMID: 37344574 DOI: 10.1038/s41598-023-37281-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/19/2023] [Indexed: 06/23/2023] Open
Abstract
Two-dimensional shear wave elastography (2D-SWE) evaluates liver stiffness using a non-invasive method, but studies in the paediatric population are rare. This study evaluated the role of 2D-SWE in the diagnosis and severity of paediatric non-alcoholic fatty liver disease (NAFLD). In total, 131 patients with NAFLD and 25 healthy controls were enrolled in this study. The diagnosis and severity of NAFLD were initially assessed using the ultrasound fatty liver index (US-FLI), and all participants underwent 2D-SWE. US-FLI semi-quantitatively measures the severity of NAFLD on a scale of 2-8. The assessment of liver stiffness measurement (LSM) by 2D-SWE is presented in kilopascals (kPa). The NAFLD group was characterised by significantly higher LSM (4.40 ± 0.90 kPa) than the control group (3.76 ± 0.28 kPa) (P < 0.001). 2D-SWE significantly correlated with age, height, weight, body mass index, glucose, aspartate aminotransferase, alanine aminotransferase, high-density lipoprotein cholesterol, US-FLI, and triglyceride-glucose index (P < 0.001). In the receiver operating characteristic curve analysis, the area under the curve of LSM for predicting US-FLI ≥ 2 and ≥ 6 was 0.784 (P < 0.001) and 0.819 (P < 0.001), respectively. In conclusion, we suggest that 2D-SWE can be used as a non-invasive diagnostic tool for diagnosing and assessing the severity of paediatric NAFLD.
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Affiliation(s)
- Jong Seo Yoon
- Department of Paediatrics, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Kyoung Ja Lim
- Department of Radiology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, 05355, South Korea.
| | - Il Tae Hwang
- Department of Paediatrics, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
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18
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Lee MS, Kim DJ, Lee H. Trends in health behaviors and mental health among Korean adolescents in Korea over 5 years, 2017-2021: focusing on the comparisons before and during the COVID-19 pandemic. Front Public Health 2023; 11:1139110. [PMID: 37139372 PMCID: PMC10149801 DOI: 10.3389/fpubh.2023.1139110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Objectives We investigated recent trends in health behaviors and mental health conditions among Korean adolescents from 2017 to 2021 and compared the changes before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods Data analysis was conducted on 289,415 adolescents participating in the Korea Youth Risk Behavior Web-Based Survey, an annual cross-sectional study from 2017 to 2021. All analysis was conducted using sex stratification, and the annual percentage change (APC) was calculated. Results Alcohol consumption and smoking decreased in the first year of the COVID-19 pandemic compared with before, except for girls from the low-income level. The prevalence of inadequate physical activity for both boys and girls increased in 2020 compared with the pre-COVID-19 period and decreased again by 2021. The prevalence of obesity in both sexes increased regardless of the period (boys, APC = 8.2%, 95% confidence intervals (CI), 6.4-10.1; girls, APC = 3.3%, 95% CI, 1.8-4.8). The prevalence of stress, depression, and suicidal ideation, plans, and attempts for both sexes decreased in 2020 compared to the pre-COVID-19 period. By 2021, this prevalence had returned to a level similar to before the pandemic. No significant APC changes were observed in the prevalence of mental health. Conclusions These findings demonstrate the trends and APCs in health behaviors and mental health conditions among Korean adolescents over the last 5 years. We must pay attention to the heterogeneous and multifaceted features of the COVID-19 pandemic.
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Affiliation(s)
- Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Jun Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Public Health, Graduate School, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hooyeon Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Public Health, Graduate School, The Catholic University of Korea, Seoul, Republic of Korea
- *Correspondence: Hooyeon Lee
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