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Cucuzzella M, Bailes J, Favret J, Paddu N, Bradley AB. Beyond Obesity and Overweight: The Clinical Assessment and Treatment of Excess Body Fat in Children : Part 1 - Insulin Resistance as the Root Cause of Pediatric Obesity. Curr Obes Rep 2024; 13:276-285. [PMID: 38709471 DOI: 10.1007/s13679-024-00565-0] [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] [Accepted: 03/26/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE OF REVIEW Pediatric obesity and comorbidities related to insulin resistance continue to be a growing public health crisis. If lifestyle measures are unsuccessful, pharmacological and surgical interventions are offered. In this paper, we describe the driving force of the obesity crisis: hyperinsulinemia and the development of insulin resistance. We give historical background of key policy issues which have contributed to this pandemic as well as the physiologic mechanisms of insulin resistance. The prevalence of obesity will continue to rise unless the root cause of hyperinsulinemia is addressed. RECENT FINDINGS Current research on insulin resistance demonstrates that a decreased consumption of carbohydrates is an effective first-line dietary intervention for the treatment of obesity and related metabolic diseases. Evidence shows it is safe and beneficial. A low-carbohydrate eating pattern can be helpful to address pediatric obesity. However, there must be policy guardrails in place to ensure that this is a sustainable and viable option for children and their families. There must be a change in the nutritional environment to help individuals battle the chronic disease of obesity.
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Affiliation(s)
- Mark Cucuzzella
- West Virginia University School of Medicine, Morgantown, WV, USA.
| | | | - Jenny Favret
- Duke Pediatrics Healthy Lifestyles Program, Durham, NC, USA
| | - Nina Paddu
- Vanderbilt University Medical Center, Nashville, TN, USA
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Alruwaili BF, Bayyumi DF, Alruwaili OS, Alsadun RS, Alanazi AS, Hadi A, Alruwaili NKS, Thirunavukkarasu A, Aldaghmani NF, Alrayes AA. Prevalence and Determinants of Obesity and Overweight Among Children and Adolescents in the Middle East and North African Countries: An Updated Systematic Review. Diabetes Metab Syndr Obes 2024; 17:2095-2103. [PMID: 38799280 PMCID: PMC11127655 DOI: 10.2147/dmso.s458003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024] Open
Abstract
In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and obesity. This updated systematic review sought to measure the prevalence and determinants of obesity and overweight among children and adolescents in MENA countries. A literature search for relevant observational studies published in English was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Twenty-one published articles during the past five years were included in the systematic review. Varied approaches were used to diagnose childhood overweight and obesity, including the International Obesity Taskforce (IOTF), Centre for Disease Control (CDC), World Health Organization (WHO), and Saudi Growth Pattern Curves. We found that the combined prevalence of childhood overweight and obesity in the Middle East is up to 49.4%, depending on the methods applied in their studies. Risk factors identified were age, male gender, lack of sufficient physical activity, consumption of fried food, perceived stress level, number of family members, family size, mother's occupation, education level, family history of obesity, high energy consumption from carbohydrates, ≥2 hours spent on watching television on weekend days with overweight, and always eating breakfast while watching television with obesity. The results of this review indicate that the issue of childhood and adolescent overweight and obesity in the Middle East is substantial and concerning. Most of the risk factors identified are modifiable and, if given appropriate attention, could significantly reduce the burden of associated chronic complications.
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Affiliation(s)
- Bashayer Farhan Alruwaili
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Duaa Fahad Bayyumi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Ohud Saud Alruwaili
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Razan Saud Alsadun
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | | | - Amal Hadi
- Department of Family Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Nada Kareem S Alruwaili
- Department of Primary Healthcare, Ministry of Health, Aljouf Health Cluster, Sakaka, Saudi Arabia
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Zhang PP, Wang YX, Gu JY, Xu M, Zhou Y, Wang HJ, Lau PWC, Wang H, Li L. Cardiorespiratory fitness attenuates the association between fatness and cardiometabolic risk in Chinese children. Front Endocrinol (Lausanne) 2024; 15:1361447. [PMID: 38812818 PMCID: PMC11133549 DOI: 10.3389/fendo.2024.1361447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/17/2024] [Indexed: 05/31/2024] Open
Abstract
Background Childhood obesity tends to persist into adulthood, predisposing individuals to cardiometabolic risk (CMR). This study aims to investigate the mediating role of cardiorespiratory fitness (CRF) in the associations between multiple fatness indicators and individual CMR markers and clustered CMR-score, and explore sex differences. Methods We recruited 1,557 children (age: 8 to 10, male/female: 52.7%/47.3%) in September 2022 in Ningbo, China. Physical examinations, overnight fasting blood test, and CRF was evaluated. The CMR-score was calculated by summing age- and sex-specific z scores of four CMR markers, including mean arterial blood pressure, triglycerides, the total cholesterol to high-density lipoprotein cholesterol ratio, and homeostatic model assessment for insulin resistance. Generalized linear mixed models were used to identify the associations, mediation analyses were performed to dissect the function of CRF. Results Partial correlation analyses revealed positive associations between high fatness indicators (including body mass index [BMI], BMI z score, body fat mass index [BFMI] and waist-to-height ratio [WHtR]) and increased CMR markers, whereas high CRF was associated with decreased CMR markers (all P < 0.05). In the mediation analyses, CRF emerged as a partial mediator, attenuating the relationship between four fatness indicators and CMR-score. Specifically, CRF mediated 6.5%, 7.7%, 5.3%, and 12.5% of the association between BMI, BMI z score, BFMI, WHtR and CMR-score (all P < 0.001). And the mediating effects of CRF between WHtR and four individual CMR markers was particularly robust, ranging from 10.4% to 21.1% (all P < 0.05). What's more, CRF mediates the associations between WHtR and CMR-score more pronounced in girls than boys with a mediation effect size of 17.3% (P < 0.001). Conclusion In Chinese children, CRF partially mitigates the adverse effects of fatness on CMR, underscoring the significance of enhancing CRF in children.
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Affiliation(s)
- Ping-Ping Zhang
- Ningbo Center for Healthy Lifestyle Research, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - You-Xin Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jia-Yin Gu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Miao Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Ye Zhou
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Patrick W C. Lau
- Department of Sport, Physical Education & Health, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
- Laboratory of Exercise Science and Health, Beijing Normal University-Hong Kong Baptist University United International College (UIC), Zhuhai, Guangzhou, China
| | - Hui Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Li Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
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Wu S, Huang Y, Wang L, Zhao X, Lv Q, Wu Q. The Optimal Cut-Off Point of Physical Activity for the Prevention of Childhood Overweight and Obesity. CHILDREN (BASEL, SWITZERLAND) 2024; 11:569. [PMID: 38790564 PMCID: PMC11119031 DOI: 10.3390/children11050569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024]
Abstract
Childhood obesity might threaten children's current and adulthood health outcomes. Previous studies have illustrated the positive effects of physical activity on weight control; however, there is a lack of evidence on the optimal dose of physical activity. Therefore, we aimed to explore the relationship between physical activity and overweight and obesity, as well as the optimal threshold for physical activity. The median (interquartile range) and number (proportion) were used to describe the statistics. The Mann-Whitney U test and chi-square test were used for an univariable analysis. The generalized additive model with a smooth function was used to depict the preliminary relationship between physical activity and overweight and obesity. The cut-off level of physical activity was identified using AddFor algorithms, and a logistic regression model was applied to explore the multivariable relationship between physical activity and overweight and obesity after adjusting for control variables. According to the statistical analyses, 24.3% of 842 children and adolescents had overweight and obesity. The average number of days that the participants engaged in more than one hour of physical activity was three days a week. The optimal cut-off level of physical activity for the prevention of childhood overweight and obesity was 4 times a week. The participants who exercised more than four times a week (AOR(95% CI) = 0.56(0.38, 0.83), p = 0.004) were less likely to be overweight and obese. In the context of the general lack of physical activity among children and adolescents, we recommend that children and adolescents engage in 60 min of physical activity more than four times a week for a healthy weight.
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Affiliation(s)
| | | | | | | | | | - Qingqing Wu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (S.W.); (Y.H.); (L.W.); (X.Z.); (Q.L.)
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Coant N, Rendja K, Bellini L, Flamment M, Lherminier J, Portha B, Codogno P, Le Stunff H. Role of Sphingosine Kinase 1 in Glucolipotoxicity-Induced Early Activation of Autophagy in INS-1 Pancreatic β Cells. Cells 2024; 13:636. [PMID: 38607078 PMCID: PMC11011436 DOI: 10.3390/cells13070636] [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: 10/24/2023] [Revised: 03/04/2024] [Accepted: 03/27/2024] [Indexed: 04/13/2024] Open
Abstract
Insulin-producing pancreatic β cells play a crucial role in the regulation of glucose homeostasis, and their failure is a key event for diabetes development. Prolonged exposure to palmitate in the presence of elevated glucose levels, termed gluco-lipotoxicity, is known to induce β cell apoptosis. Autophagy has been proposed to be regulated by gluco-lipotoxicity in order to favor β cell survival. However, the role of palmitate metabolism in gluco-lipotoxcity-induced autophagy is presently unknown. We therefore treated INS-1 cells for 6 and 24 h with palmitate in the presence of low and high glucose concentrations and then monitored autophagy. Gluco-lipotoxicity induces accumulation of LC3-II levels in INS-1 at 6 h which returns to basal levels at 24 h. Using the RFP-GFP-LC3 probe, gluco-lipotoxicity increased both autophagosomes and autolysosmes structures, reflecting early stimulation of an autophagy flux. Triacsin C, a potent inhibitor of the long fatty acid acetyl-coA synthase, completely prevents LC3-II formation and recruitment to autophagosomes, suggesting that autophagic response requires palmitate metabolism. In contrast, etomoxir and bromo-palmitate, inhibitors of fatty acid mitochondrial β-oxidation, are unable to prevent gluco-lipotoxicity-induced LC3-II accumulation and recruitment to autophagosomes. Moreover, bromo-palmitate and etomoxir potentiate palmitate autophagic response. Even if gluco-lipotoxicity raised ceramide levels in INS-1 cells, ceramide synthase 4 overexpression does not potentiate LC3-II accumulation. Gluco-lipotoxicity also still stimulates an autophagic flux in the presence of an ER stress repressor. Finally, selective inhibition of sphingosine kinase 1 (SphK1) activity precludes gluco-lipotoxicity to induce LC3-II accumulation. Moreover, SphK1 overexpression potentiates autophagic flux induced by gluco-lipotxicity. Altogether, our results indicate that early activation of autophagy by gluco-lipotoxicity is mediated by SphK1, which plays a protective role in β cells.
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Affiliation(s)
- Nicolas Coant
- Unité BFA, Université Paris Cité, CNRS UMR 8251, 75006 Paris, France; (N.C.); (B.P.)
- Department of Pathology and Stony Brook Cancer Center, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794, USA
| | - Karima Rendja
- Unité BFA, Université Paris Cité, CNRS UMR 8251, 75006 Paris, France; (N.C.); (B.P.)
| | - Lara Bellini
- Unité BFA, Université Paris Cité, CNRS UMR 8251, 75006 Paris, France; (N.C.); (B.P.)
| | - Mélissa Flamment
- Inserm, UMR-S 872, Centre de Recherche des Cordeliers, 75006 Paris, France
| | - Jeannine Lherminier
- INRA, UMR1347 Agroécologie, ERL CNRS 6300, Plateforme DImaCell, Centre de Microscopie INRA/Université de Bourgogne, 21065 Dijon, France
| | - Bernard Portha
- Unité BFA, Université Paris Cité, CNRS UMR 8251, 75006 Paris, France; (N.C.); (B.P.)
| | - Patrice Codogno
- INSERM U1151-CNRS UMR 8253, Institut Necker Enfants-Malades, University Paris Descartes, 75006 Paris, France
| | - Hervé Le Stunff
- Unité BFA, Université Paris Cité, CNRS UMR 8251, 75006 Paris, France; (N.C.); (B.P.)
- CNRS UMR 9197, Institut des Neurosciences Paris-Saclay, Saclay, University Paris, 91400 Saclay, France
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Hu N, Wu Y, Yao Q, Huang S, Li W, Yao Z, Ye C. Association between late bedtime and obesity in children and adolescents: a meta-analysis. Front Pediatr 2024; 12:1342514. [PMID: 38560399 PMCID: PMC10978672 DOI: 10.3389/fped.2024.1342514] [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: 11/22/2023] [Accepted: 02/13/2024] [Indexed: 04/04/2024] Open
Abstract
Background Short sleep duration has been related to obesity in children and adolescents. However, it remains unknown whether late bedtime is also associated with obesity and whether the association is independent of sleep duration. A meta-analysis was performed to address this issue. Methods In order to accomplish the aim of the meta-analysis, a comprehensive search was conducted on databases including PubMed, Embase, and Web of Science to identify observational studies. The cutoff to determine late bedtime in children in this meta-analysis was consistent with the value used among the included original studies. As for obesity, it was typically defined as a body mass index (BMI) > 95th percentile of age and sex specified reference standards or the International Obesity Task Force defined age- and gender-specific cut-off of BMI. The Cochrane Q test was employed to evaluate heterogeneity among the included studies, while the I2 statistic was estimated. Random-effects models were utilized to merge the results, considering the potential impact of heterogeneity. Results Tweleve observational studies with 57,728 participants were included. Among them, 6,815 (11.8%) were obese. Pooled results showed that late bedtime reported by the participants or their caregivers was associated with obesity (odds ratio [OR]: 1.27, 95% confidence interval [CI]: 1.16-1.39, p < 0.001; I2 = 0%). Subgroup analysis showed consistent results in studies with (OR: 1.33, 95% CI: 1.04-1.70, p = 0.02) and without adjustment of sleep duration (OR: 1.27, 95% CI: 1.14-1.41, p < 0.001). Further subgroup analysis also showed that the association was not significantly affected by study location, design, age of the participants, or diagnostic methods for obesity (p for subgroup difference all >0.05). Conclusion Late bedtime is associated with obesity in children and adolescents, which may be independent of sleep duration.
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Affiliation(s)
| | | | | | | | | | | | - Chunfeng Ye
- Department of Pediatrics, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Chung ST, Davis F, Patel T, Mabundo L, Estrada DE. Reevaluating First-line Therapies in Youth-Onset Type 2 Diabetes. J Clin Endocrinol Metab 2024; 109:e870-e872. [PMID: 37624230 PMCID: PMC11032239 DOI: 10.1210/clinem/dgad508] [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: 07/05/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 08/26/2023]
Abstract
The prevalence of youth-onset type 2 diabetes is growing worldwide and current first-line treatment with metformin and intensive behavior and lifestyle changes are suboptimal in over 50% of youth within 2 years of diagnosis. This perspective article is a call to action for reevaluation of existing strategies and critical appraisal of metformin as first-line therapy in youth-onset type 2 diabetes. Increased attention should be given to novel therapeutics approved in youth, including glucagon-like 1 receptor agonists, sodium glucose cotransporter-2, and sociocultural interventions that will promote diabetes self-management.
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Affiliation(s)
- Stephanie T Chung
- Section on Pediatric Diabetes, Obesity, and Metabolism, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
- Division of Endocrinology and Diabetes, Children’s National Hospital, Washington, DC 20010, USA
| | - Faith Davis
- Section on Pediatric Diabetes, Obesity, and Metabolism, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Tejal Patel
- Division of Endocrinology and Diabetes, Children’s National Hospital, Washington, DC 20010, USA
| | - Lilian Mabundo
- Section on Pediatric Diabetes, Obesity, and Metabolism, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Doris E Estrada
- Division of Endocrinology and Diabetes, Children’s National Hospital, Washington, DC 20010, USA
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Pavlidou E, Papadopoulou SK, Alexatou O, Voulgaridou G, Mentzelou M, Biskanaki F, Psara E, Tsourouflis G, Lefantzis N, Dimoliani S, Apostolou T, Sampani A, Chatziprodromidou IP, Angelakou EP, Giaginis C. Childhood Mediterranean Diet Adherence Is Associated with Lower Prevalence of Childhood Obesity, Specific Sociodemographic, and Lifestyle Factors: A Cross-Sectional Study in Pre-School Children. EPIDEMIOLOGIA 2023; 5:11-28. [PMID: 38247997 PMCID: PMC10801514 DOI: 10.3390/epidemiologia5010002] [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: 11/13/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2-5 years old. METHODS This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I. RESULTS Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002). CONCLUSIONS A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2-5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | | | - Evmorfia Psara
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Nikos Lefantzis
- Department of Oral and Maxillofacial Surgery, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sophia Dimoliani
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Thomas Apostolou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | | | - Exakousti-Petroula Angelakou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
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Guida F, Andreozzi L, Zama D, Prete A, Masetti R, Fabi M, Lanari M. Innovative strategies to predict and prevent the risk for malnutrition in child, adolescent, and young adult cancer survivors. Front Nutr 2023; 10:1332881. [PMID: 38188871 PMCID: PMC10771315 DOI: 10.3389/fnut.2023.1332881] [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: 11/03/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Children, adolescents, and young adult cancer survivors (CAYAs) constitute a growing population requiring a customized approach to mitigate the incidence of severe complications throughout their lifetimes. During cancer treatment, CAYAs cancer survivors undergo significant disruptions in their nutritional status, elevating the risks of mortality, morbidity, and cardiovascular events. The assessment of nutritional status during cancer treatment involves anthropometric and dietary evaluations, emphasizing the necessity for regular assessments and the timely identification of risk factors. Proactive nutritional interventions, addressing both undernutrition and overnutrition, should be tailored to specific age groups and incorporate a family-centered approach. Despite encouraging interventions, a notable evidence gap persists. The goal of this review is to comprehensively examine the existing evidence on potential nutritional interventions for CAYAs cancer survivors. We explore the evidence so far collected on the nutritional intervention strategies elaborated for CAYAs cancer survivors that should target both undernutrition and overnutrition, being age-specific and involving a family-based approach. Furthermore, we suggest harnessing artificial intelligence (AI) to anticipate and prevent malnutrition in CAYAs cancer survivors, contributing to the identification of novel risk factors and promoting proactive, personalized healthcare.
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Affiliation(s)
- Fiorentina Guida
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - Laura Andreozzi
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - Daniele Zama
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - Arcangelo Prete
- Pediatric Oncology and Hematology Unit "Lalla Seragnoli", Pediatric Unit-IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Riccardo Masetti
- Pediatric Oncology and Hematology Unit "Lalla Seragnoli", Pediatric Unit-IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marianna Fabi
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - Marcello Lanari
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
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