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Zhang Y, Dai K, Chen X, Cui L, Chen ZJ. Association between being large for gestational age and cardiovascular metabolic health in children conceived from assisted reproductive technology: a prospective cohort study. BMC Med 2024; 22:203. [PMID: 38764021 PMCID: PMC11104001 DOI: 10.1186/s12916-024-03419-7] [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: 06/12/2023] [Accepted: 05/03/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND To the best of our knowledge, no study has investigated the potential joint effect of large for gestational age (LGA) and assisted reproductive technology (ART) on the long-term health of children. METHODS This was a prospective cohort study that recruited children whose parents had received ART treatment in the Center for Reproductive Medicine, Shandong Provincial Hospital, affiliated to Shandong University, between January 2006 and December 2017. Linear mixed model was used to compare the main outcomes. The mediation model was used to evaluate the intermediary effect of body mass index (BMI). RESULTS 4138 (29.5%) children born LGA and 9910 (70.5%) children born appropriate for gestational age (AGA) were included in the present study. The offspring ranged from 0.4 to 9.9 years. LGAs conceived through ART were shown to have higher BMI, blood pressure, fasting blood glucose, fasting insulin, and homeostatic model assessment of insulin resistance values, even after controlling for all covariates. The odds of overweight and insulin resistance are also higher in LGA subjects. After adjusting for all covariates, LGAs conceived through ART had BMI and BMI z-scores that were 0.48 kg/m2 and 0.34 units greater than those of AGAs, respectively. The effect of LGA on BMI was identified as early as infancy and remained consistently significant throughout pre-puberty. CONCLUSIONS Compared to AGA, LGA children conceived from ART were associated with increased cardiovascular-metabolic events, which appeared as early as infancy and with no recovery by pre-puberty.
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Affiliation(s)
- Yiyuan Zhang
- Institute of Women, Children and Reproductive Health, Cheeloo College of Medicine, Shandong University, Shandong, 250012, China
- Institute of Women, Children and Reproductive Health, the Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, 250012, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250012, China
- Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences (No.2021RU001), Jinan, Shandong, 250012, China
| | - Kexin Dai
- Institute of Women, Children and Reproductive Health, Cheeloo College of Medicine, Shandong University, Shandong, 250012, China
- Institute of Women, Children and Reproductive Health, the Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, 250012, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250012, China
- Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences (No.2021RU001), Jinan, Shandong, 250012, China
| | - Xiaojing Chen
- Institute of Women, Children and Reproductive Health, Cheeloo College of Medicine, Shandong University, Shandong, 250012, China
- Institute of Women, Children and Reproductive Health, the Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, 250012, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250012, China
- Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences (No.2021RU001), Jinan, Shandong, 250012, China
| | - Linlin Cui
- Institute of Women, Children and Reproductive Health, the Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, 250012, China.
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China.
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China.
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China.
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, China.
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China.
- Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250012, China.
- Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences (No.2021RU001), Jinan, Shandong, 250012, China.
- , Jinan, China.
| | - Zi-Jiang Chen
- Institute of Women, Children and Reproductive Health, Cheeloo College of Medicine, Shandong University, Shandong, 250012, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250012, China
- Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences (No.2021RU001), Jinan, Shandong, 250012, China
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
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Yang J, Kuang Y, Yang X, Li C, Qi M, Fu P, Zeng X. The impact of age-specific childhood body-mass index on adult cardiometabolic traits: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 14:1159547. [PMID: 38288476 PMCID: PMC10822942 DOI: 10.3389/fendo.2023.1159547] [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: 02/06/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
Objective To evaluate the causal relationship between childhood body-mass index (BMI) at different ages and adult cardiometabolic traits. Methods We retrieved genetic instrument variables (IVs) for exposures (standardized BMI at newborn, infant, toddler and late childhood), cardiometabolic traits and potential confounders or mediators (adult BMI, SHBG, testosterone and age at menarche) from the corresponding genome-wide association analysis. We performed univariate and multivariable Mendelian randomization (MR) to dissect associations between age-specific childhood BMI and adult cardiometabolic outcomes. Odds ratio was used to present the direction of the causal association. Results In univariate MR, higher newborn BMI was causally associated with reduced risk for type 2 diabetes in women. Late childhood BMI was associated with increased risk for female diabetes and coronary artery disease (CAD), myocardial infarction (MI), and chronic kidney disease (CKD) in general population. Among these associations, only association between late childhood BMI with MI remained significant after adjusting for adult male BMI and sex hormones, (OR = 1.120, 95% CI 1.023-1.226, p = 0.014). Besides, in multivariable MR, we found evidence for causal association between newborn BMI with reduced risk for CAD (OR = 0.862, 95% CI 0.751-0.989, p = 0.034) and MI (OR = 0.864, 95% CI 0.752-0.991, p = 0.037) in men. No obvious impact of infant or toddler BMI was identified on the above-mentioned diseases. For continuous cardiometabolic traits, in all age epochs except infant, higher BMI was associated with increased level of fasting glucose in women. Conclusion BMI at birth and late childhood exerts different impact on adult cardiometabolic diseases, while BMI at infant and toddler ages is not causally associated with these outcomes. The effect of childhood BMI may be influenced by sex disparities.
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Affiliation(s)
- Jun Yang
- Department of Mathematics, Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yalan Kuang
- West China Biomedical Big Data Center, West China Hospital, Chengdu, China
| | - Xiaoyan Yang
- West China Biomedical Big Data Center, West China Hospital, Chengdu, China
| | - Chunyang Li
- West China Biomedical Big Data Center, West China Hospital, Chengdu, China
| | - Mei Qi
- Division of Nephrology, The Second People’s Hospital of Tibet Autonomous Region, Lhasa, China
| | - Ping Fu
- Division of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoxi Zeng
- West China Biomedical Big Data Center, West China Hospital, Chengdu, China
- Division of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
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Lazzeri MFL, Mastorci F, Piaggi P, Doveri C, Marinaro I, Trivellini G, Casu A, Devine C, Ait-Ali L, Vassalle C, Pingitore A. A Close Association between Body Weight, Health-Related Quality of Life, and Risk Behaviors in a Sample of Italian High School Students. Nutrients 2023; 15:5107. [PMID: 38140366 PMCID: PMC10745845 DOI: 10.3390/nu15245107] [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: 11/13/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Adolescents experience rapid physical, cognitive, and psychosocial growth with different factors contributing to health and well-being. In this view, an important role is played by body weight and related perceptions. The purpose was to determine, in a sample of Italian high school students, whether health-related quality of life (HRQoL) is associated with the different weight status categories (underweight, normal weight, overweight, obese), even considering sex differences. MATERIAL AND METHODS Data were collected from 1826 adolescents (n = 735 males). HRQOL was analyzed using the Italian version of KIDSCREEN-52. RESULTS Overweight adolescents showed reductions in psychological well-being (p < 0.05) and self-perception (p < 0.05) compared with individuals in other BMI categories. Subjects with obesity reported increased bullying victimization (p < 0.05) and reductions in self-perception and eating disorders (p < 0.001), while underweight individuals were characterized by altered adherence to the Mediterranean diet (p < 0.001), eating disorders (p < 0.001), and problematic use of social media (p < 0.05). No sex differences were found, except for socio-economic status perceptions, where underweight girls reported higher economic well-being than boys (p < 0.05). CONCLUSIONS Our findings may suggest that there is an association between weight status categories and HRQoL that is more pronounced in underweight and overweight adolescents. The association between BMI categories and psychosocial dimensions opens the need to define specific domains on which such preventive interventions should focus, always through a personalized perspective.
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Affiliation(s)
- Maria Francesca Lodovica Lazzeri
- Clinical Physiology Institute, CNR, Via Moruzzi, 56124 Pisa, Italy; (M.F.L.L.); (C.D.); (I.M.); (G.T.); (A.C.); (C.D.); (L.A.-A.); (A.P.)
| | - Francesca Mastorci
- Clinical Physiology Institute, CNR, Via Moruzzi, 56124 Pisa, Italy; (M.F.L.L.); (C.D.); (I.M.); (G.T.); (A.C.); (C.D.); (L.A.-A.); (A.P.)
| | - Paolo Piaggi
- Department of Information Engineering, University of Pisa, 56126 Pisa, Italy;
| | - Cristina Doveri
- Clinical Physiology Institute, CNR, Via Moruzzi, 56124 Pisa, Italy; (M.F.L.L.); (C.D.); (I.M.); (G.T.); (A.C.); (C.D.); (L.A.-A.); (A.P.)
| | - Irene Marinaro
- Clinical Physiology Institute, CNR, Via Moruzzi, 56124 Pisa, Italy; (M.F.L.L.); (C.D.); (I.M.); (G.T.); (A.C.); (C.D.); (L.A.-A.); (A.P.)
| | - Gabriele Trivellini
- Clinical Physiology Institute, CNR, Via Moruzzi, 56124 Pisa, Italy; (M.F.L.L.); (C.D.); (I.M.); (G.T.); (A.C.); (C.D.); (L.A.-A.); (A.P.)
| | - Anselmo Casu
- Clinical Physiology Institute, CNR, Via Moruzzi, 56124 Pisa, Italy; (M.F.L.L.); (C.D.); (I.M.); (G.T.); (A.C.); (C.D.); (L.A.-A.); (A.P.)
| | - Caleb Devine
- Clinical Physiology Institute, CNR, Via Moruzzi, 56124 Pisa, Italy; (M.F.L.L.); (C.D.); (I.M.); (G.T.); (A.C.); (C.D.); (L.A.-A.); (A.P.)
| | - Lamia Ait-Ali
- Clinical Physiology Institute, CNR, Via Moruzzi, 56124 Pisa, Italy; (M.F.L.L.); (C.D.); (I.M.); (G.T.); (A.C.); (C.D.); (L.A.-A.); (A.P.)
| | | | - Alessandro Pingitore
- Clinical Physiology Institute, CNR, Via Moruzzi, 56124 Pisa, Italy; (M.F.L.L.); (C.D.); (I.M.); (G.T.); (A.C.); (C.D.); (L.A.-A.); (A.P.)
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Li ZA, Samara A, Ray MK, Rutlin J, Raji CA, Shimony JS, Sun P, Song SK, Hershey T, Eisenstein SA. Childhood obesity is linked to putative neuroinflammation in brain white matter, hypothalamus, and striatum. Cereb Cortex Commun 2023; 4:tgad007. [PMID: 37207193 PMCID: PMC10191798 DOI: 10.1093/texcom/tgad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 05/21/2023] Open
Abstract
Neuroinflammation is both a consequence and driver of overfeeding and weight gain in rodent obesity models. Advances in magnetic resonance imaging (MRI) enable investigations of brain microstructure that suggests neuroinflammation in human obesity. To assess the convergent validity across MRI techniques and extend previous findings, we used diffusion basis spectrum imaging (DBSI) to characterize obesity-associated alterations in brain microstructure in 601 children (age 9-11 years) from the Adolescent Brain Cognitive DevelopmentSM Study. Compared with children with normal-weight, greater DBSI restricted fraction (RF), reflecting neuroinflammation-related cellularity, was seen in widespread white matter in children with overweight and obesity. Greater DBSI-RF in hypothalamus, caudate nucleus, putamen, and, in particular, nucleus accumbens, correlated with higher baseline body mass index and related anthropometrics. Comparable findings were seen in the striatum with a previously reported restriction spectrum imaging (RSI) model. Gain in waist circumference over 1 and 2 years related, at nominal significance, to greater baseline RSI-assessed restricted diffusion in nucleus accumbens and caudate nucleus, and DBSI-RF in hypothalamus, respectively. Here we demonstrate that childhood obesity is associated with microstructural alterations in white matter, hypothalamus, and striatum. Our results also support the reproducibility, across MRI methods, of findings of obesity-related putative neuroinflammation in children.
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Affiliation(s)
- Zhaolong Adrian Li
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, United States
| | - Amjad Samara
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110 United States
| | - Mary Katherine Ray
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
| | - Jerrel Rutlin
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
| | - Cyrus A Raji
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110 United States
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
| | - Peng Sun
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Sheng-Kwei Song
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
| | - Tamara Hershey
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, United States
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110 United States
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
| | - Sarah A Eisenstein
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
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Fortes JS, Pinto RM, de Souza RF, Godoy FR, da Cruz RS, de M e Silva D, Filho HPL, da Cruz AD, Minasi LB. The influence of six polymorphisms of uncoupling protein 3 (UCP3) gene and childhood obesity: a case-control study. BMC Pediatr 2023; 23:87. [PMID: 36810017 PMCID: PMC9942342 DOI: 10.1186/s12887-023-03905-6] [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: 11/26/2021] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Obesity is defined as a multifactorial disease, marked by excessive accumulation of body fat, responsible for compromising the individual's health over the years. The energy balance is essential for the proper functioning of the body, as the individual needs to earn and spend energy in a compensatory way. Mitochondrial Uncoupling Proteins (UCP) help in energy expenditure through heat release and genetic polymorphisms could be responsible for reducing energy consumption to release heat and consequently generate an excessive accumulation of fat in the body. Thus, this study aimed to investigate the potential association between six UCP3 polymorphisms, that have not yet been represented in ClinVar®, and pediatric obesity susceptibility. METHODS A case-control study was conducted with 225 children from Central Brazil. The groups were subdivided into obese (123) and eutrophic (102) individuals. The polymorphisms rs15763, rs1685354, rs1800849, rs11235972, rs647126, and rs3781907 were determined by real-time Polymerase Chain Reaction (qPCR). RESULTS Biochemical and anthropometric evaluation of obese group showed higher levels of triglycerides, insulin resistance, and LDL-C and low level of HDL-C. Insulin resistance, age, sex, HDL-C, fasting glucose, triglyceride levels, and parents' BMI explained up to 50% of body mass deposition in the studied population. Additionally, obese mothers contribute 2 × more to the Z-BMI of their children than the fathers. The SNP rs647126 contributed to 20% to the risk of obesity in children and the SNP rs3781907 contribute to 10%. Mutant alleles of UCP3 increase the risk for triglycerides, total cholesterol, and HDL-C levels. The polymorphism rs3781907 is the only one that could not be a biomarker for obesity as the risk allele seem to be protective gains the increase in Z-BMI in our pediatric population. Haplotype analysis demonstrated two SNP blocks (rs15763, rs647126, and rs1685534) and (rs11235972 and rs1800849) that showed linkage disequilibrium, with LOD 76.3% and D' = 0.96 and LOD 57.4% and D' = 0.97, respectively. CONCLUSIONS The causality between UCP3 polymorphism and obesity were not detected. On the other hand, the studied polymorphism contributes to Z-BMI, HOMA-IR, triglycerides, total cholesterol, and HDL-C levels. Haplotypes are concordant with the obese phenotype and contribute minimally to the risk of obesity.
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Affiliation(s)
- Jakeline S. Fortes
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
- Genetics and Molecular Biology Graduate Program, Federal University of Goiás, Campus Samambaia, Goiânia, GO 74690-900 Brazil
| | - Renata M. Pinto
- Pediatrics Department, Federal University of Goiás, Câmpus Colemar Natal E Silva (Câmpus I), Rua 235, Setor Leste Universitário, Goiânia, GO Brazil
| | - Raissa F. de Souza
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
| | - Fernanda R. Godoy
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
- Genetics and Molecular Biology Graduate Program, Federal University of Goiás, Campus Samambaia, Goiânia, GO 74690-900 Brazil
| | - Raphael S. da Cruz
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
- Physiotherapy Undergraduate Course, Centro Universitário de Goiânia – UNICEUG, Goiânia, GO Brazil
| | - Daniela de M e Silva
- Genetics and Molecular Biology Graduate Program, Federal University of Goiás, Campus Samambaia, Goiânia, GO 74690-900 Brazil
| | | | - Aparecido D. da Cruz
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
- Genetics and Molecular Biology Graduate Program, Federal University of Goiás, Campus Samambaia, Goiânia, GO 74690-900 Brazil
- Human Cytogenetics and Molecular Genetics Laboratory/CRER, State Health Secretary of Goiás, Goiânia, GO Brazil
| | - Lysa B. Minasi
- Replicon Research Group, Genetics Graduate Program, School of Medical and Life Sciences, Pontifical Catholic University of Goiás, Rua 235, N. 40, Setor Leste Universitário, Goiânia, GO 74605-050 Brazil
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Clinical and physical characteristics of thinness in adolescents: the HELENA study. Eur J Nutr 2023; 62:1731-1742. [PMID: 36802024 DOI: 10.1007/s00394-023-03104-0] [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: 05/31/2022] [Accepted: 01/31/2023] [Indexed: 02/22/2023]
Abstract
PURPOSE Thinness in adolescence has not been studied as extensively as overweight or obesity. The aim of this study was to assess the prevalence, characteristics, and health impacts of thinness in a European adolescent population. METHODS This study included 2711 adolescents (1479 girls, 1232 boys). Blood pressure, physical fitness, sedentary behaviors, physical activity (PA), and dietary intake were assessed. A medical questionnaire was used to report any associated diseases. A blood sample was collected in a subgroup of the population. Thinness and normal weight were identified using the IOTF scale. Thin adolescents were compared with adolescents of normal weight. RESULTS Two hundred and fourteen adolescents (7.9%) were classified as being thin; the prevalence rates were 8.6% in girls and 7.1% in boys. Systolic blood pressure was significantly lower in adolescents with thinness. The age at the first menstrual cycle was significantly later in thin female adolescents than in those with normal weight. Upper-body muscular strength measured in performance tests and time spent in light PA were significantly lower in thin adolescents. The Diet Quality Index was not significantly lower in thin adolescents, but the percentage of adolescents who skipped breakfast was higher in adolescents with a normal weight (27.7% vs 17.1%). Serum creatinine level and HOMA-insulin resistance were lower and vitamin B12 level was higher in thin adolescents. CONCLUSIONS Thinness affects a notable proportion of European adolescents with no physical adverse health consequences.
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Mulu A, Neupane S. The Association of Maternal BMI with Overweight among Children Aged 0-59 Months in Kenya: A Nationwide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1413. [PMID: 36674176 PMCID: PMC9859472 DOI: 10.3390/ijerph20021413] [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: 12/28/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Childhood overweight is a growing global public health challenge and is prevalent in many countries. We aimed at exploring the prevalence of childhood overweight and the association of maternal body mass index (BMI), maternal demographic factors, and child-related factors with childhood overweight among Kenyan children aged 0-59 months. This study utilized Kenya's 2014 demographic and health survey, which was based on national representative cross-sectional data. A total of 8316 children and their mothers' data were analyzed. Overweight in children and maternal BMI were defined using WHO standard criteria. Multivariate logistics regression models were used to study the association of maternal BMI and childhood overweight. Nationally 5% of Kenyan children aged 0-59 months are overweight (5.5% male vs. 3.8% female). The highest prevalence in overweight among children was found in Central region (6.9%) and lowest in North Eastern (3.1%) which could be explained by the various economic disparities. Maternal BMI with underweight was associated with lower odds (OR 0.30, 95% CI 0.14-0.64) whereas, overweight and obesity were associated with higher odds of overweight (OR for overweight 1.64, 95% CI 1.28-2.11 and OR for obesity 1.74, 95% CI 1.22-2.47) among their children compared to normal weight mothers. Overweight among children is of great concern and therefore initiatives to tackle both child and maternal health are urgently needed.
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Affiliation(s)
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland
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Martínez-Navarro I, Vilchis-Gil J, Cossío-Torres PE, Hernández-Mendoza H, Klünder-Klünder M, Layseca-Espinosa E, Galicia-Cruz OG, Rios-Lugo MJ. Relationship of Serum Zinc Levels with Cardiometabolic Traits in Overweight and Obese Schoolchildren from Mexico City. Biol Trace Elem Res 2022:10.1007/s12011-022-03533-8. [PMID: 36572827 PMCID: PMC9792317 DOI: 10.1007/s12011-022-03533-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/13/2022] [Indexed: 12/28/2022]
Abstract
Zinc (Zn) participates as a cofactor for many enzymes in the cellular metabolism, and its serum levels have been associated with different metabolic diseases, especially obesity (OB). Nevertheless, its associations are not clear in the children population. The objective of this study is to evaluate the association between serum Zn levels (SZn) with overweight/obesity status (OW/OB), as well as its cardiometabolic traits in a population of children in Mexico City. Anthropometrical data (body mass index z score (BMIz)), demographic variables (age and sex), and cardiometabolic traits (total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglycerides (TG), fasting plasma glucose (FPG), and insulin) were analyzed in this cross-sectional study. SZn were measured by inductively coupled plasma mass spectrometry (ICP-MS). The population included 210 children from Mexico City (girls (n = 105) and boys (n = 105)) between ages 6 and 10 years. Normal-weight (NW) schoolchildren had higher SZn concentrations (66 µg/dL; IQR: 48 to 91) compared to OW or OB schoolchildren (61 µg/dL; IQR: 45 to 76). The data showed a significant negative association between SZn and BMIz without sex exclusion (r = - 0.181 and p = 0.009). The boy's population did not show an association between the SZn and BMIz compared to the girl's population which showed a significant negative association (r = - 0.277 and p = 0.004). In addition, other associations were found between SZn and TC (boys (r = 0.214 and p = 0.025), LDLc (boys (r = 0.213 and p = 0.029), and TG (girls (r = - 0.260 and p = 0.007)). Moreover, 38.6% of the total children in our population study had Zn deficiency (ZnD). NW schoolchildren had higher SZn concentrations compared to OW or OB schoolchildren. A diet low in Zn can be a factor to evaluate in the development of childhood OB in Mexico. However, further studies need to be performed on the children Mexican population to replicate and confirm our findings.
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Affiliation(s)
- Israel Martínez-Navarro
- Posgrado de Ciencias Basicas, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Av. Venustiano Carranza 2405, CP 78210, San Luis Potosí, S.L.P, México
| | - Jenny Vilchis-Gil
- Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, Secretaría de Salud, CP 06720, Ciudad de Mexico, México
| | - Patricia Elizabeth Cossío-Torres
- Departamento de Salud Pública y Ciencias Médicas, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Av. Venustiano Carranza 2405, CP 78210, San Luis Potosí, S.L.P, México
| | - Héctor Hernández-Mendoza
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, CP 78377, San Luis, S.L.P, México.
- Hospital General de Soledad de Graciano Sánchez, Secretaría de Salud, Valentín Amador 1112, Soledad de Graciano Sánchez, CP 78435, San Luis Potosí, S.L.P., Mexico.
| | - Miguel Klünder-Klünder
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Secretaría de Salud, CP 06720, Ciudad de Mexico, México
| | - Esther Layseca-Espinosa
- Centro de Investigación en Ciencias de La Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, CP 78210, San Luis Potosí, S.L.P, México
| | - Othir Gidalti Galicia-Cruz
- Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Av. Venustiano Carranza 2405, CP 78210, San Luis Potosí, S.L.P, México
| | - María Judith Rios-Lugo
- Centro de Investigación en Ciencias de La Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, CP 78210, San Luis Potosí, S.L.P, México.
- Facultad de Enfermería y Nutrición, Unidad de Posgrado, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, CP 78210, San Luis Potosí, S.L.P, México.
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de Bont J, Bennett M, León-Muñoz LM, Duarte-Salles T. Prevalencia e incidencia de sobrepeso y obesidad en 2,5 millones de niños y adolescentes en España. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.06.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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10
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English L, Carmona YR, Peterson KE, Jansen EC, Téllez Rojo MM, Torres Olascoaga L, Cantoral A. Changes in Sugar Sweetened Beverage Intake Are Associated with Changes in Body Composition in Mexican Adolescents: Findings from the ELEMENT Cohort. Nutrients 2022; 14:719. [PMID: 35277078 PMCID: PMC8839416 DOI: 10.3390/nu14030719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023] Open
Abstract
Changes in consumption of sugar sweetened beverage (SSBs) have been associated with increased body mass index (BMI), but little work has evaluated the effect on waist circumference (WC) and body fat percentage during adolescence, a period characterized by rapid growth and change in dietary behaviors. We examined the relationship of changes in SSB intake and changes in adiposity over two years in 464 Mexican adolescents. Food frequency questionnaires were used to sum intake of regular soda, coffee with sugar, tea with sugar, sweetened water with fruit, chocolate milk, corn atole, and a sweetened probiotic milk beverage. Linear regression models were used to estimate the associations of changes in SSBs with changes in BMI, body fat percentage, and WC, adjusting for sex, socioeconomic status, screen time, physical activity, age, and change in age. Adolescents who increased their daily SSB intake by >2 serving had a −2.72% higher body fat percentage (95% CI: 0.61, 4.82); a 1−2 serving increase was associated with a 2.49 cm increase (95% CI: 0.21, 4.76) in WC compared with those with no change in intake. Within an adolescent sample, changes in SSB intake were related to concomitant changes in body fat percentage and WC, but not BMI.
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Affiliation(s)
- Lindsey English
- Department of Nutrition and Dietetics, University of North Dakota, Grand Forks, ND 58202, USA;
| | - Yanelli R. Carmona
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; (Y.R.C.); (K.E.P.); (E.C.J.)
| | - Karen E. Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; (Y.R.C.); (K.E.P.); (E.C.J.)
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Erica C. Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; (Y.R.C.); (K.E.P.); (E.C.J.)
| | - Martha María Téllez Rojo
- Center for Health and Nutrition Research, National Institute of Public Health in Mexico, Cuernavaca 62100, Mexico; (M.M.T.R.); (L.T.O.)
| | - Libni Torres Olascoaga
- Center for Health and Nutrition Research, National Institute of Public Health in Mexico, Cuernavaca 62100, Mexico; (M.M.T.R.); (L.T.O.)
| | - Alejandra Cantoral
- Department of Health, Universidad Iberoamericana Ciudad de México, Mexico City 01219, Mexico
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11
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Elkhatib Smidt SD, Hitt T, Zemel BS, Mitchell JA. Sex differences in childhood sleep and health implications. Ann Hum Biol 2022; 48:474-484. [PMID: 35105205 DOI: 10.1080/03014460.2021.1998624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
CONTEXT Sleep is critical for optimal childhood metabolic health and neurodevelopment. However, there is limited knowledge regarding childhood sex differences in sleep, including children with neurodevelopmental disorders, and the impact of such differences on metabolic health. OBJECTIVE To evaluate if sex differences in childhood sleep exist and if sleep associates with metabolic health outcomes equally by sex. Using autism spectrum disorder (ASD) as a case study, we also examine sleep sex differences in children with a neurodevelopmental disorder. METHODS A narrative review explored the literature focussing on sex differences in childhood sleep. RESULTS Sex differences in sleep were not detected among pre-adolescents. However, female adolescents were more likely to report impaired sleep than males. Childhood obesity is more common in males. Shorter sleep duration may be associated with obesity in male pre-adolescents/adolescents; although findings are mixed. ASD is male-predominant; yet, there was an indication that pre-adolescent female children with ASD had more impaired sleep. CONCLUSION Sex differences in sleep appear to emerge in adolescence with more impaired sleep in females. This trend was also observed among pre-adolescent female children with ASD. Further research is needed on sex differences in childhood sleep and metabolic health and the underlying mechanisms driving these differences.
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Affiliation(s)
- Stacey D Elkhatib Smidt
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Sleep Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Talia Hitt
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jonathan A Mitchell
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Vanoli J, Coull BA, Ettinger de Cuba S, Fabian PM, Carnes F, Massaro MA, Poblacion A, Bellocco R, Kloog I, Schwartz J, Laden F, Zanobetti A. Postnatal exposure to PM 2.5 and weight trajectories in early childhood. Environ Epidemiol 2022; 6:e181. [PMID: 35169661 PMCID: PMC8835545 DOI: 10.1097/ee9.0000000000000181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Inconsistent evidence has assessed the impact of air pollution exposure on children's growth trajectories. We investigated the role of 90-day average postnatal fine particulate matter (PM2.5) exposures by estimating the magnitude of effects at different ages, and the change in child weight trajectory by categories of exposure. METHODS We obtained weight values from electronic health records at each hospital visit (males = 1859, females = 1601) from birth to 6 years old children recruited into the Boston-based Children's HealthWatch cohort (2009-2014). We applied mixed models, adjusting for individual and maternal confounders using (1) varying-coefficient models allowing for smooth non-linear interaction between age and PM2.5, (2) factor-smooth interaction between age and PM2.5 quartiles. Additionally, we stratified by sex and low birthweight (LBW) status (≤2500 g). RESULTS Using varying-coefficient models, we found that PM2.5 significantly modified the association between age and weight in males, with a positive association in children younger than 3 years and a negative association afterwards. In boys, for each 10 µg/m3 increase in PM2.5 we found a 2.6% increase (95% confidence interval = 0.8, 4.6) in weight at 1 year of age and a -0.6% (95% confidence interval = -3.9, 2.9) at 5 years. We found similar but smaller changes in females, and no differences comparing growth trajectories across quartiles of PM2.5. Most of the effects were in LBW children and null for normal birthweight children. CONCLUSIONS This study suggests that medium-term postnatal PM2.5 may modify weight trajectories nonlinearly in young children, and that LBW babies are more susceptible than normal-weight infants.
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Affiliation(s)
- Jacopo Vanoli
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Statistics and Quantitative Methods, Universita degli Studi di Milano-Bicocca, Milan, Italy
| | - Brent A. Coull
- Department of Biostatistics, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Patricia M. Fabian
- Department of Environmental Health, School of Public Health, Boston University, Boston, Massachusetts
| | - Fei Carnes
- Department of Environmental Health, School of Public Health, Boston University, Boston, Massachusetts
| | - Marisa A. Massaro
- Department of Environmental Health, School of Public Health, Boston University, Boston, Massachusetts
| | - Ana Poblacion
- Department of Pediatrics, School of Medicine, Boston University, Boston, Massachusetts
| | - Rino Bellocco
- Department of Statistics and Quantitative Methods, Universita degli Studi di Milano-Bicocca, Milan, Italy
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Joel Schwartz
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Francine Laden
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Antonella Zanobetti
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
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Durão C, Severo M, Oliveira A, Lopes C. Sex-Heterogeneity on the Association between Dietary Patterns at 4 Years of Age with Adiposity and Cardiometabolic Risk Factors at 10 Years of Age. Nutrients 2022; 14:nu14030540. [PMID: 35276899 PMCID: PMC8839534 DOI: 10.3390/nu14030540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 02/04/2023] Open
Abstract
To evaluate the association of dietary patterns (DP) at 4 years with adiposity and cardiometabolic risk factors at 10 years, considering sex-heterogeneity. This prospective analysis included 3823 children enrolled in the population-based birth cohort, Generation XXI (Porto-Portugal, 2005-2006). Diet at 4 years was assessed by FFQ, with three DP being identified: high in energy-dense foods (EDF), intermediate in snacks (snacking), and healthier (reference). BMI at 10 years was considered as the Z-score according to the WHO. Other adiposity indicators-fat mass percentage (FM%), fat mass index (FMI), and waist-to-height ratio (WHtR)-were converted to z-scores using the sample's sex-specific means and standard deviations, as were the cardiometabolic risk factors (systolic and diastolic blood pressure, lipid profile, and insulin resistance). The associations of DP at 4 years with later adiposity or cardiometabolic factors were estimated by linear regression or by multinomial logistic regression models. In fully adjusted models, the EDF DP was significantly positively associated with the BMI (EDF vs. healthier: β = 0.139; 95% CI: 0.031, 0.246, P-interaction = 0.042) and obesity (OR = 2.68; 95% CI 1.55, 4.63, P-interaction = 0.005) only in girls, among whom, it increased insulin (β = 0.165; 95% CI: 0.020, 0.311) and HOMA-IR (β = 0.159; 95% CI: 0.013, 0.306) at 10 years. An EDF DP at 4 years is associated with later adiposity, insulin, and HOMA-IR in girls.
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Affiliation(s)
- Catarina Durão
- EPIUnit-Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (C.D.); (M.S.); (A.O.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- NOVA Medical School, NOVA University of Lisbon, 1169-056 Lisbon, Portugal
| | - Milton Severo
- EPIUnit-Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (C.D.); (M.S.); (A.O.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Public Health and Forensic Sciences and Medical Education Department, University of Porto Medical School, University of Porto, 4200-319 Porto, Portugal
| | - Andreia Oliveira
- EPIUnit-Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (C.D.); (M.S.); (A.O.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Public Health and Forensic Sciences and Medical Education Department, University of Porto Medical School, University of Porto, 4200-319 Porto, Portugal
| | - Carla Lopes
- EPIUnit-Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (C.D.); (M.S.); (A.O.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Public Health and Forensic Sciences and Medical Education Department, University of Porto Medical School, University of Porto, 4200-319 Porto, Portugal
- Correspondence: ; Tel.:+351-220-426-640
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14
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Gopalan M, Lombardi CM, Bullinger LR. Effects of parental public health insurance eligibility on parent and child health outcomes. ECONOMICS AND HUMAN BIOLOGY 2022; 44:101098. [PMID: 34929550 PMCID: PMC9301861 DOI: 10.1016/j.ehb.2021.101098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
Many states expanded their Medicaid programs to low-income adults under the Affordable Care Act (ACA). These expansions increased Medicaid coverage among low-income parents and their children. Whether these improvements in coverage and healthcare use lead to better health outcomes for parents and their children remains unanswered. We used longitudinal data on a large, nationally representative cohort of elementary-aged children from low-income households from 2010 to 2016. Using a difference-in-differences approach in state Medicaid policy decisions, we estimated the effect of the ACA Medicaid expansions on parent and child health. We found that parents' self-reported health status improved significantly post-expansion in states that expanded Medicaid through the ACA by 4 percentage points (p < 0.05), a 4.7% improvement. We found no significant changes in children's use of routine doctor visits or parents' assessment of their children's health status. We observed modest decreases in children's body mass index (BMI) of about 2% (p < 0.05), especially for girls.
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Obesity risk in 10-year-old children, based on attributes observed at 4 years of age, provides evidence on how to target interventions to lower obesity rates in mid-childhood. NUTR HOSP 2022; 39:738-744. [DOI: 10.20960/nh.03949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Neves SC, Rodrigues LM, Bento PADSS, Minayo MCDS. Risk factors involved in adolescent obesity: an integrative review. CIENCIA & SAUDE COLETIVA 2021; 26:4871-4884. [PMID: 34787182 DOI: 10.1590/1413-812320212611.3.30852019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 03/02/2020] [Indexed: 02/04/2023] Open
Abstract
The scope of this study was to examine the risk factors for the development of obesity in adolescence. The objective was to identify risk factors for adolescent obesity by means of an Integrative Review of the Literature. The PICO strategy was used to formulate the following central line of inquiry: What are the risk factors for the development of obesity during adolescence? The VHL and EBSCOhost research databases were consulted, resulting in a selection of 25 articles for in-depth study. The phenomenon of obesity was understood as the result of biological, social, psychological, and nutritional factors. The research revealed a lack of consensus on the risks and benefits, which makes evidence-based recommendations difficult. The study identified proposals that can be implemented, such as a change in eating habits, weight control and the practice of physical exercise. Such behavioral changes can be recommended within the context of the family, schools, and health services. The review recommends prevention strategies and the recognition of school as the ideal medium for health promotion through education. From a political and social standpoint, it is necessary to challenge the prevalence of publicity of the food industry that entices adolescents to consume processed foods with high fat and sugar content.
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Affiliation(s)
- Simone Carvalho Neves
- Enfermagem Souza Marques, Fundação Técnico-Educacional Souza Marques. Av. Ernani Cardoso 335/345, Cascadura. 21310.310 Rio de Janeiro RJ Brasil.
| | | | - Paulo Alexandre de Souza São Bento
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
| | - Maria Cecília de Souza Minayo
- Departamento de Estudos sobre Violência e Saúde Jorge Careli (Claves), Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
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Taş Torun Y, İçen S, Gül H, Döğer E. A cross-sectional study on the correlates of food addiction symptoms in adolescents seeking treatment for obesity: eating attitudes and gender differences. J Addict Dis 2021; 40:326-335. [PMID: 34783640 DOI: 10.1080/10550887.2021.1990638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Multidisciplinary approach including psychiatric support, have come to the fore in the treatment of obesity. Food addiction and disordered eating behaviors are among major psychiatric problems that have important effects on both clinical manifestation and response to treatment. This study aimed to investigate correlates of food addiction among adolescents who are seeking treatment for obesity. METHOD This study included 126 adolescents between 11 and 18 years of age, 48 patients in the "study group" who are seeking treatment for obesity (BMI for age greater than 95th percentile) and 78 adolescents (BMI for age under 85th percentile) in the "control group" who were reached via online survey. All participants were requested to complete self-report based measurement tools of Yale Food Addiction Scale (YFAS) and Eating Attitude Test-40 (EAT-40). RESULTS 47.9% adolescents (n = 23) in the study group met food addiction diagnosis according to diagnostic evaluation of YFAS; which was significantly higher than 5.1% (n = 4) adolescents in the control group (p < 0.001). EAT-40 total scores and the scores in subscales of "anxiety of gaining weight," "dieting," and "thin body preoccupation" were significantly higher in the study group. Gender differences were observed when food addiction symptoms were correlated with eating attitudes among the study group. CONCLUSIONS Comparing to the controls, food addiction and disordered eating behaviors were more common in adolescents seeking treatment for obesity. Gender differences in the correlates of food addiction symptoms imply that different approaches might be needed for psychological interventions.
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Affiliation(s)
- Yasemin Taş Torun
- Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Sarper İçen
- Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Hesna Gül
- Department of Child and Adolescent Psychiatry, Gulhane Research and Training Hospital, Ankara, Turkey
| | - Esra Döğer
- Department of Pediatric Endocrinolgy and Metabolism, Gazi University, Ankara, Turkey
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Bekelman TA, Ringham BM, Sauder KA, Johnson SL, Harrall KH, Glueck DH, Dabelea D. Adherence to index-based dietary patterns in childhood and BMI trajectory during the transition to adolescence: the EPOCH study. Int J Obes (Lond) 2021; 45:2439-2446. [PMID: 34304241 PMCID: PMC8542564 DOI: 10.1038/s41366-021-00917-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/10/2021] [Accepted: 07/19/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND In the United States, one in five adolescents are obese. Index-based dietary patterns are measures of the overall diet that have the potential to serve as valuable obesity risk stratification tools. However, little is known about the association between adherence to index-based dietary patterns in childhood and BMI during the transition from childhood to adolescence. OBJECTIVE To prospectively examine the relationship between adherence to three index-based dietary patterns in childhood and BMI trajectory during the transition to adolescence. METHODS The study included 581 children enrolled in a Colorado prospective cohort study conducted between 2006 and 2015. Dietary intake was assessed with the Block Kids Food Frequency Questionnaire at age 10 years. Scores were calculated for the Healthy Eating Index-2010 (HEI-2010), the alternate Mediterranean (aMED) diet, and the Dietary Approaches to Stop Hypertension (DASH) diet. Weight and height were assessed via anthropometry at two research visits (ages 10 and 16 years), with interim clinical measurements extracted from Kaiser Permanente medical records. Separate mixed models were used to assess the association between each diet index score and BMI over a 6-year period. Models were stratified by sex and adjusted for age, race/ethnicity, income, and exposure to gestational diabetes. RESULTS Median (IQR) number of BMI assessments was 14 (10-18). Among girls, for every ten-unit increase in HEI-2010 score, there was an average 0.64 kg/m2 decrease (p = 0.007) in BMI over time, after adjustment for covariates. Among girls, there was no association between BMI and aMED (β = -0.19, p = 0.24) or DASH (β = 0.28, p = 0.38). Among boys, there was no statistically significant association between BMI and HEI-2010 (0.06, p = 0.83), aMED (0.07, p = 0.70), or DASH (0.42, p = 0.06). CONCLUSIONS Efforts to prevent adolescent obesity could benefit from considering the degree of adherence to federal dietary guidance, as assessed by the HEI, in the period preceding adolescence, especially among girls.
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Affiliation(s)
- Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | - Brandy M. Ringham
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado
| | - Katherine A. Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Susan L. Johnson
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kylie H. Harrall
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado
| | - Deborah H. Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, Colorado,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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19
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Knebusch V, Williams J, Yordi Aguirre I, Weber MW, Rakovac I, Breda J. Effects of the coronavirus disease 2019 pandemic and the policy response on childhood obesity risk factors: Gender and sex differences and recommendations for research. Obes Rev 2021; 22 Suppl 6:e13222. [PMID: 34184392 PMCID: PMC8420308 DOI: 10.1111/obr.13222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 12/15/2022]
Abstract
Childhood obesity is a public health concern globally, with generally higher prevalence rates in boys compared to girls. Although biological sex is an important determinant, gender roles and norms influence the exposure and vulnerability to risk factors for noncommunicable diseases. Norms and roles might be reinforced or change due to coronavirus disease 2019 (COVID-19) related measures as well as the exposure to risk factors for childhood obesity. COVID-19 related changes, such as home confinement, influence a child's risk of obesity. Using Dahlgren and Whitehead's model of the main determinants of health, this paper aims to provide a roadmap for future research on sex, gender, and childhood obesity during the time of COVID-19. It examines how COVID-19 has led to important changes in children's general socioeconomic, cultural, and environmental conditions, social and community networks, and individual lifestyle factors and how these may affect a child's risk for obesity. It focuses on the influence of gender and sex and outlines key considerations and indicators to examine in future studies concerned with promoting health and gender equity and equality. We need to understand the differential impact of COVID-19 related measures on girls' and boys' risk for obesity to adequately react with preventive measures, policies, and programs.
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Affiliation(s)
- Veronika Knebusch
- Gender and Human Rights, WHO European Office for Investment for Health and Development, Venice, Italy
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Isabel Yordi Aguirre
- Gender and Human Rights, WHO European Office for Investment for Health and Development, Venice, Italy
| | - Martin W Weber
- World Health Organization (WHO) Child and Adolescent Health and Development, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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20
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McCoy SM, Rupp K. Physical activity participation, flourishing and academic engagement in adolescents with obesity. Pediatr Obes 2021; 16:e12796. [PMID: 33908183 DOI: 10.1111/ijpo.12796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 03/17/2021] [Accepted: 04/07/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Adolescents with obesity are less likely to flourish and be academically engaged in comparison to their healthy weight peers. However, it is unknown how participation in physical activity influences flourishing and academic engagement in adolescents with obesity. The current study examined engagement in varying levels of physical activity and the likelihood of flourishing and academic engagement in adolescents with obesity. METHODS Analyses included 26 764 adolescents, ages 10-17 years, from the parent-reported, combined 2016-2017 National Survey of Children's Health. Participants were grouped by physical activity levels (none, low, moderate, daily). Outcome variables included flourishing (finishing tasks, staying calm when faced with a challenge and showing interest in new things) and academic engagement (completing all required homework and caring about doing well in school). Logistic regression models, adjusted for age, sex, race, household income, highest level of education in the household, behavioural conduct problems and depression assessed the likelihood of each outcome comparing physical activity levels among adolescents with obesity. RESULTS Adolescents with obesity who participated in any amount of physical activity (low, moderate and daily) or sports had significantly greater likelihood of flourishing and academic engagement compared those that did not engage in any physical activity (p's < 0.05). CONCLUSIONS Participation in even low amounts of physical activity or participation in sports increases the likelihood of flourishing and academic engagement in adolescents with obesity, which expands on previous findings that adolescents with obesity are less likely to flourish and be academically engaged in comparison to their healthy weight peers.
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Affiliation(s)
- Stephanie M McCoy
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Kristie Rupp
- Department of Health and Movement Sciences, Southern Connecticut State University, New Haven, Connecticut, USA
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21
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Abstract
Eating disorders such as anorexia nervosa, female athlete triad, bulimia nervosa, obesity, and binge eating initially emerge during adolescence. These disorders are present primarily in females, but males may also present with these conditions. Dentistry has a pivotal role in the management of patients with such diet-related disorders. Because dentists examine their patients at frequent intervals and may be the health care professionals with whom patients feel more comfortable discussing eating disorders, dentists must have knowledge of the etiology, diagnostic criteria, systemic effects, and intraoral manifestations of eating disorders. In addition, the dental professional may be the first health care provider to identify the condition and refer the patient appropriately to medical colleagues for subsequent treatment. This chapter provides dentists with current and relevant information to recognize, diagnose, and integrate dental treatment for their adolescent patients who may exhibit manifestations of an eating disorder.
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22
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Anderson LN, Fatima T, Shah B, Smith BT, Fuller AE, Borkhoff CM, Keown-Stoneman CDG, Maguire JL, Birken CS. Income and neighbourhood deprivation in relation to obesity in urban dwelling children 0-12 years of age: a cross-sectional study from 2013 to 2019. J Epidemiol Community Health 2021; 76:274-280. [PMID: 34489332 PMCID: PMC8862044 DOI: 10.1136/jech-2021-216455] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 08/08/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Childhood obesity is a major public health concern. This study evaluated the independent and joint associations of family-level income, neighbourhood-level income and neighbourhood deprivation, in relation to child obesity. METHODS A cross-sectional study was conducted in children ≤12 years of age from TARGet Kids! primary care network (Greater Toronto Area, 2013-2019). Parent-reported family income was compared with median neighbourhood income and neighbourhood deprivation measured using the Ontario Marginalization Index. Children's height and weight were measured and body mass index (BMI) z-scores (zBMI) were calculated. ORs and 95% CIs were estimated for the three exposure variables separately using multilevel multinomial logistic regression models with zBMI categories as the outcome, adjusting in model 1 for age, sex, ethnicity and number of family members and in model 2 adding family income. A joint measure was derived combining income and deprivation measures. RESULTS A total of 5962 children were included. Low family income (Q1 vs Q5: OR=4.69, 95% CI 2.65 to 8.29), low neighbourhood income (Q1 vs Q5: OR=2.18, 95% CI 1.33 to 3.58) and high neighbourhood deprivation (Q1 vs Q5: OR=2.45, 95% CI 1.52 to 3.95) were each associated with increased OR of child obesity. However, after adjustment for family income, the association for both neighbourhood income (OR=1.39, 95% CI 0.82 to 2.34) and deprivation (OR=1.56, 95% CI 0.94 to 2.58) and obesity was attenuated. Children from low-income families living in low-income or high deprivation neighbourhoods had higher OR of obesity. CONCLUSION Child obesity was independently associated with low family-level income and a joint measure suggests that neighbourhood also matters. Socioeconomic inequalities at both individual and neighbourhood levels should be addressed in childhood obesity interventions.
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Affiliation(s)
- Laura N Anderson
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada .,Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Tooba Fatima
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Bindra Shah
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Brendan T Smith
- Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anne E Fuller
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Cornelia M Borkhoff
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Charles D G Keown-Stoneman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
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23
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de Bont J, Bennett M, León-Muñoz LM, Duarte-Salles T. The prevalence and incidence rate of overweight and obesity among 2.5 million children and adolescents in Spain. ACTA ACUST UNITED AC 2021; 75:300-307. [PMID: 34384717 DOI: 10.1016/j.rec.2021.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/24/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION AND OBJECTIVES Childhood obesity trends are plateauing in Spain, but limited information is available about how they differ by region. This study assessed childhood and adolescent the prevalence and incidence of overweight and obesity from 2005 to 2017 across 8 Spanish regions. METHODS This longitudinal study used height and weight measurements from 2.5 million children aged 2 to 17 years to calculate overweight and obesity, according to the World Health Organization (WHO) guidelines. Data were obtained from The Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria, and the Information System for Research in Primary Care. Prevalence and incidence rates and trends from 2005 to 2017 were calculated and stratified by age, sex, and region. RESULTS The overall obesity prevalence increased in boys and girls from age 2 (0.8%; 95%CI, 0.8-0.9 in both sexes) until peaking at age 7 in girls (17.3%; 95%CI, 17.1-17.5) and age 9 in boys (24.1%; 95%CI 23.9-24.3). The highest and lowest obesity prevalences were observed in Murcia and Navarre. Overall obesity prevalence trends decreased from 2005 to 2017 in all age-sex groups and in most regions. Highest obesity incidence rates were found in children aged 6 to 7 years, (4.5 [4.5-4.5] and 3.5 [3.5-3.5] new obesity cases per 100 person-years in boys and girls, respectively). Boys had higher prevalence and incidence rates than girls across all regions. Overweight/obesity prevalence and incidence rates and their trends were consistently higher than the obesity results, although a similar pattern was observed across sex and age. CONCLUSIONS Overweight and obesity prevalence slightly decreased in Spain from 2005 to 2017, but regional, sex, and age differences persisted. Because incidence peaked around the age of 6 years, it may be important to begin health promotion programs at an early age.
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Affiliation(s)
- Jeroen de Bont
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain; ISGlobal, Barcelona, Spain; Centro de Investigación en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Matthew Bennett
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
| | - Luz M León-Muñoz
- División de Farmacoepidemiología y Farmacovigilancia, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
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24
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Longitudinal Associations between Intake of Fruit and Vegetables and Height Attainment from Preschool to School Entry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116106. [PMID: 34198900 PMCID: PMC8201233 DOI: 10.3390/ijerph18116106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022]
Abstract
To examine associations between fruit and vegetable intake in young childhood and height attainment during preschool and at school entry. Data for this study was based on "The Healthy Start" primary intervention study, which included 635 obesity-prone children, (58% boys), from the greater Copenhagen area, with a mean (SD) age of 4.0 (1.1) years (age range 2-6 years) at baseline. In the current study, 553 children (57% boys) were included with information on dietary intake at baseline and height measured at baseline (preschool age), and 511 children (56.8% boys) with the height measured at school entry (~6 years old). Height was measured by trained health professionals during the intervention and by school nurses at school entry. Information on intakes of fruit and vegetables, separately and combined, was gathered with four-day dietary records reported by parents. Participants were grouped into tertiles for their intakes at baseline. Compared to boys with low consumption, those with a moderate and high intakes of fruit and vegetables (F&V) had a greater attained height at preschool of 1.3 cm (95% confidence interval (CI): 0.3; 2.3) and at school entry of 2.4 cm (95% CI: 0.8; 3.9) and 1.8 cm (95% CI: 0.2; 3.4), respectively, also after adjustment for differences in age, body mass index (BMI), and total energy intake. Additional adjustment for mid-parental height and parents' education did not alter the significant associations between moderate consumption of F&V and attained height at preschool and school entry. There was no association among girls. Our results showed that a moderate consumption of F&V was directly associated with higher attainment in height at preschool and school entry in boys. From a public health perspective, it should be prioritized to continue developing intervention programs to improve fruit and vegetable intake.
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Taghizadeh S, Khodayari-Zarnaq R, Farhangi MA. Childhood obesity prevention policies in Iran: a policy analysis of agenda-setting using Kingdon's multiple streams. BMC Pediatr 2021; 21:250. [PMID: 34044800 PMCID: PMC8155654 DOI: 10.1186/s12887-021-02731-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric obesity is one of the most important health challenges of the twenty-first century. Primary prevention of childhood obesity, can lessen its consequences. This study aims to assess childhood obesity prevention policies in Iran through a policy analysis of agenda-setting using Kingdon's multiple streams. METHODS A qualitative study was conducted using in-depth interviews with 39 key informants and document review from different stages of the policymaking process of childhood and adolescent obesity prevention programs in Iran. The analysis of documents and interviews were guided based on Kingdon's multiple streams (problem, policy and political streams). RESULTS The important factors of the problem stream were the high prevalence of childhood and adolescent obesity and its risk factors in Iran. In the policy stream, a focus on preventing non-communicable diseases in the health system, increasing the workforce in health centers, promoting health school programs, and creating healthy eating buffets in schools was identified. Under the political stream, the impact of the WHO ECHO program in 2015 and the implementation of the health system transformation plan in Iran in the new government took place after 2013, caused the Iran ECHO program entered the agenda and implemented from 2016. CONCLUSIONS Now that a window of opportunity for childhood and adolescent obesity prevention policymaking has been created, the problems such as the therapeutic approach in the health system, the existence of sanctions against Iran and outbreak of coronavirus disease-19 (COVID-19), have hindered the successful implementation of this policy and the opportunity window has not been well used. However, actors need political support from the high levels of government to keep this policy on the agenda.
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Affiliation(s)
- Shahnaz Taghizadeh
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahim Khodayari-Zarnaq
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Department of Community Nutrition, Tabriz University of Medical Sciences, 5166614711, Attar Nishabouri St, PO BOX: 14711, Tabriz, I. R Iran
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Abstract
OBJECTIVE The effects of adverse childhood experiences (ACE) on children and adolescents' health status such as obesity are understudied. The current study addressed the effect of ACE on obesity status during childhood utilising multiple waves of national panel data. DESIGN Longitudinal survey. SETTING Data were drawn from three waves of the second cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II). NSCAW II study sampled cases from Child Protective Services investigations that were closed between February 2008 and April 2009 nationwide. We measured ACE cumulatively and as separate events and stratified by gender. PARTICIPANTS Totally, 3170 youth births to 14 years of age at baseline. RESULTS A count measure of ACE is indeed associated with greater odds of obesity during childhood. Differential effects for different types of ACE were also found, most notably neglect. For girls, physical and psychological neglect increased odds of obesity. CONCLUSIONS Findings support evidence for the importance of using both a count measure of ACE as well as separating out single events by gender.
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27
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Garrido-Miguel M, Martínez-Vizcaíno V, Oliveira A, Martínez-Andrés M, Sequí-Domínguez I, Hernández-Castillejo LE, Cavero-Redondo I. Prevalence and trends of underweight in European children and adolescents: a systematic review and meta-analysis. Eur J Nutr 2021; 60:3611-3624. [PMID: 33779808 DOI: 10.1007/s00394-021-02540-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/11/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed at providing prevalence trend estimates of underweight among children and adolescents in Europe from 2000 to 2017. METHODS MEDLINE, Web of Science, Scopus and CINAHL were searched from their inception up to March 2020. Moreover, searches were conducted on health institutions' websites to identify studies not published in scientific journals. Underweight was defined according to the body mass index (BMI) cut-offs proposed by the International Obesity Task Force (IOTF) and the World Health Organization (WHO) definition criteria. The Mantel-Haenszel method was used to compute the pooled prevalence estimates whenever there was no evidence of heterogeneity; otherwise, the DerSimonian and Laird random-effects method was used. Subgroup analyses by sex, age range (2-13 and 14-18 years old), study year (2000-2006 and 2007-2017), country and European region were conducted. RESULTS A total of 49 studies with data from 323,420 children and adolescents aged 2 to 18 years, from 26 countries were included. From 2000 to 2017, according to the IOTF criteria, the prevalence of underweight showed an increasing trend in Eastern, Northern and Southern Europe, where the underweight prevalence ranged from 9.1 to 12.0%, from 4.1 to 6.8%, and from 5.8 to 6.7%, respectively. In Western Europe, the prevalence of underweight tended to decrease, from 14.0 to 11.8%. No significant differences were found by sex or age range. CONCLUSION The prevalence of underweight is considerable (overall, around 8-9%), particularly in Eastern Europe, and follows a slight upward trend during the past decade. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017056924.
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Affiliation(s)
- Miriam Garrido-Miguel
- Universidad de Castilla-La Mancha, Health and Social Research Center, C/ Santa Teresa Jornet, s/n, 16071, Cuenca, Spain.,Universidad de Castilla-La Mancha, Faculty of Nursing, Albacete, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, C/ Santa Teresa Jornet, s/n, 16071, Cuenca, Spain. .,Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile.
| | - Andreia Oliveira
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - María Martínez-Andrés
- Universidad de Castilla-La Mancha, Health and Social Research Center, C/ Santa Teresa Jornet, s/n, 16071, Cuenca, Spain.,Universidad de Castilla-La Mancha, Faculty of Nursing, Albacete, Spain
| | - Irene Sequí-Domínguez
- Universidad de Castilla-La Mancha, Health and Social Research Center, C/ Santa Teresa Jornet, s/n, 16071, Cuenca, Spain
| | | | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, C/ Santa Teresa Jornet, s/n, 16071, Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
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28
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Song Q, Song J, Li C, Wang Y, Qi L, Wang H. Genetic variants in the FAM3C gene are associated with lipid traits in Chinese children. Pediatr Res 2021; 89:673-678. [PMID: 32316026 DOI: 10.1038/s41390-020-0897-3] [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: 09/19/2019] [Revised: 03/12/2020] [Accepted: 04/01/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Previous studies have related FAM3C gene with childhood bone health, and the regulation of lipid metabolism in hepatocytes. The present case-control study aimed to analyze the association of FAM3C genetic variants with overweight/obesity and lipid traits among Chinese children. METHODS Two genetic variants (rs7776725 and rs7793554) within the FAM3C gene were genotyped in 3305 Chinese children aged 6-18 years. RESULTS In the whole study population, the T-allele of rs7776725 and A-allele of rs7793554 within the FAM3C gene were associated with 40.2% (95% CI: 11.6-76.1%; P = 0.004) and 29.1% (6.9-56.0%; P = 0.008) increased risk of dyslipidemia, higher triglyceride (P = 0.014 and P = 0.001) and lower HDL-C (P = 0.015 and P = 0.003). In addition, we found that rs7776725 interacted with sex on dyslipidemia (Pfor interaction = 0.004), and sex-stratified analyses showed that it was significantly associated with dyslipidemia only in girls (P = 8.78 × 10-5). The variant also showed nominally significant interactions with sex on total cholesterol and LDL-C (Pfor interaction = 0.012 and 0.008). CONCLUSION We found that FAM3C genetic variants were associated with dyslipidemia and lipid traits among Chinese children. In addition, we found significant gene-by-sex interactions. Our findings provided evidence supporting the role of FAM3C gene in regulating lipid metabolism in humans. IMPACT FAM3C genetic variants were associated with dyslipidemia and lipid traits among Chinese children. In addition, we found significant gene-by-sex interactions. FAM3C/rs7776725 was associated with dyslipidemia and lipid traits only in girls. Our findings provided evidence supporting the role of FAM3C gene in regulating lipid metabolism in humans.
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Affiliation(s)
- Qiying Song
- Department of Maternal and Child Health, School of Public Health, Peking University, 100191, Beijing, China
| | - Jieyun Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, 100191, Beijing, China
| | - Chenxiong Li
- Department of Maternal and Child Health, School of Public Health, Peking University, 100191, Beijing, China
| | - Yang Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, 100191, Beijing, China
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, 100191, Beijing, China.
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Saliba K, Cuschieri S. Amidst the COVID-19 pandemic childhood obesity is still an epidemic-spotlight on obesity's multifactorial determinants. HEALTH SCIENCES REVIEW (OXFORD, ENGLAND) 2021; 1:100006. [PMID: 34977915 PMCID: PMC8639479 DOI: 10.1016/j.hsr.2021.100006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/30/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE Childhood obesity is a global epidemic and a chronic disease. Multifactorial determinants have long been linked with childhood obesity. These have been challenged with the onset of COVID-19 and the associated mitigation measures. The study aimed to re-highlight these determinants while exploring the effects of the ongoing COVID-19 pandemic on these pre-existing childhood obesity determinants, while providing evidence that may be beneficial for the post-COVID-19 recovery plan. METHODS A PubMed literature search (2016-2021) using the keywords, "childhood obesity", "gender", "sex", "obesity in youth", "obesity in adolescents", "COVID-19″ and "SARS-CoV2" was performed. RESULTS Genetic predisposition, biologically low leptin levels, certain cultural beliefs and socio-economic statuses, as well as exposure to an "obesogenic" environment were found to have a positive association with childhood obesity. Additionally, the onset of COVID-19 further aggravates the childhood obesity epidemic, increasing childrens' susceptibility to obesity and all associated consequential diseases. DISCUSSION A possible key to the control and prevention of the burden of childhood obesity, lies in dealing with its precursors and risk factors. Certain factors, including socio-cultural norms, cultural beliefs and geographical factors are amenable. COVID-19 further challenged these and it is evident that the childhood obesity epidemic is still a critical one. Encouraging preventative interventions, such as screening programs, public awareness and policies targeting the environment, amongst others, are recommended.
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Affiliation(s)
- Katya Saliba
- Medical Student, Faculty of Medicine and Surgery University of Malta, Msida, Malta,Corresponding author
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine & Surgery, University of Malta, Rm 425, Biomedical Building, Msida, Malta
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30
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Davis NL, Tolfrey K, Jenney M, Elson R, Stewart C, Moss AD, Cornish JM, Stevens MCG, Crowne EC. Combined resistance and aerobic exercise intervention improves fitness, insulin resistance and quality of life in survivors of childhood haemopoietic stem cell transplantation with total body irradiation. Pediatr Blood Cancer 2020; 67:e28687. [PMID: 33044779 DOI: 10.1002/pbc.28687] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/01/2020] [Accepted: 08/21/2020] [Indexed: 01/17/2023]
Abstract
PURPOSE To investigate the effects of a supervised combined resistance and aerobic training programme on cardiorespiratory fitness, body composition, insulin resistance and quality of life (QoL) in survivors of childhood haematopoietic stem cell transplantation (HSCT) with total body irradiation (TBI). PARTICIPANTS HSCT/TBI survivors (n = 20; 8 females). Mean (range) for age at study and time since HSCT/TBI was 16.7 (10.9-24.5) and 8.4 (2.3-16.0) years, respectively. METHODS After a 6-month run-in, participants undertook supervised 45- to 60-minute resistance and aerobic training twice weekly for 6 months, with a 6-month follow-up. The following assessments were made at 0, 6 (start of exercise programme), 12 (end of exercise programme) and 18 months: Body composition via dual energy X-ray absorptiometry, homeostatic model assessment of insulin resistance (HOMA-IR), cardiorespiratory fitness (treadmill-based peak rate of oxygen uptake (VO2 peak) test), QoL questionnaires (36-Item Short Form Health Survey (SF-36) and Minneapolis-Manchester Quality of Life Instrument (MMQL). RESULTS Results expressed as mean (standard deviation) or geometric mean (range). There were significant improvements in VO2 peak (35.7 (8.9) vs 41.7 (16.1) mL/min/kg, P = 0.05), fasted plasma insulin (16.56 (1.48-72.8) vs 12.62 (1.04-54.97) mIU/L, P = 0.03) and HOMA-IR (3.65 (0.30-17.26) vs 2.72 (0.22-12.89), P = 0.02) after the exercise intervention. There were also significant improvements in the SF-36 QoL general health domain (69.7 (14.3) vs 72.7 (16.0), P = 0.001) and the MMQL school domain (69.1 (25.2) vs (79.3 (21.6), P = 0.03) during the exercise intervention. No significant changes were observed in percentage body fat, fat mass or lean mass. CONCLUSION The supervised 6-month combined resistance and aerobic exercise programme significantly improved cardiorespiratory fitness, insulin resistance and QoL in childhood HSCT/TBI survivors, with no change in body composition, suggesting a metabolic training effect on muscle. These data support a role for targeted physical rehabilitation services in this group at high risk of diabetes and cardiovascular disease.
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Affiliation(s)
- Nikki L Davis
- Department of Paediatric Endocrinology and Diabetes, Level 6 UHBristol Education Centre, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Keith Tolfrey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Cardiff, UK
| | - Ruth Elson
- Department of Paediatric Oncology, Bristol Royal Hospital for Children, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Claire Stewart
- Stem cells, Ageing and Molecular Physiology Unit, Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, Merseyside, UK
| | - Andrew D Moss
- Stem cells, Ageing and Molecular Physiology Unit, Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, Merseyside, UK
| | - Jacqueline M Cornish
- Department of Paediatric Oncology, Bristol Royal Hospital for Children, Bristol, UK
| | - Michael C G Stevens
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Elizabeth C Crowne
- Department of Paediatric Endocrinology and Diabetes, Level 6 UHBristol Education Centre, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
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Rambaran K, Teelucksingh S, Gowrie Sankar S, Boyne M, Xuereb G, Giorgetti A, Zimmermann MB. High prevalence of childhood overweight and obesity in ten Caribbean countries: 2018 cross-sectional data and a narrative review of trends in Trinidad and Tobago. CHILD AND ADOLESCENT OBESITY 2020. [DOI: 10.1080/2574254x.2020.1847632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Kirin Rambaran
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Surujpal Teelucksingh
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Sesh Gowrie Sankar
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Michael Boyne
- Department of Medicine, The University of the West Indies, Mona, Jamaica
| | - Godfrey Xuereb
- Regional Office for the Americas, Pan American Health Organization, Washington, DC, USA
| | - Ambra Giorgetti
- Human Nutrition, ETH Zurich, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Michael B. Zimmermann
- Human Nutrition, ETH Zurich, Swiss Federal Institute of Technology, Zurich, Switzerland
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Parental Child-feeding in the Context of Child Temperament and Appetitive Traits: Evidence for a Biopsychosocial Process Model of Appetite Self-Regulation and Weight Status. Nutrients 2020; 12:nu12113353. [PMID: 33143216 PMCID: PMC7692583 DOI: 10.3390/nu12113353] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/17/2020] [Accepted: 10/29/2020] [Indexed: 12/20/2022] Open
Abstract
Pediatric obesity is a serious public health challenge and there is a need for research that synthesizes the various linkages among the child and parental factors that contribute to pediatric overweight and obesity. The main objective of this study was to examine potential mechanisms and pathways that might explain how child temperament is indirectly related to child body composition through appetitive traits and parental child-feeding practices. Participants consisted of 221 children between 4–6 years of age (51% males, mean age = 4.80 years, standard deviation = 0.85) and their parents (90.5% biological mothers, (Mage) = 32.02 years, (SDage) = 6.43) with 71% of the parents being married. Study variables included child temperament (negative affectivity and effortful control), child appetitive traits (food avoidance and food approach), controlling parental child-feeding practices (restrictive feeding and pressure to eat), and child body composition. Body composition were indexed by parent perceptions, body mass index (BMI), and percent body fat. Results showed that children with low levels of effortful control are more prone to exhibit food avoidance, which in turn is likely to elicit parental pressure to eat that in turn is linked to high child weight status. In addition, children with high levels of negative affectivity are prone to exhibit a food approach, which in turn is likely to elicit restrictive feeding from parents that in turn is linked to high child objective weight status. Findings situate controlling parental child-feeding practices in the context of child temperament and appetitive traits using a biopsychosocial framework of appetite self-regulation and weight. Results highlight that child appetite self-regulation processes and parental child-feeding practices could be essential components to target in childhood obesity preventive interventions.
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33
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Iguacel I, Gasch-Gallén Á, Ayala-Marín AM, De Miguel-Etayo P, Moreno LA. Social vulnerabilities as risk factor of childhood obesity development and their role in prevention programs. Int J Obes (Lond) 2020; 45:1-11. [PMID: 33033393 DOI: 10.1038/s41366-020-00697-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/08/2020] [Accepted: 09/26/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Large socioeconomic, gender, and ethnic inequalities exist in terms of childhood obesity worldwide. Children from low socioeconomic status families are more likely to have overweight/obesity and related cardiometabolic problems and future cancer risk. A wider concept are social vulnerabilities defined as social or economic characteristics or experiences negatively affecting children through behavioral, biological factors, or mental health. Social vulnerabilities include also therefore low subjective perceptions of social position. OBJECTIVE This study aims to identify social vulnerabilities and to summarize their impact as obesity development risk factor. Preventive programs implemented targeting these vulnerable groups and their effectiveness are also discussed. METHODS Literature review based on the experience of the authors social vulnerabilities identified as risk factors for childhood obesity were children whose parents lack of a social network, low support from formal and informal sources, parental unemployment, belonging to a minority group or having migrant background, adverse childhood experiences including household dysfunction, violence and childhood maltreatment and other traumatic experiences, gender inequalities and being part of nontraditional families. RESULTS The impact of social vulnerabilities on childhood obesity is independent of SES; however, SES exacerbates or buffer the effect social vulnerabilities have on different lifestyles and stress. Behavioral, biological, and mental health mechanisms may explain the association between social vulnerabilities and childhood obesity. CONCLUSIONS Behaviors such as dietary intake, physical activity, sedentary behaviors, and sleep are negatively affected by the stress and low levels of mental health derived from social vulnerabilities. It seems that high energy intakes rather than low physical activity levels might be the main driving force behind the obesity epidemic in vulnerable groups. Most of the prevention programs identified did not take into account social vulnerabilities and inequalities making them ineffective in most vulnerable groups. Interventions conducted in children from socially vulnerable group suggest modest but promising effects.
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Affiliation(s)
- Isabel Iguacel
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain. .,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. .,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain. .,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Ángel Gasch-Gallén
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Alelí M Ayala-Marín
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Pilar De Miguel-Etayo
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences; University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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Ling J, Kao TSA, Robbins LB. Body mass index, waist circumference and body fat are positively correlated with hair cortisol in children: A systematic review and meta-analysis. Obes Rev 2020; 21:e13050. [PMID: 32543094 DOI: 10.1111/obr.13050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/18/2020] [Accepted: 05/01/2020] [Indexed: 12/20/2022]
Abstract
The current body of research lacks a meta-analysis of the relationship between hair cortisol concentration (HCC) and anthropometry in children. Therefore, this systematic review and meta-analysis was conducted to examine this relationship and explore possible moderators between HCC and body mass index (BMI/BMI z-score). Eleven databases were searched: CINAHL, Cochrane, Embase, PsycEXTRA, Psychology and Behavioral Sciences, PsycINFO, PubMed, Scopus, Social Sciences Full Text, Sociological Abstracts and Web of Sciences. Random-effects models and exploratory moderator analyses with mixed-effects models were performed using the Comprehensive Meta-Analysis software. The meta-analysis showed small positive correlations between HCC and BMI (r = 0.08, 95% confidence interval [CI]: 0.02, 0.14, n = 18, p = .009), BMI z-score (r = 0.10, 95% CI: 0.03, 0.16, n = 12, p = .003), waist circumference (r = 0.10, 95% CI: 0.04, 0.17, n = 10, p = .001) and body fat including fat mass index (r = 0.06, 95% CI: 0.02, 0.11, n = 3, p = .005). The relationship between HCC and BMI/BMI z-score was significantly moderated by children's sex. Results from this meta-analysis provide initial objective support for a small positive relationship between HCC and anthropometric factors.
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Affiliation(s)
- Jiying Ling
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Tsui-Sui Annie Kao
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Lorraine B Robbins
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
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35
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Shah B, Tombeau Cost K, Fuller A, Birken CS, Anderson LN. Sex and gender differences in childhood obesity: contributing to the research agenda. BMJ Nutr Prev Health 2020; 3:387-390. [PMID: 33521549 PMCID: PMC7841817 DOI: 10.1136/bmjnph-2020-000074] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/12/2020] [Accepted: 08/20/2020] [Indexed: 12/20/2022] Open
Abstract
Childhood obesity is a major public health challenge and its prevalence continues to increase in many, but not all, countries worldwide. International data indicate that the prevalence of obesity is greater among boys than girls 5–19 years of age in the majority of high and upper middle-income countries worldwide. Despite this observed sex difference, relatively few studies have investigated sex-based and gender-based differences in childhood obesity. We propose several hypotheses that may shape the research agenda on childhood obesity. Differences in obesity prevalence may be driven by gender-related influences, such as societal ideals about body weight and parental feeding practices, as well as sex-related influences, such as body composition and hormones. There is an urgent need to understand the observed sex differences in the prevalence of childhood obesity; incorporation of sex-based and gender-based analysis in all childhood obesity studies may ultimately contribute to improved prevention and treatment.
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Affiliation(s)
- Bindra Shah
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Anne Fuller
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Catherine S Birken
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Laura N Anderson
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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36
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de Bont J, Díaz Y, Casas M, García-Gil M, Vrijheid M, Duarte-Salles T. Time Trends and Sociodemographic Factors Associated With Overweight and Obesity in Children and Adolescents in Spain. JAMA Netw Open 2020; 3:e201171. [PMID: 32186743 PMCID: PMC7081120 DOI: 10.1001/jamanetworkopen.2020.1171] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Time-trend studies of overweight and obesity in childhood by sociodemographic factors are important for prioritizing public health initiatives. However, little is known about these trends in Spain, where high levels of obesity are found and where important demographic changes have occurred during the last 2 decades. OBJECTIVE To examine how time trends in the prevalence and incidence of overweight and obesity among children and adolescents differ by age, sex, socioeconomic status, urban/rural residence, and nationality. DESIGN, SETTING, AND PARTICIPANTS This cohort study included 1.1 million children and adolescents (aged 2-17 years) with at least 1 measure of height and weight in Catalonia, Spain, from 2006 to 2016. Electronic health records were accessed from the Information System for Research in Primary Care. Data analysis was conducted from January to December 2018. MAIN OUTCOMES AND MEASURES Prevalence and incidence rates and trends of overweight/obesity and obesity (overweight/obesity defined as having of BMI z score greater than 2.0 among children aged <5 years and greater than 1.0 among children aged ≥5 years; obesity defined as having of BMI z score greater than 3.0 among children aged <5 years and greater than 2.0 among children aged ≥5 years) between 2006 and 2016 were calculated and stratified by sociodemographic characteristics (ie, age, sex, deprivation index, urban/rural residence, and nationality). RESULTS The study population included 1 166 609 children and adolescents (570 982 [48.9%] girls; median [interquartile range] age at entry to electronic health record system, 2.4 [0-7.7] years; 1 006 892 [86.3%] with Spanish nationality). Of 941 041 children (80.7%) who lived in urban areas, 197 427 (20.7%) lived in the most deprived areas. Overall, the prevalence of overweight/obesity and obesity decreased between 2006 and 2016 in all sex and age groups; for example, among boys and girls aged 6 to 11 years, overweight/obesity prevalence decreased from 41.9% (95% CI, 41.5%-42.2%) to 39.9% (95% CI, 39.6%-40.3%) and from 39.7% (95% CI, 39.3%-40.2%) to 37.6% (95% CI, 37.3%-38.0%), respectively. Incidence rates of overweight/obesity and obesity were highest among children aged 6 to 7 years (overweight/obesity among boys: 11.9 [95% CI, 11.8-12.0] new cases per 100 person-years; obesity among boys: 4.9 [95% CI, 4.8-4.9] new cases per 100 person-years). Prevalence and incidence rates were highest in the most deprived areas, in urban areas, and among children with North, Central, or South American nationalities. Between 2006 and 2016, prevalence increased in the most deprived areas in almost all sex and age groups. Among girls aged 6 to 11 years living in the most deprived areas, the obesity prevalence ratio increased from 1.59 (95% CI, 1.46-1.74) to 2.03 (95% CI, 1.88-2.19) compared with those living in the least deprived areas. Furthermore, during this period, prevalence increased among children with non-Spanish nationalities, especially in the African and Asian nationality groups (eg, boys aged 6-11 years with Asian nationality compared with Spanish nationality, 2006: prevalence rate, 0.78 [95% CI, 0.60-1.01]; 2016: prevalence rate, 1.27 [95% CI, 1.15-1.39]). Incidence rates decreased among younger groups (eg, ≤7 years: incidence rate ratio for January 1, 2006, to June 30, 2011, vs July 1, 2011, to December 31, 2016: 0.94; 95% CI, 0.91-0.98) but remained stable in older groups. CONCLUSIONS AND RELEVANCE In this study, the overall prevalence and incidence rates of childhood overweight/obesity and obesity slightly decreased during the last decade. However, increased deprivation disparities in childhood obesity were found, given that the prevalence increased among children living in deprived areas and with non-Spanish nationalities.
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Affiliation(s)
- Jeroen de Bont
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Yesika Díaz
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Maribel Casas
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Maria García-Gil
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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Yang Z, Phung H, Hughes AM, Sherwood S, Harper E, Kelly P. Trends in overweight and obesity by socioeconomic status in Year 6 school children, Australian Capital Territory, 2006-2018. BMC Public Health 2019; 19:1512. [PMID: 31718605 PMCID: PMC6852987 DOI: 10.1186/s12889-019-7645-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/20/2019] [Indexed: 01/10/2023] Open
Abstract
Background Due to the high prevalence and adverse consequences, overweight and obesity in children continues to be a major public health concern worldwide. Socioeconomic background and health-related behaviours (such as diet, physical activity and sedentary behaviors) are important factors associated with weight status in children. Using a series of height and weight assessments from the Australian Capital Territory Physical Activity and Nutrition Survey (ACTPANS), trends in prevalence of overweight and obesity by socioeconomic status were examined in ACT Year 6 school children between 2006 and 2018. Methods The ACTPANS has been conducted every 3 years since 2006. A total of 6729 children were surveyed. Complete data on height and weight were available for 6384 (94.9%) participants. Trends in the prevalence of overweight and obesity and associations between weight status and risk factors (such as socioeconomic status, physical activity, screen time and consumption of sugar-sweetened soft drinks (SSD)) were examined using logistic regression. Results The prevalence of overweight and obesity remained stable in girls (from 22.5% in 2006 to 21.6% in 2018) but declined in boys (from 27.8 to 17.9%). During the same period, levels of physical activity increased slightly, while screen time and the consumption of fast food and SSD decreased. Socioeconomic gradient, based on the school-level Index of Community Socio-Educational Advantage (ICSEA), was highly associated with prevalence of overweight and obesity. Since 2006, the estimated prevalence of overweight and obesity has remained high in the lowest SES groups, but a concurrent downward trend was observed in the highest SES group, leading to increasing disparity between SES groups. Children in the lowest ICSEA quintile were more likely to be overweight or obese compared to those in the moderate and highest ICSEA quintiles. Children in lower ICSEA quintiles also reported lower levels of physical activity, higher levels of screen time, and higher levels of fast food and SSD consumption compared to those in higher ICSEA quintiles. Conclusions While recent trends in overweight and obesity in ACT children are encouraging, the prevalence remains unacceptably high, especially in those from low socioeconomic backgrounds. Additional prevention efforts are required to address the socioeconomic disparity.
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Affiliation(s)
- Zongjian Yang
- Preventive and Population Health, ACT Health Directorate, 2-6 Bowes Street, Phillip, Canberra, ACT 2606, Australia.
| | - Hai Phung
- Preventive and Population Health, ACT Health Directorate, 2-6 Bowes Street, Phillip, Canberra, ACT 2606, Australia.,School of Medicine, Griffith University, Brisbane, Australia
| | - Ann-Maree Hughes
- Preventive and Population Health, ACT Health Directorate, 2-6 Bowes Street, Phillip, Canberra, ACT 2606, Australia
| | - Sommer Sherwood
- Preventive and Population Health, ACT Health Directorate, 2-6 Bowes Street, Phillip, Canberra, ACT 2606, Australia
| | - Emily Harper
- Preventive and Population Health, ACT Health Directorate, 2-6 Bowes Street, Phillip, Canberra, ACT 2606, Australia
| | - Paul Kelly
- Preventive and Population Health, ACT Health Directorate, 2-6 Bowes Street, Phillip, Canberra, ACT 2606, Australia.,Medical School, Australian National University, Canberra, Australia
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38
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Prevalence and Predictors of Obesity among 7- to 17-Year-Old Schoolchildren in Urban Arusha, Tanzania. J Nutr Metab 2019; 2019:3106597. [PMID: 31772772 PMCID: PMC6854959 DOI: 10.1155/2019/3106597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/21/2019] [Accepted: 09/30/2019] [Indexed: 01/01/2023] Open
Abstract
Background Childhood obesity is currently increasing at an alarming rate worldwide. Childhood obesity research has not been reported in urban Arusha before. This is therefore the first study to investigate the prevalence and predictors of childhood obesity in urban Arusha. Methods A cross-sectional study was conducted involving 451 schoolchildren. Overweight was defined to range from 85th to 94th BMI percentile for age and sex while obesity was defined as above 94th BMI percentile for age and sex. Chi-square test was used for comparison between child sex and sociobehaviors, and multiple logistic regression was used to determine the significant predictor factors at P values = 0.05. Results The overall prevalence of overweight and obesity was 17.7% (80/451) with 12.6% (57/451) being obese and 5.1% (23/451) being overweight. Results from univariate logistic regression showed child sex, random sleeping time, and random eating habit were the significant predictor factors. However, when all the predictor factors were used in the final multiple logistic regression model, only random sleeping time and random eating habit of different food items irrespective of their nature were significant at P=0.000, AOR = 4.47, and 95% CI = 2.00–10.01, and P=0.012, AOR = 2.54, and 95% CI = 1.23–5.33, respectively. Conclusions The prevalence of obesity was as higher as twice the prevalence observed in other previous studies in Tanzania. Being a girl, random sleeping time and random eating habit were independent predictors. In addition to larger sample sizes, longitudinal studies are needed in order to track individuals and population level trends in BMI over time.
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Garrido-Miguel M, Cavero-Redondo I, Álvarez-Bueno C, Rodríguez-Artalejo F, Moreno LA, Ruiz JR, Ahrens W, Martínez-Vizcaíno V. Prevalence and Trends of Overweight and Obesity in European Children From 1999 to 2016: A Systematic Review and Meta-analysis. JAMA Pediatr 2019; 173:e192430. [PMID: 31381031 PMCID: PMC6686782 DOI: 10.1001/jamapediatrics.2019.2430] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Studies of trends in excess weight among European children throughout the last few decades have rendered mixed results. Additionally, some studies were outdated, were based on self-reported weight and height, or included only a few European countries. OBJECTIVE To assess prevalence trends in measured overweight and obesity among children across Europe from 1999 to 2016 using a systematic methodology. DATA SOURCES MEDLINE, Embase, CINAHL, and Web of Science were searched from their inception until May 2018. Moreover, searches were conducted on health institutions' websites to identify studies not published in scientific journals. STUDY SELECTION The inclusion criteria were: (1) studies reporting the population-based prevalence of excess weight (overweight plus obesity) or obesity according to body mass index cutoffs proposed by the International Obesity Task Force; (2) cross-sectional or follow-up studies; and (3) studies including populations aged 2 to 13 years. DATA EXTRACTION AND SYNTHESIS Literature review and data extraction followed established guidelines. The Mantel-Haenszel method was used to compute the pooled prevalence estimates and their 95% CI whenever there was no evidence of heterogeneity (I2 < 50%); otherwise, the DerSimonian and Laird random-effects method was used. Subgroup analyses by study year, country, or European region (Atlantic, Iberian, Central, and Mediterranean) were conducted. Prevalence estimates were calculated as an aggregate mean, weighted by the sample size and the number of individuals in each study. RESULTS A total of 103 studies (477 620 children aged 2 to 13 years) with data from 28 countries were included. The combined prevalence of overweight and obesity in the Iberian region tended to decrease from 30.3% (95% CI, 28.3%-32.3%) to 25.6% (95% CI, 19.7%-31.4%) but tended to increase in the Mediterranean region from 22.9% (95% CI, 17.9%-27.9%) to 25.0% (95% CI, 14.5%-35.5%). No substantial changes were observed in Atlantic Europe or Central Europe, where the overweight and obesity prevalence changed from 18.3% (95% CI, 14.0%-23.9%) to 19.3% (95% CI, 17.7%-20.9%) and from 15.8% (95% CI, 13.4%-18.5%) to 15.3% (95% CI, 11.6%-20.3%), respectively. CONCLUSIONS AND RELEVANCE The prevalence of childhood overweight and obesity is very high, but trends have stabilized in most European countries. There are substantial between-country differences in the current levels and trends of overweight and obesity. The rising prevalence in some Mediterranean countries is worrisome. TRIAL REGISTRATION PROSPERO identifier: CRD42017056924.
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Affiliation(s)
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz, Madrid, Spain,CIBERESP and IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain ,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; ,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Jonatan R. Ruiz
- Promoting Fitness And Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain,Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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Reilly J, Zhu L, Hunt MJO, Hovarter R, Flood MB. Comparison of Rural Childhood BMI Percentiles: Prevalence and Trends in a Midwest County, 2008-2016. J Sch Nurs 2019; 37:298-305. [PMID: 31416395 DOI: 10.1177/1059840519868766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The number of children who are obese and overweight continues as a public health challenge despite decades of research. The purpose of this article is to describe trends in body mass index (BMI) percentile data collected from 11- to 14-year-old school children in 2008-2009 and 2015-2016 in rural Wisconsin. The BMI percentiles from 1,347 students were compared using time, gender, age, and school (public vs. parochial) as predictors. The trend over time indicated a decrease in students of healthy weight and an increase in those overweight or obese. Also noted was a significantly higher proportion of children who were overweight or obese in parochial compared to public schools. Discussed are the observed trends, community-wide initiatives implemented, as well as how schools can employ a more comprehensive approach to childhood obesity that first ensures community readiness and involves school, home, and community.
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Affiliation(s)
- Janet Reilly
- Nursing and Health Studies, University of Wisconsin-Green Bay, Green Bay, WI, USA
| | - Le Zhu
- Human Biology, University of Wisconsin-Green Bay, Green Bay, WI, USA
| | - Megan J Olson Hunt
- Mathematics and Statistics, University of Wisconsin-Green Bay, Green Bay, WI, USA
| | - Rebecca Hovarter
- Nursing and Health Studies, University of Wisconsin-Green Bay, Green Bay, WI, USA
| | - M Brigid Flood
- Retired from a Wisconsin county health department, WI, USA
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Peckins MK, Negriff S, Schneiderman JU, Gordis EB, Susman EJ. The Moderating Role of Cortisol Reactivity on the Link Between Maltreatment and Body Mass Index Trajectory Across Adolescence. J Adolesc Health 2019; 65:239-247. [PMID: 31043344 PMCID: PMC6650365 DOI: 10.1016/j.jadohealth.2019.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/02/2019] [Accepted: 02/26/2019] [Indexed: 01/30/2023]
Abstract
PURPOSE Child maltreatment increases risk for obesity, yet differential effects of maltreatment type remain unclear. Cortisol reactivity may help clarify these effects, given links among cortisol reactivity, maltreatment, and obesity. We examined these associations in boys and girls across adolescence. METHODS We collected data from 454 adolescents (212 girls) across four waves (aged 8-13 years at Time 1), including 303 maltreated youth. We modeled body mass index (BMI) percentile trajectories arrayed by age separately for boys and girls and tested whether cortisol reactivity at Time 1 moderated the association between maltreatment type and BMI growth. RESULTS In girls, cortisol reactivity moderated the association between maltreatment type and quadratic change in BMI. At low levels of cortisol, sexually abused girls had a steeper quadratic increase in BMI compared with comparison (-.65, 95% confidence interval [CI] -1.09 to -.22) and physically abused (-.76, 95% CI -1.29, -.24) girls. At high levels of cortisol, sexually abused girls did not differ from comparison (.15, 95% CI -.40 to .70) or physically abused (.21, 95% CI -.38 to .80) girls in quadratic change in BMI. In boys, cortisol reactivity did not moderate the association between maltreatment type and BMI growth. CONCLUSIONS The combination of lower cortisol reactivity and sexual abuse may put girls at risk for BMI increase during later adolescence. Given the negative consequences of high BMI, identifying and intervening with these girls could lead to better health and well-being among this group. Cortisol reactivity may not play the same role among boys.
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Affiliation(s)
- Melissa K. Peckins
- Department of Psychology, University of Michigan, Ann Arbor, Michigan,Corresponding Author: Melissa K. Peckins, Mailing address: 1004 East Hall, 530 Church Street, Ann Arbor, MI 48109-1043, , Fax: 734-764-2580, Phone: 845-558-7198
| | - Sonya Negriff
- Department of Research and Evaluation, Kaiser Permanente, Pasadena, California
| | - Janet U. Schneiderman
- Suzanne Dworak-Peck School of Social Work, Department of Nursing, University of Southern California, Los Angeles, California
| | - Elana B. Gordis
- Department of Psychology, University at Albany, State University of New York, Albany, New York
| | - Elizabeth J. Susman
- Department of Biobehavioral Health, Pennsylvania State University, State College, Pennsylvania
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Prevalence of Overweight and Obesity among European Preschool Children: A Systematic Review and Meta-Regression by Food Group Consumption. Nutrients 2019; 11:nu11071698. [PMID: 31340602 PMCID: PMC6682909 DOI: 10.3390/nu11071698] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/18/2019] [Accepted: 07/18/2019] [Indexed: 12/13/2022] Open
Abstract
The aim of this review was to estimate the prevalence of overweight and obesity among European children aged 2–7 years from 2006 to 2016 and to analyze these estimations by gender, country, and food group consumption. We searched CINAHL, EMBASE, MEDLINE, and Web of Science databases from their inception until 27 February 2019 including cross-sectional studies and baseline measurements of cohort studies with overweight and obesity defined according to the International Obesity Task Force criteria. Both the inverse-variance fixed-effects method and the DerSimonian and Laird random effects method were used to determinate pooled prevalence estimates and their respective 95% confidence intervals (CIs). A total of 32 studies (n = 197,755 children) with data from 27 European countries were included. Overall, the pooled prevalence estimates of overweight/obesity in European children (aged 2–7 years) during the period 2006–2016 was 17.9% (95% CI: 15.8–20.0), and the pooled prevalence estimate of obesity was 5.3% (95% CI: 4.5–6.1). Southern European countries showed the highest prevalence of excess weight. Additional measures to address the obesity epidemic in early life should be established, especially in European countries where the prevalence of excess weight is very high.
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Breitenstein RS, Doane LD, Lemery-Chalfant K. Early life socioeconomic status moderates associations between objective sleep and weight-related indicators in middle childhood. Sleep Health 2019; 5:470-478. [PMID: 31153801 DOI: 10.1016/j.sleh.2019.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/22/2019] [Accepted: 04/01/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study tested whether early socioeconomic status moderated links between objective and subjective sleep and weight indicators during middle childhood. DESIGN The study design was cross-sectional but included data from earlier assessment points in the study. SETTING Data were collected from families across the state of Arizona. PARTICIPANTS Participants were 382 children recruited from birth records (49.5% female; Mage = 8.47 years; 56.5% European American; 25.1% Latino; 25% living at or below the poverty line). MEASUREMENTS Assessments included socioeconomic status at 12 months of age, and sleep and weight indicators at 8 years. RESULTS Longer sleep durations predicted lower body mass index and decreased odds of being overweight/obese across all children, regardless of socioeconomic background. For children from low socioeconomic backgrounds, longer sleep duration predicted lower percent body fat, greater efficiency predicted lower percent body fat and body mass index and smaller waist circumference, and more sleep problems predicted larger waist circumference. For children from low socioeconomic backgrounds, greater sleep duration and efficiency also predicted the lowest odds of being overweight/obese, and more sleep problems predicted the greatest odds of being overweight/obese. CONCLUSIONS Early life may be a sensitive period that sets the stage for stronger links between sleep and weight indicators in middle childhood. Findings offer important information regarding the protective role of sleep in the promotion of health, as well as the negative consequences that may be stronger for children who experienced low early-life socioeconomic status.
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Affiliation(s)
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ
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Serum 25-hydroxyvitamin D is associated with obesity and metabolic parameters in US children. Public Health Nutr 2019; 23:1214-1222. [PMID: 31120008 DOI: 10.1017/s1368980019001137] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To explore the relationships of serum 25-hydroxyvitamin D (25(OH)D) with obesity and metabolic parameters in US children. DESIGN Cross-sectional analysis. We evaluated the associations between serum 25(OH)D and multiple measurements of adiposity, serum lipid concentrations, fasting glucose and insulin resistance in children aged 6-18 years with adjustments for multiple covariates. SETTING The National Health and Nutrition Examination Survey, 2001-2006. PARTICIPANTS A nationally representative sample of 6311 children and adolescents aged 6-18 years. RESULTS Among US children and adolescents, the prevalence of vitamin D deficiency has been especially high in older children, girls and the non-Hispanic Black population. Higher odds of obesity were found at a 25(OH)D concentration of <30 nmol/l (deficiency) than at >50 nmol/l under both criteria for obesity in children (OR = 3·27, Ptrend ≤ 0.001). Moreover, increased odds of having abnormal HDL-cholesterol (OR = 1·71, Ptrend ≤ 0.001) and impaired insulin resistance (OR = 4·15, Ptrend ≤ 0·001) were found for children deficient in 25(OH)D compared with those with normal 25(OH)D concentrations. When the children and adolescents were stratified by gender, we found stronger associations between serum 25(OH)D concentration and both HDL-cholesterol and insulin resistance in girls. No association of 25(OH)D with any other metabolic parameter was found. CONCLUSIONS Our results suggest a potential harmful association between low serum 25(OH)D concentration and the risk of obesity among children. However, the underlying mechanisms require further investigation.
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Keller KL, Kling SMR, Fuchs B, Pearce AL, Reigh NA, Masterson T, Hickok K. A Biopsychosocial Model of Sex Differences in Children's Eating Behaviors. Nutrients 2019; 11:nu11030682. [PMID: 30909426 PMCID: PMC6470823 DOI: 10.3390/nu11030682] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 12/11/2022] Open
Abstract
The prevalence of obesity and eating disorders varies by sex, but the extent to which sex influences eating behaviors, especially in childhood, has received less attention. The purpose of this paper is to critically discuss the literature on sex differences in eating behavior in children and present new findings supporting the role of sex in child appetitive traits and neural responses to food cues. In children, the literature shows sex differences in food acceptance, food intake, appetitive traits, eating-related compensation, and eating speed. New analyses demonstrate that sex interacts with child weight status to differentially influence appetitive traits. Further, results from neuroimaging suggest that obesity in female children is positively related to neural reactivity to higher-energy-dense food cues in regions involved with contextual processing and object recognition, while the opposite was found in males. In addition to differences in how the brain processes information about food, other factors that may contribute to sex differences include parental feeding practices, societal emphasis on dieting, and peer influences. Future studies are needed to confirm these findings, as they may have implications for the development of effective intervention programs to improve dietary behaviors and prevent obesity.
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Affiliation(s)
- Kathleen L Keller
- Department of Nutritional Science, The Pennsylvania State University, University Park, PA 16802, USA.
- Department of Food Science, The Pennsylvania State University, University Park, PA 16803, USA.
| | - Samantha M R Kling
- Department of Nutritional Science, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Bari Fuchs
- Department of Nutritional Science, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Alaina L Pearce
- Department of Nutritional Science, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Nicole A Reigh
- Department of Nutritional Science, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Travis Masterson
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH 03756, USA.
| | - Kara Hickok
- Department of Nutritional Science, The Pennsylvania State University, University Park, PA 16802, USA.
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The Global Financial Crisis and Overweight among Children of Single Parents: A Nationwide 10-Year Birth Cohort Study in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061001. [PMID: 30897687 PMCID: PMC6466597 DOI: 10.3390/ijerph16061001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/07/2019] [Accepted: 03/12/2019] [Indexed: 12/22/2022]
Abstract
Evidence suggests that socioeconomically disadvantaged children may experience a greater increase in overweight risk during macroeconomic downturns. We examined whether inequalities in the risk of overweight between Japanese children from single- and two-parent households increased after the 2008 global financial crisis. We used data from ten waves (2001 to 2011) of a nationwide longitudinal survey following all Japanese children born within 2 weeks in 2001 (boys: n = 15,417, girls: n = 14,245). Child overweight was defined according to age- and sex-specific cut-offs for Body Mass Index (BMI). Interaction between a binary measure of crisis onset (September 2008) and single-parent status was assessed using generalized estimating equation models. Covariates included baseline household income and income loss during the crisis. Girls from single-parent households showed a greater increase in the odds of overweight after crisis onset (adjusted odds ratio (AOR), 1.23; 95% confidence interval (CI), 1.04–1.46) compared to girls from households with two parents, regardless of household financial status. A similar though statistically non-significant trend was observed among boys (AOR, 1.10; 95% CI, 0.92–1.30). Child overweight risk by single-parent status may increase during macroeconomic downturns, at least among girls. Financial aid to single-parent households may not suffice to redress this gap.
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Al Yazeedi B, Berry DC. Childhood Overweight and Obesity is Increasing in Gulf Cooperation Council Countries: A Review of the Literature. J Transcult Nurs 2019; 30:603-615. [DOI: 10.1177/1043659619829528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: A review was conducted to examine the prevalence and risk factors of developing overweight and obesity in children residing in Gulf Cooperation Council (GCC) countries. Method: PubMed, Medline, and Google Scholar databases using PRISMA guidelines were searched from January 1, 2007, to January 1, 2017. The inclusion criteria were (a) studies written in English, (b) clinical trials that examined risk factors of childhood overweight or obesity, (c) studies involving children 5 to 10 years of age, and (d) studies conducted in GCC countries. Results: Three main types of childhood obesity risk factors were identified (individual, familial, and lifestyle behavioral factors). The dietary, physical activity, and screen time lifestyle behavior risk factor findings were inconclusive. Discussion: Childhood obesity is increasing in GCC countries. Lifestyle behavior risk factors are still unclear. Researchers need to use instruments that have been psychometric tested and culturally acceptable. A follow-up review should be conducted.
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Affiliation(s)
| | - Diane C. Berry
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Do EK, Zucker NL, Huang ZY, Schechter JC, Kollins SH, Maguire RL, Murphy SK, Hoyo C, Fuemmeler BF. Associations between imprinted gene differentially methylated regions, appetitive traits and body mass index in children. Pediatr Obes 2019; 14:e12454. [PMID: 30231188 PMCID: PMC6437681 DOI: 10.1111/ijpo.12454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/15/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Knowledge regarding genetic influences on eating behaviours is expanding; yet less is known regarding contributions of epigenetic variation to appetitive traits and body mass index (BMI) in children. OBJECTIVE The purpose of this study was to explore relationships between methylation at differentially methylated regions (DMRs) of imprinted genes (insulin-like growth factor 2/H19 and Delta-like, Drosophila, homolog 1/maternally expressed gene 3) using DNA extracted from umbilical cord blood leucocytes, two genetically influenced appetitive traits (food responsiveness and satiety responsiveness) and BMI. METHODS Data were obtained from participants (N = 317; mean age = 3.6 years; SD = 1.8 years) from the Newborn Epigenetic STudy. Conditional process models were implemented to investigate the associations between DMRs of imprinted genes and BMI, and test whether this association was mediated by appetitive traits and birthweight and moderated by sex. RESULTS Appetitive traits and birthweight did not mediate the relationship between methylation at DMRs. Increased insulin-like growth factor 2 DMR methylation was associated with higher satiety responsiveness. Higher satiety responsiveness was associated with lower BMI. Associations between methylation at DMRs, appetitive traits and BMI differed by sex. CONCLUSIONS This is one of the first studies to demonstrate associations between epigenetic variation established prior to birth with appetitive traits and BMI in children, providing support for the need to uncover genetic and epigenetic mechanisms for appetitive traits predisposing some individuals to obesity.
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Affiliation(s)
- E. K. Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - N. L. Zucker
- Duke Center for Eating Disorders and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Z. Y. Huang
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, US
| | - J. C. Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - S. H. Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - R. L. Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - S. K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, US
| | - C. Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - B. F. Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
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Rupp K, McCoy SM. Flourishing and academic engagement among adolescents with overweight and obesity. Int J Adolesc Med Health 2018; 33:/j/ijamh.ahead-of-print/ijamh-2018-0180/ijamh-2018-0180.xml. [PMID: 30496139 DOI: 10.1515/ijamh-2018-0180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/09/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Overweight and obesity in adolescence are associated with several negative health indicators; the association with flourishing, an indicator of overall well-being, is less clear. OBJECTIVES To examine associations between weight status and indicators of flourishing and academic engagement in adolescents. SUBJECTS Analyses included 22,078 adolescents (10-17 years) from the 2016 National Survey of Children's Health. METHODS Adolescents were grouped according to body mass index (BMI) classification; outcomes included indicators of flourishing and academic engagement. Logistic regression models assessed the odds of each outcome comparing adolescents with overweight and adolescents with obesity to healthy weight adolescents. RESULTS For flourishing, adolescents with overweight and adolescents with obesity were less likely to stay calm during a challenge (17% and 30%, respectively; p < 0.01); adolescents with obesity were 30% less likely to finish a task they started (p < 0.001), and 34% less likely to show interest in new things (p < 0.001) in comparison to healthy weight peers. Adolescents with obesity were 26% less likely to care about doing well in school (p < 0.001), and adolescents with overweight and adolescents with obesity were significantly less likely to complete all required homework (19% and 34%, respectively) (p < 0.001), in comparison to healthy weight peers. CONCLUSIONS A comprehensive approach to addressing overweight and obesity in adolescence should target improving academic engagement and flourishing to promote overall well-being.
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Affiliation(s)
- Kristie Rupp
- Brooklyn College of the City University of New York, Department of Kinesiology, 2900 Bedford Avenue Brooklyn, NY 11210, United States of America
| | - Stephanie M McCoy
- School of Kinesiology and Nutrition, University of Southern Mississippi, 118 College Drive #5142, Hattiesburg, MS 39406, USA
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Mazidi M, Banach M, Kengne AP. Prevalence of childhood and adolescent overweight and obesity in Asian countries: a systematic review and meta-analysis. Arch Med Sci 2018; 14:1185-1203. [PMID: 30393474 PMCID: PMC6209725 DOI: 10.5114/aoms.2018.79001] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 07/10/2018] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION We conducted a systematic review and meta-analysis to estimate the prevalence of overweight and obesity in children (aged 5-12 years) and adolescents (aged 12-19 years) in Asian countries. Study design: Systematic review and meta-analysis. MATERIAL AND METHODS We comprehensively searched specialised databases for relevant studies conducted in Asian countries between January 1, 1999, and May 30, 2017. Random effects models (using the DerSimonian-Laird method) and generic inverse variance methods were used for quantitative data synthesis. Sensitivity analysis was conducted using the 'leave-one-out' method. Heterogeneity was quantitatively assessed using the I2 index. Systematic review registration: CRD42016033061. RESULTS Among 22,286 identified citations, 41 studies met the inclusion criteria with n = 71,998 and n = 353,513 for children and adolescents. The pooled prevalence (overall, boys and girls) was 5.8% (n = 4175), 7.0% (n = 2631) and 4.8% (n = 1651) for obesity in children aged 5-11 years; 8.6% (n = 30,402), 10.1% (n = 17,990) and 6.2% (n = 10,874) for obesity in adolescents age 12-19 years. For overweight in children the values for overall, boys and girls were 11.2% (n = 7900), 11.7% (n = 4280) and 10.9% (n = 3698) respectively; and for overweight in adolescents, 14.6% (n = 46,886), 15.9% (27,183), and 13.7% (20,574). These findings were robust in sensitivity analyses. In children and adolescents a higher percentage of boys than girls are obese (children = 7.0 vs. 4.8%, adolescents = 10.1 vs. 6.2%, p < 0.001, respectively). Furthermore, in children and adolescents a higher percentage of boys than girls are overweight (children = 11.7 vs. 10.9%, adolescents = 15.9 vs. 13.7%, p < 0.001, respectively). CONCLUSIONS In view of the number of children who are overweight or obese, the associated detrimental effects on health, and the cost to health-care systems, implementation of programmes to monitor and prevent unhealthy weight gain in children and adolescents is needed throughout Asian countries.
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Affiliation(s)
- Mohsen Mazidi
- Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz (MUL), Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Andre Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa
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