Children with Down syndrome: association of Bcl-I polymorphism of nuclear receptor subfamily 3 group C member 1 gene with obesity

BACKROUND

This study aimed to assess the possible association between rs41423247 (Bcl-I) polymorphism in the gene for the human glucocorticoid receptor (GR) called Nuclear Receptor Subfamily 3 Group C Member 1 (NR3C1) with obesity in Egyptian children with and without Down syndrome.

METHODS

The Bcl-I polymorphism was assessed, using real-time PCR, in 300 children divided into four groups: Down-obese, Down-non obese, normal-obese, and normal non-obese.

RESULTS

There was no significant difference between normal-obese and normal-non obese children regarding the Bcl-I genotypes and allele frequencies, while there was a significant difference between Down-obese and Down-non obese children regarding the Bcl-I GC genotype frequency. Again, there was a highly significant difference between Down-obese and normal-non obese children and between children with Down-syndrome (obese and non-obese) and normal children (obese and non-obese) regarding the Bcl-I genotypes and alleles frequencies.

CONCLUSIONS

Our study found a weak association of the G allele of Bcl-I rs41423247 with the presence of obesity among normal Egyptian children, while there was a significant association of the mutant C allele of the Bcl-I rs41423247 with Down syndrome, suggesting a possible association with Down syndrome pathophysiology.

IMPACT

Bcl-I polymorphism is not strikingly associated with obesity in normal children. The GG genotype is higher in obese normal children but without significant difference. The significant increase of the mutant C allele in Down-children than normal children. This may be relevant to Down syndrome's pathophysiology which disturbs the whole genome's balance.

The association of a low glycaemic index diet in pregnancy with child body composition at 5 years of age: A secondary analysis of the ROLO study

INTRODUCTION

Childhood obesity remains a significant global health concern. Early intervention through maternal diet during pregnancy represents a possible mode of improving childhood adiposity.

AIM

To examine the impact of a low glycaemic index diet during pregnancy on offspring anthropometry at 5 years of age.

METHODS

This is a secondary analysis of 387 children from the ROLO pregnancy study 5 years' post-intervention. At the follow-up, BMI, circumferences and skinfold thickness were obtained. A subgroup of 103 children had a DXA scan completed. Statistical analyses included Independent sample t tests, Mann Whitney-U tests and chi-square tests to compare the intervention and control groups. Adjusted analysis using linear regression controlled for significant confounders between participants who returned at follow-up and those that did not.

RESULTS

There were no significant differences in BMI (16.05 kg/m² vs 16.16 kg/m² , P = 0.403), general adiposity (36.60 mm vs 36.00 mm, P = 0.920), central adiposity (0.61 mm vs 0.60 mm, P = 0.540), total fat mass (4.91 kg vs 4.71 kg, P = 0.377) or total lean mass (14.29 kg vs 14.56 kg, P = 0.386) between the intervention and control groups, respectively. No associations were observed in 5-year outcomes in adjusted analyses when controlling for maternal age at delivery, maternal early pregnancy BMI, maternal education and gestational age.

CONCLUSION

Our study found no evidence that a low glycaemic index diet in pregnancy impacts offspring anthropometry 5 years' post-intervention. Therefore, modulating maternal carbohydrate quality in pregnancy may not be an appropriate approach to improving weight status in childhood. Future research should investigate the impact of other dietary practices in pregnancy on child health.

Prevalence of overweight and obesity in children and adolescents with intellectual disabilities in China

BACKGROUND

Overweight and obesity in children and adolescents has become a worldwide epidemic. There are several studies that have concentrated on the prevalence rate of children and adolescents with intellectual disabilities (ID), whereas data on such a population on the mainland of China remain unclear. The purpose of this study was to investigate the prevalence rate of overweight and obesity among school-aged children and adolescents with ID on China's mainland.

METHODS

This study employed a cross-sectional design to examine the body weight status of 1873 children and adolescents (ages 6-18 years old) with ID in 35 special education schools. Body mass index was calculated, and the concepts of overweight and obesity were defined according to the standard of the Working Group for Obesity in China.

RESULTS

Data indicated that 18.2% (95% CI: 16.5%-20.0%) of children and adolescents with ID were overweight and 14.4% (95% CI: 12.8%-16.0%) were obese. Boys with ID were more likely to be overweight than girls with ID (OR = 1.48[95% CI: 1.13-1.94], P < 0.05). Children and adolescents with Down syndrome or autism spectrum disorder had a trend to be classified as overweight (OR = 1.76[95% CI: 1.22-2.54], P < 0.05; OR = 1.57[95% CI: 1.17-2.09], P < 0.05, respectively) or obesity (OR = 1.82[95% CI: 1.23-2.69], P < 0.05; OR = 1.40 [95% CI: 1.02-1.93], P < 0.05, respectively) compared with those with ID without these conditions. Moreover, children and teenagers with ID living in urban areas had a predisposition to be overweight (OR = 2.16[95% CI: 1.14-4.09], P < 0.05) or obese (OR = 3.25[95% CI: 1.41-7.50], P < 0.05) relative to those who lived in rural areas.

CONCLUSION

Results indicated that in China, the prevalence rate of overweight and obesity among school-aged children and adolescents with ID was remarkably high. Therefore, future research should make every effort to focus on reducing and preventing overweight and obesity of this population in China.

The prevalence of obesity in children and young people with Down syndrome

BACKGROUND

Overweight and obesity is a growing concern among individuals with intellectual disabilities; however, little is known about the prevalence among children and youth with Down syndrome (CYDS). The purpose of this study was to determine the prevalence of overweight/obesity among CYDS in South West Ireland.

METHODS

This cross-sectional study measured height and weight of 61 CYDS aged 4-16 years. Body mass index (BMI) was calculated and percentage body fat (PBF) was measured using bio-electrical impendence analysis (BIA).

RESULTS

Using the International Obesity Task Force BMI cut-offs, 51.6% of males and 40% of females were overweight/obese compared to 32% and 14.8%, respectively, using PBF. The mean PBF for males was 18.76 versus females 22.38 (p < .05). There is a higher prevalence of overweight/obesity, particularly in males, compared to the general population of children.

CONCLUSIONS

The difference in estimation of overweight/obesity between BMI and BIA has implications for research and clinical practice.

Trends in the dietary patterns and prevalence of obesity among Greenlandic school children

OBJECTIVE

The aim of the study was to examine the trends in the dietary patterns of selected food items and in the prevalence of self-perceived obesity in a population of Greenlandic schoolchildren.

STUDY DESIGN

The study is based on three school surveys among Greenlandic schoolchildren, class 6 to 11 in public schools, and contributing to the Health Behaviour in School-aged Children (HBSC) Study. Data are collected through self-completed questionnaires administered in the classroom. Three surveys have been carried out in Greenland in 1994, 1998 and 2002 with the participation of 2,999, 3,057 and 2,010 pupils, respectively.

RESULTS

The intake of vegetables has increased significantly since 1994, and the intake of fruits, sweets and soft drink has decreased significantly at a 5% level. An unchanged high proportion of schoolchildren report to be on a diet or consider themselves obese.

CONCLUSION

Most of the observed trends are positive, with regard to intake of vegetables and sweets and consumption of soft drinks. The fact that a high proportion of schoolchildren consider themselves to be obese must be assumed to have a negative impact on the psychological well-being of this population. The results of the survey can reveal changes which have occurred over time for the specified population. This knowledge can be used in public health work and planning.

Association of obesity with chronic disease and musculoskeletal factors

SummaryIntroduction:overweight and obesity in adolescents are major public health problems with particular interest, because of their potential association with risk factors for development of diseases. The study aimed to determine the prevalence of overweight and obesity in adolescents in southern Portugal and investigate the association with risk factors for development of cardiovascular, respiratory and musculoskeletal diseases.Methods:the sample consisted of 966 adolescents aged 10 to 16 years. The calculation of body mass index (BMI), evaluation of blood glucose, total cholesterol and triglycerides, blood pressure, spirometry and application of low back pain (LBP) questionnaire were performed.Results:178 (18.4%) adolescents were overweight and 52 (5.4%) obese. None of the variables revealed a statistically significant association with overweight and obesity. The presence of high blood pressure was observed in 200 (20.7%) individuals and hypertension in 158 (16.4%) adolescents. Overweight and obese adolescents are 2.3 times more likely to develop signs of pre-hypertension and hypertension. 559 (57.9%) students had restrictive respiratory disorders and 23 (2.4%) had obstructive disorders. Those who were overweight and obese had 0.64 probability of having restrictive respiratory disorders.Conclusion:there was a high prevalence of overweight and obesity in Portuguese adolescents and these showed a statistically significant relationship with the development of pre-hypertension and hypertension, and restrictive respiratory disorders.

Availability of state-based obesity surveillance data on high school students with disabilities in the United States

The aim of this study was to assess the availability of public health surveillance data on obesity among American children with disabilities in state-based surveillance programs. We reviewed annual cross-sectional datasets in state-level surveillance programs for high school students, implemented 2001-2011, for the inclusion of weight and height and disability screening questions. When datasets included a disability screen, its content and consistency of use across years were examined. We identified 54 surveillance programs with 261 annual datasets containing obesity data. Twelve surveillance programs in 11 states included a disability screening question that could be used to extract obesity data for high school students with disabilities, leaving the other 39 states with no state-level obesity data for students with disabilities. A total of 43 annual datasets, 16.5 % of the available datasets, could be used to estimate the obesity status of students with disabilities. The frequency of use of disability questions varied across states, and the content of the questions often changed across years and within a state. We concluded that state surveillance programs rarely contained questions that could be used to identify high school students with disabilities. This limits the availability of data that can be used to monitor obesity and related health statuses among this population in the majority of states.

Prevalence of obesity-related chronic health conditions in overweight adolescents with disabilities

The prevalence of 15 common obesity-related chronic health conditions was examined in a convenience sample of adolescents, ages 12-18 years old, with mobility and non-mobility limitations (n = 208 and 435, respectively). In both groups, overweight adolescents (BMI ≥ 85th %ile) had a significantly higher number of obesity-related chronic health conditions than their counterparts with healthy weight status (2.74 versus 1.74 for the mobility limitation group, and 1.79 versus 1.45 for the non-mobility limitation group). Prevalence of high blood cholesterol was significantly higher among overweight adolescents than healthy weight adolescents across the two groups. While prevalence of asthma and early maturation appeared to increase as a function of body weight for both groups, a significant difference was found only in the group with non-mobility limitations. Across the two groups, there was a clear tendency toward a higher prevalence of chronic health conditions in overweight adolescents compared to their healthy weight counterparts. Greater efforts must be made to address the higher rates of obesity-related health conditions in youth with disabilities during childhood and adolescence to avoid significant health consequences and health care costs in adulthood.

O brincar criativo e a obesidade infantil

A obesidade infantil é uma das doenças mais preocupantes atualmente, o estudo de seus fatores psicológicos é escasso, podendo se vincular a características específicas do brincar. Este trabalho objetiva investigar se há algum prejuízo causado pela dificuldade de expressão da criatividade no brincar de crianças obesas e, em caso positivo, qual a sua natureza. Foram realizados cinco estudos de caso com meninos obesos entre 7 e 10 anos, de nível sócio-econômico médio e famílias intactas, com aplicação do Teste do Desenho da Figura Humana (DFH) e Teste de Apercepção Temática Infantil (CAT-A). Observou-se que a dificuldade das crianças em criar, simbolizar e brincar gerava sentimento de solidão e abandono. As figuras parentais foram vistas como ambivalentes, não suprindo as necessidades afetivas e a dependência dos filhos, mas exigindo sua autonomia. O comer compulsivo apresentou-se como única maneira de interagir com o ambiente, preenchendo a privação afetiva experienciada nas relações precoces.

Youth BMI trajectories: evidence from the NLSY97

We examined heterogeneity in BMI trajectory classes among youth and variables that may be associated with trajectory class membership. We used data from seven rounds (1997-2003) of the 1997 National Longitudinal Survey of Youth (NLSY97), a nationally representative, longitudinal survey of people born between 1980 and 1984 who were living in the United States in 1997. The analyses were based on an accelerated longitudinal design. General growth mixture modeling implemented in Mplus (version 4.1) was used to identify subtypes of youth BMI growth trajectories over time. Four distinct youth BMI trajectories were identified. Class 1 includes youth at high risk for becoming obese by young adulthood (at age 12 and 23, approximately 67 and 90%, respectively, are classified as obese, and almost 72% will have had a BMI>or=40 at some time during this developmental period). Class 2 includes youth at moderate-to-high risk (at age 12 and 23, approximately 55 and 68%, respectively, are classified as obese). Class 3 includes youth at low-to-moderate risk (i.e., at age 12 and 23, approximately 8 and 27%, respectively, are classified as obese). Class 4 includes youth at low risk (few of these youth are obese at any age during this developmental period). These results highlight the importance of considering heterogeneity in BMI growth among youth and early interventions among those most at risk of the adverse health consequences of excess weight.

Effect of dietary behaviour modification on anthropometric indices and eating behaviour in obese adolescent girls

AIM

This paper is a report of a study conducted to evaluate the effects of behaviour modification on anthropometric indices and to explore if behaviour modification could improve eating behaviour in adolescents.

BACKGROUND

Obesity is currently the most important nutritional disease of children and adolescents. To date, several attempts to achieve weight loss in children have been made, but little is known about their effects on improving eating behaviours.

METHOD

Sixty obese adolescent girls participated in a behaviour modification program which was held for 16 weeks in 2007. The participants were randomly selected from two different schools and were assigned to an experimental and control group (30 participants each). Anthropometric indices and eating behaviours were assessed before and after the program. Eating behaviour was assessed using the Dutch Eating Behaviour Questionnaire.

RESULT

There were statistically significant differences in changes in body weight (-2.75 kg vs. 0.62 kg), body mass index (-1.07 kg/m(2) vs. 0.24 kg/m(2)) and arm circumference (-2.31 cm vs. 0.5 cm) in the experimental group in contrast to controls (P < 0.001). There were also statistically significant differences in scores for eating behaviour, emotional eating (0.63, 0.17), external eating (0.99, 0.05) and restrained eating (0.72, 0.03) in the experimental vs. the control group respectively (P < 0.001).

CONCLUSION

Nurses, more than other healthcare professionals, can address obesity in adolescents and they should not concentrate solely on weight reduction, but also encourage children to acquire a healthy lifestyle.

Examining attendance, academic performance, and behavior in obese adolescents

Although academics and safety continue to rank as high-priority issues in public schools, educators and administrators are beginning to recognize the importance of student health on school success. This move toward a holistic approach suggests that efforts to improve a student's physical, social, and emotional well-being are as important as efforts to increase test scores. Adolescent obesity is epidemic, and it is a complex integration of social, psychological, and physical factors that exacerbate the turbulent transitional years of adolescence. Adolescents are vulnerable to issues related to weight, and they are at risk for suffering obesity's negative effects, thereby resulting in unfortunate school outcomes such as decreased rates of attendance, poor academic performance, and school suspensions. Disparities related to overweight and obesity exist; therefore, the negative effects of obesity may disproportionately affect minorities and poor schoolchildren. Examining school outcomes for the overweight or obese adolescent is crucial and may provide valuable insight into constructive changes required for a responsive school environment.

Reducing premature osteoarthritis in the adolescent through appropriate screening

Osteoarthritis affects all ages. The etiology of this debilitating disease is multifactorial; however, several genes are linked to osteoarthritis. Sports participation, injury to the joint, obesity, and genetic susceptibility predispose adolescent athletes to the development of premature osteoarthritis. Assessment for the risk of osteoarthritis includes obtaining a family history to detect any genetic predisposition, obtaining body weight and body mass index, and identifying the patient's exercise regime and sports participation. Strategies to prevent the development of osteoarthritis in the adolescent include patient education, exercises to build quadriceps strength, low-impact activities, and the maintenance of a healthy weight. The devastating effects of premature osteoarthritis can be reduced if an assessment for risk of the disease is performed during adolescence.

Obesity, fitness and health in Taiwanese children and adolescents

OBJECTIVE

To examine the prevalence of childhood and adolescent obesity in Taiwan and investigate the association between excess weight and physical fitness and blood pressure.

DESIGN

Cross-sectional study.

SUBJECTS

A total of 13 935 children and adolescents aged 6-18 years (boys: 7031, girls: 6904) were involved in the 1999 survey and 24 586 (boys: 12 367, girls: 12 219) were available in the 2001 survey.

MEASUREMENTS

Weight, height, systolic and diastolic blood pressures, and health-related fitness tests (bent-leg curl-ups, sit-and-reach test and step test) were measured.

RESULTS

The overall prevalence of obesity (including overweight) in boys was 19.8% in 1999 and 26.8% in 2001. It was lower in girls with 15.2% in 1999 and 16.5% in 2001. The normal weight group performed better (P<0.05) than the overweight/obese group in all fitness tests except in the 2001 sit-and-reach test where there were no differences between the two groups. The risk of hypertension increased nearly two times for the overweight/obese-fit group and nearly three times for the overweight/obese-unfit group compared to the normal weight-fit group (adjusted odds ratio (AOR)=1.93, 95%CI=1.514-2.451 and AOR=2.93, 95%CI=2.493-3.454, respectively).

CONCLUSION

Overall, the findings demonstrated that there is an increasing trend in overweight/obesity prevalence for Taiwanese youth even in a 2-year period. The overweight/obese youngsters tend to have poorer muscular strength and cardiovascular endurance than the normal weight group. The overweight/obese and unfit group had a greater risk of hypertension than other groups. However, this risk was significantly lower if obese/overweight children had a higher than average level of cardiovascular fitness.