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Nitzan I, Shakarchy N, Megreli J, Akavian I, Derazne E, Afek A, Peled A. Body mass index and visual impairment in Israeli adolescents: A nationwide study. Pediatr Obes 2024; 19:e13083. [PMID: 37989292 DOI: 10.1111/ijpo.13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/22/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Previous research on the association between body mass index (BMI) and visual impairment (VI) in youth has reported inconsistent findings. We aimed to investigate this association in a national cohort of Israeli adolescents. METHODS This retrospective, population-based, cross-sectional study included 1 697 060 adolescents (56.4% men; mean age 17 years) who underwent mandatory pre-military service assessments from 1993 to 2017. BMI was classified based on the US age- and sex-matched percentiles. Unilateral or bilateral VI was classified as best-corrected visual acuity (BCVA) worse than 6/9 in either or both eyes, respectively. Sex-stratified regression models adjusted for sociodemographic variables were used to analyse the BMI-VI relationship. RESULTS Overall, 17 871 (1.05%) and 5148 (0.30%) adolescents had unilateral and bilateral VI, respectively. Compared with high-normal BMI (50th to 85th percentile), adjusted odds ratios (ORs) for unilateral and bilateral VI gradually increased with higher BMI, reaching 1.33 (1.13-1.55) and 1.80 (1.37-2.35) in men with severe obesity, and 1.51 (1.24-1.84) and 1.52 (1.08-2.14) in women with severe obesity, respectively. Men with underweight also had increased ORs for unilateral and bilateral VI (1.23; 1.14-1.33 and 1.59; 1.37-1.84, respectively), a pattern not observed in women (0.96; 0.86-1.07 and 1.02; 0.83-1.25, respectively). Results were maintained when the outcome was restricted to mild VI, as well as in subgroups of adolescents with unimpaired health and those without moderate-to-severe myopia. CONCLUSIONS Abnormal BMI, and particularly obesity, is associated with increased OR for VI in late adolescence.
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Affiliation(s)
- Itay Nitzan
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine and 'Tzameret', Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nitzan Shakarchy
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine and 'Tzameret', Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jacob Megreli
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine and 'Tzameret', Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Inbal Akavian
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine and 'Tzameret', Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Central Management, Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - Alon Peled
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Assaf-Harofeh Medical Center, Zerifin, Israel
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Torbahn G, Brauchmann J, Axon E, Clare K, Metzendorf MI, Wiegand S, Pratt JS, Ells LJ. Surgery for the treatment of obesity in children and adolescents. Cochrane Database Syst Rev 2022; 9:CD011740. [PMID: 36074911 PMCID: PMC9454261 DOI: 10.1002/14651858.cd011740.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Child and adolescent overweight and obesity have increased globally and are associated with significant short- and long-term health consequences. OBJECTIVES To assess the effects of surgery for treating obesity in childhood and adolescence. SEARCH METHODS For this update, we searched Cochrane Central Register of Controlled Trials, MEDLINE, Latin American and Caribbean Health Science Information database (LILACS), World Health Organization International Clinical Trials Registry Platform (ICTRP)and ClinicalTrials.gov on 20 August 2021 (date of the last search for all databases). We did not apply language restrictions. We checked references of identified studies and systematic reviews. SELECTION CRITERIA We selected randomised controlled trials (RCTs) of surgical interventions for treating obesity in children and adolescents (age < 18 years) with a minimum of six months of follow-up. We excluded interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or which included participants with a secondary or syndromic cause of obesity, or who were pregnant. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two review authors independently extracted data and assessed the risk of bias using the Cochrane Risk of Bias 2.0 tool. Where necessary, we contacted authors for additional information. MAIN RESULTS With this update, we did not find any new RCTs. Therefore, this updated review still includes a single RCT (a total of 50 participants, 25 in both the intervention and comparator groups). The intervention focused on laparoscopic adjustable gastric banding surgery, which was compared to a control group receiving a multi-component lifestyle programme. The participating population consisted of Australian adolescents (a higher proportion of girls than boys) aged 14 to 18 years, with a mean age of 16.5 and 16.6 years in the gastric banding and lifestyle groups, respectively. The trial was conducted in a private hospital, receiving funding from the gastric banding manufacturer. For most of the outcomes, we identified a high risk of bias, mainly due to bias due to missing outcome data. Laparoscopic gastric banding surgery may reduce BMI by a mean difference (MD) of -11.40 kg/m2 (95% CI -13.22 to -9.58) and weight by -31.60 kg (95% CI -36.66 to -26.54) compared to a multi-component lifestyle programme at two years follow-up. The evidence is very uncertain due to serious imprecision and a high risk of bias. Adverse events were reported in 12/25 (48%) participants in the intervention group compared to 11/25 (44%) in the control group. A total of 28% of the adolescents undergoing gastric banding required revisional surgery. The evidence is very uncertain due to serious imprecision and a high risk of bias. At two years of follow-up, laparoscopic gastric banding surgery may increase health-related quality of life in the physical functioning scores by an MD of 16.30 (95% CI 4.90 to 27.70) and change in health scores by an MD of 0.82 (95% CI 0.18 to 1.46) compared to the lifestyle group. The evidence is very uncertain due to serious imprecision and a high risk of bias. No data were reported for all-cause mortality, behaviour change, participants' views of the intervention and socioeconomic effects. Finally, we have identified three ongoing RCTs that are evaluating the efficacy and safety of metabolic and bariatric surgery in children and adolescents. AUTHORS' CONCLUSIONS Laparoscopic gastric banding led to greater body weight loss compared to a multi-component lifestyle program in one small study with 50 participants. These results have very limited application, primarily due to more recent recommendations derived from observation studies to avoid the use of banding in youth due to long-term reoperation rates. This systematic review update still highlights the lack of RCTs in this field. The authors are concerned that there may be ethical barriers to RTCs in this field, despite the lack of other effective therapies for severe obesity in children and adolescents and the significant morbidity and premature mortality caused by childhood obesity. Nevertheless, future studies, whether pre-registered and planned non-randomised or pragmatic randomised trials, should assess the impact of the surgical procedure and post-operative care to minimise adverse events, including the need for post-operative adjustments and revisional surgery. Long-term follow-up is also critical to comprehensively assess the impact of surgery as participants enter adulthood.
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Affiliation(s)
- Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Nuremberg, Germany
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
| | - Jana Brauchmann
- Center for Chronically Sick Children, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Emma Axon
- Cochrane Skin, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | | | - Maria-Inti Metzendorf
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Susanna Wiegand
- Center for Chronically Sick Children, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Janey Sa Pratt
- Department of Pediatric Surgery, Stanford University, Standford, CA, USA
| | - Louisa J Ells
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
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Pinhas-Hamiel O, Bardugo A, Reichman B, Derazne E, Landau Z, Tokatly Latzer I, Lerner-Geva L, Rotschield J, Tzur D, Ben-Zvi D, Afek A, Twig G. Attention-Deficit/Hyperactivity Disorder and Obesity: A National Study of 1.1 Million Israeli Adolescents. J Clin Endocrinol Metab 2022; 107:e1434-e1443. [PMID: 34850003 DOI: 10.1210/clinem/dgab846] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The incidences of obesity and attention-deficit/hyperactivity disorder (ADHD) have increased in parallel over recent decades. We assessed the association between obesity and ADHD in a national sample of adolescents. METHOD In a nationwide population-based study of 1 118 315 adolescents (57% males; mean age 17 years), risks of obesity were compared between individuals with severe and mild ADHD and those without ADHD. Diagnoses of ADHD were confirmed by specialists in either neurology or psychiatry. Adolescents requiring regular and continuous treatment with stimulants with no improvement of symptoms under treatment were classified as having severe ADHD; data were available from 2004 to 2019. During 2015 to 2019, the diagnosis of ADHD was defined, and 65 118 (16.76%) of 388 543 adolescents with mild symptoms who required medications only for learning or who used stimulants irregularly were defined as having mild ADHD. RESULTS The prevalence of severe and mild ADHD was 0.3% and 20.1%, respectively. Obesity was more prevalent among adolescents with severe ADHD than among those without ADHD (13.5% vs 7.5%). In the mild ADHD group 12.6% of males and 8.4% of females were diagnosed with obesity compared to 9.7% and 6.4%, respectively, in the non-ADHD group. The adjusted odds of severe ADHD for males and females with obesity were 1.77 (1.56-2.02) and 2.09 (1.63-2.66) times the odds for males and females with low-normal body mass index, respectively, and 1.42 (1.37-1.48) and 1.42 (1.34-1.50) for males and females with mild ADHD, respectively. The elevated risk persisted in several sensitivity analyses. CONCLUSIONS Both adolescents with severe and mild ADHD are at increased risk for obesity.
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Affiliation(s)
- Orit Pinhas-Hamiel
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Aya Bardugo
- The Israeli Defense Forces Medical Corps and the Department of Military Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Brian Reichman
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel
| | - Estela Derazne
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Zohar Landau
- Pediatrics Department, Barzilai Medical Center, Ashkelon, Israel
| | - Itay Tokatly Latzer
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Liat Lerner-Geva
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel
| | - Jacob Rotschield
- The Israeli Defense Forces Medical Corps and the Department of Military Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dorit Tzur
- The Israeli Defense Forces Medical Corps and the Department of Military Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Danny Ben-Zvi
- The Hebrew University-Hadassah Medical School, Jerusalem, Israel
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Arnon Afek
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Central Management, Sheba Medical Center, Tel-Hashomer, Israel
| | - Gilad Twig
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- The Israeli Defense Forces Medical Corps and the Department of Military Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Institute of Endocrinology and Metabolism, Sheba Medical Center, Tel-Hashomer, Israel
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4
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Tsur AM, Akavian I, Derazne E, Tzur D, Vivante A, Grossman E, Rotem RS, Fishman B, Afek A, Coresh J, Chodick G, Twig G. Adolescent Blood Pressure and the Risk for Early Kidney Damage in Young Adulthood. Hypertension 2022; 79:974-983. [PMID: 35253445 DOI: 10.1161/hypertensionaha.121.18748] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent guidelines classified blood pressure above 130/80 mm Hg as hypertension. However, outcome data were lacking. OBJECTIVE To determine the association between blood pressure in adolescence and the risk for early kidney damage in young adulthood. METHODS In this nationwide cohort study, we included 629 168 adolescents aged 16 to 20 who underwent medical examinations before mandatory military service in Israel. We excluded 30 466 adolescents with kidney pathology, hypertension, or missing blood pressure or anthropometric data at study entry. Blood pressure measurements at study entry were categorized according to the Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents: group A (<120/<80 mm Hg; Reference group), group B (120/<80-129/<80 mm Hg), group C (130/80-139/89 mm Hg), and group D (≥140/90 mm Hg). Early kidney damage in young adulthood was defined as albuminuria of ≥30 mg/g with an estimated glomerular filtration rate of 60 mL/(min·1.73 m2) or over. RESULTS Of 598 702 adolescents (54% men), 2004 (0.3%) developed early kidney damage during a mean follow-up of 15.1 (7.2) years. The adjusted hazard ratios for early kidney damage in blood pressure group C were 1.17 (1.03-1.32) and 1.51 (1.22-1.86) among adolescents with lean (body mass index <85th percentile) and high body mass index (body mass index ≥85th percentile), respectively. Corresponding hazard ratios for kidney disease in group D were 1.49 (1.15-1.93) and 1.79 (1.35-2.38) among adolescents with lean and high body mass index, respectively. CONCLUSIONS Blood pressure of ≥130/80 mm Hg was associated with early kidney damage in young adulthood, especially in adolescents with overweight and obesity.
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Affiliation(s)
- Avishai M Tsur
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.).,Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel (A.M.T., I.A., G.T.).,Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel. (A.M.T., E.G., B.F.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
| | - Inbal Akavian
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.).,Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel (A.M.T., I.A., G.T.)
| | - Estela Derazne
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.)
| | - Dorit Tzur
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.)
| | - Asaf Vivante
- Department of Pediatrics B and Pediatric Nephrology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel. (A.V.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
| | - Ehud Grossman
- Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel. (A.M.T., E.G., B.F.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
| | - Ran S Rotem
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (R.S.R., G.C.).,Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA (R.S.R.)
| | - Boris Fishman
- Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel. (A.M.T., E.G., B.F.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
| | - Arnon Afek
- Central Management, Sheba Medical Center, Tel-Hashomer, Israel. (A.A.)
| | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.C.)
| | - Gabriel Chodick
- Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.).,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (R.S.R., G.C.)
| | - Gilad Twig
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.).,Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel (A.M.T., I.A., G.T.).,Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel-Hashomer, Israel. (G.T.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
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5
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Chodick G, Omer-Gilon M, Derazne E, Puris G, Rotem R, Tzur D, Pinhas-Hamiel O, Cukierman-Yaffe T, Shina A, Zucker I, Tirosh A, Afek A, Shalev V, Twig G. Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes. EClinicalMedicine 2021; 42:101211. [PMID: 34849479 PMCID: PMC8609013 DOI: 10.1016/j.eclinm.2021.101211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pregestational excessive body mass index (BMI) is linked to an increased risk for gestational diabetes mellitus (GDM), but less is known on the effect of adolescent BMI on GDM occurrence. The study aimed to investigate possible associations of adolescent BMI and changes in BMI experienced before first pregnancy, with gestational diabetes risk. METHODS This retrospective study was based on linkage of a military screening database of adolescent health status (Israel Defence Forces) including measured height and weight, with medical records (Maccabi Healthcare Services, MHS) of a state-mandated health provider. The latter covers about 25% of the Israeli population; about 90% of pregnant women undergo screening by the two-step Carpenter-Coustan method. Adolescent BMI was categorized according to Center of Disease Control and Prevention percentiles. Only first documented pregnanies were analyzed and GDM was the outcome. FINDINGS Of 190,905 nulliparous women, 10,265 (5.4%) developed GDM. Incidence proportions of GDM were 5.1%, 6.1%, 7.3%, and 8.9% among women with adolescent normal BMI, underweight, overweight, and obesity (p<0.001), respectively. In models that accounted for age at pregnancy, birth year, and sociodemographic variables, the adjusted odd ratios (aORs) for developing GDM were: 1.2 (95%CI, 1.1-1.3), 1.5 (1.4-1.6), and 1.9 (1.7-2.1) for adolescent underweight, overweight, and obesity (reference group, normal BMI). Adolescent BMI tracked with BMI notes in the pre-pregnancy period (r=63%). Resuming normal pre-pregnancy BMI from overweight or obesity in adolescence diminished GDM risk, but this diminished risk was not observed among those who returned to a normal per-pre-pregnancy BMI from being underweight in adolescence. Sustained overweight or obesity conferred an aOR for developing GDM of 2.5 (2.2-2.7); weight gain from adolescent underweight and normal BMI to pre-pregnancy excessive BMI conferred aORs of 3.1 (1.6-6.2) and 2.6 (2.2-2.7), respectively. INTERPRETATION Change in BMI status from adolescence to pre-pregnancy may contribute to GDM risk. Identifying at-risk populations is important for early preventive interventions. FUNDING None.
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Affiliation(s)
- Gabriel Chodick
- Maccabitech Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Corresponding Authors: Gabriel Chodick, PhD, Maccabitech Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Maayan Omer-Gilon
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gal Puris
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Ran Rotem
- Maccabitech Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA
| | - Dorit Tzur
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Tali Cukierman-Yaffe
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - Avi Shina
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Inbar Zucker
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Israeli Ministry of Health, Jerusalem, Israel
| | - Amir Tirosh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Varda Shalev
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gilad Twig
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
- Co-Corresponding Authors: Gilad Twig, M.D., MPH, Ph.D., Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Ramat-Gan, Israel
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6
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Muhsen K, Na’amnih W, Goldsmith R, Maya M, Zeidan N, Kassem E, Ornoy A. Associations of Feeding Practices in Early Life and Dietary Intake at School Age with Obesity in 10- to 12-Year-Old Arab Children. Nutrients 2021; 13:nu13062106. [PMID: 34205416 PMCID: PMC8234619 DOI: 10.3390/nu13062106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/13/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022] Open
Abstract
Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10–12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10–12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10–12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (W.N.); (M.M.)
- Correspondence: ; Tel.: +972-3-6405945; Fax: +972-3-6409868
| | - Wasef Na’amnih
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (W.N.); (M.M.)
| | | | - Maayan Maya
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel; (W.N.); (M.M.)
| | - Nuha Zeidan
- Clalit Health Service, Diet and Nutrition Unit, P.O. Box 789, Arara 30026, Israel;
| | - Eias Kassem
- Department of Pediatrics, Hillel Yaffe Medical Center, Hadera 38100, Israel;
| | - Asher Ornoy
- Laboratory of Teratology, Department of Medical Neurobiology, The Hebrew University Hadassah Medical School, Jerusalem 9112002, Israel
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
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7
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Tsur AM, Hershkovich S, Zucker I, Lutski M, Pinhas-Hamiel O, Vivante A, Fischman M, Amir O, Rotchild J, Gerstein HC, Cukierman-Yaffe T, Friedensohn L, Mosenzon O, Derazne E, Tzur D, Tirosh A, Afek A, Raz I, Twig G. Stuttering and Incident Type 2 Diabetes: A Population-Based Study of 2.2 Million Adolescents. J Clin Endocrinol Metab 2021; 106:978-987. [PMID: 33449080 DOI: 10.1210/clinem/dgaa988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE To investigate the association between stuttering in adolescence and incident type 2 diabetes in young adulthood. METHODS This nationwide population-based study included 2 193 855 adolescents of age 16 to 20 years who were assessed for military service between 1980 and 2013. Diagnoses of stuttering in adolescence were confirmed by a speech-language pathologist. Diabetes status for each individual as of December 31, 2016, was determined by linkage to the Israeli National Diabetes Registry. Relationships were analyzed using regression models adjusted for socioeconomic variables, cognitive performance, coexisting morbidities, and adolescent body mass index. RESULTS Analysis was stratified by sex (Pinteraction = 0.035). Of the 4443 (0.4%) adolescent men with stuttering, 162 (3.7%) developed type 2 diabetes, compared with 25 678 (2.1%) men without stuttering (adjusted odds ratio [OR] 1.3; 95% CI, 1.1-1.6). This relationship persisted when unaffected brothers of men with stuttering were used as the reference group (adjusted OR = 1.5; 95% CI, 1.01-2.2), or when the analysis included only adolescents with unimpaired health at baseline (adjusted OR = 1.4; 95% CI, 1.1-1.7). The association was stronger in later birth cohorts, with an adjusted OR of 2.4 (1.4-4.1) for cases of type 2 diabetes before age 40. Of the 503 (0.1%) adolescent women with stuttering 7 (1.4%) developed type 2 diabetes, compared with 10 139 (1.1%) women without stuttering (OR = 2.03; 95% CI, 0.48-2.20). CONCLUSIONS Adolescent stuttering is associated with an increased risk for early-onset type 2 diabetes among men.
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Affiliation(s)
- Avishai M Tsur
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
- Department of Medicine "B," Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Inbar Zucker
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
| | - Miri Lutski
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5266202, Israel
| | - Asaf Vivante
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Fischman
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
| | - Ofer Amir
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Rotchild
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | | | - Tali Cukierman-Yaffe
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Limor Friedensohn
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Ofri Mosenzon
- The Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Amir Tirosh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Itamar Raz
- The Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Gilad Twig
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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