Interventions Aimed at Decreasing Obesity in Hispanic Children in the First 1000 Days: A Systematic Review.

The prevalence of obesity is higher among Hispanic children than among all other ethnicities, and recent efforts have been focused on addressing this growing disparity. The objective of this review was to examine the evidence for interventions designed to reduce obesity in Hispanic children in the first 1000 days of life and to assess and summarize the effectiveness of the interventions. A literature search was conducted using MEDLINE, Scopus, and PubMed. Included in the review were published studies that evaluated an intervention designed to prevent or reduce obesity in Hispanic children in the first 1000 days of life. Quality was assessed using the GRADE system. Out of 134 citations that were retrieved, 11 articles underwent full-text review, and 5 articles met study inclusion criteria. Only one study was of high quality, and the rest were of low or moderate quality. Three of the studies were lifestyle interventions, and two were educational interventions. Four out of the five interventions led to significant improvements in the outcome measures assessed. Very few published studies tested interventions in the population of Hispanic children ages 0-2 years. Limited evidence does suggest that these interventions may improve behaviors related to factors known to increase the risk for obesity. Future research should focus on designing interventions using common themes observed among successful studies. Further, these studies should also include clinical measures of obesity to further establish their effectiveness.

Expression of macrophage genes within skeletal muscle correlates inversely with adiposity and insulin resistance in humans.

Local inflammation in obese adipose tissue has been shown to contribute to insulin resistance; however, the role of macrophage infiltration within skeletal muscle is still debatable. This study aimed to evaluate the association of skeletal muscle macrophage gene expression with adiposity levels and insulin sensitivity in obese patients. Twenty-two nondiabetic obese patients and 23 healthy lean controls were included. Obese patients underwent a 3-month weight loss intervention. Macrophage gene expression in skeletal muscle (quantitative real-time polymerase chain reaction), body composition (dual-energy X-ray absorptiometry), and insulin sensitivity (homeostatic model assessment (HOMA) and oral glucose tolerance test) were compared between groups and their associations were analyzed. To validate skeletal muscle findings, we repeated the analyses with macrophage gene expression in adipose tissue. Expression levels of macrophage genes (CD68, CD11b, CD206, CD16, CD40, and CD163) were lower in skeletal muscle tissue of obese versus lean participants. Macrophage gene expression was also found to be inversely associated with adiposity, fasting insulin, and HOMA (r = -0.4 ∼ -0.6, p < 0.05), as well as positively associated with insulin sensitivity (r = 0.4 ∼ 0.8, p < 0.05). On the other hand, adipose tissue macrophage gene expression showed higher levels in obese versus lean participants, presenting a positive association with adiposity levels. Macrophage gene expression, in both skeletal and adipose tissue samples, was only minimally affected by the weight loss intervention. In contrast with the established positive relationship between adiposity and macrophage gene expression, an unexpected inverse correlation between these 2 variables was observed in skeletal muscle tissue. Additionally, muscle macrophage gene expression was inversely correlated with insulin resistance.