Predictors of successful weight loss in children treated at a community hospital-based tertiary care pediatric weight management program.

Childhood obesity is a major public health concern. However, predictors of successful outcomes for patients treated at multidisciplinary community hospital-based pediatric weight management programs remain poorly understood. We conducted a retrospective analysis to evaluate 633 pediatric patients from ages 2 to 18 at a tertiary pediatric weight management program in 2018. Predictors were evaluated in univariate comparisons, and significant variables were included in a linear regression analysis to identify factors associated with improvements in body mass index relative to the age- and sex-specific 95th percentile body mass index (%BMIp95). We found that male sex and increased number of clinical visits were independently and significantly associated with reductions in %BMIp95. Baseline %BMIp95, age, preferred language, and insurance status were not significant predictors of outcomes. A total of 398 (63%) patients experienced a decrease in %BMIp95 from baseline to follow-up. One quarter (24.8%) of patients experienced a decrease in %BMIp95 of at least 5%, a threshold associated with cardiometabolic improvements. Further, we observed significant improvements in cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, HbA1c, and waist circumference. These findings support a potential need for sex- and gender-tailored care as well as the benefits of increased access to pediatric weight management programs.

Child-feeding practices among Chinese-American and non-Hispanic white caregivers.

This study compared child-feeding and related practices with child weight status between Chinese-American and non-Hispanic white caregivers who attended three community health centers. Study participants were caregivers of 50 Chinese-American and 108 non-Hispanic white children aged 2-12 years who completed a short version of the child feeding questionnaire in English or Chinese. The feeding behaviors assessed were concern, pressure, restriction, and monitoring. Child body mass index (BMI) z-scores were calculated from child weight and height measured in clinic by clinicians trained in anthropometrics. The sample was stratified into 2-5 and 6-12 years age groups to account for developmental differences. Internal consistency (Cronbach's alpha) was moderate to high and similar by ethnicity for all four behaviors for Chinese-Americans and non-Hispanic whites. In models adjusted for confounding variables, Chinese-American caregivers had higher mean scores than non-Hispanic white caregivers for concern and restriction in all age groups and monitoring in 2-5 year-olds. No feeding practices were associated with child BMI in Chinese-Americans; concern and restriction were associated with child BMI in non-Hispanic whites in 2-5 year-olds. These results suggest that differences in child-feeding practices exist between Chinese-American and non-Hispanic white caregivers.

Consumption of recommended food groups among children from medically underserved communities.

This cross-sectional study of 2- to 12-year-olds living in medically underserved areas examined the proportion of children meeting the food group intake recommendations for fruits, vegetables, total grains, dairy, and meat/meat alternatives by age group and body weight status. Based on 24-hour recalls collected between July 2004 and March of 2005, mean food group intake and deviation from the recommended intake amounts were determined (actual intake minus recommended intake). Measured weight and height were used to calculate body mass index z scores using the Centers for Disease Control and Prevention growth charts. Data analyses were done for two age groups (2- to 5-year-olds and 6- to 12-year-olds) (n=214), by weight status categories (underweight or healthy weight [< 85 th percentile], overweight [85 th to 94 th percentile], or obese [> or = 95th percentile]), and were repeated for the subset of children with biologically plausible reports. The majority of children lived in low-income households. More 2- to 5-year-olds met intake recommendations compared with 6- to 12-year-olds. Overall, the proportion of children meeting the food group intake recommendations was low with the exception of the meat group, which was met by 52% and 93% of the 2- to 5- and 6- to 12-year-old children, respectively. There was a positive association between the proportion of younger children meeting the fruits or total grains recommendation and increasing body weight. The data support the importance of community-level nutrition intervention programs to improve children's diet quality in low-income, medically underserved areas and suggest that such interventions may help reduce the risk of obesity.

Ligand binding and inhibition of an oxygen-sensitive soluble guanylate cyclase, Gyc-88E, from Drosophila.

Soluble guanylate cyclase (sGC) uses a ferrous heme cofactor as a receptor for NO and once bound activates the enzyme for the conversion of GTP to cGMP. The heme cofactor in sGC does not bind oxygen, thereby allowing it to selectively bind NO despite a cellular concentration of oxygen (microM) that is much higher than signaling concentrations of nitric oxide (nM). The molecular details of this ligand discrimination against oxygen have emerged and allowed for predictions regarding ligand specificity in the sGC family. The results reported here show that Gyc-88E from Drosophila is a hemoprotein that binds oxygen, as well as NO and CO. All three ligands form 6-coordinate complexes. Gyc-88E is active as a homodimer (5600 +/- 243 nmol min(-1) mg(-1)) and is inhibited by O2, CO, and NO (3.2-, 2.9-, and 2-fold, respectively). The Km for GTP was 0.66 +/- 0.15 mM in air (273 microM oxygen) and 0.82 +/- 0.15 mM under anaerobic conditions. The Ki for oxygen was calculated to be 51 +/- 28 microM. The biochemical properties of Gyc-88E are unique for guanylate cyclases and suggest a possible function as an oxygen sensor.

Vitamin E status in children with cystic fibrosis and pancreatic insufficiency.

Vitamin E status was compared in 69 children (7.0-10.0 years) with cystic fibrosis and pancreatic with the National Health and Nutrition Examination Survey III sample (6.0-11.9 years). With median vitamin E intakes of 6 mg/day (dietary) and 224 mg/day (supplemental), children with cystic fibrosis had higher serum alpha-tocopherol:cholesterol ratios, higher alpha-tocopherol, and lower cholesterol levels than in the National Health and Nutrition Examination Survey.

Nitric oxide binding to prokaryotic homologs of the soluble guanylate cyclase beta1 H-NOX domain.

The heme cofactor in soluble guanylate cyclase (sGC) is a selective receptor for NO, an important signaling molecule in eukaryotes. The sGC heme domain has been localized to the N-terminal 194 amino acids of the beta1 subunit of sGC and is a member of a family of conserved hemoproteins, called the H-NOX family (Heme-Nitric Oxide and/or OXygen-binding domain). Three new members of this family have now been cloned and characterized, two proteins from Legionella pneumophila (L1 H-NOX and L2 H-NOX) and one from Nostoc punctiforme (Np H-NOX). Like sGC, L1 H-NOX forms a 5-coordinate Fe(II)-NO complex. However, both L2 H-NOX and Np H-NOX form temperature-dependent mixtures of 5- and 6-coordinate Fe(II)-NO complexes; at low temperature, they are primarily 6-coordinate, and at high temperature, the equilibrium is shifted toward a 5-coordinate geometry. This equilibrium is fully reversible with temperature in the absence of free NO. This process is analyzed in terms of a thermally labile proximal Fe(II)-His bond and suggests that in both the 5- and 6-coordinate Fe(II)-NO complexes of L2 H-NOX and Np H-NOX, NO is bound in the distal heme pocket of the H-NOX fold. NO dissociation kinetics for L1 H-NOX and L2 H-NOX have been determined and support a model in which NO dissociates from the distal side of the heme in both 5- and 6-coordinate complexes.

A molecular basis for NO selectivity in soluble guanylate cyclase.

Soluble guanylate cyclases (sGCs) function as heme sensors that selectively bind nitric oxide (NO), triggering reactions essential to animal physiology. Recent discoveries place sGCs in the H-NOX family (heme nitric oxide/oxygen-binding domain), which includes bacterial proteins from aerobic and anaerobic organisms. Some H-NOX proteins tightly bind oxygen (O2), whereas others show no measurable affinity for O2, providing the basis for selective NO signaling in aerobic cells. Using a series of wild-type and mutant H-NOXs, we established a molecular basis for ligand discrimination. A distal pocket tyrosine is requisite for O2 binding in the H-NOX family. These data suggest that sGC uses a kinetic selection against O2; we propose that the O2 dissociation rate in the absence of this tyrosine is fast and that a stable O2 complex does not form.