Early childhood caries, obesity and anthropometric measurements: Is there a relationship?

This brief research report explored the relationship among obesity, anthropometric measurements, and early childhood caries (ECC), in 3-5 years-old children. Three hundred and ninety-one Brazilian preschoolers were given anthropometric examinations for the assessment of general, peripheral, and central adiposity, by the following measures: body mass index (BMI), hip circumference, and waist circumference. Obesity status was determined by BMI according to WHO standards. Parent's age and BMI were assessed by questionnaire, and sucrose exposure was tracked by means of a food diary. For the assessment of ECC, dental examinations were performed according to modified WHO criteria. Also, the presence of dental biofilm in maxillary incisors was detected. A direct association between BMI and ECC was found in the bivariate analysis and the best possibility of logistic regression model showed that hip circumference (HC) values ≥62 centimeters (OR = 1.63; p = 0.033) jointly with the presence of dental biofilm (OR = 2.38; p = 0.000), children's ages ≥37 months (OR = 5.09; p = 0.012), and mothers younger than 35 years (OR = 1.96; p = 0.004) were significantly connected with ECC. In conclusion, peripheral adiposity (represented by HC) in young children was in fact associated with ECC. Thus, hip circumference might be a valuable tool for exploring the relationship between caries and obesity in the early years of life.

Firmicutes Levels in the Mouth Reflect the Gut Condition With Respect to Obesity and Early Childhood Caries.

The present cross-sectional study investigated whether Firmicutes (F) and Bacteroidetes (B) levels in the mouth reflected the gut condition in obesity and early childhood caries (ECC). Eighty preschoolers (3-5 years) were equally assigned into four groups: 1. obese + ECC, 2. obese + caries-free (CF), 3. eutrophic + ECC, and 4. eutrophic + CF. Nutritional status and ECC were assessed based on the WHO criteria. Dental biofilm and fecal samples were collected for F and B quantification using RT-PCR analysis. Data were evaluated using three-way-ANOVA and Pearson's correlation (α = 0.05). Regardless of the anatomical location effect (p = 0.22), there were higher values for F in the obese children + ECC compared with those in obese + caries-free (CF) in both mouth and gut (p < 0.05). The correlation for F at these sites was negative in obese children + ECC (r = -0.48; p = 0.03) and positive in obese children + CF (r=0.50; p = 0.03). Bacteroidetes were influenced by ECC (p = 0.03) and the anatomical location (p = 0.00), and the levels tended to be higher in the mouth of the obese children + ECC (p = 0.04). The F/B ratio was higher in the gut and was affected by the anatomical location (p = 0.00). This preliminary study suggested that modulated by ECC, counts of oral Firmicutes reflected corresponding condition in the gut of obese preschoolers. In addition, we first evidenced that the Firmicutes phylum behave differently according to the nutritional status and caries experience and that supragingival biofilm and gut could share levels of similarity.

Prevalência de obesidade infantil: há motivo de preocupação? / Prevalence of childhood obesity: is there a cause for concern?

O objetivo deste estudo foi determinar a prevalência de sobrepeso/obesidade em pré-escolares e investigar a relação entre o índice de massa corporal (IMC) das crianças e o de seus pais. Para tanto, conduziu-se uma pesquisa transversal com 968 crianças, de 3-5 anos, regularmente matriculadas em pré-escolas públicas. O estado nutricional infantil foi definido pelo IMC após aferição do peso e estatura no próprio ambiente escolar, considerando-se o sexo e a idade em meses. De acordo com os critérios da Organização Mundial da Saúde (OMS), as crianças foram classificadas em eutróficas, baixo peso, risco de sobrepeso, sobrepeso ou obesas. O IMC dos pais foi calculado com os dados de peso e estatura obtidos por meio de questionário. Observou-se que 1% de crianças tinham baixo peso, 62% eram eutróficas, 17% apresentavam risco de sobrepeso, 12% sobrepeso e 8% obesidade. O IMC infantil mostrou-se positivamente correlacionado com o IMC materno e paterno (p < 0,05). Concluiu-se que a prevalência de obesidade e sobrepeso infantil na população estudada é alarmante e que o IMC da criança foi correlacionado ao dos pais. Tais achados devem ser motivo de preocupação das autoridades, reforçando a necessidade de estratégias de atenção à saúde abrangendo todo o núcleo familiar.

This study aimed to determine the prevalence of overweight/obesity in preschoolers and to investigate the relationship between the body mass index (BMI) of the children and of their parents. Therefore, a cross-sectional study was conducted with 968 children aging 3-5 years old from public preschools. The children's nutritional status was defined by the BMI, after measuring their weight and height at the preschool, considering sex and age in months. According to the World Health Organization (WHO) criteria, the children were classified as eutrophic, thin, at risk of being overweight, overweight or obese. The parents' BMI was calculated using weight and height data obtained through a questionnaire. One percent of children were thin, 62% eutrophic, 17% at risk of overweight, 12% were overweight and 8% obese. Children's BMI was positively correlated with maternal and paternal BMI (p <0.05). It was concluded that the prevalence of obesity and overweight in the population studied is alarming, and the child's BMI was correlated to their parents' BMI. Such findings should be of concern for the authorities, reinforcing the need for health care strategies covering the entire family.

Relationship Between Mutans Streptococci and Lactobacilli in the Oral Cavity and Intestine of Obese and Eutrophic Children With Early Childhood Caries-Preliminary Findings of a Cross-Sectional Study.

This brief communication assessed whether there was any relationship between the counts of lactobacilli (LB) and mutans streptococci (MS) in the oral cavity and intestine of obese and eutrophic children with early childhood caries (ECC). Seventy-eight preschoolers were assigned into the following groups: 1. obese children with ECC (OECC), 2. eutrophic children with ECC (EECC), 3. obese caries-free children (OCF), and 4. eutrophic caries-free children (ECF). The diagnosis of obesity and ECC was based on the World Health Organization criteria. Dental plaque and fecal samples were collected to assess the counts of MS and LB using selective media. Data were evaluated by Poisson regression analysis, Wilcoxon test, and Sign test. Microbial indicators of ECC in obese children were MS counts in the intestine [rate ratio (RR): 4.38] and presence of LB in the oral cavity (RR: 2.12). The indicators in eutrophic children were MS levels and the presence of LB, both in the oral cavity (RR: 6.35/1.50) and intestine (RR: 2.35/2.38) (p < 0.05). The comparison between MS levels in the mouth and in the intestine revealed significant differences only in the ECF group (p = 0.04). Regarding LB presence in the mouth vs. in the intestine, except for the OCF group (p = 0.03), no other statistical differences were found. Our preliminary findings highlighted that the levels of MS and the presence of LB in the oral cavity, as well as in the lower gastrointestinal tract were associated with ECC. Moreover, obesity was found to influence this relationship.

Childhood Obesity and Firmicutes/Bacteroidetes Ratio in the Gut Microbiota: A Systematic Review.

BACKGROUND: The aim of the present study was to undertake a systematic review exploring the relationship between childhood obesity and fecal microorganisms, to answer the following question: "Are Firmicutes and Bacteroidetes a significant risk indicator/factor for obesity in children?" The main search terms were "child" and "obesity" together with "gut microbiota" (PubMed: 2005-2017). The minimal requirements for inclusion were the evaluation of gut microbiota composition and BMI in children between 0 and 13 years of age. METHODS: Assessed articles were carefully classified according to a predetermined criterion, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were considered. Seven articles were critically appraised and used as a basis for conclusions. RESULTS: Three studies showed a positive association between Bacteroides fragilis and obesity. In addition, a high value of evidence indicated that a decrease in the Bacteroidetes phylum and in Bacteroides/Prevotella groups was related to high BMI. For the Firmicutes phylum, one high-quality study highlighted that it was positively correlated with weight gain. With regard to Firmicutes species, Clostridium leptum, Eubacterium hallii, and Lactobacillus spp. indicated adipose tissue storage, while Clostridium difficile and the Staphylococcus genus were correlated with low BMI. Despite the fact that only one study did not perform real-time polymerase chain reaction to quantify the microorganisms, its results corroborated those of the studies that did. CONCLUSIONS: Changes in Firmicutes and Bacteroidetes phyla/species levels might in fact be significant indicators/factors for childhood obesity. However, given the small number of articles appraising these entire phyla and the heterogeneity among the species assessed, further well-designed studies are required to improve the knowledge.