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1.
J Am Assoc Nurse Pract ; 31(6): 344-351, 2019 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-31157651

RESUMO

BACKGROUND AND PURPOSE: As the incidence of global obesity increases, concerns about adverse health outcomes in adolescents continues to rise. The complexity and expense of this problem require early recognition and specific preventive treatments. Knowledge of genetics and determinants of food choices contributing to adolescent obesity warrants further examination. The primary goal was to appraise the literature from the past decade (2007-2017) on the current state of food choice and genetic determinants of adolescent overweight/obesity in the United States. The secondary goal was to determine trends in the literature and areas for future research. METHODS: A systematic review of research studies in the United States from 2007 to 2017 was completed. Database searches were conducted using CINAHL, Embase, PsycINFO, PsycArticles, PubMed, Scopus, Academic Search Complete, Web of Science, BIOSIS, and the Cochrane Library. A total of 535 studies were selected. Of these, 283 studies focused on determinants of food choices and 165 studies focused on genetic factors. CONCLUSIONS: A total of 41 full-text articles included in this literature review contained studies limited exclusively to adolescents. Stress factors related to food choices demonstrated a new trend being explored. The need for precision health, the application of genetic information, could uncover ways food choices affect adolescent obesity. IMPLICATIONS FOR PRACTICE: The etiology of adolescent obesity requires that nurses gain knowledge of genetics and food choice determinants to inform personalized treatments for adolescents, which may establish effective interventions that promote healthy weight achievement.


Assuntos
Comportamento Alimentar/psicologia , Obesidade Pediátrica/diagnóstico , Adolescente , Comportamento de Escolha , Feminino , Humanos , Incidência , Estilo de Vida , Masculino , Obesidade Pediátrica/genética , Obesidade Pediátrica/psicologia , Fatores Socioeconômicos , Estados Unidos
2.
Value Health ; 22(3): 348-354, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30832973

RESUMO

OBJECTIVES: To examine the concurrent validity of the Weight-specific Adolescent Instrument for Economic evaluation (WAItE) as compared with the generic, preference-based Child Health Utility 9D (CHU-9D) and the weight-specific Youth Quality of Life-Weight (YQOL-W) and also to examine the test-retest reliability of the WAItE. METHODS: An online survey was used to administer the 3 instruments on a sample of adolescents (aged 11-18 years). Individual responses were converted into either utility scores (CHU-9D) or health-related quality-of-life scores (WAItE and YQOL-W). A 10% subsample of the respondents also completed the WAItE 1 week after completion to assess test-retest reliability. RESULTS: One thousand adolescents completed the online survey. There was a strong correlation between the WAItE and both the CHU-9D (0.731; P<.001) and the YQOL-W (0.747; P<.001). All 3 instruments were able to discriminate according to different weight status categories and a measure of self-assessed health. Unlike the CHU-9D or the YQOL-W, the WAItE did not show a substantial ceiling effect. The WAItE also showed acceptable levels of test-retest reliability. CONCLUSIONS: The study results are encouraging, and illustrate that the WAItE can be used to reliably and accurately measure weight-specific outcomes in the younger population. The WAItE can also be used to assess outcomes in cost-effectiveness analysis of weight management interventions for young people, given the instrument is less likely to display ceiling effects and may thus be more sensitive in measuring change that results from interventions developed for this population.


Assuntos
Peso Corporal , Obesidade Pediátrica/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Adolescente , Peso Corporal/fisiologia , Criança , Feminino , Humanos , Masculino , Obesidade/diagnóstico , Obesidade/psicologia , Obesidade Pediátrica/diagnóstico , Distribuição Aleatória , Reprodutibilidade dos Testes
3.
Nutrients ; 11(3)2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-30917561

RESUMO

We examined the effectiveness of a computerised decision-support tool (DST), designed for paediatric healthcare professionals, as a means to tackle childhood obesity. A randomised controlled trial was conducted with 65 families of 6⁻12-year old overweight or obese children. Paediatricians, paediatric endocrinologists and a dietitian in two children's hospitals implemented the intervention. The intervention group (IG) received personalised meal plans and lifestyle optimisation recommendations via the DST, while families in the control group (CG) received general recommendations. After three months of intervention, the IG had a significant change in dietary fibre and sucrose intake by 4.1 and -4.6 g/day, respectively. In addition, the IG significantly reduced consumption of sweets (i.e., chocolates and cakes) and salty snacks (i.e., potato chips) by -0.1 and -0.3 portions/day, respectively. Furthermore, the CG had a significant increase of body weight and waist circumference by 1.4 kg and 2.1 cm, respectively, while Body Mass Index (BMI) decreased only in the IG by -0.4 kg/m². However, the aforementioned findings did not differ significantly between study groups. In conclusion, these findings indicate the dynamics of the DST in supporting paediatric healthcare professionals to improve the effectiveness of care in modifying obesity-related behaviours. Further research is needed to confirm these findings.


Assuntos
Técnicas de Apoio para a Decisão , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/prevenção & controle , Software , Algoritmos , Criança , Feminino , Humanos , Masculino , Refeições , Fatores de Risco , Programas de Redução de Peso
4.
PLoS Med ; 16(2): e1002744, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30742624

RESUMO

BACKGROUND: Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact. METHODS AND FINDINGS: We conducted an individual participant data meta-analysis of data from 162,129 mothers and their children from 37 pregnancy and birth cohort studies from Europe, North America, and Australia. We assessed the individual and combined associations of maternal pre-pregnancy BMI and gestational weight gain, both in clinical categories and across their full ranges, with the risks of overweight/obesity in early (2.0-5.0 years), mid (5.0-10.0 years) and late childhood (10.0-18.0 years), using multilevel binary logistic regression models with a random intercept at cohort level adjusted for maternal sociodemographic and lifestyle-related characteristics. We observed that higher maternal pre-pregnancy BMI and gestational weight gain both in clinical categories and across their full ranges were associated with higher risks of childhood overweight/obesity, with the strongest effects in late childhood (odds ratios [ORs] for overweight/obesity in early, mid, and late childhood, respectively: OR 1.66 [95% CI: 1.56, 1.78], OR 1.91 [95% CI: 1.85, 1.98], and OR 2.28 [95% CI: 2.08, 2.50] for maternal overweight; OR 2.43 [95% CI: 2.24, 2.64], OR 3.12 [95% CI: 2.98, 3.27], and OR 4.47 [95% CI: 3.99, 5.23] for maternal obesity; and OR 1.39 [95% CI: 1.30, 1.49], OR 1.55 [95% CI: 1.49, 1.60], and OR 1.72 [95% CI: 1.56, 1.91] for excessive gestational weight gain). The proportions of childhood overweight/obesity prevalence attributable to maternal overweight, maternal obesity, and excessive gestational weight gain ranged from 10.2% to 21.6%. Relative to the effect of maternal BMI, excessive gestational weight gain only slightly increased the risk of childhood overweight/obesity within each clinical BMI category (p-values for interactions of maternal BMI with gestational weight gain: p = 0.038, p < 0.001, and p = 0.637 in early, mid, and late childhood, respectively). Limitations of this study include the self-report of maternal BMI and gestational weight gain for some of the cohorts, and the potential of residual confounding. Also, as this study only included participants from Europe, North America, and Australia, results need to be interpreted with caution with respect to other populations. CONCLUSIONS: In this study, higher maternal pre-pregnancy BMI and gestational weight gain were associated with an increased risk of childhood overweight/obesity, with the strongest effects at later ages. The additional effect of gestational weight gain in women who are overweight or obese before pregnancy is small. Given the large population impact, future intervention trials aiming to reduce the prevalence of childhood overweight and obesity should focus on maternal weight status before pregnancy, in addition to weight gain during pregnancy.


Assuntos
Índice de Massa Corporal , Análise de Dados , Ganho de Peso na Gestação/fisiologia , Obesidade Pediátrica/epidemiologia , Austrália/epidemiologia , Estudos de Coortes , Europa (Continente)/epidemiologia , Feminino , Humanos , América do Norte/epidemiologia , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Obesidade Pediátrica/diagnóstico , Gravidez , Fatores de Risco
5.
Value Health ; 22(2): 239-246, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30711070

RESUMO

BACKGROUND: The Weight-Specific Adolescent Instrument for Economic Evaluation (WAItE) is a new condition-specific patient reported outcome measure that incorporates the views of adolescents in assessing the impact of above healthy weight status on key aspects of their lives. Presently it is not possible to use the WAItE to calculate quality adjusted life years (QALYs) for cost-utility analysis (CUA), given that utility scores are not available for health states described by the WAItE. OBJECTIVE: This paper examines different regression models for estimating Child Health Utility 9 Dimension (CHU-9D) utility scores from the WAItE for the purpose of calculating QALYs to inform CUA. METHODS: The WAItE and CHU-9D were completed by a sample of 975 adolescents. Nine regression models were estimated: ordinary least squares, Tobit, censored least absolute deviations, two-part, generalized linear model, robust MM-estimator, beta-binomial, finite mixture models, and ordered logistic regression. The mean absolute error (MAE) and mean squared error (MSE) were used to assess the predictive ability of the models. RESULTS: The robust MM-estimator with stepwise-selected WAItE item scores as explanatory variables had the best predictive accuracy. CONCLUSIONS: Condition-specific tools have been shown to be more sensitive to changes that are important to the population for which they have been developed for. The mapping algorithm developed in this study facilitates the estimation of health-state utilities necessary for undertaking CUA within clinical studies that have only collected the WAItE.


Assuntos
Algoritmos , Análise Custo-Benefício/métodos , Indicadores Básicos de Saúde , Obesidade Pediátrica/economia , Anos de Vida Ajustados por Qualidade de Vida , Inquéritos e Questionários , Adolescente , Peso Corporal/fisiologia , Criança , Feminino , Humanos , Masculino , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia
6.
BMC Musculoskelet Disord ; 20(1): 84, 2019 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-30777046

RESUMO

BACKGROUND: Lower extremity defects in healthy children raises interest of researchers as confirmed by numerous published original and review articles. The relationship between lower extremity postural defects and body mass are unclear as published data are inconclusive. The aim of the present cross-sectional study was to analyse the prevalence of lower extremity defects in a large group of 8- to 12-year-old children; and further to assess the probability of defects associated with values of body mass variables. METHODS: The study included prospective anthropometric measurements data of 6992 children (3476 boys and 3516 girls) from Gdansk (Northern Poland). Standard screening test used in Poland for assessment of lower limb defects were used (intermalleolar or intercondylar distance for knee alignment, linear vertical compass for valgus heel, computer podoscope or classical footprint and measuring the Sztriter-Godunow index for flatfeet). Body mass was assessed with local centile charts and IOTF cutoffs. Prevalence of postural defects was compared with an aid of Pearson's chi-squared test and Fisher's exact test. Probability of lower extremities postural defect was estimated on the basis of logistic regression analysis, and expressed as an odds ratio (OR) and its 95.0% CI. RESULTS: The study demonstrated that cumulative prevalence of lower extremity defects (31.5%) was lower than reported in most published studies, most common defects were valgus heel (21.8%) and valgus knee (14.5%). Boys were significantly more frequently diagnosed with lower limb defects overall (p < 0.001), as well as with varus knee, valgus heel, flatfoot of any degree. Limb defects were found in 90,2% of obese children, 25,7% of normal weight and 15,1% of underweight children. CONCLUSIONS: Prevalence of some lower extremities defects seems to be sex specific. Prevalence varied across body weight categories and was rising with the increase of BMI. Increased body mass is correlated with a higher risk of developing lower extremity postural defects in children.


Assuntos
Índice de Massa Corporal , Peso Corporal/fisiologia , Deformidades Congênitas das Extremidades Inferiores/diagnóstico , Deformidades Congênitas das Extremidades Inferiores/epidemiologia , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Antropometria/métodos , Criança , Estudos Transversais , Feminino , Humanos , Extremidade Inferior/patologia , Masculino , Polônia , Estudos Prospectivos
7.
Nutr Metab Cardiovasc Dis ; 29(2): 177-184, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30660687

RESUMO

BACKGROUND AND AIMS: Obesity and insulin resistance development are related to known risk factors (such as diet) that begin in childhood. Among dietary factors, the consumption of ultra-processed foods has received attention. The present study investigated the association between ultra-processed foods consumption at preschool age and changes in anthropometric measurements from preschool to school age and glucose profile at school age. METHODS AND RESULTS: The present study was a follow-up of a randomized controlled trial, conducted with 307 children of low socioeconomic status from São Leopoldo, Brazil. At ages 4 and 8 years, children's anthropometric assessments were collected from preschool to school age including body-mass index (BMI) for-age, waist circumference (WC), waist-to-height ratio (WHtR) and skinfold. At the age 8 years, blood tests were performed to measure glucose profile. Dietary data were collected through 24-h recalls and the children's ultra-processed food intake was assessed. Linear regression analysis was used to assess the relationship between ultra-processed food consumption and the outcomes. The percentage of daily energy provided by ultra-processed foods was 41.8 ± 8.7 (753.8 ± 191.0 kcal) at preschool age and 47.8 ± 8.9 (753.8 ± 191.0 kcal) at school age, on average. The adjusted linear regression analyses showed that ultra-processed food consumption at preschool age was a predictor of an increase in delta WC from preschool to school age (ß = 0.07; 95%CI 0.01-0.14; P = 0.030), but not for glucose metabolism. CONCLUSION: Our data suggest that early ultra-processed food consumption played a role in increasing abdominal obesity in children. These results reinforce the importance of effective strategies to prevent the excessive consumption of ultra-processed foods, especially in early ages.


Assuntos
Antropometria , Glicemia/metabolismo , Fast Foods/efeitos adversos , Manipulação de Alimentos , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/epidemiologia , Fatores Etários , Biomarcadores/sangue , Brasil , Criança , Comportamento Infantil , Desenvolvimento Infantil , Pré-Escolar , Ingestão de Energia , Comportamento Alimentar , Feminino , Humanos , Estudos Longitudinais , Masculino , Valor Nutritivo , Obesidade Abdominal/sangue , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Obesidade Pediátrica/sangue , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Classe Social
8.
Nutr Metab Cardiovasc Dis ; 29(2): 159-169, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30660688

RESUMO

BACKGROUND AND AIMS: Various lifestyle, anthropometric, socio-demographic and perinatal characteristics have been separately associated with elevated blood pressure in children and adolescents. The aim of this study was to simultaneously evaluate all potential risk factors and to identify the most dominant correlates of early adolescence hypertension in a large group of school children 9-13 years old. METHODS AND RESULTS: A cross-sectional study with 1444 schoolchildren 9-13 years old, having full data on lifestyle, anthropometric, socio-demographic and perinatal indices, as well as blood pressure measurements. Early adolescents born large for their gestational age (LGA) (OR, 95% C.I. 0.49 (0.25-0.97)), those with higher levels of moderate to vigorous physical activity (MVPA) (OR, 95% C.I. 0.71 (0.53-0.96)) and those of a higher socioeconomic status (SES) (OR, 95% C.I. 0.51 (0.33-0.79)), had lower risk of hypertension, compared with their counterparts with appropriate birth weight, low levels of PA and with low SES respectively, independently of the variables used in the multivariate model. On the other hand, overweight and obese early adolescents (OR, 95% C.I. 2.61 (1.88-3.62)), those with central obesity (OR, 95% C.I. 1.75 (1.12-2.73)) and those having a hypertensive father (OR, 95% C.I. 1.93 (1.20-3.12)) had higher risk of hypertension compared with normal weight early adolescents and those without a family history of hypertension. CONCLUSIONS: Among the parameters examined, early adolescence abnormal body weight and central obesity, low PA, non LGA, low SES family and family history of hypertension were found to be independently associated with higher risk of hypertension. The identified correlates of early adolescence hypertension can be used by public health initiatives for early detection and management of this major public health problem, prioritizing early adolescents and families at the highest possible risk for hypertension.


Assuntos
Hipertensão/epidemiologia , Estilo de Vida , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/epidemiologia , Classe Social , Determinantes Sociais da Saúde , Adolescente , Desenvolvimento do Adolescente , Idade de Início , Antropometria , Peso ao Nascer , Criança , Desenvolvimento Infantil , Estudos Transversais , Exercício , Feminino , Grécia/epidemiologia , Inquéritos Epidemiológicos , Estilo de Vida Saudável , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Hipertensão/prevenção & controle , Masculino , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Obesidade Abdominal/prevenção & controle , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/prevenção & controle , Fatores de Proteção , Fatores de Risco , Comportamento de Redução do Risco
9.
Acta Diabetol ; 56(2): 219-226, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30637483

RESUMO

AIMS: In this study, we investigated whether adipose tissue insulin resistance (IR) is affected by the degree of obesity during the fasting and post-prandial state, independent of glucose tolerance among obese children and adolescents. We also tested whether systemic subclinical inflammation is associated with adipose tissue IR. METHODS: Subjects were recruited to the Yale Pathophysiology of Type 2 Diabetes in Youth Study (NCT01967849). An oral glucose-tolerance test was performed to establish glucose-tolerance status and blood samples were drawn for measurement of free fatty acids (FFAs), to calculate the area under the curve (AUC) of FFA. Adipose tissue insulin resistance was calculated as the product of insulin and FFA concentrations. RESULTS: In total, 671 children and adolescents (58.6% females) were included with a mean age of 13.3(2.7) years and BMI Z score of 2.45(0.31). The degree of obesity emerged as an independent predictor of both fasting and post-prandial adipose IR, p < 0.0001. Higher degree of obesity was associated with greater AUC FFA (lower suppression) compared to lower degree of obesity, p = 0.01. Furthermore, higher levels of IL-6 were positively associated with post-prandial adipose tissue IR, p = 0.02. CONCLUSIONS: The degree of obesity in childhood and adolescence is strongly associated with adipose tissue IR independent of glucose tolerance. This is reflected not only in calculated indices of adipose IR but also in lower suppression of FFAs during the OGTT regardless of glucose tolerance or fasting adipose tissue IR. Furthermore, markers of subclinical inflammation such as IL-6 are associated with adipose tissue IR, independent of other factors.


Assuntos
Tecido Adiposo/metabolismo , Glicemia/metabolismo , Ácidos Graxos não Esterificados/sangue , Resistência à Insulina/fisiologia , Obesidade Pediátrica , Adolescente , Área Sob a Curva , Índice de Massa Corporal , Criança , Estudos de Coortes , Correlação de Dados , Diabetes Mellitus Tipo 2/complicações , Jejum/metabolismo , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/metabolismo , Período Pós-Prandial/fisiologia , Índice de Gravidade de Doença , Estados Unidos
10.
Cardiovasc Diabetol ; 18(1): 9, 2019 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-30660185

RESUMO

BACKGROUND: Reports on body mass index (BMI) trajectories from childhood into late adolescence, their determinants, and subsequent cardiometabolic risk markers, particularly among European populations have been few. Moreover, sex-specific investigation is necessary considering the sex difference in BMI, and the sex-specific association between BMI and some cardiometabolic risk markers. METHODS: Using a sample from the DOrtmund Nutritional and Anthropometric Longitudinally Designed study, we explored sex-specific trajectories of the BMI standard deviation score (SDS) from 4 to 18 years of age in 354 males and 335 females by latent (class) growth models. The determinants of trajectory were assessed by logistic regression. We identified cardiometabolic risk markers that were highly associated with BMI SDS trajectory by random forest regression, and finally we used generalized linear models to investigate differences in the identified cardiometabolic risk markers between pairs of trajectories. RESULTS: We observed four: 'low-normal weight', 'mid-normal weight', 'high-normal weight', and 'overweight', and three: ''low-normal weight', 'mid-normal weight', and 'high-normal weight' trajectories in males and females, respectively. Higher maternal prepregnancy BMI was associated with the 'overweight' trajectory, and with 'high-normal weight' trajectory in both sexes. In addition, employed mothers and first-born status were associated with 'high-normal weight' trajectory in females. BMI SDS trajectory was associated with high-density lipoprotein-cholesterol and interleukin-18 (IL-18) in males, and diastolic blood pressure and interleukin-6 (IL-6) in females. However, only males following the 'overweight' trajectory had significantly higher IL-18 when compared to their 'low-normal weight' counterpart. CONCLUSIONS: We identified sex-specific distinct trajectories of BMI SDS from childhood into late adolescence, higher maternal prepregnancy BMI as a common determinant of the 'high-normal weight' and 'overweight' trajectories, and 'overweight' trajectory being associated with elevated IL-18 in late adolescence-young adulthood. This study emphasizes the role of maternal prepregnancy BMI in overweight, and highlights IL-18 as a cardiometabolic signature of overweight across life.


Assuntos
Desenvolvimento do Adolescente , Índice de Massa Corporal , Desenvolvimento Infantil , Síndrome Metabólica/epidemiologia , Obesidade Pediátrica/epidemiologia , Adolescente , Adulto , Fatores Etários , Biomarcadores/sangue , Pressão Sanguínea , Peso Corporal , Criança , Pré-Escolar , Feminino , Alemanha/epidemiologia , Humanos , Interleucina-18/sangue , Interleucina-6/sangue , Lipídeos/sangue , Estudos Longitudinais , Masculino , Fenômenos Fisiológicos da Nutrição Materna , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Prevalência , Prognóstico , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
11.
Diab Vasc Dis Res ; 16(2): 196-206, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30688518

RESUMO

AIM: To investigate the association between visceral adipose tissue loss and insulin resistance and hyperleptinemia in adolescents with obesity submitted to interdisciplinary weight-loss therapy. METHODS: A total of 172 post-pubertal adolescents (body mass index greater than the 95th percentile of the Centers for Disease Control and Prevention reference growth charts) were recruited for the study. The adolescents were assigned to long-term weight-loss therapy. Body composition, visceral and subcutaneous fat, glucose metabolism, lipid profile, hepatic enzymes and leptin concentration were measured. After the therapy, the adolescents were allocated to three different groups according to the tertile of visceral fat reduction. RESULTS: Positive effects on body composition were observed in all analysed groups independent of visceral fat reduction. It was found that visceral fat was an independent predictor of insulin resistance in the investigated population. Obese adolescents who lost a higher proportion of visceral adipose tissue (>1.8 cm) demonstrated improved metabolic and inflammatory parameters twice as much than those who presented smaller losses. Positive correlations between visceral fat reduction and glucose metabolism, lipid profile, hepatic enzymes and homeostasis model assessment of insulin resistance index were demonstrated. CONCLUSION: The magnitude of the reduction in visceral fat was an independent predictor of insulin resistance, hyperleptinemia and metabolic disorders related to obese adolescents.


Assuntos
Adiposidade , Resistência à Insulina , Gordura Intra-Abdominal/fisiopatologia , Leptina/sangue , Síndrome Metabólica/prevenção & controle , Obesidade Pediátrica/terapia , Perda de Peso , Adolescente , Fatores Etários , Biomarcadores/sangue , Glicemia/metabolismo , Feminino , Nível de Saúde , Humanos , Insulina/sangue , Lipídeos/sangue , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Obesidade Pediátrica/sangue , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
13.
Pediatr Obes ; 14(2): e12494, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30590878

RESUMO

BACKGROUND: Waist circumference (WC) and z scores of body mass index (BMI) are commonly used to predict childhood obesity, although BMI and WC have a limited sensitivity. OBJECTIVES: To generate an artificial neural network (ANN), using the input parameters age, height, weight, and WC, to predict excess body fat in children. METHODS: As part of the National Health and Nutrition Examination Survey (NHANES) study, in the years 1999 to 2004, the body fat percentage of randomly selected Americans from 8 to 19 years were measured using whole-body dual energy X-ray absorptiometry (DXA) scans. Excess body fat was defined as a body fat percentage ≥ 85th centile. RESULTS: The data of 1999 children (856 female) were eligible. In females, the sensitivity of the BMI, WC, and ANN approaches to predict excess body fat were 0.751 (95% CI, 0.730-0.771), 0.523 (0.487-0.559), and 0.782 (0.754-0.810), respectively. In males, the sensitivity of the BMI, WC, and ANN approaches to predict excess body fat were 0.721 (95% CI, 0.699-0.743), 0.572 (0.549-0.594), and 0.795 (0.768-0.821). CONCLUSIONS: Only in boys, the diagnostic performance in identifying excess body fat was better by using an ANN than by applying BMI and WC z scores. In girls, the ANN and BMI z scores performed comparable and significantly better than WC z scores.


Assuntos
Absorciometria de Fóton/métodos , Tecido Adiposo/diagnóstico por imagem , Redes Neurais (Computação) , Obesidade Pediátrica/diagnóstico , Adolescente , Índice de Massa Corporal , Peso Corporal , Criança , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Autoimagem , Sensibilidade e Especificidade , Circunferência da Cintura , Adulto Jovem
14.
J Pediatr Endocrinol Metab ; 32(1): 41-47, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30530882

RESUMO

Background Obesity is associated with oxidative stress, which is related to increased advanced glycation end product (AGE) formation. AGEs accumulated in skin collagen can be measured with skin autofluorescence (sAF). There are conflicting reports on the influence of obesity on sAF in adults and no data in children. Therefore, this study evaluated sAF in pediatric patients with and without obesity. Methods In this cross-sectional study, participants aged 4-18 years were included: patients with obesity (body mass index standard deviation score [BMI-SDS] >2.3) and lean controls (BMI-SDS >-1.1 to <1.1). sAF was measured using the AGE Reader®. Participants were stratified according to age (<10, ≥10 to <13, ≥13 to <15, ≥15 to <17 and ≥17 years) and skin type (I-VI). Results In total, 143 patients and 428 controls were included. In patients, there was no influence of age on sAF (p=0.09). In controls, sAF was higher in children aged <10 years compared to ≥10 to <13 and ≥13 to <15 years (p=0.02; p=0.04). Stratified by age, sAF was higher in patients compared to controls in all age categories, except <10 years of age (p<0.01), while this was not observed when stratified by skin type (p>0.05). Skin type and BMI were significant covariates for sAF. Conclusions BMI was a covariate for sAF; however, no difference in sAF was observed between children with and without obesity, stratified by skin type. Duration of obesity as well as accuracy of the AGE Reader® might explain this difference. Further research is warranted, in which patients should be matched for age and skin type.


Assuntos
Biomarcadores/metabolismo , Fluorescência , Produtos Finais de Glicação Avançada/metabolismo , Obesidade Pediátrica/diagnóstico , Pele/metabolismo , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Imagem Óptica , Obesidade Pediátrica/metabolismo , Prognóstico , Medição de Risco , Pele/química
15.
Pediatr Ann ; 47(12): e487-e493, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30543377

RESUMO

Sustaining weight loss can be challenging, as physiological responses to weight loss, including metabolic and hormonal adaptations and decreased energy expenditure, promote weight regain. Paired with sustained dietary changes, physical activity can promote weight maintenance after successful weight loss, as physical activity can help maintain fat-free mass. We present several illustrative cases to highlight the potential use of body composition measurement using a bioelectrical impedance analysis (BIA) scale to augment obesity management counseling in a tertiary care pediatric weight-management clinic. BIA does require some interpretation, as it can be affected by hydration status and time of day, as well as patient age, sex, and body mass index. Nonetheless, BIA can be a helpful aid to obesity counseling. More research is needed to better understand how to use change in percent body fat over time as a motivational tool for management of children with obesity. [Pediatr Ann. 2018;47(12):e487-e493.].


Assuntos
Adiposidade , Manejo da Obesidade/métodos , Obesidade Pediátrica/diagnóstico , Adolescente , Criança , Feminino , Humanos , Masculino , Obesidade Pediátrica/terapia , Pletismografia de Impedância
16.
Rev. andal. med. deporte ; 11(4): 192-198, dic. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181212

RESUMO

Objetivo: Comparar de forma longitudinal diferentes criterios diagnósticos de sobrepeso y obesidad en niños y niñas de 6 a 11 años. Método: 155 sujetos (86 niñas y 69 niños) pertenecientes a los tres colegíos públicos de La Algaba (Sevilla) fueron estudiados a lo largo de los seis cursos de Educación Primaria (2011-2017). Semestralmente se midió peso, talla y se calculó el Índice de Masa Corporal. Las prevalencias de sobrepeso y obesidad se calcularon mediante los percentiles 85 y 95 del Índice de Masa Corporal respectivamente, utilizando las tablas de los Centers for Disease Control and Prevention de Atlanta (United States of America), la Fundación Orbegozo y la Organización Mundial de la Salud. También se utilizó el criterio de extrapolación de Cole. Resultado: La evolución del peso, la talla y del Índice de Masa Corporal es lineal e idéntica para niños y niñas. La prevalencia de sobrepeso y obesidad en niñas se mantiene estable a lo largo del estudio con los cuatro criterios empleados. En niños muestra una tendencia creciente con todos los criterios salvo con el de la Organización Mundial de la Salud. La prevalencia de sobrepeso es mayor que la de obesidad en todos los casos, salvo con el criterio Centers for Disease Control and Prevention que ocurre lo contrario. La prevalencia total (sobrepeso y obesidad) es menor con el criterio de Orbegozo, tanto para niños (32.7%) como para niñas (27.1%) y el valor más alto con el criterio de la Organizacíon Mundial de la Salud (51% para ambos). Conclusiones: Es de gran importancia que al facilitar datos de prevalencia se informe de qué criterios se están utilizando y no comparar nunca datos obtenidos con diferentes criterios de diagnóstico o comparando periodos de tiempo donde estos criterios hayan variado


Objective: To compare longitudinally different diagnostic criteria of overweight and obesity in children from 6 to 11 years old. Method: 155 children (86 girls and 69 boys) belonging to the three public schools of La Algaba (Seville) were studied throughout the six courses of Primary Education (2011-2017). Weight, height and were measured every six months and Body Mass Index were calculated every six months.The prevalences of overweight and obesity were calculated using the 85th and 95th Body Mass Index percentiles respectively, using the tables of the Centers for Disease Control and Prevention of Atlanta (USA), the Orbegozo Foundation and the World Health Organization. The Cole extrapolation criterion was also used. Results: The evolution of weight, height and Body Mass Index is linear and identical for boys and girls. The prevalence of overweight and obesity in girls remains stable throughout the study with the four criteria used. In children it shows a growing trend with all the criteria except that of the World Health Organization. The prevalence of overweight is greater than that of obesity in all cases, except with the Centers for Disease Control and Prevention criterion that the opposite occurs. The total prevalence (overweight and obesity) is lower with the Orbegozo criterion, both for children (32.7%) and for girls (27.1%) and the highest value is reached with the World Health Organization criterion (51% for both). Conclusions: It is of great importance that, when providing prevalence data, it is reported which criteria are being used and never compare data obtained with different diagnostic criteria or comparing periods of time where these criteria have varied


Objetivo: Comparar os diferentes critérios diagnósticos de sobrepeso e obesidade em meninos e meninas de 6 a 11 anos. Método: Foram estudados 155 sujeitos (86 meninas e 69 meninos) pertencentes à três escolas públicas de La Algaba (Sevilha) ao longo dos seis anos do Ensino Fundamental (2011-2017). Peso, altura e IMC foram medidos a cada seis meses. As prevalências de sobrepeso e obesidade foram calculadas a partir dos percentis 85 e 95 do IMC, respectivamente, utilizando as tabelas do CDC de Atlanta (EUA), da Fundação Orbegozo, da OMS e o critério de extrapolação Cole. Resultado: O aumento do peso, altura e IMC é linear e idêntica para meninos e meninas. A prevalência de sobrepeso e obesidade em meninas permanece estável ao longo do estudo de acordo com os quatro critérios utilizados. Já em meninos, há uma tendência crescente com todos os critérios, exceto o da OMS. A prevalência de sobrepeso é maior que a da obesidade em todos os casos, exceto de acordo com o critério do CDC. A prevalência total (sobrepeso e obesidade) é menor de acordo com o critério de Orbegozo, tanto para meninos (32,7%) quanto para meninas (27,1%). Em contrapartida, o maior valor de prevalência é observado através do diagnóstico de acordo com o critério da OMS (51% para ambos). Conclusões: É de suma importância que, ao fornecer dados de prevalência, sejam especificados quais os critérios diagnóstico estão sendo utilizados e evitar que dados obtidos de diferentes critérios sejam comparados


Assuntos
Humanos , Masculino , Feminino , Criança , Antropometria/métodos , Pesos e Medidas Corporais/estatística & dados numéricos , Composição Corporal/fisiologia , Obesidade Pediátrica/diagnóstico , Sobrepeso/diagnóstico , Estudos Longitudinais , Peso Corporal , Estatura , Índice de Massa Corporal , Reprodutibilidade dos Testes , Variações Dependentes do Observador
17.
Rev. Rol enferm ; 41(11/12,supl): 53-56, nov.-dic. 2018. ilus
Artigo em Inglês | IBECS | ID: ibc-179941

RESUMO

Currently, weight disorders, have reached a large part of the world population.Obesity in children, including toddlers, is a serious public health problem. There are many parents who do not recognize their children's overweight/obesity and toddlers parents of are less likely to recognize this problem. It is known that identifying overweight/obesity is critical to implementing pre-vention strategies and interventions as early as possible. We carried out a descriptive study of quantitative approach. It was applied: "Toddler Silhouette Scale" to parents of toddlers who attend day care centers in located the district of Viseu, Portugal. Data processed using IBM-SPSS24. It was concluded that 83.3% of the parents reported that their child had normal weight, 13.3% underweight and 3.3% overweight. Regarding the silhouette that they consider ideal, the totality of the parents, select silhouettes referring to the normal weight. In the evaluation of the current silhouette of the child, 6.7% opts for the image 1 (low Weight) and 3.3% for the image 6 (overweight), all the others select images of normal weight. According to the weight records of the individual health report, 3.3% of the children were underweight, 10% overweight and 6.7% obese. Our results corroborate those of the author of the scale who concluded that most parents correctly identify the silhouette that matches their child's actual weight. A study carried out in Portugal, revealed an absence of parental perception about the excess weight of the children


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Obesidade Pediátrica/epidemiologia , Sobrepeso/epidemiologia , Imagem Corporal , Pesos e Medidas Corporais/estatística & dados numéricos , Estado Nutricional , Percepção Social , Obesidade Pediátrica/diagnóstico , Sobrepeso/diagnóstico , Pais
18.
J Am Coll Cardiol ; 72(25): 3310-3319, 2018 12 25.
Artigo em Inglês | MEDLINE | ID: mdl-30527619

RESUMO

Cardiovascular disease is the leading cause of death and disability in the world, largely because of risk factors modifiable by changes in behavior. There is evolving evidence that our behavior as adults has its roots in the environment that we live in from early childhood. Early sustained multicomponent educational programs focused on health promotion in children may represent a window of opportunity to potentially prevent disease in adulthood. The integration of school-based, family-based, and community-based strategies, along with the support of public policies, are likely necessary for the success of these programs. In this review, the authors describe the future of promoting health. Specifically: 1) reasons why children should be a focus for health promotion (alarming trends of risk factors, association between unhealthy factors and subclinical disease, and cost-effectiveness); 2) strategies for health promotion in children (school-based, family-based, and community-based approaches) along with legislative efforts; and 3) research gaps are discussed.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Exercício/fisiologia , Promoção da Saúde/tendências , Obesidade Pediátrica/prevenção & controle , Serviços de Saúde Escolar/tendências , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Criança , Promoção da Saúde/métodos , Humanos , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Fatores de Risco
19.
Gac. sanit. (Barc., Ed. impr.) ; 32(5): 477-480, sept.-oct. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-174197

RESUMO

Objective: To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain. Method: Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used. Results: The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables. Discussion: The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher


Objetivo: Evaluar si existen diferencias relevantes entre los valores de prevalencia de sobrepeso y obesidad infantil en función de los tipos de criterios utilizados (Fundación Orbegozo, International Obesity Task Force, Organización Mundial de la Salud), y el modo en que su uso afecta a las tendencias sobre obesidad registradas para ambos sexos en España entre 2005 y 2011. Método: Estudio transversal, en una población de entre 2 y 15 años de edad. Se usaron tres criterios diagnósticos de sobrepeso y obesidad. Resultados: Los niños, según los tres criterios utilizados, presentaron valores superiores de sobrepeso y obesidad en comparación con las niñas. Las cifras más bajas de sobrepeso y obesidad se observaron al emplear las tablas de Orbegozo. Discusión: Las prevalencias de sobrepeso y obesidad varían de manera significativa según los criterios utilizados para definir sobrepeso y obesidad. Los percentiles de la Fundación Orbegozo proporcionan las estimaciones más bajas, y los estándares de crecimiento de la Organización Mundial de la Salud las más altas


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Obesidade Pediátrica/diagnóstico , Sobrepeso/diagnóstico , Antropometria/métodos , Obesidade Pediátrica/epidemiologia , Sobrepeso/epidemiologia , Espanha/epidemiologia , Estudos Transversais , Gráficos de Crescimento
20.
Nutrients ; 10(8)2018 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-30103429

RESUMO

There is a general belief that having breakfast is an important healthy lifestyle factor; however, there is scarce evidence on the influence of breakfast quality and energy density on cardiometabolic risk in children, as well as on the role of physical activity in this association. The aims of this paper were (i) to examine the associations of breakfast quality and energy density from both solids and beverages with cardiometabolic risk factors, and (ii) to explore whether physical activity levels may attenuate these relationships in children with overweight/obesity from two projects carried out in the north and south of Spain. Breakfast consumption, breakfast quality index (BQI) score, BEDs/BEDb (24 h-recalls and the KIDMED questionnaire), and physical activity (PA; accelerometry) were assessed, in 203 children aged 8⁻12 years who were overweight or obese. We measured body composition (Dual X-ray Absorptiometry), uric acid, blood pressure, lipid profile, gamma-glutamyl-transferase (GGT), glucose, and insulin, and calculated the HOMA and metabolic syndrome z-score. The BQI score was inversely associated with serum uric acid independently of a set of relevant confounders (ß = -0.172, p = 0.028), but the relationship was attenuated after further controlling for total PA (p < 0.07). BEDs was positively associated with total and HDL cholesterol, and systolic blood pressure regardless of confounders (all p < 0.05), while BEDb was positively associated with HOMA in either active/inactive children (all p < 0.03). In conclusion, higher breakfast quality and lower breakfast energy density should be promoted in overweight/obesity children to improve their cardiometabolic health.


Assuntos
Desjejum , Fenômenos Fisiológicos da Nutrição Infantil , Ingestão de Energia , Exercício , Estilo de Vida Saudável , Síndrome Metabólica/prevenção & controle , Valor Nutritivo , Obesidade Pediátrica/fisiopatologia , Fatores Etários , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etiologia , Síndrome Metabólica/fisiopatologia , Estado Nutricional , Obesidade Pediátrica/complicações , Obesidade Pediátrica/diagnóstico , Fatores de Proteção , Fatores de Risco , Espanha
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