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1.
PLoS One ; 15(1): e0216516, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31978089

RESUMO

Childhood obesity is an undeniable reality that has rapidly increased in many countries. Obesity at an early age not only increases the risks of chronic diseases but also produces a problem for the whole healthcare system. One way to alleviate this problem is to provide each patient with an appropriate menu that is defined by a mathematical model. Existing mathematical models only partially address the objective and constraints of childhood obesity; therefore, the solutions provided are insufficient for health specialists to prepare nutritional menus for individual patients. This manuscript proposes a multiobjective mathematical programming model to aid in healthy nutritional menu planning that may prevent childhood obesity. This model provides a plan for combinations and amounts of food across different schedules and daily meals. This approach minimizes the major risk factors of childhood obesity (i.e., glycemic load and cholesterol intake). In addition, this approach considers the minimization of nutritional mismatch and total cost. The model is solved using a deterministic method and two metaheuristic methods. Test instances associated with children aged 4-18 years were created with the support of health professionals to complete this numerical study. The quality of the solutions generated using the three methods was similar, but the metaheuristic methods provided solutions in a shorter computational time. These results are submitted to statistical hypothesis tests to be validated. The numerical results indicate proper guidelines for personalized plans for individual children.


Assuntos
Dieta , Ácidos Graxos/metabolismo , Estado Nutricional/fisiologia , Obesidade Pediátrica/dietoterapia , Adolescente , Animais , Criança , Pré-Escolar , Ingestão de Energia/fisiologia , Feminino , Humanos , Masculino , Refeições , Planejamento de Cardápio/normas , Leite/metabolismo , Política Nutricional , Obesidade Pediátrica/epidemiologia , Fatores de Risco
2.
Metas enferm ; 22(10): 14-20, dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185327

RESUMO

Objetivo: describir la calidad del desayuno de los niños y las niñas de 4 a 9 años de un municipio de Madrid, y de sus cuidadores familiares. Método: se diseñó un estudio descriptivo transversal en el Centro de Salud Alicante en Fuenlabrada (Madrid) con la población infantil de entre 4 y 9 años, que acudían a consulta de Enfermería para revisiones programadas junto al familiar/tutor con quien realizaban habitualmente el desayuno. Los datos se recogieron mediante entrevista clínica y exploración antropométrica en consulta, empleándose el cuestionario "Test de desayuno saludable" de la Comunidad de Madrid para obtener los datos de la calidad del desayuno. Se llevó a cabo un análisis descriptivo, usando media y desviación estándar (DE) para las variables cuantitativas y frecuencias para las cualitativas. Resultados: participaron 289 niños/as, con una edad media (DE) de 5,83 (1,98) años. 240 niños (83,1%) presentaban normopeso, 29 (10%) sobrepeso y 20 (6,9%) obesidad. La calidad global del desayuno fue adecuada en el 38,7% de los casos mientras que el 61,3% restante necesitaba mejorar o replantearse el desayuno por no alcanzar el mínimo requerido. El 25,6% de los cuidadores hacía un desayuno de calidad, mientras que el 74,4% necesitaba mejorar o replantearse sus hábitos dietéticos en el desayuno. Conclusiones: un desayuno nutricionalmente adecuado se asocia con un mejor rendimiento físico e intelectual y mejor estado de salud, incluyendo la prevención de la obesidad. En el presente estudio los datos para un desayuno de calidad revelan que más de la mitad de los niños/as de 4-9 años de edad necesitan mejorar o replantearse el desayuno


Objective: to describe the quality of breakfast in 4-to-9-year old boys and girls and their family caregivers in a Madrid district. Method: a descriptive cross-sectional study was designed at the Centro de Salud Alicante in Fuenlabrada (Madrid) with the pediatric population between 4 and 9-year-old who attended the Nursing Unit for scheduled routine examinations with the relative/tutor with whom they had breakfast usually. Data were collected through clinical interview and anthropometric examination during the visit; the "Healthy Breakfast Test" of the Community of Madrid was used to obtain data about the quality of breakfast. A descriptive analysis was conducted, using mean and standard deviation (SD) for the quantitative variables, and frequencies for qualitative variables. Results: the study included 289 boys and girls, with a mean age (SD) of 5.83 (1.98) years; 240 children (83.1%) presented normal weight, 29 (10%) overweight and 20 (6.9%) obesity. The overall quality of breakfast was adequate in 38.7% of cases, while the remaining 61.3% needed to improve or reconsider breakfast because they did not reach the minimum required. Of caregivers, 25.6% had a quality breakfast, while 74.4% needed to improve or reconsider their diet habits at breakfast. Conclusions: a nutritionally adequate breakfast is associated with better physical and intellectual performance and better health status, including the prevention of obesity. In the present study, quality breakfast data revealed that over half of 4-to-9-year-old children needed to improve or reconsider their breakfast


Assuntos
Humanos , Masculino , Feminino , Criança , Pré-Escolar , Desjejum , Enfermagem no Consultório , Nutrição do Lactente , Alimentação Escolar , Antropometria , Inquéritos e Questionários , Pesquisa Qualitativa , Cuidadores , Obesidade Pediátrica/dietoterapia , Serviços de Enfermagem Escolar
3.
Artigo em Inglês | MEDLINE | ID: mdl-31547451

RESUMO

The purpose of this pilot study was to assess the acceptability to adolescents (11-18 years old) and their parents using a revised protein-sparing modified fast (rPSMF) for 12 months as an intervention for severe obesity in a tertiary pediatric weight management clinic (PWMC). To assess acceptability (satisfaction, confidence) with the rPSMF protocol, surveys were completed by adolescents and parents at baseline, 1, 3, 6, and 12 months, with adolescent height and weight measured. Analyses were conducted to assess differences in satisfaction and confidence based on adolescent response (weight loss) and adherence to the rPSMF. Adolescents' adherence with the rPSMF was close to 50% in the first 3 months, but dropped to 14.7% at 6 months. Adolescents were most confident with choosing low carbohydrate foods at baseline. Over 12 months, adolescents and parents reported weight loss as "the most liked" part of the rPSMF. Adolescents who were adherent were more satisfied with their weight loss than their non-adherent peers. Parents and adolescents reported lack of food variety and difficulty following the protocol as challenges with the rPSMF. Adolescents and their parents were able to follow the rPSMF protocol, with weight loss, but with decreased adherence over time.


Assuntos
Proteínas na Dieta/administração & dosagem , Jejum , Obesidade Mórbida/dietoterapia , Pais , Cooperação do Paciente , Obesidade Pediátrica/dietoterapia , Adolescente , Criança , Dieta Redutora , Feminino , Alimentos , Humanos , Masculino , Projetos Piloto , Perda de Peso
4.
Artigo em Inglês | MEDLINE | ID: mdl-31443606

RESUMO

Treatment options are limited for children and adolescents with severe obesity. One alternative treatment is the protein-sparing modified fast (PSMF), a low-carbohydrate, high-protein diet that can result in substantial weight loss. The aim of the study is to evaluate the adherence and efficacy of a revised PSMF (rPSMF) for severe obesity in a pediatric tertiary care weight-management program. The rPSMF with 1200-1800 calories, 40-60 g of carbohydrate/day and 1.2-1.5 g protein/kg of ideal bodyweight was implemented over 12 months. Twenty-one participants enrolled in the study. Mean age 16.2 ± 1.4 years, females (76.2%) and mean weight at baseline was 119 ± 19.9 kg. Regardless of adherence to the rPSMF, the mean weight change at 1 month was -3.7 ± 3.5 kg, (range -13.5 kg to 0.9 kg); at 3 months was -5.5 ± 5.1 kg, (range -19.3 kg to 1.8 kg) and at 6 months was -4.7 ± 6.6 kg, (range -18.3 kg to 8.6 kg). At 12 months, the mean weight change was -1.3 ± 10.6 kg (range -17.7 kg to 14.8 kg). Parent and child-reported physical and psychosocial quality of life (HRQOL) improved. Despite limited adherence, the rPSMF diet resulted in clinically significant weight loss and improved HRQOL for children and adolescents with severe obesity.


Assuntos
Dieta Rica em Proteínas e Pobre em Carboidratos , Obesidade Mórbida/dietoterapia , Cooperação do Paciente/estatística & dados numéricos , Obesidade Pediátrica/dietoterapia , Programas de Redução de Peso/métodos , Adolescente , Criança , Ingestão de Energia , Jejum , Feminino , Humanos , Masculino , Obesidade , Projetos Piloto , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento , Perda de Peso , Programas de Redução de Peso/estatística & dados numéricos
5.
Nutrients ; 11(6)2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31146440

RESUMO

Differences in postprandial insulin, glucose, and/or free fatty acid concentrations, following the consumption of breakfast, have been demonstrated to be dependent on habitual breakfast patterns. This study examined the effects of habitual breakfast patterns on postprandial appetite, satiety, and hormonal responses along with daily food intake following the consumption of normal-protein (NP) vs. higher-protein (HP) breakfasts in overweight adolescents. Thirty-seven girls (age: 19 ± 1 year; BMI: 29.0 ± 3.4 kg/m2) participated in the semi-randomized crossover design study. Participants were grouped according to whether they habitually skipped (SKIP, n = 18) or consumed breakfast (CONSUME, n = 19), and consumed a NP (350 kcal; 13 g protein) or HP (350 kcal; 35 g protein) breakfast for 3 days/pattern. On day 4, breakfast was provided, and appetite questionnaires and blood samples were collected throughout an 8 h testing day. Daily food intake was also assessed. Regardless of habitual breakfast patterns, the consumption of HP breakfast led to greater daily fullness (29,030 ± 6,010 min × mm) vs. NP breakfast (26,910 ± 5580 min × mm; p = 0.03). Daily protein consumption was greater (98 ± 15 g vs. 78 ± 15 g), and carbohydrate consumption was lower (331 ± 98 g vs. 367 ± 94 g) with HP vs. NP (both, p < 0.001). No other differences were observed. These data suggest that the recommendation to consume a HP breakfast for improved satiety and ingestive behavior is appropriate for overweight adolescent girls, regardless of habitual breakfast patterns.


Assuntos
Comportamento do Adolescente , Regulação do Apetite , Desjejum , Proteínas na Dieta/administração & dosagem , Comportamento Alimentar , Obesidade Pediátrica/dietoterapia , Resposta de Saciedade , Adolescente , Fatores Etários , Estudos Cross-Over , Feminino , Humanos , Missouri , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/psicologia , Fatores Sexuais , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
6.
Rev Gastroenterol Mex ; 84(2): 185-194, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31101468

RESUMO

AIM: To identify and discuss the efficacy of dietary interventions, antioxidant supplementation, physical activity, and nutritional and psychologic counseling in the treatment of children and adolescents with non alcoholic fatty liver disease associated with obesity. MATERIALS AND METHODS: A scoping review of studies on nutritional and educational interventions and physical activity in pediatric patients with non alcoholic fatty liver disease was conducted. A search for randomized clinical trials or quasi-experimental studies published up to December 2017 was carried out, utilizing seven databases (Medline, EBSCO, OVID, Science Direct, JSTOR, Wiley, and Biblioteca Digital UDG). RESULTS: From a total of 751 articles, 729 were excluded due to the criteria of age, design, language, diagnostic method, and outcome variables. The analysis included 22 articles. The most frequently used intervention variables were diet and physical activity. The interventions had different durations, but most were carried out for one year. Some authors employed ascorbic acid, vitamin E, or omega-3 fatty acid supplementation. There were varying degrees of improvement in the variables analyzed in the majority of the studies, such as a decrease in ALT levels, a reduced frequency of steatosis determined through imaging studies, and a decrease in body mass index. CONCLUSIONS: The dietary interventions, omega-3 fatty acid supplementation, physical activity, and nutritional and psychologic counseling were identified as efficacious measures in the treatment of non alcoholic fatty liver disease associated with obesity in children and adolescents, according to biochemical or imaging study indicators, within the time frame of the intervention.


Assuntos
Dieta , Exercício Físico , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/terapia , Obesidade Pediátrica/complicações , Obesidade Pediátrica/terapia , Adolescente , Criança , Feminino , Humanos , Masculino , Hepatopatia Gordurosa não Alcoólica/dietoterapia , Educação de Pacientes como Assunto , Obesidade Pediátrica/dietoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
J Med Syst ; 43(7): 198, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31119385

RESUMO

Obesity is considered a global epidemic of the twenty-first century by the World Health Organization (WHO). Specifically, the Canary Islands has the highest level of this disease in Europe and 40% of children in Spain are overweight or obese. This increase is a direct result of changes in the lifestyles of the population and its nutrition. Because of this, we have designed an educational program based on motor games, active videogames and virtual learning environments to improve the long-term health of children. This article presents and analyzes the results of a study on the nutritional knowledge and adherence to the Mediterranean diet of 46 obese children aged 6 to 12 years in the Canary Islands who participated in an educational program. The study design was quasi-experimental, with two groups (experimental and control). A long-term longitudinal study (3 years) was carried out. A set of evaluation instruments was used for the different phases. The results show significant improvements between the experimental and control groups in terms of their knowledge of healthy nutrition and their adherence to the Mediterranean diet. As a main conclusion, we emphasize that a gamified educational intervention program supported by ICT helps to motivate and promote improvements in the nutrition of children.


Assuntos
Dietoterapia , Promoção da Saúde/métodos , Obesidade Pediátrica/dietoterapia , Jogos de Vídeo , Criança , Feminino , Humanos , Masculino , Espanha
8.
Nutrients ; 11(5)2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31100916

RESUMO

Objectives and Study: Salicylic acid (SA), a phenolic compound produced by plants, may play a beneficial role on health. A pilot study showed that children with obesity had lower serum SA than normal-weight children. The aim of this trial was to evaluate the effect of a 1-year nutritional-behavioral intervention on serum SA levels and to study a possible association between SA levels and metabolic profile changes in children with obesity. METHODS: This was an interventional longitudinal observational uncontrolled cohort study. Forty-nine children with obesity, aged >6 years were evaluated. BMI (body mass index) z-scores were calculated. Fasting blood samples were analyzed for lipids, insulin, and glucose. The most significant metabolic variables were calculated. Serum SA was measured using a gas chromatography-mass spectrometry method. The 1-year intervention was based on the promotion of a balanced and normocaloric diet, in accordance with the national guidelines for treatment of childhood obesity. Additionally, behavioral education, based on the revised CALO-RE (Coventry, Aberdeen, and London-REfined) taxonomy, was performed. RESULTS: At the end of intervention, children showed an increase in serum SA levels (mean (Standard Deviation, SD) 0.06 (0.02) vs. 0.09 (0.05) µmol/L; p < 0.001), a reduction of BMI z-score (3.14 (0.79) vs. 3.02 (0.82); p < 0.001), TyG index (4.52 (0.20) vs. 4.48 (0.23); p < 0.001), AIP (atherogenic index of plasma) (0.36 (0.21) vs. 0.27 (0.25); p < 0.001), and triglycerides/HDL (high density lipoprotein) cholesterol (2.57 (1.28) vs. 2.18 (1.22); p < 0.001) ratio. No statistically significant change in HOMA-IR (homeostasis model assessment index) was observed (4.20 (3.29) vs. 4.03 (2.28)). An association between the longitudinal variation of serum SA and HOMA-IR was found (correlation coefficient: -0.338, p = 0.02). CONCLUSION: Nutritional-behavioral intervention may improve the circulating SA and the metabolic profile in children with obesity. Serum SA could influence mainly glucose metabolism. Further larger studies are needed to evaluate whether a nutritional intervention based on specific advice regarding the quantity and type of fruit and vegetables (FV) consumption could provide benefits in terms of metabolic syndrome.


Assuntos
Terapia Comportamental , Obesidade Pediátrica/sangue , Obesidade Pediátrica/dietoterapia , Ácido Salicílico/sangue , Proteína C-Reativa , Criança , Comportamento Alimentar , Feminino , Frutas , Glucose/metabolismo , Humanos , Lipídeos/sangue , Masculino , Verduras
9.
J Nurs Res ; 27(5): e48, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30958391

RESUMO

BACKGROUND: Most studies that have investigated factors influencing eating habits among obese children have focused mainly on individual or interpersonal factors and applied quantitative research methods. PURPOSE: This study was undertaken to identify the barriers in home and school settings that hamper healthy eating in overweight and obese children in South Korea. METHODS: Focus group interviews were conducted with 15 overweight/obese children and 15 parents. A standard manual with open-ended questions was developed. Content analysis was used to identify key findings. RESULTS: Participants were aware of the importance of home and school environments in shaping children's eating habits. Five major barriers, respectively, at home and at school emerged from the data. At home, the food preferences of parents affected the eating habits of their children. Moreover, parents worried about providing differentiated diets for siblings and about the permissiveness of grandparents toward grandsons. Furthermore, working parents preferred easy-to-prepare instant foods and said that their children ate overly quickly. At school, children cited time pressures, poor cafeteria environments, and ineffective nutrition education as barriers, whereas parents worried about inconsistent management by teachers and the unsafe food environment around the school. CONCLUSIONS: These environment-related barriers may be resolved through changes in the behavior of children, parents, and teachers as well as through the continued efforts of schools, community stakeholders, and policymakers, all of whose cooperation is essential to fostering a healthy food environment for children.


Assuntos
Barreiras de Comunicação , Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Obesidade Pediátrica/dietoterapia , Adulto , Criança , Serviços de Saúde da Criança , Feminino , Grupos Focais , Educação em Saúde , Promoção da Saúde , Humanos , Entrevistas como Assunto , Masculino , República da Coreia , Serviços de Saúde Escolar
10.
Nutr. hosp ; 36(2): 275-281, mar.-abr. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184318

RESUMO

Introducción: una dieta baja en oligosacáridos, disacáridos, monosacáridos y polioles fermentables (FODMAP) puede ser eficaz en el tratamiento de los pacientes pediátricos con síndrome de intestino irritable (SII). Su complejidad y efectos secundarios hacen de la misma una alternativa terapéutica secundaria. Objetivo: demostrar que la educación nutricional, dirigida a optimizar la dieta de los niños con SII, es capaz de mejorar sus síntomas gastrointestinales sin tener que realizar una dieta baja en FODMAP. Métodos: estudio de intervención prospectivo. Se analizaron los cambios de los síntomas gastrointestinales, mediante el cuestionario pediátrico de calidad de vida para síntomas gastrointestinales (PedsQL(TM) síntomas GI), tras recibir educación nutricional basada en alimentación saludable. Asimismo, se analizaron los cambios antropométricos y de hábitos dietéticos tras dicha intervención. Resultados: se incluyeron 21 pacientes (12 niñas) con edad media de 10,6 años (5-14 años). Se observó una dieta con un exceso de ingesta de azúcares simples, grasas saturadas y sal junto con un déficit de fibra. Tras la intervención, se apreció un aumento de 8,07 puntos en el cuestionario (IC del 95%: 13,42 a -2,73; p = 0,005). Además, se observó una pérdida de peso significativa en los pacientes con sobrepeso y obesidad (disminución del Z-score de índice de masa corporal [IMC] 0,62 DE; p = 0,001). Se observaron cambios significativos en los hábitos dietéticos: aumento de consumo de hidratos de carbono complejos, frutas y verduras y disminución de azúcares simples. Conclusiones: la alimentación saludable resulta eficaz para mejorar los síntomas gastrointestinales en pacientes pediátricos con SII, sin requerir la exclusión de FODMAP


Background: a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) may be effective in the treatment of pediatric patients with irritable bowel syndrome (IBS). Its complexity and side effects make it a secondary therapeutic alternative. Objective: to demonstrate that nutritional education, aimed at optimizing the diet of children with IBS, is able to improve gastrointestinal symptoms of children without following a diet low in FODMAP. Methods: prospective intervention study. Changes in gastrointestinal symptoms were analyzed by means of the Pediatric Quality of Life Inventory(TM) Gastrointestinal Symptoms (PedsQL(TM) GI Symptoms), after receiving nutritional education based on a healthy diet. Likewise, anthropometric changes and dietary habits were analyzed. Results: twenty-one patients were included (12 girls) with a mean age of 10.6 years (5-14 years). A diet with excess intake of simple sugars, saturated fats and salt along with fiber deficit was observed. After the intervention, an increase in 8.07 points was observed in the inventory (95% CI: 13.42 a -2.73, p = 0.005). Additionally, significant weight loss was observed in overweight and obese patients (decrease in body mass index [BMI]; Z-score 0.62 SD, p = 0.001). Significant changes in dietary habits were observed: increased consumption of complex carbohydrates, fruits and vegetables and reduction of simple sugars. Conclusions: healthy eating is effective to improve gastrointestinal symptoms in pediatric patients with IBS, without requiring the exclusion of FODMAP


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Dieta Saudável , Síndrome do Intestino Irritável/dietoterapia , Dieta com Restrição de Carboidratos/efeitos adversos , Dieta com Restrição de Carboidratos/métodos , Sobrepeso/dietoterapia , Educação de Pacientes como Assunto , Obesidade Pediátrica/dietoterapia , Estudos Prospectivos , Qualidade de Vida , Perda de Peso
11.
Nutr Hosp ; 36(2): 275-281, 2019 Apr 10.
Artigo em Espanhol | MEDLINE | ID: mdl-30868906

RESUMO

Introduction: Background: a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) may be effective in the treatment of pediatric patients with irritable bowel syndrome (IBS). Its complexity and side effects make it a secondary therapeutic alternative. Objective: to demonstrate that nutritional education, aimed at optimizing the diet of children with IBS, is able to improve gastrointestinal symptoms of children without following a diet low in FODMAP. Methods: prospective intervention study. Changes in gastrointestinal symptoms were analyzed by means of the Pediatric Quality of Life Inventory™ Gastrointestinal Symptoms (PedsQL™ GI Symptoms), after receiving nutritional education based on a healthy diet. Likewise, anthropometric changes and dietary habits were analyzed. Results: twenty-one patients were included (12 girls) with a mean age of 10.6 years (5-14 years). A diet with excess intake of simple sugars, saturated fats and salt along with fiber deficit was observed. After the intervention, an increase in 8.07 points was observed in the inventory (95% CI: 13.42 a -2.73, p = 0.005). Additionally, significant weight loss was observed in overweight and obese patients (decrease in body mass index [BMI]; Z-score 0.62 SD, p = 0.001). Significant changes in dietary habits were observed: increased consumption of complex carbohydrates, fruits and vegetables and reduction of simple sugars. Conclusions: healthy eating is effective to improve gastrointestinal symptoms in pediatric patients with IBS, without requiring the exclusion of FODMAP.


Assuntos
Síndrome do Intestino Irritável/dietoterapia , Adolescente , Criança , Pré-Escolar , Dieta com Restrição de Carboidratos/efeitos adversos , Dieta com Restrição de Carboidratos/métodos , Feminino , Humanos , Masculino , Sobrepeso/dietoterapia , Educação de Pacientes como Assunto , Obesidade Pediátrica/dietoterapia , Estudos Prospectivos , Qualidade de Vida , Perda de Peso
12.
Medicina (Kaunas) ; 55(3)2019 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-30901958

RESUMO

Background and objectives: The efficacy of a weight correction programme can be affected by such predictors as the number of contact hours, gender, age, baseline weight, parental weight status, psycho-emotional status, insulin resistance, and socioeconomic status. The aim of this current study was to evaluate the overall efficacy of the Weight Correction Programme at Children's Clinical University Hospital, and explore the impact of the probable predictors. We evaluated the efficacy depending on gender, age, parental weight status, signs of depression, baseline body mass index z-score (z-BMI), and baseline waist circumference. Materials and Methods: The data were gathered from medical records. The inclusion criteria were as follows: Entered the programme by 13 June 2017, at least five years old, follow-up data available. All the respondents were divided into two age groups: <10 years old and ≥10 years old. Results: The study included 181 respondents. They were 5 to 17 years old on the first day of participation in the Weight Correction Programme. Results indicated that 117 (65%) patients managed to reduce z-BMI and 69 (38%) patients achieved clinically significant reduction of z-BMI. Boys had four times higher odds (odds ratio (OR) = 4,22; CI 1.37⁻13.05; p = 0.012) to reduce their z-BMI by at least 0.20 units than girls. The respondents of the older age group (≥10 years) had a better chance to reduce z-BMI than the younger ones (OR = 11,51; CI 2.04⁻64.83; p = 0.006). The odds to reduce z-BMI were lower by 7% for every extra cm of waist circumference (OR = 0.93; CI 0.88⁻0.99; p = 0.014) for reducing z-BMI. The follow-up time was also a positive predictor, and with every month the odds for clinically significant z-BMI reduction increased by 7% (OR = 1.07; CI 1.00⁻1.15; p = 0.047). The parental weight status, signs of depression, and baseline z-BMI were not significant predictors. Conclusions: More than half of the patients of the respondents managed to reduce their z-BMI. Female gender, younger age, and larger waist circumference were negative predictors.


Assuntos
Hospitais Municipais , Hospitais Pediátricos , Hospitais Universitários , Obesidade Pediátrica/dietoterapia , Obesidade Pediátrica/reabilitação , Programas de Redução de Peso/métodos , Adolescente , Fatores Etários , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Depressão/prevenção & controle , Depressão/psicologia , Exercício Físico/fisiologia , Terapia por Exercício/métodos , Feminino , Seguimentos , Humanos , Letônia , Masculino , Relações Pais-Filho , Análise de Regressão , Fatores Sexuais , Circunferência da Cintura , Programas de Redução de Peso/estatística & dados numéricos
13.
Nutrients ; 11(2)2019 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-30717465

RESUMO

The sustainability of education focused on improving the dietary and lifestyle behaviours of teenagers has not been extensively studied. The aim of this study was to determine the sustainability of diet-related and lifestyle-related school-based education on sedentary and active lifestyle, diet quality and body composition of Polish pre-teenagers in a medium-term follow-up study. An education-based intervention study was carried out on 464 students aged 11⁻12 years (educated/control group: 319/145). Anthropometric measurements were taken and body mass index (BMI) and waist-to-height ratios (WHtR) were calculated, both at the baseline and after nine months. Dietary data from a short-form food frequency questionnaire (SF-FFQ4PolishChildren) were collected. Two measures of lifestyle (screen time, physical activity) and two diet quality scores (pro-healthy, pHDI, and non-healthy, nHDI) were established. After nine months, in the educated group (vs. control) a significantly higher increase was found in nutrition knowledge score (mean difference of the change: 1.8 points) with a significantly higher decrease in physical activity (mean difference of the change: -0.20 points), nHDI (-2.3% points), the z-WHtR (-0.18 SD), and the z-waist circumference (-0.13 SD). Logistic regression modelling with an adjustment for confounders revealed that after nine months in the educated group (referent: control), the chance of adherence to a nutrition knowledge score of at least the median was over 2 times higher, and that of the nHDI category of at least the median was significantly lower (by 35%). In conclusion, diet-related and lifestyle-related school-based education from an almost one-year perspective can reduce central adiposity in pre-teenagers, despite a decrease in physical activity and the tendency to increase screen time. Central adiposity reduction can be attributed to the improvement of nutrition knowledge in pre-teenagers subjected to the provided education and to stopping the increase in unhealthy dietary habits.


Assuntos
Composição Corporal , Dieta , Exercício Físico , Educação em Saúde , Obesidade Abdominal/dietoterapia , Serviços de Saúde Escolar , Comportamento Sedentário , Índice de Massa Corporal , Criança , Comportamento Alimentar , Feminino , Seguimentos , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Humanos , Estilo de Vida , Masculino , Obesidade Pediátrica/dietoterapia , Polônia , Instituições Acadêmicas , Estudantes , Razão Cintura-Estatura
14.
Curr Nutr Rep ; 7(4): 303-309, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30353367

RESUMO

PURPOSE OF REVIEW: Interventions that aim to alter child eating behaviors often focus on parents as a proximal influence. Yet, parents can be difficult to engage. Therefore, intervention recommendations are often not implemented as designed. The goal of this review is to highlight factors at multiple contextual levels that are important to consider when developing interventions to address child eating, due to their implications for overcoming parent engagement challenges. RECENT FINDINGS: Intervention studies suggest that parents are often the key to successfully changing child eating behaviors, and many interventions focus on feeding. Factors such as child eating phenotypes, parent stress, family system dynamics, and sociodemographic constraints have also been identified as shaping food parenting. Challenges at multiple contextual levels can affect the likelihood of parent engagement. Addressing factors at the child-, parent-, family-, and broader social-contextual levels of influence is essential in order to promote best practices for parent-focused feeding interventions.


Assuntos
Comportamento do Adolescente , Cuidadores/psicologia , Comportamento Infantil , Relações Familiares , Comportamento Alimentar , Poder Familiar/psicologia , Pais/psicologia , Obesidade Pediátrica/dietoterapia , Comportamento Social , Adolescente , Comportamento do Adolescente/etnologia , Criança , Comportamento Infantil/etnologia , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Sinais (Psicologia) , Características Culturais , Comportamento Alimentar/etnologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Estado Nutricional , Poder Familiar/etnologia , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/psicologia , Fatores de Risco , Resultado do Tratamento
15.
Nutrients ; 10(10)2018 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-30322156

RESUMO

High rates of childhood obesity require integral treatment with lifestyle modifications that achieve weight loss. We evaluated a lifestyle intervention on nutrient adequacy and diet quality in children and adolescents with abdominal obesity. A randomized controlled trial was performed on 107 participants, assigned either to a usual care group or to an intensive care group that followed a moderate hypocaloric Mediterranean diet and received nutritional education. Intake adequacy was evaluated using Dietary Reference Intakes and diet quality through the Diet Quality Index for Adolescents (DQI-A), the Healthy Lifestyle Diet-Index (HLD-I) and the Mediterranean Diet Quality Index (KIDMED). Both groups achieved a significant reduction in BMI standard deviation score (BMI-SDS), glucose and total cholesterol levels. Intake of Calcium, Iodine and vitamin D were higher in the intensive care group, with enhanced compliance with recommendations. Higher dietary scores were associated with lower micronutrient inadequacy. DQI-A and HLD-I were significantly higher in the intensive care group vs. usual care group after the treatment. In conclusion, we observed that an intensive lifestyle intervention was able to reduce BMI-SDS in children with abdominal obesity. Furthermore, participants significantly improved dietary indices getting closer to the nutritional recommendations. Therefore, these diet quality indices could be a valid indicator to evaluate micronutrient adequacy.


Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Dieta Mediterrânea , Estado Nutricional , Valor Nutritivo , Obesidade Abdominal/dietoterapia , Obesidade Pediátrica/dietoterapia , Comportamento de Redução do Risco , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Fatores Etários , Criança , Feminino , Humanos , Masculino , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Educação de Pacientes como Assunto , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Recomendações Nutricionais , Espanha , Fatores de Tempo , Resultado do Tratamento , Perda de Peso
16.
J Nutr Educ Behav ; 50(9): 918-923, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30297017

RESUMO

OBJECTIVE: To determine parents' (1) accuracy in using portion size estimation aids (PSEAs) to estimate portion sizes and (2) use of PSEAs at home. METHODS: Parents (n = 37) of children in a pediatric weight management clinic were recruited, enrolled in a parallel-design, randomized, controlled trial, and assigned to receive a 2-dimensional (2D) or 3D PSEA. Percent absolute estimation accuracy was examined across groups and food types. Survey responses were organized according to frequencies and percentages were calculated. RESULTS: Main effects of group, food type, and group × food type interaction were significant (all P < .05). The 2D PSEAs yielded more accurate estimates of portion sizes for amorphous foods. Overall, parents' estimation accuracy was poor. Participants were satisfied and found the PSEAs to be useful. CONCLUSIONS AND IMPLICATIONS: The 2D PSEAs led to greater accuracy in estimating portions of amorphous foods. Parents showed poor accuracy in estimating portion sizes. This study highlights the role of dietitians and nutrition educators in enhancing portion estimation accuracy.


Assuntos
Dieta/instrumentação , Pais , Obesidade Pediátrica/dietoterapia , Tamanho da Porção/normas , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Pessoa de Meia-Idade , Modelos Teóricos , Avaliação Nutricional
17.
Nutrients ; 10(9)2018 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-30235828

RESUMO

The role of nutrition and diet in the development of non-alcoholic fatty liver disease (NAFLD) is still not fully understood. In the present study, we determined if dietary pattern and markers of intestinal permeability differ between overweight children with and without NAFLD. In addition, in a feasibility study, we assessed the effect of a moderate dietary intervention only focusing on nutrients identified to differ between groups on markers of intestinal barrier function and health status. Anthropometric data, dietary intake, metabolic parameters, and markers of inflammation, as well as of intestinal permeability, were assessed in overweight children (n = 89, aged 5⁻9) and normal-weight healthy controls (n = 36, aged 5⁻9). Sixteen children suffered from early signs of NAFLD, e.g., steatosis grade 1 as determined by ultrasound. Twelve children showing early signs of NAFLD were enrolled in the intervention study (n = 6 intervention, n = 6 control). Body mass index (BMI), BMI standard deviation score (BMI-SDS), and waist circumference were significantly higher in NAFLD children than in overweight children without NAFLD. Levels of bacterial endotoxin, lipopolysaccharide-binding protein (LBP), and proinflammatory markers like interleukin 6 (IL-6) and tumor necrosis factor α (TNFα) were also significantly higher in overweight children with NAFLD compared to those without. Total energy and carbohydrate intake were higher in NAFLD children than in those without. The higher carbohydrate intake mainly resulted from a higher total fructose and glucose intake derived from a significantly higher consumption of sugar-sweetened beverages. When counseling children with NAFLD regarding fructose intake (four times, 30⁻60 min within 1 year; one one-on-one counseling and three group counselings), neither alanine aminotransferase (ALT) nor aspartate aminotransferase (AST) activity in serum changed; however, diastolic blood pressure (p < 0.05) and bacterial endotoxin levels (p = 0.06) decreased markedly in the intervention group after one year. Similar changes were not found in uncounseled children. Our results suggest that a sugar-rich diet might contribute to the development of early stages of NAFLD in overweight children, and that moderate dietary counseling might improve the metabolic status of overweight children with NAFLD.


Assuntos
Bebidas , Comportamento Infantil , Açúcares da Dieta/efeitos adversos , Comportamento Alimentar , Frutose/efeitos adversos , Hepatopatia Gordurosa não Alcoólica/etiologia , Obesidade Pediátrica/etiologia , Bebidas/efeitos adversos , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Aconselhamento , Açúcares da Dieta/administração & dosagem , Açúcares da Dieta/metabolismo , Endotoxinas/sangue , Estudos de Viabilidade , Feminino , Frutose/administração & dosagem , Frutose/metabolismo , Humanos , Mediadores da Inflamação/sangue , Intestinos/microbiologia , Intestinos/fisiopatologia , Masculino , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Hepatopatia Gordurosa não Alcoólica/psicologia , Estado Nutricional , Obesidade Pediátrica/dietoterapia , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/psicologia , Permeabilidade , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Circunferência da Cintura
18.
Curr Nutr Rep ; 7(4): 227-234, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30155750

RESUMO

PURPOSE OF REVIEW: The incidence of type 2 diabetes among children and adolescents has sharply increased, highly influenced by prevalence of obesity in youth. Here, we provide an overview of the pathogenesis of diabetes, and summarize recent dietary interventions investigating effects of diet on metabolic risk factors in overweight and obese youth. RECENT FINDINGS: Seven dietary interventions were identified randomly assigning participants to weekly or bi-weekly dietary counseling sessions over 12-24-week period, with mixed results. Four interventions showed significant reductions in fasting insulin and insulin resistance levels relative to baseline concentrations ranging from 26 to 50%. Recent evidence is mixed, with four studies showing improvements to insulin concentrations and insulin resistance in obese children and adolescents associated with energy restriction and/or change to carbohydrate consumption. Further work is needed to investigate long-term effects of dietary factors including carbohydrate quality and energy restriction on metabolic health and diabetes prevention early in life.


Assuntos
Obesidade Pediátrica/dietoterapia , Comportamento de Redução do Risco , Adiposidade , Adolescente , Distribuição por Idade , Glicemia/metabolismo , Restrição Calórica , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Medicina Baseada em Evidências , Feminino , Humanos , Incidência , Insulina/sangue , Resistência à Insulina , Masculino , Estado Nutricional , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/fisiopatologia , Prevalência , Fatores de Proteção , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco
19.
Nutrients ; 10(8)2018 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-30103535

RESUMO

The objective of the present cross-sectional study was to examine the associations of physical activity and the adherence to the Mediterranean dietary pattern (MDP) with bone mineral content (BMC) and density (BMD) in children with overweight and obesity. A total of 177 (n = 80 girls) children with overweight and obesity aged 8 to 12 years old participated in the study. Both BMC and BMD were assessed by Dual-Energy X-ray absorptiometry. Dietary patterns were assessed by the KIDMED questionnaire and two 24-hour recalls. Physical activity was assessed by accelerometers for 7 consecutive days (24 hours/day). Low adherence to the MDP was observed in 82.4% of participants. Higher physical activity levels (of at least moderate intensity) and lower sedentary time were significantly associated with BMC and BMD in children with low adherence to the MDP (all p < 0.05). No associations were observed between physical activity and BMC and BMD in children with high adherence to the MDP. In conclusion, engaging in moderate to vigorous physical activity and reducing the time spent in sedentary behavior might be particularly beneficial for improving bone health in overweight or obese children with poor adherence to the Mediterranean dietary pattern.


Assuntos
Densidade Óssea , Comportamento Infantil , Dieta Mediterrânea , Exercício Físico , Comportamento Alimentar , Cooperação do Paciente , Obesidade Pediátrica/dietoterapia , Fatores Etários , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Estudos Transversais , Feminino , Estilo de Vida Saudável , Humanos , Masculino , Estado Nutricional , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
20.
JBI Database System Rev Implement Rep ; 16(7): 1495-1502, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29995710

RESUMO

REVIEW QUESTION/OBJECTIVE: To update an existing systematic review series of randomized controlled trials (RCT) that include a dietary intervention for the management of overweight or obesity in children or adolescents.Specifically, the review questions are: In randomized controlled trials of interventions which include a dietary intervention for the management of overweight or obesity in children or adolescents.


Assuntos
Dietética/métodos , Obesidade Pediátrica/dietoterapia , Guias de Prática Clínica como Assunto , Adolescente , Criança , Exercício Físico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
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