Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.159
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-34206056

RESUMO

(1) Background: The prevalence of overweight and obesity among children has increased tremendously in the ASEAN region, including Malaysia. In Malaysia, the National Strategic Plan for Non-Communicable Diseases (2015-2025) provides the overall framework for its response to the non-communicable diseases (NCD) epidemic. Preventing childhood obesity is one of the key strategies for early intervention to prevent NCDs. The objective of this research is to examine the current status of policy interventions in addressing childhood obesity in Malaysia. (2) Methods: A panel of 22 stakeholders and experts from Malaysia, representing the government, industry, academia and non-governmental organizations, were sampled using a modified Delphi technique. Data were collected using a modified NCD scorecard under four domains (governance, risk factors, surveillance and research and health systems response). A heat map was used to measure the success of the four realms of the NCD scorecard. For each domain of the NCD scorecard, the final score was grouped in quintiles. (3) Results: A total of 22 participants responded, comprising of eight (36.4%) males and 14 (63.4%) females. All the domains measured in implementing policies related to childhood obesity were of low progress. Nine governance indicators were reported as 22.5% (low progress), four in the risk factors domain, and two in the surveillance. This shows that timely and accurate monitoring, participatory review and evaluation, and effective remedies are necessary for a country's surveillance system. (4) Conclusion: Although Malaysia has published several key strategic documents relating to childhood obesity and implemented numerous policy interventions, we have identified several gaps that must be addressed to leverage the whole-of-government and whole-of-society approach in addressing childhood obesity in the country.


Assuntos
Doenças não Transmissíveis , Obesidade Pediátrica , Criança , Feminino , Política de Saúde , Humanos , Malásia/epidemiologia , Masculino , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Formulação de Políticas
2.
Nutrients ; 13(6)2021 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-34205416

RESUMO

Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10-12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10-12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10-12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity.


Assuntos
Dieta , Ingestão de Alimentos/fisiologia , Obesidade Pediátrica/epidemiologia , Árabes , Aleitamento Materno/estatística & dados numéricos , Criança , Cultura , Gorduras na Dieta/administração & dosagem , Ingestão de Energia , Comportamento Alimentar , Métodos de Alimentação , Feminino , Seguimentos , Idade Gestacional , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Israel/epidemiologia , Masculino , Fatores Socioeconômicos
3.
Artigo em Inglês | MEDLINE | ID: mdl-34207231

RESUMO

Early childhood is a critical period for obesity prevention. This randomized controlled study evaluated the effectiveness of an educational intervention preventing obesity in preschool-age children. A nutritional education intervention, with a follow-up session one year later, was conducted with parents of children aged 3 to 4 years of public schools in the province of Málaga. The main outcome variable was the body mass index z-score (zBMI). The prevalence of overweight or obesity was the secondary outcome variable. The sample comprised 261 students (control group = 139). Initial BMI, weight, height-for-age and prevalence of overweight and obesity were similar for both groups. After the first year of the intervention, the zBMI of the intervention group decreased significantly from 0.23 to 0.10 (p = 0.002), and the subgroup of patients with baseline zBMI above the median decreased from 1 to 0.72 (p = 0.001), and in the second year from 1.01 to 0.73 (p = 0.002). The joint prevalence of overweight and obesity increased in the control group (12.2% to 20.1%; p = 0.027), while in the intervention group, there were no significant changes. This preschool educational intervention with parents improved their children's BMI, especially those with a higher BMI for their age, and favored the prevention of overweight or obesity.


Assuntos
Obesidade Pediátrica , Índice de Massa Corporal , Criança , Pré-Escolar , Educação em Saúde , Humanos , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Instituições Acadêmicas
4.
Nutrients ; 13(6)2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34207655

RESUMO

Lower resting energy expenditure (REE) may partially explain the disproportionate prevalence of overweight/obesity among black African women. As no previous studies have investigated the REE of Southern African (South. Afr.) children, we aimed to determine, by sex and population group, the REE of 6- to 9-year-old urban school children. In a cross-sectional study with quota sampling, REE was measured with indirect calorimetry (IC). Confounders considered were: body composition (BC) (fat-free mass (FFM), FFM index, fat mass (FM), FM index), assessed using multifrequency bioelectrical impedance analysis, and physical activity (PA) measured with a pedometer. Multivariate regression was used to calculate REE adjusted for phenotypes (BC, z-scores of weight-for-age, height-for-age, body mass index-for-age) and PA. Sex and population differences in REE were determined with two-way ANOVA. Ninety-four healthy children (59.6% girls; 52.1% black) with similar socioeconomic status and PA opportunities participated. Despite BC variations, sex differences in REE were not significant (41 kcal/day; P = 0.375). The REE of black participants was lower than of white (146 kcal/day; P = 0.002). When adjusted for FFM and HFA z-score, the differences in REE declined but remained clinically meaningful at 91 kcal/day (P = 0.039) and 82 kcal/day (P = 0.108), respectively. We recommend the development of population-specific REE prediction equations for South. Afr. children.


Assuntos
Metabolismo Basal , Saúde da Criança/estatística & dados numéricos , Obesidade Pediátrica/epidemiologia , Saúde da População/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Acelerometria/métodos , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Análise de Variância , Composição Corporal , Calorimetria Indireta , Criança , Estudos Transversais , Impedância Elétrica , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Exercício Físico , Feminino , Humanos , Masculino , Obesidade Pediátrica/etnologia , Prevalência , Análise de Regressão , Fatores de Risco , Fatores Sexuais , África do Sul/epidemiologia , África do Sul/etnologia
5.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209665

RESUMO

(1) Background: The present study aimed to investigate the association between home-related factors, community environmental factors, and sugar-sweetened beverages (SSBs) intake among Northeastern Chinese children. (2) Methods: Cross-sectional. Children with complete data were included in the analysis (n = 901). A questionnaire modified according to BEVQ-15 measured the intake of SSBs. Logistic regression was applied to determine the factors associated with the consumption of SSBs. IBM SPSS Statistics 23.0 was applied to perform all statistical analyses. (3) Results: The mean total amount of SSBs consumed on a weekly basis was 2214.04 ± 2188.62 mL. Children's weekly pocket money, frequency of SSBs purchase, SSBs availability at home, the number of accessible supermarkets, and frequency of weekly visits to convenience stores were all found to be associated with a high intake of SSBs among all children. Among children of normal weight, the findings indicated that weekly pocket money, SSBs availability at home, and number of accessible supermarkets were associated with a high SSBs intake. At the same time, frequency of SSBs purchase, mother's SSBs intake, and frequency of weekly visits to convenience stores were associated with a high SSBs intake among children with obesity. (4) Conclusions: Given the potential negative health effects of high SSBs intake, it is crucial to pay attention to home-related factors and community environment.


Assuntos
Comportamento de Ingestão de Líquido , Abastecimento de Alimentos/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Bebidas Adoçadas com Açúcar/estatística & dados numéricos , Adolescente , Criança , China/epidemiologia , Comportamento do Consumidor , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Humanos , Modelos Logísticos , Masculino , Obesidade Pediátrica/epidemiologia , Características de Residência/estatística & dados numéricos , Bebidas Adoçadas com Açúcar/efeitos adversos , Bebidas Adoçadas com Açúcar/provisão & distribuição , Inquéritos e Questionários
6.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209914

RESUMO

This study examines the impact of longitudinal dietary trajectories on obesity and early childhood caries (ECC) in preschool children in Australia. Mother-infant dyads from the Healthy Smiles Healthy Kids study were interviewed at 4 and 8 months, and 1, 2, and 3 years of age. Children underwent anthropometric and oral health assessments between 3 and 4 years of age. Multivariable logistic regression and negative binomial regression analysis were performed for the prevalence of overweight and obesity, and the number of tooth surfaces with dental caries, respectively. The intake of core, discretionary, and sugary foods showed distinct quadratic (n = 3) trajectories with age. The prevalence of overweight or obesity was 10% (n = 72) and that of early childhood caries (ECC) was 33% (mean decayed, missing, and filled tooth surfaces (dmfs) score: 1.96). Children with the highest trajectories of discretionary foods intake were more likely to be overweight or obese (adjusted OR: 2.51, 95 %CI: 1.16-5.42). Continued breastfeeding beyond 12 months was associated with higher dmfs scores (adjusted IRR: 2.17, 95 %CI: 1.27-3.73). Highest socioeconomic disadvantage was the most significant determinant for overweight or obesity (adjusted OR: 2.86, 95 %CI: 1.11-7.34) and ECC (adjusted IRR: 2.71, 95 %CI: 1.48-4.97). Targeted health promotion interventions should be designed to prevent the incidence of two highly prevalent conditions in preschool children.


Assuntos
Cárie Dentária/epidemiologia , Dieta/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Obesidade Pediátrica/epidemiologia , Antropometria , Austrália/epidemiologia , Aleitamento Materno , Pré-Escolar , Índice CPO , Cárie Dentária/etiologia , Dieta/efeitos adversos , Inquéritos sobre Dietas , Comportamento Alimentar , Feminino , Humanos , Lactente , Modelos Logísticos , Estudos Longitudinais , Masculino , Obesidade Pediátrica/etiologia , Prevalência , Fatores Socioeconômicos
7.
Wiad Lek ; 74(5): 1099-1103, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34090271

RESUMO

OBJECTIVE: The aim: Of the work was to study and evaluate the risk factors and the level of primary medical care for children with overweight and obesity. PATIENTS AND METHODS: Materials and methods: A sociological survey was conducted in main (413 persons) and control group (396 persons) and the copying from the history of the child's development (f.112/a) of 280 obese children was conducted. RESULTS: Results: It was defined that on the development of excess weight in children and adolescents, biological and social and hygienic factors had a significant impact (η ≥ 3%; p<0,001) and that the level of primary medical care for obese children (proved diagnosis of obesity in the history of the child (f. №.112/а) had only 61,7±2,7% of patients) was insufficient. CONCLUSION: Conclusions: Identification of comprehensive priority activities for solving problem of children overweight and obesity based on the results of conducted research were done.


Assuntos
Obesidade Pediátrica , Adolescente , Criança , Humanos , Sobrepeso , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/terapia , Fatores de Risco , Inquéritos e Questionários , Ganho de Peso
8.
Nutrients ; 13(5)2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-34068354

RESUMO

Lockdown during the COVID-19 pandemic imposed changes in children's daily routine that could lead to changes in behavior patterns. Using a survey targeted at children under 17 years of age, we described dietary (adherence to Mediterranean diet, AMD) and sleeping habits (disorders of initiating and maintaining sleep) after the implementation of lockdown, and examined the probability of the inadequate frequency of physical activity (PA) and use of TV and electronic devices (TV-ED) before and after lockdown through generalized estimating equation models, accounting for age and gender differences. From 3464 children included, 53.2% showed optimal AMD; 79.2% referred to delayed bedtime; and 16.3% were suspected of sleeping disorders after the implementation of lockdown. Delay in bedtime was more frequent among children older than 6 years, and inadequate sleeping hours among those younger than 11 years. There were no gender differences in AMD or sleeping habits. The odds of inadequate frequency of PA and TV-ED use were greater after lockdown, with a greater risk for TV-ED use. Boys were at greater risk of inadequate PA frequency and TV-ED use. Odds ratio of inadequate PA was greater at older ages. Lockdown could influence changes in children's habits that could lead to risk factors for non-communicable diseases during adulthood if such behaviors are sustained over time.


Assuntos
COVID-19/epidemiologia , Saúde da Criança , Hábitos , Doenças não Transmissíveis/epidemiologia , Pandemias , Obesidade Pediátrica/epidemiologia , SARS-CoV-2 , Adolescente , Criança , Pré-Escolar , Exercício Físico , Feminino , Humanos , Masculino , Espanha/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-34068152

RESUMO

INTRODUCTION: During the last three decades, there has been an excess weight epidemic due to changes in nutrition and lifestyle. Few data on the prevalence of overweight and obesity in children in Romania were published, without a single study representative at the national level. There are reports on the higher level of overweight and obesity in urban areas compared to rural ones. This study aimed to estimate the prevalence of underweight, overweight, obesity and severe obesity in children enrolled in schools from the urban area. MATERIAL AND METHODS: For this cross-sectional study, children from 177 schools from the urban area of five counties from the northwestern part of Romania were included after the parents signed written informed consent. Anthropometric data were recorded (weight, height) based on World Health Organization (WHO) recommendations and Body-Mass-Index (BMI), and the z-score for BMI were calculated. The nutritional status was estimated using three reference criteria: WHO, International Obesity Task Force (IOTC) and the Center for Disease Control and Prevention (CDC). RESULTS: We analyzed data of 21,650 children (48.19% boys) age between 7 and 18 years. The prevalence of overweight was 13.8%, 16.2% and 20.3%, of obesity was 10.7%, 10.0% and 5.7% and of severe obesity was 5.1%, 1.2% and 1.6% (using WHO, CDC and IOTF cut-offs). Underweight was present in 5.2% (WHO), 6% (CDC) and 2.6% (IOTF). The highest prevalence of overweight (including obesity) was found in children aged 10 years, and the lowest in adolescents at 18 years. Boys have a higher prevalence of excess weight than girls. Using IOTF cut-offs, the prevalence of obesity and severe obesity was lower than using WHO criteria. CONCLUSIONS: The prevalence of overweight (including obesity) in children from the urban area of Western Romania was recorded at alarming levels, higher in boys and at the pre-puberty ages. There are significant differences based on the reference system used. It is important to correctly choose the reference for the definition of overweight and obesity to have the correct estimation of the target for public health measures.


Assuntos
Obesidade Pediátrica , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Sobrepeso/epidemiologia , Obesidade Pediátrica/epidemiologia , Prevalência , Romênia/epidemiologia , Instituições Acadêmicas , Magreza/epidemiologia
10.
BMC Public Health ; 21(1): 1233, 2021 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-34174853

RESUMO

BACKGROUND: Obesity is a chronic disease that contributes to additional comorbidities including diabetes, kidney disease and several cancers. Change4Campbelltown implemented a 'whole of system' approach to address childhood overweight and obesity. We present methods to track implementation and stakeholder engagement in Change4Campbelltown. METHODS: Change4Campbelltown aimed to build capacity among key leaders and the broader community to apply techniques from systems thinking to develop community-led actions that address childhood obesity. Change4Campbelltown comprised development of a stakeholder-informed Causal Loop Diagram (CLD) and locally-tailored action plan, formation of key stakeholder and community working groups to prioritise and implement actions, and continuous monitoring of intervention actions. Implementation data included an action register, stakeholder engagement database and key engagement activities and were collected quarterly by the project management team over 2 years of reporting. RESULTS: Engagement activities increased level of community engagement amongst key leaders, the school-sector and community members. Community-led action increased as engagement increased and this action is mapped directly to the primary point of influence on the CLD. As action spread diversified across the CLD, the geographical spread of action within the community increased. CONCLUSIONS: This paper provides a pragmatic example of the methods used to track implementation of complex interventions that are addressing childhood overweight and obesity.


Assuntos
Obesidade Pediátrica , Austrália , Criança , Participação da Comunidade , Humanos , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Instituições Acadêmicas
12.
Nutrients ; 13(5)2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-34062990

RESUMO

Obesogenic endocrine-disrupting chemicals, such as bisphenol A (BPA) and its analogue bisphenol S (BPS), seem to play an important role in the development of obesity, although contradictory results have been reported. The aim of the present study was to conduct a gender analysis of the factors associated with exposure to dietary bisphenols in 585 Spanish adolescents. Dietary BPA and BPS exposure was assessed using a food frequency questionnaire. Foods and macronutrients accounting for more than 95% of energy intake were selected for analysis. Stepwise regression was used to estimate the foods that most contributed to dietary bisphenol exposure in the sample. Gender-related factors associated with greater dietary bisphenol exposure were evaluated using multivariate logistic regression models. Canned tuna was the main dietary source of BPA and BPS in both adolescent boys and girls. Overweight/obese girls showed a higher risk of high dietary exposure to BPA (odds ratio (OR): 3.38, 95% confidence interval (CI): 1.25-9.07) and total bisphenols (OR: 2.81, 95% CI: 1.03-7.67) in comparison with girls with a BMI lower than 25 kg/m2. Present results indicate a positive association of dietary exposure to both total bisphenols and BPA with being overweight/obese in adolescent girls.


Assuntos
Compostos Benzidrílicos/análise , Exposição Dietética/análise , Obesidade Pediátrica/etiologia , Fenóis/análise , Fatores Sexuais , Sulfonas/análise , Adolescente , Compostos Benzidrílicos/efeitos adversos , Índice de Massa Corporal , Inquéritos sobre Dietas , Exposição Dietética/efeitos adversos , Ingestão de Alimentos , Feminino , Humanos , Masculino , Razão de Chances , Obesidade Pediátrica/epidemiologia , Fenóis/efeitos adversos , Análise de Regressão , Fatores de Risco , Espanha/epidemiologia , Sulfonas/efeitos adversos
13.
Niger J Clin Pract ; 24(6): 841-846, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34121731

RESUMO

Background: Obesity is an important cosmopolitan cause of morbidity in children and adolescence age groups. Information on obesity in this age group in Nigeria is scant. Aim: To determine the prevalence of obesity and the associated morbidities seen at the Paediatric Endocrinology clinic of Ekiti State University Teaching Hospital, South West, Nigeria. Methods: A retrospective review of all obese children attending the Paediatric Endocrinology clinic. Sociodemographic and other information related to paediatric obesity and associated morbidities were extracted from the case notes. Data obtained was analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 21 obese children attended the clinic in the 10 years of study. The 21 children were made of 14 (66.7%) girls and 7 (33.3%) boys, giving a 2:1 female to male ratio. The ages of the children ranged from 1 to 16 years with a mean age of 8.79 ± 4.35 years. Obesity was secondary to a nutritional cause in 16 (76.2%) of the cases and Type 1 diabetes mellitus, Type 2 diabetes mellitus, Cushing's syndrome, Iatrogenic Cushing's syndrome and post-meningitis in the remaining 1 (4.8%) case each. Seventeen (81%) of the children were from the higher socioeconomic class, and the remaining three (19.0%) from lower socioeconomic class. Four (19.0%) of the children had hypertension with their blood pressure (BP) above the 95th percentile for age and sex. Hypertension was more common among the higher socioeconomic group, children older than 10 years and the female gender. This association was not statistically significant. A greater proportion of children with body mass index (BMI) >30 had significantly higher rates of hypertension (P < 0.001). Conclusion: Obesity is a common disease condition amongst children attending paediatric endocrine clinic. Strategies to control obesity and progression of severity of obesity may have a place in reducing the prevalence of hypertension in obese children and adolescents.


Assuntos
Diabetes Mellitus Tipo 2 , Obesidade Pediátrica , Adolescente , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Hospitais de Ensino , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Obesidade Pediátrica/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco
15.
BMC Public Health ; 21(1): 983, 2021 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-34034717

RESUMO

BACKGROUND: Greater understanding about the prevention and treatment of overweight and obesity in preschool children within public health care is needed. This study assessed the impact of The First Steps module in routine primary health care including mapping of height/weight and diet followed by parental counselling of healthy habits on overweight and obesity in children aged 2 to 7 years. Further, we explored the experiences of public health nurses (PHNs) with the module. METHODS: Body weight and height obtained in 2014 and 2016 were extracted retrospectively for 676 children from the health records of children at 2, 4, or 6 years of age in five child health centers in Southern Norway. Sex- and age-adjusted body mass index (BMI) z-scores and weight status classifications were calculated according to the International Obesity Task Force reference values. Impact was assessed as change in mean BMI z-scores for children with under-, normal-, and overweight, respectively, and as proportion of children with overweight and obesity. In focus groups, PHNs described their experiences with the practical application of the module. Focus group transcripts were analyzed using Braun and Clarke's thematic analysis. RESULTS: Mean BMI z-scores decreased from 2014 to 2016 in overweight children (- 0.26) and increased in children with under- (0.63) and normal weight (0.06), whereas the proportion of children with overweight and obesity was stable. PHNs believed that the module provides them with new tools that are useful for addressing the intricacies of childhood obesity. They described counseling sessions with families as "moving upstream in a river" and that overweight and obesity may be one of many complex challenges for these families. CONCLUSIONS: Mean BMI z-score decreased in children with overweight during the 2 years after initiation of The First Steps module. PHNs considered the module as useful for addressing children's overweight and obesity, which was perceived as one of several complex challenges for most of these families. Specialist and evidence-based support is needed to address overweight and obesity in children in primary care. Further research should focus on integrating the issues relating to overweight and obesity within other family problems.


Assuntos
Obesidade Pediátrica , Índice de Massa Corporal , Pré-Escolar , Humanos , Noruega/epidemiologia , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Saúde Pública , Estudos Retrospectivos
16.
BMC Pediatr ; 21(1): 250, 2021 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-34044800

RESUMO

BACKGROUND: Pediatric obesity is one of the most important health challenges of the twenty-first century. Primary prevention of childhood obesity, can lessen its consequences. This study aims to assess childhood obesity prevention policies in Iran through a policy analysis of agenda-setting using Kingdon's multiple streams. METHODS: A qualitative study was conducted using in-depth interviews with 39 key informants and document review from different stages of the policymaking process of childhood and adolescent obesity prevention programs in Iran. The analysis of documents and interviews were guided based on Kingdon's multiple streams (problem, policy and political streams). RESULTS: The important factors of the problem stream were the high prevalence of childhood and adolescent obesity and its risk factors in Iran. In the policy stream, a focus on preventing non-communicable diseases in the health system, increasing the workforce in health centers, promoting health school programs, and creating healthy eating buffets in schools was identified. Under the political stream, the impact of the WHO ECHO program in 2015 and the implementation of the health system transformation plan in Iran in the new government took place after 2013, caused the Iran ECHO program entered the agenda and implemented from 2016. CONCLUSIONS: Now that a window of opportunity for childhood and adolescent obesity prevention policymaking has been created, the problems such as the therapeutic approach in the health system, the existence of sanctions against Iran and outbreak of coronavirus disease-19 (COVID-19), have hindered the successful implementation of this policy and the opportunity window has not been well used. However, actors need political support from the high levels of government to keep this policy on the agenda.


Assuntos
COVID-19 , Obesidade Pediátrica , Adolescente , Criança , Política de Saúde , Humanos , Irã (Geográfico)/epidemiologia , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Formulação de Políticas , Política , SARS-CoV-2
17.
BMC Public Health ; 21(1): 1005, 2021 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-34049524

RESUMO

BACKGROUND: In parallel with the increased prevalence of childhood overweight and obesity, the proportion of eating out in China has increased dramatically in recent years. The purpose of the study was to explore the association between frequency of eating out with overweight and obesity among Chinese children. METHODS: The representative sample was recruited from Chinese National Nutrition and Health Survey (CNNHS) in 2010-2012, which included Chinese children aged 6-17 years (7685 boys and 7576 girls). Frequency of eating out was collected by interview-administered questionnaire and categorized as: 0, 1-2 and ≥ 3 times per week. Height and weight were measured, consequently body mass index was calculated. RESULTS: The prevalence of eating out among Chinese children aged 6-17 years old was 23.2%. Children who ate out 0, 1-2, ≥3 times per week were accounted for 76.8, 10.9 and 12.3% respectively. Findings revealed that eating out three times per week or more was statistically significant associated with higher prevalence of overweight and obesity among boys (OR = 1.20,95CI:1.04-1.38) compared with those ate out less than three times per week. However, no significantly association was observed among girls (OR = 0.91, 95CI:0.78-1.01). In additional, Younger children, rural children, children from low income family, those with leisure exercises (certain physical activities regularly carried out such as swimming, walking, running, equipment fitness), leisure time sedentary behaviors (LTSB)(> 2 h/d) were relatively more likely to eat out. CONCLUSIONS: The results illustrated that eating out three times or more had a significantly positive effect on overweight and obesity among boys in China.


Assuntos
Sobrepeso , Obesidade Pediátrica , Adolescente , Índice de Massa Corporal , Criança , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Sobrepeso/epidemiologia , Obesidade Pediátrica/epidemiologia
18.
Curr Opin Anaesthesiol ; 34(3): 299-305, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33935177

RESUMO

PURPOSE OF REVIEW: Childhood obesity is a public health emergency that has reached a pandemic level and imposed a massive economic burden on healthcare systems. Our objective was to provide an update on (1) challenges of obesity definition and classification in the perioperative setting, (2) challenges of perioperative patient positioning and vascular access, (3) perioperative implications of childhood obesity, (3) anesthetic medication dosing and opioid-sparing techniques in obese children, and (4) research gaps in perioperative childhood obesity research including a call to action. RECENT FINDINGS: Despite the near axiomatic observation that obesity is a pervasive clinical problem with considerable impact on perioperative health, there have only been a handful of research into the many ramifications of childhood obesity in the perioperative setting. A nuanced understanding of the surgical and anesthetic risks associated with obesity is essential to inform patients' perioperative consultation and their parents' counseling, improve preoperative risk mitigation, and improve patients' rescue process when complications occur. SUMMARY: Anesthesiologists and surgeons will continue to be confronted with an unprecedented number of obese or overweight children with a high risk of perioperative complications.


Assuntos
Anestésicos , Obesidade Pediátrica , Medicina Perioperatória , Anestésicos/efeitos adversos , Criança , Humanos , Posicionamento do Paciente , Obesidade Pediátrica/epidemiologia
19.
BMC Public Health ; 21(1): 885, 2021 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-33964905

RESUMO

BACKGROUND: Parental weight is studied as an important determinant of childhood obesity; however, obesity-related metabolic abnormalities have been less considered as determinants of childhood obesity. This study aimed to investigate the association between maternal obesity phenotypes and incidence of obesity in their offspring. METHODS: This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study. A total of 2151 non-obese children who had complete parental information were followed for incidence of obesity over a mean of 148.7 ± 34.7 months. Obesity in children was defined using the World Health Organization criteria. Maternal body mass index (BMI) was classified into three categories: normal weight, overweight and obese. Dysmetabolic status was considered as having metabolic syndrome or diabetes. Metabolic syndrome and diabetes were defined according to the Joint Interim Statement and American diabetes association criteria, respectively. Considering maternal BMI categories and metabolic status, six obesity phenotypes were defined as followed: 1) normal weight and normal metabolic status, 2) overweight and normal metabolic status, 3) obese and normal metabolic status, 4) normal weight and dysmetabolic status, 5) overweight and dysmetabolic status, and 6) obese and dysmetabolic status. The association between maternal obesity phenotypes and incidence of obesity in children was studied using Cox proportional regression hazard model. RESULTS: In male offspring, the risk of incidence of obesity significantly increased in those with maternal obesity phenotypes including overweight/normal metabolic: 1.75(95% CI: 1.10-2.79), obese/normal metabolic: 2.60(95%CI: 1.51-4.48), overweight/dysmetabolic: 2.34(95%CI: 1.35-4.03) and obese/dysmetabolic: 3.21(95%CI: 1.94-5.03) compared to the normal weight/normal metabolic phenotype. Similarly, in girls, the risk of incidence of obesity significantly increased in offspring with maternal obesity phenotypes including overweight/normal metabolic: 2.39(95%CI: 1.46-3.90), obese/normal metabolic: 3.55(95%CI: 1.94-6.46), overweight/dysmetabolic: 1.92(95%CI: 1.04-3.52) and obese/dysmetabolic: 3.89(95%CI: 2.28-6.64) compared to normal weight/normal metabolic phenotype. However, maternal normal weight/dysmetabolic phenotype did not significantly change the risk of obesity in both male and female offspring. CONCLUSION: Except for normal weight/dysmetabolic phenotype, all maternal obesity phenotypes had significant prognostic values for incidence of offspring obesity with the highest risk for obese/dysmetabolic phenotype. This study provides valuable findings for identifying the first line target groups for planning interventions to prevent childhood obesity.


Assuntos
Obesidade Materna , Obesidade Pediátrica , Índice de Massa Corporal , Criança , Estudos de Coortes , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Estudos Longitudinais , Masculino , Sobrepeso , Obesidade Pediátrica/epidemiologia , Fenótipo , Gravidez , Prognóstico , Fatores de Risco
20.
Medicine (Baltimore) ; 100(18): e25302, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950919

RESUMO

ABSTRACT: Childhood obesity is a growing epidemic in the United States, and is associated with an increased risk of lower-extremity physeal fractures, and fractures requiring operative intervention. However, no study has assessed the risk upper extremity physeal fractures among overweight children. Our purpose was to compare the following upper-extremity fracture characteristics in overweight and obese children with those of normal-weight/underweight children (herein, "normal weight"): mechanism of injury, anatomical location, fracture pattern, physeal involvement, and treatment types. We hypothesized that overweight and obese children would be higher risk for physeal and complete fractures with low-energy mechanisms and would therefore more frequently require operative intervention compared with normal-weight children.We performed a cross-sectional review of our database of 608 patients aged 2 to 16 years, and included patients who sustained isolated upper-extremity fractures at our level-1 pediatric tertiary care center from January 2014 to August 2017. Excluded were patients who sustained pathologic fractures and those without basic demographic or radiologic information. Using body mass index percentile for age and sex, we categorized patients as obese (≥95th percentile), overweight (85th to <95th percentile), normal weight (5th to <85th percentile), or underweight (<5th percentile). The obese and overweight groups were analyzed both separately and as a combined overweight/obese group. Demographic data included age, sex, height, and weight. Fractures were classified based on fracture location, fracture pattern (transverse, comminuted, buckle, greenstick, avulsion, or oblique), physeal involvement, and treatment type. Of the 608 patients, 58% were normal weight, 23% were overweight, and 19% were obese. There were no differences in the mean ages or sex distributions among the 3 groups.Among patients with low-energy mechanisms of injury, overweight/obese patients had significantly greater proportions of complete fractures compared with normal-weight children (complete: 65% vs 55%, P = .001; transverse: 43% vs 27%, P = .006). In addition, the overweight/obese group sustained significantly more upper-extremity physeal fractures (37%) than did the normal-weight group (23%) (P = .007).Compared with those in normal-weight children, upper-extremity fracture patterns differ in overweight and obese children, who have higher risk of physeal injuries and complete fractures caused by low-energy mechanisms.Level of Evidence: Level III, retrospective comparative study.


Assuntos
Ossos da Extremidade Superior/lesões , Fraturas Ósseas/epidemiologia , Obesidade Pediátrica/epidemiologia , Distribuição por Idade , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Centros de Atenção Terciária/estatística & dados numéricos , Estados Unidos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...