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1.
Nutr Metab Cardiovasc Dis ; 31(1): 306-313, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33500107

RESUMO

BACKGROUND AND AIMS: Many studies have examined the association between overweight or obesity assessed by body mass index and left ventricular hypertrophy (LVH) in children or adolescents, but only few studies have assessed the relation with abdominal obesity in children. This study aimed to assess the association of abdominal obesity assessed by waist circumference (WC), high blood pressure (BP) and their joint effect on LVH and left ventricular (LV) geometric remodeling in Chinese children. METHODS AND RESULTS: Data were from a cross-sectional survey of 1319 Chinese children aged 6-11 years who had undergone cardiac ultrasound. Compared with normal WC, the adjusted odds ratios (ORs) for abdominal obesity were 6.78 (95% confidence interval [CI] 3.77-12.16) for LVH, 2.80 (1.55-5.05) for CR, 5.43 (2.84-10.39) for EH, and 20.05 (4.46-90.08) for CH, respectively. Compared with children with both normal WC and normal BP, the adjusted ORs for those with abdominal obesity and normal BP were 6.98 (3.71-13.10) for LVH, 2.87 (1.47-5.60) for CR, 5.52 (2.70-11.26) for EH, and 15.20 (4.51-78.13) for CH. The adjusted ORs for those with abdominal obesity and high BP were 7.12 (3.27-15.50) for LVH, 4.71 (2.04-10.85) for CR, 7.49 (3.23-17.40) for EH, and 8.65 (1.32-56.89) for CH. The ORs for those with high BP and normal WC were not significant for these cardiac outcomes (P > 0.05). CONCLUSIONS: LVH and LV geometric remodeling were associated more strongly with abdominal obesity than with high BP in Chinese children, stressing the need to prevent childhood abdominal obesity for reducing cardiac risk.


Assuntos
Pressão Sanguínea , Hipertensão/epidemiologia , Hipertrofia Ventricular Esquerda/epidemiologia , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/epidemiologia , Função Ventricular Esquerda , Remodelação Ventricular , Fatores Etários , Grupo com Ancestrais do Continente Asiático , Criança , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Prevalência , Medição de Risco
2.
JAMA Netw Open ; 3(12): e2030415, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33346848

RESUMO

Importance: Treatment of pediatric obesity is challenging. Preclinical studies in mice indicated that weight and metabolism can be altered by gut microbiome manipulation. Objective: To assess efficacy of fecal microbiome transfer (FMT) to treat adolescent obesity and improve metabolism. Design, Setting, and Participants: This randomized, double-masked, placebo-controlled trial (October 2017-March 2019) with a 26-week follow-up was conducted among adolescents aged 14 to 18 years with a body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 30 or more in Auckland, New Zealand. A total of 87 individuals took part-565 individuals responded to advertisements, 328 were ineligible, and 150 declined participation. Clinical data were analyzed from September 2019 to May 2020. Interventions: Single course of oral encapsulated fecal microbiome from 4 healthy lean donors of the same sex or saline placebo. Main Outcomes and Measures: Primary outcome was BMI standard deviation score at 6 weeks using intention-to-treat analysis. Secondary outcomes included body composition, cardiometabolic parameters, well-being, and gut microbiome composition. Results: Eighty-seven participants (59% female adolescents, mean [SD] age 17.2 [1.4] years) were randomized 1:1, in groups stratified by sex, to FMT (42 participants) or placebo (45 participants). There was no effect of FMT on BMI standard deviation score at 6 weeks (adjusted mean difference [aMD] -0.026; 95% CI -0.074, 0.022). Reductions in android-to-gynoid-fat ratio in the FMT vs placebo group were observed at 6, 12, and 26 weeks, with aMDs of -0.021 (95% CI, -0.041 to -0.001), -0.023 (95% CI, -0.043 to -0.003), and -0.029 (95% CI, -0.049 to -0.008), respectively. There were no observed effects on insulin sensitivity, liver function, lipid profile, inflammatory markers, blood pressure, total body fat percentage, gut health, and health-related quality of life. Gut microbiome profiling revealed a shift in community composition among the FMT group, maintained up to 12 weeks. In post-hoc exploratory analyses among participants with metabolic syndrome at baseline, FMT led to greater resolution of this condition (18 to 4) compared with placebo (13 to 10) by 26 weeks (adjusted odds ratio, 0.06; 95% CI, 0.01-0.45; P = .007). There were no serious adverse events recorded throughout the trial. Conclusions and Relevance: In this randomized clinical trial of adolescents with obesite, there was no effect of FMT on weight loss in adolescents with obesity, although a reduction in abdominal adiposity was observed. Post-hoc analyses indicated a resolution of undiagnosed metabolic syndrome with FMT among those with this condition. Further trials are needed to confirm these results and identify organisms and mechanisms responsible for mediating the observed benefits. Trial Registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN12615001351505.


Assuntos
Transplante de Microbiota Fecal , Microbioma Gastrointestinal/fisiologia , Obesidade Pediátrica , Qualidade de Vida , Adolescente , Índice de Massa Corporal , Método Duplo-Cego , Transplante de Microbiota Fecal/efeitos adversos , Transplante de Microbiota Fecal/métodos , Feminino , Humanos , Masculino , Monitorização Fisiológica/métodos , Nova Zelândia , Obesidade Pediátrica/metabolismo , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/psicologia , Obesidade Pediátrica/terapia , Resultado do Tratamento
3.
Medicine (Baltimore) ; 99(36): e21968, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899034

RESUMO

The aim of this study is twofold: firstly, to investigate the plantar pressure distribution differences in children coming from 4 different weight categories and secondly to analyze the presence of sex-related plantar pressure distribution differences.Overall, 416 children, aged 7 to 12 years old were randomly selected from 6 different local schools, and voluntarily participated in the study. Two hundred twenty six of them were men, while 190 were women (mean age: 9.93 ±â€Š1.02 years; height: 1.39 ±â€Š0.8 m; body mass: 37.76 ±â€Š10.34 kg; BMI: 19.24 ±â€Š4.02 kg/m). Based on the body mass index (BMI) the sample was grouped in the following categories: underweight (UW); normal weight (NW); overweight (OW), and obese (OB). Besides, the plantar load distribution parameters (total plantar load distribution and load distribution in forefoot and rearfoot) were assessed employing freeMed Maxi; Sensor Medica device. Shapiro-Wilk test was used to test the data distribution. Between-groups comparisons were conducted using Mann-Whitney U test, or using Kruskal-Wallis test associated with pairwise comparisons.There were significant differences in load distribution between weight categories, with (OW) and (NW) being significantly different with (O), P = .03 and P = .04, respectively. No significant differences were found on load distribution on the rearfoot and forefoot between categories. The sex effect, particularly among boys, revealed a different pattern of load distribution among (O) compared with other categories. This effect was not detected among women. Different profile of load distribution on the rearfoot and forefoot between boys and girls was found, with girls bearing significantly more weight in the right rearfoot compared with boys (P = .001).It can be concluded that the weight status of the children can affect the plantar load distribution, with obese category being different from (NW) and (OW). Additionally, the sex plays a role when it comes to the load distribution in different regions of the foot. Moreover, since the young age, due to growth and development process, is accompanied with anatomical foot changes which might be affected from numerous factors, assessing plantar pressure distribution in young children results to be a quite complicated matter.


Assuntos
Peso Corporal , Articulações do Pé/fisiopatologia , Pé/fisiopatologia , Obesidade Pediátrica/fisiopatologia , Criança , Feminino , Humanos , Masculino , Caracteres Sexuais
4.
Artigo em Inglês | MEDLINE | ID: mdl-32883044

RESUMO

With the current obesity epidemic and the decline of fitness among school-aged children, the importance of obesity interventions to promote physical activity and healthy habits has become indisputable. The purpose of this study was to assess the efficacy of a school-based multicomponent intervention in increasing physical activity (PA) levels, actual physical abilities, and perceived physical abilities in clinical and nonclinical samples of overweight/obese boys and girls aged 10-12 years. The clinical intervention group (n = 35) participated in a 7-month after-school program in addition to curricular physical education lessons, while the nonclinical control group (n = 29) received usual curricular lessons. Measures included levels of PA and fitness and individual's perceptions of physical ability. After treatment, the intervention group showed improved PA levels, perceived physical ability, and throwing and jumping task performances compared to the control group. Results indicate that a multicomponent program can improve levels of PA, fitness, and perceived competence of overweight participants. Findings highlight the importance of a comprehensive healthy lifestyle program that includes physical, psychosocial, and behavioral factors and suggest practical implications for educators, trainers, and teachers in identifying best practices targeting childhood obesity.


Assuntos
Sobrepeso , Obesidade Pediátrica , Educação Física e Treinamento , Criança , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Estilo de Vida , Masculino , Sobrepeso/fisiopatologia , Obesidade Pediátrica/fisiopatologia , Aptidão Física , Instituições Acadêmicas
5.
Nutr Metab Cardiovasc Dis ; 30(10): 1840-1847, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32736956

RESUMO

BACKGROUND AND AIM: To compare cardiometabolic risk profile and preclinical signs of target organ damage in youth with normal and elevated blood pressure (BP), according to the American Academy of Pediatrics (AAP) guidelines. METHODS AND RESULTS: This cross-sectional multicenter study included 2739 youth (5-17 year-old; 170 normal-weight, 610 overweight and 1959 with obesity) defined non hypertensive by the AAP guidelines. Anthropometric, biochemical and liver ultrasound data were available in the whole population; carotid artery ultrasound and echocardiographic assessments were available respectively in 427 and 264 youth. Elevated BP was defined as BP ≥ 90th to <95th percentile for age, gender and height in children or BP ≥ 120/80 to <130/80 in adolescents. The overall prevalence of elevated BP was 18.3%, and significantly increased from normal-weight to obese youth. Young people with elevated BP showed higher levels of body mass index (BMI), insulin resistance and a higher prevalence of liver steatosis (45% vs 36%, p < 0.0001) than normotensive youth, whilst they did not differ for the other cardiometabolic risk factors, neither for carotid intima media thickness or left ventricular mass. Compared with normotensive youth, individuals with elevated BP had an odds ratio (95%Cl) of 3.60 (2.00-6.46) for overweight/obesity, 1.46 (1.19-1.78) for insulin-resistance and 1.45 (1.19-1.77) for liver steatosis, controlling for centers, age and prepubertal stage. The odds for insulin resistance and liver steatosis persisted elevated after correction for BMI-SDS. CONCLUSION: Compared to normotensive youth, elevated BP is associated with increased BMI, insulin resistance and liver steatosis, without significant target organ damage.


Assuntos
Pressão Sanguínea , Doenças Cardiovasculares/epidemiologia , Obesidade Pediátrica/epidemiologia , Pré-Hipertensão/epidemiologia , Adolescente , Fatores Etários , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Doenças das Artérias Carótidas/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Hipertrofia Ventricular Esquerda/epidemiologia , Resistência à Insulina , Itália/epidemiologia , Masculino , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/fisiopatologia , Prevalência , Medição de Risco , Fatores de Risco
6.
PLoS One ; 15(8): e0236991, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785234

RESUMO

Disruption of circadian rhythms and variations in the FTO gene may interfere with energy homeostasis and play a role in the development of obesity. The current study assessed the association of common polymorphisms in the CLOCK and FTO genes with standardized body mass index scores (BMI z-scores) and their potential modification of the impact of a culinary nutrition and physical activity intervention in school-age children. Anthropometric measurements were collected in 121 children at the baseline and one-year follow-up of a controlled trial of a school-based culinary nutrition and physical activity intervention. Genotypes of the CLOCK polymorphism (rs1801260) and the FTO polymorphism (rs9939609) were obtained from buccal swabs. Linear mixed-effects regression was applied to evaluate the genetic association and adjust for clusters within families and schools. In our participants, obesity affected 6.6% (8/121) of the children at the baseline and 6.4% (7/109) of the children at the follow-up. The associations between the age- and sex-adjusted BMI z-scores and the two polymorphisms did not reach statistically significance. Yet, sex potentially modified the association between rs1801260 and BMI z-scores. In girls, the G allele carriers had a higher BMI z-scores at the baseline and the follow-up. These polymorphisms did not modify the effect of our culinary nutrition and physical activity intervention on BMI z-scores. Sex is a potential modifier for the association between the CLOCK polymorphism, rs1801260, and BMI z-scores in school-age children. Further investigation is warranted to delineate the sex-dependent role of the CLOCK polymorphisms in the development of childhood obesity.


Assuntos
Índice de Massa Corporal , Proteínas CLOCK/genética , Obesidade Pediátrica/genética , Polimorfismo de Nucleotídeo Único , Dioxigenase FTO Dependente de alfa-Cetoglutarato/genética , Dioxigenase FTO Dependente de alfa-Cetoglutarato/fisiologia , Proteínas CLOCK/fisiologia , Criança , Ritmo Circadiano/genética , Ritmo Circadiano/fisiologia , Dieta Redutora , Exercício Físico , Feminino , Frequência do Gene , Predisposição Genética para Doença , Humanos , Masculino , Obesidade Pediátrica/dietoterapia , Obesidade Pediátrica/fisiopatologia , Caracteres Sexuais , Programas de Redução de Peso
7.
J Sports Sci ; 38(21): 2508-2516, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32646282

RESUMO

Physical training is recommended for obese paediatric populations. We investigated the effects of recreational judo training (JT) upon body composition and distribution, cardiorespiratory fitness, and heart rate variability (HRV) in overweight or obese children. A controlled trial (RBR-9d94td) was conducted with 35 children (8-13 years) assigned into groups according to their body mass index (BMI): eutrophic (EU; n = 15; z-BMI ≤ +l and ≥ -2) and overweight or obese (OB; n = 20; z-BMI > +1 and ≤ +3). The 12-week JT included 60-min sessions performed 2 times/week at 65-75% maximal heart rate (HR). BMI, waist circumference, blood pressure, HRV, peak oxygen uptake (VO2peak), gas exchange threshold (GET), and body fractioning were assessed. Significant reductions in OB (P < 0.05) occurred for whole body and trunk fat (~3%), trunk/limb fat-ratio (~4%), resting HR (~3%), and sympathovagal balance (log LF:HF, ~85%). Increases (P < 0.05) occurred in lean mass (~8%), parasympathetic modulation (log HF, ~4%), VO2peak (~5-10%), and VO2 (~15%), speed (~10%) and slope (~13%) at GET. Markers of cardiorespiratory fitness (relative VO2, slope and speed at GET) in OB approached EU after JT. In conclusion, a relatively short JT intervention to improved body composition, autonomic modulation, and physical fitness in obese children.


Assuntos
Composição Corporal , Aptidão Cardiorrespiratória , Terapia por Exercício/métodos , Frequência Cardíaca , Artes Marciais , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/terapia , Adolescente , Pressão Sanguínea , Índice de Massa Corporal , Criança , Feminino , Humanos , Análise de Intenção de Tratamento , Masculino , Sobrepeso/fisiopatologia , Sobrepeso/terapia , Nervo Vago/fisiologia
8.
PLoS One ; 15(7): e0235951, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32678852

RESUMO

BACKGROUND: Little evidence from developing countries on dietary transition demonstrates the effects of comprehensive childhood obesity interventions on dietary diversity and food variety among younger children. This study aimed to evaluate the effects of comprehensive childhood obesity interventions on dietary diversity among younger children. METHODS: A total of 4846 children aged 7-13 years were included based on a multicenter randomized controlled trial for childhood obesity interventions in 38 primary schools. Nutrition education intervention (NE), physical activity intervention (PA) and comprehensive intervention including both NE and PA (CNP) were carried out separately for 2 semesters. Dietary Diversity Score (DDS9 and DDS28 for 9 and 28 food groupings, respectively), Food Variety Score (FVS, the number of food items) and the proportions of different foods consumed were calculated according to the food intake records collected with the 24-h dietary recall method. RESULTS: The intervention effects per day of comprehensive intervention group were 0 (95% Confidence Interval (CI): 0, 0.1; p = 0.382) on DDS9, 0.1 (95% CI: -0.1, 0.2; p = 0.374) on DDS28 and 0.1 (95% CI: -0.1, 0.3; p = 0.186) on FVS of overall diet, which was 0.1 (95% CI: 0, 0.1; p < 0.001) on DDS9, 0 (95% CI: 0, 0.1; p = 0.168) on DDS28 and 0.1 (95% CI: 0, 0.1; p = 0.067) on FVS of dietary scores of breakfast only. Additionally, CNP group had greater increases in cereals, meat and fruits, and more decreases in eggs, fish and dried legumes consumption proportions as compared with the control group. Decreasing side effect on dietary diversity and food variety were found for PA intervention, but not for NE intervention only. CONCLUSIONS: Though the comprehensive obesity intervention didn't improve the overall dietary diversity per day, the positive intervention effects were observed on breakfast foods and some foods' consumption.


Assuntos
Dieta , Obesidade Pediátrica/epidemiologia , Instituições Acadêmicas/estatística & dados numéricos , Criança , China/epidemiologia , Exercício Físico , Feminino , Humanos , Masculino , Obesidade Pediátrica/fisiopatologia
9.
PLoS One ; 15(7): e0236261, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687510

RESUMO

Dietary and physical activity behaviors formed early in life can increase risk for childhood obesity and have continued negative consequences for lifelong health. Previous research has highlighted the importance of both genetic and environmental (e.g., cultural environment or parental lifestyle) contributions to obesity risk, although these studies typically involve genetically-related individuals residing in the same household, where genetic similarity and rearing environment are inextricably linked. Here we utilize a sibling-adoption design to independently estimate genetic and environmental contributions to obesity risk in childhood and describe how these influences might vary as children age. As part of a prospective adoption study, the current investigation used data from biological siblings reared either apart or together, and nonbiological siblings reared together to estimate the contributions of genetics and environment to body mass indices (BMI) in a large cohort of children (N = 711). We used a variance partitioning model to allocate variation in BMI to that which is due to shared genetics, common environment, or unique environment in this cohort during middle childhood and adolescence. We found 63% of the total variance in BMI could be attributed to heritable factors in middle childhood sibling pairs (age 5-11.99; 95% CI [0.41,0.85]). Additionally, we observed that common environment explained 31% of variation in BMI in this group (95% CI [0.11,0.5]), with unique environment and error explaining the remaining variance. We failed to detect an influence of genetics or common environment in older sibling pairs (12-18) or pairs spanning childhood and adolescence (large sibling age difference), but home type (adoptive versus birth) was an important predictor of BMI in adolescence. The presence of strong common environment effects during childhood suggests that early interventions at the family level in middle childhood could be effective in mitigating obesity risk in later childhood and adolescence.


Assuntos
Adoção , Índice de Massa Corporal , Interação Gene-Ambiente , Obesidade Pediátrica/epidemiologia , Irmãos , Adolescente , Criança , Desenvolvimento Infantil/fisiologia , Educação Infantil , Pré-Escolar , Feminino , Humanos , Masculino , Obesidade Pediátrica/genética , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/prevenção & controle , Estudos Prospectivos
10.
BMC Public Health ; 20(1): 1139, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32690079

RESUMO

BACKGROUND: Numerous movement skills and physical fitness tests have been developed for children in high-income countries. However, adaptation of these tests to low-resource settings has been slow and norms are still unavailable for children living in low-income communities. The aim of this paper was to describe the development and validation of the Performance and Fitness (PERF-FIT) test battery, a new test to assess motor skill-related physical fitness in children in low-resource settings. METHOD: The PERF-FIT test was developed in a stepwise manner. This involved defining the relevant domains of the construct of interest and selecting and evaluating test items. The Content Validity Index (CVI) was used to estimate content validity. Following development of the PERF-FIT test, a preliminary study was performed to validate items and to examine the feasibility of implementing the test in a low-resource community. Structural validity was also determined based on data from eighty (n = 80) children (aged 7-12 years) using principal component analysis. RESULTS: The CVI for the throw and catch item was 0.86 and 1.00 for the other nine items, leading to a total CVI score of 0.99. The hierarchical sequence of the item series was demonstrated by highly significant (p < 0.001) linear trends, confirming the increase in difficulty of subsequent items. Principal component analysis revealed three factors; the first component is represented by locomotor skills that require static and dynamic balance, the second component by throwing and catching items and the third component by agility and power items. These findings suggest that it is feasible to implement the PERF-FIT in low-resource settings. CONCLUSION: The PERF-FIT test battery is easy to administer and may be suitable for measuring skill-related physical fitness in in low-resource settings. It has excellent content validity and good structural validity. After minor adaptions, further studies should be conducted to establish normative values, evaluate reliability, and document criterion and cross-cultural validity of this test.


Assuntos
Obesidade Pediátrica/fisiopatologia , Aptidão Física , Brasil , Criança , Serviços de Saúde da Criança , Estudos de Viabilidade , Feminino , Humanos , Masculino , Destreza Motora , Movimento , Pobreza , Reprodutibilidade dos Testes
11.
PLoS One ; 15(6): e0234316, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520942

RESUMO

Handgrip strength (HGS) is a well-established indicator of muscle strength and can help to identify risk of sarcopenic obesity in children. This study explores the relationship between adiposity and muscular strength in healthy Chilean adolescents. Adolescents (n = 491) aged 10-17 were selected from five schools in Santiago, Chile. HGS was determined by dynamometry. Anthropometry (weight, height, waist and mid arm circumference), physical activity and socioeconomic status were also measured. Relative HGS (RHGS) was calculated by dividing maximum HGS of the dominant hand by body-mass index (BMI) and low RHGS was categorized as <25th percentile by sex. Logistic regression was used to determine the relationship between two markers of adiposity (abdominal obesity category by waist circumference and nutritional status measured by BMI category) and low RHGS, adjusting for possible confounding variables. Participants were on average 13.6y (2.4), 32.8% were overweight or obese and 37.5% were at risk of or had abdominal obesity. RHGS was 1.25 kg/kg/m2 overall, with a significant difference by sex (1.51 for boys versus 1.14 for girls). In adjusted analyses, boys and girls with risk of abdominal obesity, had 3.3 (1.6-6.6) and 4.1 (1.8-9.3) increased odds of low RHGS, respectively, compared to boys and girls with normal waist circumference. Those with abdominal obesity compared to normal WC, had 8.5 (3.4-21.4) and 6.5 (2.0-21.3) increased odds of low RHGS for boys and girls, respectively. We observed similar associations for BMI category. In our sample of healthy adolescents, higher adiposity related to greater odds of low muscle strength measured by dynamometry. Considering the demographic shift from a young to an aging population in many countries, along with the increasing prevalence of obesity beginning in childhood, understanding how adiposity relates to low muscle strength is of growing importance.


Assuntos
Força da Mão/fisiologia , Sobrepeso/epidemiologia , Obesidade Pediátrica/epidemiologia , Adiposidade/fisiologia , Adolescente , Índice de Massa Corporal , Peso Corporal , Criança , Chile/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Avaliação Nutricional , Estado Nutricional , Obesidade Abdominal/epidemiologia , Obesidade Pediátrica/metabolismo , Obesidade Pediátrica/fisiopatologia , Prevalência , Fatores de Risco , Circunferência da Cintura/fisiologia
12.
Nutr Metab Cardiovasc Dis ; 30(7): 1196-1200, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32482455

RESUMO

BACKGROUND AND AIM: Exercise timing has been suggested to affect appetite and energy intake (EI). The aim of this study was to examine the impact of exercising immediately before or after a meal on EI, appetite sensations and food reward (FR) in adolescents with obesity. METHODS AND RESULTS: Seventeen adolescents with obesity completed 3 experimental sessions (randomized controlled trial): rest + lunch (CON); exercise + lunch (EX-MEAL); lunch + exercise (MEAL-EX). The exercise consisted of cycling 30 min at 65%V̇O2peak. Outcomes included ad libitum EI (weighed lunch and dinner), FR (Leeds Food Preference Questionnaire at pre- and post-combination of exercise/rest and lunch, and pre-dinner) and appetite sensations (visual analogue scales). EI was not different between conditions. Compared with CON, relative EI at lunch was lower in EX-MEAL and MEAL-EX (p ≤ 0.05) and daily only in MEAL-EX (p < 0.01). Postprandial fullness was higher in EX-MEAL compared to CON. Compared with CON, both EX-MEAL and MEAL-EX attenuated the increase in wanting for sweet food and reduced explicit liking for fat. CONCLUSIONS: These preliminary results suggest that exercising immediately before or after a meal produce few differences in appetite and have small beneficial effects on overall energy balance in adolescents with obesity, as well as on FR. CLINICAL TRIALS: NCT03967782.


Assuntos
Comportamento do Adolescente , Comportamento Infantil , Ingestão de Energia , Exercício Físico , Comportamento Alimentar , Obesidade Pediátrica/terapia , Período Pós-Prandial , Adolescente , Fatores Etários , Regulação do Apetite , Ciclismo , Criança , Feminino , França , Humanos , Masculino , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/psicologia , Recompensa , Fatores de Tempo
13.
Cardiovasc Diabetol ; 19(1): 79, 2020 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-32534575

RESUMO

Severe obesity among children and adolescents is a significant global public health concern. The prevalence has markedly increased over the last decades, becoming common in many countries. Overwhelming rates of obesity among youth have prompted efforts to identify an evidence-based immediate- and long-term cardiometabolic risk factor profile in childhood-onset severe obesity, and to highlight gaps that require further investigation. The PubMed database was systematically searched in accordance with PRISMA guidelines. The search yielded 831 results, of which 60 fulfilled stringent criteria and were summarized in this review. The definition of severe obesity was variable, with only one half the publications using the definition BMI > 120% of the 95th percentile. Point estimates of the prevalence of at least one cardiometabolic risk factor in children with severe obesity reportedly range from 67 to 86%. Cross-sectional studies indicate that children and adolescents with severe obesity are at greater risk than those with mild obesity for type 2 diabetes, hypertension, fatty liver disease and dyslipidemia, already at childhood and adolescence. Robust epidemiological data on the long-term risk and actual point estimates in adulthood are lacking for these diseases as well as for other diseases (coronary heart disease, stroke, chronic kidney disease and cancer). Recent longitudinal studies indicate an increased risk for cardiomyopathy, heart failure, cardiovascular mortality and all-cause mortality in adulthood for adolescents with severe obesity compared to those with mild obesity. Given the alarming increase in the prevalence of severe obesity, the persistence of adiposity from childhood to adulthood and the precarious course of young adults with chronic comorbidities, the economic and clinical services burden on the healthcare system is expected to rise.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Neoplasias/epidemiologia , Obesidade Pediátrica/epidemiologia , Adiposidade , Adolescente , Fatores Etários , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Criança , Pré-Escolar , Comorbidade , Diabetes Mellitus/diagnóstico , Feminino , Humanos , Masculino , Neoplasias/diagnóstico , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Adulto Jovem
14.
Nutr Metab Cardiovasc Dis ; 30(9): 1544-1553, 2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32571613

RESUMO

BACKGROUND AND AIMS: Pediatric obesity associates with both low-grade inflammation and cardiometabolic risk on the population level. Yet on an individual patient level, overweight/obesity does not always equal increased cardiometabolic risk. In this study, we examine whether low-grade inflammation associates with cardiometabolic risk in Danish children, independent of degree of adiposity. We further assess the value of integrating multiple inflammation markers to identify children with very-high cardiometabolic risk profiles. METHOD AND RESULTS: We studied 2192 children and adolescents aged 6-18 years from an obesity clinic cohort and a population-based cohort, in a cross-sectional study design. Anthropometry, blood pressure, pubertal stage and body composition by dual-energy X-ray absorptiometry were assessed, and biomarkers including fasting serum high sensitivity C-reactive protein (hsCRP), white blood cells (WBC), resistin, lipid profile and glucose metabolism were measured. Adjusted correlation analysis and odds ratios were calculated. We found that, independent of degree of adiposity, having high-normal inflammation marker concentrations associated with increased cardiometabolic risk: for girls, hsCRP >0.57-9.98 mg/L (mid/upper tertile) associated with ~2-fold higher odds of dyslipidemia and hepatic steatosis (vs. lower tertile). For both sexes, WBC >7.0-12.4 109/L (upper tertile) associated with 2.5-fold higher odds of insulin resistance. Lastly, children with multiple inflammation markers in the high-normal range exhibited the most severe cardiometabolic risk profile. CONCLUSION: Low-grade inflammation associates with cardiometabolic risk in children independent of degree of adiposity. The associations vary with sex and inflammation marker measured. Finally, integrating multiple low-grade inflammation markers identifies a very-high-risk subgroup of children with overweight/obesity and may have clinical value.


Assuntos
Mediadores da Inflamação/sangue , Inflamação/epidemiologia , Síndrome Metabólica/epidemiologia , Obesidade Pediátrica/epidemiologia , Adiposidade , Adolescente , Fatores Etários , Biomarcadores/sangue , Glicemia/metabolismo , Criança , Comorbidade , Estudos Transversais , Dinamarca/epidemiologia , Feminino , Humanos , Inflamação/sangue , Inflamação/diagnóstico , Inflamação/fisiopatologia , Resistência à Insulina , Lipídeos/sangue , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Obesidade Pediátrica/sangue , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Prognóstico , Medição de Risco , Fatores de Risco , Fatores Sexuais
15.
Obesity (Silver Spring) ; 28(8): 1382-1385, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32352652

RESUMO

OBJECTIVE: The aim of this study was to test the hypothesis that youths with obesity, when removed from structured school activities and confined to their homes during the coronavirus disease 2019 pandemic, will display unfavorable trends in lifestyle behaviors. METHODS: The sample included 41 children and adolescents with obesity participating in a longitudinal observational study located in Verona, Italy. Lifestyle information including diet, activity, and sleep behaviors was collected at baseline and 3 weeks into the national lockdown during which home confinement was mandatory. Changes in outcomes over the two study time points were evaluated for significance using paired t tests. RESULTS: There were no changes in reported vegetable intake; fruit intake increased (P = 0.055) during the lockdown. By contrast, potato chip, red meat, and sugary drink intakes increased significantly during the lockdown (P value range, 0.005 to < 0.001). Time spent in sports activities decreased by 2.30 (SD 4.60) h/wk (P = 0.003), and sleep time increased by 0.65 (SD 1.29) h/d (P = 0.003). Screen time increased by 4.85 (SD 2.40) h/d (P < 0.001). CONCLUSIONS: Recognizing these adverse collateral effects of the coronavirus disease 2019 pandemic lockdown is critical in avoiding depreciation of weight control efforts among youths afflicted with excess adiposity. Depending on duration, these untoward lockdown effects may have a lasting impact on a child's or adolescent's adult adiposity level.


Assuntos
Infecções por Coronavirus/epidemiologia , Dieta , Estilo de Vida , Obesidade Pediátrica/fisiopatologia , Pneumonia Viral/epidemiologia , Isolamento Social , Adolescente , Betacoronavirus , Criança , Exercício Físico , Comportamento Alimentar , Feminino , Alimentos , Humanos , Itália/epidemiologia , Estudos Longitudinais , Masculino , Pandemias , Sono , Inquéritos e Questionários
16.
BMC Cardiovasc Disord ; 20(1): 231, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429858

RESUMO

BACKGROUND: Children with congenital heart disease (CHD) have an elevated risk of future cardiovascular disease but the underlying mechanisms are unclear. Abdominal obesity (measured as waist circumference) is a risk factor for adult onset of cardiovascular diseases and is correlated with low physical activity levels, commonly found in children with congenital heart disease. Elevated waist circumference may be a mechanism by which cardiovascular disease risk is elevated in children with CHD. The purpose of this study was to compare waist circumference between children with and without CHD, while considering potential confounders. We hypothesized that children with CHD would have higher measures of waist circumference when controlling for differences in birthweight, lean mass, and physical activity. METHODS: Thirty-two children with CHD (10.9 ± 2.6 years; 12 female) from the Children's Healthy-Heart Activity Monitoring Program in Saskatchewan, and 23 healthy controls (11.7 ± 2.5 years; 10 female) were studied. Waist circumference, physical activity (physical activity questionnaire), body composition (lean mass; dual x-ray absorptiometry), and birthweight were assessed. Analysis of covariance, Mann-Whitney U, and independent sample t-tests were used to assess group differences (p < 0.05). RESULTS: Children with CHD had greater waist circumference than controls, controlling for lean mass, physical activity, birthweight, and sex (F (1, 49) = 4.488, p = 0.039). Physical activity, lean mass, and birthweight were not significantly different between groups (p > 0.05). CONCLUSION: Our findings generate a novel hypothesis-higher waist circumferences in children with CHD compared to age-matched controls, may contribute to an elevated risk of cardiovascular disease.


Assuntos
Cardiopatias Congênitas/complicações , Obesidade Abdominal/diagnóstico , Obesidade Pediátrica/diagnóstico , Circunferência da Cintura , Adolescente , Fatores Etários , Estudos de Casos e Controles , Criança , Estudos Transversais , Feminino , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/fisiopatologia , Cardiopatias Congênitas/terapia , Humanos , Masculino , Obesidade Abdominal/complicações , Obesidade Abdominal/fisiopatologia , Obesidade Pediátrica/complicações , Obesidade Pediátrica/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco , Saskatchewan
17.
BMC Cardiovasc Disord ; 20(1): 239, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429894

RESUMO

BACKGROUND: This study evaluated the association of frequency of potato and rice consumption with cardiometabolic risk factors in children and adolescents. METHODS: This nationwide cross-sectional survey was conducted on 14,400 children and adolescents. Fasting blood was obtained from a sub-sample of 4200 randomly selected students. Physical examination and laboratory tests were conducted under standard protocols. Metabolic Syndrome (Mets) was defined based on the Adult Treatment Panel III criteria modified for the pediatric age group. The self-reported frequency consumption of white rice and potato was reported on a daily or non-daily basis. RESULTS: The participation rate for the whole study and for blood sampling were 99 and 91.5%, respectively. Overall, 49.4% of the participants were girls while 50.6% were boys. The frequency of daily consumption of white rice and potato was 84.4 and 21.3%, respectively. In the multivariable linear regression model, daily consumption of potato increased body mass index (ß: 0.05, SE: 0.20, p = 0.010), waist (ß: 0.63, SE: 0.24, p = 0.008), and hip circumferences (ß: 0.62, SE: 0.26, p = 0.019). Moreover, in the multivariable logistic regression, daily consumption of potato was significantly associated with an increased risk of overweight (OR: 1.21, 95% CI: 1.04-1.39, P = 0.012). The potato and rice consumption had no statistically significant association with other cardiometabolic risk factors. CONCLUSIONS: Daily consumption of potato was significantly associated with higher anthropometric measures, whereas rice consumption had no statistically significant association with cardiometabolic risk factors. Future research to examine the possible obesogenic effects of intake of potato on children and adolescents is recommended.


Assuntos
Carboidratos da Dieta/efeitos adversos , Síndrome Metabólica/epidemiologia , Oryza/efeitos adversos , Obesidade Pediátrica/epidemiologia , Solanum tuberosum/efeitos adversos , Adolescente , Fatores Etários , Criança , Estudos Transversais , Inquéritos sobre Dietas , Carboidratos da Dieta/administração & dosagem , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Estado Nutricional , Valor Nutritivo , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/fisiopatologia , Recomendações Nutricionais , Medição de Risco , Fatores de Risco
18.
J Pediatr ; 221: 181-187.e1, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32446478

RESUMO

OBJECTIVE: To study leukocyte-endothelium interaction, a measure of the initial phase of atheromatosis, in children with overweight or obesity. STUDY DESIGN: A prospective study was conducted in 77 children aged 7-16 years; 47 were children with overweight/obesity and 30 were normal weight. Polymorphonuclear neutrophils (PMNs) and peripheral blood mononuclear cells were isolated from venous blood samples and the interaction of leukocytes over a monolayer of human umbilical vein endothelial cells was analyzed using flow chamber microscopy. The variables studied included leukocyte rolling velocity, rolling flux, and adhesion to endothelial cells. These were compared between children with overweight/obesity and control children. Correlation between the measures of leukocyte-endothelium interaction and anthropometric and biochemical variables was evaluated. RESULTS: In comparison with normal weight children, the PMNs and peripheral blood mononuclear cells of the overweight/obesity group showed a reduction in rolling velocity (P = .000 and P = .001, respectively) and an increase in rolling flux (P = .001 and P = .004), and adhesion (P = .003 and P = .002). The homeostasis model of insulin resistance was correlated inversely with rolling velocity and positively with rolling flux in PMNs. C-reactive protein was correlated positively with rolling flux and adhesion in both types of leucocytes. Fat mass index was correlated with all measures of leukocyte-endothelial interaction and proved to be the main predictor of leukocyte adhesion in the multiple regression analysis (P = .001 for PMNs and P = .006 for peripheral blood mononuclear cells). CONCLUSIONS: Excess fat mass in children is related to the activation of the leukocyte-endothelium interaction, potentially contributing to the development of atherosclerosis.


Assuntos
Células Endoteliais/fisiologia , Leucócitos Mononucleares/fisiologia , Obesidade Pediátrica/fisiopatologia , Adolescente , Proteína C-Reativa/análise , Estudos de Casos e Controles , Adesão Celular/fisiologia , Movimento Celular/fisiologia , Criança , Feminino , Humanos , Resistência à Insulina/fisiologia , Masculino , Neutrófilos/fisiologia , Estudos Prospectivos
19.
Nutr Metab Cardiovasc Dis ; 30(5): 822-828, 2020 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-32278607

RESUMO

BACKGROUND AND AIM: This study aimed to: i) examine the differences in insulin resistance (IR) across adiposity levels; and ii) ascertain whether high levels of adiponectin attenuate the detrimental association of adiposity with IR in adolescents. METHODS AND RESULTS: A total of 529 adolescents aged 12-18 years participated in this cross-sectional study (267 girls). Anthropometry and body adiposity parameters [body mass index (BMI), sum of skinfolds, body fat percentage (BF %) by bio-impedance analysis and waist circumference (WC)], were measured according to standardized procedures and categorized into age- and sex-specific quartiles. Socioeconomic status, pubertal stage and lifestyle determinants (Mediterranean diet adherence and cardiorespiratory fitness) were gathered and used as confounders. Serum adiponectin and IR (homeostasis model assessment of insulin resistance [HOMA-IR] estimated from fasting serum insulin and glucose were assessed. Analysis of covariance (ANCOVA) showed that HOMA-IR increased in a linear fashion throughout the quartiles of all adiposity measures (p < 0.001 for all), independently of age, sex, pubertal stage, socioeconomic status, adherence to the Mediterranean diet and cardiorespiratory fitness. Two-way ANCOVA showed that adolescents in the higher quartile of adiposity for BF%, BMI, WC and skinfolds sum (Q4) presented the highest adiponectin levels, and had 0.77 Standard Deviation (SD), 0.8 SD, 0.85 SD and 0.8 SD lower HOMA-IR, respectively (p < 0.01) than their low adiponectin group counterparts, after adjustments for potential confounders. CONCLUSION: Higher adiponectin levels may attenuate the detrimental association between adiposity and IR, particularly in subjects with higher adiposity.


Assuntos
Adiponectina/sangue , Adiposidade , Resistência à Insulina , Síndrome Metabólica/sangue , Obesidade Pediátrica/sangue , Adolescente , Fatores Etários , Biomarcadores/sangue , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/fisiopatologia , Portugal/epidemiologia , Medição de Risco , Fatores de Risco , Regulação para Cima
20.
Ethiop J Health Sci ; 30(1): 143-146, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32116443

RESUMO

Background: Projection of the effectiveness of house-hold physical activity may be a vital tool to improve active lifestyle. Although ampe is a common house-hold recreational physical activity among all population groups especially school children in Ghana, no empirical evidence of its effects on the anthropometric and physiological parameters of the children. This pilot study examined the effect of ampe exercise programme on the anthropometric and physiological parameters of school children. Methods: Purposive and stratified sampling techniques were applied to recruit 78 school children (ages of 9 to 12, mean age of 10.65±0.94 years). The participants attended 40 minutes of ampe exercise program three times per week, for four weeks consecutively. Body mass index, waist circumference, hip circumference, waist-to-hip ratio; % body fat, diastolic blood pressure, systolic blood pressure and heart rate were measured prepost training. Results: Ampe exercise programme produced positive effects on all parameters. Body weight (0.31%) and body mass index (0.58%) decreased significantly (P<0.05). Systolic blood pressure (3.15%), diastolic blood pressure (1.92%) and heart rate (2.13) significantly improved (P<0.05). CONCLUSION: Ampe exercise programme is effective as paediatric obesity house-hold intervention to provide the impetus for active lifestyles of school children.


Assuntos
Antropometria , Terapia por Exercício/métodos , Exercício Físico , Obesidade Pediátrica/terapia , Estudantes/estatística & dados numéricos , Pressão Sanguínea , Índice de Massa Corporal , Peso Corporal , Criança , Feminino , Gana , Humanos , Estilo de Vida , Masculino , Obesidade Pediátrica/fisiopatologia , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Circunferência da Cintura , Relação Cintura-Quadril
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