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Frontiers in Endocrinology 2023The aim of present meta-analysis was to determine the effects of exercise training (Exe) on insulin resistance (IR) and body weight in children and adolescents with... (Meta-Analysis)
Meta-Analysis
AIM
The aim of present meta-analysis was to determine the effects of exercise training (Exe) on insulin resistance (IR) and body weight in children and adolescents with overweight or obesity.
METHODS
PubMed, Web of Science, and Scopus were searched for original articles, published through October 2022 that included exercise versus control interventions on fasting glucose, insulin, HOMA-IR, and body weight outcomes in children and adolescents with overweight or obesity. Standardized mean differences (SMD) for fasting insulin, and weighted mean differences (WMD) for fasting glucose, HOMA-IR, body weight (BW), and 95% confidence intervals were determined using random effects models.
RESULTS
Thirty-five studies comprising 1,550 children and adolescents with overweight and obesity were included in the present meta-analysis. Exercise training reduced fasting glucose (WMD=-2.52 mg/dL, p=0.001), fasting insulin (SMD=-0.77, p=0.001), HOMA-IR (WMD=-0.82, p=0.001), and BW (WMD=-1.51 kg, p=0.001), as compared to a control. Subgroup analyses showed that biological sex, intervention duration, type of exercise training, BMI percentile, and health status (with or without diagnosed condition), were sources of heterogeneity.
CONCLUSION
Exercise training is effective for lowering fasting glucose, fasting insulin, HOMA-IR, and BW in children and adolescents with overweight or obesity and could provide an important strategy for controlling IR and related factors. With clear evidence for the effectiveness of exercise interventions in this vulnerable population, it is important to determine effective approaches for increasing exercise training in children and adolescents with overweight or obesity.
Topics: Adolescent; Child; Humans; Body Weight; Exercise; Glucose; Insulin; Insulin Resistance; Overweight; Pediatric Obesity
PubMed: 37635963
DOI: 10.3389/fendo.2023.1178376 -
Preventive Medicine Reports Oct 2023Sleep restriction in children can trigger the development of problems such as impaired cognition, behavioral problems, cardiovascular problems, and obesity. In addition,... (Review)
Review
Sleep restriction in children can trigger the development of problems such as impaired cognition, behavioral problems, cardiovascular problems, and obesity. In addition, the inflammatory profile of children can also be influenced by sleep restriction. The aimed to review and analyze the association between time and sleep quality with inflammatory biomarkers in children and adolescents. Three electronic databases (MEDLINE, Web of Science and Scopus) were searched from August 30, 2022. The search strategy used the following descriptors: children and adolescents; sleep, and inflammatory profile. This review protocol is registered in the PROSPERO database (CRD42020188969). We obtained 2.724 results of articles with potentially relevant titles. Sixteen percent of the articles were excluded because they were duplicates, 84.3% were excluded after reading the title, and 0.9% were studied from systematic reviews or textbooks (0.9%). Accelerometers are the most commonly used method for the objective measurement of sleep time, while the PSQI questionnaire is the most commonly used subjective method to measure sleep quality. The results indicated an inconsistent association between sleep time and CRP in the literature. Sixty percent of studies used the Pittsburgh Sleep Quality Index (PSQI) for subjective assessment of sleep quality and possible sleep disorders. However, only one retrieved study showed significant association between sleep quality and CRP. Thus, sleep time does not present significant association with inflammatory biomarkers; whereas, poor sleep quality shows positive association with CRP with a lower magnitude.
PubMed: 37519445
DOI: 10.1016/j.pmedr.2023.102327 -
Clinical Oral Investigations Dec 2023To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in... (Meta-Analysis)
Meta-Analysis Review
Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of non-surgical periodontal treatment in patients with concurrent systemic conditions.
OBJECTIVE
To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in patients with concurrent systemic conditions (diabetes, CVD, erectile dysfunction, chronic kidney disease, rheumatoid arthritis, polycystic ovarian syndrome, obesity, pregnancy). We hypothesised that NSPT results in better periodontal outcomes when compared to untreated controls after follow-up.
MATERIALS AND METHODS
A systematic search (PUBMED/EMBASE) was conducted from 1995 to 2023 to identify randomised controlled trials (RCTs) with a minimum follow-up of 3 months. The primary outcome was the difference in mean probing depth (PD), and the secondary outcomes were mean clinical attachment loss (CAL), percentage of sites with PD ≤ 3 mm (%PD ≤ 3 mm) and percentage of sites with bleeding on probing (%BOP) between the treated and untreated control group in patients with comorbidities.
RESULTS
The electronic search resulted in 2,403 hits. After removing duplicates, 1,565 titles and abstracts were screened according to the eligibility criteria, resulting in 126 articles for full-text screening. Following this, 44 studies were analysed. Restricting to studies with low bias or some concerns, NSPT group demonstrated a 0.55 mm lower mean PD (95%CI: -0.69; -0.41) after 3 months compared to the control group.
CONCLUSION
Compared to the untreated controls, NSPT notably reduced mean PD, mean CAL, and %BOP while increasing %PD ≤ 3 mm in patients with concurrent systemic conditions. These findings suggest that NSPT is also an effective procedure in managing periodontitis in patients with concurrent systemic conditions.
TRIAL REGISTRATION
This systematic review was registered under the protocol registration number CRD42021241517/PROSPERO.
Topics: Male; Female; Pregnancy; Humans; Randomized Controlled Trials as Topic; Dental Care; Patients; Arthritis, Rheumatoid; Periodontitis
PubMed: 38147183
DOI: 10.1007/s00784-023-05392-6 -
Obesity Reviews : An Official Journal... Feb 2021A growing body of research links traffic-related environmental factors to childhood obesity; however, the evidence is still inconclusive. This review aims to fill this... (Meta-Analysis)
Meta-Analysis
A growing body of research links traffic-related environmental factors to childhood obesity; however, the evidence is still inconclusive. This review aims to fill this important research gap by systematically reviewing existing research on the relationship between traffic-related environmental factors and childhood obesity. Based on the inclusion criteria, 39 studies are selected with environmental factors of interest, including traffic flow, traffic pollution, traffic noise, and traffic safety. Weight-related behaviours include active travel/transport, physical activity (PA), and intake of a high trans-fat diet or stress symptoms; weight-related outcomes are mainly body mass index (BMI) or BMI z-scores and overweight/obesity. Of 16 studies of weight-related behaviours, significant associations are reported in 11 out of 12 studies on traffic flow (two positively and nine negatively associated with PA), five out of six studies on traffic safety (four positively and one negatively associated with PA), one study on traffic pollution (positively with unhealthy food consumption), and one study on traffic noise (negatively associated with PA). Among 23 studies of weight-related outcomes, significant associations are reported in six out of 14 studies on traffic flow (five positively and one negatively associated with obesity outcome), seven out of 10 studies on traffic pollution (all positively associated with obesity outcome), and two out of five on traffic noise (all positively associated with obesity outcome). Our findings show that long-term traffic pollution is weakly positively associated with children's BMI growth, and traffic flow, pollution, and noise could affect weight-related behaviours. Associations between traffic density and noise and weight status are rather inconclusive.
Topics: Body Mass Index; Child; Exercise; Humans; Overweight; Pediatric Obesity
PubMed: 32003149
DOI: 10.1111/obr.12995 -
Obesity Reviews : An Official Journal... Feb 2021The lack of access to fruit/vegetable markets (FVMs) is thought to be a risk factor for childhood obesity by discouraging healthy dietary behaviours while encouraging...
The lack of access to fruit/vegetable markets (FVMs) is thought to be a risk factor for childhood obesity by discouraging healthy dietary behaviours while encouraging access to venues that offer more unhealthy food (and thus the compensatory intake of those options). However, findings remain mixed, and there has not been a review of the association between FVM access and childhood obesity. A comprehensive and systematic understanding of this epidemiologic relationship is important to the design and implementation of relevant public health policies. In this study, a literature search was conducted in the Cochrane Library, PubMed, and Web of Science for articles published before 1 January 2019 that focused on the association between neighbourhood FVM access and weight-related behaviours and outcomes among children and adolescents. Eight cross-sectional studies, two longitudinal studies, and one ecological study conducted in five countries were identified. The median sample size was 2142 ± 1371. Weight-related behaviours and outcomes were used as the outcome variable in two and eight studies, respectively, with one study using both weight-related behaviours and outcomes as outcome variables. We still found a negative association between access to FVMs in children's residential and school neighbourhoods and weight-related behaviours and an inconclusive association between FVM access and overweight or obesity. This conclusion should be regarded as provisional because of a limited amount of relevant evidence and may not be a strong guide for policymaking. Nonetheless, it points to an important research gap that needs to be filled if successful public health interventions are to be undertaken.
Topics: Adolescent; Child; Cross-Sectional Studies; Diet; Fruit; Humans; Pediatric Obesity; Vegetables
PubMed: 31943666
DOI: 10.1111/obr.12980 -
Italian Journal of Pediatrics Mar 2023Childhood obesity is increasing all over the world. It is associated with a reduction in quality of life and a relevant burden on society costs. This systematic review... (Review)
Review
Childhood obesity is increasing all over the world. It is associated with a reduction in quality of life and a relevant burden on society costs. This systematic review deals with the cost-effectiveness analysis (CEA) of primary prevention programs on childhood overweight/obesity, in order to benefit from cost-effective interventions.We screened and evaluated all the studies with a cost-effectiveness analysis on childhood obesity primary prevention program by PUBMED and Google Scholar, using inclusion and exclusion criteria. The quality of the studies was assessed by Drummond's checklist.Ten studies were included. Two of them examined the cost-effectiveness of community-based prevention programs, four focused only on school-based programs while four more studies examined both community-based and school-based programs. The studies were different in terms of study design, target population, health and economic outcomes. Seventy per cent of the works had positive economic results.The majority of the studies showed effective economic outcomes applying primary prevention programs on childhood obesity. It is important to increase homogeneity and consistency among different studies.
Topics: Child; Humans; Pediatric Obesity; Cost-Benefit Analysis; Quality of Life; Cost-Effectiveness Analysis; Primary Prevention
PubMed: 36864472
DOI: 10.1186/s13052-023-01424-9 -
International Journal of Obesity (2005) Feb 2024Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are potentially obesogenic for children. We undertook a systematic review to synthesize this literature and explore... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are potentially obesogenic for children. We undertook a systematic review to synthesize this literature and explore sources of heterogeneity in previously published epidemiological studies.
METHODS
Studies that collected individual-level PFAS and anthropometric data from children up to 12 years of age were identified by searching six databases. We excluded studies that only evaluated obesity measures at the time of birth. A full-text review and quality assessment of the studies was performed using the Office of Health Assessment and Translation (OHAT) criteria. Forest plots were created to summarize measures of association and assess heterogeneity across studies by chemical type and exposure timing. Funnel plots were used to assess small-study effects.
RESULTS
We identified 24 studies, of which 19 used a cohort design. There were 13 studies included in the meta-analysis examining various chemicals and outcomes. Overall prenatal exposures to four different types of PFAS were not statistically associated with changes in body mass index (BMI) or waist circumference. In contrast, for three chemicals, postnatal exposures were inversely related to changes in BMI (i.e., per log10 increase in PFOS: BMI z-score of -0.16 (95% CI: -0.22, -0.10)). There was no substantial heterogeneity in the reported measures of association within prenatal and postnatal subgroups. We observed modest small-study effects, but correction for these effects using the Trim and Fill method did not change our summary estimate(s).
CONCLUSION
Our review found no evidence of a positive association between prenatal PFAS exposure and pediatric obesity, whereas an inverse association was found for postnatal exposure. These findings should be interpreted cautiously due to the small number of studies. Future research that can inform on the effects of exposure mixtures, the timing of the exposure, outcome measures, and the shape of the exposure-response curve is needed.
Topics: Pregnancy; Child; Female; Humans; Pediatric Obesity; Body Mass Index; Fluorocarbons; Environmental Pollutants
PubMed: 37907715
DOI: 10.1038/s41366-023-01401-6 -
BMC Public Health Aug 2017Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD) risk factors during childhood and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD) risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap.
METHODS
Studies were included if they met the following criteria: (1) longitudinal and cohort studies (including case-cohort), (2) childhood exposure and adult outcomes collected on the same individual over time, (3) childhood obesity, as defined by the original study authors, (4) English-language articles, (5) studies published up to June, 2015, (6) one or more of the following CVD risk factors [systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), and triglycerides (TG)], (7) outcome(s) not self-reported, and (8) exposure measurements (child's adiposity) assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher's r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed.
RESULTS
Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and positively associated with adult SBP (Zr = 0.11; 95% CI: 0.07, 0.14), DBP (Zr = 0.11; 95% CI: 0.07, 0.14), and TG (Zr =0.08; 95% CI: 0.03, 0.13), and significantly and inversely associated with adult HDL (Zr = -0.06; 95% CI: -0.10, -0.02). For those studies that adjusted for adult body mass index (BMI), associations were reversed, suggesting that adult BMI may be a potential mediator. Nine studies had more than 33% of items that placed them at an increased risk for bias.
CONCLUSIONS
The results of this study suggest that childhood obesity may be a risk factor for selected adult CVD risk factors. However, a need exists for additional, higher-quality studies that include, but are not limited to, both unadjusted and adjusted measures such as BMI before any definitive conclusions can be reached.
SYSTEMATIC REVIEW AND META-ANALYSIS
PROSPERO 2015: CRD42015019763 .
Topics: Adiposity; Adolescent; Adult; Blood Pressure; Body Mass Index; Cardiovascular Diseases; Child; Cholesterol, HDL; Cholesterol, LDL; Cohort Studies; Humans; Mortality, Premature; Overweight; Pediatric Obesity; Risk Factors; Triglycerides
PubMed: 28851330
DOI: 10.1186/s12889-017-4691-z -
International Journal of Environmental... Jun 2022The dramatic lifestyle changes forced by COVID-19-related lockdown promoted weight gain, with a stronger impact on obese subjects, at higher risk of severe infection.... (Meta-Analysis)
Meta-Analysis
The dramatic lifestyle changes forced by COVID-19-related lockdown promoted weight gain, with a stronger impact on obese subjects, at higher risk of severe infection. The PubMed database was searched to identify original studies assessing: (1) the extent and risk factors of lockdown-induced weight increase; and (2) the impact of obesity on the risk of hospital admission in children and adolescents. A systematic literature review and meta-analyses were performed. Twenty out of 13,986 identified records were included. A significant weight increase was reported in the majority of subjects, with no apparent gender or age differences. It was induced by a higher consumption of hypercaloric/hyperglycemic/junk food and/or the reduction of physical activity, often associated with an altered sleep-wake cycle. On the other hand, obesity increased the risk of hospitalization (OR = 4.38; 95% C.I. 1.46-13.19; = 0.009; = 96%) as compared to the normal weight population. COVID-19 and obesity represent epidemic conditions with reciprocal detrimental impact. Urgent public health interventions, targeting the various age and social strata, and involving governmental authorities, health care personnel, teachers and families are warranted to increase awareness and actively promote healthy lifestyles to contrast pediatric obesity and its detrimental consequences at a global level.
Topics: Adolescent; COVID-19; Child; Communicable Disease Control; Exercise; Humans; Life Style; Pediatric Obesity; Weight Gain
PubMed: 35805260
DOI: 10.3390/ijerph19137603 -
JAMA Pediatrics Jul 2015Obesity affects nearly one-sixth of US children and results in alterations to body composition and physiology that can affect drug disposition, possibly leading to... (Review)
Review
IMPORTANCE
Obesity affects nearly one-sixth of US children and results in alterations to body composition and physiology that can affect drug disposition, possibly leading to therapeutic failure or toxic side effects. The depth of available literature regarding obesity's effect on drug safety, pharmacokinetics, and dosing in obese children is unknown.
OBJECTIVE
To perform a systematic literature review describing the current evidence of the effect of obesity on drug disposition in children.
EVIDENCE REVIEW
We searched the MEDLINE, Cochrane, and EMBASE databases (January 1, 1970-December 31, 2012) and included studies if they contained data on drug clearance, volume of distribution, or drug concentration in obese children (aged ≤18 years). We compared exposure and weight-normalized volume of distribution and clearance between obese and nonobese children. We explored the association between drug physicochemical properties and clearance and volume of distribution.
FINDINGS
Twenty studies met the inclusion criteria and contained pharmacokinetic data for 21 drugs. The median number of obese children studied per drug was 10 (range, 1-112) and ages ranged from newborn to 29 years (1 study described pharmacokinetics in children and adults together). Dosing schema varied and were either a fixed dose (6 [29%]) or based on body weight (10 [48%]) and body surface area (4 [19%]). Clinically significant pharmacokinetic alterations were observed in obese children for 65% (11 of 17) of the studied drugs. Pharmacokinetic alterations resulted in substantial differences in exposure between obese and nonobese children for 38% (5 of 13) of the drugs. We found no association between drug lipophilicity or Biopharmaceutical Drug Disposition Classification System class and changes in volume of distribution or clearance due to obesity.
CONCLUSIONS AND RELEVANCE
Consensus is lacking on the most appropriate weight-based dosing strategy for obese children. Prospective pharmacokinetic trials in obese children are needed to ensure therapeutic efficacy and enhance drug safety.
Topics: Body Composition; Body Weight; Child; Child, Preschool; Drug Dosage Calculations; Humans; Metabolic Clearance Rate; Obesity; Pharmacokinetics
PubMed: 25961828
DOI: 10.1001/jamapediatrics.2015.132