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Nutrients Apr 2022Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are... (Review)
Review
Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.
Topics: Africa South of the Sahara; Child, Preschool; Home Environment; Humans; Obesity; Overweight; Risk Factors
PubMed: 35565675
DOI: 10.3390/nu14091706 -
Microbiology Spectrum Apr 2022Diet and gut microbiota are known to modulate metabolic health. Our aim was to apply a metagenomics approach to investigate whether the diet-gut microbiota-metabolism...
Diet and gut microbiota are known to modulate metabolic health. Our aim was to apply a metagenomics approach to investigate whether the diet-gut microbiota-metabolism and inflammation relationships differ in pregnant overweight and obese women. This cross-sectional study was conducted in overweight ( = 234) and obese ( = 152) women during early pregnancy. Dietary quality was measured by a validated index of diet quality (IDQ). Gut microbiota taxonomic composition and species diversity were assessed by metagenomic profiling (Illumina HiSeq platform). Markers for glucose metabolism (glucose, insulin) and low-grade inflammation (high sensitivity C-reactive protein [hsCRP], glycoprotein acetylation [GlycA]) were analyzed from blood samples. Higher IDQ scores were positively associated with a higher gut microbiota species diversity ( = 0.273, = 0.007) in obese women, but not in overweight women. Community composition (beta diversity) was associated with the GlycA level in the overweight women (= 0.04) but not in the obese. Further analysis at the species level revealed a positive association between the abundance of species Alistipes finegoldii and the GlycA level in overweight women (logfold change = 4.74, = 0.04). This study has been registered at ClinicalTrials.gov under registration no. NCT01922791 (https://clinicaltrials.gov/ct2/show/NCT01922791). We observed partially distinct diet-gut microbiota-metabolism and inflammation responses in overweight and obese pregnant women. In overweight women, gut microbiota community composition and the relative abundance of A. finegoldii were associated with an inflammatory status. In obese women, a higher dietary quality was related to a higher gut microbiota diversity and a healthy inflammatory status.
Topics: Cross-Sectional Studies; Diet; Feces; Female; Humans; Inflammation; Metagenomics; Microbiota; Obesity; Overweight; Pregnancy; Pregnant Women
PubMed: 35343768
DOI: 10.1128/spectrum.00893-21 -
The Journal of Clinical Endocrinology... Dec 2022Maternal dysglycaemia and prepregnancy obesity are associated with adverse offspring outcomes. Epigenetic mechanisms such as DNA methylation (DNAm) could contribute. (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
Maternal dysglycaemia and prepregnancy obesity are associated with adverse offspring outcomes. Epigenetic mechanisms such as DNA methylation (DNAm) could contribute.
OBJECTIVE
To examine relationships between maternal glycaemia, insulinemic status, and dietary glycemic indices during pregnancy and an antenatal behavioral-lifestyle intervention with newborn DNAm.
METHODS
We investigated 172 women from a randomized controlled trial of a lifestyle intervention in pregnant women who were overweight or obese. Fasting glucose and insulin concentrations and derived indices of insulin resistance (HOMA-IR), β-cell function (HOMA-%B), and insulin sensitivity were determined at baseline (15) and 28 weeks' gestation. Dietary glycemic load (GL) and index (GI) were calculated from 3-day food diaries. Newborn cord blood DNAm levels of 850K CpG sites were measured using the Illumina Infinium HumanMethylationEPIC array. Associations of each biomarker, dietary index and intervention with DNAm were examined.
RESULTS
Early pregnancy HOMA-IR and HOMA-%B were associated with lower DNAm at CpG sites cg03158092 and cg05985988, respectively. Early pregnancy insulin sensitivity was associated with higher DNAm at cg04976151. Higher late pregnancy insulin concentrations and GL scores were positively associated with DNAm at CpGs cg12082129 and cg11955198 and changes in maternal GI with lower DNAm at CpG cg03403995 (Bonferroni corrected P < 5.99 × 10-8). These later associations were located at genes previously implicated in growth or regulation of insulin processes. No effects of the intervention on cord blood DNAm were observed. None of our findings were replicated in previous studies.
CONCLUSION
Among women who were overweight or obese, maternal pregnancy dietary glycemic indices, glucose, and insulin homeostasis were associated with modest changes in their newborn methylome.
TRIAL REGISTRATION
ISRCTN29316280.
Topics: Infant, Newborn; Female; Pregnancy; Humans; Overweight; DNA Methylation; Insulin Resistance; Obesity; Insulin; Glucose
PubMed: 36137169
DOI: 10.1210/clinem/dgac553 -
BMC Public Health Sep 2021This study was done as part of a larger study that aims to identify the most impactful and cost-effective strategies for the prevention and control of overweight and...
BACKGROUND
This study was done as part of a larger study that aims to identify the most impactful and cost-effective strategies for the prevention and control of overweight and obesity in Kenya. Our objective was to involve stakeholders in the identification of the strategies that would be included in our larger study. The results from the stakeholder engagement are analyzed and reported in this paper.
DESIGN
This was a qualitative study. A one-day stakeholder workshop that followed a deliberative dialogue process was conducted.
PARTICIPANTS
A sample of stakeholders who participate in the national level policymaking process for health in Kenya.
OUTCOME MEASURE
Strategies for the prevention and control of overweight and obesity in Kenya.
RESULTS
Out of the twenty-three stakeholders who confirmed attendance, fifteen participants attended the one-day workshop. The stakeholders identified a total of 24 strategies for the prevention and control of overweight and obesity in Kenya. From the ranking process carried out the top six strategies identified were: a research-based strategy for the identification of the nutritional value of indigenous foods, implementation of health promotion strategies that focus on the creation of healthy environments, physical activity behavior such as gym attendance, jogging, walking, and running at the individual level, implementation of school curricula on nutrition and health promotion, integration of physical education into the new Competency-Based Education policy, and policies that increase use of public transport.
CONCLUSION
The stakeholders identified and ranked strategies for the prevention and control of overweight and obesity in Kenya. This informs future overweight and obesity prevention research and policy in Kenya and similar settings.
Topics: Health Promotion; Humans; Kenya; Obesity; Overweight; Schools
PubMed: 34488690
DOI: 10.1186/s12889-021-11649-0 -
BMJ Open Apr 2022To determine the prevalence and associated factors of overweight and obesity among primary school children (6-11 years old) in Thanhhoa city in 2021.
OBJECTIVE
To determine the prevalence and associated factors of overweight and obesity among primary school children (6-11 years old) in Thanhhoa city in 2021.
DESIGN
Cross-sectional study.
SETTING
Seven primary schools in Thanhhoa city, Vietnam.
PARTICIPANTS
782 children (and their parents).
PRIMARY AND SECONDARY OUTCOME MEASURES
Two-stage cluster random sampling was used for selecting children and data were collected from January to February 2021. A self-administrated questionnaire was designed for children and their parents. Children's height and weight were measured and body mass index (BMI)-for-age z-scores were computed using the WHO Anthro software V.1.0.4. Data were analysed using R software V.4.1.2. The associations between potential factors and childhood overweight/obesity were analysed through univariate and multivariate logistic regression analyses. Variables were selected using the Bayesian Model Averaging method.
RESULTS
The prevalence of overweight/obesity among primary school children in Thanhhoa city was 35.93% (overweight 21.61% and obesity 14.32%). The proportion of overweight girls was nearly equal to that of boys (20.78% and 22.52%, respectively, p=0.6152) while the proportion of boys with obesity was four times as many as that of girls (23.86% and 5.62%, respectively, p<0.0001). Child's sex was the factor significantly associated with childhood overweight/obesity. Boys had double the risk of being overweight/obese than girls (adjusted OR: aOR=2.48, p<0.0001). Other potential factors which may be associated with childhood overweight/obesity included mode of transport to school, the people living with the child, mother's occupation, father's education, eating confectionery, the total time of doing sports, and sedentary activities.
CONCLUSION
One in every three primary school children in Thanhhoa city were either overweight or obese. Parents, teachers and policy-makers can implement interventions in the aforementioned factors to reduce the rate of childhood obesity. In forthcoming years, longitudinal studies should be conducted to determine the causal relationships between potential factors and childhood overweight/obesity.
Topics: Bayes Theorem; Body Mass Index; Child; Cross-Sectional Studies; Female; Humans; Male; Overweight; Pediatric Obesity; Prevalence; Schools; Vietnam
PubMed: 35459674
DOI: 10.1136/bmjopen-2021-058504 -
The Journal of the American Osteopathic... Jun 2016Many factors contribute to the diagnosis of obesity in a patient. Anthropometric measurements, such as the waist circumference and percentage of body fat, are used in... (Review)
Review
Many factors contribute to the diagnosis of obesity in a patient. Anthropometric measurements, such as the waist circumference and percentage of body fat, are used in the newly released obesity algorithm to risk stratify patients. Staging methods, which use the identification of comorbidities and disease burden to assess the severity of obesity, can result in treating a patient sooner than if the traditional body mass index is used. Obesity is a growing concern in the medical field, and providing additional avenues through which to diagnose obesity and address obesity-related health risks can improve prevention efforts and lead to expedited weight management. Obesity is a growing concern in the medical field, and providing additional avenues through which to diagnose obesity and address obesity-related health risks can improve prevention efforts and lead to expedited weight management.
Topics: Algorithms; Body Mass Index; Humans; Obesity; Overweight
PubMed: 27214774
DOI: 10.7556/jaoa.2016.078 -
Canadian Family Physician Medecin de... Jun 2019To examine the mortality risk presented by normal-weight central obesity, to identify a clinical measure to aid in the identification of this phenotype, and to explore... (Review)
Review
OBJECTIVE
To examine the mortality risk presented by normal-weight central obesity, to identify a clinical measure to aid in the identification of this phenotype, and to explore the means for mitigation of this risk.
QUALITY OF EVIDENCE
Only prospective cohort studies (level II) comparing participants with central obesity at normal weight with those at higher levels of body mass index (BMI) were found. Good level I studies were available to demonstrate the effect of diet and exercise interventions on central obesity and mortality.
MAIN MESSAGE
Participants with atherogenic dyslipidemia who are centrally obese at normal BMI are at similar, and possibly higher, mortality risk compared with those who are centrally obese and overweight or obese according to their BMI. Waist-to-height ratio might be the most pragmatic clinical measure of central obesity. The Mediterranean diet is an effective intervention to prevent ongoing weight gain while reducing abdominal girth. Low levels of exercise can also reduce waist circumference. Weight loss need not be an objective.
CONCLUSION
A waist-to-height ratio exceeding 0.5 at normal BMI identifies elevated mortality risk for cardiometabolic disease. This risk might equal or exceed that of centrally obese patients who are overweight or obese. Modest dietary and exercise interventions can be effective in mitigation of this risk.
Topics: Body Mass Index; Body Weight; Cardiovascular Diseases; Humans; Obesity, Abdominal; Overweight; Risk Assessment; Risk Factors; Waist-Height Ratio
PubMed: 31189627
DOI: No ID Found -
International Journal of Environmental... Aug 2014The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this... (Review)
Review
BACKGROUND
The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies.
METHODS
A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and (7) studies that reported outcome data.
RESULTS
A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions.
DISCUSSION
Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.
Topics: Culture; Global Health; Humans; Overweight; Pediatric Obesity; Schools; Socioeconomic Factors; United States
PubMed: 25170684
DOI: 10.3390/ijerph110908940 -
International Journal of Obesity (2005) Mar 2024Mental disorders are important comorbidities in youth with obesity. Aim was to describe the clinical characteristics and outcome of youth with overweight or obesity...
BACKGROUND
Mental disorders are important comorbidities in youth with obesity. Aim was to describe the clinical characteristics and outcome of youth with overweight or obesity having comorbid mental disorders.
METHODS
Data from children, adolescents, and young adults (age 6-30 years) with overweight or obesity and mental disorders (depression, anxiety disorder, eating disorder, attention deficit disorder (ADHD)) from 226 centers in Germany and Austria participating in the Adiposity Patient Registry (APV) were analyzed and compared with those without reported mental disorders using regression modeling.
RESULTS
Mental health comorbidity was reported in a total of 3969 out of 114,248 individuals with overweight or obesity: 42.5% had ADHD, 31.3% anxiety disorders, 24.3% depression, and 12.9% eating disorders. Being male (OR 1.39 (95%CI 1.27;1.52)), of older age (1.42 (1.25;1.62)), or with extreme obesity (1.45 (1.30;1.63)) were most strongly associated with mental health comorbidity. Regression analysis showed that mean BMI-SDS was significantly higher in the group of individuals with depression and eating disorders (BMI-SDS 2.13 (lower; upper mean:2.09;2.16) and 2.22 (2.17;2.26)) compared to those without reported mental health comorbidity (BMI-SDS 2.008 (2.005;2.011); p < 0.001). In youth with ADHD, BMI-SDS was lower compared to those without reported mental disorders (BMI-SDS 1.91 (1.89;1.93) vs 2.008 (2.005;2.011); p < 0.001). Proportion of severe obesity was higher in individuals with depression (23.7%), anxiety disorders (17.8%), and eating disorders (33.3%), but lower in ADHD (10.3%), compared to those without reported mental disorders (13.5%, p < 0.002). Proportions of dyslipidaemia and abnormal carbohydrate metabolism were not different in youth with and without reported mental health comorbidity. BMI-SDS change after one year of lifestyle intervention program ranged between -0.22 and -0.16 and was similar in youth without and with different mental disorders.
CONCLUSION
Health care professionals caring for youth with overweight or obesity should be aware of comorbid mental disorders and regular mental health screening should be considered.
Topics: Child; Humans; Male; Adolescent; Young Adult; Adult; Female; Overweight; Mental Health; Obesity; Attention Deficit Disorder with Hyperactivity; Comorbidity; Obesity, Morbid
PubMed: 38195831
DOI: 10.1038/s41366-023-01449-4 -
Public Health Nutrition Aug 2023To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental...
OBJECTIVES
To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental risk factors associated with childhood overweight and obesity in urban Indonesia.
DESIGN
Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socio-economic background, children's diet, physical activity, screen time and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution.
SETTING
Public primary schools in Central Jakarta, sampled at random.
PARTICIPANTS
Children ( 1674) aged 6-13 years from 18 public primary schools.
RESULTS
Among the children, 31·0 % were overweight or obese. The prevalence of obesity was higher in boys (21·0 %) than in girls (12·0 %). Male sex and height (aOR = 1·67; 95 % CI 1·30, 2·14 and aOR = 1·16; 95 % CI 1·14, 1·18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR = 0·43; 95 % CI 0·37, 0·50). Maternal education was positively associated with children's BMI at the median of the Z-score distribution ( = 0·026). Dietary and physical activity risk scores were not associated with children's BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles ( = 0·022 and 0·023, respectively).
CONCLUSIONS
This study illustrated the demographic, behavioural and environmental risk factors for overweight and obesity among primary schoolchildren in a middle-income country. To foster healthy behaviours in primary schoolchildren, parents need to ensure a positive home food environment. Future sex-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.
Topics: Child; Female; Male; Humans; Overweight; Pediatric Obesity; Indonesia; Body Mass Index; Risk Factors
PubMed: 37138496
DOI: 10.1017/S1368980023000897