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Current Opinion in Pediatrics Feb 2023In 2020, obesity prevalence among US children reached 19.7%, impacting about 14.7 million children and adolescents. Food insecurity among children is also a public... (Review)
Review
PURPOSE OF REVIEW
In 2020, obesity prevalence among US children reached 19.7%, impacting about 14.7 million children and adolescents. Food insecurity among children is also a public health concern but has largely decreased or remained stable over the past decade, reaching 6.2% of US households with children in 2021. Given food insecurity and obesity's interconnected nature and their negative consequences on children's health, it is of interest to assess the Supplemental Nutrition Assistance Program's (SNAP's) impact on childhood food security, dietary quality, disease risk, and health outcomes.
RECENT FINDINGS
Evidence suggests that SNAP participants, including children, struggle to meet key dietary guidelines and perform poorly on key health indicators when compared with income-eligible and higher income nonparticipants. Children participating in SNAP were more likely to have elevated disease risk and consume more sugar-sweetened beverages (SSBs), more high-fat dairy, and more processed meats than income-eligible nonparticipants. However, research suggests that federal food assistance programs with more stringent nutrition standards - the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the National School Lunch Program (NSLP) and School Breakfast Program (SBP) - improve dietary quality, increase birth weight and gestation periods, and reduce childhood obesity, infant mortality and healthcare costs.
SUMMARY
After reviewing the evidence on SNAP's impacts on food insecurity, dietary quality, and health as well as research on the health impacts of other more successful federal food assistance programs, we provide three policy recommendations to strengthen SNAP's effectiveness as a health intervention for children and families.
Topics: Infant; Adolescent; Humans; Child; Female; Food Assistance; Poverty; Pediatric Obesity; Diet; Nutritional Status
PubMed: 36354297
DOI: 10.1097/MOP.0000000000001192 -
Frontiers in Endocrinology 2020
Topics: Health Status; Humans; Life Style; Metabolic Syndrome; Pediatric Obesity
PubMed: 33250860
DOI: 10.3389/fendo.2020.613703 -
Journal of Pediatric Endocrinology &... Apr 2018Obesity is highly prevalent in children under the age of 5 years, although its identification in infants under 2 years remains difficult. Several clinical prediction... (Review)
Review
Obesity is highly prevalent in children under the age of 5 years, although its identification in infants under 2 years remains difficult. Several clinical prediction models have been developed for obesity risk in early childhood, using a number of different predictors. The predictive capacity (sensitivity and specificity) of these models varies greatly, and there is no agreed risk threshold for the prediction of early childhood obesity. Of the existing models, only two have been practically utilized, but neither have been particularly successful. This commentary suggests how future research may successfully utilize existing early childhood obesity prediction models for intervention. We also consider the need for such models, and how targeted obesity intervention may be more effective than population-based intervention.
Topics: Body Weight; Child; Humans; Models, Statistical; Pediatric Obesity; Predictive Value of Tests; Prevalence
PubMed: 29668465
DOI: 10.1515/jpem-2018-0110 -
Ugeskrift For Laeger Aug 2021WHO declared obesity a disease in 1979 and has named childhood obesity one of the most pervasive health challenges in the 21st century. The Danish Paediatric Society... (Review)
Review
WHO declared obesity a disease in 1979 and has named childhood obesity one of the most pervasive health challenges in the 21st century. The Danish Paediatric Society concordantly declares childhood obesity a chronic disease. Early treatment of obesity can prevent the disease from escalating into significant psychosocial and somatic complications arising in most organs with the potential to compromise normal growth and development. As argued in this review, the recognition of childhood obesity as a disease will help to increase the development of new treatment measures and health policies to prevent and manage obesity.
Topics: Adolescent; Child; Chronic Disease; Humans; Pediatric Obesity
PubMed: 34378524
DOI: No ID Found -
The Lancet. Global Health Aug 2023
Topics: Humans; Child; Pediatric Obesity; Risk Factors
PubMed: 37474221
DOI: 10.1016/S2214-109X(23)00284-X -
JPMA. the Journal of the Pakistan... Oct 2022Syndromic obesity is sometimes encountered in clinical practice, but may often be misdiagnosed. This is more often seen in the south Asian region due to higher rates of...
Syndromic obesity is sometimes encountered in clinical practice, but may often be misdiagnosed. This is more often seen in the south Asian region due to higher rates of consanguinity. This article simplifies the clinical features which should prompt a high index of clinical suspicion, and ensure a detailed assessment for syndromic obesity including a genetic test. This manuscript lists various aspects of history and physical examination in an alliterative manner.
Topics: Humans; Asian People; Causality; Consanguinity; Genetic Testing; Obesity; Pediatric Obesity; Asia, Southern
PubMed: 36661013
DOI: 10.47391/JPMA.22-103 -
Trends in Endocrinology and Metabolism:... Jan 2024Exercise has systemic health benefits through effects on multiple tissues, with intertissue communication. Recent studies indicate that exercise may improve breastmilk... (Review)
Review
Exercise has systemic health benefits through effects on multiple tissues, with intertissue communication. Recent studies indicate that exercise may improve breastmilk composition and thereby reduce the intergenerational transmission of obesity. Even if breastmilk is considered optimal infant nutrition, there is evidence for variations in its composition between mothers who are normal weight, those with obesity, and those who are physically active. Nutrition early in life is important for later-life susceptibility to obesity and other metabolic diseases, and maternal exercise may provide protection against the development of metabolic disease. Here we summarize recent research on the influence of maternal obesity on breastmilk composition and discuss the potential role of exercise-induced adaptations to breastmilk as a kick-start to prevent childhood obesity.
Topics: Child; Infant; Humans; Female; Pregnancy; Milk, Human; Pediatric Obesity; Lactation
PubMed: 37735048
DOI: 10.1016/j.tem.2023.08.019 -
Childhood Obesity (Print) Jun 2022Treatment options for adolescents with obesity are limited. Yet, therapies previously reserved for adults, such as medications and bariatric surgery, are increasingly... (Observational Study)
Observational Study
Treatment options for adolescents with obesity are limited. Yet, therapies previously reserved for adults, such as medications and bariatric surgery, are increasingly available to adolescents in tertiary obesity treatment settings. We aimed to identify the factors associated with selecting an advanced obesity treatment (diets, medications, and surgery) beyond lifestyle therapy among adolescents presenting to a tertiary, pediatric weight management program. We conducted a secondary analysis of adolescents ( = 220) who participated in a longitudinal, observational case-control study within a pediatric weight management program. The exposures were potential individual and clinical factors, including sociodemographic characteristics and comorbidities. The outcome was treatment selection, dichotomized into lifestyle vs. advanced treatment. We modeled associations between these factors and treatment selection using logistic regression, controlling for confounding variables (age, race/ethnicity, sex, and insurance). The study population included a majority of non-Hispanic Black (50.5%) and Hispanic/Latino (19.5%) adolescents, of whom 25.5% selected advanced treatment. Adolescents were more likely to choose an advanced treatment option if they had a greater BMI [odds ratio (OR) 1.09, 95% confidence interval (95% CI) 1.04-1.15], lived further from the clinic (OR 1.03, 95% CI 1.00-1.05), and had an elevated glycohemoglobin level (OR 2.46, 95% CI 1.24-4.92). A significant fraction of adolescents seeking obesity treatment in a specialized care setting chose new and emerging obesity treatments, particularly those at high risk of developing diabetes. These findings can inform patient-clinician obesity treatment discussions in specialty care settings. Clinical Trial Registration number: NCT03139877.
Topics: Adolescent; Adult; Bariatric Surgery; Case-Control Studies; Child; Humans; Obesity, Morbid; Pediatric Obesity; Weight Reduction Programs
PubMed: 34757829
DOI: 10.1089/chi.2021.0190 -
Current Obesity Reports Jun 2017To critique the evidence from recent and ongoing obesity prevention interventions in the first 1000 days in order to identify evidence gaps and weaknesses, and to make... (Review)
Review
PURPOSE OF REVIEW
To critique the evidence from recent and ongoing obesity prevention interventions in the first 1000 days in order to identify evidence gaps and weaknesses, and to make suggestions for more informative future intervention trials.
RECENT FINDINGS
Completed and ongoing intervention trials have had fairly modest effects, have been limited largely to high-income countries, and have used relatively short-term interventions and outcomes. Comparison of the evidence from completed prevention trials with the evidence from systematic reviews of behavioral risk factors shows that some life-course stages have been neglected (pre-conception and toddlerhood), and that interventions have neglected to target some important behavioral risk factors (maternal smoking during pregnancy, infant and child sleep). Finally, while obesity prevention interventions aim to modify body composition, few intervention trials have used body composition measures as outcomes, and this has limited their sensitivity to detect intervention effects. The new WHO Healthy Lifestyles Trajectory (HeLTI) initiative should address some of these weaknesses. Future early obesity prevention trials should be much more ambitious. They should, ideally: extend their interventions over the first 1000 days; have longer-term (childhood) outcomes, and improved outcome measures (body composition measures in addition to proxies for body composition such as the BMI for age); have greater emphasis on maternal smoking and child sleep; be global.
Topics: Body Composition; Body Mass Index; Child Development; Child, Preschool; Clinical Trials as Topic; Early Medical Intervention; Evidence-Based Medicine; Humans; Infant; Pediatric Obesity; Research Design; Risk Factors; Risk Reduction Behavior; Time Factors; Treatment Outcome
PubMed: 28434107
DOI: 10.1007/s13679-017-0255-x -
Hormone Research in Paediatrics 2018Statistical models have been developed for the prediction or diagnosis of a wide range of outcomes. However, to our knowledge, only 7 published studies have reported... (Review)
Review
Statistical models have been developed for the prediction or diagnosis of a wide range of outcomes. However, to our knowledge, only 7 published studies have reported models to specifically predict overweight and/or obesity in early childhood. These models were developed using known risk factors and vary greatly in terms of their discrimination and predictive capacities. There are currently no established guidelines on what constitutes an acceptable level of risk (i.e., risk threshold) for childhood obesity prediction models, but these should be set following consideration of the consequences of false-positive and false-negative predictions, as well as any relevant clinical guidelines. To date, no studies have examined the impact of using early childhood obesity prediction models as intervention tools. While these are potentially valuable to inform targeted interventions, the heterogeneity of the existing models and the lack of consensus on adequate thresholds limit their usefulness in practice.
Topics: Child; Child, Preschool; Female; Humans; Male; Models, Biological; Pediatric Obesity; Predictive Value of Tests; Risk Factors
PubMed: 30739117
DOI: 10.1159/000496563