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Pharmacological Research Feb 2023Asthma affects more than 300 million people of all ages worldwide, including about 10-15% of school-aged children, and its prevalence is increasing. Severe asthma (SA)... (Review)
Review
Asthma affects more than 300 million people of all ages worldwide, including about 10-15% of school-aged children, and its prevalence is increasing. Severe asthma (SA) is a particular and rare phenotype requiring treatment with high-dose inhaled corticosteroids plus a second controller and/or systemic glucocorticoid courses to achieve symptom control or remaining "uncontrolled" despite this therapy. In SA, other diagnoses have been excluded, and potential exacerbating factors have been addressed. Notably, obese asthmatics are at higher risk of developing SA. Obesity is both a major risk factor and a disease modifier of asthma in children and adults: two main "obese asthma" phenotypes have been described in childhood with high or low levels of Type 2 inflammation biomarkers, respectively, the former characterized by early onset and eosinophilic inflammation and the latter by neutrophilic inflammation and late-onset. Nevertheless, the interplay between obesity and asthma is far more complex and includes obese tissue-driven inflammatory pathways, mechanical factors, comorbidities, and poor response to corticosteroids. This review outlines the most recent findings on SA in obese children, particularly focusing on inflammatory pathways, which are becoming of pivotal importance in order to identify selective targets for specific treatments, such as biological agents.
Topics: Humans; Pediatric Obesity; Asthma; Comorbidity; Adrenal Cortex Hormones; Inflammation
PubMed: 36642111
DOI: 10.1016/j.phrs.2023.106658 -
Archives of Endocrinology and Metabolism Oct 2021Obesity is a complex and multifactorial disease that is influenced by physiological, environmental, socioeconomic, and genetic factors. In recent decades, this serious... (Review)
Review
Obesity is a complex and multifactorial disease that is influenced by physiological, environmental, socioeconomic, and genetic factors. In recent decades, this serious disease has impacted a large number of adolescents as a result of lifestyle factors. A lack of exercise and the consumption of excessive calories from an inadequate diet are the main contributors to adolescent obesity. However, genetic and hormonal factors might also play a role. The short- and long-term consequences of this disease include chronic issues such as type 2 diabetes and cardiovascular disorders and an increase in early mortality rates. Although it is a serious disease, obesity in adolescents can be controlled with diet and exercise. When these lifestyle changes do not obtain the expected results, we can intensify the treatment by adding medication to the practice of diet and exercise. Additionally, for more severe cases, bariatric surgery can be an option. The purpose of this review is to clarify the current epidemiology, risks, and comorbidities and discuss news about the main treatments and the necessary improvements in this context.
Topics: Adolescent; Diabetes Mellitus, Type 2; Diet; Exercise; Humans; Life Style; Pediatric Obesity
PubMed: 34591402
DOI: 10.20945/2359-3997000000393 -
Current Opinion in Endocrinology,... Feb 2015To highlight the recent findings on sleep-obesity associations in children. We focus on sleep duration, sleep timing and chronotype, and describe the potential... (Review)
Review
PURPOSE OF REVIEW
To highlight the recent findings on sleep-obesity associations in children. We focus on sleep duration, sleep timing and chronotype, and describe the potential mechanisms underlying sleep-obesity associations.
RECENT FINDINGS
Poor sleep is increasingly common in children and associations between short sleep duration in early childhood and obesity are consistently found. Less is known about the infancy period, and the findings in adolescents are inconsistent. Sleep timing patterns may also contribute to obesity risk. Variable and shifted sleep schedules and evening chronotypes have recently been linked to adiposity in adults; less is known about children. Further, there is little understanding regarding the mechanisms of association. The timing of eating, dietary intake, obesogenic eating behaviors, and changes in appetite-regulating hormones have been identified as possible mechanisms for sleep-obesity associations and may be promising avenues for future research. Longitudinal and experimental work with children is needed to determine the nature of associations.
SUMMARY
Beyond sleep duration, sleep timing patterns may contribute to obesity risk. Biological and behavioral processes have been proposed as mechanisms that may explain the association. Understanding the pathways through which poor sleep patterns could increase obesity risk in children may provide novel avenues for intervention.
Topics: Body Mass Index; Circadian Rhythm; Feeding Behavior; Humans; Pediatric Obesity; Risk Factors; Sleep; Sleep Wake Disorders; Time Factors
PubMed: 25517022
DOI: 10.1097/MED.0000000000000125 -
Frontiers in Bioscience (Landmark... Jun 2016Childhood obesity and its sequelae are a major public health problem in both the USA and globally. This review will focus on a systems medicine approach to obesity.... (Review)
Review
Childhood obesity and its sequelae are a major public health problem in both the USA and globally. This review will focus on a systems medicine approach to obesity. Systems medicine is an integrative approach utilizing the vast amount of data garnered from "omics" technology and integrating these data with conventional pathophysiology as well as diverse environmental factors such as diet, exercise, community dynamics and the intestinal microbiome. Omics technology includes genomics, epigenomics, metagenomics, metabolomics and proteomics. In addition to unraveling etiology, the goals of a systems medicine approach are to provide actionable and evidenced-based clinical approaches. In the case of childhood obesity, an additional goal is characterizing measureable risk factors/biomarkers for obesity at the earliest possible age and devising age-appropriate optimal intervention strategies. It is also important to establish the age at which interventions could be critical. As discussed below, it is possible that some of the pathophysiological and epigenetic changes resulting from childhood obesity could become more irreversible the longer the obesity remains untreated.
Topics: Adolescent; Blood Glucose; Child; Diabetes Mellitus, Type 2; Epigenesis, Genetic; Genome-Wide Association Study; Histone Deacetylases; Humans; Hypertension; Insulin Resistance; Islet Amyloid Polypeptide; Metabolic Syndrome; Oxidative Stress; Pediatric Obesity; Repressor Proteins; Systems Biology
PubMed: 27100491
DOI: 10.2741/4441 -
Current Obesity Reports Mar 2020To examine associations between video game play and obesity in children.
PURPOSE OF REVIEW
To examine associations between video game play and obesity in children.
RECENT FINDINGS
Based on a scoping review of 26 studies (25 cross-sectional; 1 longitudinal) published in 2013-2018, 14 studies (53%) reported no association between video game play and obesity, and 12 studies reported positive associations. In a review of 8 systematic reviews, there was preliminary evidence on the effectiveness of exergame (physically active) play for weight reduction and to attenuate weight gain but little indication that interventions effectively reduced video game play or general screen time. This review found ambiguous evidence on the extent to which video game play is or is not significantly associated with obesity in children and preliminary evidence of exergame play as a tool for weight reduction and attenuation of weight gain. Several gaps existed in understanding the relationship between video game play and obesity, and prospective and interventional trials are needed.
Topics: Child; Databases, Factual; Humans; Pediatric Obesity; Television; Video Games; Weight Gain
PubMed: 32077041
DOI: 10.1007/s13679-020-00368-z -
Social Science & Medicine (1982) Oct 2022Several studies have documented a link between maternal employment and childhood obesity, but the mechanisms are not clear. This study investigated the association of... (Observational Study)
Observational Study
Several studies have documented a link between maternal employment and childhood obesity, but the mechanisms are not clear. This study investigated the association of maternal employment with children's weight status and detailed weight-related behaviors using data from Phase I of Family Matters, a cross-sectional, observational study of 150 children aged 5-8 from six racial/ethnic groups (White, Black, Latinx, Native American, Hmong, and Somali) and their families from the Minneapolis/St. Paul, MN metropolitan area recruited in 2015-2016. Weight status (objectively measured), child dietary intake (three 24-h dietary recalls), physical activity (eight days of hip-mounted accelerometer data on children), and sleep (eight daily parent reports on children's sleep hours) were examined across four categories of maternal employment status: stay-at-home caregivers, working part-time, working full-time, and unemployed/unable to work. This study found that children's weight status and physical activity levels were similar across all categories of maternal employment. However, there were significant differences in aspects of children's diets by maternal employment status and, compared to children with stay-at-home mothers, children's sleep was significantly lower if their mother worked full-time. These findings highlight that dietary and sleep interventions tailored to the mother's employment status may be fruitful.
Topics: Child; Cross-Sectional Studies; Diet; Employment; Female; Humans; Mothers; Pediatric Obesity
PubMed: 36067580
DOI: 10.1016/j.socscimed.2022.115303 -
Nutrients Dec 2023Nutrition interventions to prevent pediatric obesity can help to establish healthy habits to improve current and future health. The objective of this umbrella review of... (Review)
Review
Nutrition interventions to prevent pediatric obesity can help to establish healthy habits to improve current and future health. The objective of this umbrella review of systematic reviews (SRs) is to examine the impact of obesity prevention interventions with a nutrition component on body mass index measures, overweight/obesity prevalence, and cost-effectiveness in participants 2-17 years old. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods were used, and this umbrella review was registered on PROSPERO (CRD42023443033). Included SRs were required to search ≥2 databases and to assess the risk of bias (RoB) of primary studies, and they were published 2017-June 2023. Database searches identified 4776 articles, and 31 SRs were included. In all age groups combined, interventions with both nutrition and physical activity were effective and cost-effective in all settings combined, and in the community setting specifically. In children ≤5 years old, interventions in the home and family, community, and healthcare settings demonstrated some efficacy, whereas in children 6-12 years old, school interventions were most effective. Evidence with individuals 13-17 years was limited. The certainty of evidence was generally low due to RoB in included studies, inconsistency, and imprecision. Pediatric obesity prevention interventions with nutrition should be tailored to the developmental stage to ensure appropriateness and efficacy.
Topics: Child; Humans; Child, Preschool; Adolescent; Pediatric Obesity; Systematic Reviews as Topic; Body Mass Index; Overweight; Exercise
PubMed: 38140356
DOI: 10.3390/nu15245097 -
Current Obesity Reports Jun 2018In the modern obesogenic environment, food cues play a crucial role in the development of obesity by disrupting hormone and energy balance mechanisms. Thus, it is... (Review)
Review
PURPOSE OF REVIEW
In the modern obesogenic environment, food cues play a crucial role in the development of obesity by disrupting hormone and energy balance mechanisms. Thus, it is critical to understand the neurobiology of feeding behaviors and obesity in the context of ubiquitous food cues. The current paper reviews the physiology of feeding, hormonal regulation of energy balance, and food cue responses and discusses their contributions to obesity.
RECENT FINDINGS
Food cues have strong impact on human physiology. Obese individuals have altered food cue-elicited responses in the brain and periphery, overpowering hormone and energy balance regulation. Disrupted homeostasis during food cue exposure leads to continued food intake, unsuccessful weight management, and poor treatment outcomes, which further contributes to obesity epidemic. Findings from the review emphasize the crucial role of food cues in obesity epidemic, which necessitates multidimensional approaches to the prevention and treatment of obesity, including psychosocial interventions to reduce food cue reactivity, along with conventional treatment.
Topics: Adult; Animals; Child; Child Behavior; Child Nutritional Physiological Phenomena; Cues; Diet, Healthy; Energy Intake; Energy Metabolism; Food Preferences; Humans; Obesity; Pediatric Obesity; Risk; Self-Control; Weight Reduction Programs
PubMed: 29619632
DOI: 10.1007/s13679-018-0303-1 -
Hormone Research in Paediatrics 2022The prevalence of obesity in childhood has increased dramatically in recent decades with increased risk of developing cardiometabolic and other comorbidities. Childhood... (Review)
Review
BACKGROUND
The prevalence of obesity in childhood has increased dramatically in recent decades with increased risk of developing cardiometabolic and other comorbidities. Childhood adiposity may also influence processes of growth and puberty.
SUMMARY
Growth patterns of obesity during childhood have been shown to be associated with increased linear growth in early childhood, leading to accelerated epiphyseal growth plate (EGP) maturation. Several hormones secreted by the adipose tissue may affect linear growth in the context of obesity, both via the growth hormone IGF-1 axis and via a direct effect on the EGP. The observation that children with obesity tend to mature earlier than lean children has led to the assumption that the degree of body fatness may trigger the neuroendocrine events that lead to pubertal onset. The most probable link between obesity and puberty is leptin and its interaction with the kisspeptin system, which is an important regulator of puberty. However, peripheral action of adipose tissue could also be involved in changes in the onset of puberty. In addition, nutritional factors, epigenetics, and endocrine-disrupting chemicals are potential mediators linking pubertal onset to obesity. In this review, we focused on interactions of obesity with linear growth and pubertal processes, based on basic research and clinical data in humans.
KEY MESSAGE
Children with obesity are subject to accelerated linear growth with risk of impaired adult height and early puberty, with its psychological consequences. The data highlight another important objective in combatting childhood obesity, for the prevention of abnormal growth and pubertal patterns.
Topics: Adipose Tissue; Adult; Body Height; Child; Child, Preschool; Human Growth Hormone; Humans; Pediatric Obesity; Puberty
PubMed: 34130293
DOI: 10.1159/000516171 -
Journal of Medicine and Life 2016Obesity is considered a condition presenting a complex, multi-factorial etiology that implies genetic and non-genetic factors. The way the available information should... (Review)
Review
Obesity is considered a condition presenting a complex, multi-factorial etiology that implies genetic and non-genetic factors. The way the available information should be efficiently and strategically used in the obesity and overweight prohylaxisprogrammes for children all over the world is still unclear for most of the risk factors. Mothers' pre-conception weight and weight gain during pregnancy are two of the most important prenatal determinants of childhood obesity. Maternal obesity and gestational weight gain are associated with foetal macrosomia and childhood obesity, and this effect extends into adulthood. Obesity and the metabolic syndrome in children originate in intrauterine life. The current obesity epidemic is probably the result of our evolutive inheritance associated with the consumption of highly processed food with an increased calorific value. The determination of risk factors involved in child obesity are: genetic predisposition, diet, sedentary behaviors, socioeconomic position, ethnic origin, microbiota, iatrogenic, endocrine diseases, congenital and acquired hypothalamic defects, usage of medications affecting appetite. However, the vast majority of patients will not have any of these identifiable conditions. Regardless of the aetiology, all the patients should be considered for modifiable lifestyle risk factors and screened for the complications of obesity.
Topics: Child; Diet; Female; Humans; Microbiota; Pediatric Obesity; Pregnancy; Risk Factors; Sedentary Behavior; Socioeconomic Factors
PubMed: 27928443
DOI: No ID Found