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Obesity Facts 2020As in many other countries around the world, the Netherlands has a high prevalence of overweight and obesity in children. About 1 in 7 of children aged 2-19 years has... (Review)
Review
BACKGROUND
As in many other countries around the world, the Netherlands has a high prevalence of overweight and obesity in children. About 1 in 7 of children aged 2-19 years has either overweight or obesity.
SUMMARY
In this paper the national and local activities aimed at the prevention and management of obesity in children and adolescents in the Netherlands are reviewed. It is recommended to, nationally as well as locally, take an integrated-systems approach that tackles the obesogenic food environment as well as upstream and downstream determinants of obesity. Efforts should take a life course approach and be focused on promoting obesity prevention as well as improving the management of children who already have obesity. The national policies in the Netherlands rely heavily on self-regulation by stakeholders such as supermarkets, restaurants, and the food industry. Local policies and actions such as the whole-systems approach in Amsterdam are promising. Future directions include development of tools for the operationalization and evaluation of local systems approaches. Regulation by national and local governments is necessary to ensure a healthy food environment for children and their families, but health policies require intersectoral action. Key Messages: In the Netherlands many policies are in place or under development, especially at the municipal level (e.g., in Amsterdam), but more substantial action is urgently required.
Topics: Adolescent; Child; Humans; Netherlands; Overweight; Pediatric Obesity; Prevalence; Public Health
PubMed: 32810860
DOI: 10.1159/000509588 -
International Journal of Obesity (2005) Jul 2016Despite the increasing number of medications recently approved to treat obesity among adults, few agents have been formally evaluated in children or adolescents for this... (Review)
Review
Despite the increasing number of medications recently approved to treat obesity among adults, few agents have been formally evaluated in children or adolescents for this indication. Moreover, there is a paucity of guidance in the literature addressing best practices with regard to pediatric obesity pharmacotherapy clinical trial design, and only general recommendations have been offered by regulatory agencies on this topic. The purposes of this article are to (1) offer a background of the current state of the field of pediatric obesity medicine, (2) provide a brief review of the literature summarizing pediatric obesity pharmacotherapy clinical trials, and (3) highlight and discuss some of the unique aspects that should be considered when designing and conducting high-quality clinical trials evaluating the safety and efficacy of obesity medications in children and adolescents. Suggestions are offered in the areas of target population and eligibility criteria, clinical trial end-point selection, trial duration, implementation of lifestyle modification therapy and recruitment and retention of participants. Efforts should be made to design and conduct trials appropriately to ensure that high-quality evidence is generated on the safety and efficacy of various medications used to treat pediatric obesity.
Topics: Anti-Obesity Agents; Body Mass Index; Child; Directive Counseling; Exenatide; Humans; Hypoglycemic Agents; Metformin; Pediatric Obesity; Peptides; Randomized Controlled Trials as Topic; Risk Reduction Behavior; Venoms; Weight Loss
PubMed: 27113643
DOI: 10.1038/ijo.2016.69 -
Childhood Obesity (Print) Feb 2016This systematic review synthesizes the literature on incidence of obesity during childhood. (Review)
Review
BACKGROUND
This systematic review synthesizes the literature on incidence of obesity during childhood.
METHODS
We searched PubMed, Excerpta Medica database (EMBASE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL), and used the Web of Science tool in June 2015. Studies were included if they were published in English, presented results from primary or secondary analyses, used data about children in the US, provided obesity incidence data on children 0 to 18 years born after 1970, and did not pertain to clinically defined populations (disease, medication use, etc.). Author(s), study year, study design, location, sample size, age, and obesity incidence estimates were abstracted.
RESULTS
Nineteen studies were included, three of which used nationally representative data. The median study-specific annual obesity incidences among studies using U.S. Centers for Disease Control and Prevention (CDC) growth charts were 4.0%, 3.2%, and 1.8% for preschool (2.0-4.9 years), school aged (5.0-12.9 years), and adolescence (13.0-18.0 years), respectively. This pattern of declining obesity incidence with age was consistent between and within studies.
CONCLUSIONS
Studies of childhood obesity in the US indicate declining incidence with age. Childhood obesity prevention efforts should be targeted to ages before obesity onset. Longitudinal data and consistent obesity definitions that correlate with long-term morbidity are needed to better characterize the life history of obesity.
Topics: Child; Female; Humans; Incidence; Male; Pediatric Obesity; Public Health; United States
PubMed: 26618249
DOI: 10.1089/chi.2015.0055 -
Current Obesity Reports Sep 2018Children with obesity experience disordered eating attitudes and behaviors at high rates, which increases their risk for adult obesity and eating disorder development.... (Review)
Review
PURPOSE OF THE REVIEW
Children with obesity experience disordered eating attitudes and behaviors at high rates, which increases their risk for adult obesity and eating disorder development. As such, it is imperative to screen for disordered eating symptoms and identify appropriate treatments.
RECENT FINDINGS
Family-based multicomponent behavioral weight loss treatment (FBT) is effective at treating childhood obesity and demonstrates positive outcomes on psychosocial outcomes, including disordered eating. FBT utilizes a socio-ecological treatment approach that focuses on the development of individual and family healthy energy-balance behaviors as well as positive self- and body esteem, supportive family relationships, richer social networks, and the creation of a broader environment and community that facilitates overall physical and mental health. Existing literature suggests FBT is an effective treatment option for disordered eating and obesity in children. Future work is needed to confirm this conclusion and to examine the progression and interaction of obesity and disordered eating across development to identify the optimal time for intervention.
Topics: Adolescent; Adolescent Behavior; Age Factors; Child; Child Behavior; Comorbidity; Feeding Behavior; Feeding and Eating Disorders; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Healthy Lifestyle; Humans; Male; Pediatric Obesity; Risk Factors; Risk Reduction Behavior; Treatment Outcome; Weight Loss
PubMed: 30069717
DOI: 10.1007/s13679-018-0316-9 -
American Journal of Preventive Medicine Jun 2016The "first 1,000 days"-conception through age 24 months-are critical for the development and prevention of childhood obesity. This study systematically reviews existing... (Review)
Review
CONTEXT
The "first 1,000 days"-conception through age 24 months-are critical for the development and prevention of childhood obesity. This study systematically reviews existing and ongoing interventions during this period, identifies gaps in current research, and discusses conceptual frameworks and opportunities for future interventions.
EVIDENCE ACQUISITION
PubMed, Embase, Web of Science, and ClinicalTrials.gov were searched to identify completed and ongoing interventions implemented during pregnancy through age 24 months that aimed to prevent overweight/obesity between ages 6 months and 18 years. English-language, controlled interventions published between January 1, 1980 and December 12, 2014, were analyzed between December 13, 2014 and March 15, 2015.
EVIDENCE SYNTHESIS
Of 34 completed studies from 26 unique identified interventions, nine were effective. Effective interventions focused on individual- or family-level behavior changes through home visits, individual counseling or group sessions in clinical settings, a combination of home and group visits in a community setting, and using hydrolyzed protein formula. Protein-enriched formula increased childhood obesity risk. Forty-seven ongoing interventions were identified. Across completed and ongoing interventions, the majority target individual- or family-level changes, many are conducted in clinical settings, and few target early-life systems and policies that may impact childhood obesity.
CONCLUSIONS
Obesity interventions may have the greatest preventive effect if begun early in life. Yet, few effective interventions in the first 1,000 days exist, and many target individual-level behaviors of parents and infants. Interventions that operate at systems levels and are grounded in salient conceptual frameworks hold promise for improving future models of early-life obesity prevention.
Topics: Diet, Healthy; Health Behavior; Humans; Infant; Parents; Pediatric Obesity; Risk Factors; Time Factors
PubMed: 26916260
DOI: 10.1016/j.amepre.2015.11.010 -
PloS One 2023The roles of minerals in obesity received increasing attention recently due to its oxidant or antioxidant functions and effects on insulin and glucose metabolism that...
BACKGROUND
The roles of minerals in obesity received increasing attention recently due to its oxidant or antioxidant functions and effects on insulin and glucose metabolism that may be associated with obesity. Herein, this study aims to explore the association between minerals and obesity and body mass index (BMI) in children with different ages, and hope to provide some references for prevention and management in children with high-risk of obesity.
METHODS
Data of children aged 2-17 years old were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2007-2014 in this cross-sectional study. Weighted univariate and multivariate logistic regression and liner regression analyses were used to screen covariates, and explore the association between minerals [including calcium (Ca), phosphorus (P), magnesium (Mg), iron (Fe), zinc (Zn), copper (Cu), sodium (Na), potassium (K) and selenium (Se)] and childhood obesity and BMI. The evaluation indexes were β, odds ratios (ORs) and 95% confidence intervals (CIs). These relationships were also investigated in age subgroups.
RESULTS
Among 10,450 eligible children, 1,988 (19.02%) had obesity. After adjusting for covariates, we found the highest quartile of dietary Fe [OR = 0.74, 95%CI: (0.58, 0.95)] and Zn [OR = 0.70, 95%CI: (0.54, 0.92)] intakes were associated with low odds of childhood obesity, while that of dietary Na intake seemed to be positively linked to childhood obesity [OR = 1.35, 95%CI: (1.05, 1.74)]. High dietary intakes of Ca, Na and K were positively associated with children's BMI, on the contrary, dietary Fe and Zn consumptions had a negative one (all P<0.05). Additionally, these associations were also found in children with different age (all P<0.05).
CONCLUSION
Dietary Fe and Zn intakes played positive roles in reducing childhood obesity or BMI, while the intakes of Na should be controlled suitably.
Topics: Humans; Child; Child, Preschool; Adolescent; Cross-Sectional Studies; Nutrition Surveys; Pediatric Obesity; Minerals; Nutritional Status; Zinc; Selenium; Sodium; Calcium, Dietary
PubMed: 38150411
DOI: 10.1371/journal.pone.0295765 -
Childhood Obesity (Print) Dec 2021Recent data estimate the prevalence of pediatric obesity at 19.3%. Emphasis on primary prevention and early identification is needed to avoid development of serious...
Recent data estimate the prevalence of pediatric obesity at 19.3%. Emphasis on primary prevention and early identification is needed to avoid development of serious medical and psychosocial sequelae. The objective of this initiative is to assess baseline knowledge and comfort among trainees at an inner-city pediatric residency program in identifying children with overweight/obesity, evaluating associated risk factors and comorbidities, and providing effective counseling. Key topics from 2 major guidelines on pediatric obesity assessment, prevention, and treatment were incorporated into the development of a resident questionnaire, which consisted of 12 knowledge-based questions and a Likert scale evaluating self-perceived knowledge and comfort on 7 skills. Forty-six percent of eligible residents completed the questionnaire ( = 28). The mean score on the objective knowledge-based section was 44% ± 13%, with no differences by training year. The percentage of residents with correct responses by topic ranged from 14% to 79%. The mean self-perceived knowledge rating was 3.56 ± 0.86. The mean self-perceived comfort rating was 3.53 ± 0.89. Neither the self-perceived knowledge nor comfort rating was a significant predictor of performance on the objective knowledge-based section when controlling for postgraduate year status. Significant gaps in knowledge were discovered among pediatric residents with regard to appropriate screening, assessment, and counseling practices related to pediatric overweight/obesity. These deficits were not consistently reflected in residents' self-perceived knowledge and comfort ratings. The results of this initiative highlight the need for incorporation of standardized curricula on childhood overweight/obesity into pediatric resident education.
Topics: Child; Curriculum; Health Knowledge, Attitudes, Practice; Humans; Internship and Residency; Pediatric Obesity; Surveys and Questionnaires
PubMed: 34227847
DOI: 10.1089/chi.2021.0095 -
Obesity (Silver Spring, Md.) Feb 2019A growing number of youth suffer from obesity and in particular severe obesity for which intensive lifestyle intervention does not adequately reduce excess adiposity. A... (Review)
Review
A growing number of youth suffer from obesity and in particular severe obesity for which intensive lifestyle intervention does not adequately reduce excess adiposity. A treatment gap exists wherein effective treatment options for an adolescent with severe obesity include intensive lifestyle modification or metabolic and bariatric surgery while the application of obesity pharmacotherapy remains largely underutilized. These youth often present with numerous obesity-related comorbid diseases, including hypertension, dyslipidemia, prediabetes/type 2 diabetes, obstructive sleep apnea, nonalcoholic fatty liver disease, musculoskeletal problems, and psychosocial issues such as depression, anxiety, and social stigmatization. Current pediatric obesity treatment algorithms for pediatric primary care providers focus primarily on intensive lifestyle intervention with escalation of treatment intensity through four stages of intervention. Although a recent surge in the number of Food and Drug Administration-approved medications for obesity treatment has emerged in adults, pharmacotherapy options for youth remain limited. Recognizing treatment and knowledge gaps related to pharmacological agents and the urgent need for more effective treatment strategies in this population, discussed here are the efficacy, safety, and clinical application of obesity pharmacotherapy in youth with obesity based on current literature. Legal ramifications, informed consent regulations, and appropriate off-label use of these medications in pediatrics are included, focusing on prescribing practices and prescriber limits.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Treatment Outcome
PubMed: 30677262
DOI: 10.1002/oby.22385 -
Nature Reviews. Endocrinology Feb 2020Despite the rising incidence of childhood obesity, international data from Eurostat show that the prevalence of obesity among those aged 15-19 years remains under 5%,... (Review)
Review
Despite the rising incidence of childhood obesity, international data from Eurostat show that the prevalence of obesity among those aged 15-19 years remains under 5%, which offers an important opportunity for preventing subsequent adult obesity. Young people engage poorly, even obstructively, with conventional health initiatives and are often considered 'hard to reach'. However, when approached in the language of youth, via IT, they express great concern, and unwanted weight gain in young people can be prevented by age-appropriate, independent, online guidance. Additionally, when shown online how 'added value' by industry can generate consumer harms as free market 'externalities', and how obesogenic 'Big Food' production and distribution incur environmental and ethical costs, young people make lasting behavioural changes that attenuate weight gain. This evidence offers a novel approach to obesity prevention, handing the initiative to young people themselves and supporting them with evidence-based methods to develop, propagate and 'own' social movements that can simultaneously address the geopolitical concerns of youth and obesity prevention.
Topics: Adolescent; Child; Health Promotion; Humans; Pediatric Obesity; Social Behavior; Weight Gain; Young Adult
PubMed: 31784715
DOI: 10.1038/s41574-019-0288-1 -
Current Obesity Reports Jun 2017Childhood cancer survivors experience excessive weight gain early in treatment. Lifestyle interventions need to be initiated early in cancer care to prevent the early... (Review)
Review
PURPOSE OF REVIEW
Childhood cancer survivors experience excessive weight gain early in treatment. Lifestyle interventions need to be initiated early in cancer care to prevent the early onset of obesity and cardiovascular disease (CVD). We reviewed the existing literature on early lifestyle interventions in childhood cancer survivors and consider implications for clinical care.
RECENT FINDINGS
Few lifestyle interventions focus on improving nutrition in childhood cancer survivors. A consistent effect on reducing obesity and CVD risk factors is not evident from the limited number of studies with heterogeneous intervention characteristics, although interventions with a longer duration and follow-up show more promising trends. Future lifestyle interventions should be of a longer duration and include a nutrition component. Interventions with a longer duration and follow-up are needed to assess the timing and sustainability of the intervention effect. Lifestyle interventions introduced early in cancer care are both safe and feasible.
Topics: Adolescent; Adolescent Development; Age of Onset; Cancer Survivors; Child; Child Development; Child Nutritional Physiological Phenomena; Child, Preschool; Diet, Healthy; Early Medical Intervention; Exercise; Female; Humans; Male; Neoplasms; Nutritional Status; Pediatric Obesity; Risk Factors; Risk Reduction Behavior; Time Factors; Treatment Outcome; Young Adult
PubMed: 28455678
DOI: 10.1007/s13679-017-0260-0