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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 -
Obesity (Silver Spring, Md.) Dec 2023This prospective cohort study aimed to empirically derive phenotypes of children and adolescents with overweight and obesity.
OBJECTIVE
This prospective cohort study aimed to empirically derive phenotypes of children and adolescents with overweight and obesity.
METHODS
Latent class analyses using Mplus were carried out in the Growing Up Today Study. Information on participants' weight status, disordered eating behaviors, body image and weight concerns, depressive symptoms, and pubertal timing, as well as and maternal weight status, were included in the latent class analyses, which were stratified by sex. Mixed-effects regression was used to examine associations of the obesity phenotypes with adult weight gain, between age 20 and 35 years, independent of weight at beginning of follow-up and duration of follow-up.
RESULTS
Among the girls, four obesity phenotypes were identified: 1) "early puberty"; 2) "mothers with obesity"; 3) "high weight concerns"; and 4) "mixed." Only three phenotypes were identified among the boys: 1) "high weight concerns"; 2) "mothers with obesity"; and 3) "mixed." Participants who had overweight or obesity in childhood or adolescence gained more weight in young adulthood than their leaner peers, but the patterns of weight gain in young adulthood varied by phenotype of obesity in childhood and adolescence.
CONCLUSIONS
These results support examining risk factors for and treatment outcomes by obesity phenotypes.
Topics: Male; Adult; Female; Adolescent; Humans; Child; Young Adult; Pediatric Obesity; Overweight; Prospective Studies; Risk Factors; Weight Gain; Body Mass Index
PubMed: 37987184
DOI: 10.1002/oby.23893 -
Pediatric Obesity Apr 2024Obesity is a heterogeneous disease with variable treatment response. Identification of the unique constellation of contributors to obesity may allow for targeted...
BACKGROUND
Obesity is a heterogeneous disease with variable treatment response. Identification of the unique constellation of contributors to obesity may allow for targeted interventions and improved outcomes.
OBJECTIVE
Identify empirically derived phenotypes of pediatric patients with obesity based on appetitive and psychological correlates of obesity.
METHODS
This cross-sectional study included patients aged 5-12 years who were treated in a weight management clinic and completed standard intake questionnaires including Child Eating Behavior Questionnaire (CEBQ), Vanderbilt ADHD Scale and Pediatric Symptom Checklist. Phenotypes were elicited using latent profile analysis of 12 indicators: eight CEBQ subscales, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms.
RESULTS
Parents/guardians of 384 patients (mean age 9.8 years, mean BMI 30.3 kg/m ) completed the intake questionnaires. A 4-phenotype model best fits the data. Hedonic Impulsive phenotype (42.5%) exhibited high food enjoyment and hyperactivity/impulsivity. Inattentive Impulsive phenotype (27.4%) exhibited overall low food approach and high food avoid behaviours, and highest inattention. Hedonic Emotional phenotype (20.8%) scored the highest on food enjoyment, internalizing and externalizing symptoms. Picky Eating phenotype (9.3%) scored the lowest on food approach, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms.
CONCLUSION
Appetitive traits and psychological symptoms appear to cluster in distinct patterns, giving rise to four unique phenotypic profiles, which, if replicated, may help inform the development of tailored treatment plans.
Topics: Humans; Child; Cross-Sectional Studies; Obesity; Feeding Behavior; Food Fussiness; Surveys and Questionnaires; Phenotype; Pediatric Obesity
PubMed: 38290813
DOI: 10.1111/ijpo.13101 -
Minerva Pediatrics Dec 2023Obesity is a condition that increases the risk of developing several health problems, resulting in high health care costs worldwide. Therefore, it is important to...
BACKGROUND
Obesity is a condition that increases the risk of developing several health problems, resulting in high health care costs worldwide. Therefore, it is important to investigate several avenues for the control of this condition. This study aimed to identify a dermatoglyphical condition that distinguishes obesity individuals from those of appropriate weight.
METHODS
The sample comprised 2172 children and teenagers between the ages of 10 and 19 years, female and male, from public and private schools of the municipality of Joaçaba, Santa Catarina, Brazil.
RESULTS
In a comparison of qualitative variables, i.e., patterns, significant differences were observed between groups, including a higher frequency of ulnar loops (LU) on the index and middle fingers (MET2 and MET3) in the appropriate weight group. In the obesity group, a greater frequency of whorls (W) on fingers MET2 and MET3 was observed in males. In females, there were statistically significant correlations between the presence of radial loops (LR) on MET3 in the appropriate weight group and arches (A) in the obesity group.
CONCLUSIONS
The study uncovered dermatoglyphical marks characteristic of obesity individuals.
Topics: Child; Humans; Male; Female; Adolescent; Young Adult; Adult; Pediatric Obesity; Dermatoglyphics; Fingers; Brazil; Schools
PubMed: 33438850
DOI: 10.23736/S2724-5276.20.05731-X -
Reviews in Endocrine & Metabolic... Oct 2023Worldwide, far too many children and adolescents are living with the disease of obesity. Despite decades of public health initiatives, rates are still rising in many... (Review)
Review
Worldwide, far too many children and adolescents are living with the disease of obesity. Despite decades of public health initiatives, rates are still rising in many countries. This raises the question of whether precision public health may be a more successful approach to preventing obesity in youth. In this review, the objective was to review the literature on precision public health in the context of childhood obesity prevention and to discuss how precision public health may advance the field of childhood obesity prevention. As precision public health is a concept that is still evolving and not fully identifiable in the literature, a lack of published studies precluded a formal review. Therefore, the approach of using a broad interpretation of precision public health was used and recent advances in childhood obesity research in the areas of surveillance and risk factor identification as well as intervention, evaluation and implementation using selected studies were summarized. Encouragingly, big data from a multitude of designed and organic sources are being used in new and innovative ways to provide more granular surveillance and risk factor identification in obesity in children. Challenges were identified in terms of data access, completeness, and integration, ensuring inclusion of all members of society, ethics, and translation to policy. As precision public health advances, it may yield novel insights that can contribute to strong policies acting in concert that ultimately lead to the prevention of obesity in children.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Public Health; Risk Factors
PubMed: 37055611
DOI: 10.1007/s11154-023-09802-8 -
Indian Pediatrics Sep 2023American Academy of Pediatrics (AAP) have released their first comprehensive clinical practice guideline that outlines evidence-based evaluation and treatment of... (Review)
Review
American Academy of Pediatrics (AAP) have released their first comprehensive clinical practice guideline that outlines evidence-based evaluation and treatment of children and adolescents with overweight and obesity. This article reviews the same, along with implication in our setting and the need for updating our guideline, which is almost two decades old.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Overweight; Academies and Institutes
PubMed: 37705267
DOI: No ID Found -
Obesity Reviews : An Official Journal... Apr 2024Obesity in children remains a major public health problem, with the current prevalence in youth ages 2-19 years estimated to be 19.7%. Despite progress in identifying... (Review)
Review
Obesity in children remains a major public health problem, with the current prevalence in youth ages 2-19 years estimated to be 19.7%. Despite progress in identifying risk factors, current models do not accurately predict development of obesity in early childhood. There is also substantial individual variability in response to a given intervention that is not well understood. On April 29-30, 2021, the National Institutes of Health convened a virtual workshop on "Understanding Risk and Causal Mechanisms for Developing Obesity in Infants and Young Children." The workshop brought together scientists from diverse disciplines to discuss (1) what is known regarding epidemiology and underlying biological and behavioral mechanisms for rapid weight gain and development of obesity and (2) what new approaches can improve risk prediction and gain novel insights into causes of obesity in early life. Participants identified gaps and opportunities for future research to advance understanding of risk and underlying mechanisms for development of obesity in early life. It was emphasized that future studies will require multi-disciplinary efforts across basic, behavioral, and clinical sciences. An exposome framework is needed to elucidate how behavioral, biological, and environmental risk factors interact. Use of novel statistical methods may provide greater insights into causal mechanisms.
Topics: Infant; Child; Adolescent; United States; Humans; Child, Preschool; Pediatric Obesity; Risk Factors; Weight Gain; National Institutes of Health (U.S.); Public Health
PubMed: 38204366
DOI: 10.1111/obr.13690 -
Neuroscience and Biobehavioral Reviews Oct 2023In the United States, adolescent obesity is a growing epidemic associated with maladaptive executive functioning. Likewise, data link the microbiome to obesity. Emerging... (Review)
Review
In the United States, adolescent obesity is a growing epidemic associated with maladaptive executive functioning. Likewise, data link the microbiome to obesity. Emerging microbiome research has demonstrated an interconnection between the gut microbiome and the brain, indicating a bidirectional communication system within the gut-microbiome-brain axis in the pathophysiology of obesity. This narrative review identifies and summarizes relevant research connecting adolescent obesity as it relates to three core domains of executive functioning and the contribution of the gut microbiome in the relationship between obesity and executive functions in adolescence. The review suggests that (1) the interconnection between obesity, executive function, and the gut microbiome is a bidirectional connection, and (2) the gut microbiome may mediate the neurobiological pathways between obesity and executive function deficits. The findings of this review provide valuable insights into obesity-associated executive function deficits and elucidate the possible mediation role of the gut microbiome.
Topics: Adolescent; Humans; Gastrointestinal Microbiome; Executive Function; Pediatric Obesity; Microbiota; Brain
PubMed: 37524139
DOI: 10.1016/j.neubiorev.2023.105337 -
Current Cardiology Reports May 2024Examine the current state of literature related to the impact of obesity in children and adolescents on health-related physical fitness and the resultant cardiometabolic... (Review)
Review
PURPOSE OF REVIEW
Examine the current state of literature related to the impact of obesity in children and adolescents on health-related physical fitness and the resultant cardiometabolic disease risk.
RECENT FINDINGS
Cardiorespiratory fitness of children and adolescents has declined over the past few decades which corresponds with an increase in obesity rates. Children with obesity are more likely to have low cardiorespiratory fitness which is associated with higher cardiometabolic disease risk and poorer mental health. The impact of obesity on muscular fitness in children and adolescents is more difficult to ascertain, but in general measures of physical function are lower in children with obesity which has also been associated with higher cardiometabolic disease risk. Components of health-related physical fitness are trending negatively in children and adolescents and appear to be related to the increase in prevalence of obesity. The resultant cardiometabolic disease risk has also risen which suggests a greater disease burden in the future. These disparaging findings highlight the need for aggressive interventions to improve physical fitness in children and adolescents.
Topics: Humans; Adolescent; Child; Pediatric Obesity; Cardiorespiratory Fitness; Physical Fitness; Cardiovascular Diseases; Cardiometabolic Risk Factors; Risk Factors; Exercise; Muscle, Skeletal
PubMed: 38460068
DOI: 10.1007/s11886-024-02036-3 -
Current Opinion in Pediatrics Feb 2024This article outlines what is currently known regarding the relationship between neighborhood deprivation and pediatric obesity. It discusses the intersectionality... (Review)
Review
PURPOSE OF REVIEW
This article outlines what is currently known regarding the relationship between neighborhood deprivation and pediatric obesity. It discusses the intersectionality between neighborhood deprivation, race, ethnicity, and pediatric obesity. We conclude by proposing several potential solutions to disparities in pediatric obesity related to neighborhood deprivation.
RECENT FINDINGS
Neighborhood deprivation, independent of individual socioeconomic status, is a risk factor for pediatric obesity. The obesogenic characteristics of high deprivation neighborhoods (e.g., lack of safe spaces to be active, easy access to fast food) and the psychological aspects of residing within high deprivation neighborhoods may also contribute to this risk. Intervention strategies and policies designed to address neighborhood related risk for pediatric obesity are needed.
SUMMARY
Pediatric obesity is a growing problem of complex etiology. Neighborhood risk factors should be considered when assessing risk burden and when designing intervention strategies.
Topics: Child; Humans; Pediatric Obesity; Socioeconomic Factors; Residence Characteristics; Risk Factors; Ethnicity
PubMed: 38001559
DOI: 10.1097/MOP.0000000000001317