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Nature Communications Dec 2023Globally, childhood obesity is on the rise and the effect of objectively measured movement behaviour on body composition remains unclear. Longitudinal and causal...
Globally, childhood obesity is on the rise and the effect of objectively measured movement behaviour on body composition remains unclear. Longitudinal and causal mediation relationships of accelerometer-based sedentary time (ST), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with dual-energy X-ray absorptiometry-measured fat mass were examined in 6059 children aged 11 years followed-up until age 24 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort. Over 13-year follow-up, each minute/day of ST was associated with 1.3 g increase in fat mass. However, each minute/day of LPA was associated with 3.6 g decrease in fat mass and each minute/day of MVPA was associated with 1.3 g decrease in fat mass. Persistently accruing ≥60 min/day of MVPA was associated with 2.8 g decrease in fat mass per each minute/day of MVPA, partly mediated by decrease insulin and low-density lipoprotein cholesterol. LPA elicited similar and potentially stronger fat mass-lowering effect than MVPA and thus may be targeted in obesity and ST prevention in children and adolescents, who are unable or unwilling to exercise.
Topics: Adolescent; Humans; Child; Sedentary Behavior; Longitudinal Studies; Pediatric Obesity; Body Mass Index; Exercise; Accelerometry
PubMed: 38086810
DOI: 10.1038/s41467-023-43316-w -
Preventing Chronic Disease Oct 2023Childhood obesity has been associated with numerous poor health conditions, with geographic disparities demonstrated. Limited research has examined the association...
INTRODUCTION
Childhood obesity has been associated with numerous poor health conditions, with geographic disparities demonstrated. Limited research has examined the association between rurality and food security, physical activity, and overweight or obesity among children. We examined rates of food security, physical inactivity, and overweight or obesity among rural and urban children and adolescents, and associations between rurality and these 3 outcomes.
METHODS
We used cross-sectional data from a nationally representative sample of children and adolescents aged 10 to 17 years from the 2019-2020 National Survey of Children's Health (N = 23,199). We calculated frequencies, proportions, and unadjusted associations for each variable by using descriptive statistics and bivariate analyses. We used multivariable logistic regression models to examine the association between rurality and food security, physical activity, and overweight or obesity.
RESULTS
After adjusting for sociodemographic factors, rural children and adolescents had higher odds than urban children and adolescents of being overweight or obese (adjusted odds ratio = 1.30; 95% CI, 1.11-1.52); associations between rurality and physical inactivity and food insecurity were not significant.
CONCLUSION
The information from this study is timely for policy makers and community partners to make informed decisions on the allocation of healthy weight and obesity prevention programs for children and adolescents in rural settings. Our study provides information for public health programming and the designing of appropriate dietary and physical activity interventions needed to reduce disparities in obesity prevention among children and adolescents.
Topics: Child; Humans; Adolescent; Overweight; Pediatric Obesity; Cross-Sectional Studies; Exercise; Food Security; Body Mass Index
PubMed: 37857462
DOI: 10.5888/pcd20.230136 -
Obesity Reviews : An Official Journal... Feb 2024Bariatric surgery and weight loss devices have been considered as a therapeutic option in some settings for adolescents with severe obesity. We conducted a systematic... (Review)
Review
BACKGROUND
Bariatric surgery and weight loss devices have been considered as a therapeutic option in some settings for adolescents with severe obesity. We conducted a systematic review and qualitative evidence synthesis of factors affecting adolescent and caregiver decision-making processes around such interventions, as well as post-surgery demands and challenges, so that their experiences might be better understood and improved support given. No previous qualitative evidence synthesis has been published on this topic.
METHODS AND FINDINGS
We searched 10 bibliographic databases and followed-up gray literature and citations sources. We performed a qualitative evidence synthesis on 19 primary qualitative research studies in adolescents aged 13 years or older. They reported diverse motivations and incentives for considering these interventions, including the physical and social problems resulting from living with obesity, and an awareness of the benefits and limitations of interventions. They reported that they need: information, physical and emotional support and, in some cases, financial assistance. There was high confidence in a majority of these findings (GRADE CERQual).
CONCLUSIONS
We found that supportive interventions accompanying bariatric surgery should be in place to offer: practical help; address anxieties and uncertainties; and facilitate both appropriate decision-making and the achievement of young people's desired outcomes.
Topics: Adolescent; Humans; Caregivers; Pediatric Obesity; Bariatric Surgery; Obesity, Morbid; Weight Loss; Qualitative Research
PubMed: 37916534
DOI: 10.1111/obr.13654 -
Frontiers in Endocrinology 2023
Topics: Humans; Child; Pediatric Obesity; Metabolic Syndrome
PubMed: 37564982
DOI: 10.3389/fendo.2023.1239914 -
Acta Bio-medica : Atenei Parmensis Aug 2023Short sleep duration causes many changes in several hormones (leptin, ghrelin, insulin, cortisol, growth hormone) and increases sympathetic activity with elevated levels... (Observational Study)
Observational Study
BACKGROUND AND AIM
Short sleep duration causes many changes in several hormones (leptin, ghrelin, insulin, cortisol, growth hormone) and increases sympathetic activity with elevated levels of catecholamines, which causes an energy imbalance and leads to overweight or obesity and insulin resistance. The present study aimed to analyze the relationship between sleep duration and insulin resistance in obese adolescents with metabolic syndrome.
METHODS
An observational cross-sectional research design concluded 124 obese adolescents with metabolic syndrome (MetS) aged 13-18 years. Anthropometry, blood pressure, and blood tests were conducted to determine obesity according to CDC 2000. MetS determination based on International Diabetes Federation 2007. Insulin resistance was assessed using HOMA-IR. Sleep duration was determined based on direct interviews with the research subjects. The obtained data were analyzed using the Spearman correlation test, Chi-Square, Mann-Whitney, and T-test (significant at P <0.05).
RESULTS
The subjects were dominated by male adolescents 67.5%. There was a strong relationship between age and sleep duration (p = 0.035). Subjects were divided into two age groups based on sleep duration: those with < 8 hours and > 8 hours of sleep. There was a significant difference in fasting insulin levels and HOMA IR value between the two groups, higher in the subjects with < 8 hours of sleep than the subjects with > 8 hours of sleep. Sleep duration and HOMA-IR values as a marker of insulin resistance had a significant negative correlation (rs= -0.581; P <0.001) and insulin levels (rs=-0.565, P <0.001).
CONCLUSIONS
Sleep duration has a robust negative correlation with the HOMA-IR value, which is a parameter of insulin resistance. (www.actabiomedica.it).
Topics: Adolescent; Humans; Male; Blood Glucose; Body Mass Index; Cross-Sectional Studies; Insulin; Insulin Resistance; Metabolic Syndrome; Pediatric Obesity; Sleep Duration; Female
PubMed: 37539611
DOI: 10.23750/abm.v94i4.14142 -
Pediatric Obesity Sep 2023As childhood obesity prevalence increases, determining which patients respond to anti-obesity medications would strengthen personalized approaches to obesity treatment.... (Randomized Controlled Trial)
Randomized Controlled Trial
Evaluating potential predictors of weight loss response to liraglutide in adolescents with obesity: A post hoc analysis of the randomized, placebo-controlled SCALE Teens trial.
BACKGROUND
As childhood obesity prevalence increases, determining which patients respond to anti-obesity medications would strengthen personalized approaches to obesity treatment. In the SCALE Teens trial among pubertal adolescents with obesity (NCT02918279), liraglutide 3.0 mg (or maximum tolerated dose) significantly reduced body mass index (BMI) standard deviation score on average versus placebo. That said, liraglutide effects on BMI reduction varied greatly among adolescents, similar to adults.
OBJECTIVES
To identify post hoc characteristics predictive of achieving ≥5% and ≥10% BMI reductions at 56 weeks with liraglutide versus placebo in adolescents from the SCALE Teens trial.
METHODS
Logistic regression analysis was performed in 251 adolescents treated with liraglutide (n = 125) or placebo (n = 126) for 56 weeks. Baseline characteristics (selected a priori) included sex, race, ethnicity, age, Tanner (pubertal) stage, glycemic status (hyperglycemia [type 2 diabetes/prediabetes] vs. normoglycemia), obesity category (Class II/III vs. I), severity of depression symptoms (Patient Health Questionnaire-9), and weight variability (weight fluctuations over time). The effects of early responder status (≥4% BMI reduction at week 16) on week 56 response were assessed using descriptive statistics.
RESULTS
Baseline characteristics did not affect achievement of ≥5% and ≥10% BMI reductions at week 56 in adolescents treated with liraglutide. Further, there was no association between weight variability and BMI reduction. Early liraglutide responders appeared to have greater BMI and body weight reductions at week 56 compared with early non-responders.
CONCLUSIONS
This secondary analysis suggests that adolescents with obesity may experience significant BMI reductions after 56 weeks of liraglutide treatment, regardless of their sex, race, ethnicity, age, pubertal stage, glycemic status, obesity category, severity of depression symptoms, or weight variability. Early response may predict greater week 56 response.
Topics: Adolescent; Adult; Child; Humans; Anti-Obesity Agents; Diabetes Mellitus, Type 2; Liraglutide; Pediatric Obesity; Weight Loss; Treatment Outcome
PubMed: 37264767
DOI: 10.1111/ijpo.13061 -
BMC Women's Health Apr 2024Polycystic ovary syndrome (PCOS) has previously been associated with several comorbidities that may have shared genetic, epigenetic, developmental or environmental...
BACKGROUND
Polycystic ovary syndrome (PCOS) has previously been associated with several comorbidities that may have shared genetic, epigenetic, developmental or environmental origins. PCOS may be influenced by prenatal androgen excess, poor intrauterine or childhood environmental factors, childhood obesity and learned health risk behaviors. We analyzed the association between PCOS and several relevant comorbidities while adjusting for early-life biological and socioeconomic conditions, also investigating the extent to which the association is affected by familial risk factors.
METHODS
This total-population register-based cohort study included 333,999 full sisters, born between 1962 and 1980. PCOS and comorbidity diagnoses were measured at age 17-45 years through national hospital register data from 1997 to 2011, and complemented with information on the study subjects´ early-life and social characteristics. In the main analysis, sister fixed effects (FE) models were used to control for all time-invariant factors that are shared among sisters, thereby testing whether the association between PCOS and examined comorbidities is influenced by unobserved familial environmental, social or genetic factors.
RESULTS
Three thousand five hundred seventy women in the Sister sample were diagnosed with PCOS, of whom 14% had obesity, 8% had depression, 7% had anxiety and 4% experienced sleeping, sexual and eating disorders (SSE). Having PCOS increased the odds of obesity nearly 6-fold (adjusted OR (aOR): 5.9 [95% CI:5.4-6.5]). This association was attenuated in models accounting for unobserved characteristics shared between full sisters, but remained considerable in size (Sister FE: aOR: 4.5 [95% CI: 3.6-5.6]). For depression (Sister FE: aOR: 1.4 [95% CI: 1.2-1.8]) and anxiety (Sister FE: aOR: 1.5 [95% CI: 1.2-1.8), there was a small decrease in the aORs when controlling for factors shared between sisters. Being diagnosed with SSE disorders yielded a 2.4 aOR (95% CI:2.0-2.6) when controlling for a comprehensive set of individual-level confounders, which only decreased slightly when controlling for factors at the family level such as shared genes or parenting style. Accounting for differences between sisters in observed early-life circumstances influenced the estimated associations marginally.
CONCLUSION
Having been diagnosed with PCOS is associated with a markedly increased risk of obesity and sleeping, sexual and eating disorders, also after accounting for factors shared between sisters and early-life conditions.
Topics: Child; Pregnancy; Female; Humans; Adolescent; Young Adult; Adult; Middle Aged; Polycystic Ovary Syndrome; Cohort Studies; Siblings; Pediatric Obesity; Comorbidity
PubMed: 38580996
DOI: 10.1186/s12905-024-03028-9 -
Acta Neuropathologica Communications Oct 2023Rare cases of paraneoplastic obesity in children suggest sporadic obesity might also arise from an adaptive immune cell-mediated mechanism. Since the hypothalamus is a...
Rare cases of paraneoplastic obesity in children suggest sporadic obesity might also arise from an adaptive immune cell-mediated mechanism. Since the hypothalamus is a central regulator of feeding behavior and energy expenditure, we quantified lymphocytic inflammation in this region in a cohort of obese and non-obese human post-mortem brains. We report that CD8-positive cytotoxic T-cells are increased in hypothalamic median eminence/arcuate nucleus (ME/Arc) and bed nucleus of the stria terminalis in 40% of obese compared to non-obese patients, but not in other hypothalamic nuclei or brain regions. CD8 T-cells were most abundant in individuals with concurrent obesity and diabetes. Markers of cytotoxic T-cell induced damage, activated caspase 3 and poly-ADP ribose, were also elevated in the ME/Arc of obese patients. To provoke CD8 cytotoxic T-cell infiltrates in ventromedial region of hypothalamus in mice we performed stereotactic injections of an adeno-associated virus expressing immunogenic green fluorescent protein or saline. AAV but not saline injections triggered hypothalamic CD8 T-cell infiltrates associated with a rapid weight gain in mice recapitulating the findings in human obesity. This is the first description of the neuropathology of human obesity and when combined with its reconstitution in a mouse model suggests adaptive immunity may drive as much as 40% of the human condition.
Topics: Animals; Humans; Mice; Arcuate Nucleus of Hypothalamus; CD8-Positive T-Lymphocytes; Hypothalamus; Pediatric Obesity; T-Lymphocytes
PubMed: 37814324
DOI: 10.1186/s40478-023-01659-x -
Frontiers in Endocrinology 2023Childhood obesity leads to early subclinical atherosclerosis and arterial stiffness. Studying biomarkers like trimethylamine N-oxide (TMAO), linked to cardio-metabolic...
Connections between serum Trimethylamine N-Oxide (TMAO), a gut-derived metabolite, and vascular biomarkers evaluating arterial stiffness and subclinical atherosclerosis in children with obesity.
INTRODUCTION
Childhood obesity leads to early subclinical atherosclerosis and arterial stiffness. Studying biomarkers like trimethylamine N-oxide (TMAO), linked to cardio-metabolic disorders in adults, is crucial to prevent long-term cardiovascular issues.
METHODS
The study involved 70 children aged 4 to 18 (50 obese, 20 normal-weight). Clinical examination included BMI, waist measurements, puberty stage, the presence of acanthosis nigricans, and irregular menstrual cycles. Subclinical atherosclerosis was assessed by measuring the carotid intima-media thickness (CIMT), and the arterial stiffness was evaluated through surrogate markers like the pulse wave velocity (PWV), augmentation index (AIx), and peripheral and central blood pressures. The blood biomarkers included determining the values of TMAO, HOMA-IR, and other usual biomarkers investigating metabolism.
RESULTS
The study detected significantly elevated levels of TMAO in obese children compared to controls. TMAO presented positive correlations to BMI, waist circumference and waist-to-height ratio and was also observed as an independent predictor of all three parameters. Significant correlations were observed between TMAO and vascular markers such as CIMT, PWV, and peripheral BP levels. TMAO independently predicts CIMT, PWV, peripheral BP, and central SBP levels, even after adding BMI, waist circumference, waist-to-height ratio, puberty development and age in the regression model. Obese children with high HOMA-IR presented a greater weight excess and significantly higher vascular markers, but TMAO levels did not differ significantly from the obese with HOMA-IR
CONCLUSION
Our study provides compelling evidence supporting the link between serum TMAO, obesity, and vascular damage in children. These findings highlight the importance of further research to unravel the underlying mechanisms of this connection.
Topics: Adult; Female; Humans; Child; Pediatric Obesity; Carotid Intima-Media Thickness; Vascular Stiffness; Pulse Wave Analysis; Acanthosis Nigricans; Atherosclerosis; Biomarkers
PubMed: 37850094
DOI: 10.3389/fendo.2023.1253584 -
Obesity Reviews : An Official Journal... Jan 2024Child obesity is a serious public health challenge affected by both individual choice and societal and environmental factors. The main modifiable risk factors for child... (Review)
Review
Child obesity is a serious public health challenge affected by both individual choice and societal and environmental factors. The main modifiable risk factors for child obesity are unhealthy eating and low levels of physical activity, both influenced by aspects of the built environment. Coordinated government policy across jurisdictions, developed using strong research evidence, can enable built environments that better support healthy lifestyles. This study reviewed current Australian and Western Australian government policies to understand if and how they address the impact of the built environment on child obesity, physical activity, sedentary behavior, and diet. Current government policy documents related to the built environment and child health were analyzed using the Comprehensive Analysis of Policy on Physical Activity framework. Ten Australian and 31 Western Australian government policy documents were identified. Most referred to the role of the built environment in supporting physical activity. Very few policies mentioned the built environment's role in reducing sedentary behaviors, supporting healthy eating, and addressing obesity. Few recognized the needs of children, and none mentioned children in policy development. Future government policy development should include the voices of children and child-specific built environment features. Inter-organizational policies with transparent implementation and evaluation plans are recommended.
Topics: Humans; Pediatric Obesity; Australia; Exercise; Policy; Built Environment
PubMed: 37804083
DOI: 10.1111/obr.13650