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Preventive Medicine Dec 2016To assess the associations of aerobic, resistance, and combined exercise with changes in insulin resistance, fasting glucose, and fasting insulin in children and... (Meta-Analysis)
Meta-Analysis Review
Effects of aerobic, resistance, and combined exercise training on insulin resistance markers in overweight or obese children and adolescents: A systematic review and meta-analysis.
OBJECTIVE
To assess the associations of aerobic, resistance, and combined exercise with changes in insulin resistance, fasting glucose, and fasting insulin in children and adolescents who are overweight or obese.
DATA SEARCHES
MEDLINE via Pubmed, Cochrane-CENTRAL, SPORTDiscus, and LILACS.
STUDY SELECTION
Randomized clinical trials of at least six weeks of duration that evaluated the ability of exercise training to lower at least one of the following outcomes: insulin resistance-HOMA, fasting glucose, and fasting insulin in children and/or adolescents classified as obese or overweight.
DATA EXTRACTION AND ANALYSIS
Two independent reviewers extracted data and assessed the quality of the included studies. Differences (exercise training group minus control group) in the outcomes evaluated were analyzed using a random effects model.
RESULTS
Of 1853 articles retrieved, 17 studies were included. The meta-analysis showed that physical training in general was not associated with a reduction in fasting glucose levels compared to the control, but it was associated with reductions in fasting insulin levels (-3.37μU/ml; CI 95%, -5.16μU/ml to -1.57μU/ml; I, 54%, p=0.003) and HOMA (-0.61; CI 95%, -1.19 to -0.02; I, 49%, p=0.040). In addition, each modality (aerobic, resistance, and combined) was compared to the control group. Aerobic exercise was associated with declines in fasting insulin levels (-4.52μU/ml; CI 95%, -7.40 to -1.65; I, 65%, p=0.002) and in HOMA (-1.33; 95% confidence interval, -2.47 to -0.18; I, 73%, p=0.005).
CONCLUSIONS
Exercise training, especially aerobic training, is associated with the reduction of fasting insulin levels and HOMA in children and adolescents with obesity and overweight, and may prevent metabolic syndrome and type 2 diabetes.
Topics: Adolescent; Biomarkers; Diabetes Mellitus, Type 2; Exercise; Humans; Insulin Resistance; Pediatric Obesity; Randomized Controlled Trials as Topic; Resistance Training
PubMed: 27773709
DOI: 10.1016/j.ypmed.2016.10.020 -
Obesity Reviews : An Official Journal... Oct 2016Marketing of foods and beverages high in fat, sugar and salt are suggested to contribute to poor dietary behaviours in children and diet-related diseases later in life.... (Meta-Analysis)
Meta-Analysis Review
Marketing of foods and beverages high in fat, sugar and salt are suggested to contribute to poor dietary behaviours in children and diet-related diseases later in life. This systematic review and meta-analysis of randomized trials aimed to assess the effects of unhealthy food and beverage marketing on dietary intake (grams or kilocalories) and dietary preference (preference score or percentage of participants who selected specific foods/beverages) among children 2 to 18 years of age. We searched MEDLINE, EMBASE and PsycINFO up to January 2015 for terms related to advertising, unhealthy foods or beverages among children. Randomized trials that assessed the effects of unhealthy food and beverage marketing compared with non-dietary advertisement or no advertisement in children were considered eligible. Two authors independently extracted information on study characteristics and outcomes of interest and assessed risk of bias and the overall quality of evidence using grade methodology. Meta-analysis was conducted separately for dietary intake and preference using a random-effects model. We identified 29 eligible studies, of which 17 studies were included for meta-analysis of dietary preference and nine for meta-analysis of dietary intake. Almost half of the studies were at high risk of bias. Our meta-analysis showed that in children exposed to unhealthy dietary marketing, dietary intake significantly increased (mean difference [MD] = 30.4 kcal, 95% confidence interval [CI] 2.9 to 57.9, and MD = 4.8 g, 95%CI 0.8 to 8.8) during or shortly after exposure to advertisements. Similarly, children exposed to the unhealthy dietary marketing had a higher risk of selecting the advertised foods or beverages (relative risk = 1.1, 95%CI 1.0 to 1.2; P = 0.052). The evidence indicates that unhealthy food and beverage marketing increases dietary intake (moderate quality evidence) and preference (moderate to low quality evidence) for energy-dense, low-nutrition food and beverage. Unhealthy food and beverage marketing increased dietary intake and influenced dietary preference in children during or shortly after exposure to advertisements. © 2016 World Obesity.
Topics: Advertising; Beverages; Child; Child Behavior; Child Nutritional Physiological Phenomena; Consumer Behavior; Cues; Diet; Energy Intake; Fast Foods; Food Preferences; Humans; Marketing; Nutritive Value; Pediatric Obesity; Randomized Controlled Trials as Topic; Television
PubMed: 27427474
DOI: 10.1111/obr.12445 -
Pediatrics Feb 2017Despite their important influence on child health, it is assumed that fathers are less likely than mothers to participate in pediatric obesity treatment and prevention... (Review)
Review
CONTEXT
Despite their important influence on child health, it is assumed that fathers are less likely than mothers to participate in pediatric obesity treatment and prevention research.
OBJECTIVE
This review investigated the involvement of fathers in obesity treatment and prevention programs targeting children and adolescents (0-18 years).
DATA SOURCES
A systematic review of English, peer-reviewed articles across 7 databases. Retrieved records included at least 1 search term from 2 groups: "participants" (eg, child*, parent*) and "outcomes": (eg, obes*, diet*).
STUDY SELECTION
Randomized controlled trials (RCTs) assessing behavioral interventions to prevent or treat obesity in pediatric samples were eligible. Parents must have "actively participated" in the study.
DATA EXTRACTION
Two authors independently extracted data using a predefined template.
RESULTS
The search retrieved 213 eligible RCTs. Of the RCTs that limited participation to 1 parent only (n = 80), fathers represented only 6% of parents. In RCTs in which participation was open to both parents (n = 133), 92% did not report objective data on father involvement. No study characteristics moderated the level of father involvement, with fathers underrepresented across all study types. Only 4 studies (2%) suggested that a lack of fathers was a possible limitation. Two studies (1%) reported explicit attempts to increase father involvement.
LIMITATIONS
The review was limited to RCTs published in English peer-reviewed journals over a 10-year period.
CONCLUSIONS
Existing pediatric obesity treatment or prevention programs with parent involvement have not engaged fathers. Innovative strategies are needed to make participation more accessible and engaging for fathers.
Topics: Adolescent; Behavior Therapy; Child; Child, Preschool; Father-Child Relations; Female; Humans; Infant; Male; Mother-Child Relations; Parenting; Pediatric Obesity; Randomized Controlled Trials as Topic; Risk Factors; Single-Parent Family
PubMed: 28130430
DOI: 10.1542/peds.2016-2635 -
Italian Journal of Pediatrics Mar 2017Obesity and headache are two highly prevalent diseases both in adults and children and they are associated with a strong personal and social impact. Many studies suggest... (Review)
Review
Obesity and headache are two highly prevalent diseases both in adults and children and they are associated with a strong personal and social impact. Many studies suggest that obesity is comorbid with headache in general, and migraine in particular and obesity seems to be a risk factor for migraine progression and for migraine frequency both in adults and in children. Research shows that there are multiple areas of overlap between migraine pathophysiology and the central and peripheral pathways regulating feeding: inflammatory mediators such as the calcitonin gene-related protein (CGRP), neurotransmitters such as serotonin, peptides such as orexin and adipocytokines such as adiponectin (ADP) and leptin could explain the common pathogenesis. In this paper we discussed the association between obesity and migraine through the analysis of the most recent studies in children and we reviewed data from literature in order to assess the association between obesity and headache and to clarify the possible common pathogenic mechanisms.
Topics: Child; Comorbidity; Global Health; Humans; Migraine Disorders; Pediatric Obesity; Risk Assessment; Risk Factors
PubMed: 28270183
DOI: 10.1186/s13052-017-0344-1 -
The International Journal of Behavioral... Sep 2021Excessive screen time ([Formula: see text] 2 h per day) is associated with childhood overweight and obesity, physical inactivity, increased sedentary time, unfavorable... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Excessive screen time ([Formula: see text] 2 h per day) is associated with childhood overweight and obesity, physical inactivity, increased sedentary time, unfavorable dietary behaviors, and disrupted sleep. Previous reviews suggest intervening on screen time is associated with reductions in screen time and improvements in other obesogenic behaviors. However, it is unclear what study characteristics and behavior change techniques are potential mechanisms underlying the effectiveness of behavioral interventions. The purpose of this meta-analysis was to identify the behavior change techniques and study characteristics associated with effectiveness in behavioral interventions to reduce children's (0-18 years) screen time.
METHODS
A literature search of four databases (Ebscohost, Web of Science, EMBASE, and PubMed) was executed between January and February 2020 and updated during July 2021. Behavioral interventions targeting reductions in children's (0-18 years) screen time were included. Information on study characteristics (e.g., sample size, duration) and behavior change techniques (e.g., information, goal-setting) were extracted. Data on randomization, allocation concealment, and blinding was extracted and used to assess risk of bias. Meta-regressions were used to explore whether intervention effectiveness was associated with the presence of behavior change techniques and study characteristics.
RESULTS
The search identified 15,529 articles, of which 10,714 were screened for relevancy and 680 were retained for full-text screening. Of these, 204 studies provided quantitative data in the meta-analysis. The overall summary of random effects showed a small, beneficial impact of screen time interventions compared to controls (SDM = 0.116, 95CI 0.08 to 0.15). Inclusion of the Goals, Feedback, and Planning behavioral techniques were associated with a positive impact on intervention effectiveness (SDM = 0.145, 95CI 0.11 to 0.18). Interventions with smaller sample sizes (n < 95) delivered over short durations (< 52 weeks) were associated with larger effects compared to studies with larger sample sizes delivered over longer durations. In the presence of the Goals, Feedback, and Planning behavioral techniques, intervention effectiveness diminished as sample size increased.
CONCLUSIONS
Both intervention content and context are important to consider when designing interventions to reduce children's screen time. As interventions are scaled, determining the active ingredients to optimize interventions along the translational continuum will be crucial to maximize reductions in children's screen time.
Topics: Child; Humans; Pediatric Obesity; Screen Time; Sedentary Behavior; Time Factors
PubMed: 34530867
DOI: 10.1186/s12966-021-01189-6 -
Journal of Nutrition Education and... Sep 2023This systematic review aimed to study the effect of a cooking intervention on obesity among children and adolescents aged < 18 years.
INTRODUCTION
This systematic review aimed to study the effect of a cooking intervention on obesity among children and adolescents aged < 18 years.
METHODS
Articles that studied the effect of cooking intervention with at least 4 sessions among children and adolescents on obesity (from January, 2000 to December, 2021) were included for analysis. Of the 500 articles identified through PubMed and ScienceDirect database, 9 studies qualified to be included in this review.
RESULTS
One-third of the studies found a positive effect of a cooking intervention on obesity among children and adolescents. School-based studies conducted among elementary school students were promising. Centers for Disease Control and Prevention body mass index percentile was the most common tool used to identify children and adolescents with overweight and obesity. The majority of the studies had a strong methodology.
DISCUSSION
All studies showed improvement in diet-related factors. Active participation of parents is crucial in making childhood interventions successful. It is difficult to delineate the effect of cooking alone on obesity as almost all studies had multicomponent interventions.
IMPLICATIONS FOR RESEARCH AND PRACTICE
These diverse results highlight the need for longitudinal studies in natural settings to comprehend the effect of long-term cooking on obesity in children and adolescents.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Exercise; Overweight; Body Mass Index; Cooking
PubMed: 37516953
DOI: 10.1016/j.jneb.2023.06.004 -
PloS One 2021Obesity is a serious social and public health problem in the world, especially in children and adolescents. For school-age children with obesity, this stage is in the... (Meta-Analysis)
Meta-Analysis
Effects of aerobic exercise and resistance exercise on physical indexes and cardiovascular risk factors in obese and overweight school-age children: A systematic review and meta-analysis.
BACKGROUND
Obesity is a serious social and public health problem in the world, especially in children and adolescents. For school-age children with obesity, this stage is in the transition from childhood to adolescence, and both physical, psychological, and external environments will be full of challenges. Studies have showed that school-age children are the largest proportion of people who continue to be obese in adulthood. Physical exercise is considered as an effective way to control weight. Therefore, we focus on this point to study which factors will be improved to reduce childhood obesity.
OBJECTIVE
To assess the effects of aerobic and resistance exercise on physical indexes, such as body mass index (BMI) and body fat percentage, and cardiovascular risk factors such as VO2peak, triglycerides (TG) and low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), insulin and insulin resistance in school-age children who are overweight or obese.
METHOD
PubMed, SPORTDiscus, Medline, Cochrane-Library, Scopus, Ovid and Web of Science were searched to locate studies published between 2000 and 2021 in obese and overweight school-age children between 6-12 years old. The articles are all randomized controlled trials (RCTs) and in English. Data were synthesized using a random-effect or a fixed-effect model to analyze the effects of aerobic and resistance exercise on six elements in in school-age children with overweight or obese. The primary outcome measures were set for BMI.
RESULTS
A total of 13 RCTs (504 participants) were identified. Analysis of the between-group showed that aerobic and resistance exercise were effective in improving BMI (MD = -0.66; p < 0.00001), body fat percentage (MD = -1.29; p = 0.02), TG (std.MD = -1.14; p = 0.005), LDL (std.MD = -1.38; p = 0.003), TC (std.MD = -0.77; p = 0.002), VO2peak (std.MD = 1.25; p = 0.001). However, aerobic and resistance exercise were not significant in improving HDL (std.MD = 0.13; p = 0.27).
CONCLUSIONS
Aerobic exercise and resistance exercise are associated with improvement in BMI, body fat percentage, VO2peak, TG, LDL, TC, while not in HDL in school-age children with obesity or overweight. Insulin and insulin resistance were not able to be analyzed in our review. However, there are only two articles related to resistance exercise in children with obesity and overweight at school age, which is far less than the number of 12 articles about aerobic exercise, so we cannot compare the effects of the two types of exercises.
Topics: Adipose Tissue; Body Mass Index; Child; Exercise; Heart Disease Risk Factors; Humans; Lipids; Pediatric Obesity; Publication Bias; Resistance Training; Risk; Schools
PubMed: 34543302
DOI: 10.1371/journal.pone.0257150 -
The Journal of Clinical Endocrinology... Mar 2017Multiple interventions are available to reduce excess body weight in children. We appraised the quality of evidence supporting each intervention and assessed the... (Review)
Review
OBJECTIVE
Multiple interventions are available to reduce excess body weight in children. We appraised the quality of evidence supporting each intervention and assessed the effectiveness on different obesity-related outcomes.
METHODS
We conducted a systematic search for systematic reviews of randomized controlled trials evaluating pediatric obesity interventions applied for ≥6 months. We assessed the quality of evidence for each intervention using GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach.
RESULTS
From 16 systematic reviews, we identified 133 eligible randomized controlled trials. Physical activity interventions reduced systolic blood pressure and fasting glucose (low to moderate quality of evidence). Dietary interventions with low-carbohydrate diets had a similar effect to low-fat diets in terms of body mass index (BMI) reduction (moderate quality of evidence). Educational interventions reduced waist circumference, BMI, and diastolic blood pressure (low quality of evidence). Pharmacological interventions reduced BMI (metformin, sibutramine, orlistat) and waist circumference (sibutramine, orlistat) and increased high-density lipoprotein cholesterol (sibutramine) but also raised systolic and diastolic blood pressure (sibutramine). Surgical interventions (laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, sleeve gastrectomy) resulted in the largest BMI reduction (moderate quality of evidence). Combined interventions consisting of dietary modification, physical activity, behavioral therapy, and education significantly reduced systolic and diastolic blood pressure, BMI, and triglycerides. Combined parent-child interventions and parent-only interventions had similar effects on BMI (low quality of evidence).
CONCLUSIONS
Several childhood obesity interventions are effective in improving metabolic and anthropometric measures. A comprehensive multicomponent intervention, however, appears to have the best overall outcomes.
Topics: Adolescent; Anti-Obesity Agents; Appetite Depressants; Bariatric Surgery; Behavior Therapy; Blood Glucose; Blood Pressure; Body Mass Index; Child; Cholesterol, HDL; Cyclobutanes; Diet Therapy; Diet, Carbohydrate-Restricted; Diet, Fat-Restricted; Exercise; Exercise Therapy; Gastrectomy; Gastric Bypass; Humans; Hypoglycemic Agents; Lactones; Metformin; Orlistat; Patient Education as Topic; Pediatric Obesity; Treatment Outcome; Triglycerides; Waist Circumference
PubMed: 28359101
DOI: 10.1210/jc.2016-2574 -
Arteriosclerosis, Thrombosis, and... Apr 2015Childhood obesity is associated with risk factors for cardiovascular disease. Arterial stiffness is considered one of the earliest detectable measures of vascular... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Childhood obesity is associated with risk factors for cardiovascular disease. Arterial stiffness is considered one of the earliest detectable measures of vascular damage. There is controversy in the literature regarding the effects of childhood obesity on arterial stiffness. The objective of this study is to systematically review the literature and to conduct a meta-analysis comparing measures of central arterial stiffness in children and adolescents with obesity to healthy body mass index controls.
APPROACH AND RESULTS
Literature searches were conducted using databases (eg, MEDLINE, EMBASE) and citations cross-referenced. Studies assessing central pulse wave velocity or β-stiffness index were included. A random effects meta-analysis of the standardized mean difference and 95% confidence intervals in arterial stiffness between children with obesity and control children was performed for each arterial stiffness measure. A total of 523 studies were identified. Fifteen case-control studies were included, with 2237 children/adolescents (1281 with obesity, 956 healthy body mass index controls) between 5 and 24 years of age. All studies measuring carotid and aortic β-stiffness index and 10/12 studies measuring central pulse wave velocity reported greater arterial stiffness in children/adolescents with obesity compared with controls. A random effects meta-analysis was performed revealing a significant effect of obesity on pulse wave velocity (standardized mean difference=0.718; 95% confidence interval=0.291-1.415), carotid β-stiffness index (0.862; 0.323-1.402), and aortic β stiffness index (1.017; 0.419-1.615).
CONCLUSION
These findings indicate that child/adolescent obesity is associated with greater arterial stiffness. However, further research is needed to address confounders, such as pubertal status, that may affect this relationship in children. In the future, these techniques may be useful in risk stratification and guiding clinical management of obese children to optimize cardiovascular outcomes.
Topics: Adolescent; Age Factors; Body Mass Index; Cardiovascular Diseases; Child; Child, Preschool; Female; Humans; Male; Odds Ratio; Pediatric Obesity; Predictive Value of Tests; Pulse Wave Analysis; Risk Assessment; Risk Factors; Vascular Stiffness; Young Adult
PubMed: 25633314
DOI: 10.1161/ATVBAHA.114.305062 -
Obesity Reviews : An Official Journal... Dec 2017Regular school attendance is a key determinant of student's academic achievement and psychosocial development. Obesity may affect children's school attendance through... (Meta-Analysis)
Meta-Analysis Review
Regular school attendance is a key determinant of student's academic achievement and psychosocial development. Obesity may affect children's school attendance through its detrimental impact on their physical and mental health. A literature search was conducted in the PubMed, Web of Science and Cochrane Library for articles published until April 2017 that examined the relationship between unhealthy body weight and school absenteeism among children and adolescents. Thirteen studies total (10 cross-sectional and three longitudinal) conducted in seven countries were identified. The mean and median sample sizes were 24,861 and 3,113, respectively. Ten studies objectively measured children's height and weight, and three were based on parents' self-report. Four studies measured absenteeism using school administrative data, and nine administered questionnaires on children's parents. Among them, 11 reported a statistically significant positive association between childhood overweight/obesity and school absence, whereas two reported null effect. The meta-analysis found that the odds of being absent from school was 27% and 54% higher among children with overweight and obesity than among their normal weight counterparts, respectively. Future studies should adopt an experimental study design and accurate measures on school attendance and delineate the underlining pathways linking childhood obesity to school absenteeism through obesity-related illnesses and psychosocial problems.
Topics: Absenteeism; Adolescent; Child; Humans; Pediatric Obesity; Schools
PubMed: 28925105
DOI: 10.1111/obr.12599