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Obesity Reviews : An Official Journal... Mar 2020Obesity and dental caries in children are significant health problems. The aims of this review are to identify whether children aged 6 years and younger with overweight... (Meta-Analysis)
Meta-Analysis
Obesity and dental caries in children are significant health problems. The aims of this review are to identify whether children aged 6 years and younger with overweight and/or obesity have higher dental caries experience compared with children with normal weight and, secondly, to identify the common risk factors associated with both conditions. Medline, Embase, and seven other databases were systematically searched followed by lateral searches from reference lists, grey literature, theses, conference proceedings, and contacting field experts. Longitudinal observational studies addressing overweight and/or obesity and dental caries in children aged 6 years and younger were included. A random effects model meta-analyses were applied. Nine studies were included in this review. Children with overweight and obesity had a significantly higher dental caries experience compared with children with normal weight (n = 6). The pooled estimates showed that difference in caries experience between the two groups was statistically significant. Low levels of parental income and education were identified to be associated with both conditions in the sample population. Children with overweight and obesity are more vulnerable to dental caries. Low levels of parental income and education influence the relationship between the two conditions. However, the quality of evidence varied considerably; therefore, findings should be interpreted cautiously.
Topics: Child; Child, Preschool; Databases, Factual; Dental Caries; Educational Status; Female; Humans; Infant; Male; Pediatric Obesity; Poverty; Risk Factors
PubMed: 31721413
DOI: 10.1111/obr.12960 -
International Journal of Environmental... Jun 2022The dramatic lifestyle changes forced by COVID-19-related lockdown promoted weight gain, with a stronger impact on obese subjects, at higher risk of severe infection.... (Meta-Analysis)
Meta-Analysis
The dramatic lifestyle changes forced by COVID-19-related lockdown promoted weight gain, with a stronger impact on obese subjects, at higher risk of severe infection. The PubMed database was searched to identify original studies assessing: (1) the extent and risk factors of lockdown-induced weight increase; and (2) the impact of obesity on the risk of hospital admission in children and adolescents. A systematic literature review and meta-analyses were performed. Twenty out of 13,986 identified records were included. A significant weight increase was reported in the majority of subjects, with no apparent gender or age differences. It was induced by a higher consumption of hypercaloric/hyperglycemic/junk food and/or the reduction of physical activity, often associated with an altered sleep-wake cycle. On the other hand, obesity increased the risk of hospitalization (OR = 4.38; 95% C.I. 1.46-13.19; = 0.009; = 96%) as compared to the normal weight population. COVID-19 and obesity represent epidemic conditions with reciprocal detrimental impact. Urgent public health interventions, targeting the various age and social strata, and involving governmental authorities, health care personnel, teachers and families are warranted to increase awareness and actively promote healthy lifestyles to contrast pediatric obesity and its detrimental consequences at a global level.
Topics: Adolescent; COVID-19; Child; Communicable Disease Control; Exercise; Humans; Life Style; Pediatric Obesity; Weight Gain
PubMed: 35805260
DOI: 10.3390/ijerph19137603 -
Critical Reviews in Oncogenesis 2019Obesity in the United States has been identified as one of the most prevalent health epidemics affecting both adults and children, and it has become the focus of a...
BACKGROUND
Obesity in the United States has been identified as one of the most prevalent health epidemics affecting both adults and children, and it has become the focus of a variety of primary, secondary, and tertiary healthcare interventions.
OBJECTIVES
To summarize and assess the efficacy of current practices in the management and treatment of pediatric overweight and obesity.
METHODS
An extensive review of the literature was performed. This review examined five areas of intervention most commonly used to manage and treat pediatric overweight and obesity: physical activity, nutritional and behavioral interventions, pharmaceutical management, and surgical procedures.
RESULTS
Of 82 sources, 43 studies met our inclusion and exclusion criteria. However, after evaluating study strength using the PEDro, 24 were included in this systematic review. The studies, which included RCTs and cohort studies of levels I and II evidence, respectively, were evaluated for methodological quality using the PEDro scale. Programs that combined decreased sedentary behaviors and nutritional modifications had the most significant results in changes in body mass index (BMI) and weight gain or weight loss.
CONCLUSION
To ensure successful management and treatment of pediatric obesity, the most successful paradigm of intervention is through a multidisciplinary approach: physical activity, nutrition, and behavioral strategies. Behavioral interventions should support and reinforce physical activity and nutritional modifications. Because of the potential health risks involved to the child, pharmaceutical and surgical approaches are considered only when all other interventions have failed.
Topics: Cohort Studies; Diet, Healthy; Exercise; Humans; Overweight; Pediatric Obesity; Randomized Controlled Trials as Topic; Risk Reduction Behavior; Treatment Outcome
PubMed: 32422025
DOI: 10.1615/CritRevOncog.2019033037 -
Obesity Reviews : An Official Journal... Feb 2021A growing body of research links traffic-related environmental factors to childhood obesity; however, the evidence is still inconclusive. This review aims to fill this... (Meta-Analysis)
Meta-Analysis
A growing body of research links traffic-related environmental factors to childhood obesity; however, the evidence is still inconclusive. This review aims to fill this important research gap by systematically reviewing existing research on the relationship between traffic-related environmental factors and childhood obesity. Based on the inclusion criteria, 39 studies are selected with environmental factors of interest, including traffic flow, traffic pollution, traffic noise, and traffic safety. Weight-related behaviours include active travel/transport, physical activity (PA), and intake of a high trans-fat diet or stress symptoms; weight-related outcomes are mainly body mass index (BMI) or BMI z-scores and overweight/obesity. Of 16 studies of weight-related behaviours, significant associations are reported in 11 out of 12 studies on traffic flow (two positively and nine negatively associated with PA), five out of six studies on traffic safety (four positively and one negatively associated with PA), one study on traffic pollution (positively with unhealthy food consumption), and one study on traffic noise (negatively associated with PA). Among 23 studies of weight-related outcomes, significant associations are reported in six out of 14 studies on traffic flow (five positively and one negatively associated with obesity outcome), seven out of 10 studies on traffic pollution (all positively associated with obesity outcome), and two out of five on traffic noise (all positively associated with obesity outcome). Our findings show that long-term traffic pollution is weakly positively associated with children's BMI growth, and traffic flow, pollution, and noise could affect weight-related behaviours. Associations between traffic density and noise and weight status are rather inconclusive.
Topics: Body Mass Index; Child; Exercise; Humans; Overweight; Pediatric Obesity
PubMed: 32003149
DOI: 10.1111/obr.12995 -
Obesity Reviews : An Official Journal... Feb 2021The lack of access to fruit/vegetable markets (FVMs) is thought to be a risk factor for childhood obesity by discouraging healthy dietary behaviours while encouraging...
The lack of access to fruit/vegetable markets (FVMs) is thought to be a risk factor for childhood obesity by discouraging healthy dietary behaviours while encouraging access to venues that offer more unhealthy food (and thus the compensatory intake of those options). However, findings remain mixed, and there has not been a review of the association between FVM access and childhood obesity. A comprehensive and systematic understanding of this epidemiologic relationship is important to the design and implementation of relevant public health policies. In this study, a literature search was conducted in the Cochrane Library, PubMed, and Web of Science for articles published before 1 January 2019 that focused on the association between neighbourhood FVM access and weight-related behaviours and outcomes among children and adolescents. Eight cross-sectional studies, two longitudinal studies, and one ecological study conducted in five countries were identified. The median sample size was 2142 ± 1371. Weight-related behaviours and outcomes were used as the outcome variable in two and eight studies, respectively, with one study using both weight-related behaviours and outcomes as outcome variables. We still found a negative association between access to FVMs in children's residential and school neighbourhoods and weight-related behaviours and an inconclusive association between FVM access and overweight or obesity. This conclusion should be regarded as provisional because of a limited amount of relevant evidence and may not be a strong guide for policymaking. Nonetheless, it points to an important research gap that needs to be filled if successful public health interventions are to be undertaken.
Topics: Adolescent; Child; Cross-Sectional Studies; Diet; Fruit; Humans; Pediatric Obesity; Vegetables
PubMed: 31943666
DOI: 10.1111/obr.12980 -
Current Obesity Reports Sep 2017The purposes of this study were to review the evidence on longitudinal associations between child and adolescent obesity and academic achievement and to provide... (Review)
Review
PURPOSE
The purposes of this study were to review the evidence on longitudinal associations between child and adolescent obesity and academic achievement and to provide perceptions of adolescents with obesity and their parents on this topic.
RECENT FINDINGS
Synthesis of 31 studies (from 17 cohorts) suggested that relationships between obesity and academic achievement are not well established, except for adolescent girls' maths attainment, potentially mediated by both weight-related bullying and executive cognitive functions. Focus groups with adolescent girls with obesity confirmed experiences of psychosocial distress at school particularly during Physical Education. Adolescents perceived that obesity was not related to academic achievement directly, but by their attitude to school. Interventions are warranted to promote psychosocial wellbeing and cognitive abilities linked to academic achievement in adolescent girls with obesity. Physical Education should be a positive experience for children and adolescents with obesity.
Topics: Academic Success; Adolescent; Child; Focus Groups; Humans; Longitudinal Studies; Pediatric Obesity
PubMed: 28695352
DOI: 10.1007/s13679-017-0272-9 -
Nutrients Feb 2023A healthy diet is essential to prevent childhood obesity, however, adherence to a healthy diet is challenging. The aim of this study was to give a comprehensive overview... (Meta-Analysis)
Meta-Analysis Review
A healthy diet is essential to prevent childhood obesity, however, adherence to a healthy diet is challenging. The aim of this study was to give a comprehensive overview of the literature investigaating associations between food and beverages and overweight/obesity in children and adolescents in order to identify dietary risk factors. A systematic search was performed in four databases and observational studies were included. Meta-analysis was performed using the random effect model. Sixty records met inclusion criteria and 14 different food or beverage categories were identified. A higher intake of sugar-sweetened beverages increased the odds of overweight/obesity by 1.20 ( < 0.05) ( = 26) and higher intake of fast food increased the odds of overweight/obesity by 1.17 ( < 0.05) ( = 24). Furthermore, higher intake of meat (OR 1.02, < 0.05 (:7)) and refined grains (OR 1.28, < 0.05 (:3)) was associated with an increased risk of overweight/obesity. In contrast, higher intake of whole grain (OR 0.86, = 0.04 (:5)) and more surprisingly sweet bakery (OR 0.59, < 0.05 (:3)) was associated with a decreased risk of overweight/obesity. In conclusion, a higher intake of sugar-sweetened beverages and a higher intake of fast food was identified as the primary dietary risk factors for overweight/obesity. Future research is needed to strengthen the generalizability of these results.
Topics: Humans; Child; Adolescent; Overweight; Pediatric Obesity; Beverages; Diet; Fast Foods
PubMed: 36771470
DOI: 10.3390/nu15030764 -
Nutrition, Metabolism, and... Sep 2017The prevalence of obesity is continually increasing worldwide. Determining risk factors for obesity may facilitate effective preventive programs. The present review... (Review)
Review
AIM
The prevalence of obesity is continually increasing worldwide. Determining risk factors for obesity may facilitate effective preventive programs. The present review focuses on sleep duration as a potential risk factor for childhood obesity. The aim is to summarize the evidence on the association of sleep duration and obesity and to discuss the underlying potential physiological and/or pathophysiological mechanisms.
DATA SYNTHESIS
The Ovid MEDLINE, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for papers using text words with appropriate truncation and relevant indexing terms. All studies objectively measuring sleep duration and investigating the association between sleep duration and obesity or factors (lifestyle and hormonal) possibly associated with obesity were included, without making restrictions based on study design or language. Data from eligible studies were extracted in tabular form and summarized narratively. After removing duplicates, 3540 articles were obtained. Finally, 33 studies (including 3 randomized controlled trials and 30 observational studies) were included in the review.
CONCLUSION
Sleep duration seems to influence weight gain in children, however, the underlying explanatory mechanisms are still uncertain. In our review only the link between short sleep duration and the development of insulin resistance, sedentarism and unhealthy dietary patterns could be verified, while the role of other mediators, such as physical activity, screen time, change in ghrelin and leptin levels, remained uncertain. There are numerous evidence gaps. To answer the remaining questions, there is a need for studies meeting high methodological standards and including a large number of children.
Topics: Adipokines; Adolescent; Age Factors; Biomarkers; Blood Glucose; Child; Diet; Exercise; Feeding Behavior; Female; Humans; Insulin; Insulin Resistance; Life Style; Male; Nutritional Status; Pediatric Obesity; Risk Assessment; Risk Factors; Sedentary Behavior; Sleep; Sleep Wake Disorders; Time Factors; Weight Gain
PubMed: 28818457
DOI: 10.1016/j.numecd.2017.07.008 -
The Cochrane Database of Systematic... Mar 2014The prevalence of overweight and obesity in childhood and adolescence is high. Excessive body fat at a young age is likely to persist into adulthood and is associated... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The prevalence of overweight and obesity in childhood and adolescence is high. Excessive body fat at a young age is likely to persist into adulthood and is associated with physical and psychosocial co-morbidities, as well as lower cognitive, school and later life achievement. Lifestyle changes, including reduced caloric intake, decreased sedentary behaviour and increased physical activity, are recommended for prevention and treatment of child and adolescent obesity. Evidence suggests that lifestyle interventions can benefit cognitive function and school achievement in children of normal weight. Similar beneficial effects may be seen in overweight or obese children and adolescents.
OBJECTIVES
To assess whether lifestyle interventions (in the areas of diet, physical activity, sedentary behaviour and behavioural therapy) improve school achievement, cognitive function and future success in overweight or obese children and adolescents compared with standard care, waiting list control, no treatment or attention control.
SEARCH METHODS
We searched the following databases in May 2013: CENTRAL, MEDLINE, EMBASE, CINAHL Plus, PsycINFO, ERIC, IBSS, Cochrane Database of Systematic Reviews, DARE, ISI Conference Proceedings Citation Index, SPORTDiscus, Database on Obesity and Sedentary Behaviour Studies, Database of Promoting Health Effectiveness Reviews (DoPHER) and Database of Health Promotion Research. In addition, we searched the Network Digital Library of Theses and Dissertations (NDLTD), three trials registries and reference lists. We also contacted researchers in the field.
SELECTION CRITERIA
We included (cluster) randomised and controlled clinical trials of lifestyle interventions for weight management in overweight or obese children three to 18 years of age. Studies in children with medical conditions known to affect weight status, school achievement and cognitive function were excluded.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected studies, extracted data, assessed quality and risk of bias and cross-checked extracts to resolve discrepancies when required. Authors were contacted to obtain further study details and were asked to provide data on the overweight and obese study population when they were not reported separately.
MAIN RESULTS
Of 529 screened full-text articles, we included in the review six studies (14 articles) of 674 overweight and obese children and adolescents, comprising four studies with multicomponent lifestyle interventions and two studies with physical activity only interventions. We conducted a meta-analysis when possible and a sensitivity analysis to consider the impact of cluster-randomised controlled trials and/or studies at 'high risk' of attrition bias on the intervention effect. We prioritised reporting of the sensitivity analysis when risk of bias and differences in intervention type and duration were suspected to have influenced the findings substantially. Analysis of a single study indicated that school-based healthy lifestyle education combined with nutrition interventions can produce small improvements in overall school achievement (mean difference (MD) 1.78 points on a scale of zero to 100, 95% confidence interval (CI) 0.8 to 2.76; P < 0.001; N = 321; moderate-quality evidence). Single component physical activity interventions produced small improvements in mathematics achievement (MD 3.00 points on a scale of zero to 200, 95% CI 0.78 to 5.22; P value = 0.008; one RCT; N = 96; high-quality evidence), executive function (MD 3.00, scale mean 100, standard deviation (SD) 15, 95% CI 0.09 to 5.91; P value = 0.04; one RCT; N = 116) and working memory (MD 3.00, scale mean 100, SD 15, 95% CI 0.51 to 5.49; P value = 0.02; one RCT; N = 116). No evidence suggested an effect of any lifestyle intervention on reading, vocabulary and language achievements, attention, inhibitory control and simultaneous processing. Pooling of data in meta-analyses was restricted by variations in study design. Heterogeneity was present within some meta-analyses and may have been explained by differences in types of interventions. Risk of bias was low for most assessed items; however in half of the studies, risk of bias was detected for attrition, participant selection and blinding. No study provided evidence of the effect of lifestyle interventions on future success. Whether changes in academic and cognitive abilities were connected to changes in body weight status was unclear because of conflicting findings and variations in study design.
AUTHORS' CONCLUSIONS
Despite the large number of childhood obesity treatment trials, evidence regarding their impact on school achievement and cognitive abilities is lacking. Existing studies have a range of methodological issues affecting the quality of evidence. Multicomponent interventions targeting physical activity and healthy diet could benefit general school achievement, whereas a physical activity intervention delivered for childhood weight management could benefit mathematics achievement, executive function and working memory. Although the effects are small, a very large number of children and adolescents could benefit from these interventions. Therefore health policy makers may wish to consider these potential additional benefits when promoting physical activity and healthy eating in schools. Future obesity treatment trials are needed to examine overweight or obese children and adolescents and to report academic and cognitive as well as physical outcomes.
Topics: Achievement; Adolescent; Child; Educational Status; Executive Function; Exercise; Humans; Life Style; Mathematics; Overweight; Pediatric Obesity; Randomized Controlled Trials as Topic; Sensitivity and Specificity
PubMed: 24627300
DOI: 10.1002/14651858.CD009728.pub2 -
Preventive Medicine Feb 2024The incidence of obesity and overweight in children and adolescents is increasing worldwide and becomes a global health concern. This study aims to evaluate the accuracy... (Meta-Analysis)
Meta-Analysis
The incidence of obesity and overweight in children and adolescents is increasing worldwide and becomes a global health concern. This study aims to evaluate the accuracy of available prediction models in early identification of obesity and overweight in general children or adolescents and identify predictive factors for the models, thus provide a reference for subsequent development of risk prediction tools for obesity and overweight in children or adolescents. Related publications were obtained from several databases such as PubMed, Embase, Cochrane Library, and Web of Science from their inception to September 18th, 2022. The novel Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed to assess the bias risk of the included studies. R4.2.0 and Stata15.1 softwares were used to conduct meta-analysis. This study involved 45 cross-sectional and/or prospective studies with 126 models. Meta-analyses showed that the overall pooled index of concordance (c-index) of prediction models for children/adolescents with obesity and overweight in the training set was 0.769 (95% CI 0.754-0.785) and 0.835(95% CI 0.792-0.879), respectively. Additionally, a large number of predictors were found to be related to children's lifestyles, such as sleep duration, sleep quality, and eating speed. In conclusions, prediction models can be employed to predict obesity/overweight in children and adolescents. Most predictors are controllable factors and are associated with lifestyle. Therefore, the prediction model serves as an excellent tool to formulate effective strategies for combating obesity/overweight in pediatric patients.
Topics: Adolescent; Child; Humans; Cross-Sectional Studies; Overweight; Pediatric Obesity; Prospective Studies; Risk Assessment; Risk Factors
PubMed: 38103795
DOI: 10.1016/j.ypmed.2023.107823