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Obesity Reviews : An Official Journal... Feb 2021Street connectivity, as a neighbourhood built environmental factor, may affect individual physical activity (PA) and subsequently weight status. However, these... (Meta-Analysis)
Meta-Analysis
Street connectivity, as a neighbourhood built environmental factor, may affect individual physical activity (PA) and subsequently weight status. However, these associations remain inconclusive. This study aimed to systematically review the association between street connectivity and childhood obesity. A literature search was conducted in the Cochrane Library, PubMed, and Web of Science for articles published before January 1, 2019. All original studies that investigated the association between street connectivity and weight-related behaviours or outcomes among children and adolescents were included. Forty-seven articles were identified, including eight longitudinal and 41 cross-sectional studies conducted in eight countries. The sample size ranged from 88 to 46 813. Street intersection density (SID), measured by Geographic Information Systems in 36 studies and reported in 13 studies, was the main indicator used to represent street connectivity. Forty-four studies examined the association between SID and weight-related behaviours, including overall PA (n = 15), moderate-to-vigorous PA (n = 13), active transport (n = 12), dog walking (n = 1), walking (n = 1), sedentary behaviours (n = 2), and TV viewing (n = 1). Fifteen studies focused on the association between SID and weight-related outcomes. Overall, evidence from this systematic review and meta-analyses suggested a positive association between street connectivity and PA. However, it was difficult to draw a conclusion on the association between street connectivity and BMI. More longitudinal evidence is needed to confirm the causal association between street connectivity and weight status.
Topics: Child; Cross-Sectional Studies; Environment Design; Humans; Pediatric Obesity; Residence Characteristics; Walking
PubMed: 31507068
DOI: 10.1111/obr.12943 -
JAMA Network Open Jul 2020The appropriate approach for weight loss among children and adolescents with overweight and obesity remains unclear. (Meta-Analysis)
Meta-Analysis
IMPORTANCE
The appropriate approach for weight loss among children and adolescents with overweight and obesity remains unclear.
OBJECTIVE
To evaluate the difference in the treatment outcomes associated with behavioral weight loss interventions led by laypersons and professionals in comparison with unsupervised control arms among children and adolescents with overweight and obesity.
DATA SOURCES
For this systematic review and meta-analysis, the Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, the Cochrane Library, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases were searched from January 1, 1996, to June 1, 2019.
STUDY SELECTION
Included in this study were randomized clinical trials (RCTs) of behavioral interventions lasting at least 12 weeks for children and adolescents (aged 5-18 years) with overweight and obesity. Exclusion criteria included non-RCT studies, interventions lasting less than 12 weeks, adult enrollment, participants with other medical diagnoses, pharmacological treatment use, and articles not written in English. Two of 6 reviewers independently screened all citations. Of 25 586 citations, after duplicate removal, 78 RCTs (5780 participants) met eligibility criteria.
DATA EXTRACTION AND SYNTHESIS
A bayesian framework and Markov chain Monte Carlo simulation methods were used to combine direct and indirect associations. Random-effects and fixed-effect network meta-analysis models were used with the preferred model chosen by comparing the deviance information criteria. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.
MAIN OUTCOMES AND MEASURES
The immediate and sustained changes in weight and body mass index (BMI) standardized mean difference (SMD) were primary outcomes planned before data collection began, whereas waist circumference and percent body fat were secondary outcomes. The hypothesis being tested was formulated before the data collection.
RESULTS
Of 25 586 citations retrieved, we included 78 RCTs (5780 participants), with a follow-up of 12 to 104 weeks. Compared with the control condition, random-effects models revealed that professional-led weight loss interventions were associated with reductions in weight (mean difference [MD], -1.60 kg [95% CI, -2.30 to -0.99 kg]; 68 trials; P < .001) and BMI (SMD, -0.30 [95% CI, -0.39 to -0.20]; 59 trials; P < .001) that were not sustained long term (weight MD, -1.02 kg [95% CI, -2.20 to 0.34 kg]; 21 trials; P = .06; BMI SMD, -0.12 [95% CI, -0.46 to 0.21]; 20 trials; P < .001). There was no association between layperson-led interventions and weight loss in the short-term (MD, -1.40 kg [95% CI, -3.00 to 0.26 kg]; 5 trials; P = .05) or long-term (MD, -0.98 kg [95% CI, -3.60 to 1.80 kg]; 1 trial; P = .23) compared with standard care. No difference was found in head-to-head trials (professional vs layperson MD, -0.25 kg [95% CI -1.90 to 1.30 kg]; 5 trials; P = .38).
CONCLUSIONS AND RELEVANCE
This systematic review and meta-analysis found that professional-led weight loss interventions were associated with short-term but not sustained weight reduction among children and adolescents with overweight or obesity, and the evidence for layperson-led approaches was insufficient to draw firm conclusions.
Topics: Adolescent; Child; Health Personnel; Humans; Pediatric Obesity; Weight Reduction Programs
PubMed: 32658289
DOI: 10.1001/jamanetworkopen.2020.10364 -
Clinical Obesity Feb 2018Survivors of childhood brain tumours (SCBT) have increased cardiometabolic risks, but the determinants of these risks are unclear. This systematic review aims to compare... (Meta-Analysis)
Meta-Analysis Review
Survivors of childhood brain tumours (SCBT) have increased cardiometabolic risks, but the determinants of these risks are unclear. This systematic review aims to compare the prevalence of overweight and obesity as well as adiposity measures between SCBT and non-cancer controls. The PubMed, EMBASE, MEDLINE, CINAHL and the Cochrane Library databases were searched. The primary outcomes were the prevalence of overweight and obesity based on body mass index. The secondary outcomes were adiposity measures including percent fat mass, waist-to-hip and waist-to-height ratios. Forty-one studies were included in the meta-analysis. The prevalence of overweight and obesity combined was similar between overall SCBT, SCBT excluding craniopharyngioma and non-cancer controls (42.6%, 95% CI 30.1-55.1 vs. 31.7%, 95% CI 20.4-43.0 vs. 40.4%, 95% CI 34.0-46.8). We also found that SCBT have higher percent fat mass (mean difference 4.1%, 95% CI 2.0-6.1), waist-to-hip ratio (mean difference 0.07, 95% CI 0.02-0.13) and waist-to-height ratio (mean difference 0.06, 95% CI 0.01-0.10) than non-cancer controls. We conclude that SCBT have similar overweight and obesity distribution but higher adiposity than non-cancer controls. More studies were needed to explore the determinants of adiposity and its contribution to cardiometabolic outcomes in SCBT.
Topics: Adiposity; Adolescent; Brain Neoplasms; Cancer Survivors; Chi-Square Distribution; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Odds Ratio; Overweight; Pediatric Obesity; Prevalence; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; Young Adult
PubMed: 29024558
DOI: 10.1111/cob.12224 -
International Journal of Environmental... Apr 2023Childhood obesity is considered a major public health problem. To help prevention and intervention programs targeting families with obese children, this paper is aimed... (Review)
Review
Childhood obesity is considered a major public health problem. To help prevention and intervention programs targeting families with obese children, this paper is aimed at synthesizing multifactorial and transactional data resulting from studies and reviews assessing relational factors between the child and his or her parents and the child's obesity risk, including the child's and CG's attachment quality, parental feeding practices, and family routines. It is also aimed at assessing the mediation of these links by specific self-regulatory capacities across different developmental periods (0-2, 2-8, and 8-18 years old). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were applied in the review methodology. Ten papers were analyzed, including seven empirical studies and three reviews proposing etiological models of childhood obesity. The quality of empirical studies was assessed, and a synthetical model of the results was proposed. This literature review showed that the caregiver's (CG) and the child's attachment quality, along with controlling or permissive feeding practices, and few family routines are mostly mediated by appetite dysregulation and emotional regulation strategies with the development of child obesity. New research topics are proposed to understand other facets of childhood obesity, as well as how to better prevent and treat it.
Topics: Humans; Child; Male; Female; Pediatric Obesity; Family Practice; Feeding Behavior; Appetite; Emotional Regulation
PubMed: 37107778
DOI: 10.3390/ijerph20085496 -
Obesity Reviews : An Official Journal... Feb 2021Childhood obesity is one of the most pressing public health issues nowadays. The environmental factors have been identified as potential risks for obesity, as they may...
Childhood obesity is one of the most pressing public health issues nowadays. The environmental factors have been identified as potential risks for obesity, as they may influence people's lifestyle behaviours. Lack of access to supermarkets that usually provide healthy food options has been found to be a risk factor for childhood obesity in several studies. However, findings remained inconclusive. We aimed to systematically review the association between access to supermarkets and childhood obesity. A literature search was conducted in the Cochrane Library, PubMed, Web of Science, and Embase for studies published before 1 January 2019. Twenty-four studies conducted in four countries were identified, from which data on the basic characteristics of studies and participants, measures of access to supermarkets, and associations between access to supermarkets and weight-related behaviours and outcomes were extracted. The median sample size was 1858 participants. Half of the included studies indicated a negative association, one fourth reported a positive association, and the remaining one fourth did not find a significant association. Better designed studies are necessary to achieve a robust understanding of this epidemiological relationship in the future.
Topics: Child; Humans; Pediatric Obesity; Residence Characteristics; Risk Factors; Supermarkets
PubMed: 31482658
DOI: 10.1111/obr.12937 -
Revista Paulista de Pediatria : Orgao... Dec 2016To assess the effects of obesity on lung volume and capacity in children and adolescents. (Review)
Review
OBJECTIVE
To assess the effects of obesity on lung volume and capacity in children and adolescents.
DATA SOURCE
This is a systematic review, carried out in Pubmed, Lilacs, Scielo and PEDro databases, using the following Keywords: Plethysmography; Whole Body OR Lung Volume Measurements OR Total Lung Capacity OR Functional Residual Capacity OR Residual Volume AND Obesity. Observational studies or clinical trials that assessed the effects of obesity on lung volume and capacity in children and adolescents (0-18 years) without any other associated disease; in English; Portuguese and Spanish languages were selected. Methodological quality was assessed by the Agency for Healthcare Research and Quality.
DATA SYNTHESIS
Of the 1,030 articles, only four were included in the review. The studies amounted to 548 participants, predominantly males, with sample size ranging from 45 to 327 individuals. 100% of the studies evaluated nutritional status through BMI (z-score) and 50.0% reported the data on abdominal circumference. All demonstrated that obesity causes negative effects on lung volume and capacity, causing a reduction mainly in functional residual capacity in 75.0% of the studies; in the expiratory reserve volume in 50.0% and in the residual volume in 25.0%. The methodological quality ranged from moderate to high, with 75.0% of the studies classified as having high methodological quality.
CONCLUSIONS
Obesity causes deleterious effects on lung volume and capacity in children and adolescents, mainly by reducing functional residual capacity, expiratory reserve volume and residual volume.
Topics: Adolescent; Child; Humans; Lung; Lung Volume Measurements; Pediatric Obesity
PubMed: 27130483
DOI: 10.1016/j.rpped.2016.02.008 -
BMC Public Health Jan 2024Childhood obesity remains a significant public health concern. Sleep duration and quality among children and youth are suboptimal worldwide. Accumulating evidence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Childhood obesity remains a significant public health concern. Sleep duration and quality among children and youth are suboptimal worldwide. Accumulating evidence suggests an association between inadequate sleep and obesity risk, yet it is unclear whether this relationship is causal. This systematic review examines the efficacy of sleep interventions alone or as a part of lifestyle interventions for the management of overweight or obesity among children and adolescents.
METHODS
A keyword/reference search was performed twice, in January 2021 and May 2022 in MEDLINE/PubMed, EMBASE/Ovid, PsycINFO/EBSCO, The Cochrane Library, Web of Science Core Collection/Web of Science, SciELO/Web of Science, and CINAHL/EBSCO. Study eligibility criteria included youth with overweight or obesity between 5 and 17, were RCTs or quasi-randomized, and focused on the treatment of overweight and obesity with a sleep behavior intervention component. Risk of bias was assessed using the Cochrane Risk of Bias assessment tool (RoB2). A Meta-analysis was conducted to estimate the effect of interventions with a sleep component on BMI. The study protocol was registered in PROSPERO (CRD42021233329).
RESULTS
A total of 8 studies (2 quasi-experiments, 6 RCTs) met inclusion criteria and accounted for 2,231 participants across 7 countries. Only one study design isolated the effect of sleep in the intervention and reported statistically significant decreases in weight and waist circumference compared to control, though we rated it at high risk of bias. Our meta-analysis showed no significant overall effect on children's BMI as a result of participation in an intervention with a sleep component (Cohen's d = 0.18, 95% CI= -0.04, 0.40, Z = 1.56, P = .11), though caution is warranted due to substantial heterogeneity observed across studies (Tau = 0.08; X = 23.05, df = 7; I = 83.73%).
CONCLUSIONS
There were mixed results on the effect of sleep interventions across included studies on BMI, other weight-related outcomes, diet, physical activity, and sleep. Except for one study at low risk of bias, three were rated as 'some concerns' and four 'high risk of bias'. Findings from this study highlight the need for additional RCTs isolating sleep as a component, focusing on children and adolescents living with overweight and obesity.
Topics: Adolescent; Child; Humans; Overweight; Pediatric Obesity; Life Style; Diet; Sleep
PubMed: 38287352
DOI: 10.1186/s12889-024-17708-6 -
Journal of Renal Nutrition : the... Jul 2023Childhood obesity is considered one of the important risk factors for many long-term morbidities. However, the long-term consequences of childhood obesity on kidney... (Review)
Review
Childhood obesity is considered one of the important risk factors for many long-term morbidities. However, the long-term consequences of childhood obesity on kidney function are largely unknown. In this systematic review, all prospective or retrospective cohort studies and nested case-control articles which investigated association of childhood obesity with later life kidney function were searched via some international databases including PubMed, Scopus, Web of Science and Google Scholar. After screening 6,843 published articles, 8 prospective cohorts studies were included in the qualitative synthesis. All the included studies were published in the last 10 years. The overall follow-up duration of studies ranged from 8 to 64 years. Out of 8 included studies, 6 reported a statistically significant positive association between higher BMI levels in early life and greater renal disease risk in later life. Evidence from various populations implicates a positive link between obesity in early life and kidney disease in later life.
Topics: Child; Humans; Pediatric Obesity; Prospective Studies; Retrospective Studies; Kidney Diseases; Kidney
PubMed: 36963736
DOI: 10.1053/j.jrn.2023.03.003 -
Molecular Medicine (Cambridge, Mass.) Nov 2021The alarming trend of paediatric obesity deserves our greatest awareness to hinder the early onset of metabolic complications impacting growth and functionality....
BACKGROUND
The alarming trend of paediatric obesity deserves our greatest awareness to hinder the early onset of metabolic complications impacting growth and functionality. Presently, insight into molecular mechanisms of childhood obesity and associated metabolic comorbidities is limited. This systematic review aimed at scrutinising what has been reported on putative metabolites distinctive for metabolic abnormalities manifesting at young age by searching three literature databases (Web of Science, Pubmed and EMBASE) during the last 6 years (January 2015-January 2021). Global metabolomic profiling of paediatric obesity was performed (multiple biological matrices: blood, urine, saliva and adipose tissue) to enable overarching pathway analysis and network mapping. Among 2792 screened Q1 articles, 40 met the eligibility criteria and were included to build a database on metabolite markers involved in the spectrum of childhood obesity. Differential alterations in multiple pathways linked to lipid, carbohydrate and amino acid metabolisms were observed. High levels of lactate, pyruvate, alanine and acetate marked a pronounced shift towards hypoxic conditions in children with obesity, and, together with distinct alterations in lipid metabolism, pointed towards dysbiosis and immunometabolism occurring early in life. Additionally, aberrant levels of several amino acids, most notably belonging to tryptophan metabolism including the kynurenine pathway and its relation to histidine, phenylalanine and purine metabolism were displayed. Moreover, branched-chain amino acids were linked to lipid, carbohydrate, amino acid and microbial metabolism, inferring a key role in obesity-associated insulin resistance.
CONCLUSIONS
This systematic review revealed that the main metabolites at the crossroad of dysregulated metabolic pathways underlying childhood obesity could be tracked down to one central disturbance, i.e. impending insulin resistance for which reference values and standardised measures still are lacking. In essence, glycolytic metabolism was evinced as driving energy source, coupled to impaired Krebs cycle flux and ß-oxidation. Applying metabolomics enabled to retrieve distinct metabolite alterations in childhood obesity(-related insulin resistance) and associated pathways at early age and thus could provide a timely indication of risk by elucidating early-stage biomarkers as hallmarks of future metabolically unhealthy phenotypes.
Topics: Amino Acids; Carbohydrate Metabolism; Humans; Lipid Metabolism; Metabolic Networks and Pathways; Pediatric Obesity
PubMed: 34742239
DOI: 10.1186/s10020-021-00394-0 -
European Archives of Paediatric... Apr 2017To provide a systematic review and meta-analyses investigating the association between overweight/obesity as defined by Body Mass Index (BMI) and periodontal disease in... (Meta-Analysis)
Meta-Analysis Review
AIM
To provide a systematic review and meta-analyses investigating the association between overweight/obesity as defined by Body Mass Index (BMI) and periodontal disease in terms of clinical periodontal outcomes.
MATERIALS AND METHODS
A systematic search of the literature was conducted by two authors (SR and SD) independently in the Cochrane Library, PubMed, Web of Science (ISI), Scopus, Scielo, Lilacs and System for Information on Grey Literature in Europe (SIGLE) for full articles published until September 2015. Studies analysing the association between overweight/obesity as defined by Body Mass Index (BMI) and periodontal disease in children and/or adolescents (age ≤18 years) were included. The Gwets AC1 inter-rater reliability coefficient for screening data was calculated using Agreestat 2011.1. Meta-analyses were carried out by using RStudio version 0.97.551-©2009-2012 RStudio, Inc. software.
RESULTS
A total of 769 titles and abstracts were screened and 12 articles met the inclusion criteria for the systematic review while only 7 were selected for meta-analyses. The Gwets AC1 inter-rater reliability coefficient for screening data was excellent (0.98; CI 0.98-0.99). A positive association between overweight/obesity and a number of periodontal diseases was seen. For the association between prevalent periodontal disease and obesity in children, the overall fixed-effects OR and 95% CI was 1.46 (1.20-1.77) with a χ statistic for heterogeneity (Q) of 33.4 with 6 degrees of freedom (P < 0.005).
CONCLUSION
The available evidence suggests a significantly positive association between periodontal disease and obesity in children. Paediatric dentists should be aware of periodontal alterations as a potential hazard associated with obesity.
Topics: Adolescent; Body Mass Index; Child; Comorbidity; Humans; Overweight; Pediatric Obesity; Periodontal Diseases
PubMed: 28238103
DOI: 10.1007/s40368-017-0272-1