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Pediatrics International : Official... Jan 2022The circadian clock system is an evolutionarily conserved system by which organisms adapt their metabolic activities to environmental inputs, including nutrient... (Review)
Review
The circadian clock system is an evolutionarily conserved system by which organisms adapt their metabolic activities to environmental inputs, including nutrient availability. The disruption of this system has been pathogenically linked to the disintegration of metabolic homeostasis, leading to the development of metabolic complications, including obesity. Lifestyle factors that disrupt this system have been found to be associated with the development of metabolic disorder, which is most evidenced by the finding that shift workers are at an increased risk of developing various disorders, such as obesity and obesity-related complications. Lifestyle factors that contribute to a misalignment between the internal clock system and environmental rhythms have also been identified in children. A short sleep duration and skipping breakfast are prevalent in children and there is mounting evidence that these factors are associated with an increased risk of pediatric obesity; however, the underlying mechanisms have not yet been elucidated in detail. Our current understanding of the impact of lifestyle factors that cause a misalignment between the internal clock system and environmental rhythms on the development of pediatric obesity is summarized herein, with a discussion of potential mechanistic factors.
Topics: Child; Circadian Clocks; Circadian Rhythm; Homeostasis; Humans; Metabolic Diseases; Pediatric Obesity
PubMed: 34525248
DOI: 10.1111/ped.14992 -
The Lancet. Child & Adolescent Health Jan 2019The onset of puberty in adolescents and whether it is related to obesity is an ongoing topic for debate. Epidemiological cross-sectional and longitudinal studies show a... (Review)
Review
The onset of puberty in adolescents and whether it is related to obesity is an ongoing topic for debate. Epidemiological cross-sectional and longitudinal studies show a shift towards earlier onset of puberty in girls who are obese; however, the situation is less clear in boys. Boys who are overweight seem to mature earlier, and boys who are obese mature later, than boys at a healthy weight. The underlying mechanisms are not yet fully understood, and whether earlier onset of puberty in obese girls is based on the activation of the hypothalamic-pituitary-gonadal axis is unclear. The most promising link between obesity and puberty is the adipokine leptin and its interaction with the kisspeptin system, which is an important regulator of puberty. However, peripheral action of adipose tissue (eg, via other adipokines, aromatase activity) could also be involved in changes to the onset of puberty. In addition, nutritional factors, epigenetics, or endocrine disrupting chemicals are potential mediators linking the onset of puberty to obesity. This Review summarises our knowledge concerning the relationship between obesity and onset and tempo of puberty, and the consequences of early puberty on obesity.
Topics: Adolescent; Female; Humans; Male; Pediatric Obesity; Puberty
PubMed: 30446301
DOI: 10.1016/S2352-4642(18)30306-7 -
World Review of Nutrition and Dietetics 2013Childhood obesity remains an important public health concern and prevention programmes should be the priority in order to decrease the prevalence of obesity. The aim of... (Review)
Review
Childhood obesity remains an important public health concern and prevention programmes should be the priority in order to decrease the prevalence of obesity. The aim of this review is to summarize the most effective types of intervention for treating obesity in children and adolescents. A number of identified strategies used to treat childhood obesity range from lifestyle approaches, pharmacotherapy to surgical intervention. Dietary treatment of obese children and adolescents should aim to ensure adequate growth and development by reducing excessive fat mass accumulation, avoiding loss of lean body mass, improving well-being and self-esteem, and preventing cyclical weight regain. Management protocols involve behaviour modifications, family support, and lifestyle changes which are difficult to put into practice and may require multidisciplinary professional teams. The cornerstone of weight loss programmes is to achieve a negative energy balance. There is evidence that dietary interventions are more effective in achieving weight loss when combined with other strategies, such as increasing physical activity levels and/or psychological interventions to promote behavioural changes. Psychological interventions have been employed in an effort to achieve long-term maintenance of behavioural change. Childhood obesity treatments should involve a combination of lifestyle changes including strategies to reduce energy intake, increase physical activity, reduce sedentary activities, facilitate family involvement and change behaviours associated with eating and physical activity. However, drug therapy in obese children must not be used as isolated treatment but as complementary to the traditional treatments of diet, physical activity and lifestyle changes. Besides, surgical procedures have been used to treat severe morbid obesity in children and adolescents when more conservative treatments have proven to be inadequate.
Topics: Adolescent; Child; Cognitive Behavioral Therapy; Diet; Humans; Life Style; Motor Activity; Pediatric Obesity; Prevalence; Randomized Controlled Trials as Topic; Weight Loss
PubMed: 24029793
DOI: 10.1159/000351493 -
The Nursing Clinics of North America Dec 2021Pediatric obesity is a heterogeneous, chronic, relapsing disease associated with metabolic and psychosocial complications. Weight-based victimization, including... (Review)
Review
Pediatric obesity is a heterogeneous, chronic, relapsing disease associated with metabolic and psychosocial complications. Weight-based victimization, including unrelenting microaggressions, negatively impacts child mental and physical health. Evidence-based guidelines offer individualized, stepwise approaches to obesity treatment. Pediatric nurses positively impact children with obesity by providing affirmation, clinical management, and psychosocial support. Pediatric nurses are respected and positioned to present evidence-based obesity education, correct common obesity myths, sensitively address obesity-related bias and discrimination, and model person-first language and actions. This article shares how nurses in multiple practice areas can make a meaningful impact on the lives of children and adolescents with obesity.
Topics: Adolescent; Bullying; Child; Crime Victims; Family; Humans; Nurse's Role; Pediatric Obesity; Social Stigma; United States
PubMed: 34749897
DOI: 10.1016/j.cnur.2021.07.006 -
Pediatric Endocrinology, Diabetes, and... 2023There has been a global increase in the average body mass index (BMI) in children and an alarming trend of increasing weight among the youngest children in recent...
There has been a global increase in the average body mass index (BMI) in children and an alarming trend of increasing weight among the youngest children in recent decades. Childhood excess weight and obesity result in premature adult mortality and morbidity. Obesity is not only a risk factor for other diseases but is also a complex, multifactorial disease in its own right, linked to a genetic predisposition influenced by an increasingly permissive environment from intrauterine life throughout childhood and adolescence into adulthood. Knowledge of the prevalence of obesity from the earliest life stages and its trajectory is essential to raise awareness of the risks at each stage and to indicate the potential age of prevention and intervention. Taking effective anti-obesity measures in children, both preventive and therapeutic, is now a necessity, with successful interventions used to decrease body weight and thus reduce health consequences. Identified risk factors in the first 1,000 days of life and even earlier, before conception, suggest that this is a key period for the development of overweight and obesity, and it appears to be the best time for preventive action. The growing phenomenon of obesity among children requires not only prevention but also integral treatment. Lifestyle change intervention programs are considered key to the treatment of childhood obesity. Obesity trajectories, the higher effectiveness of applied interventions observed in younger age groups, and the dependence of the risk of developing complications on the duration of obesity confirm the need for early diagnosis and treatment of obesity in children from an early age. The main aim should be to prevent the onset of obesity, thus reducing the future health, social, and financial consequences.
Topics: Adult; Adolescent; Child; Humans; Pediatric Obesity; Body Weight; Body Mass Index; Overweight; Risk Factors
PubMed: 38282496
DOI: 10.5114/pedm.2023.133122 -
Pediatrics Mar 2021
Topics: Child; Humans; Hypoglycemic Agents; Metformin; Pediatric Obesity
PubMed: 33608414
DOI: 10.1542/peds.2020-044982 -
BMC Pediatrics Apr 2024Family-based obesity management interventions targeting child, adolescent and parental lifestyle behaviour modifications have shown promising results. Further... (Review)
Review
Family-based obesity management interventions targeting child, adolescent and parental lifestyle behaviour modifications have shown promising results. Further intervening on the family system may lead to greater improvements in obesity management outcomes due to the broader focus on family patterns and dynamics that shape behaviours and health. This review aimed to summarize the scope of pediatric obesity management interventions informed by family systems theory (FST). Medline, Embase, CINAHL and PsycInfo were searched for articles where FST was used to inform pediatric obesity management interventions published from January 1980 to October 2023. After removal of duplicates, 6053 records were screened to determine eligibility. Data were extracted from 50 articles which met inclusion criteria; these described 27 unique FST-informed interventions. Most interventions targeted adolescents (44%), were delivered in outpatient hospital settings (37%), and were delivered in person (81%) using group session modalities (44%). Professionals most often involved were dieticians and nutritionists (48%). We identified 11 FST-related concepts that guided intervention components, including parenting skills, family communication, and social/family support. Among included studies, 33 reported intervention effects on at least one outcome, including body mass index (BMI) (n = 24), lifestyle behaviours (physical activity, diet, and sedentary behaviours) (n = 18), mental health (n = 12), FST-related outcomes (n = 10), and other outcomes (e.g., adiposity, cardiometabolic health) (n = 18). BMI generally improved following interventions, however studies relied on a variety of comparison groups to evaluate intervention effects. This scoping review synthesises the characteristics and breadth of existing FST-informed pediatric obesity management interventions and provides considerations for future practice and research.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Diet; Life Style; Body Mass Index; Exercise
PubMed: 38566046
DOI: 10.1186/s12887-024-04646-w -
Current Obesity Reports Jun 2016This paper describes the epidemiologic evidence linking parent-child relationships, self-regulation, and weight status with a focus on early childhood. The emotional... (Review)
Review
This paper describes the epidemiologic evidence linking parent-child relationships, self-regulation, and weight status with a focus on early childhood. The emotional quality of parent-child interactions may influence children's risk for obesity through multiple pathways. Prospective studies linking observer ratings of young children's self-regulation, particularly inhibitory control, to future weight status are discussed. Although findings are preliminary, promoting positive relationships between parents/caregivers and young children holds promise as a component of efforts to prevent childhood obesity. Multi-disciplinary collaborations between researchers with training in developmental science and child health should be encouraged.
Topics: Child, Preschool; Energy Intake; Feeding Behavior; Food Preferences; Humans; Inhibition, Psychological; Parent-Child Relations; Parenting; Pediatric Obesity; Prospective Studies; Social Environment
PubMed: 27037572
DOI: 10.1007/s13679-016-0208-9 -
Pediatric Obesity Mar 2020Pediatric obesity impacts on multiple domains of psychological health, including self-esteem and body image. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Pediatric obesity impacts on multiple domains of psychological health, including self-esteem and body image.
OBJECTIVE
To determine the effect of multicomponent pediatric obesity treatment interventions on self-esteem and body image.
METHODS
A systematic search of published literature up to June 2019 was undertaken using electronic databases MEDLINE, EMBASE, Cochrane Library, and PsychINFO. Eligible studies implemented an obesity treatment intervention, including a dietary and physical activity component with/without a behavioral component, in children and adolescents with overweight/obesity, and assessed self-esteem and/or body image. Data were extracted by one reviewer and cross-checked. Meta-analysis was used to combine outcome data and moderator analysis conducted to identify intervention characteristics influencing outcomes.
RESULTS
64 studies were identified. Meta-analysis of 49 studies (n = 10471) indicated that pediatric obesity treatment results in increased self-esteem postintervention (standardized mean difference, [SE] 0.34 [0.03], P < .001, I 87%), maintained at follow-up (0.35 [0.05] P < .001, I 79%, 17 studies). Similarly, meta-analysis of 40 studies (n = 2729) indicated improvements in body image postintervention (0.40 [0.03], P < .001, I 73%), maintained at follow-up (0.41 [0.08], P < .001, I 89%, 16 studies).
CONCLUSIONS
Pediatric obesity treatment improves self-esteem and body image in the short and medium term. These findings may underpin improvements in other psychological outcomes.
Topics: Adolescent; Body Image; Child; Diet; Exercise; Humans; Pediatric Obesity; Self Concept; Weight Loss
PubMed: 32020780
DOI: 10.1111/ijpo.12600 -
Obesity Reviews : An Official Journal... May 2024Obstructive sleep apnea (OSA) is a prevalent complication that affects up to 60% of children and adolescents with obesity. It is associated with poorer cardiometabolic... (Review)
Review
Screening for obstructive sleep apnea (OSA) in children and adolescents with obesity: A scoping review of national and international pediatric obesity and pediatric OSA management guidelines.
Obstructive sleep apnea (OSA) is a prevalent complication that affects up to 60% of children and adolescents with obesity. It is associated with poorer cardiometabolic outcomes and neurocognitive deficits. Appropriate screening and intervention for OSA are crucial in the management of children with obesity. We performed a scoping review of international and national pediatric obesity (n = 30) and pediatric OSA (n = 10) management guidelines to evaluate the recommendations on OSA screening in pediatric obesity. Sixteen (53%) of the pediatric obesity guidelines had incorporated OSA screening to varying extents, with no consistent recommendations on when and how to screen for OSA, and subsequent management of OSA in children with obesity. We provide our recommendations that are based on the strength and certainty of evidence presented. These include a clinical-based screening for OSA in all children with body mass index (BMI) ≥ 85th percentile or those with rapid BMI gain (upward crossing of 2 BMI percentiles) and the use of overnight polysomnography to confirm the diagnosis of OSA in those with high clinical suspicion. We discuss further management of OSA unique to children with obesity. An appropriate screening strategy for OSA would facilitate timely intervention that has been shown to improve cardiometabolic and neurocognitive outcomes.
Topics: Adolescent; Humans; Child; Pediatric Obesity; Sleep Apnea, Obstructive; Body Mass Index; Polysomnography; Cardiovascular Diseases
PubMed: 38355893
DOI: 10.1111/obr.13712