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Obesity Reviews : An Official Journal... Apr 2024Childhood obesity prevention initiatives are complex interventions that aim to improve children's obesity-related behaviors and provide health promoting environments.... (Review)
Review
BACKGROUND
Childhood obesity prevention initiatives are complex interventions that aim to improve children's obesity-related behaviors and provide health promoting environments. These interventions often impact individuals, communities, and outcomes not primarily targeted by the intervention or policy. To accurately capture the effectiveness and cost-effectiveness of childhood obesity prevention interventions, an understanding of the broader impacts (or spillover effects) is required. This systematic review aims to assess the spillover effects of childhood obesity prevention interventions.
METHODS
Six academic databases and two trial registries were searched (2007-2023) to identify studies reporting quantifiable obesity-related and other outcomes in individuals or communities not primarily targeted by an obesity prevention intervention. Critical appraisal was undertaken for studies that reported statistically significant findings, and a narrative synthesis of the data was undertaken.
RESULTS
Twenty academic studies and 41 trial records were included in the synthesis. The most commonly reported spillovers were diet or nutrition-related, followed by BMI and physical activity/sedentary behavior. Spillovers were mostly reported in parents/caregivers followed by other family members. Nine of the 20 academic studies reported statistically significant spillover effects.
CONCLUSION
Limited evidence indicates that positive spillover effects of childhood obesity prevention interventions can be observed in parents/caregivers and families of targeted participants.
Topics: Child; Humans; Pediatric Obesity; Exercise; Diet; Nutritional Status; Caregivers
PubMed: 38156507
DOI: 10.1111/obr.13692 -
Diabetes Research and Clinical Practice Jan 2024Considering the role of adipokine on diseases related to metabolic syndrome and even chronic diseases, it seems necessary to investigate effective interventions on these... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Considering the role of adipokine on diseases related to metabolic syndrome and even chronic diseases, it seems necessary to investigate effective interventions on these factors. This study aimed to comprehensively investigate the effects of metformin on adipokines.
METHODS
A comprehensive search was conducted in five databases using established keywords. The purpose of this search was to uncover controlled studies that have examined the impact of metformin on adipokines, specifically leptin, adiponectin, and resistin. The random-effects model analysis was used to provide pooled weighted mean difference and 95% confidence intervals.
RESULTS
Forty-nine studies were included in this article. The pooled findings showed that that the administration of metformin significantly decreases leptin (WMD: -3.06 ng/ml, 95 % CI: -3.81, -2.30, P < 0.001) and resistin (WMD: -1.27 µg/mL, 95 % CI: -2.22, -0.31, P = 0.009) levels in different populations compared to the control group. However, no significant effect of this antidiabetic drug on adiponectin levels was reported. The results obtained from the subgroup results in the present study also showed that metformin in people with a BMI greater than 30 kg/m compared to a BMI ≤ 30 kg/m causes a significant decrease in leptin levels and an increase in adiponectin levels. Also, metformin in lower doses (≤1500 mg/day) and younger people (<30 years) causes a significant increase in adiponectin levels.
CONCLUSIONS
In general, considering the role of adipokines on metabolic disease and even chronic disease, this drug can be used as a potentially useful drug, especially in obese people, to improve these factors.
Topics: Humans; Adipokines; Adiponectin; Leptin; Metformin; Randomized Controlled Trials as Topic; Resistin
PubMed: 38154535
DOI: 10.1016/j.diabres.2023.111076 -
Obesity Reviews : An Official Journal... Apr 2024Prior studies identified variable associations between competitive food and beverage policies (CF&B) and youth obesity, potentially due to differences across population... (Review)
Review
Prior studies identified variable associations between competitive food and beverage policies (CF&B) and youth obesity, potentially due to differences across population subgroups. This review summarizes the evidence on associations between CF&B policies and childhood obesity within gender, grade level/ age, race/ethnicity, and/or socioeconomic levels. PubMed, EMBASE, CINAHL, and ERIC database searches identified studies published in English in Canada and the United States between January 1, 2000, and February 28, 2022. Of the 18 selected studies, six were cross-sectional, two correlational, nine were before/after designs, and one study utilized both a cross-sectional and pre-post design. Twelve studies reported findings stratified by a single sociodemographic factor, with grade level/age as the most frequently reported. Although the evidence varied, greater consistency in direction of associations and strengths of evidence were seen among middle school students. Six studies reported findings jointly by multiple sociodemographic subgroups with evidence suggesting CF&B associations with slower rate of increase or plateaus or declines in obesity among multiple subgroups, though the strengths of evidence varied. Over the past two decades, there have been relatively limited subgroup analyses on studies about CF&B policies and childhood obesity. Studies are needed with stronger designs and analyses disaggregated, particularly by race/ethnicities and socioeconomic factors, across places and time.
Topics: Adolescent; Humans; Child; United States; Pediatric Obesity; Food; Beverages; Socioeconomic Factors; Policy
PubMed: 38151337
DOI: 10.1111/obr.13678 -
Clinical Oral Investigations Dec 2023To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in... (Meta-Analysis)
Meta-Analysis Review
Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of non-surgical periodontal treatment in patients with concurrent systemic conditions.
OBJECTIVE
To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in patients with concurrent systemic conditions (diabetes, CVD, erectile dysfunction, chronic kidney disease, rheumatoid arthritis, polycystic ovarian syndrome, obesity, pregnancy). We hypothesised that NSPT results in better periodontal outcomes when compared to untreated controls after follow-up.
MATERIALS AND METHODS
A systematic search (PUBMED/EMBASE) was conducted from 1995 to 2023 to identify randomised controlled trials (RCTs) with a minimum follow-up of 3 months. The primary outcome was the difference in mean probing depth (PD), and the secondary outcomes were mean clinical attachment loss (CAL), percentage of sites with PD ≤ 3 mm (%PD ≤ 3 mm) and percentage of sites with bleeding on probing (%BOP) between the treated and untreated control group in patients with comorbidities.
RESULTS
The electronic search resulted in 2,403 hits. After removing duplicates, 1,565 titles and abstracts were screened according to the eligibility criteria, resulting in 126 articles for full-text screening. Following this, 44 studies were analysed. Restricting to studies with low bias or some concerns, NSPT group demonstrated a 0.55 mm lower mean PD (95%CI: -0.69; -0.41) after 3 months compared to the control group.
CONCLUSION
Compared to the untreated controls, NSPT notably reduced mean PD, mean CAL, and %BOP while increasing %PD ≤ 3 mm in patients with concurrent systemic conditions. These findings suggest that NSPT is also an effective procedure in managing periodontitis in patients with concurrent systemic conditions.
TRIAL REGISTRATION
This systematic review was registered under the protocol registration number CRD42021241517/PROSPERO.
Topics: Male; Female; Pregnancy; Humans; Randomized Controlled Trials as Topic; Dental Care; Patients; Arthritis, Rheumatoid; Periodontitis
PubMed: 38147183
DOI: 10.1007/s00784-023-05392-6 -
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 -
The Journal of Clinical Endocrinology... Apr 2024Prematurity increases the long-term risks for endocrine and metabolic morbidity of offspring, but there is uncertainty regarding the risks for early-term deliveries... (Meta-Analysis)
Meta-Analysis
CONTEXT
Prematurity increases the long-term risks for endocrine and metabolic morbidity of offspring, but there is uncertainty regarding the risks for early-term deliveries (370/7-386/7 weeks of gestation).
OBJECTIVE
We aim to evaluate whether early-term deliveries increase the long-term risk for type 1 diabetes and obesity of offspring up to the age of 18 years compared with full-term children. PubMed, Medline, and EMBASE were searched. Observational cohort studies addressing the association between early-term delivery and long-term risk for type 1 diabetes and obesity, were included. Two independent reviewers extracted data and assessed risk of bias. Pooled relative risks (RRs) and heterogeneity were determined. Publication bias was assessed by funnel plots with Egger's regression line and contours, and sensitivity analyses were performed.
RESULTS
Eleven studies were included following a screen of 7500 abstracts. All studies were scored as high quality according to the Newcastle-Ottawa Quality Assessment Scale. Early-term delivery was significantly associated with an increased risk for type 1 diabetes (RR 1.19, 1.13-1.25), while the association was weaker for overweight and obesity (RR 1.05, 0.97-1.12). It is challenging to determine whether the association between early-term births and long-term morbidity represents a cause and effect relationship or is attributable to confounders. Most of the included studies adjusted for at least some possible confounders.
CONCLUSION
Compared with full-term offspring, early-term delivery poses a modest risk for long-term pediatric type 1 diabetes. Our analysis supports that, whenever medically possible, elective delivery should be avoided before 39 completed weeks of gestation.
Topics: Pregnancy; Female; Child; Humans; Adolescent; Risk Factors; Diabetes Mellitus, Type 1; Obesity; Parturition; Overweight
PubMed: 38079466
DOI: 10.1210/clinem/dgad715 -
Cureus Nov 2023Child and adolescent obesity represents a significant and escalating health concern in the United States. Notably, Hispanic adolescents face a higher prevalence of... (Review)
Review
Child and adolescent obesity represents a significant and escalating health concern in the United States. Notably, Hispanic adolescents face a higher prevalence of obesity and an increased risk of cardiovascular disease compared to their peers from different racial and ethnic backgrounds. This was obtained through systematic investigations in which different approaches were used. Therefore, obesity interventions of long duration, at least one year, and with a beginning phase intensive enough to produce significant early weight loss may be needed for adolescents with obesity. Surprisingly, despite this elevated risk, there is a glaring underrepresentation of Hispanics in obesity intervention studies aimed at youth. It is therefore imperative to develop interventions tailored specifically to overweight adolescents, with a particular focus on the Hispanic population. While researchers have addressed numerous interventions targeting adolescent obesity, many of these initiatives have demonstrated limited treatment efficacy, failed to achieve all desired treatment objectives, experienced high attrition rates, and encountered waning participant engagement. To evaluate the impact of adopting a healthy lifestyle among pediatric patients struggling with obesity, we undertook a comprehensive systematic review of the literature, and with the information obtained from the articles chosen, we will undergo a meta-analysis. Our review encompassed a 10-year span of published literature, drawing upon online databases including the Cochrane Library, PubMed, Web of Science, PubMed Central, and Google Scholar. Our review exclusively considered randomized controlled trials that focused on the effectiveness of various lifestyle modifications for pediatric patients grappling with obesity. We synthesized the pooled incidence, risk ratio, and associated 95% confidence intervals to gauge the efficacy of these interventions, employing the fixed-effect model to account for potential between-study variations rather than the random-effect model. After the calculation of each one of the studies selected, we could conclude that it gave good outcomes after the modification of lifestyle in these patients, giving a statistical significance and p-value in our three representative figures of <0.001.
PubMed: 38073975
DOI: 10.7759/cureus.48525 -
World Journal of Pediatrics : WJP Feb 2024The long-term sequelae of COVID-19 in children and adolescents remain poorly understood and characterized. This systematic review and meta-analysis sought to summarize... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The long-term sequelae of COVID-19 in children and adolescents remain poorly understood and characterized. This systematic review and meta-analysis sought to summarize the risk factors for long COVID in the pediatric population.
METHODS
We searched six databases from January 2020 to May 2023 for observational studies reporting on risk factors for long COVID or persistent symptoms those were present 12 or more weeks post-infection using multivariable regression analyses. Trial registries, reference lists of included studies, and preprint servers were hand-searched for relevant studies. Random-effects meta-analyses were conducted to pool odds ratios for each risk factor. Individual study risk of bias was rated using QUIPS, and the GRADE framework was used to assess the certainty of evidence for each unique factor.
RESULTS
Sixteen observational studies (N = 46,262) were included, and 19 risk factors were amenable to meta-analysis. With moderate certainty in the evidence, age (per 2-year increase), allergic rhinitis, obesity, previous respiratory diseases, hospitalization, severe acute COVID-19, and symptomatic acute COVID-19 are probably associated with an increased risk of long COVID. Female sex, asthma, comorbidity, and heart diseases may be associated with an increased risk of long COVID, and Asian and Black races may be associated with a decreased risk of long COVID. We did not observe any credible subgroup effects for any risk factor.
CONCLUSIONS
The current body of literature presents several compelling risk factors for the development of long COVID in the pediatric population. Further research is necessary to elucidate the pathophysiology of long COVID.
Topics: Humans; Adolescent; Child; Female; COVID-19; Post-Acute COVID-19 Syndrome; Disease Progression; Hospitalization; Risk Factors
PubMed: 38055113
DOI: 10.1007/s12519-023-00765-z -
Acta Bio-medica : Atenei Parmensis Dec 2023The relationship between precocious or early puberty and its treatment has received significant research attention, yielding diverse outcomes. This short review aims to...
BACKGROUND
The relationship between precocious or early puberty and its treatment has received significant research attention, yielding diverse outcomes. This short review aims to comprehensively analyze and summarize research articles to elucidate the potential link between precocious or early pubertal onset (CPP) and crucial health factors.
METHODS
We conducted a systematic review of studies published from -January 2000 to March 2023, sourced from databases of Medline, PubMed, Google Scholar and Web of Science. We assessed the relationship between CPP and final adult height (FHt), bone health, reproductive function, body mass index, metabolic and cardiovascular abnormalities, and increased cancer risk.
RESULTS
Upon reviewing and analyzing selected studies, the following key findings emerged: (a) treating CPP in girls before age 6-7 and in boys before age 9 improves FHt; (b) bone mineral density (BMD) decreases during GnRHa treatment but normalizes afterward, with no lasting effects on peak bone mass during puberty; (c) GnRH treatment does not negatively affect menstrual cycles; however, untreated CPP increases the risk of premature or early-onset menopause; (d) the incidence of PCOS/hyperandrogenemia may be slightly elevated in women with a history of CPP, but overall reproductive function remains largely unaffected; (e) earlier thelarche and menarche may enhance susceptibility to breast carcinogenesis; (f) CPP contributes to an increased risk of obesity and type 2 diabetes in both genders; (g) early menarche may slightly increase the risk of coronary heart disease and ischemic strokes and (h) early pubertal timing increases the risk of depression and anxiety disorders.
CONCLUSION
Monitoring and early diagnosis of these conditions are of paramount importance for successful management.
Topics: Female; Humans; Male; Child; Diabetes Mellitus, Type 2; Gonadotropin-Releasing Hormone; Puberty, Precocious; Obesity; Puberty
PubMed: 38054666
DOI: 10.23750/abm.v94i6.15316 -
Clinical Nutrition (Edinburgh, Scotland) Jan 2024Multiple lifestyle-based childhood obesity interventions have been conducted to address childhood obesity, but individual's response to the universal intervention... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Multiple lifestyle-based childhood obesity interventions have been conducted to address childhood obesity, but individual's response to the universal intervention approach varied greatly. Whether gene variants related to children and adolescents' varied responses to obesity interventions remained unclear.
AIMS
To determine the associations of gene variants with the changes in obesity- and metabolism-related indicators after obesity interventions in children and adolescents.
METHODS
Ten databases and registers (including grey literature) were searched. The lifestyle-based obesity interventions in children and adolescents (≤18 years) that reported the changes in obesity- (body mass index (BMI), BMI Z-score, waist circumference (WC), waist-to-hip ratio (WHR), etc) and metabolism-related (glucose, cholesterol, etc) indicators by genotype after interventions were included. Our primary outcome was the mean difference of the changes in BMI Z-score by genotype after interventions, and secondary outcomes were changes in the remaining obesity- and metabolism-related indicators after interventions. We used the random-effects model to synthesize the results.
RESULTS
This review included 50 studies (15,354 children and adolescents with overweight/obesity) covering 102 genes and 174 single nucleotide polymorphisms (SNPs). Approximately three-quarters of SNPs showed no evidence of association with the changes in obesity- or metabolic-related indicators after interventions. One quarter of SNPs were minorly associated with the changes in the BMI Z-score (median effect size: 0.001) with little clinical significance. Only 6 (12 %) studies focused on the accumulated effect of multiple gene variants.
CONCLUSIONS
Gene variants that have been explored appear to play a minor role in lifestyle-based obesity interventions in children and adolescents. More high-quality studies based on the design of randomized controlled trials are needed to examine the accumulated effect of multiple gene variants in childhood obesity interventions.
PROSPERO REGISTRY NUMBER
This systematic review and meta-analysis was registered at PROSPERO as CRD42022312177.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Overweight; Body Mass Index; Life Style
PubMed: 38052139
DOI: 10.1016/j.clnu.2023.11.031