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PloS One 2024Many studies have demonstrated the beneficial health effects of caffeine. However, its association with obesity prevalence and caffeine intake remains controversial....
BACKGROUND
Many studies have demonstrated the beneficial health effects of caffeine. However, its association with obesity prevalence and caffeine intake remains controversial. Notably, the impact of caffeine on children and adolescents needs to be more adequately represented in large-scale epidemiological investigations.
OBJECTIVE
This study examines the association between caffeine intake and obesity prevalence in children and adolescents aged 2 to 19.
METHODS
This study used the database from the National Health and Nutrition Examination Survey (NHANES, 2011-2020 March) to perform a cross-sectional study. A total of 10,001 classified children and adolescents were included in this analysis. All data were survey-weighted, and corresponding logistic regression models were performed to examine the associations between caffeine intake and the prevalence of obesity.
RESULTS
In a fully adjusted model, a per-quartile increase in caffeine intake was associated with a 0.05% increased prevalence of obesity. In the subgroup analysis, the multivariate-adjusted ORs (95% CIs) of the prevalence of obesity for per-quartile 1.3497 (1.2014, 1.5163) increments in caffeine intake were 1.5961 (1.3127, 1.9406) for boys and 1.4418 (1.1861, 1.7525) for girls, 1.5807 (1.3131, 1.9027) for white race and 1.3181 (1.0613, 1.6370), 1.0500 (0.6676, 1.6515) for the age of 2-5, 1.4996 (1.1997, 1.8745) for the age of 6-12, and 1.2321 (0.9924, 1597) for the age of 13-19.
CONCLUSION
The study suggested that higher caffeine intake may have a protective effect against obesity in specific subgroups, particularly among no overweight individuals. However, the association was not significant in other groups, indicating the need for a nuanced understanding of caffeine's impact on obesity in diverse populations.
Topics: Humans; Caffeine; Child; Female; Male; Adolescent; Cross-Sectional Studies; Nutrition Surveys; Prevalence; Child, Preschool; Young Adult; Obesity; Pediatric Obesity; United States
PubMed: 38829842
DOI: 10.1371/journal.pone.0300566 -
JAMA Network Open Jun 2024Results from long-term follow-up after biliopancreatic diversion with duodenal switch (DS) are scarce. (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
IMPORTANCE
Results from long-term follow-up after biliopancreatic diversion with duodenal switch (DS) are scarce.
OBJECTIVE
To compare weight loss, health outcomes, and quality of life 10 years or more after Roux-en-Y-gastric bypass (RYGB) and DS surgery in patients with severe obesity-that is, a body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 50 to 60.
DESIGN, SETTING, AND PARTICIPANTS
This open-label randomized clinical trial was conducted at 2 academic bariatric centers in Sweden and Norway. Sixty patients with a BMI of 50 to 60 were included from March 1, 2006, to August 31, 2007. Data were analyzed from August 12, 2022, to January 25, 2023.
INTERVENTIONS
Laparoscopic RYGB or laparoscopic DS.
MAIN OUTCOMES AND MEASURES
The main outcome was change in BMI after 10 or more years. Secondary outcomes included anthropometric measures, lipid and glycemic profiles, bone mass density, adverse events, gastrointestinal tract symptoms, and health-related quality of life.
RESULTS
Forty-eight of the original 60 patients (80%) were assessed after a median of 12 (range, 9-13) years (mean [SD] age, 48.0 [6.0] years; 35 women [73%]). At follow-up, the mean BMI reductions were 11.0 (95% CI, 8.3-13.7) for RYGB and 20.3 (95% CI, 17.6-23.0) for DS, with a mean between-group difference of 9.3 (95% CI, 5.4-13.1; P < .001). Total weight loss was 20.0% (95% CI, 15.3%-24.7%) for RYGB and 33.9% (95% CI, 27.8%-40.0%) for DS (P = .001). Mean serum lipid levels, except high-density lipoprotein cholesterol and hemoglobin A1c, improved more in the DS group during follow-up. Bone mass was reduced for both groups from 5 to 10 years, with lower bone mass after DS at 10 years. Quality-of-life scores (Obesity-Related Problem Scale and the 36-Item Short Form Health Survey) were comparable across groups at 10 years. The total number of adverse events was higher after DS (135 vs 97 for RYGB; P = .02). More patients in the DS group developed vitamin deficiencies (21 vs 11 for RYGB; P = .008) including 25-hydroxyvitamin D deficiency (19 for DS vs 9 for RYGB; P = .005). Four of 29 patients in the DS group (14%) developed severe protein-caloric malnutrition, of whom 3 (10%) underwent revisional surgery.
CONCLUSIONS AND RELEVANCE
In this randomized clinical trial, BMI reduction was greater after DS, but RYGB had a better risk profile over 10 years. Biliopancreatic diversion with DS may not be a better surgical strategy than RYGB for patients with a BMI of 50 to 60.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT00327912.
Topics: Humans; Gastric Bypass; Female; Male; Middle Aged; Body Mass Index; Adult; Obesity, Morbid; Weight Loss; Quality of Life; Treatment Outcome; Sweden; Norway; Duodenum; Laparoscopy; Biliopancreatic Diversion
PubMed: 38829616
DOI: 10.1001/jamanetworkopen.2024.14340 -
The World Allergy Organization Journal May 2024Real-world data on the range and impact of comorbid health conditions that affect pediatric asthma are scant, especially from developing countries. Lack of data hinders... (Review)
Review
Real-world data on the range and impact of comorbid health conditions that affect pediatric asthma are scant, especially from developing countries. Lack of data hinders effective diagnosis, treatment, and overall management of these complex cases. We, hereby, describe the common pediatric asthma comorbid conditions in terms of evidence for association, potential mechanisms of impact on asthma control, and treatment benefit. Obesity, upper airway allergies, dysfunctional breathing, multiple sensitizations, depressive disorders, food allergy, and gastro-esophageal reflux are common associations with difficult-to-treat asthma. On the other hand, asthma symptoms and/or management may negatively impact the well-being of children through drug adverse effects, worsening of anaphylaxis symptoms, and disturbing mental health. Awareness of these ailments may be crucial for designing the optimum care for each asthmatic child individually and may ultimately improve the quality of life of patients and their families. A multidisciplinary team of physicians is required to identify and manage such comorbidities aiming to mitigate the over-use of asthma pharmacotherapy. Asthma research should target relevant real-world difficulties encountered at clinical practice and focus on interventions that would mitigate the impact of such comorbidities. Finally, policymakers and global healthcare organizations are urged to recognize pediatric asthma control as a healthcare priority and allocate resources for research and clinical interventions. In other words, global asthma control needs support by compassionate scientific partnership.
PubMed: 38827329
DOI: 10.1016/j.waojou.2024.100909 -
Frontiers in Genetics 2024Gene variants in the gene are strongly associated with circulating bilirubin levels in several populations, as well as other variants of modest effect across the...
Gene variants in the gene are strongly associated with circulating bilirubin levels in several populations, as well as other variants of modest effect across the genome. However, the effects of such variants are unknown regarding the Native American ancestry of the admixed Latino population. Our objective was to assess the Native American genetic determinants of serum bilirubin in Chilean admixed adolescents using the local ancestry deconvolution approach. We measured total serum bilirubin levels in 707 adolescents of the Chilean Growth and Obesity Cohort Study (GOCS) and performed high-density genotyping using the Illumina-MEGA array (>1.7 million genotypes). We constructed a local ancestry reference panel with participants from the 1000 Genomes Project, the Human Genome Diversity Project, and our GOCS cohort. Then, we inferred and isolated haplotype tracts of Native American, European, or African origin to perform genome-wide association studies. In the whole cohort, the rs887829 variant and others near were the unique signals achieving genome-wide statistical significance (b = 0.30; = 3.34 × 10). After applying deconvolution methods, we found that significance is also maintained in Native American (b = 0.35; = 3.29 × 10) and European (b = 0.28; = 1.14 × 10) ancestry components. The rs887829 variant explained a higher percentage of the variance of bilirubin in the Native American (37.6%) compared to European ancestry (28.4%). In Native American ancestry, carriers of the TT genotype of this variant averaged 4-fold higher bilirubinemia compared to the CC genotype ( = 2.82 × 10). We showed for the first time that variants are the primary determinant of bilirubin levels in Native American ancestry, confirming its pan-ethnic relevance. Our study illustrates the general value of the local ancestry deconvolution approach to assessing isolated ancestry effects in admixed populations.
PubMed: 38826804
DOI: 10.3389/fgene.2024.1382103 -
Scientific Reports May 2024Sociodemographic and lifestyle factors (sleep, physical activity, and sedentary behavior) may predict obesity risk in early adolescence; a critical period during the...
Sociodemographic and lifestyle factors (sleep, physical activity, and sedentary behavior) may predict obesity risk in early adolescence; a critical period during the life course. Analyzing data from 2971 participants (M = 11.94, SD = 0.64 years) wearing Fitbit Charge HR 2 devices in the Adolescent Brain Cognitive Development (ABCD) Study, glass box machine learning models identified obesity predictors from Fitbit-derived measures of sleep, cardiovascular fitness, and sociodemographic status. Key predictors of obesity include identifying as Non-White race, low household income, later bedtime, short sleep duration, variable sleep timing, low daily step counts, and high heart rates (AUC = 0.726). Findings highlight the importance of inadequate sleep, physical inactivity, and socioeconomic disparities, for obesity risk. Results also show the clinical applicability of wearables for continuous monitoring of sleep and cardiovascular fitness in adolescents. Identifying the tipping points in the predictors of obesity risk can inform interventions and treatment strategies to reduce obesity rates in adolescents.
Topics: Humans; Machine Learning; Adolescent; Female; Male; Pediatric Obesity; Child; Sleep; Exercise; Risk Factors; Sedentary Behavior; Cardiorespiratory Fitness
PubMed: 38821981
DOI: 10.1038/s41598-024-60811-2 -
Diabetes Research and Clinical Practice Jun 2024This review aims to identify and report epidemiological associations between modifiable lifestyle risk factors for overweight or obesity in children and adolescents with... (Review)
Review
This review aims to identify and report epidemiological associations between modifiable lifestyle risk factors for overweight or obesity in children and adolescents with type 1 diabetes (T1D). A systematic literature search of medical databases from 1990 to 2023 was undertaken. Inclusion criteria were observational studies reporting on associations between dietary factors, disordered eating, physical activity, sedentary and sleep behaviours and measures of adiposity in children and adolescents (<18 years) with T1D. Thirty-seven studies met inclusion criteria. Studies were mostly cross-sectional (89 %), and 13 studies included adolescents up to 19 years which were included in this analysis. In adolescents with T1D, higher adiposity was positively associated with disordered eating behaviours (DEB) and a higher than recommended total fat and lower carbohydrate intake. A small amount of evidence suggested a positive association with skipping meals, and negative associations with diet quality and sleep stage. There were no published associations between overweight and physical activity, sedentary behaviours and eating disorders. Overall, the findings infer relationships between DEB, fat and carbohydrate intake and adiposity outcomes in people with T1D. Prospective studies are needed to determine causal relationships and to investigate sleep stages. High quality studies objectively measuring physical activity and include body composition outcomes are needed.
Topics: Humans; Adolescent; Diabetes Mellitus, Type 1; Child; Risk Factors; Life Style; Exercise; Pediatric Obesity; Overweight; Feeding Behavior; Sedentary Behavior; Female
PubMed: 38821415
DOI: 10.1016/j.diabres.2024.111724 -
JMIR Public Health and Surveillance May 2024Childhood obesity is a significant public health problem representing the most severe challenge in the world. Antibiotic exposure in early life has been identified as a...
BACKGROUND
Childhood obesity is a significant public health problem representing the most severe challenge in the world. Antibiotic exposure in early life has been identified as a potential factor that can disrupt the development of the gut microbiome, which may have implications for obesity.
OBJECTIVE
This study aims to evaluate the risk of developing obesity among children exposed to antibiotics early in life.
METHODS
An Italian retrospective pediatric population-based cohort study of children born between 2004 and 2018 was adopted using the Pedianet database. Children were required to be born at term, with normal weight, and without genetic diseases or congenital anomalies. We assessed the timing of the first antibiotic prescription from birth to 6, 12, and 24 months of life and the dose-response relationship via the number of antibiotic prescriptions recorded in the first year of life (none, 1, 2, and ≥3 prescriptions). Obesity was defined as a BMI z score >3 for children aged ≤5 years and >2 for children aged >5 years, using the World Health Organization growth references. The obese incidence rate (IR) × 100 person-years and the relative 95% CI were computed using infant sex, area of residence, preschool and school age, and area deprivation index, which are the covariates of interest. A mixed-effect Cox proportional hazards model was used to estimate the hazard ratio and 95% CI for the association between antibiotic exposure in early life and child obesity between 24 months and 14 years of age, considering the family pediatricians as a random factor. Several subgroup and sensitivity analyses were performed to assess the robustness of our results.
RESULTS
Among 121,540 children identified, 54,698 were prescribed at least an antibiotic within the first year of life and 26,990 were classified as obese during follow-up with an incidence rate of 4.05 cases (95% CI 4.01-4.10) × 100 person-year. The risk of obesity remained consistent across different timings of antibiotic prescriptions at 6 months, 1 year, and 2 years (fully adjusted hazard ratio [aHR] 1.07, 95% CI 1.04-1.10; aHR 1.06, 95% CI 1.03-1.09; and aHR 1.07, 95% CI 1.04-1.10, respectively). Increasing the number of antibiotic exposures increases the risk of obesity significantly (P trend<.001). The individual-specific age analysis showed that starting antibiotic therapy very early (between 0 and 5 months) had the greatest impact (aHR 1.12, 95% CI 1.08-1.17) on childhood obesity with respect to what was observed among those who were first prescribed antibiotics after the fifth month of life. These results were consistent across subgroup and sensitivity analyses.
CONCLUSIONS
The results from this large population-based study support the association between early exposure to antibiotics and an increased risk of childhood obesity. This association becomes progressively stronger with both increasing numbers of antibiotic prescriptions and younger age at the time of the first prescription.
Topics: Humans; Italy; Pediatric Obesity; Female; Male; Anti-Bacterial Agents; Child, Preschool; Infant; Retrospective Studies; Child; Infant, Newborn; Cohort Studies; Risk Factors
PubMed: 38820573
DOI: 10.2196/51734 -
PloS One 2024Childhood and adolescent obesity are major, preventable public health concerns. Studies to date are inconclusive regarding an association between caesarean section (CS)...
BACKGROUND
Childhood and adolescent obesity are major, preventable public health concerns. Studies to date are inconclusive regarding an association between caesarean section (CS) delivery and offspring obesity, with fewer studies conducted in late adolescence. This study examined the association between CS delivery, with a specific focus on planned CS, and induction of labour and adolescent body mass index (BMI) and body fat percentage (BF%) at age 17 years.
METHODS
Data on 8,880 mother-child pairs from the United Kingdom Millennium Cohort Study were analysed. The exposures were mode of delivery (normal vaginal delivery (VD) (reference), assisted VD, planned CS and emergency CS) and mode of delivery by induction of labour status. Crude and adjusted binary logistic regression and linear regression models were fitted examining BMI and BF% at age 17 years respectively, adjusting for several potential confounders.
RESULTS
Adolescents born by CS did not have an elevated BMI or BF% compared to those born by normal VD. The fully adjusted results for overweight and obesity in children born by planned CS, compared to VD, were 1.05 (95% CI: 0.86-1.28) and 0.94 (95% CI: 0.72-1.23), respectively. The results were similar for the associations between CS and BF%, and between induction of labour and BMI.
CONCLUSION
Overall, this large longitudinal study did not support an association between CS or induction of labour and overweight, obesity or BF%. It is possible that previously reported associations are due to residual or unmeasured confounding and/or underlying indications for CS delivery.
Topics: Humans; Cesarean Section; Female; United Kingdom; Adolescent; Longitudinal Studies; Body Mass Index; Male; Pregnancy; Obesity; Pediatric Obesity; Adult; Labor, Induced
PubMed: 38820521
DOI: 10.1371/journal.pone.0301684 -
Journal of Sports Sciences Apr 2024We assessed whether changes in children's body mass index (BMI), physical fitness and health-related quality of life observed post-2020 United Kingdom COVID-19 lockdown...
We assessed whether changes in children's body mass index (BMI), physical fitness and health-related quality of life observed post-2020 United Kingdom COVID-19 lockdown remained 12 and 18 months later. Twenty-metre shuttle run test (20mSRT), handgrip strength, standing broad jump, sit-and-reach, height, body mass, and health-related quality of life (Kidscreen27 questionnaire) were measured in 90 children (8-9 years) during October 2019 ("T0"), November 2020 ("T1"), November 2021 ("T2") and June 2022 ("T3"). Mixed-effects models showed age- and sex-normalised BMI increased from T0 (mean: 0.71) to T1 (0.97), remaining elevated at T2 (0.95) and T3 (0.89). Decreases in 20mSRT performance were observed from T0 (22.0) to T1 (19.3), then increased at T2 (23.5) and T3 (28.3). Standing broad jump and handgrip strength increased over time. The proportion of children with overweight/obesity increased from T0 (32%) to T3 (48%). Health-related quality of life decreased for "Physical Wellbeing" yet increased for "Autonomy & Parents". Our findings highlight that lockdowns may have had lasting implications for children's health, and the urgent need to reduce overweight and obesity in North East England. Improving health and fitness behaviours to maximise long-term health outcomes and build resilience to future emergencies and disruptions to health behaviours is also paramount.
Topics: Humans; Child; COVID-19; Quality of Life; Male; Female; Body Mass Index; Physical Fitness; England; Hand Strength; SARS-CoV-2; Pediatric Obesity; Pandemics
PubMed: 38819118
DOI: 10.1080/02640414.2024.2359259 -
Frontiers in Endocrinology 2024Polycystic ovary syndrome (PCOS) is often associated with metabolic-associated fatty liver disease (MAFLD). MAFLD has been associated with altered hepatic function,... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Polycystic ovary syndrome (PCOS) is often associated with metabolic-associated fatty liver disease (MAFLD). MAFLD has been associated with altered hepatic function, systemic dysmetabolism, and abnormal circulating levels of signaling molecules called organokines. Here, we assessed the effects of two randomized treatments on a set of organokines in adolescent girls with PCOS and without obesity, and report the associations with circulating biomarkers of liver damage, which were assessed longitudinally in the aforementioned studies as safety markers.
MATERIALS AND METHODS
Liver enzymes [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT)] were assessed as safety markers in previous randomized pilot studies comparing the effects of an oral contraceptive (OC) with those of a low-dose combination of spironolactone-pioglitazone-metformin (spiomet) for 1 year. As a endpoint, the organokines fibroblast growth factor-21 (FGF21), diazepam-binding protein-1 (DBI), and meteorin-like protein (METRNL) were assessed by ELISA after 6 months of OC (N = 26) or spiomet (N = 28). Auxological, endocrine-metabolic, body composition (using DXA), and abdominal fat partitioning (using MRI) were also evaluated. Healthy, age-matched adolescent girls (N = 17) served as controls.
RESULTS
Circulating ALT and GGT levels increased during OC treatment and returned to baseline concentrations in the post-treatment phase; in contrast, spiomet treatment elicited no detectable changes in ALT and GGT concentrations. In relation to organokines after 6 months of treatment, (1) FGF21 levels were significantly higher in PCOS adolescents than in control girls; (2) DBI levels were lower in OC-treated girls than in controls and spiomet-treated girls; and (3) no differences were observed in METRNL concentrations between PCOS girls and controls. Serum ALT and GGT levels were directly correlated with circulating METRNL levels only in OC-treated girls (R = 0.449, P = 0.036 and R = 0.552, P = 0.004, respectively).
CONCLUSION
The on-treatment increase in ALT and GGT levels occurring only in OC-treated girls is associated with circulating METRNL levels, suggesting enhanced METRNL synthesis as a reaction to the hepatic changes elicited by OC treatment.
CLINICAL TRIAL REGISTRATION
https://doi.org, identifiers 10.1186/ISRCTN29234515, 10.1186/ISRCTN11062950.
Topics: Humans; Female; Polycystic Ovary Syndrome; Adolescent; Metformin; Fibroblast Growth Factors; Liver; Alanine Transaminase; Pioglitazone; Biomarkers; Spironolactone; Aspartate Aminotransferases; gamma-Glutamyltransferase; Non-alcoholic Fatty Liver Disease; Contraceptives, Oral; Hypoglycemic Agents
PubMed: 38818508
DOI: 10.3389/fendo.2024.1325230