-
Revista de Gastroenterologia de Mexico... 2019To identify and discuss the efficacy of dietary interventions, antioxidant supplementation, physical activity, and nutritional and psychologic counseling in the... (Review)
Review
AIM
To identify and discuss the efficacy of dietary interventions, antioxidant supplementation, physical activity, and nutritional and psychologic counseling in the treatment of children and adolescents with non alcoholic fatty liver disease associated with obesity.
MATERIALS AND METHODS
A scoping review of studies on nutritional and educational interventions and physical activity in pediatric patients with non alcoholic fatty liver disease was conducted. A search for randomized clinical trials or quasi-experimental studies published up to December 2017 was carried out, utilizing seven databases (Medline, EBSCO, OVID, Science Direct, JSTOR, Wiley, and Biblioteca Digital UDG).
RESULTS
From a total of 751 articles, 729 were excluded due to the criteria of age, design, language, diagnostic method, and outcome variables. The analysis included 22 articles. The most frequently used intervention variables were diet and physical activity. The interventions had different durations, but most were carried out for one year. Some authors employed ascorbic acid, vitamin E, or omega-3 fatty acid supplementation. There were varying degrees of improvement in the variables analyzed in the majority of the studies, such as a decrease in ALT levels, a reduced frequency of steatosis determined through imaging studies, and a decrease in body mass index.
CONCLUSIONS
The dietary interventions, omega-3 fatty acid supplementation, physical activity, and nutritional and psychologic counseling were identified as efficacious measures in the treatment of non alcoholic fatty liver disease associated with obesity in children and adolescents, according to biochemical or imaging study indicators, within the time frame of the intervention.
Topics: Adolescent; Child; Diet; Exercise; Female; Humans; Male; Non-alcoholic Fatty Liver Disease; Patient Education as Topic; Pediatric Obesity; Randomized Controlled Trials as Topic
PubMed: 31101468
DOI: 10.1016/j.rgmx.2019.02.001 -
The Journal of Pediatrics Sep 2021To determine the weight, body mass index (BMI), cardiometabolic, and gastrointestinal effects of glucagon-like peptide-1 (GLP-1) receptor agonists in children with... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To determine the weight, body mass index (BMI), cardiometabolic, and gastrointestinal effects of glucagon-like peptide-1 (GLP-1) receptor agonists in children with obesity.
STUDY DESIGN
Web of Science, PubMed/MEDLINE, and Scopus databases from 01/01/1994-01/01/2021 for randomized control trials examining the weight, BMI, cardiometabolic, or gastrointestinal effects of GLP-1 receptor agonists in children and adolescents with obesity. Data were extracted by 2 independent surveyors and a random effects model was applied to meta-analyze generic inverse variance outcomes. Primary outcomes were related to weight and cardiometabolic profile, and secondary outcomes of interest were gastrointestinal-related treatment-emergent adverse events.
RESULTS
Nine studies involving 574 participants were identified, of which 3 involved exenatide and 6 involved liraglutide. GLP-1 receptor agonists use caused a modest reduction in body weight (mean difference [MD] -1.50 [-2.50,-0.50] kg, I 64%), BMI (MD -1.24 [-1.71,-0.77] kg/m, I 0%), and BMI z score (MD -0.14 [-0.23,-0.06], I 43%). Glycemic control was improved in children with proven insulin resistance (glycated hemoglobin A1c MD -1.05 [-1.93,-0.18] %, I 76%). Although no lipid profile improvements were noted, a modest decrease in systolic blood pressure was detected (MD -2.30 [-4.11,-0.49] mm Hg; I 0%). Finally, analysis of gastrointestinal-related treatment-emergent adverse events revealed an increased risk of nausea (risk ratio 2.11 [1.44, 3.09]; I 0%), without significant increases in other gastrointestinal symptoms.
CONCLUSIONS
This meta-analysis indicates that GLP-1 receptor agonists are safe and effective in modestly reducing weight, BMI, glycated hemoglobin A1c, and systolic blood pressure in children and adolescents with obesity in a clinical setting, albeit with increased rates of nausea.
PROSPERO ID
CRD42020195869.
Topics: Adolescent; Blood Glucose; Blood Pressure; Body Mass Index; Child; Glucagon-Like Peptide-1 Receptor; Glycated Hemoglobin; Humans; Pediatric Obesity
PubMed: 33984333
DOI: 10.1016/j.jpeds.2021.05.009 -
Circulation Sep 2018This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary... (Review)
Review
This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.
Topics: Adolescent; Adolescent Behavior; Age Factors; American Heart Association; Child; Child Behavior; Child, Preschool; Exercise; Health Behavior; Health Knowledge, Attitudes, Practice; Healthy Lifestyle; Humans; Infant; Pediatric Obesity; Play and Playthings; Protective Factors; Risk Assessment; Risk Factors; Risk Reduction Behavior; Screen Time; Sedentary Behavior; Time Factors; United States
PubMed: 30354382
DOI: 10.1161/CIR.0000000000000591 -
Experimental & Molecular Medicine Jul 2020Childhood obesity has reached epidemic levels and is a serious health concern associated with metabolic syndrome, nonalcoholic fatty liver disease, and gut microbiota... (Randomized Controlled Trial)
Randomized Controlled Trial
Childhood obesity has reached epidemic levels and is a serious health concern associated with metabolic syndrome, nonalcoholic fatty liver disease, and gut microbiota alterations. Physical exercise is known to counteract obesity progression and modulate the gut microbiota composition. This study aims to determine the effect of a 12-week strength and endurance combined training program on gut microbiota and inflammation in obese pediatric patients. Thirty-nine obese children were assigned randomly to the control or training group. Anthropometric and biochemical parameters, muscular strength, and inflammatory signaling pathways in mononuclear cells were evaluated. Bacterial composition and functionality were determined by massive sequencing and metabolomic analysis. Exercise reduced plasma glucose levels and increased dynamic strength in the upper and lower extremities compared with the obese control group. Metagenomic analysis revealed a bacterial composition associated with obesity, showing changes at the phylum, class, and genus levels. Exercise counteracted this profile, significantly reducing the Proteobacteria phylum and Gammaproteobacteria class. Moreover, physical activity tended to increase some genera, such as Blautia, Dialister, and Roseburia, leading to a microbiota profile similar to that of healthy children. Metabolomic analysis revealed changes in short-chain fatty acids, branched-chain amino acids, and several sugars in response to exercise, in correlation with a specific microbiota profile. Finally, the training protocol significantly inhibited the activation of the obesity-associated NLRP3 signaling pathway. Our data suggest the existence of an obesity-related deleterious microbiota profile that is positively modified by physical activity intervention. Exercise training could be considered an efficient nonpharmacological therapy, reducing inflammatory signaling pathways induced by obesity in children via microbiota modulation.
Topics: Case-Control Studies; Child; Endurance Training; Exercise; Female; Gastrointestinal Microbiome; Humans; Inflammation; Male; Metabolomics; Pediatric Obesity; Phylogeny; Principal Component Analysis; Signal Transduction
PubMed: 32624568
DOI: 10.1038/s12276-020-0459-0 -
Journal of Obesity 2015Parents play a critical role in developing and shaping their children's physical activity (PA) and sedentary behaviours, particularly in the early years of life. The aim... (Review)
Review
Parents play a critical role in developing and shaping their children's physical activity (PA) and sedentary behaviours, particularly in the early years of life. The aim of this systematic review is to identify current literature investigating associations of parental influences with both PA and screen time in young children. This systematic review was conducted in November 2013 using 6 electronic databases covering research literature from January 1998 to November 2013. Thirty articles that met inclusion criteria were identified. These studies covered five important aspects of parenting: (1) parenting practices; (2) parents' role modelling; (3) parental perceptions of children's PA and screen viewing behaviours; (4) parental self-efficacy; and (5) general parenting style. Findings suggest that parents' encouragement and support can increase children's PA, and reducing parents' own screen time can lead to decreased child screen time. Improving parenting practices, parental self-efficacy or changing parenting style may also be promising approaches to increasing PA time and decreasing screen time of young children.
Topics: Adult; Body Mass Index; Child; Child Behavior; Child, Preschool; Exercise; Female; Humans; Male; Parent-Child Relations; Parenting; Parents; Pediatric Obesity; Sedentary Behavior; Television; Time Factors; Video Games
PubMed: 25874123
DOI: 10.1155/2015/546925 -
Obesity Reviews : An Official Journal... Sep 2019This review aimed to investigate the impact of obesity treatment, with a dietary component, on eating disorder (ED) prevalence, ED risk, and related symptoms in children... (Meta-Analysis)
Meta-Analysis
This review aimed to investigate the impact of obesity treatment, with a dietary component, on eating disorder (ED) prevalence, ED risk, and related symptoms in children and adolescents with overweight or obesity. Four databases were searched to identify pediatric obesity treatment interventions, with a dietary component, and validated pre-post intervention assessment of related outcomes. Of 3078 articles screened, 36 met inclusion criteria, with a combined sample of 2589 participants aged 7.8 to 16.9 years. Intervention duration ranged from 1 week to 13 months, with follow-up of 6 months to 6 years from baseline. Prevalence of ED was reported in five studies and was reduced post-intervention. Meta-analyses showed a reduction in bulimic symptoms (eight studies, standardized mean difference [SE], -0.326 [0.09], P < 0.001), emotional eating (six studies, -0.149 [0.06], P = 0.008), binge eating (three studies, -0.588 [0.10], P < 0.001), and drive for thinness (three studies, -0.167 [0.06], P = 0.005) post-intervention. At follow-up, a reduction in ED risk (six studies, -0.313 [0.13], P = 0.012), emotional eating (five studies, -0.259 [0.05], P < 0.001), eating concern (three studies, -0.501 [0.06], P < 0.001), and drive for thinness (two studies, -0.375 [0.07], P < 0.001) was found. Structured and professionally run obesity treatment was associated with reduced ED prevalence, ED risk, and symptoms.
Topics: Adolescent; Adolescent Behavior; Behavior Therapy; Child; Child Behavior; Feeding and Eating Disorders; Female; Guidelines as Topic; Humans; Male; Obesity Management; Pediatric Obesity; Prevalence; Risk Factors
PubMed: 31131531
DOI: 10.1111/obr.12866 -
Journal of Pediatric Gastroenterology... May 2021Childhood obesity has high societal and economic impact but current treatment approaches are sub-optimal. In the last decade, important studies have been conducted...
Role of Dietary Factors, Food Habits, and Lifestyle in Childhood Obesity Development: A Position Paper From the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition.
Childhood obesity has high societal and economic impact but current treatment approaches are sub-optimal. In the last decade, important studies have been conducted aiming to identify strategies to prevent obesity during critical periods of life. Updated recommendations for childhood obesity prevention are needed. We present data from systematic reviews and meta- analysis, randomised controlled trials (RCTs) and large observational studies, published from 2011 onwards that consider the possible role of the following factors in obesity development: breast-feeding; macronutrient composition and method of complementary feeding; parenting style; dietary patterns; sugar-sweetened beverage consumption; eating behaviour (eg, skipping breakfast, family dinners. etc); meal frequency and composition (fast foods, snacking), portion size; dietary modulators of gut microbiota (including pre-, pro-, and synbiotics); physical activity and sedentary behaviour. We used the Medline database and the Cochrane Library to search for relevant publications. Important research gaps were also identified. This position paper provides recommendations on dietary factors, food habits, and lifestyle to prevent childhood obesity development, based on the available literature and expert opinion. Clinical research and high-quality trials are urgently needed to resolve numerous areas of uncertainty.
Topics: Child; Diet; Feeding Behavior; Female; Gastroenterology; Humans; Life Style; Pediatric Obesity
PubMed: 33720094
DOI: 10.1097/MPG.0000000000003075 -
Pharmacological Research Feb 2023Asthma affects more than 300 million people of all ages worldwide, including about 10-15% of school-aged children, and its prevalence is increasing. Severe asthma (SA)... (Review)
Review
Asthma affects more than 300 million people of all ages worldwide, including about 10-15% of school-aged children, and its prevalence is increasing. Severe asthma (SA) is a particular and rare phenotype requiring treatment with high-dose inhaled corticosteroids plus a second controller and/or systemic glucocorticoid courses to achieve symptom control or remaining "uncontrolled" despite this therapy. In SA, other diagnoses have been excluded, and potential exacerbating factors have been addressed. Notably, obese asthmatics are at higher risk of developing SA. Obesity is both a major risk factor and a disease modifier of asthma in children and adults: two main "obese asthma" phenotypes have been described in childhood with high or low levels of Type 2 inflammation biomarkers, respectively, the former characterized by early onset and eosinophilic inflammation and the latter by neutrophilic inflammation and late-onset. Nevertheless, the interplay between obesity and asthma is far more complex and includes obese tissue-driven inflammatory pathways, mechanical factors, comorbidities, and poor response to corticosteroids. This review outlines the most recent findings on SA in obese children, particularly focusing on inflammatory pathways, which are becoming of pivotal importance in order to identify selective targets for specific treatments, such as biological agents.
Topics: Humans; Pediatric Obesity; Asthma; Comorbidity; Adrenal Cortex Hormones; Inflammation
PubMed: 36642111
DOI: 10.1016/j.phrs.2023.106658 -
Journal of the Formosan Medical... Mar 2019Huge amount microorganisms resides in human intestine, and many contribute to the maturation and homeostasis of immune system. The diversity of gut ecology are affected... (Review)
Review
Huge amount microorganisms resides in human intestine, and many contribute to the maturation and homeostasis of immune system. The diversity of gut ecology are affected by the gestational age, delivery type, feeding sources, and antibiotics use in neonates. Recent studies pointed out that disturbance of gut microbiota, so called dysbiosis, could result in several pediatric diseases including obesity, non-alcoholic fatty liver disease (NAFLD), metabolic syndromes, allergic diseases, and inflammatory bowel diseases. However, there are no single species can be proven to play a key factor in pediatric obesity and NAFLD at present. Various probiotics may confer benefit to these gut microbiota-related pediatric diseases. The clinical application is still limited. This review article aimed to elucidate evidently the relationship between gut microbiota and pediatric obesity/NAFLD and to discuss the potential probiotics use in pediatric obesity and NAFLD.
Topics: Child; Dysbiosis; Gastrointestinal Microbiome; Host-Pathogen Interactions; Humans; Non-alcoholic Fatty Liver Disease; Pediatric Obesity; Probiotics; Randomized Controlled Trials as Topic
PubMed: 30509561
DOI: 10.1016/j.jfma.2018.11.006 -
Current Problems in Pediatric and... Sep 2020
Topics: Adolescent; Child; Female; Humans; Male; Overweight; Pediatric Obesity
PubMed: 32952064
DOI: 10.1016/j.cppeds.2020.100872