Showing papers in "Pediatric Obesity in 2011"
TL;DR: While the prevalence of overweight and obesity appears to be stabilizing at different levels in different countries, it remains high, and a significant public health issue.
Abstract: Until quite recently, there has been a widespread belief in the popular media and scientific literature that the prevalence of childhood obesity is rapidly increasing However, high quality evidence has emerged from several countries suggesting that the rise in the prevalence has slowed appreciably, or even plateaued This review brings together such data from nine countries (Australia, China, England, France, Netherlands, New Zealand, Sweden, Switzerland and USA), with data from 467,294 children aged 2-19 years The mean unweighted rate of change in prevalence of overweight and obesity was +000 (049)% per year across all age ×sex groups and all countries between 1995 and 2008 For overweight alone, the figure was +001 (056)%, and for obesity alone -001 (024)% Rates of change differed by sex, age, socioeconomic status and ethnicity While the prevalence of overweight and obesity appears to be stabilizing at different levels in different countries, it remains high, and a significant public health issue Possible reasons for the apparent flattening are hypothesised
600 citations
TL;DR: Results suggest that children raised in authoritative homes ate more healthy, were more physically active and had lower BMI levels, compared to children who were raised with other styles.
Abstract: Despite emerging efforts to investigate the influence parents have on their children's weight status and related dietary and activity behaviors, reviews regarding the role of general parenting are ...
408 citations
TL;DR: Recommendations for the definition of childhood obesity were previously published in 1995 by the European Childhood Obesity Group (ECOG), but new references appeared later, and a clarification of the different definitions was needed.
Abstract: Childhood obesity is considered a major issue because of its high prevalence and because of its severe consequences on adult health. Prevalence studies are carried out in numerous countries. Analysis of time trends and geographic comparisons are particularly useful, as they may help to identify factors promoting obesity. These studies require adequate definitions of nutritional status and standardized protocols, but in practice, the references, cut-offs and the terminology used vary considerably, and consequently ambiguous information may be found in the literature. Recommendations for the definition of childhood obesity were previously published in 1995 by the European Childhood Obesity Group (ECOG), but new references appeared later. A clarification of the different definitions was needed. Currently used classifications of nutritional status in children are summarized, and recommendations for the references, cut-offs and terms to be used in different contexts are provided. These new ECOG recommendations should help harmonize the various protocols and improve comparisons between studies.
212 citations
TL;DR: The degree of pediatric obesity is substantial and will likely have profound impact on adult morbid obesity and other morbidities, especially among Hispanic boys and non-Hispanic black girls.
Abstract: Introduction. This study aims to describe the trends and racial/ethnic differences in prevalence of severe obesity among US children. Methods. We examined height and weight measurements from US chi...
201 citations
TL;DR: This guide aims to facilitate the reporting of dietary intake and food habits in the context of obesity using valid and reliable measures, thus contributing to the evidence-base for nutrition policies and programs relating to obesity.
Abstract: Dietary intake and food habits are important contributors to the obesity epidemic. They are highly modifiable components of energy balance and are usually targeted in both obesity prevention and tr...
180 citations
TL;DR: Results indicate that BMI-related differences in gross motor coordination were more pronounced as children belonged to an older age group, emphasizing the need of an early focus on motor skill improvement to encourage overweight and obese children to be physically active.
Abstract: Objective. The purpose of this study was to investigate differences in gross motor coordination in healthy-weight, overweight, and obese children of different ages. Methods. Using a cross-sectional...
165 citations
TL;DR: The global trend of stabilizing prevalence rates of childhood obesity at a high level is confirmed and age- and gender-specific differences found in trends of ov/ob prevalence may help optimise preventive and therapeutic measures.
Abstract: Objective: Trends of overweight (ov)/obesity (ob) prevalence among German children aged 4–16 years were studied between 1999 and 2008. Subjects: Body mass index (BMI) data (>P90 [ov] and >P97 [ob])...
150 citations
TL;DR: Dysregulation of the stress system through increased secretion of cortisol and catecholamines, especially in the evening hours, and in concert with concurrently elevated insulin concentrations, leads to development of central obesity, insulin resistance and the metabolic syndrome.
Abstract: Chronic distress contributes to the development of obesity and comorbid states. Stress is the disturbance of the complex dynamic equilibrium that all organisms must maintain, and is associated with activation of the Stress system comprising of the hypothalamic–pituitary–adrenal axis and the arousal/sympathetic nervous systems. The stress system functions in a baseline circadian fashion and interacts with other systems of the organism to regulate a variety of behavioral, endocrine, metabolic, immune and cardiovascular functions. The experience of perceived or real uncontrollable intense and/or chronic stress (distress) may lead to several psychopathologic conditions, including anxiety, depressive and psychosomatic disorders, substance abuse, obesity and the metabolic syndrome, and osteoporosis, as well as impaired reproductive and immune functions. Developing children and adolescents are particularly vulnerable to the effects of chronic stress. Both behavioral and biological pathways are involved i...
137 citations
TL;DR: In this paper, the authors developed accelerometer cut points to classify physical activities (PA) by intensity in preschoolers and to investigate discrepancies in PA levels when applying different levels of intensity.
Abstract: Objective. The present study aimed to develop accelerometer cut points to classify physical activities (PA) by intensity in preschoolers and to investigate discrepancies in PA levels when applying ...
135 citations
TL;DR: It is shown that despite the emerging observational evidence for the role of parenting in children's weight-related outcomes, few interventions have been developed that address general parenting in the prevention of childhood obesity.
Abstract: Observational studies increasingly emphasize the impact of general parenting on the development of childhood overweight and obesity. The aim of the current literature review was to provide an overv...
131 citations
TL;DR: Obese 5-year-old boys were significantly more likely to have abnormal scores for conduct problems, hyperactivity and inattention problems, peer relationship problems, prosocial behaviours and total difficulties than their normal weight counterparts.
Abstract: Objectives We examined cross-sectional and longitudinal associations between obesity and emotional and behavioural problems in a nationally representative sample of young children Methods Data were available from 11 202 children (50% boys) participating in the UK's Millennium Cohort Study Height and weight were measured at 3 and 5 years and children defined as obese using IOTF cut-offs for body mass index (BMI) Emotional and behavioural problems were parentally assessed using the Strengths and Difficulties Questionnaire Adjusted linear and multinomial regression analyses were conducted separately for boys and girls Results At age 3, obese boys had more conduct problems, and obese girls had more prosocial behaviours, than their normal weight counterparts At age 5, obese boys had more conduct problems, hyperactivity and inattention problems, peer relationship problems and total difficulties Obese girls only had more peer relationship problems Obese 3-year-olds were not at increased risk of abnormal scores; in contrast, obese 5-year-old boys were significantly more likely to have abnormal scores for conduct problems, hyperactivity and inattention problems, peer relationship problems, prosocial behaviours and total difficulties Obesity, at age 3, was also predictive of peer relationship problems at age 5 in boys (95% CI: 026 [001, 052]) Conclusions Childhood obesity is associated with emotional and behavioural problems from a very young age Obese boys are at particular risk Further research is required to examine effect modifiers and mediating factors in these associations Recognition and response to these mental health problems should be a goal of pediatric obesity interventions and policies
TL;DR: The prevalence for overweight/obesity among PortugueseChildren and adolescents vary according to the cut-off points used and are also of concern requiring strategies to promote healthy weight gain among children and adolescents.
Abstract: Purpose. The aim of this research was to report the prevalence of overweight and obesity in a representative sample of Portuguese youth. Methods. This was a school-based study performed in Portugal...
TL;DR: To address food marketing to children, governments need to develop clearer statements of the objectives to be achieved, define the indicators that can demonstrate this achievement, and require the relevant stakeholders to account for the progress being made.
Abstract: Objectives. To describe the global regulatory environment around food marketing to children in 2009 and to identify changes in this environment since 2006. Methods. Informants able to provide infor...
TL;DR: Despite regulation, children in the UK are exposed to more TV advertising for unhealthy than healthy food items, even at peak children's viewing times, and there remains scope to strengthen the rules regarding advertising of HFSS foods around programming popular with children and adults alike.
Abstract: Objective. To provide the most comprehensive analysis to date of the extent of food advertising on UK television channels popular with young people following regulatory reform of this type of marke...
TL;DR: The results imply that interventions to prevent inequalities in childhood obesity should begin in pre-school years, with daughters of more educated women being less adipose.
Abstract: Background. Socioeconomic inequalities in obesity are consistently observed in high-income countries. The development of such inequalities across childhood; however, has not been studied using long...
TL;DR: Future research should examine whether eating behaviours can be modified to reduce children's risk of becoming overweight or obese, and potential determinants of eating behaviours should be explored.
Abstract: Objective. No study has examined a comprehensive set of approach and avoidance eating behaviours and their relationship with bodyweight among North American children. The purpose of this study was ...
TL;DR: The rising trend of BMI in Indian children and adolescents observed in this multicentric study rings alarm bells in terms of associated adverse health consequences in adulthood.
Abstract: Objectives. To estimate prevalence of overweight and obesity in apparently healthy children from five zones of India in the age group of 2 to 17 years and to examine trends in body mass index (BMI)...
TL;DR: This review focuses on metabolic differences of adipose tissue at different sites of the body, with emphasis in pediatrics, and investigates various approaches of BAT and SWAT transplantation, including new sources of adipocyte progenitors.
Abstract: This review focuses on metabolic differences of adipose tissue at different sites of the body, with emphasis in pediatrics. Adipose tissue is composed of various cell types, which include adipocytes and other cells of the stromal vascular fraction such as preadipocytes, blood cells, endothelial cells and macrophages. Mammals have two main types of adipose tissue: white adipose tissue (WAT), and brown adipose tissue (BAT), each of which possesses unique cell autonomous properties. WAT and BAT differ at the functional, as well as the morphological and molecular levels. WAT accumulates surplus energy mainly in the form of triacylglycerols and BAT dissipates energy directly as heat. Recently, functional BAT in humans has been located in the neck, supraclavicular, mediastinal and interscapular areas. WAT is distributed throughout the body in the form of two major types: subcutaneous adipose tissue (SWAT) and the intra-abdominal visceral adipose tissue (VWAT). VWAT tissue is associated with insulin resistance, diabetes mellitus, dyslipidaemia, hypertension, atherosclerosis, hepatic steatosis, and overall mortality whereas SWAT and BAT have intrinsic beneficial metabolic properties. Subcutaneous and visceral adipocytes derive from different progenitor cells that exhibit a different gene expression pattern. SWAT responds better to the antilipolytic effects of insulin and other hormones, secrets more adiponectin and less inflammatory cytokines, and is differentially affected by molecules involved in signal transduction as well as drugs compared with VWAT. Current research is investigating various approaches of BAT and SWAT transplantation, including new sources of adipocyte progenitors. This may be important for the potential treatment of childhood obesity.
TL;DR: Overweight and obesity in adolescents are associated with significantly lowerHRQOL scores, and girls and younger (< 15 years) adolescents reported greater mean negative HRQOL differences associated with excess weight.
Abstract: Objective. To determine whether the health-related quality of life (HRQOL) of overweight and obese adolescents is significantly lower than that of their healthy weight counterparts, and if so, whet...
TL;DR: The conventional definition of metabolic syndrome, using the conventional definition, is not a reliable method for predicting the MetS at mean age 22, but it does predict adverse levels of cardiovascular risk factors.
Abstract: Objective. The value of metabolic syndrome (MetS) in childhood and adolescence and its stability into young adulthood have been questioned. This study compared the MetS in late childhood (mean age 13) versus a cluster score of the MetS components as predictors of young adult (mean age 22) cardiovascular risk. Methods. Anthropometrics, blood pressure, lipid profile, and insulin resistance (insulin clamp) were obtained in 265 individuals at mean ages 13 and 22. The MetS was defined dichotomously by current pediatric and adult criteria. The MetS cluster score used the average of deviates of the MetS components standardized to their means and standard deviations at mean age 13. Results. The MetS was rarely present at mean age 13 and did not predict MetS at mean age 22 but identified individuals who continued to have adverse levels of risk factors at mean age 22. In contrast to the standard MetS definition, the MetS cluster score tracked strongly and at mean age 22 was significantly higher in the indiv...
TL;DR: WC was found to increase with age in both sexes, but boys had higher WC values at every age and percentile, but Chinese children had the highest WC compared to Malays, Indians and other ethnicities.
Abstract: Background. The prevalence of obesity is increasing rapidly and abdominal obesity especially is known to be a risk factor for metabolic syndrome and other non-communicable diseases. Waist circumfer...
TL;DR: This clinical obesity treatment was safe and effective in reducing body mass index (BMI) standard deviation score (SDS) independent of baseline adiposity, age (boys), or social class in these young people.
Abstract: Objectives. Clinically-relevant protocols for the treatment of childhood obesity are lacking. This study report results for a clinic-based structured treatment program for chronic childhood obesity...
TL;DR: Evidence is provided for the effectiveness of the multi-component intervention Lekker Fit! among pupils of grades 3-5 and adds to the growing body of evidence that school-based programs with a focus on PA are most effective in reducing childhood obesity.
Abstract: Objectives. The purpose of this study was to evaluate the effect of a school-based intervention program to reduce overweight and improve fitness in primary school children. Methods. A cluster rando...
TL;DR: Findings indicate that childhood obesity might have adverse effects on gross motor development, and overweight participants showed poorer performance on locomotor and object-control tasks than their non-overweight peers.
Abstract: Objective. The aim of the study was to examine the gross motor skill performance of overweight and non-overweight preschool children from South of Italy, and to investigate possible differences by gender. Methods. Participants were 38 boys and 42 girls (4.5 ± 0.5 yr) categorized as overweight (n = 38) and non-overweight (n = 42), according to the IOTF body mass index (BMI) cut-off points. The Test of Gross Motor Development was used to assess seven locomotor skills (run, gallop, hop, leap, horizontal jump, skip and slide) and five object-control skills (two-hand strike, stationary bounce, catch, kick and overhand throw). The raw, standard and percentile scores and the Gross Motor Development Quotient (GMDQ) were calculated for each participant. ANOVA 2 (gender) x 2 (group) was conducted on the subtest standard scores and the GMDQ. Results. No differences in performance were found between boys and girls on the subscale standard scores and the GMDQ. Significant main effects (p < 0.001) were reported...
TL;DR: Gender, ethnicity, age, baseline values of outcomes, initial weight status and socioeconomic status were the most frequently studied potential moderators and the moderator with the most convincing evidence was gender.
Abstract: The aim of this review was to systematically review the results and quality of studies investigating the moderators of school-based interventions aimed at energy balance-related behaviors. We systematically searched the electronic databases of Pubmed, EMBASE, Cochrane, PsycInfo, ERIC and Sportdiscus. In total 61 articles were included. Gender, ethnicity, age, baseline values of outcomes, initial weight status and socioeconomic status were the most frequently studied potential moderators. The moderator with the most convincing evidence was gender. School-based interventions appear to work better for girls than for boys. Due to the inconsistent results, many studies reporting non-significant moderating effects, and the moderate methodological quality of most studies, no further consistent results were found. Consequently, there is lack of insight into what interventions work for whom. Future studies should apply stronger methodology to test moderating effects of important potential target group segmentations.
TL;DR: The results suggest that leptin deficiency caused by mutations in the leptin gene may frequently be seen in obese Pakistani children from Central Punjab.
Abstract: Background: Congenital leptin deficiency is a rare human genetic condition clinically characterized by hyperphagia and acute weight gain usually during the first postnatal year. The worldwide data ...
TL;DR: In this paper, the relationship between the omega-3 index, weight status and insulin resistance in children was examined in a study with school-age children between 5-12 years, classified as non-obese or obese on the basis of body mass index (BMI) z-scores.
Abstract: Objectives. Recent studies in adults have suggested that the plasma level of omega-3 fatty acids may be associated with weight status and abdominal adiposity, limited studies exist in paediatric populations. The present study examined the relationship between the omega-3 index, weight status and insulin resistance in children. Methods. School-age children between 5–12 years, classified as non-obese or obese on the basis of body mass index (BMI) z-scores, were examined. Fat intake was assessed using a parent reported 135-item semi-quantitative food frequency questionnaire. Erythrocyte fatty acid composition was determined using gas chromatography. The Omega-3 index (O3I) was calculated by adding eicosapentaenoic and docosahexaenoic acid % (weight/weight) values. Results. Obese children had altered erythrocyte fatty acid composition unrelated to reported dietary intake. A greater proportion of obese (BMI z-score > 2.25) children (33%) had an omega-3 index of < 4.0 (high risk) compared with non-obese...
TL;DR: In this paper, the authors examined the cross-sectional association between measurements of obesity and subclinical impairment of cardiac autonomic modulation (CAM) in a population-based sample of children.
Abstract: Objective. To examine the cross-sectional association between measurements of obesity and subclinical impairment of cardiac autonomic modulation (CAM) in a population-based sample of children. Methods. Data from 616 grade K-5 children randomly selected from Central Pennsylvania were utilized. Obesity was defined using the International Obesity Task Force (IOTF) age- and sex-specific cut-off criteria and classified as normal weight, overweight, and obese. CAM was measured by heart rate variability (HRV) analysis of beat-to-beat RR intervals, including time domain measures i.e., the standard deviation of all RR intervals (SDNN), the square root of the mean of the sum of squares of differences between adjacent RR intervals (RMSSD), and mean heart rate (HR); and frequency domain measures i.e., high frequency power (HF), low frequency power (LF), and LF/HF ratio. Results. The prevalence of obesity and overweight in children was 12.3%, and 16.5%, respectively. Age, race, sex, and sleep disorder breathin...
TL;DR: The continued advertising of unhealthy foods indicates that this self-regulatory code does not adequately protect children, and these advertisements continue to comprise the majority during peak viewing times.
Abstract: Introduction. This study evaluated the impact of the Australian Food and Grocery Council (AFGC) self-regulatory initiative on unhealthy food marketing to children, introduced in January 2009. The s...
TL;DR: Evidence is provided that childhood obesity, and how it develops, is associated with standing sagittal postural alignment in adolescence, and with different BMI trajectory classes, adjusting for gender.
Abstract: Objectives. To identify distinct age-related trajectory classes of body mass index (BMI) z-scores from childhood to adolescence, and to examine the association of these trajectories with measures o...