Considering rapid global increase in children obesity and high prevalence of dyslipidemia in obese and overweight children, this study aimed to evaluate the effect of an educational course on changes of lipid profile in children.
This non-pharmacological clinical trial study was performed on 4-18 year-old children attending outpatient clinics of Isfahan Endocrine and Metabolism Research Center (Iran). Anthropometric measurements were conducted for all children. Fasting blood samples were taken from right hand of the participants at the first laboratory visit. Biochemical tests including measurement of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were also carried out. Children took part in one educational session in which they were taught about ways and benefits of having regular physical activity once a day and having healthy foods. All children were followed up for about four months and anthropometrics and biochemical tests were repeated. Data was analyzed using SPSS16.
A total number of 412 children (245 girls and 167 boys) were divided into four age groups of under 6, 6-9, 10-13, and 14-18 years old. Baseline anthropometric measures were significantly higher in boys. However, there was no difference between boys and girls in baseline lipid profile. Children's body mass index (BMI) z-score increased in all age groups except for 14-18 year-old boys. In boys older than 10 years, there were significant reductions in LDL-C and TC. In girls over 10 years of age, there was a significant increase in HDL-C. Although anthropometric measurements did not change in children (except for 14-18 year-old-boys), there was a significant reduction in children's lipid profile after the study.
Our study showed that although one session of interventional education had no significant effects on children's anthropometric measurements, it could change their lipid profile. Moreover, the intervention was more effective on improving lipid profile in children over 10 years of age. Therefore, effective interventional strategies must be invented and implemented on children based on their age group.
Children Obesity; Education; Anthropometry; Lipid Profile; Lifestyle
Background and Objectives
Obesity is a chronic disease that requires good eating habits and an active life style. Obesity may start in childhood and continue until adulthood. Severely obese children have complications such as diabetes, hypercholesterolemia, hypertension and atherosclerosis. The goal of this study was to determine the effects of exercise programs on anthropometric, metabolic, and cardiovascular parameters in obese children.
Subjects and Methods
Fifty four obese children were included. Anthropometric data such as blood pressures, body mass index (BMI) and obesity index (OI) were measured. Blood glucose, total cholesterol, triglycerides, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), high sensitive-CRP (hs-CRP), brachial-ankle pulse wave velocity (BaPWV) and ankle brachial index (ABI) were measured. Physical fitness measurements were done. Obese children were divided into three groups: an aerobic exercise group (n=16), a combined exercise group (n=20), and a control group (n=18). Obese children exercised in each program for 10 weeks while those in the control group maintained their former lifestyle. After 10 weeks, anthropometric data and cardiovascular parameters were compared with the data obtained before the exercise program.
LDL-C, waist circumference, and systolic blood pressure decreased significantly in the aerobic exercise group compared to the control group (p<0.05). Waist circumference and systolic blood pressure decreased significantly in the combined exercise group compared to controls (p<0.05). Physical fitness level increased significantly after the exercise programs (p<0.05 vs. control). PWV did not show a significant change after exercise.
A short-term exercise program can play an important role in decreasing BMI, blood pressure, waist circumference, LDL-C and in improving physical fitness. Future investigations are now necessary to clarify the effectiveness of exercise on various parameters.
Obesity; Exercise; Cardiovascular disease
Central obesity is an important risk factor for cardiovascular diseases (CVD). Preventive interventions from childhood are necessary due to the increasing prevalence of childhood obesity. Body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WSR) are anthropometric indices for measurement of obesity. This study aimed to assess the association between these anthropometric indices and dyslipidemia in obese children and adolescents.
This retrospective study was done on the records of 2064 obese children and adolescents aged 6-18 years at the obesity clinic, in Isfahan Cardiovascular Research center. Age, gender, weight, height, WC, hip circumference (HC), triglyceride (TG), total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), Fasting blood sugar (FBS), diastolic blood pressure (DBP) and systolic blood pressure (SBP) were taken from patients’ record. Receiver operating characteristics (ROC) curve and Pearson correlation were used to analyze the data.
2064 girls and boys aged 6-18 years were divided into 3 age groups of 6-9.9 years, 10-13.9 years and 14-18 years. Prevalence of high LDL-C, TC, TG, FBS, SBP, DBP and low HDL-C was higher among the boys compared to the girls. There was a significant association between TC, LDL-C, TG and FBS with BMI, WC, WHR and WSR. However, no significant correlation was seen between HDL-C and the four anthropometric indices.
Our study showed a significant correlation between BMI, WC and WSR with high levels of TC, TG and LDL-C in children and adolescents. Correlation between WHR and dyslipidemia in this study was significant but its predictive value was weaker than other three indices.
Body Mass Index; Waist Circumference; Waist to Hip Ratio; Waist to Height Ratio; Dyslipidemia; Children; Adolescents
Schools represent a key potential venue for addressing childhood obesity.
To assess the feasibility of Power-Up, an after-school program to decrease obesity risk among African American children, using community-based participatory research (CBPR) principles.
Teachers led 14 weekly nutrition and physical activity sessions during after-school care at the Woodlawn Community School on Chicago’s South Side. Forty African American children ages 5 to 12 participated; their 28 parents discussed similar topics weekly at pickup time, and families practiced relevant skills at home. Pre- and post-intervention anthropometrics, blood pressure, dietary measures, and health knowledge and beliefs for children and parents were compared in univariate analysis.
At baseline, 26% of children were overweight; 28% were obese. Post-intervention, mean body mass index (BMI) z scores decreased from 1.05 to 0.81 (p < .0001). Changes were more pronounced for overweight (−0.206 z-score units) than for obese children (−0.062 z-score units; p = .01). Girls decreased their combined prevalence of overweight/obesity from 52% to 46%; prevalence across these categories did not change for boys. The prevalence of healthful attitudes rose, including plans to “eat more foods that are good for you” (77% to 90%; p = .027) and “planning to try some new sports” (80% to 88%; p = .007).
Children in the Power-Up program reduced mean BMI z scores significantly. The after-school venue proved feasible. The use of CBPR principles helped to integrate Power-Up into school activities and contributed to likelihood of sustainability. Engaging parents effectively in the after-school time frame proved challenging; additional strate gies to engage parents are under development. Plans are underway to evaluate this intervention through a randomized study.
After-school; childhood obesity; community-based participatory research; African American; nutrition; physical activity
Obesity is an important public health issue and its prevalence is reaching epidemic proportions in both developed and developing countries. The aim of the present study was to determine associations of overweight (OW), obesity (OB) and abdominal obesity (AO) with marital status and educational level in Greek adults of both genders based on data from the National Epidemiological Survey on the prevalence of obesity.
The selection was conducted by stratified sampling through household family members of Greek children attending school during 2003. A total of 17,341 Greek men and women aged from 20 to 70 years participated in the survey and had anthropometric measurements (height, weight, and waist circumference) for the calculation of prevalence of OW, OB and AO. WHO cut-offs were used to define overweight and obesity categories. Waist circumference of more than 102 cm in men and 88 cm in women defined AO. Marital status and educational level were recorded using a specially designed questionnaire and were classified into 4 categories.
The overall prevalence of OB was 22.3% (25.8% in men, 18.4% in women), that of OW 35.2% (41.0% in men, 29.8% in women) and that of AO 26.4% in men and 35.9% in women. Ahigher risk of OB was found in married men (OR: 2.28; 95% CI: 1.85-2.81) and married women (OR: 2.31; 95% CI: 1.73-3.10) than in the respective unmarried ones. Also, a higher risk of AO was found in married men (OR: 3.40; 95% CI: 2.86-4.03) and in married women (OR: 2.40; 95% CI 2.00-2.88) compared to unmarried ones. The risk for being obese was lower among educated women (primary school, OR: 0.76; 95% CI: 0.60-0.96, high school, OR: 0.58; 95% CI: 0.46-0.74 and University, OR: 0.64; 95% CI: 0.49-0.81) than among illiterates. No significant differences were found among men.
In Greek adults, marital status was significantly associated with obesity and abdominal obesity status in both genders while educational level was inversely associated with obesity status only in women.
The epidemic of obesity is increasing in all countries. However, the number of controlled studies focusing on childhood obesity, with a long follow-up is still limited. Even though Behavioral Therapy shows some efficacy, it requires a prolonged teamwork that is not always available in public health settings. In addition, Behavioral Therapy is not always accepted. We describe a new intensive and sustainable family-based, Therapeutic Education program for childhood obesity.
Controlled clinical study: a family-based Therapeutic Education program without dietetic prescription involving overweight and obese children/adolescents, without evident psychological troubles, and their families. The program consisted of three clinical and therapeutic education sessions, carried out by a single physician. Further sessions were carried out every six months in the first year and then every year.
Study population: 190 overweight children, 85 treated with a therapeutic education program (45 males and 40 females, mean age of 10.43 ± 3) with an average BMI% of 154.72 ± 19.6% and 105 matched children, treated with traditional dietary approach.
Children's Body Mass Index (BMI) % and BMI Standard Deviation Score measured at baseline and after a three year-follow-up, were compared. Statistical tests: ANOVA-RM (repeated measures) controlled for distribution by Kolmogorov-Smirnov, Bartlett's test or correspondent non-parametric procedures, X2 tests or Fisher's exact test and simple linear regression.
After a follow-up of 2.7 ± 1.1 years, 72.9% of the children who followed the Therapeutic Education Program obtained a BMI% reduction, compared to 42.8% of children who followed the traditional dietary treatment. Weight reduction was good in moderately obese children and in the severely obese. In addition, a smaller proportion of children treated with therapeutic education had negative results (BMI increase of >10%) compared to those treated with dietary approach (11.8% vs. 25.7%); finally, periodic phone calls reduced the drop-out rate in the therapeutic education group.
These results indicate the efficacy and sustainability of the Therapeutic Education program, that was completely carried out by a single pediatrician; in addition, it met with an elevated participant acceptance, suggesting a convenient therapeutic solution for skilled pediatricians and selected obese children, when Behavioral Therapy is not available or teamwork is poor.
Treatment of childhood obesity is difficult, and successful management may differ in various areas with different cultural backgrounds. The present study was conducted to assess the effect of lifestyle modification family-based intervention in young Iranian children.
This field trial study was conducted in 2011 among 156 obese children in Tehran, Iran. They were randomly assigned to intervention and control groups. At baseline, anthropometric measurements and biochemical analysis were performed. The second and third phases consisted of training sessions for parents of the intervention group. At the fourth phase, there was no training program. In all four phases, questionnaires on demographic characteristics, lifestyle and food frequency were completed by interviewing with mothers, and biochemical analysis was repeated at the end of the study.
During the second and third phases of the study, weight and height increased significantly in both groups, although weight increased more slowly, and waist and hip circumferences was decreased in the intervention group. Serum triglycerides and cholesterol decreased significantly in the intervention group (P < 0.05). Analysis of food group consumption showed that in the intervention group, not only consumption of milk, dairy and nuts group increased significantly but also the corresponding figure decreased for bread and cereals, sugar and confectionery ingredients; moreover, the family's oil and fat consumption decreased significantly (P < 0.05). Watching TV and playing on the computer decreased significantly in the intervention group; however, walking time increased significantly in both groups (P < 0.05).
The family-based lifestyle program had limited but desirable effects on anthropometric and metabolic outcomes of the obese children. We suggest that a longer period of intervention may have more favorable results.
Children; family-based intervention; obesity
To examine maternal parenting behaviors, child temperament and their potential interactions in families of obese children and demographically similar families of nonoverweight children.
A total of 77 obese youth (M body mass index (BMI) z-score values, zBMI = 2.4; ages 8–16, 59% female, 50% African American) and their parents were recruited from a pediatric weight management clinic and compared to 69 families of nonoverweight youth (M zBMI = − 0.03). Comparison youth were classmates of each obese participant matched on gender, race and age.
Maternal report of child temperament, parenting style and anthropometric assessments were obtained.
Compared to nonoverweight youth, mothers of obese youth described their child as having a more difficult temperament and their parenting style as lower in behavioral control. A logistic regression model indicated that difficult temperament, lower behavioral control and the interaction of low maternal warmth and difficult child temperament were associated with increased odds of a child being classified as obese.
Treatment-seeking obese youth and their parents are characterized by different parent and child factors when compared to nonoverweight comparison families. These findings direct investigators to test more complex models of the relation between parent and child characteristics and their mutual role in the weight-related behavior change process.
psychosocial; family; children; adolescence
The purpose of this study was to assess the effects of a six-months’ nutrition program, delivered and taught by classroom teachers with in-service nutrition training, on the prevention of overweight and obesity among children in grades 1 to 4. In this randomized trial, four hundred and sixty four children from seven elementary schools were allocated to a nutrition educational program delivered by their own teachers. Intervened teachers had 12 sessions of three hours each with the researchers throughout six months, according to the topics nutrition and healthy eating, the importance of drinking water and healthy cooking activities. After each session, teachers were encouraged to develop activities in class focused on the learned topics. Sociodemographic, anthropometric, dietary, and physical activity assessments were performed at baseline and at the end of the intervention. In the intervention group the increase in Body Mass Index (BMI) z-score was significantly lower than in the control group (p = 0.009); fewer proportion of children became overweight in the intervened group compared with the control (5.6% vs. 18.4%; p = 0.037). Our study provides further support to decrease the overweight epidemic, involving classroom teachers in a training program and making them dedicated interventionists.
BMI z-score; children; obesity; overweight; trained teachers; health promotion
Pediatric obesity has become a global public health problem. Data on the lifestyle behaviors, dietary habits, and familial factors of overweight and obese children and adolescents are limited. The present study aims to compare health-related factors among normal-weight, overweight, and obese Chinese children and adolescents.
We conducted a cross-sectional study consisted of 4262 children and adolescents aged 5–18 years old from rural areas of the northeast China. Anthropometric measurements and self-reported information on health-related variables, such as physical activities, sleep duration, dietary habits, family income, and recognition of weight status from the views of both children and parents, were collected by trained personnel.
The prevalence rates of overweight and obesity were 15.3 and 6.4%, respectively. Compared to girls, boys were more commonly overweight (17.5% vs. 12.9%) and obese (9.5% vs. 3.1%). Approximately half of the parents with an overweight or obese child reported that they failed to recognize their child’s excess weight status, and 65% of patients with an overweight child reported that they would not take measures to decrease their child’s body weight. Obese children and adolescents were more likely to be nonsnackers [odds ratio (OR): 1.348; 95% confidence interval (CI): 1.039–1.748] and to have a family income of 2000 CNY or more per month (OR: 1.442; 95% CI: 1.045–1.99) and less likely to sleep longer (≥7.5 h) (OR: 0.475; 95% CI: 0.31–0.728) than the normal-weight participants.
Our study revealed a high prevalence of overweight and obesity in a large Chinese pediatric population. Differences in sleep duration, snacking, family income, and parental recognition of children’s weight status among participants in different weight categories were observed, which should be considered when planning prevention and treatment programs for pediatric obesity.
Overweight; Obesity; Children; Adolescents; Health-related factors
Background and Aims
A polymorphism in adiponutrin/patatin-like phospholipase-3 gene (PNPLA3), rs738409 C->G, encoding for the I148M variant, is the strongest genetic determinant of liver fat and ALT levels in adulthood and childhood obesity. Aims of this study were i) to analyse in a large group of obese children the role of the interaction of not-genetic factors such as BMI, waist circumference (W/Hr) and insulin resistance (HOMA-IR) in exposing the association between the I148M polymorphism and ALT levels and ii) to stratify the individual risk of these children to have liver injury on the basis of this gene-environment interaction.
1048 Italian obese children were investigated. Anthropometric, clinical and metabolic data were collected and the PNPLA3 I148M variant genotyped.
Children carrying the 148M allele showed higher ALT and AST levels (p = 0.000006 and p = 0.0002, respectively). Relationships between BMI-SDS, HOMA-IR and W/Hr with ALT were analysed in function of the different PNPLA3 genotypes. Children 148M homozygous showed a stronger correlation between ALT and W/Hr than those carrying the other genotypes (p: 0.0045) and, therefore, 148M homozygotes with high extent of abdominal fat (W/Hr above 0.62) had the highest OR (4.9, 95% C. I. 3.2–7.8, p = 0.00001) to develop pathologic ALT.
We have i) showed for the first time that the magnitude of the association of PNPLA3 with liver enzymes is driven by the size of abdominal fat and ii) stratified the individual risk to develop liver damage on the basis of the interaction between the PNPLA3 genotype and abdominal fat.
The aim of this study was to determine the most frequent skin disorders in obese female schoolchildren in primary and intermediate schools in the Al-Khobar area, Eastern Saudi Arabia.
This was a cross-sectional study conducted in the Al-Khobar area. It involved 2239 female schoolchildren randomly selected from 30 regular public and private primary and preparatory schools. A multi-stage stratified random sampling technique with proportional allocation was used. Data was collected using clinical examination and anthropometric measurements.
The skin diseases that were most common in obese schoolchildren were: dandruff, acne, xerosis, acanthosis nigricans, folliculitis, alopecia, stria distensae (stretch marks) and callosity.
Conclusions and recommendations:
obesity is associated with specific skin disorders. Health education programs on skin diseases and obesity should be provided to all schoolchildren, their families and teachers.
Dermatoses; skin disorders; obese schoolchildren; Al-Khobar; Saudi Arabia
Dyslipidemia is a marker for ischemic heart disease (IHD), which can be detected in early childhood and tracks to adulthood. Dyslipidemia, along with factors like diet, obesity and sedentary activity, increases the risk of a child developing IHD in adulthood. Early detection and modification of these risk factors can prevent IHD.
To study the lipid profile in children born to parents with history of premature IHD and also to study the effect of diet, lifestyle factors, and obesity in the study group.
Materials and Methods:
Fifty children of parents with premature IHD and 50 control children without any family history of IHD were analyzed for cardiovascular risk factors such as lipid profile, body mass index (BMI) and hypertension. The effects of modifiable risk factors like diet and physical activity on lipid profile were analyzed. The correlation between parent and child lipid profile was studied.
Mean total cholesterol, low density lipoprotein cholesterol and triglycerides were significantly higher (P<0.05) in children with family history of IHD as compared to children without family history. There was a positive correlation between lipid levels of parents and their children. Children with elevated BMI, a sedentary lifestyle, and excess oily/junk diet intake showed increased incidence of dyslipidemia (P<0.05).
Children of IHD patients have significant incidence of dyslipidemia. The risk factors like BMI, diet and physical activity increase the incidence of dyslipidemia. Therefore, all children of premature IHD patients should be screened for dyslipidemia.
Cardiovascular risk factors; dyslipidemia; ischemic heart disease
Objective. To evaluate the effect of a family-based intervention on anthropometric and
metabolic markers in overweight and obese children.
Methods. Overweight or obese 8–12 years olds (n = 93) were randomized into intervention or
control groups. The intervention group participated in a program aiming for lifestyle changes
regarding food habits and physical activity. Anthropometric measures and venous blood
samples were collected from all children at baseline and after 1 year.
Results. BMI z-scores decreased in both groups, 0.22 (P = 0.002) and 0.23 (P = 0.003) in intervention and control group, respectively, during the 1-year study, but there was no difference in BMI between the groups at 1-year measurement (P = 0.338). After 1 year, there was a significant difference in waist circumference, waist/hip ratio, and apolipoprotein B/A1 ratio between intervention and control group. Conclusions. The intervention had limited effects on anthropometrics and metabolic markers, which emphasizes the need of preventing childhood overweight and obesity.
Childhood obesity has reached epidemic proportions and is impacting children's health globally. In adults, obesity is associated with chronic low-grade inflammation that leads to insulin resistance, which is one of the important mechanisms through which dysregulation of metabolism occurs. There is limited information available about the contribution of inflammation to metabolic health in obese children, and how individual and lifestyle factors impact this risk. One of the paediatric groups at risk of higher rates of obesity includes the survivors of childhood brain tumours. The aim of this study was to evaluate the mechanisms that contribute to inflammation in obese survivors of childhood brain tumours.
Methods and analysis
This is a prospective cohort study. We will recruit lean and obese survivors of childhood brain tumours, and a control group composed of lean and obese children with no history of tumours. We will measure circulating and urinary cytokine levels and cytokine gene expression in monocytes. In addition, the methylation patterns of cytokine genes and that of toll-like receptor genes will be evaluated. These will be correlated with individual and lifestyle factors including age, sex, ethnicity, puberty, body mass index, fasting lipid levels, insulin sensitivity, diet, exercise, sleep, stress and built environment. The sample size calculation showed that we need 25 participants per arm
Ethics and dissemination
This study has received ethics approval from the institutional review board. Once completed, we will publish this work in peer-reviewed journals and share the findings in presentations and posters in meetings.
This study will permit the interrogation of inflammation as a contributor to obesity and its complications in obese survivors of childhood brain tumours and compare them with lean survivors and lean and obese controls with no history of tumours, which may help identify therapeutic and preventative interventions to combat the rising tide of obesity.
Obesity and type 2 diabetes have emerged as critical health issues among Latino youth. Although both conditions manifest early in life, very few diabetes prevention programs have been developed to specifically meet the needs of this population. The authors describe the development, implementation, and metabolic impact of a culturally informed, community-based diabetes prevention program for obese Latino youth.
A lifestyle education program was developed to address the health needs of Latino youth served by a community-based medical clinic. The program consisted of group education sessions delivered to children and their families to address nutrition, physical activity, family roles and responsibilities, and self-esteem. The metabolic impact of the program was evaluated by assessing body mass index (BMI), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol, triglycerides, glucose, and insulin.
On entry, the prevalence of risk factors among the 102 youth (mean BMI, 30.4 ± 4.9 kg/m2) was substantial (68.6% with low HDL cholesterol, 32.1% with elevated triglycerides, 9.4% with impaired fasting glucose, 39.4% with elevated total cholesterol, 43.0% with elevated LDL cholesterol, and 60.6% with hyperinsulinemia). The 50 youth who returned after the program for follow-up measurements exhibited significant health improvements, including a 3.8% reduction in BMI; 5.4% and 8.6% decreases in total and LDL cholesterol, respectively; a 9.3% increase in HDL cholesterol; and a 24.0% decrease in fasting insulin (all P values < .05).
These promising findings suggest that a community-based diabetes prevention program for obese Latino youth is a feasible strategy for improving health in this high-risk population. Further studies are warranted to examine whether similar programs can be implemented in diverse communities and settings.
health disparities; community health; obesity; diabetes; Latino
Reversing the obesity epidemic requires the development and evaluation of childhood obesity intervention programs. Lifestyle Triple P is a parent-focused group program that addresses three topics: nutrition, physical activity, and positive parenting. Australian research has established the efficacy of Lifestyle Triple P, which aims to prevent excessive weight gain in overweight and obese children. The aim of the current randomized controlled trial is to assess the effectiveness of the Lifestyle Triple P intervention when applied to Dutch parents of overweight and obese children aged 4–8 years. This effectiveness study is called GO4fit.
Parents of overweight and obese children are being randomized to either the intervention or the control group. Those assigned to the intervention condition receive the 14-week Lifestyle Triple P intervention, in which they learn a range of nutritional, physical activity and positive parenting strategies. Parents in the control group receive two brochures, web-based tailored advice, and suggestions for exercises to increase active playing at home. Measurements are taken at baseline, directly after the intervention, and at one year follow-up. Primary outcome measure is the children’s body composition, operationalized as BMI z-score, waist circumference, and fat mass (biceps and triceps skinfolds). Secondary outcome measures are children’s dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, parental self-efficacy, and body composition of family members (parents and siblings).
Our intervention is characterized by a focus on changing general parenting styles, in addition to focusing on changing specific parenting practices, as obesity interventions typically do. Strengths of the current study are the randomized design, the long-term follow-up, and the broad range of both self-reported and objectively measured outcomes.
Current Controlled Trials NTR 2555
NL 31988.068.10 / MEC 10-3-052
Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to control children's daily sedentary life style and their intakes of high caloric foods in order to prevent obesity. Recent assessment of breastfeeding in Korea has shown that the rate is between 63% and 89%; thus, up-to-dated evidence-based nutritional management of breastfeeding infants to prevent common nutrient deficiencies or excesses should be taught to all clinicians and health care providers.
Breastfeeding; Iron deficiency anemia; Vitamin D deficiency; Complementary feeding; Obesity
Increasing epidemic proportions of overweight children in the United States presents formidable challenges for education and healthcare. Given the popularity and pervasiveness of video gaming culture in North American children, the perfect opportunity arises to investigate the potential of video games to promote healthful behaviour. Our objective was to systematically review the literature for possible benefits of active and educational video games targeting diet and physical activity in children. A review of English-language journal articles from 1998 to 2011 using EMBASE and PubMed was conducted. Thirty-four studies concerned with children, video games, physical, and/or nutritional outcomes were included. Results of these studies that showed some benefit (increased physical activity and nutritional knowledge as a result of gaming) demonstrate the possibility of video games to combat childhood obesity—looking beyond the stigma attached to gaming.
Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Consequently, both over-consumption of calories and reduced physical activity are involved in childhood obesity.
Almost all researchers agree that prevention could be the key strategy for controlling the current epidemic of obesity. Prevention may include primary prevention of overweight or obesity, secondary prevention or prevention of weight regains following weight loss, and avoidance of more weight increase in obese persons unable to lose weight. Until now, most approaches have focused on changing the behaviour of individuals in diet and exercise. It seems, however, that these strategies have had little impact on the growing increase of the obesity epidemic. While about 50% of the adults are overweight and obese in many countries, it is difficult to reduce excessive weight once it becomes established. Children should therefore be considered the priority population for intervention strategies. Prevention may be achieved through a variety of interventions targeting built environment, physical activity, and diet. Some of these potential strategies for intervention in children can be implemented by targeting preschool institutions, schools or after-school care services as natural setting for influencing the diet and physical activity. All in all, there is an urgent need to initiate prevention and treatment of obesity in children.
To examine beliefs about the role of parenting in feeding and childhood obesity among mothers of lower socioeconomic status.
Individual semi-structured audio-taped interview with 91 mothers of preschool-aged children (49% of mothers obese, 21% of children obese) in the Midwestern United States. Participant comments were transcribed and common themes identified using the constant comparative method and NVivo software.
Mothers often described their parents’ feeding style as authoritarian or neglectful, and their own current style as comparatively indulgent and better. Mothers described parents of overweight children as inept or neglectful, but never described their own parenting as such.
Conclusions and Implications
Encouraging mothers to reflect on how they were fed as children, how it may impact their current parenting, and how the relationship between mothering and child obesity is complex are important nutrition education opportunities.
childhood obesity; feeding behavior; low income; obesity; maternal beliefs
Diet and physical activity (PA) are essential components of nutritional status. Adequate nutrition and an active lifestyle are key factors during childhood, because food habits track into adulthood. Children spend more time in school than in any other environment away from home. Studying the diet factors and patterns of PA that affect obesity risk in children during school hours and the complete school day can help identify opportunities to lower this risk. We directly measured the time children spent performing moderate to vigorous PA (MVPA) at school, compared the amount and intensity of PA during school hours with after-school hours, and tried to determine if diet behaviors and PA or inactivity were associated with excess weight and body fat. This cross-sectional study included 143 normal-weight (NLW) and 48 obese children aged 8–10 y. Diet data were obtained from two 24-h recalls. Body composition was measured by bioimpedance. Screen time and sports participation data were self-reported. NLW children drank/ate more dairy servings than the obese children, who consumed more fruit-flavored water than the NLW group. Consumption of soft drinks, sugar-added juices, and fresh juices was low in both groups. Children were less active during school hours than after school. MVPA was lower during school hours in the obese group than in the NLW group. Schools, parents, and authorities should be more involved in promoting strategies to improve the dietary habits and PA levels of school-aged children, because this group is not achieving the recommended level of daily MVPA.
Our goal is to estimate the prevalence of obesity, glucose intolerance, hypertension, dyslipidemia, and metabolic syndrome among urban children and adolescents aged 6–19 years and to raise awareness about noncommunicable diseases (NCDs) among school children in Chennai, South India.
The Obesity Reduction and Awareness and Screening of Noncommunicable Diseases through Group Education project plans to reach out to children and adolescents using two approaches: the school and the community approach. The school approach aims to reach out to a representative sample of approximately 20,000 urban school children and adolescents, aged 6–19 years, covering 50 schools from all parts of Chennai. Anthropometric measures will include height, weight, waist, body fat, and blood pressure. Data on demographics, family profile, behavioral aspects, physical activity, and food pattern will be obtained by using a validated questionnaire. Awareness about metabolic NCDs like obesity and diabetes will be increased by educating the children and adolescents about healthy lifestyles. Through the community approach, 2000 children and adolescents from randomly selected residential colonies in Chennai will be screened for obesity, glucose intolerance, hypertension, dyslipidemia, and metabolic syndrome.
Awareness about NCDs will be increased among children and their parents in Chennai. This study will also provide valuable epidemiological data on obesity, glucose intolerance, dyslipidemia, hypertension and metabolic syndrome in children and adolescents in urban India.
awareness; early onset type 2 diabetes; childhood diabetes; metabolic syndrome; noncommunicable diseases; obesity; school
There is little information on the association between watching Television (TV) and obesity in the Arabian Peninsula.
Aim of the Study:
The aim of this study was to explore the association between the watching of television and obesity in Saudi children of school-age.
Materials and Methods:
A case-controlled study was conducted with students between the ages of 9 and 14 years who attended the school health clinic in King Abdulaziz Housing for National Guard (Iskan), Riyadh, Saudi Arabia, during the study period (February to April 2012). During each clinic, children were selected by simple random sampling (five obese and five non-obese). For data collection, two trained physicians interviewed the participants using a 20-item Arabic questionnaire. Well-trained nurses collected the anthropometric measurements of weight and height.
The study included 397 students. Higher (body mass index) BMI was associated with a higher number of televisions at home (P < 0.001), watching TV for more than three hours per day at the weekend (P = 0.047), eating more than three snacks per day (P = 0.005), watching TV at night (P = 0.026), and siblings’ decisions on how much TV to watch (P = 0.025). The prevalence of childhood obesity was significantly lower among those whose mothers determined how much TV they could watch (P = 0.03). In logistic regression analysis, the increase in the child's age, the presence of more than one TV at home, having his or her own TV, and an increase in the number of hours of watching TV over the weekend were significantly associated with an increased risk of childhood obesity. Personal computers and the Internet were not significantly associated with an increased risk of childhood obesity.
The present investigation revealed that watching TV represents an important risk factor for obesity in children of school-age.
Obesity; Saudi Arabia; school-age children; television
OBJECTIVE: To provide educational material to the Bronx community in their places of recreation as well as uncover attitudes and perceptions about the obesity epidemic. METHODS: Our medical team equipped a mobile health unit, called Vehicle Assisted Nutrition (VAN), with educational material and drove it to seven recreation sites in the Bronx. At these sites, participants completed a short survey, and our staff took body mass index (BMI) measurements. The medical team also distributed patient education materials pertaining to lifestyle modification and obesity. BMI and survey responses were compared and analyzed with statistical software. RESULTS: Obesity rates at these sites averaged 29.9% normal weight, 40.2% overweight, 18% class-1 obese and 11% class-2 obese or greater. Only 22.2% of normal weight, 23.3% of overweight and 43.6% of class-1 obese respondents stated that their weight was a problem (p<0.001). Most (80.6%) of the class-2 obese or greater respondents, however, stated that their weight was a problem (p<0.001). More than 44% of normal weight, 59.4% of overweight, 71.3 of class-1 obese and 90.3% of the class-2 obese or greater participants stated they were willing to do something about it (p=0.006). Of those surveyed, 37.5% of the normal weight, 54.7% of the overweight, 56.9% of the class-1 obese and 63.6% of the class-2 obese or greater indicated that they would like our help (p=0.035). More than 66% of normal weight, 41.8% of the overweight, 56.9% of the class-1 obese, and 68.9% of the class-2 obese or greater stated that they would be interested in a class to lose weight (p=0.008). CONCLUSION: Medical practitioners need to recognize the role of patients' attitudes about weight loss and clarify for patients the definitions of exercise.