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Weight development in children with obesity without treatment: A Danish cohort study with long-term follow-up.
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-02-04 DOI: 10.1111/ijpo.70001
Rasmus Møller Jørgensen, Jens Meldgaard Bruun, Mette Fogh, Iris Iglesia Altaba, Luis A Moreno, Henrik Støvring, Jane Nautrup Østergaard

Introduction: Limited insight exists into the weight development in children with obesity not receiving obesity treatment.

Methods: This cohort study included 467 Danish children aged 5-10 years with obesity (iso-BMI >30 kg/m2) not receiving treatment. Data from mandatory health check-ups on school-children's height and weight (converted to BMI z-scores) were merged with the Danish National Registries. A multivariable logistic regression weighted for the duration of follow-up was used to estimate odds ratios (OR) for normalization of BMI (iso-BMI 18.5-25 kg/m2) and obesity remission (iso-BMI 18.5-30 kg/m2).

Results: During a median follow-up of more than 6 years, 7.9% of the children normalized their BMI, while 45.4% obtained obesity remission. BMI z-score at inclusion acted as a strong inverse predictor for normalizing BMI (OR 0.14 per one-unit SD, CI: 0.03-0.53) and for obesity remission (OR 0.17 per one-unit SD, CI: 0.08-0.37). No other significant predictors were observed in the weighted multivariable models.

Conclusion: Higher BMI z-scores inversely predict normalizing BMI and achieving obesity remission in untreated children. Given that many children naturally achieve obesity remission or weight normalization, resources should focus on understanding barriers of obesity maintenance and to develop effective strategies for those who do not experience improvement.

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引用次数: 0
Childhood obesity trajectories and adolescent mental health: A UK cohort study
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-30 DOI: 10.1111/ijpo.13206
I Gusti Ngurah Edi Putra, Michael Daly, Eric Robinson

Background

There is limited evidence on how changes in obesity from childhood to adolescence are associated with adolescent mental health. We examined the associations between childhood obesity trajectories, obesity episodes, and mental health at age 17.

Methods

Data were from the UK Millennium Cohort Study. Obesity trajectory groups at ages 7 and 17 (n = 8306) and previous obesity episodes (number of sweeps with obesity) at ages 7, 11 and 14 (n = 7246) were examined. Caregiver and self-reported internalising and externalising symptoms at age 17 were used to measure mental health. Linear regression models were used.

Results

Relative to never developing obesity, obesity development (β = 1.01; 95% CI = 0.71, 1.32) and persistence (β = 1.18; 95% CI = 0.74, 1.61) were associated with higher internalising symptoms at age 17 and worsening (increase in scores) of these symptoms between ages 7 and 17 (β = 0.87; 95% CI = 0.57, 1.17 and β = 0.86; 95% CI = 0.56, 1.26 for development and persistence, respectively). Obesity development was associated with higher externalising symptoms at age 17 (β = 0.52; 95% CI = 0.25, 0.80) and worsening of these symptoms over time (β = 0.30; 95% CI = 0.07, 0.53). Having multiple past obesity episodes was not associated with worsening mental health independent of follow-up weight status. There were no differences in mental health outcomes between children who reversed versus never developed obesity.

Conclusions

Obesity development or persistence from ages 7 to 17 are associated with worsening mental health. If childhood obesity is reversed, there appears to be no evidence of a negative association between previous obesity and mental health at age 17.

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引用次数: 0
Sleep-disordered breathing and cardiometabolic and inflammatory markers in children with overweight/obesity: The role of cardiorespiratory fitness. 超重/肥胖儿童的睡眠呼吸障碍、心脏代谢和炎症标志物:心肺健康的作用
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-21 DOI: 10.1111/ijpo.13207
Lucia V Torres-Lopez, Abel Plaza-Florido, Jose J Gil-Cosano, Jairo H Migueles, Francisco B Ortega, Cristina Cadenas-Sanchez

Objectives: To investigate the association of sleep-disordered breathing (SDB) severity with cardiometabolic and inflammatory markers independently of the adiposity levels; and to explore the role of cardiorespiratory fitness in these associations in children with overweight/obesity.

Methods: A total of 109 children aged 8-11 years with overweight/obesity were included in this cross-sectional study. SDB was assessed using a scale of the reduce version of the Paediatric Sleep Questionnaire. Cardiometabolic markers included fasting blood lipids biomarkers (i.e., low- and high-density lipoprotein cholesterol, and triglycerides), blood pressure, insulin, glucose, and the homeostatic model assessment index. Inflammatory markers (i.e., interleukin-6, interleukin-1β, C-reactive protein [CRP], and tumour necrosis factor alpha) were analysed. Cardiorespiratory fitness was assessed by the 20 m shuttle-run test.

Results: No significant associations were found between SDB severity and most of the cardiometabolic markers after correcting for adiposity and multiple comparisons (all p's >0.05). SDB severity was positively related to CRP (β = 0.352, p = 0.002), yet not with the remaining inflammatory markers analysed. The interaction effect of cardiorespiratory fitness presented a positive trend in the association of SDB with CRP (p = 0.1). When stratified analyses by cardiorespiratory fitness levels were conducted, a positive relation was found between SDB and CRP in the low cardiorespiratory fitness group (β = 0.465, p = 0.014), but not in the high cardiorespiratory fitness group (β = 0.236, p = 0.108).

Conclusion: SDB severity was positively associated with CRP independently of the adiposity levels, but not with other inflammatory or cardiometabolic risk factors in children with overweight/obesity. Moreover, our results suggest that higher levels of cardiorespiratory fitness may attenuate the adverse effect of SDB severity on systematic inflammation in children with overweight/obesity.

目的:探讨睡眠呼吸障碍(SDB)严重程度与独立于肥胖水平的心脏代谢和炎症指标的关系;并探讨在超重/肥胖儿童中,心肺健康在这些关联中的作用。方法:本横断面研究共纳入109例8-11岁超重/肥胖儿童。使用儿科睡眠问卷的简化版量表评估SDB。心脏代谢标志物包括空腹血脂生物标志物(即低、高密度脂蛋白胆固醇和甘油三酯)、血压、胰岛素、葡萄糖和稳态模型评估指标。分析炎症标志物(即白细胞介素-6、白细胞介素-1β、c反应蛋白[CRP]和肿瘤坏死因子α)。采用20米穿梭跑试验评价心肺功能。结果:校正肥胖和多重比较后,SDB严重程度与大多数心脏代谢指标之间无显著相关性(p < 0.05)。SDB严重程度与CRP呈正相关(β = 0.352, p = 0.002),但与其余炎症标志物分析无关。在心肺适能的交互作用下,SDB与CRP呈正相关(p = 0.1)。按心肺适能水平分层分析时,低心肺适能组SDB与CRP呈正相关(β = 0.465, p = 0.014),高心肺适能组不呈正相关(β = 0.236, p = 0.108)。结论:在超重/肥胖儿童中,SDB严重程度与CRP呈正相关,独立于肥胖水平,但与其他炎症或心脏代谢危险因素无关。此外,我们的研究结果表明,较高的心肺健康水平可能会减轻SDB严重程度对超重/肥胖儿童系统性炎症的不利影响。
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引用次数: 0
Interaction between breastfeeding duration and an obesity genetic risk score to predict body fat composition in European adolescents: The HELENA study 在欧洲青少年中,母乳喂养持续时间和肥胖遗传风险评分预测体脂组成的相互作用:HELENA研究。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-21 DOI: 10.1111/ijpo.13205
Georgios K. Baxevanis, Iris Iglesia, Miguel Seral-Cortes, Sergio Sabroso-Lasa, Paloma Flores-Barrantes, Frédéric Gottrand, Aline Meirhaeghe, Anthony Kafatos, Kurt Widhalm, Nele Hockamp, Dénes Molnár, Ascensión Marcos, Esther Nova, Marcela González-Gross, Eva Gesteiro, Ángel Gutiérrez, Yannis Manios, Costas A. Anastasiou, Gerardo Rodríguez, Luis A. Moreno, the HELENA Study Group

Background

Although the genetic interplay with the environment has a major impact on obesity development, little is known on whether breastfeeding could modulate the genetic predisposition to obesity.

Objectives

To investigate whether breastfeeding attenuates the effect of an obesity genetic risk score (GRS) on adiposity in European adolescents.

Methods

Totally 751 adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study were included, divided according to breastfeeding status into never breastfed, 1–3 months and ≥4 months. Adjusting by socioeconomic status and lifestyle factors multiple linear regression models were used to assess (1) the main effect of breastfeeding duration and (2) its interaction effect with an obesity GRS, to predict different adiposity measures.

Results

A significant negative association between ≥4 months of breastfeeding and waist circumference (WC) z-score was observed [β (95% confidence interval), p-value] = [β = −0.189 (−0.37, −0.00), p = 0.044]. Also, significant interaction effects were observed for 1–3 and ≥4 months of breastfeeding and obesity GRS regarding body mass index (BMI) z-score [β = 0.155 (0.06, 0.24), p = 0.001] and [β = 0.108 (0.01, 0.18), p = 0.020, respectively] and fat mass index (FMI) z-score [β = 0.134 (0.04, 0.22), p = 0.003] and [β = 0.100 (0.01, 0.18), p = 0.026, respectively].

Conclusions

Breastfeeding modulates the association between the obesity GRS and body composition in adolescents.

背景:虽然遗传与环境的相互作用对肥胖的发展有重大影响,但母乳喂养是否能调节肥胖的遗传易感性尚不清楚。目的:研究母乳喂养是否会减弱欧洲青少年肥胖遗传风险评分(GRS)对肥胖的影响。方法:采用欧洲青少年营养健康生活方式(HELENA)横断面研究纳入751名青少年,按母乳喂养状况分为从不母乳喂养、1-3个月和≥4个月。经社会经济地位和生活方式因素调整后,采用多元线性回归模型评估(1)母乳喂养时间的主要影响以及(2)其与肥胖GRS的交互作用,以预测不同的肥胖措施。结果:≥4个月母乳喂养与腰围(WC) z-score呈显著负相关[β(95%可信区间),p值]= [β = -0.189 (-0.37, -0.00), p = 0.044]。此外,1-3个月和≥4个月母乳喂养与肥胖GRS在体重指数(BMI) z-score [β = 0.155 (0.06, 0.24), p = 0.001]和脂肪质量指数(FMI) z-score [β = 0.134 (0.04, 0.22), p = 0.003]和[β = 0.100 (0.01, 0.18), p = 0.026]方面存在显著交互作用。结论:母乳喂养调节了青少年肥胖GRS与体成分的关系。
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引用次数: 0
Effect of a physical activity and healthy eating lifestyle intervention in pregnancy on fetal growth trajectories: The DALI randomised controlled trial. 孕期体育活动和健康饮食生活方式干预对胎儿生长轨迹的影响:DALI随机对照试验
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-19 DOI: 10.1111/ijpo.13199
Anna M Dieberger, Mireille N M van Poppel, Gernot Desoye, David Simmons, Jürgen Harreiter, Roland Devlieger, Carmen Medina, Deborah A Lawlor, Ahmed Elhakeem

Background: Obesity during pregnancy is related to fetal overgrowth. Effective interventions that can mitigate this risk are needed.

Objectives: This study aimed to investigate the effect of a lifestyle intervention for pregnant women with obesity on fetal growth trajectories.

Methods: In the DALI trial, pregnant women with a body mass index ≥29.0 kg/m2 and without gestational diabetes at baseline were randomized to counselling on physical activity (PA), healthy eating (HE) or a combination (PA + HE), or to usual care (UC). Fetal growth trajectories were modelled based on a combination of estimated fetal weight (EFW) from repeated ultrasound scans and weight measured at birth. Differences in fetal growth trajectories between groups were assessed.

Results: Three hundred eighty-four women were included. Those in the PA + HE intervention had slower EFW gain from 32 weeks onwards, with differences (PA + HE vs. UC) at 32, 36 and 40 weeks of -54.1 g (-146.7 to 38.9 g), -84.9 g (-194.0 to 24.7 g), and -99.8 g (-227.1 to 28.1 g), respectively. Effects appeared stronger in males, with a difference at 40 weeks of -185.8 g (-362.5 g to -9.2 g) versus -23.4 g (-190.4 g to 143.5 g) in females.

Conclusions: A lifestyle intervention for pregnant women with obesity resulted in attenuated fetal growth, which only reached significance in male offspring. Future larger trials are needed to confirm these findings and elucidate underlying pathways.

背景:妊娠期肥胖与胎儿过度生长有关。需要采取有效的干预措施来减轻这种风险。目的:本研究旨在探讨生活方式干预对肥胖孕妇胎儿生长轨迹的影响。方法:在DALI试验中,基线时体重指数≥29.0 kg/m2且无妊娠糖尿病的孕妇被随机分配到身体活动咨询(PA)、健康饮食(HE)或组合(PA + HE)或常规护理(UC)组。胎儿生长轨迹是基于反复超声扫描估计的胎儿体重(EFW)和出生时测量的体重的组合来建模的。评估两组间胎儿生长轨迹的差异。结果:共纳入384名女性。PA + HE干预组的EFW从32周开始增加较慢,差异(PA + HE与UC)在32、36和40周分别为-54.1 g(-146.7至38.9 g)、-84.9 g(-194.0至24.7 g)和-99.8 g(-227.1至28.1 g)。对雄性的影响更大,在40周时,雌性为-185.8 g (-362.5 g至-9.2 g),而雌性为-23.4 g (-190.4 g至143.5 g)。结论:对肥胖孕妇进行生活方式干预可导致胎儿生长减慢,仅在男性后代中有显著意义。未来需要更大规模的试验来证实这些发现并阐明潜在的途径。
{"title":"Effect of a physical activity and healthy eating lifestyle intervention in pregnancy on fetal growth trajectories: The DALI randomised controlled trial.","authors":"Anna M Dieberger, Mireille N M van Poppel, Gernot Desoye, David Simmons, Jürgen Harreiter, Roland Devlieger, Carmen Medina, Deborah A Lawlor, Ahmed Elhakeem","doi":"10.1111/ijpo.13199","DOIUrl":"https://doi.org/10.1111/ijpo.13199","url":null,"abstract":"<p><strong>Background: </strong>Obesity during pregnancy is related to fetal overgrowth. Effective interventions that can mitigate this risk are needed.</p><p><strong>Objectives: </strong>This study aimed to investigate the effect of a lifestyle intervention for pregnant women with obesity on fetal growth trajectories.</p><p><strong>Methods: </strong>In the DALI trial, pregnant women with a body mass index ≥29.0 kg/m<sup>2</sup> and without gestational diabetes at baseline were randomized to counselling on physical activity (PA), healthy eating (HE) or a combination (PA + HE), or to usual care (UC). Fetal growth trajectories were modelled based on a combination of estimated fetal weight (EFW) from repeated ultrasound scans and weight measured at birth. Differences in fetal growth trajectories between groups were assessed.</p><p><strong>Results: </strong>Three hundred eighty-four women were included. Those in the PA + HE intervention had slower EFW gain from 32 weeks onwards, with differences (PA + HE vs. UC) at 32, 36 and 40 weeks of -54.1 g (-146.7 to 38.9 g), -84.9 g (-194.0 to 24.7 g), and -99.8 g (-227.1 to 28.1 g), respectively. Effects appeared stronger in males, with a difference at 40 weeks of -185.8 g (-362.5 g to -9.2 g) versus -23.4 g (-190.4 g to 143.5 g) in females.</p><p><strong>Conclusions: </strong>A lifestyle intervention for pregnant women with obesity resulted in attenuated fetal growth, which only reached significance in male offspring. Future larger trials are needed to confirm these findings and elucidate underlying pathways.</p>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":" ","pages":"e13199"},"PeriodicalIF":2.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term follow-up of the impact of brief sleep and lifestyle interventions in infancy on BMI z-score at 11 years of age: The POI randomized controlled trial 婴儿期短暂睡眠和生活方式干预对11岁时BMI z-score影响的长期随访:POI随机对照试验
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-17 DOI: 10.1111/ijpo.13204
Rachael W. Taylor, Barbara C. Galland, Anne-Louise M. Heath, Andrew R. Gray, Kim A. Meredith-Jones, Sarah A. Fortune, Trudy A. Sullivan, Taiwo Adebowale, Deborah McIntosh, Rosie F. Jackson, Barry J. Taylor

Objective

To determine whether BMI differences observed at 5 years of age, from early intervention in infancy, remained apparent at 11 years.

Methods

Participants (n = 734) from the original randomized controlled trial (n = 802) underwent measures of body mass index (BMI), body composition (DXA), sleep and physical activity (24-h accelerometry, questionnaire), diet (repeated 24-h recalls), screen time (daily diaries), wellbeing (CHU-9D, WHO-5), and family functioning (McMaster FAD) around their 11th birthday. Following multiple imputation, regression models explored the effects of two interventions (‘Sleep’ vs. ‘Food, Activity and Breastfeeding’ [FAB]) using a 2 × 2 factorial design.

Results

Five hundred twelve children (48% female, mean [SD] age 11.1 [0.1] years) returned for the 11-year assessment (63% of original sample). Significant differences in BMI z-score (mean difference; 95% CI: −0.16; −0.41, 0.08) or the risk of overweight (including obesity) (odds ratio; 95% CI: 0.85; 0.56, 1.29) were no longer observed between children who had received the sleep intervention compared with those who had not. By contrast, children who had received the FAB intervention had greater BMI z-scores (0.24; 0.01, 0.47) and a higher risk of obesity (1.56; 1.03, 2.36) than children not enrolled in FAB. No significant differences were observed in any lifestyle variables nor wellbeing measures across all groups.

Conclusions

Sustained reductions in BMI and obesity risk from an early sleep intervention were not apparent 9 years later, whereas a more traditional lifestyle intervention resulted in increased rates of obesity, not explained by any differences in lifestyle behaviours measured.

Clinical Trial Registry

ClinicalTrials.gov number NCT00892983, https://clinicaltrials.gov/study/NCT00892983.

目的:确定5岁时观察到的BMI差异,从婴儿期早期干预到11岁时是否仍然明显。方法:来自原始随机对照试验(n = 802)的参与者(n = 734)在11岁生日前后接受了身体质量指数(BMI)、身体成分(DXA)、睡眠和身体活动(24小时加速度计、问卷)、饮食(24小时重复回忆)、屏幕时间(每日日记)、健康(chu9d、WHO-5)和家庭功能(McMaster FAD)的测量。在多重输入之后,回归模型探讨了两种干预措施(“睡眠”和“睡眠”)的影响。“食物、活动和母乳喂养”[FAB]),采用2 × 2因子设计。结果:512名儿童(48%为女性,平均[SD]年龄11.1[0.1]岁)返回进行11年评估(占原始样本的63%)。BMI z-score差异显著(mean difference;95% ci: -0.16;-0.41, 0.08)或超重(包括肥胖)的风险(优势比;95% ci: 0.85;0.56, 1.29)的差异在接受睡眠干预的儿童和未接受睡眠干预的儿童之间不再被观察到。相比之下,接受FAB干预的儿童BMI z分数更高(0.24;0.01, 0.47)和较高的肥胖风险(1.56;1.03, 2.36)高于未参加FAB的儿童。在所有人群中,没有观察到任何生活方式变量和健康指标的显著差异。结论:9年后,早期睡眠干预对体重指数和肥胖风险的持续降低并不明显,而更传统的生活方式干预导致肥胖率增加,这不能用生活方式行为的任何差异来解释。临床试验注册:ClinicalTrials.gov编号NCT00892983, https://clinicaltrials.gov/study/NCT00892983。
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引用次数: 0
Effectiveness of behavioural and psychological interventions for managing obesity in children and adolescents: A systematic review and meta-analysis framed using minimal important difference estimates based on GRADE guidance to inform a clinical practice guideline 管理儿童和青少年肥胖的行为和心理干预的有效性:基于GRADE指南的最小重要差异估计框架的系统回顾和荟萃分析,为临床实践指南提供信息。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-16 DOI: 10.1111/ijpo.13193
M. Henderson, S. A. Moore, S. Harnois-Leblanc, B. C. Johnston, D. Fitzpatrick-Lewis, A. M. Usman, D. Sherifali, R. Merdad, A. M. Rigsby, Z. Esmaeilinezhad, K. M. Morrison, J. Hamilton, G. D. C. Ball, C. S. Birken, the Steering Committee for Updating Canada's Clinical Practice Guideline for Managing Pediatric Obesity

Objective

Conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) of behavioural and psychological interventions for managing paediatric obesity.

Methods

Eligible studies, published between 1985 and 2022, included 0 to 18 year olds with outcomes reported ≥3 months post-baseline, including patient-reported outcome measures (PROMs), cardiometabolic and anthropometric outcomes, and adverse events (AEs). We pooled data using a random effects model and assessed certainty of evidence (CoE) related to minimally important difference estimates for outcomes using GRADE.

Results

We included 73 unique RCTs (n = 6305 participants, 53% female). Intervention types included physical activity (n = 1437), nutrition (n = 447), psychological (n = 1336), technology-based (n = 901) or multicomponent (≥2 intervention types, n = 2184). Physical activity had a small effect on health-related quality of life (HRQoL), varying effects ranging from moderate to very large on blood pressure, lipids and insulin resistance, and a small effect on BMIz. Nutrition had a small effect on lipids, insulin resistance and BMIz. Psychological interventions showed a small effect on HRQoL and triglycerides and moderate benefits on depressive symptoms, while technology interventions showed small benefits on blood pressure and BMIz. Multicomponent interventions had a large benefit on anxiety, small benefit on depressive symptoms, with large to very large benefits on lipids, and small benefits for diastolic blood pressure, insulin resistance and BMIz. AEs were reported infrequently, and when reported, were described as mild.

Conclusion

Physical activity and multicomponent interventions showed improvements in PROMs, cardiometabolic and anthropometric outcomes. Future trials should consistently measure PROMs, evaluate outcomes beyond the intervention period, and study children <6 years of age.

目的:对行为和心理干预治疗儿童肥胖的随机对照试验(rct)进行系统回顾和荟萃分析。方法:1985年至2022年间发表的符合条件的研究,纳入0至18岁的患者,基线后报告≥3个月的结果,包括患者报告的结果测量(PROMs)、心脏代谢和人体测量结果以及不良事件(ae)。我们使用随机效应模型汇总数据,并使用GRADE评估与结果的最小重要差异估计相关的证据确定性(CoE)。结果:我们纳入了73项独特的随机对照试验(n = 6305名参与者,53%为女性)。干预类型包括身体活动(n = 1437)、营养(n = 447)、心理(n = 1336)、技术(n = 901)或多成分(≥2种干预类型,n = 2184)。体育活动对健康相关生活质量(HRQoL)的影响很小,对血压、血脂和胰岛素抵抗的影响从中等到非常大不等,对bmi的影响很小。营养对血脂、胰岛素抵抗和bmi的影响很小。心理干预对HRQoL和甘油三酯的影响较小,对抑郁症状的影响中等,而技术干预对血压和体重指数的影响较小。多组分干预对焦虑有很大的好处,对抑郁症状有很小的好处,对血脂有很大到很大的好处,对舒张压,胰岛素抵抗和BMIz有很小的好处。ae很少被报道,即使被报道,也被描述为轻微的。结论:体力活动和多组分干预可改善PROMs、心脏代谢和人体测量结果。未来的试验应持续测量PROMs,评估干预期后的结果,并对儿童进行研究
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引用次数: 0
Association between body mass index at birth and neonatal health outcomes in preterm infants: A retrospective analysis 早产儿出生时体重指数与新生儿健康结局的关系:一项回顾性分析
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-14 DOI: 10.1111/ijpo.13203
Chuntian Liu, Yijia Chen, Mengqing Pan, Xiaoyu Lu, Jianhong Xu, Xiaochun Chen

Background

Studies on how birth body mass index (BMI) affects health outcomes in preterm infants are relatively limited.

Aim

To analyze the association between BMI at birth and neonatal health outcomes in extremely low and very low birth weight preterm infants in China.

Methods

Used data from the Chinese Premature Infant Informatization Platform (2022–2023). Preterm infants were categorized based on their birth BMI z-scores into three groups: low BMI group (< −2), normal BMI group (−2 to 2) and high BMI group (>2). The relationship between BMI and neonatal health outcomes was then analyzed.

Results

The final analysis included 1662 extremely low and very low birth weight preterm infants. The results indicated that low BMI was significantly associated with an increased risk of respiratory distress syndrome (RDS) (AOR 1.61, 95% CI 1.31–2.30), bronchopulmonary dysplasia (BPD) (AOR 1.34, 95% CI 1.00–1.80) and necrotizing enterocolitis (NEC) (AOR 1.57, 95% CI 1.01–2.42). High BMI was significantly associated with an increased risk of RDS (AOR 1.60, 95% CI 1.05–2.45).

Conclusions

BMI at birth is significantly associated with the risks of RDS, BPD and NEC in ELBW and VLBW, highlighting the importance of monitoring BMI as an additional risk predictor in a population of neonates already at high risk for adverse outcomes.

背景:关于出生体重指数(BMI)如何影响早产儿健康结局的研究相对有限。目的:分析中国极低和极低出生体重早产儿出生时体重指数与新生儿健康结局的关系。方法:使用中国早产儿信息化平台(2022-2023)数据。根据早产儿出生时BMI z-score分为3组:低BMI组(< -2)、正常BMI组(-2 ~ 2)和高BMI组(bb0 2)。然后分析BMI与新生儿健康结局之间的关系。结果:最终分析了1662例极低和极低出生体重早产儿。结果显示,低BMI与呼吸窘迫综合征(RDS) (AOR 1.61, 95% CI 1.31-2.30)、支气管肺发育不良(BPD) (AOR 1.34, 95% CI 1.00-1.80)和坏死性小肠结肠炎(NEC) (AOR 1.57, 95% CI 1.01-2.42)的风险增加显著相关。高BMI与RDS风险增加显著相关(AOR 1.60, 95% CI 1.05-2.45)。结论:出生时的BMI与ELBW和VLBW中RDS、BPD和NEC的风险显著相关,强调了在已经处于不良结局高风险的新生儿群体中监测BMI作为额外风险预测因子的重要性。
{"title":"Association between body mass index at birth and neonatal health outcomes in preterm infants: A retrospective analysis","authors":"Chuntian Liu,&nbsp;Yijia Chen,&nbsp;Mengqing Pan,&nbsp;Xiaoyu Lu,&nbsp;Jianhong Xu,&nbsp;Xiaochun Chen","doi":"10.1111/ijpo.13203","DOIUrl":"10.1111/ijpo.13203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Studies on how birth body mass index (BMI) affects health outcomes in preterm infants are relatively limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To analyze the association between BMI at birth and neonatal health outcomes in extremely low and very low birth weight preterm infants in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Used data from the Chinese Premature Infant Informatization Platform (2022–2023). Preterm infants were categorized based on their birth BMI z-scores into three groups: low BMI group (&lt; −2), normal BMI group (−2 to 2) and high BMI group (&gt;2). The relationship between BMI and neonatal health outcomes was then analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final analysis included 1662 extremely low and very low birth weight preterm infants. The results indicated that low BMI was significantly associated with an increased risk of respiratory distress syndrome (RDS) (AOR 1.61, 95% CI 1.31–2.30), bronchopulmonary dysplasia (BPD) (AOR 1.34, 95% CI 1.00–1.80) and necrotizing enterocolitis (NEC) (AOR 1.57, 95% CI 1.01–2.42). High BMI was significantly associated with an increased risk of RDS (AOR 1.60, 95% CI 1.05–2.45).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BMI at birth is significantly associated with the risks of RDS, BPD and NEC in ELBW and VLBW, highlighting the importance of monitoring BMI as an additional risk predictor in a population of neonates already at high risk for adverse outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prenatal exposure to particulates and anthropometry through 9 years of age in a birth cohort 出生队列中9岁前的产前颗粒物暴露和人体测量。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-09 DOI: 10.1111/ijpo.13202
Ian R. Trees, Abhisek Saha, Diane L. Putnick, Priscilla K. Clayton, Pauline Mendola, Rajeshwari Sundaram, Edwina H. Yeung

Background

Previous research observed links between prenatal air pollution and risk of childhood obesity but the timing of the exposure is understudied. Aim: We examined prenatal particulate matter (PM10, PM2.5) exposure and child anthropometry.

Materials & Methods

Children's body mass index z-scores (zBMI) at 0–3 (N = 4370) and 7–9 (n = 1191) years were derived from reported anthropometry at paediatric visits. We ran linear mixed models for six windows, adjusting for maternal, child, and neighbourhood factors.

Results

PM10 exposure across pregnancy and at multiple windows was associated with higher zBMI in both early and middle childhood. For instance, one interquartile range increase in PM10 exposure during the first 2 weeks of pregnancy was associated with higher zBMI at 0–3 (0.05, 95% CI: 0.01, 0.10) and 7–9 (0.14, 95% CI: 0.02, 0.23). PM2.5 exposure during the final 2 weeks of gestation was associated with higher zBMI at 7–9 years (B: 0.12, 95% CI: 0.04, 0.22).

Conclusion

Even at low levels of air pollution, prenatal PM10 exposure was associated with higher zBMI in childhood.

背景:先前的研究发现了产前空气污染与儿童肥胖风险之间的联系,但暴露的时间尚未得到充分研究。目的:我们检查了产前颗粒物(PM10, PM2.5)暴露和儿童人体测量。材料与方法:0-3岁(N = 4370)和7-9岁(N = 1191)儿童身体质量指数z-分数(zBMI)来源于儿科就诊时报告的人体测量数据。我们运行了六个窗口的线性混合模型,调整了母亲、儿童和邻里因素。结果:PM10在怀孕期间和多个窗口暴露与儿童早期和中期较高的zBMI有关。例如,怀孕前两周PM10暴露增加一个四分位数范围与0-3 (0.05,95% CI: 0.01, 0.10)和7-9 (0.14,95% CI: 0.02, 0.23)较高的zBMI相关。妊娠最后2周暴露于PM2.5与7-9岁时较高的zBMI相关(B: 0.12, 95% CI: 0.04, 0.22)。结论:即使在低水平的空气污染下,产前PM10暴露与儿童时期较高的zBMI有关。
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引用次数: 0
Associations between parent and adolescent weight outcomes within two parent approaches to family-based adolescent obesity treatment: Secondary analyses from the TEENS+ pilot trial 基于家庭的青少年肥胖治疗的两种父母方法中父母和青少年体重结果之间的关联:来自TEENS+试点试验的二次分析。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-07 DOI: 10.1111/ijpo.13198
Kristina L. Tatum, Katlyn Garr, Elizabeth L. Adams, Laura J. Caccavale, Edmond P. Wickham III, Jessica Gokee LaRose, Suzanne E. Mazzeo, Hollie A. Raynor, Melanie K. Bean

Objective

To examine associations between parent and adolescent weight change within two parent approaches to adolescent obesity treatment.

Methods

Adolescent (Mage = 13.7 ± 1.2 years; MBMI = 34.9 ± 7.0 kg/m2) and parent (MBMI = 36.4 ± 7.3 kg/m2) dyads (N = 82) were randomized to TEENS+Parents as Coaches (PAC) or TEENS+parent weight loss (PWL). Anthropometrics were assessed at baseline (0-month), 4 months (post) and 7 months (after 3-month maintenance period). Regression analyses examined associations between parent and adolescent ΔBMI0-4m and ΔBMI4-7m, with parent group as a moderator.

Results

Post-treatment, parent and adolescent ∆BMI0-4m were positively related (β = 0.68, p < 0.001), with no group interaction. Parent and adolescent ΔBMI4-7m were related (β = 0.48, p = 0.012) during maintenance, moderated by parent group (β = −0.49, p = 0.010): positive relationships persisted in PAC (β = 0.39, p = 0.011), but not PWL (β = −0.19, p = 0.211).

Discussion

Parent and adolescent weight changes were positively related during treatment in both parent groups. During maintenance, weight change associations persisted only in PAC. These patterns prompt further exploration of parent factors driving weight change relationships.

目的:探讨两种父母治疗青少年肥胖的方法中父母与青少年体重变化之间的关系。方法:青少年(年龄= 13.7±1.2岁;MBMI = 34.9±7.0 kg/m2)和父母(MBMI = 36.4±7.3 kg/m2)二组(N = 82)随机分为青少年+父母作为教练组(PAC)和青少年+父母减肥组(PWL)。在基线(0个月)、4个月(术后)和7个月(3个月维持期后)对人体测量进行评估。回归分析检验了父母与青少年ΔBMI0-4m和ΔBMI4-7m之间的关系,父母组是一个调节因素。结果:治疗后维持期间,父母与青少年的∆BMI0-4m呈正相关(β = 0.68, p = 0.48, p = 0.012),受父母组的调节(β = -0.49, p = 0.010); PAC持续呈正相关(β = 0.39, p = 0.011), PWL无显著正相关(β = -0.19, p = 0.211)。讨论:在治疗期间,父母和青少年体重变化呈正相关。在维持期间,体重变化关联仅在PAC中持续存在。这些模式促使进一步探索驱动体重变化关系的母体因素。
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引用次数: 0
期刊
Pediatric Obesity
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