Pediatric Obesity最新文献

Background: Previous studies suggest that in utero exposures may impact future weight gain trajectories in infancy. Leukocyte telomere length (LTL) collected at birth may be an additional variable to test in models for childhood obesity as adult studies suggest that LTL may be predictive of metabolic disease.

Methods: Using a primarily Latinx mother-child longitudinal cohort design, we assessed the relationship between newborn LTL measured via quantitative PCR and obesity at 12 months (WFA ≥ 95th percentile). Secondary outcomes included weight-for-age (WFA) Z scores at 12 months and covariates included birth anthropometrics and maternal prenatal health. Logistic and linear regression models were used to assess independent predictors for infant obesity and WFA Z scores.

Results: We followed 302 children until 12 months including 65.89% with Latinx ethnicity and 4.97% had obesity at 12 months. Independent predictors of obesity at 12 months included higher birthweight Z scores (OR 2.24, 1.16, 5.05) and WFA Z scores at 6 months (OR 1.56, 1.19, 2.05). Longer LTL at birth and higher Apgar scores at 5 min were protective (OR 0.04, 95%CI 0.002, 0.79 and OR 0.30, 95%CI 0.13-0.72, respectively). LTL at birth was negatively associated with WFA Z scores at 12 months of age in multivariable models (Coeff = -0.58, 95%CI -1.05, -0.12).

Conclusions: LTL at birth may be a marker, in addition to birthweight, that can be used to assess an infant's risk for subsequent obesity. Future studies are needed to better assess and determine possible maternal exposures associated with shorter newborn LTL.

Introduction: Ultra-processed foods (UPF) are frequently consumed by children, possibly contributing to childhood obesity. It is unknown if UPF consumption among Australian children differentiates by sociodemographic factors.

Objectives: To describe schoolchildren's intake of UPF across sexes, age, geographic location and socioeconomic status (SES). To analyse associations between UPF intake and indicators of obesity.

Methods: UPF consumption of children aged 8-12 years in Victoria (Australia) was examined using 24-h dietary-recall data classified by the NOVA system. UPF intake was compared across sociodemographic groups. Regression analysis explored the association between UPF intake and BMI z-score, overweight/obesity and abdominal obesity.

Results: UPF comprised 47.2% of total energy intake (range 23.7%-72.2%), with no significant differences across sex, age group (8-9 vs. 10-12 years), geographic location or SES. Including all children, there were no associations between UPF intake and obesity indicators. In age-stratified models, among children aged 10-12 years, a 10% increment in the proportion of UPF in the diet (% g/day) was significantly associated with a 0.07 (95% CI 0.01, 0.12) higher body mass index (BMI) z-score and a 19% (odds ratio 1.19, 95% CI 1.07, 1.33) increase in the odds of central obesity. No associations between UPF intake and indicators of obesity were found in the younger 8- to 9-year-old group.

Conclusions: UPF contributed greatly to the dietary intake of primary schoolchildren. Among older children, higher intake of UPF was associated with higher BMI z-score and central adiposity. Further longitudinal research in Australian pediatric samples to understand UPF impact upon adiposity outcomes across different stages of childhood is needed.

Background: A predisposition to elevated food reward may hinder weight loss success during multidisciplinary interventions. However, this has not been consistently demonstrated in adults, nor at all in children.

Objective: To test the associations between explicit and implicit food reward and preference at baseline and prospective changes in weight and body composition in adolescents with obesity.

Methods: A meta-analysis of 6 clinical trials in adolescents with obesity was undertaken using frequentist and Bayesian linear mixed models. Participants from each study took part in similar 12-week multidisciplinary interventions. Liking and wanting for foods varying in fat content and sweet taste were assessed at enrolment, and both anthropometrics were tracked from enrolment to post-intervention.

Results: In a grand sample of N = 132 adolescents with obesity, liking and wanting for high-fat foods did not significantly predict changes in weight or fat mass. However, implicit wanting for sweet foods predicted changes in standardised body and lean mass, such that a greater wanting for sweet foods was associated with greater loss of body (p = 0.039, η²p = 0.05) and lean mass (p < 0.001, η²p = 0.13) in both frequentist and Bayesian analyses.

Conclusions: Baseline implicit wanting for sweet (high carbohydrate, low protein), but not energy-dense, foods may be more strongly related to prospective changes in lean mass than fat mass during weight loss in adolescents with obesity. Further research is needed to clarify whether low protein intake can account for this effect.

Background: To date, research on the natural history of hyperphagia, weight gain and health outcomes in individuals with Bardet-Biedl syndrome (BBS) has been limited. Understanding these characteristics is important for disease burden management.

Objectives: The international Clinical Registry Investigating BBS (CRIBBS) is a registry of individuals with BBS to investigate the severity of hyperphagia, the natural history of weight gain and the frequency of obesity-associated health outcomes in paediatric individuals with BBS.

Methods: Paediatric participants (<18 years of age) enrolled in CRIBBS were evaluated to assess weight and weight loss interventions, hyperphagia and the frequency of cardiac, endocrine/diabetic and renal health outcomes.

Results: Of 331 children, 81.0% had obesity at baseline and 22.7% reported use of weight loss diet or medication at baseline or later. Among participants with ≥2 weight measurements ≥2 years apart (n = 186), 17.2% had a higher weight classification from the first to the last assessment. Increasing hyperphagia severity was associated with increasing obesity. The prevalence of cardiac, diabetic, endocrine and renal health outcomes increased with obesity class.

Conclusion: Hyperphagia and obesity are highly prevalent in children with BBS. Many children with BBS also experience adverse health outcomes. Timely diagnosis and targeted treatment of hyperphagia and obesity are needed.

Background: Curbing the rise in overweight and obesity in childhood is of top priority in the public health agenda.

Objective: To examine the effectiveness of a 2-year school-based intervention on children's body mass index (BMI) z-score, considering children's baseline weight status, as well as to identify socio-demographic factors that could predict a positive weight outcome.

Methods: Data were collected from 9255 children 5-12 years, from six European countries, participating in the Feel4Diabetes study. The intervention group received a lifestyle intervention, aiming to promote a healthy and active lifestyle. Children's anthropometrics were measured at baseline and 2-year follow-up.

Results: Children with overweight, but not with obesity, at baseline randomized in the intervention group had a higher reduction in BMI z-scores compared to the control group. In logistic regression models, older age, female sex, overweight or obesity increased the likelihood of any decrease in BMI z-score in the intervention group. Mother's obesity and a lower family income were associated with a decreased probability of a positive weight outcome from the intervention.

Conclusions: The Feel4Diabetes school-based intervention demonstrated that it could effectively improve the BMI z-score among children with overweight, but not with obesity. Family's characteristics (mother's weight and family income) may affect the effectiveness of such interventions and should be considered in relevant public health efforts.

Background: Understanding stakeholder preferences and values for early childhood initiatives to support healthy diets, physical activity and reduce sedentary behaviour is key for effective intervention design and resource allocation. This study aims to estimate the preferences for and value of outcomes from the perspectives of parents/caregivers of Australian children aged from birth to 5 years.

Methods: Discrete choice experiment, 466 parent/caregivers recruited from online platform. Participants selected between two healthy lifestyle initiatives or a "neither" option. Initiatives were described by attributes including cost, participation and outcomes. Mixed multinomial logistic models were used to determine preferences and willingness-to-pay per annum framed as an increase in income taxes.

Results: Effect on diet was the most important influence on parent/caregiver choice to participate (p < 0.01), followed by effect on physical activity (p < 0.01), wellbeing (p < 0.01) and healthy growth (p < 0.01). Parents/caregivers were less sensitive to cost for initiatives aimed at specific children (e.g., targeted initiatives for a priority population). Willingness-to-pay estimates ranged from AUD$176 for improved wellbeing to $219 for healthier diets.

Conclusions: Results suggest that leveraging the potential for healthier diets, followed by healthier physical activity behaviours, as a key benefit of participation may be particularly attractive to parents/caregivers. In addition, some level of equity preference could be acceptable to parents/caregivers in the allocation of scarce resources.