Pediatric Obesity最新文献_第5页

The effectiveness of multidisciplinary weight loss interventions is associated with initial cardiorespiratory fitness in adolescents with obesity 多学科减肥干预的有效性与肥胖青少年最初的心肺功能有关。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-06-23 DOI: 10.1111/ijpo.13147

Brahim Allali, Bruno Pereira, Alicia Fillon, Lili Pouele, Julie Masurier, Charlotte Cardenoux, Laurie Isacco, Yves Boirie, Martine Duclos, David Thivel, Valérie Julian

Background

The identification of predictive parameters of the success of multidisciplinary weight loss interventions (MWLI) appears essential to optimize obesity management. The association between baseline cardiorespiratory fitness (CRF) and changes in anthropometric parameters and body composition during MWLI remains underexplored in adolescents with obesity.

Objectives

To assess whether baseline CRF was associated with the effectiveness of a 16-week MWLI measured through improved body mass, body mass index (BMI) and body composition (percentage of total fat mass (FM) as the main criterion).

Methods

Cardiorespiratory fitness and body composition were respectively measured by peak oxygen consumption (VO_2peak) during maximal exercise tests and dual-photon x-ray absorptiometry (DXA), before (T0) and after (T1) a 16-week MWLI in 165 adolescents (aged 13.3 ± 1.38 years, 61.2% female, BMI 35.11 ± 5.16 kg/m²).

Results

Reductions in BMI and total FM percentage between T0 and T1 were greater in subjects with a baseline VO_2peak ≥ 3rd quartile compared to the first quartile (p < 0.001) and the interquartile range (p < 0.05 and p < 0.001, respectively). Baseline VO_2peak and VO₂ at the first ventilator threshold were positively correlated with the reductions in body mass, BMI and total and visceral FM percentages and with the increase in lean mass (LM) percentage between T0 and T1 after adjustment for age and gender (p < 0.001).

Conclusion

Initial CRF is associated with the success of MWLI in adolescents with obesity. Improving their aerobic fitness before starting a MWLI might be a promising strategy to optimize its benefits.

背景：确定多学科减肥干预（MWLI）成功的预测参数似乎对优化肥胖管理至关重要。在肥胖症青少年中，基线心肺功能（CRF）与多学科减肥干预期间人体测量参数和身体成分变化之间的关系仍未得到充分探讨：评估基线CRF是否与为期16周的MWLI的有效性相关，MWLI通过改善体重、体重指数（BMI）和身体成分（以总脂肪量百分比（FM）为主要标准）来衡量：方法：分别在 165 名青少年（年龄为 13.3 ± 1.38 岁，61.2% 为女性，体重指数为 35.11 ± 5.16 kg/m2）进行为期 16 周的小量运动疗法之前（T0）和之后（T1），通过最大运动测试期间的峰值耗氧量（VO2peak）和双光子 X 射线吸收测定法（DXA）测量他们的心肺功能和身体成分：结果：与第一四分位数相比，基线 VO2 峰值≥第三四分位数的受试者在 T0 和 T1 之间 BMI 和总 FM 百分比的降低幅度更大（p 2 峰值和首次呼吸机阈值时的 VO2 与体重、BMI、总 FM 百分比和内脏 FM 百分比的降低以及 T0 和 T1 之间瘦体重（LM）百分比的增加呈正相关，调整年龄和性别后（p 结论：最初的 CRF 与治疗相关：最初的 CRF 与肥胖青少年的 MWLI 成功与否有关。在开始进行有氧运动前提高他们的有氧体能可能是优化有氧运动益处的一个有前途的策略。

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引用次数: 0

The association of breastfeeding duration on metabolic syndrome among children and adolescents, stratified by birth weight for gestational age 母乳喂养时间与儿童和青少年代谢综合征的关系（按胎龄体重分层）。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-06-18 DOI: 10.1111/ijpo.13145

Wen Yuan, Jianuo Jiang, Sha-sha Song, Jieyu Liu, Manman Chen, Qiaoxin Shi, Yi Zhang, Li Chen, Yang Qin, Ruolin Wang, Tongjun Guo, Xinxin Wang, Qi Ma, Yanhui Dong, Jun Ma

Background and Objectives

This study aimed to examine the associations between breastfeeding duration and metabolic syndrome (MetS) in adolescents and to further investigate the role of birth weight for gestational age (GA) on these associations.

Methods

A total of 10 275 participants aged 7 to 18 years were included applying multistage cluster random sampling from a Chinese national survey. Birth weight was classified into small for GA (SGA), appropriate for GA (AGA) and large for GA (LGA). Information was collected through a self-administered questionnaire, physical examination and blood biochemical examination. Multivariable linear regression, logistic regression models, restricted cubic spline models were applied to assess the relationships of breastfeeding duration and MetS with different birth weight for GA.

Results

The prevalence of non-breastfeeding, 0–5, 6–12 and >12 months groups were 16.2%, 23.1%, 42.5% and 18.2%, and the prevalence of SGA and LGA was 11.9% and 12.7%, respectively. Prolonged breastfeeding duration was associated with higher odds of MetS (β: 0.08, 95% CI: 0.03, 0.13), WC (β: 3.49, 95% CI: 2.82, 4.16) and SBP (β: 2.34, 95% CI: 1.80, 2.89). SGA and prolonged breastfeeding synergistically increased MetS risks, but LGA appeared to offset the adverse effects of prolonged breastfeeding.

Conclusion

Prolonged breastfeeding may increase children's MetS risks. SGA synergies with prolonged breastfeeding increased MetS burden in children and adolescents, while LGA mitigated the risks. This reminds us that intensive attention should be paid to both early birth weight and subsequent living environment for children and adolescents' lifelong health.

背景和目的：本研究旨在探讨母乳喂养持续时间与青少年代谢综合征（MetS）之间的关系，并进一步研究胎龄体重（GA）对这些关系的影响：方法：采用多阶段整群随机抽样方法，从中国一项全国性调查中纳入了 10 275 名 7 至 18 岁的参与者。出生体重分为小胎龄（SGA）、适龄（AGA）和大胎龄（LGA）。通过自填问卷、体格检查和血液生化检查收集信息。应用多变量线性回归、逻辑回归模型、限制性立方样条模型评估母乳喂养时间和 MetS 与不同出生体重的 GA 的关系：非母乳喂养、0-5 个月、6-12 个月和大于 12 个月组的患病率分别为 16.2%、23.1%、42.5% 和 18.2%，SGA 和 LGA 的患病率分别为 11.9% 和 12.7%。延长母乳喂养时间与较高的 MetS（β：0.08，95% CI：0.03，0.13）、WC（β：3.49，95% CI：2.82，4.16）和 SBP（β：2.34，95% CI：1.80，2.89）几率相关。SGA和长期母乳喂养协同增加了MetS风险，但LGA似乎抵消了长期母乳喂养的不利影响：结论：长期母乳喂养可能会增加儿童患 MetS 的风险。SGA与长期母乳喂养的协同作用增加了儿童和青少年的 MetS 负担，而 LGA 则减轻了风险。这提醒我们，为了儿童和青少年的终生健康，应密切关注早期出生体重和随后的生活环境。

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引用次数: 0

Effectiveness and predictors of weight loss response to phentermine plus lifestyle modifications among youth in a paediatric weight management clinical setting 在儿科体重管理临床环境中，青少年对芬特明和生活方式调整的减肥效果和预测因素。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-06-17 DOI: 10.1111/ijpo.13143

Eric M. Bomberg, Justin Clark, Kyle D. Rudser, Amy C. Gross, Aaron S. Kelly, Claudia K. Fox

Background

Anti-obesity medications (AOMs) are promising lifestyle modification (LSM) adjuncts for obesity treatment, and phentermine is commonly prescribed in paediatric weight management clinics. Determining ‘real-world’ AOM effectiveness and characteristics predicting response is important.

Objectives

We sought to describe phentermine plus LSM effectiveness and identify baseline characteristics predicting response.

Methods

This was a retrospective cohort study among youth seen in a US academic-based weight management clinic from 2012 to 2020. Baseline characteristics (e.g., body mass index (BMI), liver transaminases, eating-related behaviours) and outcomes (%BMI of 95th percentile (%BMIp95), BMI, %BMI change, weight) were determined through electronic health records and intake surveys.

Results

Among 91 youth prescribed phentermine plus LSM over 8 years (mean %BMIp95 150%), %BMIp95 was statistically significantly reduced at 1.5, 3, 6 and 12 months (peak reduction 10.9 percentage points at 6 months; p < 0.001). Considering multiple comparisons, the presence of baseline elevated alanine aminotransferase was associated with statistically significant smaller 1.5-month %BMIp95 reductions (p = 0.001) and higher food responsiveness with smaller 3- (p = 0.001) and 6-month (p < 0.001) reductions.

Conclusions

Phentermine plus LSM reduced %BMIp95 among youth in a weight management clinic, and baseline characteristics may help determine those more or less likely to respond. Prospective studies are needed to further characterize effectiveness and confirm response predictors.

背景：抗肥胖药物（AOMs）是治疗肥胖症的有前途的生活方式调整（LSM）辅助手段，芬特明是儿科体重管理诊所的常用处方药。确定 "真实世界 "中 AOM 的有效性和预测反应的特征非常重要：我们试图描述芬特明加 LSM 的有效性，并确定预测反应的基线特征：这是一项回顾性队列研究，研究对象是2012年至2020年在美国一家学术性体重管理诊所就诊的青少年。基线特征（如体重指数 (BMI)、肝脏转氨酶、饮食相关行为）和结果（BMI 第 95 百分位数百分比 (%BMIp95)、BMI、BMI 变化百分比、体重）通过电子健康记录和入院调查确定：在 91 名服用芬特明加 LSM 超过 8 年的青少年中（平均体重指数 p95 百分位数为 150%），体重指数 p95 百分位数在 1.5、3、6 和 12 个月时有显著降低（在 6 个月时达到峰值，降低了 10.9 个百分点；p 结论：芬特明加 LSM 可降低体重指数 p95 百分位数：芬特明加 LSM 可降低体重管理诊所中青少年的体重指数 p95%，基线特征可能有助于确定哪些人更有可能或更不可能做出反应。需要进行前瞻性研究，以进一步确定疗效特征并确认反应预测因素。

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引用次数: 0

Primary care perspectives on prescribing anti-obesity medication for adolescents 基层医疗机构对为青少年开具抗肥胖药物的看法。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-06-16 DOI: 10.1111/ijpo.13146

Rutha Chivate, Pamela Schoemer, Maya I. Ragavan, Kristin Ray, Megan O. Bensignor, Andrea B. Goldschmidt, Mary Ellen Vajravelu

Background

Recent pediatric guidelines recommend clinicians offer anti-obesity medication (AOM) as an adjunct to intensive lifestyle intervention.

Objective

To investigate pediatricians' perspectives about prescribing AOM, including barriers and facilitators.

Methods

An investigator-developed survey was emailed to primary care pediatric physicians (n = 187) and advanced practice providers (n = 190) within an academic-affiliated network. The survey evaluated how willing clinicians were to prescribe AOM and their agreement with 25 statements about barriers and facilitators. Three vignettes explored AOM decision-making. Multinomial logistic regression was used to determine relative risk ratios for willingness to prescribe by agreement with each statement.

Results

Among 74 respondents (20% response rate), 24% were willing, 42% uncertain and 34% unwilling to prescribe. Most (64%) agreed that AOM should be managed only by specialists. Willingness to prescribe was associated with clinician motivation and belief in guideline practicality and applicability. Unwillingness was associated with beliefs that patients would not continue AOM long enough for benefit and that there was insufficient time or resources to implement. In vignettes, 52% were willing to prescribe AOM for a patient with severe obesity and metabolic complications, versus 11% for a patient with obesity and possible disordered eating.

Conclusions

Willingness to prescribe AOM was low and was associated with perceived practicality and appropriateness for patients.

背景：最近的儿科指南建议临床医生提供抗肥胖药物（AOM）作为强化生活方式干预的辅助手段：最近的儿科指南建议临床医生提供抗肥胖药物（AOM），作为强化生活方式干预的辅助手段：调查儿科医生对开具抗肥胖药物处方的看法，包括障碍和促进因素：通过电子邮件向一个学术附属网络内的初级儿科医师（187 人）和高级医疗服务提供者（190 人）发送了一份由研究人员开发的调查问卷。调查评估了临床医生开具 AOM 处方的意愿以及他们对 25 项障碍和促进因素声明的认同程度。三个小故事探讨了 AOM 的决策问题。采用多项式逻辑回归法根据对每项陈述的同意程度确定处方意愿的相对风险比：在 74 名受访者中（回复率为 20%），24% 愿意开处方，42% 不确定，34% 不愿意。大多数受访者（64%）同意 AOM 只应由专科医生管理。愿意开处方与临床医生的积极性以及对指南实用性和适用性的信念有关。不愿意处方则与以下信念有关：患者不会持续服用AOM足够长的时间以获得益处，以及没有足够的时间或资源来实施。在小故事中，52%的人愿意为患有严重肥胖症和代谢并发症的患者开具AOM处方，而为患有肥胖症和可能存在饮食紊乱的患者开具AOM处方的比例仅为11%：开具AOM处方的意愿较低，这与患者认为的实用性和适当性有关。

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引用次数: 0

Associations between paediatric obesity, chemical mixtures and environmental factors, in a national cross-sectional study of Canadian children 一项针对加拿大儿童的全国横断面研究显示，小儿肥胖症、化学混合物和环境因素之间存在关联。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-06-14 DOI: 10.1111/ijpo.13117

Rose Dugandzic, Natalia Konstantelos, Yamei Yu, Eric Lavigne, Sebastian Srugo, Justin J. Lang, Kristian Larsen, Tyler Pollock, Paul Villeneuve, Errol M. Thomson, Miranda MacPherson, Robert Dales, Sabit Cakmak

Background

Whilst single chemical exposures are suspected to be obesogenic, the combined role of chemical mixtures in paediatric obesity is not well understood.

Objectives

We aimed to evaluate the potential associations between chemical mixtures and obesity in a population-based sample of Canadian children.

Methods

We ascertained biomonitoring and health data for children aged 3–11 from the cross-sectional Canadian Health Measures Survey from 2007 to 2019. Several chemicals of interest were measured in blood or urine and paediatric obesity was defined based on measured anthropometrics. Using quantile-based G computational analysis, we quantified the effects of three chemical mixtures selected a priori. Models were adjusted for sociodemographic and environmental factors identified through a directed acyclic graph. Results are presented through adjusted relative risks (RR) with 95% confidence intervals (95% CI).

Results

We included 9147 children. Of these, 24.1% were overweight or obese. Exposure to the mixture of bisphenol A, acrylamide, glycidamide, metals, parabens and arsenic increased the risk of childhood overweight or obesity by 45% (95% CI 1.09, 1.93), obesity by 109% (95% CI 1.27, 3.42) and central obesity by 82% (95% CI 1.30, 2.56).

Conclusions

Our findings support the role of early childhood chemical exposures in paediatric obesity and the potential combined effects of chemicals.

背景：虽然人们怀疑单一化学物质的暴露会导致肥胖，但对化学混合物在儿童肥胖中的综合作用却不甚了解：我们的目的是在加拿大儿童人群样本中评估化学混合物与肥胖之间的潜在关联：我们从 2007 年至 2019 年的加拿大健康措施横断面调查中确定了 3-11 岁儿童的生物监测和健康数据。对血液或尿液中的几种相关化学物质进行了测量，并根据测量的人体测量数据对小儿肥胖进行了定义。利用基于量子的 G 计算分析，我们量化了事先选定的三种化学混合物的影响。根据有向无环图确定的社会人口和环境因素对模型进行了调整。结果通过调整后的相对风险 (RR) 和 95% 置信区间 (95% CI) 显示：我们纳入了 9147 名儿童。其中，24.1%的儿童超重或肥胖。接触双酚 A、丙烯酰胺、缩水甘油醚、金属、对羟基苯甲酸酯和砷的混合物会使儿童超重或肥胖的风险增加 45% (95% CI 1.09, 1.93)，肥胖的风险增加 109% (95% CI 1.27, 3.42)，中心性肥胖的风险增加 82% (95% CI 1.30, 2.56)：我们的研究结果表明，儿童早期接触化学品会导致儿童肥胖，而且化学品可能会产生综合影响。

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引用次数: 0

Impact of COVID-19 pandemic on children overweight in Japan in 2020 COVID-19 大流行对 2020 年日本超重儿童的影响。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-05-29 DOI: 10.1111/ijpo.13128

Tomoki Kawahara, Satomi Kato Doi, Aya Isumi, Yusuke Matsuyama, Yukako Tani, Takeo Fujiwara

Objectives

This study aimed to explore the association between the coronavirus disease (COVID-19) pandemic and overweight incidence among preadolescent elementary school children in Japan.

Methods

A population-based longitudinal study was conducted in Adachi City, Tokyo, Japan, using data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study. The control group (2016–2018) comprised 434 children, and the COVID-19 exposure group (2018–2020) included 3500 children. Overweight was defined as a body mass index (BMI) z-score of 1 SD or more according to the World Health Organization standards. The study design involved comparing BMI z-scores before and after exposure to the pandemic, considering the associated lifestyle changes and potential consequences on physical activity, parental employment status and income.

Results

By 6th grade, the prevalence of overweight increased from 17.7% to 19.2% in the control group and 22.5% to 29.5% in the COVID-19 exposure group. Difference-in-differences analysis revealed that children's exposure to COVID-19 significantly increased BMI z-scores (coefficient 0.22, 95% confidence interval (CI) 0.14–0.29) and a higher odds ratio of overweight (odds ratio 2.51, 95% CI 1.12–5.62), even after adjusting for time-varying covariates.

Conclusion

The COVID-19 pandemic has been associated with an increased prevalence of overweight among elementary school children in Japan.

研究目的本研究旨在探讨冠状病毒病（COVID-19）大流行与日本青春期前小学生超重发生率之间的关联：在日本东京足立市开展了一项基于人群的纵向研究，使用的数据来自足立市儿童生活困难对健康的影响（A-CHILD）研究。对照组（2016-2018年）包括434名儿童，COVID-19暴露组（2018-2020年）包括3500名儿童。根据世界卫生组织的标准，超重定义为体重指数（BMI）z-score达到或超过1 SD。研究设计包括比较接触大流行病前后的体重指数 z 值，同时考虑到相关生活方式的改变以及对体育锻炼、父母就业状况和收入的潜在影响：到六年级时，对照组的超重率从 17.7% 上升到 19.2%，而 COVID-19 暴露组的超重率从 22.5% 上升到 29.5%。差异分析显示，即使在调整了随时间变化的协变量后，儿童接触 COVID-19 也会显著增加体重指数 z 值（系数为 0.22，95% 置信区间（CI）为 0.14-0.29）和更高的超重几率（几率比为 2.51，95% CI 为 1.12-5.62）：结论：COVID-19 大流行与日本小学生超重率增加有关。

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引用次数: 0

Is family meal frequency associated with obesity in children and adolescents? A cross-sectional study including 155 451 participants from 43 countries 家庭进餐频率与儿童和青少年肥胖是否有关？一项横断面研究，包括来自 43 个国家的 155 451 名参与者。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-05-26 DOI: 10.1111/ijpo.13124

José Francisco López-Gil, Yasmin Ezzatvar, Ana Ojeda-Rodríguez, Pablo Galan-Lopez, Josefa María Panisello Royo, Anelise Reis Gaya, Cesar Agostinis-Sobrinho, Nerea Martín-Calvo

Objective

This study tried to examine the association between the frequency of family meals and excess weight using large and representative samples of children and adolescents from 43 countries.

Methods

This cross-sectional study used data from the Health Behaviour in School-aged Children (HBSC), which included nationally representative samples of children and adolescents aged 10–17 years, involving a total of 155 451 participants (mean age = 13.6 years; standard deviation [SD] = 1.6; 51.4% girls). Family meal frequency was gauged through the following question: ‘How frequently do you and your family typically share meals?’ The possible responses were: ‘never’, ‘less often’, ‘approximately once a week’, ‘most days’ and ‘every day’. The body weight and height of the participants were self-reported and utilized to calculate body mass index (BMI). Subsequently, BMI z-scores were computed based on the International Obesity Task Force criteria, and the prevalence of excess weight was defined as +1.31 SD for boys and + 1.24 SD for girls, with obesity defined as +2.29 SD for boys and + 2.19 SD for girls. Generalized linear mixed models were conducted to examine the associations between the frequency of family meals and excess weight or obesity.

Results

The lowest predicted probabilities of having excess weight and obesity were observed for those participants who had family meals every day (excess weight: 34.4%, 95% confidence interval [CI] 31.4%–37.5%; obesity: 10.8%, 95% CI 9.0%–13.0%).

Conclusions

A higher frequency of family meals is associated with lower odds of having excess weight and obesity in children and adolescents.

研究目的本研究试图利用来自 43 个国家的大量具有代表性的儿童和青少年样本，研究家庭聚餐频率与超重之间的关系：这项横断面研究使用了学龄儿童健康行为（HBSC）的数据，其中包括具有全国代表性的 10-17 岁儿童和青少年样本，共有 155 451 人参与（平均年龄 = 13.6 岁；标准差 [SD] = 1.6；51.4% 为女孩）。家庭进餐频率是通过以下问题来衡量的："您和您的家人通常多长时间一起进餐一次？可能的回答有："从不"、"较少"、"大约一周一次"、"大多数日子 "和 "每天"。受试者的体重和身高均为自我报告，用于计算体重指数（BMI）。随后，根据国际肥胖问题工作组的标准计算出体重指数 z 值，并将超重率定义为：男生 +1.31 SD，女生 + 1.24 SD；肥胖率定义为：男生 +2.29 SD，女生 + 2.19 SD。我们采用广义线性混合模型来研究家庭聚餐频率与超重或肥胖之间的关系：结果：每天都有家庭聚餐的参与者体重超标和肥胖的预测概率最低（体重超标：34.4%，95% 置信区间[CI] 31.4%-37.5%；肥胖：10.8%，95% 置信区间 9.0%-13.0%）：结论：家庭聚餐频率越高，儿童和青少年体重超标和肥胖的几率越低。

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引用次数: 0

Television watching during meals is associated with higher ultra-processed food consumption and higher free sugar intake in childhood 在儿童时期，吃饭时看电视与较高的超加工食品摄入量和较高的游离糖摄入量有关。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-05-24 DOI: 10.1111/ijpo.13130

Nerea Martín-Calvo, Ane Usechi, Elise Fabios, Santiago Felipe Gómez, José Francisco López-Gil

Background

The consumption of ultra-processed foods (UPFs) is associated with an increased risk of noncommunicable diseases and mortality in adults. The aim of this study was to analyse the association between mealtime television (TV) watching and UPF consumption in childhood.

Materials and Methods

Participants in the SENDO project recruited in 2015–2023 were classified into three categories based on the frequency at which they watched TV during meals. Dietary information was collected with a validated 147-item semi-quantitative food frequency questionnaire. Generalized mixed models were used to compare mean UPF consumption between groups after accounting for the main confounders. The predictive margins of participants who had a free sugar intake >10% of their energy intake in each category were also calculated.

Results

Totally 970 subjects (482 girls) with a mean age of 5.00 years (SD = 0.85) were studied. Children who watched TV during meals ≥4 times/week consumed a mean of 4.67% more energy from UPF than those who watch TV <3 times/month. The adjusted proportions of children who had a free sugar intake >10% of their energy intake in the categories of <3 times/month, 1–3 times/week and ≥4 times/week exposure to TV during meals were 44.9%, 45.9% and 58.7%, respectively.

Conclusion

TV watching during meals is associated with higher consumption of UPFs and a higher risk of exceeding 10% of TEI in free sugar intake in childhood.

背景：超加工食品（UPFs）的消费与成人非传染性疾病和死亡风险的增加有关。本研究旨在分析儿童期进餐时间看电视（TV）与超高加工食品摄入量之间的关联：2015-2023年招募的SENDO项目参与者根据进餐时看电视的频率被分为三类。通过经过验证的 147 项半定量食物频率问卷收集饮食信息。在考虑了主要的混杂因素后，采用广义混合模型比较了各组的平均 UPF 消费量。此外，还计算了游离糖摄入量大于各类能量摄入量 10% 的受试者的预测幅度：研究共涉及 970 名受试者（482 名女孩），平均年龄为 5.00 岁（SD = 0.85）。在进餐期间看电视≥4 次/周的儿童从 UPF 中摄入的能量平均比看电视占其能量摄入 10%的儿童多 4.67%：进餐时看电视与更高的 UPF 消费量和儿童期游离糖摄入量超过 TEI 10%的风险有关。

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引用次数: 0

Young children's choices and thoughts about pro-social behaviour towards others with overweight 幼儿对他人超重的亲社会行为的选择和想法。

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-05-19 DOI: 10.1111/ijpo.13129

Gemma Dearing, Gary J. Latchford, Ian D. Caterson, Andrew J. Hill

Objectives

This study aimed to investigate weight bias within young children's pro-social choices between characters who differed in body size.

Methods

Seventy-six children aged 4–6 years read stories asking them to choose who they would first help, share with, comfort, and steal from, between a healthy weight and child with overweight. They also selected the one character they would most like to play with. Children's reasoning for these choices was recorded and analysed.

Results

The character with overweight was helped first in only a third of the choices made. Children chose the characters with overweight more often as the target for anti-social action. In friendship selections, children overwhelmingly rejected the characters with overweight. However, weight bias was not prominent in the reasons children gave for the choices. Most children were not negative about body shape, weight or appearance. Similarly, in friendship choices, these were mostly expressed positively to the character chosen. Only a small minority of children were explicitly negative about the character with overweight.

Conclusions

A better understanding of weight bias acquisition and variation between children will benefit those working in health care and educational settings. Future research should link with developmental theory, such as on social categorization and theory of mind.

研究目的本研究旨在调查幼儿在对不同体型的人物做出亲社会选择时的体重偏差：方法：76 名 4-6 岁的儿童阅读了一个故事，要求他们在体重健康的儿童和体重超标的儿童之间选择他们首先会帮助谁、与谁分享、安慰谁和偷谁的东西。他们还选择了自己最想与之玩耍的角色。对儿童做出这些选择的理由进行了记录和分析：结果：只有三分之一的选择首先帮助了超重的角色。孩子们更多地选择体重超标的角色作为反社会行动的目标。在友情选择中，绝大多数儿童拒绝超重的角色。不过，体重偏见在儿童给出的选择理由中并不突出。大多数儿童对体形、体重或外貌并不持否定态度。同样，在友谊选择中，他们大多对所选角色持肯定态度。只有少数儿童明确对超重的角色持否定态度：结论：更好地了解儿童体重偏差的形成和变化，将使医疗保健和教育机构的工作人员受益匪浅。未来的研究应与社会分类和心智理论等发展理论相结合。

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引用次数: 0

Lifestyle-based subtypes of childhood obesity and their association with cardiometabolic factors: A cluster analysis 基于生活方式的儿童肥胖亚型及其与心脏代谢因素的关系：聚类分析

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-05-15 DOI: 10.1111/ijpo.13127

Jia-Shuan Huang, Rema Ramakrishnan, Quan-Zhen Liu, Cheng-Rui Wang, Song-Ying Shen, Ming-Xi Huang, Xue-Ling Wei, Xiu Qiu, Jian-Rong He

Background

Lifestyle factors play an important role in the development and management of childhood obesity and its related cardiometabolic complications.

Objective/Methods

We aimed to explore childhood obesity subtypes based on lifestyle factors and examine their association with cardiometabolic health. We included 1550 children with obesity from the National Health and Nutrition Examination Survey. Cluster analysis identified obesity subtypes based on four lifestyle factors (physical activity, diet quality, sedentary time and smoking). Multiple linear regression assessed their association with cardiometabolic factors.

Results

Five subtypes of childhood obesity were identified: unhealthy subtype (n = 571; 36.8%), physically active subtype (n = 185; 21.1%), healthy diet subtype (n = 404; 26.1%), smoking subtype (n = 125; 8.1%) and non-sedentary subtype (n = 265; 17.1%). Compared with the unhealthy subtype, the physically active subtype had lower insulin and HOMA-IR levels, and smoking subtype was associated with lower HDL levels. When compared with children with normal weight, all obesity subtypes had worse cardiometabolic profile, except the physically active subtype who had similar DBP, HbA1c and TC levels; smoking subtype who had similar TC levels; and healthy diet and non-sedentary subtypes who had similar DBP levels.

Conclusion

Children of different lifestyle-based obesity subtypes might have different cardiometabolic risks. Our new classification system might help personalize assessment of childhood obesity.

背景：生活方式因素在儿童肥胖症及其相关心脏代谢并发症的发展和管理中发挥着重要作用：我们旨在探索基于生活方式因素的儿童肥胖亚型，并研究其与心脏代谢健康的关系。我们从全国健康与营养调查中纳入了 1550 名肥胖儿童。聚类分析根据四种生活方式因素（体育锻炼、饮食质量、久坐时间和吸烟）确定了肥胖亚型。多元线性回归评估了这些亚型与心脏代谢因素的关系：结果：发现了五种儿童肥胖亚型：不健康亚型（n = 571；36.8%）、体力活动亚型（n = 185；21.1%）、健康饮食亚型（n = 404；26.1%）、吸烟亚型（n = 125；8.1%）和非久坐亚型（n = 265；17.1%）。与不健康亚型相比，体力活动亚型的胰岛素和HOMA-IR水平较低，而吸烟亚型的高密度脂蛋白水平较低。与体重正常的儿童相比，所有肥胖亚型的心血管代谢状况都较差，只有体力活动亚型的DBP、HbA1c和TC水平相似；吸烟亚型的TC水平相似；健康饮食亚型和非久坐亚型的DBP水平相似：结论：不同生活方式的肥胖亚型儿童可能有不同的心脏代谢风险。我们的新分类系统可能有助于对儿童肥胖进行个性化评估。

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引用次数: 0