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Development and application of a cost tool for a primary care-based intensive health behaviour and lifestyle treatment. 开发和应用以初级保健为基础的健康行为和生活方式强化治疗的费用工具。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-06-18 DOI: 10.1111/ijpo.70028
Cara F Ruggiero, Dustin D French, Justin D Smith, Meghan E Perkins, Janice Liebhart, Jeanne Lindros, Jeremiah Salmon, Vincent Biggs, Allison J Wu, Davene R Wright, Elsie M Taveras, Lauren Fiechtner

Objective: This paper aims to describe the development and application of a cost tool to help predict return on investment and sustainability of the Healthy Weight Clinic Family Healthy Weight Program (FHWP) through insurance reimbursement.

Methods: Case studies to apply the cost tool were conducted with 3 sites to assess the break-even point for clinic patient volume (i.e., financial neutral point: operational costs = revenue) during implementation. Financial neutral points were based on average reimbursement rates per health centre.

Results: The annual fixed cost of the intervention ranged from $65 252 to $79 024. The average revenue ranged from $806-$1663 per patient through medical reimbursement, and the clinics needed to care for an average of 37-81 patients annually to break even.

Conclusions: Use of an adaptable cost tool that captures reimbursement of clinical provider time and a minimum stream of clinical volume can equip decision-makers in planning financially to implement and sustain a clinically based FHWP.

目的:本文旨在描述成本工具的开发和应用,以帮助通过保险报销来预测健康体重诊所家庭健康体重计划(FHWP)的投资回报和可持续性。方法:应用成本工具在3个站点进行案例研究,评估实施期间临床患者数量的盈亏平衡点(即财务中性点:运营成本=收入)。财务中立点是根据每个保健中心的平均偿还比率计算的。结果:干预的年固定费用为65 252美元至79 024美元。通过医疗报销,每个病人的平均收入从806美元到1663美元不等,诊所每年平均需要照顾37-81名病人才能实现收支平衡。结论:使用一种适应性强的成本工具,捕捉临床提供者时间和最小临床量流的报销,可以使决策者在财务上计划实施和维持基于临床的FHWP。
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引用次数: 0
Racial and ethnic disparities in obesity trends among US children and adolescents aged 2-19, 2011-2023. 2011-2023年美国2-19岁儿童和青少年肥胖趋势的种族和民族差异
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-06-12 DOI: 10.1111/ijpo.70032
Kathy Hu, Renee A Underwood, Yun Shen

This brief report examined obesity prevalence among US youth from 2011 to 2023 using National Health and Nutrition Examination Survey data. Obesity prevalence significantly increased overall, particularly among non-Hispanic Black children and adolescents. Findings highlighted worsening racial disparities and underscored an urgent need for targeted early childhood obesity prevention efforts.

这份简短的报告使用国家健康和营养检查调查数据,调查了2011年至2023年美国年轻人的肥胖患病率。肥胖患病率总体上显著增加,尤其是在非西班牙裔黑人儿童和青少年中。研究结果强调了日益恶化的种族差异,并强调了有针对性的早期儿童肥胖预防工作的迫切需要。
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引用次数: 0
Differences across four major US urban areas in metabolic syndrome in the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth) 西班牙裔社区儿童健康研究/拉丁裔青年研究(SOL Youth)中代谢综合征在美国四个主要城市地区的差异
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-19 DOI: 10.1111/ijpo.70027
Lauren Iacono, Paola Filigrana, Monica Batalha, Krista M. Perreira, Linda C. Gallo, Bharat Thyagarajan, Martha L. Daviglus, Amber Pirzada, Alan M. Delamater, Frank J. Penedo, Kelly R. Evenson, Carmen R. Isasi

Background

Although Hispanic/Latino youth experience a high burden of cardiometabolic risk factors, few studies address regional differences.

Objective

We assessed differences between urban areas in metabolic syndrome and cardiometabolic markers among US Hispanic/Latino youth and examined underlying factors explaining these differences.

Methods

Cross-sectional study of youth (n = 1466, aged 8–16 years) in four US urban areas (Chicago, Bronx, Miami and San Diego) of the Hispanic Community Children's Health Study/Study of Latinos. Metabolic syndrome was ascertained following the International Diabetes Federation criteria. Socio-demographics, perceived environmental characteristics and diet quality were collected through questionnaires. Physical activity was measured using accelerometry. Survey regression models assessed the association between urban areas and metabolic syndrome.

Results

There were differences across urban areas in socio-demographic, behavioural and perceived environmental characteristics. Relative to youth in the four urban areas, youth in Chicago (odds ratios [OR]: 2.39, 95% confidence interval [CI]: 1.29, 4.42), but not Bronx and San Diego, had higher odds of metabolic syndrome, while youth in Miami had lower odds of this syndrome (OR: 0.32, 95% CI: 0.12, 0.85).

Conclusion

We found differences across US urban areas in metabolic syndrome in Hispanic/Latino youth. Although behavioural and environmental characteristics partially explained these differences, future research is needed to understand persistent differences.

背景:尽管西班牙裔/拉丁裔青年经历了心脏代谢危险因素的高负担,但很少有研究解决区域差异。目的:我们评估了城市地区在美国西班牙裔/拉丁裔青年中代谢综合征和心脏代谢标志物的差异,并研究了解释这些差异的潜在因素。方法:对西班牙裔社区儿童健康研究/拉丁裔研究的四个美国城市地区(芝加哥、布朗克斯、迈阿密和圣地亚哥)的青少年(n = 1466,年龄8-16岁)进行横断面研究。代谢综合征是根据国际糖尿病联合会的标准确定的。通过问卷调查收集社会人口统计学、感知环境特征和饮食质量。用加速度计测量身体活动。调查回归模型评估了城市地区与代谢综合征之间的关系。结果:不同城市在社会人口、行为和感知环境特征方面存在差异。相对于四个城市地区的年轻人,芝加哥的年轻人(比值比[OR]: 2.39, 95%可信区间[CI]: 1.29, 4.42),而布朗克斯和圣地亚哥的年轻人患代谢综合征的几率更高,而迈阿密的年轻人患代谢综合征的几率更低(OR: 0.32, 95% CI: 0.12, 0.85)。结论:我们发现美国城市地区西班牙裔/拉丁裔青年代谢综合征存在差异。虽然行为和环境特征部分解释了这些差异,但需要未来的研究来理解持续的差异。
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引用次数: 0
Mediterranean diet and obesity polygenic risk interaction on adiposity in European children: The IDEFICS/I.Family Study 地中海饮食和肥胖多基因风险在欧洲儿童肥胖中的相互作用:IDEFICS/I。家庭研究。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-19 DOI: 10.1111/ijpo.70023
Miguel Seral-Cortes, Gabin Drouard, Guiomar Masip, Leonie H. Bogl, Stefaan De Henauw, Ronja Foraita, Timm Intemann, Lauren Lissner, Denes Molnar, Rajini Nagrani, Valeria Pala, Catalina Picó, Paola Russo, Gianluca Tognon, Michael Tornaritis, Toomas Veidebaum, Marvin N. Wright, Pilar De Miguel-Etayo, Luis A. Moreno, Idoia Labayen, the IDEFICS/I.Family Consortia

Background and Objectives

To examine whether changes in the Mediterranean Diet (MD) or any of its MD food groups modulate the genetic susceptibility to obesity in European youth, both in cross-sectional and longitudinal analyses.

Methods

For cross-sectional analysis, 1982 participants at baseline, 1649 in follow-up 1 (FU1) and 1907 in follow-up 2 (FU2), aged 2–16 years of the IDEFICS/I.Family studies were considered. For the longitudinal design, 1254 participants were included. Adherence to MD was assessed using the Mediterranean Diet Score (MDS), and genetic susceptibility to high BMI was assessed with a polygenic risk score (BMI-PRS). Multiple linear regression models were fitted to estimate gene × MD effects on markers of obesity.

Results

In cross-sectional analyses, at baseline, higher MDS was associated with higher BMI in children with high genetic susceptibility (β = 0.12; 95% CI = [0.01, 0.24]). However, 6 years later, at FU2, higher MDS was associated with lower BMI (β = −0.19; 95% CI = [−0.38, −0.01]) in children with high genetic susceptibility, showing an attenuating MDS effect. Also in FU2, vegetables and legumes (V&L) showed inverse associations with BMI (β = −0.01; CI = [−0.02, −0.00]) and WC (β = −0.02; CI = [−0.03, −0.00]) regardless of the obesity genetic risk, although the effect sizes were small. In the longitudinal analyses, no MDS-obesity associations or gene × diet interaction effects were observed.

Conclusions

In cross-sectional analysis (baseline and FU2), the MD modulated the association between obesity susceptibility and adiposity indicators in European youth, having an exacerbating effect in children measured during infancy years and an attenuating effect in early adolescent years.

背景和目的:通过横断面和纵向分析,研究地中海饮食(MD)或其任何MD食物组的变化是否会调节欧洲青年肥胖的遗传易感性。方法:进行横断面分析,1982名基线参与者,1649名随访1 (FU1)和1907名随访2 (FU2),年龄2-16岁的IDEFICS/I。考虑了家庭研究。纵向设计纳入1254名受试者。使用地中海饮食评分(MDS)评估MD的依从性,并使用多基因风险评分(BMI- prs)评估高BMI的遗传易感性。采用多元线性回归模型估计基因× MD对肥胖标志物的影响。结果:在横断面分析中,基线时,高MDS与高遗传易感性儿童的高BMI相关(β = 0.12;95% ci =[0.01, 0.24])。然而,6年后,在FU2时,高MDS与低BMI相关(β = -0.19;95% CI =[-0.38, -0.01]),显示MDS效应减弱。在FU2中,蔬菜和豆类(V&L)与BMI呈负相关(β = -0.01;CI =[-0.02, -0.00])和WC (β = -0.02;CI =[-0.03, -0.00]),与肥胖遗传风险无关,尽管效应量很小。在纵向分析中,没有观察到mds -肥胖相关或基因-饮食相互作用效应。结论:在横断面分析(基线和FU2)中,MD调节了欧洲青年肥胖易感性和肥胖指标之间的关联,在婴儿期测量的儿童中具有加剧效应,在青少年早期具有减弱效应。
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引用次数: 0
Effect of a care-coordinated responsive parenting intervention on obesogenic risk behaviours among mother–infant dyads enrolled in WIC 护理协调响应性父母干预对WIC中母婴双体肥胖风险行为的影响。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-15 DOI: 10.1111/ijpo.70020
Yining Ma, Lisa Bailey-Davis, Amy M. Moore, Cara F. Ruggiero, Carolyn F. McCabe, Jennifer S. Savage

Background

Integrating health care and social care presents opportunities to deliver responsive parenting (RP) interventions for childhood obesity prevention.

Objectives

This analysis examined the effect of an integrated RP intervention on infant obesogenic risk behaviours.

Methods

This secondary analysis included 228 mother–infant dyads in the Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study, a pragmatic randomized clinical trial that integrated care between paediatric clinicians and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) nutritionists to encourage RP. Mothers were randomized to a 6-month RP intervention or standard care. The Early Healthy Lifestyle risk assessment tool was completed at infant ages 2 and 6 months. Logistic regression examined study group effects on obesogenic risk behaviours, while t-tests assessed study group effects on a total obesogenic risk behaviour score. Models adjusted for milk type and parity.

Results

RP mothers were less likely to report nighttime feedings at 2 (adjusted odds ratio [aOR] 0.21, 95% confidence interval [CI] 0.07–0.62) and 6 months (aOR 0.36, 95% CI 0.16–0.81); pressure to finish the bottle (aOR 0.53, 95% CI 0.30–0.93) and using screens when feeding/playing at 2 months (aOR 0.34, 95% CI 0.17–0.67); and putting their infant to bed after 8:00 PM at 6 months (aOR 0.46, 95% CI 0.21–0.97). RP mothers had significantly lower obesogenic risk behaviour scores at 2 months (p = 0.009) but not at 6 months (p = 0.06) compared to standard care.

Conclusions

The WEE Baby Care intervention decreased some obesogenic risk behaviours among WIC mother–infant dyads. Integrated care in health and social settings can be used to provide patient-centred RP guidance to improve early obesogenic risk behaviours in high-risk populations.

背景:整合卫生保健和社会保健提供了提供响应性育儿(RP)干预儿童肥胖预防的机会。目的:本分析考察了综合RP干预对婴儿肥胖危险行为的影响。方法:这一次要分析包括228对妇女、婴儿和儿童增强婴儿早期健康生活方式(WEE Baby)护理研究中的母婴对,这是一项实用的随机临床试验,将儿科临床医生和妇女、婴儿和儿童特殊补充营养计划(WIC)营养学家之间的护理结合起来,以鼓励RP。母亲们被随机分为6个月RP干预组和标准护理组。在婴儿2个月和6个月时完成早期健康生活方式风险评估工具。逻辑回归检验了研究组对致肥风险行为的影响,而t检验评估了研究组对致肥风险行为总分的影响。模型调整牛奶类型和胎次。结果:RP母亲在2个月(调整优势比[aOR] 0.21, 95%可信区间[CI] 0.07-0.62)和6个月(aOR 0.36, 95%可信区间[CI] 0.16-0.81)时报告夜间喂养的可能性较小;压力完成奶瓶(aOR 0.53, 95% CI 0.30-0.93)和在2个月喂养/玩耍时使用屏幕(aOR 0.34, 95% CI 0.17-0.67);并在6个月大时让婴儿在晚上8点后睡觉(aOR 0.46, 95% CI 0.21-0.97)。与标准护理相比,RP母亲在2个月时的肥胖风险行为评分显著降低(p = 0.009),但在6个月时则没有(p = 0.06)。结论:WEE婴儿护理干预降低了WIC母婴的某些肥胖危险行为。卫生和社会环境中的综合护理可用于提供以患者为中心的RP指导,以改善高危人群的早期致胖风险行为。
{"title":"Effect of a care-coordinated responsive parenting intervention on obesogenic risk behaviours among mother–infant dyads enrolled in WIC","authors":"Yining Ma,&nbsp;Lisa Bailey-Davis,&nbsp;Amy M. Moore,&nbsp;Cara F. Ruggiero,&nbsp;Carolyn F. McCabe,&nbsp;Jennifer S. Savage","doi":"10.1111/ijpo.70020","DOIUrl":"10.1111/ijpo.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Integrating health care and social care presents opportunities to deliver responsive parenting (RP) interventions for childhood obesity prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This analysis examined the effect of an integrated RP intervention on infant obesogenic risk behaviours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This secondary analysis included 228 mother–infant dyads in the Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study, a pragmatic randomized clinical trial that integrated care between paediatric clinicians and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) nutritionists to encourage RP. Mothers were randomized to a 6-month RP intervention or standard care. The Early Healthy Lifestyle risk assessment tool was completed at infant ages 2 and 6 months. Logistic regression examined study group effects on obesogenic risk behaviours, while <i>t</i>-tests assessed study group effects on a total obesogenic risk behaviour score. Models adjusted for milk type and parity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RP mothers were less likely to report nighttime feedings at 2 (adjusted odds ratio [aOR] 0.21, 95% confidence interval [CI] 0.07–0.62) and 6 months (aOR 0.36, 95% CI 0.16–0.81); pressure to finish the bottle (aOR 0.53, 95% CI 0.30–0.93) and using screens when feeding/playing at 2 months (aOR 0.34, 95% CI 0.17–0.67); and putting their infant to bed after 8:00 PM at 6 months (aOR 0.46, 95% CI 0.21–0.97). RP mothers had significantly lower obesogenic risk behaviour scores at 2 months (<i>p</i> = 0.009) but not at 6 months (<i>p</i> = 0.06) compared to standard care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The WEE Baby Care intervention decreased some obesogenic risk behaviours among WIC mother–infant dyads. Integrated care in health and social settings can be used to provide patient-centred RP guidance to improve early obesogenic risk behaviours in high-risk populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Weight loss following lisdexamfetamine in children and adolescents with attention deficit hyperactivity disorder and overweight and obesity 患有注意缺陷多动障碍、超重和肥胖的儿童和青少年服用利地胺后体重减轻。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-15 DOI: 10.1111/ijpo.70024
Mostafa Salama, Kaitlin Leopold, Roland Hentz, Seema Kumar

Objective

To examine change in weight status following initiation of lisdexamfetamine in children with attention deficit hyperactivity disorder (ADHD) and overweight or obesity.

Study Design

A retrospective chart review included children aged 2 to <18 years treated with lisdexamfetamine for ADHD. Body mass index (BMI) data for up to 2 years after initiation of lisdexamfetamine were analysed using linear mixed effects models with autoregressive-1 correlation structure on time of follow-up per patient.

Results

The analysis included 330 children ≤18 years, median age 10 years (interquartile range 8.1–13) comprising 55 children with severe obesity, 88 with mild-moderate obesity, 131 with overweight and 56 with healthy weight, 68% male and 32% female. At 2 years after initiation of lisdexamfetamine in the severe obesity group, the BMI Z-score decreased by −0.41 (95% confidence intervals [CI] [−0.57, −0.25], p < 0.001) and BMI percent of the 95th percentile decreased by −11.2% (95% CI [−15.8 to −6.7], p < 0.001). In the mild–moderate obesity group, BMI Z-score decreased by −0.44 (95% CI [−0.56, −0.31], p < 0.001) and BMI% of the 95th percentile decreased by −11.1% at 24 months (95% CI [−13.9 to −8.4], p < 0.001). In the mild–moderate obesity and overweight groups, younger children (ages 4–10) showed greater reduction in their BMI (p < 0.001 and p = 0.029, respectively).

Conclusion

Reduction in BMI for age was noted for up to 2 years following initiation of lisdexamfetamine in children with ADHD and overweight and obesity. Further studies are warranted to study the weight loss effect of lisdexamfetamine in children with obesity.

目的:研究患有注意缺陷多动障碍(ADHD)和超重或肥胖的儿童开始服用利地氨苯他明后体重状况的变化。研究设计:回顾性图表分析纳入2至32%的儿童。结果:分析纳入330名≤18岁的儿童,中位年龄为10岁(四分位数范围8.1-13),其中重度肥胖儿童55名,轻度-中度肥胖儿童88名,超重儿童131名,健康体重儿童56名,男性68%,女性32%。在重度肥胖组开始使用利地氨苯胺2年后,BMI z评分下降了-0.41(95%可信区间[CI] [-0.57, -0.25], p)。结论:在患有ADHD、超重和肥胖的儿童中,利地氨苯胺开始使用利地氨苯胺后长达2年的时间里,BMI随年龄的下降都是明显的。利地安非他明对肥胖儿童的减肥效果有待进一步研究。
{"title":"Weight loss following lisdexamfetamine in children and adolescents with attention deficit hyperactivity disorder and overweight and obesity","authors":"Mostafa Salama,&nbsp;Kaitlin Leopold,&nbsp;Roland Hentz,&nbsp;Seema Kumar","doi":"10.1111/ijpo.70024","DOIUrl":"10.1111/ijpo.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine change in weight status following initiation of lisdexamfetamine in children with attention deficit hyperactivity disorder (ADHD) and overweight or obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>A retrospective chart review included children aged 2 to &lt;18 years treated with lisdexamfetamine for ADHD. Body mass index (BMI) data for up to 2 years after initiation of lisdexamfetamine were analysed using linear mixed effects models with autoregressive-1 correlation structure on time of follow-up per patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 330 children ≤18 years, median age 10 years (interquartile range 8.1–13) comprising 55 children with severe obesity, 88 with mild-moderate obesity, 131 with overweight and 56 with healthy weight, 68% male and 32% female. At 2 years after initiation of lisdexamfetamine in the severe obesity group, the BMI <i>Z</i>-score decreased by −0.41 (95% confidence intervals [CI] [−0.57, −0.25], <i>p</i> &lt; 0.001) and BMI percent of the 95th percentile decreased by −11.2% (95% CI [−15.8 to −6.7], <i>p</i> &lt; 0.001). In the mild–moderate obesity group, BMI <i>Z</i>-score decreased by −0.44 (95% CI [−0.56, −0.31], <i>p</i> &lt; 0.001) and BMI% of the 95th percentile decreased by −11.1% at 24 months (95% CI [−13.9 to −8.4], <i>p</i> &lt; 0.001). In the mild–moderate obesity and overweight groups, younger children (ages 4–10) showed greater reduction in their BMI (<i>p</i> &lt; 0.001 and <i>p</i> = 0.029, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Reduction in BMI for age was noted for up to 2 years following initiation of lisdexamfetamine in children with ADHD and overweight and obesity. Further studies are warranted to study the weight loss effect of lisdexamfetamine in children with obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075092","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
Geographic and ethnic inequalities in total and central obesity, and physical fitness among preschool children: Insights from the PREFIT project 学龄前儿童总体肥胖和中心肥胖以及身体健康的地理和种族不平等:来自PREFIT项目的见解。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-13 DOI: 10.1111/ijpo.70021
Cristina Cadenas-Sanchez, Jorge R. Fernández-Santos, Mairena Sánchez-López, Natalia García-Corada, Diego Moliner-Urdiales, Nuria Romero-Parra, Manuel A. Rodriguez Perez, Pere Palou, Cecilia Dorado-García, German Vicente-Rodríguez, Francisco B. Ortega, David Jiménez-Pavón

Background and objectives

Obesity and physical fitness are known to be influenced by various geographic factors and ethnicity in children. However, there is limited evidence on the level to which these factors can influence very early in life, at preschool age. This study aimed to describe and compare total and central obesity and physical fitness according to geographic factors and ethnicity in preschoolers.

Methods

This cross-sectional study included 3179 preschoolers (4.6 ± 0.9y, 52.8% boys). Geographic factors (location and type of area: rural/urban) were assessed based on the school setting, while ethnicity was determined through parental self-report. Total and central obesity and physical fitness (cardiorespiratory fitness, muscular strength, speed-agility, balance) were assessed using the PREFIT battery.

Results

Preschoolers from southern regions of Spain presented higher total obesity along with lower performance in cardiorespiratory fitness and lower-limb muscular strength compared to their northern peers (p ≤ 0.017). However, they demonstrated greater levels of upper-limb muscular strength and balance (p < 0.001). Preschoolers from rural areas of Spain showed higher central obesity but better fitness performance compared to those from urban areas (p ≤ 0.004). White and African preschoolers showed lower levels of total and central obesity than Latin preschoolers (p ≤ 0.003) and performed better in upper-limb muscular strength and speed–agility compared to Asian or Latin preschoolers (p ≤ 0.037).

Conclusion

This study highlights significant physical health inequalities among preschoolers based on geographical factors and ethnic backgrounds. These findings underscore the need for targeted public health strategies to address socioeconomic and environmental determinants of early-life health disparities.

背景和目的:儿童的肥胖和身体健康受到各种地理因素和种族的影响。然而,关于这些因素在生命早期,即学龄前影响程度的证据有限。本研究旨在根据地理因素和种族描述和比较学龄前儿童的总体和中心肥胖和身体健康。方法:对3179名学龄前儿童(4.6±0.9岁,男孩占52.8%)进行横断面研究。地理因素(位置和区域类型:农村/城市)根据学校环境进行评估,而种族则通过父母自我报告确定。使用PREFIT电池评估总肥胖和中心性肥胖以及身体健康(心肺健康、肌肉力量、速度敏捷性、平衡)。结果:与北部地区相比,西班牙南部地区的学龄前儿童总体肥胖程度较高,心肺健康和下肢肌肉力量表现较差(p≤0.017)。然而,他们表现出更高水平的上肢肌肉力量和平衡(p结论:这项研究强调了基于地理因素和种族背景的学龄前儿童之间显著的身体健康不平等。这些发现强调需要制定有针对性的公共卫生战略,以解决造成生命早期健康差异的社会经济和环境决定因素。
{"title":"Geographic and ethnic inequalities in total and central obesity, and physical fitness among preschool children: Insights from the PREFIT project","authors":"Cristina Cadenas-Sanchez,&nbsp;Jorge R. Fernández-Santos,&nbsp;Mairena Sánchez-López,&nbsp;Natalia García-Corada,&nbsp;Diego Moliner-Urdiales,&nbsp;Nuria Romero-Parra,&nbsp;Manuel A. Rodriguez Perez,&nbsp;Pere Palou,&nbsp;Cecilia Dorado-García,&nbsp;German Vicente-Rodríguez,&nbsp;Francisco B. Ortega,&nbsp;David Jiménez-Pavón","doi":"10.1111/ijpo.70021","DOIUrl":"10.1111/ijpo.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and objectives</h3>\u0000 \u0000 <p>Obesity and physical fitness are known to be influenced by various geographic factors and ethnicity in children. However, there is limited evidence on the level to which these factors can influence very early in life, at preschool age. This study aimed to describe and compare total and central obesity and physical fitness according to geographic factors and ethnicity in preschoolers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study included 3179 preschoolers (4.6 ± 0.9y, 52.8% boys). Geographic factors (location and type of area: rural/urban) were assessed based on the school setting, while ethnicity was determined through parental self-report. Total and central obesity and physical fitness (cardiorespiratory fitness, muscular strength, speed-agility, balance) were assessed using the PREFIT battery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preschoolers from southern regions of Spain presented higher total obesity along with lower performance in cardiorespiratory fitness and lower-limb muscular strength compared to their northern peers (<i>p</i> ≤ 0.017). However, they demonstrated greater levels of upper-limb muscular strength and balance (<i>p</i> &lt; 0.001). Preschoolers from rural areas of Spain showed higher central obesity but better fitness performance compared to those from urban areas (<i>p</i> ≤ 0.004). White and African preschoolers showed lower levels of total and central obesity than Latin preschoolers (<i>p</i> ≤ 0.003) and performed better in upper-limb muscular strength and speed–agility compared to Asian or Latin preschoolers (<i>p</i> ≤ 0.037).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights significant physical health inequalities among preschoolers based on geographical factors and ethnic backgrounds. These findings underscore the need for targeted public health strategies to address socioeconomic and environmental determinants of early-life health disparities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adverse childhood experiences and appetitive traits in adolescence: A prospective cohort study 不良童年经历与青春期食欲特征:一项前瞻性队列研究。
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-08 DOI: 10.1111/ijpo.70022
Alexandra Costa, Sílvia Fraga, Marion M. Hetherington, Andreia Oliveira

Objective

To explore the association between adverse childhood experiences (ACEs) and appetitive traits in adolescence.

Methods

Participants were 4118 children from the Generation XXI cohort. ACEs were assessed at age 10 with a self-administered questionnaire covering 15 different experiences and analysed by exposure categories (0, 1–3, 4–5 and ≥6) and dimensions identified through component analysis. Appetitive traits at age 13 were measured with the Children's Eating Behaviour Questionnaire, completed by parents. Multivariable linear regression analysis, adjusted for sociodemographic factors, was used.

Results

Ninety-six percent reported at least one ACE, with 26% reporting ≥6. Those who reported at least one ACE had higher scores on food approach traits, indicative of an avid appetite. A dose–response relationship was observed between the number of ACEs and Food Responsiveness, Emotional Overeating and Desire to Drink. Participants with ≥6 ACEs scored higher on Enjoyment of Food (β̂= 0.19, 95% confidence interval [CI] [0.06, 0.31]) and Emotional Undereating (β̂= 0.13, 95% CI [0.01, 0.25]), and lower on Slowness in Eating (β̂ = −0.19, 95%CI [−0.32, −0.06]). Analysis by ACEs dimensions revealed more consistent associations with food approach traits.

Conclusion

Greater ACE exposure was associated with appetitive traits that increase obesity risk, suggesting that these traits may contribute to explaining the association between ACEs and obesity.

目的:探讨不良童年经历与青少年食欲特征的关系。方法:研究对象为来自21代队列的4118名儿童。在10岁时通过一份涵盖15种不同经历的自填问卷对ace进行评估,并根据暴露类别(0、1-3、4-5和≥6)和成分分析确定的维度进行分析。13岁时的食欲特征由父母填写的儿童饮食行为问卷进行测量。采用多变量线性回归分析,调整社会人口因素。结果:96%的患者报告至少一次ACE, 26%的患者报告至少一次ACE% reporting ≥6. Those who reported at least one ACE had higher scores on food approach traits, indicative of an avid appetite. A dose-response relationship was observed between the number of ACEs and Food Responsiveness, Emotional Overeating and Desire to Drink. Participants with ≥6 ACEs scored higher on Enjoyment of Food ( β ̂ $$ hat{beta } $$ = 0.19, 95% confidence interval [CI] [0.06, 0.31]) and Emotional Undereating ( β ̂ $$ hat{beta} $$ = 0.13, 95% CI [0.01, 0.25]), and lower on Slowness in Eating ( β ̂ $$ hat{beta} $$  = -0.19, 95%CI [-0.32, -0.06]). Analysis by ACEs dimensions revealed more consistent associations with food approach traits.Conclusion: Greater ACE exposure was associated with appetitive traits that increase obesity risk, suggesting that these traits may contribute to explaining the association between ACEs and obesity.
{"title":"Adverse childhood experiences and appetitive traits in adolescence: A prospective cohort study","authors":"Alexandra Costa,&nbsp;Sílvia Fraga,&nbsp;Marion M. Hetherington,&nbsp;Andreia Oliveira","doi":"10.1111/ijpo.70022","DOIUrl":"10.1111/ijpo.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the association between adverse childhood experiences (ACEs) and appetitive traits in adolescence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 4118 children from the Generation XXI cohort. ACEs were assessed at age 10 with a self-administered questionnaire covering 15 different experiences and analysed by exposure categories (0, 1–3, 4–5 and ≥6) and dimensions identified through component analysis. Appetitive traits at age 13 were measured with the Children's Eating Behaviour Questionnaire, completed by parents. Multivariable linear regression analysis, adjusted for sociodemographic factors, was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-six percent reported at least one ACE, with 26% reporting ≥6. Those who reported at least one ACE had higher scores on food approach traits, indicative of an avid appetite. A dose–response relationship was observed between the number of ACEs and Food Responsiveness, Emotional Overeating and Desire to Drink. Participants with ≥6 ACEs scored higher on Enjoyment of Food (<span></span><math>\u0000 <mrow>\u0000 <mover>\u0000 <mrow>\u0000 <mi>β</mi>\u0000 <mspace></mspace>\u0000 </mrow>\u0000 <mo>̂</mo>\u0000 </mover>\u0000 </mrow></math>= 0.19, 95% confidence interval [CI] [0.06, 0.31]) and Emotional Undereating (<span></span><math>\u0000 <mrow>\u0000 <mover>\u0000 <mi>β</mi>\u0000 <mo>̂</mo>\u0000 </mover>\u0000 </mrow></math>= 0.13, 95% CI [0.01, 0.25]), and lower on Slowness in Eating (<span></span><math>\u0000 <mrow>\u0000 <mover>\u0000 <mi>β</mi>\u0000 <mo>̂</mo>\u0000 </mover>\u0000 </mrow></math> = −0.19, 95%CI [−0.32, −0.06]). Analysis by ACEs dimensions revealed more consistent associations with food approach traits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Greater ACE exposure was associated with appetitive traits that increase obesity risk, suggesting that these traits may contribute to explaining the association between ACEs and obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 8","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958845","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
Associations between healthy eating index and anthropometric outcomes in multiethnic elementary-aged children 多民族小学年龄儿童健康饮食指数与人体测量结果之间的关系
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-08 DOI: 10.1111/ijpo.70018
Amanda M. Jústiz, Matthew J. Landry, Jaimie N. Davis

Introduction

High adiposity in children can predict cardiometabolic risk in adulthood. This study investigated if changes in dietary quality, measured by the Healthy Eating Index (HEI), are associated with changes in anthropometric measurements in children.

Methods

This secondary analysis used data from TX Sprouts, a cluster randomized controlled trial that investigated the effects of a 1-year school nutrition program on child diet and obesity. 24-hour dietary recalls were used to measure HEI-2020 at baseline and post-intervention. Anthropometric outcomes were BMI, waist circumference, and body fat percentage via bioelectrical impedance. Linear regression models assessed associations between changes in HEI-2020 total and component scores and anthropometrics.

Results

Participants (n = 424) were 53% male, 56% Hispanic, and the average age was 9.3 years. A 10-point increase in total HEI-2020 score was associated with a 0.4% (95% CI: 0.1%–0.6%) decrease in body fat percentage. Increases in whole grain and decreases in refined grain component scores were associated with decreases in body fat percentage. Changes in total or component scores were not associated with changes in BMI, BMI-Z, or waist circumference.

Conclusion

This study found associations between increased diet quality and decreased body fat percentage in a primarily low-income, multi-ethnic population of children.

儿童的高肥胖可以预测成年后的心脏代谢风险。本研究调查了以健康饮食指数(HEI)衡量的饮食质量的变化是否与儿童人体测量值的变化有关。方法:这项二次分析使用了来自TX芽菜的数据,这是一项随机对照试验,调查了1年学校营养计划对儿童饮食和肥胖的影响。24小时饮食回顾用于测量基线和干预后的HEI-2020。人体测量结果是通过生物电阻抗测量BMI、腰围和体脂率。线性回归模型评估了HEI-2020总分和分值变化与人体测量学之间的关系。结果:参与者(n = 424) 53%为男性,56%为西班牙裔,平均年龄为9.3岁。HEI-2020总分每增加10分,体脂率就会下降0.4% (95% CI: 0.1%-0.6%)。全谷物含量的增加和精制谷物含量的减少与体脂率的降低有关。总得分或成分得分的变化与BMI、BMI- z或腰围的变化无关。结论:本研究发现,在低收入、多种族的儿童中,饮食质量的提高与体脂率的降低存在关联。
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引用次数: 0
The correlation of apolipoprotein B and apolipoprotein A1 with metabolic dysfunction-associated steatotic liver disease in children and adolescents with obesity 载脂蛋白B和载脂蛋白A1与肥胖儿童和青少年代谢功能障碍相关的脂肪变性肝病的相关性
IF 2.7 3区 医学 Q1 PEDIATRICS Pub Date : 2025-05-06 DOI: 10.1111/ijpo.70017
Xiao-Yan Shi, Ya-Kun Liu, Yan Chen, Zhi-Ying Jiang, Meng-Xuan Ye, Jian Wang

Background

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a prevalent liver condition in children and teenagers with obesity. Unfortunately, there is no standardized treatment.

Objective

To examine the connection between apolipoprotein B (apoB), apolipoprotein A1 (apoA1), and the apoB/apoA1 ratio with the occurrence of MASLD in this population.

Methods

A retrospective study was made on children and adolescents with obesity in a children's hospital between the period 2020 and 2022. Anthropometric data, ultrasound results, and blood biochemistry were analysed to assess the connection between apoB, apoA1, and the presence of MASLD.

Results

Of the 916 participants included, 313 were diagnosed with MASLD. The level of serum apoB reflected a substantial dose–response correlation with the odds of having MASLD. When apoB levels exceeded the 50th percentile, the risk increased significantly, and at the 95th percentile, the odds were 4.83 times higher than at the 50th percentile (95% CI: 2.02–11.56). The ratio of apoB/apoA1 at the 95th percentile was connected to a 2.41-fold higher prevalence compared to the 50th percentile (95% CI: 1.33–4.37). No significant correlation was found between the levels of apoA1 and MASLD prevalence.

Conclusion

Elevated levels of apoB and the apoB/apoA1 ratio have been strongly connected to increased MASLD prevalence in children and adolescents with obesity; hence, signifying their potential usefulness as biomarkers for early detection and intervention.

背景:代谢功能障碍相关的脂肪变性肝病(MASLD)已成为儿童和青少年肥胖的一种普遍肝脏疾病。不幸的是,没有标准化的治疗方法。目的:探讨载脂蛋白B (apoB)、载脂蛋白A1 (apoA1)及载脂蛋白/载脂蛋白A1比值与该人群MASLD发生的关系。方法:对某儿童医院2020 ~ 2022年收治的肥胖儿童和青少年进行回顾性研究。对人体测量数据、超声结果和血液生化进行分析,以评估载脂蛋白ob、载脂蛋白a1与MASLD存在之间的联系。结果:在纳入的916名参与者中,313名被诊断为MASLD。血清载脂蛋白水平反映了与MASLD发生率的剂量-反应相关性。当载脂蛋白ob水平超过第50百分位时,风险显著增加,在第95百分位时,风险是第50百分位的4.83倍(95% CI: 2.02-11.56)。与第50百分位相比,第95百分位的apoB/apoA1比值与2.41倍的患病率相关(95% CI: 1.33-4.37)。apoA1水平与MASLD患病率之间未发现显著相关性。结论:apoB和apoB/apoA1比值的升高与肥胖儿童和青少年MASLD患病率的增加密切相关;因此,表明它们作为早期检测和干预的生物标志物的潜在用途。
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引用次数: 0
期刊
Pediatric Obesity
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