L. Nate Overholtzer, Hedyeh Ahmadi, Katherine Bottenhorn, Eustace Hsu, Megan M. Herting
Background
Despite the growing epidemic of paediatric obesity, questions remain regarding potential neural mechanisms for individual risk. Delay discounting is a cognitive process of comparison of valuation between immediate and delayed reward, which has been inconsistently linked to weight status. Moreover, central to the brain's reward system is the nucleus accumbens, a region structurally and functionally altered in obesity.
Objectives/Methods
This study aimed to examine the relationships between two continuous metrics of weight status, performance on a monetary delay-discounting task and nucleus accumbens functional connectivity in 10–12-year-olds from the Adolescent Brain and Cognitive Development (ABCD) Study.
Results
Using multilevel longitudinal linear modelling, we found greater discounting was associated with higher BMI Z-scores (BMIz) and waist-to-height ratio Z-scores (WHtRz) (N = 3819). Moreover, we observed functional connectivity of the nucleus accumbens to the cingulo-opercular, dorsal attention, fronto-parietal, salience and ventral attention networks were predictive of BMIz (N = 1817). Nucleus accumbens functional connectivity was not found to mediate the association between delay-discounting behaviour and BMIz.
Conclusions
Delay discounting and nucleus accumbens functional connectivity are independently related to weight status in a large sample of early adolescents. A better understanding of the relationship between reward and overeating behaviours may better inform obesity interventions.
摘要背景尽管儿科肥胖症日益流行，但有关个人风险的潜在神经机制问题依然存在。延迟折现是一种比较即时奖励和延迟奖励之间价值的认知过程，它与体重状况的关系并不一致。此外，大脑奖赏系统的核心是伏隔核，肥胖症患者的伏隔核在结构和功能上都会发生改变。目标/方法本研究旨在探讨青少年大脑和认知发展（ABCD）研究中 10-12 岁青少年体重状况的两个连续指标、货币延迟贴现任务的表现和伏隔核功能连接之间的关系。结果通过多层次纵向线性建模，我们发现更高的折现率与更高的体重指数 Z 值（BMIz）和腰围身高比 Z 值（WHtRz）相关（N = 3819）。此外，我们还观察到伏隔核与蝶鞍、背侧注意、前顶叶、显著性和腹侧注意网络的功能连接可预测 BMIz（N = 1817）。结论在大量青少年样本中，延迟贴现和伏隔核功能连通性与体重状况有独立的关系。更好地了解奖赏与暴饮暴食行为之间的关系可以更好地为肥胖干预提供依据。
{"title":"Delay discounting and nucleus accumbens functional connectivity are related to weight status in adolescents from the ABCD study","authors":"L. Nate Overholtzer, Hedyeh Ahmadi, Katherine Bottenhorn, Eustace Hsu, Megan M. Herting","doi":"10.1111/ijpo.13173","DOIUrl":"10.1111/ijpo.13173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the growing epidemic of paediatric obesity, questions remain regarding potential neural mechanisms for individual risk. Delay discounting is a cognitive process of comparison of valuation between immediate and delayed reward, which has been inconsistently linked to weight status. Moreover, central to the brain's reward system is the nucleus accumbens, a region structurally and functionally altered in obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives/Methods</h3>\u0000 \u0000 <p>This study aimed to examine the relationships between two continuous metrics of weight status, performance on a monetary delay-discounting task and nucleus accumbens functional connectivity in 10–12-year-olds from the Adolescent Brain and Cognitive Development (ABCD) Study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using multilevel longitudinal linear modelling, we found greater discounting was associated with higher BMI Z-scores (BMIz) and waist-to-height ratio Z-scores (WHtRz) (<i>N</i> = 3819). Moreover, we observed functional connectivity of the nucleus accumbens to the cingulo-opercular, dorsal attention, fronto-parietal, salience and ventral attention networks were predictive of BMIz (<i>N</i> = 1817). Nucleus accumbens functional connectivity was not found to mediate the association between delay-discounting behaviour and BMIz.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Delay discounting and nucleus accumbens functional connectivity are independently related to weight status in a large sample of early adolescents. A better understanding of the relationship between reward and overeating behaviours may better inform obesity interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259024","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}
Aaron S. Kelly, Melanie Bahlke, Jennifer L. Baker, Carine de Beaufort, Ruth M. Belin, Helena Fonseca, Paula M. Hale, Jens-Christian Holm, Daniel S. Hsia, Ania M. Jastreboff, Petur B. Juliusson, Madhumita Murphy, Jonathan Pak, Elizabeth Paul, Bryan Rudolph, Gitanjali Srivastava, Christoffer W. Tornøe, Daniel Weghuber, Claudia K. Fox
Anti-obesity medications (AOMs) have emerged as one element of comprehensive obesity clinical care intended to improve long-term health outcomes for children and adolescents. The number of pediatric AOM clinical trials has burgeoned in recent years as new pharmacotherapeutics have been developed. Factors related to growth and development in children and adolescents can present unique challenges in terms of designing and conducting clinical trials investigating the safety and efficacy of AOMs. These barriers can delay the AOM development and evaluation process, increase the cost of performing trials, create challenges in the interpretation of results, influence the generalizability of the findings and present ethical dilemmas. In an effort to address these issues and provide guidance to streamline the process of designing and conducting pediatric AOM clinical trials, relevant key stakeholders convened a series of roundtable meetings to discuss, debate and achieve harmonization on design features. Stakeholder participants included a multidisciplinary group of international pediatric obesity experts, patient (parent) representatives and representatives from academic medicine, key regulatory agencies and industry. Topics of discussion included primary efficacy end-points, secondary end-points, eligibility criteria, trial run-in and follow-up phases, use of active comparators and guidelines for down-titration and/or stopping rules for excessive weight reduction. Consensus recommendations were agreed upon. Regarding end-points, emphasis was placed on moving away from BMI z-score as a primary outcome, incorporating multiple alternative BMI-related outcomes and measuring adiposity/body fat as a prominent secondary end-point. Trial eligibility criteria were carefully considered to maximize generalizability while maintaining safety. The limited value of trial run-in phases was discussed. It was also underscored that designing trials with extended follow-up periods after AOM withdrawal should be avoided owing to ethical issues (including possible psychological harm) related to weight regain without providing the opportunity to access other treatments. The panel emphasized the value of the randomized, placebo-controlled trial but recommended the thoughtful consideration of the use of active comparators in addition to, or instead of, placebo to achieve clinical equipoise when appropriate. Finally, the panel recommended that clinical trial protocols should include clear guidance regarding AOM down-titration to avoid excessive weight reduction when applicable.
摘要抗肥胖药物（AOMs）已成为旨在改善儿童和青少年长期健康状况的全面肥胖症临床治疗的一个组成部分。近年来，随着新药物疗法的开发，儿科抗肥胖药物临床试验的数量激增。与儿童和青少年生长发育相关的因素可能会给设计和开展研究AOM安全性和有效性的临床试验带来独特的挑战。这些障碍可能会延误AOM的开发和评估过程，增加试验成本，给结果解释带来挑战，影响研究结果的推广性，并带来伦理难题。为了解决这些问题，并为简化儿科 AOM 临床试验的设计和实施过程提供指导，相关的主要利益相关者召开了一系列圆桌会议，就设计特点进行讨论、辩论和协调。利益相关方的与会者包括国际儿科肥胖症专家、患者（家长）代表以及来自学术界、主要监管机构和行业的代表组成的多学科小组。讨论的主题包括主要疗效终点、次要终点、资格标准、试验开始阶段和随访阶段、活性参照物的使用以及体重过度减轻的降量治疗和/或停药规则指南。会议达成了一致建议。在终点方面，强调不再将体重指数 z 值作为主要结果，而是纳入多种与体重指数相关的替代结果，并将测量脂肪率/体脂作为重要的次要终点。对试验资格标准进行了仔细考虑，以在保证安全性的同时最大限度地提高可推广性。会议讨论了试验磨合期的有限价值。会议还强调，由于与体重反弹有关的伦理问题（包括可能的心理伤害），应避免在停用AOM后设计延长随访期的试验，而不提供接受其他治疗的机会。专家小组强调了随机、安慰剂对照试验的价值，但建议在适当的时候，深思熟虑地考虑在使用安慰剂的同时使用或代替安慰剂，以实现临床平衡。最后，专家小组建议，临床试验方案应包括有关 AOM 剂量下调的明确指导，以避免在适用情况下过度减轻体重。
{"title":"Considerations for the design and conduct of pediatric obesity pharmacotherapy clinical trials: Proceedings of expert roundtable meetings","authors":"Aaron S. Kelly, Melanie Bahlke, Jennifer L. Baker, Carine de Beaufort, Ruth M. Belin, Helena Fonseca, Paula M. Hale, Jens-Christian Holm, Daniel S. Hsia, Ania M. Jastreboff, Petur B. Juliusson, Madhumita Murphy, Jonathan Pak, Elizabeth Paul, Bryan Rudolph, Gitanjali Srivastava, Christoffer W. Tornøe, Daniel Weghuber, Claudia K. Fox","doi":"10.1111/ijpo.13161","DOIUrl":"10.1111/ijpo.13161","url":null,"abstract":"<p>Anti-obesity medications (AOMs) have emerged as one element of comprehensive obesity clinical care intended to improve long-term health outcomes for children and adolescents. The number of pediatric AOM clinical trials has burgeoned in recent years as new pharmacotherapeutics have been developed. Factors related to growth and development in children and adolescents can present unique challenges in terms of designing and conducting clinical trials investigating the safety and efficacy of AOMs. These barriers can delay the AOM development and evaluation process, increase the cost of performing trials, create challenges in the interpretation of results, influence the generalizability of the findings and present ethical dilemmas. In an effort to address these issues and provide guidance to streamline the process of designing and conducting pediatric AOM clinical trials, relevant key stakeholders convened a series of roundtable meetings to discuss, debate and achieve harmonization on design features. Stakeholder participants included a multidisciplinary group of international pediatric obesity experts, patient (parent) representatives and representatives from academic medicine, key regulatory agencies and industry. Topics of discussion included primary efficacy end-points, secondary end-points, eligibility criteria, trial run-in and follow-up phases, use of active comparators and guidelines for down-titration and/or stopping rules for excessive weight reduction. Consensus recommendations were agreed upon. Regarding end-points, emphasis was placed on moving away from BMI <i>z</i>-score as a primary outcome, incorporating multiple alternative BMI-related outcomes and measuring adiposity/body fat as a prominent secondary end-point. Trial eligibility criteria were carefully considered to maximize generalizability while maintaining safety. The limited value of trial run-in phases was discussed. It was also underscored that designing trials with extended follow-up periods after AOM withdrawal should be avoided owing to ethical issues (including possible psychological harm) related to weight regain without providing the opportunity to access other treatments. The panel emphasized the value of the randomized, placebo-controlled trial but recommended the thoughtful consideration of the use of active comparators in addition to, or instead of, placebo to achieve clinical equipoise when appropriate. Finally, the panel recommended that clinical trial protocols should include clear guidance regarding AOM down-titration to avoid excessive weight reduction when applicable.</p>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"19 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.13161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259025","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}
Gita Wahi, Julie St-Pierre, Bradley C. Johnston, Donna Fitzpatrick-Lewis, Ali Usman, Diana Sherifali, Roah Merdad, Zahra Esmaeilinezhad, Catherine S. Birken, Jill Hamilton, Mélanie Henderson, Sarah A. Moore, Geoff D. C. Ball, Katherine M. Morrison, the Steering Committee for Updating Canada's Clinical Practice Guideline for Managing Pediatric Obesity
Objective
To summarize the literature on pharmacotherapy for managing paediatric obesity.
Methods
A systematic review and meta-analysis were conducted of randomized controlled trials (RCTs) with <18-year-olds of pharmacotherapeutic agents published up to November 2022. Estimates of effect for outcomes were presented relative to minimal important differences and GRADE certainty of evidence. We examined data on patient/proxy-reported outcome measures (PROMs), cardiometabolic risk factors, anthropometry and adverse events (AEs).
Results
Overall, 35 RCTs were included. Trials examined metformin (n = 26), glucagon-like peptide-1 receptor agonists (GLP1RAs) (n = 7) and a lipase inhibitor (orlistat; n = 2). Intervention duration varied (3−24 months). Metformin had little to no benefit on PROMs (e.g., health-related quality of life [HRQoL]; 6 RCTs), moderate reductions in triglycerides, a moderate decline in insulin resistance, a small to moderate decline in BMI z-score (BMIz) and a moderate increase in mild to moderate gastrointestinal AEs. Response to GLP1RAs was heterogeneous and results of subgroup analysis demonstrated variability of impact. Liraglutide (2 RCTs) resulted in a small reduction in HOMA-IR and BMIz, but little to no benefit on other outcomes. Exenatide (4 RCTs) had a moderate reduction on blood pressure and a small decrease in BMIz with little to no benefit on other outcomes. Semaglutide (1 RCT) had a small benefit on HRQoL, a small reduction on SBP, a moderate reduction on total cholesterol and LDL-cholesterol, a large reduction on triglyceride, and a very large decline in BMIz accompanied by a small increase in mild to moderate gastrointestinal AEs. Orlistat had a moderate reduction in DBP and little to no benefit in other outcomes measured, but had a very large increased risk of mild to moderate gastrointestinal AEs. Serious AEs were rare and for interventions with sufficent AE reporting, were considered not likely attributable to the interventions.
Conclusion
Few studies examined the impact of pharmacotherapy on PROMs. There is evidence that metformin and GLP1RAs lead to important improvements in cardiometabolic and anthropometric outcomes while accompanied by mild to moderate AEs. Long-term effectiveness and safety of GLP1RAs remain to be evaluated.
{"title":"Effectiveness of pharmacological 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","authors":"Gita Wahi, Julie St-Pierre, Bradley C. Johnston, Donna Fitzpatrick-Lewis, Ali Usman, Diana Sherifali, Roah Merdad, Zahra Esmaeilinezhad, Catherine S. Birken, Jill Hamilton, Mélanie Henderson, Sarah A. Moore, Geoff D. C. Ball, Katherine M. Morrison, the Steering Committee for Updating Canada's Clinical Practice Guideline for Managing Pediatric Obesity","doi":"10.1111/ijpo.13169","DOIUrl":"10.1111/ijpo.13169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To summarize the literature on pharmacotherapy for managing paediatric obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were conducted of randomized controlled trials (RCTs) with <18-year-olds of pharmacotherapeutic agents published up to November 2022. Estimates of effect for outcomes were presented relative to minimal important differences and GRADE certainty of evidence. We examined data on patient/proxy-reported outcome measures (PROMs), cardiometabolic risk factors, anthropometry and adverse events (AEs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 35 RCTs were included. Trials examined metformin (<i>n</i> = 26), glucagon-like peptide-1 receptor agonists (GLP1RAs) (<i>n</i> = 7) and a lipase inhibitor (orlistat; <i>n</i> = 2). Intervention duration varied (3−24 months). Metformin had little to no benefit on PROMs (e.g., health-related quality of life [HRQoL]; 6 RCTs), moderate reductions in triglycerides, a moderate decline in insulin resistance, a small to moderate decline in BMI z-score (BMIz) and a moderate increase in mild to moderate gastrointestinal AEs. Response to GLP1RAs was heterogeneous and results of subgroup analysis demonstrated variability of impact. Liraglutide (2 RCTs) resulted in a small reduction in HOMA-IR and BMIz, but little to no benefit on other outcomes. Exenatide (4 RCTs) had a moderate reduction on blood pressure and a small decrease in BMIz with little to no benefit on other outcomes. Semaglutide (1 RCT) had a small benefit on HRQoL, a small reduction on SBP, a moderate reduction on total cholesterol and LDL-cholesterol, a large reduction on triglyceride, and a very large decline in BMIz accompanied by a small increase in mild to moderate gastrointestinal AEs. Orlistat had a moderate reduction in DBP and little to no benefit in other outcomes measured, but had a very large increased risk of mild to moderate gastrointestinal AEs. Serious AEs were rare and for interventions with sufficent AE reporting, were considered not likely attributable to the interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Few studies examined the impact of pharmacotherapy on PROMs. There is evidence that metformin and GLP1RAs lead to important improvements in cardiometabolic and anthropometric outcomes while accompanied by mild to moderate AEs. Long-term effectiveness and safety of GLP1RAs remain to be evaluated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"19 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.13169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138820","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}
Sumudu N. Seneviratne, Sanathanee Sachchithananthan, Pavithra S. Angulugaha Gamage, Renuka Peiris, Vithanage P. Wickramasinghe, Noel Somasundaram
Objective
Assess longer-term changes in food habits and anthropometry among Grades 1–2 primary school students from four public schools in Colombo, Sri Lanka, following a 3-week programme including a classroom-based motivational storybook discussion and self-monitoring food diary (FD).
Methods
This follow-up study assessed changes from baseline (pre-intervention) BMI z-scores and food habits (increased healthy food-item consumption/decreased unhealthy food-item consumption reflected by an increase in FD score) and parental perceptions (anonymous questionnaires) among 863 students (aged 6–8 years), between 9 and 12 months after completing the programme (November 2019–February 2020).
Results
Food habits showed sustained improvement from baseline mean FD score (baseline vs. follow-up: 51 ± 23% vs. 67 ± 22%, p < 0.001), with children from all BMI subgroups (underweight [UW], normal weight [NW], overweight [OW] and obesity [OB]) showing a significant increase in FD scores (ranging from 14.1% to 17.2%, p < 0.001). BMI z-scores increased in children living with UW (−2.85 to −2.21, p < 0.00) and NW (−0.70 to −0.57, p < 0.001), but did not change in children with OW (+1.5 to +1.49, p = 0.83) and OB (+2.85 to +2.21, p = 0.19). Most parents (n = 497, 97.8%) reported satisfaction with programme outcomes.
Conclusion
This programme led to sustained improvement in food habits among young primary school children from all BMI categories, increase in BMI towards the median among children living with UW and NW, and stabilization of BMI in children with OW and OB, suggesting it as a useful tool for improving nutritional status of young children in low- and middle-income countries (LMIC) facing the double burden of under- and overnutrition.
{"title":"Improved food habits and anthropometry among primary school children following a novel healthy eating programme","authors":"Sumudu N. Seneviratne, Sanathanee Sachchithananthan, Pavithra S. Angulugaha Gamage, Renuka Peiris, Vithanage P. Wickramasinghe, Noel Somasundaram","doi":"10.1111/ijpo.13171","DOIUrl":"10.1111/ijpo.13171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Assess longer-term changes in food habits and anthropometry among Grades 1–2 primary school students from four public schools in Colombo, Sri Lanka, following a 3-week programme including a classroom-based motivational storybook discussion and self-monitoring food diary (FD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This follow-up study assessed changes from baseline (pre-intervention) BMI <i>z</i>-scores and food habits (increased healthy food-item consumption/decreased unhealthy food-item consumption reflected by an increase in FD score) and parental perceptions (anonymous questionnaires) among 863 students (aged 6–8 years), between 9 and 12 months after completing the programme (November 2019–February 2020).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Food habits showed sustained improvement from baseline mean FD score (baseline vs. follow-up: 51 ± 23% vs. 67 ± 22%, <i>p</i> < 0.001), with children from all BMI subgroups (underweight [UW], normal weight [NW], overweight [OW] and obesity [OB]) showing a significant increase in FD scores (ranging from 14.1% to 17.2%, <i>p</i> < 0.001). BMI <i>z</i>-scores increased in children living with UW (−2.85 to −2.21, <i>p</i> < 0.00) and NW (−0.70 to −0.57, <i>p</i> < 0.001), but did not change in children with OW (+1.5 to +1.49, <i>p</i> = 0.83) and OB (+2.85 to +2.21, <i>p</i> = 0.19). Most parents (<i>n</i> = 497, 97.8%) reported satisfaction with programme outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This programme led to sustained improvement in food habits among young primary school children from all BMI categories, increase in BMI towards the median among children living with UW and NW, and stabilization of BMI in children with OW and OB, suggesting it as a useful tool for improving nutritional status of young children in low- and middle-income countries (LMIC) facing the double burden of under- and overnutrition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124382","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}
Dietary interventions and increased physical activity are the cornerstones for management of the paediatric non-alcoholic fatty liver disease (NAFLD). Though, no specific diet has been proven superior, Indo-Mediterranean diet (IMD) has shown promise in adult literature. Thus, we aimed to compare the effect of IMD and a standard calorie-restricted diet (CRD) in Indian overweight children and adolescents with biopsy-proven NAFLD.
Methods
Thirty-nine consecutive biopsy-proven NAFLD children between the ages of 8 and 18 years were randomized into either IMD or CRD for 180 days, and various parameters were evaluated at baseline and then after 180 days (NCT05073588).
Results
A total of 34 subjects (18 in IMD and 16 in CRD group) completed the study. There was a significantly higher decrease in controlled attenuation parameter (CAP) values (as a marker of hepatic steatosis; on transient elastography) (95% CI: 4.2–73.4, p = 0.042), weight (95% CI: 0.75–5.5, p = 0.046) and body mass index (BMI) (95% CI: 0.21–2.05, p = 0.014) (but not in Pediatric NAFLD Fibrosis Index or PNFI; as a marker of hepatic fibrosis) in IMD group compared to the CRD group. Liver stiffness measurement, serum cholesterol and low-density lipoprotein levels and HOMA-IR decreased only in the IMD group (p < 0.001). Our statistical model showed that delta-Weight was the only independent variable associated with delta-CAP.
Conclusion
Both IMD and CRD can improve the various anthropometric, clinical, imaging and biochemical parameters but IMD was superior to CRD in terms of reducing CAP values and weight/BMI over 180 days in overweight/obese NAFLD children.
{"title":"Effect of Indo-Mediterranean diet versus calorie-restricted diet in children with non-alcoholic fatty liver disease: A pilot randomized control trial","authors":"Aniket Deshmukh, Vikrant Sood, Bikrant Bihari Lal, Rajeev Khanna, Seema Alam, Shiv Kumar Sarin","doi":"10.1111/ijpo.13163","DOIUrl":"10.1111/ijpo.13163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dietary interventions and increased physical activity are the cornerstones for management of the paediatric non-alcoholic fatty liver disease (NAFLD). Though, no specific diet has been proven superior, Indo-Mediterranean diet (IMD) has shown promise in adult literature. Thus, we aimed to compare the effect of IMD and a standard calorie-restricted diet (CRD) in Indian overweight children and adolescents with biopsy-proven NAFLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-nine consecutive biopsy-proven NAFLD children between the ages of 8 and 18 years were randomized into either IMD or CRD for 180 days, and various parameters were evaluated at baseline and then after 180 days (NCT05073588).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 34 subjects (18 in IMD and 16 in CRD group) completed the study. There was a significantly higher decrease in controlled attenuation parameter (CAP) values (as a marker of hepatic steatosis; on transient elastography) (95% CI: 4.2–73.4, <i>p</i> = 0.042), weight (95% CI: 0.75–5.5, <i>p</i> = 0.046) and body mass index (BMI) (95% CI: 0.21–2.05, <i>p</i> = 0.014) (but not in Pediatric NAFLD Fibrosis Index or PNFI; as a marker of hepatic fibrosis) in IMD group compared to the CRD group. Liver stiffness measurement, serum cholesterol and low-density lipoprotein levels and HOMA-IR decreased only in the IMD group (<i>p</i> < 0.001). Our statistical model showed that delta-Weight was the only independent variable associated with delta-CAP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both IMD and CRD can improve the various anthropometric, clinical, imaging and biochemical parameters but IMD was superior to CRD in terms of reducing CAP values and weight/BMI over 180 days in overweight/obese NAFLD children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"19 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118572","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}
Joseph Carrello, Vicki Brown, Anagha Killedar, Alison Hayes
Background
Breastfeeding is a protective measure against childhood overweight and obesity. However, many children are not breastfed the recommended duration, with those from disadvantaged backgrounds more likely to cease breastfeeding early.
Objectives
Investigate the association between duration of any breastfeeding and body mass index (BMI) and estimate the health, economic and equity impacts of increasing breastfeeding duration to at least 6 months.
Methods
We modelled the association between any breastfeeding duration and BMI at age 6/7 years, using a nationally representative cohort of 3935 Australian children (survey weighted to 221 103 children). We then used a simulation model to predict the impact of increasing breastfeeding duration to at least 6 months in all children on prevalence of overweight (including obesity) and associated healthcare costs to age 16/17 years.
Results
Achieving breastfeeding duration of at least 6 months could prevent 2933 cases of overweight at age 16/17 years, translating to healthcare cost-savings of AUD $4.29 million. Although most cases (68%) would come from low socio-economic backgrounds this would make only a minor difference in reducing inequalities.
Conclusion
Efforts to support increased breastfeeding duration could result in reduced prevalence of overweight and obesity and save healthcare costs, however, additional action would be required to improve equity.
{"title":"The effects of duration of any breastfeeding on body mass index in Australian children: Exploration of health, economic and equity impacts","authors":"Joseph Carrello, Vicki Brown, Anagha Killedar, Alison Hayes","doi":"10.1111/ijpo.13167","DOIUrl":"10.1111/ijpo.13167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Breastfeeding is a protective measure against childhood overweight and obesity. However, many children are not breastfed the recommended duration, with those from disadvantaged backgrounds more likely to cease breastfeeding early.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Investigate the association between duration of any breastfeeding and body mass index (BMI) and estimate the health, economic and equity impacts of increasing breastfeeding duration to at least 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We modelled the association between any breastfeeding duration and BMI at age 6/7 years, using a nationally representative cohort of 3935 Australian children (survey weighted to 221 103 children). We then used a simulation model to predict the impact of increasing breastfeeding duration to at least 6 months in all children on prevalence of overweight (including obesity) and associated healthcare costs to age 16/17 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Achieving breastfeeding duration of at least 6 months could prevent 2933 cases of overweight at age 16/17 years, translating to healthcare cost-savings of AUD $4.29 million. Although most cases (68%) would come from low socio-economic backgrounds this would make only a minor difference in reducing inequalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Efforts to support increased breastfeeding duration could result in reduced prevalence of overweight and obesity and save healthcare costs, however, additional action would be required to improve equity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142102716","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}
Esther M. Leerkes, Cheryl Buehler, Laurie Wideman, Yu Chen, Lenka H. Shriver
Background
Childhood obesity remains a public health crisis and identification of unique prenatal and early infancy predictors of obesity risk are critically needed.
Objectives
We test a comprehensive biopsychosocial model of the predictors of rapid weight gain (RWG) in the first 6 months of life.
Methods
Two hundred and ninety nine pregnant women and their infants participated. Maternal prenatal psychobiological risk (PPBR) was assessed during the third trimester via maternal anthropometrics, serum biomarkers (insulin, leptin, adiponectin), and maternal report of pregnancy complications, substance use, mental health and stress. Infant stress reactivity was measured at 2 months (cortisol output, resting RSA, observed irritability, negative emotionality). At 2 and 6 months, maternal self-report of obesogenic feeding practices and observed maternal sensitivity during three tasks were collected. RWG was classified based on change in weight-for-age z scores from birth to 6 months (>0.67 SD).
Results
Obesogenic feeding practices predicted greater likelihood of RWG, β = 0.30, p = .0.01, independent of other predictors and covariates. Obesogenic feeding practices was the only proposed intervening mechanism that produced a significant indirect effect of PPBR on RWG, b = 0.05, S.E. = 0.04, 95% CI [0.002, 0.15], β = 0.06.
Conclusion
Identifying proclivity towards obesogenic feeding practices and providing support to reduce these behaviours may enhance childhood obesity prevention efforts.
{"title":"Biopsychosocial predictors of rapid weight gain from birth to 6 months","authors":"Esther M. Leerkes, Cheryl Buehler, Laurie Wideman, Yu Chen, Lenka H. Shriver","doi":"10.1111/ijpo.13170","DOIUrl":"10.1111/ijpo.13170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Childhood obesity remains a public health crisis and identification of unique prenatal and early infancy predictors of obesity risk are critically needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We test a comprehensive biopsychosocial model of the predictors of rapid weight gain (RWG) in the first 6 months of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two hundred and ninety nine pregnant women and their infants participated. Maternal prenatal psychobiological risk (PPBR) was assessed during the third trimester via maternal anthropometrics, serum biomarkers (insulin, leptin, adiponectin), and maternal report of pregnancy complications, substance use, mental health and stress. Infant stress reactivity was measured at 2 months (cortisol output, resting RSA, observed irritability, negative emotionality). At 2 and 6 months, maternal self-report of obesogenic feeding practices and observed maternal sensitivity during three tasks were collected. RWG was classified based on change in weight-for-age z scores from birth to 6 months (>0.67 SD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Obesogenic feeding practices predicted greater likelihood of RWG, <i>β</i> = 0.30, <i>p</i> = .0.01, independent of other predictors and covariates. Obesogenic feeding practices was the only proposed intervening mechanism that produced a significant indirect effect of PPBR on RWG, <i>b</i> = 0.05, S.E. = 0.04, 95% CI [0.002, 0.15], <i>β</i> = 0.06.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Identifying proclivity towards obesogenic feeding practices and providing support to reduce these behaviours may enhance childhood obesity prevention efforts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"19 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142102715","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}
Dabin Yeum, Timothy J. Renier, Travis D. Masterson, Delaina D. Carlson, Grace A. Ballarino, Reina K. Lansigan, Ruth J. F. Loos, Jennifer A. Emond, Diane Gilbert-Diamond
Objective
The objective of this study is to evaluate obesity-related genetic factors in relation to excess consumption and assess if food cues modify associations.
Methods
Children (9–12 years) completed a randomized crossover experiment. During two visits, children ate a preload and then snacks ad libitum while watching television, embedded with food or non-food advertisements to assess eating in the absence of hunger (EAH). Primary exposures were obesity-associated genotypes, FTO rs9939609 and MC4R rs571312, and a paediatric-specific polygenic risk score (PRS). Outcomes included consumption of all snacks (total EAH) and gummy candy only (gummy candy EAH). Linear mixed-effects models tested whether genetic exposures related to EAH outcomes. We tested for effect modification by food cues using multiplicative interaction terms.
Results
Among 177 children, each FTO risk allele was associated with a 30% increase in gummy candy EAH (p = 0.025) in adjusted models. Food cue exposure exacerbated associations between the FTO variant with gummy candy EAH (p = 0.046). No statistically significant associations were found between MC4R and EAH.
Conclusion
The results suggest children with the FTO rs9939609 risk allele may be predisposed to excess consumption of candy and that this association may be exacerbated by food cues.
{"title":"Genetic associations with consumption of palatable foods in the absence of hunger in response to food cues in children","authors":"Dabin Yeum, Timothy J. Renier, Travis D. Masterson, Delaina D. Carlson, Grace A. Ballarino, Reina K. Lansigan, Ruth J. F. Loos, Jennifer A. Emond, Diane Gilbert-Diamond","doi":"10.1111/ijpo.13168","DOIUrl":"10.1111/ijpo.13168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to evaluate obesity-related genetic factors in relation to excess consumption and assess if food cues modify associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children (9–12 years) completed a randomized crossover experiment. During two visits, children ate a preload and then snacks ad libitum while watching television, embedded with food or non-food advertisements to assess eating in the absence of hunger (EAH). Primary exposures were obesity-associated genotypes, <i>FTO</i> rs9939609 and <i>MC4R</i> rs571312, and a paediatric-specific polygenic risk score (PRS). Outcomes included consumption of all snacks (total EAH) and gummy candy only (gummy candy EAH). Linear mixed-effects models tested whether genetic exposures related to EAH outcomes. We tested for effect modification by food cues using multiplicative interaction terms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 177 children, each <i>FTO</i> risk allele was associated with a 30% increase in gummy candy EAH (<i>p</i> = 0.025) in adjusted models. Food cue exposure exacerbated associations between the <i>FTO</i> variant with gummy candy EAH (<i>p</i> = 0.046). No statistically significant associations were found between <i>MC4R</i> and EAH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results suggest children with the <i>FTO</i> rs9939609 risk allele may be predisposed to excess consumption of candy and that this association may be exacerbated by food cues.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091254","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}
Ana Gabriela Chávez-Vázquez, Miguel Klünder-Klünder, Desiree Lopez-Gonzalez, Jenny Vilchis-Gil, América Liliana Miranda-Lora
Background
Evidence shows that overweight and obesity are associated with advanced bone age (BA).
Objective
To analyse the effect of adiposity on BA among Mexican children.
Methods
This cross-sectional study included 902 children (5–18 years old). Anthropometric measurements, dual-energy X-ray absorptiometry (DXA) and automated hand X-ray-based BA measurements were obtained. BA curves of children stratified by sex and age were created based on nutritional status. We also calculated odds ratios for advanced BA associated with the body mass index (BMI), waist/height ratio and adiposity estimated using DXA (total and truncal fat mass).
Results
Participants with overweight/obesity by BMI (SDS ≥1) advanced earlier in BA than did normal weight participants (6.0 vs. 12.0 years in boys and 6.0 vs. 10.3 in girls, p < 0.01); similarly, participants with a greater body fat percentage (SDS ≥1) exhibited earlier advanced BA (7.5 vs. 10.0 years in boys and 6.0 vs. 9.6 in girls, p < 0.01). Differences were also observed according to the waist/height ratio and truncal fat. Children with a BMI or DXA SDS ≥1 had greater odds of presenting an advanced BA of more than 1 year (OR 1.79–3.55, p < 0.05).
Conclusions
Increased adiposity in children, mainly in boys, is associated with advanced BA at earlier ages.
背景：有证据表明，超重和肥胖与骨龄（BA）增大有关：有证据表明，超重和肥胖与骨龄（BA）提前有关：分析肥胖对墨西哥儿童骨龄的影响：这项横断面研究包括 902 名儿童（5-18 岁）。方法：这项横断面研究纳入了 902 名儿童（5-18 岁），对他们进行了人体测量、双能量 X 射线吸收测量（DXA）和基于手部 X 射线的自动 BA 测量。根据营养状况绘制了按性别和年龄分层的儿童 BA 曲线。我们还计算了晚期 BA 与体重指数 (BMI)、腰围/身高比和 DXA 估计的脂肪含量（总脂肪量和躯干脂肪量）相关的几率比：结果：体重指数（BMI）超重/肥胖（SDS ≥1）的参与者比体重正常的参与者更早进入 BA 阶段（男孩为 6.0 岁对 12.0 岁，女孩为 6.0 岁对 10.3 岁，P儿童（主要是男孩）脂肪含量的增加与 BA 早熟有关。
{"title":"Association between bone age maturity and childhood adiposity","authors":"Ana Gabriela Chávez-Vázquez, Miguel Klünder-Klünder, Desiree Lopez-Gonzalez, Jenny Vilchis-Gil, América Liliana Miranda-Lora","doi":"10.1111/ijpo.13166","DOIUrl":"10.1111/ijpo.13166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evidence shows that overweight and obesity are associated with advanced bone age (BA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To analyse the effect of adiposity on BA among Mexican children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study included 902 children (5–18 years old). Anthropometric measurements, dual-energy X-ray absorptiometry (DXA) and automated hand X-ray-based BA measurements were obtained. BA curves of children stratified by sex and age were created based on nutritional status. We also calculated odds ratios for advanced BA associated with the body mass index (BMI), waist/height ratio and adiposity estimated using DXA (total and truncal fat mass).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants with overweight/obesity by BMI (SDS ≥1) advanced earlier in BA than did normal weight participants (6.0 vs. 12.0 years in boys and 6.0 vs. 10.3 in girls, <i>p</i> < 0.01); similarly, participants with a greater body fat percentage (SDS ≥1) exhibited earlier advanced BA (7.5 vs. 10.0 years in boys and 6.0 vs. 9.6 in girls, <i>p</i> < 0.01). Differences were also observed according to the waist/height ratio and truncal fat. Children with a BMI or DXA SDS ≥1 had greater odds of presenting an advanced BA of more than 1 year (OR 1.79–3.55, <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Increased adiposity in children, mainly in boys, is associated with advanced BA at earlier ages.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"19 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071614","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}
Jomanah A. Bakhsh, My H. Vu, Sarah Jeanne Salvy, Michael I. Goran, Alaina P. Vidmar
Background
The precise mechanisms underlying the health benefits of time-restricted eating (TRE) are unclear, particularly in adolescents.
Objectives
This secondary analysis examines the impact of 8-h TRE on energy intake, dietary composition and quality in adolescents with obesity, using data from a 12-week randomized, controlled pilot trial.
Methods
Participants (14–18 years with BMI >95th percentile) were assigned to either 8-h TRE with real-time or blinded continuous glucose monitoring or a control group with a 12+ h eating window. Dietary intake was analysed using the Nutrient Data System Recall 24-h Dietary Recall and the Healthy Eating Index (HEI-2020) for assessing diet quality.
Results
The study included 44 participants (32 TRE, 12 control), predominantly female and Hispanic/Latino. The TRE group showed a significant reduction in mean energy intake (−441 kcal/day), carbohydrates (−65 g/day), added sugar (−19 g/day) and fat (−19 g/day), while the control group had a similar reduction in energy intake (−437 kcal/day) and carbohydrates (−63 g/day), but no significant changes in added sugar or fat. The percent energy intake from protein increased more in the TRE group compared to the control. The TRE group experienced a significant improvement in diet quality, with a 6.3-point increase in HEI-2020 score; however, between-group comparisons were not statistically significant.
Conclusion
There were no significant differences between the TRE and control groups in energy intake, dietary composition or quality. Future research with larger sample sizes is needed to further evaluate the potential impact of TRE on dietary behaviours.
{"title":"Effects of 8-h time-restricted eating on energy intake, dietary composition and quality in adolescents with obesity","authors":"Jomanah A. Bakhsh, My H. Vu, Sarah Jeanne Salvy, Michael I. Goran, Alaina P. Vidmar","doi":"10.1111/ijpo.13165","DOIUrl":"10.1111/ijpo.13165","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The precise mechanisms underlying the health benefits of time-restricted eating (TRE) are unclear, particularly in adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This secondary analysis examines the impact of 8-h TRE on energy intake, dietary composition and quality in adolescents with obesity, using data from a 12-week randomized, controlled pilot trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (14–18 years with BMI >95th percentile) were assigned to either 8-h TRE with real-time or blinded continuous glucose monitoring or a control group with a 12+ h eating window. Dietary intake was analysed using the Nutrient Data System Recall 24-h Dietary Recall and the Healthy Eating Index (HEI-2020) for assessing diet quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 44 participants (32 TRE, 12 control), predominantly female and Hispanic/Latino. The TRE group showed a significant reduction in mean energy intake (−441 kcal/day), carbohydrates (−65 g/day), added sugar (−19 g/day) and fat (−19 g/day), while the control group had a similar reduction in energy intake (−437 kcal/day) and carbohydrates (−63 g/day), but no significant changes in added sugar or fat. The percent energy intake from protein increased more in the TRE group compared to the control. The TRE group experienced a significant improvement in diet quality, with a 6.3-point increase in HEI-2020 score; however, between-group comparisons were not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There were no significant differences between the TRE and control groups in energy intake, dietary composition or quality. Future research with larger sample sizes is needed to further evaluate the potential impact of TRE on dietary behaviours.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"19 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071626","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}
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