Pediatric Obesity最新文献_第8页

Projected impact of anti-obesity pharmacotherapy use on racial and ethnic disparities in adolescent obesity 抗肥胖药物疗法的使用对青少年肥胖症种族和民族差异的影响预测。

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-02-06 DOI: 10.1111/ijpo.13103

Mary Ellen Vajravelu, Patricia Y. Chu, David A. Frank, Maya I. Ragavan, Ravy K. Vajravelu

Background

Paediatric obesity disproportionately impacts individuals from minoritized racial and ethnic backgrounds. Recent guidelines support use of anti-obesity pharmacotherapy for adolescents with obesity, but the potential impact on disparities in obesity prevalence has not been evaluated.

Objectives

To model changes in obesity prevalence with increasing utilization of anti-obesity pharmacotherapy among adolescents.

Methods

Data representative of American adolescents ages 12–17 years were obtained from the National Health and Nutrition Examination Survey, cycles 2011 through pre-pandemic 2020. A body mass index (BMI) reduction of 16.7% was applied to each participant based on clinical trial results of weekly subcutaneous semaglutide 2.4 mg among adolescents. Utilization disparities were based on utilization of the same medication class among adults. Obesity prevalence was calculated assuming utilization of 10%–100%, stratified by race and ethnicity.

Results

Among 4442 adolescents representing 26 247 384 American adolescents, projected overall obesity prevalence decreased from 22.2% to 8.4% with 100% utilization. However, disparities increased relative to Non-Hispanic White youth, with prevalence among Non-Hispanic Black and Mexican American youth ranging from 40%–60% higher to 90%–120% higher, respectively.

Conclusions

Increasing utilization of anti-obesity pharmacotherapy may widen relative disparities in obesity, particularly if utilization is unequal. Advocacy for equitable access is needed to minimize worsening of obesity-related disparities.

背景：儿科肥胖症对少数种族和民族背景的人造成了极大的影响。最近的指南支持对患有肥胖症的青少年使用抗肥胖药物治疗，但尚未评估其对肥胖患病率差异的潜在影响：目的：模拟随着青少年使用抗肥胖药物疗法的增加，肥胖患病率的变化情况：方法：从美国国家健康与营养调查（National Health and Nutrition Examination Survey）中获得了 2011 年至 2020 年大流行前的 12-17 岁美国青少年的代表性数据。根据青少年每周皮下注射 2.4 毫克塞马鲁肽的临床试验结果，将每位参与者的体重指数（BMI）降低 16.7%。用药差异是根据成人使用同类药物的情况计算得出的。假设使用率为 10%-100%，按种族和民族分层计算肥胖患病率：在代表 26 247 384 名美国青少年的 4442 名青少年中，预计总体肥胖率从 22.2% 降至 8.4%，使用率为 100%。然而，与非西班牙裔白人青少年相比，差距有所扩大，非西班牙裔黑人和墨西哥裔美国青少年的患病率分别高出 40%-60% 到 90%-120% 不等：增加抗肥胖药物疗法的使用可能会扩大肥胖的相对差异，尤其是在使用不平等的情况下。需要倡导公平使用，以尽量减少肥胖相关差异的恶化。

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引用次数: 0

Performance of mid-upper arm circumference to identify adolescents with obesity and metabolic syndrome: NHANES 2011–2018 analysis 中上臂围识别肥胖和代谢综合征青少年的性能：NHANES 2011-2018 分析。

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-02-06 DOI: 10.1111/ijpo.13107

Beshada Rago Jima, Binyam Girma Sisay, Ilili Feyesa, Hamid Yimam Hassen

Background

Mid-upper arm circumference (MUAC) was recommended for screening of adolescents with obesity, although its diagnostic performance with respect to high-precision assessment of body composition remains unknown.

Objective

To evaluate the diagnostic performance of MUAC in identifying obesity and metabolic syndrome in U.S. adolescents.

Methods

A cross-sectional study was conducted using National Health and Nutrition Examination Survey (NHANES) data (2011–2018) of adolescents aged 12–19. We calculated the area under the receiver operating characteristic curve, sensitivity, specificity, positive and negative predictive values and likelihood ratios of MUAC in identifying obesity and metabolic syndrome.

Results

In our study, data of 5496 adolescents, including 2665 females, were analysed. The prevalence of obesity was higher in boys (14%) than girls (10%), whilst metabolic syndrome was more common in males (2.6%) than females (1.7%). The area under the curve (AUC) of MUAC in identifying obesity was 0.69 in boys and 0.86 in girls, whilst the AUC of MUAC in identifying metabolic syndrome was 0.91 in boys and 0.87 in girls. The optimal MUAC cut-off for identifying adolescents with obesity was 28.3 cm in boys (sensitivity: 64.8%, specificity: 85.5%) and 30.8 cm in girls (sensitivity: 67.9%, specificity: 90.1%).

Conclusions

MUAC was a good indicator of both obesity and metabolic syndrome, with higher accuracy in girls.

背景：中上臂围（MUAC）被推荐用于青少年肥胖症筛查，但其在高精度评估身体成分方面的诊断性能仍然未知：评估 MUAC 在识别美国青少年肥胖和代谢综合征方面的诊断性能：我们利用美国国家健康与营养调查（NHANES）数据（2011-2018 年）对 12-19 岁的青少年进行了一项横断面研究。我们计算了 MUAC 在识别肥胖和代谢综合征方面的接收器操作特征曲线下面积、灵敏度、特异性、阳性和阴性预测值以及似然比：我们的研究分析了 5496 名青少年的数据，其中包括 2665 名女性。肥胖症在男生中的发病率（14%）高于女生（10%），而代谢综合征在男生中的发病率（2.6%）高于女生（1.7%）。在识别肥胖症方面，MUAC 的曲线下面积（AUC）在男孩中为 0.69，在女孩中为 0.86，而在识别代谢综合征方面，MUAC 的曲线下面积（AUC）在男孩中为 0.91，在女孩中为 0.87。识别肥胖青少年的最佳 MUAC 临界值为：男孩 28.3 厘米（灵敏度：64.8%，特异性：85.5%），女孩 30.8 厘米（灵敏度：67.9%，特异性：90.1%）：MUAC是肥胖和代谢综合征的良好指标，女孩的准确性更高。

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引用次数: 0

Variation in ultra-processed food consumption from 6 to 15 years, body weight and body composition at 15 years of age at The Pelotas 2004 Birth Cohort 佩洛塔斯 2004 年出生队列中 6 至 15 岁超加工食品消费量的变化、15 岁时的体重和身体组成

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-01-31 DOI: 10.1111/ijpo.13104

Iná S. Santos, Isabel O. Bierhals, Caroline S. Costa, Alicia Matijasevich, Luciana Tovo-Rodrigues

Background

The association of ultra-processed food (UPF) consumption with obesity and adipose tissue in children/adolescents remains poorly understood.

Objective

To assess the association of UPF consumption with excessive weight (EW—defined as BMI-for-age ≥+1 z-score) and body composition at 15 years.

Methods

In a birth cohort, daily UPF consumption was estimated by Food Frequency Questionnaires at 6 and 15 years. Those in the higher tercile of UPF consumption at both follow-ups were the ‘always-high consumers’. Air-displacement plethysmography provided fat mass (FM-kg), fat-free mass (FFM-kg), %FM, %FFM, FM index (FMI-kg/m²) and FFM index (FFMI-kg/m²). Logistic regression and linear regression were used to estimate, respectively, odds ratios and beta coefficients.

Results

Amongst 1584 participants, almost one in every seven were always-high consumers. In crude analyses, there was no association between variation in UPF consumption and EW, and body fat parameters were lower in the always-high consumer group than amongst the always-low consumers, in both sexes. With adjustment for confounders, the odds ratio for EW was higher in the always-high consumer than amongst the always-low consumer group, and the direction of the associations with FM parameters was reversed: males from the always-high consumer group presented almost twice as high FM (10.5 vs. 18.6 kg; p < 0.001) and twice as high FMI (3.4 vs. 6.3 kg/m²; p < 0.001) than the always-low consumer group, and females from the always-high consumer group presented on average 32% more FM and FMI than the always-low consumer group.

Conclusions

In crude and adjusted analyses there was a strong association between high UPF consumption from childhood to adolescence, EW and higher body fat parameters at 15 years, but its deleterious association with body adiposity was only uncovered after adjusting for confounders.

人们对儿童/青少年食用超加工食品（UPF）与肥胖和脂肪组织之间的关系仍然知之甚少。

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引用次数: 0

Diabetes screening outcomes in youth presenting for paediatric weight management: A report of the Paediatric Obesity Weight Evaluation Registry 接受儿科体重管理的青少年的糖尿病筛查结果：儿科肥胖症体重评估登记处报告

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-01-31 DOI: 10.1111/ijpo.13102

Seema Kumar, Eileen King, Helen J. Binns, Amy Christison, Suzanne E. Cuda, Jennifer K. Yee, Madeline Joseph, Shelley Kirk

Objective

Rising prevalence of obesity has led to increased rates of prediabetes and diabetes mellitus (DM) in children. This study compares rates of prediabetes and diabetes using two recommended screening tests (fasting plasma glucose [FPG] and haemoglobin A1c [HbA1c]).

Study Design

Data were collected prospectively from 37 multi-component paediatric weight management programs in POWER (Paediatric Obesity Weight Evaluation Registry).

Results

For this study, 3962 children with obesity without a known diagnosis of DM at presentation and for whom concurrent measurement of FPG and HbA1c were available were evaluated (median age 12.0 years [interquartile range, IQR 9.8, 14.6]; 48% males; median body mass index 95th percentile [%BMIp95] 134% [IQR 120, 151]). Notably, 10.7% had prediabetes based on FPG criteria (100–125 mg/dL), 18.6% had prediabetes based on HbA1c criteria (5.7%–6.4%), 0.9% had DM by FPG abnormality (≥126 mg/dL) and 1.1% had DM by HbA1c abnormality (≥6.5%). Discordance between the tests was observed for youth in both age groups (10–18 years [n = 2915] and age 2–9 years [n = 1047]).

Conclusion

There is discordance between FPG and HbA1c for the diagnosis of prediabetes and DM in youth with obesity. Further studies are needed to understand the predictive capability of these tests for development of DM (in those diagnosed with prediabetes) and cardiometabolic risk.

肥胖症发病率的上升导致了儿童糖尿病前期和糖尿病（DM）发病率的上升。本研究使用两种推荐的筛查测试（空腹血浆葡萄糖 [FPG] 和血红蛋白 A1c [HbA1c]）对糖尿病前期和糖尿病的发病率进行了比较。

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引用次数: 0

Appetitive and psychological phenotypes of pediatric patients with obesity 儿科肥胖症患者的食欲和心理表型。

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-01-30 DOI: 10.1111/ijpo.13101

Claudia K. Fox, Stephen J. Molitor, David M. Vock, Carol B. Peterson, Scott J. Crow, Amy C. Gross

Background

Obesity is a heterogeneous disease with variable treatment response. Identification of the unique constellation of contributors to obesity may allow for targeted interventions and improved outcomes.

Objective

Identify empirically derived phenotypes of pediatric patients with obesity based on appetitive and psychological correlates of obesity.

Methods

This cross-sectional study included patients aged 5–12 years who were treated in a weight management clinic and completed standard intake questionnaires including Child Eating Behavior Questionnaire (CEBQ), Vanderbilt ADHD Scale and Pediatric Symptom Checklist. Phenotypes were elicited using latent profile analysis of 12 indicators: eight CEBQ subscales, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms.

Results

Parents/guardians of 384 patients (mean age 9.8 years, mean BMI 30.3 kg/m²) completed the intake questionnaires. A 4-phenotype model best fits the data. Hedonic Impulsive phenotype (42.5%) exhibited high food enjoyment and hyperactivity/impulsivity. Inattentive Impulsive phenotype (27.4%) exhibited overall low food approach and high food avoid behaviours, and highest inattention. Hedonic Emotional phenotype (20.8%) scored the highest on food enjoyment, internalizing and externalizing symptoms. Picky Eating phenotype (9.3%) scored the lowest on food approach, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms.

Conclusion

Appetitive traits and psychological symptoms appear to cluster in distinct patterns, giving rise to four unique phenotypic profiles, which, if replicated, may help inform the development of tailored treatment plans.

背景：肥胖症是一种异质性疾病，对治疗的反应各不相同。确定导致肥胖的独特因素可能有助于采取有针对性的干预措施并改善治疗效果：根据肥胖的食欲和心理相关因素，确定儿科肥胖症患者的经验表型：这项横断面研究纳入了在体重管理诊所接受治疗的 5-12 岁患者，他们填写了标准的入院问卷，包括儿童进食行为问卷 (CEBQ)、范德比尔特多动症量表和儿科症状检查表。通过对12个指标（CEBQ的8个分量表、注意力不集中、多动/冲动、内化症状和外化症状）进行潜在特征分析，得出表型：384名患者（平均年龄9.8岁，平均体重指数30.3 kg/m2）的家长/监护人填写了入组问卷。4种表型模型最符合数据。享乐型冲动表型（42.5%）表现出高度的食物享受和多动/冲动。注意力不集中冲动型表型（27.4%）总体表现为低食物接近行为和高食物回避行为，注意力最不集中。享乐情绪表型（20.8%）在享受食物、内化和外化症状方面得分最高。挑食表型（9.3%）在进食、注意力不集中、多动/冲动、内化和外化症状方面得分最低：结论：食欲特征和心理症状似乎以不同的模式聚集在一起，形成了四种独特的表型特征。

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引用次数: 0

South-to-South parental migration patterns and excess weight among children: Insights from a national cross-sectional study in Colombia 父母南移模式与儿童超重：哥伦比亚全国横断面研究的启示。

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-01-29 DOI: 10.1111/ijpo.13099

Carlos Devia, Karen Flórez, Sergio A. Costa, Terry T.-K. Huang

Background

Evidence from Latin America suggests that children embedded in South-to-North migrant networks (i.e. relatives who live abroad, typically in the United States) are at increased risk of excess weight. It is unclear if the same findings apply to children embedded in Latin American intraregional migration or South-to-South migration networks.

Objective

To compare excess weight among Colombian children embedded in South-to-South migration networks (n = 334) to children with non-migrant parents (n = 4272) using Colombia's 2015 National Survey of the Nutritional Situation.

Methods

Prevalence ratios (PRs) for excess weight (BMI z-score ≥1) by parent migration history were estimated using weighted multivariable logistic regression adjusting for demographics, child behaviours, community and household indicators, including household food insecurity.

Results

Most migrant parents returned to Colombia from Venezuela (84%) and reported higher household food insecurity rates than non-migrant parents (59% versus 32%). Models excluding household food insecurity showed that excess weight among children with migrant parents was 51% lower (PR = 0.49; 95% CI 0.25, 0.98) than among children with non-migrant parents. After adjustment for household food insecurity, no statistically significant differences were found.

Conclusion

Colombian children with return migrant parents from Venezuela experienced less excess weight than children with non-migrant parents, but higher rates of food insecurity in migrant households might partially explain this difference. This study calls attention to two serious public health concerns for Colombian children—those who have excess weight and those who lack sufficient food, particularly among migrant returnees (a situation that may have worsened since the COVID-19 pandemic).

背景：来自拉丁美洲的证据表明，生活在南来北往移民网络中的儿童（即生活在国外，通常是美国的亲戚）体重超标的风险较高。目前尚不清楚这些研究结果是否也适用于拉丁美洲区域内移民或南南移徙网络中的儿童：利用哥伦比亚2015年全国营养状况调查（National Survey of the Nutritional Situation），比较南南移徙网络中的哥伦比亚儿童（n = 334）与父母均非移民的儿童（n = 4272）的超重情况：采用加权多变量逻辑回归估算了父母移民史导致超重（BMI z-score≥1）的流行率（PRs），并对人口统计学、儿童行为、社区和家庭指标（包括家庭粮食不安全）进行了调整：大多数移民父母从委内瑞拉返回哥伦比亚（84%），他们报告的家庭粮食不安全率高于非移民父母（59% 对 32%）。排除家庭粮食不安全因素的模型显示，父母为移民的儿童的超重率比父母为非移民的儿童低 51%（PR = 0.49；95% CI 0.25，0.98）。在对家庭粮食不安全因素进行调整后，没有发现统计学上的显著差异：结论：父母从委内瑞拉回国的哥伦比亚儿童的超重情况少于父母不是移民的儿童，但移民家庭的粮食不安全率较高可能是造成这种差异的部分原因。这项研究呼吁人们关注哥伦比亚儿童的两个严重的公共卫生问题--体重超标和缺乏足够食物，尤其是在移民回国者中（自 COVID-19 大流行以来，这种情况可能有所恶化）。

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引用次数: 0

Cost-effectiveness analysis of individual-level obesity treatment in paediatrics: A scoping review 儿科个人肥胖症治疗的成本效益分析：范围综述。

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-01-29 DOI: 10.1111/ijpo.13100

Ashwin Dhillon, Madeline Mayer, Lynn Kysh, D. Steven Fox, Elizabeth Hegedus, Alaina P. Vidmar

Objectives

This scoping review informs a health economics perspective on the treatment of paediatric obesity. The results detail recently published research findings on the cost-effectiveness of paediatric obesity treatments and identify key characteristics of cost-effective interventions.

Methods

A structured search was applied to six databases with no data restriction through March 2023: Medline, Embase, Cochrane CENTRAL, CINAHL, and PsycINFO. Studies that included a cost analysis of an individual level, weight management intervention (behavioural, pharmacotherapy, and surgical) in youth, with obesity, ages 2 to 21 years were eligible for inclusion.

Results

Of the 4371 records identified in the initial search, 353 underwent full-text review, 39 studies met the pre-specified inclusion criteria. The majority were published after 2010 (n = 36/39, 92%) and applied to high-income countries (n = 39/39, 100%). Thirty-five of the studies assessed the cost-effectiveness of lifestyle interventions (90%), and four studies assessed surgical outcomes (10%). No pharmacotherapy studies met eligibility criteria. Although the outcome measures differed across the studies, all four surgical interventions were reported to be cost-effective. Thirty of the 35 (85%) lifestyle modification studies were reported to be cost-effective compared to the study comparator examined.

Conclusions

There is a small amount of evidence that individual-level paediatric obesity treatment interventions are cost-effective and, in some cases cost-saving, with most of this work conducted on behavioural interventions. The economic evaluation of paediatric obesity interventions poses various methodologic challenges, which should be addressed in future research to fully use the potential of economic evaluation as an aid to decision-making.

目的：本范围界定综述从卫生经济学的角度探讨了儿科肥胖症的治疗问题。研究结果详细介绍了近期发表的有关儿科肥胖症治疗成本效益的研究成果，并确定了具有成本效益的干预措施的主要特征：方法：在 2023 年 3 月之前，对六个无数据限制的数据库进行了结构化检索：Medline、Embase、Cochrane CENTRAL、CINAHL 和 PsycINFO。凡是对 2 至 21 岁青少年肥胖症患者的体重管理干预措施（行为疗法、药物疗法和手术疗法）进行成本分析的研究均符合纳入条件：在初步搜索出的 4371 条记录中，有 353 条进行了全文审阅，39 项研究符合预先规定的纳入标准。大部分研究发表于 2010 年之后（n = 36/39，92%），适用于高收入国家（n = 39/39，100%）。其中 35 项研究评估了生活方式干预的成本效益（90%），4 项研究评估了手术效果（10%）。没有符合资格标准的药物疗法研究。尽管各项研究的结果衡量标准有所不同，但所有四项手术干预措施均被报告为具有成本效益。据报道，在 35 项生活方式调整研究中，有 30 项（85%）与所审查的比较研究相比具有成本效益：有少量证据表明，个人层面的儿科肥胖症治疗干预措施具有成本效益，在某些情况下还能节省成本，其中大部分工作是针对行为干预措施开展的。对儿科肥胖症干预措施进行经济评估在方法上存在各种挑战，在未来的研究中应解决这些挑战，以充分利用经济评估的潜力作为决策的辅助工具。

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引用次数: 0

The metabolic load-capacity model and cardiometabolic health in children and youth with obesity 肥胖儿童和青少年的代谢负荷能力模型与心脏代谢健康。

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-01-23 DOI: 10.1111/ijpo.13098

Camila E. Orsso, Flavio T. Vieira, Nandini Basuray, Reena L. Duke, Mohammadreza Pakseresht, Daniela A. Rubin, Faria Ajamian, Geoff D. C. Ball, Catherine J. Field, Steven B. Heymsfield, Mario Siervo, Carla M. Prado, Andrea M. Haqq

Background

The metabolic load-capacity index (LCI), which represents the ratio of adipose to skeletal muscle tissue-containing compartments, is potentially associated with cardiometabolic diseases.

Objectives

To examine the associations between the LCI and cardiometabolic risk factors in children and youth with obesity.

Methods

This is a cross-sectional study including 10–18 years-old participants with a BMI of ≥95^th. LCI by air-displacement plethysmography (ADP) was calculated as fat mass divided by fat-free mass, and LCI by ultrasound (US) as subcutaneous adipose tissue divided by skeletal muscle thickness. Sex-specific medians stratified participants into high versus low LCI. Single (inflammation, insulin resistance, dyslipidemia and hypertension) and clustered cardiometabolic risk factors were evaluated. Linear and logistic regression models tested the associations between these variables, adjusted for sexual maturation.

Results

Thirty-nine participants (43.6% males; 59% mid-late puberty) aged 12.5 (IQR: 11.1–13.5) years were included. LCI by ADP was positively associated with markers of inflammation and dyslipidemia; having a higher LCI predicted dyslipidemia in logistic regression. Similarly, LCI by US was positively associated with markers of dyslipidemia and blood pressure. In mid-late pubertal participants, LCI by US was positively associated with markers of insulin resistance and inflammation.

Conclusions

Participants with unfavourable cardiometabolic profile had higher LCI, suggesting its potential use for predicting and monitoring cardiometabolic health in clinical settings.

背景：代谢负荷能力指数（LCI）代表了脂肪与骨骼肌组织的比率，可能与心脏代谢疾病有关：代谢负荷能力指数（LCI）代表了脂肪组织与骨骼肌组织的比率，可能与心脏代谢疾病有关：研究肥胖儿童和青少年的负荷能力指数与心脏代谢风险因素之间的关系：这是一项横断面研究，研究对象包括体重指数≥95th的10-18岁儿童和青少年。通过空气位移胸压计（ADP）计算的低密度脂蛋白胆固醇指数为脂肪量除以无脂肪量，通过超声波（US）计算的低密度脂蛋白胆固醇指数为皮下脂肪组织除以骨骼肌厚度。性别特异性中位数将参与者分为高LCI和低LCI两类。对单一（炎症、胰岛素抵抗、血脂异常和高血压）和聚集的心脏代谢风险因素进行了评估。线性和逻辑回归模型检验了这些变量之间的关联，并根据性成熟程度进行了调整：39名参与者（43.6%为男性；59%为青春期中后期）的年龄为12.5（IQR：11.1-13.5）岁。ADP的LCI与炎症指标和血脂异常呈正相关；在逻辑回归中，LCI越高，血脂异常越明显。同样，US 的低密度脂蛋白胆固醇指数与血脂异常和血压指标呈正相关。在青春期中后期的参与者中，US法的LCI与胰岛素抵抗和炎症指标呈正相关：结论：心血管代谢状况不佳的参与者LCI较高，这表明LCI可用于临床预测和监测心血管代谢健康状况。

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引用次数: 0

Association between sugar-free beverage intake and childhood obesity among Chinese children and adolescents 中国儿童和青少年无糖饮料摄入量与儿童肥胖之间的关系。

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-01-08 DOI: 10.1111/ijpo.13096

Jun Zhang, Yan Li, Fan Li, Min He, Jingxi Li, Shuangxia Zhang, Wenzhi Zhao, Yuhan Tang, Yanyan Li, Jingfan Xiong, Ping Yao

Background

The relationship between sugar-free beverage (SFB) intake and childhood obesity among Chinese children is unknown.

Objectives

To describe the status of SFB consumption among children and adolescents in China and assess the association between SFB intake and different types of obesity.

Methods

The study was based on the baseline data of an ongoing cohort project named Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen (EMSNGS). Food frequency questionnaires were used to collect information on SFB consumption in 3227 students aged 9–17. Physical and clinical examinations were conducted by trained investigators and clinicians. Multivariable binary logistic regression models were performed to assess the association between SFB intake and general obesity, overweight/obesity, abdominal obesity, metabolically unhealthy overweight (MUOW)/metabolically unhealthy obesity (MUO).

Results

The median age of the participants was 13.28 years. Among the participants, 55.2% were boys, and 66.1% were adolescents. The median SFB consumption was 16.67 mL/d. After adjusting for potential confounding factors, each 100 mL increase in daily SFB intake was associated with an increased risk of overweight/obesity (OR = 1.14; 95%CI: 1.06–1.23), abdominal obesity (OR = 1.12; 95%CI: 1.03–1.23), and MUOW/MUO (OR = 1.12; 95%CI: 1.02–1.21), respectively. Stratified analyses showed that family income may have an impact on the association between SFB intake and overweight/obesity (P for interaction = 0.021) and abdominal obesity (P for interaction = 0.031).

Conclusion

SFB intake was positively associated with childhood obesity in Chinese children, particularly among individuals with high-income families.

背景：无糖饮料（SFB）摄入量与中国儿童肥胖的关系尚不清楚：无糖饮料（SFB）摄入量与中国儿童肥胖之间的关系尚不清楚：描述中国儿童和青少年的无糖饮料摄入情况，评估无糖饮料摄入量与不同类型肥胖之间的关系：方法：本研究基于正在进行的队列项目 "深圳市校本营养与生长评估监测"（EMSNGS）的基线数据。研究使用食物频率调查问卷收集了3227名9-17岁学生的食物消费量信息。体格和临床检查由经过培训的调查员和临床医生进行。通过多变量二元逻辑回归模型评估了SFB摄入量与一般肥胖、超重/肥胖、腹部肥胖、代谢性不健康超重（MUOW）/代谢性不健康肥胖（MUO）之间的关系：参与者的年龄中位数为 13.28 岁。参与者中 55.2% 为男孩，66.1% 为青少年。自来水饮用量的中位数为 16.67 毫升/天。在对潜在的混杂因素进行调整后，每天的 SFB 摄入量每增加 100 毫升，超重/肥胖（OR = 1.14；95%CI：1.06-1.23）、腹部肥胖（OR = 1.12；95%CI：1.03-1.23）和 MUOW/MUO （OR = 1.12；95%CI：1.02-1.21）的风险就分别增加。分层分析表明，家庭收入可能会影响SFB摄入量与超重/肥胖（交互作用P=0.021）和腹部肥胖（交互作用P=0.031）之间的关系：结论：SFB摄入量与中国儿童肥胖呈正相关，尤其是高收入家庭的儿童。

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引用次数: 0

Effectiveness of a paediatric weight management intervention for rural youth (iAmHealthy): Primary outcomes of a cluster randomised control trial 针对农村青少年的儿科体重管理干预措施（iAmHealthy）的有效性：分组随机对照试验的主要结果。

IF 3.8 3区医学 Q1 PEDIATRICS

Pediatric Obesity

Pub Date : 2024-01-03 DOI: 10.1111/ijpo.13094

Ann Davis, Brittany Lancaster, Kandace Fleming, Rebecca Swinburne Romine, Bethany Forseth, Eve-Lynn Nelson, Meredith Dreyer Gillette, Myles Faith, Debra K. Sullivan, Kelley Pettee Gabriel, Kelsey Dean, Megan Olalde

Background

Youth in rural areas are disproportionally affected by obesity. Given the unique barriers rural populations face, tailoring and increasing access to obesity interventions is necessary.

Objective

This paper evaluates the effectiveness of iAmHealthy, a family-based paediatric obesity intervention delivered to rural children, compared to a Newsletter Control.

Methods

Participating schools (n = 18) were randomly assigned to iAmHealthy or Newsletter Control. iAmHealthy consists of individual health coaching and group sessions delivered via televideo to a participant's home. The child and parent's body mass index (BMI), child physical activity and child dietary intake were assessed at baseline, post-treatment (8 months) and follow-up (20 months). Multilevel modeling estimated the effect of treatment at both time points.

Results

Parent and child dyads were recruited (n = 148) and randomised to iAmHealthy (n = 64) or the Control group (n = 84). The Control group had significant increases in child BMIz from baseline to follow-up. iAmHealthy youth had no significant changes in BMIz from baseline to post or follow-up. Child dietary intake, physical activity and parent BMI results are also discussed.

Conclusions

This trial extends previous paediatric obesity work by simultaneously increasing convenience and dose of treatment. Results suggest iAmHealthy resulted in a change in BMIz trajectories and long-term health behaviour for youth.

背景：农村地区的青少年受肥胖症的影响尤为严重。鉴于农村人口面临的独特障碍，有必要量身定制并增加肥胖干预措施：本文评估了 iAmHealthy 的效果，与通讯对照组相比，iAmHealthy 是一种以家庭为基础、针对农村儿童的儿科肥胖症干预措施：iAmHealthy包括个人健康指导和小组课程，通过远程视频传送到参与者家中。在基线、治疗后（8 个月）和随访（20 个月）期间，对儿童和家长的体重指数 (BMI)、儿童体力活动和儿童饮食摄入量进行了评估。多层次模型估算了两个时间点的治疗效果：招募了家长和儿童二人组（n = 148），并随机分配到 iAmHealthy 组（n = 64）或对照组（n = 84）。iAmHealthy 青少年的体重指数（BMIz）从基线到后期或随访均无明显变化。此外，还讨论了儿童饮食摄入、体育锻炼和家长体重指数的结果：这项试验通过同时增加治疗的便利性和剂量，扩展了之前的儿童肥胖症研究。结果表明，iAmHealthy 使青少年的 BMIz 轨迹和长期健康行为发生了变化。

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引用次数: 0