Pediatric Obesity最新文献

Aims

This research explores the relationships between food addiction (FA), eating behaviours, and weight status in school-aged children and adolescents, aiming to understand how FA influences weight.

Methods

By using a cross-sectional design, 426 healthy children and their parents were enroled in Eastern China. FA was assessed using the Chinese version of the Dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C 2.0), while eating patterns were identified using latent profile analysis (LPA) derived from the Children's Eating Behaviour Questionnaire (CEBQ). Weight status was indicated by Body Mass Index Z Score (BMIZ) and waist-to-height ratio (WHtR). The associations among FA, eating patterns, and weight status were explored using structural equation modelling (SEM).

Results

Two eating patterns, the Responsive and the Controlled Eating Patterns, were identified. The Responsive Eating Pattern was characterized by high food responsiveness, enjoyment of food, emotional eating, fast eating, low satiety responsiveness, and food fussiness and was associated with FA and weight status (p < 0.001). The SEM results showed the Responsive Eating Pattern partially mediated the relationship between FA and weight status, with a mediation effect of 1.183 (95% CI [0.784, 1.629]) for BMIZ and 0.043 (95% CI [0.025, 0.063]) for WHtR.

Conclusion

Increased FA is associated with a higher weight status through a specific eating behaviour pattern characterized by high responsiveness to food, emotional and rapid eating habits, and low satiety. The findings suggest that targeted interventions should take these eating behaviour patterns into account to reduce the impact of FA on weight status among children and adolescents.

Objective

To investigate population trajectories of behavioural risk factors of obesity from childhood to adolescence and their associations with body mass index (BMI) in children across European regions.

Methods

Data were harmonised between the European multi-centre IDEFICS/I.Family and the Amsterdam Born Children and their Development Cohort. Participants were aged 2.0–9.9 and 5.0–7.5 years at baseline, respectively, and were followed until age 18 years. Behavioural risk factors of interest included diet, physical activity, media use and sleep. Mixed effects models were used for statistical analyses to account for repeated measurements taken from the same child.

Results

The study included a total of 14 328 individuals: 4114, 4582, 3220 and 2412 participants from Northern, Southern, Eastern Europe and Amsterdam, respectively. Risk factor means and prevalences changed with age, but the trajectories were mostly similar across regions. Almost no associations between behavioural factors and BMI were found at the age of 6 years. At 11 years, daily sugar-sweetened foods consumption, use of active transport, sports club membership and longer nocturnal sleep duration were negatively associated with BMI in most regions; positive associations were found with media use. Most associations at 11 years of age persisted to 15 years.

Conclusions

Whilst population trajectories of media use and nocturnal sleep duration are similar across European regions, those of other behavioural risk factors like active transport and daily vegetable consumption differ. Also, associations between behavioural risk factors and BMI become stronger with age and show similar patterns across regions.

Background

Cord blood (CB) leptin is positively associated with adiposity at birth, but the association with child adiposity is unclear.

Objectives

We hypothesized that CB leptin is positively associated with adiposity in peripubertal children and with childhood leptin.

Methods

Leptin was measured in 986 CB and 931 childhood stored samples from a prospective birth cohort. Adiposity measures were collected at birth and mean age 11.5 years. Linear and logistic regression analyses were used to evaluate associations between log-transformed CB leptin and neonatal and childhood adiposity measures as continuous and categorical variables, respectively.

Results

CB leptin was positively associated with neonatal and childhood adiposity. Childhood associations were attenuated when adjusted for maternal body mass index (BMI) and glucose, but remained statistically significant for childhood body fat percentage (β = 1.15%, confidence interval [CI] = 0.46–1.84), body fat mass (β = 0.69 kg, 95% CI = 0.16–1.23), sum of skin-folds (β = 1.77 mm, 95% CI = 0.31–3.24), log-transformed child serum leptin (β = 0.13, 95% CI = 0.06–0.20), overweight/obesity (OR = 1.21, 95% CI = 1.03–1.42), obesity (OR = 1.31, 95% CI = 1.04–1.66) and body fat percentage >85th percentile (OR = 1.38, 95% CI = 1.12–1.73). Positive associations between newborn adiposity measures and CB leptin confirmed previous reports.

Conclusion

CB leptin is positively associated with neonatal and childhood adiposity and child leptin levels, independent of maternal BMI and maternal hyperglycemia. CB leptin may be a biomarker of future adiposity risk.

Background

Non-alcoholic fatty liver disease (NAFLD) is on the rise among youth. Identifying biomarkers of NAFLD progression/risk can aid in prevention efforts.

Aims

This pilot study investigated associations of two endotoxin biomarkers—lipopolysaccharide-binding protein (LBP) and anti-endotoxin core immunoglobulin G (EndoCab)—with markers of NAFLD among 99 Latino/Latina adolescents (11–19 years) with obesity.

Materials & Methods

We used linear regression to examine associations of each endotoxin biomarker (per 1-SD) with hepatic fat fraction (HFF), liver volume, and liver stiffness.

Results

We found positive associations of LBP with HFF and liver volume. Each 1-SD increment in LBP corresponded with 2.35% (95% CI: 0.46%, 4.23%) higher HFF and 0.14 (0.06, 0.23) L greater liver volume after adjusting for age, sex, and maternal education. Accounting for abdominal adiposity and Tanner stage did not change results. Excluding 72 participants with NAFLD attenuated associations of LBP with HFF but associations with liver volume persisted (0.11 [0.01, 0.21] L). EndoCab was not associated with any liver outcomes. Neither endotoxin biomarker predicted liver stiffness.

Discussion/conclusion

While additional research is warranted, our results support LBP as a biomarker of NAFLD risk/progression in high-risk youth.

Background and Objectives

Breastfeeding during infancy is associated with healthier beverage consumption later in childhood, but little is known about this relation during infancy. This was a longitudinal study of breastfeeding and less healthy beverage consumption during the first year of life, in a birth cohort study conducted 2013–2018 in the Southeastern United States (n = 666).

Methods

We estimated monthly rates of 100% juice and sugar-sweetened beverage (SSB) consumption comparing infants who were exclusively or partially breastfed, versus those who were not, in multivariable adjusted models.

Results

Mothers had a median age of 26.5 years, 71% identified as Black/African-American, and 61% reported household incomes <$20 000/year. The prevalence of any breastfeeding during the first month was 78.2% and 18.7% at month 12. By age 12 months, infants consumed juice a mean (SD) 9.1 (10.1) times per week and SSBs 3.6 (9.5) times per week. Breastfed infants had a 38% lower incidence rate of weekly juice consumption (95% CI 52%, 15%, p = 0.003) and a 57% lower incidence rate of weekly SSB consumption (95% CI 76%, 22%, p = 0.006), compared with infants who were not breastfed.

Conclusions

Research on early-life correlates of dietary health should focus on the earliest beverages, given evidence that consumption of obesogenic beverages may begin prior to age 1 year.

Background

Previous research on the association between body mass index (BMI) and visual impairment (VI) in youth has reported inconsistent findings. We aimed to investigate this association in a national cohort of Israeli adolescents.

Methods

This retrospective, population-based, cross-sectional study included 1 697 060 adolescents (56.4% men; mean age 17 years) who underwent mandatory pre-military service assessments from 1993 to 2017. BMI was classified based on the US age- and sex-matched percentiles. Unilateral or bilateral VI was classified as best-corrected visual acuity (BCVA) worse than 6/9 in either or both eyes, respectively. Sex-stratified regression models adjusted for sociodemographic variables were used to analyse the BMI-VI relationship.

Results

Overall, 17 871 (1.05%) and 5148 (0.30%) adolescents had unilateral and bilateral VI, respectively. Compared with high-normal BMI (50th to 85th percentile), adjusted odds ratios (ORs) for unilateral and bilateral VI gradually increased with higher BMI, reaching 1.33 (1.13–1.55) and 1.80 (1.37–2.35) in men with severe obesity, and 1.51 (1.24–1.84) and 1.52 (1.08–2.14) in women with severe obesity, respectively. Men with underweight also had increased ORs for unilateral and bilateral VI (1.23; 1.14–1.33 and 1.59; 1.37–1.84, respectively), a pattern not observed in women (0.96; 0.86–1.07 and 1.02; 0.83–1.25, respectively). Results were maintained when the outcome was restricted to mild VI, as well as in subgroups of adolescents with unimpaired health and those without moderate-to-severe myopia.

Conclusions

Abnormal BMI, and particularly obesity, is associated with increased OR for VI in late adolescence.

Background

There is evidence for a link between hyperactivity and obesity, especially among older children. Both conditions seem to be multifactorial in origin and hypotheses of common underlying issues, such as emotional dysregulation, have been suggested. However, studies of the co-occurrence of the two conditions in younger age groups have been inconclusive.

Objectives

We aimed to study the longitudinal associations of psychological strengths and difficulties at 4 years of age with health behaviours, body composition, physical fitness, and cardiovascular disease (CVD) risk factors 5 years later.

Methods

Parents of 226 4-year-old children filled out the Strengths and Difficulties Questionnaire (SDQ). At 9 years of age, we assessed health behaviours, physical fitness, body composition, and CVD risk factors. Associations were examined with linear regression models that were adjusted for sex, age of the child at 9, and maternal education.

Results

In the adjusted models, hyperactivity at 4 was associated with higher fat-free mass (β = 0.18, p = 0.007) and lower levels of sedentary behaviour (β −0.14, p = 0.043) at 9 years. Furthermore, greater emotional problems at 4 were associated with lower intake of fruit and vegetables (β −0.14, p = 0.038) at 9 years. However, there were no statistically significant associations between psychological difficulties and fat-mass index.

Conclusions

Our novel data provide no evidence of an association between hyperactivity in preschool age and obesity or obesity-related behaviours in school age. Future studies examining how psychological factors relate to obesity development should consider a developmental perspective.

Objective

To estimate national and provincial prevalence of obesity and excess weight in the child and adolescent population in Spain by sex and sociodemographic characteristics, and to explore sources of inequalities in their distribution, and their geographical patterns.

Methods

ENE-COVID is a nationwide representative seroepidemiological survey (68 287 participants) stratified by province and municipality size (April–June 2020). Participants answered a questionnaire which collected self-reported weight and height, that allowed estimating crude and model-based standardized prevalences of obesity and excess weight in the 10 543 child and adolescent participants aged 2–17 years.

Results

Crude prevalences (WHO growth reference) were higher in boys than in girls (obesity: 13.4% vs. 7.9%; excess weight: 33.7% vs. 26.0%; severe obesity: 2.9% vs. 1.2%). These prevalences varied with age, increased with the presence of any adult with excess weight in the household, while they decreased with higher adult educational and census tract average income levels.

Obesity by province ranged 1.8%–30.5% in boys and 0%–17.6% in girls; excess weight ranged 15.2%–49.9% in boys and 10.8%–40.8% in girls. The lowest prevalences of obesity and excess weight were found in provinces in the northern half of Spain. Sociodemographic characteristics only partially explained the observed geographical variability (33.6% obesity; 44.2% excess weight).

Conclusions

Childhood and adolescent obesity and excess weight are highly prevalent in Spain, with relevant sex, sociodemographic and geographical differences. The geographic variability explained by sociodemographic variables indicates that there are other potentially modifiable factors on which to focus interventions at different geographic levels to fight this problem.