Childhood Obesity最新文献

Background: The objective of this study was to test the association of Pro-Inflammatory/Anti-Inflammatory Food Intake Score (PAIFIS) and inflammatory biomarkers: C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 levels in a sample of Brazilian children. Methods: This cross-sectional study included children aged 5-8 years. Levels of inflammatory biomarkers and habitual food intake were measured using a quantitative food frequency questionnaire (FFQ) to estimate PAIFIS and anthropometric and socioeconomic data. The Mann-Whitney test, Spearman's correlation test, and nonparametric regression models with Kernel effects were used for analysis. Results: PAIFIS showed an association with increased TNF-α in the univariate analysis [β = 0.53, 95% confidence interval (CI) 0.05-1.15] and the multivariate analysis adjusted for the sum of skinfolds (ΣSF) and income (β = 0.31, 95% CI 0.00-1.11). ΣSF was associated with an increase in TNF-α (β = 15.0, 95% CI 3.16-36.1) and CRP (β = 0.013, 95% CI 0.004-0.022). Conclusions: The PAIFIS shows a positive association with TNF-α. Adiposity was also identified as an important risk factor for inflammation.

Recent literature proposed an association between physical activity (PA) and carotenoid status due to their overlapping role in mediating oxidative stress. However, this relationship has yet to be explored in young children. This study examined the relationship between objectively measured PA (ActiGraph triaxial accelerometry) and skin carotenoid levels (pressure-mediated reflection spectroscopy) in a sample of 3- to 5-years-old. Fourteen children (44 ± 7 months old, 71% male) from a single child care center were included in this cross-sectional analysis. Linear regression modeling indicated more time spent in PA was associated with higher skin carotenoid scores (β = 3.448, p = 0.032). These findings from our pilot study indicate a potential cross-sectional link between physical activity and carotenoid status in young children.

Background: While studies have described poorer health-related quality of life (HRQOL) among youth with obesity, less is known about health factors contributing to this perception. The study aims were to link patient-reported outcomes (PROs) data to electronic health record (EHR) data to describe the association between PROs and obesity-related health factors. Methods: Youth and parents of youth receiving care from weight management programs at eight PEDSnet sites completed PROMIS® measures assessing global health, fatigue, stress, and family relationships. EHR data were extracted, including demographics, anthropometrics, diagnoses, medications, and visits for the period encompassing 12 months prior to and after the date of survey. Linear regression analyses describe the association between PROMIS® scores and the diagnosis of obesity-related comorbidities, medications for obesity-related comorbidities, and health care utilization. Results: In total, 1249 youth (56% with severe obesity) of diverse backgrounds (60% public insurance, 24% non-Hispanic Black, 24% Hispanic) were included. The diagnosis of many obesity-related comorbidities and use of medications for obesity-related conditions were associated with worse global health fatigue and stress scores. The strongest associations that were consistent across many of the PROMIS® measures included number of chronic medications, number of comorbidities, having a neuropsychological diagnosis, and body mass index percentile trajectory. Conclusions: This study details the association of the health issues experienced by youth with obesity and PROs, offering targets in weight management treatment to improve youth and family perception of overall health and well-being.

Background: Maternal depression has been linked with increased risk of childhood obesity. Furthermore, maternal negative affectivity in early childhood has been associated with food fussiness. We explored the relationship between longitudinal maternal well-being mid-pregnancy, at 2 years and 5 years postpartum and children's appetitive traits at 5 years of age. Methods: This is a secondary analysis of the ROLO (randomized control trial of low glycemic diet in pregnancy) longitudinal birth cohort study including pregnancy (n = 279), 2 years (n = 168), and 5 years (n = 295) postpartum. Maternal well-being was measured using the World Health Organization-Five Well-Being Index. Children's appetitive traits were measured at 5 years of age using the Children's Eating Behavior Questionnaire. Bivariate correlation and then linear regression, adjusted for potential confounders, were used to determine relationships between maternal well-being at each timepoint and offspring's appetitive traits at 5 years old. Results: Mean maternal well-being was higher at 5 years postpartum (63.3%) than mid-pregnancy (58.2%) or at 2 years postpartum (61.0%) (p = 0.001). No relationships were observed between maternal well-being mid-pregnancy and child's appetitive traits at 5 years. In adjusted regression, at 2 years postpartum, maternal well-being was negatively associated with "Emotional Overeating" (B = -0.029, p = 0.024), "Satiety Responsiveness" (B = -0.040, p = 0.014), "Slowness Eating" (B = -0.072, p = <0.001), and "Emotional Undereating" (B = -0.054, p = 0.010) and positively associated with "Enjoyment of Food" (B = 0.050, p = 0.007). Maternal well-being at 5 years postpartum was negatively associated with "Satiety Responsiveness" (B = -0.025, p = 0.033) and "Slowness Eating" (B = -0.031, p = 0.024). Conclusion: Maternal well-being in early childhood may influence children's appetitive traits; however, further research is required to fully explore this relationship.

Background: Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have occurred mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity. Methods: This cluster randomized controlled feasibility trial included an online program designed to improve diet and PA along with administration of prebiotic fiber for 12 weeks in 123 4th and 5th grade students where 98% were eligible for free or reduced fee lunch. Of these 56% were male; 71% Latinx; 15% African American; and 14% Other. Results: A decrease in body fat (BF) was associated with higher pre-test BF. Lower BMI was associated with a decrease in fecal Tenericutes and an increase in Actinobacteria. Conclusion: Prebiotic fiber was evaluated in additional studies. Determining those most responsive to prebiotic fiber can also permit individual recommendations for greater inclusion in usual diet choices.

Background: Head Start (HS) is the largest federally funded early childhood education program in the United States. It prepares children socially, emotionally, and academically and sets the foundation for school readiness and academic success. In 2024, the Head Start Program Performance Standards were updated to provide enhanced support and workforce stability, including improvements in health and wellness. This study assessed the availability, participation, satisfaction, and interest in Workplace Wellness Programs (WWPs) for HS educators. Methods: An electronic survey was sent to nearly 74,000 HS grantees and educators; 2,611 complete surveys were included in the analysis. Descriptive analyses examined the availability, participation, satisfaction, and interest in WWPs, and multivariate regression analyses identified factors associated with WWP participation. Results: Approximately 71% of HS educators reported access to at least one WWP. The most common programs available were health education and promotion (51%), stress management (25%), and healthy lunch and snack options (20%). Participation rates for available programs ranged from 6% to 93%, and interest in unavailable programs ranged from 40% to 93%. Job dissatisfaction was associated with lower odds of participating in any WWP or in health education and wellness programs. Receipt of community food assistance was associated with lower odds of participating in nutrition and stress management programs. Conclusions: There is considerable variability in availability, participation, and interest in WWPs among HS educators. Research is needed to understand if expression of interest would translate into take-up of WWPs, identify strategies to reduce barriers, and increase participation.

Background: Enhancing the quality of Family Child Care Home (FCCH) meals is an opportunity to impact children's diet and health. The purpose of this study is to assess Happy Healthy Homes (HHH) randomized controlled trial impact on health-related foods and nutrients served to and consumed by young children and achievement of Child and Adult Care Food Program (CACFP) requirements and best practices. Methods: Forty-five CACFP participating FCCHs in a moderately sized midwestern city were recruited in 2017-2018 and randomized to nutrition intervention (NUT n = 24) or control (CON n = 21). Participants received two in-home, individual 90-minute education sessions, one 3-hour small group class, and a 15-minute check-in phone call over 3 months. Outcomes include 3- and 12-month served and consumed fiber, sugar, grains, vegetables, and fruit and achievement of CACFP Best Practices. Primary analyses at 12 months used a mixed model under an intent-to-treat paradigm to account for repeated measures on participants with 3-month outcomes. Sensitivity analyses were completed on those with complete 12-month measures. Results: There were no statistically significant group-by-time effects for foods served, consumed, or CACFP Best Practices score in the primary analysis. However, in sensitivity analysis, the CACFP Best Practice score (out of 18) increased in NUT +0.5 from 8.9 ± 1.5 at baseline at 12 months and decreased -0.9 in CON from 9.9 ± 1.7 at baseline, group by time p = 0.05. Conclusions: The HHH intervention did improve the CACFP Best Practices score for lunches served. The study's effect may have been limited due to sample size and attrition. Trial Registration: Clinicaltrials.gov, NCT03560050. Retrospectively registered on 23 May 2018. First participant enrolled October 2017.

Background: Examining sedentary time (ST) by disaggregating the day into periods such as before, during, and after preschool allows interventionists to understand when sedentary behaviors are most severe. This study aimed to determine if there are sex differences in ST before, during, and after preschool hours in US preschoolers. Methods: A secondary analysis of a two-cohort study with a sample size of 292 preschoolers (67% African Americans/Blacks; 100% from low-income families) was used. Measures were collected in Fall 2017 and Fall 2018. Preschoolers wore an accelerometer on the non-dominant wrist for 8 consecutive days to obtain ST minutes before, during, and after preschool periods. Three separate linear regressions were conducted to test sex differences in ST before, during, and after preschool hours. ST for each period of the day was considered the outcome variable predicted by sex and covarying for BMI percentile. Results: Girls were more sedentary than boys during preschool (F (1, 226) = 5.15, p = 0.006; b = -0.09 [-0.15, -0.03]), but not before preschool (F(1, 225) = 0.98, p = 0.32; b = 2.50 [-2.46, 7.45]) nor after preschool (F(1, 227) = 3.62, p = 0.06; b = 6.60 [-0.21, 13.42]). Conclusions: This difference in ST could have an unfavorable health impact among preschool girls. Given that childhood obesity prevalence dramatically increases from preschool age to childhood, there is a need to design family-based interventions that provide parents/caregivers strategies to develop habits around healthy eating and physical activity that they can carry into later life stages.

Background: The COVID-19 pandemic has exacerbated the obesity epidemic, with both adults and children demonstrating rapid weight gain during the pandemic. However, the impact of having a COVID-19 diagnosis on this trend is not known. Methods: Using longitudinal data from January 2019 to June 2023 collected by the US National Institute for Health's National COVID Cohort Collaborative (N3C), children (age 2-18 years) with positive COVID-19 test results {n = 11,474, 53% male, mean [standard deviation (SD)] age 5.57 [±3.29] years, 54% White, mean [SD] 5.2 [±2.9] BMI observations per participant} were matched with COVID-19-negative children with identical demographic characteristics and similar observation window. We compared BMI percentile trajectories between the COVID-19-positive and COVID-19-negative cohorts, with further evaluation performed on COVID-19-positive patients stratified by hospitalization status. Results: COVID-19-positive patients had a greater increase in $\%BM{I}_{p95}$ than COVID-19-negative patients (average increase of 2.34 (±7.73) compared to 1.46 (±6.09), p < 0.0005). COVID-19-positive patients gained more weight after their diagnosis of COVID-19 than before. Nonhospitalized children gained more weight than hospitalized children [average increase in $\%BM{I}_{p95}$ of 2.38 (±7.65) compared to 1.87 (±8.54)]. Mixed-effect regression analyses demonstrated that these associations remained even after adjusting for time, demographics, and baseline $\%BM{I}_{p95}$. Conclusions: Having a COVID-19 diagnosis was associated with more rapid weight gain, especially after diagnosis and early in the pandemic. Future research should explore the reasons for this association and the implications for future health emergencies.