James T Nugent, Kaitlin R Maciejewski, Emily B Finn, Randall W Grout, Charles T Wood, Denise Esserman, Jeremy J Michel, Yuan Lu, Mona Sharifi
Objective: (1) To describe the prevalence of high blood pressure (BP) and the association with BMI in young children with overweight/obesity; (2) to evaluate the accuracy of a single high BP to diagnose sustained hypertension over three visits. Methods: We used pre-intervention data from the Improving Pediatric Obesity Practice Using Prompts (iPOP-UP) trial. We included children aged 3-12 years with BMI ≥85th percentile at well-visits in 2019-2021 at 84 primary care practices in 3 US health systems in the Northeast, Midwest, and South. BP percentiles were calculated from the first visit with BP recorded during the study period. Hypertensive-range BP was defined by the 2017 American Academy of Pediatrics guideline. We tested the association between BMI classification and hypertensive BP using multivariable logistic regression. Results: Of 78,280 children with BMI ≥85th percentile, 76,214 (97%) had BP recorded during the study period (mean 7.4 years, 48% female, 53% with overweight, and 13% with severe obesity). The prevalence of elevated or hypertensive BP was 31%, including 27% in children with overweight and 33%, 39%, and 49% with class I, II, and III obesity, respectively. Higher obesity severity was associated with higher odds of hypertensive BP in the multivariable model. Stage 2 hypertensive BP at the initial visit had specificity of 99.1% (95% confidence interval 98.9-99.3) for detecting sustained hypertension over ≥3 visits. Conclusions: High BP is common in 3- to 12-year-olds with overweight/obesity, with higher obesity severity associated with greater hypertension. Children with overweight/obesity and stage 2 BP are likely to have sustained hypertension and should be prioritized for evaluation. Trial Registration: ClinicalTrials.gov Identifier: NCT05627011.
{"title":"High Blood Pressure in Children Aged 3 to 12 Years Old With Overweight or Obesity.","authors":"James T Nugent, Kaitlin R Maciejewski, Emily B Finn, Randall W Grout, Charles T Wood, Denise Esserman, Jeremy J Michel, Yuan Lu, Mona Sharifi","doi":"10.1089/chi.2023.0143","DOIUrl":"https://doi.org/10.1089/chi.2023.0143","url":null,"abstract":"<p><p><b><i>Objective:</i></b> (1) To describe the prevalence of high blood pressure (BP) and the association with BMI in young children with overweight/obesity; (2) to evaluate the accuracy of a single high BP to diagnose sustained hypertension over three visits. <b><i>Methods:</i></b> We used pre-intervention data from the Improving Pediatric Obesity Practice Using Prompts (iPOP-UP) trial. We included children aged 3-12 years with BMI ≥85th percentile at well-visits in 2019-2021 at 84 primary care practices in 3 US health systems in the Northeast, Midwest, and South. BP percentiles were calculated from the first visit with BP recorded during the study period. Hypertensive-range BP was defined by the 2017 American Academy of Pediatrics guideline. We tested the association between BMI classification and hypertensive BP using multivariable logistic regression. <b><i>Results:</i></b> Of 78,280 children with BMI ≥85th percentile, 76,214 (97%) had BP recorded during the study period (mean 7.4 years, 48% female, 53% with overweight, and 13% with severe obesity). The prevalence of elevated or hypertensive BP was 31%, including 27% in children with overweight and 33%, 39%, and 49% with class I, II, and III obesity, respectively. Higher obesity severity was associated with higher odds of hypertensive BP in the multivariable model. Stage 2 hypertensive BP at the initial visit had specificity of 99.1% (95% confidence interval 98.9-99.3) for detecting sustained hypertension over ≥3 visits. <b><i>Conclusions:</i></b> High BP is common in 3- to 12-year-olds with overweight/obesity, with higher obesity severity associated with greater hypertension. Children with overweight/obesity and stage 2 BP are likely to have sustained hypertension and should be prioritized for evaluation. <b>Trial Registration:</b> ClinicalTrials.gov Identifier: NCT05627011.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jason E Lang, Veronica M Carrion, Dharini M Bhammar, Janna B Howard, Sarah C Armstrong
Introduction: Children with obesity suffer excess dyspnea that contributes to sedentariness. Developing innovative strategies to increase exercise tolerance and participation in children with obesity is a high priority. Because inspiratory training (IT) has reduced dyspnea, we sought to assess IT in children with obesity. Methods: We conducted a 6-week randomized IT trial involving 8- to 17-year-olds with obesity. Participants were randomized 1:1 to either high [75% of maximal inspiratory pressure (MIP)] or low resistance control (15% of MIP) three times weekly. Assessments included adherence, patient satisfaction, and changes in inspiratory strength and endurance, dyspnea scores and total activity level. Results: Among 27 randomized, 24 (89%) completed the intervention. Total session adherence was 72% which did not differ between treatment groups. IT was safe, and more than 90% felt IT benefitted breathing and general health. IT led to a mean improvement (95% CI) in inspiratory strength measured by MIP of 10.0 cm H2O (-3.5, 23.6; paired t-test, p = 0.139) and inspiratory endurance of 8.9 (1.0, 16.8; paired t-test, p = 0.028); however, there was no significant difference between high- and low-treatment groups. IT led to significant reductions in dyspnea with daily activity (p < 0.001) and in prospectively reported dyspnea during exercise (p = 0.024). Among the high- versus low-treatment group, we noted a trend for reduced dyspnea with daily activity (p = 0.071) and increased daily steps (865 vs. -51, p = 0.079). Discussion: IT is safe and feasible for children with obesity and holds promise for reducing dyspnea and improving healthy activity in children with obesity. Breathe-Fit trial NCT05412134.
{"title":"A Randomized Trial of Inspiratory Training in Children and Adolescents With Obesity.","authors":"Jason E Lang, Veronica M Carrion, Dharini M Bhammar, Janna B Howard, Sarah C Armstrong","doi":"10.1089/chi.2023.0183","DOIUrl":"https://doi.org/10.1089/chi.2023.0183","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Children with obesity suffer excess dyspnea that contributes to sedentariness. Developing innovative strategies to increase exercise tolerance and participation in children with obesity is a high priority. Because inspiratory training (IT) has reduced dyspnea, we sought to assess IT in children with obesity. <b><i>Methods:</i></b> We conducted a 6-week randomized IT trial involving 8- to 17-year-olds with obesity. Participants were randomized 1:1 to either high [75% of maximal inspiratory pressure (MIP)] or low resistance control (15% of MIP) three times weekly. Assessments included adherence, patient satisfaction, and changes in inspiratory strength and endurance, dyspnea scores and total activity level. <b><i>Results:</i></b> Among 27 randomized, 24 (89%) completed the intervention. Total session adherence was 72% which did not differ between treatment groups. IT was safe, and more than 90% felt IT benefitted breathing and general health. IT led to a mean improvement (95% CI) in inspiratory strength measured by MIP of 10.0 cm H<sub>2</sub>O (-3.5, 23.6; paired <i>t</i>-test, <i>p</i> = 0.139) and inspiratory endurance of 8.9 (1.0, 16.8; paired <i>t</i>-test, <i>p</i> = 0.028); however, there was no significant difference between high- and low-treatment groups. IT led to significant reductions in dyspnea with daily activity (<i>p</i> < 0.001) and in prospectively reported dyspnea during exercise (<i>p</i> = 0.024). Among the high- versus low-treatment group, we noted a trend for reduced dyspnea with daily activity (<i>p</i> = 0.071) and increased daily steps (865 vs. -51, <i>p</i> = 0.079). <b><i>Discussion:</i></b> IT is safe and feasible for children with obesity and holds promise for reducing dyspnea and improving healthy activity in children with obesity. Breathe-Fit trial NCT05412134.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2023-05-26DOI: 10.1089/chi.2022.0236
Elizabeth N Dougherty, Isabella Randall, Alissa A Haedt-Matt, Eva Pila, Kathryn Smith, Shirlene Wang, Chih-Hsiang Yang, Scott G Engel, Andrea B Goldschmidt
Background: A bidirectional association between shape and weight concerns (SWC) and physical activity (PA) has been previously documented. This relationship may be particularly salient among youth with overweight/obesity, given that social marginalization of larger bodies has been associated with elevated SWC and barriers to PA. This pilot study explores reciprocal relationships between momentary SWC and accelerometer-assessed PA behavior. Methods: Youth with overweight/obesity (N = 17) participated in a 14-day ecological momentary assessment protocol, during which they were prompted to respond to questions about SWC several times per day. They also continuously wore Actiwatch 2 accelerometers to capture light and moderate-to-vigorous PA behavior. Results: Hierarchical linear modeling revealed a unidirectional association between SWC and PA, whereby after engaging in a higher duration of PA, participants reported lower SWC. SWC did not predict subsequent PA. Conclusion: The findings support a negative temporal relationship between PA and SWC. While further work is needed to replicate and extend these preliminary findings, they may suggest that PA acutely benefits SWC among youth with overweight and obesity.
背景:以前有文献记载,对体形和体重的关注(SWC)与体育锻炼(PA)之间存在双向关系。这种关系在超重/肥胖青少年中可能尤为突出,因为社会对体型较大者的边缘化与SWC升高和体育锻炼障碍有关。本试验性研究探讨了瞬间 SWC 与加速度计评估的 PA 行为之间的相互关系。研究方法超重/肥胖青少年(17 人)参加了为期 14 天的生态瞬时评估方案,在此期间,他们每天都要回答几次有关 SWC 的问题。他们还持续佩戴 Actiwatch 2 加速计,以捕捉轻度和中度至剧烈运动行为。研究结果层次线性模型显示,SWC 与 PA 之间存在单向联系,即在参与较长时间的 PA 后,参与者报告的 SWC 较低。SWC 无法预测随后的 PA。结论研究结果支持 PA 与 SWC 之间的负时间关系。虽然还需要进一步的工作来复制和扩展这些初步研究结果,但这些研究结果可能表明,在超重和肥胖的青少年中,体育锻炼对SWC有明显的益处。
{"title":"Accelerometer-Based Physical Activity and Shape and Weight Concerns Among Youth With Overweight and Obesity: A Pilot Exploratory Ecological Momentary Assessment Study.","authors":"Elizabeth N Dougherty, Isabella Randall, Alissa A Haedt-Matt, Eva Pila, Kathryn Smith, Shirlene Wang, Chih-Hsiang Yang, Scott G Engel, Andrea B Goldschmidt","doi":"10.1089/chi.2022.0236","DOIUrl":"10.1089/chi.2022.0236","url":null,"abstract":"<p><p><b><i>Background:</i></b> A bidirectional association between shape and weight concerns (SWC) and physical activity (PA) has been previously documented. This relationship may be particularly salient among youth with overweight/obesity, given that social marginalization of larger bodies has been associated with elevated SWC and barriers to PA. This pilot study explores reciprocal relationships between momentary SWC and accelerometer-assessed PA behavior. <b><i>Methods:</i></b> Youth with overweight/obesity (<i>N</i> = 17) participated in a 14-day ecological momentary assessment protocol, during which they were prompted to respond to questions about SWC several times per day. They also continuously wore Actiwatch 2 accelerometers to capture light and moderate-to-vigorous PA behavior. <b><i>Results:</i></b> Hierarchical linear modeling revealed a unidirectional association between SWC and PA, whereby after engaging in a higher duration of PA, participants reported lower SWC. SWC did not predict subsequent PA. <b><i>Conclusion:</i></b> The findings support a negative temporal relationship between PA and SWC. While further work is needed to replicate and extend these preliminary findings, they may suggest that PA acutely benefits SWC among youth with overweight and obesity.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2023-07-13DOI: 10.1089/chi.2023.0015
Pierce A Brody, Mehul Mehra, Madison Horinek, Salome M Herzstein, Jacqueline Chan
Background: Childhood obesity (CO) is rapidly increasing in prevalence and developing into a health crisis of developed nations. The condition is associated with increased risk of developing various comorbidities later in life. Current treatment algorithms primarily target family education. Thus, this study aims to understand the quality of information online regarding CO and common comorbidities, determine the readability of online information, and report patterns in public interest over time using Google Trends. Methods: Four validated quality of information tools and 6 readability tools were implemented across 36 websites derived from 4 Google searches. Pearson's correlation coefficient was used to determine the associations between Google Trends' relative search volumes (RSVs) and biennial BMI-based cumulative proportion of CO. Results: Results showed variable information quality among the websites as scores ranged from "fair" to "very poor." Using six readability formulas, no website scored at or below the sixth grade reading level recommended by the American Medical Association. Google Trends' RSVs for the term "Childhood Obesity" were repeatedly increased in the months that fall in the US academic school year (October-November and February-May), and decreased within months in the US vacation periods (December-January and June-September). Search volumes were also negatively correlated with CO and pediatric type 2 diabetes prevalence. Conclusions: In summary, while Google Trends analysis showed that schools may play a role in increasing interest and awareness online, quality of information and readability analysis displayed that the information and its accessibility are far too variable to be reliable.
{"title":"Assessing Patterns in Childhood Obesity Patient Education: A Quality of Online Health Information and Google Trends Analysis.","authors":"Pierce A Brody, Mehul Mehra, Madison Horinek, Salome M Herzstein, Jacqueline Chan","doi":"10.1089/chi.2023.0015","DOIUrl":"10.1089/chi.2023.0015","url":null,"abstract":"<p><p><b><i>Background:</i></b> Childhood obesity (CO) is rapidly increasing in prevalence and developing into a health crisis of developed nations. The condition is associated with increased risk of developing various comorbidities later in life. Current treatment algorithms primarily target family education. Thus, this study aims to understand the quality of information online regarding CO and common comorbidities, determine the readability of online information, and report patterns in public interest over time using Google Trends. <b><i>Methods:</i></b> Four validated quality of information tools and 6 readability tools were implemented across 36 websites derived from 4 Google searches. Pearson's correlation coefficient was used to determine the associations between Google Trends' relative search volumes (RSVs) and biennial BMI-based cumulative proportion of CO. <b><i>Results:</i></b> Results showed variable information quality among the websites as scores ranged from \"fair\" to \"very poor.\" Using six readability formulas, no website scored at or below the sixth grade reading level recommended by the American Medical Association. Google Trends' RSVs for the term \"Childhood Obesity\" were repeatedly increased in the months that fall in the US academic school year (October-November and February-May), and decreased within months in the US vacation periods (December-January and June-September). Search volumes were also negatively correlated with CO and pediatric type 2 diabetes prevalence. <b><i>Conclusions:</i></b> In summary, while Google Trends analysis showed that schools may play a role in increasing interest and awareness online, quality of information and readability analysis displayed that the information and its accessibility are far too variable to be reliable.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9776754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2023-06-22DOI: 10.1089/chi.2023.0049
Revi Bonder, Geoff D C Ball, Annick Buchholz, Madison L Giles, Katherine M Morrison, Amy C McPherson
Background: Children with disabilities are twice as likely to have overweight/obesity than their typically developing peers. Higher weights in these individuals may compound challenges already experienced with their disability, including mobility and activities of daily living. However, children with disabilities often find it challenging accessing weight management care. It is therefore important to understand the experiences and needs of the health care professionals (HCPs) who work in specialized pediatric weight management clinics about providing weight-related care to children with disabilities. Methods: Employing an interpretive description approach, purposeful sampling was used to recruit 17 HCP participants working in pediatric weight management settings in Canada. Qualitative semistructured interviews were conducted online or via telephone. All interview recordings were transcribed and a reflexive thematic analysis approach was used to develop themes from the data. Results: Four themes were developed: (1) infrequent referrals leads to a lack of experience with children with disabilities; (2) adapting group-based clinics can be challenging; (3) perceived lack of disability-specific knowledge causes moral distress; and (4) disability-specific training and greater interdisciplinary collaboration are desired. Conclusions: This work identifies the urgent need for more evidence-based, specialized, weight-related treatment options for children with disabilities, as well as more support for HCPs working in existing programs.
{"title":"Weight Management for Children With Disabilities: Exploring the Perspectives of Health Care Professionals Working in Pediatric Weight Management Clinics in Canada.","authors":"Revi Bonder, Geoff D C Ball, Annick Buchholz, Madison L Giles, Katherine M Morrison, Amy C McPherson","doi":"10.1089/chi.2023.0049","DOIUrl":"10.1089/chi.2023.0049","url":null,"abstract":"<p><p><b><i>Background:</i></b> Children with disabilities are twice as likely to have overweight/obesity than their typically developing peers. Higher weights in these individuals may compound challenges already experienced with their disability, including mobility and activities of daily living. However, children with disabilities often find it challenging accessing weight management care. It is therefore important to understand the experiences and needs of the health care professionals (HCPs) who work in specialized pediatric weight management clinics about providing weight-related care to children with disabilities. <b><i>Methods:</i></b> Employing an interpretive description approach, purposeful sampling was used to recruit 17 HCP participants working in pediatric weight management settings in Canada. Qualitative semistructured interviews were conducted online or via telephone. All interview recordings were transcribed and a reflexive thematic analysis approach was used to develop themes from the data. <b><i>Results:</i></b> Four themes were developed: (1) infrequent referrals leads to a lack of experience with children with disabilities; (2) adapting group-based clinics can be challenging; (3) perceived lack of disability-specific knowledge causes moral distress; and (4) disability-specific training and greater interdisciplinary collaboration are desired. <b><i>Conclusions:</i></b> This work identifies the urgent need for more evidence-based, specialized, weight-related treatment options for children with disabilities, as well as more support for HCPs working in existing programs.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9730436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2023-06-30DOI: 10.1089/chi.2023.0021
Christine N Moser, Mirae J Fornander, Christina M Roberts, Anna M Egan, Gail Robertson
Background: Transgender/gender diverse (TGD) youth are at risk for weight-related problems. We describe factors associated with their body mass index (BMI) category. Methods: Chart review of 228 TGD patients, 12-20 years (u = 15.7, standard deviation 1.3), 72% female assigned at birth. BMI percentile was calculated using CDC growth charts. We examined bivariate relationships of 18 clinically derived factors, utilizing analysis of variance (ANOVA) for continuous variables and chi-squared/Fisher's exact test for categorical variables. Nonparametric Classification and Regression Tree (CART) analyses were used to predict BMI category. Results: Almost half (49.6%) of TGD youth presenting for their initial visit for pediatric gender-affirming care fell in the healthy weight range, 4.4% in the underweight range, 16.7% in the overweight range, and 29.4% in the obese range. Self-described weight, weight management intentions, unhealthy weight management, prescription of psychiatric medications, and medications associated with weight gain were associated with BMI category. Use of psychiatric medications (54.8%) and medications associated with weight gain (39.5%) was associated with BMI in the overweight/obese categories. Youth with obesity most often reported unhealthy weight management. In CART models, self-described weight was the strongest predictor of BMI category. Conclusion: TGD youth have high rates of underweight and overweight/obesity. Unhealthy BMI should be treated as part of gender-affirming care. Self-described body weight is associated with weight category. More than half of TGD youth were prescribed psychiatric medications; those with overweight and obesity were more likely prescribed psychiatric and medications with associated weight gain. Youth with obesity were most likely to use unhealthy weight management.
{"title":"Body Mass Index Categories of Transgender and Gender Diverse Youth: Clinical Associations and Predictors.","authors":"Christine N Moser, Mirae J Fornander, Christina M Roberts, Anna M Egan, Gail Robertson","doi":"10.1089/chi.2023.0021","DOIUrl":"10.1089/chi.2023.0021","url":null,"abstract":"<p><p><b><i>Background:</i></b> Transgender/gender diverse (TGD) youth are at risk for weight-related problems. We describe factors associated with their body mass index (BMI) category. <b><i>Methods:</i></b> Chart review of 228 TGD patients, 12-20 years (<i>u</i> = 15.7, standard deviation 1.3), 72% female assigned at birth. BMI percentile was calculated using CDC growth charts. We examined bivariate relationships of 18 clinically derived factors, utilizing analysis of variance (ANOVA) for continuous variables and chi-squared/Fisher's exact test for categorical variables. Nonparametric Classification and Regression Tree (CART) analyses were used to predict BMI category. <b><i>Results:</i></b> Almost half (49.6%) of TGD youth presenting for their initial visit for pediatric gender-affirming care fell in the healthy weight range, 4.4% in the underweight range, 16.7% in the overweight range, and 29.4% in the obese range. Self-described weight, weight management intentions, unhealthy weight management, prescription of psychiatric medications, and medications associated with weight gain were associated with BMI category. Use of psychiatric medications (54.8%) and medications associated with weight gain (39.5%) was associated with BMI in the overweight/obese categories. Youth with obesity most often reported unhealthy weight management. In CART models, self-described weight was the strongest predictor of BMI category. <b><i>Conclusion:</i></b> TGD youth have high rates of underweight and overweight/obesity. Unhealthy BMI should be treated as part of gender-affirming care. Self-described body weight is associated with weight category. More than half of TGD youth were prescribed psychiatric medications; those with overweight and obesity were more likely prescribed psychiatric and medications with associated weight gain. Youth with obesity were most likely to use unhealthy weight management.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9699627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2023-06-27DOI: 10.1089/chi.2023.0033
Wendy S Moore, Mildred M Maldonado-Molina, Amy R Mobley, Karla P Shelnutt, Megan A McVay
Background: Childhood obesity can be addressed through family-based pediatric weight management; however, treatment enrollment in the United States is low. This study aimed to identify parental factors associated with intentions to initiate a family-based pediatric weight management program. Methods: Cross-sectional survey data were collected from an online panel of US parents with at least one 5- to 11-year-old child identified as likely to have overweight or obesity. Participants viewed a video about a hypothetical family-based pediatric weight management program, rated their 30-day initiation intentions for that program, and answered additional related questionnaires. Results: Participants (n = 158) identified as White/Caucasian (53%) or Black/African American (47%), were primarily female (61.4%) and married/cohabitating (81.6%) with children who were predominantly girls (53.2%) and, on average, 9-year-olds. Higher parents' perception of program effectiveness predicted initiation intentions (p < 0.001), while concern for their child's weight and parent depression and anxiety levels did not. Higher initiation intentions and perceived program effectiveness were reported by Black/African American participants (p < 0.01) and those with at least a bachelor's degree (p < 0.01) compared to White/Caucasian participants and those without a bachelor's degree, respectively. Initiation intentions were higher for those with greater financial security (p = 0.020) and fewer than three children in the home (p = 0.026). Participants endorsed initiation barriers of time constraints (25%), possible lack of enjoyment for the child (16.9%), and lack of family support (15%). Conclusions: Future program enrollment efforts may need to focus on strategies to increase perceived program effectiveness, although further research is needed that measures actual enrollment in real-world contexts.
背景:儿童肥胖症可以通过基于家庭的儿科体重管理来解决;然而,美国的治疗注册率很低。本研究旨在确定与家长是否有意启动家庭式儿科体重管理计划相关的因素。研究方法我们从一个在线调查小组中收集了横断面调查数据,该调查小组的美国家长至少有一名 5-11 岁的孩子被确认为可能超重或肥胖。参与者观看了一段关于假想的家庭式儿科体重管理计划的视频,对他们30天内启动该计划的意愿进行了评分,并回答了其他相关问卷。结果:参与者(n = 158)均为白人/高加索人(53%)或黑人/非洲裔美国人(47%),以女性为主(61.4%),已婚/同居(81.6%),子女以女孩为主(53.2%),平均年龄为 9 岁。家长对计划有效性的认知程度越高,就越倾向于参与计划(p p p p = 0.020),家中子女人数少于 3 人(p = 0.026)。参加者认可的启动障碍包括时间限制(25%)、孩子可能不喜欢(16.9%)和缺乏家庭支持(15%)。结论:未来的计划注册工作可能需要将重点放在提高计划有效性的策略上,尽管还需要进一步的研究来衡量现实世界中的实际注册情况。
{"title":"Parental Factors Associated With Intentions to Initiate a Family-Based Pediatric Weight Management Program.","authors":"Wendy S Moore, Mildred M Maldonado-Molina, Amy R Mobley, Karla P Shelnutt, Megan A McVay","doi":"10.1089/chi.2023.0033","DOIUrl":"10.1089/chi.2023.0033","url":null,"abstract":"<p><p><b><i>Background:</i></b> Childhood obesity can be addressed through family-based pediatric weight management; however, treatment enrollment in the United States is low. This study aimed to identify parental factors associated with intentions to initiate a family-based pediatric weight management program. <b><i>Methods:</i></b> Cross-sectional survey data were collected from an online panel of US parents with at least one 5- to 11-year-old child identified as likely to have overweight or obesity. Participants viewed a video about a hypothetical family-based pediatric weight management program, rated their 30-day initiation intentions for that program, and answered additional related questionnaires. <b><i>Results:</i></b> Participants (<i>n</i> = 158) identified as White/Caucasian (53%) or Black/African American (47%), were primarily female (61.4%) and married/cohabitating (81.6%) with children who were predominantly girls (53.2%) and, on average, 9-year-olds. Higher parents' perception of program effectiveness predicted initiation intentions (<i>p</i> < 0.001), while concern for their child's weight and parent depression and anxiety levels did not. Higher initiation intentions and perceived program effectiveness were reported by Black/African American participants (<i>p</i> < 0.01) and those with at least a bachelor's degree (<i>p</i> < 0.01) compared to White/Caucasian participants and those without a bachelor's degree, respectively. Initiation intentions were higher for those with greater financial security (<i>p</i> = 0.020) and fewer than three children in the home (<i>p</i> = 0.026). Participants endorsed initiation barriers of time constraints (25%), possible lack of enjoyment for the child (16.9%), and lack of family support (15%). <b><i>Conclusions:</i></b> Future program enrollment efforts may need to focus on strategies to increase perceived program effectiveness, although further research is needed that measures actual enrollment in real-world contexts.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9692838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1089/chi.2024.74367.cfp
Cody D Neshteruk, Erik A Willis
{"title":"Call for Special Issue Papers Honoring Dr. Dianne Stanton Ward: Promotion of Health and Wellness in Early Childhood Settings.","authors":"Cody D Neshteruk, Erik A Willis","doi":"10.1089/chi.2024.74367.cfp","DOIUrl":"https://doi.org/10.1089/chi.2024.74367.cfp","url":null,"abstract":"","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2023-06-21DOI: 10.1089/chi.2022.0234
June M Tester, Lan Xiao, Courtney A Chau, Lydia Tinajero-Deck, Shylaja Srinivasan, Lisa G Rosas
Background: There is a range of responses among individuals seen for medical management of their obesity. This retrospective analysis of longitudinal data considers the relationship between identified prediabetes and subsequent weight change among children (8-17 years) in a weight management clinic. Methods: Analysis included 733 patients (2687 visits in 2008-2016) with overweight and obesity (but not diabetes) whose referral laboratories included a hemoglobin A1c (HbA1c) within 90 days. Mixed-effects modeling examined the association between baseline prediabetes (serum HbA1c 5.7%-6.4%) and growth curve of percentage of the 95th percentile for BMI (%BMIp95). Random effects (individual growth curves) and fixed effects (prediabetes status, starting age and %BMIp95, sex, race/ethnicity, and linear slope and quadratic term of months since the initial visit) were modeled. Interactions between prediabetes and elapsed time estimated the influence of a recent prediabetic-range HbA1c on weight during the subsequent 12 months. Results: Mean %BMIp95 was 125.5% (SD 22.5), corresponding to severe obesity, and 35% had prediabetes. Adjusted monthly decrease in %BMIp95 was stronger for children with prediabetes compared with the peers in this clinic (slope: -0.62, standard error 0.10, p < 0.001). Conclusion: There was greater weight improvement among children with prediabetes compared with their peers with normal HbA1c.
{"title":"Greater Improvement in Obesity Among Children With Prediabetes in a Clinical Weight Management Program.","authors":"June M Tester, Lan Xiao, Courtney A Chau, Lydia Tinajero-Deck, Shylaja Srinivasan, Lisa G Rosas","doi":"10.1089/chi.2022.0234","DOIUrl":"10.1089/chi.2022.0234","url":null,"abstract":"<p><p><b><i>Background:</i></b> There is a range of responses among individuals seen for medical management of their obesity. This retrospective analysis of longitudinal data considers the relationship between identified prediabetes and subsequent weight change among children (8-17 years) in a weight management clinic. <b><i>Methods:</i></b> Analysis included 733 patients (2687 visits in 2008-2016) with overweight and obesity (but not diabetes) whose referral laboratories included a hemoglobin A1c (HbA1c) within 90 days. Mixed-effects modeling examined the association between baseline prediabetes (serum HbA1c 5.7%-6.4%) and growth curve of percentage of the 95th percentile for BMI (%BMIp95). Random effects (individual growth curves) and fixed effects (prediabetes status, starting age and %BMIp95, sex, race/ethnicity, and linear slope and quadratic term of months since the initial visit) were modeled. Interactions between prediabetes and elapsed time estimated the influence of a recent prediabetic-range HbA1c on weight during the subsequent 12 months. <b><i>Results:</i></b> Mean %BMIp95 was 125.5% (SD 22.5), corresponding to severe obesity, and 35% had prediabetes. Adjusted monthly decrease in %BMIp95 was stronger for children with prediabetes compared with the peers in this clinic (slope: -0.62, standard error 0.10, <i>p</i> < 0.001). <b><i>Conclusion:</i></b> There was greater weight improvement among children with prediabetes compared with their peers with normal HbA1c.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9677275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2023-06-15DOI: 10.1089/chi.2022.0216
Junia N de Brito, Mark A Pereira, Aaron S Kelly, Darin J Erickson, Nancy E Sherwood, Susan M Mason, Katie A Loth, Simone A French, Nicholas G Evanoff, Donald R Dengel, Alicia S Kunin-Batson
Background: This study examined the associations between BMI trajectories and emerging cardiometabolic risk (CMR) in children living in low-income and racially and ethnically diverse households in the United States. Methods: Data were drawn from NET-Works randomized intervention trial and NET-Works 2 prospective follow-up study (N = 338). BMI was measured across 6 follow-up visits and biomarkers of cardiometabolic risk (CMR) at the sixth visit. Group-based trajectory modeling identified child BMI trajectories. Adjusted multivariable linear regressions evaluated the associations between BMI trajectories and CMR. Results: We identified two BMI trajectories: 25% followed a trajectory of steep BMI increase, and 75% followed a moderate decreasing BMI trajectory over time. Relative to children in the moderate decreasing trajectory, children in the increasing trajectory had higher adjusted mean levels of C-reactive protein [CRP; 3.3; 95% confidence interval (CI): 1.6 to 5.0], leptin (63.1; 95% CI: 44.3 to 81.8), triglycerides (35.4; 95% CI: 22.1 to 48.6), triglyceride/high-density lipoprotein (HDL) ratio (1.2; 95% CI: 0.8 to 1.6), hemoglobin A1c (HbA1C; 0.1; 95% CI: 0.03 to 0.2), fasting glucose (1.8; 0.1 to 3.5) and insulin (8.8; 95% CI: 6.5 to 11.0), overall CMR score (0.7; 95% CI: 0.5 to 0.9), and lower adiponectin (-1.3; 95% CI: -2.5 to -0.1) and HDL (-10.8; 95% CI: -14.3 to -7.4). Conclusions: Children with high BMIs early in childhood were more likely to maintain an accelerated BMI trajectory throughout childhood, which was associated with adverse CMR in pre-adolescence. To advance health equity and support children's healthy weight and cardiovascular health trajectories, public health efforts are needed to address persistent disparities in childhood obesity and CMR.
{"title":"Body Mass Index Trajectories and Biomarkers of Cardiometabolic Risk in Children from Low-Income and Racially and Ethnically Diverse Households.","authors":"Junia N de Brito, Mark A Pereira, Aaron S Kelly, Darin J Erickson, Nancy E Sherwood, Susan M Mason, Katie A Loth, Simone A French, Nicholas G Evanoff, Donald R Dengel, Alicia S Kunin-Batson","doi":"10.1089/chi.2022.0216","DOIUrl":"10.1089/chi.2022.0216","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study examined the associations between BMI trajectories and emerging cardiometabolic risk (CMR) in children living in low-income and racially and ethnically diverse households in the United States. <b><i>Methods:</i></b> Data were drawn from NET-Works randomized intervention trial and NET-Works 2 prospective follow-up study (<i>N</i> = 338). BMI was measured across 6 follow-up visits and biomarkers of cardiometabolic risk (CMR) at the sixth visit. Group-based trajectory modeling identified child BMI trajectories. Adjusted multivariable linear regressions evaluated the associations between BMI trajectories and CMR. <b><i>Results:</i></b> We identified two BMI trajectories: 25% followed a trajectory of steep BMI increase, and 75% followed a moderate decreasing BMI trajectory over time. Relative to children in the moderate decreasing trajectory, children in the increasing trajectory had higher adjusted mean levels of C-reactive protein [CRP; 3.3; 95% confidence interval (CI): 1.6 to 5.0], leptin (63.1; 95% CI: 44.3 to 81.8), triglycerides (35.4; 95% CI: 22.1 to 48.6), triglyceride/high-density lipoprotein (HDL) ratio (1.2; 95% CI: 0.8 to 1.6), hemoglobin A1c (HbA1C; 0.1; 95% CI: 0.03 to 0.2), fasting glucose (1.8; 0.1 to 3.5) and insulin (8.8; 95% CI: 6.5 to 11.0), overall CMR score (0.7; 95% CI: 0.5 to 0.9), and lower adiponectin (-1.3; 95% CI: -2.5 to -0.1) and HDL (-10.8; 95% CI: -14.3 to -7.4). <b><i>Conclusions:</i></b> Children with high BMIs early in childhood were more likely to maintain an accelerated BMI trajectory throughout childhood, which was associated with adverse CMR in pre-adolescence. To advance health equity and support children's healthy weight and cardiovascular health trajectories, public health efforts are needed to address persistent disparities in childhood obesity and CMR.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9631319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}