Pub Date : 2019-01-01DOI: 10.1080/2574254X.2019.1688594
E. van Hoek, L. Koopman, E. Feskens, A. Janse
ABSTRACT Objective: Epicardial adipose tissue thickness (EATT) is suggested to play a role in the development of cardiovascular disease. In adolescents it is correlated with BMI z-score, cardiovascular risk factors, and pro- and anti-inflammatory markers. EATT of overweight/obese children was compared with EATT of normal weight peers (cross-sectional design). We investigated the association between EATT, cardiovascular risk factors and pro- and anti-inflammatory markers and the effect of a one year, multidisciplinary, treatment program on EATT in overweight/obese children (longitudinal design). Methods: EATT was measured by echocardiography (25 obese, 8 overweight and 15 normal weight children; median age 5.1 years). In the overweight/obese children blood pressure, lipid profile, glucose, insulin, high sensitive CRP, and adiponectin concentrations were measured. In overweight/obese children participating in a multidisciplinary treatment program, measurements were repeated after 4 and 12 months. Results: EATT was significantly higher in the overweight (median 1.38mm) and obese (median 1.57mm) children compared to normal weight children (median 0.87mm). Among obese children EATT was significantly inversely associated with adiponectin (r = −0.485). Conclusions: EATT is increased in overweight/obese children and is inversely associated with adiponectin. Echocardiographic measurement of EATT is easy and might serve as a simple tool for cardio-metabolic risk stratification.
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Pub Date : 2018-01-01DOI: 10.1080/2574254X.2018.1477495
C. Flodmark
There have been numerous attempts by the WHO (World Health Organization) to recognize and support actions to fight obesity. However, it was not until 1995 that the WHO identified overweight as the most significant cause of ill health rather than underweight in many developing countries. In the first special obesity consultation in 1997 the escalating medical costs globally were highlighted [1]. The conclusion was that overweight and obesity were replacing more traditional problems such as undernutrition and infectious diseases as the most significant causes of ill-health [2]. Obesity comorbidities such as coronary heart disease, hypertension and stroke, certain types of cancer, non-insulin-dependent diabetes mellitus, gallbladder disease, dyslipidaemia, osteoarthritis and gout, pulmonary disease including sleep apnoea were given as examples in the 1997 special obesity consultation. Furthermore, individuals with obesity suffered from social bias, prejudice and discrimination, by both the general public and health professionals [2]. In spite of this awareness neither local governments nor the WHO have been successful in changing the societal framework to promote routine spontaneous physical activity and transforming the food system. Low energy-density food of high nutrient quality has not become the norm [1]. There was an interesting attempt in Istanbul to engage the broad European political level [3]. The Swedish government presented 79 steps to engage different parts of the society with actions divided into different political areas [4]. The different responsible bodies in the Swedish proposals were the national government, local governments, different authorities (national board of health, national board of public health, regulator authority for buildings, national school authority, traffic authority, food authority, agriculture authority, consumer authority etc.), national sports associations, health care etc. The principle to point out specific parts of the society as responsible, regardless if it was a state authority or an association, gave a good possibility to plan future actions. However, no financial support was given, and no specific actions were ever taken. The WHO Commission on Ending Childhood Obesity has proposed an implementation plan [5], which was approved by the 70 World Health Assembly on 31 May 2017. It pointed out that almost three quarters of the 42 million children under 5 years who are overweight CHILD AND ADOLESCENT OBESITY 2018, VOL. 1, NO. 1, 1–4 https://doi.org/10.1080/2574254X.2018.1477495
{"title":"Who is listening to WHO?","authors":"C. Flodmark","doi":"10.1080/2574254X.2018.1477495","DOIUrl":"https://doi.org/10.1080/2574254X.2018.1477495","url":null,"abstract":"There have been numerous attempts by the WHO (World Health Organization) to recognize and support actions to fight obesity. However, it was not until 1995 that the WHO identified overweight as the most significant cause of ill health rather than underweight in many developing countries. In the first special obesity consultation in 1997 the escalating medical costs globally were highlighted [1]. The conclusion was that overweight and obesity were replacing more traditional problems such as undernutrition and infectious diseases as the most significant causes of ill-health [2]. Obesity comorbidities such as coronary heart disease, hypertension and stroke, certain types of cancer, non-insulin-dependent diabetes mellitus, gallbladder disease, dyslipidaemia, osteoarthritis and gout, pulmonary disease including sleep apnoea were given as examples in the 1997 special obesity consultation. Furthermore, individuals with obesity suffered from social bias, prejudice and discrimination, by both the general public and health professionals [2]. In spite of this awareness neither local governments nor the WHO have been successful in changing the societal framework to promote routine spontaneous physical activity and transforming the food system. Low energy-density food of high nutrient quality has not become the norm [1]. There was an interesting attempt in Istanbul to engage the broad European political level [3]. The Swedish government presented 79 steps to engage different parts of the society with actions divided into different political areas [4]. The different responsible bodies in the Swedish proposals were the national government, local governments, different authorities (national board of health, national board of public health, regulator authority for buildings, national school authority, traffic authority, food authority, agriculture authority, consumer authority etc.), national sports associations, health care etc. The principle to point out specific parts of the society as responsible, regardless if it was a state authority or an association, gave a good possibility to plan future actions. However, no financial support was given, and no specific actions were ever taken. The WHO Commission on Ending Childhood Obesity has proposed an implementation plan [5], which was approved by the 70 World Health Assembly on 31 May 2017. It pointed out that almost three quarters of the 42 million children under 5 years who are overweight CHILD AND ADOLESCENT OBESITY 2018, VOL. 1, NO. 1, 1–4 https://doi.org/10.1080/2574254X.2018.1477495","PeriodicalId":72570,"journal":{"name":"Child and adolescent obesity (Abingdon, England)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/2574254X.2018.1477495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47766394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1080/2574254X.2018.1547070
B. Bohn, R. Stachow, I. Gellhaus, Johannes Matthias, H. Lichtenstern, R. Holl
ABSTRACT Objective: The objective of this study is to analyze whether sociodemographic characteristics or cardiovascular risk factors differ in children and adolescents at the beginning of a lifestyle intervention (LI) for obesity within Germany. Methods: A total of 40,942 children and adolescents with German residence from the APV-registry were included. Subjects were assigned to the 16 federal states of Germany according to their postal code. Sociodemographic and cardiovascular risk factors at the beginning of a LI for obesity were compared between the federal states. Logistic models were implemented for the prevalence of extreme obesity, hypertension, dyslipidemia, abnormal carbohydrate metabolism, nonalcoholic fatty liver disease (NAFLD), and treatment modality (inpatient vs. outpatient). Results: Age at the beginning of a LI ranged from 11.5 to 13.5 years. Proportion with a migration background was between 5.8% and 49.7%. Within Germany, extreme obesity in children and adolescents initiating a LI strongly differed between 35.6% and 50.8%. Regional differences were also found for obesity-related risk factors: hypertension (39.0–68.1%), dyslipidemia (24.9–44.6%), NAFLD (9.4–20.4%), abnormal carbohydrate metabolism (0.7–6.2%) (all p < 0.0001). Inpatient treatment varied between 11.2% and 88.2%. Overall, no clear regional pattern was observed. Conclusion: Several factors as individual socioeconomic status, personal attitude, treatment accessibility, or regional differences in reimbursement decisions might have contributed to the disparities.
{"title":"Heterogeneity in sociodemographic characteristics and cardiovascular risk factors at the initiation of a lifestyle intervention for obesity within Germany: an APV multicenter study on 40,942 children and adolescents","authors":"B. Bohn, R. Stachow, I. Gellhaus, Johannes Matthias, H. Lichtenstern, R. Holl","doi":"10.1080/2574254X.2018.1547070","DOIUrl":"https://doi.org/10.1080/2574254X.2018.1547070","url":null,"abstract":"ABSTRACT Objective: The objective of this study is to analyze whether sociodemographic characteristics or cardiovascular risk factors differ in children and adolescents at the beginning of a lifestyle intervention (LI) for obesity within Germany. Methods: A total of 40,942 children and adolescents with German residence from the APV-registry were included. Subjects were assigned to the 16 federal states of Germany according to their postal code. Sociodemographic and cardiovascular risk factors at the beginning of a LI for obesity were compared between the federal states. Logistic models were implemented for the prevalence of extreme obesity, hypertension, dyslipidemia, abnormal carbohydrate metabolism, nonalcoholic fatty liver disease (NAFLD), and treatment modality (inpatient vs. outpatient). Results: Age at the beginning of a LI ranged from 11.5 to 13.5 years. Proportion with a migration background was between 5.8% and 49.7%. Within Germany, extreme obesity in children and adolescents initiating a LI strongly differed between 35.6% and 50.8%. Regional differences were also found for obesity-related risk factors: hypertension (39.0–68.1%), dyslipidemia (24.9–44.6%), NAFLD (9.4–20.4%), abnormal carbohydrate metabolism (0.7–6.2%) (all p < 0.0001). Inpatient treatment varied between 11.2% and 88.2%. Overall, no clear regional pattern was observed. Conclusion: Several factors as individual socioeconomic status, personal attitude, treatment accessibility, or regional differences in reimbursement decisions might have contributed to the disparities.","PeriodicalId":72570,"journal":{"name":"Child and adolescent obesity (Abingdon, England)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/2574254X.2018.1547070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46688418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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