Muscle force and power in obese and overweight children

The study investigated differences in skeletal muscle function between obese and non-obese children using a force platform. Forty obese children and adolescents (age range 8 to 18 years; 21 girls) and 40 age- and sex-matched controls performed two tests: (1) single two-legged jump, a countermovement jump for maximal height; (2) multiple one-legged hopping on the forefoot, a test of maximal force. In the single two-legged jump, obese subjects had higher absolute peak force (1.62 kN vs 1.09 kN) and peak power (2.46 kW vs 2.06 kW), but lower body weight-related peak force (2.10 vs 2.33) and lower peak power per body mass (30.9 W/kg vs 41.6 W/kg). Jump height (29.3 cm vs 37.5 cm) and maximal vertical velocity (1.92 ms(-1) vs 2.31 ms(-1)) were reduced in obese children. In multiple one-legged hopping, obese subjects had 72% and 84% higher absolute peak force on the left and right foot, respectively. However, forces relative to body weight were 24% and 23% lower in the obese group than in the control group. In conclusion, obese children and adolescents have increased muscle force and power. This partly compensates for the effect of high body weight on muscle performance.     

The association between sleep pattern and nutrients intake pattern in healthy overweight and obese adults

Few studies have investigated the association between sleep pattern and nutrient intake pattern. This study was conducted to examine the associations between patterns of nutrient intake and sleep pattern. 108 overweight and obese individuals were recruited to participate in the present cross-sectional study. Participant underwent sleep evaluation through ActiGraph. A 3-day food dietary record was obtained to estimate food intake for each participant. The average of total sleep duration was 7.07 h, average of wake after sleep onset was 0.43 h, average of sleep latency was 0.14 h, and finally, average of sleep efficacy was 93.66%. Moreover, based on principal component analysis, six nutrient intake patterns were identified: the first and second patterns accounting for 53.88% of the total variance and the third and fourth patterns made up 13.6% of the total variance. Totally, the six patterns constitute 74.8% of the total variance. Our results showed that the second nutrient pattern had a negative correlation with total sleep time (P = 0.03); it was positively correlated with sleep latency (P = 0.004). The sixth nutrient pattern was negatively associated with total sleep time (P = 0.007). It was observed that higher intake of the fourth pattern had a negative correlation with total sleep time (P = 0.03). Higher intake of the fifth pattern was positively associated with sleep latency (P = 0.05). In summary, we found that nutrient patterns are correlated with sleep pattern.

     

Comparison of body composition methods in overweight and obese children.

The objective of the present study was to investigate the accuracy of percent body fat (%fat) estimates from dual-energy X-ray absorptiometry, air-displacement plethysmography (ADP), and total body water (TBW) against a criterion four-compartment (4C) model in overweight and obese children. A volunteer sample of 30 children (18 male and 12 female), age of (mean +/- SD) 14.10 +/- 1.83 yr, body mass index of 31.6 +/- 5.5 kg/m, and %fat (4C model) of 41.2 +/- 8.2%, was assessed. Body density measurements were converted to %fat estimates by using the general equation of Siri (ADPSiri) (Siri WE. Techniques for Measuring Body Composition. 1961) and the age- and gender-specific constants of Lohman (ADPLoh) (Lohman TG. Exercise and Sport Sciences Reviews. 1986). TBW measurements were converted to %fat estimates by assuming that water accounts for 73% of fat-free mass (TBW73) and by utilizing the age- and gender-specific water contents of Lohman (TBWLoh). All estimates of %fat were highly correlated with those of the 4C model (r > or = 0.95, P < 0.001; SE < or = 2.14). For %fat, the total error and mean difference +/- 95% limits of agreement compared with the 4C model were 2.50, 1.8 +/- 3.5 (ADPSiri); 1.82, -0.04 +/- 3.6 (ADPLoh); 2.86, -2.0 +/- 4.1 (TBW73); 1.90, -0.3 +/- 3.8 (TBWLoh); and 2.74, 1.9 +/- 4.0 DXA (dual-energy X-ray absorptiometry), respectively. In conclusion, in overweight and obese children, ADPLoh and TBWLoh were the most accurate methods of measuring %fat compared with a 4C model. However, all methods under consideration produced similar limits of agreement.     

Differences in physical activity between non-overweight, overweight and obese children

The purpose of the study was to find out differences in moderate to vigorous physical activity among non-overweight, overweight and obese children, and between boys and girls. The sample included 364 children (179 boys and 185 girls), aged 6.4 years (+/- 0.3 SD). Physical activity was assessed by 7-day questionnaire. Age adapted BMI was used as overweight and obesity indicator. The children were divided into non-overweight, overweight and obese groups. It was found out, that there are significant differences in non-overweight, overweight and obese children (p < 0.05). Boys were significantly (p < 0.05) less moderate to vigorous physical active than girls, especially in indoor activities. There were also significant differences (p < 0.05) in moderate to vigorous physical activity among non-overweight and obese boys and among overweight and obese boys in weekends and total weekly activity. In girls there are significant differences (p < 0.05) in non-overweight, overweight and groups in weekends and total weekly activity. It is possible to conclude, that obese boys and overweight and obese girls, are prone to less physical activity.     

Cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children

Objective

To assess from a societal perspective the incremental cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children. The intervention was modelled on the LEAP (live, eat and play) trial, a randomised controlled trial conducted by the Centre for Community Child Health, Melbourne, Australia in 2002-2003. This study was undertaken as part of the assessing cost-effectiveness (ACE) in obesity project which evaluated, using consistent methods, 13 interventions targeting unhealthy weight gain in children and adolescents.

Method

A logic pathway was used to model the effects of the intervention compared to no intervention on body mass index (BMI) and health outcomes (disability-adjusted life years—DALYs). Disease costs and health benefits were tracked until the cohort of eligible children reached the age of 100 years or death. Simulation-modelling techniques were used to present a 95% uncertainty interval around the cost-effectiveness ratio. The intervention was also assessed against a series of filters (‘equity’, ‘strength of evidence’, ‘acceptability’, ‘feasibility’, sustainability’ and ‘side-effects’) to incorporate additional factors that impact on resource allocation decisions.

Results

The intervention, as modelled, reached 9685 children aged 5-9 years with a BMI z-score of ≥3.0, and cost $AUD6.3M (or $AUD4.8M excluding time costs). It resulted in an incremental saving of 2300 BMI units which translated to 511 DALYs. The cost-offsets stemming from the intervention totalled $AUD3.6M, resulting in a net cost per DALY saved of $AUD4670 (dominated; $0.1M) (dominated means intervention costs more for less effect).

Conclusion

Compared to a ‘no intervention’ control group, the intervention was cost-effective under current assumptions, although the uncertainty intervals were wide. A key question related to the long-term sustainability of the small incremental weight loss reported, based on the 9-month follow-up results for LEAP.     

Urinary markers of nucleic acid oxidation in Danish overweight/obese children and youths

Urinary excretion of the RNA and DNA oxidation markers, 8-oxo-7,8-dihydroguanosine (8-oxoGuo) and 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) in newly diagnosed adult type 2 diabetics are reported to be long-term predictors of mortality independent of conventional risk factors. In the current study, we investigated the relationships between urinary markers of nucleic acid oxidation concentrations and the degree of obesity and glucose metabolism in overweight compared to lean children. Forty-two (24 girls) overweight and 35 lean (19 girls) children and adolescents were recruited from the Registry of the Danish Childhood Obesity Biobank. Anthropometric measurements were collected at baseline and glucose metabolism was assessed by an oral glucose tolerance test. A urine sample was obtained during the test. Linear regression did not demonstrate any associations between the urinary markers and the degree of obesity or glucose metabolism in lean and obese children. However, sub-analyses adjusted for age, sex, and the degree of obesity showed positive associations between the 2 h glucose and the urinary markers, 8-oxoGuo (p?=?0.02, r²=?0.63) and 8-oxodG (p?=?0.046, r²=?0.48), and between the insulinogenic index and 8-oxoGuo (p?=?0.03, r^2?=^?0.60) in the 12 obese children exhibiting impaired glucose tolerance. Excretion of the urinary markers of nucleic acid oxidation and the degree of obesity or the glucose metabolism were not associated in this study. Nevertheless, obese children with impaired glucose tolerance seem to exhibiting an increased oxidative stress level, but due to the small sample size in this study, further investigations are required to elucidate this correlation.     

Proficiency deficiency: mastery of fundamental movement skills and skill components in overweight and obese children

The purpose of this observational study was to compare the mastery of 12 fundamental movement skills (FMS) and skill components between a treatment-seeking sample of overweight/obese children and a reference sample from the United States. Mastery of six locomotor and six object-control skills (24 components in each subdomain) were video-assessed by one assessor using the test of gross motor development-2 (TGMD-2). The 153 overweight/obese children (mean ± s.d. age = 8.3 ± 1.1 years, BMI z-score = 2.78 ± 0.69, 58% girls, 77% obese) were categorized into age groups (for the underhand roll and strike: 7-8 years and 9-10 years; all other FMS: 6-7 years and 8-10 years) and mastery prevalence rates were compared with representative US data (N = 876) using χ(2) analysis. For all 12 skills in all age groups, the prevalence of mastery was lower among overweight/obese children compared with the reference sample (all P < 0.05). This was consistent for 18 locomotor and upto 21 object-control skill components (all P < 0.05). Differences were largest for the run, slide, hop, dribble, and kick. Specific movement patterns that could be targeted for improvement include positioning of the body and feet, the control or release of an object at an optimal position, and better use of the arms to maintain effective force production during the performance of FMS. Physical activity programs designed for overweight and obese children may need to address deficiencies in FMS proficiency to foster the movement capabilities required for participation in health-enhancing physical activity.     

Objectively measured sedentary behavior,physical activity,and plasma lipids in overweight and obese children

Objective:

This study examines the associations between objectively measured sedentary behavior, light physical activity (LPA), and moderate‐to‐vigorous physical activity (MVPA), and plasma lipids in overweight and obese children.

Design and Methods:

Cross‐sectional analyses were conducted among 126 children aged 5.5‐9.9 years. Sedentary behavior, LPA, and MVPA were assessed using accelerometry. Fasting blood samples were analyzed for plasma lipids (high‐density lipoprotein cholesterol [HDL‐C], low‐density lipoprotein cholesterol [LDL‐C], total cholesterol [TC], and triglycerides [TG]).

Results:

MVPA was not related to plasma lipids (P > 0.05). Independent of age, sex, energy intake, and waist circumference z‐score, sedentary behavior and LPA were associated with HDL‐C (β = ?0.23, 95% CI ?0.42 to ?0.04, P = 0.020; β = 0.20, 95% CI 0.14 to 0.39, P = 0.036, respectively). The strength of the associations remained after additionally adjusting for MVPA (sedentary behavior: β = ?0.22, 95% CI ?0.44 to 0.006, P = 0.056; LPA: β = 0.19, 95% CI ?0.005 to 0.38, P = 0.056, respectively).

Conclusion:

Substituting at least LPA for sedentary time may contribute to the development of healthy HDL‐C levels among overweight and obese children, independent of their adiposity. Comprehensive prevention and treatment strategies to improve plasma HDL‐C among overweight and obese children should target reductions in total sedentary time and promote the benefits of LPA, in addition to promoting healthy levels of adiposity, healthy dietary behaviors, and MVPA.

     

Prevalence of overweight and obesity among the affluent adolescent school children of Amritsar, Punjab

In the present study, an attempt has been made to assess the prevalence of overweight and obesity in adolescent children (between 10-15 years of age) of the affluent families of Amritsar district of Punjab, a state in rapid economic and epidemiological transition. A total of 640 children (323 boys and 317girls) were measured for height and weight. Overweight and obesity were assessed using age and sex-specific body mass index (BMI) cut-off points. 9.91% boys and 11.99% girls were overweight, and 4.95% boys and 6.31% girls were obese. The prevalence of overweight and obesity among the affluent children in Amritsar was as high or higher as in some industrialized countries.     

A short-term diet and exercise intervention ameliorates inflammation and markers of metabolic health in overweight/obese children

The present study was designed to examine the effects of short-term diet and exercise on markers of metabolic health, serum-stimulated production of inflammatory biomarkers from cultured monocytes and adipocytes, and serum lipomics. Twenty-one overweight/obese children (9 boys and 12 girls, age 13.0 ± 0.5 yr, BMI 33.0 ± 1.8 kg/m(2)) were placed on a 2-wk ad libitum, high-fiber, low-fat diet and daily exercise regimen. Fasting serum samples were taken pre- and postintervention for determination of cytokines, metabolic risk markers, and lipomics. Monocytes and adipocytes were incubated with pre- and postintervention serum to investigate changes in cytokine secretion. Correlative associations were calculated, followed by hierarchical clustering to determine relationships between fatty acid (FA) species and clinical biomarkers. Despite remaining overweight/obese, interleukin (IL)-6, IL-8, TNFα, PAI-1, resistin, amylin, leptin, insulin, and IL-1ra decreased and adiponectin increased. Culture studies indicated decreases in monocyte secretion of IL-6, TNFα, and IL-1β and adipocyte secretion of IL-6. Lipomic analysis revealed a decrease in total lipids and decreases in saturated FAs and an increase in 18:1/18:0. In general, Pearson's correlations revealed that inflammatory markers are negatively associated with a cluster of polyunsaturated FAs and positively correlated with several saturated FAs. These results indicate significant modification of multiple indices of metabolic health with short-term rigorous lifestyle modification in overweight/obese children prior to obesity reversal.     

Total salivary IgA,serum C3c and IgA in obese school children

Studies of the immunologic function in adult obese humans and experimental models indicate that excess adiposity is associated with impairments in host defense mechanisms. The aim of this work was to analyze the secretory and humoral immune system in obese children (n = 105, 55 boys, 50 girls ), between 6 and 13 years of age. Samples of non-stimulated saliva and whole blood were collected from fasting patients. Total salivary IgA (IgAsal), serum C3 complement (C3c) and Immunoglobulin A (IgA) were determined by quantitative radial immunodifussion on agar gel layers ( Diffu-plate, Biocienti;fica SA ). Results, expressed as mg/dl, were compared to laboratory reference values from healthy children of either sex in the same range of age that belong to the same socioeconomic class (n = 60). Data (Mean +/- 1 SD) of the whole population were: IgAsal: 11.4 +/- 4.8 vs 14.8 +/- 6.9; C3c: 190.7 +/- 53.1 vs 126.3 +/- 45.5; IgA: 194.5 +/- 101.5 vs 157.2 +/- 19.9. Data distribution showed higher frecuencies near the zone of the highest reference values for serum C3c; when results of IgA and IgAsal were expressed as percentage of the mean reference value, 51% and 48.6% of the whole studied population presented data lower than 100% and 75% respectively. These results show a compromised secretory immune system without incidence of clinical symptoms and infections, whereas humoral immunity might not be profoundly affected.     

Psychosocial predictors of 4‐year BMI change in overweight and obese children in primary care

Objective:

This study aimed to determine whether (( 1 ) ) initial and/or (( 2 ) ) changes in psychosocial functioning predict body mass index (BMI) z‐score change over 4 years in overweight/mildly obese 5‐ to 9‐year old children presenting to primary care.

Design and Methods:

Eligible participants (n = 258) were overweight/mildly obese children (IOTF criteria) recruited into the LEAP2 trial (ISRCTN52511065) from 3,958 children visiting general practitioners in Melbourne, Australia from May 2005 to July 2006. Predictors were change scores calculated from repeated measures of parent‐ and child‐reported child health‐related quality of life (PedsQL) and self‐esteem; child‐reported desire to be thinner; and parent‐reported child weight concern. Outcome was measured BMI z‐score change from baseline to 4 years.

Results:

The 189 respondents (61% female; 73% retention) showed little mean change in BMI z‐score (?0.08) but wide variation (standard deviation 0.50, range ?1.32 to 1.20). Only one baseline measure (better parent‐reported PedsQL School Functioning) predicted improving BMI z‐score. However, parents and children consistently reported that changes in psychosocial functioning (i.e., PedsQL Social and Global Self‐esteem) were inversely related to BMI z‐score change scores. The strongest predictors of decreases in BMI z‐scores were changes in child‐reported body‐image variables, i.e., improvements in Physical Appearance Self‐esteem (β =0.40, 95% CI ?0.98 to ?0.15, P < 0.01) and declines in Desire to be Thinner (β = 0.33, 95% CI 0.04 to 0.23, P < 0.01).

Conclusions:

At presentation to primary care, it seems unlikely that targeting the psychosocial factors measured in this study would influence BMI z‐score change in overweight/mildly obese children. Subsequent change in psychosocial well‐being covaries with BMI z‐score change and may have important adolescent ramifications; the causal directions for these associations require further research.

     

Food consumption, activity, and overweight among elementary school children in an Appalachian Kentucky community

In the U.S., child overweight is on the rise and is implicated in later adult chronic illness. Given that overweight is hardly tractable, prevention as compared to treatment is seen as a better alternative for lowering the risk of long-term health consequences. To increase the success of prevention efforts, many argue that programs must be "culturally sensitive and targeted toward specific populations at greater risk. However, there exists a limited understanding of how overweight is distributed across the landscape, among and within populations and groups. This paper reports the prevalence of overweight among 54 school children in a rural, Appalachian community with a high rate of poverty, and it compares boys to girls. Thirty-seven percent of boys and 10.3% of girls are overweight, based on the 90th percentile body mass index (BMI). Analysis of food intake indicates a pattern of food consumption that is high in fatty and sugary foods and low in fruit and vegetable consumption. Analysis of activity indicates that children report more low-intensity activity than high; that overweight children report more episodes of video/computer play compared to nonoverweight children; and that boys spend more time than girls in front of the computer/television screen.     

Use of complementary and alternative therapies by overweight and obese adults

Objective: Obesity is associated with higher health‐care costs due, in part, to higher use of traditional health care. Few data are available on the relationship between obesity and the use of complementary and alternative medicine (CAM). Methods and Procedures: We analyzed data on CAM use from the 2002 National Health Interview Survey (NHIS) Alternative Medicine Supplement (n = 31,044). We compared the use of CAM overall, within the past 12 months, between normal weight (BMI from 18 to <25), overweight (from 25 to <30), mildly obese (from 30 to <35), moderately obese (from 35 to <40), and extremely obese (>40) adults. For the primary analysis, our multivariable model was adjusted for sociodemographic factors, insurance status, medical conditions, and health behaviors. We performed additional analyses to explore the association of BMI and the use of seven CAM modalities. Results: We found that adults with obesity have lower prevalence of use of yoga therapy, and similar prevalence of use of several CAM modalities, including relaxation techniques, natural herbs, massage, chiropractic medicine, tai chi, and acupuncture, compared to normal‐weight individuals. After adjustment for sociodemographic factors, insurance status, medical conditions, and health behaviors, adults with obesity were generally less likely to use most individual CAM modalities, although the magnitude of these differences were quite modest in many cases. Discussion: Even though adults with obesity have a greater illness burden and higher utilization of traditional medical care, adults with higher BMIs were no more likely to use each of the individual CAM therapies studied. Additional research is needed to improve our understanding of CAM use by adults with obesity.     

Are there sex differences in the prevalence of overweight and adiposity in elementary school children in Austria

Based on the data of 203 male and 179 female schoolchildren from Eastern Austria (Burgenland), aged between 6 and 10 years, sex typical differences in body composition (absolute and relative body fat, lean body mass) and weight status were analyzed. Body composition analyses were carried out by means of BIA method, weight status was estimated using BMI percentiles (BMI > 90th percentile defined overweight, BMI > 97th percentile defined obesity). Statistically significant sex differences were found for all body composition parameters, girls exhibited a significantly higher amount of absolute and relative body fat, whereas their male counterparts exhibited a significantly higher amount of lean body mass. Regarding weight status, no statistically significant sex differences were observable, however, a higher amount of girls could be classified as overweight or obese. Evolutionary and sociocultural explanations for these observations are discussed.