Body Mass Index Z-score Research Articles

Peak expiratory flow, core performance and physical activity in normal-weight, overweight, and obese adolescents.

The objectives of this study were to (1) compare peak expiratory flow (PEF), physical activity (PA), and core performance among normal-weight, overweight, and obese adolescents and (2) explore the relationships between PEF, physical activity, core performance, and anthropometric measurements across these groups. Ninety adolescents aged 10-13 yr were categorized based on BMI: normal weight (n = 30, 5th to < 85th percentile, BMI-Z score -2 to < 1), overweight (n = 30, 85th to < 95th percentile, BMI-Z score 1 to < 2), and obese (n = 30, > 95th percentile, BMI-Z score > 2). PEF and percent-predicted values ofPEF(PEF% pred) values were calculated. Waist and neck circumferences were measured. Physical activity levels were assessed using the Physical Activity Questionnaire for Older Children (PAQ-C), from which total and subscores were derived. Core performance was evaluated through modified push-up (MPU) and sit-up tests. The PEF% pred and PAQ-C scores showed no significant differences between groups (p > 0.05). However, MPU repetition rates were significantly lower in obese adolescents compared to overweight (p = 0.019) and normal-weight peers (p < 0.001). There was a significant correlation between PEF% pred and PAQ-C total scores (p = 0.014), as well as out-of-school subscores (p = 0.039) in overweight adolescents. Similarly, PEF% pred was linked to MPU repetitions in obese adolescents (p = 0.029). Obese adolescents exhibited decreased core performance relative to their overweight and normal-weight counterparts, which correlated with the PEF% pred. Physical activity was associated with PEF% pred exclusively in overweight adolescents.

Investigation of the psychometric properties of the Comprehensive Feeding Practices Questionnaire in Turkish parents.

The Comprehensive Feeding Practices Questionnaire (CFPQ) measures parental attitudes towards feeding practices that directly influence children's eating habits. This study aims to determine the reliability and validity of the Turkish adaptation of the CFPQ developed by Musher-Eizenman etal. Validity and reliability analyses were conducted for the Turkish version of the CFPQ (T-CFPQ). In addition to reliability analyses and partial correlations between scale dimensions, correlations between scale dimensions according to mothers' BMI and children's BMI z-scores were also examined. Parents with children aged 18 months to 8 years living in the community. The study sample consisted of 274 parents with children aged 18 months to 8 years who agreed to participate in the online survey. In this study, forty-seven items and twelve-factor structure describing feeding practices were supported by the confirmatory factor analysis. Although most of the dimensions of the T-CFPQ showed significant correlations with each other, the highest correlation was found between the encourage balance/variety and the dimension of modelling and teaching nutrition (r = 0·53; 0·50) (P < 0·05). There was a negative correlation between the child's BMI z-score and the pressure to eat dimension (r = -0·173; P < 0·01) and a positive correlation between the restriction for weight dimension (r = 0·339; P < 0·01). Maternal BMI was negatively associated with the involvement dimension (r = -0·121; P < 0·05) and positively associated with the restriction for weight dimension (r = 0·154; P < 0·01). The findings revealed that the T-CFPQ is a valid and reliable measurement tool that can be applied to obtain the necessary information for evaluating nutritional interactions between parent and child.

Impact of lumacaftor/ivacaftor on the bacterial and fungal respiratory pathogens in cystic fibrosis: a prospective multicenter cohort study in Sweden.

A significant decline in pulmonary exacerbation rates has been reported in CF patients homozygous for F508del treated with lumacaftor/ivacaftor. However, it is still unclear whether this reduction reflects a diminished microbiological burden. The aim of this study was to determine the impact of lumacaftor/ivacaftor on the bacterial and fungal burden. The study is a prospective multicenter cohort study including 132 CF patients homozygous for F508del treated with lumacaftor/ivacaftor. Clinical parameters as well as bacterial and fungal outcomes 1 year after initiation of lumacaftor/ivacaftor were compared to data from 2 years prior to initiation of the treatment. Changes in the slope of the outcomes before and after the onset of treatment were assessed. Lung function measured as ppFEV1 (p < 0.001), body mass index (BMI) in adults (p < 0.001), and BMI z-score in children (p = 0.007) were improved after initiation of lumacaftor/ivacaftor. In addition, the slope of the prevalence of Streptococcus pneumoniae (p = 0.007) and Stenotrophomonas maltophilia (p < 0.001) shifted from positive to negative, that is, became less prevalent, 1 year after treatment, while the slope for Candida albicans (p = 0.009), Penicillium spp (p = 0.026), and Scedosporium apiospermum (p < 0.001) shifted from negative to positive. The current study showed a significant improvement in clinical parameters and a reduction of some of CF respiratory microorganisms 1 year after starting with lumacaftor/ivacaftor. However, no significant changes were observed for Pseudomonas aeruginosa, Staphylococcus aureus, or Aspergillus fumigatus, key pathogens in the CF context.

Eating patterns and risk of eating disorders in adolescents

Adolescence is a critical period for the onset of eating disorders, which affect an adolescent's diet and can have adverse and long-term health consequences. The relationship between the risk of eating disorders and the diet of Russian adolescents has been little studied. The objective of the research was to characterize the relationship between the risk of eating disorders and dietary patterns in a sample of Russian schoolchildren. Material and methods. The continuous cross-sectional study included tenth-graders of secondary schools (n=379, 63.1% girls) aged 16.0±0.5 years. The Russian version of the Eating Disorder Inventory was used to assess the risk of eating disorders. Dietary information was obtained from questionnaires completed by adolescents, characterizing the frequency of meals (at home and at school) during the week, the variety of dishes, and the frequency of consumption of foods and dishes. Anthropometric measurements were carried out to calculate body mass index (BMI), waist circumference (WC)/height index. Results. The eating patterns of schoolchildren were significantly disrupted, more so in girls. They were statistically significantly less likely than boys to consume meat, milk, nuts, and butter, and were more likely to skip breakfast. Significant correlations were shown between BMI Z-score and WC/height index in girls with body dissatisfaction (R=0.19 and 0.18, respectively, p<0.01), desire to lose weight (R=0.26 and 0.25, respectively, p<0.01) and bulimic tendencies (R=0.13, p<0.05 for WC/height). In boys, the drive for thinness was significantly associated only with abdominal fat deposition (R=0.26, p<0.01). Body dissatisfaction and desire for thinness in boys were associated with statistically significantly lower consumption of candies, chocolate, ice cream, cookies and potatoes; in girls - with rare consumption of candies, ice cream, sweet carbonated drinks, juices, fast food, as well as bread, meat and sausages, butter, skipping breakfast and dinner. Conclusion. The tendency to develop eating disorder in adolescence is more common in girls and is associated with dietary restrictions affecting important components of the diet necessary for normal growth and development.

Comparative analysis of gut microbiota in children with obstructive sleep apnea: assessing the efficacy of 16S rRNA gene sequencing in metabolic function prediction based on weight status.

Analyzing bacterial microbiomes consistently using next-generation sequencing (NGS) is challenging due to the diversity of synthetic platforms for 16S rRNA genes and their analytical pipelines. This study compares the efficacy of full-length (V1-V9 hypervariable regions) and partial-length (V3-V4 hypervariable regions) sequencing of synthetic 16S rRNA genes from human gut microbiomes, with a focus on childhood obesity. In this observational and comparative study, we explored the differences between these two sequencing methods in taxonomic categorization and weight status prediction among twelve children with obstructive sleep apnea. The full-length NGS method by Pacbio® identified 118 genera and 248 species in the V1-V9 regions, all with a 0% unclassified rate. In contrast, the partial-length NGS method by Illumina® detected 142 genera (with a 39% unclassified rate) and 6 species (with a 99% unclassified rate) in the V3-V4 regions. These approaches showed marked differences in gut microbiome composition and functional predictions. The full-length method distinguished between obese and non-obese children using the Firmicutes/Bacteroidetes ratio, a known obesity marker (p = 0.046), whereas the partial-length method was less conclusive (p = 0.075). Additionally, out of 73 metabolic pathways identified through full-length sequencing, 35 (48%) were associated with level 1 metabolism, compared to 28 of 61 pathways (46%) identified through the partial-length method. The full-length NGS also highlighted complex associations between body mass index z-score, three bacterial species (Bacteroides ovatus, Bifidobacterium pseudocatenulatum, and Streptococcus parasanguinis ATCC 15912), and 17 metabolic pathways. Both sequencing techniques revealed relationships between gut microbiota composition and OSA-related parameters, with full-length sequencing offering more comprehensive insights into associated metabolic pathways than the V3-V4 technique. These findings highlight disparities in NGS-based assessments, emphasizing the value of full-length NGS with amplicon sequence variant analysis for clinical gut microbiome research. They underscore the importance of considering methodological differences in future meta-analyses.

Total airway mechanics and fractional exhaled nitric oxide levels of children living in banjihas (semi-basements).

The ISAAC phase III study in Korea found a higher incidence of wheezing illnesses among residents in basements or semi-basements. This study investigates the link between living in banjihas (semi-basements) and airway resistance and Th2 airway inflammation in Korean children, compared to those on higher floors. We assessed 575 fifth- and sixth-grade students (aged 10-12) in an inner-city area of South Korea. The study utilized impulse oscillometry to measure small and total airway resistance (Rrs20-5 and Rrs0, respectively) and Fractional Exhaled Nitric Oxide (FeNO) measurements to evaluate airway inflammation. We also considered a range of biological and environmental factors, including allergen sensitization, serum 25-hydroxyvitamin D levels, and urinary metabolites like VOCs, bisphenol, and triclosan. Participants were categorized by living floors: banjihas, first-fifth floors, and sixth floors or higher. Twenty-five children (4.3%) lived in banjihas, 311 (54.1%) on the first to fifth floor, and 239 (41.6%) on the sixth floor or above. Despite similar levels of allergen sensitization and urinary pollutant metabolite levels across all groups, banjiha dwellers showed significantly higher total airway resistance (adjusted &1: 0.633, 95%CI: 0.156, 1.109; P = 0.009) and a greater prevalence of elevated FeNO levels (> 35 ppb) (P = 0.033). These findings persisted after adjusting for critical factors like height, gender, BMI z-score, and birth conditions. Children in banjihas exhibit elevated airway resistance and FeNO levels independently of allergen sensitization or pollution exposure, underscoring the necessity for enhanced focus on their respiratory health in such living conditions.

Correlation between gross motor coordination and basic coordination capacities in normal-weight and overweight/obese children aged 9-10 years.

Gross motor coordination (GMC) plays a crucial factor in children's motor development and daily activities. It encompasses various sub-capacities, such as spatial orientation, rhythm, and motor reaction, collectively referred to as basic coordination capacities (BCC). However, children who are overweight and obese (OW/OB) often display poorer GMC. This study aims to examine the impact of gender and weight status (BMI categories) on children's GMC and BCC. It also seeks to investigate the impact of BCC and BMI on GMC. The study involved 266 participants, 135 in the NW group (boys: n = 75; girls: n = 60) and 131 in the OW/OB group (boys: n = 68; girls: n = 63). An NW status is defined by a BMI z-score between ≥-2SD to ≤1SD, while an OW/OB status corresponds to a BMI z-score > 1SD. Physical activity was assessed using the Physical Activity Questionnaire for Children, developed by the University of Saskatchewan, Canada. We used six field tests to evaluate BCC, including single leg standing test (static balance), YBT (dynamic balance), rhythmic sprint test (rhythm), reaction time test (motor reaction), target standing broad test (kinesthetic differentiation), and numbered medicine ball running test (spatial orientation). GMC was evaluated with Kiphard-Schilling's Body Coordination Test (KTK). The motor quotient (MQ) was primarily affected by weight status (F = 516.599, p < 0.001; gender: F = 6.694, p = 0.01), with no significant interaction effect (F = 0.062, p = 0.803). In BCC, gender had a significant main effect on rhythm capacity (F = 29.611, p < 0.001) and static balance (F = 11.257, p = 0.001) but did not significant influence other sub-capacities (p > 0.05). Weight status impacted dynamic balance (F = 11.164, p = 0.001). The interaction of gender and weight status significantly impacted motor reaction (F = 1.471, p = 0.024) and kinesthetic differentiation (F = 5.454, p = 0.02), but did not affect other sub-capacities (p > 0.05). The physical activity was not significant affected by gender (F = 0.099, p = 0.753), weight status (F = 0.171, p = 0.679) and the interactions of two variables (F = 0.06, p = 0.806). In the regression analysis, except motor reaction (p > 0.05), other BCC sub-capacities influenced GMC to varying extents (β = -0.103-0.189, p < 0.05). Nonetheless, only two types of balance significantly mediated the relationship between BMI and GMC (BMI→MQ: β = -0.543, p < 0.001; BMI→YBT: β = -0.315, p < 0.001; BMI→SLS: β = -0.282, p < 0.001; SLS→MQ: β = 0.189, p < 0.001; YBT→MQ: β = 0.182, p < 0.001). Compared to gender, the main effect of weight status on most GMC and BCC's sub-capacities was more pronounced. OW/OB children exhibited poorer GMC, which is related to their reduced static and dynamic balance due to excess weight. Kinesthetic differentiation, spatial orientation, and rhythm capacity are not significantly associated with BMI, but these sub-capacities positively influence gross motor coordination (GMC), except for hand-eye motor reaction.

Puberty in girls with Prader-Willi syndrome: cohort evaluation and clinical recommendations in a Latin American tertiary center.

Prader-Willi syndrome (PWS) is a genetic disorder characterized by hypothalamic-pituitary deficiencies including hypogonadism. In girls with PWS, hypogonadism can present early in childhood, leading to genital hypoplasia, delayed puberty, incomplete pubertal development, and infertility. In contrast, girls can present with premature activation of the adrenal axis leading to early pubarche and advanced bone age. We aim to evaluate the progression of puberty and adrenarche signals in girls with PWS. A longitudinal retrospective cohort study included girls with PWS followed at a Pediatric Endocrinology Outpatient Clinic in a Tertiary University Hospital in Sao Paulo, Brazil from 2002 to 2022. Data collected via chart review included clinical information on birth history, breast and pubic hair Tanner stages, presence of genital hypoplasia, age at menarche, regularity of menstrual cycles, body mass index (BMI) z-score, final height, age of initiation of estrogen replacement and growth hormone replacement, as well as results for PWS genetic subtype; biochemical investigation (LH, FSH, estradiol, DHEA-S); radiographic bone age and pelvic ultrasound. A total of 69 girls were included in the study and the mean age of puberty onset was 10.2 years in those who started puberty after the age of 8 years. Breast Tanner stage IV was reached by 29.1% girls at a mean age of 14.9 years. Spontaneous menarche was present in 13.8% and only one patient had regular menstrual cycles. Early adrenarche was seen in 40.4% of cases. Our study demonstrated in a large sample that girls with PWS often present with delayed onset of puberty despite frequent premature adrenarche. Based on our results, we suggest an estrogen replacement protocol for girls with PWS to be started at the chronological age or bone age of 12-13 years, taking into consideration the uterus size. Further prospective studies are needed.

Utility of a high-intensity interval training app as a remote exercise support strategy in children with obesity: An exploratory study of adherence, effect, and perceptions of its use.

This study aimed to explore the utility of a high-intensity interval training (HIIT) app as a remote exercise support strategy in children with obesity through assessing adherence, possible effects on obesity-related outcomes, and perceptions of its use to support counseling and improve the treatment of children with obesity. Thirty-seven children (94.6% with obesity; 45.9% girls), with a mean age of 10.4 (±1.8) years and a mean body mass index (BMI) z-score of 3.31 (±1.09) were recruited to use the app during 6 weeks. Assessments were performed at baseline, 6 (end of intervention), and 12 weeks (follow up). Thirty-two (86.3%) participants completed both intervention and follow-up assessments and were analyzed. On average, children used the HIIT app 2.5 times per week (95% confidence interval (CI): 1.9 to 3.0), with the highest perceived exertion of 4.1 (95% CI: 3.6 to 4.5). No over-time differences were found in body composition, physical activity, screen time, sleep duration, or water intake after the intervention; however, an over-time decrease in sugary beverages intake (Δ-0.9, 95% CI: -1.6 to -0.1, p = .019). No differences in body composition were found at follow up. Although none of the children or parents perceived impairments in nutritional behavior, general wellbeing, or fitness as a consequence of intervention, most children (64.5%), but not parents, perceived improvements in nutritional behavior and general wellbeing. Although feasible, the 6-week effect of HIIT app use is modest or absent regarding body composition, movement, and nutritional behavior change, probably due to its low volume. More studies are needed to explore the utility of HIIT apps as a remote exercise support strategy for children with obesity further.

PM2.5 constituents associated with childhood obesity and larger BMI growth trajectory: A 14-year longitudinal study

BackgroundThe association of specific PM2.5 chemical constituents with childhood overweight or obesity (OWOB) remain unclear. Furthermore, the long-term impacts of PM2.5 exposure on the trajectory of children's body mass index (BMI) have not been explored. MethodsWe conducted a longitudinal study among 1,450,830 Chinese children aged 6–19 years from Beijing and Zhongshan in China during 2005–2018 to examine the associations of PM2.5 and its chemical constituents with incident OWOB risk. We extracted PM2.5 mass and five main component exposure from Tracking Air Pollution in China (TAP) dataset. Cox proportional hazards models were applied to quantify exposure–response associations. We further performed principal component analysis (PCA) to handle the multi-collinearity and used quantile g-computation (QGC) approach to analyze the impacts of exposure mixtures. Additionally, we selected 125,863 children with at least 8 physical examination measurements and combined group-based trajectory models (GBTM) with multinomial logistic regression models to explore the impacts of exposure to PM2.5 mass and five constituents on BMI and BMI Z-score trajectories during 6–19 years. ResultsWe observed each interquartile range increment in PM2.5 exposure was significantly associated with a 5.1 % increase in the risk of incident OWOB (95 % confidence Interval [CI]: 1.036–1.066). We also found black carbon, sulfate, organic matter, often linked to fossil combustion, had comparable or larger estimates of the effect (HR = 1.139–1.153) than PM2.5. Furthermore, Exposure to PM2.5 mass, sulfate, nitrate, ammonium, organic matter and black carbon was significantly associated with an increased odds of being in a larger BMI trajectory and being assigned to persistent OWOB trajectory. ConclusionsOur findings provide evidence that the constituents mainly from fossil fuel combustion may have a perceptible influence on increased OWOB risk associated with PM2.5 exposure in China. Moreover, long-term exposure to PM2.5 contributes to an increased odds of being in a lager BMI and a persistent OWOB trajectories.

Assessment of Knowledge, Attitudes and Behaviors Regarding Balanced Nutrition and Nutritional Status Among Adolescents at the Yayasan Bandung Senior High School, Deli Serdang Regency

Background: Malnutrition during adolescence can slow growth and delay puberty. Adequate nutritional knowledge, attitudes, and behavior among adolescents are crucial to prevent health issues that can continue into adulthood. Objectives: To assess the knowledge, attitudes, and behaviors related to balanced nutrition and nutritional status among adolescents at the Yayasan Bandung Senior High School, Deli Serdang Regency. Methods: The research design used was a cross-sectional design with a total of 80 adolescents aged 14 to 18 years at the Yayasan Bandung Senior High School, Deli Serdang Regency. The subject taking technique was stratified random sampling. Knowledge, attitudes, and behaviors of balanced nutrition were obtained through questionnaires. Height and weight data were analyzed using WHO Anthro Plus to determine the Z-score of Body Mass Index according to age. Data analysis used the Spearman test to determine the relationship between variables. Results: Most adolescents had good nutritional status, namely 68.8%, while the percentage of overnutrition and obesity was 18.8% and undernutrition was 12.5%. Adolescents have a high level of knowledge of balanced nutrition of 20 adolescents (25%). Balanced nutrition attitudes were categorized as high, namely 43 adolescents (53.8%), while high category balanced nutritional behaviors were only 6 adolescents (7.5%). The results of the bivariate test (Spearman Correlation) showed a relationship between attitudes and behavior-balanced nutrition (p&lt;0.05). Conclusions: There is a relationship between attitudes and behavior of balanced nutrition in adolescence the Bandung Higher Education Foundation High School, Deli Serdang Regency.

Nadir Hastalıklarda Telenütrisyon Desteği Olumlu Etkiler Oluşturabilir: Spinal Musküler Atrofi Tip 2 Olgu Sunumu

In this case report, the 6-month telenutrition counseling process of a 13-year-old male patient diagnosed with spinal muscular atrophy type 2 was discussed. Severe malnutrition was observed in the patient, who used a wheelchair and was fed orally. As a result of examining all the findings, a 6-month telenutrition counseling process was started with a diet containing 50 kcal/kg of energy and 1.85 g/kg of protein per day. At the end of the process, the patient’s body weight increased from 30.5 kg to 35 kg, the body mass index increased from 13.6 kg/m2 to 15.6 kg/m2, and the body mass index Z-score value for age increased from -3.04 to -1.75. The family expressed satisfaction with the counseling process. Patients diagnosed with spinal muscular atrophy require medical nutritional therapy counseling. Telenutrition counseling is considered beneficial in reaching patients and ensuring the treatment process.

Underweight in the first 2 years of life and nutrition risk in later childhood: a prospective cohort study.

Children with underweight in the first 2 years have lower body mass index z-score (zBMI) and height-for-age z-score (HAZ) in later childhood. It is not known if underweight in the first 2 years is associated with nutrition risk in later childhood. (1) Determine the relationship between underweight (zBMI < -2) in the first 2 years and nutrition risk measured by the Nutrition Screening for Toddlers and Preschoolers (NutriSTEP) score from 18 months to 5 years. (2) Explore the relationship between underweight in the first 2 years and the NutriSTEP subscores for eating behaviours and dietary intake from 18 months to 5 years. This was a prospective study, including healthy full-term children in Canada aged 0-5 years. zBMI was calculated using measured heights and weights and the WHO growth standards. NutriSTEP score was measured using a parent-completed survey and ranged from 0 to 68. Nutrition risk was defined as a score ≥21. Linear mixed effects models were used. Four thousand nine hundred twenty-nine children were included in this study. At enrolment, 51.9% of participants were male. The prevalence of underweight children was 8.8%. Underweight in the first 2 years was associated with higher NutriSTEP (0.79, 95% CI: 0.29,1.29), higher eating behaviour subscore (0.24, 95% CI: 0.03, 0.46) at 3 years and higher odds of nutrition risk (OR: 1.39, 95% CI: 1.07,1.82) at 5 years. Children with underweight in the first 2 years had higher nutrition risk in later childhood. Further research is needed to understand the factors which influence these relationships.

Efficacy and safety of a smartphone application-based treatment of ketogenic diet in pediatric refractory epilepsy.

We aimed to find predictors for smartphone application-based ketogenic diet (KD) treatment effectiveness and safety. The efficacy was evaluated according to the reduction in seizure frequency after the intervention of KD; safety was evaluated based on adverse effects. The ordinal logistic regression analysis was used to explore the influencing factors of efficacy. The study sample included 116 males and 65 females with a median age of 2.27 years. The baseline frequency of seizure was more than five times/day in 123 children, 50.83% of them received three or more antiepileptic drugs (AEDs). Seventy-two patients' KD initiation mode was outpatient, and 73 completed the 12-month follow-up. A total of 88 (48.62%) patients had reported a reduction in seizure ≥50%. Compared with 12 months, those who had received KD therapy for only 3 (P = 0.009) and 6 months (P = 0.005) were more likely to show negative outcomes. Outpatient initiation had better outcomes (P = 0.029) than inpatient initiation. For the number of AEDs applied, patients on two AEDs were more likely to achieve better outcomes (P = 0.001). Adverse events had been noted among 77 patients; BMI Z-score at KD initiation was associated with adverse effects (P = 0.003). Our study suggested that outpatient initiation and long-term treatment of KD should be encouraged. Our research shows that the KD is a helpful treatment for children with refractory epilepsy, reducing seizures by more than 50% in nearly half of the cases, with some experiencing complete seizure freedom. We used a smartphone app to improve communication between patients and their healthcare teams, resulting in a high retention, and app usage was linked to reduced adverse effects. We recommend early consideration of KD treatment for patients failing two AED, encourage outpatient initiation, and advocate for longer-term KD use.

BMI Z-Score (SDS) versus Calculated Body Fat Percentage: Association with Cardiometabolic Risk Factors in Obese Children and Adolescents

Introduction: BMI or BMI-standardized deviation score (SDS) in children and adolescents is still the standard for weight classification. [BMJ. 2019;366:4293] developed a formula to calculate body fat percentage (%BF) based on age, sex, height, weight, and ethnicity. Using data from the German/Austrian APV registry, we investigated whether the calculated %BF is superior to BMI-SDS in predicting arterial hypertension, dyslipidaemia, and impaired glucose metabolism. Methods: 94,586 children and adolescents were included (12.5 years, 48.3% male). Parental birth country (BC) was used to depict ethnicity (15.8% migration background); 95.67% were assigned to the ethnicity “white.” %BF was calculated based on the Hudda formula. The relationship between BMI-SDS or %BF quartiles and outcome variables was investigated by logistic regression models, adjusted for age, sex, and migration background. Vuong test was applied to analyse predictive power. Results: 58.4% had arterial hypertension, 33.5% had dyslipidaemia, and 11.6% had impaired glucose metabolism. Boys were significantly more often affected, although girls had higher calculated %BF (each p < 0.05). After adjustment, both models revealed significant differences between the quartiles (all p < 0.001). The predictive power of BMI-SDS was superior to %BF for all three comorbidities (all p < 0.05). Discussion: The prediction of cardiometabolic comorbidities by calculated %BF was not superior to BMI-SDS. This formula developed in a British population may not be suitable for a central European population, which is applicable to this possibly less heterogeneous collective. Additional parameters, especially puberty status, should be taken into account. However, objective determinations such as bioimpedance analysis may possibly be superior to assess fat mass and cardiometabolic risk than calculated %BF.

Sex-specific differences in ectopic fat and metabolic characteristics of paediatric nonalcoholic fatty liver disease.

Sex-specific differences in obesity-related metabolic characteristics of non-alcoholic fatty liver disease (NAFLD) have rarely been explored, particularly in children with biopsy-verified NAFLD. The influence of sex hormones on ectopic fat disposition may cause inter-sex differences in various metabolic factors. This study aimed to assess the sex-based differences in ectopic fat and metabolic characteristics in children with NAFLD. We enrolled 63 children with biopsy-verified NAFLD (48 boys; mean age, 12.9 ± 3.2 years; mean body mass index z-score [BMI-z], 2.49 ± 1.21). Ectopic fat in the liver and pancreas was quantified based on magnetic resonance imaging within 2 days of the liver biopsy. Laboratory tests, body composition, blood pressure, and anthropometric measurements were also assessed. Sex-based differences were neither observed in age, BMI-z, or total body fat percentage nor in the proportions of obesity, abdominal obesity, diabetes, dyslipidaemia, hypertension, or metabolic syndrome. Furthermore, liver enzyme levels, lipid profiles, and pancreatic fat did not differ between the sexes. However, boys had significantly higher fasting insulin (median 133.2 vs. 97.8 pmol/L; p = 0.039), fasting plasma glucose (median 5.30 vs. 4.83 mmol/L; p = 0.013), homeostasis model assessment of insulin resistance (median 5.4 vs. 3.6; p = 0.025), serum uric acid (404.1 ± 101.2 vs. 322.4 ± 87.1 μmol/L; p = 0.009), and liver fat (median 26.3% vs. 16.3%; p = 0.014). Male-predominant hepatic steatosis and insulin resistance caused by sex-specific ectopic fat accumulation may contribute to higher uric acid levels in boys than in girls with NAFLD.

Effects of an antenatal dietary intervention in women with obesity or overweight on child outcomes at 8–10 years of age: LIMIT randomised trial follow-up

BackgroundThe LIMIT randomised controlled trial looked at the effect of a dietary and lifestyle intervention compared with routine antenatal care for pregnant women with overweight and obesity on pregnancy outcomes. While women in the intervention group improved diet and physical activity with a reduction of high birth weight, other outcomes were similar. We have followed the children born to women in this study at birth, 6 and 18 months and 3–5 years of age and now report follow-up of children at 8–10 years of age.MethodsChildren at 8–10 years of age who were born to women who participated in the LIMIT randomised trial, and whose mother provided consent to ongoing follow-up were eligible for inclusion. The primary study endpoint was the incidence of child BMI z-score > 85th centile for child sex and age. Secondary study outcomes included a range of anthropometric measures, neurodevelopment, child dietary intake, and physical activity. Analyses used intention to treat principles according to the treatment group allocated in pregnancy. Outcome assessors were blinded to the allocated treatment group.ResultsWe assessed 1,015 (Lifestyle Advice n = 510; Standard Care n = 505) (48%) of the 2,121 eligible children. BMI z-score > 85th percentile was similar for children of women in the dietary Lifestyle Advice Group compared with children of women in the Standard Care Group (Lifestyle Advice 479 (45%) versus Standard Care 507 (48%); adjusted RR (aRR) 0.93; 95% CI 0.82 to 1.06; p = 0.302) as were secondary outcomes. We observed that more than 45% of all the children had a BMI z-score > 85th percentile, consistent with findings from follow-up at earlier time-points, indicating an ongoing risk of overweight and obesity.ConclusionsDietary and lifestyle advice for women with overweight and obesity in pregnancy has not reduced the risk of childhood obesity, with children remaining at risk of adolescent and adult obesity. Other strategies are needed to address the risk of overweight and obesity in children including investigation of preconception interventions to assess whether this can modify the effects of maternal pre-pregnancy BMI. The LIMIT randomised controlled trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).

Predictors of visceral and subcutaneous adipose tissue and muscle density: The ShapeUp! Kids study

Background and aimsBody fat distribution, i.e., visceral (VAT), subcutaneous adipose tissue (SAT) and intramuscular fat, is important for disease prevention, but sex and ethnic differences are not well understood. Our aim was to identify anthropometric, demographic, and lifestyle predictors for these outcomes. Methods and resultsThe cross-sectional ShapeUp!Kids study was conducted among five ethnic groups aged 5–18 years. All participants completed questionnaires, anthropometric measurements, and abdominal MRI scans. VAT and SAT areas at four lumbar levels and muscle density were assessed manually. General linear models were applied to estimate coefficients of determination (R2) and to compare the fit of VAT and SAT prediction models. After exclusions, the study population had 133 male and 170 female participants. Girls had higher BMI-z scores, waist circumference (WC), and SAT than boys but lower VAT/SAT and muscle density. SAT, VAT, and VAT/SAT but not muscle density differed significantly by ethnicity. R2 values were higher for SAT than VAT across groups and improved slightly after adding WC. For SAT, R2 increased from 0.85 to 0.88 (girls) and 0.62 to 0.71 (boys) when WC was added while VAT models improved from 0.62 to 0.65 (girls) and 0.57 to 0.62 (boys). VAT values were significantly lower among Blacks than Whites with little difference for the other groups. ConclusionThis analysis in a multiethnic population identified BMI-z scores and WC as the major predictors of MRI-derived SAT and VAT and highlights the important ethnic differences that need to be considered in diverse populations.

Overweight or obesity in children born after assisted reproductive technologies in Denmark: A population-based cohort study.

The association between assisted reproductive technologies (ARTs) and the body mass index (BMI) of children remains controversial. Confounding by morbidity and other factors associated with parental infertility may have biased studies comparing children born after ART with children born after no treatment. We investigated the associations between different fertility treatments and BMI in children at age 5 to 8 years, adjusting for and stratifying by causes of parental infertility. This Danish cohort study included 327,301 children born between 2007 and 2012 (51% males, median age at follow-up 7 years). Of these, 13,675 were born after ART, 7,728 were born after ovulation induction with or without intrauterine insemination [OI/IUI], and 305,898 were born after no fertility treatments. Using the International Obesity Task Force (IOTF) standards, we defined overweight (BMI ≥ IOTF-25) and obesity (BMI ≥ IOTF-30). We compared children born after ART versus OI/IUI; intracytoplasmic sperm injection (ICSI) versus conventional in vitro fertilization (IVF); and frozen-thawed versus fresh embryo transfer and estimated crude and adjusted prevalences of children with overweight or obesity at age 5 to 8 years, prevalence odds ratios (PORs), and differences in mean BMI z-scores. Adjustment was performed using stabilized inverse probability of treatment weights, including parity, year of conception, parental causes of infertility, age, educational level, comorbidities, maternal country of origin, BMI, and smoking as covariates. The crude prevalence of obesity was 1.9% in children born after ART, 2.0% in those born after OI/IUI, and 2.7% in those born after no fertility treatment. After adjustment, children born after ART and OI/IUI had the same prevalence of being overweight (11%; POR 1.00, 95% confidence interval [CI] 0.91 to 1.11; p = 0.95) or obese (1.9%; POR 1.01, 95% CI 0.79 to 1.29; p = 0.94). Comparison of ICSI with conventional IVF yielded similar pattern (POR 0.95, 95% CI 0.83 to 1.07; p = 0.39 for overweight and POR 1.16, 95% CI 0.84 to 1.61; p = 0.36 for obesity). Obesity was more prevalent after frozen-thawed (2.7%) than fresh embryo transfer (1.8%) (POR 1.54, 95% CI 1.09 to 2.17; p = 0.01). The associations between fertility treatments and BMI were only modestly different in subgroups defined by the cause of infertility. Study limitations include potential residual confounding, restriction to live births, and lack of detailed technical information about the IVF procedures. We found no association with BMI at age 5 to 8 years when comparing ART versus OI/IUI or when comparing ICSI versus conventional IVF. However, use of frozen-thawed embryo transfer was associated with a 1.5-fold increased risk of obesity compared to fresh embryo transfer. Despite an elevated relative risk, the absolute risk difference was low.

Association between gut microbiota at 3.5 years of age and body mass index at 5 years: results from two French nationwide birth cohorts.

The relationship between gut microbiota and changes in body mass index (BMI) or pediatric overweight in early life remains unclear, and information regarding the preterm population is scarce. This study aimed to investigate how the gut microbiota at 3.5 years of age is associated with (1) later BMI at 5 years, and (2) BMI z-score variations between 2 and 5 years in children from two French nationwide birth cohorts. Bacterial 16S rRNA gene sequencing was performed to profile the gut microbiota at 3.5 years of age in preterm children (n = 143, EPIPAGE 2 cohort) and late preterm/full-term children (n = 369, ELFE cohort). The predicted abundances of metabolic functions were computed using PICRUSt2. Anthropometric measurements were collected at 2 and 5 years of age during medical examinations or retrieved from children's health records. Statistical analyses included multivariable linear and logistic regressions, random forest variable selection, and MiRKAT. The Firmicutes to Bacteroidetes (F/B) ratio at 3.5 years was positively associated with the BMI z-score at 5 years. Several genera were positively ([Eubacterium] hallii group, Fusicatenibacter, and [Eubacterium] ventriosum group) or negatively (Eggerthella, Colidextribacter, and Ruminococcaceae CAG-352) associated with the BMI z-scores at 5 years. Some genera were also associated with variations in the BMI z-scores between 2 and 5 years of age. Predicted metabolic functions, including steroid hormone biosynthesis, biotin metabolism, glycosaminoglycan degradation, and amino sugar and nucleotide sugar metabolism, were associated with lower BMI z-scores at 5 years. The unsaturated fatty acids biosynthesis pathway was associated with higher BMI z-scores. These findings indicate that the gut microbiota at 3.5 years is associated with later BMI during childhood, independent of preterm or term birth, suggesting that changes in the gut microbiota that may predispose to adult obesity begin in early childhood.