Fat In Children Research Articles

Dietary fat intakes, food sources, and tracking across early childhood: results from the Melbourne InFANT Program.

Despite the important role of dietary fat in early childhood, our understanding of fat intake trends during this period is limited, particularly among Australian children. This study aimed to describe total and saturated fat (SFA) intake trends, food sources, and tracking in young Australian children. Data of children at ages 9 months (n = 393), 18 months (n = 284), 3.5 years (n = 244), and 5 years (n = 240) from the Melbourne InFANT Program were used. Dietary intakes were collected via three 24-hour recalls. Food groups and nutrient intakes were calculated using the 2007 AUSNUT Food Composition Database. Descriptive statistics were used to summarize fat intake and key food sources of fat. Tracking of fat intake was examined using Pearson correlations of residualized fat scores between time points. Total and SFA intake (g/d) increased over time in early childhood. The percentage of energy from total fat decreased from 9 to 18 months but remained stable until 5 years of age. The percentage of energy from SFA decreased across early childhood. Milk and milk products were the primary sources of both total fat and SFA, followed by breads/cereals, and cakes/cookies. Slight to moderate tracking of fat was observed in most age groups. This study described trends and food sources of young children's fat intakes and showed that early fat intakes track up to age 5 years. The study will contribute to the development and refinement of fat recommendations in young Australian children and inform the design of interventions to improve fat intake.

Beyond Obesity and Overweight: The Clinical Assessment and Treatment of Excess Body Fat in Children : Part 1 - Insulin Resistance as the Root Cause of Pediatric Obesity.

Pediatric obesity and comorbidities related to insulin resistance continue to be a growing public health crisis. If lifestyle measures are unsuccessful, pharmacological and surgical interventions are offered. In this paper, we describe the driving force of the obesity crisis: hyperinsulinemia and the development of insulin resistance. We give historical background of key policy issues which have contributed to this pandemic as well as the physiologic mechanisms of insulin resistance. The prevalence of obesity will continue to rise unless the root cause of hyperinsulinemia is addressed. Current research on insulin resistance demonstrates that a decreased consumption of carbohydrates is an effective first-line dietary intervention for the treatment of obesity and related metabolic diseases. Evidence shows it is safe and beneficial. A low-carbohydrate eating pattern can be helpful to address pediatric obesity. However, there must be policy guardrails in place to ensure that this is a sustainable and viable option for children and their families. There must be a change in the nutritional environment to help individuals battle the chronic disease of obesity.

Beyond Obesity and Overweight: the Clinical Assessment and Treatment of Excess Body Fat In Children : Part 2 - the Prescription of Low-Carbohydrate Eating as the First Approach.

Pediatric obesity and comorbidities related to insulin resistance continue to be a growing public health crisis. If lifestyle measures are unsuccessful, pharmacological and surgical interventions are offered. In this paper, we describe the driving force of the obesity crisis: hyperinsulinemia and the development of insulin resistance. We give historical background of key policy issues which have contributed to this pandemic as well as the physiologic mechanisms of insulin resistance. The prevalence of obesity will continue to rise unless the root cause of hyperinsulinemia is addressed. Current research on insulin resistance demonstrates that a decreased consumption of carbohydrates is an effective first-line dietary intervention for the treatment of obesity and related metabolic diseases. Evidence shows it is safe and beneficial. A low-carbohydrate eating pattern can be helpful to address pediatric obesity. However, there must be policy guardrails in place to ensure that this is a sustainable and viable option for children and their families. There must be a change in the nutritional environment to help individuals battle the chronic disease of obesity.

Development and Validation of a Simple Equation to Fat Mass and Percentage of Body Fat in Children and Adolescents

Development and Validation of a Simple Equation to Fat Mass and Percentage of Body Fat in Children and Adolescents

Assessment of Epicardial Fat in Children: Its Role as a Cardiovascular Risk Factor and How It Is Influenced by Lifestyle Habits.

Epicardial adipose tissue (EAT) stands out as a distinctive repository of visceral fat, positioned in close anatomical and functional proximity to the heart. EAT has emerged as a distinctive reservoir of visceral fat, intricately interlinked with cardiovascular health, particularly within the domain of cardiovascular diseases (CVDs). The aim of our overview is to highlight the role of EAT as a marker for cardiovascular risk in children. We also explore the influence of unhealthy lifestyle habits as predisposing factors for the deposition of EAT. The literature data accentuate the consequential impact of lifestyle choices on EAT dynamics, with sedentary behavior and unwholesome dietary practices being contributory to a heightened cardiovascular risk. Lifestyle interventions with a multidisciplinary approach are therefore pivotal, involving a nutritionally balanced diet rich in polyunsaturated and monounsaturated fatty acids, regular engagement in aerobic exercise, and psychosocial support to effectively mitigate cardiovascular risks in children. Specific interventions, such as high-intensity intermittent training and circuit training, reveal favorable outcomes in diminishing the EAT volume and enhancing cardiometabolic health. Future clinical studies focusing on EAT in children are crucial for advancing our understanding and developing targeted strategies for cardiovascular risk management in this population.

Nutrient intake and nutritional status of 4-10-year-old Hungarian children

The growing trend of childhood obesity is a major public health issue. Collaborations between medical and healthcare professionals, preventive and health preservative programs, dietary habit and nutrient intake studies are indispensable. A representative study has been performed among 4-10-year-old Hungarian children by gender, age, size of settlement and region. The study included 733 assessable questionnaires and 666 dietary records. Data on children's eating habits were collected by using the internationally recommended three-day dietary record method. Body weight and height measurements were taken for each child to determine nutritional status. Data were analyzed with statistical methods. The rate of overweight and obesity is 23%. Energy intake differs significantly between body mass index groups. The children's fat intake is excessive (34.2 energy%), the saturated fatty acid intake exceeds the recommended 10 energy%, omega fatty acid ratio is disadvantageous and the children's cholesterol intake is high. The average energy from carbohydrates is below the recommended 57 energy%, from added sugar it is 11%, which affects 52% of the children. Their low fibre intake (19.4 g/day) is due to low fruit, vegetable (263 g/day) and whole grain consumption. Of the micronutrients, sodium intake is 3-4 times higher than the recommended. In 35% of the children, the calcium intake is below the critical threshold, due to unfavourable milk and milk product consumption (290 g/day). Vitamin D intake was low in 98-100% of the children. Compared to the results of other European and national studies performed among children, adolescent and adults, the nutritional status and nutrient intake of our sample is unfavourable. Comprehensive intervention, education of the children with the involvement of their parents is essential to reduce obesity. Orv Hetil. 2023; 164(14): 533-540.

Intake of Different Types of Fatty Acids in Infancy Is Not Associated with Growth, Adiposity, or Cardiometabolic Health up to 6 Years of Age

Background: Studies in adults indicate that a lower saturated and higher unsaturated fat intake is associated with a lower risk of metabolic syndrome and cardiovascular diseases. However, studies on fat intake in relation to cardiometabolic health during childhood are scarce.Objective: We examined associations between dietary intake of fatty acids (FAs) at age 1 y and measures of growth, adiposity, and cardiometabolic health up to age 6 y.Methods: This study was conducted in 2927 children participating in the Generation R Study, a multiethnic, prospective, population-based cohort in the Netherlands. We measured children's total fat intake and intakes of saturated FAs (SFAs), monounsaturated FAs (MUFAs), and polyunsaturated FAs (PUFAs) at a median age of 12.9 mo (95% range: 12.2, 18.9 mo) with a food-frequency questionnaire. We repeatedly measured their height and weight up to age 6 y. At 6 y of age, we measured body fat percentage, diastolic and systolic blood pressure, and serum insulin, triacylglycerol, and HDL cholesterol. These outcomes were combined into a cardiometabolic risk factor score. We examined associations of FA intake with repeated measures of height, weight, and body mass index by using linear mixed models and with cardiometabolic outcomes by using linear regression models, adjusting for sociodemographic and lifestyle factors and taking into account macronutrient substitution effects.Results: In multivariable models, we observed no associations of a higher intake of total fat or SFAs, MUFAs, or PUFAs with growth, adiposity, or cardiometabolic health when fat was consumed at the expense of carbohydrates. In subsequent models, there were also no associations observed for higher MUFA or PUFA intakes at the expense of SFAs with any of the outcomes. Results did not differ by sex, ethnicity, age, or birth weight.Conclusion: The results of this study did not support our hypothesis that intake of different types of FAs was associated with adiposity or cardiometabolic health among children.

Functional Gastrointestinal Disorders and Abdominal Visceral Fat in Children and Adolescents.

Few reports have investigated the correlation between functional gastrointestinal disorders (FGIDs) and the degree of obesity in children and adolescents. Thus, this study aimed to examine the relationship between FGIDs and the degree of obesity in children and adolescents. Children and adolescents (<19 years old) who had undergone abdominopelvic computed tomography and had been diagnosed with FGIDs from 2015 to 2016 were included in this retrospective case-control study in a ratio of 1:2. Abdominal visceral fat was measured using an image analysis software. The mean age of all 54 FGID patients was 12.9±3.4 years, and the male: female ratio was 1:1.2. We observed no difference in body mass index (BMI) between the FGID and control groups (19.5±4.6 vs. 20.6±4.3 kg/m2, p=0.150). However, the FGID group had less abdominal visceral fat than that of the control group (26.2±20.0 vs. 34.4±26.9 cm2, p=0.048). Boys in the FGID group had lower BMI (18.5±3.5 vs. 20.9±4.3 kg/m2, p=0.019) and less abdominal visceral fat (22.8±15.9 vs. 35.9±31.8 cm2, p=0.020) than those of boys in the control group. However, we found no difference in BMI (20.5±5.3 vs. 20.4±4.2 kg/m2, p=0.960) and abdominal visceral fat (29.0±22.9 vs. 33.1±22.1 cm2, p=0.420) between girls in both groups. Our study revealed a difference in the relationship between FGID and the degree of obesity according to sex, which suggests that sex hormones influence the pathogenesis of FGIDs. Multicenter studies with larger cohorts are required to clarify the correlation between FGID subtypes and the degree of obesity.

Health-Related Physical Fitness is Associated with Total and Central Body Fat in Children Aged 6 to 10 Years

Study purpose. This study purpose was to investigate whether health-related physical fitness is associated with total and central body fat in school children aged 6–10 years.&#x0D; Materials and methods. A total of 2197 Macedonian children aged 6–10 years (1096 boys and 1101 girls) participated in the study. Health-related physical fitness was measured by the modified EUROFIT test battery: the 20 m shuttle run test (cardiorespiratory fitness); the handgrip strength test, the standing long jump and the 30 s sit-ups tests (muscular strength); the 4×10 m shuttle run test (motor fitness) and the sit and reach test (flexibility). Body mass index, body fat percentage and waist circumference were used as markers of total and central body fat, respectively.&#x0D; Results. The standing long jump, the 30 s sit-ups, the 4×10 m shuttle run and the 20 m shuttle run tests were negatively associated with all markers of total and central body fat in boys and girls after controlling for age (p&lt;0.01). The handgrip strength test was positively associated with all markers of total and central body fat (p&lt;0.01). No statistically significant correlation was established between the markers of total and central body fat and the sit and reach test.&#x0D; Conclusions. The present study broadens previous findings in children and adolescents which demonstrate correlations between the health-related physical fitness components, chiefly the muscle strength, the agility and cardiorespiratory fitness and total central adiposity. Fitness assessment should be introduced in future epidemiological and intervention studies in school children because it seems to be an important factor determining health.

Clinical Significance of Pancreatic Fat in Children

Recently, interest in pancreatic fat has increased, and fatty pancreas is considered to be related to nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome. We aimed to evaluate the prevalence of echogenic pancreas in children and its related factors. We retrospectively analyzed the data of patients aged 5 to 18 years who had undergone abdominal sonography between January 2020 and December 2020. Patients with chronic or pancreatic diseases were excluded. Of 102 patients, 27 (26.5%) had echogenic pancreas and 55 (53.9%) had NAFLD. Among the 55 patients with NAFLD, 18 (32.7%) had an echogenic pancreas. Patients with echogenic pancreas had significantly higher fasting glucose, low-density lipoprotein cholesterol, and triglyceride levels than those without echogenic pancreas. The proportion of NAFLD and obesity was higher in the echogenic group; however, only the proportion of obese subjects showed a significant difference. In multivariate analysis, family history of diabetes mellitus (DM) and/or dyslipidemia and presence of DM and/or dyslipidemia were factors related to the presence of echogenic pancreas. Echogenic pancreas is relatively common in children. Echogenic pancreas, typically observed in patients with a family history of DM and/or dyslipidemia, was strongly associated with metabolic syndrome, even in the absence of fatty liver.

Effects of Strength Training on Body Fat in Children and Adolescents with Overweight and Obesity: A Systematic Review with Meta-Analysis.

Childhood overweight and obesity represent a growing public health problem worldwide. Since the 1980s, the global prevalence of overweight and obesity in childhood and adolescence has increased by 47%. The promotion of exercise is an important intervention to reduce the physical damage of obesity. The meta-analysis was conducted in accordance with the general guidelines for the reporting of systematic reviews and meta-analyses (PRISMA). The PubMed, SciELO, ScienceDirect and Google Scholar databases were searched from August to December 2021. The search yielded 722 titles published between 2000 and 2021. After screening the titles and abstracts, 64 duplicate articles were detected, and 27 articles were ultimately included in the systematic review, including 26 articles published in English and one published in Spanish. There was a statistically significant effect of the strength training interventions on the percentage of body fat, Test of 0 i = (p = 0.00, z = 6.92), Test of 0 = (p = 0.00, Q (9) = 42.63). The findings reveal that strength training has a positive impact on the treatment of body fat in children and adolescents with overweight and obesity.

Maternal Android Adiposity and Vitamin D Status in Lactation Are Positive Predictors of Child Adiposity and Vitamin D Status at 2 Years of Age: A Follow-Up Study From Montréal

Abstract Objectives Recent evidence suggests that fetal exposure to both maternal excess adiposity and low maternal vitamin D status is associated with body composition of the children. The objective was to explore whether maternal android adiposity and maternal serum 25-hydroxyvitamin D (25(OH)D) during early lactation relate to child adiposity and vitamin D status at 2 years of age. Methods The present study is a follow-up of a sub-group who completed a double-blinded randomized parallel group-controlled trial of vitamin D supplementation (400 or 1000 IU/d) across infancy (NCT02563015). In this follow-up, 68 (49%) children (37 males, 31 females) returned at 24 months of age; the study was closed at the onset of the COVID-19 pandemic precluding follow-up in the remainder. Body composition (dual-energy X-ray absorptiometry) and serum 25(OH)D (immunoassay) were measured at baseline (0.2–1.5 mo postpartum) in mothers and at 24 months of age in children. Data were analyzed using a linear fixed effects model with covariates (sex, skin tone, child age, maternal 25(OH)D concentrations, parental age, and maternal android fat mass) followed by Tukey post hoc tests adjusted for multiple comparisons. Results At baseline, mothers were 31.6 (range: 19.9, 41.4) years with mean serum 25(OH)D 66.0 ± 25.3 nmol/L, percentage fat mass was 33.8 ± 5.4% and android fat mass 217.9 ± 79.7 g. In children at 24-months, mean serum 25(OH)D was above the cut-point for sufficiency of 50 nmol/L and not different between males and females (males: 82.0 ± 17.6 and females: 76.5 ± 14.0 nmol/L, P = 0.16). Postpartum maternal serum 25(OH)D was a positive predictor of children's 25(OH)D concentrations (β = 0.25 ± 0.08 nmol/L, P = 0.0031) at 24 months. Similarly, postpartum maternal android fat mass was a positive correlate of children's android fat mass (β = 0.03 ± 0.01 g, P = 0.0201). Maternal gynoid fat mass was not related to children's gynoid fat mass (P = 0.76). Overall, female children had higher android and gynoid fat mass compared to male counterparts (P = 0.0348). Conclusions Maternal android adiposity and maternal serum 25-hydroxyvitamin D are separate important modifiable correlates of children adiposity and vitamin D status at 2 years of age. These findings reinforce the importance of maternal programming of body composition and vitamin D status in children. Funding Sources The Canadian Institutes of Health Research.

Relationship between Sleep Quality and the Percentage of Body Fat in Children (Ages 9–12 Years) in the Public Elementary School of IKIP I Makassar City

This study aimed to determine the relationship of sleep quality with the percentage of body fat in children (ages 9-12 years) in the Elementary School Complex of IKIP I Makassar. The study used the Analytical Survey design with a cross-sectional approach. The researcher will compare the causes and consequences variables simultaneously and explain the relationship between the research variables through hypothesis testing. This study uses quantitative methods, namely through assessing sleep quality and body fat percentage using a questionnaire. The data was collected through in-depth interviews and observations of children. Sampling uses purposive sampling and data analysis using the Chi-Square test. The results of the study showed that there was no significant relationship between sleep quality and body fat percentage. However, after being tested based on the components of sleep quality, it was seen that good sleep quality and poor sleep quality in component 3 (sleep duration). Moreover, component 4 (daily sleep efficiency) had a significant relationship between sleep duration and daily sleep efficiency with body fat percentage. Recommendations from this research are needed on the relationship between sleep quality and student achievement index.

Quantitative Analysis of Pancreatic Fat in Children with Obesity Using Magnetic Resonance Imaging and Ultrasonography

PurposeThe aim of this study was to evaluate the pancreatic fat fraction (PFF) using magnetic resonance imaging (MRI) in children with and without obesity and to correlate PFF with body mass index (BMI) z-score, hepatic fat fraction (HFF), and ultrasonography-derived pancreato-perihepatic fat index (PPHFI).MethodsThis prospective study included 45 children with obesity and 19 without obesity (control group). PFF and HFF were quantitatively assessed using the abdominal multi-echo Dixon method for MRI. The PPHFI was assessed using transabdominal ultrasonography. Anthropometric, MRI, and ultrasonographic characteristics were compared between the two groups. Correlations between PFF, HFF, PPHFI, and BMI z-scores in each group were also analyzed.ResultsThe PFF, HFF, PPHFI, and BMI z-score were higher in the group with obesity than in the control group (PFF: 6.65±3.42 vs. 1.78±0.55, HFF: 19.5±13.0 vs. 2.31±1, PPHFI: 3.65 ±1.63 vs. 0.94±0.31, BMI z-score: 2.27±0.56 vs. 0.42±0.54, p<0.01, respectively). PFF was correlated with BMI z-scores, PPHFI, and HFF in the obesity group, and multivariate analysis showed that PFF was strongly correlated with BMI z-score and PPHFI (p<0.05). The BMI z-score was strongly correlated with PFF in the control group (p<0.01).ConclusionThese results suggest that MRI-derived PFF measures are associated with childhood obesity. PFF and PPHFI were also highly correlated in the obesity group. Therefore, PFF may be an objective index of pancreatic fat content and has the potential for clinical utility as a non-invasive biomarker for the assessment of childhood obesity.

Body Fat in Children with Chronic Kidney Disease - A Comparative Study of Bio-impedance Analysis with Dual Energy X-ray Absorptiometry.

Introduction:Nutritional impairment in patients with chronic kidney disease (CKD) is due to decreased body stores of both protein and fat. We need a tool that can be used in clinics to determine and monitor fat composition with a special focus on normalizing fat measurements to height in these children. Bio-impedance analysis (BIA), a portable and simple tool, has been used to estimate body fat in children with CKD but needs validation against the reference tool dual energy X-ray absorptiometry (DXA). The purpose of the cross-sectional study was to estimate the prevalence of low body fat in children with stages 2-5 CKD (non-dialysis) and CKD 5D (dialysis), and to compare fat measures from two different methods namely BIA and DXA.Method:Children in stages 2–5 CKD (n = 19) and in CKD 5D (n = 14) were recruited for assessment of fat mass (FM, Kg) by BIA and DXA, from which percent body fat (BF %) and fat mass index (FMI, Kg/M2) were obtained. Low body fat was defined as <5th age and gender centile for BF% or FMI by DXA and BF% by BIA.Results:Low body fat was detected equally using BF% and FMI in 18% of children by DXA while only 12% were detected using BF% by BIA. In children with CKD2–5, a good degree of reliability was found with FMI measurements (ICC 0.76 CI [0.48,0.9]) and poor reliability in children with CKD 5D (ICC 0.58 CI [0.1,0.84]). BF% had poor to fair reliability in the children with CKD 2-5 and CKD 5D (ICC 0.64 [0.28,0.84] and 0.53 [0.02,0.82]), respectively. Comparing BF% and FMI obtained by BIA and DEXA, BIA overestimated BF% by 3.5% in comparison to DXA.Conclusion: In children with CKD, body fat is preserved in the majority. Among the two measures of fat, BF% estimated by BIA did not compare well with DXA while FMI measure was comparable with a lower bias. However, due to lack of reference values in Indian children for FMI obtained by BIA, BIA cannot be used to measure fat in this population.

Fibroblast Growth Factor-21 to Adiponectin Ratio: A Potential Biomarker to Monitor Liver Fat in Children With Obesity.

Background: There is a pressing need for effective and non-invasive biomarkers to track intrahepatic triglyceride (IHTG) in children at-risk for non-alcoholic fatty liver disease (NAFLD), as standard-of-care reference tools, liver biopsy and magnetic resonance imaging (MRI), are impractical to monitor the course disease.Objective: We aimed to examine the association between serum fibroblast growth factor (FGF)-21 to adiponectin ratio (FAR) and IHTG as assessed by MRI in children with obesity.Methods: Serum FGF21 and adiponectin levels and IHTG were measured at two time points (baseline, 6 months) in obese children enrolled in a clinical weight loss program. The association between percent change in FAR and IHTG at final visit was examined using a multiple linear regression model.Results: At baseline, FAR was higher in the subjects with NAFLD (n = 23, 35.8 ± 41.9 pg/ng) than without NAFLD (n = 35, 19.8 ± 13.7 pg/ng; p = 0.042). Forty-eight subjects completed both visits and were divided into IHTG loss (≥1% reduction than baseline), no change (within ±1% change), and gain (≥1% increase than baseline) groups. At 6 months, the percent change in FAR was different among the three groups (p = 0.005). Multiple linear regression showed a positive relationship between percent change in FAR and the final liver fat percent in sex and pubertal stage-similar subjects with NAFLD at baseline (slope coefficient 6.18, 95% CI 1.90–10.47, P = 0.007), but not in those without NAFLD.Conclusions: Higher value in percent increase in FAR is positively associated with higher level of IHTG percent value at 6 months in children with baseline NAFLD. FAR could be a potential biomarker to monitor the changes in IHTG in children with NAFLD.

Development And Cross-validation Of A Bmi-based Equation For Percent Fat In Children With Intellectual Disability

Development And Cross-validation Of A Bmi-based Equation For Percent Fat In Children With Intellectual Disability

Blood Pressure, Fitness, And Fatness In Children The Arkansas Active Kids Study

PURPOSE: The role of cardiorespiratory fitness (CRF) in pediatric health is gaining recognition. However, the quality and quantity of the current evidence are insufficient to inform clinical pediatric guidelines. Objective: to evaluate the association between direct measures of CRF and blood pressure status as determined by the 2017 screening guidelines from the American Academy of Pediatrics in school-age children. METHODS: Children (n=218) 7 to 10 years old participated in a single-study visit. Children were deemed to have high blood pressure (HBP) if blood pressure status was: elevated, stage-1 or stage-2 hypertension. CRF (V02peak) was measured using an incremental cycle ergometer test. Body composition was measured with DXA, and physical activity with accelerometers (7±1 days). Blood was sampled in the fasting state and estimated glomerular filtration rate (eGRF) calculated using the updated Schwartz equation. Children were categorized as having excess weight (EW) or normal weight (NW) if their fat mass index was above or below 1 z-score, respectively. Children were further classified into EW/NW more-fit or EW/NW less-fit using the groups’ median VO2peak. Multiple logistic regression analyses were used to model the probability of high blood pressure against VO2peak. RESULTS: Participants’ average age was 9 years, with 70% of EW children having HBP vs. 24% in the NW group (p<.0001). The probability of HBP decreased with increasing VO2peak in the EW group only (β=0.09, p=0.0095). There was no association between CRF and probability of HBP in NW children. eGFR was lower in the less-fit groups than in more-fit groups regardless of adiposity status, even after adjusting for age and blood pressure status (adjusted mean difference between more-fit and less-fit groups: EW=7.1 ml·min-1·1.73 m-2, p=0.0046 and NW= 2.9 ml·min-1·1.73 m-2p=0.0144). CONCLUSION: The probability of HBP dramatically decreases with increasing CRF in children with EW but not in children with NW. eGFR is lower in children with lower CRF, regardless of obesity status, but the effect of CRF on and kidney function is greater in EW than in NW kids. Funding USDA-ARS Projects 59-6250-4-001 and 6026-51000-012-06S. ECD partially supported by ArCAPT-8UG1OD024945.

Stabilization of BMIz Score is Associated with a Decrease in Visceral Fat in Children with Obesity.

BMIz-score (BMIz) is commonly used to assess childhood obesity. Whether change in BMIz score predicts change in visceral fat remains unclear. The objective of the work was to study changes in visceral fat, cardiovascular fitness (CVF), and metabolic health over 6 months in children with stable/decreased-BMIz vs. increased-BMIz. Ninety children with obesity, referred for lifestyle intervention were studied (mean age 11±3.1 years, 50% girls, 22% Hispanic). Assessment included abdominal and total fat by dual X-ray absorptiometry (DXA), sub-maximal VO2 for CVF, anthropometrics, and fasting insulin, glucose, HDL-C, triglycerides, AST and ALT at 0 and 6 months. Sixty-three children (70%) showed a stable/decrease in BMIz over 6 months. There was no significant change in total body fat between groups (-1.3±2.9% in BMIz-stable/down vs. - 0.6 ± 2.6% BMIz-up, p=0.459); however, BMIz-stable/down group showed a decrease in visceral fat compared to the BMIz-up group (-258±650 g vs.+137±528 g, p=0.009). BMIz-stable/down group also demonstrated increased CVF (+1.2 ml/kg/min, p<0.001), not seen in the BMIz-up group. Neither group had significant changes in metabolic markers. Preventing BMIz increase in obese children predicts a significant decrease in visceral fat even if total body fat is unchanged. This is often associated with increased fitness. Thus, increasing fitness level and keeping BMI stable are strategic initial goals for obese children.

Maternal Prepregnancy Overweight and Obesity Are Associated with Reduced Physical Fitness But Do Not Affect Physical Activity in Childhood: The Amsterdam Born Children and Their Development Study.

Maternal overweight/obesity during pregnancy increases offspring's risks of obesity and cardiovascular disease (CVD). A possible pathway is by reduced physical fitness and physical activity (PA) levels in children of overweight/obese mother. We assessed whether maternal prepregnancy overweight/obesity independently determines cardiorespiratory fitness (CRF), muscular strength, moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) in 8- to 9-year-old children. We also assessed whether child's fat mass (FM) mediates these associations. One hundred ninety-four children of Dutch ethnicity aged 8.6 (± 0.4) years were randomly selected from a prospective birth cohort, the Amsterdam Born Children and their Development (ABCD) study. CRF was assessed by the 20-m multistage shuttle run test (20-m MSRT), muscular strength by hand dynamometry, and MVPA and SB by accelerometry. The association of prepregnancy body mass index (BMI) ≥ 25 kg/m2 with these outcome measures was assessed by multivariable linear regressions. Mean (± standard deviation) attained 20-m MSRT stage was 5.3 (± 1.7). Compared with children from normal weight women, children of women with prepregnancy overweight/obesity attained a 0.80 (95% confidence interval: 0.15-1.50) lower stage, adjusted for child's sex and MVPA. This association was not mediated by birthweight or child's FM at age 5 years. Maternal prepregnancy overweight/obesity was not associated with child's muscular strength, MVPA, or SB. Maternal prepregnancy overweight/obesity was associated with reduced childhood CRF, but not with muscular strength, PA, or SB. Birthweight and FM at age 5 years did not mediate this association. Reduced CRF may partly explain the increased CVD risk in children of overweight/obese women.