Consequences Of Childhood Obesity Research Articles

Mexican American Parental Knowledge and Perceptions of Childhood Obesity: An Integrative Review.

For the past two decades, childhood obesity has remained a national public health concern, particularly among Hispanic populations. Multiple cross-sectoral obesity prevention strategies have been implemented yet remain unsuccessful in generating sustainable lifestyle changes. The purpose of this integrative review, using the Whittemore and Knafl method, was to examine the literature from 2009 to 2018 regarding Mexican American parental knowledge and perceptions of childhood obesity. The CINAHL, PubMed, PsycINFO, and ERIC databases were used to search the literature, and 13 peer-reviewed articles met the inclusion criteria. Three main themes emerged from the literature synthesis: (1) parental misperception of child body weight and size, (2) influence of cultural health and growth beliefs on parental perception of child weight, and (3) parental perspectives of causes and consequences of childhood obesity and how to address it. However, cultural variations in parental perceptions were found; therefore, attempts to generalize Mexican Americans' cultural practices should be avoided. Studies using qualitative approaches are needed to gain deeper insights about Mexican American culture regarding children's health as it relates to body weight, the roles of different family members in the Mexican American childrearing tradition, and the impact of their associated health beliefs.

COULD LOWER EXTREMITY INJURIES INCREASE BMI IN CHILDREN?

PURPOSE: The purpose of this investigation is to examine the relationship between forced sedentariness attributed to the management of a lower extremity injury and change in BMI in pediatric patients. INTRODUCTION: Over the past 30 years, childhood obesity has significantly increased. Lack of physical activity and rising levels of sedentary living are associated with rising childhood obesity. As the effects of childhood obesity are long lasting, it is important to characterize childhood conditions that lead to increases in BMI. Traumatic lower extremity injuries in children commonly result in casting and forced immobilization. Children and adolescents who cease physical activity at a younger age are at a higher risk for weight gain and inactive lifestyles as adults. Presently, the data examining short term and longitudinal effects of injury on weight changes are lacking. Therefore, the purpose of this investigation is to examine the relationship between forced sedentariness attributed to the management of a lower extremity injury and change in BMI in pediatric patients. METHODS: Eighty eight subjects aged 5 to 18 with lower extremity fractures managed with non-weight bearing for a minimum of 6 weeks were identified. This group was compared to a cohort of controls, who presented to the pediatric orthopaedic clinic for upper extremity injuries. For each subject, BMI was calculated from height and weight data obtained at each clinic visit for which the data were available for a minimum of 6 months. Percent change in BMI was then calculated and compared between the lower extremity injury group and controls utilizing ANOVA. Logistic regression was then performed to determine if age, gender, and undergoing surgery were correleated with a BMI change of greater than 10%. RESULTS: The results of initial ANOVA analysis demonstrated no difference in BMI trends between children with lower extremity injuries and controls. On average, both groups showed a modest increase in BMI over time (lower extremity injuries = 3.40%, controls = 3.23%). Logistic analysis of the lower extremity revealed male gender to be associated with a 10% increase in BMI during the study period, though this was not significant (p = 0.153) CONCLUSIONS: Our investigation yielded a negative result. As there is limited literature on BMI trends in children, our power calculation may have underestimated the subjects needed to demonstrate a statistically significant difference between groups. SIGNIFICANCE: The increases observed in both groups may indicate that the experience of being injured is associated with increases in BMI regardless of the location of injury. Further investigation would involve assessing BMI trends prospectively to identify opportunities to obviate possible weight gain with injury.

Beverage Intake and Its Effect on Body Weight Status among WIC Preschool-Age Children.

Given the prevalence and consequences of childhood obesity, efforts are being made to identify risk factors and design evidence-based interventions to reduce its impact. Food and beverage consumption habits are established early in life, making preschool-age children an important group to focus on. This cross-sectional study explored beverage intake and its association with body weight status among low-income preschool-age children enrolled in the Special Supplementation Nutrition Program for Women, Infants, and Children (WIC). Authorized representatives for children between the ages of 3 and 4.9 years were interviewed at WIC clinics in Broward County, Florida. Anthropometric data were collected from the WIC data system. The intake of sugar-sweetened beverages (SSB), particularly fruit drinks, was significantly higher in overweight/obese children when compared with their under/normal weight counterparts. Independent of body weight status, the preschool-age children were consuming on average over twice as much as the recommended intake of 100% fruit juice per day for that age group. Close to 80% of the overweight/obese children consumed low-fat or fat-free milk most often than any other type of milk. The intake of SSB was positively correlated with both the intakes of 100% fruit juice and milk, and negatively correlated with the intake of water. When body weight status, race/ethnicity, and intake of other beverages were held constant, SSB intake was positively associated with milk intake and negatively associated with water intake. Results from this study support the need to encourage water intake and discourage SSB intake in an effort to reduce the risk for overweight and obesity in WIC-participating preschool-age children. Emphasizing the need to follow the recommendation to limit 100% fruit juice intake to 4 to 6 oz. per day is important when counseling families with young children. Efforts to increase awareness of the health consequences associated with consuming high-fat milk should continue.

Exploring Childhood Obesity Perceptions Among Caregivers of African American Children

Childhood obesity efforts have been characterized by low levels of caregiver involvement. This qualitative study explores caregiver perceptions about childhood obesity prevention. We conducted 12 in-depth interviews with caregivers of African American children aged 8–11 years. We used thematic analysis to identify consistent patterns of preventing childhood obesity and encouraging healthy behaviors. Four themes emerged including rural culture and the built environment, physical and social health effects of childhood obesity, measuring childhood obesity, and preventive strategies. Caregivers are cognizant of childhood obesity risk factors and discussed challenges in their rural environment when attempting to practice and maintain health behaviors for their children. They also stated that caregivers were vital in preventing childhood obesity. Our findings highlight the value of involving caregivers in the design and implementation of childhood obesity initiatives. Additionally, future childhood obesity efforts should equip caregivers and children with behavioral skills and resources to assist in developing healthy habits.

The health care costs of childhood obesity in Australia: An instrumental variables approach

The effect of childhood obesity on medical costs incurred by the Australian Government is estimated using five waves of panel data from the Longitudinal Study of Australian Children, which is linked to public health insurance administrative records from Medicare Australia. Instrumental variables estimators are used to address concerns about measurement error and selection bias. The additional annual medical costs due to overweight and obesity among 6 to 13 year olds is about $43 million (in 2015 AUD). This is driven by a higher utilisation of general practitioner and specialist doctors. The results suggest that the economic consequences of childhood obesity are much larger than previously estimated.

Cognitive and Psycho-Social Effects of Childhood Obesity

Childhood obesity has been declared as a global epidemic. Several studies have reported inverse associations of childhood obesity with cognitive and psycho-social functioning of obese children. The present study is an attempt to understand the cognitive and psycho-social aspects of childhood obesity in Indian context. The objective of the study was to compare the cognitive functions (memory, attention, and visual retention) and psychosocial functioning (body shape concerns and insecurity) of obese children with normal weight controls. The cross sectional research was carried out. Purposive sampling was used to collect the sample of 30 obese children and 30 normal weight children (controls) from schools in Delhi. The inclusion criteria for cases and controls were obese and normal weight children as per ICMR criteria, within the age range of 10-14 years. Children with previous history of head injury or other physical, medical or neurological problems, chronic medical illness and other metabolic disorders (diabetes and thyroid), were excluded from the study. All the children were assessed on cognitive functions (Digit symbol test and immediate memory test) and psycho-social functioning (Body Shape Questionnaire, Mohsen’s security insecurity questionnaire). The performance of obese children was found to be poor compared to normal weight children by using t-test. Obese children performed significantly poor on attention and visual retention and immediate memory for direct reciprocation. However, there was no significant difference on reverse immediate memory test. Obese children were also found to be more insecure compared to the normal weight controls about their body image. Obese children expressed high body shape concerns compared to normal weight counterparts. Findings suggest independent associations of specific cognitive and psycho-social aspects with childhood obesity that can be targeted for prevention and management of this global epidemic.

Evaluation of the Transdisciplinary Obesity Prevention Research Sciences Program

To develop and evaluate an applied research methods curriculum for undergraduates on the causes and consequences of childhood obesity. The Transdisciplinary Obesity Prevention Research Sciences Program (TOPRS) has been developed by a multidisciplinary team from the University of Illinois at Urbana-Champaign, Purdue University, and California State University, Fresno. Students learn about the causes, consequences and correlates of obesity from an ecological framework from cell to society. The class format is a “flipped” version with students viewing 10 minute microlectures and class time spent in interactive discussions and activities focusing on research design and methodologies. Each micro-lecture is presented by national experts in nutritional sciences, animal science, child development, early care and education, community health, and public health. A pilot study included 53 undergraduate students at two institutions. Pre-and-post changes in nutrition related knowledge, confidence in research skills, and interest in attending graduate school were measured. A significant change in knowledge was found in the following areas: breastfeeding and pediatric nutrition, changing food environment and media, culturally relevant interventions focused on increasing healthy eating, childcare & feeding practices, family mealtimes and nutrition, and diabetes. Additionally, at the end of the course students were more confident in their research skills and also more likely to consider attending graduate or professional school. The innovative curriculum was effective at increasing nutrition related knowledge, research skills, and interest in graduate school. The curriculum represents a model for integrative, interdisciplinary program development and will be available for dissemination.

Adiposity in Children and CVD Risk: ApoB48 Has a Stronger Association With Central Fat Than Classic Lipid Markers.

Atherosclerotic vascular disease begins in childhood and while progression is multifactorial, obesity in early life is an important risk factor for its development. To determine whether fasting apoB48 remnant lipoproteins (relative to classic lipid markers), is elevated with increasing central adiposity over time in a cohort of Canadian children with a family history of obesity. Data were drawn from the ongoing prospective cohort of 630 Caucasian families in Québec, Canada, recruited to assess determinants and effects of childhood obesity (Québec Adiposity and Lifestyle Investigation in Youth [QUALITY]cohort). Children who attended baseline and first followup clinic visits (n =570; age 9.6 y). Trunk fat mass was determined by dual energy x-ray absorptiometry. Central fat mass index was calculated as CFMI = trunk fat mass/height(2) (kg/m(2)) and groups created (CFMI <1.5; 1.5-3.0; ≥3.0 kg/m(2)) to suggest lower, moderate, or higher central adiposity. Changes over time in outcomes (apoB48, triglyceride and total, low-, and high-density lipoprotein cholesterol) were compared using paired t test and multiple regression that adjusted for age, sex, and Tanner stage. Classic lipid markers (total and low-density lipoprotein cholesterol) improved at followup, whereas apoB48 became worse (increased). ApoB48 increased with increasing central adiposity, highest (37%) in children who transitioned from lower- to moderate-CFMI groups (ΔapoB48 = 1.5 μg/mL). For every 1 kg/m(2) increase in central adiposity over the 2-y period, an increase in apoB48 was 14-fold greater among children with lower baseline CFMI, compared with higher CFMI. Increased fasting concentrations of apoB48 may be representative of changes in adiposity at lower levels of central fat (early periods of risk).

Development and Evaluation of the Transdisciplinary Obesity Prevention Research Sciences Program

The Transdisciplinary Obesity Prevention Research Sciences Program (TOPRS) is an applied research methods curriculum for undergraduates on the causes and consequences of childhood obesity that has been developed by a multidisciplinary team from the University of Illinois at Urbana‐Champaign, Purdue University, and California State University‐Fresno. To address the need of the contemporary workforce the course has been developed to integrate transdisciplinary approaches 1) to knowledge about the causes, consequences and correlates of obesity from an ecological framework from cell to society, 2) hands‐on research experience, and 3) a professional development series. The program development was an iterative process of integrating rigorous evaluation results with curriculum design. The class format is a “flipped” version with students viewing 10 minute lectures and class time spent in interactive discussions and activities focusing on research design and methodologies. The lectures are presented by national experts in nutritional sciences, animal science, child development, family science, early care and education, community health, and public health. The professional development activities reinforce leadership and team building skills. The pilot evaluation revealed students’ (N = 53) increased knowledge related to obesity causes and consequences. Students increased in their research‐related abilities and reported having a better understanding of the research process. Furthermore, students increased in self‐confidence in their research skills and their intention to choose a research‐oriented career by the end of the program. Finally, the program strengthened students’ understanding of the importance of collaboration and teamwork. Additionally, the program helped students understand the importance of interdisciplinary approaches by increasing appreciation of the complexity of obesity prevention. In conclusion, the innovative curriculum development will be available for use, and also represents a model for integrative, interdisciplinary program development.Support or Funding InformationThis material is based upon work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture.

Evidence base for the prevention and management of child obesity

Obesity in childhood is a public health priority. The prevalence of overweight and obesity in children has increased since the mid 1990s, although prevalence is now stabilising. The National Child Measurement Programme shows that a third of 10–11 year olds in England are currently overweight or obese. Obesity increases the risk of poor physical health and mental health in childhood, and children who are obese are more likely to be obese in adulthood. Four tiers of services are recommended in the care pathway: universal prevention services; lifestyle weight management services often run in the community; specialist support from a clinical team; and surgery (in exceptional circumstances to over 12s). The current evidence on prevention indicates that interventions targeting schools and the home are promising, and reducing free sugar intake and sugar sweetened drinks is fast becoming a policy imperative. The evidence of the effectiveness of tier 2 weight management services is mixed, indicating that childhood obesity is hard to treat. Future research is turning to a whole systems approach to tackle childhood obesity. In this article we aim to outline how childhood obesity is measured, the scale of the problem globally and in the UK, the determinants and the consequences of childhood obesity. We will then give an overview of prevention and treatment interventions.

A Community Based Systems Diagram of Obesity Causes.

IntroductionApplication of system thinking to the development, implementation and evaluation of childhood obesity prevention efforts represents the cutting edge of community-based prevention. We report on an approach to developing a system oriented community perspective on the causes of obesity.MethodsGroup model building sessions were conducted in a rural Australian community to address increasing childhood obesity. Stakeholders (n = 12) built a community model that progressed from connection circles to causal loop diagrams using scripts from the system dynamics literature. Participants began this work in identifying change over time in causes and effects of childhood obesity within their community. The initial causal loop diagram was then reviewed and elaborated by 50 community leaders over a full day session.ResultsThe process created a causal loop diagram representing community perceptions of determinants and causes of obesity. The causal loop diagram can be broken down into four separate domains; social influences; fast food and junk food; participation in sport; and general physical activity.DiscussionThis causal loop diagram can provide the basis for community led planning of a prevention response that engages with multiple levels of existing settings and systems.

Çocukluk Çağı Obezitesinin Sol Ventrikül Diyastolik Fonksiyonları Üzerine Etkisi

Çocukluk Çağı Obezitesinin Sol Ventrikül Diyastolik Fonksiyonları Üzerine Etkisi

Effect of an obesity pamphlet on parental perception and knowledge of excess weight in their children: results of a randomised controlled trial.

This study examined the effectiveness of a brief educational intervention in increasing parental knowledge of childhood obesity risk factors and ability to correctly identify their child's weight status. Eighty parents were randomly allocated to an experimental group given an obesity pamphlet or a control group given a stress management pamphlet. A survey measured parents' knowledge about risk factors, cause and consequences of childhood obesity, and perception of their child's weight. Parents with overweight or obese children increased their understanding of childhood obesity immediately after receiving the intervention, but did not differ significantly on perception of their child's weight. The experimental intervention increased knowledge of health risks associated with childhood obesity in parents of overweight or obese children. Parental perception of their child's weight status did not improve, suggesting that other factors have a role to play. SO WHAT? The obesity pamphlet may be a useful tool in a multifaceted approach targeting childhood obesity.

Obesity and arterial stiffness in children: systematic review and meta-analysis.

Childhood obesity is associated with risk factors for cardiovascular disease. Arterial stiffness is considered one of the earliest detectable measures of vascular damage. There is controversy in the literature regarding the effects of childhood obesity on arterial stiffness. The objective of this study is to systematically review the literature and to conduct a meta-analysis comparing measures of central arterial stiffness in children and adolescents with obesity to healthy body mass index controls. Literature searches were conducted using databases (eg, MEDLINE, EMBASE) and citations cross-referenced. Studies assessing central pulse wave velocity or β-stiffness index were included. A random effects meta-analysis of the standardized mean difference and 95% confidence intervals in arterial stiffness between children with obesity and control children was performed for each arterial stiffness measure. A total of 523 studies were identified. Fifteen case-control studies were included, with 2237 children/adolescents (1281 with obesity, 956 healthy body mass index controls) between 5 and 24 years of age. All studies measuring carotid and aortic β-stiffness index and 10/12 studies measuring central pulse wave velocity reported greater arterial stiffness in children/adolescents with obesity compared with controls. A random effects meta-analysis was performed revealing a significant effect of obesity on pulse wave velocity (standardized mean difference=0.718; 95% confidence interval=0.291-1.415), carotid β-stiffness index (0.862; 0.323-1.402), and aortic β stiffness index (1.017; 0.419-1.615). These findings indicate that child/adolescent obesity is associated with greater arterial stiffness. However, further research is needed to address confounders, such as pubertal status, that may affect this relationship in children. In the future, these techniques may be useful in risk stratification and guiding clinical management of obese children to optimize cardiovascular outcomes.

Abstract 454: Childhood Determinants of Subendocardial Viability Ratio in Biracial (Black-White) Young Adults: The Bogalusa Heart Study

Background: non-invasive estimation of myocardial oxygen supply and demand as measured by Subendocardial Viability Ratio (SEVR) continues to gain importance in the early detection of coronary artery disease (CAD). While adult risk factor associations with SEVR have been documented, especially in patients with CAD, no information is available on the childhood predictors of SEVR in relatively young and healthy adults. Methods: this aspect was examined in 610 non-institutionalized individuals (68.7% whites, 54.6% females; aged 29.4 - 51.3 years) that participated in the Bogalusa Heart Study and had cardiovascular risk factors information available since childhood. SEVR was estimated in adulthood through applanation tonometry of the radial artery. The average value of childhood measurements was used as the childhood value, standardized to age, race and sex-specific z-scores. Multivariable linear regression analyses were used to estimate childhood risk factor associations with SEVR in adulthood. Results: Blacks and females had significantly lower mean levels of SEVR (p&lt;0.001) compared to their counterparts. Body Mass Index (BMI) in childhood resulted as the only significant predictor of SEVR in white (β= -0.19, p&lt;0.01), but not in black (β= 0.06, p=0.59) adults. No significant associations were observed in other childhood risk factors such as: high density lipoprotein cholesterol, low density lipoprotein cholesterol and blood pressure (both, systolic and diastolic) Conclusion: These findings support the hypothesis that the impact of risk factors on adult cardiovascular disease starts early in life and differs among white and black race groups. Further, the adverse effects of childhood obesity on coronary microcirculation in adulthood, as measured through SEVR, underscores the importance of primordial prevention of CV risk factors at an early age, especially obesity, to avoid regrettable complications in adulthood.

The effect of childhood obesity on cardiac functions

Obesity is a metabolic disorder defined as excessive accumulation of body fat, which is made up of genetic, environmental, and hormonal factors and has various social, psychological, and medical complications. Childhood obesity is a major indicator of adult obesity. The aim of this study is to evaluate the cardiac functions via electrocardiography (ECG), echocardiography (ECHO), and treadmill test in childhood obesity. A patient group consisting of 30 obese children and a control group consisting of 30 non-obese children were included in the study. The age range was between 8 and 17 years. Anthropometric measurements, physical examination, ECG, ECHO, and treadmill test were done in all patients. P-wave dispersion (PD) was found to be statistically significantly high in obese patients. In ECHO analysis, we found that end-diastolic diameter, end-systolic diameter, left ventricle posterior wall thickness, and interventricular septum were significantly greater in obese children. In treadmill test, exercise capacity was found to be significantly lower and the hemodynamic response to exercise was found to be defective in obese children. Various cardiac structural and functional changes occur in childhood obesity and this condition includes important cardiovascular risks. PD, left ventricle end-systolic and end-diastolic diameter, left ventricle posterior wall thickness, interventricular septum thickness, exercise capacity, and hemodynamic and ECG measurements during exercise testing are useful tests to determine cardiac dysfunctions and potential arrhythmias even in early stages of childhood obesity. Early recognition and taking precautions for obesity during childhood is very important to intercept complications that will occur in adulthood.

The effects of childhood obesity on compressive tibiofemoral force and muscle functions during normal walking

The effects of childhood obesity on compressive tibiofemoral force and muscle functions during normal walking

Microalbuminuria and obesity in children

Microalbuminuria is considered as a marker of endothelial dysfunction and found to be associated with nephropathy and cardiomyopathy in diabetic and nondiabetic obese patients. In this study, we sought to investigate the effect of childhood obesity on microalbuminuria in children. A total of 96 children who were clinically healthy were enrolled from July 2007 through March 2012. Height, weight and body composition of fat mass (FM) and fat free mass (FFM) were measured in each subject. Body mass index (BMI), fat mass index (FMI), fat free mass index (FFMI) and percent body fat (PBF) were calculated. Serum creatinine, cholesterol, triglyceride (TG), high-density lipoprotein (HDL) cholesterol, fasting insulin, glucose, spot urine microalbumin/creatinine ratio, and glomerular filtration rate (GFR) were obtained. We divided the children into two groups according to the presence of microalbuminuria, based on the age specific reference range of spot urine microalbumin/creatinine ratio(1) and the differences between two groups were analyzed. Urine creatinine and FFMI in microalbuminuria group were found to be significantly decreased compared to control group. There were no significant differences between two groups in anthropometric and other biochemical parameters associated with obesity. In two groups comparison according to BMI z-score: lean (BMI z-score <2) and obese (BMI z-score ≥2), obese children showed significantly higher serum creatinine, TG, FM, PBF and FMI and lower HDL cholesterol. However, no significant differences in the urinary microalbumin excretion and FFMI were observed. In our study, urinary microalbumin excretion is associated with FFMI rather than obesity in children. This suggests that microalbuminuria might be strongly associated with FFM rather than obesity during growth. Further studies to elucidate the implication of microalbumiuria in obese children should be followed.

Always the fat kid: the truth about the enduring effects of childhood obesity

Always the fat kid: the truth about the enduring effects of childhood obesity

Societal solutions to childhood origins of coronary artery disease

Childhood obesity and associated risks result in premature cardiovascular damage and disease with a consequent, large burden to society. There are causes for childhood obesity that are rooted in the socioeconomic milieu. Interventions that are population-based, and aimed towards prevention as opposed to treatment, are likely to be most effective in curtailing childhood obesity. Reforms to federal and state managed social welfare programs provide a compelling opportunity to affect the course and consequences of childhood obesity.