Group Of Obese Children Research Articles

Analysis of leptin, adiponectin and adiponectin gene polymorphism and leptin receptor in obese children and adolescents

Background: The aim of this study was to determine serum levels of leptin and adiponectin of obese children to identify the influence of leptin receptor gene polymorphisms on leptin resistance and leptin levels, as well as the association between the polymorphisms of adiponectin gene and adiponectin levels.Materials and methods: A case-control study comparing a study group of 74 obese children (age 13.34±2.60 years) to a normal weight-age matched (age 13.39±2.64 years) control group of 69 children. In both groups, body mass index (BMI) and waist/hip circumference, systolic and diastolic blood pressure were measured. Also, the leptin and adiponectin levels, as well as glucose and lipid metabolism parameters, and highly sensitive C-reactive protein (hs-CRP) were measured. Insulin sensitivity was evaluated using fasting insulinemia and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). All subjects were tested for gene-tic polymorphisms in LEPRQ223R (rs1137101), ADIPOQ G276T (rs1501299) and ADIPOT45G (rs2241766).Results: The phenotypes of the obese children study group were significantly higher than in the control group in weight, BMI, waist/hip circumferences and systolic blood pressure (SBP) (P<0.001). We confirmed that in obese children the levels of leptin in the blood are increased and levels of adiponectin are decreased (P<0.001). The differences of the genotype distributions of leptin receptor (LEPRQ223R) and adiponectin (ADIPOG276T and ADIPOT45G) gene polymorphisms in the study group of obese chil-dren and a control group was not observed.Conclusion: In this study, we demonstrated increased leptin level and significantly decreased level of adiponectin in the obese children group compared with the control group. The results of the analysis of glucose metabolism and lipidogram between the two groups showed that insulin, HOMA-IR, and triglycerides, as well as hsCRP were increased and significantly different in the group of obese children compared to the control group, as expected. However, by including a significantly larger number of tested and control samples of both sexes and age-specific groups, with a larger number of tested SNPs, the genes investigated in this study would probably give better insight into a multicomplex disease such as obesity.

Effects of Endurance Exercise Intensities on Autonomic and Metabolic Controls in Children with Obesity: A Feasibility Study Employing Online Exercise Training.

Exercise is one of the major determinants of a healthy lifestyle, which is particularly important in childhood and serves as a powerful preventive tool. On the other hand, obesity and arterial hypertension rates are increasing in children, representing a huge risk for developing major cardiovascular and metabolic diseases in adult life. Of fundamental importance is the modality and volume of exercise required to obtain benefits. In this feasibility study, we considered a group of obese children, studied before and after a 12-week online exercise training program, and subdivided the participants into two groups considering the volume of exercise performed (above or below 1200 MET·min/week). This threshold level was applied in two different ways: subdivision A considered the total weekly physical activity volume (considering both time spent walking for at least 10 min consecutively and time spent performing structured exercise) and subdivision B considered only the weekly volume of structured exercise. We assessed autonomic and metabolic control and auxological and lifestyle parameters. We observed that the improved volume of structured exercise was associated with reduced arterial pressure percentile only in subdivision B and an improvement in markers of vagal and metabolic control was evident. Moreover, the 12-week online exercise training program, defined considering individual fitness level and progressively adapted as the goal was reached, proved to be sustainable from an economical and organizational point of view.

Comparison of the Activity of Fecal Enzymes and Concentration of SCFA in Healthy and Overweight Children

In modern societies obesity has become a serious issue which must be urgently addressed. The health implications of neglected obesity are substantial, as not only does it affect individuals' everyday lives, but it also leads to significantly increased mortality due to the development of several disorders such as type-2 diabetes, cardiovascular diseases, cancers, and depression. The objective of this research was to investigate the alterations in selected health markers caused by overweight and obesity in children. The measured parameters were the activity of the fecal enzymes, the concentration of short-chain fatty acids (SCFAs), and the concentration of branched-chain fatty acids (BCFAs). The activity of the fecal enzymes, specifically α-glucosidase, α-galactosidase, β-glucosidase, β-galactosidase, and β-glucuronidase, was determined using spectrophotometry at a wavelength of 400 nm. Furthermore, concentrations of lactic acid, SCFAs (formic, acetic, propionic, butyric, and valeric acids), and BCFAs (isobutyric and isovaleric acids) were determined using the HPLC method. The obtained results reveal that obese children have different fecal enzyme activity and a different profile of fatty acids from children of normal weight. The group of obese children, when compared to children of normal weight, had increased concentrations of BCFAs (p < 0.05) and higher activity of potentially harmful enzymes such as β-glucosidase and β-glucuronidase (p < 0.05). In comparison, children of normal weight exhibited significantly increased concentrations of lactic acid and SCFAs (especially formic and butyric acids) (p < 0.05). Furthermore, their α-glucosidase and α-galactosidase activity were higher when compared to the group of obese children (p < 0.05). These results suggest that the prevalence of obesity has a significant impact on metabolites produced in the gastrointestinal tract, which might result in a higher chance of developing serious diseases.

Lipid metabolism and renal function markers in obese adolescents.

To investigate the relationship of renal function markers and lipid metabolism parameters in obese adolescents. The study comprised 76 children aged 11-17 years, hospitalised due to: obesity (group I - 19 children) or obesity accompanied by obesity-induced hypertension (group II - 30 children) or normosthenic children with a diagnosed tension headaches (control group - 27 children). A subgroup with metabolic syndrome (MS - 16 children) was also separated. Renal function was assessed on the basis of: serum creatinine concentration, glomerular filtration rate estimated using Schwartz eqation (eGFR), determination of plasma and urinary neutrophil gelatinase-associated lipocalin and cystatin C. On the basis of statistical analysis, it was checked whether renal function markers depend on lipid metabolism parameters. In the study groups mean creatinine concentrations were significantly higher and eGFR values significantly lower than in the control group, but they remained within norm. Differences in plasma and urinary neutrophil gelatinase-associated lipocalin concentrations were not significant. Mean cystatin C concentrations were significantly higher in the group of obese children. Multiple linear regression analysis showed that the most important predictor was: LDL-C for urinary neutrophil gelatinase-associated lipocalin (R2 = 0.42) and TG for eGFR (R2 = 0.44) concentrations in group I; cholesterol for creatinine concentrations in MS group (R2 = 0.44). Renal function of the obese adolescents included in the study was normal and the associations with lipid metabolism were poorly expressed.

Body Mass and Biochemical Indexes in Obese Children: Changes in Metabolic Syndrome Development

Biochemical indices in obese children for early metabolic syndrome (MS) diagnostics were analyzed. Prospective study enrolled control (n=32, -1.0≤BMI SD score ≤+1.0) and obese (n=40, BMI SD score&gt;+2.0) groups of children (12 yr mean age). Obese children demonstrated enhanced total cholesterol, triglycerides, LDL, ALT, fasting insulin, HOMA-IR and elevated atherogenic index (AI). In most obese children, cardiovascular (40%) and hepatic (85%) disturbances were observed. Association of obesity with hepatic pathology was reflected in all examinees by correlations between BMI and ALT (r=0.511, p=0.001) and between BMI and ALT/AST ratio (r=0.638, p=0.001). AI increased in parallel with ALT/AST ratio elevation (r=0.436, р=0.006). Value of ALT/AST ratio in obese children group with signs of MS was 1.0 (0.5-1.6), exceeding value in control group (0.6; 0.3-1.1). To clarify ALT/AST ratio reference values as a manifestation of MS in obese children, an analysis of data from a larger number of patients is required. Control group demonstrated correlations between plasma coenzyme Q10 and total cholesterol (r=0.474, p=0.009) as well as between coenzyme Q10 and ALT (r=0.412, p=0.023) attesting to adequate lipoprotein antioxidant function and normal action of liver. In obese children, these relationships were distorted indicating advisability to prevent MS with membrane-stabilizing and/or antioxidant agents.

Assessment of nutritional status and adequacy of fiber intake in a group of obese children and adolescents

Background: Childhood obesity is one of the most serious public health challenges of the 21st century. Its prevalence has increased at an alarming rate according to recent WHO reports. Some studies suggest this increase to changes in diet patterns with the shift to a processed low-fiber diet. Dietary fiber has shown different protective health benefits against obesity and its comorbidities. Current dietary fiber intake status in obese children and adolescents is understudied. Aim of the work: to assess the adequacy of fiber intake in obese children and adolescents. Methods: A observation of a group of obese pediatric patients. All included patients were subjected to detailed medical history and clinical examination obtained from interviews with them or their medical records with special emphasis on anthropometric measures in form of weight, height and waist circumference, age of diagnosis, dietary intake, lifestyle, drugs, and possible complications. Dietary assessment through 24 h recall from all participants with an analysis of fiber according to 2nd Edition food composition tables for Egypt of National Institute of Nutrition Results: obese children and adolescents in the current study consumed less than 25% of their daily required intake.

Vascular endothelial growth factor C gene expression and its serum level as potential biomarkers for obesity in Egyptian children

Background and objectivesObesity is a serious health issue among children, and it's linked to a higher risk of chronic illness. Increased adipose tissue, which is highly vascularized due to angiogenesis, causes adverse health problems. Angiogenesis and lymphangiogenesis are regulated by vascular endothelial growth factor C (VEGF-C), and poor lymphatic vessel function is linked to increased adipocyte accumulation. Therefore, our study analyzes VEGF-C gene expression and its serum level in children with obesity in Egypt and correlates them with metabolic, clinical, and biochemical parameters. Subjects & methodsWe compared VEGF-C gene expression in blood and its serum level from 50 unrelated children with obesity and 50 normal healthy controls chosen randomly of matched age and gender recruited from Pediatric Clinics, both inpatient and outpatient, Menoufia University, Egypt, from March to June 2021, in a case-control study. The expression levels of VEGF-C mRNA were evaluated using a real-time quantitative reverse transcription-polymerase chain reaction and the serum VEGF-C level was measured using an enzyme-linked immunosorbent assay (ELISA). ResultsFasting plasma glucose, fasting insulin, homeostatic model assessment for insulin resistance (HOMA-IR), triacylglycerol (TAG), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDLC), serum VEGF-C, and VEGF-C expression levels were significantly higher in obese children group compared with the control (P < 0.001). In addition, serum VEGF-C levels were significantly inversely correlated with FT4 (P = 0.009) and significantly directly correlated with total cholesterol (P = 0.005) and LDL-C levels (P = 0.006) in the obese children group. Moreover, VEGF-C expression levels were also significantly inversely correlated with HDL-C levels (P = 0.001) and significantly directly correlated with fasting insulin (P = 0.002) and HOMA-IR (P = 0.001) in the obese children group. ConclusionVEGF-C gene expression and its serum levels could be used for follow-up of obese children with metabolic abnormalities.

Hypertension in obese children is associated with vitamin D deficiency and serotonin dysregulation

BackgroundObesity and hypertension represent serious health issues affecting the pediatric population with increasing prevalence. Hypovitaminosis D has been suggested to be associated with arterial hypertension. Serotonin by modulating nitric oxide synthase affect blood pressure regulation. The biological mechanism by which vitamin D specifically regulates serotonin synthesis was recently described. The aim of this paper is to determine the associations between vitamin D, serotonin, and blood pressure in obese children.MethodsOne hundred and seventy-one children were enrolled in the prospective cross-sectional study. Two groups of children divided according to body mass index status to obese (BMI ≥95th percentile; n = 120) and non-obese (n = 51) were set. All children underwent office and ambulatory blood pressure monitoring and biochemical analysis of vitamin D and serotonin. Data on fasting glucose, insulin, HOMA, uric acid, and complete lipid profile were obtained in obese children.ResultsHypertension was found only in the group of obese children. Compared to the control group, obese children had lower vitamin D and serotonin, especially in winter. The vitamin D seasonality and BMI-SDS were shown as the most significant predictors of systolic blood pressure changes, while diastolic blood pressure was predicted mostly by insulin and serotonin. The presence of hypertension and high-normal blood pressure in obese children was most significantly affected by vitamin D deficiency and increased BMI-SDS.ConclusionsDysregulation of vitamin D and serotonin can pose a risk of the onset and development of hypertension in obese children; therefore, their optimization together with reducing body weight may improve the long-term cardiovascular health of these children.

Characteristics of blood pressure level in children with different body weight

BACKGROUND: Essential arterial hypertension (AH) develops more often in children with accompanying risk factors — obesity, overweight, positive heredity and genetic predisposition.AIM: Study of peculiarities of arterial hypertension clinical course in adolescents with normal body weight, overweight and obesity.MATERIALS AND METHODS: The study was conducted on children with arterial hypertension who received treatment in two hospitals in Voronezh in 2016–2020. A retrospective analysis of the children’s case histories was carried out taking into account the anamnesis, clinical laboratory and instrumental examination data and the pharmacotherapy. Some children underwent polymerase chain reaction genetic testing to determine pathological alleles of genes regulating blood pressure (BP).RESULTS: 96 patients aged 9 to 17 took part in the study. The group with normal body weight included 38 children (39.6%), median age 16.4 (aged 10.7; 17.9), with overweight — 33 people (34.4%), median age 15.2 (aged 12.0; 17.9), with obesity — 25 children (26.0%), median age 14.5 (aged 9.2; 17.9). Obese children developed arterial hypertension at earlier age (p = 0.023). According to blood pressure daily monitoring (BPDM), pathological values of systolic blood pressure (SBP) during the day (above the 95th percentile) among children with normal body weight were observed in 17 patients (44.7%), with excess body weight — in 14 people (42.4%), with obesity — in 16 people (64%), p = 0.031. Accurate difference values between the groups were obtained in terms of time index (TI) of SBP at night (p = 0.006). Time index of diastolic BP during the day &gt; 50% was observed only in the obese children group — 4 people (16%) (p = 0.042). Pathological alleles of the angiotensinogen gene (AGT: 704 T&gt;C), aldosterone synthase gene (CYP11B2: -344 C&gt;T) and endothelial nitrogen synthase type 3 (NOS3: -786 T&gt; C) were identified most frequently during genetic testing in some patients.CONCLUSION: Children with obesity developed earlier arterial hypertension compared to the same-age children with normal body weight and more often had unfavorable type of arterial hypertension according to BPDM. These results can be used to choose individual therapy and to develop special attention as regards certain target organs damage.

Using Transcranial Magnetic Therapy In Combination With Electrostimulation For Correcting Neuroendocrine-Immune Disorders In Obese Boys

Objective — To justify the use of low-intensity transcranial magnetic therapy (TCMT) in combination with electrostimulation (TES) for the correction of neuroendocrine-immune disorders. Material and Methods — Fifty adolescent boys with exogenous constitutional obesity 13-15 years of age were examined. The control group consisted of 30 boys aged 13-15 years without obesity and concomitant pathology. The examination included an assessment of complaints, anamnesis of the disease, life history, objective data, hormonal status, neurotransmitters and cytokines. By random sampling, the group of obese children was divided into two subgroups: subgroup 1a (n=24), who received TCMT in combination with TES, and subgroup 1b – comparison group (n=22), who received placebo therapy with disconnected electrodes. Both groups of children received identical recommendations regarding the nutrition. The effectiveness of the therapy was evaluated after 3 months. The treatment course comprised 10 procedures. Statistical processing of the obtained data was carried out using the statistical software package Statistica 8. Results — An increase in the levels of testosterone and β – endorphin as well as a decrease in estradiol and kisspeptin, which was accompanied by a decrease in body weight was observed in children of subgroup 1a (n=24) under the influence of TCMT in combination with TES. In subgroup 1b (n=22) receiving placebo therapy with disconnected electrodes, there was also a decrease in body weight, but at a much lower level. Conclusion — The use of TCMT in combination with TES led to the normalization of neuroendocrine-immune disorders and contributed to weight loss.

Association of electrical bioimpedance vectors with the nutritional classification of vulnerable multiethnic children.

Monitoring growth and body composition in childhood is vital for early detection of health and nutrition problems during child development. The bioelectrical impedance vector analysis (BIVA) revealed its effectiveness as an indicator of nutritional status. This study aimed to measure the bioimpedance vectors of a sample of multiethnic children and evaluate the utility of BIVA for the classification of the nutritional status in a group of children with greater vulnerability, including in the presence of obesity. This is a cross-sectional study that analyzed the bioelectrical impedance of a sample of 321 children from public daycare centers, aged 1-4 years, using the RXc graph method (tetrapolar analysis at 50kHz frequency). The 95%, 75%, and 50% tolerance ellipses were plotted by age group. The Z-scores of bioimpedance parameters (Xc/H-Z and R/H-Z) were calculated regarding age, which were used to build reference tolerance ellipses for a single group, regardless of age. Such ellipses were evaluated for their ability to recognize the pattern and classify the deviations, using individual vectors of obese children. The mean impedance vectors showed progressively higher reactances and lower resistances with age. In the group of obese children, the individual vectors located outside the 95% baseline tolerance ellipse were 12.5%, 18.75%, and 11.1% of the cases for the WHZ, WAZ, and BMIZ criteria, respectively, all above the expected 5%, but much below expectations. This may be a problem with the obesity criteria used, as WHZ, WAZ, and BMIZ do not differentiate fat from lean mass. Bioimpedance vector analysis reflects differences in the bioelectric patterns of children classified as obese. Provided the obesity criteria are constructed based on fat measurements, rather than lean mass, the use of tolerance ellipses in the BIVA chart is promising as a tool for monitoring nutritional status where measuring body composition is difficult, because constant tissue hydration cannot be assumed.

Влияние избыточной массы тела и ожирения на клиническое течение бронхиальной астмы у детей

Актуальность. На сегодняшний день вопрос влияния избыточной массы тела и ожирения на клиническое течение бронхиальной астмы у детей остается малоизученным и требует дальнейших исследований. Цель: изучить клинические особенности течения бронхиальной астмы у детей с избыточной массой тела и ожирением. Материалы и методы. Проведено исследование 94 больных бронхиальной астмой детей в возрасте от 6 до 18 лет. В зависимости от индекса массы тела пациенты были разделены на следующие клинические группы: 30 детей с нормальной массой тела, 45 детей с избыточной массой тела и 19 детей с ожирением. Методы исследования: общеклинические, антропометрия, лабораторные, анкетно-опросный (опросник контроля бронхиальной астмы ACТ). Статистическую обработку полученных данных проводили с помощью статистического пакета IBM SPSS Statistics Base (версия 22) и программного обеспечения EZR, версия 1.32 (графический интерфейс среды R (версия 2.13.0)). Результаты. Установлено, что для детей групп с избыточной массой тела и ожирением характерен ранний дебют астмы (3 [3; 4]) года) с длительным персистирующим характером. Для всех трех групп наиболее существенными по частоте были жалобы на кашель, причем в группе нормального веса — на сухой (83,3 ± 7,4 %), а в группах с избыточной массой тела и ожирением — на влажный (соответственно 66,7 ± 7,0 % и 73,7 ± 10,1 %), и одышку при физической нагрузке: группа нормальной массы тела — 46,7 ± 9,1 %, избыточной массы тела — 82,2 ± 5,7 % и ожирения — 100 %. Для групп избыточной массы тела и ожирения также существенными по частоте были жалобы на ночные приступы удушья — 68,9 ± 6,9 % и 73,3 ± 10,1 % соответственно. χ2-тест показал статистически значимые различия между тремя группами по этому показателю: χ2(2) = 15,947; p &lt; 0,001. У больных из группы ожирения чаще встречалось (70,0 ± 10,5 %) тяжелое течение бронхиальной астмы, выявлены статистически значимые различия между тремя группами по тесту: χ2(2) = 5,2463, p &lt; 0,001. Неконтролируемая астма статистически значимо преобладала в группе детей с ожирением. Выявлена статистически значимая разница между различными весовыми группами в потребности в бронхолитиках: H(2) = 40,756; p &lt; 0,001, и в количестве ночных приступов астмы: H(2) = 17,803, p &lt; 0,001. Выводы. Проведенное нами исследование свидетельствует о значительном влиянии избыточной массы тела и ожирения на клиническое течение бронхиальной астмы у детей, может быть основанием для коррекции терапии астмы у таких пациентов.

Cardiopulmonary Capacity in Overweight and Obese Children and Adolescents: A Cross-Sectional Study.

Background: One of the objective methods of assessing the level of cardiopulmonary capacity in overweight and obese children and adolescents is cardiopulmonary exercise testing (CPET).Aims: The purpose of present study is an evaluation of aerobic capacity in high body mass index (BMI) children and adolescents by comparing them with a normal weight control group by CPET.Methods and Procedures: The subjects were recruited from participants of the Program of Treatment for Overweight and Obese Children organized by a local pediatric rehabilitation center in Poland. Based on BMI for age and gender, two validation groups were selected: (1) a group of overweight children (n = 49) and (2) a group of obese children (n = 48). The study included also 53 normal weight participants as a reference group (REF). The study consisted of two parts: anthropometric measurements and CPET. The Godfrey protocol for CPET was applied.Outcomes and Results: In this study, obese children and adolescents showed similar absolute VO2peak values in liters per minute (1.64 L/min) compared to overweight children (1.48 L/min), but significantly higher than children with normal body weight (1.39 L/min). The obese children and adolescents presented lower VO2peak in relation to body weight (25.44 ml/kg/min) compared to their peers with normal body weight (36.5 ml/kg/min), and overweight children (29.18 ml/kg/min).Conclusion and Implications: The main finding of our study was recognition of significant differences between cardiopulmonary capacity parameters in obese children in comparison not only to normal weight peers, but to overweight, too.

Carotid intima media-thickness is increased in obese children metabolically healthy, metabolically unhealthy, and with metabolic syndrome, compared to the non-obese controls.

The prevalence of obesity continues to increase. Obesity is associated with cardiovascular risk factors: elevated blood pressure, dyslipidemia and glycemic alterations, causing metabolic syndrome. A subgroup of obese, Metabolically Healthy Obese (MHO), appears to be less prone to the development of metabolic disturbances. Carotid intima-media thickness (cIMT) is a non-invasive marker of subclinical atherosclerosis and it is associated with increased risk of CVD events. To investigate the cardiovascular risk, demonstrated through the increase of cIMT in obese subjects without Metabolic Syndrome (MetS), we have studied cIMT in MHO, metabolically unhealthy obese (MUO) and obese with MetS diagnosed with the IDEFICS criteria and compared to a control group. 224 obese children aged 6 to 21 years (13,50 ± 4.01 years) and 103 normal weight subjects aged 7 to 19 years (13.2 ± 4.1 years) were studied. The body mass index (BMI) of the obese children was ≥ the 95th percentile. Based on the IDEFICS criteria, we divided the obese subjects in three groups: MHO if no criteria were out of range, MUO if, at least, one of the criteria was out of range and MetS group if all the IDEFICS criteria were present. In all the subjects cIMT was measured with color Doppler by a vascular surgeon. Differences in the means of the variables were tested by ANOVA. Based on the IDEFICS criteria, 32 subjects were affected by MetS (14..3%), 66 were considered MUO (29.4%) and 126 MHO (56.3%). Comparison of mean cIMT highlighted a significant difference (p < 0.05) between the groups of obese children (MHO, MUO and MetS) and controls for both carotid arteries. We did not find significative difference in the value of cIMT in MHO, MUO and MetS subjects, and all groups showed cIMT value higher compared to cIMT of the controls.

Quality of life of obese preschoolers

The prevalence of obesity in childhood and adolescence tends to increase, and its presence is associated with a change in the quality of life (QOL). Nevertheless, the question of the influence of obesity on the QОL of Russian children in preschool years remains unexplored, while this age refers to the period of obesity manifestation. Purpose of the study - to examine the quality of life of preschool children with obesity and determine the optimal methods of disease preventing. Material and methods. A retrospective cross-sectional study was conducted to examine the QOL of preschool children. The test group included children with primary exogenous (alimentary) obesity of grade 1, who underwent outpatient treatment in a polyclinic (n=40, 43% girls). The control group included children of I-II health categories with body mass index (BMI) of the 25-85th percentile (n=40, 50% girls). The diagnosis was verified based on the BMI, considering gender and age >=95 percentile and Z-score ranging from +2.0 to +2.5. We assessed QOL based on the general PedsQL 4.0 questionnaire adapted for Russian-speaking users. As a result, we received the characteristics of physical (PF), emotional (EF), social (SF), and role (RF) functioning in the presence of the disease and without it. When categorizing the QOL level, we used the following intervals: 100 to 91 points - high level of QOL, 90 to 81 - medium level, 80 to 71 - low level, less than 70 - very low level. Results. It was found out that the average value of the generalized QOL indicator according to self-reports in the group of obese children was 20.3% lower (p<0.01) than in the group of healthy children and did not exceed 70 points, which corresponded to a very low QOL level. The absolute difference between groups exceeds the criterion of clinical significance. In the course of detailed analysis, the lowest values were obtained for EF indicators (65.3±21.6 points) with a relative difference in the control group of up to 21.6% (p<0.01). The emotional component was closely related to SF (r=0.63, р<0.01), PF (r=0.67, р<0.01) and RF (r=0.61, р<0.01). The parents of the children with obesity assessed their QOL at a very low level (on the average at 64.4±19.2 points), which was 21.5% lower (p<0.01) than the same indicator according to the estimates given by the parents of healthy children. Conclusion. Therefore, preschool children with obesity are aware of the limitations associated with the disease and point out a particularly low level of functioning, primarily emotional. The QOL indicators of the children with obesity were 19-22% lower than that of their healthy peers. The opinions of the parents were consistent with the self-reports the children provided. Due to the rapid increase in obesity among children, it is advisable to promote systematic educational programs on healthy eating developed as part of the national project for disease prevention.

Investigation of the relationship between plantar pressure behaviour and plantar surface sensitivity in children with idiopathic toe walking

Flatfoot has a very high incidence of obese children. Functional parameters such as plantar pressures and center of pressure (COP) are sensitive to foot type. However, previous foot biomechanical studies of obese children rarely excluded the flatfoot as a prerequisite of the participants involved.This study aimed to determine whether it is essential to define flatfoot as a subject screening criterion in the foot biomechanical study for obese children.Foot types were classified by arch index (AI). Totally 21 obese children with flatfoot (OF group) along with matched control groups of obese children with normal foot (ON group) and normal-weighted children with flatfoot (NF group) were selected from our database. Barefoot walking trails were conducted using Footscan® plate system. Peak force (PF), peak pressure (PP), pressure-time integral (PTI), contact area (CA) and COP data were recorded. Independent t-test and effect size were used to compare the data between the study group and the control groups. Intraclass correlation coefficient was used to measure the between-trail reliability for the dependent variables.In comparison with the OF group, an upward trend for PF, PP and PTI was found for the ON group, while an opposite tendency for the NF group. The OF group displayed a significant larger CA under the midfoot region than the NF group even if there is no significant difference for AI. The OF group displayed a more medial shift of COP progression compared to the ON group. But no significant differences were found for COP parameters between the OF group and the NF group.This study provided substantial evidence to support that prospective foot biomechanical research on the obese group needs to identify the flatfoot as one of the subject screening criteria to carry out more reliable results without producing confounding effects.

Mixed factors affecting plantar pressures and center of pressure in obese children: Obesity and flatfoot

BackgroundFlatfoot has a very high incidence of obese children. Functional parameters such as plantar pressures and center of pressure (COP) are sensitive to foot type. However, previous foot biomechanical studies of obese children rarely excluded the flatfoot as a prerequisite of the participants involved. Research questionThis study aimed to determine whether it is essential to define flatfoot as a subject screening criterion in the foot biomechanical study for obese children. MethodsFoot types were classified by arch index (AI). Totally 21 obese children with flatfoot (OF group) along with matched control groups of obese children with normal foot (ON group) and normal-weighted children with flatfoot (NF group) were selected from our database. Barefoot walking trails were conducted using Footscan® plate system. Peak force (PF), peak pressure (PP), pressure-time integral (PTI), contact area (CA) and COP data were recorded. Independent t-test and effect size were used to compare the data between the study group and the control groups. Intraclass correlation coefficient was used to measure the between-trail reliability for the dependent variables. ResultsIn comparison with the OF group, an upward trend for PF, PP and PTI was found for the ON group, while an opposite tendency for the NF group. The OF group displayed a significant larger CA under the midfoot region than the NF group even if there is no significant difference for AI. The OF group displayed a more medial shift of COP progression compared to the ON group. But no significant differences were found for COP parameters between the OF group and the NF group. SignificanceThis study provided substantial evidence to support that prospective foot biomechanical research on the obese group needs to identify the flatfoot as one of the subject screening criteria to carry out more reliable results without producing confounding effects.

Self-perception and Parents’ Perceptions of the Nutritional Status Based on BMI in School Children of Dhaka City

Background &amp; objective: Childhood underweight or overweight prevention efforts are unlikely to be successful without a better understanding of how parents perceive the problem of underweight or overweight in their children. This study was carried out with the objective of comparing perceptions (parents’ and self) of the nutritional status with the actual nutritional status measured by BMI.&#x0D; Materials &amp; Methods: This Cross-sectional study was carried out in the Department of Pediatrics, Sir Salimullah Medical College, Mitford hospital, Dhaka over a period of 12 months, from July 2008 to June 2009. Three schools in Dhaka Metropolitan city were selected by multistage sampling (lottery method). A self– administered parents’ questionnaire was filled by parents. Then the student’s nutritional status was defined according to age and gender specific body mass index percentile from CDC-2000 reference as underweight (&lt; 5th percentile), normal (5th - 85th percentile), overweight (85th - &lt;95th percentile),) and obese (95th percentile and above). Chi-square test was used for testing statistical significance.&#x0D; Results: This study found the double burden of under nutrition and obesity in school children of Dhaka city (41.4% as underweight, 48.5% as normal weight, 5.6% as overweight, and 4.5% as obese). Obesity (6% vs. 2.2%) and overweight (6.6% vs. 2.2%) was higher in boys than girls, although underweight was almost similar (42% vs. 41%) in boys and girls. Majority of children (602 among 1026) failed to perceive their actual body image (58.7%) and almost half of the parents (371 among 772) also failed to perceive the actual body image of their children (48.1%). Among underweight, overweight and obese children 87.3% had incorrect self-perception of nutritional status. 75% of parents’ perception was incorrect in the above mentioned group.&#x0D; Conclusion: Underweight and obese school children had the most incorrect self-perception. Similarly parents of the underweight and obese children group had the most incorrect parents’ perception. These are the alarming situation and demand our immediate attention.&#x0D; TAJ 2019; 32(2): 7-13

Psychological impact of obesity in children

Background Obesity is a growing public health problem among both children and adults. Obesity comorbidities are not limited to somatic complications, but extend to involve several psychological consequences. Stigmatization represents a major psychological stress that adversely affects children’s self-esteem. Aim This study aimed to assess the prevalence of common psychiatric disorders (depression, anxiety, oppositional defiant disorder) in a group of obese children in comparison with those with normal weight. Participants and methods This case–control study included 60 children with obesity (BMI ≥95th age-specific and sex-specific percentiles) and 60 age-matched and sex-matched normal-weight children (BMI 5th–85th age-specific and sex-specific percentiles) as the control group. Detailed assessments of history and anthropometric indices of central and peripheral obesity, in addition to psychiatric assessment for depression, anxiety, and oppositional defiant disorder, were carried out. Results 46.7% of children with obesity were victims of bullying. Children with obesity have significantly higher rate of depression and low self-esteem in comparison with healthy peers. Girls were more affected than boys. There is a significant relation between depression and central obesity. The childhood depression inventory score is correlated directly to BMI and waist circumference. Conclusion Children with obesity are at a higher risk for depression, with the severity of depression correlated positively with BMI and central obesity.

Assessment of diet quality, nutrient intake, and dietary behaviours in obese children compared to healthy children.

Obesity has been recognised by the World Health Organisation as the most common chronic disease in the world. An increase in the prevalence of childhood obesity has been seen in Poland. The aim of this study was to compare the dietary behaviours, quality of diet, and nutrient intake in a group of obese children compared to children with normal body weight. A total of 105 children aged between seven and 15 years were surveyed. The test group consisted of 52 obese patients from a Dietary Clinic in the Children's University Hospital in Cracow, without accompanying chronic diseases, and 53 normal weight patients. Chil-dren's nutritional behaviours and diet were assessed with a questionnaire (FFQ) and a 24-hour recall. To assess diet quality the Healthy Eating Indicator (HDI) was used. The diet of the studied obese children was rich in highly processed and high-fat products, and poor in vegetables, fruits, and wholegrain products. Obese children consumed on average 73.42 ±19.60 kcal per body weight whereas normal-weight children consumed 49.89 ±12.20 (p < 0.01) and obtained more energy from fat than from carbohydrates. A low intake of vitamins A and D, folic acid, calcium, iodine, and iron in both groups was observed. The HDI showed a low-quality diet in nearly 40% of obese children. Dietary treatment of obese children should concentrate not only on reduction of calories from food products but also on choices of high-nutrient-density products and on developing healthy eating habits.