Improve Weight Status Research Articles

Factors guiding gastrostomy tube decision-making for caregivers of children with cystic fibrosis: a scoping review protocol

IntroductionWhile ensuring appropriate growth is essential for all children, optimising nutritional status in children with cystic fibrosis (CF) is critical for improving health outcomes. Nutritional challenges in CF are multifactorial...

The Effectiveness of Integrating Psychotherapy Into Overweight/Obesity Interventions on Youth’s Weight Status and Depressive Symptoms: A Narrative Review

Introduction: Childhood obesity and youth depression are serious ongoing global crises of the 21st century. Many researchers have often attributed this to the well-established association between them. Consequently, psychotherapies are increasingly being integrated into interventions to improve weight status and depression outcomes for individuals with overweight and/or obesity (OW/OB). However, the effectiveness of these interventions has not yet been reviewed for youth with OW/OB. Such youth tend to be at a higher risk of developing comorbid depressive symptoms, which can likely persist into adulthood. Therefore, this narrative review explored the effectiveness of psychotherapy integrations within OW/OB interventions on youth’s weight statuses and their depressive symptoms contemporaneously. Methods: Medline, Embase, PsycInfo, PubMed, and Scopus were accessed. English peer-reviewed empirical articles, reviews, meta-analyses, clinical trials, and pilot studies from the last ten years and those that investigated the effectiveness of OW/OB interventions integrated with psychotherapy among youth (5-18 years) were included. Keywords related to diet, psychotherapy, OW/OB, youth, and depression were used. Non-peer-reviewed sources, reviews lacking sufficient transparency in their methodology, editorials, letters, study protocols, commentaries, preprints, and dissertations were excluded. Results: Four studies, including two pilot studies, were included. Overall, we found high heterogeneity in their intervention components and conditions, study designs, participants, and results. Among youth, all studies found no significant improvements in weight status as per the authors’ set significance thresholds. Mixed results were obtained for the effect on youth’s depressive symptoms. Discussion: There is an alarming lack of recent literature investigating the impact of integrated evidence-based psychotherapies within OW/OB interventions on youth’s weight statuses and depressive symptoms. It is important to investigate their effectiveness in equipping youth with OW/OB with skills to make sustained lifestyle changes and cope with weight discrimination and depressive symptoms. We attributed the weak success of these interventions to the lack of cultural adaptations and standardization of study types, intervention structures, components, and conditions. Conclusion: It is important for researchers to continue investigating the success of such interventions on youth with OW/OB’s physical and mental outcomes simultaneously. This will further inform the interdisciplinary approach needed to deliver appropriate care to these youth.

231 An evaluation of the dietetic service in a Geriatric Assessment Unit—nutritional status and outcomes

Abstract Background In 2021 the Geriatric Assessment Unit (GAU) was established, a 0.5 WTE dietitian was appointed to the multidisciplinary team. The Comprehensive Older Age Assessment (COAA) developed by the MDT included two nutritional screening tools—Malnutrition Universal Screening Tool (MUST) and the SARC-F questionnaire for sarcopenia. A MUST score of ≥2 and a SARC-F score of ≥4 were automatic dietetic referrals, referrals were also sent if a clinical concern was identified by the MDT. The aim of this review is to investigate the dietetic referral rates, nutritional status and compile a summary clinical outcomes. Methods A review of the dietetic excel database for the GAU, 2021 and 2022 was completed. The review included statistics on: (1) Referral rate, (2) Total number of dietetic interventions and a breakdown of new versus review patients, (3) MUST and SARRC- F score, (4) Body Mass Index (BMI) & weight status and (5) Review of the dietetic outcome following intervention e.g. follow up versus discharge rate and weight status at review appointments. Results The data for 2021 and 2022 were combined—77.5% of patients attending the GAU were referred to the dietitian, 80% of patients referred attended a one to one consultation. 55% of all dietetic interventions were for new patients and 45% review patients. Average BMI was 25.5 kg/m2 and 27.7 kg/m2 in 2021 and 2022 respectively. 13% had a MUST score of ≥2. 49.8% had a SCAR –F score ≥ 4. 41% of patients had reported or documented weight loss. 70% required dietetic review. At dietetic review 39.5% had desirable weight gain, 39.5% were weight stable, with only 16% having an undesirable weight loss. Conclusion The requirements and benefits of a dietetic service can be seen in the high referral rate, documented concerns of weight loss and percentage of patients with a SARC-F score ≥ 4, leading to patient specific dietetic intervention, with a stable or improved weight status at dietetic review.

Longitudinal associations between sleep and weight status in infants and toddlers.

The limited research assessing relationships between sleep duration and weight status in infants and toddlers relies primarily on parent-reported sleep and cross-sectional studies. Examine whether average sleep duration and changes in sleep duration among 6-24-month-old children were associated with weight-for-length z-scores, and whether these associations varied by race/ethnicity, socioeconomic status and sex. Data were collected when children were approximately 6, 12, 18 and 24 months old (N = 116). Sleep duration was measured using actigraphy. Weight-for-length z-scores were calculated using children's height and weight. Physical activity was assessed using accelerometry. Diet was assessed using a feeding frequency questionnaire. Demographic characteristics included sex, race/ethnicity and socioeconomic status. Separate associations of between- and within-person changes in sleep duration were estimated with weight-for-length z-score treated as the outcome variable in linear mixed model analyses. Additional models were assessed that included interactions between sleep and demographic characteristics. At time points where children slept longer at night compared to their own average, their weight-for-length z-score was lower. This relationship was attenuated by physical activity levels. Increasing sleep duration can improve weight status outcomes in very young children who have low physical activity levels.

Glucagon-like peptide-1 analog therapy in rare genetic diseases: monogenic obesity, monogenic diabetes, and spinal muscular atrophy.

Implementing genetic analyses have unraveled rare alterations causing early-onset obesity and complications, in whom treatment is challenging. We aimed to report on the effects of adjuvant off-label therapy with liraglutide, glucagon-like peptide-1 analogue (GLP-1a), in rare genetic diagnoses. Case scenarios and review of the literature. Case 1: Nine-year-old boy with early-onset severe obesity and nonalcoholic fatty liver disease (NAFLD) due to a homozygous mutation in the MC4R gene deteriorated under lifestyle change and metformin therapy [at 10.5 years: body mass index (BMI) 51.2kg/m2, 226% of the 95th percentile, fat percentage (FP) 65% and muscle-to-fat ratio (MFR) z-score of -2.41]. One year of liraglutide treatment halted progressive weight gain [BMI 50.3kg/m2, 212% of the 95th percentile, 63.7% FP and MFR z-score of -2.34], with biochemical improvement. Case 2: Twelve-year-old boy with obesity presented with diabetes and progressive NAFLD. Exome analysis revealed two heterozygous mutations compatible with monogenic diabetes (HNF1A) and familial hypercholesterolemia (LDLR). Lifestyle modifications resulted in clinical and laboratory improvement (BMI 87th percentile, 32.8% FP, MFR z-score of -1.63, HbA1c 5.5%) without the expected recovery in liver transaminases. Liraglutide treatment augmented the improvement in weight status (BMI 68th percentile, 22.6% FP, MFR z-score of -1.13) with normalization of liver transaminases. Case 3: Nineteen-year-old male with spinal muscular atrophy type 3 presented with sarcopenic obesity and comorbidities. Treatment strategy included dietary counseling and multiple drug therapies (metformin, anti-hypertensive and statins). Liraglutide therapy led to a gradual recovery of metabolic complications allowing tapering-down other medications. Considering the pleiotropic effects of GLP1-a beyond BMI reduction, this treatment modality may serve as a game changer in challenging cases.

Differences in Adherence to American Heart Association's Life's Essential 8, Diet Quality, and Weight Loss Strategies Between Those With and Without Recent Clinically Significant Weight Loss in a Nationally Representative Sample of US Adults.

Background The American Heart Association defines ideal cardiovascular health based on 8 risk factors (Life's Essential 8 [LE8]); a high LE8 score (range 0-100) reflects greater adherence to their recommendations. Weight status influences cardiovascular health, yet individuals may use detrimental diet and weight loss strategies to improve weight status. We assessed differences in LE8 adherence, diet quality, and weight loss strategies between those with and without a recent history of clinically significant weight loss (CSWL). Methods and Results Data from 2007 to 2016 National Health and Nutrition Examination Survey questionnaires, clinical measures, and 24-hour dietary recalls were assessed to determine LE8 adherence, diet quality (Healthy Eating Index), and weight loss strategies between adults with: (1) intentional CSWL ≥5%; and (2) non-CSWL <5%, weight maintenance, or weight gain over the past 12 months using ANCOVA and chi-square tests. Those with CSWL demonstrated higher scores for diet quality (P=0.014), physical activity (P<0.001), and blood lipids (P<0.001). Those without CSWL reported lower BMI (P<0.001). There were no differences in total LE8 cardiovascular health scores between those with and without CSWL. More individuals with CSWL reported weight loss strategies of exercising (P=0.016); those without CSWL reported skipping meals (P=0.002) and using prescription diet pills (P<0.001). Conclusions Greater adherence to the LE8 recommendations was observed among individuals with CSWL, although overall LE8 scores were low. Future research should address the implementation of evidence-based strategies that improve diet quality while promoting optimal cardiovascular health among those with intent to lose weight.

From childhood obesity risk to healthy growth in the U.S.: A 10-year social work research & policy update

Childhood obesity is a major health issue and a prominent chronic health condition for children in the United States (U.S.), caused by a multitude of factors. Most existing models of childhood obesity prevention have not worked, yielding little to no effect on improving weight status or the proximal health behaviors most attributed to obesity risk: nutritional intake, physical activity, sedentary behaviors, and sleep. There is an urgent need for new approaches to prevent health disparities that are responsive to impacts of economic inequality on healthy child growth in marginalized populations. In this Short Commentary, a social justice update is provided to motivate a new generation of research that promotes equitable and healthy child growth under present-day social, economic, and political circumstances. Social work-specific research and policy recommendations are provided to guide future research that targets underlying social and economic determinants of weight-related health disparities in childhood. Recommendations include research on cross-disciplinary metrics to better capture reductions in health disparities and the development and testing of policy and system interventions that address structural issues and strengthen health resources in marginalized communities. Progress in reducing disparities in childhood obesity will likely remain inhibited until recommendations from social work research are incorporated to strengthen existing medical and public health models and redirect the childhood obesity epidemic toward equitable, healthy child growth.

The effect of oral nutrition supplements and appetite stimulants on weight status among pediatric cancer patients: A systematic review.

The objective of this study was to identify the use and impact of oral nutrition supplements (ONSs) and appetite stimulants on weight status among pediatric patients diagnosed with malignancy. We performed a literature search of trials using Medline PubMed, CINAHL, Web of Science Core Collection, Scopus, and Cochrane Database of Systematic Reviews and included all prospective studies except review articles and case-reports/series that assessed ONSs or appetite stimulants among patients (0-20 years old) diagnosed with a pediatric malignancy. Databases were searched through May 17, 2022. There were six trials included with three studies related to ONS and the remaining on appetite stimulants. No studies that compared both ONS and appetite stimulants were found. To assess quality, we used the Risk of Bias in Nonrandomized Studies of Interventions and the Revised Cochrane Risk of Bias Tool for Randomized Trials depending on the study design. The studies all had pediatric patients diagnosed with a variety of malignancy types. All studies demonstrated improvement of weight status in the treatment group across various malignancy types. However, none of the studies addressed nutrition intakes outside of ONS consumption, compliance to ONSs, or frequency of ONS use. Despite the short durations (3-6 months) and significant differences in the timing of intervention initiation (ONS or appetite stimulants), these treatment modalities can improve weight status. Further research is needed to identify the best intervention for improving weight status.

Evidence of Concurrent Stunting and Obesity among Children under 2 Years from Socio-Economically Disadvantaged Backgrounds in the Era of the Integrated Nutrition Programme in South Africa.

In view of persistent stunting and increasing rates of obesity coexisting among children in the era of the Integrated Nutrition Programme, a cross-sectional study was conducted to determined concurrent stunting and obesity (CSO) and related factors using a random sample of child–mother pairs (n = 400) in Mbombela, South Africa. Sociodemographic data was collected using a validated questionnaire, and stunting (≥2SD) and obesity (>3SD) were assessed through respective length-for-age (LAZ) and body mass index (BAZ) z-scores. Using SPSS 26.0, the mean age of children was 8 (4; 11) months, and poor sociodemographic status was observed, in terms of maternal singlehood (73%), no education or attaining primary education only (21%), being unemployed (79%), living in households with a monthly income below R10,000 (≈$617), and poor sanitation (84%). The z-test for a single proportion showed a significant difference between the prevalence of CSO (41%) and non-CSO (69%). Testing for the two hypotheses using the Chi-square test showed no significant difference of CSO between boys (40%) and girls (41%), while CSO was significantly different and high among children aged 6–11 months (55%), compared to those aged 0–5 months (35%) and ≥12 months (30%). Further analysis using hierarchical logistic regression showed significant associations of CSO with employment (AOR = 0.34; 95%CI: 0.14–0.78), maternal education status (AOR = 0.39; 95%CI: 0.14–1.09) and water access (AOR = 2.47; 95%CI: 1.32; 4.63). Evidence-based and multilevel intervention programs aiming to prevent CSO and addressing stunting, while improving weight status in children with social disadvantages, are necessary.

Assessing Body Measurements, Nutritional Behaviors, And Sleep Behaviors Following Implementation of Mhealth in Appalachian State University College Students

Upon completion, participants will be able to assess the potential impact of a mHealth-based health behavior and weight management intervention on college students. Chronic diseases such as obesity are common in college students. College students struggle to develop strategies to maintain healthy weight and lifestyle behaviors. mHealth programs are accessible to college students’ schedules. My Quest in the High Country collaborated with Appalachian State University (ASU) Student Health Services and the Blue Cross Institute for Health and Human Services Interprofessional Clinic to create a 24-week mHealth intervention to improve weight status, health behaviors and biometrics in ASU students.

Health literacy as a key to improving weight status among Palestinian adolescents living in chronic conflict conditions: a cross-sectional study

ObjectiveTo examine the moderating role of health literacy in the association between direct exposure to violence and weight status among Palestinian adolescents.DesignA household cross-sectional study conducted in 2017.SettingA Palestinian district...

Weight Status Among Minnesota Hispanic or Latino/a Youth: An Exploration of Protective Factors.

Pediatric obesity disproportionately impacts Hispanic or Latino/a adolescents. Culturally appropriate family-based behavioral initiatives to improve weight status are warranted. The purpose of this research was to determine prevalence rates and identify protective factors associated with having overweight/obesity (body mass index ≥ 85th percentile) to inform Hispanic or Latino/a-targeted behavioral intervention development. Secondary data analyses of a population-based statewide survey. Minnesota public high schools. Male (n = 2,644) and female (n = 2,798) Hispanic or Latino/a 9th and 11th graders (N = 5,442). Obesity-related behaviors (meeting fruit and vegetable [F&V] and physical activity [PA] recommendations), family caring, family country/region of origin, and weight status. Stepwise logistic regression models (F&V, PA), stratified by biological sex, were used to identify protective factors of overweight/obesity. The overall prevalence of meeting F&V and PA recommendations was 11.0% and 11.8%, respectively. Meeting F&V recommendations was not protective against overweight/obesity in either sex. Yet, males and females who met PA recommendations had significantly lower odds of having overweight/obesity (p < .05). In F&V and PA models, family caring was protective against overweight/obesity in females (p < .05), and family country/region of origin was protective against overweight/obesity in both sexes (p < .05). Findings illustrate a need for obesity prevention initiatives for Hispanic or Latino/a youth. More research is needed to understand the protective nature of family caring and country/region of origin.

Associations between changes in caregiver’s and child’s weight status in a community-based obesity intervention programme

ObjectivesWe examined whether caregivers of children/adolescents enroled in a randomised controlled trial (RCT) of a family-centred intervention indirectly achieved reductions in body mass index (BMI), and if these were associated with changes in their children’s BMI.MethodsRCT participants were New Zealand children/adolescents aged 4.8–16.8 years with BMI ≥ 98th percentile or >91st with weight-related comorbidities. Participants and accompanying caregivers were assessed at baseline, 12, and 24 months.ResultsOverall, caregivers’ BMI was unchanged at 12 or 24 months. Among Māori participants, reductions in caregivers’ BMI at 12 months were associated with reductions in their children’s BMI SDS at 12 (r = 0.30; p = 0.038) and 24 months (r = 0.39; p = 0.009). Further, children identifying as Māori whose caregivers’ BMI decreased at 12 months had greater BMI SDS reductions at 12 months [−0.30 (95% CI −0.49, −0.10); p = 0.004] and 24 months [−0.39 (95% CI −0.61, −0.16); p = 0.001] than children of caregivers with increased/unchanged BMI.ConclusionsThis intervention programme for children/adolescents with obesity did not indirectly reduce caregiver weight status. However, reductions in caregivers’ BMI were key to BMI SDS reductions among Māori participants. Given the intergenerational nature of obesity, our findings highlight the importance of culturally relevant, family-focused programmes to achieve clinically meaningful improvements in weight status across the family.

Il modello di gestione del bambino sovrappeso e obeso in Regione Emilia-Romagna: primi risultati

Child and adolescent obesity is a complex, multifactorial but also largely preventable disease; as a consequence its management needs a multilevel and integrated approach to be successful. This article describes the Preventive Diagnostic Therapeutic Assistance Pathways (PPDTA) for children with overweight and obesity delivered by trained multidisciplinary teams in the Emilia-Romagna Region. The regional “Guidelines for early detection, assessment and treatment of childhood obesity” were launched in 2013 (DGR 783/2013) and in 2017 WHO/Europe mentioned them as good practice and Country example. Training in childhood obesity prevention and management was delivered for all the primary care paediatricians (PCPs) and the members of the multidisciplinary teams. The PPDTA is based on three progressive levels: Level 1: PCPs. Level 2: a multidisciplinary team consisting of paediatricians, sports medicine doctors, exercise specialists, dieticians and psychologists experienced in paediatric obesity defines the clinical condition of children referred by the PCPs and runs the lifestyle change multi-component interventions. Level 3: is carried out by specialized clinicians in the hospital setting on a multidisciplinary basis for children with more severe and complicated obesity. In case of therapeutic failure, the PCP refers the child to the second-level multidisciplinary team. The second-level assessment and intervention are conducted at public health departments or at public health centres. During treatment, each team member uses the same tools, such as motivational interviewing for encouraging behaviour change. A standard evaluation framework is in place to assess the quality and effectiveness of the weight multidisciplinary management services, with three types of regional evaluation indicators: anthropometrics, lifestyle changes (eating habits, sedentary and physical activity) and equity. An improvement in weight status was observed in both children and adolescents with overweight and obesity. Interventions targeting at specific behaviours, such as increasing fruit and vegetable intake, habitually eating a balanced breakfast and reducing sedentary behaviour have been found effective as well.

Scale-up of the Physical Activity 4 Everyone (PA4E1) intervention in secondary schools: 24-month implementation and cost outcomes from a cluster randomised controlled trial

BackgroundPhysical Activity 4 Everyone (PA4E1) is an evidence-based program effective at increasing adolescent physical activity (PA) and improving weight status. This study aimed to determine a) the effectiveness of an adapted implementation intervention to scale-up PA4E1 at 24-month follow-up, b) fidelity and reach, and c) the cost and cost-effectiveness of the implementation support intervention.MethodsA cluster randomised controlled trial using a type III hybrid implementation-effectiveness design in 49 lower socio-economic secondary schools, randomised to a program (n = 24) or control group (n = 25). An adapted implementation intervention consisting of seven strategies was developed to support schools to implement PA4E1 over 24-months. The primary outcome was the proportion of schools implementing at least four of the 7 PA practices, assessed via computer assisted telephone interviews (CATI) with Head Physical Education Teachers. Secondary outcomes included the mean number of PA practices implemented, fidelity and reach, cost and cost-effectiveness. Logistic regression models assessed program effects.ResultsAt baseline, no schools implemented four of the 7 PA practices. At 24-months, significantly more schools in the program group (16/23, 69.6%) implemented at least four of the 7 PA practices than the control group (0/25, 0%) (p < 0.001). At 24-months, program schools were implementing an average of 3.6 more practices than control schools (4.1 (1.7) vs. 0.5 (0.8), respectively) (P < 0.001). Fidelity and reach of the implementation intervention were high (> 75%). The total cost of the program was $415,112 AUD (2018) ($17,296 per school; $117.30 per student).ConclusionsThe adapted implementation intervention provides policy makers and researchers with an effective and potentially cost-effective model for scaling-up the delivery of PA4E1 in secondary schools. Further assessment of sustainability is warranted.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12617000681358 prospectively registered 12th May 2017.

Differences in Adherence to Cardiovascular Lifestyle Recommendations, Diet Quality, and Weight Loss Strategies in 2007-2016 NHANES by Weight Loss Status

Describe lifestyle behavior differences and weight loss intention behaviors for those with clinically significant weight loss. The American Heart Association Life’s Simple 7 (LS7) assesses modifiable behaviors associated with cardiovascular disease (CVD) risk. A high LS7 score (range 0-14) reflects adherence to recommendations. Individuals often employ diet and weight loss strategies to improve weight status, though many engage in detrimental practices. There is a need to identify differences in LS7 adherence, diet quality, and weight loss strategies between those with and without clinically significant weight loss (CSWL). Data from 2007-2016 National Health and Nutrition Examination Survey (NHANES) questionnaires, clinical measures, and 24-hour dietary recalls were assessed to determine differences in LS7 adherence, diet quality (Healthy Eating Index), and weight loss strategies between adults with: (1) intentional CSWL ≥5%; and (2) non-CSWL <5%, weight maintenance, or weight gain. ANOVA and chi-square tests were used to assess differences. While greater LS7 adherence was observed among non-CSWL individuals (n=17,499; 7.5±0.0 vs 7.4±0.1, p=0.028), those with CSWL (n=2,844) demonstrated higher diet quality (total HEI 52.9±0.4 vs 52.0±0.2, p=0.019) and more physical activity minutes/week (75.9±3.1 vs 68.3±1.5, p=0.017). However, 74% of all individuals demonstrated low adherence to dietary recommendations. A greater proportion of CSWL individuals reported strategies of exercising (p=0.016); non-CSWL individuals reported greater use of skipping meals (p=0.002) or prescription diet pills (p<0.001) to lose weight. Greater adherence to diet and physical activity recommendations was observed among individuals with CSWL, though overall LS7 adherence was low. Future research should address the implementation of evidence-based strategies that improve diet quality and reduce CVD risk among those with intent to lose weight.

Design, Implementation, and Examination of a Remote Patient Monitoring System for Pediatric Obesity: Protocol for an Open Trial Pilot Study.

BackgroundPediatric obesity is a critical public health issue. Augmenting care in multidisciplinary pediatric obesity clinics with innovative evidence-based technology to improve weight status and health outcomes is needed.ObjectiveThis study describes the design and methods of an open trial pilot study to examine a remote patient monitoring system (RPMS) for children aged 8-17 years who are receiving treatment in a multidisciplinary pediatric obesity clinic.MethodsParticipants will include 45 youth with obesity and their parents. Families will receive standard care in the clinic and the RPMS for 3 months. The RPMS consists of a tablet, weight scale, and pedometer. The system provides daily educational content and involves the use of the pedometer and weekly weigh-ins. Children and parents will complete baseline, posttreatment (month 3), and follow-up assessments (month 6). The primary aim of the study is to examine feasibility and satisfaction with the RPMS and assess its initial effectiveness.ResultsWe hypothesize high feasibility and satisfaction, with rates over 75%. Furthermore, after RPMS treatment, children will exhibit improved weight status, health outcomes, dietary intake, physical activity, health-related quality of life, self-efficacy, and home-food environment compared to before treatment. These gains are expected to persist at follow-up.ConclusionsThis study is novel in that it is the first to design, implement, and examine an RPMS in a pediatric obesity clinic. If the RPMS is feasible, effective, and easily accessible, it may prove to be a practical, acceptable, and cost-effective weight management treatment for youth seeking treatment for severe obesity.Trial RegistrationClinicalTrials.gov NCT04029597; https://clinicaltrials.gov/ct2/show/NCT04029597International Registered Report Identifier (IRRID)DERR1-10.2196/29858

Is School Gardening Combined with Physical Activity Intervention Effective for Improving Childhood Obesity? A Systematic Review and Meta-Analysis.

School gardening activities (SGA) combined with physical activities (PA) may improve childhood dietary intake and prevent overweight and obesity. This study aims to evaluate the effect of SGA combined with PA on children’s dietary intake and anthropometric outcomes. We searched studies containing randomized controlled trials up to January 2021 in Web of Science, PubMed, Cochrane Library, and the EBSCO database on this topic for children aged 7 to 12 years. Fourteen studies met the requirements for meta-analysis (n = 9187). We found that SGA has no obvious effect on improving children’s BMI (WMD = −0.49; p = 0.085; I2 = 86.3%), BMI z-score (WMD = −0.12; p = 0.235; I2 = 63.0%), and WC (WMD = −0.98; p = 0.05; I2 = 72.9%). SGA can effectively improve children’s FVs (WMD = 0.59, p = 0.003, I2 = 95.3%). SGA combined with PA can significantly increase children’s FVs but cannot greatly improve weight status. Although more studies on this topic are needed to prove the effectiveness of this method, the results of our review show that both SGA and SGA combined with PA has a modest but positive impact of reducing BMI and WC outcomes but can significantly increase children’s FVs.

The association of a low glycaemic index diet in pregnancy with child body composition at 5 years of age: A secondary analysis of the ROLO study.

Childhood obesity remains a significant global health concern. Early intervention through maternal diet during pregnancy represents a possible mode of improving childhood adiposity. To examine the impact of a low glycaemic index diet during pregnancy on offspring anthropometry at 5 years of age. This is a secondary analysis of 387 children from the ROLO pregnancy study 5 years' post-intervention. At the follow-up, BMI, circumferences and skinfold thickness were obtained. A subgroup of 103 children had a DXA scan completed. Statistical analyses included Independent sample t tests, Mann Whitney-U tests and chi-square tests to compare the intervention and control groups. Adjusted analysis using linear regression controlled for significant confounders between participants who returned at follow-up and those that did not. There were no significant differences in BMI (16.05 kg/m2 vs 16.16 kg/m2 , P=0.403), general adiposity (36.60 mm vs 36.00 mm, P=0.920), central adiposity (0.61 mm vs 0.60 mm, P=0.540), total fat mass (4.91 kg vs 4.71 kg, P=0.377) or total lean mass (14.29 kg vs 14.56 kg, P=0.386) between the intervention and control groups, respectively. No associations were observed in 5-year outcomes in adjusted analyses when controlling for maternal age at delivery, maternal early pregnancy BMI, maternal education and gestational age. Our study found no evidence that a low glycaemic index diet in pregnancy impacts offspring anthropometry 5 years' post-intervention. Therefore, modulating maternal carbohydrate quality in pregnancy may not be an appropriate approach to improving weight status in childhood. Future research should investigate the impact of other dietary practices in pregnancy on child health.

Influences of persistent overweight on perceptual-motor proficiency of primary school children: the North-West CHILD longitudinal study

BackgroundOverweight can be a precursor of poor motor execution, negatively impacting the overall development of school-aged children on various levels. This study determined the long-term influences of overweight on perceptual-motor proficiency (PMP) of primary school children in the North-West Province of South Africa.MethodsThe study, which included 381 participants, formed part of the NW-CHILD longitudinal study from Grade 1 (6.86 years, ± 0.39) in 2010 to Grade 7 (12.9 years, ± 0.38) in 2016. Socioeconomic categories, called quintiles, were used to compare high and low socioeconomic status groups. Overweight was identified when BMI values fell above the 85th percentile, using age- and gender-specific cut-off points. The group was categorised into 4 BMI groups (never overweight, persistent overweight, overweight-to-normal and normal-to-overweight). The Bruininks Oseretsky Test of Motor Proficiency-2 (BOT-2) Short Form and selected composites measuring strength, balance, and running speed and agility were used to assess PMP.ResultsA repeated measures ANOVA analysis indicated specific PMP differences between different BMI groups, but not total motor proficiency (BOT-2 Short Form total) differences. Practical significant group differences (Cohen’s d-values) were found in running speed and agility, strength, balance and the BOT-2 total, over seven primary school years. The persistent overweight group showed the poorest performance over time, but also showed deteriorating skills and a gradual widening in perceptual-motor skills performance, compared to the other groups. BMI-related differences in perceptual-motor coordination were also more pronounced in older age groups.ConclusionsPersistent overweight negatively impacts specific motor-proficiency components, while improving weight status can counter these effects, which highlights the importance of timeous intervention to combat obesity at a young age.