Obesity Task Force Research Articles

Meta Analysis the Effect of Intervention Based School toward Nutrition on Body Mass Index

Background: Body mass index (BMI) is a metric used to define anthropometric characte­ristics and classify interpretations of individual fatness indexes. The International Association For The Study Of Obesity (IASO) and the Inter­national Obesity Task Force (IOTF) calculate that 200 million school children worldwide are overweight or obese. This study aims to estimate the magnitude of the effect of school-based interventions for nutrition on body mass index based on a number of previous primary studies. Subjects and Method: This study is a syste­matic study and meta-analysis, with the following PICO Population = students (SMP) and (SMA) with obesity. Intervention= School-based inter­ventions for nutrition. Comparison= no inter­vention. Outcomes in the form of body mass index. The articles used in this study were obtained from several databases, including PubMed, ScienceDirect, and Google Scholar. This article was collected for 1 month. The keywords to search for articles were as follows: “School-based intervention” AND “Nutrition ” “AND “ Obesity “ AND “BMI” OR “Body Mass Index” AND “Randomized Controlled Trial”. The articles included in this study are full-text articles with a Randomized Controlled Trial study design. Arti­cles were collected using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application Results: A total of 9 articles were reviewed in this meta-analysis. The study showed that school-based interventions for nutrition had an effect on lowering body mass index (Standardized Mean Difference = -0.23; 95% CI = -0.39 to 0.007 p= 0.005). Conclusion: School-based interventions for nutrition lower body mass index. Keywords: school-based interventions, nutrition, obesity, Body mass index . Correspondence: Wulandari. Masters Program In Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: Wulan074@gmail.com. Journal of Epidemiology and Public Health (2021), 06(02): 192-200 https://doi.org/10.26911/jepublichealth.2021.06.02.06

Correlates of dietary energy misreporting among European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study.

This study examined the correlates of dietary energy under-reporting (UR) and over-reporting (OV) in European adolescents. Two self-administered computerised 24-h dietary recalls and physical activity data using accelerometry were collected from 1512 adolescents aged 12·5-17·5 years from eight European countries. Objective measurements of height and weight were obtained. BMI was categorised according to Cole/International Obesity Task Force (IOTF) cut-off points. Diet-related attitudes were assessed via self-administered questionnaires. Reported energy intake (EI) was compared with predicted total energy expenditure to identify UR and OV using individual physical activity objective measures. Associations between misreporting and covariates were examined by multilevel logistic regression analyses. Among all, 33·3 % of the adolescents were UR and 15·6 % were OV when considering mean EI. Overweight (OR 3·25; 95 % CI 2·01, 5·27) and obese (OR 4·31; 95 % CI 1·92, 9·65) adolescents had higher odds for UR, whereas underweight individuals were more likely to over-report (OR 1·67; 95 % CI 1·01, 2·76). Being content with their own figures (OR 0·61; 95 % CI 0·41, 0·89) decreased the odds for UR, whereas frequently skipping breakfast (OR 2·14; 95 % CI 1·53, 2·99) was linked with higher odds for UR. Those being worried about gaining weight (OR 0·55; 95 % CI 0·33, 0·92) were less likely to OV. Weight status and psychosocial weight-related factors were found to be the major correlates of misreporting. Misreporting may reflect socially desirable answers and low ability to report own dietary intakes, but also may reflect real under-eating in an attempt to lose weight or real over-eating to reflect higher intakes due to growth spurts. Factors influencing misreporting should be identified in youths to clarify or better understand diet-disease associations.

Immunometabolism in Obese Asthmatics: Are We There Yet?

Obesity is now recognised as a worldwide epidemic. The recent International Association for the Study of Obesity/International Obesity Taskforce (IASO/IOTF) analysis estimates that approximately 1.0 billion adults are currently overweight and a further 475 million are obese. Obesity has huge psychosocial impact with obese children and adolescents facing discrimination and stigmatization in many areas of their lives leading to body dissatisfaction, low self-esteem and depression. Indeed, obesity is recognised as an important risk factor for the development of several chronic diseases such as hypertension, cancer, asthma and metabolic syndrome. Chronic low grade systemic inflammation is considered as a hallmark of obesity and may possibly explain the link between obesity and chronic disease, in particular the increased incidence, prevalence and severity of asthma in obese individuals. There is now strong evidence for infiltration of immune and inflammatory cells into adipose tissue that drives systemic inflammation and subsequent end organ damage. In addition to adipocytes, the key adipose tissue resident immune cells are macrophages and mast cells. Immunometabolism, as an emerging field of investigation, explores the pivotal role of these immune cells in translating immunological changes to metabolic effects in obesity. Abundance of free fatty acids, along with other inflammatory cytokines shift the balance of metabolic homeostasis to pro-inflammatory status by influencing the development of inflammatory cell lineage, which, further exhibits distinct functional phenotypes. There is emerging evidence for macrophage activation and functional polarization of an anti-inflammatory M2 phenotype towards a pro-inflammatory M1 phenotype of macrophages in obese adipose tissue. Similarly, studies in both obese humans and murine models reveal the pathognomic presence of an increased number of mast cells in visceral adipose tissue. These suggest a possible contribution of mast cells to the unique metabolome of obese asthma. This review examines proposed multilevel interactions between metabolic and immune systems in obese asthmatics that underlie the negative effects of obesity and may offer significant therapeutic promise.

Passport to Health: An Innovative Tool to Enhance Healthy Lifestyle Choices

Obesity in children and adolescents has become an epidemic in the United States. The ramifications of obesity at a young age are longstanding and affect physical health, emotional health, and the economics of the health care industry. The Strong Pediatric Practice at Golisano Children's Hospital is a large inner-city practice serving more than 14,000 urban children and adolescents, the majority living below the poverty level. The Obesity Task Force, which comprises four nurse practitioners, two nurses, a nutritionist, and one physician, developed and implemented the “Passport to Health” tool in an attempt to encourage providers to assess and work with families around the issues of weight and activity, a need that was identified through chart audits. The Passport to Health supports the policy statements on prevention of overweight and obesity by the Centers for Disease Control and Prevention, National Association of Pediatric Nurse Practitioners, and American Academy of Pediatrics. Quality assurance standards for managed care that mandate body mass index (BMI) assessment and nutrition counseling in all children and adolescents also is supported by this tool. The Passport to Health also provides the same message as a current community initiative in the Rochester area that has received widespread media coverage. This tool includes a visual color-coded indicator of the child's BMI status and a synopsis of specific healthy eating and activity goals, and it permits an individualized goal to be established. The Passport to Health translates information that the provider knows about the BMI status into information that the family and child can embrace and understand. Chart audits as well as exit interviews have demonstrated that use of the Passport to Health has increased the assessment, identification, and counseling by providers in relation to healthy eating and activity. Chart audits found that nurse practitioners embraced this practice change more readily than did other providers. We also found that the use of the Passport to Health has increased the involvement of the child and adolescent in discussions about weight and activity status. Recommendations to encourage future practice changes have been established and will be implemented. The changes include intensive education with providers who were less likely to utilize the Passport to Health tool. The Passport to Health could be implemented easily in any pediatric practice setting.

Accuracy of simple clinical and epidemiological definitions of childhood obesity: systematic review and evidence appraisal

<h3>Introduction and Aim</h3> The optimum means of defining obesity in children is unclear, creating variation in practice, and hindering obesity surveillance, prevention and treatment. The authors aimed to review evidence on the use of body mass index (BMI) and waist circumference for diagnosis of high body fat content and adverse cardiometabolic risk factors in children and adolescents. <h3>Methods</h3> A systematic literature review was performed in MEDLINE and EMBASE from January 2002 to January 2008, following our last systematic review of this topic (to end 2001–2002).1 The authors collected evidence in 0–18 year olds which compared the accuracy of BMI vs waist circumference, and compared BMI interpreted relative to national reference data vs BMI interpreted relative to Cole/International Obesity Task Force (IOTF) international reference data.2 Reference lists of all eligible papers in the search and from recent guidelines on paediatric obesity were all checked manually for additional studies. Studies were only included if “diagnostic accuracy” of BMI and/or waist were reported (summary statistics such as sensitivity and specificity; area under the curve; predictive values; ROC, analysis). Evidence was appraised using the Quality Assessment of Studies of Diagnostic Accuracy in Systematic Reviews method.3 <h3>Results</h3> Ten studies compared diagnostic accuracy of BMI vs waist circumference: they reported no improved identification of adverse cardiometabolic risk profiles from waist circumference over that provided by high BMI. Eight studies compared BMI with national reference data vs the international approach: 5/8 found significantly poorer accuracy (lower sensitivity) using BMI with the international approach; 3/8 found similar sensitivity; in 7/7 studies which compared specificity this was similar. <h3>Conclusion</h3> The present review provides no compelling evidence for use of either high waist circumference or BMI interpreted using the IOTF approach in preference to the use of national BMI percentiles for the identification of children and adolescents with excess fatness and adverse cardiometabolic risk profile.