Overweight-obese Children Research Articles

Evaluating basic motor competence in Italian children post-COVID-19 pandemic

Motor competence assessment represents one of the most important topics in the field of motor development and physical education. The present cross-sectional study aims to assess basic motor competence, self-perception and enjoyment during PA in a sample of normal weight and overweight-obese children post covid-19 pandemic. The sample (N= 107, age= 8-9 years old) was recruited from an experimental project in Lecce (Apulia). Motor competence assessment was conducted with MOBAK 3-4 protocol, and self-perception and enjoyment were evaluated with two validates questionnaires. Multivariate analysis of variance (MANOVA) has been performed to assess effect of gender and BMI on considered variables. Results from MANOVA showed significant main effect for gender [F(10,93) = 2.353, p= .013, η²= 0,218] and BMI cutoff [F(10,93) = 2.351, p= .013, η²= 0,218]. However, interaction effect was no significant. Moreover, independent t-test highlighted significant differences in catching, dribbling, balancing and object movement according to gender (p< .05), and in balancing, rolling and self-movement according to BMI cutoff (p< .05). Self-efficacy differed significantly between male and female. No effect was found for enjoyment. Further studies should investigate the effect of BMI and factors related to physical activity on motor competence development.

The Role of Mothers’ Varied Parenting Styles in Childhood Obesity

Objective: The aim of this study is to evaluate the role of mothers' democratic, authoritarian, permissive, and overprotective parenting styles in childhood obesity and mothers' perception of their children's body weight. Method: The research was cross-sectional in design, and a total of 94 children aged between two and six years were included, together with their mothers. Mothers were administered the Parental Attitude Scale, and children's Body Mass Index (BMI) was classified using age- gender-specific tables of the International Obesity Task Force (IOTF). The effect of mothers' parental attitudes on their children's BMI groups was evaluated. However, mothers matched their child's appearance to the appearance they thought corresponded to the age and gender-specific weight plot and mothers' weight perceptions were evaluated. Results: The prevalence of overweight-obesity among children was found to be 19.2%. There wasn’t statistically difference between democratic, authoritarian, overprotective and permissive parenting styles and BMI categories of children (p=0.819, p=0.878, p=0.319, p=0.494). The mothers of overweight-obese children perceived their children as significantly overweight compared to other children (p

Abnormal blood pressure and pediatric obesity phenotype: Red flags for clinical practice

Background and aimssystolic and diastolic blood pressure values identify different subtypes of Primary Hypertension. In pediatric age, hypertension is often related to obesity. Characterization of an individual's Blood Pressure (BP) status needs multiple measurements in the course of time, but this is rarely the case, principally in everyday pediatrics. Thus, the finding of abnormal BP values even in a single routine check visit should need a special attention. The aim of this study was to evaluate if even a single abnormal measurement could be a marker of metabolic risk, according to clinical and/or metabolic phenotype and subtypes of hypertension in a population of overweight/obese children and adolescents. Methods and resultsWe reviewed data from 489 overweight-obese children and adolescents. BP values were classified according to American Academy of Pediatrics Guidelines (2017). Considering study design, we used the term “Abnormal” instead of “High” BP. Data on lipid profile, glucose metabolism and ultrasonographic pattern of the liver were recorded. Mean age was 9.4 ± 2.5 years: 76.9% had normal BP values. Children with Abnormal BP harbored more frequently an unfavorable metabolic profile. Children with Abnormal Systolic-Diastolic BP values had higher BMI z-score and Waist to Height ratio (p = 0.022 and p = 0.032). Hepatic Steatosis was detected in 4.5%, 14.8 % and 17.6 % of children with normal, abnormal systolic and abnormal systo-diastolic blood pressure, respectively. (p < 0.001). ConclusionIdentification of abnormal BP subtypes even in a single measurement could be useful for identification of specific clinical-metabolic phenotypes allowing an individual targeted management of obesity-related comorbidities.

Relationship between anthropometric indicators and dyslipidemias in overweight-obese children in a primary care center in Peru

La obesidad infantil es un problema de salud pública que se ha vuelto epidémica a nivel mundial, el consumo de alimentos con alto nivel de procesamiento además de niveles altos de azúcar, grasas trans y sodio así como de bebidas con mucha azúcar, sumado a esto a la poca o nula actividad física son causas principales de el exceso de peso en niños y niñas, el cual se asocia a una importante prevalencia de disturbios metabólicos como las dislipidemias, además que de persistir en la adultez aumenta el riesgo de padecer enfermedades cardiovasculares como la hipertensión arterial, los desórdenes cerebrovasculares y patologías metabólicas como la diabetes mellitus. El objetivo del estudio fue determinar la relación entre indicadores antropométricos y dislipidemias en niños con sobrepeso y obesidad. Se realizó una investigación cuantitativa de diseño no experimental, analítico de corte transversal. La muestra constó de 313 niños entre 6 a 13 años procedentes del distrito de San Juan de Lurigancho de Lima, atendidos en consulta externa del Hospital Aurelio Díaz Ufano de junio del 2022 a mayo del 2023, el tipo de muestreo fue no probabilístico por conveniencia, se realizaron mediciones antropométricas (peso, talla y circunferencia de cintura) y se determinó el perfil lipídico en sangre, se usó el programa IBM SPSS Statistics 25 para el análisis de datos y el coeficiente de correlación de Kendall para hallar asociación entre variables. Se obtuvo como resultados que el 52,4 % fueron varones, se encontró una prevalencia de 20,8% de sobrepeso y 39,9 % de obesidad, además de obesidad abdominal en 24,3%. Entre las dislipidemias se encontró hipertrigliceridemia en 33,5%, hipercolesterolemia en 7,3%, colesterol LDL elevado en 5,1% y el colesterol HDL disminuido en 4,2%. Se encontró relación estadísticamente significativa (p&lt;0,05) de todos los indicadores antropométricos con alteración del colesterol LDL, colesterol no HDL y triglicéridos. Se concluye que la alteración de indicadores antropométricos en la obesidad infantil como el índice de masa corporal, la circunferencia de cintura y el índice cintura/talla se relaciona a diferentes formas de dislipidemias.

Growth in height and its association with overweight and obesity in Mexican children: an evaluation based on a nationally representative sample (ENSANUT 2018).

Chronological age and height records (7,097 boys and 6,167 girls) were obtained from the Mexican National Survey of Health and Nutrition database. Height growth curves were fitted using the Preece-Baines 1 (PB1) model and the LMS method. Age at peak height velocity (APHV) was 12.4 and 12.7 years for overweight-obese and normal-weight boys, respectively, and was 9.6 and 10.4 years for overweight-obese and normal-weight girls, respectively. Growth velocity was higher at the age of take-off (TO) in overweight-obese children than in normal-weight children (5.2 cm/year vs. 5 cm/year in boys and 6.1 cm/year vs. 5.6 cm/year in girls); nevertheless, the growth velocity at APHV was higher for normal-weight children than for overweight-obese children (7.4 cm/year vs. 6.6 cm/year in boys and 6.8 cm/year vs. 6.6 cm/year in girls, respectively). Distance curves developed in the present study and by the World Health Organization (WHO) using LMS showed similar values for L and S parameters and a higher M value compared with the WHO reference values. This study concluded that overweight-obese children had earlier APHV and lower PHV than normal-weight children. Furthermore, Mexican children and adolescents were shorter than the WHO growth reference by age and sex.

Hyperuricemia And Its Relation With Obesity Among Children In Anbar Province

Background; The prevalence of pediatric hyperuricemia is increasing worldwide. No other similar study was done in Anbar province previously. Objective: This study was designed to show the prevalence of hyperuricemia among children from 6 to 16 years old in Ramadi teaching hospital for maternity and childhood, Anbar province, Iraq. Studying the relation of hyperuricemia with childhood obesity, in addition to its relation with gender, residency, and economic status of their families. Material and Methods: Across sectional study was done for 6 months from the first of January 2021 to the end of June 2021, to determine the expected prevalence of hyperuricemia among a randomized sample of children of ages from 6-16 years with either gender. Weight and height were measured for all cases, a body mass index was calculated for each child for estimation of obesity. For all studied cases, other data was collected for socioeconomic status and residency. All cases were sent for serological calculation of uric acid levels. Results: The total number of studied children was 520, the overall prevalence of hyperuricemia among these cases was (11.3%). The overweight's and obese children had a higher prevalence of hyperuricemia (29.3 %) compared with only (3.3%) among those who were not. Girls had more prevalence than boys with female to male ratio (2.2:1). Most of the cases were from middle-economic status families with a non-significant relation when compared with control, while it was more and significant among urban area residence. Conclusions: A higher prevalence of hyperuricemia was found among obese children in Anbar province, and this requires a specific educational program given to the families in explaining the risk and how to deal with obesity.

REGIONAL OBSERVATORY OF PHYSICAL FITNESS IN CHILDREN AND ADOLESCENTS IN SOUTHERN ITALY: A THIRTY-YEAR COMPARISON BETWEEN 1990-2020

International literature showed that lower physical activity levels are associated with a progressive decline in physical fitness levels in children and adolescents over the past decades. The present cross-sectional study aims to assess trends in physical fitness levels among young adolescents in Lecce (Apulia region, Italy) comparing motor performances in 1990 and 2020. The sample consisted of 107 children attending the secondary school in Lecce in 1990, and 118 children attending secondary school in the same province in 2020, divided according to gender and BMI cut-off (normal weight and overweight/obese). Physical fitness assessment included standing long jump, medicine ball throw 2kg, 30-m dash and Cooper endurance running proposed both in 1990 and 2020. The analysis of variance (ANOVA) was performed to compare motor performances (1990 vs 2020) according to gender and BMI, and on total sample according to BMI; chi-square test was carried out to underline differences between Normal Weight, Overweight and Obese distribution in 1990 and 2020, and linear regression analysis was executed to investigate the variance in motor test explained by BMI, both in 1990 and 2020 groups. Results showed that: (a) sample in 1990 performed significantly better than those in 2020 in all of the above physical fitness test, independently for gender and BMI cut-off, (b) the percentage of overweight obese children has increased significantly from 1990 to 2020, and (c) BMI is a key factor influencing almost all motor performance in 2020.

Nutritional and Obesity Status of Children and Adolescents with ADHD: a case-control study

Objective: Due to their prone to obesity and unbalanced nutrient intake this study was carried out to evaluate the daily energy and nutrient intake and obesity status of children and adolescents with attention deficit hyperactivity disorder (ADHD). Methods: The study was conducted on a total of 390 children (169 ADHD and 221 control groups) between the ages of 6-17 years. Body weight and height were measured and height-for-age-z-score (HAZ), weight-for-age-z-score (WAZ) and BMI-z-score (BMIZ) were calculated. 24-hour dietary recalls of the participants were recorded, and energy and nutrients intake were analysed. The ratio of meeting daily energy and nutrients adequacy according to age and gender was calculated. Results: The HAZ values of the children with a mean age of 10±2 years were within the normal range in most of both groups. The ratio of overweight-obese children was 43.8% in the ADHD group and 39.8% in the control group, respectively. The ratio of energy from fat was high in both groups (ADHD: 39%, control: 41%) (p &lt;0.05). It was found that folic acid and thiamine were sufficient in both groups, pyridoxine was consumed in borderline excess, other vitamins were consumed in excess. All minerals except sodium were sufficient and sodium was consumed more. Folic acid and water consumption were found to be less in children with ADHD (p &lt;0.05). Conclusion: Overweight and obese rates are common among children and adolescents with ADHD, and their eating habits are similar to those of their healthy peers. Bangladesh Journal of Medical Science Vol. 22 No. 01 January’23 Page : 171-179

Cardiometabolic Risk in Children and Adolescents: The Paradox between Body Mass Index and Cardiorespiratory Fitness.

ResumoFundamento Foi demonstrado que o risco cardiometabólico está inversamente associado à aptidão cardiorrespiratória (APCR) e positivamente associado ao índice de massa corporal (IMC).Objetivo Analisar a associação de fatores de risco cardiometabólicos com IMC e APCR combinados em escolares de um município do sul do Brasil.Métodos Estudo transversal com uma amostra de 1252 escolares de sete a 17 anos. Foram avaliados colesterol total (CT), HDL-c, LDL-c, triglicerídeos (TG), pressão arterial sistólica (PAS) e diastólica (PAD). APCR e IMC foram agrupados em uma variável e os escolares classificados como eutróficos/aptos, eutróficos/inaptos, excesso de peso/aptos e excesso de peso/inaptos. Análises foram realizadas por meio de Regressão de Poisson e uma alfa de 0,05 foi adotado.Resultados Escolares classificados com excesso de peso/aptos demonstraram uma razão de prevalência (RP) de 1,50 (1,04 – 2,16) para TG alterado, 3,05 (2,05 – 4,54) para PAS e 2,70 (1,87 – 3,88) para PAD elevada. Escolares com excesso de peso/ inaptos apresentaram RP para CT alto de 1,24 (1,11 – 1,39) e 1,51 (1,11 – 2,04) para baixos níveis de HDL. Além disso, apresentaram um risco de 2,07 (1,60 – 2,69) para TG alterado, 3,26 (2,31 – 4,60) para PAS e 2,42 (1,76 – 3,32) para PAD elevada.Conclusão O IMC apresentou um papel central na associação com o risco e a APCR demonstrou atenuar a associação entre fatores de risco e excesso de peso. Escolares com excesso de peso apresentaram um risco cardiometabólico mais elevado, mas o tamanho do efeito foi maior entre os inaptos.

Forearm Fractures in Overweight-Obese Children and Adolescents: A Matter of Bone Density, Bone Geometry or Body Composition?

Forearm fractures in children and adolescents are associated with increased body mass index (BMI). This bone site is non-weight-bearing and therefore is appropriate to explore the effect of BMI on bone mineral density (BMD) and bone geometry, avoiding the confounding effect of increased weight-associated mechanical loading. The aim of this review was to summarize available evidence on bone indices and body composition assessed by peripheral quantitative computed tomography (pQCT) or dual X-ray absorptiometry (DXA) at the forearm level in overweight (Ow) or obese (Ob) subjects. We conducted a review of the literature according to the PICOS model. A total of 46 studies were identified following the literature search. A final number of 12 studies were included in this review. pQCT studies evidenced that Ow and Ob children typically have normal or increased volumetric BMD (vBMD), total bone area and cortical area, with normal or reduced cortical thickness at the forearm. Outcomes from DXA evaluations are less conclusive. In almost all the studies fat mass and lean mass area at the forearm are increased. A higher fat-to-lean mass ratio has been observed in few studies. Bone strength was reported as normal or increased compared to normal weight peers. In Ow or Ob children-adolescents, vBMD, bone size and bone strength are not reduced compared to normal weight peers. The local higher fat-to-lean mass ratio may give a mismatch between bone strength and the load experienced by the distal forearm during a fall, resulting in increased risk of forearm fractures.

Parents’ perception of overweight-obese children Quality of Life in different settings

Abstract Background Children's Health-Related Quality of Life (HRQoL) has been frequently investigated, in particular among individuals affected by chronic diseases. It is reported that agreement between child and parent ratings regarding the child's HRQoL is strongly influenced by the latter's health status. To our knowledge, there is no evidence of how this agreement is related to different healthcare settings. Thus, our study aims to examine the relationship between child's and parent-proxy reported HRQoL of similar overweight/obese children according to the recruitment setting. Methods A cross-sectional study was conducted among 68 overweight/obese children, aged 6-10, recruited in a primary school (Group1, G1) and in a hospital outpatient clinic (Group2, G2) of Imola (Italy) in 2019. HRQoL was assessed using Italian version 4.0 of the Pediatric Quality of Life (PedsQL) questionnaire. For each child, we obtained self-reported children's and parents' perceived children's HRQoL total score (5 questions investigating Physical Health domain and 10 questions investigating Psychosocial Health domain divided in Emotional, Social and School Functioning). Results In G1 there were n = 42 overweight/obese children and in G2 n = 26. The correlation between children's reported and parents' perceived HRQoL scores is lower in G1 (Physical Health: r=-0,17; Psychosocial Health: r = 0.38) compared to G2 (Physical Health: r = 0.80; Psychosocial Health: r = 0.66). Notably, in G1, parents tend to overestimate their children's HRQoL, specifically in the Physical Health domain. Conclusions Correlation between children's and parents' HRQoL scores is higher in the clinical setting compared to the school setting. Implementing this questionnaire on a large scale would allow us to identify settings which need awareness-raising initiatives to improve parents' knowledge about their children's health. Key messages Parents’ overestimate children’s HRQoL in the school setting, particularly in the Physical Health domain. Children’s HRQoL misinterpretation might determine less targeted actions to improve their wellbeing and highlights the need for raising parents’ awareness about obesity and its effects on children.

Effect of different interval training protocols on adiposity indicators in overweight-obese children and adolescents: a systematic review and meta-analysis

ABSTRACT The present meta-analysis verified the impact of different protocols of high-intensity interval training (HIIT) on indicators of adiposity in overweight and obese children and adolescents. Searches were performed in the databases: PubMed, ScienceDirect, SPORTDiscus, LILACS and SciELO. Were included studies without caloric restriction that aimed to verify the effect of HIIT interventions on the adiposity indicators in overweight children and adolescents published until December 2018. The PEDro scale was used to assess the risk of bias. The meta-analysis was conducted in the Revman software using standardized mean difference (SMD) data and 95% confidence intervals (CI). Seventeen studies were selected, which involved 289 children and adolescents with overweight and obesity. HIIT interventions (mean=11.7±5.9 weeks) produced significant decreases in body fat percentage (SMD=-0.65; CI=-1.07, -0.23) and waist circumference (SMD=-0.34; CI=-0.49, -0.18). Also, major relative risk of decrease in body fat percentage were observed in favour to protocols with work/recovery interval ratios of 1:1 and 2:1. HIIT protocols with ratios (work/recovery intervals) 1:1 and 2:1 promote significant reductions in fat percentage and waist circumference in overweight and obese children, independently of the total work time.

Sexual maturity assessment in Indian children-a study from western India.

Pubertal assessment is crucial as puberty is the transition from childhood to adulthood. Pubertal assessment, growth, and secular trend in puberty need to be explored further in India. The objectives were to assess Sexual Maturity Rating (SMR) among children and establish normative data of puberty from western India. We also compared age of attainment of various stages of puberty with BMI and secular trend in menarche. A cross-sectional observational study was undertaken at a tertiary care pediatric center. The study population were healthy girls and boys between 6 and 18years. Demographic data was noted. Anthropometry and SMR assessment (Tanner staging) were performed. The age of menarche was noted among the girls and their mothers. Data were analyzed using SPSS 21. In girls, median age of thelarche, pubarche, and menarche was 9.37 (8.5-10.2), 10.18 (9.87-10.49), and 12.55years (12.41-12.75) respectively. There was an early appearance of thelarche but menarche was delayed in overweight-obese girls (statistically not significant). Age of menarche showed a shift to left in girls as compared to their mothers (p=0.036). In boys, median age of testicular stage 2 and pubarche was 10.7 (9.9-11.8) and 11.6years (11.1-12.1) respectively. In overweight-obese boys the pubertal milestones were achieved earlier (statistically not significant). Normative data on pubertal assessment from western India is presented. Age of menarche shows a shift to left in girls as compared to their mothers. Pubertal milestones were observed at a younger age in overweight obese children which was not significant.

Cutaneous manifestations of Paediatric Obesity: Relation with insulin resistance

Background: Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Gender-specific BMI-for-age percentile curves are used to define overweight and obesity in paediatric age group. Aim: To study the prevalence of cutaneous manifestations of obesity in pediatric population and to analyse the relation with BMI and Insulin Resistance. Materials and methods: A total of 138 overweight obese children between 5-18 years were enrolled. Anthropometric measurements and dermatological examination and relevant blood investigations were done. Insulin resistance was calculated using HOMAIR (Homeostatic Model Assessment for Insulin Resistance). Results: Maximum number of patients were between 15-18 years of age (n=63). Among 138 children, 75 were males, while 63 were females. According to BMI values, 72cases were categorized as overweight and 66 obese. The cutaneous manifestations were seen to be present in 89.1% of patients. It was more in obese (96.96%) as compared to overweight children (81.94%). HOMA-IR >2.6 was observed among 75 (54.35%) cases. It was observed that cutaneous manifestations were more in children with HOMA-IR levels >2.6 (96%) as compared to HOMA-IR levels Conclusion: Obesity is strongly related to several skin alterations that could be considered as markers of excessive weight. Insulin resistance (IR) has emerged as an important disorder among young obese individuals. Thus, improving insulin sensitivity can prove to be highly effective potential therapeutic strategy for obesity and obesity-related comorbidities. Keywords: Obesity, Overweight, Insulin resistance, Cutaneous manifestations, Adolescent Children, HOMA-IR.

Metabolic Syndrome in Obese Children over Five Years Old

Background: Obesity is an important pediatric public health problem associated with increased risk of many complications in childhood and increased morbidity and mortality throughout adult life. Objectives: To assess the prevalence of Metabolic Syndrome in obese children and the relationship between Metabolic Syndrome and Body mass index (BMI), sex, age and family risk factors like obesity, hypertension, diabetes mellitus and cardiovascular disease. Materials and Methods: An analytic cross-sectional study was conducted in 178 overweight and obese children and adolescents aged 5-16 years old seen at the General Pediatric Clinic of the Tishreen University Hospital between March 2020 and February 2021. Weight, high, waist Circumference and blood pressure were measured. Blood samples were taken after 12 hours fasting and fasting blood glucose (FBG), total cholesterol (T Cho), high- density lipoprotein cholesterol (HDL) and low- density lipoprotein cholesterol (LDL) were measured. The Metabolic Syndrome MS was diagnosed based on pediatric and adolescent criteria adapted from the National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATP III) definition. Results: A total of 178 children, 82 males (46.1%) and 96 females (53.9%) with mean age 9.9±2.5 SD were in our study. Out of the 178 children, 62 (34.8%) were overweight, 101 (56.7%) obese and 15 (8.4%) were severe obese. According to the NCEP ATP III, (32.6%) out of (178) children were diagnosed with MS. Among children with MS, most components of MS were increased waist circumference WC (93.1%), increased TG (86.2%), reduced HDL (51.7%), increased BP (50%) and increased FBS (25.9%). MS prevalence was 12.9%, 36.6%, 86.7% in overweight, obese and severe obese children respectively

Efficacy of Home-Based Callisthenic Resistance Training on Cardiovascular Disease Risk in Overweight Compared to Normal Weight Preadolescents

Background: Childhood overweightness/obesity is likely to further challenge worldwide public health if effective preventative measures, such as physical activity interventions, are not put in place as prescribed by public health organizations, such as the World Health Organisation (WHO). Objectives: This study attempted to determine and compare the efficacy of home-based callisthenic resistance training on cardiovascular disease (CVD) risk in overweight children compared to normal-weight children. Methods: A quantitative study was undertaken, and 15 previously sedentary overweight/obese children (OOC) and 15 previously sedentary normal-weight children (NWC), aged 9 - 11 years, were assigned to a six-week, 45-minute, non-consecutive callisthenic resistance training program consisting of six exercises. An additional 15 previously sedentary normal-weight children were assigned to a non-exercising control group (NON). Results: In the OOC, the six-week callisthenic resistance training program significantly (P ≤ 0.05) decreased body mass (from 44.54 ± 10.53 to 43.77 ± 10.38 kg, P = 0.002), BMI (23.27 ± 5.05 to 22.85 ± 5.00 kg.m-2, P = 0.002), percentage body fat (from 33.01 ± 5.15 to 31.94 ± 5.55%, P = 0.042), fat mass (from 15.01 ± 5.45 to 14.30 ± 5.33 kg, P = 0.001), sum of skinfolds (from 46.46 ± 11.65 to 44.38 ± 11.61 mm, P = 0.032), and run/walk time (from 21.70 ± 5.06 to 20.71 ± 4.96 min; P = 0.003). In the NWC, hip circumference was found to be decreased (from 73.26 ± 5.84 to 72.76 ± 5.88 cm, P = 0.031), as was the sum of skinfolds (from 29.38 ± 10.18 to 25.84 ± 8.11mm, P = 0.035). Conclusions: This study demonstrated that home-based callisthenic resistance training can have positive impacts on overall body composition and may prove to be a cost-effective and essential tool in the fight against childhood overweight/obesity whether in normal weight or even overweight/obese children.

Comparison between health-related quality of life in normal-weight and overweight-obese children

Abstract Background In Italy 32% of 6-10 aged children were overweight in 2017-2018. Measures of Health-Related Quality of Life (HRQoL) assess important aspects of health daily activities, physical symptoms, social interactions and emotional well-being. It is suggested that HRQoL is influenced by children's weight status. The aim of the study is to compare HRQoL among normal-underweight and overweight-obese children in an Italian sample. Methods A cross-sectional study was conducted in 2019 among 144 children, aged 6-10, recruited in a primary school in Bologna (Italy). Children were divided in Group1 (G1: normal-underweight) and Group2 (G2: overweight-obese) using the International Obesity Task Force cut points. HRQoL was assessed using 4.0 Italian version of PedsQL questionnaire. We obtained summary scores for children's total HRQoL and two subscales: one for physical health and one for emotional, social and school functioning. Results Of 144 children, 98 (68%) and 46 (32%) were respectively in G1 and G2. HRQoL total scores were 73.10±1.30 in G1 and 69.28±1.96 in G2 (p = 0.051). We analysed separately children in Grade 1 and Grade 3-4. In Grade 1, there were 68 children: 48 (71%) in G1 and 20 (29%) in G2. In grade 3-4 there were 76 children: 50 (66%) in G1 and 26 (34%) in G2. HRQoL total scores in grade 3-4 were: 73.28±1.63 in G1 and 72.66±2.32 in G2 (p = 0.41). In Grade 1, HRQoL total scores were 72.92±2.05 in G1 and 64.89±3.15 in G2 (p = 0.02); at subscale levels, means for physical health were 77.73±1.92 in G1 and 72.5±3.58 in G2 (p = 0.08) and means for emotional, social and school functioning were 70.35±2.48 in G1 and 60.83±4.04 in G2 (p = 0.02). Conclusions The effects of child overweight and obesity on health-related QOL was more evident in children aged 6-7, especially regarding emotional, social and school functioning. Prevention of childhood overweight and obesity is important not only to avoid health consequences of weight but also to improve children' quality of life. Key messages Overweight is a public health problem in Italy not only among adults, but even among children. Overweight has a negative impact on quality of life, therefore a healthy lifestyle should be promoted.

Association of Apelin Levels in Overweight-obese Children with Pubertal Development, but Not with Insulin Sensitivity: 6.5 Years Follow up Evaluation

ABSTRACT Background Obesity in youth is associated with increased risk of metabolic disorders. Adipose tissue hormones are involved in body-weight regulation. Among these, apelin is recognized as an insulin-sensitizer adipokine. Data on apelin levels in obese children and its relation to insulin-sensitivity are limited. Objective We aimed to evaluate apelin levels in relation to obesity and insulin sensitivity in a large cohort of overweight/obese children and adolescents. Furthermore, these youths were reevaluated after a median 6.5 years of follow-up, thus allowing assessing changes in apelin levels in relation to increasing age and weight changes. Methods Clinical data in 909 children and adolescents were collected between 2007 and 2010. Two hundred and one were reexamined at a median 6.5 years of follow-up. All subjects at baseline and at follow-up underwent an OGTT. Apelin levels were measured on sera by ELISA method. Results At baseline, lower apelin levels were associated with increasing age and puberty (Tanner ≥II 0.67 ± 0.96 ng/mL vs. Tanner I 0.89 ± 1.13 ng/mL, p < .002), but not with body-weight. At follow-up, apelin levels in the 201 subjects reexamined were significantly lower than at baseline (0.45 ± 0.77 ng/mL at follow-up, 0.68 ± 0.95 ng/mL baseline, p < .001), confirming the effects of age and puberty. Body-weight did not affect apelin levels. Multiple regression analysis confirmed that sex and puberty were associated with lower apelin levels, independently from age and insulin-sensitivity. Conclusions Apelin levels decrease significantly with pubertal development, whilst body-weight in children and adolescents did not determine changes in apelin. Reduced levels of apelin in children and adolescents may therefore represent a necessary response to maintain the “physiological” insulin resistance of puberty. Abbreviations: ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; G: glucose; BMI: Body mass index; DBP: Diastolic blood pressure; ELISA: enzyme-linked immunosorbent assay; HDL-C: High-density lipoprotein-cholesterol; HOMA-B: Homeostatic model assessment for beta-cell function; HOMA-IR: Homeostatic model assessment of insulin-resistance; INS: Insulin; ISI: insulin-sensitivity index; LDL-C: Low-density lipoprotein cholesterol; NW: normal weight; OB: obese; OGTT: oral glucose tolerance test; OW: overweight; SBP: Systolic blood pressure; TC: Total cholesterol; TGs: Triglycerides

Comment on “Plasmatic adipocyte biomarkers and foot pain associated with flatfoot in schoolchildren with obesity”

OBJECTIVE The aim of this study was to determine the potential association of foot pain and plasmatic adipocytes as physiological biomarkers of childhood obesity with the incidence of flatfoot in a cohort of Egyptian school children aged 6 -12 years. METHODS A total of 550 Egyptian schoolchildren (220 boys and 330 girls) aged 6-12 years were randomly invited to participate in this descriptive survey analysis. For all children, we assessed the diagnosis and severity of flatfoot as well as plasma adipocytes, as well as adiponectin, leptin, resistin, IL-6, and TNF-α, using the Dennis method and immunoassay techniques respectively. Foot pain was assessed by using a standard VAS of 100 mm and Faces Pain Scale, respectively. RESULTS Flat foot was predicted in 30.4% of school-age children, most of them showed a higher frequency of overweight (33.3%) and obesity (62.5%). Boys showed higher ranges of flat foot than girls. Foot pain significantly correlated with flat foot and obesity among the studied populations. In overweight-obese children, plasmatic adipocyte variables, as well as adiponectin, leptin, resistin, IL-6, TNF-α showed significant correlations with foot stance, especially in boys. Also, the studied adipocyte variables along with BMI, age, gender explained about~65% of the variance of flatfoot with pain among our school-age students. CONCLUSION Foot pain showed an association with flat foot and childhood obesity in 30.4% of school-age students (6-12 years). Foot pain was shown to correlate positively with the incidence of flat foot and changes in adiposity markers, as well as adiponectin, leptin, resistin, Il-6, TNF-α.

CHARACTERIZATION OF BODY COMPOSITION IN NORTH OF PARANÁ: LONGITUDINAL STUDY

INTRODUCTION: Brazil lives with the nutritional transition, which is characterized by a reduction in malnutrition and an increase in obesity. OBJECTIVES: To perform a longitudinal analysis classifying the BMI of children and adolescents enrolled in the year 2014 to 2018 in the municipal schools of Jacarezinho, Cambara and Andira - PR, characterizing their body composition, as well as the prevalence of malnutrition and childhood obesity, in order to support preventive health, social and cultural analyzes. METHODOLOGY: This is a longitudinal study of approximately 4,682 overweight (obese and overweight) children and adolescents from 2014 to 2018, in which body mass and height were evaluated. RESULTS: The highest percentage is eutrophic, however there is a prevalence of overweight and obesity according to the Cole method (2007), regarding malnutrition. Moreover, when the percentage of each city is observed, the city of Cambara presents a higher percentage in relation to the others, around 33%. CONCLUSION: There was an average increase in childhood obesity in relation to malnutrition in the cities of Jacarezinho, Cambara and Andira - PR characterizing the nutritional transition. In addition, all cities when analyzed generally had an increase in childhood obesity over the years 2014 to 2018 and when analyzed only the city of Cambara, it has a percentage of 33% that is higher than expected by the World Health Organization.