Percentage Of Overweight Research Articles

Lunchbox content and dietary outcomes of Dutch primary school children explored by sociodemographics

Abstract Background Most children fail to meet recommended guidelines for a healthy diet. Children living in low socioeconomic areas are less likely to have healthy eating behaviours. In this study we investigated the food Dutch primary school children bring from home, and their dietary, health and school related outcomes explored by sociodemographics. Methods 5 primary schools, with high deprivation scores and a high percentage of overweight, have been included in this study (ClinicalTrials.gov NCT06058325). With observations in September 2023 we mapped the content of lunchboxes, including snacks, of children. Questionnaires for all parents and children in grade 5-8 focused on dietary and health outcomes of children and perceived class factors. Preliminary baseline data were analysed using descriptive statistics. Exploratory analyses will be conducted to show differences by sociodemographics (e.g. age, sex, parental financial stress). Results 297 lunchboxes were observed, 98.7% contained sandwiches, half being brown bread. Most children brought fruit from home for either lunch or morning snack, 13.8% not at all. 21.9% brought vegetables. 135 children completed the questionnaire: 43.0% boys, mean age 9.3 years old (SD 1.12). Children ate fruit and vegetables on an average of 5.9 (SD 1.69) and 4.9 (SD 2.23) days a week. Whereas 80% of children eats fruit every day at school, only 20% of children eats vegetables every day at school. Most children perceived their health as good (89.3%) and felt happy (89.6%). On a scale of 1 (low) to 5 (high), they rated concentration, social climate and comfort in class an average of 3.8 (SD 1.05), 4.3 (SD 1.07) and 4.3 (SD 0.92) respectively. Conclusions Lunchboxes of Dutch primary school children mainly contain sandwiches. Whereas most children eat fruit at school, the majority of children do not eat vegetables at school. A healthy school lunch might increase vegetable consumption of children and could affect health and school related outcomes. Key messages • Most Dutch primary school children eat sandwiches during lunch at school, but in half of the cases this is not brown bread as recommended by nutritional guidelines. • Most Dutch primary school children bring fruit to eat as snack or lunch, but no vegetables to eat at school. The majority also self-reported the lack of eating vegetables at school on a daily basis.

Body Mass Index and Surgical Diagnosis of Endometriosis: Do Obese Patients Experience an Operative Delay?

Objectives: The objective of this study was to quantify the time to diagnosis of endometriosis by laparoscopy for patients of varying body mass index (BMI), as well as the safety of laparoscopy for endometriosis by BMI. Materials and Methods: We performed a retrospective cohort study of reproductive-age women receiving a primary laparoscopic diagnosis of endometriosis at an academic tertiary hospital from January 2017 to December 2020. Patients excluded were those undergoing repeat laparoscopy, with previously histologically diagnosed endometriosis, asymptomatic endometriosis, an unknown first gynecologic encounter, or an unknown initial BMI. Our primary outcome was time to surgical diagnosis of endometriosis by BMI class. Our secondary outcome was the evaluation of peri/postoperative risk of laparoscopy for endometriosis. Results: A total of 152 patients received a primary surgical diagnosis of endometriosis, including 44% normal or underweight patients, 29% overweight patients, and 27% obese patients. Obese patients experienced a delay from gynecologic presentation to diagnostic laparoscopy (18.4 months, interquartile range [IQR] 3.1–42.8) compared to overweight patients (9.0 months, IQR 2.5–23.2) and normal and underweight patients (3.8 months, IQR 1.1–17.0) (P = 0.02). Although a higher percentage of overweight and obese patients was Hispanic and non-Hispanic Black, multiple linear regression maintained a significant relationship between time to surgery and BMI (P = 0.03). Perioperative and postoperative complications did not differ by BMI class. There were no differences in repeat laparoscopy for endometriosis within 3 years by BMI (P = 0.99). Conclusion: BMI is independently associated with time to surgical diagnosis of endometriosis in our retrospective study. Diagnostic laparoscopy appears safe in obese patients, without significant perioperative morbidity.

Prevalence of Overweight and Obesity of Preschool Children in Vranje (Serbia) According to the WHO and CDC Recommendations

Overweight and obesity are widespread worldwide among children of all age groups, and the prevalence among preschool children has been steadily increasing over the past twenty years. The aim of was to determine the prevalence of overweight and obesity of preschool children in Serbia based on the recommendations given by the WHO (World Health Organization) and the CDC (Centers for Disease Control and Prevention). The sample of respondents consisted of children from the preschool institution “Our Child” (serb. Naše dete) from Vranje, Serbia. A total of 380 children participated, of which 195 were boys (51.3%) and 185 were girls (48.7%). The age of the child ranged from 2 to 7 years, that is, from 26 to 84 months. In order to determine the weight status, the children’s body weight and height were measured, on the basis of which the Body Mass Index (BMI) was calculated. The obtained BMI values were interpreted based on the recommendations given by the WHO and the recommendations given by the CDC. Research results based on the WHO recommendations showed that 11.1% of the total number of children are overweight and 11.8% are obese, while based on the CDC recommendations, 11.8% of the total number of children are overweight and 7.9% are obese. Also, the research showed that there is no difference in the weight status categories between boys and girls. However, the results show that the proportions of overweight and obese children obtained using the WHO recommendations differ significantly from the proportions of overweight and obese children obtained using the CDC recommendations. High percentages of overweight and obesity among preschool children in Vranje require adequate measures to be taken in order to stop and reduce their growth.

Determination of plasma lysophosphatidylethanolamines (lyso-PE) by LC-MS/MS revealed a possible relation between obesity and lyso-PE in Japanese preadolescent children: The Hokkaido study.

Lysophosphatidylethanolamines (lyso-PEs) are the partial hydrolysis products of phosphatidylethanolamine. Although lyso-PEs are important biomarkers in various diseases, their determination is limited by the lack of simple and efficient quantification methods. This study aims to develop an improved quantitative method for the determination of lyso-PEs and its application to an epidemiological study. Single reaction monitoring channels by collision-induced dissociation for seven lyso-PEs were established using liquid chromatography-tandem mass spectrometry. Plasma lyso-PEs were extracted with a single-phase method using an isotopically labelled internal standard for quantification. The proposed method was adopted to define lyso-PEs in plasma samples of children aged 9-12years living in Sapporo, Japan. The limit of detection and limit of quantification for each lyso-PE ranged between 0.001-0.015 and 0.002-0.031pmol/μL, respectively. Recoveries were found to be > 91% for all the species. The analysis results of children's plasma showed that the total lyso-PE concentrations in boys (n = 181) and girls (n = 161) were 11.53 and 11.00pmol/μL (median), respectively. Participants were further classified by the percentage of overweight and subgrouped as underweight (n = 12), normal range (n = 292), or overweight (n = 38). Interestingly, the reduction of lyso-PE 16:0 and increased lyso-PE 22:6 were observed in overweight children compared with normal range (Fold change: 0.909 and 1.174, respectively). This study successfully established a simple quantitative method to determine lyso-PE concentrations. Furthermore, our method revealed the possible relation between plasma lyso-PEs and overweight status.

Does Body Mass Index Impact the Clinical Response to Dupilumab Therapy in Atopic Dermatitis? A Monocentric Study of 170 Patients.

Background: Dupilumab is a monoclonal antibody used for the treatment of moderate/severe atopic dermatitis (AD). In recent years, several studies have confirmed the positive association between AD and overweight/obesity, and a report demonstrated the effect of weight reduction on the improvement of AD symptoms. Methods: The weight of 170 patients under treatment with dupilumab was recorded at baseline and after 48 weeks (T48). Clinical monitoring was mainly conducted using the Eczema Area and Severity Index (EASI). The study aimed to assess a possible correlation between the clinical outcome of dupilumab therapy and BMI. Results: Although not statistically significant, patients with a BMI < 25 have a higher EASI percentage improvement than patients with a BMI ≥ 25 at any time point, and the percentage of overweight and obese patients that does not reach EASI-75 at T48 is higher compared to normal-weight patients (13.5% vs. 5.9%). Despite this, in the multivariate regression analysis, no baseline characteristic, including BMI, appears to increase the risk of not reaching EASI-75. In addition, the results show no differences in BMI between baseline and T48 in any age/sex group. Conclusions: The results suggest that overweight and obese patients have a lower response to dupilumab when considering the EASI score, but this difference does not appear to be clinically significant. Furthermore, dupilumab treatment does not seem to impact weight.

Sustained underweight in rural areas and emergence of overweight in urban Ethiopian women: a multivariate analysis of EDHS data 2000–2016

A growing body of evidence indicates the emergence of overweight/obesity in developing countries before the battle against undernutrition has been won. We conducted this study to quantify the reduction of underweight and the emergence of overweight among Ethiopian women from 2000 to 2016 and evaluate factors explaining the progress. We used the four Ethiopian Demographic and Health Surveys (2000–2016) to analyze body mass index (BMI) trends among women. Data from 43,815 non-pregnant, non-puerperal reproductive-age women was used to evaluate the linear change in BMI and changes in the percentage of overweight and underweight over time. Using multivariate decomposition analysis of change in underweight and overweight percentages, we identified sources of change in BMI in the past 16 years of the survey periods. The BMI of Ethiopian reproductive-age women increased by 0.88 kg/m2 from 2000 to 2016. The increment was pronounced in urban areas with 1.46 kg/m2. There has been a significant reduction in underweight women since 2000 (p-value < 0.001), and 87.62% of the changes were attributed to behavioral changes toward weight management. And there was a significant upswing in overweight women from 2000 to 2016 (p-value < 0.001) as well. A compositional change of factors including region, women’s age, women’s educational status, religion, type of place of residence, and use of contraceptives contributed to 57.51% of the observed increment in the percentage of overweight women. A relatively slow decrease in underweight and an increment in overweight have been observed. This progress can be disaggregated into persistent underweight in the rural and poorest, and swift development of overweight in the urban and richest communities. Targeted nutrition interventions for both underweight and overweight women are mandatory. Nutritional interventions in Ethiopia should focus on behavioral change to reduce hunger and malnutrition as well as to avert the emergence of overweight or obesity in the affected communities.

Duración de la lactancia materna y condición nutricional de los lactantes en España. Estudio LAyDI (PAPenRed)

IntroductionBreastfeeding appears to protect the onset of obesity in infants. The aim is to know whether breastfeeding duration of is associated with the risk of obesity in infants and toddlers aged 12 and 24 months. Material and methodsProspective longitudinal study in a cohort of children born in Spain between April 2017 and March 2018 (LAyDI study) in the paediatric primary care system conducted in the framework of the PAPenRed research network. Analysis of breastfeeding duration (group 1: fewer than 6 months; group 2: 6 months or more) and its association with anthropometric variables. ResultsA total of 1495 patients attended the 12 months preventive child health visit and 1073 patients the 24 months visit. We found a statistically significant association between breastfeeding duration and weight-for-age, BMI-for-age and weight-for-length/height at 12 and 24 months; breastfeeding duration of less than 6 months was significantly associated with overweight and obesity (based on BMI-for-age and weight-for-length/height) at ages 12 and 24 months. Maternal pre-pregnancy BMI acted as a modifier on the association between breastfeeding duration and overweight and obesity (based on BMI-for-age). ConclusionsA breastfeeding duration of less than 6 months is associated with a higher percentage of overweight and obesity at ages 12 and 24 months, although maternal pre-pregnancy BMI modifies this relationship at 24 months.

Age- and height-dependent bias of underweight and overweight assessment standards for children and adolescents.

Precision in evaluating underweight and overweight status among children and adolescents is paramount for averting health and developmental issues. Existing standards for these assessments have faced scrutiny regarding their validity. This study investigates the age and height dependencies within the international standards set by the International Obesity Task Force (IOTF), relying on body mass index (BMI), and contrasts them with Japanese standards utilizing the percentage of overweight (POW). We scrutinized a comprehensive database comprising 7,863,520 children aged 5-17 years, sourced from the School Health Statistics Research initiative conducted by Japan's Ministry of Education, Culture, Sports, Science, and Technology. Employing the quantile regression method, we dissected the structure of weight-for-height distributions across different ages and sexes, quantifying the potentially biased assessments of underweight and overweight status by conventional criteria. Applying IOFT criteria for underweight assessment revealed pronounced height dependence in males aged 11-13 and females aged 10-11. Notably, a discernible bias emerged, wherein children in the lower 25th percentile were classified as underweight five times more frequently than those in the upper 25th percentile. Similarly, the overweight assessment displayed robust height dependence in males aged 8-11 and females aged 7-10, with children in the lower 25th percentile for height deemed obese four or five times more frequently than their counterparts in the upper 25th percentile. Furthermore, using the Japanese POW criteria for assessment revealed significant age dependence in addition to considerably underestimating the percentage of underweight and overweight cases under the age of seven. However, the height dependence for the POW criterion was smaller than the BMI criterion, and the difference between height classes was less than 3-fold. Our findings underscore the intricacies of age-dependent changes in body composition during the growth process in children, emphasizing the absence of gold standards for assessing underweight and overweight. Careful judgment is crucial in cases of short or tall stature at the same age, surpassing sole reliance on conventional criteria results.

Dietary Supplementation of Myo-Inositol, Cocoa Polyphenols, and Soy Isoflavones Improves Vasomotor Symptoms and Metabolic Profile in Menopausal Women with Metabolic Syndrome: A Retrospective Clinical Study.

Background and Objectives: Hormonal changes physiologically occurring in menopausal women may increase the risk of developing metabolic and vasomotor disturbances, which contribute to increase the risk of developing other concomitant pathologies, such as metabolic syndrome (MetS). Materials and Methods: Retrospective data from 200 menopausal women with MetS and vasomotor symptoms taking one sachet per day of the dietary supplement INOFOLIC® NRT (Farmares srl, Rome, Italy) were collected. Each sachet consisted of myo-Inositol (2000 mg), cocoa polyphenols (30 mg), and soy isoflavones (80 mg, of which 50 mg is genistin). Patients recorded their symptoms through a medical questionnaire at the beginning of the administration (T0) and after 6 months (T1). Results: We observed an improvement in both the frequency and the severity of hot flushes: increased percentage of 2-3 hot flushes (28 at T0 vs. 65% at T1, p value < 0.001) and decreased percentage of 4-9 hot flushes (54% at T0 vs. 18% at T1, p value < 0.001). Moreover, symptoms of depression improved after supplementation (87% at T0 vs. 56% at T1 of patients reported moderate depression symptoms, p value < 0.001). Regarding metabolic profile, women improved body mass index and waist circumference with a reduction in the percentage of overweight and obesity women (88% at T0 vs. 51% at T1, p value = 0.01; 14% at T0 vs. 9% at T1, p value = 0.04). In addition, the number of women suffering from non-insulin dependent diabetes reduced (26% at T0 vs. 16% at T1, p value = 0.04). Conclusions: These data corroborate previously observed beneficial effects of the oral administration of myo-Inositol, cocoa polyphenols, and soy isoflavones against menopausal symptoms in the study population. Considering the promising results of the present study, further prospective controlled clinical trials are needed to deeply understand and support the efficacy of these natural compounds for the management of menopausal symptoms.

Exploring Influential Factors on Customer Satisfaction with Clothing for Overweight and Obese Women: A Focus on Generations Y and Z in Sri Lanka

Purpose: At present, global trade in textiles and clothing is expanding across the world. The increase in the percentage of overweight and obese women creates tendency to focus on the demand for plus-size clothes. Prior studies confirmed that there is a low attention paid to women's plus-size clothing in Sri Lanka when compared to other countries such as the United Kingdom, Australia, and England. The main purpose of this study is to identify the factors affecting clothing satisfaction of overweight and obese women in Generation Y and Z in Sri Lanka.&#x0D; Design: Acknowledging Renoux’s theory of retail satisfaction, the study used three influencing factors; shopping system, buying system, and consuming system. Shopping system considers displaying plus-size mannequins, creating a separate section for plus-size cloth and providing proper and sufficient information. Buying system focuses on new clothing designs, maintaining a reasonable price range, high-quality materials, and adequate the space in the store. Consuming system focuses on body proportion, body image, and the length of time a garment is held after purchase. A self-administered questionnaire is used to gather data from 287 respondents via online survey. This study adopted quantitative analyses. Influencing factors were determined through the multiple regression analysis.&#x0D; Findings: Results revealed that the buying system and shopping system have statistically significant influences on overweight and obese women's clothing satisfaction and buying system recorded the highest influence. However, consuming system has an insignificant influence on overweight and obese women's clothing satisfaction.&#x0D; Research Implications: Under the shopping system, displaying plus-size mannequin and allocating a separate section for plus-size could stimulate clothing satisfaction of overweight and obese women. Offering a reasonable price range and providing an adequate fit-on-room are the significant factors to be considered in buying system. &#x0D; Future Research Suggestions: Quantitative approach limited the ability to address the problems of overweight and obese women's clothing satisfaction in depth. Shopping mechanism, the ability to do online or offline shopping, store attributes and human attributes should focus on further studies.

Prevalence and associated factors of obesity in patients with major depressive disorder at different ages of onset.

Major depressive disorder (MDD) and obesity are two serious public health problems. Although there have been some research on both, there have few studies on differences in obesity among MDD patients at different ages of onset. The study aims to evaluate the prevalence and factors associated with obesity in MDD patients at different ages of onset. This study totally recruited 1718 first-episode drug-naive MDD patients aged from 18 to 60years. All subjects were divided into two subgroups: early adulthood onset (EAO, 18-45years) and mid-adulthood onset (MAO, 45-60years). Clinical symptoms of patients were evaluated using the 17-item Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale. Baseline parameters including body mass index (BMI), blood pressure, and hematological biochemical parameters were assessed to investigate the association between these parameters and weight gain risk. The percentages of overweight and obesity patients with MDD in EAO group were 54.4% and 4.1%, respectively, and the percentages of overweight and obesity patients with MDD in MAO group were 60.4% and 2.8%, respectively. MDD patients in the MAO group had a longer duration of illness and higher scores in HAMD, HAMA, and PANSS positive subscale. They also had higher levels of thyroid stimulating hormone (TSH), anti-thyroglobulin (TgAb), fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressures (SBP and DBP) levels. BMI did not differ significantly between the two groups. In the EAO group, statistically significant differences were found among normal weight, overweight and obese group in duration of illness, age of onset, TSH, TgAb, thyroid peroxidase antibody (TPOAb), free thyroxine (FT4), TC, triglycerides (TG), SBP and DBP. The TSH, TgTb and SBP were identified as risk factors for weight gain. In the MAO group, statistically significant differences were found among normal weight, overweight and obese group in TSH and FBG. The two indicators were identified as risk factors for weight gain. There were no significant differences in the weight of MDD patients at different ages of onset, while the factors that could potentially lead to obesity did show some differences.

Prevalence of Metabolic Syndrome and Its Risk Factors Influence on Microvascular Complications in Patients With Type 1 and Type 2 Diabetes Mellitus.

Diabetes mellitus (DM) long-term macrovascular and microvascular complications pose significant health risks and increase mortality. In DM patients, metabolic syndrome (MetSy) either precedes or coexists with the condition. Central obesity, poor glycemic control, hypertension, elevated triglycerides (TG), and low high-density lipoproteins (HDL-C) are the components of MetSy. The purpose of this study is to investigate related diabetic microvascular complications in type 1 DM (T1DM) by comparing them with type 2 DM (T2DM), determine potential risk factors, and estimate prevalence based on the diagnosis of MetSy. This study included 160 T1DM and 160 T2DM patients, totaling 320 DM patients. It was carried out from April 20, 2022, to September 31, 2023, at the Sheikh Zayed Hospital, Rahim Yar Khan, in the Outdoor Diabetic Clinic and Medicine Department. A unique questionnaire was utilized to gather socio-demographic, general, clinical, and laboratory data for the MetSy criteria set forth by the International Diabetes Federation (IDF). The blood pressure, BMI, and waist circumference (WC) were measured, while venous fasting blood was used to assess biochemical markers such as HDL-C, TG, and fasting blood sugar. The microvascular diabetes complications were identified using abdominal ultrasound, fundus ophthalmoscopy, and routine laboratory tests.We quantified and analyzed these variables individually for T1DM and T2DM patients with or without MetSy and compared them in the presence or absence of diabetes microvascular complications. MetSy prevalence was 25.62% (41, n=160) for T1DM and 60.62% (97, n=160) for T2DM, totaling 43.12%. Among T1DM patients with MetSy, the majority were married males, aged 36-49 years, with a BMI of 26.69±2.20 kg/m2 and a WC of 85.12±4.23, and 67.5% (108) patients had diabetes microvascular complications. Comparatively, in T2DM with MetSy, the majority were married females aged 50-59 years with a BMI of 29.79 ± 4.65 kg/m² and a large WC of 93.43±4.49, and 75% (123) patients had diabetes microvascular complications. Overall, this study noted significant p-values for hypertension, elevated TG, low HDL-c, high WC, obesity, female gender in T2DM, and above 36 years of age in both groups with MetSy. Diabetic retinopathy (DR) at 32.4% (p<0.001) was the most prevalent T1DM microvascular complication, followed by nephropathy (30.6%), neuropathy (DN) at 28.1%, and gastroparesis (DG) at 22.3%. Whereas in T2DM, the prevalence of DN was 36.3% (p<0.001), followed by DKD (29.3%), DG (28.9%), and DR (24.9%). Nearly a quarter of T1DM patients had MetSy, with increasing percentages of overweight and obese patients who are more likely to have DR, DKD, or DN. MetSy affects two-thirds of T2DM patients, with married obese females aged 50-59 being more susceptible than males, who are more likely to suffer DN, DKD, or DG. Risk factors that contribute to the MetSy burden in T1DM and T2DM include hypertension, poor glycemic management, low HDL-C, high TG, and a higher BMI or WC. Increasing age, female gender in T2DM, longer diabetes duration, and co-morbid hypertension were independent predictors of microvascular complications. DR, DN, DKD, and gastroparesis are the most prevalent diabetic microvascular sequelae. The clinical management of diabetic patients with healthy lifestyle adaptations, good glycemic control, antihypertensives, and statins will contribute greatly to MetSy prevention.

Maternal body mass index and necrotizing enterocolitis: A case-control study.

Our aim was to determine if maternal body mass index (BMI) is associated with necrotizing enterocolitis (NEC) in a large urban delivery center. This single center retrospective case-control study included 291 infants under gestational age of 33 weeks admitted to the neonatal intensive care unit (NICU) during a 10-year period. Cases of stage 2 and 3 NEC were matched at a ratio of 2 controls (n = 194) to 1 case (n = 97). Maternal BMI was categorized as normal (≤24.9), overweight (25-29.9) and obese (≥30). Chi-square and stepwise logistic regression were used for analysis. A power analysis was performed to determine if sample size was sufficient to detect an association. Stepwise logistic regression demonstrated no association between NEC and maternal obesity. Maternal hypertension, pre-eclampsia, premature rupture of membranes, maternal exposure to antibiotics, placental abruption and gestational diabetes were not associated with NEC. Power analysis showed the sample size was sufficient to detect an association of NEC with maternal BMI in three groups analyzed. In this case-control study, there was an association between NEC and maternal overweight but not obesity at delivery. Our results did not show a significant association of NEC with maternal obesity. The percent of overweight and obese mothers prior to pregnancy and at delivery was significantly higher in our population than the national average and may be responsible for the limited ability to reveal any association between maternal obesity and NEC.

A pragmatic trial of a family-centered approach to childhood obesity treatment: Rationale and study design

BackgroundFamily-based behavioral treatment (FBT) is an effective intensive health behavior and lifestyle treatment for obesity reduction in children and adolescents, but families have limited access. The purpose of this randomized, pragmatic, comparative effectiveness trial was to examine changes in child relative weight in a 12-month, enhanced standard of care (eSOC) intervention combined with FBT (eSOC+FBT) vs. eSOC alone. MethodsChildren aged 6 to 15 years with obesity, and their primary caregiver, were recruited from primary care clinics. Families were randomized 1:1 to eSOC, a staged approach led by the primary care provider that gradually intensified dependent on a child's response to care and aligns with the American Medical Association guidelines, or the eSOC+FBT arm, which included regular meetings with a health coach for healthy eating, physical activity, positive parenting strategies, and managing social and environmental cues. Both treatments align with the 2023 American Academy of Pediatrics clinical practice guidelines. Assessments occurred at baseline, midpoint (month 6), end-of-intervention (month 12), and follow-up (month 18). Primary outcome was change from baseline to 12 months in child percent overweight (percentage above the median body mass index in the general US population normalized for age and sex). Secondary outcomes were parent weight, child psychosocial factors, heterogeneity of treatment effects, and cardiometabolic risk factors. Exploratory outcomes assessed reach, effectiveness, adoption, implementation, and maintenance. ConclusionThis pragmatic trial will generate evidence for the comparative effectiveness of implementing two guidelines-based approaches in primary care for obesity reduction in children and adolescents.Trial registration:ClinicalTrials.gov Identifier: NCT03843424

Contradictions in Chilean public education policy: physical education and health case.

The purpose of this text is to point out the contradiction existing in Chilean educational public policy regarding the curricular reform that converted the subjects of Physical Education and Health, History, Arts, and Religion into optional subjects for the 3rd and 4th years of high school. As far as Physical Education is concerned, scientific evidence shows that such conversion to the status of optional subject goes against the policies of other executive ministries and against the possibilities of reversing the statistics that show Chile as one of the countries in America with the highest percentage of overweight and obese children and adolescents.

Exploring Sleep Study As a Potential Diagnostic Tool for Polycythemia: An Indian Perspective

Introduction Polycythemia, characterized by elevated red blood cell count and hematocrit levels, affects approximately 3.4% of the population based on WHO 2016 criteria. However, existing studies predominantly focus on Caucasian populations, leaving a knowledge gap in Indian population data. Moreover, the emphasis on JAK2 mutation as a diagnostic marker has overlooked other potential risk factors like hypoxia induced sleep disturbances as causes for secondary Polycythemia. This study aims to fill these gaps by exploring the impact of overlooked risk factors and their association with polycythemia incidence. Methods Clinical data from patients evaluated for Polycythemia at two tertiary care centers in south India between January 2021 and May 2023 were collected with Institutional Research Board approval (n=316). From all the Polycythemia patients who attended Hematology out patient department, two cohorts were identified: patients who underwent JAK2 mutation study and those who underwent a sleep study. Baseline characteristics, risk factors (e.g., smoking, snoring), comorbidities (diabetes, hypertension, dyslipidemia), constitutional symptoms (pruritus, headache, blackouts, or dizziness), and vascular complications (coronary artery disease or cerebrovascular events) were recorded. Additional details such as apnoea-hypopnea index (AHI) and nocturnal desaturation were documented for those patients who had undergone sleep study. Patients who were having moderate and severe AHI were considered as sleep study positive. As many were home sleep test and due to other patient related factors, using oxygen desaturation index for hypoxemia was not relied upon. Statistical analysis was conducted using Chi-square test and t-test for equality of means. Results A retrospective analysis of 316 patients with a diagnosis of erythrocytosis as per the WHO 2016 criteria (Figure-1) was done. Among them, 278 underwent JAK2 mutation study, with 32 testing positive. Meanwhile, out of the 98 patients who underwent sleep study, 30 tested positive. The probability of testing positive in a sleep study was higher than testing JAK2 mutation positive. Patients in the sleep study-positive group were significantly younger (mean age 45.93±12.1 years) compared to the JAK2-positive group (mean age 56.72±14.8 years) (p=0.003). The sleep study-positive group comprised of only males, while the JAK2-positive group included both males (71.8%) and females (21.9%) (p&amp;lt;0.05). In the sleep study group, most patients were diagnosed incidentally during routine blood investigations, while the majority in the JAK2-positive group presented with symptoms (p&amp;lt;0.001).There was a higher percentage of overweight (46.7%) or obese (20%) patients in the sleep study group, while the majority in the JAK2-positive group had a normal BMI (58.1%) (p=0.05). Co-morbidities were similar in the two groups leading to no significant statistical difference. Both groups required venesection without significant differences (Table -1). Conclusion Sleep study shows promise as a relevant diagnostic tool for certain cases of erythrocytosis. Patients who test positive for sleep study may differ from those with a positive JAK2 mutation in terms of age, gender distribution, BMI, and presentation. However, both groups share similar co-morbidities and initiation of venesection rates. The low incidence of JAK2 mutation in polycythemia patients necessitates the consideration of sleep study as an additional evaluation tool. Our study was limited by its retrospective nature. Moreover, many patients who had performed sleep studies had not done a JAK2 mutation test. Further research is needed to validate these findings and enhance the understanding of causative role of sleep apnoea in JAK2 unmutated polycythemia in Indian population.

Relationship of body mass index to percent body fat determined by deuterium isotopic dilution and impedancemetry among Tunisian schoolchildren.

This study aims to evaluate the relation of body mass index (BMI) to fat mass among children by two techniques impedancemetry and deuterium oxide dilution (D2O). This study was carried out in 156 schoolchildren aged between 8 and 11 years. The children received interrogation specifying lifestyle and food habits. Body composition was determined using the impedancemetry and D2O technique. The results showed a difference between the percentage of obese and overweight children according to BMIZ classification (30.1%), bioelectrical impedance method (14.7%) and D2O technique (42.9%). Despite the difference between the last two classifications, we found a significant correlation between body fat percentages determined by impedancemetry and D2O technique (r = 0.695, p<0.01). Bioelectrical impedance analysis underestimated %BF by 78.02% in overall children, by 70.05% in boys and by 84.73% in girls compared to D2O technique. This study has demonstrated that the percentage of overweight and obesity varied according the methods used. Further development of body composition methods is needed in children for the real determination of the obesity prevalence and therefore a better monitoring of this public health problem.

Barriers in the Management of Obesity in Mexican Children and Adolescents through the COVID-19 Lockdown-Lessons Learned and Perspectives for the Future.

Our study comprised two phases. The initial descriptive cross-sectional phase included surveys of children who are overweight or obese and their parents/guardians from the Pediatric Obesity Clinic at the Child Welfare Unit (UBI, acronym in Spanish) in the Hospital General de México "Dr. Eduardo Liceaga" (n = 129). The participants were studied to explore changes in lifestyle, physical activity, sleep patterns, eating behaviors, food consumption, anxiety, and depression. In the second phase, the biochemical, body composition, and anthropometric parameters of 29 pre-COVID-19 patients were compared before and after the lockdown. The survey showed more moderate anxiety and depression, alterations in sleep, physical inactivity, and an increase in the consumption of animal products, fruits, cereals, tubers, sugary drinks, and ultra-processed food. In the study's comparative phase, we observed a substantial increase in BMI z-score (p = 0.01), waist circumference (p < 0.001), fat mass (p < 0.001), percentage of adiposity (p = 0.002), and basal glucose (p = 0.047) and a drop in lean mass (p = 0.008). The pandemic led to a loss of routines and socioeconomic changes that made it difficult to address weight and obesity in young people. The results show that managing obesity in our patients involves considering both lifestyle and the social environment. This encourages us to consider a comprehensive and personalized approach.

Determining the Best Approach: Comparing and Contrasting the Impact of Different Coping Strategies on Work-Related Stress and Burnout Among Saudi Commercial Pilots.

Background Many physiological, psychological, and environmental stressors can be experienced by pilots throughout their careers, which may affect their mental and psychological health and their performance consequently. Stressing factors of aviation and commercial operations can result in pilots' burnout, which is a description of the response to chronic emotional exhaustion and loss of motivation. Objective The objective of this study was to determine the prevalence of burnoutand compare the effects of different coping strategies on burnout levels among commercial pilots in the Kingdom of Saudi Arabia, 2023 Methods The study was a cross-sectional survey utilizing an online form of a validated questionnaire administered to pilots of Saudi commercial airlines in the Kingdom of Saudi Arabia. The study targeted on-duty Saudi commercial pilots, excluding retired and in-training pilots, with an estimated population of around 2000. A sample size of 311 was determined using an equation considering a 5% margin of error, 95% confidence level, and a 60.3%burnout prevalence rate. Non-probability snowball sampling method was used to achieve sample size. Results A total of 321 pilots were included, mostly Saudis. The participants had a median age of 47, and the majority were married with one to two children. BMI classifications showed high percentages of overweight and obese individuals. The study found that most pilots experienced medium levels of burnout (70.1%). Nationality, marital status, and shorter sleeping duration were significantly associated with higher burnout levels. Common challenges included long duties (79.4%), irregular working hours (72.3%), and time away from home (55.5%). Coping strategies included rest and sleep (81%), exercise (59.2%), and relaxation behaviors (50.5%). Stressors such as long duties, irregular working hours, and work conflicts were significantly associated with higher burnout levels. However, no significant associations were found between coping strategies and burnout levels. Conclusion The study found that most pilots experienced medium levels of burnout. In addition, common challenges included long duties, irregular working hours, and time away from home. The study emphasizes the need to address work-related stressors, implement interventions, and support pilots' mental health. Promoting healthy coping strategies and understanding individual resilience is important. Further research and organizational efforts are required to mitigate burnout and enhance the quality of life for aviation professionals, benefiting both individuals and the industry.

Relación entre el perfil oxidativo y el índice de diversidad de la dieta en adultos mayores de una zona urbano-marginal de Costa Rica

Background and objectiveThe older we get, the greater the production of reactive oxygen species and therefore the greater the oxidative stress, which is related to the deterioration of the health of older adults. This study analyzed the relationship between the oxidative profile and the dietary diversity index in an urban-marginal population of older adults in Costa Rica. MethodsEighty-eight older adults were studied and various markers of oxidative stress, serum glucose levels, lipid profile, and some micronutrients were determined. In addition, the body mass index (BMI) was calculated and the dietary diversity index (DDI) was determined. ResultsLipid peroxidation and DNA oxidation, a mean plasma antioxidant capacity percentage of 39.54±10.67%, which decreased with age, were evidenced. 67% of the participants had alterations in glycemia, 73% had one or more alterations in blood lipid levels, 55% had insufficient vitamin D levels, and 68.6% were overweight. The average IDD was 4.91 points, indicating that the diet was not very diverse. No relationship was found between IDD and nutritional status, between nutritional status and oxidative stress, nor between biochemical variables and oxidative stress. ConclusionThe adults studied presented high oxidative stress, a high percentage of overweight, and a low IDD. A higher IDD was associated with a lower blood concentration of MDA and a higher % PAC.