Prevalence Of Obesity In Youth Research Articles

A qualitative exploration on the needs of health care providers working with adolescents who are undergoing bariatric surgery

BackgroundWith increasing prevalence of severe obesity in youth, more adolescents are becoming candidates for bariatric surgery. In Canada, bariatric surgery in adolescents is in its infancy, and long-term health outcomes are not well known. It is unknown what health care providers (HCPs) are using to prepare and guide their adolescent patients for bariatric surgery. The needs of HCPs should be explored with the aim to improve patient outcomes. Therefore, the purpose of this study was to investigate the resource needs of HCPs working with adolescents living with severe obesity who are undergoing bariatric surgery. MethodsThis qualitative study consisted of a focus group with seven HCPs from an adolescent bariatric program using a semi-structured interview guide. The focus group discussion was audio-recorded, and the recording was transcribed verbatim. A thematic analysis was conducted. ResultsFour data-generated themes emerged highlighting the perceived needs and challenges faced by HCPs. These included (1) gaps in patient education materials on the subject of the bariatric surgery process, obesity as a chronic disease and mental health, (2) the need for designing resources that are teen-friendly, adaptable, and accessible, (3) the need for resources to facilitate decision-making and patient evaluation delivering more streamlined care and; (4) challenges to addressing resource needs due to limited clinical time and budgets. ConclusionThis needs assessment study highlights the need for appropriate resources for patient education, as well as pre and post-operative preparation. The hope is that HCPs can improve quality of care delivered and positively impact surgical outcomes in their patients.

The COVID-19 lockdown increased obesity disparities; Will the increases in type 2 diabetes continue?

The aim of this study was to compare the prevalence of the increases in pediatric obesity during the COVID-19 lockdown with the annual increases in obesity in the National Health and Nutrition Examination Survey (NHANES). This study compared two reports of increases in the prevalence of obesity in youth during the COVID-19 lockdown with the annual rate of increase in obesity in NHANES. When expressed as multiples, the changes in prevalence among elementary school children observed in two population-based surveys were 28 to 63 times greater than the annual changes in the prevalence of obesity observed in NHANES. Increases in Black and Hispanic youth were greater than those in White youth. The net impact of the COVID-19 lockdown increased the disparities in obesity among this age group. The rapid increases in obesity are likely to persist and may be associated with an increase in the prevalence of severe obesity as these children age. Furthermore, the increased susceptibility to diabetes in Hispanic and Black children, as well as the reported increase in diabetes among 0- to 18-year-old individuals during the COVID-19 pandemic, may lead to an increased incidence of type 2 diabetes in minority youth with obesity.

Digital behaviour change interventions to promote physical activity in overweight and obese adolescents: a systematic review protocol

BackgroundWith the increasing prevalence of obesity in youth, behavioural interventions to alter its modifiable risk factors such as physical activity can support the management of this epidemic. Digital behaviour changes interventions (DBCI) such as mobile applications, websites and wearables have the potential to reach many adolescents to promote physical activity as its use may be more accessible, effective and engaging compared to traditional face-to-face approaches. However, there is insufficient evidence on their use at promoting physical activity amongst overweight and obese adolescents. This review aims to assess the effectiveness of DBCIs aiming to increase physical activity in overweight and obese adolescents (aged 10–19 years) and the behaviour change techniques used in these interventions.MethodsElectronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane and Scopus) will be searched for English language studies from January 2000 to December 2022 using appropriate search terms relating to digital interventions, physical activity, adolescents and obesity. Experimental studies (either randomised or non-randomised controlled trials) assessing effects of DBCIs on physical activity behaviour, objectively or subjectively measured, in overweight and obese (body mass index [BMI] ≥ 85th percentile for age) adolescents will be eligible for inclusion. Intervention characteristics will be coded using the Template for Intervention Description and Replication (TIDieR) checklist and the BCT taxonomy v1. Risk of bias and the overall quality of the included studies will be assessed using Cochrane’s Collaboration’s tool and GRADE approach respectively. If the data allows, meta-analyses using random effect models will be conducted to assess the effects of DBCIs on physical activity.DiscussionThe proposed systematic review will summarise the effectiveness of digital behaviour change interventions aiming to increase physical activity in overweight and obese adolescents, as well as adding new information on the behaviour change techniques used in these interventions. The findings of this review will facilitate stakeholders with a current, rigorous and reliable research base to support the development and implementation of effective health promotion interventions for this population.Systematic review registrationPROSPERO CRD42021270008.

Weight Management Outcomes of Youth with Autism Spectrum Disorder Seeking Treatment from a Multidisciplinary Team.

Youth with Autism Spectrum Disorder (ASD) are at an increased risk for developing obesity when compared to their typically developing peers. Given higher prevalence of obesity in youth with ASD, understanding factors relating to success in obesity treatment provides insight into implementing efficacious treatments for youth. The current study examines age, sleep, and metabolic factors potentially affecting success in 74 youth (Mage = 11.66) attending a multidisciplinary weight management treatment program over a year. Multilevel modeling indicated that higher baseline BMI class category, medications at baseline, and absence of sleep difficulties predicted greater reduction in BMI after a year of treatment.

Obesogenic environment and childhood obesity.

The increasing prevalence of obesity in youth has contributed to the growing global burden of chronic diseases (e.g. diabetes, cardiovascular diseases and cancers), which has been largely accounted for by obesogenic behaviours and environments. Previous studies have focused on the influences on obesity of multidimensional environmental indicators, which have mixed effects, for example, built environmental factors, food environmental factors and neighbourhood safety. After a thorough search of all databases, I found a limited body of reviews on the associations of basic environmental factors. A basic environmental factor, from a perspective of geographic information systems, is an indicator constructed by only one-step spatial function, without ambiguous effects on obesity. In contrast to basic obesogenic environmental factors, an example of mixed environmental factor is neighbourhood safety, which is a complex measure of night light, crime rate, traffic volume, speed limit, smoothness of roads and many other factors of injury. Without a sufficient, up-to-date understanding of the roles of basic obesogenic environmental factors in obesity, the uncertainties will propagate and lead to more uncertainties in the association between indicators and obesity.

Normal-Weight Obesity Is Associated with Poorer Cardiometabolic Profile and Lower Physical Fitness Levels in Children and Adolescents.

Normal-weight obesity (NWO) syndrome has been shown to be associated with cardiometabolic dysfunction. However, little is known regarding this potential relationship in Latin American children and adolescents. The aim of this study was two-fold: (i) to investigate whether Colombian youth with NWO syndrome have a poorer cardiometabolic profile and physical fitness performance than normal-weight lean (NWL) peers; and (ii) to determine if physical fitness levels are related to prevalence of normal-weight obesity in youth. This was an analytical cross-sectional study of 1919 youths (9–179 years old, 53.0% girls) in the capital area of Colombia. NWO was defined as a body mass index < 25 kg/m2 and a validated body fat percentage above the sex-age-specific 90th percentile for Colombian children and adolescents. Body fat was estimated using bioelectrical impedance analysis, cardiorespiratory fitness (CRF) was estimated using the 20-meter shuttle run test, and muscular fitness with the handgrip test. Biochemical profile blood samples were collected for cardiometabolic risk factors. After adjusting for chronological age, pubertal stage, and Mediterranean diet adherence, the NWO group (boys and girls) had significantly higher values for cardiometabolic risk factors, and waist circumference (WC) than the NWL group. The prevalence of NWO was lower in youth classified with healthy CRF (boys, odds ratio (OR) = 0.54, 95% confidence interval (CI) 0.37 to 0.78; girls, OR = 0.35, 95% CI 0.24 to 0.50), p < 0.001. Our findings indicate that using only body mass index for the assessment of cardiometabolic risk likely misrepresents true adiposity and suggest the need to include the assessment of body fat in the routine clinical evaluation of individuals during childhood and adolescence.

Dietary Interventions and Type 2 Diabetes in Youth: a Fresh Look at the Evidence.

The incidence of type 2 diabetes among children and adolescents has sharply increased, highly influenced by prevalence of obesity in youth. Here, we provide an overview of the pathogenesis of diabetes, and summarize recent dietary interventions investigating effects of diet on metabolic risk factors in overweight and obese youth. Seven dietary interventions were identified randomly assigning participants to weekly or bi-weekly dietary counseling sessions over 12-24-week period, with mixed results. Four interventions showed significant reductions in fasting insulin and insulin resistance levels relative to baseline concentrations ranging from 26 to 50%. Recent evidence is mixed, with four studies showing improvements to insulin concentrations and insulin resistance in obese children and adolescents associated with energy restriction and/or change to carbohydrate consumption. Further work is needed to investigate long-term effects of dietary factors including carbohydrate quality and energy restriction on metabolic health and diabetes prevention early in life.

State Agency Support of Weight-Related School Policy Implementation.

In this study, we describe state agency strategies to support weight-related policy implementation in schools, and examine the association among state support, obesity prevalence, and strength of state policies governing school nutrition and physical education. The 2012 School Health Policies and Practices Study describes prevalence of implementation support state agencies provided to schools/districts. Implementation support items were analyzed by weight-related policy area (eg, advertising, wellness policy) and by type of support (eg, technical assistance). Results were summed to create a total weight-related policy support score. Linear regression was used to examine associations between policy support and state youth obesity prevalence (2011-2012 National Survey for Children's Health), overall and stratified by state policy strength (2012 Classification of Laws Associated with School Students). States provided support most commonly for school meals and wellness policies (89% and 81%, respectively) and least often for after-school PE (26%). Most states (80%) provided technical assistance. The total weight-related policy support score had a significant positive association with state-level youth overweight/obesity prevalence (p = .03). State agencies appear to be responding to their youth obesity prevalence with technical support. Schools and state agencies should work in collaboration to provide a healthy school environment for all students.

Effect of participation in a park-based afterschool program on cardiovascular disease risk among severely obese youth

ObjectivesThe prevalence of severe obesity in youth is rising, despite reports of obesity rates stabilizing overall. While reports on treatment outcomes for youth with severe obesity (bariatric surgery, behavioral and pharmacological treatments) exist, very few community-based programs have reported changes in health outcomes in this population. We assessed changes in cardiovascular health risk profiles among racial/ethnic minority youth with severe obesity who participated in Fit2Play™, a park-based afterschool health promotion program. Study designA longitudinal cohort study. MethodsChildren aged 6–14 years (N = 1546, 51% Hispanic, 44% non-Hispanic black) who participated in the Fit2Play™ in one of 34 urban park sites for one school year over five separate school years (2010–2015) had height, weight, four-site skinfold thicknesses, systolic blood pressure (SBP)/diastolic blood pressure (DBP), fitness tests, and a health/wellness knowledge test collected at the beginning and end of the school year. Two-level repeated measures mixed models examined changes in cardiovascular health outcomes (body mass index [BMI], skinfold thickness, systolic/diastolic blood pressure percentile [SBPP/DBPP], cardiorespiratory fitness [PACER]) in youth with severe obesity over 1- and 2-year follow-up. ResultsCompared with baseline, BMI decreased 13% (incidence rate ratio [IRR] 95% confidence interval [CI]: 0.83–0.90), sumof skinfold thicknesses decreased 5% (IRR 95% CI: 0.91–0.99), SBPP decreased 5% (IRR 95% CI: 0.90–0.99), DBPP decreased 19% (IRR 95% CI: 0.77–0.86), and PACER scores increased 12% (IRR 95% CI: 1.0–1.27) after two years of participation in the Fit2Play™ program. ConclusionsFindings here support community/park-based youth programs as effective and accessible treatment options for reducing cardiovascular disease risk among youth with severe obesity.

The Association of Parental/Caregiver Chronic Stress with Youth Obesity: Findings from the Study of Latino Youth and the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

Prior studies indicate that chronic stress is associated with obesity in adults. However, whether parental/caregiver stress is associated with obesity in their offspring has not been widely examined in Hispanic/Latino populations. In this study, we evaluated the role of caregiver chronic stress on child obesity and whether home food environment or child lifestyle behaviors explained the association. The study included a sample of Hispanic/Latino youth and their caregivers (n = 473) from the Study of Latinos (SOL) Youth study and the Hispanic Community Health Study/SOL Sociocultural Study, which enrolled children aged 8-16 years from four cities (Bronx, Chicago, Miami, and San Diego), and provided assessments of adult chronic stress. Poisson regression models were used to assess the association between parental/caregiver stress and child obesity, adjusting for potential confounders. Twenty-two percent of caregivers did not report any chronic stressors, 48% reported 1-2, and 29% reported ≥3 stressors. The prevalence of obesity in youth increased with number of caregiver stressors from 23% among those without caregiver stressors to 35% among those with ≥3 stressors (p for trend 0.03). After model adjustment, youths whose caregivers reported ≥3 stressors were more likely to be obese than youths whose caregivers reported no stressors (prevalence ratio = 1.53; 95% confidence interval 1.01-2.32). This association was independent of food home environment, child diet quality, and child physical activity, but it was not independent of caregiver obesity. These findings suggest that parental/caregiver chronic stress is related to obesity in their children. Future research is needed to confirm this association in longitudinal studies and in other population groups.

Correlation between Obesity, Diet, Physical Activity and Sedentary Behaviour among School-aged Children and Young Adolescents in Macedonia

Diet and physical activity education in school-aged children and young adolescents are in the focus of the modern healthcare and education system. The aims of our cross-section study were to estimate the prevalence of obesity in youth, and the significant correlation between nutrition status, health behavioural and biological markers. The sample size was 400 randomly selected school-aged children and adolescent from 14 to 18 years old. They were divided into two population groups of school-aged children (12-13 years old) and young adolescent (17-18 years). Standardized, non-quantitative Food Frequency Questionnaire (FFQ) and the International Questionnaire for assessment of Physical Activity (IPAQ-short version) were used as well as the anthropometric measurements: body weight and height, body mass index (BMI kg/m2) presented in percentile using the WHO Child Growth Standards. Statistical analysis was included descriptive statistics, Pearson Chi-square test and Logistic regression analysis using SPSS Statistics 17.0. In accordance with the distribution of Pearson Chi-square=16.94 (p<0.001), there was statistical significance between nutritional status of study participants in both, first and second study groups. Also, there was significant difference in high intensity sports activity between two groups (Pearson Chi-square=26.59; p<0.001). Sedentary behaviour had the highest influence on development of childhood obesity (Wald=2.81; p=0.09). Significant correlation was estimated between obesity and sweetness food (pasta, rise and potatoes), soft drinks, but drinking water had a protective effect. Prevention and treatment of pediatric overweight and obesity require systems-level approaches that include the skills of registered dietitians, sports coaches as well as consistent and integrated messages and environmental support across all sectors of society, especially educational sector. The next step is to develop an innovative “Skills for health” model including nutrition and physical activity education program in Macedonia.

Enabling Healthy Living

The increasing burden of overweight and obesity in the United States (U.S.) demands a better understanding of its local and regional spatial patterns and trends. The study examines the hypothesis that there are spatial differences in the prevalence of overweight and obesity in U.S. youths at regional and local levels. It used spatial, statistical, and spatiotemporal analyses and a synthesis of regionally and locally relevant data from a cohort of large, nationally representative, longitudinal data sets, the National Longitudinal Survey of Youth (NLSY`97) to analyze overweight and obesity prevalence. Specifically, the methods used included the spatial Generalized Linear Mixed Model (GLMM), spatial interpolation techniques (Inverse Distance Weighting – IDW), and Kulldorf's scan space-time analysis. The paper analyzed 12 waves (1997–2008) of data from the NLSY data sets. Its findings revealed there is an upward trend both in males and in females in obesity prevalence in US youths during the twelve-year period. Youth obesity prevalence was also higher among females than among males. The cohort shows evidence of increase in overweight and obesity prevalence. There are mixed trends in youth obesity prevalence patterns in rural and urban areas. Counties identified as consistently experiencing higher prevalence of obesity and with the potential of becoming an obesogenic environment are Copiah, Holmes, and Hinds in Mississippi; Harris and Chamber, Texas; Oklahoma and McCain, Oklahoma; Jefferson, Louisiana; and Chicot and Jefferson, Arkansas. The twelve-year study indicated spatial variation in obesity and overweight prevalence among U.S. youths, with pockets of clustered prevalence. This information can guide programs, policies, and initiatives for obesity prevention at regional and local levels.

Metabolic Syndrome: A Construct with Limited Relevance to Children

The prevalence of obesity in youth has increased dramatically over the last 3 decades. Similar to adults, obese children often display clusterings of risk factors associated with heightened risk for future cardiovascular disease. In adults, this clustering is commonly referred to as the metabolic syndrome and is used to identify individuals at high risk for premature cardiovascular disease and diabetes. Conversely, the relevance of a pediatric metabolic syndrome diagnosis to predict future adult cardiovascular outcomes is less clear. Many pediatric definitions of the metabolic syndrome have been proposed, yet no consensus has been adopted due to inconsistent study results, lack of translational relevance of childhood classifications to future disease, and instability of the criteria used for various definitions. Given absence of substantial evidence for using a dichotomous metabolic syndrome diagnosis over individual cardiometabolic risk factors, clinicians and experts must proceed with caution when diagnosing metabolic syndrome to guide treatments recommendations.

Use of metformin in pediatric type 2 diabetes

Abstract In the last 10 years the incidence of type 2 diabetes (T2DM) in children and adolescents has increased, due to increasing prevalence of obesity in youth. Therefore, the prevalence of diabetes-related complications such as hypertension, hyperlipidemia and microalbuminuria has also increased in pediatric T2DM. The pathogenesis of T2DM in children involves genetic and environmental factors that will determine the increase of insulin resistance and decrease of beta pancreatic insulin secretion. Only metformin and insulin are approved for clinical use in children in the majority of countries. The aim of this paper is to review the benefits of the treatment with metformin in children and adolescents with T2DM.

&lt;b&gt;Food behaviors and youth obesity in Pakistan&lt;/b&gt; - doi: 10.4025/actascihealthsci.v35i2.11885

The epidemic of obesity took off from about 1980 and in almost all countries has been rising inexorably ever since. Only in 1997 did world health organization accept that this was a major public health problem. It is also becoming an important public health problem among Pakistani children due to changes in life style and other factors. The increasing prevalence of childhood obesity and its concomitant health risks justify widespread efforts toward prevention. A Cross-sectional study was conducted to elaborate the various types of foods and change in eating behavior leading to abnormal weight gain among the youth. A total of 504 male and female students of class six to ten were selected through simple random sampling. Anthropometric measurements were done with calibrated instruments using the age and sex specific BMI cut off points according to World Health Organization growth reference. Results showed significant proportion of girls (86%) and boys (85%) had abnormal waist to hip ratio. The determinants of the obesity lie within the rapid changes in food intake behavior and lifestyle patterns which had a clear and significant impact on the prevalence of obesity in youth of Pakistan.

Determining Left Ventricular Hypertrophy in Overweight-Obese Youth Using Electrocardiogram Criteria

There is an escalating prevalence of obesity in youth that increases the risk for cardiovascular alterations such as left ventricular hypertrophy (LVH). The purpose of this study is to identify the most effective electrical voltage measurement for determining LVH in youth who are overweight and obese. A retrospective chart review was conducted to determine sensitivity, specificity, and the receiver operator characteristic (ROC) curve of 4 popular electrical voltage measures. Our findings indicated the sensitivity and specificity for Cornell product (50.0%; 96.2%), Cornell voltage (52.9%; 98.0%), Romhilt Estes (50.0%; 100.0%), and Sokolow-Lyon index (60.0%; 86.4%) consecutively. The Romhilt-Estes and Cornell voltage measures displayed the highest specificity and could prove to be beneficial as a screening method to rule out LVH in overweight and obese youth.

Geographic Disparities in State and District Policies Targeting Youth Obesity

States and school districts nationwide have enacted policies targeting youth obesity, but many policies lack specific requirements or enforcement language. Geographic disparities in youth obesity could worsen if policies are weaker in areas with higher obesity prevalence. To determine if state or district policy strength varies with youth obesity prevalence across Census divisions. Policies in five domains related to nutrition and physical activity in schools were obtained from all states and nationally representative samples of 578 and 592 public school districts in the 2006-2007 and 2008-2009 school years, respectively. Policy language strength was rated on a 0-100 scale on both the state and district level. Regression models were used to determine if mean 2006-2007 strength scores, and changes in mean scores from 2006-2007 to 2008-2009, were associated with youth obesity prevalence across Census divisions. Analyses were conducted in 2010. State and district policies governing foods sold outside of school meal programs ("competitive foods") were stronger in 2006-2007 in the two divisions with the highest youth obesity prevalence (East South Central, West South Central). Furthermore, mean competitive food policy strength increased the most from 2006-2007 to 2008-2009 in these divisions. The West South Central had the weakest district physical education policies in 2006-2007, however, and was the only division in which average strength of district school meal policies decreased. State and districts in Census divisions with the highest youth obesity prevalence are taking steps to restrict competitive foods in schools, but many have not targeted other policy domains as aggressively.

State Disparities in Time Trends of Adolescent Body Mass Index Percentile and Weight-Related Behaviors in the United States

Evidence is conflicting as to whether youth obesity prevalence has reached a plateau in the United States overall. Trends vary by state, and experts recommend exploring whether trends in weight-related behaviors are associated with changes in weight status trends. Thus, our objective was to estimate between-state variation in time trends of adolescent body mass index (BMI) percentile and weight-related behaviors from 2001 to 2007. A time series design combined cross-sectional Youth Risk Behavior Survey data from 272,044 adolescents in 29 states from 2001 to 2007. Self-reported height, weight, sports participation, physical education, television viewing, and daily consumption of 100% fruit juice, milk, and fruits and vegetables were collected. Linear mixed models estimated state variance in time trends of behaviors and BMI percentile. Across states, BMI percentile trends were consistent despite differences in behavioral trends. Boys experienced a modest linear increase in BMI percentile (ß=0.18, 95% CI: 0.07, 0.30); girls experienced a non-linear increase, as the rate of increase declined over time from 1.02 units in 2001-2002 (95% CI: 0.68, 1.36) to 0.23 units in 2006-2007 (95% CI: -0.09, 0.56). States in which BMI percentile decreased experienced a greater decrease in TV viewing than states where BMI percentile increased. Otherwise, states with disparate BMI percentile trends did not differ with respect to behaviors. Future research should explore the role of other behaviors (e.g., soda consumption), measurement units (e.g., portion size), and societal trends (e.g., urban sprawl) on state and national adiposity trends.

Physical Activity-Induced Improvements in Markers of Insulin Resistance in Overweight and Obese Children and Adolescents

Childhood obesity is a significant, worldwide, public health problem. Coinciding with the increasing prevalence of obesity in youth, Type 2 diabetes has emerged as a critical health condition in this population. In the U.S. alone, approximately 215,000 U.S. youth under the age of 20 were diagnosed with diabetes, with the majority of 10-19 years old diagnosed with Type 2 diabetes. Additionally, the exact number of youth that may have Type 2 diabetes yet remain undiagnosed is unknown. Increasing physical activity to encourage weight loss among youth may reduce the incidence of Type 2 diabetes in youth; however, several recent studies reported positive associations between physical activity and components of Type 2 diabetes without weight loss in youth. These findings support previous studies in adults which observed physical activity-induced improvements in insulin dynamics without changes in body fat. The purpose of this review was to identify studies which examined the effect of physical activity without dietary intervention on markers of insulin resistance in overweight and obese youth. These studies provide strong evidence that physical activity alone, without dietary intervention, can have a positive, significant impact on insulin resistance risk and potentially prevent the development of type 2 diabetes in overweight and obese youth. The studies reviewed provide support for future interventions to shift the focus from reducing obesity to increasing physical activity for the prevention of type 2 diabetes in obese youth.

Prediabetes and type 2 diabetes in youth: an emerging epidemic disease?

The prevalence of obesity in youth is increasing alarmingly among children and adolescents in the United States. The problem falls disproportionately on African-American and Hispanic children. Many of the metabolic and cardiovascular complications associated with obesity are already present during childhood and are closely linked to the concomitant insulin resistance/hyperinsulinemia and degree of obesity. Moreover, these co-morbidities persist into adulthood. The progression from normal glucose tolerance to type 2 diabetes mellitus involves an intermediate stage known as prediabetes or impaired glucose regulation. Prediabetes is characterized by peripheral insulin-resistance and impaired glucose sensitivity of first-phase insulin secretion. On the other hand, in overt type 2 diabetes mellitus beta-cell failure becomes fully manifested. Progression from prediabetes to type 2 diabetes mellitus in youth is characterized by marked weight gain and further reduction in insulin secretion and insulin resistance. Reverting obesity through lifestyle modification, that involves nutrition education, behavior modification and exercise, is an important step to prevent the progression to diabetes.