scholarly journals Heterogeneity in sociodemographic characteristics and cardiovascular risk factors at the initiation of a lifestyle intervention for obesity within Germany: an APV multicenter study on 40,942 children and adolescents

2018 ◽  
Vol 1 (1) ◽  
pp. 5-17
Author(s):  
Barbara Bohn ◽  
Rainer Stachow ◽  
Ines Gellhaus ◽  
Johannes Matthias ◽  
Hans Lichtenstern ◽  
...  
2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Bergum ◽  
I Sandven ◽  
TO Klemsdal

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Norwegian health department Background The evidence of the long-term effects of multiple lifestyle intervention on cardiovascular risk is uncertain. We aimed to summarize the evidence from randomized clinical trials examining the efficacy of lifestyle intervention on major cardiovascular risk factors in subjects at high cardiovascular risk. Methods  Eligible trials investigated the impact of lifestyle intervention versus usual care with minimum 24 months follow-up, reporting more than one major cardiovascular risk factor. A literature search updated April 15, 2020 identified 12 eligible studies. The results from individual trials were combined using fixed and random effect models, using the standardized mean difference (SMD) to estimate effect sizes. Small-study effect was evaluated, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient- and study-level variables. Results  Small-study effect was not identified. Lifestyle intervention reduced systolic blood pressure modestly with an estimated SMD of -0.13, 95% confidence interval (CI): -0.21 to -0.04, with moderate heterogeneity (I² = 59%), corresponding to a mean difference of approximately 2 mmHg (MD = -1.86, 95% CI: -3.14 to -0.57, p = 0.0046). This effect disappeared in the subgroup of trials judged at low risk of bias (SMD = 0.02, 95% CI: -0.08 to 0.11). For the outcome total cholesterol SMD was -0.06, 95% CI: -0.13 to 0.00, with no heterogeneity (I² = 0%), indicating no effect of the intervention. Conclusion  Lifestyle intervention resulted in only a modest effect on systolic blood pressure and no effect on total cholesterol after 24 months. Further lifestyle trials should consider the challenge of maintaining larger long-term benefits to ensure impact on cardiovascular outcomes.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2625
Author(s):  
Chiara Garonzi ◽  
Gun Forsander ◽  
Claudio Maffeis

Nutrition therapy is a cornerstone of type 1 diabetes (T1D) management. Glycemic control is affected by diet composition, which can contribute to the development of diabetes complications. However, the specific role of macronutrients is still debated, particularly fat intake. This review aims at assessing the relationship between fat intake and glycemic control, cardiovascular risk factors, inflammation, and microbiota, in children and adolescents with T1D. High fat meals are followed by delayed and prolonged hyperglycemia and higher glycated hemoglobin A1c levels have been frequently reported in individuals with T1D consuming high amounts of fat. High fat intake has also been associated with increased cardiovascular risk, which is higher in people with diabetes than in healthy subjects. Finally, high fat meals lead to postprandial pro-inflammatory responses through different mechanisms, including gut microbiota modifications. Different fatty acids were proposed to have a specific role in metabolic regulation, however, further investigation is still necessary. In conclusion, available evidence suggests that a high fat intake should be avoided by children and adolescents with T1D, who should be encouraged to adhere to a healthy and balanced diet, as suggested by ISPAD and ADA recommendations. This nutritional choice might be beneficial for reducing cardiovascular risk and inflammation.


1985 ◽  
Vol 74 (s318) ◽  
pp. 5-6 ◽  
Author(s):  
Hans K. Åkerblom ◽  
Jorma Viikari ◽  
Kauko Kouvalainen

2020 ◽  
Vol 47 (2) ◽  
pp. 68-73
Author(s):  
A.A. Akinbodewa ◽  
O.A. Adejumo ◽  
A. Ogunleye ◽  
T.T. Oluwafemi ◽  
O.A. Lamidi

Background: New evidences reveal significant association of cardiovascular risk factors to development of chronic kidney disease among children and adolescents but there is paucity of data from Africa. Objectives: We examined the association of cardiovascular risk factors to renal dysfunction among Nigerian pediatric subjects. Materials and method: This was a prospective, cross-sectional study of pediatrics aged 2 to 17 years. Blood pressure, body mass index, serum lipids and creatinine were determined. Their glomerular filtration rate was calculated using the revised Schwartz equation. Data was analyzed with SPSS 20. Test of association was by Chi square at P <0.05. Results: We studied 114 children and adolescents. There were 55 (48.2%) males and 59 (51.8%) females with mean age of 8.99±4.26 years. There were 68 (53.5%) children and 53 adolescents (46.5%). Four (3.5%) subjects had proteinuria ≥1+. Renal dysfunction (eGFR <60ml/ min/1.73m2) was found among 9 (7.9%) participants. Renal dysfunction was higher among children than adolescents (13.1% v 1.9%) (p = 0.027). The presence and clustering of risk factors were higher among subjects with renal dysfunction (p value 0.466, 95% CI 0.19-28.3). Low HDL-c (44.4%), prehypertension(22.2%) and overweight (22.2%) were the most prevalent risk factors among those with renal dysfunction. Only age demonstrated relationship to renal dysfunction in terms of mean difference (p value 0.007, 95% CI, 1.125-6.818). Conclusions: The prevalence and clustering of cardiovascular risk factors is higher among children with renal dysfunction. Age showed association  to renal dysfunction. Dyslipidemia and high body mass have propensity to influence the development of pediatric CKD. Keywords: Cardiovascular risk factors, renal dysfunction, association, pediatrics, Nigeria, Africa.


2010 ◽  
Vol 163 (5) ◽  
pp. 735-745 ◽  
Author(s):  
D Hofsø ◽  
N Nordstrand ◽  
L K Johnson ◽  
T I Karlsen ◽  
H Hager ◽  
...  

ObjectiveWeight reduction improves several obesity-related health conditions. We aimed to compare the effect of bariatric surgery and comprehensive lifestyle intervention on type 2 diabetes and obesity-related cardiovascular risk factors.DesignOne-year controlled clinical trial (ClinicalTrials.gov identifier NCT00273104).MethodsMorbidly obese subjects (19–66 years, mean (s.d.) body mass index 45.1 kg/m2(5.6), 103 women) were treated with either Roux-en-Y gastric bypass surgery (n=80) or intensive lifestyle intervention at a rehabilitation centre (n=66). The dropout rate within both groups was 5%.ResultsAmong the 76 completers in the surgery group and the 63 completers in the lifestyle group, mean (s.d.) 1-year weight loss was 30% (8) and 8% (9) respectively. Beneficial effects on glucose metabolism, blood pressure, lipids and low-grade inflammation were observed in both groups. Remission rates of type 2 diabetes and hypertension were significantly higher in the surgery group than the lifestyle intervention group; 70 vs 33%,P=0.027, and 49 vs 23%,P=0.016. The improvements in glycaemic control and blood pressure were mediated by weight reduction. The surgery group experienced a significantly greater reduction in the prevalence of metabolic syndrome, albuminuria and electrocardiographic left ventricular hypertrophy than the lifestyle group. Gastrointestinal symptoms and symptomatic postprandial hypoglycaemia developed more frequently after gastric bypass surgery than after lifestyle intervention. There were no deaths.ConclusionsType 2 diabetes and obesity-related cardiovascular risk factors were improved after both treatment strategies. However, the improvements were greatest in those patients treated with gastric bypass surgery.


Nutrition ◽  
2013 ◽  
Vol 29 (5) ◽  
pp. 744-751 ◽  
Author(s):  
Vajihe Izadi ◽  
Roya Kelishadi ◽  
Mostafa Qorbani ◽  
Mohammad EsmaeilMotlagh ◽  
Mahnaz Taslimi ◽  
...  

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