P63 Do paediatricians recognise childhood obesity?

AimThe obesity epidemic in England is growing, with 22% of 4 and 5 year olds and 34% of 10 and 11 year olds being overweight or obese.1 With obesity being linked to several different illnesses including type 2 diabetes and hypertension, it is vital that clinicians are recognising obesity among children as early as possible.This study aims to:Carry out an audit of identification of obesity in paediatric outpatients to determine whether paediatricians are effectively identifying overweight and obese children, and whether practice conforms to standards in medical guidelines.Explore the barriers to discussing overweight and obesity with parents.Carry out a prescription audit and compare against current medical guidelines.2MethodA retrospective review of all new medical patients seen during a one-week period in July was used to determine their weight status and whether they had correctly been identified by clinicians. A short questionnaire was distributed to all clinics at the chosen hospital during a one-week period in October to determine reasons why clinicians may not choose to discuss obesity with patients and their families. A prescription audit was carried out examining the drug cards of all new overweight and obese patients admitted to wards in the chosen hospital to determine if drug doses had been correctly adjusted for weight.Results21% (21) patients in the retrospective audit were classified as either overweight or obese. 28.6% of 4 and 5-year olds were found to be either overweight or obese and 14.3% of 10 and 11-year olds. Only 3 of the 21 overweight or obese patients had been recognised as overweight or obese by clinicians in their notes. The questionnaire found that the most common reasons for not discussing overweight and obesity with patients and their families was concerns about maintaining doctor/patient and doctor/parent relationships. Other reasons given were that there was not enough time in clinic appointments or that the family was already aware. Four overweight or obese patients had been prescribed drugs based on their actual weight rather than ideal weight and therefore had received an overdose. All doses for these patients were adjusted accordingly and re-prescribed in line with trust guidelines.ConclusionsThe results of our study indicate that there is need for regular height and weight checks for all paediatric patients to ensure correct identification and management of overweight and obese children. Ways of doing this may involve more regular height measurements and providing guidelines for medical professionals in how to breech the topic of weight with patients and carers. The results of our pharmacy audit indicate that some overweight and obese children are being prescribed inappropriate doses of medication with clearly shows that there is need for more monitoring of prescribing practices in overweight and obese patients.ReferencesPublic Health England. 2017. Health matters: obesity and the food environment.Trust guidelines. 2017. Drug adjustments in obese patients.

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The effect of body mass index on blood pressure in adults with hypertension

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20205542 ◽

2020 ◽

Vol 10 (1) ◽

pp. 77

Author(s):

Tushar Balchand Chudiwal ◽

Anil Gulingayya Nanjannavar

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Body Weight ◽

Body Mass ◽

Weight Status ◽

Randomized Study ◽

Normal Weight ◽

Overweight And Obesity ◽

Obese Patients ◽

Hypertensive Patients

Background: We investigated the association of body mass index (BMI) measurements in adult hypertensive patients with normal weight and overweight including obesity.Methods: This was a randomized study performed in Udaipur, India, on 200 hypertensive patients aged (32-90) years. Patients were divided according to their body weight (normal weight vs overweight and obesity) into two groups. Weight, height and BMI were measured to estimate the various categories of bodyweight.Results: We found significant relations between body weight and blood pressure. Patients with normal weight had a normal blood pressure. However, a significant increase in blood pressure was observed in patients with overweight and obesity.Conclusions: BMI is related with weight status in hypertensive overweight / obese patients.

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Evolution of the Thyroid Hormones and Thyreostimulin in Obese Children

Revista de Chimie ◽

10.37358/rc.19.10.7608 ◽

2019 ◽

Vol 70 (10) ◽

pp. 3618-3621

Author(s):

Lavinia Ochiana ◽

Emiliana Teodora Dragomir Ananie ◽

Ioana Anca Badarau ◽

Serban Papacocea ◽

Mihnea Costin Manea ◽

...

Keyword(s):

Thyroid Function ◽

Weight Status ◽

Epidemiological Data ◽

Overweight And Obesity ◽

School Age Children ◽

Overweight Children ◽

Obese Children ◽

Study Objective ◽

Metabolic Comorbidities

The study objective is the correlation of thyroid function to the weight status in a study group made up of schoolchildren in Galati County. Six of ten overweight children before puberty will became obese during adulthood. PREDATORR study published in May 2014, placed our country in the top among overweight and obesity European incidence, showing a 34.7% prevalence of overweight and 31.9% obesity in subjects in the age group 20-79 years. Unfortunately the study did not offer epidemiological data regarding children population. The data obtained allow the characterization of the thyroid function in relation to weight status in school age children, in a county both in urban and rural area, taking in account that there are fewer studies in rural in this moment. It brings further information on thyroid function and pathology in pediatric obesity in relation to metabolic comorbidities. We identified an increased fT3 and TSH in obese children, sustaining the association between dyslipidemia, thyroid function, anxiety and depression, as long as the data obtained adult are still controversial.

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Barriers to Behavior Change in Parents With Overweight or Obese Children: A Qualitative Interview Study

Frontiers in Psychology ◽

10.3389/fpsyg.2021.631678 ◽

2021 ◽

Vol 12 ◽

Author(s):

Katrin Ziser ◽

Stefanie Decker ◽

Felicitas Stuber ◽

Anne Herschbach ◽

Katrin Elisabeth Giel ◽

...

Keyword(s):

Transtheoretical Model ◽

Weight Status ◽

Overweight And Obesity ◽

Care Utilization ◽

Obese Children ◽

Barriers To Change ◽

Qualitative Interview Study ◽

Hands On ◽

Problem Awareness ◽

Specific Barriers

Overweight and obesity among children and adolescents are global problems of our time. Due to their authority and role modeling, parents play an essential part in the efficacy of prevention and intervention programs. This study assessed the barriers that parents of overweight/obese children face in preventive and interventional health care utilization. Sixteen parents were qualitatively interviewed. A content analysis was performed, and barriers to change were allocated to their stage of change according to the transtheoretical model. Among the main barriers is the underestimation of health risks caused by overweight/obesity in association with diminished problem awareness. Parents seem not necessarily in need of theoretical knowledge for prevention and interventions. They do however need support in evaluating the weight status of their child and the knowledge of whom to turn to for help as well as specific and hands-on possibilities for change. The results extend past studies by adding specific barriers to change that parents commonly experience. Possibilities to address these barriers, e.g., through trainings at the pediatric practice or adoption of conversation techniques, are discussed. Future studies might identify subgroups experiencing specific barriers and thus be able to address these in an individualized way.

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Beverage Intake and Its Effect on Body Weight Status among WIC Preschool-Age Children

Journal of Obesity ◽

10.1155/2019/3032457 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Andrea Charvet ◽

Fatma G. Huffman

Keyword(s):

Body Weight ◽

Water Intake ◽

Low Income ◽

Weight Status ◽

Fruit Juice ◽

Overweight And Obesity ◽

Preschool Age ◽

Obese Children ◽

Body Weight Status ◽

Preschool Age Children

Given the prevalence and consequences of childhood obesity, efforts are being made to identify risk factors and design evidence-based interventions to reduce its impact. Food and beverage consumption habits are established early in life, making preschool-age children an important group to focus on. This cross-sectional study explored beverage intake and its association with body weight status among low-income preschool-age children enrolled in the Special Supplementation Nutrition Program for Women, Infants, and Children (WIC). Authorized representatives for children between the ages of 3 and 4.9 years were interviewed at WIC clinics in Broward County, Florida. Anthropometric data were collected from the WIC data system. The intake of sugar-sweetened beverages (SSB), particularly fruit drinks, was significantly higher in overweight/obese children when compared with their under/normal weight counterparts. Independent of body weight status, the preschool-age children were consuming on average over twice as much as the recommended intake of 100% fruit juice per day for that age group. Close to 80% of the overweight/obese children consumed low-fat or fat-free milk most often than any other type of milk. The intake of SSB was positively correlated with both the intakes of 100% fruit juice and milk, and negatively correlated with the intake of water. When body weight status, race/ethnicity, and intake of other beverages were held constant, SSB intake was positively associated with milk intake and negatively associated with water intake. Results from this study support the need to encourage water intake and discourage SSB intake in an effort to reduce the risk for overweight and obesity in WIC-participating preschool-age children. Emphasizing the need to follow the recommendation to limit 100% fruit juice intake to 4 to 6 oz. per day is important when counseling families with young children. Efforts to increase awareness of the health consequences associated with consuming high-fat milk should continue.

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P20 Evaluation of analgesic doses prescribed postoperatively for overweight and obese children

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-nppg.29 ◽

2020 ◽

Vol 105 (9) ◽

pp. e16-e17

Author(s):

Nicola Husain ◽

Anushka Wadwa ◽

Nanna Christiansen

Keyword(s):

Body Weight ◽

Body Mass ◽

Early Warning ◽

List Type ◽

Obese Patients ◽

Overweight Children ◽

Obese Children ◽

Children's Hospital ◽

Pain Scores ◽

Early Warning Scores

AimIn England, 17% of children aged 2–15 are considered obese and a further 13% overweight.1 Physiological changes associated with obesity affect pharmacokinetic and pharmacodynamic parameters which may necessitate paediatric drug dose alteration although few guidelines exist to support this in clinical practice. This study aimed to:determine the proportion of patients at a large paediatric hospital prescribed analgesics postoperatively who are obese or overweightevaluate how analgesics are currently prescribed for these overweight and obese patientsdetermine whether doses are altered according to published recommendationsdetermine whether clinical outcomes differ for overweight or obese children compared to non-overweight childrenMethodPostoperative paediatric inpatients aged 2–15 prescribed paracetamol, ibuprofen or morphine (or combination thereof) were included in the six-week prospective study. Demographic (age, weight, height, gender), prescription (drug name, dose, route, frequency) and clinical (surgical specialty, pain scores, paediatric early warning scores) information was collected from medical notes and drug charts. Patients with significant organ impairment or requiring intensive care were excluded.Body-mass-index centile (BMI-C) was calculated for each child using a validated web-based calculator and used to classify patients as non-overweight (BMI-C <91), overweight (BMI-C ≥91 and <98) or obese (BMI-C ≥98). Prescribed paracetamol and morphine doses were evaluated against patients’ total body weight (TBW) and ideal body weight (IBW) and ibuprofen doses were evaluated against patients’ TBW and lean body mass (LBM)2 according to published dosing adjustment recommendations2 3 and compared against formulary dosing standards.4 Clinical outcome data was used to evaluate pain control and clinical status.ResultsBMI-C was calculated for 198 postoperative paediatric inpatients, and of these 142 (72%) were non-overweight, 27 (13.5%) were overweight and 29 (14.5%) were obese. Complete prescription and clinical data were available for 44 non-overweight, 22 overweight and 23 obese patients who were subjected to further analysis. Formulary dosing standards were 15 mg/kg for paracetamol, 5 mg/kg for ibuprofen and 0.1–0.2 mg/kg for morphine.[4] Mean postoperative oral paracetamol doses were 15.0 mg/TBW, 18.1 mg/IBW and 20.6 mg/IBW for non-overweight (n=43), overweight (n=22) and obese (n=23) patients respectively. Mean postoperative oral ibuprofen doses were 5.0 mg/TBW, 5.7 mg/LBM and 6.2 mg/LBM for non-overweight (n=37), overweight (n=16) and obese (n=21) patients respectively. Mean postoperative oral morphine doses were 0.14 mg/TBW, 0.17 mg/IBW and 0.18 mg/IBW for non-overweight (n=33), overweight (n=13) and obese (n=16) patients respectively. There was no significant difference in pain scores or paediatric early warning scores at 0-, 4- 12- and 24-hours post-surgery between the three cohorts.ConclusionThe proportion of patients in this study who were overweight or obese aligned with national prevalence data.[1] Children who were overweight or obese received higher doses of paracetamol, ibuprofen and morphine compared to non-overweight children, and doses of paracetamol and ibuprofen were greater than formulary dosing standards. This suggests that doses for obese or overweight children are not adequately adjusted according to IBW or LBM which may result in drug toxicity. Guidance for prescribers is need to aid identification of patients who are overweight or obese and to guide appropriate dose adjustment.ReferencesNatCen Social Research. Health Survey for England 2017: Adult and child overweight and obesity. National Statistics & NHS Digital. https://files.digital.nhs.uk/3F/6971DC/HSE17-Adult-Child-BMI-rep.pdf [accessed 4 April 2019]UK Medicines Information & Neonatal and Paediatric Pharmacists Group. How should medicines be dosed in children who are obese? 2018 https://www.sps.nhs.uk/articles/how-should-medicines-be-dosed-in-children-who-are-obese/ [accessed 20 December 2018]Sydney Children’s Hospital. Drug Dosing for Overweight and Obese Patients. 2013. http://www.schn.health.nsw.gov.au/_policies/pdf/2013-7034.pdf [accessed 15 November 2018]Evelina London Children’s Hospital. Paediatric Formulary. http://cms.ubqo.com/public/d2595446-ce3c-47ff-9dcc-63167d9f4b80 [accessed 26 December 2018].

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Evolution of the Thyroid Hormones and Thyreostimulin in Obese Children

Revista de Chimie ◽

10.37358/rc.19.10.3618 ◽

2019 ◽

Vol 70 (10) ◽

pp. 3618-3621

Keyword(s):

Thyroid Function ◽

Weight Status ◽

Epidemiological Data ◽

Overweight And Obesity ◽

School Age Children ◽

Overweight Children ◽

Obese Children ◽

Study Objective ◽

Anxiety Depression

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POS1309 PREVALENCE AND CORRELATES OF UNDERWEIGHT, OVERWEIGHT AND OBESITY AMONG PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS (JIA): EVIDENCE FROM THE NATIONAL PAEDIATRIC RHEUMATOLOGIC DATABASE (NPRD)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2058 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 936.2-937

Author(s):

F. Milatz ◽

J. Klotsche ◽

M. Niewerth ◽

J. Hörstermann ◽

D. Windschall ◽

...

Keyword(s):

Physical Activity ◽

Juvenile Idiopathic Arthritis ◽

General Population ◽

Children And Adolescents ◽

Treatment Response ◽

Weight Status ◽

Overweight And Obesity ◽

Age Group ◽

Group 3 ◽

Obesity In Children

Background:In patients with JIA, growth impairment and variance in body composition are well-known long-term complications that may be associated with prolonged drug therapy (e.g. glucocorticoids) as well as impaired physical and psychosocial well-being. An increased accumulation of body fat represents a significant risk factor for metabolic abnormalities and a modifiable variable for a number of comorbidities. Recently, evidence has emerged in favour of the potential negative influence of overweight on the course of the disease and treatment response [1].Objectives:The study aimed a) to estimate the prevalence of underweight, overweight and obesity in children and adolescents with JIA compared to the general population, and b) to investigate correlates of patients’ weight status.Methods:A cross-sectional analysis of physicians’ recorded body weights and heights of patients with JIA enrolled in the NPRD in the year 2019 was performed. Underweight (BMI <10th), overweight (BMI >90th) and obesity (BMI >97th) were defined according to age- and sex-specific percentiles used in the German reference system. For comparison with data from the general population [2], sex- and age-matched pairs of 3-17-year-old patients and controls were generated. A multinomial logistic regression analysis was performed to examine the association between weight status and patients’ clinical and self-reported outcomes.Results:In total, data from 6.515 children and adolescents with JIA (age 11.2 ± 4.1 years, disease duration 4.9 ± 3.8 years, 67% girls, 40% persistent oligoarthritis) were included. Of these, 3.334 (age 5.9 ± 2.1 years, 52.5% girls) could be considered for matched-pair analysis. Compared with the general population, patients underweight, overweight and obesity rates were 10.6% (vs. 8.1%), 8.8% (vs. 8.5%) and 6.1% (vs. 5.7%), respectively. No significant sex differences were found in either group. Largest difference in prevalence was registered for underweight, specifically in the age group 3-6 years (12.9% patients vs. 5.9% controls). Similar to the general population, higher rates of overweight were observed in adolescent patients than in affected children (19.1% age group 11-13 vs. 8.4% age group 3-6). While the highest underweight prevalence was registered in patients with RF+ polyarthritis (16%), patients with Enthesitis-related arthritis (22%), psoriatic arthritis (21%) and systemic JIA (20%) showed the highest overweight rates (including obesity). Younger age (OR = 0.51, 95% CI = 0.31-0.83), more frequent physical activity (OR = 0.92, 95% CI = 0.85-0.99) and high parental vocational education (OR = 0.39, 95% CI = 0.18-0.80) were independently associated with a lower likelihood of being overweight/obese.Conclusion:The overall prevalence of underweight, overweight and obesity in children and adolescents with JIA is comparable to that found in the general population. Behavioural health promotion, including regular physical activity, as part of the treatment strategy in JIA should preventively already begin at preschool age and necessarily be made accessible to patients of all educational levels.References:[1]Giani T et al. The influence of overweight and obesity on treatment response in juvenile idiopathic arthritis. Front Pharmacol 2019;10:637.[2]Schienkiewitz A et al. BMI among children and adolescents: prevalences and distribution considering underweight and extreme obesity. Bundesgesundheitsbl 2019;62:1225–1234.Acknowledgements:The National Paediatric Rheumatological Database has been funded by AbbVie, Chugai, Novartis and GSK.Disclosure of Interests:Florian Milatz: None declared, Jens Klotsche: None declared, Martina Niewerth: None declared, Jana Hörstermann: None declared, Daniel Windschall: None declared, Frank Weller-Heinemann Speakers bureau: Pfizer, AbbVie, SOBI, Roche and Novartis., Frank Dressler: None declared, Rainer Berendes: None declared, Johannes-Peter Haas: None declared, Gerd Horneff: None declared, Kirsten Minden Speakers bureau: Pfizer, AbbVie, Consultant of: Novartis

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Assessing the Association Between Nutritional Status, Caries, and Gingivitis in Schoolchildren: A Cross-Sectional Study

Global Pediatric Health ◽

10.1177/2333794x211001237 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110012

Author(s):

Mariane C.F. Barbosa ◽

Caio L.B. Reis ◽

Célia M.C.F. Lopes ◽

Isabela R. Madalena ◽

Erika C. Küchler ◽

...

Keyword(s):

Nutritional Status ◽

International System ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Dietary Habit ◽

Overweight Children ◽

Obese Children ◽

Cross Sectional ◽

Periodontal Index ◽

Community Periodontal Index

Objective. To evaluate if nutritional status is associated with caries and gingivitis in Brazilian schoolchildren. Material and methods. Children of both genders, age ranging from 8 to 11 years old, were included in this study. Caries was diagnosed using ICDAS (International System for Detection and Assessment of Carious Lesions) and gingivitis was diagnosed using the Community Periodontal Index. The nutritional status of each child was defined by BMI Z-score calculation. Data on oral health behavior and dietary habit were collected through parent’s questionnaires. Parametric analyzes were performed to compare the groups. The established alpha was 5%. Results. The sample consisted of 353 schoolchildren: 16 underweight children, 247 eutrophic children, 64 overweight children, and 26 were obese children. Overweight, Obese and Overweight + Obese children presented less cavitated caries lesion than Eutrophic children ( P < .05). Gingivitis was not associated with nutritional status ( P > .05). Conclusion. Caries was associated with overweight and obesity in Brazilian schoolchildren.

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Is overweight/obesity a risk factor for atopic allergic disease in prepubertal children? A case–control study

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0051 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Aysel Vehapoglu ◽

Zeynep Ebru Cakın ◽

Feyza Ustabas Kahraman ◽

Mustafa Atilla Nursoy ◽

Ali Toprak

Keyword(s):

Body Weight ◽

Allergic Disease ◽

Weight Status ◽

Normal Weight ◽

Overweight And Obesity ◽

University Hospital ◽

Healthy Children ◽

Prepubertal Children ◽

Body Weight Status ◽

Increased Risk

Abstract Objectives It is unclear whether body weight status (underweight/normal weight/overweight/obese) is associated with allergic disease. Our objective was to investigate the relationship between body weight status (body mass index; BMI) and atopic allergic disease in prepubertal children, and to compare children with atopic allergic diseases with non atopic healthy children. Methods A prospective cross sectional study of 707 prepubertal children aged 3–10 years was performed; the participants were 278 atopic children with physician-diagnosed allergic disease (allergic rhinitis and asthma) (serum total IgE level >100 kU/l and eosinophilia >4%, or positivity to at least one allergen in skin test) and 429 non atopic healthy age- and sex-matched controls. Data were collected between December 2019 and November 2020 at the Pediatric General and Pediatric Allergy Outpatient Clinics of Bezmialem Vakıf University Hospital. Results Underweight was observed in 11.6% of all participants (10.8% of atopic children, 12.2% of healthy controls), and obesity in 14.9% of all participants (18.0% of atopic children, 12.8% of controls). Obese (OR 1.71; 95% CI: 1.08–2.71, p=0.021), and overweight status (OR 1.62; 95% CI: 1.06–2.50, p=0.026) were associated with an increased risk of atopic allergic disease compared to normal weight in pre-pubertal children. This association did not differ by gender. There was no relationship between underweight status and atopic allergic disease (OR 1.03; 95% CI: 0.63–1.68, p=0.894). Conclusions Overweight and obesity were associated with an increased risk of atopic allergic disease compared to normal weight among middle-income and high-income pre pubertal children living in Istanbul.

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Prevalence and risk factors for overweight and obesity: a cross-sectional countrywide study in Burkina Faso

BMJ Open ◽

10.1136/bmjopen-2019-032953 ◽

2020 ◽

Vol 10 (11) ◽

pp. e032953

Author(s):

Seydou Kaboré ◽

Tieba Millogo ◽

Joseph Kouesyandé Soubeiga ◽

Hermann Lanou ◽

Brice Bicaba ◽

...

Keyword(s):

Burkina Faso ◽

Weight Status ◽

Fasting Blood Glucose ◽

Population Based ◽

Overweight And Obesity ◽

Blood Cholesterol ◽

Public Health Issue ◽

Proportional Odds ◽

Cross Sectional ◽

Current Smoking

ObjectiveThe objective of this study was to determine the prevalence and predictors of overweight and obesity in Burkina Faso using a population-based countrywide sample. We hypothesise that there is a significant burden related to overweight/obesity in Burkina Faso.DesignSecondary analysis of a population-based countrywide cross-sectional study.SettingBurkina Faso, all the 13 regions including both rural and urban residential areas.Participants4800 participants of both sexes, aged between 25 and 64 years.Main outcomesOverweight and obesity using body mass index cut-off levels of the WHO.ResultsThe prevalence of overweight and obesity in Burkina Faso were 13.82% (95% CI: 12.25 to 15.55) and 4.84% (95% CI: 3.99 to 5.86), respectively. Among men, the proportional odds of overweight/obesity increase with urban residency (p<0.001), greater age (p<0.002), marital status different from single (p≤0.007) and decrease with current smoking (p=0.009). Among women, the proportional odds of overweight/obesity increase with urban residency (p<0.001), primary educational level (p=0.01), high total blood cholesterol level (p<0.001) and high fasting blood glucose level (p=0.02), and decrease with current smoking (p<0.001).ConclusionOur study showed that nearly one person out of five in the adult population of Burkina has an abnormal weight status with women being more affected than men. Urban residency is a consistent risk factor in both men and women. Alcohol consumption and education were associated with an increased odds in only women. Overnutrition needs to be recognised as an important public health issue in Burkina Faso and nutrition interventions need to be reshaped to account for it.

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