scholarly journals Nutrition, metabolic syndrome, and obesity: Guidelines for the care of people with spina bifida

2020 ◽  
Vol 13 (4) ◽  
pp. 637-653
Author(s):  
Amy C. McPherson ◽  
Lorry Chen ◽  
Joseph O’Neil ◽  
Kerri A. Vanderbom

Nutritional challenges and a lack of activity can lead to health problems across the lifespan for people with spina bifida. Children and adults with spina bifida are also at greater risk of being classified as overweight or obese compared to their peers without the condition. Therefore, early recognition of nutrition problems, weight management counseling, and timely referrals for evaluation and management of diet and activity can help those with spina bifida and their families achieve a healthy lifestyle. This article details the development of the Nutrition, Metabolic Syndrome and Obesity Guidelines, which are part of the 2018 Spina Bifida Association’s Fourth Edition of the Guidelines for the Care of People with Spina Bifida. It discusses the identification and management of poor nutrition and prevention of obesity for children, adolescents, and adults with spina bifida and highlights areas requiring further research.

2020 ◽  
Vol 13 (4) ◽  
pp. 557-563
Author(s):  
Nourah Almutlaq ◽  
Joseph O’Neil ◽  
John S. Fuqua

Children with spina bifida are at greater risk of developing central precocious puberty (CPP) compared to others. Therefore, early recognition and timely referral for further evaluation by a pediatric endocrinologist allows appropriate management that reduces the impact of CPP. This article discusses the diagnosis and management of CPP in children with spina bifida. This guideline was developed for SB Transition Healthcare Guidelines from the 2018 Spina Bifida Association’s Fourth Edition of the Guidelines for the Care of People with Spina Bifida.


Author(s):  
Judith K. Ockene ◽  
Lori Pbert ◽  
Sybil Crawford ◽  
Christine F. Frisard ◽  
Jyothi A. Pendharkar ◽  
...  

ABSTRACT BACKGROUND Given the rising rates of obesity there is a pressing need for medical schools to better prepare students for intervening with patients who have overweight or obesity and for prevention efforts. OBJECTIVE To assess the effect of a multi-modal weight management curriculum on counseling skills for health behavior change. DESIGN A pair-matched, group-randomized controlled trial (2015-2020) included students enrolled in eight U.S. medical schools randomized to receive either multi-modal weight management education (MME) or traditional weight management education (TE). SETTING/PARTICIPANTS Students from the class of 2020 (N=1305) were asked to participate in an objective structured clinical examination (OSCE) focused on weight management counseling and complete pre and post surveys. A total of 70.1% of eligible students (N=915) completed the OSCE and 69.3% (N=904) completed both surveys. INTERVENTIONS: The MME implemented over three years included a web-based course, a role-play classroom exercise, a web-patient encounter with feedback, and an enhanced clerkship experience with preceptors trained in weight management counseling (WMC). Counseling focused on the 5As (Ask, Advise, Assess, Assist, Arrange) and patient-centeredness. MEASUREMENTS The outcome was student 5As WMC skills assessed using an objective measure, an OSCE, scored using a behavior checklist, and a subjective measure, student self-reported skills for performing the 5As. RESULTS Among MME students who completed two of three WMC components compared to those who completed none, exposure was significantly associated with higher OSCE scores and self-reported 5A skills. LIMITATIONS Variability in medical schools requiring participation in the WMC curriculum. CONCLUSIONS This trial revealed that medical students struggle with delivering weight management counseling to their patients who have overweight or obesity. Medical schools, though restrained in adding curricula, should incorporate should incorporate multiple WMC curricula components early in medical student education to provide knowledge and build confidence for supporting patients in developing individualized plans for weight management. NIH Trial Registry Number R01-194787


2021 ◽  
Author(s):  
Sowmya Ramesh ◽  
Ransi Ann Abraham ◽  
Avina Sarna ◽  
Harshpal S Sachdev ◽  
Nizamuddin Khan ◽  
...  

Abstract Background: In India, the prevalence of overweight among adolescents is on the rise, setting the stage for an increase in metabolic syndrome (MS). This paper presents the national prevalence of MS in adolescents in India. Methods: A nationally representative data of adolescents (10–19 years) from the Comprehensive National Nutrition Survey was used. MS was defined based on the NCEP–ATP III criteria for adolescents. Bivariate analysis was used to report socio-demographic differentials in prevalence and to assess interstate variability. Multivariate logistic regression model was constructed to measure the association between socio-demographic characteristics and prevalence of MS. Census data from 2011 was projected to 2017 to calculate burden.Results: The prevalence of MS was 5.2% among adolescents. 11.9%, 15.4%, 26.0%, 31.9% and 3.7% had central obesity, high blood pressure, hypertriglyceridemia, low HDL-cholesterol and high fasting glucose, respectively. The prevalence was higher among males (5.7% vs. 4.7%, adjusted odds ratio (AOR): 1.3, 95% confidence interval [CI]: 1.0, 1.6), those residing in urban areas (7.9% vs 4.2%, AOR: 1.4, 95% CI: 1.1, 1.8), and from wealthier households as compared to their counterparts (8.3% vs. 2.4%, AOR: 3.4, 95% CI: 2.1, 5.5). There was wide interstate variability in the prevalence of MS (0.5% – 16.5%). In 2017, 14.2 million adolescents had MS in India.Conclusions: The prevalence of MS among adolescents in India is low and clustered in urban areas and richer households. Early prevention interventions promoting a healthy lifestyle, especially in high prevalence areas, are needed to keep MS from becoming a public health issue.


2018 ◽  
Author(s):  

Significantly revised and updated, the fourth edition of this popular AAP policy manual helps you identify, prevent, and treat pediatric environmental health problems. https://shop.aap.org/pediatric-environmental-health-4th-edition-paperback/


2018 ◽  
Vol 55 (5) ◽  
pp. e139-e145 ◽  
Author(s):  
Alan C. Geller ◽  
Judith K. Ockene ◽  
Mukti Kulkarni ◽  
Linda C. Churchill ◽  
Christine F. Frisard ◽  
...  

Author(s):  
Aneeza Tausesf ◽  
Sara Hayee

Eating disorders are multifaceted mental health problems which require medical treatments and counseling from a psychological expert.In extreme condition,these eating disorders can cause serious health problems and may be lethal if these are not diagnosed and treated timely.Eating Disorder Hope organization has conducted a survey which revealed thatalmost 40% of teen age girls were suffering from at least one kind of eating disorder while91% of young females do dieting to reduce their weight. It has been estimated that about one million males and ten million females suffer from various types of eating disorders.  Bulimia nervosa is one of the eating disorders. It oftens develops in teenage or early adulthood.It is common in women than men. In bulimia nervosa, a person usually eats a lot in a short period of time. It seems that the personcannot control himself fromeating food. It happens until they are painfully full and then they will purge to end their discomfort and to compensate their calories. They will purge by forced vomitinglaxatives,diuretics or excessive exercise.Frequent self-induced vomiting can contribute to inflammation of parotidgland and can result in hand calluses. It is more common in families appearing in generations.There are many risk factors for this disease like being overweight/obesity, socio-cultural pressures to have a well tonned body, psychological impacts resulting in stress and poor self-esteem. Dieting has become a part of our culture. There are manysymptoms of bulimia. For example, patients live in a fear of gaining weight, they go through the repeated episodes of abnormal eating large amounts of food in single sitting. There is a feeling which develops in patients that they cannot control what they eat and what type of food they eat, and after bingering they are forcing themselves to vomit and do more exercise to stop weight gain. If we leave bulimia untreated it will cause kidney problems, irregular heart rhythms, digestive issues and dental problems etc. In time treatment and diagnosis of bulimia helps the person to recover well and quick and the person can get rid of this disorder completely otherwise it can be life threatening. A person experiences bulimia to manage the emotional pain he is undergoing but it only worsens the condition and the response may be to ramp up obsessive thoughts and compulsive behaviors. Nearly half of bulimia patients have a co-occuring mood disorder and more than half of bulimia patients have co-occuring anxiety disorders. Self-harm is a common condition affecting 34% of those with bulimia. Recent studies on bulimia show that in 10-15% of male members of our society who are living with this disorder, risk of suicide has increased. Statistics show that relapse of this disorder isvery common.Relapse is occurring in about30-50% of the cases, and it isleading to common cause of death in suicide.For treatment of bulimia nervosa, you may need to go for several types. Bulimia can be reduced by taking anti-depressants or psychotherapy, but using both in combination is more fruitful to overcome this disorder. Psychotherapy is very important for patients, in which the person goes to the psychiatrist to discuss the issues related to bulimia. Educating the patient on nutrition also helps in this regard. Anutritionist can prescribe the food by which a person will feel the cravings for food to a lesser extent. In severe conditions,the patient can be admitted to a hospital because sometimes there is a need fortreatment in a hospital. In many cases it is not possible to eradicate it completely.But before the situation goes wrong, we can guide a person to lead a healthier life with the help of professionally used treatments. Since we are living in an era where everyone is busy, it is important to guide and educate the children about a healthy lifestyle. There is a need to give them confidence about their physical appearance, no matter what their weight, size and shape is. Enjoyable family meals should be arranged on daily basis or regularly. Talks on physical appearances, body weight and dieting should be discouraged at home. Exercise, walk, activities like sports and swimming can help young generation to adopt a healthy lifestyle and streamline their daily life. If you observe that someone in your friends or relatives is having issues related to food which is indicating thathe or she can possibly has an eating disorder, you should talk to the person supportively and discuss the issue and help them in any way you can before the situation gets worse.


2021 ◽  
Vol 12 ◽  
Author(s):  
Raluca Sfetcu ◽  
Daciana Toma ◽  
Catalina Tudose ◽  
Cristian Vladescu

The mental health of the elderly is a matter of increased concern in the context of an aging population since currently only a small fraction of this population is receiving adequate care. The provision of treatment in primary care by the General Practitioners (GPs) has been proposed for over a decade as a potential solution, as services offered by GPs are more accessible, less susceptible to stigma, and have a more comprehensive view of the other health care problems that the elderly might suffer from. In this study, we explored the perception of Romanian GPs regarding their practice and roles in caring for the mental health of the elderly as well as the willingness to increase their future involvement in the management of dementia and other mental health problems. Data was collected via an online questionnaire structured on four dimensions: (1) GPs' sociodemographic profile and practice characteristics, (2) GPs assessment of the services available for elderly with mental health problems, (3) GPs current involvement in mental health care for different categories of problems, and (4) factors that might influence the future involvement of GPs in providing care for elderly with mental health problems. The survey was sent via the member mailing lists of the National Society for Family Medicine. Results show that GPs are currently limited by prescribing possibilities, available resources and knowledge in the area, but they are willing to expand their role in the areas of early recognition and prevention of mental health problems as well as providing disease management and collaborative care. An improved communication with mental health care professionals, a better access to resources and having more financial incentives are the three most important categories for GPs to increase their involvement. In conclusion, increasing the access to personal and professional resources and setting up functional communication channels with specialized mental health care could motivate GPs to provide timely mental health support to elderly patients.


2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
Author(s):  
Liane Rabinowich ◽  
Oren Shibolet

Nonalcoholic fatty liver disease (NAFLD) is a leading cause of liver disease in developed countries. Its frequency is increasing in the general population mostly due to the widespread occurrence of obesity and the metabolic syndrome. Although drugs and dietary supplements are viewed as a major cause of acute liver injury, drug induced steatosis and steatohepatitis are considered a rare form of drug induced liver injury (DILI). The complex mechanism leading to hepatic steatosis caused by commonly used drugs such as amiodarone, methotrexate, tamoxifen, valproic acid, glucocorticoids, and others is not fully understood. It relates not only to induction of the metabolic syndrome by some drugs but also to their impact on important molecular pathways including increased hepatocytes lipogenesis, decreased secretion of fatty acids, and interruption of mitochondrialβ-oxidation as well as altered expression of genes responsible for drug metabolism. Better familiarity with this type of liver injury is important for early recognition of drug hepatotoxicity and crucial for preventing severe forms of liver injury and cirrhosis. Moreover, understanding the mechanisms leading to drug induced hepatic steatosis may provide much needed clues to the mechanism and potential prevention of the more common form of metabolic steatohepatitis.


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