Prevalence of type 2 diabetes mellitus, metabolic syndrome, and related morbidities in overweight and obese children

Objectives The aim of the study was to determine the prevalence of metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and other comorbidities in overweight and obese children in Malatya, Turkey. Methods Retrospective cross-sectional study. We studied 860 obese and overweight children and adolescents (obese children Body mass index (BMI) >95th percentile, overweight children BMI >85th percentile) aged between 6 and 18 years. The diagnosis of MetS, impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and T2DM were defined according to modified the World Health Organization criteria adapted for children. Other comorbidities were studied. Results Subjects (n=860) consisted of 113 overweight and 747 obese children of whom 434 (50.5%) were girls. MetS was significantly more prevalent in obese than overweight children (43.8 vs. 2.7%, p<0.001), and in pubertal than prepubertal children (41.1 vs. 31.7%, p<0.001). Mean homeostasis model assessment for insulin ratio (HOMA-IR) was 3.6 ± 2.0 in the prepubertal and 4.9 ± 2.4 in pubertal children (p<0.001). All cases underwent oral glucose tolerance test and IGT, IFG, and T2DM were diagnosed in 124 (14.4%), 19 (2.2%), and 32 (3.7%) cases, respectively. Insulin resistance (IR) was present in 606 cases (70.5%). Conclusions Puberty and obesity are important risk factors for MetS, T2DM, and IR. The prevalence of MetS, T2DM, and other morbidities was high in the study cohort. Obese children and adolescents should be carefully screened for T2DM, insulin resistance, hyperinsulinism, dyslipidemia, hypertension, IGT, and IFG. The prevention, early recognition, and treatment of obesity are essential to avoid associated morbidities.

Effects of Exercise in Improving Cardiometabolic Risk Factors in Overweight Children: A Systematic Review and Meta-Analysis

This meta-analysis aims to evaluate the effects of exercise in improving cardiometabolic risk factors in overweight children and adolescents until the adolescent age, which is 18 years. A systemic search was conducted using the electronic databases PubMed/Medline, Cochrane Library, and Google Scholar, from inception to 29 June 2021. All statistical analyses were conducted in Review Manager 5.4.1. All studies meeting the inclusion criteria were selected. A random-effect model was used to pool the studies, and the results are reported in the odds ratio (OR) and corresponding 95% Confidence interval (CI). Twelve randomized control trials were selected for meta-analysis. Significant results were obtained for BMI in children after the interventions (0.38 95% CI 0.14, 0.62; p = 0.002; I2 = 65%). LDL level was also found significantly reduced (0.41 95% CI 0.01, 0.82; p = 0.05; I2 = 83%). Other factors such as HDL level, blood pressure, blood glucose level, body weight, and waist circumference were also analyzed. We found that exercise interventions significantly improved several cardiometabolic risk factors such as BMI, LDL level, BP, and blood glucose level. However, no significant effect on HDL concentration, waist circumference, and body weight were found. Long-term interventions are needed to attain improvement in all cardiometabolic risk factors.

The Role of Water-Based Exercise on Vertical Ground Reaction Forces in Overweight Children: A Pilot Study

The aquatic environment represents an adequate and safe alternative for children with overweight to exercise. However, the magnitude of the vertical ground reaction force (Fz) during these exercises is unknown in this population. Therefore, our study aimed to compare the Fz during the stationary running exercise between the aquatic and land environments in children with overweight or obesity. The study is characterized as a cross-over study. Seven children, two with overweight and five with obesity (4 boys and 3 girls; 9.7 ± 0.8 years), performed two experimental sessions, one on land and another in the aquatic environment. In both conditions, each participant performed 15 repetitions of the stationary running exercise at three different cadences (60, 80, and 100 b min−1) in a randomized order. Their apparent weight was reduced by 72.1 ± 10.4% on average at the xiphoid process depth. The peak Fz, impulse, and loading rate were lower in the aquatic environment than on land (p < 0.001). Peak Fz was also lower at 80 b min−1 compared to 100 b min−1 (p = 0.005) and loading rate was higher at 100 b min−1 compared to 80 b min−1 (p = 0.003) and 60 b min−1 (p < 0.001) in the aquatic environment, whereas impulse was significantly reduced (p < 0.001) with the increasing cadence in both environments. It can be concluded that the aquatic environment reduces all the Fz outcomes investigated during stationary running and that exercise intensity seems to influence all these outcomes in the aquatic environment.

There Is an Inverse Correlation between Basic Motor Skills and Overweight in Schoolchildren Aged 8 to 12

In the last three decades, childhood obesity has become a 21st century epidemic, a product of social development. The purpose of this study was to analyze the repercussions that overweight and obesity have for the basic motor skills of a group of children in primary school, as well as their interrelations. We analyzed a sample of 287 students from Spain, aged between 8 and 12 years. Anthropometric data were taken to determine their Body Mass Index (BMI). A scale of assessment of basic motor skills was used to evaluate their motor skills. The BMI data revealed that 11% of this sample was considered obese, and 26% was overweight. Children showed higher competence in locomotor skills than in object control and turn and rolling skills, for which motor competence levels were lower. Likewise, there was an inverse relationship between BMI and basic motor skills; children with obesity had the lowest levels of motor skills, and there was a significant difference regarding non-obese children (p ≤ 0.05). These results showed that overweight and obese children have lower basic motor skills, which can lead to the abandonment of physical activity and the preference for other activities that reinforce a sedentary lifestyle.

Specifics of functional activity of the immune system, carbohydrate and lipid metabolism in overweight and obese children with biliary dysfunction

Objective — to evaluate functional activity of the immune system, carbohydrate and lipid metabolism in children with biliary dysfunction against the background of overweight and obesity. Materials and methods. At the SI «Institute Gastroenterology of the National Academy of Medical Sciences of Ukraine» observations were performed on 108 children with the mean age 12.5 ± 2.51 years. Based on the results of investigation of motor and evacuator gallbladder (GB) function and body mass index, the pediatric patients were divided into three groups: group I included 52 overweight children with gallbladder hypofunction and obesity; group II consisted of 42 overweight children with normal gallbladder function and obesity; group III (comparison group) included 14 children with normal weight and biliary normokinesia. Investigations included anthropometric measurements and ultrasound imaging of the abdomen. ELISA was used to determine blood serum levels of insulin, interleukin‑6 (IL), IL‑10, tumour necrosis factor‑a (TNF‑a). Results. The following augmentation of the median levels was established when compared with group III: IL‑6 in 2.2 times (p < 0.05) and TNF‑a in 4.5 times (p < 0.05) in patients of group I, levels of IL‑6 in 2.3 times (p < 0.05) and TNF‑a in 4.3 times (p < 0.05) in patients of group II. The IL‑10 level in group I patients was lower in 2.5 times than in group II patients (p < 0.05), and in 4.4 times vs group III patients (p < 0.05). The serum insulin levels in children of groups I and II were in 2.2 times (p < 0.05) and 1.5 times (p < 0.05) lower, and HOMA‑IR index in 2.3 times (p < 0.05) and in 1.8 times (p < 0.05), respectively, in comparison with group III patients. The following blood serum levels vs group III were established: triglycerides (TG) increased in group I in 1.4 times (p < 0.001) and in group II in 1.5 times (p < 0.001); low density lipoproteins (LDL) and very low density lipoproteins (VLDL) were increased both in I and II groups in 1.2 times, (p < 0.01) and 1.5 times, (p < 0.001), respectively. The atherogenic index (AI) raised in 1.6 times (p < 0.001) in group I patients and in 1.5 times (p < 0.05) in group II patients compared to group III, whereas high density lipoprotein (HDL) levels were decreased in the I and II groups in 1.2 times (p < 0.01) in comparison with group III patients. Conclusions. Regardless of the gallbladder functional state in overweight and obese pediatric patients, the abnormalities of the immune system indices have been established and, consequently, carbohydrate metabolism disorders (increased levels of insulin and index HOMA‑IR). The lipid metabolism disturbances have been established in the overweight and obese children with gallbladder hypofunction (significant increase in the levels of TG, LDL, VLDL, AI and decreased HDL levels). Correlation analysis in the groups of overweight and obese children with gallbladder hypofunction showed the presence of significant relationships between biliary sludge and IL‑6, TNF‑a levels, gallbladder volume and insulin and glucose levels, gallbladder hypofunction and levels of total cholesterol, HDL, LDL and as well as between the gallbladder dimensions and atherogenic index.

Vitamin D status and obesity in children from Chile

Background Vitamin D [25(OH)D] is essential for normal bone development and maintenance. Furthermore, its deficiency has been associated with obesity, cardiovascular diseases, insulin resistance, autoimmune diseases, and certain cancers. Objective To determine the incidence of serum 25(OH)D deficiency (<20 ng/ml) among apparently healthy Chilean children (4–14 years old) from three Chilean geographic areas during May–September 2018. Materials and methods Serum 25(OH)D levels were measured by a competitive protein-binding ELISA assay in 1134 children, and correlations between serum 25(OH)D levels, BMI, and geographic area were calculated. Individuals were grouped according to their serum 25-hydroxyvitamin D levels (ng/ml): severe deficiency: <5; moderate deficiency: 5–10.9; mild deficiency: 11–20.9; insufficiency: 21–29.9 and sufficiency: 30–100. Results We found 80.4% of children had serum 25(OH)D deficiency, with 1.7% severe, 24.6% moderate, and 54.1% mild. In the three cities, the percentage of serum 25(OH)D deficit was increased when comparing overweight or obesity with a healthy weight. Additionally, an interaction effect was observed between geographic area, nutritional status, and serum 25(OH)D levels using the factorial ANOVA test (p = 0.038). In Antofagasta, there were more overweight children and also a higher percentage of children with VitD deficiency (<30 ng/ml) compared to Santiago or Concepción. Conclusion This study revealed a high prevalence of serum 25(OH)D deficiency in children between 4 and 14 years old in Chile (80.4%) during May–September 2018. Obese and overweight children had the highest prevalence of serum 25(OH)D deficiency.

A study of occurrence of non-alcoholic steatohepatitis in children with obesity and overweight

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and its increasingprevalence is associated with a concomitant rise in obesity. Anthropometric measurements and non-invasive tests (liver function tests and USG abdomen) help in early recognition of non-alcoholic steatohepatitis (NASH) and reduce consequent morbidity and mortality. Aim: This study aims to study the occurrence of NASH in obese and overweight children and to derive the correlation of NASH with clinical and biochemical parameters in overweight and obese children. Methods: This hospital-based prospective study included children (age?18 years) who met the inclusion criteria. Diagnosis of NASH was based on the USG abdomen. Measurements included anthropometry, ultrasonography, fasting glucose, alanine aminotransferase (ALT), lipid profile and additional parameters of blood pressure, fasting insulin, and homeostatic model assessment of insulin resistance (HOMA-IR). The variables were compared between children with and without NASH. Results: A total of 146 patients (female: 51.4%, male: 48.6%) were enrolled in the study. The most common age group affected was 11–18 years (50.7%) followed by 6–10 years (43.2%) and <5 years (6.2%). The occurrence of NASH in the study group was 63% of obese and overweight children. Mean weight, body mass index (BMI), waist circumference, waist-hip ratio, blood pressure (BP), serum glutamic-pyruvic transaminase (SGPT), fasting insulin level, and HOMA-IR were significantly higher in children with NASH. There was a significant association between SGPT and NASH. Elevated SGPT of 79.3% and 1.9% were observed among the subjects with and without NASH, respectively. Conclusion: Anthropometric indices and biochemical parameters were more elevated in the NASH group showing its direct correlation with hepatic steatosis.

Methodological approach of Sport and Health for Overweight children (SHOW) intervention study

Prevention and treatment of overweight among children have been a global challenge. A better understanding of different interventions to improve overweight children’s health is needed. This paper describes the methodological approach of Sport and Health for Overweight children (SHOW) study, which investigated the effects of a multicomponent intervention on health markers of overweight children. The SHOW study is a non-randomized clinical trial performed during 16 weeks enrolling 72 overweight children aged eight to 12 years in an intervention (IG = 35) and control group (CG = 37). It is a multicomponent intervention program including generalized sport initiation, health education, and weekly communication between parents and researchers. Besides characterizing the participants’, several health outcomes were analyzed in the SHOW study. Primary outcomes were accelerometer based physical activity and anthropometric indicators of overweight and obesity. Secondary outcomes were made up of cardiometabolic, fitness, behavioral, and psychological health indicators. We hypothesize that the SHOW study improves health outcomes and can be replicated in other settings as well as implemented by public policies.

Relationship of Eating Behavior, Knowledge, Attitudes, Physical Activities, and Parent Support with Obesity Events in Adolescents in Padang City

BACKGROUND: A report from the West Sumatra Provincial Health Office in December 2017 showed increase in the percentage of overweight and obese children in the city of Padang. In 2014, overweight children amounted to 4.86% and an increase in 2016 to 6.44%. AIM: This study aimed to determine the most dominant risk factors affecting the incidence of obesity in adolescents in Padang City. MATERIALS AND METHODS: This study was conducted on 484 respondents from 4 (four) schools, namely SMPN 26, SMPIT Adzkia, SMAN 3, and SMA Adabiah Padang in December 2019-February 2020. Data analysis used the Chi-square test and multiple logistic regression tests. RESULTS: The multivariate analysis results showed that adolescents’ eating behavior variable was the most dominant factor affecting adolescents’ incidence of obesity with a significance value of p < 0.05 and Exp (B) 14.11. These results showed that adolescents who behave eat poorly at 14.11 times, have the risk of obesity more than adolescents who eat well. CONCLUSIONS: Adolescent eating behavior variables can predict the incidence of obesity in adolescents together with adolescent physical activity variables, adolescent attitudes, and adolescent knowledge.