Sarcopenic obesity is increasingly found in youth, but its health consequences remain unclear. Therefore, we studied the prevalence of sarcopenia and its association with cardiometabolic risk factors as well as muscular and cardiorespiratory fitness using data from the German Children’s Health InterventionaL Trial (CHILT III) programme. In addition to anthropometric data and blood pressure, muscle and fat mass were determined with bioelectrical impedance analysis. Sarcopenia was classified via muscle-to-fat ratio. A fasting blood sample was taken, muscular fitness was determined using the standing long jump, and cardiorespiratory fitness was determined using bicycle ergometry. Of the 119 obese participants included in the analysis (47.1% female, mean age 12.2 years), 83 (69.7%) had sarcopenia. Affected individuals had higher gamma-glutamyl transferase, higher glutamate pyruvate transaminase, higher high-sensitivity C-reactive protein, higher diastolic blood pressure, and lower muscular and cardiorespiratory fitness (each p < 0.05) compared to participants who were ‘only’ obese. No differences were found in other parameters. In our study, sarcopenic obesity was associated with various disorders in children and adolescents. However, the clinical value must be tested with larger samples and reference populations to develop a unique definition and appropriate methods in terms of identification but also related preventive or therapeutic approaches.
ZusammenfassungZiel dieser Studie war es, zu analysieren, ob und wie Anbieter von Adipositaszentren ihre Programme während des ersten Covid-19-Locksdowns umsetzen oder anpassen konnten und wie dies von den teilnehmenden Familien angenommen wurde. Es wurde ein kombinierter quantitativer und qualitativer Ansatz verwendet. Im Mai 2020 füllten vierzehn von 29 Adipositaszentren in Deutschland Online-Fragebögen aus. Fünfundfünfzig teilnehmende Familien beantworteten einen Familien-Fragebogen. Alle Anbieter nahmen während der Pandemie digitale Anpassungen vor, darunter Beratung per Telefon, E-Mail und Videoanrufen. Trotz der Herausforderungen, insbesondere in Bezug auf die praktische Umsetzung, das Fehlen vertrauter Routinen und der Gruppendynamik, berichteten die Anbieter von positiven Ergebnissen im Hinblick auf die interne Organisation, die Teilnehmenden von positiven Aspekten hinsichtlich Erreichbarkeit und individueller Betreuung. Zwanzig Familien (30, 9%) beobachteten Gewichtsveränderungen bei den teilnehmenden Kindern, darunter 10 mit einer Gewichtszunahme (18,2%; M=5,0±4,0 kg).Die digitale Anpassung von Gewichtsmanagementprogrammen infolge der Covid-19-Einschränkungen war umsetzbar und wurde insbesondere durch größere zeitliche Flexibilität und verbesserte Zugänglichkeit im Wesentlichen positiv aufgenommen. Trotzdem nahm das Gewicht der Kinder während des Lockdowns zu. Um die Wirksamkeit von Gewichtsmanagementprogrammen zu maximieren, empfiehlt sich langfristig eine Kombination aus herkömmlichen Strategien und der gezielten Nutzung digitaler Elemente, z. B. bei individuellen Beratungen.
Background The global prevalence of diabetes is nearly 9%, with an upward trend in type 2 diabetes mellitus (T2DM) and gestational diabetes (GDM). Although evidence shows that vulnerable groups are affected disproportionally, these groups are difficult to reach in terms of preventive measures. Currently, there is no gold standard regarding communication strategies and/or public awareness campaigns. Methods We conducted a scoping review in September 2019. Two reviewers independently screened the results of the electronic literature search in several databases, including Medline, EMBASE, and PsycINFO. Extracted data were charted, categorized, and summarized. Results All of the included articles (n=24) targeted T2DM; none targeted GDM. We identified the following five different vulnerable groups within the identified studies: migrants (n=9), ethnic groups such as African Americans (n=8), people with low socioeconomic status (n=3), older people (n=1), and people in need of care (n=1). Three categories of communication strategies were identified as follows: adapted diabetes prevention programs (n=21), community health workers (n=5), and technical approaches (n=9). Conclusion We found different approaches for preventive interventions for T2DM. Some of these approaches were already adapted to known barriers. Communication strategies should be adapted to barriers and facilitating factors to increase participation and motivation.
BackgroundThere is a significant worldwide increase in type 2 diabetes mellitus and gestational diabetes (T2DM/GDM) linked to a range of associated comorbidities and rising healthcare costs. It has been shown that an increase in physical activity, healthy nutrition, and weight loss may prevent or delay T2DM/GDM manifestation. Despite this, it remains a key challenge to reach various populations, in particular so-called vulnerable groups, mostly with a migration background and/or low socio-economic status.Methods/designWe will conduct a scoping review to identify barriers and facilitating factors in the prevention of T2DM/GDM in vulnerable groups. An electronic literature search will be performed in MEDLINE, EMBASE, PsycINFO, PSYNDEX, Social Science Citation Index, and CINAHL. Two reviewers will independently select studies for inclusion. Extracted data will be charted, categorized, and summarized.DiscussionThe results will be used to inform the National education and communication strategy on diabetes mellitus in Germany. In particular, the results will be discussed in focus groups of experts to develop recommendations for developing preventive measures targeting vulnerable groups.Systematic review registrationPROSPERO does not register scoping reviews.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0919-y) contains supplementary material, which is available to authorized users.
Background The global prevalence of diabetes mellitus is nearly 9%, with an upward trend in type 2 and gestational diabetes mellitus (T2DM/GDM). Evidence shows that vulnerable groups are affected disproportionally. Therefore, there is an increasing need to implement policies to prevent risk factors for T2DM/GDM and to promote a healthy lifestyle. However, up to now, no gold standard in terms of communication strategies and/or public awareness campaigns is known. Methods/design We will conduct a systematic scoping review to evaluate communication strategies in the prevention of T2DM/GDM in vulnerable groups. Two reviewers will independently screen the results of the electronic literature search in PubMed, EMBASE, PsycINFO, PSYNDEX, Social Science Citation Index, and CINAHL. Extracted data will be charted, categorized, and summarized. Discussion The results will be used to inform the National education and communication strategy on diabetes mellitus in Germany. In particular, the results will be discussed in focus groups of experts to develop recommendations for communication strategies. Systematic review registration PROSPERO does not register scoping reviews.
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