Maternal exercise in obese pregnancies effectively reduces IL-6 trans-signaling and might be the underlying mechanism for the amelioration of glucose metabolism at postnatal day 21 independent of body composition.
Increasing physical activity and reduction of sedentary behaviour play important roles in health promotion and prevention of lifestyle-related diseases in children and adolescents. However, the question of how much physical activity is useful for which target group is still a matter of debate. International guidelines (World Health Organization; European Association for the Study of Obesity), which are mainly based on expert opinions, recommend 60 min of physical activity every day. Age- and sex-specific features and regional differences are not taken into account. Therefore, expert consensus recommendations for promoting physical activity of children and adolescents in Germany were developed with special respect to national data, but also with respect to aspects of specific target groups, e.g., children with a lower socio-economic status (SES) or with migration background. They propose 90 min/day of physical activity, or at least 12,000 steps daily. Additionally, lifestyle factors, especially restriction of media consumption, were integrated. The recommendations provide orientation for parents and caregivers, for institutions such as schools and kindergartens as well as for communities and stakeholders.
BackgroundIncreasing rates of overweight have been reported. In Germany, women of childbearing age are especially affected. Those women are at increased risks of several peri- and postnatal complications. The purpose of this study was to carry out Germany’s first study in terms of secular trends of overweight and weight gain during pregnancy related to foetal clinical outcomes (birth weight, Apgar score and umbilical blood pH).MethodsA database maintained by a large regional university hospital in Cologne, Germany was used to evaluate clinical routine data from 1996 to 2012. 11771 women (23.5 ± 5.4 years; 18–48 years), who gave birth to a live singleton child (>2000 gram) were included. Recommended weight gain during pregnancy was based on IOM guidelines: Total weight gain range for underweight (initial BMI < 18.5 kg/m2) is 12.5 - 18 kg/ 28–40 lbs respectively, for normal-weight (initial BMI 18.5 -24.9 kg/m2) is 11.5 - 16 kg/ 25–35 lbs respectively, for overweight (initial BMI 25.0-29.9 kg/m2) is 7–11.5 kg/ 15–25 lbs respectively and for obese (initial BMI ≥ 30.0 kg/m2) is 5–9 kg/ 11–20 lbs respectively.A one-way variance analysis was employed to test for differences in particular factors in various groups. Multiple linear regression analysis was used to model impact factors.ResultsOver the second analysed period (2005–2012), the number of women with high weight gain increased from 33.8% to 42.9% (p <0.001). 54.5% overweight and 57.7% obese women were affected (p <0.001). Women with high weight gain were 54.5% significantly more likely to give birth to an infant ≥ 4000 grams than women with normal (31.7%) or low weight gain (13.8%, p < 0.001). Women with normal weight gain had significantly better foetal outcomes in terms of the Apgar score at 5 min and umbilical cord blood pH.ConclusionThese data confirm an increase in maternal weight gain before and during pregnancy. An excessive weight gain is accompanied by macrosomia, lower Apgar scores and pH-value. Women should therefore be advised about the risks of obesity before and during pregnancy as well as excessive maternal weight gain during pregnancy.
Pregnant women should be given tailored advice/motivation according to prepregnancy body mass index. However, larger studies are necessary to evaluate these factors on pregnant women's physical activity level.
Background: Juvenile overweight is increasing, and effective preventive measures are needed. After years of arbitrarily assigning these measures disregarding socioeconomic and/or cultural differences, it has become necessary to tailor interventions more specific to these target groups. Providing data for such an intervention is the objective of this study. Methods: Influencing variables on children's weight status, motor skills and lifestyle have been analyzed among 997 first graders (53.2% male) involved in the Children's Health InterventionaL Trial (CHILT). Results: Median age was 6.9 years; 7.3% were obese, 8.8% were overweight. Children with low socioeconomic status (SES) were more likely to be obese (p = 0.029). Low SES (p ˂ 0.001), migration background (p = 0.001) and low sports activity levels (p = 0.007) contributed most to an increased consumption of television. Migration background (p = 0.003) and male gender (p < 0.001) were the strongest factors in predicting a greater consumption of computer/video games. Children with higher SES (p = 0.02), lower BMI (p = 0.035), and males (p = 0.001) performed better in motor tests. Conclusion: Children with a low SES and migration background were more likely to exhibit unfavorable health behavior patterns, higher BMI scores, and poorer motor skills. Interventions should integrate motivational and targeting strategies and consider cultural and educational differences to address these vulnerable groups.
Obesity is now a worldwide epidemic. In recent years, different phenotypes of obesity, ranging from metabolically healthy normal weight to metabolically unhealthy obese, were described. Although there is no standardized definition for these phenotypes or for metabolic health, the influence of lifestyle and early-life factors is undisputed. In this context, the ratio of muscle-to-fat tissue seems to play a crucial role. Both adipose tissue and skeletal muscle are highly heterogeneous endocrine organs secreting several hormones, with myokines and adipokines being involved in local autocrine/paracrine interactions and crosstalk with other tissues. Some of these endocrine factors are secreted by both tissues and are, therefore, termed adipo-myokines. High (cardiorespiratory) fitness as a surrogate parameter for an active lifestyle is epidemiologically linked to “better” metabolic health, even in the obese; this may be partly due to the role of adipo-myokines and the crosstalk between adipose and muscle tissue. Therefore, it is essential to consider (cardiovascular) fitness in the definition of metabolically healthy obese/metabolic health and to perform longitudinal studies in this regard. A better understanding of both the (early-life) lifestyle factors and the underlying mechanisms that mediate different phenotypes is necessary for the tailored prevention and personalized treatment of obesity.
Zusammenfassung
Hintergrund
Der Nutzen von k?rperlicher Aktivit?t bzw. einer Reduktion von vermeidbarer Sitzzeit ist im Kindes- und Jugendalter unbestritten.
Methode
Auf Basis einer qualit?tsgesicherten Literaturrecherche wurden die Empfehlungen f?r Deutschland aktualisiert und erweitert. Sie umfassen nun dezidiert das S?uglings-, Kleinkind-, Kindergarten- und Grundschulalter sowie Jugendliche.
Ergebnisse und Schlussfolgerung
Generell gilt, je mehr Bewegung desto h?her der gesundheitliche Benefit. Ab dem Kindergartenalter sollten mindestens 180, ab Grundschulalter mind. 90?min Bewegungszeit pro Tag erreicht werden. Vermeidbare Sitzzeiten, insbesondere Bildschirmmedien, sollen dagegen auf ein Minimum reduziert werden.
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