Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

Valerio, Giuliana; Maffeis, Claudio; Saggese, Giuseppe; Ambruzzi, Maria Amalia; Balsamo, Antonio; Bellone, Simonetta; Bergamini, Marcello; Bernasconi, Sergio; Bona, Gianni; Calcaterra, Valeria; Canali, Teresa; Caroli, Margherita; Chiarelli, Francesco; Corciulo, Nicola; Crinò, Antonino; Bonito, Procolo Di; Pietrantonio, Violetta Di; Pietro, Mario Di; Sessa, Anna Di; Diamanti, Antonella; Doria, Mattia; Fintini, Danilo; Franceschi, Roberto; Franzese, Adriana; Giussani, Marco; Grugni, Graziano; Iafusco, Dario; Iughetti, Lorenzo; Lamborghini, Adima; Licenziati, Maria Rosaria; Limauro, Raffaele; Maltoni, Giulio; Manco, Melania; Reggiani, Leonardo Marchesini; Marcovecchio, Loredana; Marsciani, Alberto; Giudice, Emanuele Miraglia del; Morandi, Anita; Morino, Giuseppe; Moro, B; Nobili, Valério; Perrone, Laura; Picca, Marina; Pietrobelli, Angelo; Privitera, Francesco; Purromuto, Salvatore; Ragusa, Letizia; Ricotti, Roberta; Santamaria, Francesca; Sartori, Chiara; Stilli, Stefano; Street, Maria Elisabeth; Tanas, Rita; Trifirò, Giuliana; Umano, Giuseppina Rosaria; Vania, Andrea; Verduci, Elvira; Zito, Eugenio

doi:10.1186/s13052-018-0525-6

Cited by 148 publications

(160 citation statements)

References 335 publications

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“…However, in some children, the process is accelerated due to the presence of identifiable cardiovascular risk factors such as dyslipidemia, hypertension, hyperglycemia, and obesity. All these conditions are considered as part of the metabolic syndrome [47], a condition of insulin resistance that predisposes to the development of cardiovascular diseases and type 2 diabetes mellitus. There are several definitions for metabolic syndrome; however, the clinical implication of such diagnosis is the identification of patients who need lifestyle interventions focused on increased physical activity and weight reduction.…”

Section: Vitamin D Deficiency and Cardiovascular Risk Factorsmentioning

confidence: 99%

Vitamin D and Cardiovascular Risk: Which Implications in Children?

Savastio

Pozzi

Tagliaferri

et al. 2020

IJMS

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Vitamin D (25OHD) pleiotropic effects are widely recognized and studied. Recently, vitamin D cardiovascular effects are gaining interest, especially in children, although the studies present conflicting data. Some randomized controlled trials (RCTs) have demonstrated that cardiovascular risk markers, such as lipid parameters, inflammation markers, blood pressure, and arterial stiffness, are unaffected by vitamin D supplementation. By contrast, other studies show that low vitamin D levels are associated with higher risk of cardiovascular disease (CVD) and mortality, and support that increased risk of these diseases occurs primarily in people with vitamin D deficiency. An update on these points in pediatric patients is certainly of interest to focus on possible benefits of its supplementation.

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Section: Vitamin D Deficiency and Cardiovascular Risk Factorsmentioning

confidence: 99%

Vitamin D and Cardiovascular Risk: Which Implications in Children?

Savastio

Pozzi

Tagliaferri

et al. 2020

IJMS

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“…There are now several consensus and guidelines for the management of pediatric and adolescent obesity (13,14). Last year, the pediatric committee of The American Society for Metabolic and Bariatric Surgery published new guidelines, as an update to those published in 2012, and admitted that bariatric and metabolic surgery should be considered earlier in the treatment of obese and extremely obese adolescents with cardiovascular disease, type 2 diabetes or other obesity related complications, while mental health problems, or inferior Tanner stage should not be considered contraindications, but should warrant very close follow-up (15) In this context it is imperative that primary care physicians should identify overweight and obese children so that counseling and treatment can be provided.…”

Section: Introduction/backgroundmentioning

confidence: 99%

Excellent Short- and Medium-term Result of Bariatric Surgery in Adolescence. A Single Center Study

Dobritoiu¹,

Buza²,

Catanescu³

et al. 2019

chr

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RezumatBackground: Obezitatea la copil este o problemă cu care ne confruntăm din ce în ce mai des. Deşi chirurgia metabolică aplicată copiilor a fost iniţial privită cu scepticism, numărul articolelor ştiinţifice care abordează această problemă şi susţin intervenţia cât mai rapidă este deja coniderabil. Cu toate acestea există, încă multe controverse legate de indicaţia de intervenţie chirurgicală şi rezultatele pe termen lung la aceşti pacienţi. Scop: Analizarea rezultatelor chirurgiei bariatrice la un grup de adolescenţi cu obezitate operaţi în spitalul nostru. Metoda: Am analizat retrospectiv datele tuturor pacienţilor adolescenţi cu obezitate care au fost operaţi -gastrectomie longitudinală laparoscopică sau gastric by pass în perioada 2013noiembrie 2019 într-un Centru de Excelenţă în Chirurgia Bariatrică, urmărind prezenţa preoperator a comorbidităţilor legate de obezitate, evoluţia BMI şi a comorbidităţilor la 12 şi 36 luni postoparator. Rezultate: Şaizeci şi patru de pacienţi au fost incluşi în studiu, 62 cu gastrectomie longitudinală (SG) şi doi cu bypass gastric (GBP). Vârsta medie la momentul operator a fost de 15 ani şi 5 luni (SD 18 luni). Indexul BMI mediu înainte de operaţie a fost 39.45 kg/m 2 (SD 6.9) şi a scăzut la 24.92 kg/m 2 şi 22.7kg/m 2 la 12 respectiv 36 de luni de la intervenţie. Nu s-au înregistrat complicaţii majore perioperatorii, consemnând doar un caz de disfagie prelungită, tranzitorie postoperator. Durata medie de spitalizare a fost de 3.2 zile. În primul an de monitorizare postoperatorie s-au înregistrat doar complicaţii minore, ce au putut fi controlate medical: anemie (6/61), deficit de folaţi (5/61), constipaţie (22/61), căderea părului (12/61). Concluzii: Chirurgia bariatrică şi metabolică este sigură şi eficientă în tratamentul obezităţii la adolescent, atunci când este efectuată în centre cu experienţă. AbstractBackground: Childhood obesity is becoming more frequent and the age of diagnosis has decreased. Although initially sceptic about bariatric surgery in children and adolescents the number of papers to advocate earlier bariatric interventions in this age group is now considerable. However, there are still a lot of controversies about bariatric surgery's indications and long-term results in these patients. Aim/Objective: To analyze the outcomes of bariatric surgery in a group of adolescents with obesity operated in our hospital. Methods: We analyzed retrospectively all the consecutive adolescent patients who underwent laparoscopic gastric sleeve or gastric bypass between 2013 and November 2019 in a Bariatric Center of Excellence, tracking the perioperative morbidity, the changes of BMI and comorbidities at 12 and 36 PO months. Results: Sixty-four adolescent patients were included in the study, 62 with sleeve gastrectomy (SG) and two with gastric bypass (GBP). Mean age at operation was 15 years and 5 months (SD 18 months). Mean BMI before operation was 39.45 kg/m 2 (SD 6.9) and decreased to 24.92 kg/m 2 and 22.7kg/m 2 by 12 and 36 months respectively. There were no major pe...

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“…The choice to consider a straightforward, easy to understand approach has proved to be effective, despite the NNT was still high; on the other hand, providing dietary advice based upon the best available evidence is among the duties and responsibilities of primary care pediatricians, hence it doesn't represent a further burden in their practice [23]. This study had some limits, such as the low number of pediatricians involved, the choice of considering only a few determinants (protein and sugar excess) despite the multifaceted aspects of the pathology and the lack of a parallel control group.…”

Section: Discussionmentioning

confidence: 99%

Clinical audit in the pediatric primary care office and overweight prevention in toddlers

Limauro¹,

Gallo²,

Cioffi³

et al. 2020

BMC Pediatr

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Background: Clinical audit is a process by which physicians or other health care professionals perform a regular and systematic review of their clinical practice and amend it, when necessary. An internal audit allows to review the activities carried out by professionals, in order to assess the appropriateness, effectiveness, efficiency and safety of the services provided. Aim of this study was to apply the process of clinical audit to the obesity/overweight care in toddlers. After the correction of the nutritional errors that were considered potentially responsible for the excess weight gain, the effect of the changes of dietary advice on the frequency of overweight/obesity was assessed in a cohort of children aged 24-36 months. Methods: Three Italian primary care pediatricians set up the audit strategy by recognizing the high prevalence of overweight and obesity in the entire cohort of toddlers born in 2005, 2006 and 2007 (Pre-Audit group, age 24-36 months old) under their care. By reviewing their clinical practice, they changed the protocol of weaning and feeding up to 36 months, mainly reducing protein and sugar excess. The change involved the cohorts of toddlers born in the years 2010, 2011 and 2012 (Post-Audit group). Results: Change in the approach of pediatricians to children's diet yielded a reduction of the frequency of overweight/obesity in children between 24 and 36 months of life from 26.3% in the Pre-Audit group to 13.9% in the Post-Audit group (p < 0.0001). Conclusion: Clinical audit revealed high rates of obesity/overweight among toddlers. The practice developed a new strategy for nutritional counseling, which was effective in reducing the frequency of overweight/obesity in young children.

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Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

Cited by 148 publications

References 335 publications

Vitamin D and Cardiovascular Risk: Which Implications in Children?

Vitamin D and Cardiovascular Risk: Which Implications in Children?

Excellent Short- and Medium-term Result of Bariatric Surgery in Adolescence. A Single Center Study

Clinical audit in the pediatric primary care office and overweight prevention in toddlers

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