Childhood obesity in specialist care – searching for a healthy obese child

Valle, Marketta Dalla; Laatikainen, Tiina; Kalliokoski, Tomi; Nykänen, Päivi; Jääskeläinen, Jarmo

doi:10.3109/07853890.2015.1083118

Cited by 15 publications

(15 citation statements)

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“…There were five MHO definition groups that were used in the studies included in the present review with variability in the number of risk factors included in MHO definitions. Half of the included studies (50%) underscored the lack of a universal definition , and highlighted the need for a universal definition of MHO in children. In response to these reports, we included a Delphi process with an international panel of experts to gain consensus on and establish a new, evidence‐based definition of MHO.…”

Section: Discussionmentioning

confidence: 99%

“…To date, there is no complete and comprehensive synthesis of the definitions, risk factors, and cut‐off values that are currently being applied in the MHO literature in children. Moreover, several papers highlighted the lack of a universal definition , and many papers emphasized the need for a universal definition of MHO in children . For these reasons, our purpose was to conduct a scoping review to address two fundamental questions: (i) What definitions have been used for MHO in children?…”

Section: Introductionmentioning

confidence: 99%

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Defining metabolically healthy obesity in children: a scoping review

et al. 2018

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We conducted a scoping review to identify definitions of metabolically healthy obesity (MHO), describe gaps in the literature, and establish a universal definition of MHO in children. We searched electronic databases from January 1980 to June 2017 and grey literature. Experimental, quasi-experimental, or observational studies were eligible for inclusion if they (i) included a definition of MHO that identified risk factors, cut-off values, and the number of criteria used to define MHO, and (ii) classified 2-18 year olds as overweight or obese. Two reviewers independently screened 1,711 papers for relevance and quality; we extracted data from 39 individual reports that met inclusion criteria. Most (31/39; 79%) definitions of MHO included an absence of cardiometabolic risk factors. Heterogeneity across MHO definitions, obesity criteria, and sample sizes/characteristics resulted in variable prevalence estimates (3-80%). Finally, we convened an international panel of 46 experts to complete a 4-round Delphi process to generate a consensus-based definition of MHO. Based on consensus (≥ 80% agreement), our definition of MHO included: high density lipoprotein-cholesterol > 40 mg/dl (or > 1.03 mmol/l), triglycerides ≤ 150 mg/dl (or ≤ 1.7 mmol/l), systolic and diastolic blood pressure ≤ 90th percentile, and a measure of glycemia. This definition of MHO holds potential universal value to enable comparisons between studies and inform clinical decision-making for children with obesity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Defining metabolically healthy obesity in children: a scoping review

et al. 2018

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“…The data for this longitudinal study were derived from the patient records of 654 (54% boys) children aged 2–18 years who were treated for obesity in the paediatric units of Kuopio University Hospital, Mikkeli Central Hospital or North Karelia Central Hospital, the three major hospitals in eastern Finland. The children in this study were included in our previous report on 900 children evaluated for obesity in specialist care between 2005 and 2012 . To be included in the present study, children had to have attended one or more follow‐up visits with a paediatrician during the study period.…”

Section: Methodsmentioning

confidence: 99%

Paediatric obesity treatment had better outcomes when children were younger, well motivated and did not have acanthosis nigricans

et al. 2017

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“…These hospitals are responsible for pediatric secondary and tertiary care in their hospital districts. The participants in this study were included in our first report on children ( n = 900) evaluated for obesity and cardiometabolic profile at the time of the baseline visit in specialist care ( 18 ) and in our second report ( n = 654) on the BMI SDS outcomes of the obesity treatment ( 19 ). The children in the present study had to have one or more follow-up visits with a pediatrician during the study period.…”

Section: Methodsmentioning

confidence: 99%

Girls and Boys Have a Different Cardiometabolic Response to Obesity Treatment

et al. 2018

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Background: Childhood obesity exposes individuals to cardiometabolic disturbances. We analyzed how family-based multidisciplinary obesity treatment influenced children's cardiometabolic health.Materials and methods: In this retrospective, two-year, follow-up study of 654 2- to 18-year-old children treated for obesity in three Finnish pediatric clinics in 2005–2012, blood pressure (BP), metabolic parameters, and the influence of sex, puberty and a change in body mass index standard deviation score (BMI SDS) were analyzed.Results: At baseline, at least one cardiovascular risk factor was present in 474 (80%) cases. Boys presented with more significant changes in cardiometabolic parameters than girls during the treatment. Boys' total cholesterol (TC) improved by 12 months (P = 0.009), and their low-density lipoprotein C (LDL-C) and glycosylated hemoglobin ameliorated by 12 months (P = 0.030 and 0.022, respectively) and 24 months (P = 0.043 and 0.025, respectively). Boys' triglycerides, insulin, homeostasis model assessment for insulin resistance (HOMA-IR) and systolic BP deteriorated at 24 months (P < 0.001, 0.004, 0.002, and 0.037, respectively). In all children, the number of acceptable TC, LDL-C, insulin, and HOMA-IR values increased if BMI SDS reduced 0.25 or more by 12 months.Conclusion: Minor cardiometabolic improvements were found during the obesity treatment. These findings indicate the need to assess treatment methods and focus on prevention.

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Childhood obesity in specialist care – searching for a healthy obese child

Abstract: Most obese children in specialist care have cardiovascular risk factors; this indicates that earlier intervention is needed.

Cited by 15 publications

References 55 publications

Defining metabolically healthy obesity in children: a scoping review

Defining metabolically healthy obesity in children: a scoping review

Paediatric obesity treatment had better outcomes when children were younger, well motivated and did not have acanthosis nigricans

Girls and Boys Have a Different Cardiometabolic Response to Obesity Treatment

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