Effectiveness of lifestyle interventions in child obesity: A systematic review with meta-analysis

Ho, Mandy; Garnett, Sarah P.; Baur, Louise A.; Burrow, T.; Stewart, Laura; Neve, Melinda; Collins, Clare E.

doi:10.1016/j.orcp.2012.08.111

Cited by 101 publications

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“…1,6,26,28 Moreover, our study represents one of the few evidences reported in the literature of the effectiveness of an educational program of lifestyle changes in a large cohort of children in a real life context. 20 Finally, there are some limitations to our study. First, the clinical cohort in this study is not representative of the population of children in general, but is characteristic of children at relative high cardiovascular risk and, therefore, is not generalizable.…”

Section: Discussionmentioning

confidence: 91%

“…Epidemiological reports describe an increase in children BP levels and a rise in prevalence of hypertension, which is largely driven by escalation in childhood obesity with concurrent changes in diet habits, including salt and possibly fructose exposure. 20,21 Although a Dietary Approches to Stop Hypertension (DASH)-type diet, weight loss, and increases in physical activity are being advocated by leading health experts to treat high BP in childhood and adolescence, 15,22 the efficacy of the diet and intervention strategies that maximize such efficacy in real-life settings among youth is yet to be ascertained. 23 .Few studies demonstrated the effect of body weight changes on BP values, 20 and only one randomized study showed the effectiveness of physical exercise in lowering elevated BP in obese hypertensive children.…”

Section: Discussionmentioning

confidence: 99%

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Increased Serum Uric Acid Levels Blunt the Antihypertensive Efficacy of Lifestyle Modifications in Children at Cardiovascular Risk

et al. 2016

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P rimary hypertension is a growing concern in children and adolescents in western countries largely because of its association with the ongoing obesity epidemic. Elevated serum uric acid (SUA) levels are frequently found in children with hypertension and obesity.1 Although primary hypertension in children was initially thought to reflect the underlying presence of subtle renal damage and insulin resistance, recent epidemiological and experimental data support the hypothesis that SUA may play an independent pathogenetic role in the early stages of vascular damage and the subsequent development of hypertension.2 Moreover, hyperuricemia has been associated with increased risk of hypertension development in adults in a large number of studies published to date. [3][4][5] Among participants in the Bogalusa Heart Study, SUA levels measured during childhood and greater changes in SUA from youth to adulthood were significant predictors of adult blood pressure (BP) values.6 Accordingly, recent meta-analyses indicate that high SUA levels entail an increased risk of hypertension incidence 7 with a consistent dose-response relationship, which supports causal disease-exposure association. have consistently been demonstrated to induce significant increases in SUA levels. In this context, SUA is emerging as a potentially modifiable risk factor for the prevention and treatment of hypertension. In fact, a reduction in SUA levels has been shown to prevent the development of hypertension in animal models, 10,11 and preliminary clinical trials indicate a BP-lowering effect of SUA reduction by either xanthine See Editorial Commentary, pp 845-847Abstract-Primary hypertension is a growing concern in children because of the obesity epidemic largely attributable to western lifestyles. Serum uric acid is known to be influenced by dietary habits, correlates with obesity, and could represent a risk factor for hypertension. Preliminary studies in children highlighted uric acid as a potentially modifiable risk factor for the prevention and treatment of hypertension. The effect of lifestyle changes (increase of physical activity and dietary modifications) on blood pressure values, weight status, and serum uric acid levels in a cohort of 248 children referred for cardiovascular risk assessment were evaluated over a mean 1.5-year follow-up. At baseline, 48% of children were obese and 50% showed blood pressure values >90th percentile. At follow-up, a significant improvement in weight class (24% obese; P<0.0001) and blood pressure category (22% >90th percentile; P<0.0001) was found. Systolic blood pressure z-score (P<0.0001), uric acid value (P=0.0056), and puberty at baseline (P=0.0048) were independently associated with higher systolic blood pressure z-score at follow-up, whereas a negative association was observed with body mass index z-score decrease during follow-up (P=0.0033). The risk of hypertension at followup was associated with body mass index (P=0.0025) and systolic blood pressure (P<0.0001) z-score at baseline and inversely related t...

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Increased Serum Uric Acid Levels Blunt the Antihypertensive Efficacy of Lifestyle Modifications in Children at Cardiovascular Risk

et al. 2016

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“…Although pediatric evidence regarding the efficacy of preventive antihypertensive and antiproteinuric treatment strategies in juvenile diabetes is still lacking, ample experience with adult diabetes reinforces the recommendation of aiming at a strict BP control in children with diabetes. (193). In overweight adolescents weight reduction is associated with a decrease in office BP (194,195) and is the primary therapy for obesity-related HTN (1).…”

Section: Blood Pressure Target In Diabetic and Renal Diseasementioning

confidence: 99%

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents

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Agabiti‐Rosei

Cruickshank

et al. 2016

Journal of Hypertension

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“…Ademais, de acordo com a revisão sistemática realizada por Ho et al 28 , estudos de intervenção visando a melhora do estilo de vida em crianças obesas, observaram reduções significantes nos valores de insulina e HOMA IR, corroborando com os nossos achados.…”

Section: Discussionunclassified

Efeitos De Uma Intervenção Com Pedômetro Sobre O Risco Metabólico Em Crianças Obesas

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et al. 2016

Rev Bras Med Esporte

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RESUMO Introdução: Nas últimas décadas, a incidência de obesidade na população pediátrica vem aumentando, juntamente com a inatividade física. A obesidade e a inatividade física são componentes predisponentes para o agravo dos fatores de risco metabólico, sendo de fundamental importância seu tratamento visando melhora da saúde dos jovens. Objetivo: Verificar o efeito de 12 semanas de uma intervenção focada na atividade física sobre os fatores de risco metabólico em crianças obesas. Métodos: A amostra final foi composta por 19 escolares com idade entre oito e 10 anos (10 no grupo pedômetro e nove no grupo controle). A atividade física foi mensurada e orientada por meio do pedômetro Yamax(r) sw 700 (Tóquio, Honchu, Japão). Para comparações intra e entre grupos foi aplicado a ANOVA two way para medidas repetidas com significância estipulada em p < 0,05. Resultados: O número de passos aumentou significativamente somente no grupo pedômetro após as 12 semanas de intervenção (pré 9729,7 ± 2539,8 vs. pós 13151,6 ± 3581,7). Foi observado aumento significativo do peso corporal, da estatura e do IMC no grupo controle. No grupo pedômetro, observou-se aumento significativo apenas na estatura. Com relação aos fatores de risco metabólicos, não foi encontrada mudança significativa no grupo controle, enquanto no grupo pedômetro foi observada diminuição significante nos valores de insulina (pré 12,21 ± 8,53 vs. pós 7,26 ± 4,70 µUI/ml) e HOMA IR (pré 2,76 ± 1,93 vs. pós 1,49 ± 0,93). Conclusão: A presente intervenção com atividade física a partir do estabelecimento de metas utilizando pedômetros reduziu significativamente as concentrações de insulina e o índice de homeostase (HOMA IR) em crianças obesas, independentemente da perda de peso.

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Effectiveness of lifestyle interventions in child obesity: A systematic review with meta-analysis

Cited by 101 publications

References 0 publications

Increased Serum Uric Acid Levels Blunt the Antihypertensive Efficacy of Lifestyle Modifications in Children at Cardiovascular Risk

Increased Serum Uric Acid Levels Blunt the Antihypertensive Efficacy of Lifestyle Modifications in Children at Cardiovascular Risk

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents

Efeitos De Uma Intervenção Com Pedômetro Sobre O Risco Metabólico Em Crianças Obesas

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