Metabolic Complications of Childhood Obesity

Weiss, Ram; Kaufman, Francine

doi:10.2337/dc08-s273

Cited by 171 publications

(131 citation statements)

References 79 publications

(52 reference statements)

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“…25,26 In our study, we found a higher mean waist circumference among patients with hepatic steatosis. These data warrant and support the investigation of metabolic syndrome and hepatic steatosis in these children and adolescents.…”

Section: Discussionsupporting

confidence: 55%

“…25,26 In order to test this relationship, Fishbein et al 22 used magnetic resonance imaging to assess 39 obese patients aged 6 to 18 years old, with hepatomegaly and hypertransaminasemia. The authors identified a correlation of hepatic fat fraction with visceral adiposity, but the same was not true with regard to subcutaneous adiposity and degree of obesity.…”

Section: Discussionmentioning

confidence: 99%

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Esteatose hepática em crianças e adolescentes obesos

Duarte¹,

Silva²

2011

J. Pediatr. (Rio J.)

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Objective: To assess the frequency of hepatic steatosis and metabolic syndrome among obese children and adolescents.Method: A descriptive case series was conducted with 77 patients, aged 2 to 13 years and 11 months, who were followed up from February to July 2007. Obesity was defined as body mass index ≥ P 95 adjusted for age and sex. Liver ultrasound was performed to diagnose hepatic steatosis. Metabolic syndrome was defined according to the modified criteria suggested by Cook et al. Results:Hepatic steatosis was diagnosed in 33/77 patients (42.9%), 25/33 (75.8%) with mild steatosis and 8/33 (24.2%) with moderate steatosis. Those aged less than 10 years showed only mild steatosis, and the moderate degree of the disease was restricted to adolescents. Aminotransferase alterations were found in 9.1% (3/33) of patients with hepatic steatosis and in 4.9% (2/41) of those without the disorder. Mean waist circumference was 84.74±2.84 cm for patients with hepatic steatosis and 78.24±1.60 cm for those without the disease (p = 0.04). Metabolic syndrome was diagnosed in 27.3% (21/77) of obese patients, 47.6% (10/21) of them having steatosis, 60% had mild steatosis and 40% had a moderate degree of the disorder. Conclusions:The frequency of hepatic steatosis and metabolic syndrome was high. The association of larger waist circumference with hepatic steatosis highlights the importance of taking this parameter into consideration when investigating obese patients. The histological examination of a liver fragment is considered to be the gold standard method for assessment, but it is not done often in children and adolescents because it is an invasive technique. 6 Therefore, in this population, J Pediatr (Rio J)

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Esteatose hepática em crianças e adolescentes obesos

Duarte¹,

Silva²

2011

J. Pediatr. (Rio J.)

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“…An obesity-related profile of inflammation and adipocyte dysfunction is often found in parallel with impairments in lipid metabolism (21). Elevated FFA are thought to play an important role, since higher circulating fatty acids may induce intramyocellular lipid accumulation, directly inducing IR in skeletal muscle and impairing substrate utilization (22).…”

Section: Metabolism In Child Obesity Interventionmentioning

confidence: 99%

Effect of obesity intervention programs on adipokines, insulin resistance, lipid profile, and low-grade inflammation in 3- to 5-y-old children

et al. 2013

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Background: Childhood obesity can cause the development of cardiovascular risk factors. We assessed the effect of a multidisciplinary intervention program on cardiovascular risk factors and compared this effect with a usual-care program in 3-to 5-y-old overweight or obese children. Methods: Seventy-five children were randomly assigned to a multidisciplinary intervention or a usual-care program. Anthropometry, body composition, and abdominal adipose tissue were assessed at the start and end of a 16-wk program. Concurrently, fasting concentrations of serum lipids, glucose, insulin, HbA1c, leptin, adiponectin, high-sensitive C-reactive protein (hsCRP), tumor necrosis factor (TNF)-α, and interleukin (IL)-6 were determined. results: In both groups, insulin sensitivity improved, demonstrated by decreased insulin concentrations and a decreased HOMA2-IR. In the multidisciplinary intervention group, there was also a decrease of HbA1c and TNF-α. In the usual-care group, an increase in glucose concentrations was found. Comparing both groups, changes over time were not different, besides trends in the decrease in total cholesterol and TNF-α, in favor of the multidisciplinary intervention group. Combining the results of both groups, a correlation was found between the decrease in body fat percentage (BF%), and both HOMA2-IR and triglyceride (TG) concentrations. conclusion: In 3-to 5-y-old children, both obesity intervention programs improved insulin sensitivity, in parallel with a reduced BF%. r ecent data have shown that the prevalence of childhood overweight and obesity in the Netherlands is still increasing (1). Childhood obesity is a risk factor for the development of insulin resistance (IR), dyslipidemia, and hypertension at a later age, together described as metabolic syndrome (MS) (2). MS cannot be diagnosed in children under the age of 10 y (3). However, increased concentrations of the separate components of MS have already been demonstrated in children aged 6-9 y (4).Systemic low-grade inflammation may be an underlying cause of MS, induced by the release of inflammatory cytokines from adipose tissue, and even more so from visceral adipose tissue (5,6). Increased concentrations of tumor necrosis factor (TNF)-α, high-sensitive C-reactive protein (hsCRP), and interleukin (IL)-6 have been found in obese children aged 9-13 y (7,8). The adipose tissue hormone adiponectin has anti-inflammatory properties, demonstrated by the significant inverse correlation with markers of inflammation in obese children (8). Whether these deleterious processes related to obesity are already present in overweight and obesity at a very young age is unknown, and no data on systemic low-grade inflammation are available in very young obese children.Multidisciplinary lifestyle intervention programs for obese children have proven to be successful in reducing weight (9). Recent studies demonstrated that weight loss in obese children aged 6-11 y also reduced low-grade inflammation and IR (4,8). In obese children, 9-13 y old, weight loss over a 1-y p...

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“…Currently, 24% of children ages two to five and 33% of children ages six to 11 are overweight or obese (1), putting them at risk for adolescent and adult obesity and co-morbid disease (2,3). Particularly at risk are Mexican-American children, for whom elevated body mass indices are found in 30% of two to five year olds and in 43% of six to 11 year olds (1).…”

Section: Introductionmentioning

confidence: 99%

Early Childhood Feeding: Assessing Knowledge, Attitude, and Practices of Multi-Ethnic Child-Care Providers

Freedman¹,

Alvarez²

2010

Journal of the American Dietetic Association

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Early childhood is a critical period for shaping and influencing feeding and lifestyle behaviors that have implications regarding future weight and health. With more women in the workforce, families have become reliant on childcare. Thus, the child-feeding relationship has become a shared responsibility between the parent and childcare provider. Little is known about the impact of childcare providers on development of early childhood feeding behaviors and subsequent risk for obesity, especially in the Hispanic ethnic group. This research examined child-feeding attitudes, practices and knowledge of multiethnic home-based and center-based childcare providers. Questionnaires were completed by a convenience sample of 72 providers, 50 of which completed a pre-and posttest on child feeding knowledge after receiving a 90-minute class based on Satter's division of responsibility feeding model during the spring of 2008. Results indicate many providers had practices consistent with this model. However, significant differences were reported by Hispanic providers, who were statistically more likely to encourage children to finish meals before dessert, prepare foods they perceived well-liked by children, coach children to eat foods perceived as appropriate, and not eat with children during mealtime. A significant increase in knowledge from 73% correct at pretest to 82% at posttest was noted, with significant increase in knowledge on five of 13 questions. However, knowledge was not always congruent with behavior. This study points to differences among providers based on ethnicity, and strongly recommends recruiting Hispanic childcare providers to participate in educational programs and community efforts to prevent obesity. INTRODUCTIONCurrently, 24% of children ages two to five and 33% of children ages six to 11 are overweight or obese (1), putting them at risk for adolescent and adult obesity and co-morbid disease (2,3). Particularly at risk are Mexican-American children, for whom elevated body mass indices are found in 30% of two to five year olds and in 43% of six to 11 year olds (1). Treatment of obesity is challenging, and long-term success modest (4). Consequently, preventative approaches should start in early childhood, a critical period for shaping and influencing feeding and lifestyle behaviors that impact future weight and health (5-11). Environmental factors can modulate feeding behaviors in children as young as two years of age (5,12,13). Parents and other role models who define the early childhood environment will influence a child's choices, preferences and quantities of food consumed (13)(14)(15)(16)(17)(18)(19).With more women in the workforce (20), up to 60% of children below six years of age spend at least 29 hours a week in a childcare setting (2,21,22). This suggests that children routinely eat several meals away from home each day. Childcare settings can support healthful feeding behaviors (23,24), and preschool is an optimal time to teach and practice healthful feeding habits (24). Little is know...

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Metabolic Complications of Childhood Obesity

Cited by 171 publications

References 79 publications

Esteatose hepática em crianças e adolescentes obesos

Esteatose hepática em crianças e adolescentes obesos

Effect of obesity intervention programs on adipokines, insulin resistance, lipid profile, and low-grade inflammation in 3- to 5-y-old children

Early Childhood Feeding: Assessing Knowledge, Attitude, and Practices of Multi-Ethnic Child-Care Providers

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