Edmonton Obesity Staging System for Pediatrics, quality of life and fitness in adolescents with obesity

Abstract

BackgroundBody mass index (BMI) is often used to diagnose obesity in childhood and adolescence but has limitations as an index of obesity-related morbidity. The Edmonton Obesity Staging System for Pediatrics (EOSS-P) is a clinical staging system that uses weight-related comorbidities to determine health risk in paediatric populations. The purpose of this study was to investigate the associations of EOSS-P and BMI percentile with quality of life (QOL), cardiorespiratory fitness (CRF) and muscular strength in adolescents with obesity. MethodsParticipants were enrolled at baseline in the Healthy Eating, Aerobic and Resistance Training in Youth trial (BMI = 34.6 ± 4.5 kg m À2 , age = 15.6 ± 1.4 years, N = 299). QOL, CRF (peak oxygen uptake, VO 2peak ) and muscular strength were assessed by the Pediatric QOL Inventory (PedsQL), indirect calorimetry during a maximal treadmill test and eight-repetition maximum bench and leg press tests, respectively. Participants were staged from 0 to 3 (absent to severe health risk) according to EOSS-P. Associations were assessed using age-adjusted and sex-adjusted general linear models. ResultsQuality of life decreased with increasing EOSS-P stages (p < 0.001). QOL was 75.7 ± 11.4 in stage 0/1, 69.1 ± 13.1 in stage 2 and 55.4 ± 13.0 in stage 3. BMI percentile was associated with VO 2peak (β = -0.044 mlO 2 kg À1 min À1 per unit increase in BMI percentile, p < 0.001), bench press (β = 0.832 kg per unit increase in BMI percentile, p = 0.029) and leg press (β = 3.992 kg, p = 0.003). There were no significant differences in treadmill time or VO 2peak between EOSS-P stages (p > 0.05). ConclusionAs EOSS-P stages increase, QOL decreases. BMI percentile was negatively associated with CRF and positively associated with muscular strength.

Usefulness of the Edmonton Obesity Staging System for stratifying the presence and severity of weight‐related health problems in clinical and community settings: A rapid review of observational studies

“…These included four cohort studies, 21,22,28,29 seven case series 17–20,30–32 and nine cross‐sectional studies 33–41 . Five studies were from the United States, 21,22,29,35,41 four from Canada, 19,20,28,36 four from Germany, 17,18,31,32 two from Italy 39,40 and one each from Australia, 33 Spain, 34 Poland, 30 South Korea 37 and Brazil 38 . Of these, 12 studies were in clinical populations with sample sizes between 100 and 400 in six studies, 19,28,31,32,34,41 500 and 1000 in three studies 17,38,39 and greater than 1000 in two studies 18,20 .…”

“…Of these, 12 studies were in clinical populations with sample sizes between 100 and 400 in six studies, 19,28,31,32,34,41 500 and 1000 in three studies 17,38,39 and greater than 1000 in two studies 18,20 . The other eight were in community populations with sample sizes between 100 and 1000 in three studies, 35,36,40 8000 and 10 000 in two studies 21,33 and 17 000 and 30 000 in three studies 22,29,37 . As shown below, EOSS definitions varied substantially across the studies (Table 2).…”

“…Outcomes in studies of clinical populations were mostly postoperative complications following bariatric surgery, 17–19,30,31 treatment outcomes including postoperative changes in nonalcoholic fatty liver disease (NAFLD), 19,20,30–32 as well as associations with cesarean rates, 28 disability, 39 cardiovascular disease risk markers, 41 age/sex, BMI 38,39 and lifestyle risk factors 34 . Outcomes in studies of community populations were mortality, 21,22,29 lifestyle risk factors, 35 quality of life, skeletal strength and fitness in young participants, 36 and associations with obesity, 35,37 polypharmacy and health services use, 33 as well as work ability 40 …”

“…We present the results of our quality assessment of each study in the supporting information (Table S3). Cohort studies had eight, 28 nine 21,29 and 10 22 out of 11 quality items; case series studies had six, 30–32 eight, 17 nine, 18,20 and 10 19 out of 10 quality items; and cross‐sectional studies had four, 41 five, 34,35,38,39 six 36,37 and seven 33,40 out of eight quality items.…”

“…One study reported that the EOSS was consistently associated with polypharmacy and health service use 33 . One study in young participants reported that the EOSS was inversely associated with quality of life scores, but there were no associations with objectively measured functional health (muscular strength and fitness) 36 . One study reported that higher EOSS stages were associated with poorer work ability outcomes 40 .…”