The effect of weight regain on cardiometabolic health in children with obesity: A systematic review of clinical studies

Vermeiren, Eline; Bruyndonckx, Luc; Winter, Benedicte De; Verhulst, Stijn; Eyck, Annelies Van; Hoorenbeeck, Kim Van

doi:10.1016/j.numecd.2021.05.020

Cited by 6 publications

(3 citation statements)

References 69 publications

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“…In our study, we found no significant differences in terms of total cholesterol, HDL- or LDL-cholesterol values, but triglycerides presented an ascending trend in children with obesity as opposed to the normoponderal ones. The same pattern was observed for fasting glucose levels, in resonance with other studies, which also sustain the proven effect of weight loss on basal glucose values ( 41 , 42 ). Moreover, a significant increase in ALT values was found in children with obesity, which might constitute an important, yet not single marker of childhood NAFLD ( 43 ).…”

Section: Discussionsupporting

confidence: 89%

Effects of PPARG and PPARGC1A gene polymorphisms on obesity markers

Muntean

Săsăran

Crisan

et al. 2022

Front. Public Health

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Pediatric obesity presents a multifactorial etiology, which involves genetic traits as well, including single nucleotide polymorphisms. The aim of the study is to investigate the contribution of PPARG gene polymorphisms (namely Pro12Ala rs1801282, His447His rs3856806, and Pro115Gln rs1800571) and PPARGC1A rs8192678 SNP on the anthropometric and metabolic parameters in a population of Romanian children. We conducted a cross-sectional study of 295 Caucasian children, divided according to the body mass index (BMI) z-score into the study (obese and overweight) group of 130 children and the control (normoponderal) group of 165 children. Anthropometric parameters were greater in the obese and overweight population as opposed to controls, with significant differences (p < 0.01) found for the weight (2.77 ± 1.54 SD vs. −0.04 ± 1.15 SD), body mass index (BMI) (2.28 ± 0.97 SD vs. −0.18 ± 1.19 SD), mid-upper arm circumference (MUAC) (4.59 ± 2.28 SD vs. 0.28 ± 3.45 SD), tricipital skin-fold (TSF) (3.31 ± 3.09 SD vs. 0.62 ± 7.28 SD) and waist-to-height ratio (WHtR) (0.61 ± 1.51 SD vs. −0.35 ± 1.35 SD) z-scores. Moreover, triglyceride values were higher in the study group (118.70 ± 71.99 SD vs. 77.09 ± 37.39 SD). No significant difference in the allele and genotype distribution of investigates gene polymorphisms was observed between the studied groups (p > 0.05). PPARG (rs1801282, rs3856806, and rs1800571) were not associated with demographic, anthropometric, and laboratory parameters. However, PPARGC1A rs8192678 CC genotype was associated with TSF z-score (p = 0.03), whereas total and LDL cholesterol levels were significantly higher among TT homozygotes (p < 0.01). Our data suggest that PPARG (rs1801282, rs3856806, and rs1800571) and PPARGC1A (rs8192678) gene polymorphisms were not associated with childhood and adolescence overweight and obesity. The present study identified a significant increase in fasting glucose levels, triglyceride, albumin, and ALT levels in children with excess weight, as well as expected important upward variation of anthropometric parameters (BMI, MUAC, TSF z-scores).

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Section: Discussionsupporting

confidence: 89%

Effects of PPARG and PPARGC1A gene polymorphisms on obesity markers

Muntean

Săsăran

Crisan

et al. 2022

Front. Public Health

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“…This finding may help explain the difficulty in increasing MVPA with PA interventions in overweight and obese adolescents [ 36 , 85 ]. Their low level of PL score [ 86 ] could inhibit the increase of MVPA.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of a Physical Literacy-Based Intervention for Increasing Physical Activity Levels and Improving Health Indicators in Overweight and Obese Adolescents (CAPACITES 64)

et al. 2023

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Recently, the concept of Physical Literacy (PL) has emerged as a key concept for promoting active behavior and improving health indicators in adolescents. Overweight and obese adolescents have a low level of Physical Activity (PA), low cardiorespiratory capacity, and high Body Fat percentage (%BF). However, the development of PL in the interest of health improvement has never been studied in overweight and obese adolescents. The objective of this study was to evaluate the impact of an intervention developing PL in overweight and obese adolescents in order to increase their (PA) and improve their health. The study was a prospective, single-arm, non-randomized interventional study. The intervention brings together different actions in PA and dietary education in different adolescent living environments. The study took place over a 9-month period with two data collection times (0; +9 months) and measured Body Mass Index (BMI) and BMI z score, %BF and Skeletal Muscle Mass (%SMM), Moderate-to-Vigorous intensity Physical Activity (MVPA) by accelerometry, CRF, as well as PL by the CAPL-2 tool. Thirteen adolescents (age 11.7 (±1.09) years old) improved their PL scores (+8.3 (±9.3) pts; p ≤ 0.01). BMI z score (−0.3 (±0.3), p ≤ 0.01), their %BF (−3.8 (±4.9); p ≤ 0.01), their CRF (+1.5 (±1.7) mL·min·kg−1; p ≤ 0.01), and their MVPA (+4.6 (±13.7) min/day; p = 0.36). Initiating multidimensional interventions to develop PL in overweight and obese adolescents may be a promising prospect to enable an increase in their MVPA and improve their long-term health. Longer-term randomized controlled interventional studies are needed to confirm these findings.

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“…Second, we focused on the BMI SDS as an outcome variable, whereas in obesity treatment, the focus was on improving health. When focusing on the health benefits of treatment, this might change the point of view, as the health benefits obtained in residential treatment remain present for a longer period despite weight regain ( 66 , 67 ). Nevertheless, this state of metabolic healthy obesity is a rather temporal stage before obesity-related comorbidities develop ( 68 ).…”

Section: Discussionmentioning

confidence: 99%

The Predictive Value of Adipokines and Metabolic Risk Factors for Dropouts and Treatment Outcomes in Children With Obesity Treated in a Pediatric Rehabilitation Center

Vermeiren

Eyck²,

Maele³

et al. 2022

Front. Endocrinol.

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BackgroundInpatient pediatric obesity treatments are highly effective, although dropouts and weight regain threaten long-term results. Preliminary data indicate that leptin, adiponectin, and cardiometabolic comorbidities might predict treatment outcomes. Previous studies have mainly focused on the individual role of adipokines and comorbidities, which is counterintuitive, as these risk factors tend to cluster. This study aimed to predict the dropouts and treatment outcomes by pre-treatment patient characteristics extended with cardiometabolic comorbidities (individually and in total), leptin, and adiponectin.MethodsChildren aged 8–18 years were assessed before, immediately after and 6 months after a 12-month inpatient obesity treatment. Anthropometric data were collected at each visit. Pre-treatment lipid profiles; glucose, insulin, leptin, and adiponectin levels; and blood pressure were measured. The treatment outcome was evaluated by the change in body mass index (BMI) standard deviation score (SDS) corrected for age and sex.ResultsWe recruited 144 children with a mean age of 14.3 ± 2.2 years and a mean BMI of 36.7 ± 6.2 kg/m2 corresponding to 2.7 ± 0.4 BMI SDS. The 57 patients who dropped out during treatment and the 44 patients who dropped out during aftercare had a higher pre-treatment BMI compared to the patients who completed the treatment (mean BMI, 38.3 ± 6.8 kg/m2 vs 35.7 ± 5.5 kg/m2) and those who completed aftercare (mean BMI, 34.6 ± 5.3 kg/m2 vs 37.7 ± 6.3 kg/m2) (all p<0.05). Additionally, aftercare attenders were younger than non-attenders (mean age, 13.4 ± 2.3 years vs 14.9 ± 2.0, p<0.05).Patients lost on average 1.0 ± 0.4 SDS during treatment and regained 0.4 ± 0.3 SDS post-treatment corresponding to regain of 43 ± 27% (calculated as the increase in BMI SDS post-treatment over the BMI SDS lost during treatment). A higher BMI and more comorbidities inversely predicted BMI SDS reduction in linear regression (all p<0.05).The absolute BMI SDS increase after returning home was predicted by pre-treatment leptin and systolic blood pressure, whereas the post-treatment BMI SDS regain was predicted by pre-treatment age, leptin, and adiponectin levels (all p<0.05) in multivariate linear regressions.ConclusionPatients who need treatment the most are at increased risk for dropouts and weight regain, emphasizing the urgent need for interventions to reduce dropout and support inpatients after discharge. Furthermore, this study is the first to report that pre-treatment leptin and adiponectin levels predict post-treatment BMI SDS regain, requiring further research.

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The effect of weight regain on cardiometabolic health in children with obesity: A systematic review of clinical studies

Cited by 6 publications

References 69 publications

Effects of PPARG and PPARGC1A gene polymorphisms on obesity markers

Effects of PPARG and PPARGC1A gene polymorphisms on obesity markers

The Effectiveness of a Physical Literacy-Based Intervention for Increasing Physical Activity Levels and Improving Health Indicators in Overweight and Obese Adolescents (CAPACITES 64)

The Predictive Value of Adipokines and Metabolic Risk Factors for Dropouts and Treatment Outcomes in Children With Obesity Treated in a Pediatric Rehabilitation Center

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